The Project Gutenberg EBook of A Discourse on the Plague, by Richard Mead This eBook is for the use of anyone anywhere at no cost and with almost no restrictions whatsoever. You may copy it, give it away or re-use it under the terms of the Project Gutenberg License included with this eBook or online at www.gutenberg.net Title: A Discourse on the Plague Author: Richard Mead Release Date: April 28, 2010 [EBook #32171] Language: English Character set encoding: ASCII *** START OF THIS PROJECT GUTENBERG EBOOK A DISCOURSE ON THE PLAGUE *** Produced by The Online Distributed Proofreading Team at http://www.pgdp.net (This file was produced from images generously made available by The Internet Archive/Canadian Libraries.) A DISCOURSE ON THE PLAGUE: BY _RICHARD MEAD_, Fellow of the College of Physicians, and of the Royal Society; and Physician to his MAJESTY. The NINTH EDITION corrected and enlarged. _LONDON_, Printed for A. MILLAR, against _Catharine-Street_, in the _Strand_: And J. BRINDLEY in _New-Bond-Street_. MDCCXLIV. TO THE RIGHT HONOURABLE _James Craggs_, Esq; ONE OF His MAJESTY'S Principal Secretaries of State. _SIR_, I MOST humbly offer to You my Thoughts concerning the _Prevention of the Plague_, which I have put together by your Command. As soon as you were pleased to signify to me, in his _Majesty's_ Absence, that their Excellencies the _Lords Justices_ thought it necessary for the publick Safety, upon the Account of the _Sickness_ now in _France_, that proper Directions should be drawn up to defend our selves from such a Calamity; I most readily undertook the Task, though upon short Warning, and with little Leisure: I have therefore rather put down the _principal Heads of Caution_, than a _Set of Directions in Form_. THE _first_, which relate to _the performing Quarantaines_, &c. You, who are perfectly versed in the History of _Europe_, will see are agreeable to what is practised in other Countries, with some new Regulations. _The next_, concerning the _suppressing Infection here_, are very different from the Methods taken in former Times among _Us_, and from what they commonly do _Abroad_: But, I persuade my self, will be found agreeable to Reason. I MOST heartily wish, that the wise Measures, the _Government_ has already taken, and will continue to take, with Regard to the _former_ of _these_, may make the _Rules_ about the _latter_ unnecessary. However, it is fit, we should be always provided with proper _Means of Defence_ against so terrible an _Enemy_. MAY this short _Essay_ be received as one Instance, among many others, of the Care, you always shew for Your Country; and as a Testimony of the great Esteem and Respect, with which I have the Honour to be, _SIR_, _Your most obedient, and Most humble Servant,_ R. MEAD. Nov. 25. 1720. THE CONTENTS. The Preface, Page i PART I. _Of the_ PLAGUE _in General_. CHAP I. Of the Origine and Nature of the PLAGUE, 1 CHAP II. Of the Causes which spread the PLAGUE, 41 PART II. _Of the Methods to be taken against the_ PLAGUE. CHAP I. Of preventing Infection from other Countries, 80 CHAP II. Of stopping the Progress of the PLAGUE, if it should enter our Country, 100 CHAP III. Of the Cure of the PLAGUE, 151 THE PREFACE. THIS Book having at first been written only as a Plan of Directions for preserving our Country from the =Plague=[1] was then very short and concise. An Act of Parliament being immediately after made for performing =Quarantaines= &c. according to the Rules here laid down, it passed through seven Editions in one year without any Alterations. I then thought proper to make some =Additions= to it, in order to shew the Reasonableness of the Methods prescribed, by giving a more full Description of this Disease, and collecting some Examples of the good Success which had attended such Measures, when they had been put in Practice. At the same time I annex'd a short Chapter relating to the Cure of the Plague; being induced thereto by considering how widely most Authors have erred in prescribing a Heap of useless and very often hurtful Medicines, which they recommend under the specious Titles of =Antidotes=, =Specifics= and =Alexipharmacs=: hoping that the great Resemblance, which I had observed between this Disease and the =Small Pox=, would justify my writing upon a Distemper which I have never seen. INDEED the =Small Pox= is a true =Plague=, tho' of a particular kind, bred, as I have shewn all Pestilences are, in the same hot =Egyptian= Climate, and brought into =Asia= and =Europe= by the way of Commerce; but most remarkably by the War with the =Saracens=, called the =Holy War=, at the latter end of the eleventh and the beginning of the twelfth Century[2]. Ever since which time the morbific Seeds of it have been preserved in the infected Cloaths and the Furniture of Houses: and have broken out more or less in all Countries, according as the hot and moist Temperature of the Air has favoured their Spreading and the Exertion of their Force. The =Measles= is likewise a =Plague sui generis=, and owes its Origin to the same Country. I have now revised my little Work once more: and though I cannot find any reason to change my Mind as to any material Points which regard either the =Preventing= or the =Stopping= the Progress of =Infection=; yet I have here and there added some new =Strokes= of Reasoning, and, as the Painters say, retouch'd the =Ornaments=, and hightened the =Colouring= of the =Piece=. THE Substance of the long Preface to the last Edition is as follows. I have insisted more at large upon the =Infection= of this Disease, than I could ever have thought needful at this time, after =Europe= has had Experience of the Distemper for so many Ages; had I not been surprized by the late Attempts of some Physicians in =France= to prove the contrary, even while they have the most undeniable Arguments against them before their Eyes. In particular, I cannot but very much admire to see Dr. =Chicoyneau=, and the other Physicians, who first gave us =Observations= on the =Plague=, when at =Marseilles=, relate in the =Reflections=, they afterwards published upon those Observations, the Case of a Man, who was seized with the =Plague=, upon his burying a young Woman dead of it, when no one else dared to approach the Body; and yet to see them ascribe his Disease, not to his being =infected= by the Woman, but solely to his Grief for the Loss of her, to whom he had made Love, and to a =Diarrhoea=, which had been some time upon him[3]. No question but these concurred to make his Disease the more violent; and perhaps even exposed him to contract the =Infection=: but why it should be supposed, that he was not =infected=, I cannot imagine, when there was so plain an Appearance of it. I am as much at a Loss to find any Colour of Reason for their denying =Infection= in another Case, they relate, of a =young Lady= seized with the =Plague=, upon the sudden Sight of a =PESTILENTIAL TUMOR=, just broke out upon her Maid; not allowing any thing but the Lady's Surprize to be the Cause of her Illness[4]. THE Truth is, these Physicians had engaged themselves in an =Hypothesis=, that the =Plague= was bred at =Marseilles= by a long Use of bad Aliment, and grew so fond of their Opinion, as not to be moved by the most convincing Evidence. And thus it mostly happens, when we indulge Conjectures instead of pursuing the true Course for making Discoveries in Nature. I KNOW they imagine this their Sentiment to be abundantly confirmed from some Experiments made by Dr. =Deidier=[5] upon the =Bile= taken from Persons dead of the =Plague=: which having been either poured into a Wound made on purpose in different =Dogs=, or injected into their Veins, never failed, in many Trials, to produce in them all the Symptoms of the Pestilence, even the external ones of =Bubo's= and =Carbuncles=. One Dog, upon which the Experiment succeeded, had been known, for three Months before, to devour greedily the corrupted =Flesh= of infected Persons, and =Pledgets= taken off from =Pestilential Ulcers=, without receiving any Injury. From hence they conclude[6] that this Disease is not communicated by =Contagion=, but originally bred in the Body by the Corruption of the =Bile=. This Corruption, they say, is the Effect of unwholsome Food; and the =Bile= thus corrupted produces a Thickness and a Degree of Coagulation in the Blood, which is the Cause of the =Plague=: Tho' this they allow to be inforced by a bad Season of the Year, and the =Terrors= of Mind and Despair of the Inhabitants. THESE Experiments are indeed curious, but fall very short of what they are brought to prove. The most that can be gathered from them is this: That =Dogs= do not, at least not so readily, receive =Pestilential Infection= from Men, as Men do from one another: And also, that the =Bile= is so highly corrupted in a Body infected with the =Plague=, that by putting it into the Blood of a =Dog= it will immediately breed the same Disease. BUT it does not follow from hence, that the =Bile= is the Seat of the Disease, or that other Humors of the Body are not corrupted as well as =this=. I make no question but the whole Mass of Blood is, in this Case, in a State of Putrefaction; and consequently that all the Liquors derived from it partake of the Taint. ACCORDINGLY it appeared afterwards from some Experiments made by Dr. =Couzier=[7], that not only the =Blood=, but even the =Urine= from an infected person, infused into the crural Vein of a Dog communicated the =Plague=. I will venture to affirm, that if, instead of =Bile=, =Blood=, or =Urine=, the =Matter= of the =Ulcers= had been put into a Wound made in the Dog; it would have had at least an equally pernicious Effect: As may well be concluded from the Inoculation of the Small Pox. AS to the Dog's eating the =corrupted Flesh= and =purulent Matter= of the Patients; it ought to have been considered that there are some Poisons very powerful when mixed immediately with the Blood, which will not operate in the Stomach at all: As in particular the =Saliva= of the mad Dog and the =Venom= of the Viper[8]. And therefore Dr. =Deidier= himself, some Months after his former Experiments, found that =pestiferous Bile= itself was swallowed by Dogs without any Harm[9]. THE right Inference to be made from these Experiments, I think, would have been this: That since the Blood and all the Humors are so greatly corrupted in the Plague, as that Dogs (tho' not so liable to catch the Distemper in the ordinary way of Infection, as Men are) may receive it by a small Quantity of any of these from a diseased Subject being mixed with their Blood; it may well be supposed, that the =Effluvia= from an infected Person, drawn into the Body of one who is sound, may be pestiferous and productive of the like Disorder. MY Assertion, that these =French= Physicians have before them the fullest Proofs of this =Infection=, not only appears from these Instances of it, I have observed to be recorded by themselves; but likewise from what Dr. =le Moine= and Dr. =Bailly=[10] have written, of the Manner in which the =Plague= was brought to =Canourgue= in the =Gevaudan=: as also from an amazing Instance they give us of the great Subtilty of this =Poison=, experienced at =Marvejols=: where no less than =sixty= Persons were at once infected in a =Church=, by one that came thither out of an infected House. The =Plague= was carried from =Marseilles= to =Canourgue=, as follows. A =Gally-Slave=, employed in burying the Dead at =Marseilles=, escaped from thence to the Village of =St. Laurent de Rivedolt=, a League distant from =Correjac=: where finding a Kinsman, who belonged to the latter Place, he presented him with a =Waistcoat= and a =pair of Stockings= he had brought along with him. The =Kinsman= returns to his Village, and dies in two or three Days; being followed soon after by =three Children= and their =Mother=. His =Son=, who lived at =Canourgue=, went from thence, in order to bury the Family; and, at his Return, gave to his =Brother-in-law= a =Cloak= he had brought with him: the =Brother-in-law= laying it upon his Bed, lost a little =Child= which lay with him, in one Day's Time; and two Days after, his Wife; =himself= following in seven or eight. The =Parents= of this unhappy Family, taking Possession of the =Goods= of the Deceased, underwent the same Fate. ALL this abundantly shews how inexcusable the foresaid Physicians in =France= are, in their opposing the common Opinion that the =Plague= is contagious. However, I have paid so much Regard to them, as to insist the more largely upon the Proof of that =Contagion=; lest the Opinion of those, who have had so much Experience of the Disease, might lead any one into an Error, in an Affair of such Consequence, that all my Precepts relating to =Quarantaines=, and well nigh every particular Part of my Advice, depends upon it: For if this Opinion were a Mistake, =Quarantaines=, and all the like =Means of Defence=, ought to be thrown aside as of no use. But as I continue persuaded, that we have the greatest Evidence, that the =PLAGUE= is a =contagious= Disease; so I have left, without any Alteration, all my Directions in respect to =Quarantaines=: in which, I hope, I have not recommended any Thing =prejudicial to Trade=; my Advice being very little different from what has been long practised in all the =trading= Ports of =Italy=, and in other Places. Nay, were we to be more remiss in this than our Neighbours, I cannot think but the =Fear= they would have of us, must much obstruct our =Commerce=. BUT I shall pursue this Point no farther: the rather because a very learned Physician among themselves has since, both by strong Reasoning and undeniable Instances, evinced the Reality of =Contagion=[11]. IN a word, the more I consider this Matter, the more I am convinced that the Precepts I have delivered, both with regard to the Preventing the Plague from coming into a Country, and the Treatment of it when present, are perfectly suitable to the Nature of the Distemper, and consequently the fittest to be complied with. But how far, in every Situation of Affairs, it is expedient to grant the =Powers=, requisite for putting all of them in Practice, it is not my proper Business, as a Physician, to determine. No doubt, but at all Times, these =Powers= ought to be so limited and restrained, that they may never endanger the Rights and Liberties of a People. Indeed, as I have had no other View than the Publick Good in this my Undertaking, and the Satisfaction of doing somewhat towards the Relief of Mankind, under the greatest of Calamities; so I should not, without the utmost Concern, see that any Thing of mine gave the least Countenance to Cruelty and Oppression. BUT I must confess, I find no Reason for any Apprehensions of this kind, from any thing I have advanced. For what extraordinary Danger can there be, in lodging =Powers= for the proper Management of People under the Plague, with a =Council of Health=, or other Magistrates, who shall be accountable, like all other Civil Officers, for their just Behaviour in the Execution of them? Though this I must leave to those, who are better skilled in the Nature of Government. But sure I am, that by the Rules here given, both the =Sick= will be provided for with more Humanity, and the Country more effectually defended against the Progress of the Disease, than by any of the Methods heretofore generally put in Practice, either in our own, or in other Nations. THE Usage among =Us=, established by =Act of Parliament=, of =Imprisoning= in their Houses every Family the =Plague= seizes on, without allowing any one to pass in or out, but such as are appointed by Authority, to perform the necessary Offices about the Sick, is certainly the severest Treatment imaginable; as it exposes the whole Family to suffer by the same Disease; and consequently is little less than assigning them over to the cruellest of Deaths: As I have shewn in the Discourse. THE Methods practised in =France= are likewise obnoxious to great Objections. =Crowding= the Sick together in =Hospitals= can serve to no good Purpose; but instead thereof will =promote= and =spread= the =Contagion=, and besides will expose the Sick to the greatest Hardships. It is no small Part of the Misery, that attends this terrible Enemy of Mankind, that whereas moderate Calamities open the Hearts of Men to =Compassion= and =Tenderness=, this greatest of Evils is found to have the contrary Effect. Whether Men of wicked Minds, through Hopes of Impunity, at these Times of Disorder and Confusion, give their evil Disposition full Scope, which ordinarily is restrained by the Fear of Punishment; or whether it be, that a constant View of Calamities and Distress does so pervert the Minds of Men, as to blot out all Sentiments of Humanity; or whatever else be the Cause: certain it is, that at such Times, when it should be expected to see all Men unite in one common Endeavour, to moderate the publick Misery; quite otherwise, they grow regardless of each other, and Barbarities are often practised, unknown at other Times. Accordingly =Diemerbroek= informs us, that he himself had often seen these =Hospitals= committed to the Charge of Villains, whose Inhumanity has suffered great Numbers to perish by Neglect, and that sometimes they have even smothered such as have been very weak, or have had nauseous Ulcers difficult to cure. Insomuch, that in many Places the Sick have chose to lay themselves in Fields, in the open Air, under the slightest Coverings, rather than to fall into the barbarous Hands of those who have had the Management of these Hospitals[12]. THE rigorous Restraints observed at their =Lines=, are attended also with the like Inconveniences. For by absolutely denying a Passage to People from =infected= Places, they subject to the same common Ruin, both from the Disease, and from the Disorders committed in such Places, those, whom their Fortunes would otherwise furnish with Means of escaping: and this, no doubt, in every free Country, must be looked upon as an unjust =Infringement of Liberty=, and a Diminution of Mens natural Rights, not to be allowed. NOW, under all these Difficulties, I cannot but with the greatest Satisfaction observe, that my =Precepts= are well nigh, nay altogether free from them; and yet a proper Regard is had to the Disease. As soon as ever the =Sick= are grown numerous, I advise, that they be left in their Houses, without any of those unmerciful Restraints heretofore put upon them and the Families they belonged to. I might, perhaps, have justly directed, that whenever those, who frequent or dwell in an =infected= House, go abroad, they should be obliged to carry about them =a long Stick= of some remarkable Colour, or other =visible Token=, by which People may be warned from holding too free Converse with them: this being the Practice on these Occasions, as I have heard, in some Places. The =Removal of the Sick= from their Houses, I advise only at the beginning, when it will be attended with none of the forementioned Inconveniences: but is what, for the most Part, those Sick should themselves desire. It has hardly ever been known, when the Disease did not first begin among the =Poor=. Such therefore only will be subject to this Regulation, whose Habitations by the Closeness of them are in all Respects very incommodious for diseased Persons. So that my Advice chiefly amounts to the giving Relief to the =Poor=, who shall first be =infected=, by removing them into more convenient Lodgings than their own, where they shall be better provided for than at home. And the =Removal= of them will not be attended with that Danger, it is natural for the Unskilful to apprehend in so dreadful a Disease; because it is every Day practised in the =Small-Pox=, with great Safety. And whereas I have before observed, that People have often suffered in the publick =Hospitals= by the Inhumanity of their Attendants; in this Case, little or nothing of that kind is to be