GRAND CAIROis crouded with vast Numbers of Inhabitants, who for the most part live very poorly, and nastily; the Streets are very narrow, and close: it is situate in a sandy Plain at the Foot of a Mountain, which by keeping off the Winds, that would refresh the Air, makes theHeatsvery stifling. Through the midst of it passes a greatCanal, which is filled with Water at the overflowing of theNile; and after the River is decreased, is gradually dried up: Into this the People throw all manner of Filth, Carrion,&c.so that the Stench which arises from this, and the Mud together, is insufferably offensive[42]. In this Posture ofthings, thePlagueevery Year constantly preys upon the Inhabitants; and is only stopt, when theNile, by overflowing, washes away this Load of Filth; theCold Winds, which set in at the same time, lending their Assistance, by purifying the Air.
InÆthiopiathose prodigious Swarms ofLocusts, which at some times cause a Famine, by devouring the Fruits of the Earth, unless they happen to be carried by the Winds clear off into the Sea, are observed to entail a new Mischief upon the Country, when they die and rot, by raising aPestilence[43]; the Putrefaction being hightened by the excessiveIntemperance of the Climate, which is so very great in thisCountry, that it is infested with violentRainsat one Season of the Year, for three or four Months together[44]. And it is particularly observed of this Country, that thePlagueusually invades it, whenever Rains fall during the sultry Heats ofJulyandAugust[45], that is, asLucretiusexpresses it, when the Earth is
Intempestivis pluviisque et solibus icta[46].
Intempestivis pluviisque et solibus icta[46].
Nowif we compare this last Remark of theIntemperance of the ClimateinÆthiopia, with what theArabianPhysicians[47], who lived near these Countries, declare, thatPestilencesare brought byunseasonableMoistures, Heats, and want of Winds; I believe we shall be fully instructed in the usual Cause of this Disease. Which from all these Observations compared together, I conclude to arise from thePutrefactionso constantly generated in these Countries, whenthatis hightened and increased by the ill State of Air now described; and especially from thePutrefactionof animal Substances.
Itis very plain, that animal Bodies are capable of being altered into a Matter fit to breed this Disease: because this is the Case of every one who is sick of it, the Humours in him being corrupted into a Substance which willinfectothers. And it is not improbable, that the volatile Parts with which Animals abound, may in some ill States of Air in the sultry Heats ofAfricabeconverted by Putrefaction into a Substance of the same kind: since in these colder Regions, we sometimes find them to contract a greater Degree of Acrimony than most other Substances will do byputrefying, and also more dangerous for Men to come within the reach of their Action; as in those pernicious, and even poysonous Juices, which are sometimes generated in corrupted Carcasses: Of which I have formerly given one very remarkable Instance[48], and, if it were necessary, many more might be produced, especially inhydropic Bodies, and incancerous Tumors. Nay more, we findanimal Putrefactionsometimes to produce in theseNorthernClimates very fatal Distempers, though they do not arise to the Malignity of the truePlague: For suchFeversare often bred, where a large Number of People are closely confined together; as inGoals,Sieges, andCamps.
Andperhaps it may not be here amiss to remark, that theEgyptiansof old were so sensible how much thePutridnessof dead Animals contributed towards breeding thePlague, that they worshipped the BirdIbisfor the Service it did in devouring great Numbers of Serpents; which they observed did hurt by their Stench when dead, as well as by their Bite when alive[49].
Butno kind ofPutrefactionisever hightened in theseEuropeanCountries to a degree capable of producing the truePlague: and we learn from the Observation of theArabianPhysicians, that some Indisposition of theAiris necessary in the hottest Climates, either to cause so exalted a Corruption of the forementioned Substances, or at least to enforce upon Mens Bodies the Action of theEffluviaexhaled from those Substances, while they putrefy. Both which Effects may well be expected from the sensible ill Qualities of theAirbefore described, whenever they continue and exert their Force together any considerable time.
WhatI have here advanced of the first Original of thePlague, appears to me so reasonable, that I cannot enough wonder at Authors for quitting the Consideration ofsuch manifest Causes forHidden Qualities; such asMalignant Influences of the Heavens;Arsenical,Bituminous, or otherMineral Effluvia, with the like imaginary or uncertain Agents.
Thishowever I do not say with design absolutely to exclude all Disorders in theAir, that are more latent than the intemperateHeatandMoisturebefore mentioned, from a Share in increasing and promoting the Infection of thePlague, where it is once bred: for I rather think this must sometimes be the Case; like to what is observed among us in relation to another infectious Distemper, namely, theSmall-Pox, which is most commonly spread, and propagated by the same manifest Qualities of theAiras those here described: Notwithstanding which, this Distemperis sometimes known to rage with great Violence in the very opposite Constitution ofAir,viz.in the Winter during dry and frosty Weather. But to breed a Distemper, and to give force to it when bred, are two different things. And though we should allow any such secret Change in theAirto assist in the first Production of the Disease; yet it may justly be censured in these Writers, that they should undertake to determine theSpecific Natureof these secret Changes and Alterations, which we have no means at all of discovering: Since they do not shew themselves in any such sensible manner, as to come directly under our Examination; nor yet do their Effects, in producing thePlague, point out any thing of theirSpecific Nature.
Allthat we know, is this, that the Cause of thePlague, whatever it be, is of such a Nature, that when taken into the Body, it works such Changes in the Blood and Juices, as to produce this Disease, by suddenly giving some Parts of the Humours such corrosive Qualities, that they either excite inwardInflammationsandGangrenes, or push outCarbunclesandBubo’s; theMatterof which, when suppurated, communicates the like Disease to others: But of the manner how this is done, I shall discourse in the following Chapter.
