“The infection in the air does not extend far from the infected object, but lurks chiefly (like that near carrion) to the leeward of it. I am so assured of this, that I have not scrupled going, in the open air, to windward of a person ill of the plague to feel his pulse. The rich are less liable to the plague than the poor, both because they are more careful to avoid infection, and have more large and airy apartments, and because they are more cleanly, and live on better food, and plenty of vegetables; and this I suppose is the reason why Protestants are less liable to this distemper than Catholics during their times of fasting, and likewise why the generality of Europeans are less liable to it than the Greeks, and particularly Jews.
“It is remarkable that, when the corpse is cold of a person dead of the plague, it does not infect the air by any noxious exhalations. This is so much believed in Turky, that the people there are not afraid to handle such corpses. The governor of the French hospital at Smyrna told me, that, in the last dreadful plague there, his house was rendered almost intolerable by an offensive scent; especially if he opened any of those windows which looked towards the great burying-ground, where numbers every day were left unburied; but that it had no effect on the health of himself or family.”
It is likewise a matter of the utmost importance to ascertain the time at which the disease is introduced into any town or district. Dr. Canestrinus, in a treatise on this distemper, published at Saltzburg, complains greatly of the dissensions among physicians concerning the nature of the distemper, owing to which its existence is frequently denied, and thus its ravages are propagated immensely beyond the limits which might otherwise circumscribe them. Of this he gives the following remarkable instance: “In the year 1770 a disease with uncommon symptoms prevailed at Bodrogh in Upper Hungary, which carried off a number of persons in a short time. A physician of the county of Zemplin was sent to inquire into the nature of the malady. He reported that the disease was of a suspicious nature, having a great resemblance to the plague. His report was received by the nobility and health-officers with indignation, as if untrue. Another was sent, who, without hesitation, pronounced the disease an epidemic scurvy. In the mean time the disease, being left to itself, spread wider, and raged with such violence as to carry off seventeen persons in one house. The nature of the disease now becoming apparent, proper measures were taken, and the infected separated from the sound, by which means the disease was confined within a small district.[110]” With regard to the infection of the disease, or contagion, as it is commonly called, he expresses himself as follows: “The air is not capable of diffusing the contagion to any considerable distance from the infected subject unimpaired in its power, but, like other poisonous matter, it is capable of dilution in the atmosphere, so as to be rendered at length innoxious. The contagion of the plague will be entirely prevented from spreading if all access to, and all intercourse with, the sick be strictly prohibited: whence the following forms a safe and infallible prophylactic of the disease:
“Mox, longe, tarde, cede, recede, redi.
Go quick, fly far, and slow return again.”
“No change in the habit takes place previous to the action of the contagion, but the body is from the first equally susceptible of it as of the itch, or any other infectious disease. Whilst the plague ceases in the civilized parts of Europe spontaneously, or by human precautions, its revival is prevented, from the care that is bestowed in purifying or destroying every infected substance. In the east, on the contrary, this precaution is totally neglected; whence it is probable that the disease is not reproduced anew, but that it is perpetuated by the former fomes, as happens with us in the small-pox. The matter producing the ordinary epidemics is widely diffused in the atmosphere, and capable of infecting through a widely extended space. The pestilential poison, on the contrary, is confined to the vicinity of the affected body, and becomes so dilute at the distance of a few paces only as to be incapable of further action. Hence it appears that the plague is much easier avoided than epidemic disorders. The more abundant the contagious matter is, the further probably is the power of its infection carried. This is the reason that the mere separation of the sick and suspected from the healthy is so much more efficacious in destroying it at its commencement than at a later period. To restrain epidemics within bounds is impossible; but with the contagion of the plague, it is certain that it can be confined by art to a narrow spot.”
