Virgil mentions the infectious nature of certain diseases of cattle. (Ecl. i, Georg. iii, 464.) The ancient writers on veterinary surgery and agriculture in like manner state that the plague and scabies of cattle are infectious. See Columella (vi, 5); Vegetius (Mulomed. iii, 23.)
The philosopher Marcus Antoninus alludes to the plague as being contagious. (ix, 2.) Chrysostom does the same. (In Joan. Orat. lvii.) The language of Seneca is very precise: “Itaque ut in pestilentiâ cavendum est ne corruptis jam corporibus et morbo flagrantibus assideamus, quia pericula trahemus, afflatuque ipso laborabimus.” (De Tranquil. vii.) To these we may join Isidorus Hispalensis, a much later writer: “Pestilentia est contagium quod quum unum apprehenderit celeriter ad plures transit.” And, in another place: “Pestilentia est morbus latè vagans et contagio suo quæ contigerit interimens.” Alexander Aphrodisiensis intimates that pestilential fevers are contagious, but common fevers not so. (Probl. ii, 42.)
Aretæus appears to be the first medical author who alludes to contagion in unequivocal terms. He says of elephantiasis, that it is as infectious as the plague, being communicated by respiration. Cælius Aurelianus, who was probably nearly contemporary with him, mentions as contagious diseases the plague, incubus, hydrophobia, and elephantiasis. Galen expresses his sentiments on the contagious nature of certain diseases in the following terms: “That a pestilential state of the atmosphere produces fever, is unknown to no one possessed of good understanding; and, also, that it is dangerous to associate with persons having the plague, for there is a risk of catching it, like the itch and ophthalmy. It is dangerous also to live with those labouring under consumption, and, in a word, with all those having a putrid respiration of such a nature as to render the houses in which they lie fetid.” (De Diff. Febr. i, 3.) Aëtius (xiii, 120) and our author (iv, i) state their decided opinion of the infectious nature of the plague and elephantiasis. Oribasius, Alexander, Synesius, Palladius, Actuarius, and all the Latin medical authors, with the exception of Cælius Aurelianus, have omitted to make any allusion to the contagious nature of diseases.
Of the Arabians, Rhases mentions, as diseases “which are transmitted from one person to another,” lepra (elephantiasis?), itch, consumption, and pestilential fever. These, he says, prove infectious, when one is shut up in a narrow house along with those labouring under them, or when one sits in the wind blowing from them. He states afterwards that ophthalmy and malignant pustules are sometimes contagious. (Ad Mansor. iv, 24; see also Contin. xxxiii, 5.) By malignant pustules he means the smallpox. Avicenna and Haly Abbas give the same list of contagious diseases. Avicenna says that smallpox and measles are of all diseases the most contagious. Of the other Arabians, Avenzoar alone, while treating of elephantiasis, alludes to the doctrine of contagion.
Having now done with the ancient authorities, we shall only give further the declaration of the celebrated Boccacio regarding the plague of Florence: “E fu questa pestilenza di maggior forza, percio che essa dagl’ infermi di quella per lo communicare insieme s’avventava a’ sani non altramenti che faccia il fuoco alle cose secche o unte, quando molto gli sono avvicinate.” (Decameron, Introduzione.)
The result of our investigations into the opinions of the ancients on this subject leads us to the conclusion, that all, or at least the most intelligent of the medical authorities, held that the plague is communicated, not by any specific virus, but in consequence of the atmosphere around the sick being contaminated with putrid effluvia. Hence, they maintained that mild fevers (συνηθεῖς) which show no tendency to putrescency are not communicable from one person to another. See Alexander Aphrodisiensis, (l. c.) Fracastorius, in like manner, considered putrefaction as the source of all contagion. (De Contag. i); and nearly the same opinion was maintained by the learned Fernel, Franciscus de Pedemont, Ingrassius, Ficinus, and others. (See Prælect. Mar. 77.) Although Galen several times speaks of a poison being formed in the human body, he means that the animal fluids are so altered as to become deleterious, and does not hold that there is any specific virus transmitted from one person to another. (De Loc. Affect. v, 7, vi, 5; Epidem. iii.)
