8. _Extraordinary case of yellow fever a_A Treatise on the Plague and Yellow Fever With an Appendix, containing histories of the plague at Athens in the time of the Peloponnesian War; at Constantinople in the time of Justinian; at London in 1665; at Marseilles in 1720

of it[212] was a female of about 24 years of age, in the 9th month

of pregnancy. I saw her on Monday the 17th of September. She had

then a small but painful hardness on the left parotid gland, which

had commenced some days before, and soon extended to the lips and

neighbouring parts. The centre of the tumour resembled that of the

incision of an arm about the time of the eruption of the small pox

after inoculation, exhibiting a hard, florid, shining appearance. I

recommended an emollient poultice, hoping to procure suppuration; but,

though they were repeated steadily, not the least evidence of matter

could be produced; and upon each visit I found the tumour had extended

in a rapid and formidable degree. I was called up in the course of

the night to her, and found her almost suffocated from the pressure

of the tumour on the trachea; for it had now extended itself to all

the muscles and glands of the neck and face. I changed the poultice

for an embrocation of the saturnine preparations, which were repeated

till about 10 o’clock of the following morning, when she was taken in

travail, and soon delivered of a healthy male child. For a few hours

after her delivery she appeared something better, but in the night she

grew worse, and about 12 o’clock I was called to her, when she appeared

to be expiring. At the request of her friends I entered my lancet into

the tumour the length of the instrument; but, as I had expected, not

the least particle of matter flowed, and the parts were _as hard as a

schirrus_. She continued however in agony till 3 o’clock of the day,

and then expired.”

[212] The attending physician’s name is not mentioned, having no

permission to do so.

9. _Two cases of spontaneous origin of yellow fever: from the Medical

Repository, vol._ ii, _p._ 333. “At Salem (Massachusetts) there was

a general prevalence of health at that season; though several cases

of yellow fever, and some of them fatal ones, occurred. Dr. Oliver

very judiciously inclines to the belief that the exemption of this

town from the ravages of yellow fever is owing, 1st, to the remarkably

clean state of the town; and, 2dly, to the houses being placed at such

distances as to admit of free ventilation. It was observable that the

yellow fever had a _spontaneous_ origin in two different places of the

town, where putrid matters had been suffered to accumulate, and proved

fatal to two persons in different families; these unclean spots forming

exceptions to the generally purified state of the town.”

10. _Case of fever produced by the effluvia of putrid beef._ This took

place in the federal garrison on Governor’s Island.[213] The subject

was a soldier, who had been excused from duty on account of a violent

and obstinate gonorrhœa. On removing him into a lodging without the

garrison he was seized with symptoms of fever, and on the commencement

of these the gonorrhœa ceased. For four days the fever increased, and

was attended at last with vomiting, hiccup and delirium. From the first

commencement of the disease the physician had been sensible of a very

offensive smell in the patient’s room. Being assured that this was not

owing to want of cleanliness, he caused search to be made under it, and

in the cellars found three barrels of beef so putrid that it was with

difficulty they could be removed, on account of the stench. On removing

them, however, the patient rapidly recovered, though till then he had

constantly grown worse.

[213] Medical Repository, vol. i, p. 210.

END OF THE SECOND PART.

APPENDIX.

N^o I.

_Account of the Plague at Athens, in the time of the Peloponnesian

War:--From_ THUCYDIDES.--SMITH’_s Translation._

The Peloponnesians and their allies, who had made an incursion into

Attica, with two thirds of their forces, had not been many days there

before a sickness began first to appear among the Athenians, such as

was reported to have raged before this in other parts, as about Lemnos

and other places. Yet a plague so great as this, and so dreadful a

mortality, in human memory could not be paralleled. The physicians at

first could administer no relief, through utter ignorance; nay, they

died the faster, the closer their attendance on the sick; and all

human art was totally unavailing. Whatever supplications were offered

in the temples, whatever recourse to oracles and religious rites, all

were insignificant: at last, expedients of this nature they totally

relinquished, overcome by calamity. It broke out first, as it is said,

in that part of Ethiopia which borders upon Egypt; it afterwards spread

into Egypt and Libya; and at length, on a sudden, fell on the city

of the Athenians. The contagion shewed itself first in Piræus; which

occasioned a report, that the Peloponnesians had caused poison to be

thrown into the wells; for, as yet, there were no fountains there.

After this it spread into the upper city, and then the mortality very

much increased. Let every one, physician or not, freely declare his own

sentiments about it; let him assign any credible account of its rise,

or the causes strong enough, in his opinion, to introduce so terrible

a scene. I shall only relate what it actually was, and as, from an

information in all its symptoms, none may be quite at a loss about it

if ever it should happen again, I shall give an exact detail of them;

having been sick of it myself, and seen many others afflicted with it.

This very year, (430 B. C.) as is universally allowed, had been, more

than any other, remarkably free from common disorders; or, whatever

diseases had already seized the body, they ended at length in this.

But those who enjoyed the most perfect health were suddenly, without

any apparent cause, seized at first with head-achs extremely violent,

with inflammations and fiery redness in the eyes. Within, the throat

and tongue began instantly to be red as blood; the breath was drawn

with difficulty, and had a noisome smell. The symptoms that succeeded

these were, sneezing and hoarseness; and, not long after, the malady

descended to the breast, with a violent cough; but, when once settled

in the stomach, it excited vomitings, in which was thrown up all

that matter which physicians call discharges of bile, attended with

excessive torture. A great part of the infected were subject to

such violent hiccups, without any discharge, as brought upon them

strong convulsions, to some but of a short, to others of a very long

continuance. The body, to the outward touch, was neither very hot

nor of a pallid hue, but reddish, livid, marked all over with little

pustules and sores; yet, inwardly, it was scorched with such excessive

heat that it would not bear the slightest covering of the finest linen

upon it, but must be left quite naked. They longed for nothing so

much as to be plunging in cold water; and many of those who were not

properly attended threw themselves into wells, hurried by a thirst

not to be extinguished; and, whether they drank much or little, their

torment still continued the same. The restlessness of their bodies,

and an utter inability of composing themselves to sleep, never abated

for a moment. And the body, so long as the distemper continued in its

height, had no visible waste, but withstood its rage to a miracle; so

that most of them perished within seven or nine days by the heat that

scorched their vitals, though their strength was not exhausted; or,

if they continued longer, the distemper fell into the belly, causing

violent ulcerations of the bowels, accompanied with an incessant flux,

by which many, reduced to an excessive weakness, were carried off.

For the malady, beginning in the head, and settling first there, sunk

afterwards gradually down through the whole body. And whoever got safe

through all its most dangerous stages, yet the extremities of their

bodies still retained the marks of its violence. For it shot down into

their privy members, into their fingers and toes, by losing which they

escaped with life. Some there were who lost their eyes, and some who,

being quite recovered, had at once totally lost all memory, and quite

forgot not only their most intimate friends, but even their own selves.

For, as this distemper was in general virulent beyond expression, and

its every part more grievous than had yet fallen to the lot of human

nature; so, in one particular instance, it appeared to be none of the

natural infirmities of man, since the birds and beasts that prey on

human flesh either never approached the dead bodies, of which many lay

about uninterred, or certainly perished if they tasted. One proof of

this is then the total disappearance of such birds; for not one was to

be seen, either in any other place, or about any of the carcases. But

the dogs, because of their constant familiarity with man, afforded a

more notorious proof of this event.

The nature of this pestilential disorder was in general (for I have

purposely omitted many of its varied appearances, or the circumstances

particular to some of the infected in contradistinction to others)

such as hath been described. None of the common maladies incident to

human nature prevailed at that time; or, whatever disorder any where

appeared, it ended in this. Some died merely for want of care; and

some with all the care that could possibly be taken; nor was any one

medicine discovered from whence could be promised any certain relief;

since that which gave ease to one was prejudicial to another. Whatever

difference there was in bodies in point of strength, or in point of

weakness, it availed nothing; all were equally swept away before it,

in spite of regular diet, and studied prescriptions. Yet the most

affecting circumstances of this calamity were, that dejection of mind

which constantly attended the first attack; for the mind sinking at

once into despair, they soon gave themselves up without a struggle;

and that mutual tenderness in taking care of one another, which

communicated the infection, and made them drop like sheep. This latter

case caused the mortality to be so great. For, if fear withheld them

from going near one another, they died for want of help; so that many

houses became desolate for want of needful attendance; and if they

ventured, they were gone. This was most frequently the case of the kind

and compassionate. Such persons were ashamed, out of a selfish concern

for themselves, entirely to abandon their friends, when their menial

servants, no longer able to endure the groans and lamentations of the

dying, had been compelled to fly from such a weight of calamity. But

those, especially, who had safely gone through it, took pity on the

dying and the sick, because they knew by themselves what it really

was, and were now secure in themselves; for it never seized one a

second time so as to be mortal. Such were looked upon as quite happy by

others, and were themselves at first overjoyed in their late escape,

and the groundless hope that hereafter no distemper would prove fatal

to them. Besides this reigning calamity, the general removal from the

country into the city was a heavy grievance, more particularly to

those who had been necessitated to come thither. For, as they had no

houses, but dwelled all the summer time in booths, where there was

scarce room to breathe, the pestilence destroyed them with the utmost

disorder, so that they lay together in heaps, the dying upon the dead,

and the dead upon the dying. Some were tumbling over one another in

the public streets, or lay expiring about every fountain, whither

they had crept to assuage their extraordinary thirst. The temples,

in which they had erected tents for their reception, were full of the

bodies which had expired there. For, in a calamity so outrageously

violent, and universal despair, things sacred and holy had quite lost

their distinction. Nay, all regulations observed before in matters of

sepulture were quite confounded, since every one buried where he could

find a place. Some, whose sepulchres were already filled by the numbers

which had perished in their own families, were shamefully compelled

to seize those of others. They surprised on a sudden the piles which

others had built for their own friends, and burned their dead upon

them; and some, whilst one body was burning on a pile, tossed another

body they had dragged thither upon it, and went their way.

Thus did the pestilence first give rise to those iniquitous acts

which prevailed more and more in Athens. For every one was now more

easily induced openly to do what for decency they did only covertly

before. They saw the strange mutability of outward condition; the rich

entirely cut off, and their wealth pouring suddenly on the indigent and

necessitous; so that they thought it prudent to catch hold of speedy

enjoyments and quick gusts of pleasure; persuaded that their bodies

and their wealth might be their own merely for the day. Not any one

continued resolute enough to form any honest or generous design, when

so uncertain whether he should live to effect it. Whatever he knew

could improve the pleasure or satisfaction of the present moment, that

he determined to be honour and interest. Reverence of the gods, or of

the laws of society, laid no restraints upon them; either judging that

piety or impiety were things indifferent, since they saw that all men

perished alike; or, throwing away every apprehension of being called

to account for their enormities, since justice might be prevented

by death; or rather, as the heaviest judgment to which man could be

doomed was already hanging over their heads, snatching this interval of

pleasure before it fell.

N^o II.

_Account of the Great Plague in the time of_ JUSTINIAN:--_By_ PROCOPIUS.

