It hath been observed that the plague is stopped either by great heat or great cold, but more readily by the former than the latter. “It has generally been supposed (says Dr. Canestrinus) that the cold of winter was destructive of contagious matter; but various instances of the contrary may be collected. The plague in Transylvania continued through the very severe frost in 1709. On the contrary it has been found, that excessive heat has extinguished, or at least diminished, pestilential diseases. During the plague at Aleppo the weather was unusually hot in the beginning of July, and it was remarked that the disease declined considerably; and in general Dr. Russel observed, that the plague ceased at the hottest season of the year. The plague at Ockzacow, which raged in the years 1738 and 1739, began in the month of April, and continued with violence till July, when it declined considerably, and entirely ceased in the month of September; in February of the year following it re-appeared, and totally ceased in July.”
From these facts we might be led to suppose that a warm regimen, or occasionally exposing the body to great heat, might be advantageously used by way of prevention; but Dr. Russel justly observes, that the human frame, “could it support such an application of fire and smoke as is necessary to expel or destroy contagion from infected substances, would probably receive little benefit from it, if infected; nor could those in health sustain, without prejudice, the heat and dense smoke which is probably required for the perfect extinction of the infectious effluvia floating in the confined atmosphere of a morbid body.” He is of opinion, however, that some kinds of fumigations may be of use, and he mentions some of these, but says that the perfumes ordered by the college are perhaps as proper as any, though their forms might be rendered more simple. Heat alone can scarce be thought very proper for prevention, and, when the disease is once begun, is said to be detrimental. Dr. Guthrie quotes Baron Ash saying, that “in heated rooms the disease is ungovernable: it is only in free air that it is to be treated.” But of late a discovery has been made of a surprising power in heated oil of removing this disease, insomuch that, if we can believe what has been published of it, we must suppose it to be little less than a specific. So great indeed has been the confidence put in this method, that, by order of the Academy of Sciences at Lisbon, it has been translated into Arabic, French and Portuguese.[132] “The method was first proposed by George Baldwin esq. agent for his Britannic Majesty, and consul-general at Alexandria. He communicated his method to Lewis de Pavia, chaplain and agent to St. Anthony’s Hospital at Smyrna; who, after five years experience, pronounces it to be the most effectual remedy hitherto made use of in the hospital of which he has had the management for twenty-seven years. Immediately after a person is perceived to be infected with the plague, he must be taken into a close room; and, over a brazier of hot coals, with a clean sponge, dipped in warm olive oil, his body must be very briskly rubbed all over; for the purpose of producing a profuse sweat. During the friction, sugar and juniper berries must be burned in the fire, which raise a dense and hot smoke, that contributes to the effect. The friction ought not to be continued more than four minutes, and a pint of oil is enough to be used at each time. In general the first rubbing is attended by a very copious perspiration; but, should it fail of this effect, the operation may be repeated, first wiping the body with a warm, dry cloth; and, in order to promote perspiration still farther, the patient may take any warm sudorific drink, such as elder-flower water, tea, &c. It is not necessary to touch the eyes; and other tender parts of the body must be touched gently. Every possible precaution must be made use of to prevent the patient from taking cold, nor must the linen be changed till the perspiration has entirely subsided. The operation should be repeated once a day, until evident symptoms of recovery begin to appear. If there are already tumours on the body, they should be gently and more frequently rubbed, till they appear to be in a state of suppuration, when they may be dressed with the usual plasters. The operation ought to be begun on the first appearance of the symptoms of disease; if neglected till the nerves and the mass of blood are affected, or a diarrhœa has commenced, little hopes can be entertained of a cure; but still the patient should not be despaired of, as, by an assiduous application of the means proposed, some few have recovered, even after diarrhœa had commenced. During the first four or five days the patient must observe a very abstemious diet; the author allows only a small quantity of vermicelli, simply boiled in water. Nor must any thing be taken for thirty or forty days, except very light food, as, he says, an indigestion in any state of the disorder might be dangerous. He does not allow the use of wine till forty days. There is no instance of the person rubbing a patient having taken the infection. He should previously anoint himself all over with oil, and must avoid receiving the infected person’s breath into his mouth or nostrils. The precaution to be used in all circumstances is that of carefully anointing the body, and living upon light and easily digestible food. Mr. Baldwin observes, that among upwards of a million of people carried off by the plague in Upper and Lower Egypt, in the space of four years, he could not discover a single oilman, or dealer in oil.” Lisbon, July, 1797. By Royal Permission.
