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Title: A Discourse on the Plague

Author: Richard Mead

Release Date: April 28, 2010 [EBook #32171]

Language: English

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  A
  DISCOURSE
  ON THE
  PLAGUE:

  BY

  _RICHARD MEAD_,

  Fellow of the College of Physicians,
  and of the Royal Society; and
  Physician to his MAJESTY.

  The NINTH EDITION corrected and enlarged.

  _LONDON_,
  Printed for A. MILLAR, against _Catharine-Street_,
  in the _Strand_:

  And J. BRINDLEY in _New-Bond-Street_.

  MDCCXLIV.




  TO THE
  RIGHT HONOURABLE
  _James Craggs_, Esq;

  ONE OF
  His MAJESTY'S Principal Secretaries
  of State.


_SIR_,

I MOST humbly offer to You my Thoughts concerning the _Prevention of the
Plague_, which I have put together by your Command. As soon as you were
pleased to signify to me, in his _Majesty's_ Absence, that their
Excellencies the _Lords Justices_ thought it necessary for the publick
Safety, upon the Account of the _Sickness_ now in _France_, that proper
Directions should be drawn up to defend our selves from such a Calamity;
I most readily undertook the Task, though upon short Warning, and with
little Leisure: I have therefore rather put down the _principal Heads of
Caution_, than a _Set of Directions in Form_.

THE _first_, which relate to _the performing Quarantaines_, &c. You, who
are perfectly versed in the History of _Europe_, will see are agreeable
to what is practised in other Countries, with some new Regulations. _The
next_, concerning the _suppressing Infection here_, are very different
from the Methods taken in former Times among _Us_, and from what they
commonly do _Abroad_: But, I persuade my self, will be found agreeable
to Reason.

I MOST heartily wish, that the wise Measures, the _Government_ has
already taken, and will continue to take, with Regard to the _former_ of
_these_, may make the _Rules_ about the _latter_ unnecessary. However,
it is fit, we should be always provided with proper _Means of Defence_
against so terrible an _Enemy_.

MAY this short _Essay_ be received as one Instance, among many others,
of the Care, you always shew for Your Country; and as a Testimony of the
great Esteem and Respect, with which I have the Honour to be,

  _SIR_,

      _Your most obedient, and
          Most humble Servant,_

              R. MEAD.

  Nov. 25.
  1720.




THE CONTENTS.


The Preface,                                        Page i


PART I.

_Of the_ PLAGUE _in General_.

CHAP I. Of the Origine and Nature of the PLAGUE,         1

CHAP II. Of the Causes which spread the PLAGUE,         41


PART II.

_Of the Methods to be taken against the_ PLAGUE.

CHAP I. Of preventing Infection from other Countries,   80

CHAP II. Of stopping the Progress of the PLAGUE,
if it should enter our Country,                        100

CHAP III. Of the Cure of the PLAGUE,                   151




THE PREFACE.


THIS Book having at first been written only as a Plan of Directions for
preserving our Country from the =Plague=[1] was then very short and
concise. An Act of Parliament being immediately after made for
performing =Quarantaines= &c. according to the Rules here laid down, it
passed through seven Editions in one year without any Alterations. I
then thought proper to make some =Additions= to it, in order to shew the
Reasonableness of the Methods prescribed, by giving a more full
Description of this Disease, and collecting some Examples of the good
Success which had attended such Measures, when they had been put in
Practice. At the same time I annex'd a short Chapter relating to the
Cure of the Plague; being induced thereto by considering how widely most
Authors have erred in prescribing a Heap of useless and very often
hurtful Medicines, which they recommend under the specious Titles of
=Antidotes=, =Specifics= and =Alexipharmacs=: hoping that the great
Resemblance, which I had observed between this Disease and the =Small
Pox=, would justify my writing upon a Distemper which I have never
seen.

INDEED the =Small Pox= is a true =Plague=, tho' of a particular kind,
bred, as I have shewn all Pestilences are, in the same hot =Egyptian=
Climate, and brought into =Asia= and =Europe= by the way of Commerce;
but most remarkably by the War with the =Saracens=, called the =Holy
War=, at the latter end of the eleventh and the beginning of the twelfth
Century[2]. Ever since which time the morbific Seeds of it have been
preserved in the infected Cloaths and the Furniture of Houses: and have
broken out more or less in all Countries, according as the hot and moist
Temperature of the Air has favoured their Spreading and the Exertion of
their Force. The =Measles= is likewise a =Plague sui generis=, and owes
its Origin to the same Country.

I have now revised my little Work once more: and though I cannot find
any reason to change my Mind as to any material Points which regard
either the =Preventing= or the =Stopping= the Progress of =Infection=;
yet I have here and there added some new =Strokes= of Reasoning, and,
as the Painters say, retouch'd the =Ornaments=, and hightened the
=Colouring= of the =Piece=.

THE Substance of the long Preface to the last Edition is as follows.

I have insisted more at large upon the =Infection= of this Disease,
than I could ever have thought needful at this time, after =Europe= has
had Experience of the Distemper for so many Ages; had I not been
surprized by the late Attempts of some Physicians in =France= to prove
the contrary, even while they have the most undeniable Arguments against
them before their Eyes. In particular, I cannot but very much admire to
see Dr. =Chicoyneau=, and the other Physicians, who first gave us
=Observations= on the =Plague=, when at =Marseilles=, relate in the
=Reflections=, they afterwards published upon those Observations, the
Case of a Man, who was seized with the =Plague=, upon his burying a
young Woman dead of it, when no one else dared to approach the Body; and
yet to see them ascribe his Disease, not to his being =infected= by the
Woman, but solely to his Grief for the Loss of her, to whom he had made
Love, and to a =Diarrhoea=, which had been some time upon him[3]. No
question but these concurred to make his Disease the more violent; and
perhaps even exposed him to contract the =Infection=: but why it should
be supposed, that he was not =infected=, I cannot imagine, when there
was so plain an Appearance of it. I am as much at a Loss to find any
Colour of Reason for their denying =Infection= in another Case, they
relate, of a =young Lady= seized with the =Plague=, upon the sudden
Sight of a =PESTILENTIAL TUMOR=, just broke out upon her Maid; not
allowing any thing but the Lady's Surprize to be the Cause of her
Illness[4].

THE Truth is, these Physicians had engaged themselves in an
=Hypothesis=, that the =Plague= was bred at =Marseilles= by a long Use of
bad Aliment, and grew so fond of their Opinion, as not to be moved by
the most convincing Evidence. And thus it mostly happens, when we
indulge Conjectures instead of pursuing the true Course for making
Discoveries in Nature.

I KNOW they imagine this their Sentiment to be abundantly confirmed
from some Experiments made by Dr. =Deidier=[5] upon the =Bile= taken
from Persons dead of the =Plague=: which having been either poured into
a Wound made on purpose in different =Dogs=, or injected into their
Veins, never failed, in many Trials, to produce in them all the Symptoms
of the Pestilence, even the external ones of =Bubo's= and =Carbuncles=.
One Dog, upon which the Experiment succeeded, had been known, for three
Months before, to devour greedily the corrupted =Flesh= of infected
Persons, and =Pledgets= taken off from =Pestilential Ulcers=, without
receiving any Injury. From hence they conclude[6] that this Disease is
not communicated by =Contagion=, but originally bred in the Body by the
Corruption of the =Bile=. This Corruption, they say, is the Effect of
unwholsome Food; and the =Bile= thus corrupted produces a Thickness and
a Degree of Coagulation in the Blood, which is the Cause of the =Plague=:
Tho' this they allow to be inforced by a bad Season of the Year, and
the =Terrors= of Mind and Despair of the Inhabitants.

