On the subject of carbuncles, Dr. Patrick Russel observes, that “there are certainly varieties in them, but perhaps these varieties have been unnecessarily multiplied, from the same eruption having been viewed in different stages of its progress; for all of them sooner or later are covered with a black eschar.” Dr. Alexander Russel describes them as follows: “The carbuncles were commonly protruded the second day of the disease; and though the muscular and tendinous parts were more especially affected, no part whatever could be said to be free of them. The carbuncle at first resembled an angry confluent pock in its inflammatory stage, but was attended with intense, burning pain, and surrounded by a circle of a deep scarlet hue, which soon became livid. By a progress very rapid, it then spread circularly, from the size of a silver penny to an inch and an half, two inches, nay, even three inches, diameter; and the supervening gangrene often penetrated deep into the substance of the parts affected. In such of the sick as recovered, the gangrene usually ceased spreading on the third day; and, a day or two after, signs of suppuration were observed at the edge of the black crust, the separation of which, advancing gradually, was completed rather in less time than that of the eschar in issues made by caustic. In cases where the patient died, I was informed (for I saw none of those cases myself) that a quantity of ichorous matter oozed from beneath the eschar, which remained itself shrivelled and hard, without any favourable signs of separation or digestion.”[108]
Dr. Alexander Russel also describes another kind of pustule, which he says appeared in a small number of the sick, but which his brother Dr. Patrick had no opportunity of observing in 1760. It had no livid or discoloured circle surrounding it, but was filled with laudable pus; and, when dry, the crust fell off, as in the distinct small-pox. This was looked upon as a favourable symptom, all who had it happening to recover.
We have now detailed, at considerable length, the symptoms of the plague as mentioned by authors of great eminence. To give a detail of all that has been said upon this subject would be impossible; neither indeed can it be thought necessary in the present treatise. Whatever may have been omitted or too slightly mentioned in this section, will naturally be considered when we come to treat of the cure. It now therefore only remains to say, whether the approach of a plague may be known by any visible signs, so that people might in some measure prepare themselves for the ensuing calamity.
Were we in possession of an accurate and authentic history of the world, this question might be very easily decided; but the uncertainty of ancient records, the mutilated state of those which we do possess, the diversity of opinions among mankind, and the unhappy disposition to misrepresent, so common in all ages, render it very difficult to say any thing upon the subject. If the theory hinted at in this section (that plagues arise from some commotion in the electric fluid) can be allowed to have any foundation in nature, then it ought to follow, that the forerunners of pestilence would be some electric phenomena; and, from a perusal of the first and second sections of this work, it will appear that such an opinion is not altogether unfounded.[109]
The appearance of immense numbers of insects has likewise been accounted a sign of approaching pestilence; but if we suppose their appearance to be a sign, we can scarce imagine their putrefaction to have been a cause, of pestilence. In the east we are informed by Dr. Russel that the inhabitants of Aleppo account the appearance of insects, and even eclipses, as presages of the plague. They suppose also that the stillness of frogs is a sign of pestilence; but the same author informs us that all these signs failed in 1760. Violent earthquakes and famines seem to be more certain signs, though even these are not always to be depended upon; it being evident from historical accounts that pestilence has sometimes preceded, and sometimes followed, earthquake and famine. Mr. Gibbon, however, ascribes to the above-mentioned causes, viz. insects, earthquakes, and even comets, the dreadful plague which took place in the reign of Justinian. At least, all these preceded it; but perhaps the insects were only meant to be accounted the cause of the plague. The cause of the insects must remain in obscurity. According to him, “In a damp but stagnating air, this African fever is generated from the putrefaction of animal substances, and especially from the swarms of locusts, not less destructive to mankind in their death than in their lives.”
This dreadful plague was preceded by comets and most violent earthquakes. A remarkable comet appeared in 536, supposed to be the great one observed by Sir Isaac Newton in 1680. This, we are told by astronomers, revolves round the sun in a period of 575 years; but the failure of astronomical predictions in the return of the expected comets of 1759 and 1789, shew the futility of such calculations. Another comet appeared in 539, and these comets were attended with an extraordinary paleness of the sun. Mr. Gibbon observes, that earthquakes, which he calls a fever of the earth, “raged with uncommon violence during the reign of Justinian. Each year is marked by the repetition of earthquakes of such character, that Constantinople has been shaken above forty days; of such extent, that the shock has been communicated to the whole surface of the globe, or at least of the Roman empire. An impulsive or vibrating motion was felt; enormous chasms were opened, huge and heavy bodies were discharged into the air, the sea alternately advanced and retreated beyond its ordinary bounds, and a mountain was torn from Liburnia, and thrown into the waves, where it protected as a mole the new harbour of Botrys in Phenicia.”
