A SHORT DISCOURSE CONCERNING Peſtilential Contagion, AND THE METHODS To be uſed to Prevent it.
By RICHARD MEAD, M. D. Fellow of the College of Phyſi⯑cians and of the Royal Society.
LONDON: Printed for Sam. Buckley in Amen-Corner, and Ralph Smith at the Royal-Exchange, 1720.
I Moſt humbly of⯑fer to You my Thoughts con⯑cerning the Pre⯑vention of the Plague, which I have put together []by your Command. As ſoon as you was pleaſed to ſig⯑nify to me, in his Majeſtie's Abſence; that their Excel⯑lencies 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 ra⯑ther put down the principal Heads of Caution, than a Set of Directions in Form.
[]THE firſt, which relate to the performing Qua⯑rentines, &c. You, who are perfectly verſed in the Hiſto⯑ry of Europe, will ſee are agreable to what is pra⯑ctiſed 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 A⯑broad: But, I perſuade my ſelf, will be found agre⯑able to Reaſon.
[]I moſt heartily wiſh, that the wiſe Meaſures, the Go⯑vernment has already ta⯑ken, 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 pro⯑vided with proper Means of Defence againſt ſo ter⯑rible an Enemy.
May this ſhort Eſſay be received as one Inſtance, a⯑mong many others, of the Care, you always ſhew for Your Country; and as a []Teſtimony of the great E⯑ſteem and Reſpect, with which I have the Honour to be,
THAT the Reaſonableneſs of any Method, which ſhall be propoſed to pre⯑vent the ſpreading of Con⯑tagious Diſeaſes, may the better ap⯑pear, it is neceſſary to premiſe ſome⯑what in general concerning Conta⯑gion, [2]and the Manner, by which it acts.
CONTAGION is propagated by three Cauſes, the Air; Diſeaſed Perſons; and Goods tranſported from infected Places.
WE ſhall therefore firſt enquire what alteration of the Air it is, that makes it inſections; and then, by what Means it communicates its noxious Quality to other Bodies.
THE ancienteſt and beſt Authors of Phyſick, who lived in a Coun⯑try more expoſed to theſe Calami⯑ties than ours, obſerved the Con⯑ſtitution of the Air, which preceded Peſtilential Fevers, to be great Heats attended with much Rain and South⯑erly Winds *: And one of Them takes particular Notice, that no o⯑ther [3]than a moiſt and hot Tempera⯑ment of the Air brings the Plague; and that the Duration of this Con⯑ſtitution is the Meaſure of the Vio⯑lence of the Diſtemper *.
THE Natural Hiſtory of ſeveral Countries confirms this Obſervati⯑on; in Africa particularly, if Show⯑ers fall during the ſultry Heats of July and Auguſt, the Plague enſues thereupon, with which whoſoever is infected hardly eſcapes †.
IT has beſides been remarked in all Times, that the Stinks of ſtag⯑nating Waters in hot Weather, pu⯑trid Exhalations from the Earth; and above all, the Corruption of dead Carcaſſes lying unburied, have occaſioned infectious Diſeaſes.
[4]FROM hence it appears to be a Concurrence of Cauſes, that pro⯑duces Diſeaſes of this Kind; which muſt not only meet, but exert their Force together for a conſiderable time. And when this happens, their firſt Effect is a Degree of Stag⯑nation in the Air, which is after⯑wards followed by Corruption and Putrefaction.
AND upon this account it is, that thoſe Countries are chiefly liable to theſe Calamities, where not only the Heats are very great, and the Weather continues long in the ſame State; but the Winds (the Uſe of which is by Motion to purify the Air) do not ſhift and change ſo of⯑ten as they do in Northern Climates.
INDEED Plagues ſeem to be of the Growth of the Eaſtern and Southern [5]Parts of the World, and to be tranſ⯑mitted from them into colder Cli⯑mates by the Way of Commerce. Nor do I think, that in this Iſland particularly there is any one In⯑ſtance of a Peſtilential Diſeaſe a⯑mong us of great Conſequence; which we did not receive from o⯑ther infected Places.
THIS I the rather mention, be⯑cauſe it is a common Opinion, and propagated by Authors of great Name, that we are uſually viſited with the Plague once in 30 or 40 Years; which is a mere Fancy with⯑out any Foundation either in Rea⯑ſon or Experience: and therefore People ought to be delivered from the Subjection to ſuch vain Fears.
