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MARSEILLES,
Its Prognosticks and Method of Cure.
o give some Satisfaction to the just Expectations of very many Persons, as well of this Realm as of foreign Countries, who fearing the dismal Effects of the Contagion, have done us the Honour to request of us some Account of the Nature of the Distemper that has depopulated Marseilles, and of the Success of such Remedies as we have employed against it; we have thought fit to draw up the following Relation, containing in short what is most essential in this Affair, and which may be sufficient to intelligent Persons of the Faculty, to direct their Conduct, and help them in framing a Judgment in the like Case, till we have better Means and a more convenient Leisure to present to the Publick more exact Particulars of all that we have observed on this Subject.
All the Diseased that we have seen or attended, in this terrible Distemper, commonly called the Plague, may be reduced to five principal Classes; which will take in generally all the Cases that we have observed, except a few particular ones, which cannot be brought under any general Rule.
First Class.
The First Class, observed especially in the first Period, and in the greatest Fury of the Distemper, contains such as were afflicted with the Symptoms that we shall here set down, constantly followed by a speedy Death.
These Symptoms were for the most part irregular Shiverings, the Pulse low, soft, slow, quick, unequal, concentrated; a Heaviness in the Head so considerable, that the sick Person could scarce support it, appearing to be seized with a Stupidity and Confusion, like that of a drunken Person; the Sight fixed, dull, wandering, expressing Fearfulness and Despair; the Voice slow, interrupted, complaining; the Tongue almost always white, towards the end dry, reddish, black, rough; the Face pale, Lead-coloured, languishing, cadaverous; a frequent Sickness at the Stomach; mortal Inquietudes; a general sinking and Faintness; Distraction of the Mind; dosing, an Inclination to vomit, Vomiting, &c.
The Persons thus seized, perished commonly in the Space of some Hours, of a Night, of a Day, or of two or three at farthest, as by Faintness or Extinction; sometimes, but more rarely, in convulsive Motions, and a Sort of Trembling; no Eruption, Tumour or Spot appearing without.
It is easy to judge by these Accidents, that the Sick of this kind were not in a Condition to bear Bleeding; and even such, on whom it was tried, died a little while after.
Emeticks and Catharticks were equally here useless, and often hurtful, in exhausting the Patient’s Strength, by their fatal over-working.
The Cordials and Sudorificks were the only Remedies to which we had recourse, which nevertheless could be of no Service, or at the most prolong the last Moments but for a few Hours.
Second Class.
The second Class of the Diseased that we attended during the Course of this fatal Sickness, contains such as at first had the Shiverings, as the preceding, and the same sort of Stupidity, and heavy Pain in the Head; but the Shiverings were followed by a Pulse quick, open, and bold, which nevertheless was lost upon pressing the Artery ever so little. These Sick felt inwardly a burning Heat, whilst the Heat without was moderate and temperate; the Thirst was great and inextinguishable; the Tongue white, or of an obscure red; the Voice hasty, stammering, impetuous; the Eyes reddish, fixed, sparkling; the Colour of the Face was of a red sufficiently fresh, and sometimes inclining to livid; the Sickness at the Stomach was frequent, tho’ much less than in those of the preceding Class; the Respiration was frequent, laborious, or great and rare, without Coughing or Pain; Loathings; Vomitings, bilious, greenish, blackish, bloody; the Courses of the Belly of the same Sort, but without any Tension or Pain; Ravings, or phrenetick Deliria; the Urine frequently natural, sometimes troubled, blackish, whitish, or bloody; the Sweat, which seldom smelt badly, and which was far from giving Ease to the Sick, that it always weakned them; in certain Cases Hemorrhages, which, however moderate, have been always fatal; a great Decay in the Strength, and above all, an Apprehension so strong of dying, that these poor Creatures, were incapable of any Comfort, and looked on themselves, from the first Moment of their being attacked, as destined to certain Death. But that which deserves to be well observed, and which has always seemed to characterise and distinguish this Disease from all others, is, that almost all had at the Beginning, or in the Progress of this Distemper, very painful Buboes, situated commonly below the Groin, sometimes in the Groin or Arm-pits, or in the Parotide, Maxillar, or jugular Glands; as likewise Carbuncles, especially on the Arms, Legs or Thighs, small, white, livid, black Pustles, dispersed over all the Surface of the Body.
It was very rare to see any of the diseased of this Second Class escape, though they supported themselves a little longer than those of the preceding; they perished almost all with the Marks of a gangren’d Inflammation, especially in the Brain and Thorax; and that which was most singular is, that the stronger, fatter, fuller, and more vigorous they were, the less we had to hope.
As to the Remedies, they bore Bleeding no better than those of the First Class; at least if they were not blooded at the very first Instant of their being taken Sick: It was evidently hurtful to ’em; they grew pale, and fell even in the time of their first Bleeding, or a little while after, into such Faintings, as could not in most of them be imputed to any Fear, Repugnance, or Distrust, since they demanded with Earnestness to have a Vein opened.
All Emeticks, if we except Ipecacuanha, were very often more hurtful than useful; causing such fatal Irritations and Excesses in operating, as we could neither moderate or stop.
The Catharticks that were a little strong and active, were attended with the same Inconveniences.
Such as we prescribed in the Form of a laxative Ptisan, as well as plentiful Draughts, that were diluting, nitrous, cooling, and gently alexiterial, gave some Relief, but did not hinder the Return of the Symptoms.
All Cordials and Sudorificks, if they were not soft, gentle and benign, did nothing but promote the Progress of the inward Inflammations.