This was a plague which almost consumed mankind; of which Procopius

concludes there was no other cause than the immediate hand of God

himself. For it neither came upon one part of the world alone, nor

in one season of the year; whence subtile wits (as he saith) might

make pretensions. It afflicted the whole world, and all conditions of

men, though of never so contrary a nature and disposition; sparing

no constitution nor age. The difference of men as to their places of

dwelling, diet, complexions, inclinations, &c. did no good in this

disease. Some it took in summer, some in winter, and others in other

seasons. It began among the Egyptians in Pelusium, and spread to

Alexandria, with the rest of Egypt, one way, and the other to those

parts of Palestine which border upon Egypt. From thence it travelled to

the utmost bounds of the world, as by set journies and stages, making

destruction its only business, and sparing neither island, cave, nor

top of mountain, where mankind inhabited; for, if it leaped over a

country, returning afterwards, it left it no cause to rejoice above its

fellows. It began still at the sea coast, and thence went to the inland

parts. In the second year of its progress it arrived at Constantinople,

about the middle of the spring, where it was the fortune of Procopius

then to reside. Apparitions of spirits, in all shapes human, were seen

by many, who thought the man they met struck them in some part of the

body; and so soon as they saw the spirit they were seized with the

disease. At first when they met them they repeated divine names, and

fled into churches, to no purpose. Afterwards they were afraid to hear

their friends call them, locking themselves up in their chambers, and

stopping their ears. Some dreamed they saw such sights; others that

they heard a voice tell them they were enrolled among the number of

those appointed to die. But most, without warning, became feverish

suddenly: their bodies changed not colour, nor were hot; the fever

being so remiss till evening, that neither the patient nor physician,

by his pulse, could apprehend any danger. Yet to some the same day, to

others the next, or many days after, arose a bubo, either in the groin,

the armpit, under the ear, or in other parts. These were the general

symptoms which happened alike to all the visited persons.

There were others different; whether made so by the diversity of

bodies, or by the will and pleasure of him that sent the distemper, our

author cannot say. Some were seized with drowsiness and slumbering,

others with a sharp distraction. The slumberers forgot all things: if

they were looked to, some would eat; some, that were neglected, starved

to death. Those who were distracted were vexed with apparitions; crying

there were men to kill them; and running away; being so troublesome and

unruly that their keepers were pitied as much as they themselves. No

physician or other caught the disease by touching sick or dead bodies;

many strangely continuing free, though they tended and buried infected

persons, and many catching it they knew not how, and dying instantly.

Many leapt into the water, though not from thirst; and some into the

sea. Some, without slumbering or madness, had their bubo gangrened,

and died with extreme pain; which doubtless also happened to those who

had the phrensy, though, being not themselves, they understood it not.

Some physicians hereupon, conceiving the venom and head of the disease

to lie in those plague sores, opened the dead bodies, and, searching

the sores, found an huge carbuncle growing inward. Such whose bodies

were spotted with black pimples, the bigness of a lentile, lived not a

day. Many died vomiting blood. Some that were given over by the most

eminent physicians unexpectedly recovered; others, of whose recovery

they thought themselves perfectly secure, suddenly perished. No cause

of this sickness could be reached by man’s reason. Some received

benefit by bathing, others it hurt. Many died for want of relief,

others escaped without it. In a word, no way could there be found of

preservation, either by preventing the sickness, or of mastering the

disease, no cause appearing either of their falling sick or recovery.

Women with child, who were visited, certainly died; some miscarrying,

some fairly delivered, and perishing with their children. Three women

only were safely brought to bed and recovered, their children dying;

and one died whose child had the hap to live. Such as had their sores

great, and running plentifully, escaped; the violence of the carbuncles

being thereby assuaged; and this was the most certain sign of health.

Such whose sores staid as they first arose, underwent the miserable

accident formerly mentioned. Some had their thighs withered, when the

sores rose upon them and did not run. Some escaped with diminished

tongues, and lived stammering, or uttering sounds without distinction,

all their days. In Constantinople the pestilence lasted four months;

raging three months with all extremity. In the beginning few died more

than usual. Then, growing hotter and hotter, it came to five, and

at last to ten thousand every day. At first they buried their dead

carefully; but at length all came to confusion, and many lay long

unburied; servants were without masters; rich men had none to attend

them. In the afflicted city little was to be seen but empty houses, no

trade going, or shops open.

N^o III.

_Account of the Plague at London in 1665_:--_From Dr._ HODGES _and

others._

In the beginning of September 1664 the people of London first became

alarmed by a report of the plague being broke out in Holland, where

it raged violently the former year. The United Provinces had received

it from some place in the Levant, and, certain accounts having been

received of the distemper being in Holland, several councils were

held by government with a view of concerting means for preventing its

introduction into Britain. These were held privately, and it does not

appear that any thing was positively determined upon; but thus the

knowledge that such a distemper existed in Holland was suppressed, and

the public fears dissipated until the beginning of December; when two,

supposed to be Frenchmen,[214] in Long-acre, or rather the upper end

of Drury lane, died with such suspicious symptoms that the people of

the house endeavoured to conceal the distemper of which they died. The

secretaries of state, however, having got intelligence of the matter,

caused their bodies to be inspected, when it became evident they had

died of the plague. This produced a general alarm; Dr. Hodges says,

that “hereupon some timorous neighbours, under apprehensions of a

contagion, removed into the city of London; who unfortunately carried

along with them the pestilential taint; whereby that disease, which

was before in its infancy, in a family or two, suddenly got strength,

and spread abroad its fatal poison; and, merely for want of confining

the persons first seized with it, the whole city was irrecoverably

infected.” The author of the Journal, however, says that the public

fear again subsided, though it had been still farther raised by the

death of another person in the same house about the latter end of

December; but, as no more died for six weeks, no farther notice was

taken of it until the 12th of February, when one died in another house,

but in the same parish. Soon after this an increase was observed in

the weekly list of burials at St. Giles’s parish, which augmented the

general alarm so much that few cared to pass through Drury lane or

the suspected streets, unless upon very urgent business. In a short

time a like augmentation was perceived in the bills of the adjoining

parishes, and indeed all over the town. The Journal informs us that the

usual number of burials within the bill of mortality was from 240 to

300; but from the 20th of December to January 24th they had gradually

arisen from 291 to 474. This seems inconsistent with what he had before

said of the alarm having ceased till the 12th of February; but we

shall take his own words. “This last bill (474) was really frightful;

being a greater number than had been known to have been buried in one

week since the preceding visitation of 1656. However, all this went

off again, and the weather proving cold, and the frost, which began in

December, continuing very severe, even till near the end of February,

attended with sharp though moderate winds, the bills decreased again,

and the city grew healthy, and every body began to look upon the danger

as good as over; only that still the burials in St. Giles’s continued

high. From the beginning of April especially, they stood at 25 each

week, till the week from the 18th to the 25th, when there were buried

in St. Giles’s parish 30; whereof were two of the plague, and eight of

the spotted fever, which was looked upon as the same thing; likewise

the number that died of the spotted fever on the whole increased; being

eight the week before, and twelve the week above named.”

[214] _Journal of the Plague Year._

Thus a new and still greater alarm was produced, which was yet farther

augmented by the spreading of the distemper. The journalist says indeed

that only a few were set down in the lists as having died of the

plague; the remainder of the deaths being charged to other distempers;

and accordingly one week, when the mortality bill was high, and only 14

charged to the plague, he says, “this was all knavery and collusion;

for in St. Giles’s parish they buried 40 in all; whereof it was certain

that most of them died of the plague, though they were set down of

other distempers; and though the number of all the burials was not

increased above 32, and the whole bill being but 385, yet there were

14 of the spotted fever, as well as 14 of the plague; and we took it

for granted upon the whole that there were 50 died of the plague that

week. The next bill was from the 23d of May to the 30th, when the

number of the plague was 17; but the burials in St. Giles’s were 53; a

frightful number, of whom they set down but nine of the plague; but,

on examination more strictly by the justices of the peace, and at the

lord mayor’s request, it was found there were 20 more who were really

dead of the plague in that parish, but had been set down of the spotted

fever, or other distempers, besides others concealed.”

The account given by Dr. Hodges is somewhat different from the above.

He informs us that “a very hard frost began in December and continued

three months, which seemed greatly to diminish the contagion, and

very few died during that season; though even then it was not totally

extinguished.” The journalist says that in this intermission of the

plague there was a difficulty which he could not well get over. The

first person who died of the plague he says (p. 234) was on December

20th, or thereabouts, 1664, though he had told us before (p. 2) that it

was the end of November, or _beginning_ of December the same year. “But

after this (continues he) we heard no more of any person dying of the

plague, or the distemper being in that place, till the 9th of February,

which was about seven weeks after; and then one more was buried out of

the same house: then it was hushed, and we were perfectly easy as to

the public for a great while, for there were no more entered in the

weekly bill to be dead of the plague, till the 22d of April. Now the

question seems to be thus: Where lay the seeds of the infection all

this while? How came it to stop so long, and not to stop any longer?

Either the distemper did not immediately come by contagion from body to

body, or, if it did, then a body may continue to be infected without

the disease discovering itself many days, nay, weeks together. It is

true there was a very cold winter, and long frost, which continued

three months; and this, the Doctors say, might check the infection;

but then the learned must allow me to say that if, according to their

notion, the disease was, as I may say, only frozen up, it would, like

a frozen river, have returned to its usual force and current when it

thawed; whereas the principal recess of the infection, which was from

February to April, was after the frost was broken, and the weather mild

and warm. But there is another way of solving all this difficulty,

which I think my own remembrance of the thing will supply; and that

is, the fact is not granted, namely, that there died none in those

long intervals, viz. from the 20th of December to the 9th of February,

and from thence to the 22d of April. The weekly bills are the only

evidence on the other side, and those bills were not of credit enough,

at least with me, to support an hypothesis, or determine a question of

such importance as this: for it was our received opinion at that time,

and I believe upon very good grounds, that the fraud lay in the parish

officers, searchers and persons appointed to give account of the dead,

and what diseases they died of; and, as people were very loth at first

to have the neighbours believe their houses were infected, so they

gave money to procure, or otherwise procured, the dead persons to be

returned as dying of other distempers; and this, I know, was practised

afterwards in many places; I believe I might say in all places where

the distemper came; as might be seen by the vast increase of the

numbers placed in the weekly bills under other articles of diseases,

during the time of the infection. For example, in the months of July

and August, when the plague was coming on to its highest pitch, it was

very ordinary to have from 1000 to 1200, nay to almost 1500, a week, of

other distempers: not that the numbers of those distempers were really

increased to such a degree; but the great number of families and houses

where really the infection was, obtained the favour to have their dead

returned of other distempers, to prevent the shutting up of their

houses.”

The disease continued to advance, but with such intervals and

remissions as frequently gave hopes of its disappearing entirely.

Nevertheless, about the beginning of May the inhabitants began to

leave the city in great numbers. The journalist, for his own part, was

irresolute; and sometimes would have left the city with the rest, had

it not been for the impossibility of finding an horse; “for, (says

he) though it is true that all the people did not go out of the city

of London, yet I may venture to say that in a manner all the horses

did; for there was hardly a horse to be bought or hired in the whole

city for some weeks.” Many fled on foot, carrying with them soldiers’

tents, in which they slept in the fields, it being then warm weather,

and no danger of taking cold. This way of living was also familiar in

some degree by reason of the wars which had preceded; multitudes of

those who had served in them being at that time in London. This our

author greatly approves of as a method of preventing the infection from

spreading, and thinks that had it been more generally practised, much

less damage would have been done in the country than happened at the

time from this dreadful distemper.