ON the contrary, though we have had ſeveral Strokes of this kind, yet there are Inſtances of [6]bad Contagions from abroad being brought over to us, which have proved leſs malignant here by our Air not being diſpoſed to receive ſuch Impreſſions.
THE Sweating Sickneſs, called the Sudor Anglicus and Febris Ephemera Britannica, becauſe it was common⯑ly thought to have taken its Riſe here, was moſt probably of a foreign Original, and no other than a Plague abated in its Violence by the mild Temperament of our Climate.
FOR, we learn from Hiſtories, that the firſt time this was felt here, which was in the Year 1485, it be⯑gan in the Army, with which King Henry VII. came from France, and landed in Wales *; and it was then thought to have been brought [7]into France from the famous Siege of Rhodes by the Turks 3 or 4 Years before. And of the four Returns, which this has made ſince that Time; two, viz. thoſe in the Years 1527, and 1528, may very juſtly be ſuſpected to have been owing to the Peſtilence, which at thoſe Times raged in Italy, particularly at Flo⯑rence and Naples †. And the others were very probably from a Turkiſh Infection.
I call this Diſtemper a Plague with leſſened Force, becauſe the Symptoms of it were of that kind, though in a leſs Degree; as great Faintneſs and Inquietudes, inward Burning, Pain in the Head, a De⯑lirium &c. All which were accom⯑panied with profuſe Sweats, and the Diſeaſe laſted but 24 hours. And [8]though for want of Care and due Management many died of it; yet, as a learned and wiſe Hiſtorian * obſerves, It appeared rather to be a ſurprize of Nature than obſtinate to Remedies, for if the Patient was kept warm with temperate Cordials, he commonly recovered.
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 Sep⯑tember, which was called the Dun⯑kirk Fever, as being brought by our Soldiers from that Place; where it was indeed a Malignant Diſeaſe attended with a Diarrhaea, Vomit⯑ing, &c. and probably had its Ori⯑ginal from the Peſtilential Diſtem⯑per, which ſome time before broke [9]out at Dantzick and Hamburgh: But with us was much more mild, beginning only with a Pain in the Head, and by very eaſy Means went off in large Sweats, after a Day's Confinement.
THERE being in every Air a greater Diſpoſition to Contagion at one Time than another, we have indeed ſometimes felt this Calami⯑ty with greater Fury; as particular⯑ly the laſt time in the Year 1665; when it continued in this City a⯑bout ten Months, and ſwept away by computation 97306 Perſons: But it was generally allowed, that the Contagion came by Cotton im⯑ported from Turkey *; and the long Duration of it, I believe, may juſtly be charged up the unhappy Ma⯑nagement of infected Houſes, which [10]was then directed by Publick Au⯑thority; as I ſhall ſhew anon.
AND the Hiſtory of the moſt ter⯑rible of all the Plagues, that ever were in theſe Parts of the World, which was that in the Year 1349, gives a manifeſt Proof from whence all Europe may trace the Origine of theſe Evils, viz. from Aſia: for † This taking its Riſe in China in the Year 1346, advanced through the Eaſt Indies to Syria, Turkey, Aegypt, Greece, Africa, &c. In 1347 ſome Ships from the Levant carried it to Sicily, Piſa, Genoa, &c. In 1348 it got into Savoy, Provence, Dauphiny, Catalonia, Caſtile, &c. In 1349 it ſeized England, Scot⯑land, Ireland, and Flanders; and in the next place Germany, Hun⯑gary, and Denmark; and in all [11]theſe Countries made moſt incredi⯑ble Havock.
BUT to return to the Conſiderati⯑on of the Air, which we left in a putrid State: It is to be obſerved, that Putrefaction is a kind of Fer⯑mentation, and that all Bodies in a Ferment emit a volatile active Spi⯑rit, of Power to agitate, and put into inteſtine Motions, that is, to change the Nature of other Flu⯑ids into which it inſinuates it ſelf.
IT were eaſy to ſhew from the beſt Theory of Fevers *, how the Alterations made in the Blood this Way will favour Peſtilential Diſeaſes, by rendring the Body obnoxious to them: But the Digreſſion would be too great.