With regard to diet, and the use of spiritous liquors, opinions, as may well be imagined, have been very discordant. Allen quotes Diemerbroeck advising poor people to take two or three spoonfuls of the best white wine vinegar every morning, which he looked upon to be one of the best preservatives: he recommends also the frequent application to the nostrils of a spunge dipped in treacle vinegar. With regard to himself he says that his principal care was to avoid uneasy passions of the mind; and that when he found himself any way disturbed by these, he cheered his heart by three or four glasses of wine: his common drink was beer, and also white wine, small, or moderately strong, which sometimes he drank to cheerfulness, but never to drunkenness. Dr. Patrick Russel also says, that “a glass of generous wine, or any other cordial more agreeable to the choice, may be taken before dinner, in case of languor, or oppression at the stomach, from fatigue, fœtor, or apprehension. I found a rummer of old hock very agreeable on such occasions.” Allen goes on to inform us from Diemerbroeck, that, “as to diet, it is advisable in a pestilential disposition to use temperance, which very much contributes to the preservation of health; but all sudden changes are dangerous; wherefore it is most dangerous suddenly to alter the usual rule of diet. It is very ill in the plague to go abroad with an empty stomach: hog’s flesh is looked upon to be very pernicious: all sweet things are to be avoided: wine moderately made use of is good, but the abuse of it very dangerous.—Mercurialis testifies, that among the Patavians and Venetians, most of the tipplers died, who thought to drive out the plague with strong wines.” Mr. Howard informs us, that a person in high station at Constantinople, attributed his recovery entirely to the use of green tea, others to brandy. He also mentions a Mr. Hare, master of a merchant vessel at Senegal, who, during the prevalence of a malignant fever there, was very much exposed to the infection, and who out of humanity waited upon a negro, whom nobody would go near. He took no medicines, neither did he taste either spiritous or fermented liquors, and was the only European that entirely escaped the contagion.[133]
These accounts seem to evince that little or nothing is to be expected from a change of diet. This is an attempt to change the constitution of the body, and cannot be expected to succeed any more than bleeding. There is a certain quantity, and a certain species, both of food and drink, different in different persons, necessary to preserve health, and those who require both in larger quantity or better quality than others, are no more to be charged with intemperance than those who are supported by the smallest quantity of the coarsest fare. In times of danger, therefore, those who have been accustomed to spiritous liquors ought not to give them over; neither ought those to begin the use of them who have not used them before. From the account formerly given of the structure of the human body, it appears to be furnished with an apparatus for exhaling or throwing out a perspirable matter as well as for inhaling or taking in one equally subtile. How far the skin may be able to inhale or rather imbibe surrounding effluvia, may be doubted; but with the lungs there cannot be any doubt; and the effluvia taken into them must unquestionably affect the blood, and of consequence the vital principle, almost without any medium. To deprive the body of its due portion of nourishment therefore is to throw a temptation in its way (if I may use the expression) to absorb any thing; and the same effect must ensue from any other mode of debilitating it, either by intemperance, terror, or the like; and hence to visit infected places while under any such debility must be very imprudent. Dr. Russel agrees that it is a general and rational precept, never to go abroad fasting. For those who cannot easily bear fatigue without eating between breakfast and dinner, some light food may be proper, at an intermediate hour, in order to avoid going into the chambers of the sick with an empty stomach in the forenoon. “In such circumstances (says he) after a long and fatiguing morning, I have often found myself disagreeably affected in my latter visits, and have been sensible of slight giddiness, and of the appetite flagging at dinner, as if something lay on the stomach. I have known others much more strongly affected in this manner, and consequently much more alarmed. In such cases much no doubt may depend on the fancy; but in those times the power of the imagination requires management. So intimately is it connected with the accidental state of the body, that the same risk, from which a man shrinks in a state of languor and fatigue, he will encounter undauntedly after a temperate meal: the strange, unusual sensations, which amount almost to a persuasion of having caught the infection, will often, like the phantoms of a vision, vanish after a few glasses of wine.[134] Whether any slight degree of real infection can be thus dissipated, I shall not take upon me to determine; it is sufficient for the present purpose to indicate the means of restraining those alarming sensations which, when aggravated by imagination, are apt to depress the spirits, and, according to the general opinion, to reduce the human body to that relaxed, inhaling state peculiarly susceptible of contagion.”