THESE Experiments are indeed curious, but fall very short of what they
are brought to prove. The most that can be gathered from them is this:
That =Dogs= do not, at least not so readily, receive =Pestilential
Infection= from Men, as Men do from one another: And also, that the
=Bile= is so highly corrupted in a Body infected with the =Plague=, that
by putting it into the Blood of a =Dog= it will immediately breed the
same Disease.

BUT it does not follow from hence, that the =Bile= is the Seat of the
Disease, or that other Humors of the Body are not corrupted as well as
=this=. I make no question but the whole Mass of Blood is, in this Case,
in a State of Putrefaction; and consequently that all the Liquors
derived from it partake of the Taint.

ACCORDINGLY it appeared afterwards from some Experiments made by Dr.
=Couzier=[7], that not only the =Blood=, but even the =Urine= from an
infected person, infused into the crural Vein of a Dog communicated the
=Plague=. I will venture to affirm, that if, instead of =Bile=, =Blood=,
or =Urine=, the =Matter= of the =Ulcers= had been put into a Wound made
in the Dog; it would have had at least an equally pernicious Effect: As
may well be concluded from the Inoculation of the Small Pox.

AS to the Dog's eating the =corrupted Flesh= and =purulent Matter= of
the Patients; it ought to have been considered that there are some
Poisons very powerful when mixed immediately with the Blood, which will
not operate in the Stomach at all: As in particular the =Saliva= of the
mad Dog and the =Venom= of the Viper[8]. And therefore Dr. =Deidier=
himself, some Months after his former Experiments, found that
=pestiferous Bile= itself was swallowed by Dogs without any Harm[9].

THE right Inference to be made from these Experiments, I think, would
have been this: That since the Blood and all the Humors are so greatly
corrupted in the Plague, as that Dogs (tho' not so liable to catch the
Distemper in the ordinary way of Infection, as Men are) may receive it
by a small Quantity of any of these from a diseased Subject being mixed
with their Blood; it may well be supposed, that the =Effluvia= from an
infected Person, drawn into the Body of one who is sound, may be
pestiferous and productive of the like Disorder.

MY Assertion, that these =French= Physicians have before them the
fullest Proofs of this =Infection=, not only appears from these
Instances of it, I have observed to be recorded by themselves; but
likewise from what Dr. =le Moine= and Dr. =Bailly=[10] have written, of
the Manner in which the =Plague= was brought to =Canourgue= in the
=Gevaudan=: as also from an amazing Instance they give us of the great
Subtilty of this =Poison=, experienced at =Marvejols=: where no less
than =sixty= Persons were at once infected in a =Church=, by one that
came thither out of an infected House. The =Plague= was carried from
=Marseilles= to =Canourgue=, as follows. A =Gally-Slave=, employed in
burying the Dead at =Marseilles=, escaped from thence to the Village of
=St. Laurent de Rivedolt=, a League distant from =Correjac=: where
finding a Kinsman, who belonged to the latter Place, he presented him
with a =Waistcoat= and a =pair of Stockings= he had brought along with
him. The =Kinsman= returns to his Village, and dies in two or three
Days; being followed soon after by =three Children= and their =Mother=.
His =Son=, who lived at =Canourgue=, went from thence, in order to bury
the Family; and, at his Return, gave to his =Brother-in-law= a =Cloak=
he had brought with him: the =Brother-in-law= laying it upon his Bed,
lost a little =Child= which lay with him, in one Day's Time; and two
Days after, his Wife; =himself= following in seven or eight. The
=Parents= of this unhappy Family, taking Possession of the =Goods= of the
Deceased, underwent the same Fate.

ALL this abundantly shews how inexcusable the foresaid Physicians in
=France= are, in their opposing the common Opinion that the =Plague= is
contagious. However, I have paid so much Regard to them, as to insist
the more largely upon the Proof of that =Contagion=; lest the Opinion of
those, who have had so much Experience of the Disease, might lead any
one into an Error, in an Affair of such Consequence, that all my
Precepts relating to =Quarantaines=, and well nigh every particular Part
of my Advice, depends upon it: For if this Opinion were a Mistake,
=Quarantaines=, and all the like =Means of Defence=, ought to be thrown
aside as of no use. But as I continue persuaded, that we have the
greatest Evidence, that the =PLAGUE= is a =contagious= Disease; so I
have left, without any Alteration, all my Directions in respect to
=Quarantaines=: in which, I hope, I have not recommended any Thing
=prejudicial to Trade=; my Advice being very little different from what
has been long practised in all the =trading= Ports of =Italy=, and in
other Places. Nay, were we to be more remiss in this than our
Neighbours, I cannot think but the =Fear= they would have of us, must
much obstruct our =Commerce=.

BUT I shall pursue this Point no farther: the rather because a very
learned Physician among themselves has since, both by strong Reasoning
and undeniable Instances, evinced the Reality of =Contagion=[11].

IN a word, the more I consider this Matter, the more I am convinced
that the Precepts I have delivered, both with regard to the Preventing
the Plague from coming into a Country, and the Treatment of it when
present, are perfectly suitable to the Nature of the Distemper, and
consequently the fittest to be complied with. But how far, in every
Situation of Affairs, it is expedient to grant the =Powers=, requisite
for putting all of them in Practice, it is not my proper Business, as a
Physician, to determine. No doubt, but at all Times, these =Powers=
ought to be so limited and restrained, that they may never endanger
the Rights and Liberties of a People. Indeed, as I have had no other
View than the Publick Good in this my Undertaking, and the Satisfaction
of doing somewhat towards the Relief of Mankind, under the greatest of
Calamities; so I should not, without the utmost Concern, see that any
Thing of mine gave the least Countenance to Cruelty and Oppression.

BUT I must confess, I find no Reason for any Apprehensions of this
kind, from any thing I have advanced. For what extraordinary Danger can
there be, in lodging =Powers= for the proper Management of People under
the Plague, with a =Council of Health=, or other Magistrates, who shall
be accountable, like all other Civil Officers, for their just Behaviour
in the Execution of them? Though this I must leave to those, who are
better skilled in the Nature of Government. But sure I am, that by the
Rules here given, both the =Sick= will be provided for with more
Humanity, and the Country more effectually defended against the Progress
of the Disease, than by any of the Methods heretofore generally put in
Practice, either in our own, or in other Nations.

THE Usage among =Us=, established by =Act of Parliament=, of
=Imprisoning= in their Houses every Family the =Plague= seizes on,
without allowing any one to pass in or out, but such as are appointed by
Authority, to perform the necessary Offices about the Sick, is certainly
the severest Treatment imaginable; as it exposes the whole Family to
suffer by the same Disease; and consequently is little less than
assigning them over to the cruellest of Deaths: As I have shewn in the
Discourse.