feared: for I have proposed this =Removal= of the =Sick= only, at a Time, when a long =Series= of =Calamities= has not yet bred Disorders and Hardness of Heart. Nay, it may be reasonably expected that they should rather be used with the tenderest Care, when every one shall believe the Stopping of the Distemper, and consequently their own Safety to depend upon it. And as this Treatment will be both safe and beneficial to the =Sick=, so it will be much more evidently for the Advantage of the sound Part of the Family, and of those who live near them. For as the =poorer= Sort of People subsist by their daily Labour, no sooner shall the =Plague= have broke out among them, but the sick Families, and all their Neighbours likewise, if not relieved by the Publick, shall be abandoned to perish by =Want=, unless the Progress of the Distemper put a shorter Period to their Lives. THIS Observation, that the_ Plague _usually begins among the =Poor=, was the Reason, why I did not make any Difference in my Directions for =removing the Sick=, in regard to their different Fortunes, when I first gave my Thoughts upon this Subject: which however, to prevent Cavils, I have at present done; and have shewn what Method ought to be taken, if by some unusual Chance, the =Plague= should at the beginning enter a wealthy Family. And, in this Case, I have advised nothing, which I would not most readily submit to my self: For I should much rather chuse to be thus removed from my Dwelling, with the Distemper upon me, to save my Family, than they, by being shut up with me, should be all exposed to perish. And as this Way of treating diseased Families is the most compassionate, that can be devised with any regard to the restraining the Progress of the Distemper; so it is still much preferable to what was formerly practised amongst us, on other Accounts. For, according to what I have advised, it is only required, to =remove some few= Families at the beginning of the Disease: whereas the Method of =shutting up= Houses was continued through the whole Course of the Sickness. Perhaps the Plague, under this Management, may not reach half a Score Families: I have given Instances, where it has thus been stopt in =One=. WHAT relates to the inclosing =Infected= Places with =Lines=, I have so regulated, that no body can be subjected to any Degree of Hardship thereby: for I have provided, that free Liberty be given to every one, that pleases, to depart from the =Infected= Place, without being put to any other Difficulty, than the Performance of a short =Quarantaine= of about three Weeks, in some Place of Safety. So that no one shall be compelled to continue in the infected Town, whom his own Circumstances will not confine. THIS part of my Directions is not so =general= as the rest, because some Places are too great to admit of it: which occasioned my proposing it with a Restriction[13]. But as this is a great Inconvenience to the rest of the =Country=, so it is far from being any Advantage to the =Place= thus left unguarded. For when all, who leave an =infected= Place, carry with them =Certificates= of their having submitted to such =Quarantaine=, as may remove all Cause of Suspicion, =Travelling= will be much more safe and commodious, than otherwise it can be. For want of this, when the =Plague= was last at =London=, it was difficult to withdraw from it, while the =Country= was every where afraid of =Strangers=, and the =Inns= on the =Roads= were unsafe to lodge in for those, who travelled from the =City=; when it could not be known, but =Infection= might be received in them by others come from the same Place. AND from hence it happened that the =Plague=, when last in =England=, though much more moderate, and though it continued not above one Year in the City of =London=, did yet spread it self over a great Part of =England=, getting into =Kent=, even as far as =Dover=; into =Sussex=, =Hampshire=, =Dorsetshire=, =Essex=, =Suffolk=, =Norfolk=, =Cambridgeshire=, =Northamptonshire=, =Warwickshire=, =Derbyshire=, and, to mention no more, as far as =Newcastle=[14]. THUS, as I have examined through the Course of the following =Treatise=, with all possible Care, into the Agreement of my =Precepts= with the Nature of the =Plague=; so I have now considered how far they can conveniently be put in Practice. BUT it is time to have done with a Subject by no means agreeable. I shall therefore conclude all I have to say upon this Matter, with a =Paper= well deserving Perusal, which is come to my Hands, since the following Sheets were finished; and therefore too late to be made use of in its proper Place: for which Reason, I shall give it here entire. This =Paper= contains the Methods taken by his late =Majesty=, when the =Plague= in the Year 1712. had entered his =Dominions= in =Germany=. It was delivered to me from Mr. =Backmeister=, the Secretary at =Hanover= to his =Majesty= for the =German= Affairs, who was the Person, that issued out the =Orders= that were given. This =Relation= I requested from the Secretary, being desirous to know how far the =Measures= then taken, agreed with my =Directions=: because I had been informed, that they were very successful. And I have the Satisfaction to find them very conformable to my =Precepts=; and that they had so much the desired Effect, as to stop the =Plague= from spreading beyond the small Number of =Towns= and =Villages= recited at the beginning of the =Paper=. =HANOVER=, Feb. 10. N. S. 1722. IN 1712 and 1713, the Plague raged in these Parts, at the following Places. =TOWNS.= =Lunenbourg=, =Zell=, =Haarbourg=, twice. =VILLAGES.= =Nienfeldt=, =Holdenstedt=, =Melle=, =Bienenbuttel=, =Achem=, =Trebel=, =Brinckem=, =Goldenstedt=, =Fallingbostel=. IN the last =Place=, three labouring Men, who had made their Escape from =Hamburgh=, got into a Barn in the Night, and were found dead there the next Morning, with Marks of the Plague upon them: but the Progress of the Infection was stopt by burning the Barn. AS soon as any Village was infected, the first Thing done was to make a =Line= round it, thereby to hinder the Inhabitants from communicating with others. Those who were thus shut up, were immediately furnished with Provisions: a Physician was sent to them; and especially some Surgeons; a Minister to officiate particularly to Persons infected; a Nurse; Buriers; =&c.= THE principal Management of this whole Affair consisted in two Things: 1. In =separating= the Sick from the Sound; and 2. In =cleaning= well the Houses which had been infected. WHEN any Person was taken ill, he was obliged to leave his Lodging, and retire into a =Lazaretto= or =Hospital=, built for that Purpose. The other Persons, who appeared to be well in the same House, were obliged, when it was practicable, to strip themselves in the Night quite naked, to put on other Clothes, which were provided for them, and to go to perform =Quarantaine= in a House appointed for it, after having burnt the Clothes, they had put off. Persons were made to change their Clothes, and those they put off were burnt, as often as was judged necessary: For Example, this was done when those who had recovered their Health, came out of the =Lazaretto= and went into =Quarantaine=; and likewise, when (after the Disease was ceased) the Women who attended the Sick, the Buriers, and Surgeons, went into =Quarantaine=. IN Summer, ordinary =Barracks= (or Huts) were made for those of the common People, who were obliged to quit infected Houses: which Barracks were afterwards burnt, when they had been made Use of. AS soon as the People were come out of an infected House, it was nailed up, and Centinels were posted there, that nothing might be stolen out of it. In the Country, when such a House was not of very great Value, and it might be done without Danger, it was =burnt=, and the Loss was made good to the Owner, at the Expence of the Publick. But in Towns, where this could not be done, without the Hazard of burning the Town, Men were hired to go into the Houses, and bring into the Court-Yard, or before the House, whatever Goods they found in it susceptible of Contagion, and there =burn= them: but to prevent the Fright which this might raise among the Neighbours, such Goods were sometimes put into the Cart, used to carry off dead Bodies, and so conveyed out of the Town and burnt. At first, the Method taken, was only to =bury= such Goods deep in the Ground: but it was found by several Examples, that they were dug up again, and that the Infection was thereby renewed. Before People were paid for their Houses and Effects, that were burnt, it was discovered, that they often laid some of their Goods out of the Way, and that the Contagion was spread by them: but after they came to be paid what was reasonable, by the Publick, they willingly let all be burnt, without concealing any thing. IN Summer, the Cattle were left abroad, and the Inhabitants, who had not the Plague in their Houses were obliged to look after them: In Winter, the Sound Persons were obliged, before they left an infected House, to kill the Cattle belonging to it, and to bury them ten Foot deep in the Ground near the House. So far the former Preface. I think it now proper to take Notice, that an =Act of Parliament= (as above mentioned in this Preface) formed upon the Precepts here delivered, having been passed on =December 8, 1720.= the two last =Clauses= in the said Act, relating to the =removing= of Sick Persons from their Habitations, and the making of =Lines= about Places infected, were on =October 19= of the following Year, repealed. THIS looks as if the Rules prescribed were not right and just: I must therefore observe, in Justification of myself, that this was not the Case. Nothing was urged in that Repeal against the Reasonableness of the Directions in themselves, more than in these Words: =That the Execution of them might be very grievous to the Subjects of this Kingdom=. But this I have proved to be quite otherwise. THE Truth of the Matter is this: Some great Men, both of the Lords and Commons, who were in the =Opposition to the Court=, objected that the =Ministry= were not to be intrusted with such =Powers=, lest they should abuse them; since they might, upon Occasion, by their Officers, either remove or confine Persons not favoured by the Government, on Pretence that their Houses were infected. VAIN and groundless as these Fears were, yet the Clamours industriously raised from them were so strong, that a great Officer in the State thought fit to oblige his Enemies by giving way to them: and tho' a =Motion= made in the House of Commons for repealing these two Clauses had just been rejected; yet upon making the same in the House of Lords, with his Consent, the thing was done. WHETHER private or public Considerations had the greater Share in bringing about this Compliance, I will not determine. Such =Counter-Steps= will happen in a Government, where there is too much of =Faction=, and too little of a =Public Spirit=. This I very well remember, that a learned Prelate, now dead, who had more of =Political= than of =Christian= Zeal, and was one who made the loudest Noise about the =Quarantaine= Bill, frankly owned to me in Conversation, that tho' the Directions were good, yet he and his Friends had resolved to take that Opportunity of shewing their Disaffection to the =Ministry=. BUT after all, it contributed not a little to the carrying this Point, that the Plague was now ceased at =Marseilles=, and a Stop put to its Progress in the =Provinces=. And I cannot but take notice that this last good Service was done by the same Method, which, tho' in a more moderate way, I have here proposed. For it is well known that the Regent of =France= did at last set Bounds to the Contagion by =Lines= and =Barriers= guarded by Soldiers: which wise Resolution saved not only his own but other Countries from the spreading of a Disease, which seems to have been of as violent a kind as ever was brought into =Europe=. HOWEVER, if there were any Severity in Orders of this kind, every Man ought to consider himself as a Member of the Society; by the Laws of which as he receives many Advantages, so he gives up somewhat of his own private Rights to the Public: and must therefore be perfectly satisfied with whatever is found necessary for the common Good; altho' it may, on particular Occasions, bring upon him some Inconveniences and Sufferings. Salus Populi suprema Lex est. Does any body complain of ill usage upon his House being ordered to be blown up, to stop the Progress of a Fire which endangers the whole Street: when he reflects that his Neighbour, who by this means escapes, must have suffered the same Loss for his sake, had it so happened that each had been in the other's Habitation? BUT in truth, there is no Cruelty, but on the contrary real Compassion in these Regulations, with the Limitations I have made: and I am fully persuaded that whoever with Judgment considers the nature of this Disease, will easily see that the Rules here laid down are not only the best, but indeed the only ones that can effectually answer the purpose. And therefore I should not doubt but that, if this Calamity (which God avert!) should be brought into our Country, even the Voice of the People would cry out for Help in this way: notwithstanding wrong Notions of their =Liberties= may sometimes over-possess their Minds, and make them, even under the best of Governments, impatient of any =Restraints=. PART I. Of the PLAGUE in general. CHAP. I. _Of the Origine and Nature of the Plague._ MY Design in this Discourse being to propose what Measures I think most proper to defend the Nation against the _Plague_, and for this End to consider the Nature of _Pestilential Contagion_ as far as is necessary to set forth the Reasonableness of the Precepts I shall lay down; before I proceed to any particular Directions, I shall enquire a little into the Causes, whence the _Plague_ arises, and by what Means the Infection of it is spread. IN the most ancient Times _Plagues_, like many other Diseases, were looked upon as _divine Judgments_ sent to punish the Wickedness of Mankind: and therefore the only Defence sought after was by Sacrifices and Lustrations to appease the Anger of incensed Heaven.[15] HOW much soever may be said to justify Reflexions of this Kind, since we are assured from sacred History, that divine Vengeance has been sometimes executed by _Plagues_; yet it is certain, that such Speculations pushed too far, were then attended with ill Consequences, by obstructing Inquiries into natural Causes, and encouraging a supine Submission to those Evils: against which the infinitely good and wise Author of Nature has in most Cases provided proper Remedies. UPON this Account, in After-Ages, when the Profession of Physick came to be founded upon the Knowledge of Nature, _Hippocrates_ strenuously opposed this Opinion, that _some particular Sicknesses were Divine, or sent immediately from the Gods_; and affirmed, that _no Diseases came more from the Gods than others, all coming from them, and yet all owning their proper natural Causes: that the Sun, Cold, and Winds were_ divine; _the Changes of which, and their Influences on human Bodies, were diligently to be considered by a Physician_.[16] WHICH general Position this great Author of Physick intended to be understood with respect to _Plagues_ as well as other Distempers: How far he had reason herein, will in some measure appear, when we come to search into the Causes of this Disease. BUT in order to this Inquiry, it will be convenient, in the first place, to remove an erroneous Opinion some have entertained, that the _Plague_ differs not from a _common Fever_ in any thing besides its greater Violence. Whereas it is very evident, that since the _Small-Pox_ and _Measles_ are allowed to be Distempers distinct in _Specie_ from all others, on account of certain Symptoms peculiar to them; so, for the same reason, it ought to be granted, that the _Plague_ no less differs in Kind from ordinary Fevers: For there are a Set of distinguishing Symptoms as essential to the _Pestilence_, as the respective Eruptions are to the _Small-Pox_ or _Measles_; which are indeed (as I have mentioned in the Preface) each of them _Plagues_ of a particular kind. AS the _Small-Pox_ discharges itself by _Pustules_ raised in the Skin; so in the _Plague_ the noxious Humour is thrown out either by _Tumors_ in the Glands, as by a _Parotis_, _Bubo_, and the like; or by _Carbuncles_ thrust out upon any part of the Body. And these Eruptions are so specific Marks of this Distemper, that one or other of them is never absent: unless through the extreme Malignity of the Disease, or Weakness of Nature, the Patient sinks, before there is time for any Discharge to be made this way; that Matter, which should otherwise have been cast out by external _Tumors_, seizing the _Viscera_, and producing _Mortifications_ in them. SOMETIMES indeed it happens, by this means, that these _Tumors_ in the _Glands_, and _Carbuncles_, do not appear; just as a bad kind of the _Small-Pox_ in tender Constitutions sometimes proves fatal before the _Eruption_, by a _Diarrhoea_, _Haemorrhage_, or some such Effect of a prevailing Malignity. THE _French_ Physicians having distinguished the Sick at _Marseilles_ into five _Classes_, according to the Degrees of the Distemper, observed _Bubo's_, and _Carbuncles_, in all of them, except in those of the _first Class_, who were so terribly seized, that they died in a few Hours, or at farthest in a Day or two, sinking under the Oppression, Anxiety, and Faintness, into which they were thrown by the first Stroke of the Disease; having Mortifications immediately produced in some of the _Viscera_, as appeared upon the Dissection of their Bodies[17]. And this Observation of the _French_ Physicians, which agrees with what other Authors have remarked in former _Plagues_, fully proves, that these Eruptions are so far from being caused solely by the greater _Violence_ of this Disease, than of other Fevers, that they are only absent, when the Distemper is extraordinary fierce; but otherwise they constantly attend it, even when it has proved so mild, that the first Notice, the Patient has had of his Infection, has been the Appearance of such a _Tumor_: as, besides these _French_ Physicians, other Authors of the best Credit have assured us. From whence we must conclude, that these _Eruptions_ are no less a Specific Mark of this Disease, than those are, by which the _Small Pox_ and _Measles_ are known and distinguished. And as in the first _Class_ of those attacked with the Plague, so likewise in these two Distempers we often find the Patient to dye by the violence of the Fever, before any Eruption of the Pustules can be made. THIS Circumstance of the Plague being mortal before any Eruptions appeared, was attended with a great misfortune. The Physicians and Surgeons appointed to examine the dead Bodies, finding none of the distinguishing Marks of the Disease, reported to the Magistrates that it was not the _Plague_; and persisted in their opinion, till one of them suffered for his Ignorance, and himself, with part of his Family, dyed by the Infection: this Assurance having prevented the necessary Precautions[18]. AND this in particular shews us the difference between the true _Plague_, and those _Fevers_ of extraordinary Malignity, which are the usual Forerunners of it, and are the natural Consequence of that ill State of Air, we shall hereafter prove to attend all _Plagues_. For since all those Fevers, from which People recover without any Discharge by Tumors in the Glands, or by _Carbuncles_, want the _characteristic_ Signs, which have been shewn to attend the slightest Cases of the true _Plague_; we cannot, upon any just Ground, certainly conclude them to be a less Degree only of that Distemper: but as far as appears, they are of a different Nature, are not ordinarily _Contagious_ like the _Plague_, nor yet have