As to other modes of precaution, the Doctor advises that such as are about the sick “should guard the mouth and nostrils with vinegar, avoid drawing in the breath while close to the bed side, or swallowing their spittle while in the infected chamber. Before they approach the bed in order to examine the eruptions, the bed-clothes ought to be removed, to give time for the dispersion of a confined steam which immediately discovers itself to the senses; and it will be advisable to dip the hands in vinegar before examining the parts. On coming out of the chamber it will also be proper to rinse the mouth, and wash the hands, with vinegar, plain or camphorated.” He advises also to fumigate the clothes with nitre, sulphur, and juniper berries, burnt on a red-hot iron.
“Upon returning home it may be advisable to shift clothes immediately, hanging those taken off upon lines in a small chamber, to be again smoked, and afterwards aired. The mouth and hands ought once more to be well washed, and the hair might be fumigated with a little nitre and sulphur, by means of a pipe, so as not to incommode the lungs.”
One other mode of prevention, not of the disease, but of incurring danger from it, is inoculation. This is greatly recommended by Baron Ash above mentioned, and not only for the plague among the human species, but for that among cattle, which frequently destroys great numbers of those necessary animals. The case of Mathias Degio related p. [272], shows the practicability and the safety of it. The only solid objection that can be made to it is, that those who have once had the plague are not secure from having it a second time, or oftener. Yet, if we consider the extreme fatality of the disease when it attacks in the natural way, and that the number of those who have the plague only once is much greater than of those who relapse, this practice will certainly be found to merit consideration, and, unless some objection to it be discovered greater than any that has yet appeared, seems likely to be advantageous to the human race in general.
SECTION V.
Of the Cure of the Plague.
FROM what has already been laid down in a former section concerning the nature of this distemper, it appears, in its worst and most deadly form, to consist in the sudden breaking forth of a kind of hard mortifications, or rather eschars, like those made by fire, in different parts of the body. When these happen to fall upon any of the vital parts, it is evident that no cure can be applied. When such eschars discover themselves in abundance on the external parts, it is likewise observed that the patient certainly dies; whether from the same taking place inwardly, or from nature not being able to bear the loss of substance, and to separate so many deep eschars, is uncertain: but this kind, which attacks without fever, has always been reckoned absolutely incurable. When the tendency to internal mortification is less, and the fiery blasts, if we may so call them, approach the surface, so that buboes or carbuncles begin to appear, there is then some hope that the patient may recover. Even here, however, the case must be considered as very doubtful, and we have seen that in Dr. Russel’s three first classes of patients not one recovered; nevertheless, as we are not always able to distinguish with certainty whether the patient is altogether beyond the power of medicine or not, excepting where the tokens formerly mentioned appear, this kind only is here distinguished by the name of the fatal or inevitably mortal kind of plague. In all cases, where there is time allowed, medicine ought to be employed; but, as in other diseases, different theories have bred such a contradiction of opinions, that it is with no small difficulty we can judge which has any probability of success. In this uncertainty, however, we must look upon those who have recently had an opportunity of seeing the disease as superior not only to those who have only read of it, but even to the most celebrated ancient physicians who have written upon the subject. Those who have had the best and latest opportunities of seeing the distemper are Drs. Alexander and Patrick Russel at Aleppo, and the physicians to the Russian army when the plague raged in it in 1770, &c.