Early in June the court thought proper to remove to the city of Oxford,

whither the infection did not reach. The people still continued to

remove during the whole month of July though in smaller numbers than

before; but in August the multitude of fugitives so increased that

says our author, “I began to think there would be none but magistrates

and servants left.” He informs us also that at the breaking out of

this plague the city was unusually full of people; vast numbers who

had served in the wars or who in times of trouble had been friends to

royalty had flocked into it on the restoration of Charles II, in hopes

of reaping some fruit of their former labours and sufferings; so that

on the whole he supposes there must have been upwards of an hundred

thousand people more than usual in the city. Indeed if we are to

believe that, on a representation of the state of the poor to the lord

mayor, it appeared that there were an hundred thousand ribband weavers

in Spittle-fields, we must look upon the population of London at that

time to have been incredibly great; and when the journalist computes

the number of those who fled only at two hundred thousand, we must

certainly suppose it to have been greatly underrated.

As the plague continued to become more and more violent, the

magistrates thought proper to take some means for separating the

infected from the healthy; but unhappily their mode of procedure was

such as inspired both the infected and uninfected with the utmost

terror. The houses were marked with a red cross, subscribed with

the words “LORD, HAVE MERCY UPON US!” in large letters. They were

continually guarded, day and night; and none were allowed access to

the sick, to give them either food or medicines, excepting those who

guarded them; nor were the sick themselves allowed to go abroad until

forty days after their recovery. But, though the distemper continually

advanced, it did not get to its full height until the months of August

and September. Before this time it seemed to fly from place to place;

so that great hopes were entertained, though always without foundation,

of its total removal; but now it invaded the whole city. Four or five

thousand died in a week; once eight thousand; and, in the month of

September, for some time, twelve thousand a week died. The city was

reduced to the extremity of distress.

The author of this journal had the courage not only to remain in the

city, during the whole time of the infection, but even took many

solitary walks to the house of his brother, who had removed into the

country, in order to preserve his goods from being stolen. At first he

went every day, but afterwards only once or twice a week. He tells us

also that he took many walks out of curiosity; and, though he generally

came home frighted and terrified, he could not restrain himself. “In

those walks (says he) I had many dismal scenes before my eyes; as

particularly of persons falling dead in the streets, terrible shrieks,

and screamings of women, who, in their agonies, would throw open their

chamber windows, and cry out in a dismal, surprising manner.

“It is scarce credible what dreadful cases happened in particular

families every day; people in the rage of the distemper, or in the

torment of their swellings, which was indeed intolerable, running

about raving and distracted; and oftentimes laying violent hands

upon themselves, throwing themselves out at their windows, shooting

themselves, &c. mothers murdering their own children, in their lunacy;

some dying of mere grief as a passion; some of fright and surprise,

without any infection at all; others frighted into idiotism and foolish

distractions, some into despair and lunacy; others into melancholy

madness.”

The distemper was found to rage so violently among the poorer sort,

that we are told by Dr. Hodges, some gave it the name of the _poor’s

plague_. This is confirmed by the journalist, who informs us that “the

misery of that time lay chiefly upon the poor, who, being infected, had

neither food nor physic; neither physician nor apothecary to assist

them, nor nurse to attend them; many of those died calling for help,

and even for sustenance, out of their windows, in a most miserable and

deplorable manner; but it must be added, that, whenever the cases of

such persons or families were represented to the lord mayor, they were

always relieved.” Indeed the charity of the more opulent, upon this

occasion, almost exceeds belief. Dr. Hodges informs us, that “though

the more opulent had left the town, and it was left almost uninhabited,

the commonalty who remained felt little of want; for their necessities

were relieved with a profusion of good things from the wealthy, and

their poverty was supported with plenty.” The probable reason of such

devastation among the poor, Dr. Hodges promises, p. 15, to give, and

does not; at least I have not been able to find it in his book; I

must therefore content myself with what the journalist (though no

physician) has delivered on this subject. He says, that when people

began to use proper cautions, the danger of infection was the less.

“But (says he) it was impossible to beat any thing into the heads of

the poor; they went on with the usual impetuosity of their tempers;

full of outcries and lamentations when taken, but madly careless of

themselves, fool-hardy and obstinate when well: where they could get

employment, they pushed into any kind of business, the most dangerous,

and the most liable to infection; and, if they were spoken to, their

answer would be, I must trust to GOD for that; if I am taken, then I

am provided for, and there is an end of me, or the like; or thus: Why,

what must I do? I cannot starve; I had as good have the plague, as

perish for want. I have no work, &c. This adventurous conduct of the

poor was what brought the plague among them in a most furious manner;

and this, joined to the distress of their circumstances, when taken

(with the distemper) was the reason why they died so in heaps: for I

cannot say that I could observe one jot of better husbandry among them,

I mean the labouring poor, while they were well and getting money, than

there was before; but as lavish, as extravagant, and as thoughtless of

to morrow, as ever; so that, when they came to be taken sick, they were

immediately in the utmost distress, as well for want as for sickness,

as well for lack of food as lack of health.”

In the time of so great a calamity, the magistrates exerted themselves

as far as their power and skill would permit, to lessen the sufferings

of the people. It was natural also in such a dreadful emergency to call

upon the physicians to exert themselves. Accordingly the king (Charles

II) by his royal authority commanded the College of Physicians of

London jointly to write somewhat in English, that might be a general

directory in this calamitous exigence; nor was it satisfactory to

this honoured society to discharge their regards for the public in

that only; but some were chosen out of their number, and appointed

particularly to attend the infected on all occasions; two also out

of the court of aldermen were required to see this hazardous task

executed.[215]

[215] _Hodges, p. 13, & seq._

Our author then proceeds to mention the names of some who were

employed in this laudable undertaking; particularly Dr. Glisson,

regius professor at Cambridge, Dr. Nathaniel Paget, Dr. Wharton, Dr.

Berwick and Dr. Brookes; many others he says were employed; “but (he

adds) eight or nine fell in the work, who were too much loaded with

the spoils of the enemy; among whom was Dr. Conyers, &c. After, then,

all endeavours to restrain the contagion had proved of no effect, we

applied ourselves altogether to the cure of the diseased.”

We shall not doubt of the good intentions of the physicians: of their

success we may judge from what Dr. Hodges himself says, that many died

while prescribing cures for others. To the same purpose the journalist,

p. 43: “I shall not be supposed to lessen the authority or capacity of

the physicians, when I say that the violence of the distemper, when

it came to its extremity, was like the fire the next year (1666). The

fire which consumed what the plague could not touch, defied all the

application of remedies; the fire-engines were broken, the buckets

thrown away, and the power of man was baffled and brought to an end;

so the plague defied all medicine; the very physicians were seized

with it, with their preservatives in their mouths; and men went about

prescribing to others, and telling them what to do, till the tokens

were upon them, and they dropped down dead, destroyed by that very

enemy they directed others to oppose. This was the case of several

physicians, even some of the most eminent, and of several of the most

skilful surgeons; abundance of quacks too died, who had the folly to

trust to their own medicines,” &c.

Thus, in defiance of every effort of human skill, the calamity

continued. “The contagion (says Dr. Hodges) spread its cruelties into

the neighbouring countries; for the citizens, who crowded in multitudes

into the adjacent towns, carried the infection along with them, where

it raged with equal fury; so that the plague, which at first crept from

one street to another, now reigned over whole counties, leaving hardly

any place free from its insult, and the towns upon the Thames were more

severely handled; not, perhaps, from a greater moisture in the air from

thence, but from the tainted goods rather, that were carried upon it:

moreover some cities and towns, of the most advantageous situation for

a wholesome air, did, notwithstanding, feel the common ruin. Such was

the rise, and such the progress, of this cruel destroyer, which first

began at London.”[216]

[216] _Hodges, p. 25._

But it is now time to turn from those scenes of horror. The power of

the pestilential contagion was not absolutely _immeasurable_. It had

its rise, its progress, its state and declension. Dr Hodges tells us

that, _when_ “_the worst part of the year was over, and the height of

the disease_, the plague by leisurely degrees declined, and before the

number infected decreased, its malignity began to relax, insomuch that

few died, and those chiefly such as were ill managed; hereupon that

dread which had been upon the minds of the people wore off; and the

sick cheerfully _used all the means directed for their recovery_; and

even the nurses grew either more cautious, or more faithful; insomuch

that after some time a dawn of health appeared, as sudden, and as

unexpected, as the cessation of the following conflagration; wherein,

after blowing up of houses, and using all means for its extinction to

little purpose, the flames stopped as it were of themselves for want

of fuel, or, _out of shame_, for having done so much mischief. The

pestilence, however, did not stop for want of subjects to act upon,

(as then commonly rumoured) but from the nature of the distemper.

Its decrease was, like its beginnings, moderate, &c. About the close

of the year, that is, on the beginning of November, people grew more

healthful,” &c.

The numbers who perished in this violent plague are so variously

reported that nothing certain can be said concerning it. Dr. Morton

says that upwards of forty thousand died; but from the foregoing

accounts it is evident that this calculation must be prodigiously

underrated. The journalist indeed gives strong reasons for believing

that all the accounts of the numbers who perished were much below

the truth. He thinks that an hundred thousand at least must have

fallen victims to it; and if his own assertion be true, that thirty

thousand died in the last three weeks, we cannot suppose but that

three times that number died in the course of the twelvemonth that

the disease lasted; which would fix the calculation at 120,000. This

great mortality however was soon forgot; as soon as the danger was

over, the ravages it had committed were no longer an object of terror.

The disease had its usual effect, viz. increasing the desire of the

sexes for each other. “They had the courage (says Dr. Hodges) now to

marry again, and betake to the means of repairing the past mortality;

and even women before deemed barren were said to prove prolific;

so that, although the contagion had carried off, as some computed,

about one hundred thousand, after a few months their loss was hardly

discernible.”

N^o IV.

_Account of the Plague at Marseilles in 1720:--From the Periodical

Publications of the time._

So much hath been said concerning this plague, in the first part of

this treatise, that no particular detail is requisite here. In its

symptoms it differed little if any thing from the plague of London,

described in the former number. Many died without any previous

sickness, and, while the distemper continued severe, few outlived the

third day; and so infectious was its nature, that one person in a

family was seldom attacked without its successively attacking all the

rest. The bodies were said to putrefy in 24 hours. Very considerable

sums of money were collected here, as well as in London. The conduct

of the bishop on this melancholy occasion has been greatly celebrated

by many; among others by Dr. Darwin, in his Botanic Garden, in the

following lines:

“So when Contagion, with mephitic breath,

And wither’d Famine, urg’d the work of death;

[217]Marseilles’ good Bishop, London’s gen’rous Mayor,

With food and faith, with med’cine and with prayer,

Rais’d the weak head, and stay’d the parting sigh,

Or with new life relum’d the swimming eye.

