3. The dispute is of no consequence, and the experiment will prove the same thing whether we suppose the poison to act upon the irritable fibre (the nerves and muscles) or upon the blood. The only important point to be ascertained is, whether there be in nature any substance which, applied to the internal parts of the body, or to a wound, will instantly disorder the whole in such a manner as to bring on a violent disease which may prove mortal in a short time. If any such there is, that substance, whether solid or fluid, visible or invisible, may with propriety be calledcontagion; and if any such proceedsfrom the body of a diseased person to one in health, the vapour so proceeding isinfection. As to themodeof its operation we are little concerned; the sudden manner in which people are affected shows that poisons kill by suppressing in a very short time the principle of life, which seems to be analogous to electricity, or rather the very same with it; neither is it more incredible that the poison of a serpent should kill by disturbing the natural electricity of the body, than that the stroke of a torpedo, or electrical eel, should kill by the same means. The only difference is, that, in the case of poisons, the pernicious substance is introduced into the body itself; in the torpedo, it comes with violence from without. The former we may compare to the silent discharge of an electrified jar by a point, the latter to its discharge with a violent flash by a knob. But that in poisonous bites the blood is greatly affected, and that in a very short time, we certainly know. There are some kinds of serpents whose bites are so suddenly fatal, that no cure can be applied: one of these, called the smalllaharra, is mentioned by Mr. Bancroft in his Natural History of Guiana. Mr. D’Opsonville, in his Philosophic Essays, takes notice of one in the East-Indies, which he calls thepoison serpentorserpent poison, which seems to be as bad as thelaharramentioned by Bancroft. This too is but small, viz. two feet long, and very slender. Its skin is freckled with “little traits of brown, or a pale red, and contrasted with a ground of dirty yellow: it is mostly found in dry and rocky places, and its bite proves mortal in less than one or two minutes. In the year 1759, and in the province of Cadapet, I saw several instances of it; and, among others, one very singular, in the midst of a corps of troops, commanded by M. de Bussy. An Indian Gentoo merchant perceived a Mahometan soldier of his acquaintance going to kill one of these reptiles, which he had found sleeping under his packet. The Gentoo flew to beg its life, protesting that it would do no hurt if it was not first provoked; passing at the same time his hand under its belly, to carry it out of the camp; whensuddenly it twisted round, and bit his little finger; upon which this unfortunate martyr of a fanatic charity gave a shriek, took a few steps, and fell down insensible. They flew to his assistance, applied the serpent-stone, fire, and scarifications, but they were all ineffectual; his blood was alreadycoagulated.94About an hour after I saw the body as they were going to burn it, and I thought I perceived some indications of acomplete dissolution of the blood.”
The bite of thebrulanorburning serpent, according to the same author, is almost as terrible. “This is nearly of the same form with the last, its skin is not quite so deep a brown, and is speckled with dark green spots: its poison is almost as dangerous, but it is less active, and its effects are very different. In some persons it is a devouring fire, which, as it circulates through the veins, presently occasions death; the blood dissolves into a lymphatic liquor resembling thin broth, without apparently having passed through the intermediate state ofcoagulation,95and runs from eyes, nose and ears, and even through the pores. In other subjects the poison seems to have changed the very nature of the humours in dissolving them; the skin is chapped and becomes scaly, the hair falls off, the members are tumefied, the patient feels all over his body the most racking pains, then numbness, and is not long in perishing.”
From these accounts it is plain that poisons do operate very powerfully on the blood; and if they do so in one case it is reasonable to think that they do so in all. According to the degree of strength of the poison, however, we are sure that the effects will be more or less visible to us; but, though we should not be able to perceive any alteration whatever in the consistence or colour of the vital fluid, we cannot positively say that it hasnot undergone any change; for the spirit which operates in it is too subtile for our observation. In the beginning of almost all diseases, perhaps, blood drawn from a vein will not be perceptibly different from that of a person in health; and Dr. Fordyce particularly takes notice of this in fevers; but as the disease goes on, an alteration becomes very perceptible, which gives just ground for suspicion, that there had been some alteration from the very first, though invisible to us.
After all our disputes, however, we shall find that the controversy, though ultimately important, begins more about words and trifles than any thing else. Dr. Brown used the wordexcitability, Dr. Girtanner usesirritability, and the author of this treatise, the wordsvital spiritandelectricity, to express something equally unknown to them all. The only difference is, that Drs. Brown and Girtanner speak of their excitability and irritability as a kind of power essentially inherent in living bodies, acted upon indeed by certain substances, but incapable of deriving any supply from without; the author of this treatise considers it only as a modification in the human body, or anorganization, if we please to call it so, of that fluid which he believes to be universally diffused, under the names of heat, light and electricity. Hence that portion modified or organized in the human body must be under an entire and absolute dependence upon the immense mass of surrounding fluid, and, by any alteration in the motions of it, must be often very perceptibly affected; nevertheless as this fluid was originally created to preserve and not to destroy human life, there is much less danger from anaturalthan from anartificialcommotion in it. In some visible bodies, such as poisons, the fluid acts in such a manner as to counteract the operation of that part which is organized in the blood or nerves, or both. Hence on the introduction of such into the body the disorder flies like lightning through all parts of it, and in a very short time brings on death. In those vapours properly calledcontagions, the opposite action is less violent, and therefore the disorders they produce are in proportion. Hence such diseases may eitherbe promoted or retarded by the perceptible properties of the atmosphere, which in poisons have little or no effect. There is indeed a remarkable difference in the strength of the poison secreted in the bodies of serpents at certain seasons of the year, or according to their food. M. D’Opsonville observes that the poison of serpents is in general more powerful, the more they live in hot and dry places, where they feed upon insects that are full of saline, volatile and acrimonious particles. But, notwithstanding this difference in the strength of poisons according to the circumstances of time and place, there is not the least reason to suppose that poison of a given strength would not produce the very same effects, let the state of the atmosphere be what it would.
If therefore we certainly know that there are some kinds of aerial vapours which when applied to the human body do exert a power directly opposite to the vital principle, there is no reason to doubt that such vapours may be confined among certain soft substances, such as cotton, wool, &c. and remain there for an unknown length of time, again exerting their malignant powers, when a fresh object comes in their way. Besides, as all kinds of air with which we are acquainted consist of a basis united with the ethereal fluid and volatilised by it, there is reason to suppose that contagions themselves are formed in the same manner. Some kinds of air also are very easily decomposed, in which case the basis attaches itself to some terrestrial substance, the ethereal fluid which volatilised it diffusing itself around in an invisible manner, but generally with a perceptible heat. Fixed air affords a notable example of this; for, by exposing it to lime-water, or even dry lime, alkaline salt, volatile alkali, or common water, a decomposition of the air very readily takes place, and its basis is found to be attached to those substances. What happens to fixed air may also happen tocontagion. The basis of it may have a tendency to unite itself to cotton, or such like substances, and thus may not only infect them, but concentrate itself to such a degree as to produce a disease much more violent than that of the person who gave the infection;and something of this kind has even been observed with regard to infected cotton. But now another question occurs: As fixed air, by being attached to terrestrial substances, loses its aerial property, why should the basis of contagious effluvia still retain its malignant quality though in a state of decomposition? Here we are again helped out by analogy. Fixed air is known to be capable of resuming its aerial properties occasionally, from causes unknown to us, though we cannot suppose them to be any thing else than the invisible action of the ethereal fluid so often mentioned; which, being guided by laws unknown to us, we cannot possibly comprehend. The fact, however, is certain, that the basis of fixed air does very often quit the substances to which it is attached, and assume an aerial state in great quantity, and with very mischievous effects. Thus the old lavas of volcanoes, if chemically tried will be found atalltimes to contain great quantities of the basis of fixed air, but it is only atsometimes that the mofetes which are supposed to be the air itself, break forth.96In like manner the strata under ground always contain great quantities of the aerial basis, but thedampsin mines, which are certainly known to consist mostly of fixed air, do not always appear; neither do they gradually accumulate, but come suddenly, spreading unexpected destruction among those who unfortunately come in their way. The same may take place with contagion. After remaining some time in a state of decomposition it may have a tendency to become volatile again, or it may lie dormant entirely; and this last will explain what is quoted from Dr. Russel, p.178, that sometimes commerce may be carried on with infected places without danger.