We may take this opportunity of stating that, after a pretty extensive investigation into the histories of pestilential epidemics, we have come to the conclusion that the plague has almost invariably assumed one or other of the following phases: 1st. That of cholera and dysentery. The plague described by Thucydides, and that of Ingrassias, and many other pestilential epidemics described in ancient and modern times, including the Asiatic cholera of the present age, belong to this class. 2d. That of profuse; and, as they have been termed, syncoptic sweats. The celebrated epidemic of the fifteenth century, now so admirably illustrated by M. Hecker, is the best marked instance which we possess of this form of the disease. M. Hecker, indeed, supposes that the Cardiac disease of the ancients was of a similar nature to the sweating sickness. But it strikes us (although we must admit that we have not had time to consider this point maturely), that the syncoptic fever or cardiac disease of the ancients, was not of a pestilential nature. 3d. The other form is the Glandular plague, which many late authorities would consider as the only form of the disease; but as we think erroneously, since the other types are often mixed up with this in the same epidemic. Thus in the plague of Aleppo, during the years 1760, 1761, and 1762, although the ordinary form of the disease was the glandular, a considerable proportion of the cases assumed the first form which we have noticed. And in the plague of Athens, although it commonly put on the appearance of the first form, it would appear probable, from the obscure allusion to cutaneous eruptions in the description of Thucydides, that a certain proportion of the cases were of the second type. The three forms then would appear to us to be as closely allied to one another as diphtherite, ulcerous sore-throat, and scarlatina are; that is to say, that they are all varieties of one species of disease.
SECT. XXXVII.—ON THE TREATMENT OF THOSE WHO ARE SEIZED WITH SYNCOPE FROM CRUDE HUMOURS.
Some are seized with fever while having a great collection of crude humours, and while the mouth of the stomach is at the same time disordered. In them the hypochondrium is distended with flatulence, the orifice of the stomach is more swelled than natural; in some the complexion is turned to a more white and watery, and in others to a blacker. None of these can bear the abstraction of blood without the most imminent danger; but they require evacuation, although they cannot endure phlebotomy nor purging, for even without them they are disposed to fall suddenly into a state of syncope. They are to be cured, then, by friction. It will be proper, at the commencement of the disease, to begin with rubbing the limbs from above, downwards, with moderately rough linen cloths, and afterwards, the whole arms from above, downwards. But when the limbs have been sufficiently warmed, and there is danger of a sense of lassitude, we must use a relaxing oil, and avoid all astringents. When it is winter, we must also use a sudorific one, such as the Sicyonian oil, or that of chamomile. After rubbing the limbs freely, we must next rub off the oil, and proceed to the spine, which we must rub in like manner, and then immediately return to the legs, and from them to the arms again, and afterwards to the spine again, continuing this practice for a whole day. Honied water, in which hyssop has been boiled, is most beneficial in these cases. And they must neither get farinaceous food, nor soup, nor water, nor be permitted at all to drink freely; but they ought to be contented with honied water alone for the first three days, and be rubbed in succession. If the strength be moderately good, and the contents of the stomach do not pass properly downwards, you may venture with a clyster. But if there is a greater overflow of the superfluities than proper upon the stomach, you must first boil the honied water well, for thus it will be less laxative; but when the belly is looser than proper, you must not thus stop it, but, instead of the honied water, give the juice of ptisan. But if the discharge still continue, we must support with a gruel made from chondrus. But if we ascertain from the weakness of the pulse that the powers of the system are prostrated, it will be proper to give bread out of diluted wine, provided there be no inflammation of the stomach or liver. But should they be inflamed at the same time that the body is loaded with crude humours, the state of the patient is hopeless. If you perceive that the humours are thick, give oxymel always instead of honied water; if it is summer, the patient hot, and fond of cold drink, give him cold oxymel; but when in winter, it must be hot. Baths are most prejudicial to such persons. If, when you are called, syncope has already come on, and the parts which I have mentioned are free from inflammation, give a small bit of bread out of wine, and proceed straightway to the friction in the manner I have described. In those cases in which the syncope is occasioned by yellow bile infesting the mouth of the stomach, we must give cold drink, and administer wine that is thin, of a bright yellow colour, and old.
Commentary. This Section is taken either from Oribasius (Synops. vi, 27), or Aëtius (v, 97.) These authors, however, merely abridge the account of this subject which is given by Galen. (Meth. Med. xii, 5, and Therap. ad Glauc. i.) Syncope, according to the explanation of Galen, is a sudden prostration of the vital powers, without suspension of the respiration, as in deliquium animi. Our author has given a very correct account of Galen’s treatment. He states that, the system labouring under a load, the great indication is evacuation, but that venesection cannot be borne in such cases. In short, he insists that our great dependence must be placed on friction, for the application of which he gives very minute directions. When the pulse suddenly sinks and becomes irregular, he administers wine, unless there be inflammation of the stomach or liver. In cases complicated with crude humours, he pronounces the bath to be most prejudicial, and also disapproves of very cold or very warm air. He is most particular in his directions for the selection of the most proper wine to be used, and gives some interesting observations on the principal Greek and Roman wines used in his time. He concludes his remarks with stating that thick wines ought to be avoided as injurious, and such as are watery and thin as ineffectual, whereas those of a middling kind are to be selected. He particularly praises the Ariusian and the Lesbian. The Falernian he condemns, as being too fragrant and austere, which qualities render it injurious to the head.