[217] “The bishop of Marseilles, during the time of this miserable

calamity, was indefatigable in the execution of his pastoral

office, visiting, relieving, encouraging and absolving the sick

with extreme tenderness; and though perpetually exposed to the

infection, like Sir John Lawrence, the lord mayor of London in

1665, was never seized with the disease--This last gentleman, with

undaunted resolution, continued in the city during the whole time

of the calamity, executing the duties of his office with the utmost

punctuality. The day after the disease was certainly known to be the

plague, above 40,000 servants were dismissed, and turned into the

streets to perish, for no one would receive them into their houses:

and the villages near London drove them away with pitchforks and

fire-arms. Sir John Lawrence supported _them all_, as well the needy

as those who were sick; at first by expending his own fortune, till

subscriptions could be solicited and received from all parts of the

nation.” (_Darwin’s Botanic Garden. Loves of the Plants, canto_ ii,

_p._ 61.)

N^o V.

_Account of the Plague in Syria, Cyprus &c.--From Dr._ PATRICK

RUSSEL’_s Treatise_.

This plague was preceded by violent cold, famine, and earthquakes.

In 1759 it began in Egypt, having been imported in a vessel from

Constantinople. from Alexandria in Egypt it was brought by some Jews

to Saffat, a village in Syria, near Aleppo, which had suffered much by

the earthquake; which last was for some time thought to have been the

cause of the distemper; but, when its nature was really discovered,

they comforted themselves with the thoughts that an _Egyptian_ plague

was less to be dreaded than one which came from the northward.

The distemper had been introduced into Cyprus as early as April 1759,

by a vessel from Constantinople, wrecked on the coast; and, having

thus got a footing in Egypt, Syria and Cyprus, its progress was marked

with the usual mortality. In Egypt the Europeans in Cairo remained in

confinement till the middle of July; a space considerably longer than

usual. Next year they shut up on the 9th of March, but were released on

the 24th of June. The distemper raged in the city with such fury during

1759 and 1760, that in the two years four hundred and fifty thousand

were computed to have perished; a number, however, which Dr. Russel

thinks must have been exaggerated. Cairo had been free from plague

during the whole of this century before, except in the year 1736, when

the distemper raged with such violence that ten thousand were said to

have perished in one day. It was supposed to have been brought from

Upper Egypt. In Cyprus it broke out at the village of Limsol, where it

destroyed four hundred people. During the hot months of July, August

and September the infection showed itself so little that it was thought

to have been extinguished; but in October it not only reappeared in

the places where it had before showed itself, but invaded Nicosia,

the capital of the island. Endeavours were used, by burying the dead

bodies in the night, to conceal the existence of the distemper; but

this soon became impracticable. Towards the end of January, 1760, it

raged so dreadfully in this city that the Mahometans were enjoined to

use prayers and processions to avert the wrath of Heaven. The crowds

brought together on this occasion spread the distemper still more wide,

and in the following month its ravages began at Larnica, a small town

considerable for its trade, and which, though alarmed, had hitherto

kept free, even though infected persons had been freely admitted. Here

it raged with uncommon malignity, insomuch that few of those recovered

that were infected during the month of March. It continued to prevail

till the month of April, when it spread to the very eastern extremity

of the island, into the province of Carpass; a thing hitherto unknown.

Two examples of apparent insusceptibility are related; one was a young

Greek, whose constant employment was, to nurse the sick, and assist at

the burials; the other, a Greek woman, who, having with great affection

nursed her husband and two daughters who died of the plague, continued

with admirable courage to expose herself in assisting the sick in the

neighbourhood.

Towards the end of May the infection was rapidly decreasing; the

Europeans came out of their confinement in the month of July, and the

plague at last ceased, after having destroyed 70,000 persons; nearly

one half of the whole population.

In Syria the plague appeared first in October, 1759, in the village

of Saffat. From thence it proceeded to Tripoli, where it began about

the middle of January, and did not decline till July; neither were the

Europeans thoroughly released from their confinement till towards the

end of August. One half of those infected are said to have recovered;

but five thousand perished. The city remained free from any attack

during the whole of 1761; but early in 1762 the distemper again made

its appearance in the neighbouring villages, and again began its

devouring ravages; but, though a free access was granted to infected

persons in the city, it does not appear that any general infection took

place.

In Latarkea the distemper appeared in March, 1760, made considerable

progress during the month of April, increased from the 17th of that

month to the 13th of May, raged with great violence from that time to

the 27th of June, when it suddenly decreased, the funerals falling from

20 to 9. On the 4th and 5th of July they again rose to more than 20 but

presently fell below six. Four thousand were supposed to have died,

though it was thought that as many recovered as perished. At Jerusalem

the contagion discovered itself in January or February, 1760, and about

the middle of March reached Damascus. In both places it made great

havock; but no accurate accounts were kept of those who died.

N^o VI.

_Remarkable case of a Remitting Fever at Bassorah in 1780._

In the first part of this treatise we have given an account of the

fever which prevailed at Bassorah during the year we speak of, and

likewise of the journey of the gentleman from Bassorah to Zebire, where

he was taken ill on the 4th of June; but as the first attack went off

for that day, we shall only begin the narrative from the day following,

as he himself does in these words:

5th June. From this day I date the actual commencement of my fever.

About 2 o’clock after dinner I was suddenly attacked with a violent

glowing heat all over my body, uneasiness, anxiety and oppression, but

in a very inconsiderable degree to what I afterwards experienced; also

a swelling in my tongue, which had been coming on some days, and is one

of the first symptoms of the fever that prevailed. The fit continued

about two hours; a slight perspiration succeeded, which removed the

fever, but left a head-ach, thirst, and pains in my back and limbs.

In the evening with assistance I got upon the terrace, when the moon

and stars appeared of a bright yellow, and all objects had that colour

through the whole of my disease; also the pain in making water, and

across my loins, became intolerable, like that felt in complaints of

the stone in the bladder. I took some tartar emetic, which brought up a

great deal of bile, and the next morning a purgative of Rochelle salts,

manna, tamarinds and anniseeds.

6th June. In the forenoon a free, copious perspiration, and a perfect

intermission of the fever; at night became very restless and uneasy,

could not sleep, which I partly imputed to a draught of strong

mustard whey, with some antimonial wine, which, instead of causing

perspiration, produced the opposite effect.

7th. By the advice of a physician I took some weak decoction of

bark, 1 oz. to two pints boiled to one, in the quantity of three

tea-cupfuls before dinner. At three in the afternoon I had another hot

fit, but not very severe. In the evening grew worse--heat and thirst

excessive--drank mustard whey on going to bed, but had a very bad

night--no sleep. much oppressed, severe head-ach, and pain over my

loins.

8th. Took a gentle purge of cream of tartar and manna, which operated,

and gave me some ease. Left off the bark, as it seemed to increase the

febrile symptoms, and drank sage and apple tea, decoction of prunes,

tamarinds, &c. At 10 o’clock in the forenoon a very severe hot fit;

heat intense, oppression in my stomach and breast almost insufferable.

Mr. -----, surgeon of the Eagle cruiser, gave me a most nauseous saline

mixture, which vomited and purged me severely. The quantity of bile

which came off my stomach was incredible, yet, I felt no relief, and

the agony of the hot fit continued till 4 o’clock in the afternoon,

when it went off by a most profuse perspiration. During this fit my

thirst was constant and intense. In the evening my skin became dry, the

thirst returned, and I had a very bad, sleepless night.

I now began to experience some of the dreadful symptoms which are, I

believe, peculiar to fevers in Turky and Arabia; a sensation of dread

and horror, totally unconnected with the fear of death; for, while the

patient is most afflicted with this symptom, it is for the most part

accompanied with a strong desire to put an end to his existence. The

agony from the heat of the body is beyond conception. I have heard some

of my fellow sufferers roar hideously under the violence of the pain.

9th Till noon tolerably well. About 1 o’clock the hot fit attacked me,

and was full as severe as yesterday; heat and thirst rather greater,

and but little relief for more than an hour after the perspiration

commenced. This attack left me very weak, much exhausted, with cold,

weakening sweats, quick unequal pulse, severe head-ach, confusion,

anxiety and incessant thirst; a sleepless night, startings, anxieties,

and a constant wish to terminate my sufferings by death.

10th. Forenoon, pretty free from fever. Attacked at the same hour as

yesterday. The fit more violent--delirium. The agony of the heat not

to be expressed; the whole body as if on fire; unremitting thirst,

profuse perspiration, yet no relief till late in the evening; no sleep,

a dreadful night, &c. Pulse about 120, unequal and fluttering.

A mere relation of facts can give but a faint idea of the wretched

situation to which the factory was now reduced: by this time eleven

twelfths of the inhabitants of Bussorah were taken ill, numbers

were daily dying, and the reports from Bagdad and Diarbekir, of the

increasing ravages of the plague, left the survivors not a ray of

hope that they could escape the calamity. On every countenance pain,

sickness and horror were strongly painted; nor were we even left the

comforts of sympathy, as every mind was too much engrossed with its own

sufferings to think of administering consolation to others. Four of us

lay under the portico of one of the squares of the factory, calling

out for water in a frenzy of thirst. We used to snatch it from each

other, and to supplicate for a mouthful with as much fervour as a dying

criminal for an hour of further life.

About this period of the fever my eyes became very weak, and every

object I saw was quite yellow. This effect was most perceptible at

night, in looking at the moon and stars. In the evenings we were

sometimes carried in our cots upon the terrace of the factory for

air; but the wind was so heated by the burning sands of the desert,

that we felt it more intolerable than even the lower apartments. We

all remarked that the _shemaal_, or north winds, which blew without

intermission at that time, greatly increased our heat and thirst.

The daily very evident increase of my fever, and its effects upon

others becoming more fatal and alarming, determined me, while any

strength remained, to embrace the consul’s offer of flying from the

seat of infection to Bushire, in the Ranger cruiser.

11th. After an exceeding bad night I was carried early in the morning

on board the Ranger, and was not very ill until about 9 o’clock, when l

felt the fever coming on, with new and more alarming symptoms--violent

head-ach, giddiness, dimness of sight, approaching delirium, horror,

and a most painful oppression and burning heat in my stomach.

In despair, and to try to quench the unsufferable heat in my stomach

and bowels, I took a pretty large dose of nitre. The oppression and

pain increased; in my confusion I took a paper of tartar emetic, which

immediately began to operate. From that time, about ten o’clock, till

half past two in the afternoon, I know but little of what passed:

I was almost all that time either distracted with pain, or in a

swoon; and had it not been for the extraordinary care and attention

of the commander of the cruiser, who supported me in his arms, and

administered such cordials as I, in the short moments of recollection,

could call for, I have not a doubt but I must have sunk under this

attack. He counted eight times that I fainted, and sometimes an

interval of ten minutes before he could perceive any symptoms of

returning life. I was chiefly supported by wine, hartshorn, and spirits

of lavender. About three o’clock I had recovered my recollection: most

copious and continued sweats had carried off the violence of the fever;

but faintings and total privation of strength and spirits remained

upon me till late in the evening, when I became to all appearance,

for a short time, perfectly well. A little strength returned, every

symptom of fever vanished, and my feelings were almost the same as if

in perfect health. Some circumstances having prevented the Ranger’s

carrying me to Bushire, I was taken ashore in the evening. When I was

brought to the factory I had an appetite, and ate some chicken broth

for supper. Mr. Ross, who had hitherto escaped the fever, administered

a potion of laudanum, and, I believe, antimonial wine, on going to

rest. I slept pretty well, and awoke refreshed in the morning. I,

however, soon became ill, and at noon I had a severe attack, which

continued three or four hours, and left me greatly weakened, my skin

extremely dry, pulse quick, fluttering and irregular, beating from 100

to 120, with an unquenchable thirst, which no liquids could allay. We

had no acids of any kind, which we had great reason to regret.