Thus we see that the dispute, originally begun about a word, involves at last a matter of the utmost importance; for, if it be found unreasonable to believe that any such thing as contagion exists or can exist, it follows of course that it is also unreasonable to take any precautions against it. Mr. McLean even goes a step beyond those who deny the existence of contagion; for we findhim also denying that putrid effluvia can produce epidemics; according to which doctrine, it seems, we may not only safely visit places accounted the most dangerous on account of infection, but live in all manner of filth and nastiness with impunity. It is plain that no person can ever prove that it is impossible for contagion or any thing else tohave an existence. Indeed if nothing had ever induced people to believe that it did exist, it would have been superfluous to say any thing about it. But when we have innumerable testimonies to the contrary; when the opinions of the greatest physicians, as Dr. Lind, Dr. Clarke, Dr. Mead, Dr. Sydenham, Dr. Fordyce, Dr. Russel, &c. agree that not only the plague, but every kind of fever, is infectious; when we know from the analogy of nature that contagionmayexist; when we know that there certainlyarepowers in nature able to produce it; is all this to be thrown aside merely on the strength of a theory, and a theory too which can never be proved? for it is impossible to prove thenon-existenceof any thing, much less theimpossibilityof its existence. The lives of mankind are too precious to be sported with on philosophical theories; and prudence will always suggest, that wherever danger may at any time arise, there it is proper to be on our guard.
Dismissing at length the subject of contagion in general, we now enter upon the question, Whether doth it appear from fair investigation of testimony, that the plague has, at any time, been communicated by contagion or not? And here I shall confine myself to what has been adduced by Dr. P. Russel on the subject; for, if we find that the disease has onlyoncebeen introduced by contagion, it signifies nothing though we were able to prove, which we never can do, that it had beenan hundredtimes bred in some other way. The matter is of too great importance to allow even achanceof its importation by the neglect of the precautions necessary to prevent it.
Our author begins with observing, that though the infectious nature of the plague had been a question much agitated in the schools, “it was less to be expected thatphysicians who had been engaged in practice among the infected should have persisted in the opinion that the disease was never communicated by contagion.” Such, however, has been the case. In 1720 some French physicians laboured exceedingly to prove that the plague which then raged at Marseilles and throughout Provence arose from corrupt humours bred in the body in consequence of irregularity in the seasons, and bad aliment; that it was spread by the same means, in concurrence with terror, grief, despondence, or other debilitating affections of the mind; but was neither bred nor disseminated contagion. Dr. Russel mentions in a note, seemingly with surprise, that “so lateas the year 1778, Dr. Stoll of Vienna should have written expressly against the doctrine of pestilential contagion.” To this professor he thinks it a sufficient answer to quote the following passage from Mr. Howard on Lazarettos, “It must appear very strange, that he should go back to Livy’s Roman History for proofs to establish his point, totally neglecting all the facts concerning the numerous visitations of the plague recorded in modern medical books, or which had happened during his own time. I suppose professional men will lay very little stress upon all that can be said on pestilential diseases, in general, which happened in wars and sieges two thousand years ago, as applied to the plague properly so called, a disease then confounded with various others from which the accuracy of latter observations have sufficiently distinguished it.”
Dr. Russel complains of the French physicians at Marseilles having made unfair representations; particularly that while they produce as irrefragable arguments against contagion their own escape unhurt, amid circumstances of supposed danger, they pass slightly over, or omit all mention of numbers of the medical assistants whom they saw perish in the exercise of their profession. M. Dedier, however, who at first opposed the doctrine of infection, at last renounced his opinions so far as to allow that the disease might be communicated to dogs by injecting pestiferous bile into their veins; and helikewise admitted that it might be communicated from one human creature to another, by drawing in for a considerable time the breath of a diseased person, putting on his shirt, lying in the same bed-clothes, and touching the wounded parts of one’s own body with hands embrued with the sweat or blood of one infected. He affirms, however, that the atmosphere of a person in the plague is no more to be dreaded than that of a venereal patient; and that the touching or dressing of buboes or carbuncles is not attended with any danger. He restricts the infectious quality of the humours to the bile; but theinoculationof a person by the matter of a pestilentialulcer97undoubtedly decides this point against him.
On the subject of contagion Dr. Russel observes, that the vague manner in which the word has been used has given rise to much confusion. Some, taking advantage of the inaccurate mode of expression on this subject used by Dr. Mead, attacked him with sophistical nonsense. The following may serve as a specimen, from a pamphlet entitled “Distinct Notions of the Plague, &c. by theExplainer.” Thisexplainerobserves, that, according to Dr. Mead, “air and his other causes propagate and spread contagion, not the plague; and therefore either contagion and the plague are the same, or else the plague is not considered; if the first, then his causes propagate the plague; and the plague accompanies the plague; an excellent defence! But, if the plague is out of the play, then contagion accompanies nothing.”—From writers like this we certainly can expect nothing.
The opinion of Dr. Cullen concerning contagion has been already noticed, p.179; but though he supposes it to be a matter floating in the atmosphere, he observes that contagions are never “found to act but when they are near to the sources from whence they arise; that is, either near to the bodies of men, from which they immediately issue, or near to some substances which, as having been near to the bodies of men, are embuedwith their effluvia, and in which substances these effluvia are sometimes retained in an active state for a very long time. The substances thus embued with an active matter may be calledfomites; and it appears to me probable, that contagions as they arise from fomites, are more powerful than as they arise immediately from the human body.” This opinion concerning the great power of contagion imbibed by certain substances is conformable to what was above laid down by reasoninga priorion the nature of contagion.98It is doubted by Dr. Russel, but Dr. Lind adopts it, and Van Swieten gives his opinion to the same purpose. “I am convinced, that the body of the diseased, kept exactly neat and clean, is not so liable to impress the taint, as his late wearing apparel, dirty linen, and uncleanliness of any sort about him long retained in that impure state. I say, these last contain a more concentrated and contagious poison than the newly emitted effluvia or excretions of the sick.”