[12]THIS is one ſtep towards Conta⯑gion. The next, as it ſeems to me, proceeds after this Manner. The Blood in all Malignant Fevers, eſ⯑pecially Peſtilential ones, at the lat⯑ter End of the Diſeaſe, does like Fermenting Liquors throw off a great Quantity of active Particles upon the ſeveral Glands of the Bo⯑dy, particularly upon thoſe of the Mouth and Skin, from which the Secretions are naturally the moſt conſtant and large. Theſe, in Pe⯑ſtilential Caſes, although the Air be in a right State, will generally infect thoſe, who are very near to the ſick Perſon; otherwiſe are ſoon diſperſed and loſt: But when in an evil Diſpoſition of This they meet with the ſubtle Parts, its Corrup⯑tion has generated, by uniting with them they become much more active and powerful, and likewiſe [13]more durable and laſting, ſo as to form an Infectious Matter capable of conveying the Miſchief to a great Diſtance from the diſeaſed Body, out of which it was produced.
THEY who know what ſtrange Attractions and Combinations are made by volatile Spirits will under⯑ſtanding this Reaſoning; eſpecially if they conſider, how eaſily all kinds of Effluvia are diffuſed in a warm Air, ſuch as we have deſcribed an Infectious one to be; and further, of how penetrating a Force the fi⯑neſt Parts of Animal Juices are; of which the ſtrange Stench of a mor⯑tified Limb, upon a Body yet liv⯑ing, will convince any one.
A corrupted State of Air is with⯑out doubt neceſſary to give theſe Contagious Atoms their full Force; for otherwiſe it were not eaſy to [14]conceive how the Plague, when once it had ſeized any Place, ſhould ever ceaſe, but with the Deſtructi⯑on of all the Inhabitants: Which is readily accounted for by ſuppo⯑ſing an Emendation of the Quali⯑ties of the Air, and the reſtoring of it to a healthy State capable of diſſipating and ſuppreſſing the Ma⯑lignity.
ON the other hand it is evident, that Infection is not received from the Air it ſelf, however prediſpoſed, without the Concurrence of ſome⯑thing emitted from Infected Per⯑ſons; becauſe, by ſtrictly prevent⯑ing all Intercourſe of Infected Pla⯑ces with the Neighbourhood, it may be effectually kept from ſpreading: Whereas the leaſt Wind muſt ne⯑ceſſarily convey whatever noxious Quality reſides in the Air alone, even to a great Diſtance. Of this [15]we have had a freſh Proof in the preſent unhappy Plague in France, which, by keeping careful Guard, was confined for a conſiderable Time within the Walls of Mar⯑ſeilles; ſo that none of the adja⯑cent Villages ſuffered any thing by it; till at length ſome Perſons finding Means to eſcape carried the Infection along with them. And we find, they have been able, by the like Care, ſtill to reſtrain it within moderate Bounds.
THIS is the Manner by which Infectious Effluvia are generated: The Way, by which a ſound Perſon receives the Injury, I ſuppoſe moſt commonly to be this. Theſe Conta⯑gious Particles being drawn in with the Air we breath, they taint in their Paſſage the Salival Juices, which being ſwallowed down into the Stomach preſently fix their Ma⯑lignity [16]there; as appears from the Nauſea and Vomiting, with which the Diſtemper often begins its firſt Attacks. Though I make no Que⯑ſtion but the Blood is alſo more im⯑mediately affected by hurtful Parti⯑cles being mixed through Inſpiration with it in the Lungs.
THE third Way, by which we mentioned Contagion to be ſpread, is by Goods tranſported from infected Places. It has been thought ſo dif⯑ficult to explain the Manner of this, that ſome Authors have ima⯑gined 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. As this is a ſuppoſition grounded upon no manner of Obſervation, ſo I think there is no need to have Re⯑courſe to it. If, as we have con⯑jectured, [17]the Matter of Contagion be an active Subſtance, perhaps in the Nature of a Salt, generated chiefly from the Corruption of a Humane Body, it is not hard to conceive how this may be lodged and preſerved in ſoft, porous Bo⯑dies, 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 great⯑eſt Part of which are likewiſe of [18]the Animal Kind; which Remark alone may ſerve to lead Us a little into the true Nature of Contagion.
