AN
ACCOUNT
OF THE
PLAGUE
WHICH
_RAGED AT MOSCOW_,
IN
1771.
BY CHARLES DE MERTENS, M. D.
MEMBER OF THE MEDICAL COLLEGES OF VIENNA AND
STRASBURG, FORMERLY IMPERIAL AND ROYAL
CENSOR, AND CORRESPONDING MEMBER
OF THE MEDICAL SOCIETY
AT PARIS.
TRANSLATED FROM THE FRENCH, WITH NOTES.
_LONDON_:
PRINTED FOR F. AND C. RIVINGTON, NO. 62,
ST. PAUL'S CHURCH-YARD.
1799.
PREFACE.
Histories of the Plague, exhibiting the modifications it undergoes in
different climates, must at all times and in all places be acceptable,
if not to the public at large, at least to that class of persons who
make the art of medicine their study and employ: But, to a country
situated like our own, histories of this terrible disorder occurring in
the northern parts of Europe are more particularly interesting, by
holding up to our view a picture of what it probably would be, whenever
it should visit us again. Such a picture is presented to us in the
history of the plague which depopulated Moscow and other parts of the
Russian empire, in the year 1771, and which forms the subject of the
following pages. What, at the present time, must give a greater degree
of interest to such a subject, is the danger to which we are exposed of
importing the pestilential contagion from America[1], on the one hand,
and from Turkey and the Levant on the other: For, although the cold has,
happily, suppressed for the present the pestilence which has been
committing such dreadful ravages at Philadelphia and New York; yet is it
to be feared that it may be retained in many houses, and lie dormant in
various goods, ready to break out again, whenever it shall be favoured
by the weather[2]: And no one who is acquainted with the nature of that
contagion can deny the possibility of its importation from America into
this country, either now or hereafter, by infected persons or infected
merchandise. On the other hand, are we not threatened with a similar
danger from the East? In executing the hostile operations which are
going forwards in the Mediterranean, it seems scarcely possible for our
fleets and armies to keep clear of contagion. No nation was ever long
engaged in a war with the Turks, without taking the plague. In this
respect they are as much to be dreaded by their friends as their foes.
If, in the present contest, Italy, and France, and England shall escape
this scourge, it will form an exception to past events, which all Europe
must devoutly pray for.
Under these circumstances the Translator thought it would be useful to
call the attention of the practitioners in medicine of this country, to
the subject of pestilential contagion, by publishing the following
Account of the Plague at Moscow in the year 1771. Besides the narrative
of the rise and progress of the disorder, and the description of its
symptoms and treatment, this account contains also a detail of the
methods which were successfully employed in that city for checking and
totally extinguishing the contagion; and in particular a detail of the
means by which a large edifice, situated in the centre of Moscow, and
containing about one thousand four hundred persons, was preserved from
the pestilence during the whole of the time that it raged there.
This account is translated from a treatise republished in French, and
originally written in Latin by Dr. Mertens, under the following title:
"_Traité de la Peste, contenant l'Histoire de celle qui a régné à Moscou
en 1771; par Charles de Mertens, Docteur en Medecine, &c. ouvrage publié
d'abord en Latin[3]; actuellement mis en François, &c. à Vienne, 1784_."
The author (who was physician to the Foundling-Hospital, at Moscow, and
resided in that city during the whole of the time that the plague raged
there) divides his treatise into four chapters; in the first of which he
gives a history of the plague as it appeared at Moscow; in the second,
he treats of the diagnosis; in the third, of the curative treatment; and
in the fourth, of the precautions or methods of prevention.
So many works have been published on the plague, that whoever writes a
regular treatise on this disorder cannot avoid repeating many
observations that have been made by others before him. Hence, instead of
dividing the present pamphlet into chapters and sections, and following
the original word for word throughout; the translator has taken the
liberty of extracting from the two last chapters those parts only which
contain new observations, or which have an immediate reference to the
narrative; which last he has translated entire, excepting half a dozen
lines at the beginning, that seem to have been introduced by the author
for no other purpose but that of quoting professor _Schreiber_'s[4]
work on the plague, which broke out in the Ukraine in the years 1738 and
1739.
Besides the preface[5], and some other matters noticed in their
respective places, the following topics of discussion have been omitted;
viz. 1st. _the comparison between the plague and the smallpox_; 2d. _the
reflexions on the inoculation of the plague_; 3d. _the precautions to be
employed in wars with the Turks_; and 4th. _the precautions continually
necessary in places exposed to the pestilential contagion_.
These topics have been omitted, because with regard to the first, as the
smallpox and the plague agree in no other respect but in that of being
propagated by contagion, a comparison between them seems to be quite
unnecessary; because, as to the second, the inoculation of the plague is
proved to be useless by the well-established fact, that the same person
is susceptible of taking it several times[6]; and because with regard to
the third and fourth points, they only lead to repetitions of general
and particular precautions mentioned in other parts of the pamphlet, or
suggest hints which do not apply to an insular situation like ours.
