A Discourse on the Plague.
by Richard Mead.
THE PREFACE.
THIS Book having at first been written only as a Plan of Directions for preserving our Country from the =Plague=[1] was then very short and concise. An Act of Parliament being immediately after made for performing =Quarantaines= &c. according to the Rules here laid down, it pa.s.sed through seven Editions in one year without any Alterations. I then thought proper to make some =Additions= to it, in order to shew the Reasonableness of the Methods prescribed, by giving a more full Description of this Disease, and collecting some Examples of the good Success which had attended such Measures, when they had been put in Practice. At the same time I annex"d a short Chapter relating to the Cure of the Plague; being induced thereto by considering how widely most Authors have erred in prescribing a Heap of useless and very often hurtful Medicines, which they recommend under the specious t.i.tles of =Antidotes=, =Specifics= and =Alexipharmacs=: hoping that the great Resemblance, which I had observed between this Disease and the =Small Pox=, would justify my writing upon a Distemper which I have never seen.
INDEED the =Small Pox= is a true =Plague=, tho" of a particular kind, bred, as I have shewn all Pestilences are, in the same hot =Egyptian= Climate, and brought into =Asia= and =Europe= by the way of Commerce; but most remarkably by the War with the =Saracens=, called the =Holy War=, at the latter end of the eleventh and the beginning of the twelfth Century[2]. Ever since which time the morbific Seeds of it have been preserved in the infected Cloaths and the Furniture of Houses: and have broken out more or less in all Countries, according as the hot and moist Temperature of the Air has favoured their Spreading and the Exertion of their Force. The =Measles= is likewise a =Plague sui generis=, and owes its Origin to the same Country.
I have now revised my little Work once more: and though I cannot find any reason to change my Mind as to any material Points which regard either the =Preventing= or the =Stopping= the Progress of =Infection=; yet I have here and there added some new =Strokes= of Reasoning, and, as the Painters say, retouch"d the =Ornaments=, and hightened the =Colouring= of the =Piece=.
THE Substance of the long Preface to the last Edition is as follows.
I have insisted more at large upon the =Infection= of this Disease, than I could ever have thought needful at this time, after =Europe= has had Experience of the Distemper for so many Ages; had I not been surprized by the late Attempts of some Physicians in =France= to prove the contrary, even while they have the most undeniable Arguments against them before their Eyes. In particular, I cannot but very much admire to see Dr. =Chicoyneau=, and the other Physicians, who first gave us =Observations= on the =Plague=, when at =Ma.r.s.eilles=, relate in the =Reflections=, they afterwards published upon those Observations, the Case of a Man, who was seized with the =Plague=, upon his burying a young Woman dead of it, when no one else dared to approach the Body; and yet to see them ascribe his Disease, not to his being =infected= by the Woman, but solely to his Grief for the Loss of her, to whom he had made Love, and to a =Diarrhoea=, which had been some time upon him[3]. No question but these concurred to make his Disease the more violent; and perhaps even exposed him to contract the =Infection=: but why it should be supposed, that he was not =infected=, I cannot imagine, when there was so plain an Appearance of it. I am as much at a Loss to find any Colour of Reason for their denying =Infection= in another Case, they relate, of a =young Lady= seized with the =Plague=, upon the sudden Sight of a =PESTILENTIAL TUMOR=, just broke out upon her Maid; not allowing any thing but the Lady"s Surprize to be the Cause of her Illness[4].
THE Truth is, these Physicians had engaged themselves in an =Hypothesis=, that the =Plague= was bred at =Ma.r.s.eilles= by a long Use of bad Aliment, and grew so fond of their Opinion, as not to be moved by the most convincing Evidence. And thus it mostly happens, when we indulge Conjectures instead of pursuing the true Course for making Discoveries in Nature.