any such necessary relation to it, but that such Fevers do sometimes appear, without being followed by a real _Pestilence_. ON the other hand, I would not be understood to call every _Fever_ a _Plague_, which is followed by Eruptions resembling these here mentioned: For as every _Boil_ or _Pustule_, which breaks out upon the Skin, is not an Indication of the _Small Pox_, nor every Swelling in the _Groin_ a _Venereal Bubo_; so there are _Carbuncles_ not Pestilential, and other Fevers, besides the _Plague_, which have their Crisis by _Tumors_ and _Abscesses_, and that sometimes even in the _Parotid_ or other Glands. There is indeed usually some difference between these Swellings in the _Plague_, and in other Fevers, especially in the time of their coming out: for in the _Plague_ they discover themselves sooner than in most other Cases. But the principal difference between these Diseases, is, that the Plague is infectious, the other not; at least not to any considerable Degree. AND this leads me to another Character of this Disease, whereby it is distinguished from ordinary Fevers, which is the _Contagion_ accompanying it. This is a very ancient Observation. _Thucydides_ makes it a part of his Description of the _Plague_ at _Athens_[19]; and _Lucretius_, who has almost translated this Description of _Thucydides_, dwells much upon it[20]. _Aristotle_ makes it one of his[21] _Problems_, How the _Plague infects_ those who approach to the Sick. And what is of more Consequence, _Galen_ himself is very clear in it[22]; for he has these words: +hoti syndiatribein tois loimottousin episphales, apolausai gar kindynos, hosper psoras tinos+, _&c. that it is unsafe to be about those, who have the Plague, for fear of catching it, as in the Itch_, &c. Indeed this is a thing so evident, that we find it at present the current Opinion of all Mankind, a very few Persons only excepted, who have distinguished themselves by their Singularity in maintaining the opposite Sentiment. And it is something strange that any one should make a Question of a thing so obvious, which is proved sufficiently by one Property only of the Disease, that whenever it seizes one Person in a House, it immediately after attacks the greatest part of the Family. This Effect of the _Plague_ has been so remarkable at all times, that whoever considers it well, cannot possibly, I think, have any Doubt remaining, or require any stronger Argument to convince him, that the Disease is infectious. For this very reason the _Small-Pox_ and _Measles_ are generally allowed to be _contagious_; because it is observed, that when either of these Diseases is got among a Family, it usually seizes successively the greatest part of that Family, who have not had it before: at least if such in the Family hold free Communication with the Sick. And by the same Argument the _Plague_ must be concluded to be infectious likewise. It cannot be pretended, that this is occasioned in the _Plague_ from this only, that the sound Persons are render'd more than ordinarily obnoxious to the unhealthy Air, or whatever be the common Cause of the Disease, by being put into fear and dispirited, upon seeing others in the same House taken sick: For if this were the Case, _Children_, who are too young to have any Apprehensions upon this Account, would escape better than others, the contrary of which has been always experienced. IT is true, some have not been attacked by the Disease, though constantly attending about the Sick. But this is no Objection against what is here advanced: for it is as easily understood how some Persons, by a particular Advantage of Constitution, should resist Infection, as how they should constantly breath a noxious Air without hurt. An odd Observation of _Diemerbroek_ deserves notice in this Place; That, part of a Family removed into a Town free from the _Plague_, was observed by him to be taken ill of it soon after the part left behind in the diseased Town fell sick: which certainly could scarce have happened, unless a Communication between the Healthy and the Sick, by Letters or otherwise, was capable of causing it[23]. Of the same Nature is a Circumstance recorded by _Evagrius_ of the _Plague_, which he describes, and what, he owns, surprized him very much: That, many of those, who left infected Places, were seized with the _Plague_ in the Towns to which they had retired, while the old Inhabitants of those Towns were free from the Disease[24]. But to multiply Proofs of a thing so evident, is needless; innumerable are at hand, and several will occasionally occur in the following Parts of this Discourse, when we come to speak in particular of the ways, by which this Infection is conveyed about. I shall therefore say no more in this Place, but only, that all the Appearances attending this Disease are very easily explained upon this Principle, and are hardly to be accounted for upon any other. We learn from hence the reason why when the _Plague_ makes its first Appearance in any Place, though the Number of Sick is exceeding small, yet the Disease usually operates upon them in the most violent manner, and is attended with its very worst Symptoms. Now was the Disease produced not by imported _Contagion_, but from some Cause, which had its Original in the diseased Place, and consequently from a Cause gradually bred, the contrary must happen: the Diseased would at first not only be few in Number, but their Sickness likewise more moderate than afterwards, when the morbific Causes were raised to their greatest Malignity. From the same Principle we see the reason, why People have often remained in Safety in a diseased Town, only by shutting themselves up from all Communication with such, as might be suspected of giving them the Disease. When the _Plague_ was last in _England_, while it was in the Town of _Cambridge_, the Colleges remained entirely free by using this Precaution. In the _Plague_ at _Rome_ in the Years 1656 and 1657, the _Monasteries_ and _Nunneries_, for the most part, defended themselves by the same Means[25]: Whereas at _Naples_, where the _Plague_ was a little before, these _Religious Houses_, from their Neglect herein, did not escape so well[26]. Nay the Infection entered none of the _Prisons_ at _Rome_[27], though the Nastiness of those Places exposes them very much. But, to avoid Prolixity, I shall give only one Instance more. I think it cannot be explained in any other reasonable manner, how the last _Plague_ in the City of _London_, which broke out in the parish of St. _Giles's in the Fields_ towards the latter end of the Year 1664, should lie a-sleep from _Christmas_ to the middle of _February_, and then break out again in the same Parish; and after another long rest till _April_, shew itself again in the same Place[28]. TO proceed: Whoever examines the Histories of _Plagues_ in all times, which have been described with any Exactness, will find very few, that do not agree in these essential Marks, whereby the _Plague_ may be distinguished from other _Fevers_. I confess an Instance or two may be found to the contrary; perhaps the History of our own Country furnishes the most remarkable of any[29]. But Examples of this kind are so very rare, that I think it must be concluded, that the _Plague_ is usually one and the same Distemper. IN the next place I shall endeavour to shew, that the _Plague_ has always the same Original, and is brought from _Africa_, the Country which has entail'd upon us two other infectious Distempers, the _Small-Pox_ and _Measles_. In all Countries indeed _Epidemic Diseases_ extraordinarily mortal, are frequently bred in _Goals_, _Sieges_, _Camps_, &c. which Authors have often in a large Sense called _Pestilential_: But the true _Plague_, which is attended with the distinguishing Symptoms before described, and which spreads from Country to Country, I take to be an _African_ Fever bred in _AEthiopia_ or _Egypt_, and the _Infection_ of it carried by Trade into the other Parts of the World. IT is the Observation of _Pliny_, that the _Pestilence_ always travels from the _Southern_ Parts of the World to the _Western_, that is, in his Phrase, into _Europe_[30]. And the most accurate Accounts in all Times of this Disease, wherever it has raged, bring it from _Africa_. _Thucydides_[31], in his admirable Description of the famous _Plague_ of _Athens_, says, that it began in Upper _AEthiopia_, then came into _Egypt_, from whence it was spread first into _Persia_, and afterwards into _Greece_. THERE is in all ancient History no Account of any _Plague_ so dreadful as that, which broke out at _Constantinople_ in the time of the Emperor _Justinian A. D._ 543. This is said to have spread its Infection over all the Earth, and to have lasted fifty two Years. The History of it is very well told by _Evagrius_[32], and yet more learnedly by _Procopius_[33]: and they both observe, that the Distemper had its Birth in _AEthiopia_ or _Egypt_. THIS is likewise agreeable to the modern Relations of Travellers and Merchants from _Turkey_, who generally inform us, that the frequent _Plagues_, which depopulate that Country, are brought thither from the Coast of _Africa_: insomuch that at _Smyrna_, and other Ports of that Coast, they often know the very Ship which brings it. And, in these latter Ages, since our Trade with _Turkey_ has been pretty constant, the _Plagues_ in these Parts of _Europe_ have evidently been brought from thence. THE late _Plague_ in _France_ came indisputably from _Turkey_, as I shall particularly shew in some of the following Pages. The _Plague_, which broke out at _Dantzick_ in the Year 1709, and spread from thence to _Hamburgh_, _Copenhagen_, and other Cities in the _North_, made its way thither from _Constantinople_ through _Poland_, &c. And the last _Plague_ in this City, if we may believe Dr. _Hodges_, had the same Original, being brought to us from _Holland_, but carried to them by _Cotton_ imported from _Turkey_[34]. THE greatest _Mortality_ that has happen'd in later Ages, was about the middle of the fourteenth Century; when the _Plague_ seized Country after Country for five Years together[35]. In the Year 1346 it raged in _Egypt_, _Turkey_, _Greece_, _Syria_, and the _East-Indies_; in 1347 some Ships from the _Levant_ carried it to _Sicily_, _Pisa_, _Genoa_, &c. in 1348 it got into _Savoy_, _Provence_, _Dauphiny_, _Catalonia_, and _Castile_, &c. in 1349 it seized _England_, _Scotland_, _Ireland_, and _Flanders_; and the next Year _Germany_, _Hungary_ and _Denmark_: and in all Places, where it came, it made such heavy Destruction, that it is said to have dispeopled the Earth of more than half its Inhabitants[36]. Now since _Africa_ had a share of this _Plague_ in the very beginning, I question not but it had its first Rise in that Country; and not in _China_, as _M. Villani_, in his History of those Times, relates from the Report of _Genoese_ Seamen, who came from those Parts, and said it was occasion'd there by a great _Ball of Fire_, which either burst out of the Earth, or fell down from Heaven[37]. But this Relation is so very incredible, that I cannot think we ought at all to rely upon it: seeing we have no Instance of a _Plague_, which was originally bred in that Country. IT is very remarkable, that the several Countries of _Europe_ have always suffered more or less in this way, according as they have had a greater or lesser Commerce with _Africa_; or with those Parts of the _East_, that have traded thither. Which Observation, by the by, may help to solve a Difficulty concerning the great Increase of People among the _Northern_ Nations in ancient Times, more than at present; for in those Ages, having no Communication at all with _Africa_, they were not wasted with _Plagues_, as they have been since. AS the People of _Marseilles_, from the first Foundation of their City by the _Phoceans_, were famous for Trade, and made long Voyages Southwards on the _African_ Coast[38]; so they have in all times been very liable to the Plague. A French Author[39] in a History of the late Plague at _Marseilles_ reckons up twenty Plagues that have happened in that City; notwithstanding it is by its situation one of the most healthy and pleasant Places in _France_, and the least subject to epidemic Distempers. But if we had no Records of this in History, an odd Custom among them, mentioned in Antiquity[40], of the way they made use of to clear themselves from this Distemper, would be a proof of it. Their manner at such times was, that some one poor Man offered himself to be maintained at the publick Expence with delicate Food for a whole Year: at the end of which he was led about the City dressed in consecrated Garments and Herbs; and being loaded with Curses as he went along, that the Evils of the Citizens might fall upon him, he was at last thrown into the Sea[41]. AGREEABLE to this Remark upon Trade is the Observation of _Procopius_ in his forecited History, that the _Plague_ was always found to spread from _Maritime_ Places into the _Inland_ Countries: which has ever since been confirmed by Experience. HAVING shewn this Disease to be a Distemper of a distinct Species, and to take its Rise only in _Africa_; we must next seek for its Cause in that Country and no where else. We ought therefore to consider, what there is peculiar to that Country, which can reasonably be supposed capable of producing it. Wherefore I shall briefly set down as much as serves for this purpose of the State of _Grand Cairo_ in _Egypt_, and of _AEthiopia_, the two great Seminaries of the _Plague_: Travellers relating that these Countries are more infested with it than most other Parts of _Africa_. _GRAND CAIRO_ is crouded with vast Numbers of Inhabitants, who for the most part live very poorly, and nastily; the Streets are very narrow, and close: it is situate in a sandy Plain at the Foot of a Mountain, which by keeping off the Winds, that would refresh the Air, makes the _Heats_ very stifling. Through the midst of it passes a great _Canal_, which is filled with Water at the overflowing of the _Nile_; and after the River is decreased, is gradually dried up: Into this the People throw all manner of Filth, Carrion, _&c._ so that the Stench which arises from this, and the Mud together, is insufferably offensive[42]. In this Posture of things, the _Plague_ every Year constantly preys upon the Inhabitants; and is only stopt, when the _Nile_, by overflowing, washes away this Load of Filth; the _Cold Winds_, which set in at the same time, lending their Assistance, by purifying the Air. IN _AEthiopia_ those prodigious Swarms of _Locusts_, which at some times cause a Famine, by devouring the Fruits of the Earth, unless they happen to be carried by the Winds clear off into the Sea, are observed to entail a new Mischief upon the Country, when they die and rot, by raising a _Pestilence_[43]; the Putrefaction being hightened by the excessive _Intemperance of the Climate_, which is so very great in this Country, that it is infested with violent _Rains_ at one Season of the Year, for three or four Months together[44]. And it is particularly observed of this Country, that the _Plague_ usually invades it, whenever Rains fall during the sultry Heats of _July_ and _August_[45], that is, as _Lucretius_ expresses it, when the Earth is _Intempestivis pluviisque et solibus icta_[46]. NOW if we compare this last Remark of the _Intemperance of the Climate_ in _AEthiopia_, with what the _Arabian_ Physicians[47], who lived near these Countries, declare, that _Pestilences_ are brought by _unseasonable_ Moistures, Heats, and want of Winds; I believe we shall be fully instructed in the usual Cause of this Disease. Which from all these Observations compared together, I conclude to arise from the _Putrefaction_ so constantly generated in these Countries, when _that_ is hightened and increased by the ill State of Air now described; and especially from the _Putrefaction_ of animal Substances. IT is very plain, that animal Bodies are capable of being altered into a Matter fit to breed this Disease: because this is the Case of every one who is sick of it, the Humours in him being corrupted into a Substance which will _infect_ others. And it is not improbable, that the volatile Parts with which Animals abound, may in some ill States of Air in the sultry Heats of _Africa_ be converted by Putrefaction into a Substance of the same kind: since in these colder Regions, we sometimes find them to contract a greater Degree of Acrimony than most other Substances will do by _putrefying_, and also more dangerous for Men to come within the reach of their Action; as in those pernicious, and even poysonous Juices, which are sometimes generated in corrupted Carcasses: Of which I have formerly given one very remarkable Instance[48], and, if it were necessary, many more might be produced, especially in _hydropic Bodies_, and in _cancerous Tumors_. Nay more, we find _animal Putrefaction_ sometimes to produce in these _Northern_ Climates very fatal Distempers, though they do not arise to the Malignity of the true _Plague_: For such _Fevers_ are often bred, where a large Number of People are closely confined together; as in _Goals_, _Sieges_, and _Camps_. AND perhaps it may not be here amiss to remark, that the _Egyptians_ of old were so sensible how much the _Putridness_ of dead Animals contributed towards breeding the _Plague_, that they worshipped the Bird _Ibis_ for the Service it did in devouring great Numbers of Serpents; which they observed did hurt by their Stench when dead, as well as by their Bite when alive[49]. BUT no kind of _Putrefaction_ is ever hightened in these _European_ Countries to a degree capable of producing the true _Plague_: and we learn from the Observation of the _Arabian_ Physicians, that some Indisposition of the _Air_ is necessary in the hottest Climates, either to cause so exalted a Corruption of the forementioned Substances, or at least to enforce upon Mens Bodies the Action of the _Effluvia_ exhaled from those Substances, while they putrefy. Both which Effects may well be expected from the sensible ill Qualities of the _Air_ before described, whenever they continue and exert their Force together any considerable time. WHAT I have here advanced of the first Original of the _Plague_, appears to me so reasonable, that I cannot enough wonder at Authors for quitting the Consideration of such manifest Causes for _Hidden Qualities_; such as _Malignant Influences of the Heavens_; _Arsenical_, _Bituminous_, or other _Mineral Effluvia_, with the like imaginary or uncertain Agents. THIS however I do not say with design absolutely to exclude all Disorders in the _Air_, that are more latent than the intemperate _Heat_ and _Moisture_ before mentioned, from a Share in increasing and promoting the Infection of the _Plague_, where it is once bred: for I rather think this must sometimes be the Case; like to what is observed among us in relation to another infectious Distemper, namely, the _Small-Pox_, which is most commonly spread, and propagated by the same manifest Qualities of the _Air_ as those here described: Notwithstanding which, this Distemper is sometimes known to rage with great Violence in the very opposite Constitution of _Air_, _viz._ in the Winter during dry and frosty Weather. But to breed a Distemper, and to give force to it when bred, are two different things. And though we should allow any such secret Change in the _Air_ to assist in the first Production of the Disease; yet it may justly be censured in these Writers, that they should undertake to determine the _Specific Nature_ of these secret Changes and Alterations, which we have no means at all of discovering: Since they do not shew themselves in any such sensible manner, as to come directly under our Examination; nor yet do their Effects, in producing the _Plague_, point out any thing of their _Specific Nature_. ALL that we know, is this, that the Cause of the _Plague_, whatever it be, is of such a Nature, that when taken into the Body, it works such Changes in the Blood and Juices, as to produce this Disease, by suddenly giving some Parts of the Humours such corrosive Qualities, that they either excite inward _Inflammations_ and _Gangrenes_, or push out _Carbuncles_ and _Bubo's_; the _Matter_ of which, when suppurated, communicates the like Disease to others: But of the manner how this is done, I shall discourse in the following Chapter. CHAP. II. _Of the Causes which spread the Plague._ I HAVE been thus particular in tracing the _Plague_ up to its first Origine, in order to remove, as much as possible, all Objection against what I shall say of the Causes, which excite and propagate it among us. This is done by _Contagion_. Those who are Strangers to the full Power of _this_, that is, those who do not understand how subtile it is, and how widely the Distemper may be spread by _Infection_, ascribe the Rise of it wholly to the malignant Quality of the _Air_ in all Places, wherever it happens; and, on the other hand, some have thought that the Consideration of the infectious Nature of the Disease must exclude all regard to the Influence of the _Air_: Whereas the _Contagion_ accompanying the Disease, and the Disposition of the _Air_ to promote that _Contagion_, ought equally to be considered; both being necessary to give the Distemper full force. The Design therefore of this Chapter, is to make a proper Balance between these two, and to set just Limits to the Effects of each. FOR this purpose, I shall reduce the Causes, which spread the _Plague_, to three, _Diseased Persons_, _Goods transported from infected Places_, and _a corrupted State of Air_. THERE are several Diseases, which will be communicated from the Sick to others: and this not done after the same manner in all. The _Hydrophobia_ is communicated no other way than by mixing the morbid Juices of the diseased Animal immediately with the Blood of the sound, by a _Bite_, or what is analogous thereto; the _Itch_ is given by _simple Contact_; the _Lues Venerea_ not without _a closer Contact_; but the _Measles_, _Small-Pox_, and _Plague_ are caught by a _near Approach_ only to the Sick: for in these three last Diseases Persons are render'd obnoxious to them only by residing in the same House, and conversing with the Sick. NOW it appears by the Experiments mentioned in the _Preface_, of giving the _Plague_ to _Dogs_ by putting the _Bile_, _Blood_ or _Urine_ from infected Persons, into their Veins, that the whole mass of the animal Fluids in this Disease is highly corrupted and putrefied. It is therefore easy to conceive how the _Effluvia_ or Fumes from Liquors so affected may taint the ambient Air. And this will more especially happen, when the Humours are in the greatest Fermentation, that is, at the Highth of the Fever: as it is observed that fermenting Liquors do at the latter end of their intestine Motion throw off a great Quantity of their most subtile and active Particles. And this Discharge will be chiefly made upon those Glands of the Body, in which the Secretions are the most copious, and the most easily increased: such are those of the Mouth and Skin. From these therefore the Air will be impregnated with _pestiferous Atoms_: which being taken into the Body of a sound Person will, in the Nature of a _Ferment_, put the Fluids there into the like Agitation and Disorder. THE Body, I suppose, receives them these two ways, by the _Breath_, and by the _Skin_; but chiefly by the former. I THINK it certain that _Respiration_ does always communicate to the Blood some Parts from the Air: Which is proved from this Observation, that the same Quantity of Air will not suffice long for breathing, though it be deprived of none of those Qualities, by which it is fitted to inflate the Lungs and agitate the Blood, the Uses commonly ascribed to it. And this is farther confirm'd by what the learned Dr. _Halley_ has inform'd me, that when he was several Fathom under Water in his _Diving Engine_, and breathing an Air much more condensed than the natural, he observed himself to breath more slowly than usual: Which makes it more than probable, that this conveying to the Blood some subtile Parts from the Air, is the chief Use of _Respiration_; since when a greater Quantity of _Air_ than usual was taken in at a time, and consequently more of these subtile Parts received at once by the Blood, a less frequent _Respiration_ sufficed. AS to the _Skin_, since there is a continual Discharge made thro' its innumerable _Pores_, of the matter of _insensible Perspiration_ and _Sweat_; it is very possible that the same Passages may admit subtile Corpuscles, which may penetrate into the inward Parts. Nay it is very plain that they do so, from what we observe upon the outward Application of _Ointments_ and warm _Bathings_: which have their Effects by their finest and most active Parts insinuating themselves into the Blood. IT is commonly thought, that the _Blood_ only is affected in these Cases by the morbific _Effluvia_. But I am of opinion, that there is another Fluid in the Body, which is, especially in the beginning, equally, if not more, concerned in this Affair: I mean the _Liquid of the Nerves_, usually called the _Animal Spirits_. As _this_ is the immediate Instrument of all Motion and Sensation, and has a great Agency in all the glandular Secretions, and in the Circulation of the Blood itself; any considerable Alteration made in it must be attended with dangerous Consequences. It is not possible that the whole Mass of Blood should be corrupted in so short a Time as that, in which the fatal Symptoms, in some Cases, discover themselves. Those Patients of the _first Class_, mentioned in the beginning of this Discourse, particularly the _Porters_ who opened the infected Bales of Goods in the _Lazaretto_'s of _Marseilles_, died upon the first Appearance of Infection, as it were by a sudden Stroke; being seized with Rigors, Tremblings, Heart-Sickness, Vomitings, Giddiness and Heaviness of the Head, an universal Languor and Inquietude; the Pulse low and unequal: and Death insued sometimes in a few Hours. EFFECTS so sudden must be owing to the Action of some Corpuscles of great Force insinuated into, and changing the Properties of, another subtle and active Fluid in the Body: and such an one, no doubt, is the _Nervous Liquor_. IT is not to be expected that we should be able to explain the particular manner by which this is brought about. We know too little of the Frame of the Universe, and of the Laws of _Attractions_, _Repulsions_ and _Cohesions_ among the minutest Parcels of Matter, to be able to determine all the Ways by which they affect one another, especially within animal Bodies, the most delicate and complicated of all the known Works of Nature. But we may perhaps make a probable Conjecture upon the Matter. Our great Philosopher, whose surprising Discoveries have exceeded the utmost Expectations of the most penetrating Minds, has demonstrated that there is diffused through the Universe a _subtile_ and _elastic Fluid_ of great Force and Activity. This he supposes to be the Cause of the _Refraction_ and _Reflection_ of the Rays of Light; and that by its _Vibrations_ Light communicates Heat to Bodies: and, moreover, that this readily pervading all Bodies, produces many of their Effects upon one another[50]. NOW it is not improbable that the _Animal Spirits_ are a thin Liquor, separated in the Brain, and from thence derived into the Nerves, of such a Nature that it admits, and has incorporated with it, a great Quantity of this _elastic Fluid_: which makes it a vital Substance of great Energy. And a Liquor of this kind must be very susceptible of Alterations from other active Bodies of a different Nature from it, if they approach to and are mixed with it: as we see some _Chemical Spirits_ upon their being put together, fall into a Fermentation, and make a Composition of a quite different kind. IF therefore we allow the _Effluvia_ or _Exhalations_ from a corrupted Mass of Humours in a Body that has the _Plague_ to be volatile and firey Particles, carrying with them the Qualities, of those fermenting Juices from which they proceed; it will not be hard to conceive how these may, when received into the _nervous Fluid_ of a sound Person, excite in it such intestine Motions as may make it to partake of their own Properties, and become more unfit for the Purposes of the animal Oeconomy. But of this more in another Place. THIS is one means by which the _Plague_, when once bred, is spread and increased: but the second of the forementioned Causes, namely, _Goods from infected Places_, extends the Mischief much wider. By the preceding Cause, the _Plague_ may be spread from _Person_ to _Person_, from _House_ to _House_, or perhaps from _Town_ to _Town_, tho' not to any great Distance; but this carries it into the remotest Regions. From hence the trading Parts of _Europe_ have their principal Apprehensions, and universally have recourse to _Quarantaines_ for their Security. The Universality of which Practice is a strong Argument, that _Merchandize_ will communicate _Infection_: for one cannot imagine, that so many Countries should agree in such a Custom without the most weighty Reasons. But besides, there is not wanting express Proof of this, from particular Examples, where this Injury has been done by several sorts of Goods carried from infected Places to others. Some of these I shall hereafter be obliged to mention; at present I shall confine my self to three Instances only. The _first_ shall be of the Entrance of the _Plague_ into _Rome_ in the Year 1656, which we are assured was conveyed thither from _Naples_ by Clothes and other Wares from that Place, brought first to Port _Neptuno_, and carried from thence to the Neighbouring Castle of St. _Lawrence_: which after having been kept some time there, were conveyed into _Rome_[51]. The _second_ Instance I shall take is from the Account given us of the Entrance of the Plague into _Marseilles_[52]; which being drawn up with great Exactness, may be the more rely'd on. It appears indisputably by this Account, that the Mischief was brought thither by Goods from the _Levant_. For the first, who had the Distemper, was one of the _Crew_ of the _Ship_, which brought those _Goods_: the next were those, who attended upon the same _Goods_, while they were under _Quarantaine_; and soon after the _Surgeon_, whom the Magistrates of _Marseilles_ appointed to examine the Bodies of those, who died. THIS Relation, if duly consider'd, is, I believe, sufficient to remove all the Doubts any one can have about the Power of _Merchandize_ to convey _Infection_: for it affords all the Evidence, the most scrupulous can reasonably desire. Possibly there might be some Fever of extraordinary Malignity in _Marseilles_, such as is commonly called _Pestilential_, before the Arrival of these Goods: But no such Fever has any indisputable Right to the Title of _Pestilence_, as I have before shewn. On the contrary, these two, the real _Pestilence_, and such _Pestilential Fevers_, must carefully be distinguished, if we design to avoid all Mistakes in reasoning upon these Subjects. SOME such Fever of uncommon Malignity, I say, might perhaps be in _Marseilles_ before the Arrival of these Goods. There might likewise perhaps be an Instance or two of _Fevers_ attended with _Eruptions_, bearing some Resemblance to those of the _Plague_: for such I my self have sometimes seen here in _London_. But it is not conceivable, that there should be any Appearance of the true _Plague_ before that time: for it was full six Weeks from the time of the Sailor's Death, which had given the Alarm, and raised a general Attention, before the Magistrates received Information of any one's dying of the _Plague_ in the City. And I believe it was never known, that the _Plague_, being once broke out, gave so long a Truce in hot Weather. THE _Plague_, which has this present Year almost depopulated _Messina_, affords a _third_ Instance of the same kind. By an authentic Relation of it, published here[53] we are informed, that a _Genoese_ Vessel from the _Levant_, arrived at that City; and upon notice given that a Sailor, who had touched some Cases of _Cotton Stuffs_ bought up at _Patrasso_ in the _Morea_, where the Distemper then raged, was dead of the Plague, in the Voyage; the Ship was put under _Quarantaine_: during which time the _Cotton Stuffs_ were privately landed. The Master and some Sailors dying three days after, the Vessel was burnt. These Goods lay for some time concealed, but were soon after publickly sold: upon which the Disease immediately broke out in that _Quarter_ where they were opened; and afterwards was spread through the whole City. I think it not improper, for the fuller Confirmation of the present Point, to give a Relation communicated to me by a Person of unquestionable Credit, of the like Effect from Goods, in respect to the _Small-Pox_; which Distemper is frequently carried in the Nature of the _Plague_ both to the _East_ and _West-Indies_ from these Countries, and was once carried from the _East-Indies_ to the _Cape of Good Hope_, in the following manner. About the Year 1718, a ship from the _East-Indies_ arrived at that Place: In the Voyage three Children had been sick of the _Small-Pox_: The foul Linen used about them was put into a Trunk, and lock'd up. At the Ship's Landing, this was taken out, and given to some of the Natives to be washed: Upon handling the Linen, they were immediately seized with the _Small-Pox_, which spread into the Country for many Miles, and made such a Desolation, that it was almost dispeopled. IT has been thought so difficult to explain the manner how _Goods_ retain the Seeds of _Contagion_, that some[54] Authors have imagined _Infection_ to be performed by the Means of _Insects_; the _Eggs_ of which may be conveyed from Place to Place, and make the Disease when they come to be _hatched_. But as this is a Supposition grounded upon no manner of Observation, so I think there is no need to have recourse to it. If, as we have conjectured, the _Matter_ of _Contagion_ be an active Substance generated chiefly from animal Corruption; it is not hard to conceive how this may be lodged and preserved in soft porous Bodies, which are kept pressed close together. WE all know how long a time _Perfumes_ hold their Scent, if wrapt up in proper Coverings: And it is very remarkable, that the strongest of these, like the Matter we are treating of, are mostly _animal Juices_, as _Mosch_, _Civet_, &c. and that the Substances, found most fit to keep them in, are the very same with those, which are most apt to receive and communicate Infection, as _Furrs_, _Feathers_, _Silk_, _Hair_, _Wool_, _Cotton_, _Flax_, &c. the greatest part of which are likewise of the _animal_ kind. NOTHING indeed can give us so just a Notion of _Infection_, and more clearly represent the manner of it, than _Odoriferous_ Bodies. Some of _these_ do strangely revive the animal Spirits; others instantaneously depress and sink them: We may therefore conceive that, what active particles emitted from any such Substances do, is in the like way done by _Pestiferous_ Bodies; so that _Contagion_ is no more than the effect of volatile offensive Matter drawn into the Body by our _Smelling_. THE third Cause we assigned for the spreading of _Contagion_, was a corrupted State of _Air_. Although the _Air_ be in a right State, yet a sick Person may infect those who are very near him: As we find the _Pestilence_ to continue sometimes among the _Crew_ of a Ship, after they have sailed out of the Infectious Air wherein the Disease was first caught. A remarkable Accident of this Nature is recorded to have happened in the _Plague_ at _Genoa_ in the Year 1656. Eleven Persons put to Sea in a _Felucca_, with design to withdraw themselves from the _Contagion_, and retire into _Provence_; but one of them falling sick of the _Plague_ soon after they had imbarked, infected the rest; insomuch that others being taken ill, and dying in their turns, they were not admitted any where, but were forced to return from whence they came: and by that time the Boat arrived again at _Genoa_ no more than one of them survived[55]. HOWEVER in this Case the Malady does not usually spread far, the _contagious_ Particles being soon dispersed and lost. But when in a corrupt Disposition of the _Air_ the _contagious_ Particles meet with the subtile Parts generated by that Corruption, by uniting with them they become much more active and powerful, and likewise of a more durable Nature; so as to form an infectious Matter capable of conveying the Mischief to a greater distance from the diseased Body, out of which it was produced. IN general, a _hot Air_ is more disposed to spread _Contagion_ than a cold one, as no one can doubt, who considers how much all kinds of _Effluvia_ are farther diffused in a _warm Air_, than in the contrary. But moreover, that State of _Air_, when unseasonable Moisture and want of Winds are added to its Heat, which gives birth to the _Plague_ in some Countries, will doubtless promote it in all. For _Hippocrates_ sets down the same Description of a _Pestilential State_ of Air in his Country, as the _Arabians_ do of the Constitution, which gives Rise to the _Plague_ in _Africa_[56]. _Mercurialis_ assures us the same Constitution of _Air_ attended the _Pestilence_ in his time at _Padua_[57]: and _Gassendus_ observed the same in the _Plague_ of _Digne_[58]. Besides, it is easy to shew how the _Air_, by the sensible ill Qualities discoursed of in the last Chapter, should favour infectious Diseases, by rendering the Body obnoxious to them. INDEED other hurtful Qualities of the _Air_ are more to be regarded than its Heat alone: for the _Plague_ is sometimes stopt, while the Heat of the Season increases, upon the Emendation of the _Air_ in other respects. At _Smyrna_ the _Plague_, which is yearly carried thither by Ships, constantly ceases about the 24th of _June_, by the dry and clear Weather they always have at that time: the unwholsome Damps being then dissipated that annoy the Country in the _Spring_. However, the Heat of the Air is of so much Consequence, that if any Ship brings it in the Winter Months of _November_, _December_, _January_, or _February_, it never spreads: but if later in the Year, as in _April_ or afterwards, it continues till the time before mentioned. BUT moreover, what was said before of some latent Disorders in the _Air_ having a share in spreading the _Plague_, will likewise have place in these Countries; as the last _Plague_ in the City of _London_ remarkably proves, the Seeds of which, upon its first Entrance, and while it was confined to a House or two, preserved themselves through a hard frosty _Winter_, and again put forth their malignant Quality as soon as the Warmth of the _Spring_ gave them force: but, at the latter end of the next Winter they were suppressed so as to appear no more, though in the Month of _December_ more than half the _Parishes_ of the City were infected. A _corrupted State_ of Air is, without doubt, necessary to give these contagious Atoms their full force; for otherwise it were not easy to conceive how the _Plague_, when once it had seized any Place, should ever cease but with the Destruction of all the Inhabitants: Which is readily accounted for by supposing an Emendation of the Qualities of the _Air_, and the restoring of it to a healthful State capable of dissipating and suppressing the Malignity. ON the other hand, it does not appear, that the _Air_, however corrupted, is usually capable of carrying Infection to a very great distance; but that commonly the _Plague_ is spread from Town to Town by infected Persons and Goods: for there are numberless Instances, where the _Plague_ has caused a great Mortality in Towns, while other Towns and Villages, very near them, have been