I Havebeen thus particular in tracing thePlagueup to its first Origine, in order to remove, as much as possible, all Objection against what I shall say of the Causes, which excite and propagate it among us. This is done byContagion. Those who are Strangers to the full Power ofthis, that is, those who do not understand how subtile it is, and how widely the Distemper may be spread byInfection, ascribe the Rise of it wholly to the malignant Quality of theAirin all Places, wherever it happens; and, on the other hand, some have thought that the Consideration of the infectious Nature of the Diseasemust exclude all regard to the Influence of theAir: Whereas theContagionaccompanying the Disease, and the Disposition of theAirto promote thatContagion, ought equally to be considered; both being necessary to give the Distemper full force. The Design therefore of this Chapter, is to make a proper Balance between these two, and to set just Limits to the Effects of each.
Forthis purpose, I shall reduce the Causes, which spread thePlague, to three,Diseased Persons,Goods transported from infected Places, anda corrupted State of Air.
Thereare several Diseases, which will be communicated from the Sick to others: and this not done after the same manner in all. TheHydrophobiais communicatedno other way than by mixing the morbid Juices of the diseased Animal immediately with the Blood of the sound, by aBite, or what is analogous thereto; theItchis given bysimple Contact; theLues Venereanot withouta closer Contact; but theMeasles,Small-Pox, andPlagueare caught by anear Approachonly to the Sick: for in these three last Diseases Persons are render’d obnoxious to them only by residing in the same House, and conversing with the Sick.
Nowit appears by the Experiments mentioned in thePreface, of giving thePlaguetoDogsby putting theBile,BloodorUrinefrom infected Persons, into their Veins, that the whole mass of the animal Fluids in this Disease is highly corrupted and putrefied. It is therefore easy to conceive howtheEffluviaor Fumes from Liquors so affected may taint the ambient Air. And this will more especially happen, when the Humours are in the greatest Fermentation, that is, at the Highth of the Fever: as it is observed that fermenting Liquors do at the latter end of their intestine Motion throw off a great Quantity of their most subtile and active Particles. And this Discharge will be chiefly made upon those Glands of the Body, in which the Secretions are the most copious, and the most easily increased: such are those of the Mouth and Skin. From these therefore the Air will be impregnated withpestiferous Atoms: which being taken into the Body of a sound Person will, in the Nature of aFerment, put the Fluids there into the like Agitation and Disorder.
TheBody, I suppose, receives them these two ways, by theBreath, and by theSkin; but chiefly by the former.
I thinkit certain thatRespirationdoes always communicate to the Blood some Parts from the Air: Which is proved from this Observation, that the same Quantity of Air will not suffice long for breathing, though it be deprived of none of those Qualities, by which it is fitted to inflate the Lungs and agitate the Blood, the Uses commonly ascribed to it. And this is farther confirm’d by what the learned Dr.Halleyhas inform’d me, that when he was several Fathom under Water in hisDiving Engine, and breathing an Air much more condensed than the natural, he observed himself to breath more slowlythan usual: Which makes it more than probable, that this conveying to the Blood some subtile Parts from the Air, is the chief Use ofRespiration; since when a greater Quantity ofAirthan usual was taken in at a time, and consequently more of these subtile Parts received at once by the Blood, a less frequentRespirationsufficed.
Asto theSkin, since there is a continual Discharge made thro’ its innumerablePores, of the matter ofinsensible PerspirationandSweat; it is very possible that the same Passages may admit subtile Corpuscles, which may penetrate into the inward Parts. Nay it is very plain that they do so, from what we observe upon the outward Application ofOintmentsand warmBathings: which have their Effects by their finest and mostactive Parts insinuating themselves into the Blood.
Itis commonly thought, that theBloodonly is affected in these Cases by the morbificEffluvia. But I am of opinion, that there is another Fluid in the Body, which is, especially in the beginning, equally, if not more, concerned in this Affair: I mean theLiquid of the Nerves, usually called theAnimal Spirits. Asthisis the immediate Instrument of all Motion and Sensation, and has a great Agency in all the glandular Secretions, and in the Circulation of the Blood itself; any considerable Alteration made in it must be attended with dangerous Consequences. It is not possible that the whole Mass of Blood should be corrupted in so short a Time as that, in which the fatal Symptoms, in some Cases, discover themselves.Those Patients of thefirst Class, mentioned in the beginning of this Discourse, particularly thePorterswho opened the infected Bales of Goods in theLazaretto’s ofMarseilles, died upon the first Appearance of Infection, as it were by a sudden Stroke; being seized with Rigors, Tremblings, Heart-Sickness, Vomitings, Giddiness and Heaviness of the Head, an universal Languor and Inquietude; the Pulse low and unequal: and Death insued sometimes in a few Hours.
Effectsso sudden must be owing to the Action of some Corpuscles of great Force insinuated into, and changing the Properties of, another subtle and active Fluid in the Body: and such an one, no doubt, is theNervous Liquor.
Itis not to be expected that we should be able to explain theparticular manner by which this is brought about. We know too little of the Frame of the Universe, and of the Laws ofAttractions,RepulsionsandCohesionsamong the minutest Parcels of Matter, to be able to determine all the Ways by which they affect one another, especially within animal Bodies, the most delicate and complicated of all the known Works of Nature. But we may perhaps make a probable Conjecture upon the Matter. Our great Philosopher, whose surprising Discoveries have exceeded the utmost Expectations of the most penetrating Minds, has demonstrated that there is diffused through the Universe asubtileandelastic Fluidof great Force and Activity. This he supposes to be the Cause of theRefractionandReflectionof the Rays of Light; and that by itsVibrationsLight communicates Heatto Bodies: and, moreover,thatthis readily pervading all Bodies, produces many of their Effects upon one another[50].
Nowit is not improbable that theAnimal Spiritsare a thin Liquor, separated in the Brain, and from thence derived into the Nerves, of such a Nature that it admits, and has incorporated with it, a great Quantity of thiselastic Fluid: which makes it a vital Substance of great Energy. And a Liquor of this kind must be very susceptible of Alterations from other active Bodies of a different Nature from it, if they approach to and are mixed with it: as we see someChemical Spiritsupon their being put together, fall into a Fermentation, and make a Composition of a quite different kind.