Next to a detail of all the events which took place during the raging of
the plague at Moscow, the translator has especially aimed at a full and
accurate delineation of the symptoms. In doing this, he has taken the
pains to compare the description given by Dr. _Mertens_, with those of
two other writers on the same subject; viz. _Orræus_ and _Samoïlowitz_.
Thus he flatters himself that all the different types and modifications
which the plague assumes in the Northern parts of Europe, are here
developed in such a manner, as to enable those who have never seen the
disorder, to detect it on its first appearance, or in its early
progress, should this country have the misfortune to be visited by it
again.
_January 2, 1799._
AN
ACCOUNT
OF THE
PLAGUE AT MOSCOW.
In 1769 war broke out between the Russians and Turks. The year following
intelligence was received that the Turks had carried the plague into
Wallachia and Moldavia, where it was making great ravages; and that in
the town of Jassy a number of Russians had been carried off by a
disorder, which, on its first appearance, was called by some of the
faculty, a malignant fever; but which the most eminent physicians in the
place declared to be the plague. _Baron Asch_, first physician to the
army, sent an account of this disorder in a letter, written in German,
to his brother, a physician at Moscow, who showed it to me. The
following is a translation thereof: "It attacks people in different
ways. Some are slightly indisposed, complaining for several days of a
headach, sometimes very violent, at other times less so, and now and
then ceasing altogether, and then coming on again. The patients are
affected with pains in the chest, and particularly in the neck; they
gradually become languid and dejected, with something like intoxication
and drowsiness. They have a particular taste in their mouths, which soon
turns to a bitter; at the same time they have an ardor urinæ. To these
succeed chilly and hot fits, and, lastly, all the symptoms which
characterize the plague. The disease sometimes terminates favourably by
perspiration, before the appearance of exanthemata, buboes, or
carbuncles. The contagion is sometimes more rapid and more violent in
its action; in that case the infected are suddenly seized after making a
hearty meal, after a fit of anger, or too much bodily motion, with
head-ach, nausea, and vomiting; the eyes become inflamed and watery
(_larmoyans_), and pains are felt in those parts of the body where
buboes and carbuncles are about to appear. There is no great degree of
heat. The pulse is sometimes full and hard; sometimes small, soft, and
scarcely perceptible; it often intermits, and, what should be
particularly noticed, it is often feeble. These symptoms are accompanied
with lassitude, a white tongue, dry skin, urine of a pale yellow colour,
or turbid, but without sediment; frequently with a diarrhoea, which it
is difficult to stop; and, lastly, with delirium, buboes, carbuncles,
and petechiæ[7]."
The following summer this disorder spread into Poland, and committed
great havoc there; from thence it passed to Kiow, where it destroyed
four thousand souls. Immediately on its appearance at the last-mentioned
place, all communication between that town and Moscow was cut off;
guards were stationed on all the great roads, and all travellers were
ordered to perform quarantine for several weeks.
At the end of November 1770, the anatomical dissector, at the
military-hospital in Moscow, is attacked with a putrid petechial fever,
which carries him off in three days. The attendants upon the sick[8] of
this hospital dwelt with their families in two rooms separate from the
wards. In one of these rooms they fall ill one after the other, till, at
length, all of them, to the number of eleven, are seized with a putrid
fever, accompanied with petechiæ; buboes and carbuncles appear in some
of them; and most of them die between the third and fifth day. The
attendants occupying the other room are seized in like manner with the
same disorder.
On the 22nd of December, we are required to meet at the Board of Health.
The first physician to the military-hospital states the circumstances,
which I have just related, the truth of which is confirmed by the
evidence of three other physicians, who farther report, that fifteen
among the attendants, including their wives and children, had fallen
victims to this disorder since the end of November; that five still
continued ill of it; but that it had not yet shown itself in any of the
hospital-wards. Eleven physicians were present at this consultation, and
we all agreed that the disorder under consideration was the plague,
except Dr. _Rinder_, state-physician[9], who had visited the sick,
several times, in company with Mr. _Schafonsky_, and who pronounced it
to be merely a putrid fever; an opinion which he maintained both in
conversation and by writing.
This hospital stands out of the town, near the suburb inhabited by the
Germans, from which it is separated by a small stream, called the
Yausa. We advised that it should be immediately shut up, and that guards
should be placed round it, in order to cut off all communication; that
all the attendants upon the hospital-invalids should be removed,
together with their wives and children, to a detached situation, care
being taken to separate the infected from the healthy; and, lastly, that
all the clothes and furniture, not only of those who were dead, but
likewise of those who still survived, should be burnt.