entirely free. And hence it is, that the _Plague_ sometimes spreads from Place to Place very irregularly. _Thuanus_[59] speaks of a _Plague_ in _Italy_, which one Year was at _Trent_ and _Verona_, the next got into _Venice_ and _Padua_, leaving _Vicenza_, an intermediate Place, untouched, though the next Year that also felt the same Stroke: a certain Proof that the _Plague_ was not carried by the _Air_ from _Verona_ to _Padua_ and _Venice_; for the infected _Air_ must have tainted all in its Passage. We have had lately in _France_ one Instance of the same Nature, when the _Plague_ was carried at once out of _Provence_ several Leagues into the _Gevaudan_. Usually indeed the _Plague_, especially when more violent than ordinary, spreads from infected Places into those which border upon them: which probably is sometimes effected by some little Communication infected Towns are obliged to hold with the Country about them for the sake of Necessaries, the Subtlety of the Venom now and then eluding the greatest Precautions; and at other times by such as withdraw themselves from infected Places into the Neighbourhood. I OWN it cannot be demonstrated, that when the _Plague_ makes great Ravage in any Town, the Number of Sick shall never be great enough to load the _Air_ with infectious _Effluvia_, emitted from them in such Plenty, that they may be conveyed by the Winds into a neighbouring Town or Village without being dispersed so much as to hinder their producing any ill Effects; especially since it is not unusual for the _Air_ to be so far charged with these noxious _Atoms_, as to leave no Place within the infected Town secure: insomuch that when the Distemper is at its Highth, all shall be indifferently infected, as well those who keep from the Sick, as those who are near them; though at the beginning of a _Plague_ to avoid all Communication with the Diseased, is an effectual Defence. However, I do not think this is often the Case: just as the _Smoak_, with which the _Air_ of the City of _London_ is constantly impregnated, especially in _Winter_, is not carried many Miles distant; though the Quantity of it is vastly greater than the Quantity of infectious _Effluvia_, that the most mortal _Plague_ could generate. BUT, to conclude what relates to the _Air_, since the ill Qualities of it in these _Northern_ Countries are not alone sufficient to excite the _Plague_, without imported _Contagion_, this shews the Error of a common Opinion, countenanc'd by Authors of great Name[60], that we are necessarily _visited_ with the _Plague_ once in thirty or forty Years: which is a mere Fancy, without Foundation either in Reason or Experience; and therefore People ought to be delivered from such vain Fears. Since the _Pestilence_ is never originally bred with us, but always brought accidentally from abroad, its coming can have no relation to any certain Period of Time. And although our three or four last _Plagues_ have fallen out nearly at such Intervals, yet that is much too short a Compass of Years to be a Foundation for a general Rule. Accordingly we see that almost fourscore Years have passed over without any Calamity of this kind. THE _Air_ of our Climate is so far from being ever the Original of the true _Plague_, that most probably it never produces those milder infectious Distempers, the _Small-Pox_ and _Measles_. For these Diseases were not heard of in _Europe_ before the _Moors_ had entered _Spain_: and (as I have observed in the _Preface_) they were afterwards propagated and spread through all Nations, chiefly by means of the Wars with the _Saracens_. MOREOVER, we are so far from any Necessity of these periodical Returns of the _Plague_, that, on the contrary, though we have had several Strokes of this kind, yet there are Instances of bad _Contagions_ from abroad being brought over to us, which have proved less malignant here, when our _Northern Air_ has not been disposed to receive such Impressions. THE _Sweating Sickness_, before hinted at, called _Sudor Anglicus_ and _Febris Ephemera Britannica_, because it was commonly thought to have taken its Rise here, was most probably of a foreign Original: and though not the common _Plague_ with _Glandular Tumors_, and _Carbuncles_, yet a real _Pestilence_ from the same Cause, only altered in its Appearance, and abated in its Violence, by the salutary Influence of our Climate. For it preserved an Agreement with the common _Plague_ in many of its _Symptoms_, as _excessive Faintness_ and _Inquietudes_, _inward Burnings_, &c. these _Symptoms_ being no where observed in so intense a Degree as here they are described to have been, except in the true _Plague_: And, what is much more, it was likewise a _contagious_ Disease. THE first time this was felt here, which was in the Year 1485, it began in the Army, with which King _Henry_ VII. came from _France_ and landed in _Wales_[61]: and it has been supposed by some to have been brought from the famous Siege of _Rhodes_ by the _Turks_ three or four Years before, as may be collected from what Dr. _Keyes_ says in one Place of his Treatise on this Disease[62]. Besides, of the several returns which this has made since that time, _viz._ in the Years 1506, 1517, 1528, and 1551, that in the Year 1528 may very justly be suspected to have been owing to the common _Pestilence_, which at those times raged in _Italy_[63] as I find one of our Historians has long ago conjectured[64]: and the others were very probably from a _Turkish_ Infection. If at least some of these Returns were not owing to the Remains of former Attacks, a suitable Constitution of Air returning to put the latent Seeds in Action before they were quite destroyed. It is the more probable that this Disease was owing to _imported Contagion_; because we are assured, that this Form of the Sickness was not peculiar to our Island, but that it made great Destruction with the same Symptoms in _Germany_, and other Countries[65]. I call this Distemper a _Plague_ with lessened Force: because though its carrying off thousands for want of right Management was a Proof of its Malignity, which indeed in one respect exceeded that of the common _Plague_ itself (for few, who were destroyed with it, survived the Seizure above one Natural Day) yet its going off safely with _profuse Sweats_ in twenty four Hours, when due care was taken to promote that Evacuation, shewed it to be what a learned and wise Historian calls it, _rather a Surprize to Nature, than obstinate_ to _Remedies_; who assigns this Reason for expressing himself thus, that _if the Patient was kept warm with temperate Cordials, he commonly recovered_[66]. And, what I think yet more remarkable, _Sweating_, which was the natural _Crisis_ of this Distemper, has been found by great Physicians the best Remedy against the common _Plague_: by which means, when timely used, that Distemper may sometimes be carried off without any external _Tumors_. Nay besides, a judicious Observer informs us, that in many of his Patients, when he had broken the Violence of the Distemper by such an artificial _Sweat_, a natural _Sweat_ not excited by Medicines would break forth exceedingly refreshing[67]. AND I cannot but take notice, as a Confirmation of what I have been advancing, that we had here the same kind of Fever in the Year 1713, about the Month of _September_, which was called the _Dunkirk Fever_, as being brought by our Soldiers from that Place. This probably had its Original from the _Plague_, which a few Years before broke out at _Dantzick_, and continued some time among the Cities of the _North_. With us this Fever began only with a Pain in the Head, and went off in large _Sweats_ usually after a Day's Confinement: but at _Dunkirk_ it was attended with the additional Symptoms of _Vomiting_, _Diarrhoea_, &c. TO return from this Digression: From all that has been said, it appears, I think, very plainly, that the _Plague_ is a real Poison, which being bred in the Southern Parts of the World, is carried by Commerce into other Countries, particularly into _Turky_, where it maintains itself by a kind of Circulation from Persons to Goods: which is chiefly owing to the Negligence of the People there, who are stupidly careless in this affair. That when the Constitution of the _Air_ happens to favour _Infection_, it rages there with great Violence: that at that time more especially diseased Persons give it to one another, and from them _contagious Matter_ is lodged in Goods of a loose and soft Texture, which being pack'd up and carried into other Countries, let out, when opened, the imprisoned Seeds of _Contagion_, and produce the Disease whenever the _Air_ is disposed to give them force; otherwise they may be dissipated without any considerable ill Effects. And lastly, that the _Air_ does not usually diffuse and spread these to any great Distance, if Intercourse and Commerce with the Place infected be strictly prevented. [Illustration] PART II. Of the Methods to be taken against the PLAGUE. CHAP. I. _Of preventing Infection from other Countries._ AS it is a Satisfaction to know, that the _Plague_ is not a Native of our Country, so this is likewise an Encouragement to the utmost Diligence in finding out Means to keep our selves clear from it. THIS Caution consists of two Parts: _The preventing its being brought into our Island_; and, if such a Calamity should happen, _the putting a Stop to its spreading among us_. THE first of these is provided for by the established Method of obliging Ships, that come from _infected_ Places, to _perform Quarantaine_: As to which, I think it necessary, that the following Rules be observed. NEAR to our several Ports, there should be _Lazaretto's_ built in convenient Places, on little Islands, if it can so be, for the Reception both of Men and Goods, which arrive from Places suspected of _Infection_: The keeping Men in _Quarantaine_ on board the Ship being not sufficient; the only use of which is to observe whether any die among them. For _Infection_ may be preserved so long in Clothes, in which it is once lodged, that as much, nay more of it, if Sickness continues in the Ship, may be brought on Shore at the end than at the beginning of the forty Days: Unless a new _Quarantaine_ be begun every time any Person dies; which might not end, but with the Destruction of the whole Ship's Crew. IF there has been any _contagious_ Distemper in the Ship; the _sound_ Men should leave their Clothes, which should be sunk in the Sea, the Men washed and shaved, and having fresh Clothes, should stay in the _Lazaretto_ thirty or forty Days. The reason of this is, because Persons may be recovered from a Disease themselves, and yet retain _Matter_ of _Infection_ about them a considerable time: as we frequently see the _Small-Pox_ taken from those, who have several Days before passed through the Distemper. THE _Sick_, if there be any, should be kept in Houses remote from the _Sound_, and, some time after they are well, should also be washed and shaved, and have fresh Clothes; whatever they wore while sick being sunk or buryed: And then being removed to the Houses of the _Sound_, should continue there thirty or forty Days. I AM particularly careful to destroy the _Clothes_ of the Sick, because they harbour the very _Quintessence_ of _Contagion_. A very ingenious Author[68], in his admirable Description of the _Plague_ at _Florence_ in the Year 1348, relates what himself saw: That two _Hogs_ finding in the Streets the _Rags_, which had been thrown out from off a poor Man dead of the Disease, after snuffling upon them, and tearing them with their Teeth, they fell into Convulsions, and dy'd in less than an Hour. The learned _Fracastorius_ acquaints us, that in his time, there being a _Plague_ in _Verona_, no less than twenty five Persons were successively kill'd by the Infection of one _Furr_ Garment[69]. And _Forestus_ gives a like Instance of seven Children, who dy'd by playing upon Clothes brought to _Alckmaer_ in _North-Holland_, from an infected House in _Zealand_[70]. The late Mr. _Williams_, Chaplain to Sir _Robert Sutton_, when Embassador at _Constantinople_, used to relate a Story of the same Nature told him by a _Bassa_: that in an Expedition this _Bassa_ made to the Frontiers of _Poland_, one of the _Janizaries_ under his Command dy'd of the _Plague_; whose Jacket, a very rich one, being bought by another _Janizary_, it was no sooner put on, but he also was taken sick and dy'd: and the same Misfortune befel five _Janizaries_ more, who afterwards wore it. This the _Bassa_ related to Mr. _Williams_, chiefly for the sake of this farther Circumstance, that the Incidents now mentioned prevailed upon him to order the burning of the Garment: designing by this Instance to let Mr. _Williams_ see there were _Turks_, who allowed themselves in so much Freedom of Thought, as not to pay that strict Regard to the _Mahometan_ Doctrine of Fatality, as the Vulgar among them do. IF there has been no Sickness in the Ship, I see no reason why the Men should perform _Quarantaine_. Instead of this, they may be washed, and their Clothes aired in the _Lazaretto_, as Goods, for one Week. BUT the greatest Danger is from such _Goods_, as are apt to retain Infection, such as _Cotton_, _Hemp_ and _Flax_, _Paper_ or _Books_, _Silk_ of all sorts, _Linen_, _Wool_, _Feathers_, _Hair_, and all kinds of _Skins_. The _Lazaretto_ for these should be at a Distance from that for the Men; and they must in convenient Warehouses be unpack'd, and exposed, as much as may be, to the fresh Air for forty Days. THIS may perhaps seem too long; but as we don't know how much time precisely is necessary to purge the Interstices of spongy Substances from _infectious Matter_ by fresh Air, the Caution cannot be too great in this Point. Certainly the time here proposed, having been long established by general Custom, ought not in the least to be retrenched; unless there could be a way found out of trying when Bodies have ceased to emit the noxious Fumes. Possibly this might be discovered by putting tender _Animals_ near to them, particularly little _Birds_: because it has been observed in Times of the _Plague_, that the Country has been forsaken by the _Birds_; and those kept in Houses have many of them died[71]. Now if it should be found, that _Birds_ let loose among Goods at the beginning of their _Quarantaine_, are obnoxious to the _Contagion_ in them, it may be known, in good measure, when such Goods are become clean, by repeating the Trial till _Birds_ let fly among them receive no hurt. But the Use of this Expedient can be known only by Experience. In the mean time, I own I am fond of the _Thought_, in compassion to poor Labourers, who must expose their Lives to danger, in the attendance upon this Work: and tho' I am well aware that there are _Plagues_ among Animals, which do not indifferently affect all kinds of them, some being confined to a particular _Species_, (like the Disease of the _Black Cattle_ here, a few Years since, which neither proved infectious to other Brutes, nor to Men;) yet it has always been observed that the true _Plague_ among Men has been destructive to all Creatures of what kind soever. A very remarkable Story, lately communicated to me by a Person of undoubted Credit, is too much to the purpose to be here omitted. The Fact is this. In the Year 1726, an English Ship took in Goods at _Grand Cairo_, in the time of the _Plague's_ raging there, and carried them to _Alexandria_. Upon opening one of the Bales of Wool in a Field, two _Turks_ employed in the Work were immediately killed: and some _Birds_, which happened to fly over the Place, dropp'd down dead. HOWEVER, the Use of _Quarantaines_ is not wholly frustrated by our Ignorance of the exact time required for this Purification: since the _Quarantaine_ does at least serve as a Trial whether Goods are infected or not; it being hardly possible that every one of those, who are obliged to attend upon them, can escape hurt, if they are so. And whenever that happens, the Goods must be destroyed. I TAKE it for granted, that the _Goods_ should be _opened_, when they are put into the _Lazaretto_, otherwise their being there will avail nothing. This is the constant Practice in the _Ports_ of _Italy_. That it is so at _Leghorn_, appears by the Account lately published of the Manner, in which _Quarantaines_ are there performed: and I find, that the same Rule is observed at _Venice_, from an authentic Paper, I have before me, containing the Methods made use of in that City, where _Quarantaines_ have been enjoined ever since the Year 1484; at which time, as far as I can learn, they were first instituted in _Europe_. In that Place all _Bales_ of _Cotton_, of _Camel_'s or of _Beaver_'s _Hair_, and the like, are _ript_ open from end to end, and _Holes_ made in them by the _Porters_ every Day, into which they thrust their naked Arms, in order that the Air may have free Access to every part of the Goods. That some such Cautions as these ought not to be omitted, is clearly proved by the Misfortune, which happened in the Island of _Bermudas_ about the Year 1695; where, as the Account was given me by the learned Dr. _Halley_, a Sack of _Cotton_ put on Shore by Stealth, lay above a Month without any Prejudice to the People of the House, where it was hid: but when it came to be distributed among the Inhabitants, it carried such a _Contagion_ along with it, that the Living scarce sufficed to bury the Dead. This Relation Dr. _Halley_ received from Captain _Tucker_ of _Bermudas_, Brother to Mr. _Tucker_ late Under-Secretary in our Secretary's Office. INDEED, as it has been frequently experienced, that of all the Goods, which harbour _Infection_, _Cotton_ in particular is the most dangerous, and _Turky_ is almost a perpetual _Seminary_ of the _Plague_; I cannot but think it highly reasonable, that whatever _Cotton_ is imported from that part of the World, should at all Times be kept in _Quarantaine_: Because it may have imbibed _Infection_ at the Time of its packing up, notwithstanding no Mischief has been felt from it by the Ship's Company. And the length of Time from its being pack'd up to its Arrival here, is no certain Security that it is cleared from the _Infection_. At least, it is found, that the Time employed by Ships in passing between _Turky_ and _Marseilles_, is not long enough for Goods to lose their _Infection_: as appears not only from the late Instance, but also from an Observation made in a certain _Memorial_, drawn up by the Deputy of Trade at _Marseilles_[72]. _Marseilles_ is the only Port in _France_ allowed to receive Goods from the _Levant_, on Account of its singular Convenience for _Quarantaines_, by Reason of several small _Islands_ situate about it. The _Ports_ of _France_ in the _Western Ocean_ having had a Desire to be allowed the same Liberty, their Deputies presented, in the Year 1701, a _Memorial_ to the _Royal Council of Trade_, containing several Reasons for their Pretensions. To this the _Deputy_ at _Marseilles_ makes Reply in the _Memorial_ I am speaking of, in which this Advantage of _Marseilles_ for _Quarantaines_ above the other Ports, is much insisted upon: and, to evince the Importance thereof, it is declared in express Words, that many Times Persons have been found in that Place to die of the _Plague_ in their Attendance upon Goods under _Quarantaine_. Now if it be certain, that Goods have retained Infection during their Passage from _Turkey_ to _Marseilles_; it is too hardy a Presumption to be admitted in an Affair so important as this, that they must necessarily lose all Contagion in the Time of their coming to us, because the Voyage is something longer. But besides this, there are some few Instances of Goods, that have retained their Infection many Years. In particular, _Alex. Benedictus_ gives a very distinct Relation of a Feather Bed, that was laid by seven Years on Suspicion of its being infected, which produced mischievous Effects