With regard to the original cause, our author observes, “that the plague is bred or produced originally from vitiated human effluvia, is a matter which has by no means been established on proper authority.” Setting aside therefore inquiries of this kind, he thinks it sufficient to inquire whether the infection be not communicated from a sick to a sound person by immediate contact; whether it be not also communicated at some distance through the medium of the air; and whether substances of various kinds do not imbibe the infectious effluvia, and retain them for a considerable time. So far as these points admit of proof from the experience of times past, the question concerning pestilential contagion will admit of a solution, independent of all theoretic reasoning whatever.
2. On the subject of contagion people have been embarrassed by confounding the true plague with other malignant diseases. This has been done, not only by the ancients, but by some moderns; and our author quotes Dr. Pye, saying “that any epidemic sickness,which rages with more than ordinary violence, and which occasions extraordinary mortality amongst mankind, may be, and is, properly termed a pestilence, or the plague.” By not attending to the proper distinctions, in these cases, circumstances belonging to what are commonly termed malignant or pestilential fevers will often come to be very improperly applied to the true plague.
3. “It may be remarked, that those who contend in favour of contagion, from zeal for accumulating proofs, have collected a number of facts from historical records of very unequal authority, and often with little critical skill in discrimination. Of this error their antagonists availing themselves, have selected from the mass the instances most liable to doubt or objection, and have endeavoured, by their manner of arranging them, to place the whole in a ridiculous light; while more important instances are either evasively past over, misstated in the representation, or invalidated by general declamation on the little credit due to historians in matters of physic, or the prejudices prevalent in ancient times of ignorance, and on contradictions to be found in the arguments of those who support the system of contagion.”
To this the Doctor adds the great quantity of hypothetical reasoning which has been introduced into the controversy, and above all the unfair dealing of the parties in carrying on the dispute, which has reduced the matter from “a calm inquiry in pursuit of truth, to a wrangling contest for victory.” Lastly he insists, that, had it not been for the misrepresentations and sinister dealings of those who have written against contagion, “the question seems to have been properly resolved in the affirmative;” and he complains greatly of the conduct of the Montpelier physicians in this respect, insomuch that “their misstating of circumstances, and the partiality so evidently discoverable in their narrative of cases, will serve more effectually to remove doubts on the subject, than any arguments that could be used against their hypothesis.”
On the subject of contagion our author observes, that some difficulties still remain; but these, though proper subjects of future inquiry, “do not appear to be of force sufficient to invalidate facts already established. It is well known, that the same person who has been inoculated two or three times for the small-pox without effect, even in an epidemic season, has afterwards received the infection upon repeating the operation at a distance of time when the disease was hardly sporadic. The cause of this remains unknown; but ignorance of it was never produced as an argument against the reality of variolous contagion. . . . If, of one hundred persons exposed to the infection of the plague by a near aproach to the sick, ninety should fall sick, shall human inability to assign satisfactory reasons for the escape of the other ten be converted into a positive proof against the disease having been caught by contagion? If persons retired from all commerce with the infected and their attendants, breathing the same air with the rest of the inhabitants, and nourished by the same aliment, remain untouched during the ravage of the plague, as long as they continue secluded, but, upon unguarded communication, are taken ill like others; can any rational doubt be entertained about the cause of their former security? Or if through stealth, or neglect of requisite precautions, substances tainted by the sick should be conveyed into these secluded retreats, and persons living temperately as before, ignorant of what had happened, and consequently in the midst of imaginary security, happen to be seized with the distemper; can it with any show of reason be ascribed, not to contagion, but to terror, or to colluvies in the stomach and bowels, produced by intemperance and bad aliment? The instances here alluded to are not thecreation of fancy, butstrictly consonant to repeated experiencein Turky; to say nothing at present of what has been observed at Marseilles and in various cities in Europe.”
“But a greater difficulty than that of all persons not being equally susceptible of the infection arises fromthe cessation of the plague, at a period when the supposed contagious effluvia, preserved in apparel, furniture, and other fomites, at the end of a pestilential season, must be allowed to exist, not only in a much greater quantity than can be supposed to be at once accidentally imported by commerce, but in a state also of universal dispersion over the city: the fact, however unaccountable, is unquestionably certain; the distemper seems to be extinguished by some cause or causes equally unknown as those which concurred to render it more or less epidemical in its advance and at its height. In Europe something may be ascribed to the means employed for the cleansing of houses and goods supposed liable to retain the latent seeds of infection; but, at Aleppo, where the distemper is left to take its natural course, and few or no means of purification are employed, it pursues nearly the same progress in different years: it declines and revives in certain seasons, and, at length, without the intervention of human aid, ceases entirely.”
On this we shall remark in general, that the failure of contagion in some cases to produce the usual effects may proceed from some constitution of the body, disposing it not to allow the cause to produce its usual effects at one time, though at another, the constitution may be so far changed as very readily to admit it. This opinion has been very generally received among medical people, who have, to this singularity of constitution given the name ofidiosyncrasy. It is, however laughed at by Mr. McLean. “As the fact (says he) cannot be denied, that a great majority have escaped after contact with persons ill of diseases supposed to be contagious, attempts may perhaps be made to account for it by supposing a certain peculiarity of constitution, which exempts from, or disposes to, disease. Is it the many who escape that have this happy peculiarity of constitution; or the few who are seized that are so unfortunate as to possesses it? The former are evidently too numerous to admit such an hypothesis. The property must therefore, I conclude, be given to the latter. But a child here andthere is exempted from small-pox, although exposed to its contagion. In order to preserve a consistency, this fact must be accounted for by the same or another peculiarity of constitution. Peculiarities of constitution, then, exempt from contagion in one case, and dispose to it in another; and thus a term, which in reality means nothing, may be made to account for any thing. For my own part I confess my inability to comprehend any otherpeculiaritiesofconstitution, oridiosyncrasies of habit, than what are constituted by the different degrees of health and disease; the different states of the excitability.”