I KNOW they imagine this their Sentiment to be abundantly confirmed from some Experiments made by Dr. =Deidier=[5] upon the =Bile= taken from Persons dead of the =Plague=: which having been either poured into a Wound made on purpose in different =Dogs=, or injected into their Veins, never failed, in many Trials, to produce in them all the Symptoms of the Pestilence, even the external ones of =Bubo"s= and =Carbuncles=.
One Dog, upon which the Experiment succeeded, had been known, for three Months before, to devour greedily the corrupted =Flesh= of infected Persons, and =Pledgets= taken off from =Pestilential Ulcers=, without receiving any Injury. From hence they conclude[6] that this Disease is not communicated by =Contagion=, but originally bred in the Body by the Corruption of the =Bile=. This Corruption, they say, is the Effect of unwholsome Food; and the =Bile= thus corrupted produces a Thickness and a Degree of Coagulation in the Blood, which is the Cause of the =Plague=: Tho" this they allow to be inforced by a bad Season of the Year, and the =Terrors= of Mind and Despair of the Inhabitants.
THESE Experiments are indeed curious, but fall very short of what they are brought to prove. The most that can be gathered from them is this: That =Dogs= do not, at least not so readily, receive =Pestilential Infection= from Men, as Men do from one another: And also, that the =Bile= is so highly corrupted in a Body infected with the =Plague=, that by putting it into the Blood of a =Dog= it will immediately breed the same Disease.
BUT it does not follow from hence, that the =Bile= is the Seat of the Disease, or that other Humors of the Body are not corrupted as well as =this=. I make no question but the whole Ma.s.s of Blood is, in this Case, in a State of Putrefaction; and consequently that all the Liquors derived from it partake of the Taint.
ACCORDINGLY it appeared afterwards from some Experiments made by Dr.
=Couzier=[7], that not only the =Blood=, but even the =Urine= from an infected person, infused into the crural Vein of a Dog communicated the =Plague=. I will venture to affirm, that if, instead of =Bile=, =Blood=, or =Urine=, the =Matter= of the =Ulcers= had been put into a Wound made in the Dog; it would have had at least an equally pernicious Effect: As may well be concluded from the Inoculation of the Small Pox.
AS to the Dog"s eating the =corrupted Flesh= and =purulent Matter= of the Patients; it ought to have been considered that there are some Poisons very powerful when mixed immediately with the Blood, which will not operate in the Stomach at all: As in particular the =Saliva= of the mad Dog and the =Venom= of the Viper[8]. And therefore Dr. =Deidier= himself, some Months after his former Experiments, found that =pestiferous Bile= itself was swallowed by Dogs without any Harm[9].
THE right Inference to be made from these Experiments, I think, would have been this: That since the Blood and all the Humors are so greatly corrupted in the Plague, as that Dogs (tho" not so liable to catch the Distemper in the ordinary way of Infection, as Men are) may receive it by a small Quant.i.ty of any of these from a diseased Subject being mixed with their Blood; it may well be supposed, that the =Effluvia= from an infected Person, drawn into the Body of one who is sound, may be pestiferous and productive of the like Disorder.
MY a.s.sertion, that these =French= Physicians have before them the fullest Proofs of this =Infection=, not only appears from these Instances of it, I have observed to be recorded by themselves; but likewise from what Dr. =le Moine= and Dr. =Bailly=[10] have written, of the Manner in which the =Plague= was brought to =Canourgue= in the =Gevaudan=: as also from an amazing Instance they give us of the great Subtilty of this =Poison=, experienced at =Marvejols=: where no less than =sixty= Persons were at once infected in a =Church=, by one that came thither out of an infected House. The =Plague= was carried from =Ma.r.s.eilles= to =Canourgue=, as follows. A =Gally-Slave=, employed in burying the Dead at =Ma.r.s.eilles=, escaped from thence to the Village of =St. Laurent de Rivedolt=, a League distant from =Correjac=: where finding a Kinsman, who belonged to the latter Place, he presented him with a =Waistcoat= and a =pair of Stockings= he had brought along with him. The =Kinsman= returns to his Village, and dies in two or three Days; being followed soon after by =three Children= and their =Mother=.