at the End of that great Length of Time[73]. And Sir _Theodore Mayerne_ relates, that some Clothes fouled with Blood and Matter from _Plague_ Sores being lodged between _Matting_ and the Wall of a House in Paris, gave the _Plague_ several Years after to a Workman, who took them out, which presently spread through the City[74]. WHAT makes _Cotton_ so eminently dangerous, is its great Aptitude to imbibe and retain any Sort of _Effluvia_ near it; of which I have formerly made a particular Experiment, by causing some _Cotton_ to be placed for one Day near a Piece of _putrefying Flesh_ from an amputated Limb, in a Bell-Glass, but without touching it: for the _Cotton_ imbibed so strong a Taint, that being put up in a close Box, it retained its offensive Scent above ten Months, and would, I believe, have kept it for Years. If, instead of the Fumes of _putrefied Flesh_ from a sound Body, this _Cotton_ had been thus impregnated with the Fumes of corrupted Matter from one sick of the _Plague_; I make no doubt but it would have communicated Infection. And the Experiment would have succeeded alike in both Cases, if instead of _Cotton_, _Silk_, _Wool_, or _Hair_ had been inclosed in the Vessel: Animal Substances being the most apt to attract the volatile Particles, which come from Bodies of the same Nature with themselves. AS all reasonable Provisions should be made both for the _Sound_ and _Sick_, who perform _Quarantaine_; so the strict keeping of it ought to be inforced by the severest _Penalties_. And if a Ship comes from any Place, where the _Plague_ raged, at the Time of the Ship's Departure from it, with more than usual Violence; it will be the securest Method to _sink_ all the _Goods_, and even the _Ship_ sometimes: especially if any on Board have died of the Disease. NOR ought this farther Caution to be omitted, that when the _Contagion_ has ceased in any Place by the Approach of Winter, it will not be safe to open a free Trade with _it_ too soon: because there are Instances of the _Distemper_'s being stopt by the Winter Cold, and yet the Seeds of it not destroyed, but only kept unactive, 'till the Warmth of the following Spring has given them new Life and Force. Thus in the great _Plague_ at _Genoa_ about four-score Years ago, which continued Part of two Years; the first Summer about _ten Thousand_ died; the Winter following hardly any; but the Summer after no less than _sixty Thousand_. Likewise the last _Plague_ at _London_ appeared the latter End of the Year 1664, and was stopt during the Winter by a hard Frost of near three Month's Continuance; so that there remained no farther Appearance of it 'till the ensuing Spring[75]. Now if Goods brought from such a Place should retain any of the latent _Contagion_, there will be Danger of their producing the same Mischief in the Place, to which they are brought, as they would have caused in that, from whence they came. BUT above all, it is necessary, that the _Clandestine Importing_ of Goods be punished with the utmost Rigour; from which wicked Practice I should always apprehend more Danger of bringing the _Disease_ than by any other Way whatsoever. THESE are, I think, the most material Points, to which Regard is to be had in defending ourselves again _Contagion_ from other Countries. The particular Manner of putting these Directions in Execution, as the _Visiting_ of _Ships_, _Regulation_ of _Lazaretto's_, &c. I leave to proper Officers, who ought sometimes to be assisted herein by able Physicians. CHAP. II. _Of Stopping the Progress of the_ Plague, _if it should enter our Country._ THE next Consideration is, what to do in Case, through a Miscarriage in the publick Care, by the Neglect of Officers, or otherwise, such a Calamity should be suffered to befal us. THERE is no _Evil_ in the World, in which the great Rule of _Resisting the Beginning_, more properly takes Place, than in the present Case; and yet it has unfortunately happened, that the common Steps formerly taken have had a direct Tendency to hinder the putting _this Maxim_ in Practice. AS the _Plague_ always breaks out in some particular Place, it is certain, that the Directions of the _Civil Magistrate_ ought to be such, as to make it as much for the Interest of infected Families to discover their Misfortune, as it is, when a House is on _Fire_, to call in the Assistance of the Neighbourhood: Whereas, on the contrary, the Methods taken by the Publick, on such Occasions, have always had the Appearance of a severe _Discipline_, and even _Punishment_, rather than of a _Compassionate Care_; which must naturally make the _Infected_ conceal the Disease as long as was possible. THE main Import of the _Orders_ issued out at these Times was[76]; As soon as it was found, that any House was infected, to keep it shut up, with a _large red Cross_, and these Words, _Lord, have Mercy upon us_, painted on the Door; Watchmen attending Day and Night to prevent any one's going in or out, except such _Physicians_, _Surgeons_, _Apothecaries_, _Nurses_, _Searchers_, &c. as were allowed by Authority: And this to continue at least a Month after all the Family was _dead_ or _recovered_. IT is not easy to conceive a more dismal Scene of Misery, than this: Families lock'd up from all their Acquaintance, though seized with a Distemper which the most of any in the World requires Comfort and Assistance; abandoned it may be to the Treatment of an inhumane Nurse (for such are often found at these times about the Sick;) and Strangers to every thing but the melancholy Sight of the Progress, Death makes among themselves: with small Hopes of Life left to the Survivers, and those mixed with Anxiety and Doubt, whether it be not better to die, than to prolong a miserable Being, after the Loss of their best Friends and nearest Relations. IF _Fear_, _Despair_, and all _Dejection of Spirits_, dispose the Body to receive _Contagion_, and give it a great Power, where it is received, as all Physicians agree they do; I don't see how a Disease can be more inforced than by such a Treatment. NOTHING can justify such _Cruelty_, but the Plea, that it is for the Good of the whole _Community_, and prevents the spreading of _Infection_. But this upon due Consideration will be found quite otherwise: For while _Contagion_ is kept nursed up in a House, and continually encreased by the daily Conquests it makes, it is impossible but the _Air_ should become tainted in so eminent a degree, as to spread the _Infection_ into the Neighbourhood upon the first Outlet. The shutting up Houses in this Manner is only keeping so many _Seminaries_ of _Contagion_, sooner or later to be dispersed abroad: For the waiting a Month, or longer, from the Death of the last Patient, will avail no more, than keeping a _Bale_ of infected _Goods_ unpack'd; the Poyson will fly out, whenever the _Pandora's Box_ is opened. AS these Measures were owing to the Ignorance of the true Nature of _Contagion_, so they did, I firmly believe, contribute very much to the long Continuance of the _Plague_, every time they have been practised in this City: And no doubt, they have had as ill Effects in other Countries. IT is therefore no wonder, that grievous Complaints were often made against this unreasonable Usage; and that the Citizens were all along under the greatest apprehensions of being thus _Shut up_. This occasioned their concealing the Disease as long as they could, which contributed very much to the inforcing and spreading of it: and when they were confined, it often happened that they broke out of their _Imprisonment_, either by getting out at Windows, _&c._ or by bribing the Watchmen at their Doors; and sometimes even by murdering them. Hence in the Nights, people were often met running about the Streets, with hideous _Shrieks_ of _Horror_ and _Despair_, quite _Distracted_, either from the violence of the Fever, or from the Terrors of Mind, into which they were thrown by the daily Deaths they saw of their nearest Relations. IN these miserable Circumstances, many ran away, and when they had escaped, either went to their Friends in the Country, or built Hutts or Tents for themselves in the open Fields, or got on board Ships lying in the River. A few also were saved by keeping their Houses close from all communication with their Neighbours[77]. AND it must be observed, that whenever popular Clamours prevailed so far, as to procure some Release for the _Sick_, this was remarkably followed with an Abatement of the Disease. The _Plague_ in the Year 1636 began with great Violence; but leave being given by the King's Authority for People to quit their Houses, it was observed, That _not one in twenty of the well Persons removed fell sick, nor one in ten of the Sick died_[78]. Which single Instance alone, had there been no other, should have been of Weight ever after to have determined the Magistracy against too strict Confinements. But besides this, a preceding _Plague_, _viz._ in the Year 1625, affords us another Instance of a very remarkable Decrease upon the discontinuing to _shut up_ Houses. It was indeed so late in the Year, before this was done, that the near Approach of Winter was doubtless one Reason for the Diminution of the Disease, which followed: Yet this was so very great, that it is at least past dispute, that the Liberty then permitted was no Impediment to it. For this _opening_ of the Houses was allowed of in the beginning of _September_: and whereas the last Week in _August_, there died no less than four thousand two hundred and eighteen, the very next Week the _Burials_ were diminished to three thousand three hundred and forty four; and in no longer time than to the fourth Week after, to eight hundred and fifty two[79]. SINCE therefore the Management in former Times neither answers the Purpose of _discovering the Beginning_ of the _Infection_, nor of putting a stop to it when _discovered_, other Measures are certainly to be taken; which, I think, should be of this Nature. THERE ought, in the first Place, _a Council of Health_ to be established, consisting of some of the principal Officers of State, both Ecclesiastical and Civil, some of the chief Magistrates of the City, two or three Physicians, _&c._ And this _Council_ should be intrusted with such Powers, as might enable them to see all their Orders executed with impartial Justice, and that no unnecessary Hardships, under any Pretence whatever, be put upon any by the Officers they employ. INSTEAD of _ignorant old Women_, who are generally appointed _Searchers_ in Parishes to inquire what Diseases People die of, that _Office_ should be committed to _understanding and diligent Men_: whose Business it should be, as soon as they find any have dy'd after an uncommon Manner, particularly with _livid Spots_, _Bubo's_, or _Carbuncles_, to give Notice thereof to the _Council of Health_; who should immediately send skilful Physicians to examine the suspected Bodies, and to visit the Houses in the Neighbourhood, especially of the _poorer_ Sort, among whom this Evil generally begins. And if upon their Report it appears, that a _Pestilential Distemper_ is broken out, they should without Delay order all the Families, in which the Sickness is, to be _removed_; the _Sick_ to different Places from the _Sound_: but the Houses for both should be three or four Miles out of Town; and the _Sound_ People should be _stript of all their Clothes_, and _washed_ and _shaved_, before they go into their new Lodgings. These Removals ought to be made in the Night, when the Streets are clear of People: which will prevent all Danger of spreading the Infection. And besides, all possible Care should be taken to provide such Means of Conveyance for the _Sick_, that they may receive no Injury. AS this Management is necessary with Respect to the _Poor_ and _meaner_ Sort of People; so the _Rich_, who have Conveniences, may, instead of being carried to _Lazaretto's_, be obliged to go to their Country-Houses: provided that Care be always taken to keep the _Sound_ separated from the _Infected_. And at the same Time all the Inhabitants who are yet well, should be permitted, nay encouraged to leave the Town, which, the thinner it is, will be the more healthy. NO manner of _Compassion_ and _Care_ should be wanting to the _Diseased_; to whom, when lodged in _clean_ and _airy_ Habitations, there would, with due Cautions, be no great Danger in giving Attendance. All Expences should be paid by the Publick, and no Charges ought to be thought great, which are counterbalanced with the saving a Nation from the greatest of Calamities. Nor does it seem to me at all unreasonable, that a _Reward_ should be given to the Person, that makes the first Discovery of _Infection_ in any Place: since it is undeniable, that the making known the _Evil_ to those, who are provided with proper Methods against it, is the first and main Step towards the overcoming it. ALTHOUGH the Methods taken in other Countries, as well as in our own, have generally been different from what we have here recommended; yet there are not wanting some Instances of extraordinary Success attending these Measures, whenever they have happened to be put in Practice. THE Magistrates of the City of _Ferrara_ in _Italy_ in the Year 1630, when all the Country round about them was infected with the _Plague_, observing the ill Success of the Conduct of their Neighbours, who, for Fear of losing their Commerce, did all they could to conceal the Disease, by keeping the Sick in their Houses, resolved, whenever occasion should require, to take a different Method. Accordingly, as soon as they received Information, that one had died in their City of the _Pestilence_, they immediately removed the whole Family he belonged to into a _Lazaretto_, where all, being seven in Number, likewise died. But though the Disease was thus malignant, it went no farther, being suppressed at once by this Method. Within the Space of a Year the same Case returned seven or eight Times, and this Management as often put a Stop to it. The Example of this _City_ was afterwards followed more than once by some other Towns in the same Territory with so good Success, that it was thought expedient, for the common Good, to publish in the _Memoirs_ of the People of _Ferrara_ this Declaration: _That the only Remedy against the Plague is to make the most early Discovery of it, that is possible, and thus to extinguish it in the very Beginning_[80]. NO less remarkable than this Occurrence at _Ferrara_, is what happened at _Rome_ in the _Plague_, I have taken Notice of before, in the Year 1657. When the Disease had spread itself among both Rich and Poor, and raged in the most violent Manner; the _Pope_ appointed Cardinal _Gastaldi_, to be Commissary General of Health, giving him for a Time the Power of the whole _Sacred College_, with full Commission to do whatever he should judge necessary. Hereupon he gave strict Orders, that no sick or suspected Persons should stay in their own Houses. The _Sick_ he removed, upon the first Notice, to a _Lazaretto_ in the _Island_ of the _Tyber_; and all who were in the same Houses with them to other _Hospitals_ just without the City, in order to be sent to the _Island_, if they should fall sick. At the same Time he took diligent Care to send away their _Goods_ to an airy Place to be cleansed. He executed these Regulations with so much Strictness, that no Persons of the highest Quality were exempted from this Treatment; which occasioned at first great Complaints against the _Cardinal_ for his Severity; but soon after he had general Thanks: for in two Months Time, by this means, he entirely cleared the City of the _Pestilence_, which had continued in it almost two Years. And it was particularly observed, that whereas before, when once the Disease had got into a House, it seldom ended without seizing the whole Family; in this Management scarce five out of an hundred of the sound Persons removed were infected[81]. I CANNOT but take Notice, that the _Plague_ was stopp'd at _Marseilles_ a full Fortnight by the same Measures, and probably might have been wholly extinguished, had not new Force been given it by the unseasonable Confidence of the Inhabitants upon this Intermission: which, we are informed, was so great, that they would not believe the _Pestilence_ had been at all among them, and publickly upbraided the Physicians and Surgeons for frighting them causlesly[82]. At this Time, no doubt, they must have neglected the Cautions necessary for their Security so much, as to leave us no room to be surprized, that the Disease should after this break out again with too great Violence to be a second Time overcome. BUT, besides these Examples in foreign Countries, we have one Instance of the same Nature nearer Home. When the _Plague_ was last here in _England_, upon its first Entrance into _Poole_ in _Dorsetshire_, the Magistrates immediately suppress'd it, by removing the _Sick_ into _Pest-Houses_, without the Town, as is well remember'd there to this Time. A very remarkable Occurrence has greatly contributed towards preserving all the Circumstances of this Transaction in Memory. They found some Difficulty in procuring any one to attend upon the _Sick_ after their Removal: which obliged the Town to engage a _young Woman_, then under Sentence of Death, in that Service, on a Promise to use their Interest for obtaining her Pardon. The young Woman escaped the Disease, but neglecting to solicite the Corporation for the Accomplishment of their Engagement with her, three or four Months after she was barbarously hanged by the _Mayor_ upon a Quarrel between them. I WOULD have it here observed, that 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. But the Success of this proves the Method of _Removing the Sick_, where this other cannot be practised, to be the most proper of any. WHEN the _sick Families_ are gone, all the Goods of the Houses, in which they were, should be _buried_ deep under Ground. This I prefer to _burning_ them: because, especially in a close Place, some infectious Particles may possibly be dispersed by the Smoak through the Neighbourhood; according to what _Mercurialis_ relates, that the _Plague_ in _Venice_ was augmented by burning a large Quantity of infected Goods in the City[83]. A learned Physician of my Acquaintance lately communicated to me the Relation of a Case, (given to him by an Apothecary, who was at the Place when the Thing happened) very proper to be here mentioned. The Story is this. At _Shipston_, a little Town upon the River _Stour_ in _Worcestershire_, a poor Vagabond was seen walking in the Streets with the _Small-Pox_ upon him. The People frightened took Care to have him carried to a little House, seated upon a Hill, at some Distance from the Town, providing him with Necessaries. In a few Days the Man died. They ordered him to be buried deep in the Ground, and the House with his Cloaths to be burnt. The Wind, being pretty high, blew the Smoak upon the Houses on one Side of the Town: In that Part, a few Days after, eight Persons were seized with the _Small-Pox_. So dangerous is _Heat_ in all Kinds of pestilential Distempers, and so diffusive of Contagion. And moreover the Houses themselves may likewise be demolished or pulled down, if that can conveniently be done; that is, if they are remote enough from others: otherwise it may suffice to have them thoroughly cleansed, and then plastered up. And after this, all possible Care ought still to be taken to remove whatever Causes are found to breed and promote _Contagion_. In order to this, the _Overseers_ of the Poor (who might be assisted herein by other Officers) should visit the Dwellings of all the meaner Sort of the Inhabitants; and where they find them _stifled up too close_ and _nasty_, should lessen their Number by sending some into better Lodgings, and should take Care, by all Manner of Provision and Encouragement, to make them more _cleanly_ and _sweet_. NO good Work carries its own