Iftherefore we allow theEffluviaorExhalationsfrom a corrupted Mass of Humours in a Body that has thePlagueto be volatile and firey Particles, carrying with them the Qualities, of those fermenting Juices from which they proceed; it will not be hard to conceive how these may, when received into thenervous Fluidof a sound Person, excite in it such intestine Motions as may make it to partake of their own Properties, and become more unfit for the Purposes of the animal Oeconomy. But of this more in another Place.
Thisis one means by which thePlague, when once bred, is spread and increased: but the second of the forementioned Causes, namely,Goods from infected Places, extends the Mischief much wider.By the preceding Cause, thePlaguemay be spread fromPersontoPerson, fromHousetoHouse, or perhaps fromTowntoTown, tho’ not to any great Distance; but this carries it into the remotest Regions. From hence the trading Parts ofEuropehave their principal Apprehensions, and universally have recourse toQuarantainesfor their Security. The Universality of which Practice is a strong Argument, thatMerchandizewill communicateInfection: for one cannot imagine, that so many Countries should agree in such a Custom without the most weighty Reasons. But besides, there is not wanting express Proof of this, from particular Examples, where this Injury has been done by several sorts of Goods carried from infected Places to others. Some of these I shall hereafter be obliged to mention; at present I shall confine myself to three Instances only. Thefirstshall be of the Entrance of thePlagueintoRomein the Year 1656, which we are assured was conveyed thither fromNaplesby Clothes and other Wares from that Place, brought first to PortNeptuno, and carried from thence to the Neighbouring Castle of St.Lawrence: which after having been kept some time there, were conveyed intoRome[51]. ThesecondInstance I shall take is from the Account given us of the Entrance of the Plague intoMarseilles[52]; which being drawn up with great Exactness, may be the more rely’d on. It appears indisputably by this Account, that the Mischief was brought thither by Goods from theLevant. For the first, who had the Distemper, wasone of theCrewof theShip, which brought thoseGoods: the next were those, who attended upon the sameGoods, while they were underQuarantaine; and soon after theSurgeon, whom the Magistrates ofMarseillesappointed to examine the Bodies of those, who died.
ThisRelation, if duly consider’d, is, I believe, sufficient to remove all the Doubts any one can have about the Power ofMerchandizeto conveyInfection: for it affords all the Evidence, the most scrupulous can reasonably desire. Possibly there might be some Fever of extraordinary Malignity inMarseilles, such as is commonly calledPestilential, before the Arrival of these Goods: But no such Fever has any indisputable Right to the Title ofPestilence, as I have beforeshewn. On the contrary, these two, the realPestilence, and suchPestilential Fevers, must carefully be distinguished, if we design to avoid all Mistakes in reasoning upon these Subjects.
Somesuch Fever of uncommon Malignity, I say, might perhaps be inMarseillesbefore the Arrival of these Goods. There might likewise perhaps be an Instance or two ofFeversattended withEruptions, bearing some Resemblance to those of thePlague: for such I my self have sometimes seen here inLondon. But it is not conceivable, that there should be any Appearance of the truePlaguebefore that time: for it was full six Weeks from the time of the Sailor’s Death, which had given the Alarm, and raised a general Attention, before the Magistrates received Information ofany one’s dying of thePlaguein the City. And I believe it was never known, that thePlague, being once broke out, gave so long a Truce in hot Weather.
ThePlague, which has this present Year almost depopulatedMessina, affords athirdInstance of the same kind. By an authentic Relation of it, published here[53]we are informed, that aGenoeseVessel from theLevant, arrived at that City; and upon notice given that a Sailor, who had touched some Cases ofCotton Stuffsbought up atPatrassoin theMorea, where the Distemper then raged, was dead of the Plague, in the Voyage; the Ship was put underQuarantaine: during which time theCotton Stuffswere privately landed. The Master and some Sailorsdying three days after, the Vessel was burnt. These Goods lay for some time concealed, but were soon after publickly sold: upon which the Disease immediately broke out in thatQuarterwhere they were opened; and afterwards was spread through the whole City.
I think it not improper, for the fuller Confirmation of the present Point, to give a Relation communicated to me by a Person of unquestionable Credit, of the like Effect from Goods, in respect to theSmall-Pox; which Distemper is frequently carried in the Nature of thePlagueboth to theEastandWest-Indiesfrom these Countries, and was once carried from theEast-Indiesto theCape of Good Hope, in the following manner. About the Year 1718, a ship from theEast-Indiesarrived at that Place: Inthe Voyage three Children had been sick of theSmall-Pox: The foul Linen used about them was put into a Trunk, and lock’d up. At the Ship’s Landing, this was taken out, and given to some of the Natives to be washed: Upon handling the Linen, they were immediately seized with theSmall-Pox, which spread into the Country for many Miles, and made such a Desolation, that it was almost dispeopled.
Ithas been thought so difficult to explain the manner howGoodsretain the Seeds ofContagion, that some[54]Authors have imaginedInfectionto be performed by the Means ofInsects; theEggsof which may be conveyed from Place to Place, and make the Disease when they come to behatched.But as this is a Supposition grounded upon no manner of Observation, so I think there is no need to have recourse to it. If, as we have conjectured, theMatterofContagionbe an active Substance generated chiefly from animal Corruption; it is not hard to conceive how this may be lodged and preserved in soft porous Bodies, which are kept pressed close together.
Weall know how long a timePerfumeshold their Scent, if wrapt up in proper Coverings: And it is very remarkable, that the strongest of these, like the Matter we are treating of, are mostlyanimal Juices, asMosch,Civet, &c. and that the Substances, found most fit to keep them in, are the very same with those, which are most apt to receive and communicate Infection,asFurrs,Feathers,Silk,Hair,Wool,Cotton,Flax, &c. the greatest part of which are likewise of theanimalkind.
Nothingindeed can give us so just a Notion ofInfection, and more clearly represent the manner of it, thanOdoriferousBodies. Some ofthesedo strangely revive the animal Spirits; others instantaneously depress and sink them: We may therefore conceive that, what active particles emitted from any such Substances do, is in the like way done byPestiferousBodies; so thatContagionis no more than the effect of volatile offensive Matter drawn into the Body by ourSmelling.