THE Methods practised in =France= are likewise obnoxious to great
Objections. =Crowding= the Sick together in =Hospitals= can serve to no
good Purpose; but instead thereof will =promote= and =spread= the
=Contagion=, and besides will expose the Sick to the greatest Hardships.
It is no small Part of the Misery, that attends this terrible Enemy of
Mankind, that whereas moderate Calamities open the Hearts of Men to
=Compassion= and =Tenderness=, this greatest of Evils is found to have
the contrary Effect. Whether Men of wicked Minds, through Hopes of
Impunity, at these Times of Disorder and Confusion, give their evil
Disposition full Scope, which ordinarily is restrained by the Fear of
Punishment; or whether it be, that a constant View of Calamities and
Distress does so pervert the Minds of Men, as to blot out all Sentiments
of Humanity; or whatever else be the Cause: certain it is, that at such
Times, when it should be expected to see all Men unite in one common
Endeavour, to moderate the publick Misery; quite otherwise, they grow
regardless of each other, and Barbarities are often practised, unknown
at other Times. Accordingly =Diemerbroek= informs us, that he himself
had often seen these =Hospitals= committed to the Charge of Villains,
whose Inhumanity has suffered great Numbers to perish by Neglect, and
that sometimes they have even smothered such as have been very weak, or
have had nauseous Ulcers difficult to cure. Insomuch, that in many
Places the Sick have chose to lay themselves in Fields, in the open
Air, under the slightest Coverings, rather than to fall into the
barbarous Hands of those who have had the Management of these
Hospitals[12].

THE rigorous Restraints observed at their =Lines=, are attended also
with the like Inconveniences. For by absolutely denying a Passage to
People from =infected= Places, they subject to the same common Ruin,
both from the Disease, and from the Disorders committed in such Places,
those, whom their Fortunes would otherwise furnish with Means of
escaping: and this, no doubt, in every free Country, must be looked upon
as an unjust =Infringement of Liberty=, and a Diminution of Mens natural
Rights, not to be allowed.

NOW, under all these Difficulties, I cannot but with the greatest
Satisfaction observe, that my =Precepts= are well nigh, nay altogether
free from them; and yet a proper Regard is had to the Disease. As soon
as ever the =Sick= are grown numerous, I advise, that they be left in
their Houses, without any of those unmerciful Restraints heretofore put
upon them and the Families they belonged to. I might, perhaps, have
justly directed, that whenever those, who frequent or dwell in an
=infected= House, go abroad, they should be obliged to carry about them
=a long Stick= of some remarkable Colour, or other =visible Token=, by
which People may be warned from holding too free Converse with them:
this being the Practice on these Occasions, as I have heard, in some
Places. The =Removal of the Sick= from their Houses, I advise only at
the beginning, when it will be attended with none of the forementioned
Inconveniences: but is what, for the most Part, those Sick should
themselves desire. It has hardly ever been known, when the Disease did
not first begin among the =Poor=. Such therefore only will be subject to
this Regulation, whose Habitations by the Closeness of them are in all
Respects very incommodious for diseased Persons. So that my Advice
chiefly amounts to the giving Relief to the =Poor=, who shall first be
=infected=, by removing them into more convenient Lodgings than their
own, where they shall be better provided for than at home. And the
=Removal= of them will not be attended with that Danger, it is natural
for the Unskilful to apprehend in so dreadful a Disease; because it is
every Day practised in the =Small-Pox=, with great Safety. And whereas I
have before observed, that People have often suffered in the publick
=Hospitals= by the Inhumanity of their Attendants; in this Case, little
or nothing of that kind is to be feared: for I have proposed this
=Removal= of the =Sick= only, at a Time, when a long =Series= of
=Calamities= has not yet bred Disorders and Hardness of Heart. Nay, it
may be reasonably expected that they should rather be used with the
tenderest Care, when every one shall believe the Stopping of the
Distemper, and consequently their own Safety to depend upon it. And as
this Treatment will be both safe and beneficial to the =Sick=, so it
will be much more evidently for the Advantage of the sound Part of the
Family, and of those who live near them. For as the =poorer= Sort of
People subsist by their daily Labour, no sooner shall the =Plague= have
broke out among them, but the sick Families, and all their Neighbours
likewise, if not relieved by the Publick, shall be abandoned to perish
by =Want=, unless the Progress of the Distemper put a shorter Period to
their Lives.

THIS Observation, that the_ Plague _usually begins among the =Poor=,
was the Reason, why I did not make any Difference in my Directions for
=removing the Sick=, in regard to their different Fortunes, when I first
gave my Thoughts upon this Subject: which however, to prevent Cavils, I
have at present done; and have shewn what Method ought to be taken, if
by some unusual Chance, the =Plague= should at the beginning enter a
wealthy Family. And, in this Case, I have advised nothing, which I would
not most readily submit to my self: For I should much rather chuse to be
thus removed from my Dwelling, with the Distemper upon me, to save my
Family, than they, by being shut up with me, should be all exposed to
perish. And as this Way of treating diseased Families is the most
compassionate, that can be devised with any regard to the restraining
the Progress of the Distemper; so it is still much preferable to what
was formerly practised amongst us, on other Accounts. For, according to
what I have advised, it is only required, to =remove some few= Families
at the beginning of the Disease: whereas the Method of =shutting up=
Houses was continued through the whole Course of the Sickness. Perhaps
the Plague, under this Management, may not reach half a Score Families:
I have given Instances, where it has thus been stopt in =One=.

WHAT relates to the inclosing =Infected= Places with =Lines=, I have so
regulated, that no body can be subjected to any Degree of Hardship
thereby: for I have provided, that free Liberty be given to every one,
that pleases, to depart from the =Infected= Place, without being put to
any other Difficulty, than the Performance of a short =Quarantaine= of
about three Weeks, in some Place of Safety. So that no one shall be
compelled to continue in the infected Town, whom his own Circumstances
will not confine.

THIS part of my Directions is not so =general= as the rest, because
some Places are too great to admit of it: which occasioned my proposing
it with a Restriction[13]. But as this is a great Inconvenience to the
rest of the =Country=, so it is far from being any Advantage to the
=Place= thus left unguarded. For when all, who leave an =infected= Place,
carry with them =Certificates= of their having submitted to such
=Quarantaine=, as may remove all Cause of Suspicion, =Travelling= will be
much more safe and commodious, than otherwise it can be. For want of
this, when the =Plague= was last at =London=, it was difficult to
withdraw from it, while the =Country= was every where afraid of
=Strangers=, and the =Inns= on the =Roads= were unsafe to lodge in for
those, who travelled from the =City=; when it could not be known, but
=Infection= might be received in them by others come from the same
Place.

AND from hence it happened that the =Plague=, when last in =England=,
though much more moderate, and though it continued not above one Year
in the City of =London=, did yet spread it self over a great Part of
=England=, getting into =Kent=, even as far as =Dover=; into =Sussex=,
=Hampshire=, =Dorsetshire=, =Essex=, =Suffolk=, =Norfolk=,
=Cambridgeshire=, =Northamptonshire=, =Warwickshire=, =Derbyshire=, and,
to mention no more, as far as =Newcastle=[14].

THUS, as I have examined through the Course of the following =Treatise=,
with all possible Care, into the Agreement of my =Precepts= with the
Nature of the =Plague=; so I have now considered how far they can
conveniently be put in Practice.

BUT it is time to have done with a Subject by no means agreeable.

I shall therefore conclude all I have to say upon this Matter, with a
=Paper= well deserving Perusal, which is come to my Hands, since the
following Sheets were finished; and therefore too late to be made use
of in its proper Place: for which Reason, I shall give it here entire.
This =Paper= contains the Methods taken by his late =Majesty=, when the
=Plague= in the Year 1712. had entered his =Dominions= in =Germany=. It
was delivered to me from Mr. =Backmeister=, the Secretary at =Hanover=
to his =Majesty= for the =German= Affairs, who was the Person, that
issued out the =Orders= that were given. This =Relation= I requested
from the Secretary, being desirous to know how far the =Measures= then
taken, agreed with my =Directions=: because I had been informed, that
they were very successful. And I have the Satisfaction to find them very
conformable to my =Precepts=; and that they had so much the desired
Effect, as to stop the =Plague= from spreading beyond the small Number
of =Towns= and =Villages= recited at the beginning of the =Paper=.