FROM all that has been ſaid, it appears, I think, very plainly, that the Plague is a real Poiſon, which being bred in the Eaſtern or South⯑ern Parts of the World, maintains it ſelf there by circulating from In⯑fected Perſons to Goods; which is chiefly owing to the Negligence of the People in thoſe Countries, 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 ano⯑ther, and Contagious Matter is lodg⯑ed in Goods of a looſe and ſoft Texture, which being packt up, and carried into other Countries, let out, when opened, the impri⯑ſoned [19]Seeds of Contagion: And laſtly, That the Air cannot diffuſe and ſpread theſe to any great Di⯑ſtance, if Intercourſe and Commerce with the Place infected be ſtrictly prevented.
AS it is a ſatisfaction to know, that the Plague is not a Native of our Coun⯑try, ſo this is likewiſe an Encouragement to the utmoſt Dili⯑gence in finding out Means to keep our ſelves clear from It.
[21]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 Quaren⯑tine: As to which I think it neceſ⯑ſary, that the following Rules be obſerved.
NEAR to our ſeveral Ports, there ſhould be Lazarettos built in con⯑venient 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 Quarentine on board the Ship being not ſuffi⯑cient; [22]the only Uſe of which is to obſerve whether any dye among them. For Infection may be pre⯑ſerved ſo long in Cloaths, in which it is once lodged, that as much, nay more of it, if Sickneſs conti⯑nues in the Ship, may be brought on Shoar at the End than at the be⯑ginning of the 40 Days: Unleſs a new Quarentine 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 Contagi⯑ous Diſtemper in the Ship; The Sound Men ſhould leave their Cloaths; which ſhould be burnt; the Men waſhed and ſhaved; and having freſh Cloaths, ſhould ſtay in the Lazaretto 30 or 40 Days. The reaſon of this is, becauſe Per⯑ſons may be recovered from a Di⯑ſeaſe themſelves, and yet retain [23] Matter of Infection about them a conſiderable Time; as we fre⯑quently ſee the Small-Pox taken from thoſe, who have ſeveral Days before paſſed through the Diſtem⯑per.
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 Cloaths; whatever they wore while Sick be⯑ing burnt: And then being remov⯑ed to the Houſes of the Sound, ſhould continue there 30 or 40 days.
I am particularly careful to de⯑ſtroy the Cloaths of the Sick, be⯑cauſe they Harbour the very Quint⯑eſſence of Contagion. A very inge⯑nious Author * in his admirable [24]Deſcription of the Plague at Flo⯑rence 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 tear⯑ing them with their Teeth, fell into Convulſions, and dyed in leſs than an Hour.
IF there has been no Sickneſs in the Ship, I ſee no reaſon why the Men ſhould perform Quarentine. Inſtead of this, they may be waſhed, and their Cloaths aired in the La⯑zaretto, as Goods, for one Week.
But the greateſt Danger is from ſuch Goods, as are apt to retain In⯑fection, ſuch as Cotton, Hemp and Flax, Paper or Books, Silk of all ſorts, Linen, Wool, Feathers, Hair, and all kinds of Skins. The Laza⯑retto [25]for theſe ſhould be at a Di⯑ſtance from that for the Men, and they muſt in convenient Ware⯑houſes be unpackt, and expoſed, as much as may be, to the freſh Air for 40 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: Unleſs there could be a Way found out, without hazard⯑ing Men's Lives, of trying when Bodies have done emitting the Noxious Fumes; which poſſibly might be done by putting tender Animals near to them, particularly by ſetting little Birds upon the ex⯑poſed Goods; becauſe it has been obſerved in Times of the Plague, that the Country has been forſaken [26]by the Birds; and thoſe kept in Houſes have many of them dyed *. But the Uſe of this Fancy Expe⯑rience only muſt ſhew; for I am well aware, that all Plagues do not indifferently affect all Kinds of liv⯑ing Creatures; on the contrary, moſt are confined to a particular Species of them; like the Diſeaſe of the Black Cattle a few Years ſince, which neither proved Infectious to other Brutes, nor to Men.
I take it for granted, that the Goods ſhould be opened, when they are put into the Lazaretto, other⯑wiſe their being there will avail nothing. The Misfortune, which happened in the Iſland of Bermudas about 25 Years ſince, gives a Proof of this; where, as the Account [27]has been given me by the learned Dr. Halley, a Sack of Cotton, put on Shoar 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 ſuf⯑ficed to bury the Dead.