Thethird Cause we assigned for the spreading ofContagion, was a corrupted State ofAir. Although theAirbe in a right State, yet asick Person may infect those who are very near him: As we find thePestilenceto continue sometimes among theCrewof a Ship, after they have sailed out of the Infectious Air wherein the Disease was first caught. A remarkable Accident of this Nature is recorded to have happened in thePlagueatGenoain the Year 1656. Eleven Persons put to Sea in aFelucca, with design to withdraw themselves from theContagion, and retire intoProvence; but one of them falling sick of thePlaguesoon after they had imbarked, infected the rest; insomuch that others being taken ill, and dying in their turns, they were not admitted any where, but were forced to return from whence they came: and by that time the Boat arrived again atGenoano more than one of them survived[55].
Howeverin this Case the Malady does not usually spread far, thecontagiousParticles being soon dispersed and lost. But when in a corrupt Disposition of theAirthecontagiousParticles meet with the subtile Parts generated by that Corruption, by uniting with them they become much more active and powerful, and likewise of a more durable Nature; so as to form an infectious Matter capable of conveying the Mischief to a greater distance from the diseased Body, out of which it was produced.
Ingeneral, ahot Airis more disposed to spreadContagionthan a cold one, as no one can doubt, who considers how much all kinds ofEffluviaare farther diffused in awarm Air, than in the contrary. But moreover, that State ofAir, whenunseasonable Moisture and want of Winds are added to its Heat, which gives birth to thePlaguein some Countries, will doubtless promote it in all. ForHippocratessets down the same Description of aPestilential Stateof Air in his Country, as theArabiansdo of the Constitution, which gives Rise to thePlagueinAfrica[56].Mercurialisassures us the same Constitution ofAirattended thePestilencein his time atPadua[57]: andGassendusobserved the same in thePlagueofDigne[58]. Besides, it is easy to shew how theAir, by the sensible ill Qualities discoursed of in the last Chapter,should favour infectious Diseases, by rendering the Body obnoxious to them.
Indeedother hurtful Qualities of theAirare more to be regarded than its Heat alone: for thePlagueis sometimes stopt, while the Heat of the Season increases, upon the Emendation of theAirin other respects. AtSmyrnathePlague, which is yearly carried thither by Ships, constantly ceases about the 24th ofJune, by the dry and clear Weather they always have at that time: the unwholsome Damps being then dissipated that annoy the Country in theSpring. However, the Heat of the Air is of so much Consequence, that if any Ship brings it in the Winter Months ofNovember,December,January, orFebruary, it never spreads: but if later in the Year, as inAprilor afterwards, itcontinues till the time before mentioned.
Butmoreover, what was said before of some latent Disorders in theAirhaving a share in spreading thePlague, will likewise have place in these Countries; as the lastPlaguein the City ofLondonremarkably proves, the Seeds of which, upon its first Entrance, and while it was confined to a House or two, preserved themselves through a hard frostyWinter, and again put forth their malignant Quality as soon as the Warmth of theSpringgave them force: but, at the latter end of the next Winter they were suppressed so as to appear no more, though in the Month ofDecembermore than half theParishesof the City were infected.
Acorrupted Stateof Air is, without doubt, necessary to give these contagious Atoms their full force; for otherwise it were not easy to conceive how thePlague, when once it had seized any Place, should ever cease but with the Destruction of all the Inhabitants: Which is readily accounted for by supposing an Emendation of the Qualities of theAir, and the restoring of it to a healthful State capable of dissipating and suppressing the Malignity.
Onthe other hand, it does not appear, that theAir, however corrupted, is usually capable of carrying Infection to a very great distance; but that commonly thePlagueis spread from Town to Town by infected Persons and Goods: for there are numberlessInstances, where thePlaguehas caused a great Mortality in Towns, while other Towns and Villages, very near them, have been entirely free. And hence it is, that thePlaguesometimes spreads from Place to Place very irregularly.Thuanus[59]speaks of aPlagueinItaly, which one Year was atTrentandVerona, the next got intoVeniceandPadua, leavingVicenza, an intermediate Place, untouched, though the next Year that also felt the same Stroke: a certain Proof that thePlaguewas not carried by theAirfromVeronatoPaduaandVenice; for the infectedAirmust have tainted all in its Passage. We have had lately inFranceone Instance of the same Nature, when thePlaguewas carried at once out ofProvenceseveral Leagues into theGevaudan.Usually indeed thePlague, especially when more violent than ordinary, spreads from infected Places into those which border upon them: which probably is sometimes effected by some little Communication infected Towns are obliged to hold with the Country about them for the sake of Necessaries, the Subtlety of the Venom now and then eluding the greatest Precautions; and at other times by such as withdraw themselves from infected Places into the Neighbourhood.
I ownit cannot be demonstrated, that when thePlaguemakes great Ravage in any Town, the Number of Sick shall never be great enough to load theAirwith infectiousEffluvia, emitted from them in such Plenty, that they may be conveyed by the Winds into a neighbouring Town or Village without beingdispersed so much as to hinder their producing any ill Effects; especially since it is not unusual for theAirto be so far charged with these noxiousAtoms, as to leave no Place within the infected Town secure: insomuch that when the Distemper is at its Highth, all shall be indifferently infected, as well those who keep from the Sick, as those who are near them; though at the beginning of aPlagueto avoid all Communication with the Diseased, is an effectual Defence. However, I do not think this is often the Case: just as theSmoak, with which theAirof the City ofLondonis constantly impregnated, especially inWinter, is not carried many Miles distant; though the Quantity of it is vastly greater than the Quantity of infectiousEffluvia, that the most mortalPlaguecould generate.
