vengeance upon those who had laboured for their preservation. After they
had sacrificed one victim to their blind rage, they sought for the
physicians and surgeons. Some of the lowest rabble broke into my house,
and destroyed every thing they could lay hold of; they also went in
search of the other physicians and surgeons, and pursued such as they
met with. Providence rescued us all from their hands. Little suspecting
what was to happen, I had gone four days before, by order of council, to
the Foundling-Hospital, to superintend more closely the health of the
children there.
[20] There is some little variation between this author's spelling of
these Russian names and Mr. _Coxe_'s. The last-mentioned traveller
writes the 1st. Kremlin; the 2nd. Khitaigorod; the 3rd. Bielgorod; and
the 4th. Semlainogorod. This last takes its name from the rampart of
earth with which it is surrounded. Tr.
[21] Mr. _Coxe_ describes the wooden houses of the common people in
Moscow, as mean hovels, in no degree superior to peasants cottages. It
is easy to conceive how favourable these low and crouded habitations
must have been to the harbouring and spreading of contagion. Tr.
[22] Now Prince _Orlow_.
[23] See Addenda, Note B.
[24] In Russia it is no uncommon thing to have a large edifice built of
wood in a few days. See _Coxe_'s Travels. To persons unacquainted with
this fact, the erecting of new hospitals might seem a very tardy measure
for checking the progress of the plague. Tr.
[25] _Reaumur_'s thermometer was constantly in the morning between 16
and 22 degrees below the freezing point.
[26] See Addenda, note C.
[27] Dr. _Pogaretzky_, who had the care of the pest-hospital, Laforte,
told me that some of the bearers of the dead had put on sheep-skins that
had been worn by the impested, after having exposed them to the open air
for forty-eight hours, in the month of December, when the frost was very
intense; and that none of them became infected.
[28] The author remarks in a note, that the number of deaths in the
month of September, probably amounted to as many as twenty-seven
thousand. At this time, which was during the riots, the number of deaths
could not be accurately registered.
[29] The number of these was by no means inconsiderable; for during the
height of the plague, there was scarcely a sufficient number of men,
horses, and carts to carry off the dead; many remained uninterred for
two or three days, and were at length taken away by their relations,
friends, or poor people hired for that purpose. Many of these could not
be registered, besides numbers of others who were buried in secret, and
whose illness was never reported to the Senate.
[30] According to the returns made to the Council of Health, and
published by _Orræus_ (Descriptio Pestis, p. 48,) the number of persons
carried off by the plague at Moscow in the year 1771, did not amount to
more than fifty-six thousand seven hundred and seventy-two. It is to be
remarked, however, that this list of deaths is dated only from the month
of April, whereas the plague broke out in the cloth-manufactory in the
beginning of March. Indeed, _Orræus_ himself acknowledges, (p. 49,) that
a much greater number than what appears from the reports laid before the
Council must have died of the plague, as, on pulling down the houses in
different parts of the city, so many dead bodies were found that had
been secretly interred, and as, moreover, in the beginning of the
disorder, the returns were very inaccurately made. Tr.
[31] These towns did not suffer greatly from the plague, as the
inhabitants took warning from the unhappy fate of Moscow, and attended
to the necessary precautions from the beginning. It was more destructive
in the villages, and particularly in those that were at the greatest
distance from Moscow.
[32] I mean those physicians who, with myself, remained in the town; but
not such as had the care of the pest-hospitals.
[33] Although the atmosphere may not be capable of communicating the
pestilential contagion beyond a very limited distance from its source,
yet to approach so near as within a foot of the infected, appears to us
(notwithstanding the present instance to the contrary) to be a practice
not generally safe. Dr. _Russell_ proceeded with more caution in his
examinations of the infected at Aleppo. He prescribed to most of his
patients out of a window, about fifteen feet above them. A stair passed
near one of the windows, by which he had such of the infected, whose
eruptions he wanted to examine, brought within a smaller distance, viz.
within four or five feet. _Russell_, on the Plague, book I. ch. vi. Tr.
[34] Almost all the youngest children were out at nurse in the country.
(Mr. _Coxe_ relates, that, at the time he was at Moscow, this noble
institution contained three thousand foundlings. Tr.)