=HANOVER=, Feb. 10. N. S. 1722.

IN 1712 and 1713, the Plague raged in these Parts, at the following
Places.

=TOWNS.=

  =Lunenbourg=,
  =Zell=,
  =Haarbourg=, twice.

=VILLAGES.=

  =Nienfeldt=,
  =Holdenstedt=,
  =Melle=,
  =Bienenbuttel=,
  =Achem=,
  =Trebel=,
  =Brinckem=,
  =Goldenstedt=,
  =Fallingbostel=.

IN the last =Place=, three labouring Men, who had made their Escape
from =Hamburgh=, got into a Barn in the Night, and were found dead there
the next Morning, with Marks of the Plague upon them: but the Progress
of the Infection was stopt by burning the Barn.

AS soon as any Village was infected, the first Thing done was to make
a =Line= round it, thereby to hinder the Inhabitants from communicating
with others. Those who were thus shut up, were immediately furnished
with Provisions: a Physician was sent to them; and especially some
Surgeons; a Minister to officiate particularly to Persons infected; a
Nurse; Buriers; =&c.=

THE principal Management of this whole Affair consisted in two Things:
1. In =separating= the Sick from the Sound; and 2. In =cleaning= well
the Houses which had been infected.

WHEN any Person was taken ill, he was obliged to leave his Lodging,
and retire into a =Lazaretto= or =Hospital=, built for that Purpose. The
other Persons, who appeared to be well in the same House, were obliged,
when it was practicable, to strip themselves in the Night quite naked,
to put on other Clothes, which were provided for them, and to go to
perform =Quarantaine= in a House appointed for it, after having burnt
the Clothes, they had put off. Persons were made to change their
Clothes, and those they put off were burnt, as often as was judged
necessary: For Example, this was done when those who had recovered their
Health, came out of the =Lazaretto= and went into =Quarantaine=; and
likewise, when (after the Disease was ceased) the Women who attended the
Sick, the Buriers, and Surgeons, went into =Quarantaine=.

IN Summer, ordinary =Barracks= (or Huts) were made for those of the
common People, who were obliged to quit infected Houses: which Barracks
were afterwards burnt, when they had been made Use of.

AS soon as the People were come out of an infected House, it was nailed
up, and Centinels were posted there, that nothing might be stolen out of
it. In the Country, when such a House was not of very great Value, and
it might be done without Danger, it was =burnt=, and the Loss was made
good to the Owner, at the Expence of the Publick. But in Towns, where
this could not be done, without the Hazard of burning the Town, Men were
hired to go into the Houses, and bring into the Court-Yard, or before
the House, whatever Goods they found in it susceptible of Contagion, and
there =burn= them: but to prevent the Fright which this might raise
among the Neighbours, such Goods were sometimes put into the Cart, used
to carry off dead Bodies, and so conveyed out of the Town and burnt. At
first, the Method taken, was only to =bury= such Goods deep in the
Ground: but it was found by several Examples, that they were dug up
again, and that the Infection was thereby renewed. Before People were
paid for their Houses and Effects, that were burnt, it was discovered,
that they often laid some of their Goods out of the Way, and that the
Contagion was spread by them: but after they came to be paid what was
reasonable, by the Publick, they willingly let all be burnt, without
concealing any thing.

IN Summer, the Cattle were left abroad, and the Inhabitants, who had
not the Plague in their Houses were obliged to look after them: In
Winter, the Sound Persons were obliged, before they left an infected
House, to kill the Cattle belonging to it, and to bury them ten Foot
deep in the Ground near the House.

So far the former Preface.


I think it now proper to take Notice, that an =Act of Parliament= (as
above mentioned in this Preface) formed upon the Precepts here
delivered, having been passed on =December 8, 1720.= the two last
=Clauses= in the said Act, relating to the =removing= of Sick Persons
from their Habitations, and the making of =Lines= about Places infected,
were on =October 19= of the following Year, repealed.

THIS looks as if the Rules prescribed were not right and just: I must
therefore observe, in Justification of myself, that this was not the
Case. Nothing was urged in that Repeal against the Reasonableness of
the Directions in themselves, more than in these Words: =That the
Execution of them might be very grievous to the Subjects of this
Kingdom=. But this I have proved to be quite otherwise.

THE Truth of the Matter is this: Some great Men, both of the Lords and
Commons, who were in the =Opposition to the Court=, objected that the
=Ministry= were not to be intrusted with such =Powers=, lest they should
abuse them; since they might, upon Occasion, by their Officers, either
remove or confine Persons not favoured by the Government, on Pretence
that their Houses were infected.

VAIN and groundless as these Fears were, yet the Clamours industriously
raised from them were so strong, that a great Officer in the State
thought fit to oblige his Enemies by giving way to them: and tho' a
=Motion= made in the House of Commons for repealing these two Clauses had
just been rejected; yet upon making the same in the House of Lords, with
his Consent, the thing was done.

WHETHER private or public Considerations had the greater Share in
bringing about this Compliance, I will not determine. Such
=Counter-Steps= will happen in a Government, where there is too much of
=Faction=, and too little of a =Public Spirit=. This I very well
remember, that a learned Prelate, now dead, who had more of =Political=
than of =Christian= Zeal, and was one who made the loudest Noise about
the =Quarantaine= Bill, frankly owned to me in Conversation, that tho'
the Directions were good, yet he and his Friends had resolved to take
that Opportunity of shewing their Disaffection to the =Ministry=.

BUT after all, it contributed not a little to the carrying this Point,
that the Plague was now ceased at =Marseilles=, and a Stop put to its
Progress in the =Provinces=. And I cannot but take notice that this last
good Service was done by the same Method, which, tho' in a more moderate
way, I have here proposed. For it is well known that the Regent of
=France= did at last set Bounds to the Contagion by =Lines= and =Barriers=
guarded by Soldiers: which wise Resolution saved not only his own but
other Countries from the spreading of a Disease, which seems to have
been of as violent a kind as ever was brought into =Europe=.

HOWEVER, if there were any Severity in Orders of this kind, every Man
ought to consider himself as a Member of the Society; by the Laws of
which as he receives many Advantages, so he gives up somewhat of his
own private Rights to the Public: and must therefore be perfectly
satisfied with whatever is found necessary for the common Good; altho'
it may, on particular Occasions, bring upon him some Inconveniences and
Sufferings.

     Salus Populi suprema Lex est.

Does any body complain of ill usage upon his House being ordered to be
blown up, to stop the Progress of a Fire which endangers the whole
Street: when he reflects that his Neighbour, who by this means escapes,
must have suffered the same Loss for his sake, had it so happened that
each had been in the other's Habitation?

BUT in truth, there is no Cruelty, but on the contrary real Compassion
in these Regulations, with the Limitations I have made: and I am fully
persuaded that whoever with Judgment considers the nature of this
Disease, will easily see that the Rules here laid down are not only the
best, but indeed the only ones that can effectually answer the purpose.
And therefore I should not doubt but that, if this Calamity (which God
avert!) should be brought into our Country, even the Voice of the People
would cry out for Help in this way: notwithstanding wrong Notions of
their =Liberties= may sometimes over-possess their Minds, and make them,
even under the best of Governments, impatient of any =Restraints=.