According to Dr. Sydenham the plague at London in 1665 was preceded by a very cold winter; the first continued till spring and went off suddenly towards the end of March. Peripneumonies, pleurisies, quinsies, and other inflammatory disorders, then made their appearance, along with an epidemic fever of a particular kind, which did not yield to the remedies successful in other epidemics. About the middle of the year the plague began, and increased in violence till the autumnal equinox, when it began to abate, and by the ensuing spring was entirely gone. Our author says that the plague seldom rages violently in England but once in thirty or forty years; but since his time, which is upwards of a century, no plague hath appeared. He supposes the plague and other epidemics to depend on some secret constitution of the air, but pretends not to say what that constitution is. But, besides this constitution, he is of opinion that there must be another circumstance, viz. the receiving the effluvia or seminium from an infected person. Thus he supposes that a single infected person is sufficient to poison a whole country; the general mass of atmosphere being infected by the breath of the diseased and the effluvia of the dead bodies. “Thus (says he) the way of propagating this dreadful disease by infection is rendered entirely unnecessary; for though a person be most cautiously removed from the infected, yet the air received in by breathing will of itself be sufficient to infect him, provided his juices be disposed to receive the infection. I much doubt, if the disposition of the air, though it be pestilential, is of itself able to produce the plague; but the plague being always in some place or other, it is conveyed by pestilential particles, or the coming of an infected person from some place where it rages, to an uninfected one, and is not epidemic there, unless the constitution of the air favours it. Otherwise I cannot conceive how it should happen, that, when the plague rages violently in one town in the same climate, a neighbouring one should totally escape it, by strictly forbidding all intercourse with the infected places; an instance of which we had some few years ago when the plague raged with extreme violence in most parts of Italy; and yet the Grand Duke, by his vigilance and prudence, entirely prevented its entering the borders of Tuscany.” As to the nature of the disease, when once produced, Dr. Sydenham is of opinion that it is altogether inflammatory; for which he gives the following reasons: 1. The colour of blood taken away that resembles that in pleuritic and rheumatic disorders. 2. The carbuncles resemble the mark of an actual cautery. 3. The buboes are equally disposed to inflammation with any other tumours that come to suppuration. 4. The season of the year may be adduced in proof of this; for between spring and summer, inflammatory disorders, as pleurisies, quinsies, &c. are common.
Before we put an end to this section, it may now be proper to say a few words by way of apology for the many apparent digressions from the subject which have appeared in it. In the first place, then, the work being intended for general inspection, and not merely for medical readers, it became absolutely necessary to introduce a number of things which for medical readers would have been totally superfluous. It was to be supposed that the book might come into the hands of some who had not read any thing concerning the structure of the body, who had not heard of any of the systems of medicine now prevalent, or the different doctrines they contain. It was impossible to write in an intelligible manner for such people without giving some few hints concerning all these subjects: the same consideration made it necessary to enter pretty largely into the discoveries concerning the composition of the atmosphere and various kinds of elastic fluids, concerning heat, &c. In doing this the writer was under a necessity either to adopt some of the doctrines he took notice of, or to animadvert upon them. If he has ventured freely to give his sentiments, it is not with a view to establish a theory of his own, but to direct the attention of the reader to those natural agents which seem to be at present too much overlooked, principally because they are less accessible to our senses, and of consequence less subject to experiment, than others. If therefore in this treatise it is suggested that the atmosphere acts on the human body by its internal or latent heat, and by its electricity, as well as by its other properties; if the writer is inclined to believe that these are in fact the most powerful parts of it; that we never can act without them, and that in short our life and health are in immediate dependence upon them; I say, that none of all these things are in opposition to any fact hitherto discovered, either of the medical kind or any other. On the other hand, in all ages physicians have sought for some constitution in the air, inexplicable, and perpetually unknown, to which diseases might be ascribed that could not be supposed to originate from any of its ordinary properties. To explore this constitution is as great a desideratum at the present moment as two thousand years ago; and any attempt to investigate it, or a conjecture relating to it, cannot be supposed inconsistent with any thing already discovered and ascertained. There are many things which lead us to think that electricity is very much concerned in diseases, and among the rest we must account the new discovery of Dr. Perkins’s metallic conductors a very notable proof of it. These, when first ushered into the world, were made by many a subject of ridicule; but the evidence in favour of their efficacy, both in America and in various parts of Europe, seems now to be decisive in their favour; and, if they act at all, it is almost impossible to suggest any other principle than that of electricity to which their efficacy can be owing. No doubt it is difficult to draw the line properly betwixt credulity and skepticism, but where credible testimony determines any thing to have actually happened, or where solid reasoning gives room to suppose any thing to be probable, it never can be invalidated by any argument a priori formed against the possibility of such a thing taking place.