[35] See Addenda, D.
[36] It is remarkable, that it is towards the summer-solstice, according
to _Russell_ (Natural History of Aleppo) and _Prosper Alpinus_ (Medicina
Ægyptiorum) that the plague generally ceases in Asia and Africa; whilst
in Europe it rages with the greatest fury at that season, and is only
subdued by the winter-cold.
[37] From the author's expressions in this place, the reader might be
led to believe that he meant to restrict the communication of infection
to contact of the sick and infected goods; but in other parts of his
book, he admits the possibility of the contagion being communicated by
the breath and other effluvia from the sick. Indeed there can be no
doubt that the pestilential particles are (especially in the worst forms
of the disease) contained in the moisture perspired through the skin,
and in the vapour emitted from the lungs. If not, where was the use of
the precaution, which the author adopted in his own person, of holding a
handkerchief moistened with vinegar before the mouth and nose on
approaching the sick? The conclusion, from all this is, that the sphere
of contagion in cases of the plague, extends to a greater distance
(several feet at least) than Dr. _Mertens_ imagines. Tr.
[38] For a more particular account of the symptoms, see Addenda, A.
[39] The author did not venture to feel the pulse of those impested
patients who were under his own care, lest he should take infection. As
the observations communicated to him by others on this head, which he
has inserted in his book, coincide with those of _Orræus_ and
_Samoïlowitz_, which we shall afterwards notice, we have omitted them,
to avoid repetition. Tr.
[40] It will be sufficient for readers in this country to refer to
_Sydenham_'s works, Sect. II. Cap. II. without transcribing the
quotation which the author has introduced in this place. _Sydenham_
observes of the London plague (1665), that it was most suddenly mortal
in the beginning; whereas the Russian plague was the most rapid in its
action when it was at its height. Dr. _Mertens_ reconciles this
contrariety of observation, by remarking that the London plague began in
the summer, a season the most favourable for its activity. Tr.
[41] The description and treatment of the buboes, carbuncles, and other
eruptions, which are to be found in every treatise on the Plague, the
translator has purposely omitted, that the pamphlet might not be swelled
out to an unnecessary bulk.
[42] Frequently in the progress of the disease there is no heat on the
surface of the body; but the burning heat under the axillæ shows that
the internal heat is very intense.
[43] A febrile, but not very quick pulse; sometimes almost natural.
[44] The faburra brought up by vomiting, is commonly of a dirty yellow
colour, viscid, and sometimes frothy. The quantity thrown up is
astonishingly great, much greater than is observed in any other fever.
[45] The petechiæ and other eruptions vary in size and colour. They are
mostly small and distinct, but sometimes run together and form broad
maculæ, which now and then end in carbuncles. Their colour in many
instances is livid or black, in others (when the disease is milder)
purplish, in some reddish. In convalescents, they turn first red, then
yellow, and afterwards disappear. They are so common in the beginning of
the plague, that scarcely any one dies without them; though buboes and
carbuncles are not observable. Hence those who have never seen the
plague under all its forms are apt to be deceived respecting the nature
of the disorder.
[46] The patients complain of this more than of any other symptom. The
pain begins in the frontal sinus, and the orbits of the eyes, and
afterwards extends to the temples and sides of the head as far as to the
back part, and gradually over the whole head; so, however, as to be most
violent in the fore part.
[47] The appearance of the eyes in the plague is such as, when once
seen, will ever afterwards enable even the commonest observers to
recognise the disease. The eyes are unusually prominent, and the vessels
of the tunica albuginea are turgid with blood, so as to produce a
præternatural redness. They are, moreover, watery, sometimes full of
tears (lacrymantes), and have a sparkling fierceness. But in the
advanced stage of the disease, when the powers of life become exhausted,
the eyes sink in, the redness gradually goes off, and a little while
before death they become dull, and appear as if they had a film over
them.
[48] Although the delirium is rather higher than it is in the slow type
of the plague, yet it is very rarely of the furious kind, in the present
type of the disease. The patients are affected with stupor, and lie
motionless in a dozing state; or if they awake, they are perpetually
stretching out their hands and trying to raise themselves up, as if they
wanted to get out of bed. They talk incessantly, but in consequence of
the turgid and swollen state of the tongue, their speech is broken and
stuttering, like that of drunken people, so as to be scarcely
intelligible.