In the same manner that Mr. McLean argues with regard to disease, let us argue concerning bodily strength. Some men are able to lift a weight of 6 or 700 pounds, but a great majority cannot lift above 300. Whence proceeds the difference? Is it the few who lift the great weight thatby naturehavemorestrength, or is it the many who can lift only the smaller thatby naturehaveless? This is precisely his argument, and there needs no other refutation than stating it in this manner. What he calls the states of excitability are as muchidiosyncrasiesat the time as any thing else. Mr. McLean will not deny that a person debilitated by certain causes is more liable to be seized with typhus fever than one who is not. What does this proceed from, but that the body of the one is prepared for the disease, isconstitutionallydisposed to receive it, or has anidiosyncrasyof habit disposing to it, which the other has not? It is true, that unless we point out the circumstances which constitute this idiosyncracy we do nothing; but Mr. McLean’s scheme, of resolving every thing intoexcitability, would forever prevent us from doing so. This is the great deficiency of the Brunonian system altogether; for, by attending only to the animal life of the body, he seems to have absolutely forgot that we had any thing in common with vegetables. The bones, for instance, or indeed any part of the body, cannot be formed by the power which governs it after it was formed. The growth of the human body is as strict vegetation as that of a tree; and thereforewe find that after the excitability is entirely gone, after death has taken place for a considerable time, the body still retains its form, and would do so forever, did not other powers interfere with it. Human life therefore is a compound of the vegetable and animal life, the former being the basis of the latter; and it is the vegetable life which is much more commonly the subject of disease than the animal life. In vegetables we observe anidiosyncracyof habit, as well as among animals. Some, even of the same species, are much more vigorous than others, and, among some, diseases are much more common than others. In like manner among the human race some are strong, others weak; in some the blood is much more confident, and coagulates on exposure to the air much more firmly than in others. Excitability, or excitement, is common to all, and the degrees of it (though enumerated by Yates and McLean in a kind of thermometrical scale) must be merely imaginary, because excitability is not the object of our senses. The obvious properties of the body itself, independent of any excitement whatever, are principally to be considered in medicine. These constitute the peculiar constitution, or theidiosyncracyof habit, belonging to each individual. Yet, in defiance of every confederation of these obvious properties, which all have access to observe, the new system leads us only to consider an invisible and unknown being calledexcitability. Hence diseases peculiar to certain constitutions more than others are said to be occasioned only by certain degrees of excitability common to all, or perhaps to consist in these very degrees themselves. Thus a peculiar mode of practice has been introduced, in which almost the whole materia medica is rejected. We have already quoted Dr. Girtanner, saying thatall diseases whatevermay becured, as well asproduced, by onlyfourarticles; but in the following quotation he goes still farther. “The art of pharmacy and the science of prescription will become useless; a phial of alcohol or laudanum will supply the place of that enormous quantity of drugs which crowd the shops of apothecaries. The trade of the druggist——but hold; if Icontinue this prophetic language, I shall only expose myself to ridicule,” &c. Reveries of this kind certainly deserve the most severe reproof. People may no doubt amuse themselves withtheoriesas well as any thing else, while these theories continue inoffensive; but when the belief of them leads to a rejection of what has been established by theexperienceof many ages, they begin to assume a consequence which they originally had not. We have already seen that a disbelief of the doctrine of contagion leads people into a practice accounted dangerous by many, and which cannot be proved to be safe. A total rejection of medicines, the efficacy of which have been attested by thousands, and which never can be proved to havenoefficacy, must be attended with still worse consequences, as thus we should be deprived of the means of curing those diseases which our imprudence in rejecting the former doctrine might have brought on. But, to return to the subject of the plague.
The disappearance of the disease, while all the causes that we suppose capable of producing it remain in full force, is a demonstration that it depends on something entirely distinct from the human body, and from all those powers which perceptibly act upon it. It proves that this unknown power has only a temporary existence, coming to perfection at one season, and dying away in another; sometimes capable of being revived, and sometimes not. This corresponds entirely with what has been laid down concerning contagion itself, viz. that like other aerial vapours it is capable of decomposition, and remaining for an uncertain length of time in a dormant state; but that occasionally it may revive, and appear unexpectedly, asmofetesarise from lavas, or damps in mines. After a city has been thoroughly infected with a pestilential disorder, therefore, there can be no security against its re-appearance; it being impossible to know whether the contagion may not be still existing and capable of being revived by some unknown cause, though it has been dormant ever so long. In such cases it may with propriety be said to have arisenspontaneously, though, had it not been there at a former period, therecould be no reason to think that it would have appeared at that time.
Dr. Russel next takes into consideration the plague at Marseilles in 1720, of which he says the accounts “are more full, and circumstances better authenticated, than most of the accounts of anterior plagues to be met with in books.” From the opposition to the doctrine of contagion at the time, he also supposes that the facts relative to its introduction would be severely scrutinized, and falsehoods detected: “but (says he) if, instead of such detection, the most material have been passed over in silence, and little more than hypothetical reasoning opposed to others, the main facts may be considered as established, if possible, more firmly than they were before.” These facts are stated as follows: “1. That the plague did not exist in France before the 25th of May, 1720. 2. That it was imported in goods from the Levant, by a ship which left the coast of Syria the beginning of February, and arrived at Marseilles the 25th of May. Two days after her arrival one of the sailors died; an officer of quarantine who had been put on board died on the 12th of June, and a cabin boy on the 23d. Some porters employed in opening the merchandise at the lazaretto also died about this time. Three others were taken ill in the beginning of July, with buboes in the groin and axilla. This alarmed the surgeon of the lazaretto; a consultation was held with two other surgeons on the 28th; the disease was unanimously declared to be the plague, and the three patients died next day: the surgeon of the lazaretto, with part of his family, and the priest who attended the sick, were also taken ill and died.”
From the lazaretto the disease made its way into the city, and began to appear about the 20th of June. By what means it was introduced is not directly said; but it seems to have been by smuggling infected goods. In the beginning of July it began to spread; but a kind of pause having taken place between the 12th and 23d, the physicians were reproached with having mistaken the distemper. During this supposed interval, however,it was discovered on the 18th of July that the disease had spread in a certain part of the city. A surgeon, employed to examine into the matter, declared the distemper to be the worm-fever; and about the 23d the council of health were informed of the death of fourteen persons in that quarter, and of several others falling sick. The surgeon still adhered to his opinion, but a physician declared it to be the true plague. About the end of the month it had got into the suburbs; four physicians declared it to be the true plague, but their report was not believed; they were insulted in the streets, and it was not until some of the inhabitants of better rank were taken ill, that the true state of the matter gained credit.
“Such (says Dr. Russel) was the rise of the plague at first, and its progress afterwards in the months of June and July; whence it appears, that persons on board the suspected ship, those employed in airing the goods, a surgeon and a priest, who attended the sick, were among the first infected; that the passengers from the several ships, all of which ships, the first excepted, brought foul patents, were, together with their baggage, admitted into the city, after preforming a quarentine of little more than eighteen days; that the distemper from the 20th of June till towards the end of July advanced very slowly, and sometimes seemed to pause; that it attacked chiefly the poorer sort of people, and was found in distinct quarters of the city; and lastly, that,during the first forty days, few or none of the infected recovered; a circumstance entirely consonant to what was observed in the beginning of the plague at Aleppo.”
Three other facts are mentioned by our author, viz. that the disease was evidently communicated by infection; that those who were careful to seclude themselves from all communication with the sick and with infected goods, were not infected; and lastly, that the disease, which began to rage violently in August, continued to do so through that and the following month, but declined fast in the months of October and November,and seemed to cease in the middle of winter. Some accidents happened in 1721, between the months of February and July, which gave occasional alarm; but the distemper did not spread, and ceased entirely after the summer solstice of that year.
To all this, however, objections have been made. 1. That the irregular seasons of the former year, a bad crop, and unwholesome aliment, had produced a malignant epidemic, all which, joined to the popular dread of contagion, were sufficient to produce the plague without any imported infection. To this Dr. Russel replies, that these positions, assumed as facts, had no existence; for which he refers to the publications of the times. 2. It was objected that there were instances of the plague in Marseilles before the 25th of May. These instances are only five in number, produced by M. Deidier, “who saw not the cases himself, yet (says Dr. Russel) from the very imperfect accounts he had been able to glean, he thought himself justified in declaring they bore all the marks of the true plague. Nothing (adds the Doctor) but extreme partiality to an hypothesis could have led any one practised in the plague, into such a declaration; the cases bearing every internal mark of belonging to a different class from the plague. I shall endeavour to show this in a few words.