His =Son=, who lived at =Canourgue=, went from thence, in order to bury the Family; and, at his Return, gave to his =Brother-in-law= a =Cloak= he had brought with him: the =Brother-in-law= laying it upon his Bed, lost a little =Child= which lay with him, in one Day"s Time; and two Days after, his Wife; =himself= following in seven or eight. The =Parents= of this unhappy Family, taking Possession of the =Goods= of the Deceased, underwent the same Fate.
ALL this abundantly shews how inexcusable the foresaid Physicians in =France= are, in their opposing the common Opinion that the =Plague= is contagious. However, I have paid so much Regard to them, as to insist the more largely upon the Proof of that =Contagion=; lest the Opinion of those, who have had so much Experience of the Disease, might lead any one into an Error, in an Affair of such Consequence, that all my Precepts relating to =Quarantaines=, and well nigh every particular Part of my Advice, depends upon it: For if this Opinion were a Mistake, =Quarantaines=, and all the like =Means of Defence=, ought to be thrown aside as of no use. But as I continue persuaded, that we have the greatest Evidence, that the =PLAGUE= is a =contagious= Disease; so I have left, without any Alteration, all my Directions in respect to =Quarantaines=: in which, I hope, I have not recommended any Thing =prejudicial to Trade=; my Advice being very little different from what has been long practised in all the =trading= Ports of =Italy=, and in other Places. Nay, were we to be more remiss in this than our Neighbours, I cannot think but the =Fear= they would have of us, must much obstruct our =Commerce=.
BUT I shall pursue this Point no farther: the rather because a very learned Physician among themselves has since, both by strong Reasoning and undeniable Instances, evinced the Reality of =Contagion=[11].
IN a word, the more I consider this Matter, the more I am convinced that the Precepts I have delivered, both with regard to the Preventing the Plague from coming into a Country, and the Treatment of it when present, are perfectly suitable to the Nature of the Distemper, and consequently the fittest to be complied with. But how far, in every Situation of Affairs, it is expedient to grant the =Powers=, requisite for putting all of them in Practice, it is not my proper Business, as a Physician, to determine. No doubt, but at all Times, these =Powers= ought to be so limited and restrained, that they may never endanger the Rights and Liberties of a People. Indeed, as I have had no other View than the Publick Good in this my Undertaking, and the Satisfaction of doing somewhat towards the Relief of Mankind, under the greatest of Calamities; so I should not, without the utmost Concern, see that any Thing of mine gave the least Countenance to Cruelty and Oppression.
BUT I must confess, I find no Reason for any Apprehensions of this kind, from any thing I have advanced. For what extraordinary Danger can there be, in lodging =Powers= for the proper Management of People under the Plague, with a =Council of Health=, or other Magistrates, who shall be accountable, like all other Civil Officers, for their just Behaviour in the Execution of them? Though this I must leave to those, who are better skilled in the Nature of Government. But sure I am, that by the Rules here given, both the =Sick= will be provided for with more Humanity, and the Country more effectually defended against the Progress of the Disease, than by any of the Methods heretofore generally put in Practice, either in our own, or in other Nations.
THE Usage among =Us=, established by =Act of Parliament=, of =Imprisoning= in their Houses every Family the =Plague= seizes on, without allowing any one to pa.s.s in or out, but such as are appointed by Authority, to perform the necessary Offices about the Sick, is certainly the severest Treatment imaginable; as it exposes the whole Family to suffer by the same Disease; and consequently is little less than a.s.signing them over to the cruellest of Deaths: As I have shewn in the Discourse.
THE Methods practised in =France= are likewise obnoxious to great Objections. =Crowding= the Sick together in =Hospitals= can serve to no good Purpose; but instead thereof will =promote= and =spread= the =Contagion=, and besides will expose the Sick to the greatest Hardships.