[49] The buboes are dispersed or resolved by critical sweats breaking
out on the first day of the attack. Often, at the same time, there is a
discharge from the urethra of a white, viscid fluid, resembling pus,
similar to what happens in a gleet; but this running is not accompanied
with pain, and ceases spontaneously after a few days.
[50] A moderate bleeding from the nose in the beginning of the disease,
was, especially in plethoric habits, sometimes salutary; but in most
instances it was otherwise. Such as spat up frothy blood, mixed with a
great quantity of thin phlegm, though they might not at the time exhibit
symptoms of great debility, or appear to be in danger, did,
nevertheless, contrary to expectation, die soon afterwards. Hæmorrhages
happened more frequently, and proved more fatal to women than to men. An
immoderate flow of the menses coming on suddenly and before the stated
time, carried off the patient in many instances. When pregnant women
were attacked with this type of the plague, they almost always
miscarried, and lost their lives by the subsequent hæmorrhage. This was
also very generally the case with those who were delivered after having
gone their natural time.
[51] This anxiety about the præcordia may be regarded as a pathognomonic
symptom of the plague in its most acute type. It is so excessive that
the patients are at a loss for words capable of expressing it. It does
not consist in a violent pain, but in a certain oppressive, suffocating,
and altogether intolerable sensation at the pit of the stomach. In this
state, they make known their anguish and show the danger they are in by
sighs, tears, and lamentations, writhing their bodies in the most
violent manner, and, especially when their delirium comes on, falling
down upon the ground or floor, and crawling about as long as any
muscular power remains. Others who are affected with extreme debility
from the first, although they feel the same anguish, are not capable of
tossing and writhing themselves about so much.
[52] In the same manner as those who die of the catarrhus suffocativus.
[53] Memoire sur la Peste, qui en 1771, ravagea l'Empire de Russie, sur
tout Moscou, &c. par M. D. Samoïlowitz. A Paris, 1783.
[54] This remark respecting the rare occurrence of petechiæ in the
beginning of the plague is contrary to the observations of _Mertens_ and
_Orræus_. Mr. _Samoïlowitz_ did not see much of the plague at Moscow in
the beginning; he was chiefly employed in the care of the pest-hospitals
during the height of the disorder. Tr.
[55] Feeling the pulse of impested patients with the bare fingers, is
always attended with great risk of taking the contagion, which is so
readily communicated by contact. This, however, did not deter Mr.
_Samoïlowitz_, from feeling the pulse in all the different forms or
varieties of the plague, in the usual manner; though others took the
precaution of putting on gloves, or having a leaf of tobacco applied to
the patient's wrist before they ventured upon this examination. It is
evident that much reliance cannot be placed upon the reports of those
who felt the pulse through the intervening substances just mentioned.
This and other observers have remarked, that after the pulse was once
ascertained in each form or variety of the plague, it became unnecessary
to feel it any more. According as the head-ache was either dull or
acute, the delirium high or low, &c. the physician could pronounce,
without feeling the wrist, upon the state of the pulse. Tr.
[56] If the symptoms in the decline of the plague were precisely the
same with those in the beginning, there would be but two types or
varieties of the disorder; the 1st, comprehending the phenomena of the
plague at its beginning and in its decline; and the 2d, the phenomena
which belong to its height. But from the observations of _Mertens_ and
others, it appears that although there is a great resemblance between
the plague at its decline and in the beginning (viz. that in both cases
the symptoms are less violent and less fatal than those which occur in
the middle period or at the height of the epidemic) yet there is also a
difference between them, the plague in the beginning of its career being
accompanied with petechiæ and other spots, as well as buboes; whereas at
the decline, scarcely any other external marks, besides buboes, are
observed. Tr.
[57] We suppose this query to relate to those physicians who received
reports from the surgeons and their assistants, without visiting the
sick themselves. Tr.
[58] Although Dr. _Mertens_ maintains (what we believe no physician in
these days will be disposed to contradict) that the contagion is not
disseminated by the common atmosphere; yet, in other parts of his
Treatise, he admits that the air may become infected to a certain
distance by a great number of bodies, dead of the plague, lying
unburied. Tr.