“Of the five supposed infected patients, three recovered, two died, and all had eruptions. One who died had a parotis (the most ambiguous of all pestilential tumours) without any concurrence, so far as appears, of pestilential symptoms. The tumour had appeared six days before the woman’s death, but how long she had been sick remains unknown. The other died the 16th or 17th day, a very unusual period in the plague. She also had a parotis, which did not make its appearance till the 10th or 11th day of the disease. No pestilential symptoms whatever are mentioned. Of the three who recovered, one was very ill with a fever and carbuncle; but neither the invasion nor the duration of the disease are mentioned. Another had a carbuncle and a small tumour on thethigh; and the third (which bears the nearest resemblance to a very slight infection) had also a bubo in the thigh; but the tumours in neither of these patients are described in such a manner as distinguishes them from ordinary tumours; and the apothecary, who gives the account from memory, had in all likelihood never seen a pestilential bubo before.”
“Of the persons infected for some time after the arrival of the ships from the Levant, none had eruptions, and all perished after a few days illness; which agrees entirely with what was observed at Aleppo in the beginning of the plague: hardly any of the sick recovered, and the major part died in three or four days, without any appearance of buboes. Upon the whole, therefore, I think it very clearly established, that the plague did not exist in France before the month of May, 1720. Prior to M. Deidier, however, I find a M. Pons had endeavoured to prove that the plague was in Marseilles, not only before the month of May 1720, but even in the preceding year. I have not had an opportunity of examining that gentleman’s book.”
3. It is objected that the disease was not brought from the Levant by infected goods. “Captain Chataud’s vessel, supposed to have brought the infected goods, arrived with a clean patent, or bill of health, having left the coast of Syria before the plague broke out there; she consequently cannot reasonably be thought to have transported the plague, which was not in the ports from whence she came.”
To this Dr. Russel answers, that on commercial accounts the Turks carefully conceal the appearance of the plague from the Europeans. Should reports of accidents get abroad, they are variously and contradictorily represented, and pestilential marks and tumours fraudulently concealed. Though Chataud obtained a clean patent, the plague broke out soon after his departure, and three vessels with foul patents arrived at Marseilles a few days after Chataud. “To this (says Dr. Russel) it may be further added, that, notwithstandinghis clean patent, persons acquainted with the Levant will think it far from improbable, that the plague might actually have been in Sidon when he sailed, though unknown to the magistrate, by whom the patents are granted. . . . A clean bill of health imports that the place has been free from plague, and all suspicion of plague, for a certain space of time; but the clean patents of the two first arriving from the Levant, after the cessation of the plague, are, according to Mr. Howard, deemed foul at Marseilles, and the passengers are obliged to perform a quarantine of thirty-one days. The French consuls lying under an obligation to insert in their patents a detail of circumstances, it must appear strange, when the condition of Syria at that time is considered, how Captain Chataud should have obtained a clean patent.”
Though this must certainly be deemed a sufficient answer to the objection, Dr. Russel goes on to give an account of what had happened the preceding year, when the plague had raged violently at Aleppo; and shows that, from the condition of the whole coast of Syria, a return of the plague was certainly to be expected; that the French consuls could not be ignorant of this, neither could the council of health at Marseilles be unacquainted with what had happened at Aleppo the preceding year. “The facility with which the patents seem to have been issued in Turky, and the partial indulgence of the council to Chataud’s ship, notwithstanding the very extraordinary mortality which had avowedly happened on the voyage, together with their easy confidence afterwards in the reports of the surgeon of the lazaretto, can only be accounted for from the prevailing influence of private commercial interest over a sense of official duty.”
Our author next proceeds to take notice of what happened during this ship’s voyage to Marseilles. On the 31st of January he left the coast of Syria with a clean patent, before the plague broke out. On the 25th of May he arrived at Marseilles, from Sidon, Tripoli and Cyprus. On the voyage, or at Leghorn, he lost six ofthe crew; but, by the certificates of the physicians of health at Leghorn, these died onlyof malignant fevers caused by unwholesome provisions. These last words in the Traite de la Peste are said to have been interpolated at Marseilles. At any rate, as Dr. Russel observes, they could relate only to those who died at Leghorn, not to the others, whom the physicians had not seen.
The other account is much less favourable. According to it, Chataud “left Sidon the 31st of January with a clean patent. The plague discovered itself there a few days after his departure. Having sustained some damage by bad weather, he put into Tripoli, where he embarked some merchandise; he took in also some Turks, passengers for Cyprus, together with their luggage. Soon after the ship had left Tripoli, one of these passengers fell sick and died. Two of the sailors employed to throw the corpse overboard desisted at the desire of the pilot, and the rest of the ceremony was performed by the other Mahommedan passengers; the ropes with which the body was lowered down, being by way of precaution thrown into the sea. Within a few days the two sailors who had handled the corpse were taken sick and died. At Cyprus the ship put her remaining passengers on shore, and made a very short stay. Soon after her departure from that island, a third sailor and the surgeon died of an illness of a few days duration. The captain, justly alarmed by these accidents, ordered the bedding and other things used by the deceased to be thrown into the sea; and kept himself carefully separate from the crew during the remainder of his voyage. Some time after this three more sailors fell sick, and, there being no surgeon on board, the vessel put into Leghorn, where the three sick men died, and the physician and surgeon of the lazaretto declared the disease to be a malignant pestilential fever.”
Our author considers the above account as a full proof of the plague being imported by Chataud’s vessel: he declines entering into the question about thepossibilityof importing contagion in merchandise. Howthismighttake place has already been explained; and the present instance of its having been imported is as clearly proved as can be expected. A collateral proof, with regard to the contagion of the small-pox, we have from Dr. Huxham. A beggar, ill of that disease, approached a certain town in England, but was not suffered to enter, for fear of infection. The beggar died, and the infected clothes were burnt at some distance from the town; but the smoke being blown upon it by the wind, the small-pox in a short time made its appearance, beginning in that part upon which the smoke was blown. This clearly proves thatonespecies of contagion may adhere to clothes, and is a very strong presumption that any other may do the same. It also shows that contagion, when once produced, is by no means easily destroyed; and consequently that all kinds of purification, even when used with the utmost care and diligence, are scarce sufficient to ensure safety.
It would now be superfluous to enter farther into the subject of the plague being communicated by infected goods, did not our author quote a work of Dr. Pye of London, in which the latter from the veryJournal(which has been used as containing arguments in favour of contagion) makes inferences directly opposite. “The facts related in this journal (says Dr. Pye) seemed to me to make so clearly against the modern doctrine of contagion, that if this writer had not mentioned them as undeniable instances in his favour, I should not have thought there had been any persons here in England so dull of understanding, or so much blinded with prejudice, as to stand in need of having these facts put into a more obvious light: but, having this occasion, I shall consider them more largely than otherwise I would have done, and show that the porters, who died in the lazaretto at Marseilles, received no hurt or infection from the goods.