I did not know till late in the evening that Mr. Abraham, the

vice-consul, who for some days past had been ill of the same fever, had

determined to embark in the Eagle cruiser next morning for Bushire,

as the only chance of saving his life; and a conversation which I

overheard to this effect, that as I was so very ill, and no hopes of

my recovery, it would be better to leave me to die at Bussorah, made

me still more anxious to fly from the place, although I remember well

I had not the most distant hope that I could live. I had suffered much

at the factory, and in the peevishness of illness I thought (perhaps

unjustly) that my living or dying seemed to be a matter of too little

consequence to those whom in health I had treated with much kindness

and affection.

About ten o’clock, as I was lying in my cot, on a terrace adjoining

the stairs from whence the boat was to put off, I was seized with

such a fluttering, palpitation, starting, difficulty of utterance

from the swelling of my tongue, that I lay in momentary expectation

of breathing my last. This was, however, probably the cause of my

hearing the preparations for the departure of the boat. About midnight

they were leaving the shore. I could not make myself heard, and I was

too weak to get up without help. I made several efforts, and at last

overset the cot I was lying upon, and brought myself to the floor,

from whence I crawled on my hands and knees to the side of the river.

Humanity pleaded for me, and I was taken into the boat, in a situation

of wretchedness I never can forget. We were, after being several hours

on the Euphrates, carried on board the Eagle, opposite to Margil,

a country house belonging to the factory, a few miles distant from

Bussorah.

12th. The day was uncommonly hot, and my fever came upon me about

ten o’clock. The heat was intense. Mr. ----, a young unexperienced

Frenchman, gave me tamarind water and cream of tartar, which had not

a good effect. I now discerned the first symptom of a cold fit; but

it was slight and of short duration. This day, however, I supported

the fever rather better than usual, and in the evening had a short

intermission, and slept a little during the night. The air on the river

was this day cooler and more refreshing than on shore.

13th. About eleven o’clock had a regular cold shivering fit, succeeded

by a very severe hot fever, which continued till five in the evening,

when I was somewhat relieved by perspiration. This day the agony of the

hot fit was inexpressible, with great pain in my loins, and a constant

inclination to make water, which came from me in drops like blood. I

had a very bad, sleepless night.

14th. By Mr. ----’s advice I took a dose of tartar emetic, which not

working, he gave me some ipecacuanha. I brought up a great deal of

bile, but the fever increasing, my sufferings under it were greatly

increased by the operation of the emetic, which worked powerfully both

upwards and downwards. This was a trying day indeed. I can give no idea

of what I suffered, which must have been intolerable, attended with

intervals of delirium and frequently swooning. About five the fever

began to abate a little, and at six Mr. ---- gave me a small dose of

decoction of bark, which seemed instantly to cause a return of the

fever, heat, thirst, anxiety and pain.

My fellow-sufferer, Mr. Abraham, was in violent agony this day; he

cried out repeatedly that a fire was consuming his bowels, and that

he was in exquisite torture. The captain of the cruiser had been

complaining; he, Mr. Abraham and myself lay in the same cabin. About 4

o’clock in the afternoon, when my pain was excessive, I crawled from

my cot, with an intention to drop myself from a port-hole which was

under the captain’s bed, into the river. I had nearly accomplished my

purpose, when the captain perceived me, and had me carried into my bed.

I was not delirious; and, in spite of all my resolution, the agony I

suffered this day made me repeatedly scream out. One of our seamen died

suddenly, and the blood, I was told, instantly flowed from all parts of

his body.

This evening we arrived at Bushire. On our coming to an anchor Mr.

Abraham was immediately carried ashore; but I was too ill to be moved,

and accordingly followed in the morning with Capt. Sheriff, after a

very severe, sleepless night.

The heat was so excessive this day that even the natives we had on

board sunk under it, and many of them were struck down with the sun.

By noon nobody could keep the deck; and about this time the vessel

ran aground on the bar at the mouth of the Euphrates, but fortunately

beat over, and got into the gulf. Two more of our people died in the

evening; and I should have mentioned that, in sailing down the river,

we saw them throwing many dead bodies from the vessels which were at

anchor below Bussorah, and many boats crowded with people from the

Arabian shore, passing over to Persia.

The Persians at first opposed the landing of our sick, and threatened

to burn the ship; but they were prevailed upon by the company’s agent

at Bushire, a most worthy man, to permit us to come ashore.

15th. I was so weak that it was with difficulty they could carry me

ashore in my cot; my strength was quite gone, and I was helpless as an

infant. Some grapes, water-melon and ice had been got for Mr. Abraham:

of the latter he had eaten freely; I was much pressed to do the same

but was afraid of its increasing my pain, and could hardly be prevailed

upon to taste it; I, however, swallowed a little, but by this time my

tongue and throat were so swelled that I had difficulty in getting any

thing down. About 10 o’clock I was attacked as usual; but I was become

so weak, and the fever running higher than usual, that I appeared in

the course of this day, more than once, to be in the agonies of death;

perspiration gave no relief to the violent pain and oppression I

laboured under.

The factory at Bushire is a miserable, wretched mud building, bearing

more resemblance to a stable than a human abode: the few rooms, or

rather cells, are insufferably hot, even to those in health, and the

rest of the building has no cover from the sun. In one of the best of

these recesses in the wall Mr. Abraham and I were placed, and on the

same bed, as there was not room enough for two: our agonies were great,

and our cries dreadful. About 7 o’clock in the evening I perceived my

companion in the agonies of death. The company’s agent, Mr. Beaumont,

most humanely afforded him every assistance in his power; and when

every other person was afraid to come near us, he himself attended,

and administered such cordials as he thought might give us relief. Mr.

Abraham died in great pain; and, for fear of alarming the inhabitants,

or rather commandant or sheik of the town, Mr. Beaumont thought it

necessary to conceal his death. It was some time before the dead body

could be removed, which had become very putrid, and covered with

purple spots. I have been since told that immediately after death a

great quantity of blood or bile flowed from him as black as ink, and

so highly offensive as to be smelt at some distance from the factory.

Past midnight we were both removed to the terrace, but, unfortunately

for me, there was only one spot where we could lie, and the smell of

the dead body became intolerable; I was, however, cleaned and put into

another bed by the humane assistance of Mr. Beaumont, who sat by me,

and treated me with uncommon tenderness. I recovered a little, but

passed a dreadful night indeed. I shuddered at the agony which I was

to feel on the return of the sun, and most anxiously wished for death,

as the only relief from pain that I could expect. I was unable at this

time to move hand or foot, and at times could not speak. I told Mr.

Beaumont that I thought a gentle dose of physic, if it could be got

down, might alleviate the racking pain in my breast, stomach, bowels

and loins; he accordingly prepared some salts, manna and tamarinds, and

gave it to me in the morning.

16th. At eleven o’clock the violence of the fever came on; I grew

delirious, swooned, and the symptoms of approaching death, I was

afterwards told, grew evident to those around me. My eyes were fixed,

my tongue hung from my mouth, and my face grew quite black. I recovered

from this fit about twelve o’clock, and felt excruciating pain, and a

burning suffocating heat. My stomach and bowels seemed all on fire,

my lungs played with the utmost difficulty, and I felt a pain and

sensation about my heart which I cannot describe. I was unable to move;

my servant lifted me; I fell into a swoon for a few minutes, and,

when I came to myself, a great quantity of black putrid bile flowed

from me. Relief was instantaneous, and I slept or swooned till about

5 o’clock, when I found myself free from fever, and able to speak, my

recollection clear, and my mind perfectly composed, but my body so weak

that I had no power of moving, except one of my hands. They gave me

some sustenance; I had a little sleep; but about midnight I fell into a

situation which I had all the reason to think indicated the immediate

approach of death. My tongue cleft to my mouth, my extremities were

as cold as ice, and the coldness also appeared to extend up my thigh;

my arm was destitute of pulse, nor was the smallest pulsation of the

heart perceptible; I never had my recollection clearer, or perhaps so

clear, in my life. My servant was lying by my bedside; I was convulsed

for some minutes; and, on recovering, I got out the word _boy_.

Fortunately for me he was not asleep, and heard me; I then got out the

word _wine_; on which he brought me a glass of claret, which, with

much difficulty, I got down; I felt myself much revived; I reflected

on my situation; and, although I had not the most remote idea of

surviving that night, I recollected that I had some fine powdered bark

in my trunk, and it occurred to me that, if any thing could be done to

preserve my life, it would be that medicine taken in red wine; but, my

speech immediately failing me, I could not direct the servant to give

it to me. Death seemed approaching; coldness had seized all my limbs;

my sight became confused, as I perceived from looking at the stars,

which danced before me; and the rattle or noise in my throat was very

perceptible to the servant, as he afterwards told me. I fainted and

continued in a state of insensibility, I believe, for about an hour.

The loud lamentations of the servant, bewailing his own misfortune in

losing his master in a country so remote from his own, seemed to recall

me to life; I felt as if refreshed with a little sleep, and got out

the words _bark and wine_; it was instantly brought, and the man gave

me two large tea-spoonfuls in a large glass of claret. The effect was

instantaneous, and operated like a charm; the coldness left me, I could

speak intelligibly, and could move my hands. I told the servant to give

me a tea-spoonful of the bark every hour, in a glass of claret. By 8

in the morning I had taken six doses, and more than half a bottle of

claret. I was considerably strengthened, and could converse with Mr.

Beaumont, who encouraged me to persevere in the bark, and treated me

with uncommon attention. I had been sadly neglected at Bussorah, but

this was amply made up to me by the humane and tender attentions of

Mr. Beaumont, who was a great predestinarian, and who never shunned

danger when he felt it a duty to assist a fellow creature. He waited

upon me like a nurse, consoled me under pain and sickness, and, when

my fever was at its greatest height, he has often held me in his arms,

when I wanted to be removed, or my bed shifted. About this time my

legs and thighs became covered with blotches of a dusky brown hue,

some of them as broad as the palm of the hand, quite dry, and they

itched intolerably. At the same time several little boils broke out

in different parts of my body, but there was only one, over my eye,

that came to suppuration; the others, and the eruption on my legs and

thighs, all disappeared.

I continued the bark till 12 o’clock, and then left it off till 4,

when I took another dose. The dreadful fever of the preceding days

did not return on this, but I was still extremely ill, had very great

difficulty in speaking and breathing; a swelling also in my throat,

parched tongue, and unquenchable thirst. I had not the most distant

hope of living. I tried to take some broth, but the swelling in my

throat prevented my swallowing. I passed a very bad night, with

startings, anxiety, and great pain over the kidnies; and what little

sleep I got seemed to make me worse; I was fatigued with it, and under

the constant dread of suffocation: towards morning my throat grew

worse, and my thirst was excessive.