Reward with it so much as this kind of _Charity_: and therefore, be the Expence what it will, it must never be thought unreasonable. For nothing approaches so near to the first Original of the _Plague_, as Air pent up, loaded with Damps, and corrupted with the Filthiness, that proceeds from _Animal Bodies_. OUR _common Prisons_ afford us an Instance of something like this, where very few escape what they call the _Goal Fever_, which is always attended with a Degree of _Malignity_ in Proportion to the _Closeness_ and _Stench_ of the Place: and it would certainly very well become the Wisdom of the Government, as well with regard to the Health of the _Town_, as in Compassion to the _Prisoners_, to take Care, that all _Houses of Confinement_ should be kept as airy and clean, as is consistent with the Use, to which they are designed. THE _Black Assise_ at _Oxford_, held in the Castle there in the Year 1577, will never be forgot[84]; at which the _Judges_, _Gentry_, and almost all that were present, to the Number of three hundred, were killed by a _poisonous Steam_, thought by some to have broken forth from the _Earth_; but by a _noble_ and _great_ Philosopher[85] more justly supposed to have been brought by the _Prisoners_ out of the _Goal_ into _Court_; it being observed, that they alone were not injured by it. AT the same Time, that this Care is taken of _Houses_, the proper Officers should be strictly charged to see that the _Streets_ be washed and kept clean from _Filth_, _Carrion_, and all manner of _Nusances_; which should be carried away in the _Night Time_: nor should the _Laystalls_ be suffered to be too near the City. _Beggers_ and _idle Persons_ should be taken up, and such miserable Objects, as are neither fit for the common _Hospitals_, nor _Work-Houses_, should be provided for in an _Hospital of Incurables_. ORDERS indeed of this Kind are necessary to be observed at all Times, especially in populous Cities; and therefore I am sorry to take Notice, that in these of _London_ and _Westminster_ there is no good _Police_ established in these Respects: for want of which the Citizens and Gentry are every Day annoyed more ways than one. IF these early _Precautions_, we have mentioned, prove successful, there will be no need of any Methods for _Correcting the Air_, _Purifying Houses_, or of _Rules for preserving particular Persons from Infection_: to all which, if the _Plague_ get head, so that the _Sick_ are too many to be removed (as they will be when the Disease has raged for a considerable Time) Regard must be had. AS to the _first_: _Fire_ has been almost universally recommended for this Purpose, both by the Ancients and Moderns; who have advised to make frequent and numerous _Fires_ in the Towns infected. This _Precept_, I think, is almost entirely founded upon a Tradition, that _Hippocrates_ put a stop to a _Plague_ in _Greece_ by this means. But it is to be observed, that there is no mention made of any Thing like it in the Works of _Hippocrates_. The best Authority we have for it, is the Testimony of _Galen_, though it is also mentioned by other Authors. _Galen_, recommending _Theriaca_ against the _Pestilence_, has thought fit, it seems, to compare it to _Fire_; and, upon this Conceit, relates, that _Hippocrates_ cured a _Plague_, which came from _AEthiopia_ into _Greece_, by purifying the Air with _Fires_; into which were thrown sweet-scented Herbs, and Flowers, together with Ointments of the finest Flavour. It is remarkable, that among the _Epistles_ ascribed to _Hippocrates_, which, though not genuine, yet are older than _Galen_, there is a _Decree_ said to be made by the _Athenians_ in Honour of this Father of Physicians, which, making mention of the Service he had done his Country in a _Plague_, says only, that he sent his Scholars into several Parts, with proper Instructions to cure the Disease. By which it should seem, that this Story of the _Fires_ was hardly or not at all known at the Time, when these _Letters_ were compiled. And _Soranus_ may yet more confirm us, that it was framed long after the Death of _Hippocrates_: for _Soranus_ only says in general, that _Hippocrates_ foretold the coming of the _Pestilence_, and took care of the Cities of _Greece_; without any mention of having used this particular Expedient. _Plutarch_ indeed speaks of a Practice like this as commonly approved among Physicians, which he makes use of to illustrate a certain Custom of the _Egyptians_: of whom he says, that they _purify_ the Air by the Fumes of _Resin_ and _Myrrh_, as Physicians correct the Foulness, and attenuate the Thickness thereof in Times of _Pestilence_, by _burning Sweet-Woods_, _Juniper_, _Cypress_[86] &c. THIS I take to be the Sum of what can be learned from Antiquity in Relation to this Point; from whence we may see, that Writers have concluded a little too hastily for the use of _common Fires_ in this Case, upon the Authority and Example of _Hippocrates_, though we should allow the Fact as related by _Galen_: when it will not from thence appear that _Hippocrates_ himself relied upon them; since he thought it necessary to take in the Assistance of _aromatic Fumes_. But as this Fact is not grounded upon sufficient Authority, so it is needless to insist long upon it. The Passage I have brought from _Plutarch_ will better explain what was the Sentiment of those Physicians who approved the Practice. It seems they expected from thence to dispel the Thickness and Foulness of the Air. And no doubt but such evil Dispositions of the Air, as proceed from _Damps_, _Exhalations_, and the like, may be corrected even by _common Fires_, and the Predisposition of it from these Causes to receive Infection sometimes removed. But I think this Method, if it be necessary, should be put in Practice before the coming of the _Pestilence_. For when the Distemper is actually _begun_, and rages, since it is known to _spread_ and _increased_ by the _Heat_ of the _Summer_, and on the contrary checked by the _Cold_ in _Winter_; undoubtedly, whatever increases that _Heat_, will so far add Force to the Disease: as _Mercurialis_ takes notice, that _Smiths_, and all those who worked at the _Fire_ were most severely used in the _Plague_ at _Venice_ in his Time[87]. Whether the Service _Fires_ may do by correcting any other ill Qualities of the Air, will counterbalance the Inconvenience upon this Account, Experience only can determine: and the fatal Success of the Trials made here in the last _Plague_, is more than sufficient to discourage any farther Attempts of this Nature. For _Fires_ being ordered in all the _Streets_ for three Days together, there died in one Night following no less than four thousand (if we may believe Dr. _Hodges_:) whereas in any single Week before or after, never twice that Number were carried off[88]. And we find that upon making the same Experiment in the last _Plague_ at _Marseilles_, the Contagion was every Day spread more and more thro' the City with increas'd Rage and Violence[89]. WHAT has been said of _Fires_, is likewise to be understood of _Firing of Guns_, which some have too rashly advised. The proper Correction of the Air would be to make it _fresh_ and _cool_: Accordingly the _Arabians_[90], who were best acquainted with the Nature of _Pestilences_, advise People to keep themselves as _airy_ as possible, and to chuse Dwellings exposed to the Wind, situate high, and refreshed with running Waters. AS for _Houses_, the first Care ought to be to keep them _clean_: for as _Nastiness_ is a great Source of _Infection_, so _Cleanliness_ is the greatest Preservative; which shews us the true Reason, why the _Poor_ are most obnoxious to _Contagious Diseases_. It is remarked of the _Persians_, that though their Country is surrounded every Year with the _Plague_, they seldom or never suffer any Thing by it themselves: and it is likewise known, that they are the most _cleanly_ People of any in the World, and that many among them make it a great Part of their Religion to remove _Filthiness_ and _Nusances_ of every Kind from all Places about their Cities and Dwellings[91]. BESIDES this, the _Arabians_ advise the keeping Houses _cool_, as another Method of their _Purification_, and therefore, to answer this End more fully, they directed to strew them with _cooling_ Herbs, as _Roses_, _Violets_, _Water-Lilies_, &c. and to be washed with _Water_ and _Vinegar_: than all which, especially the last, nothing more proper can be proposed. I think it not improper likewise to _fume_ Houses with _Vinegar_, either alone or together with _Nitre_, by throwing it upon a _hot Iron_ or _Tile_; though this be directly contrary to what modern Authors mostly advise, which is to make Fumes with hot things, as _Benzoin_, _Frankincense_, _Storax_, &c. from which I see no reason to expect any Virtue to destroy the Matter of _Infection_, or to keep particular Places from a Disposition to receive it; which are the only things here to be aimed at. The _Smoak_ of _Sulphur_, perhaps, as it abounds with an _acid Spirit_, which is found by Experience to be very _penetrating_, and to have a great Power to repress _Fermentations_, may promise some Service this way. AS hot Fumes appear to be generally _useless_, so the Steams of _Poisonous Minerals_ ought to be reckoned _dangerous_: and therefore I cannot but dissuade the use of all _Fumigations_ with _Mercury_ or _Arsenic_. Much less would I advise, as some have done, the wearing _Arsenic_ upon the _Pit_ of the _Stomach_ as an _Amulet_: since this Practice has been often attended with very ill Consequences, and is not grounded upon any good Authority, but probably derived from an Error in mistaking the _Arabian_ Word _Darsini_, which signifies _Cinnamon_, for the _Latin de Arsenico_, as I have formerly shewn[92]. THE next thing after the _Purifying of Houses_, is to consider by what Means particular _Persons_ may best defend themselves against _Contagion_: for the certain doing of which, it would be necessary to put the _Humours_ of the _Body_ into such a State, as not to be alterable by the _Matter of Infection_. But since this is no more to be hoped for, than a _Specific Preservative_ from the _Small-Pox_; the most that can be done, will be to keep the Body in such Order, that it may suffer as little as possible. The _first Step_ towards which, is to maintain a good State of Health, in which we are always least liable to suffer by any external Injuries; and not to weaken the Body by Evacuations. The _next_ is, to guard against all _Dejection of Spirits_, and _immoderate Passions_: for these we daily observe do expose Persons to the more common _Contagion_ of the _Small-Pox_. These Ends will be best answered by living with Temperance upon a good generous Diet, and by avoiding _Fastings_, _Watchings_, _extreme Weariness_, &c. _Another_ Defence is, to use whatever Means are proper to keep the _Blood_ from _Inflaming_. This, if it does not secure from _contracting Infection_, will at least make the _Effects_ of it less violent. The most proper Means for this, according to the Advice of the _Arabian_ Physicians, is the repeated Use of _acid Fruits_, as _Pomegranates_, _Sevil Oranges_, _Lemons_, _Tart Apples_, &c. But above all, of _Wine Vinegar_ in small Quantities, rendered grateful to the Stomach by the Infusion of some such Ingredients as _Gentian Root_, _Galangal_, _Zedoary_, _Juniper Berries_, &c. Which Medicines by correcting the _Vinegar_, and taking off some ill Effects it might otherwise have upon the Stomach, will be of good Use: but these, and all other hot _aromatic_ Drugs, though much recommended by Authors, if used alone, are most likely to do hurt by _over-heating_ the Blood. I CANNOT but recommend likewise the Use of _Issues_. The properest Place for them I take to be the inside of the Thigh a little above the Knee. Besides, the smoaking _Tobacco_, much applauded by some, since it may be put in Practice without any great Inconvenience, need not, I think, be neglected. BUT since none of these Methods promise any certain Protection; as _leaving_ the Place infected is the surest _Preservative_, so the next to it is to avoid, as much as may be, the _near Approach_ to the _Sick_, or to such as have but _lately recovered_. For the greater Security herein, it will be adviseable to avoid all _Crouds of People_. Nay, it should be the Care of the _Magistrate_ to prohibit all unnecessary _Assemblies_: and likewise to oblige all, who get over the Disease, to _confine_ themselves for some time, before they appear abroad. THE Advice to keep at a Distance from the _Sick_, is also to be understood of the _Dead Bodies_; which should be _buried_ at as great a Distance from Dwelling-Houses, as may be; put _deep_ in the Earth; and _covered_ with the exactest Care; but not with _Quick-Lime_ thrown in with them, as has been the Manner abroad: For I cannot but think that _This_, by _Fermenting_ with the putrefying Humours of the Carcases, may give rise to noxious Exhalations from the Ground. They should likewise be _carried out_ in the _Night_, while they are yet fresh and free from _Putrefaction_: Because a Carcase not yet beginning to corrupt, if kept from the Heat of the Day, hardly emits any kind of Steam or Vapour. AS for those, who must of necessity attend the _Sick_; some farther Directions should be added for their Use. These may be comprehended in two short Precepts. _One_ is, not to _swallow their Spittle_ while they are about the _Sick_, but rather to _spit_ it out: _The other_, not so much as to _draw in their Breath_, when they are very near them. The reason for both these appears from what has been said above concerning the Manner, in which a sound Person receives the Infection. But in case it be too difficult constantly to comply with these _Cautions_, _washing_ the _Mouth_ frequently with _Vinegar_, and _holding_ to the _Nostrils_ a _Sponge_ wet with the same, may in some measure supply their Place. THIS is the Sum of what I think most likely to stop the Progress of the _Disease_ in any Place, where it shall have got Admittance. If some few of these Rules refer more particularly to the City of _London_, with small Alteration they may be applied to any other _Place_. It now remains therefore only to lay down some Directions to hinder the Distemper's spreading from _Town_ to _Town_. The best Method for which, where it can be done, (for this is not practicable in very great Cities) is to cast up a _Line_ about the _Town infected_, at a convenient Distance; and by placing a _Guard_, to hinder People's passing from it without due Regulation, to other Towns: but not absolutely to forbid any to withdraw themselves, as was done in _France_, according to the usual Practice abroad; which is an unnecessary Severity, not to call it a Cruelty. I think it will be enough, if all, who desire to pass the _Line_, be permitted to do it, upon Condition they first perform _Quarantaine_ for about twenty Days in _Tents_, or other more convenient _Habitations_. But the greatest care must be taken, that none pass without conforming themselves to this Order; both by keeping diligent _Watch_, and by _punishing_, with the utmost Severity, any that shall either have done so, or attempt it. And the better to discover _such_, it will be requisite to oblige all, who travel in any Part of the Country, under the same Penalties, to carry with them _Certificates_ either of their coming from Places not _infected_, or of their passing the _Line_ by Permission. THIS I take to be a more effectual Method to keep the _Infection_ from spreading, than the absolute refusing a Passage to People upon any Terms. For when Men are in such imminent Danger of their Lives where they are, many, no doubt, if not otherwise allowed to escape, will use Endeavours to do it secretly, let the Hazard be ever so great. And it can hardly be, but some will succeed in their Attempts; as we see it has often happen'd in _France_, notwithstanding all their Care. But one that gets off thus clandestinely, will be more likely to carry the Distemper with him, than twenty, nay a hundred, that go away under the preceding Restrictions: especially because the _Infection_ of the Place, he flies from, will by this Management be rendered much more intense. For confining People, and shutting them up together in great Numbers, will make the Distemper rage with augmented Force, even to the increasing it beyond what can be easily imagined: as appears from the Account which the learned _Gassendus_[93] has given us of a memorable _Plague_, which happened at _Digne_ in _Provence_, where he lived, in the Year 1629. This was so terrible, that in one _Summer_, out of _ten thousand_ Inhabitants, it left but _fifteen hundred_, and of them all but _five_ or _six_ had gone through the _Disease_. And he assigns _this_, as the principal Cause of the great Destruction, that the Citizens were too closely confined, and not suffered so much as to go to their Country-Houses. Whereas in another _Pestilence_, which broke out in the same Place a Year and an half after, more Liberty being allowed, there did not die above _one hundred_ Persons. FOR these Reasons, I think, to allow People with proper _Cautions_ to remove from an infected Place, is the best Means to suppress the _Contagion_, as well as the most humane Treatment of the present Sufferers: and, under these Limitations, the Method of _investing_ Towns infected, which is certainly the most proper, that can be advised, to keep the Disease from spreading, will be no Inconvenience to the Places _surrounded_. On the contrary, it will rather be useful to them; since the Guard may establish such _Regulations_ for the Safety of those, who shall bring Provisions, as shall remove the Fears, which might otherwise discourage them. THE securing against all Apprehensions of this Kind, is of so great Importance, that in _Cities_ too large to be invested, as, for Example, this City of _London_, the _Magistrates_ must use all possible Diligence to supply this Defect, not only by setting up _Barriers_ without their City, but by making it in the most particular manner their Care to appoint such _Orders_ to be observed at them, as they shall judge will be most satisfactory to the Country about. THOUGH Liberty ought to be given to the _People_, yet no sort of _Goods_ must by any means be suffered to be carried over the _Line_, which are made of _Materials_ retentive of _Infection_. For in the present Case, when _Infection_ has seized any Part of a Country, much greater Care ought to be taken, that no _Seeds_ of the _Contagion_ be conveyed about, than when the Distemper is at a great Distance: because a _Bale of Goods_, which shall have imbibed the _Contagious Aura_ when pack'd up in _Turky_, or any remote Parts, when unpack'd here, may chance to meet with so healthful a Temperament of our Air, that it shall not do much hurt. But when the Air of any one of our Towns shall be so corrupted, as to maintain and spread the _Pestilence_ in it, there will be little Reason to believe, that the Air of the rest of the Country is in a much better State. FOR the same Reason _Quarantaines_ should more strictly be enjoined, when the _Plague_ is in a bordering Kingdom, than when it is more remote. THE Advice here given with respect to _Goods_, is not only abundantly confirmed from the Proofs, I have given above, that _Goods_ have a Power of spreading _Contagion_ to distant Places; but might be farther illustrated by many Instances of ill Effects from the Neglect of this Caution in Times of the _Plague_. I shall mention two, which happen'd among us during the last _Plague_. I have had occasion already to observe, that the _Plague_ was in _Poole_. It was carried to that Place by some _Goods_ contained in a _Pedlar's Pack_. The _Plague_ was likewise at _Eham_ in the Peak of _Derbyshire_, being brought thither by means of a Box sent from _London_ to a Taylor in that Village, containing