“To leave no room for objection, I shall take notice, that a guard of quarantine died on board Chataud’s ship the 12th of June; but, as this officer was no ways concerned either in unloading or opening thegoods, he could receive no hurt from them; and besides, this must have been fourteen or fifteen days after the goods had been carried out of the ship into the lazaretto. Further, six of their men are said to die at Leghorn; but the town of Leghorn was not infected from thence, which would have been more likely if there had been any infection in the case, than that Marseilles should be afterwards infected.
“If any infection or infectiousauracan be supposed to be packed up, and brought in goods, such infection or infectious aura must necessarily issue forth from them in greatest abundance, and with the greatest force, at the first opening or unpacking of them; and, as it must continue to fly off every moment, and be thereby continually diminishing, it is likewise certain, that in a very few days the goods must be in a great measure, if not entirely, cleared of it. Wherefore, if the porters could have been infected from the goods at all, it must have been at the first opening of them: but, even according to this journal, the porters that first fell sick were not taken ill before the 23d of June, whereas Chataud’s ship arrived the 25th of May preceding; so that the goods of that ship, in purifying which the porter first mentioned was employed, had been airing and purifying for twenty-six or twenty-eight days before this accident happened; and it cannot be conceived that after so long a time they should not have been entirely purged of all infection or infectious aura, if any could have been brought with them. Or if it can be supposed, which I think impossible, that any part might still be left, it must withal be supposed so much less than at first, as not to be capable of doing, those porters especially, the least hurt: to suppose otherwise would be to argue that the same man who some days before had received and borne a very great quantity and force without any injury, could then be killed by a quantity and force infinitely less.
According to the report of merchants,Frenchmen are not subject to the plague in Turky; and it cannot be conceived that so small a quantity of infectious airas can be packed up and brought in a bale of goods, should destroy them in France, or in an air and climate distant and different; when the whole atmosphere of the same infectious air is found not to injure them in very infected places, and wherein it is allowed to be bred and generated.”
Thus far Dr Pye.—Let us now hear Dr. Russel in answer.
“The death of the quarantine officer was mentioned in order to leave no room for objection; but still it may be objected that he has omitted the death of the sailor on the 27th of May, and asserted, in contradiction to the journal, that the former six sailors died at Leghorn. That Leghorn was more likely to be infected than Marseilles, is a strange notion. The ship had landed no goods there, nor had any intercourse with the shore; for the physician who visits the sick on board, remains at a distance from the ship, in a boat, and the dead bodies are sunk in the sea. As to the circumstance of the goods of Chataud’s vessel being all in the lazaretto before the 12th of June, it is a supposition to be attributed to Dr. Pye’s unacquaintance with matters of that kind; for it is impossible a ship which arrived the 25th of May should discharge the whole of her cargo in two or three days. The dispatch would have been miraculous, considering the ship lay near two leagues from the lazaretto, and was unloaded, and the boats navigated, by her own crew. It did not occur to Dr. Pye, that some time, previous to the vessels beginning to unload, is taken up in examination and other forms atPomegue, and the council of health. The loss of six men on the voyage was an extraordinary circumstance, that required deliberation; and it appears that on the 29th, after the death of the sailor on board Chataud’s vessel, the council determined the quarantine of his cargo to be forty days, commencing from the landing of the last bale; which was double the time usually allowed for a ship with a clean patent. It is very probable, therefore, that the ship did not begin tounload till after the 29th of May, and possibly had not finished when the quarantine officer died, the 12th of June, who must have been taken ill two or three days before.
“In regard to the time requisite for the complete evaporation of the infectious aura, in what proportionate gradation its activity is impaired by ventilation, and the specific quantity required to produce effect on the human body, they are matters which I apprehend will not readily be admitted to be clearly and certainly known. That the first porters were not taken ill before the 23d of June, is very true; but that the goods had been airing and purifying for twenty-six or twenty-eight days, has been shown above to be an error. The Doctor also makes two other suppositions equally erroneous. The first, that the whole of the cotton contained in a number of bales is equally imbued with infectious aura; the second, that all the bales of a ship’s cargo are opened nearly about the same time. But, as the cotton contained in these bales may not only have been collected from different villages at different times, but packed up under various circumstances relative to the materials used for embalage, and the persons employed in embaling or steeving them; it may easily be conceived how the cargo of a ship, coming even from a place where the plague actually rages, may be only partially infected, or not infected at all. The warmest advocate for contagion never contended for every bale of a ship’s cargo being equally infectious. As to the airing of the bales, it is a laborious and a tedious process. Where there is a considerable number, it takes up several days to open and arrange them, goods of different kinds must be disposed separately, accounts taken, and the cordage, &c. laid up with care where it may be found again. The laborious part of these operations is performed by the porters, who also transport the goods from the water side to the enclosure where they are to be aired: and, as the days of quarantine do not begin to be reckoned till all thegoods are landed, the porters for some days at the beginning are sufficiently employed in receiving and arranging the cargo, that being the business requiring the first dispatch. When these circumstances are considered, it will appear no extravagant supposition, that some of the last opened bales of Chataud’s cargo might still retain enough of infectious aura to infect the porter on the 23d of June. To set this retardment, almost unavoidable in the opening of bales, in a still clearer light, it should be observed, that, by the regulations at Marseilles, all suspected goods are subject to what is termedsereines; that is, a certain number of bales are taken out of the hold, and, being opened at both ends, are exposed to the air for two, three, or six days, by way of trial, in order to see if any signs of infection should appear among those employed in handling the merchandise. When these have been aired, more or less, according to circumstances, another parcel is opened and exposed to ventilation in like manner: so that, according to the burden of the ship, there may be several of these sereines, each of several days duration. In this manner, independent of accidental impediments from wind and weather, in sending the goods from the ship, it maybe supposed, were it at all necessary to make the supposition, that the porters, not only on the 23d of June, but on the 7th and 8th of July, were infected upon opening some new bales. As to the porter being infected by goods from another ship, Dr. Pye thinks it impossible, because the ship had been twelve days in port, and the goods must have been eight or nine days in airing and purifying: had he been acquainted with the practice of the sereines in quarantine, he would have been at no loss to make the accident agree exactly with his notion of the infectious aura. . . . The plain matter of fact, as it stands in the journal, is this, that six porters, employed in purifying suspected merchandise from the Levant, died of the plague; and their death was followed by that of the surgeon who attended them, and part of his family.”
From this the reader will be able to judge how far the question is decided in favour of the fact that the plague at Marseilles was actually produced by imported contagion. It seems needless to follow our author through his investigation of those facts which his adversaries have misrepresented; for these must of course be in his favour; every misrepresentation by a disputant being plainly an abandonment of his cause. Indeed the argument against contagion at that time was properly but one, and is set forth in no stronger language now than formerly. Even as long ago as 1665 Dr. Russel quotes one Gadbury an astrologer stating the difficulty as strongly, and giving a solution of it as clearly, uponhisprinciples, as the best modern theorists can do upontheirs. “If the pestilence, (says Mr. Gadbury) be infectious, and really catching in itself, it must be so equally to all persons that approach it, or that it approacheth; or else it must be infectious to some particular persons only. If it be infectious to all persons, or catching to all alike, then all persons, that come into the sight or within the scent of it, must necessarily be subject unto it. If not infectious unto all, but unto some particular persons only, I say then it ought not to be deemed or esteemed infectious at all, at least not any more infectious than are all other diseases, viz. small-pox, scurvy, pleurisy, ague, gout, &c. since (though the notion of infection be laid aside) there is not a person born into the world that hath not at some time of his life (as hisnativityshall truly show) some one disease or other. Never was any person subject to violent diseases, as plague, &c. but had a violentnativityto show it, ande contra.”