INDEED as it has been frequently experienced, that of all the Goods, which harbour Infection, Cotton in particular is the moſt dangerous, and Turkey 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 Quarentine; becauſe it may have imbibed In⯑fection at the Time of its packing up, notwithſtanding no Miſchief [28]has been felt from it by the Ship's Company.
As all reaſonable Proviſions ſhould be made both for the Sound and Sick, who perform Quarentine; ſo the ſtrict keeping of it ought to be inforced by the ſevereſt Penalties. And if a Ship come 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 Burn all the Goods, and even the Ship.
NOR ought this further Caution to be omitted, That when the Con⯑tagion 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 In⯑ſtances of the Diſtemper's being ſtopt by the Winter Cold, and yet the Seeds of it not deſtroyed, but [29]only kept unactive, till the Warmth of the following Spring has given them new Life and Force. Thus in the great Plague at Genoa near 60 Years ago, which continued part of two Years; the firſt Sum⯑mer about 10000 dyed; the Win⯑ter following hardly any; but the Summer after no leſs than 60000. So likewiſe the laſt Plague at Lon⯑don began the Autumn before the Year 1665, and was ſtopt during the Winter by a hard Froſt of near three Month's Continuance; ſo that there remained no further Ap⯑pearance of it till the enſuing Spring *. Now if Goods brought from ſuch a Place ſhould retain a⯑ny of the latent Contagion, there will be Danger of their producing the ſame Miſchief in the Place, to which they are brought, as they [30]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 Ri⯑gour; from which wicked Practice I ſhould at this Time apprehend more Danger of bringing the Di⯑ſeaſe from France, than by any o⯑ther Way whatſoever.
THESE are, I think, the moſt material Points, to which Regard is to be had in defending ourſelves againſt Contagion from other Coun⯑tries. The particular Manner of putting theſe Directions in Execu⯑tion, as the Viſiting of Ships, Re⯑gulation of Lazaretto's, &c. I leave to proper Officers, who ought ſometimes to be aſſiſted herein by able Phyſicians.
[31]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 be⯑fall us.
THERE is no Evil in the World, in which the great Rule of Reſiſt⯑ing 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 cer⯑tain, that the Directions of the Civil Magiſtrate ought to be ſuch, as to make it as much for the In⯑tereſt of Families to diſcover their [32]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 Puniſh⯑ment, rather than of a Compaſſi⯑onate Care: Which muſt naturally make the Infected conceal the Diſ⯑eaſe as long as was poſſible.
THE main Import of the Orders iſſued out at theſe Times was, As ſoon as it was found, that any Houſe was infected, to keep it ſhut up, with a large red Croſs, and Lord have Mercy upon us on the Door; and Watchmen attending Day and Night to prevent any one's going in or out, except Phyſicians, Surge⯑ons, Apothecaries, Nurſes, Search⯑ers, &c. allowed by Authority: And this to continue at leaſt a [33]Month after all the Family was dead or recovered *.
IT is not eaſy to conceive a more diſmal Scene of Miſery, than this; Families ſeized with a Diſtemper, which the moſt of any in the World requires Help and Comfort, lockt up from all their Acquaint⯑ance; left it may be to the Treat⯑ment 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, and thoſe mixed with Anxiety and Doubt, whether it be not better to Dye, than to ſurvive the Loſs of their beſt Friends, and neareſt Relations.
[34]IF Fear, Deſpair, and all De⯑jection 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 enforced, than by ſuch a Treatment.
NOTHING can juſtify ſuch Cruel⯑ty, but the Plea, that it is for the Good of the whole Community, and prevents the ſpreading of In⯑fection. But this upon due Conſi⯑deration will be found quite other⯑wiſe: For while Contagion is kept nurſed up in a Houſe, and conti⯑nually encreaſed by the daily Con⯑queſts it makes, it is impoſſible but the Air ſhould by Degrees become tainted, which by opening Win⯑dows, &c. will carry the Malig⯑nity firſt from Houſe to Houſe; [35]and then from one Street to ano⯑ther. The ſhutting up Houſes in this Manner is only keeping ſo ma⯑ny 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 practiſ⯑ed in this City: And no doubt they have had as ill Effects in o⯑ther Countries.