PART I.

Of the PLAGUE in general.




CHAP. I.

_Of the Origine and Nature of the Plague._


MY Design in this Discourse being to propose what Measures I think most
proper to defend the Nation against the _Plague_, and for this End to
consider the Nature of _Pestilential Contagion_ as far as is necessary
to set forth the Reasonableness of the Precepts I shall lay down; before
I proceed to any particular Directions, I shall enquire a little into
the Causes, whence the _Plague_ arises, and by what Means the Infection
of it is spread.

IN the most ancient Times _Plagues_, like many other Diseases, were
looked upon as _divine Judgments_ sent to punish the Wickedness of
Mankind: and therefore the only Defence sought after was by Sacrifices
and Lustrations to appease the Anger of incensed Heaven.[15]

HOW much soever may be said to justify Reflexions of this Kind, since we
are assured from sacred History, that divine Vengeance has been
sometimes executed by _Plagues_; yet it is certain, that such
Speculations pushed too far, were then attended with ill Consequences,
by obstructing Inquiries into natural Causes, and encouraging a supine
Submission to those Evils: against which the infinitely good and wise
Author of Nature has in most Cases provided proper Remedies.

UPON this Account, in After-Ages, when the Profession of Physick came to
be founded upon the Knowledge of Nature, _Hippocrates_ strenuously
opposed this Opinion, that _some particular Sicknesses were Divine, or
sent immediately from the Gods_; and affirmed, that _no Diseases came
more from the Gods than others, all coming from them, and yet all owning
their proper natural Causes: that the Sun, Cold, and Winds were_ divine;
_the Changes of which, and their Influences on human Bodies, were
diligently to be considered by a Physician_.[16]

WHICH general Position this great Author of Physick intended to be
understood with respect to _Plagues_ as well as other Distempers: How
far he had reason herein, will in some measure appear, when we come to
search into the Causes of this Disease.

BUT in order to this Inquiry, it will be convenient, in the first place,
to remove an erroneous Opinion some have entertained, that the _Plague_
differs not from a _common Fever_ in any thing besides its greater
Violence. Whereas it is very evident, that since the _Small-Pox_ and
_Measles_ are allowed to be Distempers distinct in _Specie_ from all
others, on account of certain Symptoms peculiar to them; so, for the
same reason, it ought to be granted, that the _Plague_ no less differs
in Kind from ordinary Fevers: For there are a Set of distinguishing
Symptoms as essential to the _Pestilence_, as the respective Eruptions
are to the _Small-Pox_ or _Measles_; which are indeed (as I have
mentioned in the Preface) each of them _Plagues_ of a particular kind.

AS the _Small-Pox_ discharges itself by _Pustules_ raised in the Skin;
so in the _Plague_ the noxious Humour is thrown out either by _Tumors_
in the Glands, as by a _Parotis_, _Bubo_, and the like; or by
_Carbuncles_ thrust out upon any part of the Body. And these Eruptions
are so specific Marks of this Distemper, that one or other of them is
never absent: unless through the extreme Malignity of the Disease, or
Weakness of Nature, the Patient sinks, before there is time for any
Discharge to be made this way; that Matter, which should otherwise have
been cast out by external _Tumors_, seizing the _Viscera_, and producing
_Mortifications_ in them.

SOMETIMES indeed it happens, by this means, that these _Tumors_ in the
_Glands_, and _Carbuncles_, do not appear; just as a bad kind of the
_Small-Pox_ in tender Constitutions sometimes proves fatal before the
_Eruption_, by a _Diarrhoea_, _Haemorrhage_, or some such Effect of a
prevailing Malignity.

THE _French_ Physicians having distinguished the Sick at _Marseilles_
into five _Classes_, according to the Degrees of the Distemper,
observed _Bubo's_, and _Carbuncles_, in all of them, except in those of
the _first Class_, who were so terribly seized, that they died in a few
Hours, or at farthest in a Day or two, sinking under the Oppression,
Anxiety, and Faintness, into which they were thrown by the first Stroke
of the Disease; having Mortifications immediately produced in some of
the _Viscera_, as appeared upon the Dissection of their Bodies[17]. And
this Observation of the _French_ Physicians, which agrees with what
other Authors have remarked in former _Plagues_, fully proves, that
these Eruptions are so far from being caused solely by the greater
_Violence_ of this Disease, than of other Fevers, that they are only
absent, when the Distemper is extraordinary fierce; but otherwise they
constantly attend it, even when it has proved so mild, that the first
Notice, the Patient has had of his Infection, has been the Appearance of
such a _Tumor_: as, besides these _French_ Physicians, other Authors of
the best Credit have assured us. From whence we must conclude, that
these _Eruptions_ are no less a Specific Mark of this Disease, than
those are, by which the _Small Pox_ and _Measles_ are known and
distinguished. And as in the first _Class_ of those attacked with the
Plague, so likewise in these two Distempers we often find the Patient to
dye by the violence of the Fever, before any Eruption of the Pustules
can be made.

THIS Circumstance of the Plague being mortal before any Eruptions
appeared, was attended with a great misfortune. The Physicians and
Surgeons appointed to examine the dead Bodies, finding none of the
distinguishing Marks of the Disease, reported to the Magistrates that it
was not the _Plague_; and persisted in their opinion, till one of them
suffered for his Ignorance, and himself, with part of his Family, dyed
by the Infection: this Assurance having prevented the necessary
Precautions[18].

AND this in particular shews us the difference between the true
_Plague_, and those _Fevers_ of extraordinary Malignity, which are the
usual Forerunners of it, and are the natural Consequence of that ill
State of Air, we shall hereafter prove to attend all _Plagues_. For
since all those Fevers, from which People recover without any Discharge
by Tumors in the Glands, or by _Carbuncles_, want the _characteristic_
Signs, which have been shewn to attend the slightest Cases of the true
_Plague_; we cannot, upon any just Ground, certainly conclude them to be
a less Degree only of that Distemper: but as far as appears, they are of
a different Nature, are not ordinarily _Contagious_ like the _Plague_,
nor yet have any such necessary relation to it, but that such Fevers do
sometimes appear, without being followed by a real _Pestilence_.

ON the other hand, I would not be understood to call every _Fever_ a
_Plague_, which is followed by Eruptions resembling these here
mentioned: For as every _Boil_ or _Pustule_, which breaks out upon the
Skin, is not an Indication of the _Small Pox_, nor every Swelling in
the _Groin_ a _Venereal Bubo_; so there are _Carbuncles_ not
Pestilential, and other Fevers, besides the _Plague_, which have their
Crisis by _Tumors_ and _Abscesses_, and that sometimes even in the
_Parotid_ or other Glands. There is indeed usually some difference
between these Swellings in the _Plague_, and in other Fevers, especially
in the time of their coming out: for in the _Plague_ they discover
themselves sooner than in most other Cases. But the principal difference
between these Diseases, is, that the Plague is infectious, the other
not; at least not to any considerable Degree.