But, to conclude what relates to theAir, since the ill Qualities of it in theseNorthernCountries are not alone sufficient to excite thePlague, without importedContagion, this shews the Error of a common Opinion, countenanc’d by Authors of great Name[60], that we are necessarilyvisitedwith thePlagueonce in thirty or forty Years: which is a mere Fancy, without Foundation either in Reason or Experience; and therefore People ought to be delivered from such vain Fears. Since thePestilenceis never originally bred with us, but always brought accidentally from abroad, its coming can have no relation to any certain Period of Time. And although our three or four lastPlagueshave fallen out nearly at such Intervals,yet that is much too short a Compass of Years to be a Foundation for a general Rule. Accordingly we see that almost fourscore Years have passed over without any Calamity of this kind.
TheAirof our Climate is so far from being ever the Original of the truePlague, that most probably it never produces those milder infectious Distempers, theSmall-PoxandMeasles. For these Diseases were not heard of inEuropebefore theMoorshad enteredSpain: and (as I have observed in thePreface) they were afterwards propagated and spread through all Nations, chiefly by means of the Wars with theSaracens.
Moreover, we are so far from any Necessity of these periodical Returns of thePlague, that, on thecontrary, though we have had several Strokes of this kind, yet there are Instances of badContagionsfrom abroad being brought over to us, which have proved less malignant here, when ourNorthern Airhas not been disposed to receive such Impressions.
TheSweating Sickness, before hinted at, calledSudor AnglicusandFebris Ephemera Britannica, because it was commonly thought to have taken its Rise here, was most probably of a foreign Original: and though not the commonPlaguewithGlandular Tumors, andCarbuncles, yet a realPestilencefrom the same Cause, only altered in its Appearance, and abated in its Violence, by the salutary Influence of our Climate. For it preserved an Agreement with the commonPlaguein many of itsSymptoms, asexcessive FaintnessandInquietudes,inward Burnings, &c. theseSymptomsbeing no where observed in so intense a Degree as here they are described to have been, except in the truePlague: And, what is much more, it was likewise acontagiousDisease.
Thefirst time this was felt here, which was in the Year 1485, it began in the Army, with which KingHenryVII. came fromFranceand landed inWales[61]: and it has been supposed by some to have been brought from the famous Siege ofRhodesby theTurksthree or four Years before, as may be collected from what Dr.Keyessays in one Place of his Treatise on this Disease[62].Besides, of the several returns which this has made since that time,viz.in the Years 1506, 1517, 1528, and 1551, that in the Year 1528 may very justly be suspected to have been owing to the commonPestilence, which at those times raged inItaly[63]as I find one of our Historians has long ago conjectured[64]: and the others were very probably from aTurkishInfection. If at least some of these Returns were not owing to the Remains of former Attacks, a suitable Constitution of Air returning to put the latent Seeds in Action before they were quite destroyed. It is the more probable that this Disease was owing toimported Contagion; because we are assured, that this Formof the Sickness was not peculiar to our Island, but that it made great Destruction with the same Symptoms inGermany, and other Countries[65].
I call this Distemper aPlaguewith lessened Force: because though its carrying off thousands for want of right Management was a Proof of its Malignity, which indeed in one respect exceeded that of the commonPlagueitself (for few, who were destroyed with it, survived the Seizure above one Natural Day) yet its going off safely withprofuse Sweatsin twenty four Hours, when due care was taken to promote that Evacuation, shewed it to be what a learned and wise Historian calls it,rather a Surprize to Nature, thanobstinatetoRemedies; who assigns this Reason for expressing himself thus, thatif the Patient was kept warm with temperate Cordials, he commonly recovered[66]. And, what I think yet more remarkable,Sweating, which was the naturalCrisisof this Distemper, has been found by great Physicians the best Remedy against the commonPlague: by which means, when timely used, that Distemper may sometimes be carried off without any externalTumors. Nay besides, a judicious Observer informs us, that in many of his Patients, when he had broken the Violence of the Distemper by such an artificialSweat, a naturalSweatnot excited by Medicines would break forth exceedingly refreshing[67].
AndI cannot but take notice, as a Confirmation of what I have been advancing, that we had here the same kind of Fever in the Year 1713, about the Month ofSeptember, which was called theDunkirk Fever, as being brought by our Soldiers from that Place. This probably had its Original from thePlague, which a few Years before broke out atDantzick, and continued some time among the Cities of theNorth. With us this Fever began only with a Pain in the Head, and went off in largeSweatsusually after a Day’s Confinement: but atDunkirkit was attended with the additional Symptoms ofVomiting,Diarrhœa, &c.
Toreturn from this Digression: From all that has been said, it appears, I think, very plainly, thatthePlagueis a real Poison, which being bred in the Southern Parts of the World, is carried by Commerce into other Countries, particularly intoTurky, where it maintains itself by a kind of Circulation from Persons to Goods: which is chiefly owing to the Negligence of the People there, who are stupidly careless in this affair. That when the Constitution of theAirhappens to favourInfection, it rages there with great Violence: that at that time more especially diseased Persons give it to one another, and from themcontagious Matteris lodged in Goods of a loose and soft Texture, which being pack’d up and carried into other Countries, let out, when opened, the imprisoned Seeds ofContagion, and produce the Disease whenever theAiris disposed to give them force; otherwise they may be dissipated without any considerableill Effects. And lastly, that theAirdoes not usually diffuse and spread these to any great Distance, if Intercourse and Commerce with the Place infected be strictly prevented.
Asit is a Satisfaction to know, that thePlagueis not a Native of our Country, so this is likewise an Encouragement to the utmost Diligence in finding out Means to keep our selves clear from it.
ThisCaution consists of two Parts:The preventing its beingbrought into our Island; and, if such a Calamity should happen,the putting a Stop to its spreading among us.
Thefirst of these is provided for by the established Method of obliging Ships, that come frominfectedPlaces, toperform Quarantaine: As to which, I think it necessary, that the following Rules be observed.
Nearto our several Ports, there should beLazaretto’sbuilt in convenient Places, on little Islands, if it can so be, for the Reception both of Men and Goods, which arrive from Places suspected ofInfection: The keeping Men inQuarantaineon board the Ship being not sufficient; the only use of which is to observe whether any die among them. ForInfectionmay bepreserved so long in Clothes, in which it is once lodged, that as much, nay more of it, if Sickness continues in the Ship, may be brought on Shore at the end than at the beginning of the forty Days: Unless a newQuarantainebe begun every time any Person dies; which might not end, but with the Destruction of the whole Ship’s Crew.