some Materials relating to his Trade. There being several Incidents in this latter Instance, that will not only serve to establish in particular the Precepts I have been giving, in relation to Goods, but likewise all the rest of the Directions, that have been set down, for stopping the Progress of the _Plague_ from one Town to another; I shall finish this Chapter with a particular Relation of what passed in that Place. A Servant, who first opened the foresaid _Box_, complaining that the Goods were damp, was ordered to dry them at the Fire; but in doing it, was seized with the _Plague_, and died: the same Misfortune extended itself to all the rest of the Family, except the Taylor's Wife, who alone survived. From hence the Distemper spread about and destroyed in that Village, and the rest of the Parish, though a small one, between two and three hundred Persons. But notwithstanding this so great Violence of the Disease, it was restrained from reaching beyond that Parish by the Care of the Rector; from whose Son, and another worthy Gentleman, I have the Relation. This Clergyman advised, that the _Sick_ should be removed into _Hutts_ or _Barracks_ built upon the _Common_; and procuring by the Interest of the then Earl of _Devonshire_, that the People should be well furnished with Provisions, he took effectual Care, that no one should go out of the Parish: and by this means he protected his Neighbours from Infection with compleat Success. I have now gone through the chief Branches of _Preservation_ against the _Plague_, and shall conclude with some general Directions concerning the _Cure_. CHAP. III. _Of the Cure of the Plague._ IT appears, from what has been said in the beginning of this Discourse, that the _Plague_ and the _Small-Pox_ are Diseases, which bear a great Similitude to each other: both being _Contagious Fevers_ from _Africa_, and both attended with certain _Eruptions_. And as the _Eruptions_ or _Pustules_ in the _Small-Pox_ are of two Kinds, which has caused the Distemper to be divided into two Species, the _distinct_ and _confluent_; so we have shewn two Sorts of _Eruptions_ or _Tumors_ likewise to attend the _Plague_. In the first and mildest Kind of the _Small-Pox_ the _Pustules_ rise high above the Surface of the Skin, and contain a digested _Pus_; but in the other, the _Pustules_ lie flat, and are filled with an indigested _Sanies_. The two kinds of critical _Tumors_ in the _Plague_ are yet more different. In the most favourable Case the _Morbific Matter_ is thrown upon some of the softest _Glands_ near the Surface of the Body, as upon the _inguinal_, _axillary_, _parotid_, or _maxillary_ Glands: the first Appearance of which is a small Induration, great Heat, Redness, and sharp Pain near those Glands. These _Tumors_, if the Patient recover, like the _Pustules_ of the distinct _Small-Pox_, come to a just Suppuration, and thereby discharge the Disease. In worse Cases of the Distemper, either instead of these _Tumors_, or together with them, _Carbuncles_ are raised. The first Appearance of them is a very small indurated _Tumor_, not situate near any of the fore-mention'd Glands, with a dusky Redness, violent Heat, vast Pain, and a blackish _Spot_ in the middle of the _Tumor_. This _Spot_ is the beginning of a _Gangrene_, which spreads itself more and more as the _Tumor_ increases. BUT, besides the Agreement in these critical Discharges, the two Distempers have yet a more manifest Likeness in those _livid_ and _black Spots_, which are frequent in the _Plague_, and the Signs of speedy Death: for the same are sometimes found to attend the _Small-Pox_ with as fatal a Consequence; nay, I have seen Cases, when almost every _Pustule_ has taken this Appearance. Moreover, in both Diseases, when eminently malignant, Blood is sometimes voided by the Mouth, by Urine, or the like[94]. And we may farther add, that in both Death is usually caused by Mortifications in the _Viscera_. This has constantly been found in the _Plague_ by the Physicians in _France_: and I am convinced, from Accounts I have by me, of the Dissection of a great many, who had died of the _Small-Pox_, that it is the same in that Distemper. THIS Analogy between the two Diseases, not only shews us, that we cannot expect to cure the _Plague_ any more than the _Small-Pox_, by _Antidotes_ and _Specific Medicines_; but will likewise direct us in the Cure of the Distemper, with which we are less acquainted, by the Methods found useful in the other Disease, which is more familiar to us. IN short, as in the _Small-Pox_, the chief Part of the Management consists in clearing the _Primae Viae_ in the beginning; in regulating the Fever; and in promoting the natural Discharges: so in the _Plague_ the same Indications will have Place. The great Difference lies in this, that in the _Plague_ the Fever is often much more acute than in the other Distemper; the Stomach and Bowels are sometimes inflamed; and the Eruptions require external Applications, which to the _Pustules_ of the _Small-Pox_ are not necessary. WHEN the Fever is very acute, a cool _Regimen_, commonly so beneficial in the _Small-Pox_, is here still more necessary. But whenever the Pulse is languid, and the Heat not excessive, moderate Cordials must be used. THE Disposition of the Stomach and Bowels to be inflamed, makes _Vomiting_ not so generally safe in the _Plague_ as in the _Small-Pox_. The most gentle _Emetics_ ought to be used, none better than _Ipecacuanha_; and great Caution must be had, that the Stomach or Bowels are not inflamed, when they are administer'd: for if they are, nothing but certain Death can be expected from them: otherwise at the beginning they will be always useful. Therefore upon the first Illness of the Patient it must carefully be considered, whether there appear any Symptoms of an Inflammation having seized these Parts: if there are any Marks of this, all _Vomits_ must be omitted; if not, the Stomach ought to be gently moved. THE _Eruptions_, whether _glandular Tumors_, or _Carbuncles_, must not be left to the Course of Nature, as is done in the _Small-Pox_; but all Diligence must be used, by external Applications, to bring them to _Suppurate_. Both these _Tumors_ are to be treated in most respects alike. As soon as either of them appears, fix a _Cupping-Glass_ to it without _scarifying_; and when that is removed, apply a _suppurative Cataplasm_, or _Plaster_ of warm Gums. IF the _Tumors_ do not come to _Suppuration_, which the _Carbuncle_ seldom or never does; but if a thin _Ichor_ or Matter exudes through the Pores; or if the _Tumor_ feel soft to the Touch; or lastly, if it has a black _Crust_ upon it, then it must be _opened_ by _Incision_, either according to the length of the _Tumor_, or by a _crucial Section_. And if there is any Part _mortified_, as is usually in the _Carbuncle_, it must be _scarified_. This being done, it will be necessary to stop the Bleeding, and dry up the _Moisture_ with an _actual Cautery_, dressing the Wound afterwards with _Dossils_, and _Pledgits_ spread with the common _Digestive_ made with _Terebinth. cum Vitel. Ov._ and dip'd in a Mixture of two Parts of warmed Oil of _Turpentine_, and one Part of _Sp. Sal. Ammon._ or in _Bals. Terebinth._ and over all must be put a _Cataplasm of Theriac. Lond._ THE next Day the Wound ought to be well _bathed_ with a _Fomentation_ made of warm _aromatic_ Plants with Spirit of Wine in it; in order, if possible, to make the Wound digest, by which the _Sloughs_ will separate. After this the _Ulcer_ may be treated as one from an ordinary _Abscess_. FARTHER, in the _glandular Tumors_, when they suppurate, we ought not to wait, till the _Matter_ has made its way to the outer Skin, but to open it as soon as it is risen to any Bigness: because these _Tumors_ begin deep in the Gland, and often mortify, before the Suppuration has reached the Skin, as the Physicians in _France_ have found upon dissecting many dead Bodies. THIS is the Method in which the _Plague_ must be treated in following the natural Course of the Distemper. But the Patient in most Cases runs so great Hazard in this way, notwithstanding the utmost Care, that it would be of the greatest Service to Mankind under this Calamity, if some artificial Discharge for the corrupted Humours could be found out, not liable to so great Hazard, as the natural Way. To this Purpose _large Bleeding_ and _profuse Sweating_ are recommended to us upon some Experience. DR. _Sydenham_ tried both these Evacuations with good Success, and has made two very judicious Remarks upon them. The _first_ is, that they ought not to be attempted unless in the Beginning of the Sickness, before the natural Course of the Distemper has long taken Place: because otherwise we can only expect to put all into Confusion without any Advantage. His _other_ Observation is, that we cannot expect any prosperous Event from either of these Evacuations, unless they are very copious: there being no Prospect of surmounting so violent a Malignity without bolder Methods than must be taken in ordinary Cases. AS for _Bleeding_, by some Accounts from _France_, I have been informed, that some of the Physicians there have carried this Practice so far, as upon the first Day of the Distemper to begin with bleeding about twelve Ounces, and then to take away four or five Ounces every two Hours after. They pretend to extraordinary Success from this Method, with the Assistance only of cooling _Ptisanes_, and such like Drinks, which they give plentifully at the same Time. Such profuse Bleeding as this may perhaps not suit with our Constitutions so well as with theirs; for in common Cases they use this Practice much more freely than we: Yet we must draw Blood with a more liberal Hand than in any other Case, if we expect Success from it. I shall excuse myself from defining exactly how large a Quantity of Blood is requisite to be drawn, for want of particular Experience: but I think fit to give this Admonition, that, in so desperate a Case as this, it is more prudent to run some hazard of exceeding, than to let the Patient perish for want of due Evacuation. AS for _Sweating_, which is the other Method proposed, it ought, no doubt, to be continued without Intermission full twenty-four Hours, as Dr. _Sydenham_ advises. He is so particular in his Directions about it, that I need say little. I shall only add, that _Theriaca_, and the like solid Medicines, being offensive to the Stomach, are not the most proper _Sudorifics_. I should rather commend an Infusion in boiling Water of _Virginia Snake-Root_, or, in want of this, of some other warm _Aromatic_, with the Addition of about a fourth Part of _Aqua Theriacalis_, and a proper Quantity of Syrup of Lemons to sweeten it. From which, in Illnesses of the same kind with the _Goal Fever_, which approaches the nearest to the _Pestilence_, I have seen very good Effects. WHETHER either of these Methods, of _Bleeding_, or of _Sweating_, will answer the Purpose intended by them, must be left to a larger Experience to determine; and the Trial ought by no means to be neglected, especially in those Cases, which promise but little Success from the natural Course of the Disease. _FINIS._ [Illustration] Footnotes: [1] See the Dedication. [2] _Vide_ Huet. De rebus ad eum pertinentibus, _pag._ 23. [3] Observations sur la Peste de Marseille, p. 38, 39, 40. [4] Ibid. _p._ 113. [5] _Vid._ Philos. Transactions No. 370. [6] Le Journal des Scavans, 1722. _pag._ 279. [7] _Vid._ Dissertation sur la Contagion de la Peste. A Toulouse 1724. [8] _Vid._ Mechanical Account of Poisons, _pag._ 24. [9] Vid. Philos. Trans. No. 372. [10] _Vid._ Lettre de Messieurs _Le Moine_ et _Bailly_. [11] Astruc, Dissertation sur la Contagion de la Peste. A Toulouse, 1724. 8o. [12] _Diemerbroek_ De Peste, _p._ 120. [13] In these Words, _Where it can be done_. [14] _Vid._ the _Gazettes_ of the Years 1665. _and_ 1666. [15] Celsus de Medic. in Praesat. Morbos ad iram deorum immortalium relatos esse, et ab iisdem opem posci solitam. [16] Libr. De morbo sacro; et libr. De aere, locis, et aquis. [17] Observat. et Reflex, touchant la Nature, etc. de la Peste de Marseilles, pag. 47. et suiv. [18] Journal de la Contagion a Marseilles, pag. 6. [19] Lib. 2. +Hoti heteros aph' heterou, therapeias anapimplamenoi, hosper ta probata ethneskon; kai ton pleiston phthoron touto enepoiei; eite gar me theloien dediotes allelois prosienai, apollunto eremoi, kai oikiai pollai ekenothesan aporia tou therapeusantos; eite prosioien, diephtheironto, kai malista hoi aretes ti metapoioumenoi.+ The beginning of this Passage, as it here stands, though it is found thus in all the Editions of _Thucydides_, is certainly faulty, +therapeias anapimplamenoi+ being no good Sense. The Sentence I shall presently cite from _Aristotle_ shews that this may be rectified only by removing the Comma after +heterou+, and placing it after +therapeias+, for +prosanapimplemi+ in _Aristotle_ absolutely used signifies _to infect_. With this Correction, the Sense of the Place will be as follows: _The People took Infection by their Attendance on each other, dying like Folds of Sheep. And this Effect of the Disease was the principal Cause of the great Mortality: for either the Sick were left destitute, their Friends fearing to approach them, by which means Multitudes of Families perished without Assistance; or they infected those who relieved them, and especially such, whom a Sense of Virtue and Honour obliged most to their Duty._ The Sense here ascribed to the word +anapimplemi+ is confirmed yet more fully by a Passage in _Livy_, where he describes the Infection attending a Plague or Camp Fever, which infested the Armies of the _Carthaginians_ and _Romans_ at the Siege of _Syracuse_, in such words, as shew him to have had this Passage of _Thucydides_ in view; for he says, _aut neglecti desertique, qui incidissent, morerentur; aut assidentes curantesque eadem vi morbi repletos secum traherent_. Lib. xxv. c. 26. [20] L. 6. v. 1234. ----nullo cessabant tempore apisci Ex aliis alios avidi contagia morbi. Et v. 1241. Qui fuerant autem praesto, Contagibus ibant. [21] Sect. I. +Dia ti pote ho loimos mone ton noson malista tous plesiazontas tois therapeuomenois prosanapimplesi?+ [22] +Peri diaphoras pyreton, Bib. 1.+ [23] De Peste, c. iv. annot. 6. [24] Evagrii Histor. Eccles. l. iv. c. 29. [25] Gastaldi De avertenda et profliganda Peste, p. 117. [26] Ibid. p. 118. [27] Ibid. p. 117. [28] See Bills of Mortality for the Year 1665. [29] The Sweating Sickness. [30] Nat. Hist. l. vii. c. 50. [31] Histor. l. ii. [32] Histor. Ecclesiast. l. iv. c. 29. [33] De Bello Persico, l. ii. c. 22. [34] Vid. Hodges De Peste. [35] Vid. Istorie di Matteo Villanni, l. I. c. 2. [36] Mezeray Hist. de France, Tom. i. p. 798. [37] Villani, loco citato. [38] Vid. Huet. Histoire du Commerce des Anciens, p. 88. [39] Relation Historique de tout ce qui s'est passe a Marseille pendant la derniere Peste. [40] Vid. Serv. Comment. in Virgil. AEneid, l. iii. v. 57. [41] This was a kind of _Expiatory Sacrifice_, as the _Scape-Goat_ among the Jews, _Levit._ xvi. And the Wretches thus devoted to dye for the Sins of the People were called +Katharmata+, _Purgations_. Vid. Aristophan. in Plut. ver. 454. et in Equit. ver. 1133. et Scholiast. ibid. _Suidas_ adds that when the Sacrificed Person was cast into the Water, these Words were pronounced, +Peripsema hemon genou+, _Be thou our Cleansing_. And I observe, by the by, that the Apostle _Paul_, 1 _Corinth._ iv. 13. alluding very probably to this wicked Custom, makes use of both these Words, where speaking of himself in the plural number, he says, +Hos perikatharmata tou kosmou egenethemen, panton peripsema+; for some of the best MSS. instead of +Os perikatharmata+, read +Hosper+, or +Hosperei katharmata+; that is, _We have been looked upon as Wretches fit only to be Sacrificed for the Public good, and cast out of the World by way of Attonement for the Sins of the whole Society._ [42] Vid. Le Brun Voyage au Levant, c. 38. [43] Vid. Ludolf. Histor. AEthiop. lib. i. c. 13. et D. August. De civitat. Dei, lib. iii. c. ult. [44] Vid. Ludolf. Histor. AEthiop. lib. i. c. 5. et Comment. [45] J. Leo Hist. Afric. lib. i. [46] Lib. vi. v 1100. [47] Rhas. et Avicen. [48] Essay on Poysons, p. 178. [49] Cicero de Nat. Deor. lib. i. Sec. 36. speaking of these Birds, says: _Avertunt Pestem ab Aegypto, cum volucres angues ex vastitate Libyae vento Africo invectas interficiunt atque consumunt; ex quo fit ut illae nec morsu vivae noceant, nec odore mortuae._ [50] Newton's Optics, Qu. 18 to 24. [51] Gastaldi, De Peste, p. 116. [52] Journal de ce qui s'est passe a Marseilles, _etc._ [53] Vid. The London Gazette, July 23, 1743. [54] Kircher, Langius, _&c._ [55] Toulon, Traite de la Peste. [56] _Hippocr._ Epid. l. iii. That _Hippocrates_ describes here the Constitution of Air accompanying the true _Plague_, contrary to what some have thought, _Galen_ testifies in his Comment upon this Place, in libr. De Temper. l. i. c. 4. and in lib. De differentiis Febr. lib. i. c. 4. [57] Vid. _Mercurial._ Praelect. De Pestilent. [58] Notitia Eccles. Diniensis. [59] Histor. lib. lxii. [60] Sydenham De Peste. [61] Vid. Caium, De Febr. Ephemer. Britan. and Lord _Bacon_'s History of _Henry_ VII. [62] Pag. 162. Edit. Lovan. [63] Vid. Rondinelli Contagio in Firenze, et Summonte Histor. di Napoli. [64] Lord _Herbert_'s History of _Henry_ VIII. [65] Thuani Histor. lib. 5. [66] Lord _Verulam_'s History of _Henry_ VII. [67] Vide Sydenham, De Peste, An. 1665. [68] Boccaccio Decameron. Giornat. prim. [69] De Contagione, l. iii. c. 7. [70] Observat. l. vi. Schol. ad Observ. 22. [71] Diemerbroeck, De Peste, l. 1. c. 4. [72] Memorials presented by the Deputies of the Council of Trade, in _France_, to the Royal Council, Pag. 44 and 45. [73] Alex. Benedict. De Peste, cap. 3. [74] In a Paper of Advice against the _Plague_, laid before the King and Council by Sir _Theod. Mayerne_ in the Year 1631. _MS._ [75] Hodges, De Peste. [76] Vid. _Directions for the Cure of the_ Plague _by the_ College _of_ Physicians; _and Orders by the_ Lord Mayor _and_ Aldermen _of_ London, _published_ 1665. [77] Vid. a Journal of the Plague in 1665. by a Citizen. London, 1722. [78] Discourse upon the Air, by _Tho. Cock_. [79] Vid. The shutting up Houses soberly debated, _Anno_ 1665. [80] Muratori governo della Peste, lib. I. c. 5. [81] Cardin. Gastaldi, De avertenda Peste, c. 10. [82] Journal de ce qui s'est passe a Marseilles, &c. p. 9, 10, 11. [83] De Pestilent. cap. 21. [84] Camden. Annal. Regin. Elizab. [85] Lord _Verulam_, Natural History, Cent. 10. Num. 194. [86] Plutarch lib. de Isid. et Osir. [87] De Peste, c. 22. [88] Hodges, De Peste, pag. 24. [89] Journal de la Peste de Marseilles, pag. 19. et Relation Historique de tout ce qui s'est passe a Marseilles pendant la derniere Peste, pag. 77. [90] Rhazes, De re Medica, lib. 4. c. 24. & Avicenn. Can. Med. lib. 4. c. 1. [91] Gaudereau Relation des Especes de la Peste que reconnoissent les Orientaux. [92] Mech. Account of Poisons, Essay III. [93] Notitia Ecclesiae Diniensis. [94] Vid. Observ. et Reflex. sur la Peste de Marseilles, p. 333. Transcriber's Notes: In the original text, the Preface is printed in italics. For ease of reading, non-italicized text in this section is represented by =text=. In the remainder of the text, passages in italics are indicated by _underscore_. Long "s" has been modernized. The original text includes Greek characters. For this text version these letters have been replaced with +transliterations+. The following misprints have been corrected: "Phsician" corrected to "Physician" (page 4) "that that" corrected to "that" (page 50) "Qarantaine" corrected to "Quarantaine" (page 92) "the the" corrected to "the" (page 95) Other than the corrections listed above, inconsistencies in spelling and hyphenation have been retained from the original. 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