The answer to this has been already given.—Let any other cause than contagion or infection be supposed, and the difficulty remains equally great. The probability is in favour of contagion, rather than a general disposition of the atmosphere, because in the latter case the disease would, contrary to experience, begin in a great many places at once; but the plague begins in such a secret manner that we scarce know whence it comes. Like fire, or a ferment in liquors, it diffuses itself far and wide, andlastly, like an immense inundation, the source of which is dried up, it seems to lose its power by extending too far, and dies away altogether. We cannot penetrate into the causes of those things, but, without any speculation at all, we can observe that the disease falls upon people of a certain constitution more than others, and this may be of use in preserving ourselves from it, as shall be explained in the next section.
It is still necessary to say something of the infection spreading from one person to another, and being kept off by refraining from communication with the diseased. This indeed naturally follows from its proceeding originally from the cotton: for as all the infected did not touch this cotton, there can be no other cause assigned from its spreading than by communication from one to another; and, therefore, if such communication was cut off, we should naturally think that the disease would not spread. But, in opposition to this, we have already quoted Dr. Moseley giving a long list of convents infected, though they kept themselves strictly shut up. Dr. Russel cites, in favour of prevention by shutting up, two certificates, one by the bishop of Marseilles, the other by the sheriff of the same place. To these he adds the testimony of M. Langeron, who was actively employed throughout the whole time that the plague continued, first as a commodore of the gallies, and afterwards as governor of the town and its dependencies. In opposition to these, however, he takes notice of two passages “in books of acknowledged authority,” which he is at pains to answer; the one is from the Journal already quoted, which says, “and what is unaccountable, those who have shut themselves up most securely in their own houses, and are the most careful to take in nothing without the most exact precautions, are attacked there by the plague, which creeps in no one knows how.” The other passage is taken from theRelation Historique, “that, in the height of the pestilence, the infection penetrated into places which had till then remained inaccessible; that monasteries and houses shut up in the most exact manner were no longer places of security.”
To the former of these our author answers, that “from the manner of stating the case, one would think that all these religious had been close shut up, without any communication with persons without doors; and this was certainly intended by an author who has made remarks upon it; but it will be found, upon looking into the beginning of the very paragraph cited, that the greatest part of them are represented as martyrs who had meritoriously exposed themselves. Of the twelve different orders mentioned on this occasion, the Grand Augustines only are said to have kept in their convent. But, supposing the Augustin convent to have been actually shut up, and in that state infected; it would by no means invalidate the instances brought of the preservation of the convents, the certificates concerning which were granted deliberately, after all was over; whereas the journal, written from day to day, marking circumstances rapidly as they occurred, the author, amongst various other affairs, had not always leisure or opportunity to examine minutely into circumstances. It is in this light I am inclined to consider the houses being infected which took in nothing without the most exact precautions; and the rather, because I met with several instances of the like kind at Aleppo, in the houses of the Christian and Jewish nations: but in the sequel it generally appeared there had been some improper communication carried on by the domestics, unknown to the family at the time.”
“That the atmosphere, in a city so dreadfully circumstanced as Marseilles, may become so highly tainted as to convey the plague into houses shut up, cannot confidently be affirmed to be impossible, by those who hold mediate contagion; and the concurrence of circumstances at that period in Marseilles, renders it highly probable that such accidents happened. But, in general, the pestiferous effluvia once emitted into the air, do not appear to operate at any great distance from their source; and M. Deidier asserts, that two monasteries (from their situation, one near aburial ground, the other near a pest-house) very dangerously situated, remained nevertheless untouched, which he thinks an argument against infection being conveyed by the air.”
From this long and contested account of the manner in which the plague was received into Marseilles, we see how very difficult it must be to come at a true state of facts, when a number of people think it their interest to misrepresent or conceal them. The limits of this treatise will not allow us to follow our author through the numerous details of misrepresentations and unfair methods which the adversaries of the doctrine of contagion have made use of to establish their opinion: neither shall we enter into any discussion concerning the origin of other plagues, as we should in them find the same opposite kinds of evidence without such documents for distinguishing the true from the false as Dr. Russel has produced in the case of Marseilles. A single fact only, mentioned by Mr. Howard in his Treatise on Lazarettos, shall be related, and which, if allowed to befact, decides the question as effectually as a thousand.
“When the plague raged at London in 1665, it was conveyed to the remote village of Eyam near Tideswell in Derbyshire. In this place it broke out in September 1665, and continued its ravages upwards of a year, when two hundred and fifty of the inhabitants had died of it. The worthy rector, Mr. Mompesson, whose name may rank with those of Cardinal Borromeo of Milan, and the good bishop of Marseilles, at its breaking out, resolved not to quit his parishioners, but used every argument with his wife to quit the infected spot. She, however, refused to forsake her husband, and is supposed to have died of the plague. They sent away their children. Mr. Mompesson constantly employed himself, during the dreadful visitation, in his pastoral office, and preached to his flock in a field, where nature had formed a sort of alcove in a rock, which place still retains the appellation of a church. He survived, and the entries in the parish register relative to this calamity are in his own hand writing, viz.
In 1665,
Died 6
1666,
22
20
5
53
7
78
1666
3
14
5
17
2
1
12
This plague is said to have arisen from a box of clothes sent from London while the distemper was at its height in that city. But whether this be admitted or not, it cannot well be supposed that in a small village there could either be a peculiar constitution of the air, collections of filth, immoderate heat, cold, or in short any general cause from which a plague could be supposed to arise, that would not have affected the country for a great way round. How then came this insulated spot to be so violently affected, except by contagion? No matter whether by clothes or any thing else. The very particular manner in which the numbers who died are recorded, leaves no doubt as to the fact of the distemper having been there; neither is it possible to account for its rise on any other principle than contagion.
Mr. Howard, previous to his going abroad, had been furnished, by Dr. Aikin and Dr. Jebb, with a set of queries relative to the plague, to be put to the physicians in the different countries through which he travelled. This commission he executed with great fidelity and exactness. The physicians to whom he proposed them were,Raymondof Marseilles, physician;Demollinsof do. surgeon;Giovanelli, physician to the lazaretto at Leghorn;They, to do. at Malta;Morandi, physician at Venice;Verdoni, at Trieste;Jewphysician at Smyrna;Fra. Luigi di Pavia, prior to the hospital of San Antonio at Smyrna. The questions proposed were as follow:
1. Is the infection of the plague frequently received by the French?
Though this was not asking in direct terms whether the plague is infectious or not, all to whom it was proposed seem to have viewed it in this light, Raymond of Marseilles only excepted, who answered directly, “Sometimes it is.” All the rest, except Giovanelli, agreed that it might be communicated by the touch, or by the breath. Verdoni gave an instance of its being communicated by a flower which three persons smelt at; two remained free, but the third sickened and died in twenty-four hours.