Ifthere has been anycontagiousDistemper in the Ship; thesoundMen should leave their Clothes, which should be sunk in the Sea, the Men washed and shaved, and having fresh Clothes, should stay in theLazarettothirty or forty Days. The reason of this is, because Persons may be recovered from a Disease themselves, and yet retainMatterofInfectionabout them a considerable time: as we frequently see theSmall-Poxtakenfrom those, who have several Days before passed through the Distemper.
TheSick, if there be any, should be kept in Houses remote from theSound, and, some time after they are well, should also be washed and shaved, and have fresh Clothes; whatever they wore while sick being sunk or buryed: And then being removed to the Houses of theSound, should continue there thirty or forty Days.
I amparticularly careful to destroy theClothesof the Sick, because they harbour the veryQuintessenceofContagion. A very ingenious Author[68], in his admirable Description of thePlagueatFlorencein the Year 1348, relates what himselfsaw: That twoHogsfinding in the Streets theRags, which had been thrown out from off a poor Man dead of the Disease, after snuffling upon them, and tearing them with their Teeth, they fell into Convulsions, and dy’d in less than an Hour. The learnedFracastoriusacquaints us, that in his time, there being aPlagueinVerona, no less than twenty five Persons were successively kill’d by the Infection of oneFurrGarment[69]. AndForestusgives a like Instance of seven Children, who dy’d by playing upon Clothes brought toAlckmaerinNorth-Holland, from an infected House inZealand[70]. The late Mr.Williams, Chaplain to SirRobert Sutton, when Embassador atConstantinople, used to relate a Storyof the same Nature told him by aBassa: that in an Expedition thisBassamade to the Frontiers ofPoland, one of theJanizariesunder his Command dy’d of thePlague; whose Jacket, a very rich one, being bought by anotherJanizary, it was no sooner put on, but he also was taken sick and dy’d: and the same Misfortune befel fiveJanizariesmore, who afterwards wore it. This theBassarelated to Mr.Williams, chiefly for the sake of this farther Circumstance, that the Incidents now mentioned prevailed upon him to order the burning of the Garment: designing by this Instance to let Mr.Williamssee there wereTurks, who allowed themselves in so much Freedom of Thought, as not to pay that strict Regard to theMahometanDoctrine of Fatality, as the Vulgar among them do.
Ifthere has been no Sickness in the Ship, I see no reason why the Men should performQuarantaine. Instead of this, they may be washed, and their Clothes aired in theLazaretto, as Goods, for one Week.
Butthe greatest Danger is from suchGoods, as are apt to retain Infection, such asCotton,HempandFlax,PaperorBooks,Silkof all sorts,Linen,Wool,Feathers,Hair, and all kinds ofSkins. TheLazarettofor these should be at a Distance from that for the Men; and they must in convenient Warehouses be unpack’d, and exposed, as much as may be, to the fresh Air for forty Days.
Thismay perhaps seem too long; but as we don’t know how much time precisely is necessary topurge the Interstices of spongy Substances frominfectious Matterby fresh Air, the Caution cannot be too great in this Point. Certainly the time here proposed, having been long established by general Custom, ought not in the least to be retrenched; unless there could be a way found out of trying when Bodies have ceased to emit the noxious Fumes. Possibly this might be discovered by putting tenderAnimalsnear to them, particularly littleBirds: because it has been observed in Times of thePlague, that the Country has been forsaken by theBirds; and those kept in Houses have many of them died[71]. Now if it should be found, thatBirdslet loose among Goods at the beginning of theirQuarantaine, areobnoxious to theContagionin them, it may be known, in good measure, when such Goods are become clean, by repeating the Trial tillBirdslet fly among them receive no hurt. But the Use of this Expedient can be known only by Experience. In the mean time, I own I am fond of theThought, in compassion to poor Labourers, who must expose their Lives to danger, in the attendance upon this Work: and tho’ I am well aware that there arePlaguesamong Animals, which do not indifferently affect all kinds of them, some being confined to a particularSpecies, (like the Disease of theBlack Cattlehere, a few Years since, which neither proved infectious to other Brutes, nor to Men;) yet it has always been observed that the truePlagueamong Men has been destructive to all Creatures of what kind soever.
A very remarkable Story, lately communicated to me by a Person of undoubted Credit, is too much to the purpose to be here omitted. The Fact is this. In the Year 1726, an English Ship took in Goods atGrand Cairo, in the time of thePlague’sraging there, and carried them toAlexandria. Upon opening one of the Bales of Wool in a Field, twoTurksemployed in the Work were immediately killed: and someBirds, which happened to fly over the Place, dropp’d down dead.
However, the Use ofQuarantainesis not wholly frustrated by our Ignorance of the exact time required for this Purification: since theQuarantainedoes at least serve as a Trial whether Goods are infected or not; it being hardly possible that every one of those, who areobliged to attend upon them, can escape hurt, if they are so. And whenever that happens, the Goods must be destroyed.
I takeit for granted, that theGoodsshould beopened, when they are put into theLazaretto, otherwise their being there will avail nothing. This is the constant Practice in thePortsofItaly. That it is so atLeghorn, appears by the Account lately published of the Manner, in whichQuarantainesare there performed: and I find, that the same Rule is observed atVenice, from an authentic Paper, I have before me, containing the Methods made use of in that City, whereQuarantaineshave been enjoined ever since the Year 1484; at which time, as far as I can learn, they were first instituted inEurope. In that Place allBalesofCotton, ofCamel’s or ofBeaver’sHair, and the like, areriptopen from end to end, andHolesmade in them by thePortersevery Day, into which they thrust their naked Arms, in order that the Air may have free Access to every part of the Goods. That some such Cautions as these ought not to be omitted, is clearly proved by the Misfortune, which happened in the Island ofBermudasabout the Year 1695; where, as the Account was given me by the learned Dr.Halley, a Sack ofCottonput on Shore by Stealth, lay above a Month without any Prejudice to the People of the House, where it was hid: but when it came to be distributed among the Inhabitants, it carried such aContagionalong with it, that the Living scarce sufficed to bury the Dead. This Relation Dr.Halleyreceived from CaptainTuckerofBermudas, Brother to Mr.Tuckerlate Under-Secretary in our Secretary’s Office.
