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 Diarrhœa, 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, | Haarbourg, twice. | |
| Zell, | ||
| Villages. | ||
| Nienfeldt, | Trebel, | |
| Holdenstedt, | Brinckem, | |
| Melle, | Goldenstedt, | |
| Bienenbuttel, | Fallingbostel. | |
| Achem, | ||
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.