[59] There are many reasons why the poor must be the chief victims of
the plague, whenever it rages in any country; for 1st, They are the
persons who are employed to remove or destroy infected goods, to carry
away and bury the dead, &c. 2dly, As they live in small, crouded
habitations, when any one of them is attacked by the disorder, all the
rest of the same family are exposed to the contagion, in consequence of
breathing an air tainted by the breath and other effluvia of the sick.
3dly, They are generally destitute of nurses and other necessary
attendants, and particularly they cannot have that change of linen,
which contributes in a very great degree to carry off the contagion and
promote the recovery. 4thly, When the plague is at its height, the
number of sick is so great that it becomes impossible for the physicians
and surgeons to visit all of them, even once in twenty-four hours,
though to be of real service, the visits should be repeated, in every
family, twice within that space of time. Lastly, They have not
wherewithal to procure themselves the proper food and diet; or, if these
are provided for them out of the parochial funds, by the contributions
of the wealthy, or by government, they do not strictly adhere to them,
but fly to spirituous liquors and other hurtful things. Tr.
[60] _Sydenham_ Oper. Sect. II. Cap. 2. and _Van Swieten_ Comment. Tom.
V. § 1407.
We have deemed it sufficient to refer to these authors, without
transcribing the passages which Dr. _Mertens_ has introduced. Tr.
[61] The author includes in his definition of the plague the
circumstance of the disorder being brought by infected persons or goods
from Egypt, or some other province of the Turkish empire; but as this is
a circumstance which relates merely to its origin, without serving to
mark its properties or pourtray its features, we thought it foreign to a
definition, and have accordingly omitted it. Tr.
[62] See _Chenot_ de Peste, p. 93, and _Russell_'s Aleppo, p. 229 and
235.
[63] From the manner in which the author makes mention of _James_'s
powder, it appears that it was administered in such large doses as
produced vomiting. It should have been given in small quantities, so as
to have acted as a diaphoretic, both alone, and in conjunction with
opiates. Perhaps, however, it may be objected that this and other
antimonials, in small doses, repeated at intervals of three or four
hours, are too tardy in their operation for a disease so rapid in its
progress? In larger doses they would be apt to purge. Thus there seems
to be little encouragement for administering them in any way, in cases
of the plague. Tr.
[64] As the author's observations relative to the treatment of the
buboes and carbuncles, coincide with those of other writers on this
subject, they have been purposely omitted. See _Russell_ on the Plague,
Book II. Chap. V. Tr.
[65] Why no animal food? _Orræus_ found broths and soups seasoned with
salt and vinegar, and having the fat taken off them, and even boiled
meat of a light texture, to be very restorative to the convalescent. Tr.
[66] If there should be any doubts respecting the nature of the disorder
on its first appearance, and because, as yet, only a single family
happens to be attacked with it; Dr. _Mertens_ proposes that criminals
condemned to death should be shut up with the sick, and be made to wear
their clothes. Thus in two or three weeks, according as they became
infected or not, it would be decided whether the disorder was the
plague. But in a free country, like England, neither the removing of a
family in the night-time, under the circumstances just mentioned, nor
the exposing of criminals to the contagion, are measures which would be
deemed justifiable. Indeed, it seems almost impossible to stifle the
plague, in any country, in the very beginning, before it has become
publicly known and excited a general alarm. Tr.
[67] Those who are employed to burn the goods, should not stand too near
the fire, so as to be exposed to the thick smoke which arises from it;
and the more effectually to destroy the pestilential particles, it may
be useful to throw some gun-powder or nitre into the fire. It is
infinitely better to burn the infected goods than to bury them, as some
authors recommend; since people may be tempted by avarice to dig them up
again.
[68] See _Chenot_ de Peste, p. 208.
[69] _Antrechaux_, Relation de la Peste, p. 65. _Chenot_, de Peste, p.
166.
[70] _Erndtel_ Warsavia physice illustrata, p. 171.