IT is therefore no wonder, that great Complaints were ſometimes [36]made here againſt this unreaſona⯑ble Uſage; which, when they pre⯑vailed ſo far, as to procure ſome Releaſe for the Sick, were remark⯑ably followed with an Abatement of the Diſeaſe. The Plague in the Year 1636 began with great Vi⯑olence, but Leave being given by the King's Authority for People to quit their Houſes; it was ob⯑ſerved, That not one in twenty of the well Perſons removed fell Sick, nor one in ten of the Sick dyed *. Which ſingle Inſtance alone, had there been no other, ſhould have been of Weight ever after to deter⯑mine the Magiſtracy againſt too ſtrict Confinements. But beſides this, a preceding Plague, viz. in the Year 1625, affords us another In⯑ſtance of a very remarkable De⯑creaſe upon the diſcontinuing to [37] 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 per⯑mitted was no Impediment to it: For this opening of the Houſes was allowed of in the beginning of Sep⯑tember; and whereas the laſt Week in Auguſt, there dyed no leſs than 4218, the very next Week the Burials were diminuiſhed to 3344, and in no longer time than to the fourth Week after, to 852 *.
SINCE therefore the Management in former Times neither anſwers the Purpoſe of diſcovering the Be⯑ginning of the Infection, nor of put⯑ting [38]a ſtop to it when Diſcovered, other Meaſures are certainly to be taken; which I think ſhould be of this Nature.
INSTEAD of ignorant old Women, who are generally appointed Search⯑ers in Pariſhes to enquire what Diſ⯑eaſes People dye of, That Office ſhould be committed to Under⯑ſtanding and Diligent Men, whoſe Buſineſs it ſhould be, as ſoon as they find any have dyed after an uncommon Manner, particularly with livid Spots, Buboes, or Car⯑buncles, to give Notice thereof to the Magiſtrates; who ſhould im⯑mediately ſend skilful Phyſicians to Viſit the Houſes in the Neighbour⯑hood, eſpecially of the Poorer ſort, among whom this Evil generally begins; and if upon their Report it appears, that a Peſtilential Di⯑ſtemper is broke out among the In⯑habitants, [39]They ſhould without Delay order all the Families, in which the Sickneſs is, to be Re⯑moved; The Sick to different Pla⯑ces 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 Cloaths, and waſhed and ſhaved, before they go into their new Lodg⯑ings.
NO Manner of Compaſſion and Care ſhould be wanting to the Diſ⯑eaſed; to whom, being now 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 coun⯑terbalanced with the ſaving a Nati⯑on from the greateſt of Calamities. Nor does it ſeem to me at all un⯑reaſonable, [40]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 o⯑vercoming it.
WHEN the Sick Families are gone, all the Goods of the Houſes, in which they were, ſhould be burnt; nay the Houſes themſelves; if that can conveniently be done. And after this all poſſible Care ought ſtill to be taken to remove whatever Cauſes are found to breed and pro⯑mote 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 Inha⯑bitants, and where they find [41]them ſtifled up too cloſe and naſty, ſhould leſſen their Number by ſend⯑ing ſome into better Lodgings, and ſhould take Care, by all Man⯑ner of Proviſion and Encourage⯑ment, 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 Contagion, 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 this, in which very few eſcape, what they call the Goal Fever, which is always at⯑tended with a Degree of Maligni⯑ty [42]in proportion to the Cloſeneſs and Stench of the Place: And it would certainly very well become the Wiſ⯑dom of the Government, as well with Regard to the Health of the Town, as in Compaſſion to the Pri⯑ſoners, 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 Aſſize at Oxford, held in the Caſtle there in the Year 1577, will never be forgot *; at which the Judges, Gentry, and almoſt all that were preſent, to the Number of 300, were killed by a poyſonous Steam, thought by ſome to have broke forth from the Earth; but by a noble and great Philoſopher † [43]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 pro⯑per Officers ſhould be ſtrictly charg⯑ed 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. Beggars and Idle Perſons ſhould be taken up, and ſuch miſerable Ob⯑jects, as are neither fit for the common Hoſpitals, nor Work-houſes, ſhould be provided for in an Hoſ⯑pital of Incurables.