The cold had set in later this year than usual; the weather was very
damp and rainy until the end of December, when a hard frost came on, and
continued through the remainder of the winter.
In addition to our joint report, _Field-Marshal Count Soltikoff_,
governour-general of the place, consulted me in private, and desired to
know what steps I thought adviseable under the present circumstances. On
a subject pregnant with so much danger to the public at large, I did not
hesitate to communicate my sentiments in the most unreserved manner.
Accordingly I put into the governor's hands a paper, wherein I laid
great stress upon the necessity of employing every possible precaution
with regard to the hospital, where I affirmed, that the plague had
appeared among the attendants, as before mentioned; I added, that it
would be necessary to make strict enquiries to ascertain, whether the
contagion was concealed in any part of the town, and that, wherever it
should be discovered, the same precautions, as in the case of the
hospital, should be adopted: that, for the same purpose, it would be
further necessary to desire the physicians and surgeons, whenever they
should perceive any unusual or doubtful symptoms in their patients, to
give immediate notice thereof to the Board of Health; and to order the
police-officers to appoint a consultation of physicians, whenever
several persons should fall ill in the same house. I remarked, however,
that there would be great difficulties in the business, if the contagion
existed in other parts of the town besides the hospital; but, I added,
that, even in this case, we might hope to eradicate the evil when the
frost should set in, provided speedy and proper measures were resorted
to.
We wished that what had passed on this subject should not transpire; but
the rumour of the plague having broke out at Kiow, some months before,
had produced such an effect upon the minds of the public, that the
precautions which were adopted, with regard to the military-hospital,
threw the whole city into the greatest alarm. All attempts to dissipate
the fears of the inhabitants were fruitless.
After some days, however, when it was known that only seven persons in
the hospital itself were ill of the disorder, and that the rest remained
free from infection, the public fell into the opposite extreme, and
thinking themselves in perfect security, the grandees, nobles,
merchants, common people, in a word, all the inhabitants, except the
governour and a few others, ceased to give themselves any further
trouble about the means of prevention.
This idea of security, which was countenanced by the before-mentioned
state-physician, Dr. _Rinder_, continued until the month of March. The
medical consultations ceased. In spite of all our efforts to the
contrary, every kind of precaution was neglected in the city; it was
only at the military-hospital that, by order of the Empress, the means
of prevention were still observed; in consequence whereof the plague was
entirely suppressed there, after twenty-four persons had been seized
with it, only two of whom recovered[10]. Six weeks after the death of
the last of them, all their clothes, beds, &c. together with the house,
to which they had been removed, and which was built of wood, were burnt.
The hospital was opened again at the end of February.
The generality of mankind judge of things by events only; and will never
believe that the plague is among them, until they have certain proof
thereof in the number of funerals[11]. It is owing to this and other
mistaken notions, that the plague is not put a stop to in the beginning;
at which period it may be compared to a spark which might easily be
extinguished, but which, if left to itself, bursts out into a
conflagration which nothing can resist.
The opinion which went to assure the inhabitants that they were safe
from the plague, was very generally believed, as in such cases almost
always happens[12]. It only remained for us to console ourselves with
the consciousness of having discharged our duty faithfully, and to the
best of our abilities. Would to God that the business had stopped here,
and that what afterwards took place had not confirmed the truth of our
assertions. We should not then have beheld the dreadful destruction of
so many of our fellow-creatures, nor have witnessed the most horrid of
all public calamities.
On the 11th of March we are again convened at the Board of Health. In
the centre of the town there was a large building used for manufacturing
clothing for the army; three thousand persons were employed in it,
nearly a third part of whom, of the most necessitous class, occupied the
ground-floors; the rest, after working there the whole day, returned in
the evening to their respective homes, in different parts of the town.
Dr. _Yagelsky_, at that time second physician to the Military Hospital,
whom the Governor-General had sent to the manufactory in the morning,
brings word that he had found several patients, (eight to the best of
my recollection) labouring under the same disorder, (accompanied with
petechiæ, vibices, carbuncles, and buboes) which he had seen three
months before at the military hospital; and that on seven dead bodies
which he had examined, he had perceived similar appearances. On
enquiring of the workmen in the manufactory, in what manner, and how
long this disorder had made its appearance among them, he was told that
a woman who had a swelling in her cheek, had betaken herself to one of
her relations who lived in the manufactory, and had died there; and
that, from that time, one or other of them was every day taken ill of
the disorder. They further stated, that from the period above-mentioned
to the present day, they had lost one hundred and seventeen persons,
including the seven dead bodies not yet interred. This account given by
Dr. _Yagelsky_, was corroborated by two other physicians, who had been
sent the same day to examine the patients and dead bodies.