[71] By being distributed in this manner into several houses the sick
will be less hurtful to each other; they will breathe a purer air, and
recover much sooner. _Mead_ advises the impested to be removed to tents
pitched out of the town. (This is not quite accurate. _Mead_'s words
are,--"as the advice I have been giving is founded upon this principle,
that the best method for stopping infection, is to separate the healthy
from the diseased; so in small towns and villages, where it is
practicable, if the _sound remove themselves into barracks or the like
airy habitations_, it may probably be even more useful, _than to remove
the sick_. This method has been found beneficial in France after all
others have failed.") Tr. I do not think a better method for stopping
the contagion can be suggested; but the season of the year, climate, and
other circumstances must often render this measure impracticable; in
that case, the doors and windows of the sick-rooms should remain open,
and a free circulation of air be constantly kept up. The exposure to the
air and wind seems to me to be the principal reason why the plague makes
less havoc in armies that are encamped; for although the air or wind has
very little power over the poison after it has entered the circulation,
nevertheless it carries off the effluvia and dissipates them more
quickly; so that the sound are not so readily infected by the sick.
[72] The physicians and surgeons, and all those who are about the sick,
should put over their clothes a cloak made of oil-cloth; they should
wear gloves and boots made of the same material, which should be
frequently washed with vinegar; and they should hold before the mouth
and nose, a sponge moistened with vinegar. On other preservatives, see
D.
[73] The following is the composition of these fumigating powders, as
published by the Council of Health. (See _Orræus_ p. 136, 137.)
_The strong antipestilential powder_ consisted of juniper tops (cut
small,) guaiacum shavings, juniper berries, bran, of each 6 lb, nitre 8
lb, sulphur 6 lb, myrrh 2 lb.
_The weaker antipestilential powder_ consisted of the herb abrotanum 6
lb, juniper tops 4 lb, juniper berries 3 lb, nitre 4 lb, sulphur 2-1/2
lb, myrrh 1-1/2 lb.
_The odoriferous antipestilential powder_ consisted of calamus
aromaticus 3 lb, frankincense 2 lb, amber 1 lb, storax and dried roses,
of each 1/2 lb, myrrh 1 lb, nitre 1 lb 8 oz., sulphur 4 oz.
Of these powders, the first was employed to fumigate the houses and
goods of the infected, such as woollens, furs, &c.; the second, for
fumigating houses only suspected, and more delicate articles, which
would have been spoiled by the first; the last was employed (by way of
prevention) in inhabited houses.
(We are now acquainted with a mode of destroying contagion, much more
simple and efficacious than that of fumigating with such compound and
costly powders as those mentioned in the preceding note; we mean _the
vapour extricated from nitre by means of the vitriolic acid_. See an
Account of the experiments made on board the Union Hospital-ship, to
determine the effect of the nitrous acid in destroying contagion. By
James Carmichael Smith, M.D. &c. London, 1796. Tr.)
[74] The author adds, that the smoke from the vegetable substances burnt
with them helps to keep the acid vapours longer suspended. We do not see
how. Tr.
[75] This asylum of innocence and misfortune holds the first place among
all institutions of the same kind in Europe. It was founded by the
Empress Catherine the Second. Under the auspices of this Sovereign, and
by the great attention of Mr. _de Betzky_, to whom his country owes
infinite obligations for the devotion of his time and fortune to the
encouragement of the arts and the promotion of undertakings for the
public good, this institution had nearly attained to perfection, at the
time when this account of it was written.
[76] I caused to be fixed up at the gate near the porter's lodge, two
sets of railing, at the distance of twelve feet from each other. The
people belonging to the hospital stood at the inner railing, and those
who came to see them, at the outer.
[77] There was always a guard of twenty-two men and an inferior officer.
After July, I obtained an order not to have them changed.
[78] It was not without great difficulty that we got a house for
quarantine, as well on account of obstacles occasioned by the public
calamity, as from the scarcity of houses sufficiently roomy. Hence this
business was not settled until October. In the mean time, many children
continued to be exposed at the hospital-gate. Some of these I put into a
wooden house in the vicinity; and Mr. _de Durnowo_ took others of them
under his roof. As soon as the above-mentioned quarantine-house was
ready to receive them, which was not the case till November, I sent them
thither.
[79] In this quarantine-house I also established a small hospital for
the reception of pregnant women, and the care of them after their
delivery, as long as the plague might continue. Mr. _de Durnowo_
undertook the management of this establishment.