It is no small Part of the Misery, that attends this terrible Enemy of Mankind, that whereas moderate Calamities open the Hearts of Men to =Compa.s.sion= and =Tenderness=, this greatest of Evils is found to have the contrary Effect. Whether Men of wicked Minds, through Hopes of Impunity, at these Times of Disorder and Confusion, give their evil Disposition full Scope, which ordinarily is restrained by the Fear of Punishment; or whether it be, that a constant View of Calamities and Distress does so pervert the Minds of Men, as to blot out all Sentiments of Humanity; or whatever else be the Cause: certain it is, that at such Times, when it should be expected to see all Men unite in one common Endeavour, to moderate the publick Misery; quite otherwise, they grow regardless of each other, and Barbarities are often practised, unknown at other Times. Accordingly =Diemerbroek= informs us, that he himself had often seen these =Hospitals= committed to the Charge of Villains, whose Inhumanity has suffered great Numbers to perish by Neglect, and that sometimes they have even smothered such as have been very weak, or have had nauseous Ulcers difficult to cure. Insomuch, that in many Places the Sick have chose to lay themselves in Fields, in the open Air, under the slightest Coverings, rather than to fall into the barbarous Hands of those who have had the Management of these Hospitals[12].
THE rigorous Restraints observed at their =Lines=, are attended also with the like Inconveniences. For by absolutely denying a Pa.s.sage to People from =infected= Places, they subject to the same common Ruin, both from the Disease, and from the Disorders committed in such Places, those, whom their Fortunes would otherwise furnish with Means of escaping: and this, no doubt, in every free Country, must be looked upon as an unjust =Infringement of Liberty=, and a Diminution of Mens natural Rights, not to be allowed.
NOW, under all these Difficulties, I cannot but with the greatest Satisfaction observe, that my =Precepts= are well nigh, nay altogether free from them; and yet a proper Regard is had to the Disease. As soon as ever the =Sick= are grown numerous, I advise, that they be left in their Houses, without any of those unmerciful Restraints heretofore put upon them and the Families they belonged to. I might, perhaps, have justly directed, that whenever those, who frequent or dwell in an =infected= House, go abroad, they should be obliged to carry about them =a long Stick= of some remarkable Colour, or other =visible Token=, by which People may be warned from holding too free Converse with them: this being the Practice on these Occasions, as I have heard, in some Places. The =Removal of the Sick= from their Houses, I advise only at the beginning, when it will be attended with none of the forementioned Inconveniences: but is what, for the most Part, those Sick should themselves desire. It has hardly ever been known, when the Disease did not first begin among the =Poor=. Such therefore only will be subject to this Regulation, whose Habitations by the Closeness of them are in all Respects very incommodious for diseased Persons. So that my Advice chiefly amounts to the giving Relief to the =Poor=, who shall first be =infected=, by removing them into more convenient Lodgings than their own, where they shall be better provided for than at home. And the =Removal= of them will not be attended with that Danger, it is natural for the Unskilful to apprehend in so dreadful a Disease; because it is every Day practised in the =Small-Pox=, with great Safety. And whereas I have before observed, that People have often suffered in the publick =Hospitals= by the Inhumanity of their Attendants; in this Case, little or nothing of that kind is to be feared: for I have proposed this =Removal= of the =Sick= only, at a Time, when a long =Series= of =Calamities= has not yet bred Disorders and Hardness of Heart. Nay, it may be reasonably expected that they should rather be used with the tenderest Care, when every one shall believe the Stopping of the Distemper, and consequently their own Safety to depend upon it. And as this Treatment will be both safe and beneficial to the =Sick=, so it will be much more evidently for the Advantage of the sound Part of the Family, and of those who live near them. For as the =poorer= Sort of People subsist by their daily Labour, no sooner shall the =Plague= have broke out among them, but the sick Families, and all their Neighbours likewise, if not relieved by the Publick, shall be abandoned to perish by =Want=, unless the Progress of the Distemper put a shorter Period to their Lives.