In a Memoir addressed to the Governor-General and the Senate (by whom we
had been called together) we renew our declarations, that this disorder
is the plague[13]; and we advise them to remove out of the town all the
persons dwelling in the manufactory, taking care to separate the sick
from the healthy; that they should order the clothes and furniture of
the dead and infected to be burnt; and that the strictest search should
be made to find out whether the contagion existed in any other part of
the city. The inhabitants are again seized with a panic; and they now
too well perceive the consequences of their neglect of the precautions
recommended. We were thirteen physicians at this meeting[14], two of
whom, who three months before had agreed with us that the disease which
broke out at the military hospital was the plague, now said that the
present disorder was not the plague, but a putrid fever; an opinion
which they enforced in a separate conference with the Senate. These two
physicians (Drs. _Kuhlmann_ and _Schiadan_) who still differed from us
in opinion, had been led into their error, by observing that the number
of deaths in the town was not greater than usual, but rather less than
in the preceding years, and that there were very few people ill.
Some days after, being summoned to meet the other physicians and
surgeons at the senate, where each of us was required to deliver our
sentiments explicitly, I affirmed, in the most solemn manner, that I was
thoroughly convinced that the disease under consideration was the
plague; ten of my colleagues were of the same opinion, and the two
others before mentioned still maintained the contrary[15]; nevertheless,
they admitted the propriety of adopting precautions against a disorder,
which, though not the plague, was of a contagious nature.
The first day (the 11th of March) is spent in deliberations. The
infected building is shut up, and guards are placed there, to prevent
any person from going in or coming out. Several make their escape
through the windows, and the rest are removed out of the town during the
night, the uninfected to the convent of St. Simon, and the infected to
the convent of St. Nicholas, one of which is distant six, and the other
eight versts[16]; from Moscow. These convents are surrounded with high
walls, and have only one entrance. As it was discovered that some had
died among the workmen who lived in their own houses, these were taken
to a third convent, situated in like manner out of the town. Orders were
given to the surgeons who had the care of all these people, to transmit
daily to the Board of Health a list of the sick and dead. A committee of
physicians was appointed to regulate every thing concerning the
treatment of the sick, and the keeping of those who were performing
quarantine free from infection; and great attention was paid to the
interment of the dead. Drs. _Erasmus_ and _Yagelsky_ (now no more!) were
entitled to great praise for the manner in which they acquitted
themselves in this business. When any one of those who were under
quarantine was taken ill, he was put in a separate room, and kept there
until the symptoms of the plague shewed themselves, when he was conveyed
in a carriage, by persons hired for that purpose, to the pest-house,
viz. the convent of St. Nicholas.
The public baths, where the people are accustomed to go, at least once a
week, were shut up. The town was divided into seven districts, to each
of which one physician and two surgeons were appointed, for the purpose
of examining all the sick as well as the dead bodies; in which business
police-officers were joined with them. It was forbidden to bury the dead
within the city; proper places for burying-grounds were fixed upon at
some distance from the town. It was ordered, that whenever any one of
the common people should be seized with the plague, he should be sent to
the hospital of St. Nicholas, and that, after burning his clothes and
furniture, those who had been living in the same apartment should be
detained for the space of forty days in some buildings appropriated to
that purpose out of the town; that if the like occurrence should happen
in the house of a principal inhabitant or person of rank, all the
servants who had been in the same room with the patient should perform
quarantine, and that the master, together with all his family, should
remain shut up in his own house for the space of eleven days. All this
was sanctioned and passed into the form of a law by a resolution of the
Senate. General _Peter Demitrewich de Yeropkin_, not more distinguished
by his birth and valour than by his polished manners and humane
disposition, was appointed by the Empress, Director-General of Health.
Notwithstanding what had happened, the number of those who were
convinced that the plague had reached Moscow, was as yet inconsiderable.
Dr. _Orræus_, physician to the army, who had visited impested patients
at Jassy, was now passing through Moscow in his way to Petersburgh, and
was requested to examine the sick and dead bodies before mentioned,
which he accordingly did, and declared, that the disorder was exactly
like that which, a short time before, had proved so destructive in
Moldavia and Wallachia; that it was, in fact, the plague. This was
further confirmed by Dr. _Lærch_, who was just returned from Kiow, where
he had remained during the time that the plague raged there.
The weather continued very cold until the middle of April, in
consequence of which the contagion became more fixed and inactive,
attacking only those who dwelt with the infected. In the pest-house, the
daily number of deaths did not exceed three or four; and of the
manufacturers who were performing quarantine only about the same number
fell ill.
According to the reports of the physicians, surgeons, and
police-officers, the town appeared to be healthy. Almost every body
believed that the physicians who had called the disorder the plague, had
imposed upon the public; others entertained doubts on the subject.