ORDERS indeed of this kind are neceſſary to be obſerved at all times, [44]eſpecially in populous Cities; and therefore I am ſorry to take No⯑tice, that in theſe of London and Weſtminſter there is no good Po⯑lice 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, take Effect, 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, Regard muſt be had.
As to the firſt; Fire has been al⯑moſt univerſally recommended for this Purpoſe, both by the Anci⯑ents and Moderns; who have ad⯑viſed to make frequent and nume⯑rous [45] Fires in the Towns infected: By which Means, it is ſaid, Hip⯑pocrates preſerved Greece from a Plague, which was entring into it from Aethiopia *. And it is cer⯑tain, that ſome evil Diſpoſitions of the Air, particularly ſuch as pro⯑ceed from Damps, Exhalations, &c. may be corrected by Fire, and the Prediſpoſition of it to receive Infection from theſe Cauſes ſometimes removed. But when the Diſtemper is actually begun, and rages, ſince it is known to be ſpread and increaſed by the Heat of the Summer, and on the con⯑trary checked by the cold in Win⯑ter; undoubtedly, whatever increaſes that Heat will ſo far add Force to the Diſeaſe. Whether the Service Fires may do by correcting any other ill Qualities of the Air will [46]counterbalance the Inconvenience upon this Account, Experience on⯑ly can determine; and the Fatal ſucceſs of the Tryals made here in the laſt Plague, is more than ſufficient to diſcourage any further Attempts of this Nature; for Fires being ordered in all the Streets for three Days together, there dyed in one Night following no leſs than 4000; whereas in any ſingle Week before or after, not much above three times that Number were car⯑ryed off †.
WHAT has been ſaid of Fires, is likewiſe to be underſtood of firing of Guns, which ſome have too raſh⯑ly adviſed. The proper Correcti⯑on of the Air would be to make it freſh and cool. Accordingly the [47] Arabians *, who were beſt acquaint⯑ed with the Nature of Peſtilences, adviſe People to keep themſelves as airy as poſſible, and to chuſe Dwellings expoſed to the Wind.
FOR keeping Houſes cool, they took to be the beſt Method of purifying them; and therefore to anſwer this End more fully, they directed to ſtrew them with cooling Herbs, as Roſes, Violets, Water-Lillies, &c. and to be waſhed with Water and Vinegar; than all which, eſpecially the laſt, nothing more proper can be propoſed: Though it be directly contrary to what Mo⯑dern Authors moſtly adviſe, which is to make Fumes with hot Things, as Benzoin, Frankincenſe, Aſa Foe⯑tida, Storax, &c. from which I ſee no reaſon to expect any Virtue [48]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. It is of more Conſequence to be obſerved, that as Naſtineſs is a great Source of Infection, ſo Clean⯑lineſs is the greateſt Preſervative: Which is the true Reaſon, why the Poor are moſt obnoxious to Diſ⯑aſters of this Kind.
THE next thing after the purifying of Houſes, is to conſider by what Means particular Perſons may beſt defend themſelves againſt Contagi⯑on; for the effectual 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 [49]done, will be to keep the Body in ſuch Order, that it may ſuffer as little as poſſible. The firſt Step to⯑wards 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 Dejecti⯑on of Spirits, and immoderate Paſ⯑ſions; for theſe we daily obſerve do expoſe Perſons to the more com⯑mon Contagion of the Small-Pox. Theſe Ends will be beſt anſwered by living with Temperance upon a good generous Diet, and avoiding Faſtings, Watchings, extreme Weari⯑neſs, &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. [50]The moſt proper Means for this, according to the Advice of the Arabian Phyſicians, is the repeat⯑ed Uſe of acid Fruits, as Pomegra⯑nates, Sevil Oranges, Lemons, tart Apples, &c. But above all of Wine-Vinegar in ſmall Quantities, ren⯑dered grateful to the Stomach by the Infuſion of ſome ſuch Ingre⯑dients as Gentian Root, Galangal, Zedoary, Juniper Berries, &c. Which Medicines by correcting the Vine⯑gar, and taking off ſome ill Effects it might otherwiſe have upon the Stomach, will be of good Uſe: But theſe, and all other hot Aro⯑matic Drugs, though much recom⯑mended by Authors, if uſed alone, are moſt likely to do hurt by over heating the Blood.