THIS Observation, that the_ Plague _usually begins among the =Poor=, was the Reason, why I did not make any Difference in my Directions for =removing the Sick=, in regard to their different Fortunes, when I first gave my Thoughts upon this Subject: which however, to prevent Cavils, I have at present done; and have shewn what Method ought to be taken, if by some unusual Chance, the =Plague= should at the beginning enter a wealthy Family. And, in this Case, I have advised nothing, which I would not most readily submit to my self: For I should much rather chuse to be thus removed from my Dwelling, with the Distemper upon me, to save my Family, than they, by being shut up with me, should be all exposed to perish. And as this Way of treating diseased Families is the most compa.s.sionate, that can be devised with any regard to the restraining the Progress of the Distemper; so it is still much preferable to what was formerly practised amongst us, on other Accounts. For, according to what I have advised, it is only required, to =remove some few= Families at the beginning of the Disease: whereas the Method of =shutting up= Houses was continued through the whole Course of the Sickness. Perhaps the Plague, under this Management, may not reach half a Score Families: I have given Instances, where it has thus been stopt in =One=.
WHAT relates to the inclosing =Infected= Places with =Lines=, I have so regulated, that no body can be subjected to any Degree of Hardship thereby: for I have provided, that free Liberty be given to every one, that pleases, to depart from the =Infected= Place, without being put to any other Difficulty, than the Performance of a short =Quarantaine= of about three Weeks, in some Place of Safety. So that no one shall be compelled to continue in the infected Town, whom his own Circ.u.mstances will not confine.
THIS part of my Directions is not so =general= as the rest, because some Places are too great to admit of it: which occasioned my proposing it with a Restriction[13]. But as this is a great Inconvenience to the rest of the =Country=, so it is far from being any Advantage to the =Place= thus left unguarded. For when all, who leave an =infected= Place, carry with them =Certificates= of their having submitted to such =Quarantaine=, as may remove all Cause of Suspicion, =Travelling= will be much more safe and commodious, than otherwise it can be. For want of this, when the =Plague= was last at =London=, it was difficult to withdraw from it, while the =Country= was every where afraid of =Strangers=, and the =Inns= on the =Roads= were unsafe to lodge in for those, who travelled from the =City=; when it could not be known, but =Infection= might be received in them by others come from the same Place.
AND from hence it happened that the =Plague=, when last in =England=, though much more moderate, and though it continued not above one Year in the City of =London=, did yet spread it self over a great Part of =England=, getting into =Kent=, even as far as =Dover=; into =Suss.e.x=, =Hampshire=, =Dorsetshire=, =Ess.e.x=, =Suffolk=, =Norfolk=, =Cambridgeshire=, =Northamptonshire=, =Warwickshire=, =Derbyshire=, and, to mention no more, as far as =Newcastle=[14].
THUS, as I have examined through the Course of the following =Treatise=, with all possible Care, into the Agreement of my =Precepts= with the Nature of the =Plague=; so I have now considered how far they can conveniently be put in Practice.
BUT it is time to have done with a Subject by no means agreeable.
I shall therefore conclude all I have to say upon this Matter, with a =Paper= well deserving Perusal, which is come to my Hands, since the following Sheets were finished; and therefore too late to be made use of in its proper Place: for which Reason, I shall give it here entire.
This =Paper= contains the Methods taken by his late =Majesty=, when the =Plague= in the Year 1712. had entered his =Dominions= in =Germany=. It was delivered to me from Mr. =Backmeister=, the Secretary at =Hanover= to his =Majesty= for the =German= Affairs, who was the Person, that issued out the =Orders= that were given. This =Relation= I requested from the Secretary, being desirous to know how far the =Measures= then taken, agreed with my =Directions=: because I had been informed, that they were very successful. And I have the Satisfaction to find them very conformable to my =Precepts=; and that they had so much the desired Effect, as to stop the =Plague= from spreading beyond the small Number of =Towns= and =Villages= recited at the beginning of the =Paper=.