Things went on in this way until the middle of June, during which time
nearly two hundred persons had died at the hospital of St. Nicholas. The
number of sick and dead diminished daily there, in so much that, for a
whole week, although the weather was very warm, not one fell ill of the
disorder, and there only remained in the hospital a few convalescents.
No further vestige of the disorder could be traced in the town.
As among the workmen of the manufactory, who had been removed from their
own houses to a third convent at a distance from the other two, in order
to perform quarantine, not one had been attacked with the disorder for
the space of two months, they were allowed to return to their respective
homes.
We now began to flatter ourselves that the plague had been entirely
eradicated by the precautions which had been adopted. Scarcely, however,
had we indulged in these fond hopes, when, towards the end of June, some
people are taken ill of the same disorder at the hospital of St. Simon,
where the quarantine was performed. On the 2nd of July, six people die
in one night at a house in the suburb of Preobraginsky; a seventh, who
lived with them, absconded[17]. Livid spots, buboes, and carbuncles are
found upon the dead bodies. On the following days, many of the common
people fall sick in different quarters of the town, and the mortality
increases to such a pitch, that the number of deaths, which commonly
amounted to about ten or fifteen _per_ day, and which, even during the
prevalence of putrid fevers (as was the case for the two last years) did
not exceed thirty, amounted at the end of July to as many as two hundred
in the space of twenty-four hours. The sick, as well as the dead bodies,
exhibited large purple spots and vibices; in many there were carbuncles
and buboes. Some died suddenly, or in the space of twenty-four hours,
before the buboes and carbuncles had time to come out; but the greatest
number died on the third or fourth day.
In the middle of August, the number of deaths amounted daily to four
hundred; and at the end of the same month to as many as six hundred. At
this time buboes and carbuncles were more frequent than they had been in
July. At the beginning of September there were seven hundred deaths in
the space of twenty-four hours; in a few days, there were eight hundred
deaths within the same number of hours; and a short time after, the
deaths amounted to one thousand in a day!
The havoc was still greater during the time of the riots, which began on
the 15th of September, in the evening; when an outrageous mob broke open
the pest-houses and quarantine-hospitals, renewing all the religious
ceremonies which it is customary with them to perform at the bed-side of
the sick[18], and digging up the dead bodies and burying them afresh in
the city. Agreeably to their ancient custom, the people began again to
embrace the dead, despising all manner of precaution, which they
declared to be of no avail, as the public calamity (I repeat their own
words) was sent by God, to punish them for having neglected their
ancient forms of worship. They further insisted, that as it was
pre-ordained who should and who should not die, they must await their
destiny; therefore, that all endeavours to avoid the contagion were only
a trouble to themselves, and an insult to the Divinity, whose wrath was
only to be appeased by their refusing all human assistance[19]. _General
Yeropkin_, with a small party of soldiers drawn together as speedily as
possible, dispersed the mob, and restored tranquillity in a few days,
after which every thing was placed on its former footing. This vast
concourse and intermixture of the healthy and infected, caused the
contagion to spread to such a degree, that at this time the daily number
of deaths amounted to one thousand two hundred and upwards!
Moscow, one of the largest cities in Europe, consists of four circles,
or inclosures, one within another; the smallest, which occupies the
centre, is called Kremmel, and the second, which surrounds it, Kitaya,
(or Chinese-Town); they are both inclosed by brick-walls, and the houses
within them are built of brick; the third, which is called Bielogorod
(or White-Town) is without walls, they having been levelled with the
ground; and, lastly, the fourth called Zemlanoïgorod (from Zemla, land
or earth, and Gorod, town) is defended by a ditch and rampart of
earth[20]. In the two last-named parts of Moscow the houses are, for the
most part, constructed of wood. These houses do not stand close
together, but are detached with spaces between, and, in general, only
one family inhabits each; hence they rarely consist of more than one
story, and often of a ground-floor only. The nobles keep a great number
of servants; and the common people live crouded together in small wooden
houses[21].
In winter time the nobles repair to Moscow, from all parts of the
empire, bringing with them a large train of attendants. Great numbers of
the common people, who were engaged during the summer in agricultural
labour, return to this great city in the winter, to gain subsistence by
different employments. This conflux of people makes the town so full,
from the month of December to March, that the population, at this
season, amounts, according to some computations, to two hundred and
fifty thousand; according to others, to three hundred thousand. In the
month of March, people begin to go into the country again; hence, during
the summer, the number of inhabitants is, at least, one-fourth less
than in winter. In 1771 the fear of catching the plague had caused a
much greater number to leave the city; so that I do not think that, in
the month of August, there were more than one hundred and fifty thousand
remaining in the place. An idea may be formed of the destructive nature
of this disorder, and the terrible activity of its poison, by
reflecting, that of these one hundred and fifty thousand inhabitants,
twelve hundred were daily carried off by it, (in the month of
September!) The number of deaths kept at this rate for some days, and
then diminished to one thousand. As the populace, during the riots, had
re-established all the religious ceremonies customary on burying the
dead, almost all their priests, deacons, and other ecclesiastics, fell
victims to the contagion.