Of the truth of this last assertion our author gives a remarkable, instance in his own practice about the time that the plague stopped at Bodrogh. Having been sent into Cassovia, along with two other physicians, they were informed by the surgeon of the lazaretto, that an unusual disease had broken out in the district of Zboina, which had suddenly proved fatal to many. On inquiry it was found that it had come from Bodrogh in the following manner: Two young men, returning from the vintage at Tokay, slept a night in an infected house, and stole some clothes belonging to those who had died of the plague. He who carried the clothes died by the way: his father carried home the bundle, kept them unpacked for some weeks, but having at last worn them, he and all his family fell victims to the same disease. The pestilence began to spread, and shewed an appearance of great malignity. Our author did not hesitate to declare its true nature, and in consequence of his declaration all communication was cut off between the adjacent countries and the infected spot, by a cordon of the military. The infected were separated from such as were only suspected, and these last from the sound: three infected houses were destroyed by fire, and other means (to be afterwards related) were used with a view to destroy the contagion itself. Thus the disease was prevented from spreading; and none but such as had been previously suspected were seized.
To the same purpose the Abbe Poiret thinks it an easy matter to extinguish the plague entirely. He was a witness to the ravages of the disease in Barbary, and thinks it the most easily avoided of any distemper; but the misfortune is, that there are many things in their own nature very easily accomplished, which the inattention or perverseness of mankind render utterly impracticable. Such, it is to be feared, is the extinction of the plague by the means just mentioned; for though these means might be enforced in a country district or small town, yet, where the pestilence enters a large and populous city, there are so many modes of concealing its existence, and the unknown intercourse of the sick with the sound must be so frequent, that it seems scarce possible to prevent the malady from spreading.
In London, whether it arose from a neglect of using the precautions for too long a time, or from any other cause, cannot well be known; but the attempts of the magistrates to separate the sick from the sound certainly were not attended with any good consequence. “The consternation (says Dr. Hodges) of those who were thus separated from all society, unless of the infected, was inexpressible, and the dismal apprehensions it laid them under made them but an easier prey to the devouring enemy. And this seclusion was on this account much the more intolerable, because, if a fresh person was seized in the same house but a day before another had finished the quarantine, it was to be performed over again; which occasioned such tedious confinements of sick and well together, as sometimes caused the loss of the whole. Moreover, this shutting up of infected houses made the neighbours fly from theirs, who might otherwise have been a help to them on many accounts; and I verily believe that many who were lost might have been alive, had not the tragical mark upon their doors driven proper assistance from them. And this is confirmed by the examples of other pestilential contagions, which have been observed not to cease until the doors of the sick were set open, and they had the privilege of going abroad.” The Doctor sets forth also the arguments on the other side; but whatever might have been the advantages of a separation of the sick from the healthy, if conducted in a manner less capable of hurting the feelings of humanity, it is evident that in the London plague the methods attempted to prevent the disease at least did no good.
In countries where the plague generally prevails, and the Europeans are united in the opinion that it is necessary to separate themselves from the natives, the method of shutting up is attended with the most salutary effects, as has been attested by almost every traveller who has resided there for any time. Accidents among them are very rare, though not altogether without example. At Alexandria in Egypt, M. Volney tells us, that as soon as the plague makes its appearance the European merchants shut themselves up in their khans and have no communication with the rest of the city. Their provisions are deposited at the gate of the khan, and received there by the porter, who takes them up with iron tongs, and plunges them into a barrel of water provided for the purpose. If it is necessary to speak to any one, they keep at such a distance as to prevent touching with their clothes, or breathing on one another; by which means they preserve themselves from this dreadful calamity, unless by some accidental neglect of these precautions. Some years ago a cat, which passed by one of the terraces into the houses of the French merchants at Cairo, conveyed the plague to two of them, one of whom died. This state of imprisonment continues for three or four months, during which time they have no other amusement than walking in the evening on the terraces, or playing at cards.
The doctrine of predestination, and still more the barbarism of the government, have hitherto prevented the Turks from attempting to guard against this destructive disease: the success, however, of the precautions taken by the French, has of late begun to make some impression upon many of them. The Christians of the country who traffic with the French merchants, would shut themselves up like them; but this cannot be done without permission from the Porte. A lazaretto was some years ago established at Tunis; but the Turkish police is every where so wretched, that little can be hoped for from those establishments, notwithstanding their extreme importance to commerce and the safety to the Mediterranean states. The very last year afforded a proof of this; for as violent a plague as ever was known broke out there. It was brought by vessels coming from Constantinople, the masters of which corrupted the guards, and came into port without performing quarantine. Water carriers have never been attacked by it.