Indeed, as it has been frequently experienced, that of all the Goods, which harbourInfection,Cottonin particular is the most dangerous, andTurkyis almost a perpetualSeminaryof thePlague; I cannot but think it highly reasonable, that whateverCottonis imported from that part of the World, should at all Times be kept inQuarantaine: Because it may have imbibedInfectionat the Time of its packing up, notwithstanding no Mischief has been felt from it by the Ship’s Company. And the length of Time from its being pack’d up to its Arrival here, is no certain Security that it is cleared from theInfection. At least, it is found, that the Time employed by Ships in passing betweenTurkyandMarseilles, is not long enough for Goodsto lose theirInfection: as appears not only from the late Instance, but also from an Observation made in a certainMemorial, drawn up by the Deputy of Trade atMarseilles[72].Marseillesis the only Port inFranceallowed to receive Goods from theLevant, on Account of its singular Convenience forQuarantaines, by Reason of several smallIslandssituate about it. ThePortsofFrancein theWestern Oceanhaving had a Desire to be allowed the same Liberty, their Deputies presented, in the Year 1701, aMemorialto theRoyal Council of Trade, containing several Reasons for their Pretensions. To this theDeputyatMarseillesmakes Reply in theMemorialI am speaking of, in which this AdvantageofMarseillesforQuarantainesabove the other Ports, is much insisted upon: and, to evince the Importance thereof, it is declared in express Words, that many Times Persons have been found in that Place to die of thePlaguein their Attendance upon Goods underQuarantaine. Now if it be certain, that Goods have retained Infection during their Passage fromTurkeytoMarseilles; it is too hardy a Presumption to be admitted in an Affair so important as this, that they must necessarily lose all Contagion in the Time of their coming to us, because the Voyage is something longer. But besides this, there are some few Instances of Goods, that have retained their Infection many Years. In particular,Alex. Benedictusgives a very distinct Relation of a Feather Bed, that was laid by seven Years on Suspicion of its being infected, whichproduced mischievous Effects attheEnd of that great Length of Time[73]. And SirTheodore Mayernerelates, that some Clothes fouled with Blood and Matter fromPlagueSores being lodged betweenMattingand the Wall of a House in Paris, gave thePlagueseveral Years after to a Workman, who took them out, which presently spread through the City[74].
WhatmakesCottonso eminently dangerous, is its great Aptitude to imbibe and retain any Sort ofEffluvianear it; of which I have formerly made a particular Experiment, by causing someCottonto be placed for one Day near a Pieceofputrefying Fleshfrom an amputated Limb, in a Bell-Glass, but without touching it: for theCottonimbibed so strong a Taint, that being put up in a close Box, it retained its offensive Scent above ten Months, and would, I believe, have kept it for Years. If, instead of the Fumes ofputrefied Fleshfrom a sound Body, thisCottonhad been thus impregnated with the Fumes of corrupted Matter from one sick of thePlague; I make no doubt but it would have communicated Infection. And the Experiment would have succeeded alike in both Cases, if instead ofCotton,Silk,Wool, orHairhad been inclosed in the Vessel: Animal Substances being the most apt to attract the volatile Particles, which come from Bodies of the same Nature with themselves.
Asall reasonable Provisions should be made both for theSoundandSick, who performQuarantaine; so the strict keeping of it ought to be inforced by the severestPenalties. And if a Ship comes from any Place, where thePlagueraged, at the Time of the Ship’s Departure from it, with more than usual Violence; it will be the securest Method tosinkall theGoods, and even theShipsometimes: especially if any on Board have died of the Disease.
Norought this farther Caution to be omitted, that when theContagionhas ceased in any Place by the Approach of Winter, it will not be safe to open a free Trade withittoo soon: because there are Instances of theDistemper’s being stopt by the Winter Cold, and yet the Seeds of it not destroyed, butonly kept unactive, ’till the Warmth of the following Spring has given them new Life and Force. Thus in the greatPlagueatGenoaabout four-score Years ago, which continued Part of two Years; the first Summer aboutten Thousanddied; the Winter following hardly any; but the Summer after no less thansixty Thousand. Likewise the lastPlagueatLondonappeared the latter End of the Year 1664, and was stopt during the Winter by a hard Frost of near three Month’s Continuance; so that there remained no farther Appearance of it ’till the ensuing Spring[75]. Now if Goods brought from such a Place should retain any of the latentContagion, there will be Danger of their producing the same Mischief in the Place, to which they are brought,as they would have caused in that, from whence they came.
Butabove all, it is necessary, that theClandestine Importingof Goods be punished with the utmost Rigour; from which wicked Practice I should always apprehend more Danger of bringing theDiseasethan by any other Way whatsoever.
Theseare, I think, the most material Points, to which Regard is to be had in defending ourselves againContagionfrom other Countries. The particular Manner of putting these Directions in Execution, as theVisitingofShips,RegulationofLazaretto’s, &c. I leave to proper Officers, who ought sometimes to be assisted herein by able Physicians.
Thenext Consideration is, what to do in Case, through a Miscarriage in the publick Care, by the Neglect of Officers, or otherwise, such a Calamity should be suffered to befal us.
Thereis noEvilin the World, in which the great Rule ofResisting the Beginning, more properly takes Place, than in the present Case; and yet it has unfortunately happened, that the common Steps formerly taken have had a direct Tendency to hinder the puttingthis Maximin Practice.
AsthePlaguealways breaks outin some particular Place, it is certain, that the Directions of theCivil Magistrateought to be such, as to make it as much for the Interest of infected Families to discover their Misfortune, as it is, when a House is onFire, to call in the Assistance of the Neighbourhood: Whereas, on the contrary, the Methods taken by the Publick, on such Occasions, have always had the Appearance of a severeDiscipline, and evenPunishment, rather than of aCompassionate Care; which must naturally make theInfectedconceal the Disease as long as was possible.