The people, brought to a sense of their duty, partly by the rigorous
measures employed against them, and partly by seeing that the public
calamity had been aggravated by their disorderly proceedings, now began
to implore our assistance. The monasteries and other pest-houses were
full; the sick were no longer carried thither; the contagion had spread
every where; insomuch that the city itself might be considered as one
entire hospital. All, therefore, we could now do, was to exhort every
individual to take care of himself; to warn all those who were yet free
from the contagion, to avoid, as much as possible, touching with their
bare hands any infected person; to direct them to burn the clothes, and
every thing else that had been used by those who had been ill of the
plague; and, lastly, to keep their rooms clean and well aired.
At this time _Count Gregory Orlow_[22] arrived at Moscow, invested with
full powers by the empress. I received an order, in common with the
other physicians, to deliver, in writing, my private sentiments on the
subject; we were required to turn our attention principally to the most
proper measures for destroying the contagion[23]. Having taken the
necessary steps to prevent all further popular commotions, the Count
selected, from all our papers, what appeared of most moment, and drew up
a set of regulations, as well for the treatment of the sick, as for the
keeping of those who were yet well, free from infection. He also ordered
new hospitals to be immediately built for the reception of the poor
seized with the plague[24].
Some months had elapsed since the plague had been carried to many of the
villages, as well in the vicinity as at a distance from Moscow. Persons
who fled from this city had also carried it with them to Kalomna
(Kaluga, according to _Orræus_), Yaroslaw, and Tula. Inspectors of
health, attended by physicians and surgeons, were sent to these
infected towns and villages.
A Council of Health was formed, composed of _General Yeropkin_ (who was
president), of some counsellors of state, and of three physicians, and
one surgeon. This council received daily reports from the physicians and
police-officers, and took cognizance of every thing which related to the
health of the inhabitants. Two physicians, Drs. _Pogaretzky_ and
_Meltzer_, being offered a reward of one thousand roubles, undertook,
each of them, the care of a pest-hospital; and went thither accordingly.
On the 10th of October the frost set in; from that day the disorder was
less fatal, and the contagion became more fixed. The number of sick and
dead gradually diminished; and the disorder, which a short time before
had terminated on the second or third day, now kept on to the fifth or
sixth. Neither those large purple spots, which we have before described,
nor carbuncles, were by any means so frequent as they had been; buboes
were now almost the only tumours found upon the infected.
The hard frost[25] which prevailed during the two last months of the
year, weakened the pestilential virus to such a degree, that those who
attended the sick and buried the dead were in much less danger of being
infected; and when they were infected, the symptoms were much milder; so
that at this period, several persons who had the plague were but
slightly indisposed, and walked about though they had buboes upon them.
At the close of the year 1771, this dreadful scourge ceased, by the
blessing of God, at Moscow, and in every other part of the Russian
empire. Besides the three towns before-mentioned, upwards of four
hundred villages had been infected.
The weather was intensely cold during the whole of the winter. In order
to destroy all remains of the contagion, the doors and windows of the
rooms in which there had been any persons ill of the plague, were broken
and the rooms were fumigated with the antipestilential powder[26]; the
old wooden houses were entirely demolished. The effects of the plague
were traced in every part of the city. Even as late as the month of
February, 1772, upwards of four hundred dead bodies were discovered,
which had been secretly buried the year before in private houses. So
powerful is cold in destroying the contagion, that not one of those who
were employed in digging up these bodies, and carrying them to the
public burying-grounds, became infected[27].
The total number of persons carried off by the plague amounted,
according to the reports transmitted to the Senate and Council of
Health, to upwards of seventy thousand; more than twenty-two thousand of
this number of deaths happened in the month of September alone[28]. If
we add to these, the private and clandestine interments[29], the whole
number of deaths in Moscow will amount to eighty thousand[30]: and
reckoning those who died in upwards of four hundred villages, and in
the three towns of Tula, Yaroslaw and Kalomna (or Kaluga)[31], it will
follow that this plague swept off altogether as many as an hundred
thousand persons!
For carrying away and burying the dead, criminals capitally convicted or
condemned to hard labour, were at first employed; but afterwards, when
these were not sufficient for the purpose, the poor were hired to
perform this service. Each was provided with a cloke, gloves, and a
mask made of oiled cloth; and they were cautioned never to touch a dead
body with their bare hands. But they would not attend to these
precautions, believing it to be impossible to be hurt by merely touching
the bodies or clothes of the dead, and attributing the effects of the
contagion to an inevitable destiny. We lost thousands of these people,
who seldom remained well beyond a week. I was informed by the Inspectors
of Health, that most of them fell ill about the fourth or fifth day.