18th. Left off the bark, uncertain what I ought to do--no fever, but

the same symptoms as the day before--drank a little chicken broth,

which was the only sustenance I had taken for four days before--great

oppression and heat in my stomach and bowels. Mr. Beaumont found out

an Armenian who professed physic. This man gave me a clyster, which

gave me great relief, and a water to drink, famous as a febrifuge among

the Persians; I drank of it freely, and found much benefit from it.

But the most extraordinary of all the symptoms I experienced was this,

that, the third day after the first intermission of my fever, one of my

teeth, and one of the nails of my hand, came out without the smallest

pain, only a little swelling in the gum; and, on the nail falling

off some matter flowed from the end of my finger. I never had the

tooth-ach. At this time the boil on my eye suppurated.

From the 18th of June to the 5th of July, being seventeen days, my

fever did not return. I recovered strength slowly, and could walk a

little, supported by two men. My food was chiefly chicken and veal

broth and about a glass and a half of Madeira wine a day. Yet I

had many symptoms of disease hanging about me--restless, fatiguing

nights--great thirst--bad taste in my mouth: every thing I took seemed

bitter and salt--pains in my back, sides and loins and great difficulty

in making water. In this time I passed much bile, naturally and by

clyster; and I had a purgative from the Armenian, which weakened me

greatly.

The springs lifted, as seamen term it, three days before the change.

The opinion is universal in those countries, and also in India,

particularly Bombay, where intermittents are prevalent, that the change

and full of the moon has an effect upon all intermitting diseases,

of which afterwards I had many proofs in my own case. To prevent a

relapse, I took some decoction of bark, but in too small quantities to

answer the purpose.

4th July. My water, from being thick and muddy, became quite clear.

The 5th of July, after dinner, I was taken with a slight hot fit, which

continued about two hours, and then went off by copious perspiration;

the remaining part of the evening I was entirely free from fever.

6th. I took decoction of bark--no fever.

7th. At 11 o’clock a regular cold and hot fit; the former continued

three quarters of an hour, the latter two hours. Although much less

severe than my former fever, yet I suffered a good deal from the hot

fit. Left off the bark by the advice of the Armenian, who told me that

it heated me and made me worse. Much weakened by this day’s illness;

nor did the perspiration entirely free me from the fever.

8th. Had a clyster thrown up, and early in the morning took a draught

from the Armenian, composed of fine vinegar, sugar, and a country

seed infused over night in water.--A slight hot fit, but of short

continuance.

9th. The draught of yesterday repeated--at 10 a regular cold and hot

fit, rather less violent than the last.

10th. No fever--tolerably well.

11th. Between 8 and 9 in the morning a cold and hot fit, much more

severe than the last--great heat, thirst and oppression--much weakened.

I now perceived I had got a regular tertian, and determined on the

bark, but was prevailed on by the Armenian not to use it, he promising

to cure me in a day or two. He gave me water-melon and his infusion of

vinegar and seeds.

12th. No fever--find the water-melon to disagree greatly with my

stomach.

13th. Had not as yet indulged much hopes of recovery. I felt still,

even in those days previous to this last relapse, many alarming

symptoms of disease, which made me apprehend I could not recover; and

this last attack had again reduced me so low, that it was evident that,

unless I could get removed from those scorching climates, a very short

time would put an end to my life. Except in the humanity and goodness

of Mr. Beaumont, I was without a single comfort or conveniency of life

at Bushire. The heat of the weather seemed daily to increase, and the

house we were in hardly covered us from the direct rays of the sun.

My servant was taken ill, and appeared to be dying: it was with the

greatest pleasure, therefore, I received the accounts this day of the

Eagle cruiser having arrived last night from Bussorah, on her way to

Bombay.

At half past seven o’clock I had a very severe fit; the hot fit was

uncommonly violent, and continued about three hours. I was much

reduced, and resolved at all events to take the bark in powder, and

in large doses, and to dismiss the Armenian. In this I was confirmed

by Mr. Puget, who informed me that the few survivors at Bussorah owed

their lives entirely to the bark, which had at last been given in very

large doses.

14th. I took four doses, or eight tea-spoonfuls, of powdered bark.

It purged me, and carried off a great quantity of black putrid bile.

This evening I was carried in my cot on board the Eagle, resolved at

all events, even if I had been certain of dying in the boat, to leave

Bushire, where I had hardly shelter from the sun, and where the heat

was so excessive, that Capt. Alderson of the Eagle and two passengers

were taken ill from it last night. I got on board very late, yet found

myself refreshed from the sea air.

15th. The fever did not return. I continued to take the bark as

yesterday, and found myself surprisingly strengthened. I persevered

under this course till the 3d of August, when the vessel arrived at

Muscat, and I was astonishingly recovered for the shortness of the time.

From the 14th of July to the 3d of August I had taken seven ounces

of bark; and as the fever had returned upon me the last day of the

springs at the preceding change of the moon, two days before this

change I increased my daily dose, and continued in this manner till the

4th, when the springs being over, and perceiving no symptoms of fever

remaining, I left off the bark entirely. I had generally taken six

tea-spoonfuls every day.

From the 15th of July till my arrival at Muscat, a seaport on the coast

of Arabia, my recovery was exceedingly rapid. I had a keen appetite, a

pretty good digestion, sound, refreshing sleep, and my daily increase

of strength was very perceptible. My diet, till this time, had been

generally chicken broth, rice and boiled fowl, light pudding, &c. On

leaving off the bark I observed no particular regimen, only abstaining

from salted and high-seasoned meats, and confining myself to three or

four glasses of Madeira. I found that an infusion of prunes, with a

small quantity of cream of tartar, was of much service to me during

the course of the bark, as it kept me cool, and my body open. I was

sensible, at times, during my recovery, of a slight but troublesome

pain under my fifth rib on the right side, especially when I lay on

that side; but from feeling and pressing my hand over the region of the

liver, and from other circumstances, I had no reason to suspect that

my liver was affected; and, as it soon left me, the cause was probably

trifling or accidental.

On my leaving Muscat a large boil came upon the hip-bone, the size of

a small melon, extending some way up the side, and down the thigh,

with a hard basis. After arriving at Bombay, which we did in fourteen

days, it broke, and in a few days healed up. I shall only add, that

at Bombay I was detained four months before I had an opportunity of

proceeding to Europe. In that time I had three returns of my ague, but

on taking a few doses of bark it left me. Those attacks happened at the

change of the moon. From Bombay to Europe I had three or four slight

fits of the ague; the worst on our making the coast of South Guinea, at

the settlement of Benguela, where we found the wretched remains of a

Portuguese garrison, the survivors of a fatal putrid fever, which, as

they told us, raged in those parts for eighteen months before. The last

attack I had was the day we made the Rock of Lisbon, since which time I

have had no returns of the ague, although, when the wind continues long

at east, I am sensible of a tendency to that complaint.

I shall now give a brief account of the fate of my fellow sufferers at

Bussorah. This unfortunate party consisted of capt. Sheriff, of the

Eagle cruiser; Mr. Brown, a Bengal merchant, carrying goods from India

to Aleppo; Mr. Palmer, a gentleman returning with his fortune from

Bengal to Europe; Mr. Robson, surgeon to the factory; Mr. Abraham, the

vice-consul; Dr. Ross, who had practised many years at Constantinople,

some time in Bengal, and was then taking the opportunity of

accompanying me across the desert; Mr. Smith, a merchant from India;

and an Italian Carmelite, the vicar of Bussorah, who came from Bombay.

It is unnecessary to say that the _seca dab_ is a common symptom in the

Turkish fever, or, in other words, a strong desire of self-destruction.

We had a fatal instance of it in our party. Mr. Brown, the second day

of his fever, being left alone, got to his pistols, and, throwing in

four or five balls, discharged them into his breast, and was found dead

a few minutes afterwards. I believe every one of us at times would have

done the same, had we been possessed of the means of accomplishing

it. Mr. Robson died the third day of his fever, in great agonies,

but perfectly sensible. His was a continued high fever, without any

remission. Mr. Palmer died the 4th day, under the same symptoms as

the preceding. The Carmelite, the second morning after he was taken

ill, had opened a vein in his arm, and bled to death, most probably

intentionally. Captain Sheriff was seized with the fever on his return

from Bussorah to Bushire. He died the third day, in a manner which

is even painful to relate. He was a man of singular strength of

constitution, and suffered unusual agonies before he died. His cries

were heard all over the factory; he foamed at the mouth, gnashed with

his teeth, and tore his arms with his teeth. Those who heard him

compared his cries to the bellowing of a mad bull. He was no sooner

dead but his body was covered with purple spots, and so offensive that

the people could hardly carry it out to be buried. Mr. Sheriff’s was

what they call the worst kind of plague.

Mr. --------, formerly mentioned as having escaped the plague at

Bussorah by shutting himself up in a mud house, was seized on his

voyage to Bussorah with a kind of insanity, imagining that people were

conspiring against his life, and that he was capable of overhearing,

at a great distance, even a whisper spoken to his disadvantage. He,

however, escaped the infection, and returned to England in health.

N^o VII.

_Set of Queries furnished by Doctors_ AIKIN _and_ JEBB; _and by Mr._

HOWARD _put to several foreign Physicians, during his tour; with

their Opinions concerning the Plague_.

1. Is the infection of the plague frequently received by the French?

Answer, by _Raymond_, physician at Marseilles: Sometimes it

is.----_Demollins_, surgeon do: In the lazaretto some have touched

infected bodies and things with impunity. Attributed to the temperament

of the body.----_Giovanelli_, physician to the Leghorn lazaretto: The

plague cannot be communicated but by very near approach, or touch: air

cannot be the vehicle.----_They_, physician to the Malta lazaretto: It

may happen that one person may inhabit the same chamber, or even touch

an infected person, with impunity; of which I have known instances; but

all who approach the atmosphere of an infected body may receive the

infection by respiration. Contagion is almost always received before

touching or approaching the infected person.----_Morandi_, physician

at Venice: Contact is one of the most powerful and dangerous means of

communicating the infection; but for the developement of its effects

a predisposition in the receiving body is necessary.----_Verdoni_,

physician at Trieste: It is most frequently communicated by the touch.

It has been given by a flower held and smelt at, first by two persons

who remained free; and then by a third, who sickened and died in 24

hours.----_Jew_ physician at Smyrna: The infection is in reality

communicated by the touch alone; for all who keep from contact of

infected persons or things remain free. To the effect of contact,

however, a certain disposition of the air is necessary; for we often

see infected persons arrive from other countries, yet the disease does

not spread. But what this disposition is can scarcely be conceived.

Commonly in this climate, the disease appears at the end of spring,

and continues to the middle of summer; with this particularity, that,

in cloudy weather, and during the _sirocco_ winds, the attacks are

more frequent. Also in the same diathesis of the air some receive

the infection, while others exposed to the same dangers escape it.