2. Does the plague ever rise spontaneously?
In this Verdoni alone answered positively in favour of the spontaneous rise of the plague.Theyspoke ambiguously.
3. To what distance is the air infected? How far does actual contact, wearing infected clothes, or touching other things, produce the disease?
To this question Verdoni answered in a manner seemingly inconsistent with his former answer; allowing not only that the plague was infectious, but that infected things might communicate the disease after an interval of many years. All agreed that the strength of the infection was greater or less according to circumstances; the distance at which it could act was likewise uncertain. Raymond said that the sick might be safely conversed with, across a barrier, at a few paces distance; the Jew said attwo ellsdistance, provided the chamber windows be not all shut. Giovanelli said it had been proved that the infection did not extend beyond five geometrical paces. The touch of infected clothes, or drawing in the breath of the sick, was looked upon by him and Fra. Luigi to be very dangerous.
4. What are the seasons in which the plague chiefly appears; and what is the interval between the infection and the disease?
To this it was answered by Raymond, that the two solstices are the times in which it has least power. The others agreed that hot and moist weather was favourable to its ravages; the spring, summer and first month of autumn are dreaded. These circumstances, however,must be variable in different countries. As to the time in which the infection shows itself, the answer was various. According toThey, it “sometimes acts slowly, sometimes like astroke of lightning.” According to Verdoni, “the disease generally shows itself at the instant of touch,like an electrical shock.” Sometimes the infection will be communicated from a sick person to a sound one, who without any disease may communicate it to a second, and that second to a third, in whom alone it would become active.
The other questions, relative to the symptoms, prevention and cure of the distemper, will be taken notice of in the course of the treatise. In the mean time having discussed, with a prolixity almost exceeding our bounds, such preliminaries as seemed most likely to throw some light on the nature of the distemper, we shall now proceed to the medical history of the plague, as we find it laid down in different authors.
Though this distemper has most frequently been accounted afeverin the highest degree, yet, as we have already noticed, it seems to be essentially different.99The testimonies there quoted are sufficient to establish the fact; and, were it needful, many others might be brought from authors both ancient and modern. In the plague said to have taken place in the days of Romulus,100Plutarch relates, that the people died without any sickness. To this very ancient testimony we shall add that of Dr. Patrick Russel, who closes the account of his first class of patients with the following paragraph: “That the plague, under a form of all others the most destructive, exists without its characteristic eruptions, or other external marks reckoned pestilential, can admit of no doubt; and it is to be regretted that mankind have so often, from the absence of these, been betrayed into errors of fatal consequence on its first invasion; at which early period human prudence can only be exerted in the way of defence with any probability of success.”
The symptoms of this fatal disease were sometimes a sudden loss of strength, confusion or weight in the head, giddiness at intervals, oppression about the præcordia, dejection of spirits, taciturnity, an anxious aspect, but without any symptoms of fever. In these, death ensued within twenty-four hours; some were said to have died within a few hours, but our author saw none of these, and is inclined to doubt the truth of the accounts, having in several instances, where this is said to have happened, found upon inquiry that matters had been inaccurately stated, and that the patients had really been ill one or two days.
In others the disorder was more perceptible. In a few hours the eyes became muddy, the surface of the body cold, with drowsiness, lethargy, and pain at the heart. In the progress of the distemper they frequently lost the power of speech, the skin seldom recovered its warmth, or, if it did, it was only by irregular flushings. The pulse sometimes remained nearly in its natural state, but was, for the most part, low and quick. They were “by turns delirious, confused and sensible, but the comatose disposition was most prevalent. Towards the end they suffered extreme inquietude. Vomiting in some occurred the first night; in others a diarrhœa next day; both accelerating the fatal period; but these symptoms were less frequent than in some of the other classes. Buboes appeared only in a very few who survived the third day. . . . The total absence of buboes in such patients as perished suddenly I have no doubt of, nor of their being in general very rare in others of this class; though I suspect that the buboes might sometimes have been concealed, where the disease ran out to the fourth or fifth day, and for the same reason that the reports concerning the state of the corpse were sometimes not true. . . . It was very rare to find suspicious marks of infection on the bodies [of those who died within 24 hours]. . . . Carbuncles were seldom visible till the month of May, which was later than this form of the disease. It prevailed chiefly at the rise of the plague in 1760, andits revival in the two succeeding years, decreasing as the distemper spread; and though they were found dispersed in every stage of the pestilential season, yet the number of this class was proportionably small, compared with that of others. Petechiæ, vibices, or broad, livid, roundish spots, occurred sometimes, but were not common, and the two latter were seldom visible till after death.”
This account of the most malignant form of the pestilence differs considerably from that of Dr. Hodges, who seems to think that thetokens, as he calls them, very generally were to be found on the bodies of those who died suddenly. He mentions indeed a young man who was suddenly seized with a violent palpitation of the heart, and thus continued till his death, which took place in a few hours. In this case the Doctor supposed that there might be a carbuncle broke out on the heart. Dr. Russel has considered the description of the tokens given by Dr. Hodges, and compared it with that of others called by Diemerbroeckmaculæ mortis,spotsortokensofdeath; and by this comparison it appears that the former has spoken somewhat indistinctly on the subject, confounding two different kinds of eruptions together. Dr. Hodges, however, as we have already seen (p.10) asserts, in hisLoimologia, that the tokens rise from within, and are broadest at their bases, where he also supposes the pestilential poison chiefly to lie. To the same purpose, in his Letter to a Person of Quality he says, “The tokens have their original and rise from within, and afterwards externally show themselves; which is evident, because the basis of them is larger than their outward appearance, and the internal parts are found very often spotted, when there is no discoloration visible on the skin.” Dr. Russel, after quoting Diemerbroeck, makes the following observations: “The author (Diemerbroeck) is diffuse on this subject, and thinks it a mistaken though prevalent notion, that the maculæ are merely superficial in the skin, proceeding from putrefaction, ebullition, &c. in the blood or humours: on the contrary he affirms, they arise from theinternal parts, even the periosteum, broad at the base, and tapering to their termination in the skin, being produced by theextinctionandextravasationof the vital spirits. Now (says Dr. Russel) this answers exactly to one species of the tokens described by Hodges, which therefore may be reckoned the same with themaculæ mortis, and was probably the only one observed at Nimeguen,” &c. On the same subject he quotes a book entitledMedela Pestis, in which the author says that by careful dissection thetokensmay be traced half-way deep in the flesh, and some, in the muscles of the breast, have been followed by the incision knife even to the bone. By the directions given by authority to the searchers in 1665, they were ordered to look narrowly for these tokens, which were described as “spots arising on the skin, chiefly about the breast and back, but sometimes also in other parts. Their colour is something various, sometimes more reddish, sometimes inclining a little towards a faint blue, and sometimes a brownish mixed with blue; the red ones have often a brownish circle about them, the brownish a reddish.”