The plague, as is generally the case, raged chiefly among the common
people; the nobles and better sort of inhabitants escaped the contagion,
a few only excepted, who fell victims to their rashness and negligence.
The contagion was communicated solely by contact of the sick or infected
goods; it was not propagated by the atmosphere, which appeared in no
respect vitiated during the whole of the time. When we visited any of
the sick we[32] went so near them that frequently there was not more
than a foot's distance between them and us; and although we used no
other precaution but that of not touching their bodies, clothes, or
beds, we escaped infection. When I looked at a patient's tongue, I used
to hold before my mouth and nose a pocket-handkerchief moistened with
vinegar[33].
Amid so great a number of deaths, I think there were only three persons
of family, a few of the principal citizens, and not more than three
hundred foreigners of the common class, who fell victims to the plague;
the rest consisted of the lowest order of the Russian inhabitants. The
former only purchased what was absolutely necessary for their support,
during the time of the pestilence; whereas the latter bought up every
thing which was rescued from the flames, and which of course was sold at
a very low price; they refused to burn the goods which came to them by
inheritance; and, moreover, carried away many things clandestinely, in
spite of all we could say or do to the contrary.
Two surgeons died of the plague in the town; and a great number of
surgeons-mates and pupils in the hospitals. Dr. _Pogaretzky_ and Mr.
_Samoïlowitz_, first surgeon to the hospital of St. Nicholas, both
caught the infection several times; and were cured by critical sweats
coming on at the beginning of each attack of the disorder.
The foundling hospital, which contained about a thousand children[34]
and four hundred adults (including nurses, servants, masters, and
workmen) was kept free from infection by the precautions hereafter
mentioned[35]. Only four workmen, and as many soldiers, who had got over
the fences in the night time, were seized at different times; but by
immediately separating them from the rest of the house, the disorder was
prevented from spreading any farther. Thus this building was kept free
from the plague, at the time that it raged in all the other houses
around it; a proof that the atmosphere, not only during the frost, but
even during the great heat of the summer[36], did not serve as a
vehicle for spreading the contagion, which was only propagated by
contact of the sick or infected goods[37].
The young and robust were more liable to become infected than elderly
and infirm persons; pregnant women and nurses were not secure from its
attacks. Children under four years of age were much less readily
infected, but when they were, they exhibited the worst symptoms.
All who were attacked with the plague had more or less fever; though in
some it was so slight as to be scarcely perceivable. In a few instances,
the patients were seized, from the first, with a furious delirium,
accompanied with a high degree of fever; but the greater part were
affected with debility, and only complained of oppression about the
præcordia, and head-ach[38].
After taking great pains to ascertain in what manner the plague was
introduced into the military hospital, the physician to that institution
at length found out that two soldiers had died there in the month of
November, 1770, a short time after their arrival from Choczim, where the
plague was then raging; and that a Colonel, in whose train they were,
had died upon the road. It would seem that the anatomical dissector
opened the bodies of these soldiers; and that he caught the plague of
them. The persons who waited upon the sick, either became infected by
touching the bodies of these soldiers whilst they were living; or by
handling their clothes, or their bodies after death. These attendants
afterwards spread the contagion among their families.
Thus have we traced the history of the plague which depopulated Moscow
in the year 1771, from its first appearance to its final extinction. A
plain and faithful statement of facts, even at the risk of being
tedious, is what has been aimed at in this narrative; for let it be
observed, that it is from simple details of the origin and progress of
the plague, as it appears in different places, and of the symptoms and
other circumstances with which it is accompanied, and not from the
laboured dissertations that have been written upon it by some
voluminous authors, that we can hope to acquire an accurate knowledge
of the nature of this disorder, to ascertain the manner in which its
contagion is propagated, and lastly to discover the best methods of
prevention and cure.
ADDENDA.
A.
_Symptoms more particularly described._
The symptoms of the plague vary according to the different constitutions
of the persons whom it attacks, and the season of the year in which it
appears. Sometimes it wears the mask of other diseases; but in general
it is ushered in by head-ach, stupor, resembling intoxication,
shiverings, depression of spirits, and loss of strength; these are
followed by some degree of fever, together with nausea and vomiting. The
eyes become red, the countenance melancholy, and the tongue white and
foul. In this state of things, the patients are sometimes capable of
sitting up, and going about for some hours, or even a day or two. They
feel an itching or pain in those parts of the body where buboes and
carbuncles are about to appear. During the height of the plague, many of
the infected die on the second or third day, before these tumours have
time to come out, and with no other external marks except petechiæ or
purple spots, which appear a short time before death; in some these
spots are altogether wanting. The buboes and carbuncles generally come
out on the second or third day, seldom on the fourth.