Themain Import of theOrdersissued out at these Times was[76]; Assoon as it was found, that any House was infected, to keep it shut up, with alarge red Cross, and these Words,Lord, have Mercy upon us, painted on the Door; Watchmen attending Day and Night to prevent any one’s going in or out, except suchPhysicians,Surgeons,Apothecaries,Nurses,Searchers, &c. as were allowed by Authority: And this to continue at least a Month after all the Family wasdeadorrecovered.
Itis not easy to conceive a more dismal Scene of Misery, than this: Families lock’d up from all their Acquaintance, though seized with a Distemper which the most of any in the World requires Comfort andAssistance; abandoned it may be to the Treatment of an inhumane Nurse (for such are often found at these times about the Sick;) and Strangers to every thing but the melancholy Sight of the Progress, Death makes among themselves: with small Hopes of Life left to the Survivers, and those mixed with Anxiety and Doubt, whether it be not better to die, than to prolong a miserable Being, after the Loss of their best Friends and nearest Relations.
IfFear,Despair, and allDejection of Spirits, dispose the Body to receiveContagion, and give it a great Power, where it is received, as all Physicians agree they do; I don’t see how a Disease can be more inforced than by such a Treatment.
Nothingcan justify suchCruelty, but the Plea, that it is for the Good of the wholeCommunity, and prevents the spreading ofInfection. But this upon due Consideration will be found quite otherwise: For whileContagionis kept nursed up in a House, and continually encreased by the daily Conquests it makes, it is impossible but theAirshould become tainted in so eminent a degree, as to spread theInfectioninto the Neighbourhood upon the first Outlet. The shutting up Houses in this Manner is only keeping so manySeminariesofContagion, sooner or later to be dispersed abroad: For the waiting a Month, or longer, from the Death of the last Patient, will avail no more, than keeping aBaleof infectedGoodsunpack’d; the Poyson will fly out, whenever thePandora’s Boxis opened.
Asthese Measures were owing to the Ignorance of the true Nature ofContagion, so they did, I firmly believe, contribute very much to the long Continuance of thePlague, every time they have been practised in this City: And no doubt, they have had as ill Effects in other Countries.
Itis therefore no wonder, that grievous Complaints were often made against this unreasonable Usage; and that the Citizens were all along under the greatest apprehensions of being thusShut up. This occasioned their concealing the Disease as long as they could, which contributed very much to the inforcing and spreading of it: and when they were confined, it often happened that they broke out of theirImprisonment, either by getting out at Windows,&c.or by bribing the Watchmen at their Doors; and sometimes even by murdering them. Hence in the Nights, people were often met running about the Streets, with hideousShrieksofHorrorandDespair, quiteDistracted, either from the violence of the Fever, or from the Terrors of Mind, into which they were thrown by the daily Deaths they saw of their nearest Relations.
Inthese miserable Circumstances, many ran away, and when they had escaped, either went to their Friends in the Country, or built Hutts or Tents for themselves in the open Fields, or got on board Ships lying in the River. A few also were saved by keeping their Houses close from all communication with their Neighbours[77].
Andit must be observed, that whenever popular Clamours prevailed so far, as to procure some Release for theSick, this was remarkably followed with an Abatement of the Disease. ThePlaguein the Year 1636 began with great Violence; but leave being given by the King’s Authority for People to quit their Houses, it was observed, Thatnot one in twenty of the well Persons removed fell sick, nor one in ten of the Sick died[78]. Which single Instance alone, had there been no other, should have been of Weight ever after to have determined the Magistracy against too strict Confinements. But besides this, a precedingPlague,viz.in the Year 1625, affords us another Instance of a veryremarkable Decrease upon the discontinuing toshut upHouses. It was indeed so late in the Year, before this was done, that the near Approach of Winter was doubtless one Reason for the Diminution of the Disease, which followed: Yet this was so very great, that it is at least past dispute, that the Liberty then permitted was no Impediment to it. For thisopeningof the Houses was allowed of in the beginning ofSeptember: and whereas the last Week inAugust, there died no less than four thousand two hundred and eighteen, the very next Week theBurialswere diminished to three thousand three hundred and forty four; and in no longer time than to the fourth Week after, to eight hundred and fifty two[79].
Sincetherefore the Management in former Times neither answers the Purpose ofdiscovering the Beginningof theInfection, nor of putting a stop to it whendiscovered, other Measures are certainly to be taken; which, I think, should be of this Nature.
Thereought, in the first Place,a Council of Healthto be established, consisting of some of the principal Officers of State, both Ecclesiastical and Civil, some of the chief Magistrates of the City, two or three Physicians,&c.And thisCouncilshould be intrusted with such Powers, as might enable them to see all their Orders executed with impartial Justice, and that no unnecessary Hardships, under any Pretence whatever, be put upon any by the Officers they employ.
Insteadofignorant old Women, who are generally appointedSearchersin Parishes to inquire what Diseases People die of, thatOfficeshould be committed tounderstanding and diligent Men: whose Business it should be, as soon as they find any have dy’d after an uncommon Manner, particularly withlivid Spots,Bubo’s, orCarbuncles, to give Notice thereof to theCouncil of Health; who should immediately send skilful Physicians to examine the suspected Bodies, and to visit the Houses in the Neighbourhood, especially of thepoorerSort, among whom this Evil generally begins. And if upon their Report it appears, that aPestilential Distemperis broken out, they should without Delay order all the Families, in which the Sickness is, to beremoved; theSickto different Places from theSound:but the Houses for both should be three or four Miles out of Town; and theSoundPeople should bestript of all their Clothes, andwashedandshaved, before they go into their new Lodgings. These Removals ought to be made in the Night, when the Streets are clear of People: which will prevent all Danger of spreading the Infection. And besides, all possible Care should be taken to provide such Means of Conveyance for theSick, that they may receive no Injury.