AND this leads me to another Character of this Disease, whereby it is
distinguished from ordinary Fevers, which is the _Contagion_
accompanying it. This is a very ancient Observation. _Thucydides_ makes
it a part of his Description of the _Plague_ at _Athens_[19]; and
_Lucretius_, who has almost translated this Description of _Thucydides_,
dwells much upon it[20]. _Aristotle_ makes it one of his[21]
_Problems_, How the _Plague infects_ those who approach to the Sick. And
what is of more Consequence, _Galen_ himself is very clear in it[22];
for he has these words: +hoti syndiatribein tois loimottousin
episphales, apolausai gar kindynos, hosper psoras tinos+, _&c. that it
is unsafe to be about those, who have the Plague, for fear of catching
it, as in the Itch_, &c. Indeed this is a thing so evident, that we find
it at present the current Opinion of all Mankind, a very few Persons
only excepted, who have distinguished themselves by their Singularity in
maintaining the opposite Sentiment. And it is something strange that any
one should make a Question of a thing so obvious, which is proved
sufficiently by one Property only of the Disease, that whenever it
seizes one Person in a House, it immediately after attacks the greatest
part of the Family. This Effect of the _Plague_ has been so remarkable
at all times, that whoever considers it well, cannot possibly, I think,
have any Doubt remaining, or require any stronger Argument to convince
him, that the Disease is infectious. For this very reason the
_Small-Pox_ and _Measles_ are generally allowed to be _contagious_;
because it is observed, that when either of these Diseases is got among
a Family, it usually seizes successively the greatest part of that
Family, who have not had it before: at least if such in the Family hold
free Communication with the Sick. And by the same Argument the _Plague_
must be concluded to be infectious likewise. It cannot be pretended,
that this is occasioned in the _Plague_ from this only, that the sound
Persons are render'd more than ordinarily obnoxious to the unhealthy
Air, or whatever be the common Cause of the Disease, by being put into
fear and dispirited, upon seeing others in the same House taken sick:
For if this were the Case, _Children_, who are too young to have any
Apprehensions upon this Account, would escape better than others, the
contrary of which has been always experienced.

IT is true, some have not been attacked by the Disease, though
constantly attending about the Sick. But this is no Objection against
what is here advanced: for it is as easily understood how some Persons,
by a particular Advantage of Constitution, should resist Infection, as
how they should constantly breath a noxious Air without hurt. An odd
Observation of _Diemerbroek_ deserves notice in this Place; That, part
of a Family removed into a Town free from the _Plague_, was observed by
him to be taken ill of it soon after the part left behind in the
diseased Town fell sick: which certainly could scarce have happened,
unless a Communication between the Healthy and the Sick, by Letters or
otherwise, was capable of causing it[23]. Of the same Nature is a
Circumstance recorded by _Evagrius_ of the _Plague_, which he describes,
and what, he owns, surprized him very much: That, many of those, who
left infected Places, were seized with the _Plague_ in the Towns to
which they had retired, while the old Inhabitants of those Towns were
free from the Disease[24]. But to multiply Proofs of a thing so evident,
is needless; innumerable are at hand, and several will occasionally
occur in the following Parts of this Discourse, when we come to speak in
particular of the ways, by which this Infection is conveyed about. I
shall therefore say no more in this Place, but only, that all the
Appearances attending this Disease are very easily explained upon this
Principle, and are hardly to be accounted for upon any other. We learn
from hence the reason why when the _Plague_ makes its first Appearance
in any Place, though the Number of Sick is exceeding small, yet the
Disease usually operates upon them in the most violent manner, and is
attended with its very worst Symptoms. Now was the Disease produced not
by imported _Contagion_, but from some Cause, which had its Original in
the diseased Place, and consequently from a Cause gradually bred, the
contrary must happen: the Diseased would at first not only be few in
Number, but their Sickness likewise more moderate than afterwards, when
the morbific Causes were raised to their greatest Malignity. From the
same Principle we see the reason, why People have often remained in
Safety in a diseased Town, only by shutting themselves up from all
Communication with such, as might be suspected of giving them the
Disease. When the _Plague_ was last in _England_, while it was in the
Town of _Cambridge_, the Colleges remained entirely free by using this
Precaution. In the _Plague_ at _Rome_ in the Years 1656 and 1657, the
_Monasteries_ and _Nunneries_, for the most part, defended themselves by
the same Means[25]: Whereas at _Naples_, where the _Plague_ was a little
before, these _Religious Houses_, from their Neglect herein, did not
escape so well[26]. Nay the Infection entered none of the _Prisons_ at
_Rome_[27], though the Nastiness of those Places exposes them very much.
But, to avoid Prolixity, I shall give only one Instance more. I think it
cannot be explained in any other reasonable manner, how the last
_Plague_ in the City of _London_, which broke out in the parish of St.
_Giles's in the Fields_ towards the latter end of the Year 1664, should
lie a-sleep from _Christmas_ to the middle of _February_, and then break
out again in the same Parish; and after another long rest till _April_,
shew itself again in the same Place[28].

TO proceed: Whoever examines the Histories of _Plagues_ in all times,
which have been described with any Exactness, will find very few, that
do not agree in these essential Marks, whereby the _Plague_ may be
distinguished from other _Fevers_. I confess an Instance or two may be
found to the contrary; perhaps the History of our own Country furnishes
the most remarkable of any[29]. But Examples of this kind are so very
rare, that I think it must be concluded, that the _Plague_ is usually
one and the same Distemper.

IN the next place I shall endeavour to shew, that the _Plague_ has
always the same Original, and is brought from _Africa_, the Country
which has entail'd upon us two other infectious Distempers, the
_Small-Pox_ and _Measles_. In all Countries indeed _Epidemic Diseases_
extraordinarily mortal, are frequently bred in _Goals_, _Sieges_,
_Camps_, &c. which Authors have often in a large Sense called
_Pestilential_: But the true _Plague_, which is attended with the
distinguishing Symptoms before described, and which spreads from Country
to Country, I take to be an _African_ Fever bred in _AEthiopia_ or
_Egypt_, and the _Infection_ of it carried by Trade into the other Parts
of the World.

IT is the Observation of _Pliny_, that the _Pestilence_ always travels
from the _Southern_ Parts of the World to the _Western_, that is, in his
Phrase, into _Europe_[30]. And the most accurate Accounts in all Times
of this Disease, wherever it has raged, bring it from _Africa_.
_Thucydides_[31], in his admirable Description of the famous _Plague_
of _Athens_, says, that it began in Upper _AEthiopia_, then came into
_Egypt_, from whence it was spread first into _Persia_, and afterwards
into _Greece_.

THERE is in all ancient History no Account of any _Plague_ so dreadful
as that, which broke out at _Constantinople_ in the time of the Emperor
_Justinian A. D._ 543. This is said to have spread its Infection over
all the Earth, and to have lasted fifty two Years. The History of it is
very well told by _Evagrius_[32], and yet more learnedly by
_Procopius_[33]: and they both observe, that the Distemper had its Birth
in _AEthiopia_ or _Egypt_.

THIS is likewise agreeable to the modern Relations of Travellers and
Merchants from _Turkey_, who generally inform us, that the frequent
_Plagues_, which depopulate that Country, are brought thither from the
Coast of _Africa_: insomuch that at _Smyrna_, and other Ports of that
Coast, they often know the very Ship which brings it. And, in these
latter Ages, since our Trade with _Turkey_ has been pretty constant, the
_Plagues_ in these Parts of _Europe_ have evidently been brought from
thence.

THE late _Plague_ in _France_ came indisputably from _Turkey_, as I
shall particularly shew in some of the following Pages. The _Plague_,
which broke out at _Dantzick_ in the Year 1709, and spread from thence
to _Hamburgh_, _Copenhagen_, and other Cities in the _North_, made its
way thither from _Constantinople_ through _Poland_, &c. And the last
_Plague_ in this City, if we may believe Dr. _Hodges_, had the same
Original, being brought to us from _Holland_, but carried to them by
_Cotton_ imported from _Turkey_[34].