In short, if any one escaped, which was very rare, he seem’d to owe his Cure to the external Eruptions, when they were very much raised; either solely by the Force of Nature, or by the Assistance of Remedies, as well internal as external, that determined the Blood to discharge on the Surface of the Body, the noxious Ferment wherewith it was infected.
Third Class.
The Third Class contains the two preceding; seeing we have attended, during the Course of this terrible Sickness, a great Number of Persons that have been attacked successively with the different Symptoms enumerated in the two former Classes, in such a manner, that the most part of the Signs described in the Second, were commonly the Forerunners of those which we have mentioned in the First; and the appearing of these latter Symptoms denounced an approaching Death.
In these sorts of Cases we varied our Method according to the diversity of Indications, or of the most urgent Symptoms; so that without our being obliged to enter into farther Particulars, a Judgment may be formed of the Event of this Malady, and of the Success of the Remedies, from what we before observed on the Subject of the diseased of the two preceding Classes.
Before we pass on to the Fourth Class, we believe it will not be improper to observe, that a very great Number of different Kinds of diseased Persons contained in the preceding, had very moderate Symptoms, whose Force and Malignity appeared to be much less, than in those of the same Accidents daily observed in inflammatory Fevers, or in the most common putrid ones, or in those that are vulgarly called Malignant, if we except the Signs of Fear or Despair, which were Extream, or in the highest Degree; insomuch, that of the great Number of infected Persons who have perished, there were very few, who at the very first Moment of their being seized, did not imagine themselves lost without Relief, whatever Pains we took to encourage them: And though many amongst them seemed to us, before the first Access of the Distemper, to be of a firm and courageous Disposition of Mind, and resolute under all Events, yet as soon as they felt the first Strokes, it was easy to know by their Looks, and their Discourses, that they were convinced that their Sickness was Incurable and Mortal, even at the Time when neither the Pulse, nor the Tongue, nor the Disorder in the Head, nor the Colour of the Face, nor the Disposition of the Mind, nor lastly, the Lesion of any of the other natural Functions mentioned above, gave any fatal Indication, or before there were any Grounds to be allarmed.
Fourth Class.
The fourth Class contains the Diseased attacked with the same Symptoms with those of the second, but these sorts of Accidents lessened or disappeared the second or third Day of themselves, or in Consequence of the Effects of the internal Remedies, and at the same time in Proportion to the remarkable Eruption of the Buboes and Carbuncles in which the noxious Ferment that was dispersed through the whole Mass, seemed to be collected together; so that the Tumours rising from Day to Day, at length being open, and coming to a Suppuration, the Infected escaped the Danger that threatned them, provided they had some Assistance.
These happy Events have determined us to redouble our Care during the whole Course of this Sickness, to accelerate, as much as the State of the Patient will admit, the Eruption, Elevation, Opening, and Suppuration of the Buboes and Carbuncles, in order to free, as soon as possible, by this way, the Mass of Blood, from the fatal Ferment that corrupts it; aiding Nature by a good Regimen, and by such cathartick, cordial, and sudorifick Medicines, as are proper in the present Condition and Temperature of the Sick.
Fifth and Last Class.
This Fifth and Last Class contains all such infected Persons, as without perceiving any Emotion, or there appearing any Trouble or Lesion of their natural Function, have Buboes and Carbuncles, which rise by little and little, and easily turn to Surpuration, becoming sometimes scirrhous, or which is more rare, dissipate insensibly, without leaving any bad Effect behind them; so that without any loss of Strength, and without changing their manner of Living, these infected Persons went about the Streets and publick Places, only using themselves a simple Plaister, or asking of the Physicians and Surgeons such Remedies as are necessary to these sorts of suppurating or scirrhous Tumours.
The Number of the infected contained in the two last Classes, were so considerable, that one may affirm, without any exaggeration, that more than fifteen or twenty Thousand Persons were found in these sorts of Cases; and if the Distemper had not often taken this turn, there would not have been left in this City the fourth Part of its Inhabitants.
We may very well admit a Sixth Class of such as we have seen perish without any Forerunner, or other manifest Hurt, than only a decay in Strength; and who being asked concerning their Condition, answered, that they were not sensible of any Disorder, which for the most part denoted a desperate Case, and an approaching Death; but the Number of these were very small in Comparison of such as made up the preceding Classes.
Besides all these Observations, it has happened that amongst so great a Number of infected Persons, we have seen many particular Cases, wherein, contrary to our Expectation, and all the Appearance of Reason, the Sick have perished or recovered; but we are of Opinion that it would be useless to relate them here, and to give of them a long and tedious Account; being moreover persuaded that these Sorts of particular Events can serve as no sure Rule to form a Prognostick, or how to proceed in the like Distemper. It is therefore more proper to keep to the Observations we have made, and that the rather, since they are found conformable to those of our Collegues who have laboured in concert with us in this so painful and dangerous Work; and who have always professed to relate what they have seen and observed themselves, without suffering themselves to be prejudiced by all the Reports that a vain Credulity, a popular Superstition, the Boastings of Empericks, and the Greediness of making Profit by the publick Calamity, have spread through this City.
To conclude, the Medicines we have made use of are such, whose Efficacy and manner of Operation, are generally acknowledged by a long Experience, to be adapted to satisfy all the Indications reported above; having moreover not neglected certain pretended Specificks, such as the solar Powder, the mineral Kernes, Elixirs, and other alexiterial Preparations, as have been communicated to us by charitable and well-disposed Persons; but Experience itself has convinced us, that all these particular Remedies are at the most useful only to remove some certain Accidents, when at the same time they are often noxious in a great many others, and by consequence incapable to cure a Disease characterised by a Number of different essential Symptoms.