From observation it appears, that cachectic persons, and those of

constitutions abounding in acid, do not readily take it. The contagious

miasmata may be dormant in the body for some time without doing the

least harm, till set in motion by sudden fear, or the excessive heat of

a bath.----_Fra. Luigi di Pavia_, prior of the hospital of San Antonio

at Smyrna: The plague is communicated by contact, according to all the

observations I have been able to make for eighteen years.

2. Does the plague ever rise spontaneously?

_Raymond_: Incontestible experience shows that it only proceeds from

contact.----_Demollins_: From all ages the plague has been brought to

Marseilles by merchandise or persons beyond sea.----_Giovanelli_: As

the disease always appears with the same symptoms, it is not probably

spontaneous, but the consequence of a particular contagion.----_They_:

Some contagious fevers come of themselves; others proceed from the

communication of contagion. The plague is thought to have originated

in Egypt, and spread itself from thence.----_Morandi_: Contagious

fevers do not arise of themselves, but are always the product of a

peculiar poison--_Verdoni_: I know no fever that can properly be

called contagious, and doubt if even the plague can be considered as

such. My reasons are drawn from the very different manner in which

the plague appears in different years, and the different degree in

which it spreads. I therefore conclude that contagious fevers come

of themselves.----_Jew_ physician: According to the most ancient

authorities, the plague has always been brought to Smyrna by contagion,

and was never produced here.----_Fra. Luigi_: Ancient and common

observation in this city prove that the plague is derived _solely_ from

contagion.

3. To what distance is the air infected? How far does actual contact,

wearing infected clothes, or touching other things, produce the disease?

_Raymond_: The infected are safely conversed with across a barrier,

which separates them only a few paces.----_Demollins_: The air round

the patient is infected more or less according to the degree of poison

which exhales. Here in the lazaretto they are spoken with across two

barriers, a few paces from each other, without fear of contagion.

Hence it would appear that the plague is communicated only by the

touch, or still more by wearing infected clothes.----_Giovanelli_: If

one speaks of an infected person shut up in an unventilated chamber,

it may be said that the whole chamber is dangerous; but if one speaks

of a patient exposed to the open air, it has been proved that the

infection does not extend beyond five geometrical paces from the body.

Beyond this distance one is in safety. The actual touch of an infected

person or thing is proved to be very dangerous by fatal experience;

but to what degree, is not ascertained.----_They_: The infection

extends only some paces; and the miasms, at the distance of about ten

paces, are so corrected by the air as to lose all their activity.

It may be communicated by touching infected things, especially of

a porous nature, as cloth, wool, skins, &c.----_Verdoni_: From the

moment of infection to the time when nature has entirely dissipated

the contagious principle, which usually happens in forty days, there

is always a capacity of communicating the infection. The degree of

infection is in proportion to the volume of air surrounding the

patient; the air being what absorbs, dissipates and communicates the

contagious principle. Infected substances communicate the disease for

many years, in proportion to the ventilation they have undergone, or of

which they are susceptible.----_Jew_ physician: The degree of infection

in the air about the sick depends upon the greater or less malignity of

the disease, and other circumstances. The air about poor patients is

more infectious than about the rich. These things being established, I

am of opinion that, in the greatest contagion, we may securely see a

patient at the distance of two ells, if the chamber windows be not all

shut.----_Fra. Luigi_: The infection is greater or less in proportion

to the virulence of the contagion; but I have made no observation as to

the distance. The disease is communicated by contact of all infected

things, and by close inspiration of the breath of the sick.

4. What are the seasons in which the plague chiefly appears; and what

is the interval between the infection and the disease?

_Raymond_: The plague shows itself at all seasons, but less at the two

solstices.----_Demollins_: Great ravages may be made in all seasons,

but principally in the greatest heats of summer. From the infection to

the disease is two or three days.----_Giovanelli_: The plague appears

at all times, in the same manner as poisons at all times produce their

effects. But observations show that its ravages are greater in hot

seasons than in cold; and it seems that summer and the first months of

autumn are most to be dreaded. There is no certainty as to the interval

between the infection and the disease, as it depends on the particular

constitution of the patient.----_They_: Warm, moist seasons contribute

to the production of all infectious diseases. The interval from the

infection to the seizure is various, according to the virulence of

the poison, and the constitution of the patient. Sometimes it acts

slowly, sometimes like a stroke of lightning.----_Verdoni_: The

spring is the principal season. Generally the disease shows itself at

the instant of touch, like an electrical shock. Sometimes a person

retains the contagious principle without any sensible effect, and then

unknowingly communicates it to a third, in whom, if predisposed to the

disease, it becomes active; or, otherwise, it may be communicated to

others successively in the same way, till it becomes dissipated and

annihilated, as happened at Smyrna in 1783. In bodies predisposed it

very rarely conceals itself till the third day.----_Jew_ physician:

Answered in the first.----_Fra Luigi_: The plague is most fatal in

Smyrna from April to July; and it is constantly observed that great

colds and heats much diminish it, and copious dews extinguish it. The

infection shows itself in 24 hours, more or less, according to the

difference of temperament.

5. What are the first symptoms of plague? Are they not frequently a

swelling in the glands of the groin and armpit?

_Raymond_: The plague often conceals itself under the form of an

inflammatory, ardent or malignant fever. Tumours of the glands are

often its first symptom.----_Demollins_: The first symptoms of the

plague vary; but the most common are, buboes in the armpit and groin;

parotids and carbuncles in various parts of the body.----_Giovanelli_:

The first symptoms are, debility, fever, excessive thirst, followed

by great heat; after which carbuncles or buboes appear in the

armpits, groin and parotids. The groin is sooner attacked than the

armpit.----_They_: Swellings in the armpits and groin are indeed the

characteristics of the plague; yet they are not the sole nor the

first symptoms, and often are not seen at all; as when the plague

disguises itself under the form of other diseases.----_Morandi_:

Glandular swellings are properly the symptom of the second stage,

and are preceded by those febrile symptoms which are immediately the

consequence of receiving the infection; such as pain in the head,

drowsiness, great prostration of strength, dryness of the tongue,

vomiting, hiccough, tremor, diarrhœa.----_Verdoni_: Its first symptoms

are relative to the constitution of the year, and of the body seized,

and the place where it was produced, or whence it came. In 1783 all the

parts of Natolia were infected; and the disease transported to Smyrna,

which is the centre, was extinguished without the loss of a single

person. Generally the plague of Constantinople, transported to Smyrna,

does little harm. That of Egypt causes havock, as in every country.

That of the Thebais is always cruel, and, carried to Lower Egypt,

is fatal. The inguinal glands are most generally affected.----_Jew_

physician: The swelling of the glands is seldom the first symptom.

Patients are every day seen who, being supposed ill of another

disorder, in two, three or more days show glandular swellings, or

carbuncles, by which the plague is manifested. On the contrary, many,

who from the usual signs are supposed to have the plague, become well

in a day or two, without any external swelling. The first symptoms

are, horripilation, or actual shivering, nausea or vomiting, loss

of strength, and fever. These are common to many diseases; but the

pathognomic signs are, a difference in the pulsations of the two sides,

with this circumstance, that from the diversity a prognostic arises;

it having been observed that if the pulse on the side of the tumour

or carbuncle be greater or more frequent, it bodes well; whereas, if

it be smaller, it shows greater malignity, and more is to be feared.

Further, there is observed among the first symptoms a visible pulsation

in the carotids, greatest on the affected side; and also a crystalline

vivacity in the eyes, with a kind of contraction or diminution of the

eye on the affected side.----_Fra. Luigi_: The most remarkable symptoms

of the plague are, turbidness and sparkling of the eyes, the tongue

furred with a white mucus, and very red at its tip, frequent biting

of the lips, violent pain in the head, and inability to hold it up; a

sense of great cold in the loins, vomiting, debility. Swellings of the

glands are not among the first symptoms.

6. Is it true that there are two distinct fevers with nearly the

same symptoms, one of which is properly termed the plague, and is

communicated from a distance by the air, and without contact; while the

other, which is properly termed contagion, is only communicated by the

touch, or at least by near approach to infected persons or things?

_Morandi_: It is certain, from multiplied observations, that there are

two sorts of pestilential fevers, similar in appearance; one of which

proceeds from the contamination of the air alone, and is communicable

to any distance; the other is produced alone by contact, or near

approach. The former of these is properly termed a pestilential fever,

the latter a contagious one.----_Verdoni_: The distinction of these

fevers is useless; since the same which is communicated by the touch,

is that also conveyed by the air to a certain distance, especially in

a close place.----_Jew_ physician: That there are two kinds of plague

is absolutely to be denied; yet sometimes it happens that persons are

attacked with the plague without knowing from whence it came.----_Fra.

Luigi_: I hold it for certain that there is only one species of plague,

though differing in malignity.

7. What is the method of treatment in the first stage; what in the more

advanced periods? What is known concerning bark, snakeroot, opium,

wine, pure air, the application of cold water?

_Raymond_: The disease is treated as inflammatory. No specific has

been discovered for it.----_Demollins_: At the beginning, bleeding,

vomiting, purgatives, diluents, refrigerants and antiseptics are used;

afterwards antiseptics and cordials, relatively to the temperament

and symptoms----_Giovanelli_: The plague causing always a disposition

to inflammation and putrefaction, it is always proper to bleed

proportionally to the strength, and to use a cooling regimen, with

the vegetable acids. The repeated use of emetics is also proper, both

to clean the first passages, and to dispose the virus to pass off by

the skin. In the progress it is necessary to favour the evacuation of

the virus by that issue which nature seems to point at. Thus either

antiphlogistic purgatives are given, if nature points that way, or

suppurative plasters are to be applied to any tumours which may appear.

Epispastics to the extremities are proper where nature wants rousing.

The vitriolic acid in large doses has been found very serviceable in

the plague at Moscow, attended with carbuncles. When the inflammation

is over, and marks of suppuration appear, the bark, with wine and

other cordials, is proper. The surgeon’s assistance is proper in the

treatment of boils and anthraces, which last are seldom cured without

the actual cautery.----_They_: In the beginning of pestilential fevers

bleeding is sometimes proper, and vomits almost always. In their

progress frequent subacid and cold drinks, the bark given liberally,

and vitriolic acid, have been found powerful remedies when there

was a dissolution of the blood----_Morandi_: In the first period,

evacuations, according to the particular circumstances of the case, are

proper: in the second, bark mixed with wine, and opium as a temporary

sedative. Pure air is very necessary; and fire as a corrective, with

the burning of antiseptic and aromatic substances.----_Verdoni_: As

soon as a Christian finds he has got the plague, he eats caviare,

garlic and pork; drinks brandy, vinegar and the like, to raise the

buboes. Upon these he applies greasy wool, caviare, honey of roses,

dried figs, &c. to bring them to suppuration. The Turks and Arabs drink

bezoar in powder with milk, and other sudorifics, in order to expel

the virus. They vomit, and possibly a second time. At Cairo they take

opium, and cover themselves with mattresses in order to excite sweat;

and, though parched with heat and thirst, they drink nothing. They open

the immature buboes with a red hot iron. At Constantinople and Smyrna

they eat nothing, and drink much water and lemonade. The Jews drink a

decoction of citron seeds, lemon or Seville orange peel, and their own

urine. They abstain scrupulously from animal food. In 1700 a physician

in Smyrna found bleeding very useful. Another, in another year, cured

the plague by bleeding, and an antiphlogistic regimen. My brother

in Cairo treated it like a biliary fever, with vomits, saponaceous

attenuants, and antiphlogistics; and successfully. Some sailors at

Constantinople in the frenzy of the plague have thrown themselves

into the sea; and it is said that on being taken out of it they have

recovered. My opinion upon the whole is, that the treatment ought to

be relative to the constitution of the year, and of the patient, by

which the nature of the disease itself is greatly altered.----_Jew_

physician: Bleeding in many cases may be serviceable, as I have known

patients, who were bled by mistake, recover; and others recovered

from a most desperate condition by a spontaneous hemorrhage. On the

other hand, persons have been apparently injured by both these

circumstances. The difference of effect seems to depend on the state of

the blood, whether it be disposed to coagulation or dissolution. In the

former, bleeding is useful, in the latter, hurtful. Vomits, according

to my experience, have not succeeded; yet I should not hesitate to try

ipecacuanha in substance, exhibiting half a scruple at two or three

times, in the expectation that in this manner it would not run down.

