After taking great pains to ascertain in what manner the plague was introduced into the military hospital, the physician to that institution at length found out that two soldiers had died there in the month of November, 1770, a short time after their arrival from Choczim, where the plague was then raging; and that a Colonel, in whose train they were, had died upon the road. It would seem that the anatomical dissector opened the bodies of these soldiers; and that he caught the plague of them. The persons who waited upon the sick, either became infected by touching the bodies of these soldiers whilst they were living; or by handling their clothes, or their bodies after death. These attendants afterwards spread the contagion among their families.
Thus have we traced the history of the plague which depopulated Moscow in the year 1771, from its first appearance to its final extinction. A plain and faithful statement of facts, even at the risk of being tedious, is what has been aimed at in this narrative; for let it be observed, that it is from simple details of the origin and progress of the plague, as it appears in different places, and of the symptoms and other circumstances with which it is accompanied, and not from the laboured dissertations that have been written upon it by some voluminous authors, that we can hope to acquire an accurate knowledge of the nature of this disorder, to ascertain the manner in which its contagion is propagated, and lastly to discover the best methods of prevention and cure.
ADDENDA.
[A].
Symptoms more particularly described.
The symptoms of the plague vary according to the different constitutions of the persons whom it attacks, and the season of the year in which it appears. Sometimes it wears the mask of other diseases; but in general it is ushered in by head-ach, stupor, resembling intoxication, shiverings, depression of spirits, and loss of strength; these are followed by some degree of fever, together with nausea and vomiting. The eyes become red, the countenance melancholy, and the tongue white and foul. In this state of things, the patients are sometimes capable of sitting up, and going about for some hours, or even a day or two. They feel an itching or pain in those parts of the body where buboes and carbuncles are about to appear. During the height of the plague, many of the infected die on the second or third day, before these tumours have time to come out, and with no other external marks except petechiæ or purple spots, which appear a short time before death; in some these spots are altogether wanting. The buboes and carbuncles generally come out on the second or third day, seldom on the fourth.
In some instances, the plague appears under the form of an inflammatory disorder, being accompanied with great heat, thirst, high-coloured urine, flushed cheeks, and violent delirium or phrensy; but in the greater number of cases it assumes the type of a nervous fever, being accompanied with little heat and thirst, and pale and turbid urine; the patients think themselves only slightly indisposed, until a sudden prostration of strength, and the eruption of buboes, carbuncles, petechiæ or vibices, announce to themselves, as well as to those who are about them, the danger they are in. In some few instances, the plague appears under the form of an intermittent fever.—Almost all those who are carried off by this disorder, die before the sixth day; those who get over the seventh day have a good chance of recovery[39].
The diversity of symptoms above-noticed, has given rise to the opinion that there are three different species of the plague, viz. one which is accompanied with petechiæ, another with carbuncles, and a third with buboes; but the history which we have given, clearly proves, that these are only shades or modifications of one and the same disorder, which is more or less violent under different circumstances and at different seasons. Petechiæ, buboes, and carbuncles often appear at the same time in the same patient, or occur in succession. In the month of July, great numbers of the impested died before the tumours came out, having petechiæ only; whereas in August and September, almost every patient had petechiæ, joined with buboes and carbuncles. After the middle of October, when the contagion was less virulent, although it still produced petechiæ and carbuncles, yet they were neither so malignant nor so frequent. Before this period, scarcely four patients in a hundred recovered; whereas during the latter months of the year, the proportion of recoveries was much greater. Sydenham has made the same observation respecting the plague at London[40]. Nature endeavours to throw off the poison by buboes. Carbuncles and petechiæ are not critical eruptions; they only denote a putrid condition of the humours, and a great degree of acrimony; whence it follows, that in proportion as buboes are more common, and petechiæ and carbuncles more rare, the milder the plague is[41].