THE greatest _Mortality_ that has happen'd in later Ages, was about the
middle of the fourteenth Century; when the _Plague_ seized Country after
Country for five Years together[35]. In the Year 1346 it raged in
_Egypt_, _Turkey_, _Greece_, _Syria_, and the _East-Indies_; in 1347
some Ships from the _Levant_ carried it to _Sicily_, _Pisa_, _Genoa_,
&c. in 1348 it got into _Savoy_, _Provence_, _Dauphiny_, _Catalonia_,
and _Castile_, &c. in 1349 it seized _England_, _Scotland_, _Ireland_,
and _Flanders_; and the next Year _Germany_, _Hungary_ and _Denmark_:
and in all Places, where it came, it made such heavy Destruction, that
it is said to have dispeopled the Earth of more than half its
Inhabitants[36]. Now since _Africa_ had a share of this _Plague_ in the
very beginning, I question not but it had its first Rise in that
Country; and not in _China_, as _M. Villani_, in his History of those
Times, relates from the Report of _Genoese_ Seamen, who came from those
Parts, and said it was occasion'd there by a great _Ball of Fire_, which
either burst out of the Earth, or fell down from Heaven[37]. But this
Relation is so very incredible, that I cannot think we ought at all to
rely upon it: seeing we have no Instance of a _Plague_, which was
originally bred in that Country.

IT is very remarkable, that the several Countries of _Europe_ have
always suffered more or less in this way, according as they have had a
greater or lesser Commerce with _Africa_; or with those Parts of the
_East_, that have traded thither. Which Observation, by the by, may help
to solve a Difficulty concerning the great Increase of People among the
_Northern_ Nations in ancient Times, more than at present; for in those
Ages, having no Communication at all with _Africa_, they were not wasted
with _Plagues_, as they have been since.

AS the People of _Marseilles_, from the first Foundation of their City
by the _Phoceans_, were famous for Trade, and made long Voyages
Southwards on the _African_ Coast[38]; so they have in all times been
very liable to the Plague. A French Author[39] in a History of the late
Plague at _Marseilles_ reckons up twenty Plagues that have happened in
that City; notwithstanding it is by its situation one of the most
healthy and pleasant Places in _France_, and the least subject to
epidemic Distempers. But if we had no Records of this in History, an odd
Custom among them, mentioned in Antiquity[40], of the way they made use
of to clear themselves from this Distemper, would be a proof of it.
Their manner at such times was, that some one poor Man offered himself
to be maintained at the publick Expence with delicate Food for a whole
Year: at the end of which he was led about the City dressed in
consecrated Garments and Herbs; and being loaded with Curses as he went
along, that the Evils of the Citizens might fall upon him, he was at
last thrown into the Sea[41].

AGREEABLE to this Remark upon Trade is the Observation of _Procopius_ in
his forecited History, that the _Plague_ was always found to spread from
_Maritime_ Places into the _Inland_ Countries: which has ever since been
confirmed by Experience.

HAVING shewn this Disease to be a Distemper of a distinct Species, and
to take its Rise only in _Africa_; we must next seek for its Cause in
that Country and no where else. We ought therefore to consider, what
there is peculiar to that Country, which can reasonably be supposed
capable of producing it. Wherefore I shall briefly set down as much as
serves for this purpose of the State of _Grand Cairo_ in _Egypt_, and of
_AEthiopia_, the two great Seminaries of the _Plague_: Travellers
relating that these Countries are more infested with it than most other
Parts of _Africa_.

_GRAND CAIRO_ is 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 the
_Heats_ very stifling. Through the midst of it passes a great _Canal_,
which is filled with Water at the overflowing of the _Nile_; 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 of things, the _Plague_ every Year constantly preys
upon the Inhabitants; and is only stopt, when the _Nile_, by
overflowing, washes away this Load of Filth; the _Cold Winds_, which set
in at the same time, lending their Assistance, by purifying the Air.

IN _AEthiopia_ those prodigious Swarms of _Locusts_, 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 a _Pestilence_[43]; the Putrefaction being hightened by the
excessive _Intemperance of the Climate_, which is so very great in this
Country, that it is infested with violent _Rains_ at one Season of the
Year, for three or four Months together[44]. And it is particularly
observed of this Country, that the _Plague_ usually invades it, whenever
Rains fall during the sultry Heats of _July_ and _August_[45], that is,
as _Lucretius_ expresses it, when the Earth is

     _Intempestivis pluviisque et solibus icta_[46].

NOW if we compare this last Remark of the _Intemperance of the Climate_
in _AEthiopia_, with what the _Arabian_ Physicians[47], who lived near
these Countries, declare, that _Pestilences_ are brought by
_unseasonable_ Moistures, 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 the
_Putrefaction_ so constantly generated in these Countries, when _that_
is hightened and increased by the ill State of Air now described; and
especially from the _Putrefaction_ of animal Substances.

IT is 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 will _infect_ others. And it is not improbable, that the volatile
Parts with which Animals abound, may in some ill States of Air in the
sultry Heats of _Africa_ be converted 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 by _putrefying_, 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 in _hydropic Bodies_,
and in _cancerous Tumors_. Nay more, we find _animal Putrefaction_
sometimes to produce in these _Northern_ Climates very fatal Distempers,
though they do not arise to the Malignity of the true _Plague_: For such
_Fevers_ are often bred, where a large Number of People are closely
confined together; as in _Goals_, _Sieges_, and _Camps_.

AND perhaps it may not be here amiss to remark, that the _Egyptians_ of
old were so sensible how much the _Putridness_ of dead Animals
contributed towards breeding the _Plague_, that they worshipped the Bird
_Ibis_ for 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].

BUT no kind of _Putrefaction_ is ever hightened in these _European_
Countries to a degree capable of producing the true _Plague_: and we
learn from the Observation of the _Arabian_ Physicians, that some
Indisposition of the _Air_ is 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 the _Effluvia_ exhaled
from those Substances, while they putrefy. Both which Effects may well
be expected from the sensible ill Qualities of the _Air_ before
described, whenever they continue and exert their Force together any
considerable time.

WHAT I have here advanced of the first Original of the _Plague_, appears
to me so reasonable, that I cannot enough wonder at Authors for quitting
the Consideration of such manifest Causes for _Hidden Qualities_; such
as _Malignant Influences of the Heavens_; _Arsenical_, _Bituminous_, or
other _Mineral Effluvia_, with the like imaginary or uncertain Agents.

THIS however I do not say with design absolutely to exclude all
Disorders in the _Air_, that are more latent than the intemperate _Heat_
and _Moisture_ before mentioned, from a Share in increasing and
promoting the Infection of the _Plague_, 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, the
_Small-Pox_, which is most commonly spread, and propagated by the same
manifest Qualities of the _Air_ as those here described: Notwithstanding
which, this Distemper is sometimes known to rage with great Violence in
the very opposite Constitution of _Air_, _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 the _Air_ to assist in the first Production of the
Disease; yet it may justly be censured in these Writers, that they
should undertake to determine the _Specific Nature_ of 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 the _Plague_, point out any thing of their _Specific Nature_.

ALL that we know, is this, that the Cause of the _Plague_, 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 inward _Inflammations_ and _Gangrenes_, or push out
_Carbuncles_ and _Bubo's_; the _Matter_ of which, when suppurated,
communicates the like Disease to others: But of the manner how this is
done, I shall discourse in the following Chapter.