In some instances, the plague appears under the form of an inflammatory
disorder, being accompanied with great heat, thirst, high-coloured
urine, flushed cheeks, and violent delirium or phrensy; but in the
greater number of cases it assumes the type of a nervous fever, being
accompanied with little heat and thirst, and pale and turbid urine; the
patients think themselves only slightly indisposed, until a sudden
prostration of strength, and the eruption of buboes, carbuncles,
petechiæ or vibices, announce to themselves, as well as to those who are
about them, the danger they are in. In some few instances, the plague
appears under the form of an intermittent fever.--Almost all those who
are carried off by this disorder, die before the sixth day; those who
get over the seventh day have a good chance of recovery[39].
The diversity of symptoms above-noticed, has given rise to the opinion
that there are three different species of the plague, viz. one which is
accompanied with petechiæ, another with carbuncles, and a third with
buboes; but the history which we have given, clearly proves, that these
are only shades or modifications of one and the same disorder, which is
more or less violent under different circumstances and at different
seasons. Petechiæ, buboes, and carbuncles often appear at the same time
in the same patient, or occur in succession. In the month of July,
great numbers of the impested died before the tumours came out, having
petechiæ only; whereas in August and September, almost every patient had
petechiæ, joined with buboes and carbuncles. After the middle of
October, when the contagion was less virulent, although it still
produced petechiæ and carbuncles, yet they were neither so malignant nor
so frequent. Before this period, scarcely four patients in a hundred
recovered; whereas during the latter months of the year, the proportion
of recoveries was much greater. _Sydenham_ has made the same observation
respecting the plague at London[40]. Nature endeavours to throw off the
poison by buboes. Carbuncles and petechiæ are not critical eruptions;
they only denote a putrid condition of the humours, and a great degree
of acrimony; whence it follows, that in proportion as buboes are more
common, and petechiæ and carbuncles more rare, the milder the plague
is[41].
* * * * *
To this account which Dr. _Mertens_ has given of the symptoms which the
plague at Moscow exhibited, we shall add the descriptions drawn up by
two other practitioners (_Orræus_ and _Samoïlowitz_,) who had great
opportunities of observation, and who have been more particular in
noticing some of the phenomena than our author.
According to _Orræus_ (Descriptio Pestis, &c.) the plague in Russia
appeared under four different forms or varieties. Of these, he terms the
first, _the period of infection_; the second, _the slow type_; the
third, _the acute type_; and the fourth, _the exceedingly acute type_.
1. In _the period of infection_ (which is commonly the forerunner of the
other forms of the plague) the contagion, less active and virulent,
keeps lurking in the body, and produces the following symptoms, viz.
sharp, flying pains in the glandular parts (such as the armpit and
groins) and in the muscles of the neck and breast; ardor urinæ;
drowsiness; an increased secretion of the sebaceous humour, so that the
skin is in many parts, and more especially in the hands and face, much
more unctuous and glossy than usual; the belly is costive, but when
moved, there comes away a great quantity of pulpy slimy fæces; the
patients complain of a heaviness of the body (some compare their limbs
to a mass of lead), great lassitude and faintings. A swelling, but
without much pain, of some gland (in the groin or armpit) together with
dark-red or brown spots, denote a higher degree of infection: and a bad
taste in the mouth, a viscidity of the saliva, loss of appetite,
whiteness and foulness of the tongue, and head-ach, show that the
patient is going to be attacked with the plague under one or other of
the following types. The above-mentioned symptoms, which continue for a
longer or shorter time (in some instances for several days or even
weeks) are not accompanied with fever.
2. After the period of infection above described has continued for some
time without yielding to medicine, it generally ends in _the slow type
of the plague_, which is characterized by the following symptoms; viz.
shiverings, followed by a moderate degree of heat[42], a febrile[43],
unequal, for the most part weak, and often intermitting pulse; a
constant dull pain in the head (rather, according to the expression of
some patients, a heaviness, as if the head was full of lead); urine pale
and turbid, but without sediment; tongue foul and moist; very little
thirst; depression of spirits; belly costive during the first three or
four days, with inflation of the hypochondria and borborygmi, but the
abdomen feels soft on pressure; there is frequent nausea and vomiting of
a slimy greenish-yellow faburra[44]; petechiæ and other eruptions[45]
make their appearance, in some sooner in others later; but in some they
are altogether wanting. The rudiments or germs of buboes and carbuncles,
which were forming during the period of infection, now gradually
increase in size, but without being accompanied with violent pain; and
new ones arise in other places; which, if they suppurate on the fifth,
sixth, or seventh day, save the life of the patient: on the other hand,
if no suppuration takes place, and great debility, diarrhoea, and
delirium come on, the disease terminates fatally, not, however, in some
cases till after the fourteenth day.