=HANOVER=, Feb. 10. N. S. 1722.
IN 1712 and 1713, the Plague raged in these Parts, at the following Places.
=TOWNS.=
=Lunenbourg=, =Zell=, =Haarbourg=, twice.
=VILLAGES.=
=Nienfeldt=, =Holdenstedt=, =Melle=, =Bienenb.u.t.tel=, =Achem=, =Trebel=, =Brinckem=, =Goldenstedt=, =Fallingbostel=.
IN the last =Place=, three labouring Men, who had made their Escape from =Hamburgh=, got into a Barn in the Night, and were found dead there the next Morning, with Marks of the Plague upon them: but the Progress of the Infection was stopt by burning the Barn.
AS soon as any Village was infected, the first Thing done was to make a =Line= round it, thereby to hinder the Inhabitants from communicating with others. Those who were thus shut up, were immediately furnished with Provisions: a Physician was sent to them; and especially some Surgeons; a Minister to officiate particularly to Persons infected; a Nurse; Buriers; =&c.=
THE princ.i.p.al Management of this whole Affair consisted in two Things: 1. In =separating= the Sick from the Sound; and 2. In =cleaning= well the Houses which had been infected.
WHEN any Person was taken ill, he was obliged to leave his Lodging, and retire into a =Lazaretto= or =Hospital=, built for that Purpose. The other Persons, who appeared to be well in the same House, were obliged, when it was practicable, to strip themselves in the Night quite naked, to put on other Clothes, which were provided for them, and to go to perform =Quarantaine= in a House appointed for it, after having burnt the Clothes, they had put off. Persons were made to change their Clothes, and those they put off were burnt, as often as was judged necessary: For Example, this was done when those who had recovered their Health, came out of the =Lazaretto= and went into =Quarantaine=; and likewise, when (after the Disease was ceased) the Women who attended the Sick, the Buriers, and Surgeons, went into =Quarantaine=.
IN Summer, ordinary =Barracks= (or Huts) were made for those of the common People, who were obliged to quit infected Houses: which Barracks were afterwards burnt, when they had been made Use of.
AS soon as the People were come out of an infected House, it was nailed up, and Centinels were posted there, that nothing might be stolen out of it. In the Country, when such a House was not of very great Value, and it might be done without Danger, it was =burnt=, and the Loss was made good to the Owner, at the Expence of the Publick. But in Towns, where this could not be done, without the Hazard of burning the Town, Men were hired to go into the Houses, and bring into the Court-Yard, or before the House, whatever Goods they found in it susceptible of Contagion, and there =burn= them: but to prevent the Fright which this might raise among the Neighbours, such Goods were sometimes put into the Cart, used to carry off dead Bodies, and so conveyed out of the Town and burnt. At first, the Method taken, was only to =bury= such Goods deep in the Ground: but it was found by several Examples, that they were dug up again, and that the Infection was thereby renewed. Before People were paid for their Houses and Effects, that were burnt, it was discovered, that they often laid some of their Goods out of the Way, and that the Contagion was spread by them: but after they came to be paid what was reasonable, by the Publick, they willingly let all be burnt, without concealing any thing.
IN Summer, the Cattle were left abroad, and the Inhabitants, who had not the Plague in their Houses were obliged to look after them: In Winter, the Sound Persons were obliged, before they left an infected House, to kill the Cattle belonging to it, and to bury them ten Foot deep in the Ground near the House.
So far the former Preface.
I think it now proper to take Notice, that an =Act of Parliament= (as above mentioned in this Preface) formed upon the Precepts here delivered, having been pa.s.sed on =December 8, 1720.= the two last =Clauses= in the said Act, relating to the =removing= of Sick Persons from their Habitations, and the making of =Lines= about Places infected, were on =October 19= of the following Year, repealed.