Bark may be useful in dissolutions of the blood; and also small doses

of opium, and other medicines prudently administered. In excessive

watchfulness I have known relief procured by anointing the temples with

ung. populeon. In a case of hiccough the liquor anod. miner. Hoffmanni

succeeded with one. The Turks, in the violence of the fever, take

handfuls of snow, and apply it all over their bodies, and also eat it;

and sometimes throw cold water on their feet. But whether this is of

service or not cannot be determined; as these people in other respects

pay no regard to rules of diet.----_Fra. Luigi_: They who practise

empirically in the plague use none of the recited methods, but only

strong sudorifics, and ventilation of the air; and complete the cure by

proper treatment of the sores by suppuration.

8. When the plague prevails, do the physicians prescribe to those who

have the disorder a more generous, or a more abstemious diet? and do

they prescribe any thing to the uninfected?

_Jew_ physician: In times of the plague, many are accustomed to eat

no flesh; others, no fish; but I know not whether by the advice of

physicians. For myself, I have been in many plague years, but have made

no alteration in the management of myself.----_Fra Luigi_: In Smyrna

the plague is generally treated with a rigorous diet. They only use

rice and vermicelli boiled in water; and sometimes, when the patient is

too costive, juices and herbs boiled without seasoning. From time to

time they give some acid preserves, and raisins, and, in great heats,

some slender lemonade; and a dish of good coffee with a biscuit every

day. For drink they only use toast and water; and they follow this

abstemious regimen till the fortieth day of the disease is completed,

after which they take chicken broth, lamb, and other food of easy

digestion.

9. Are convalescents subject to repeated attacks from the same

infection?

_Raymond_: Not unless they touch something infected.----_Demollins_:

Convalescents are sent to fumigated chambers, and there is no instance

of relapse.----_Giovanelli_: No instance of relapse, after being

well recovered from the first attack, have come to my knowledge; but

they are liable to fall into other disorders, such as consumption,

hæmoptoe, &c.----_They_: Convalescents are without doubt liable to

a relapse, and authors are full of instances of it. In the plague

of Messina M. Cotogno says that a man had successively fourteen

buboes, and was cured at last.----_Morandi_: All convalescents may

relapse.----_Verdoni_: They have it not twice in the same year----_Jew_

physician: Convalescents are often attacked anew, and die; but this

does not usually happen from a fresh infection taken elsewere, but from

some remains of their own contagion, excited by intemperance in food,

or the venereal act.----_Fra. Luigi_: From irregularities in eating and

drinking, bodily fatigues, affections of the mind, especially anger,

they are liable to repeated and very dangerous relapses.

10. What is the proportion of deaths, and the usual length of the

disease?

_Raymond_: The mortality is different in different seasons and

years.----_Demollins_: In the plague of Marseilles in 1720, half

the inhabitants perished. The usual length of the disease is that

of other acute disorders; but longer when the tumours come to

suppurate.----_Giovanelli_: The proportion of deaths is variable and

uncertain. As to duration, when the disease is very acute and fatal,

the patient generally dies within five days from the first invasion

of the fever, or first marks of the plague. When he recovers, no

certain termination can be assigned. If the time of healing all

the sores be reckoned, it may be to three, four or five months, or

more.----_They_: The mortality is very various. Of ten whom I treated

in the lazaretto, three died. I have observed that the fever generally

runs on to twenty or twenty-one days.----_Morandi_: The bills of

mortality in places visited by the plague usually amount to thirty

per cent, sometimes to fifty. (He seems to mean of the whole number

of inhabitants.)----_Verdoni_: The proportion of deaths varies

infinitely. It has been observed that the Jews in Constantinople and

Smyrna lose only one third; which is attributed to the care they

take of their sick. At Cairo, on the other hand, they are the first

attacked and lose more than three fourths. The Turks lose two thirds;

other nations a little more or less. Europeans in Cairo lose five

sixths. Sometimes it kills immediately; sometimes in twenty-four hours;

commonly in three days. When the patient gets over the ninth day

there are great hopes of recovery, as the buboes are then suppurated.

They may, however, die within the fortieth day, especially if they

commit any irregularity, the principal of which is eating flesh, which

instantly causes a return of fever, and death. It never passes beyond

the fortieth day.----_Jew_ physician: The mortality is various, as

also the duration: some in two, three or four days; some hold out six,

eight, or more---_Fra. Luigi_: Generally more die than survive; but in

our hospital of San Antonio of Smyrna, from the care taken of the sick,

the number recovering has, for eighteen years past, exceeded that of

the dead.

II. What are the means to prevent the plague, to stop its contagion,

and to purify infested places?

_Raymond_: There is no other method of preserving one’s self from

the plague, than avoiding the contact of infested things. Goods are

purified by exposing them to the open air for forty days; and furniture

by a strong fumigation with aromatics and sulphur.---_Demollins_:

Here, in the lazaretto, infected goods and furniture are exposed to a

current of air for forty days. The air of infested places is purified

by burning all sorts of aromatics.----_Giovanelli_: The method of

prevention is, to avoid all communication with infected persons or

goods. The means of stopping the contagion form a body of police, too

extensive to be here mentioned.----_They_: The means of prevention,

besides avoiding infected things and persons, are sobriety in living,

the use of vinegar internally and externally, and an issue. Infected

places are purified by fumigation and ventilation, by scraping the lime

from the walls, (which is then thrown into the sea) and whitewashing

them anew with lime and sea-water, by washing the floors, windows,

doors, &c. first with sea-water, and then with vinegar, taking great

care to leave nothing that is infested. The bodies of the dead are

buried in a place set apart for that purpose; and their beds and

bedding are burned. As to other things not used during the illness,

the linen is washed with soap and ley; the woollen clothes are put

into sea-water for two days, and then ventilated for twenty days.

Those which would be spoiled by water are hung on a line in the air

for 40 days, and fumigated from time to time according to their

quality----_Morandi_: A fire is to be kept constantly in the sick

chamber in all seasons. All fæces, &c. are to be immediately removed.

Clean sheets and shirts daily. The healthy must avoid commerce with

the infected; must purge gently now and then, smoke tobacco, drink

pure wine medicated with wormwood, gentian, zedoary, &c. and avoid

fear and other passions, and excess of all kinds.----_Jew_ physician:

No means of prevention are used in the Turkish dominions.---_Fra.

Luigi_: Fire, water and air are used for stopping the contagion, and

purifying places.----_Verdoni_: The best preservatives are supposed

to be sprinkling the room with vinegar and perfumes, ventilation and

fumigation. The Greeks in Smyrna during lent, when they eat only

vegetables, are seldom attacked; while among those who eat flesh the

contagion makes great havock. Hence the best means of prevention are

to eat moderately, and not at all of animal food; to drink water and

vinegar; to sprinkle the chamber with the latter; and use frequent

ventilation; to change the clothes, especially the linen, daily;

hanging in the air such as has been used, for 15 or 20 days. For

suppressing the infection every thing is to be washed that can undergo

the operation, and the walls of the chamber to be whitened with lime,

but after the 24th of June no further care is taken.

FINIS.

ERRATA.

PAGE. LINE.

20. 23. For ‘destroying three or four thousand,’ read

‘destroying sixteen hundred out of three or four

thousand.’

39. 13. from bottom, for ‘Zabira,’ read ‘Zebire.’

86. 10. for ‘obscured.’ read ‘obscure.’

153. 20. for ‘acid other,’ read ‘acid in the other.’

202. 15. from bottom, after ‘the inhabitants,’ add, ‘Farther

east it does not go.’

280. 7. from bottom, for ‘flattering,’ read ‘fluttering.’

303. 8. from bottom (in a few copies) for ‘gout, fever,’ read

‘gaol-fever.’

309. 10. for ‘safety to,’ read ‘safety of.’

460. 2. from bottom, for ‘fluid,’ read ‘fluids’

480. 12. from bottom, for ‘Black assizes,’ read ‘Black Hole.’

486. 5. for ‘Hansforth,’ read ‘Hansford;’ also in pages 489 &

510.

502. 1. for ‘parcity,’ read ‘paucity.’

513. 1. bottom, for ‘vol. x,’ read ‘vol. iii.’

Spelling inconsistencies include (but are not limited to) the following:

idiosyncracy/idiosyncrasy

occured/occurred

eat/ate

superintendant/superintendent

etherial/ethereal

oxygen/oxygene

syncopy/syncope

alledged/alleged

adviseable/advisable

Corrected misspellings include the following:

acccording → according

ackowledged → acknowledged

an an → an

and and → and

and thing → anything

attemps → attempts

authoriry → authority

bails → balls

bemost → be most

bilous → bilious

by → be

calls → call

certainiy → certainly

christain → Christian

debelitated → debilitated

destoyed → destroyed

determinining → determining

Diermerbroeck → Diemerbroeck

Dr. Power → Dr. Dover

draw → drawn

exeecd → exceed

flattering → fluttering

follwing → following

frequenly → frequently

fundemental → fundamental

gave → grave

his his → his

hulhed → hushed

imperceptiple → imperceptible

in in → in it

injuctions → injunctions

instanly → instantly

is → it

Lavosier → Lavoisier

let → lest

lways → always

must been → must have been

occuring → occurring

oelophagus → oesophagus

pamplet → pamphlet

particulaly → particularly

paticles → particles

peppercoorn → peppercorn

persons → person

phenomana → phenomena

plagae → plague

presumtive → presumptive

promiscously → promiscuously

Pythou → Python

reaching → retching

Reamur → Reaumur

Reamuru's → Reaumur's

recal → recall

remianing → remaining

sensibilty → sensibility

siuation → situation

slips → ships

steams → streams

surounding → surrounding

sypmtoms → symptoms

terrestial → terrestrial

that that → that

the → The

the the → the

though → through

to to → to

vaccillating → vacillating

vegatable → vegetable

whereever → wherever

willl → will

A Treatise on the Plague and Yellow Fever With an Appendix, containing histories of the plague at Athens in the time of the Peloponnesian War; at Constantinople in the time of Justinian; at London in 1665; at Marseilles in 1720 · 第 13 / 13 章

8. _Extraordinary case of yellow fever at Boston in 1798._ “The subject