BUT ſince none of theſe Methods promiſe any certain Protection; as [51] 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 Recover⯑ed. For the greater Security here⯑in, it will be adviſable 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 them⯑ſelves for ſome time, before they appear abroad.
THE Advice to keep at a Di⯑ſtance 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. They ſhould likewiſe be carried out [52]in the Night, while they are yet freſh and free from Putrefaction: Becauſe a Carcaſs not yet begin⯑ning to Corrupt, if kept from the Heat of the Day, hardly emits any kind of Steam or Vapour.
As for thoſe, who muſt of ne⯑ceſſity attend the Sick; ſome fur⯑ther Directions ſhould be added for their Uſe. Theſe may be com⯑prehended 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 con⯑cerning the Manner, in which a ſound Perſon receives the Infecti⯑on.
[53]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 par⯑ticularly 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, is to caſt up a Line about the Town inſected, at a convenient Diſtance; and by placing a Guard, to hin⯑der People's paſſing from it with⯑out due Regulation, to other Towns: But not abſolutely to for⯑bid any to withdraw themſelves, as they have now done in France, ac⯑cording to the uſual Practice abroad; [54]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 per⯑form Quarentine for about 20 Days in Tents, or other more conveni⯑ent Habitations. But the greateſt Care muſt be taken, that none paſs without conforming themſelves to this Order, both by keeping di⯑ligent Watch, and by puniſhing with the utmoſt Severity, any that ſhall either have done ſo, or at⯑tempt it. And the better to diſco⯑ver ſuch, it will be requiſite to o⯑blige all, who travel in any Part of the Country, under the ſame Penalties, to carry with them Cer⯑tificates either of their coming from Places not Infected, or of their paſ⯑ſing the Line by permiſſion.
[55]THIS I take to be a more effectu⯑al 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 At⯑tempts; as we ſee fell out in France notwithſtanding all their Care. But one that gets off thus clandeſtine⯑ly, will be more like to carry the Diſtemper with him, than twenty, nay a hundred, that go away un⯑der the preceding Reſtrictions: E⯑ſpecially becauſe the Infection of the Place, he flies from, will by this Management be rendered much [56]more intenſe. For confining Peo⯑ple, and ſhutting them up together in great Numbers, will make the Diſtemper rage with augmented Force, even to the increaſing it be⯑yond what can be eaſily imagin⯑ed; As appears from the Account, which the learned Gaſſendus * has given us of a memorable Plague, which happened at Digne in Pro⯑vence, where he lived, in the Year 1619. This was ſo terrible, that in one Summer out of ten thouſand Inhabitants, it left but fifteen hun⯑dred, and of them all but five or ſix had gone through the Diſeaſe. And he aſſigns this, as the princi⯑pal Cauſe of the great Deſtruction, That the Citizens were too cloſely confined, and not ſuffered ſo much as to go to their Country Houſes. [57]Whereas in another Peſtilence, which broke out in the ſame Place a year and half after, more Liberty being allowed, there did not dye 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: But 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 Mate⯑rials retentive of Infection. For in the preſent Caſe, when In⯑fection has ſeized any Part of a Country, much greater Care ought to be taken, that no Seeds of the Contagion be conveyed about, than [58]when the Diſtemper is at a great Diſtance; becauſe a Bale of Goods, which ſhall have imbibed the Con⯑tagious Aura when packt up in Turkey, or any remote Parts; yet, when unpackt here, may chance to meet with ſo healthful a Tempe⯑rament 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 ſpread and maintain 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 Quaren⯑tines ſhould more ſtrictly be en⯑joined, when the Plague is in a bordering Kingdom, than when it [...]s more remote.
[59]I have gone through the chief Branches of Preſervation againſt the Plague. And ſhall only add, that if the Burning of Goods, which has been propoſed, be thought a⯑ny Way offenſive or inconvenient, The Burying of them ſix Feet, or more, under Ground may anſwer the Purpoſe as well.
WHAT has been ſaid of the Na⯑ture of Contagion, upon which the foregoing Directions are grounded, may alſo be of Uſe towards e⯑ſtabliſhing a better Method of Cure, than Authors have common⯑ly taught: But to engage in this is beyond the preſent Deſign.