In page [128] it is said, that M. Lavoisier, by introducing the new chemical nomenclature, “has entailed the greatest curse upon the science it ever met with.” All apology for this bold assertion is absolutely necessary, and the quotation made from Dr. Ferriar may be deemed inadequate, or perhaps misapplied. In passing this censure on the nomenclature I wrote from experience. The new nomenclature, instead of promoting my improvement in chemistry, hath had a direct contrary tendency. An instance of the inconvenience and ambiguity arising from it is given p. [135], when speaking of Dr. Girtanner’s theory. But a much more remarkable example is to be met with in the review of Dr. Monro’s Chemical Treatise, where we find him censured for the very same ambiguity taken notice of with regard to Dr. Girtanner. “He might have observed (say the reviewers) the distinction between the hydrogen and inflammable air, and between the oxygen and pure air, as well as between the azote and impure air: he has mentioned these as synonimous, whereas they are terms that express bases, or substances in a concrete state (what I have called the condensable part) and the compounds of these substances and heat, when they assume the form of gases or elastic fluids.” (Monthly Rev. for 1790, p. 26.)
That the terms invented by Lavoisier and others have not been received with perfect unanimity by the chemists of the present day, is evident from Dr. Pearson’s “Translation of the New Chemical Nomenclature,” which is not only a translation, but a vindication of it. In the course of his work he quotes the translator of the Chemical Dictionary saying, that, “from the zeal of reforming language, such a number of reformers may arise, that our ears will not be less stunned, nor our understandings less perplexed, than if we were exposed to the clamour of Babel, or the thaw of words of Sir John Mandeville.” To this Dr. Pearson replies, that there is no reason to fear any such bad consequences. “The distinguished superiority of a system produced by a De Guyton, a Lavoisier, or a Bergman, would surely supercede the work of persons of inferior ability.” It is impossible to know the persons here designated, unless the Doctor points them out. If he chooses to call himself one of them, we can have no objection. He certainly has dissented, in one article, from “the system produced by De Guyton, Lavoisier and Bergman,” and this is with regard to the word azote. This is the term announced to us as the most proper for denoting a certain kind of air. But Dr. Pearson determines nitrogen to be more proper. Even this has not given entire satisfaction, for Dr. Mitchell has adopted the word septon in preference to both azote and nitrogen. Thus, instead of the original phrase phlogisticated air, used by Dr. Priestley, we have four; for as long as the works of Dr. Priestley remain, the original term will be used by some, while with others it will be so much disused that perhaps they will not understand it when it happens to occur. Nor are corrections of this kind all that we have to fear. Professor Wiegleb, who has written a System of Chemistry in quarto, has therein changed almost all the nomenclature invented by Lavoisier. Instead of it he gives a nomenclature of his own, in which he makes very much use of the termination cratia, from a Greek word signifying strength; thus, instead of saying the acid of fluor, we are to say fluoricratia. I must confess that to me the perpetual repetition of this termination has a very ridiculous appearance; but the misfortune is, that in the case of nomenclatures we have no choice. We cannot choose one and reject another: good or bad, we must take both; and were an hundred new ones to arise, we must be condemned to learn them all. Nor is even this the worst. Wiegleb’s scholars, for instance, accustomed to the language of their teacher, will be apt to put it into their writings, perhaps without proper explanation; and thus such writings must be unintelligible both to old and new chemists: and thus it will be with as many others as choose to invent new chemical terms.