CHAP. II.

_Of the Causes which spread the Plague._


I HAVE been thus particular in tracing the _Plague_ up 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 by _Contagion_. Those who are Strangers to the full Power
of _this_, that is, those who do not understand how subtile it is, and
how widely the Distemper may be spread by _Infection_, ascribe the Rise
of it wholly to the malignant Quality of the _Air_ in all Places,
wherever it happens; and, on the other hand, some have thought that the
Consideration of the infectious Nature of the Disease must exclude all
regard to the Influence of the _Air_: Whereas the _Contagion_
accompanying the Disease, and the Disposition of the _Air_ to promote
that _Contagion_, 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.

FOR this purpose, I shall reduce the Causes, which spread the _Plague_,
to three, _Diseased Persons_, _Goods transported from infected Places_,
and _a corrupted State of Air_.

THERE are several Diseases, which will be communicated from the Sick to
others: and this not done after the same manner in all. The
_Hydrophobia_ is communicated no other way than by mixing the morbid
Juices of the diseased Animal immediately with the Blood of the sound,
by a _Bite_, or what is analogous thereto; the _Itch_ is given by
_simple Contact_; the _Lues Venerea_ not without _a closer Contact_; but
the _Measles_, _Small-Pox_, and _Plague_ are caught by a _near Approach_
only 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.

NOW it appears by the Experiments mentioned in the _Preface_, of giving
the _Plague_ to _Dogs_ by putting the _Bile_, _Blood_ or _Urine_ from
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 how the _Effluvia_ or 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 with
_pestiferous Atoms_: which being taken into the Body of a sound Person
will, in the Nature of a _Ferment_, put the Fluids there into the like
Agitation and Disorder.

THE Body, I suppose, receives them these two ways, by the _Breath_, and
by the _Skin_; but chiefly by the former.

I THINK it certain that _Respiration_ does 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. _Halley_
has inform'd me, that when he was several Fathom under Water in his
_Diving Engine_, and breathing an Air much more condensed than the
natural, he observed himself to breath more slowly than usual: Which
makes it more than probable, that this conveying to the Blood some
subtile Parts from the Air, is the chief Use of _Respiration_; since
when a greater Quantity of _Air_ than usual was taken in at a time, and
consequently more of these subtile Parts received at once by the Blood,
a less frequent _Respiration_ sufficed.

AS to the _Skin_, since there is a continual Discharge made thro' its
innumerable _Pores_, of the matter of _insensible Perspiration_ and
_Sweat_; 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
of _Ointments_ and warm _Bathings_: which have their Effects by their
finest and most active Parts insinuating themselves into the Blood.

IT is commonly thought, that the _Blood_ only is affected in these Cases
by the morbific _Effluvia_. 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 the _Liquid of the Nerves_,
usually called the _Animal Spirits_. As _this_ is 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 the _first Class_,
mentioned in the beginning of this Discourse, particularly the _Porters_
who opened the infected Bales of Goods in the _Lazaretto_'s of
_Marseilles_, 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.

EFFECTS so 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 the
_Nervous Liquor_.

IT is not to be expected that we should be able to explain the
particular manner by which this is brought about. We know too little of
the Frame of the Universe, and of the Laws of _Attractions_,
_Repulsions_ and _Cohesions_ among 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 a _subtile_ and _elastic Fluid_ of great Force and Activity.
This he supposes to be the Cause of the _Refraction_ and _Reflection_ of
the Rays of Light; and that by its _Vibrations_ Light communicates Heat
to Bodies: and, moreover, that this readily pervading all Bodies,
produces many of their Effects upon one another[50].

NOW it is not improbable that the _Animal Spirits_ are 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 this _elastic 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 some _Chemical
Spirits_ upon their being put together, fall into a Fermentation, and
make a Composition of a quite different kind.

IF therefore we allow the _Effluvia_ or _Exhalations_ from a corrupted
Mass of Humours in a Body that has the _Plague_ to 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 the _nervous Fluid_ of 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.

THIS is one means by which the _Plague_, 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, the _Plague_ may be spread from _Person_ to _Person_,
from _House_ to _House_, or perhaps from _Town_ to _Town_, tho' not to
any great Distance; but this carries it into the remotest Regions. From
hence the trading Parts of _Europe_ have their principal Apprehensions,
and universally have recourse to _Quarantaines_ for their Security. The
Universality of which Practice is a strong Argument, that _Merchandize_
will communicate _Infection_: 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 my self to
three Instances only. The _first_ shall be of the Entrance of the
_Plague_ into _Rome_ in the Year 1656, which we are assured was conveyed
thither from _Naples_ by Clothes and other Wares from that Place,
brought first to Port _Neptuno_, and carried from thence to the
Neighbouring Castle of St. _Lawrence_: which after having been kept some
time there, were conveyed into _Rome_[51]. The _second_ Instance I shall
take is from the Account given us of the Entrance of the Plague into
_Marseilles_[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 the _Levant_. For the first,
who had the Distemper, was one of the _Crew_ of the _Ship_, which
brought those _Goods_: the next were those, who attended upon the same
_Goods_, while they were under _Quarantaine_; and soon after the
_Surgeon_, whom the Magistrates of _Marseilles_ appointed to examine the
Bodies of those, who died.

THIS Relation, if duly consider'd, is, I believe, sufficient to remove
all the Doubts any one can have about the Power of _Merchandize_ to
convey _Infection_: for it affords all the Evidence, the most scrupulous
can reasonably desire. Possibly there might be some Fever of
extraordinary Malignity in _Marseilles_, such as is commonly called
_Pestilential_, before the Arrival of these Goods: But no such Fever has
any indisputable Right to the Title of _Pestilence_, as I have before
shewn. On the contrary, these two, the real _Pestilence_, and such
_Pestilential Fevers_, must carefully be distinguished, if we design to
avoid all Mistakes in reasoning upon these Subjects.

SOME such Fever of uncommon Malignity, I say, might perhaps be in
_Marseilles_ before the Arrival of these Goods. There might likewise
perhaps be an Instance or two of _Fevers_ attended with _Eruptions_,
bearing some Resemblance to those of the _Plague_: for such I my self
have sometimes seen here in _London_. But it is not conceivable, that
there should be any Appearance of the true _Plague_ before 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 of any one's dying of the _Plague_ in the City.
And I believe it was never known, that the _Plague_, being once broke
out, gave so long a Truce in hot Weather.

THE _Plague_, which has this present Year almost depopulated _Messina_,
affords a _third_ Instance of the same kind. By an authentic Relation of
it, published here[53] we are informed, that a _Genoese_ Vessel from the
_Levant_, arrived at that City; and upon notice given that a Sailor, who
had touched some Cases of _Cotton Stuffs_ bought up at _Patrasso_ in the
_Morea_, where the Distemper then raged, was dead of the Plague, in the
Voyage; the Ship was put under _Quarantaine_: during which time the
_Cotton Stuffs_ were privately landed. The Master and some Sailors
dying 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 that _Quarter_ where 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 the
_Small-Pox_; which Distemper is frequently carried in the Nature of the
_Plague_ both to the _East_ and _West-Indies_ from these Countries, and
was once carried from the _East-Indies_ to the _Cape of Good Hope_, in
the following manner. About the Year 1718, a ship from the _East-Indies_
arrived at that Place: In the Voyage three Children had been sick of
the _Small-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 the _Small-Pox_, which spread into the Country
for many Miles, and made such a Desolation, that it was almost
dispeopled.

IT has been thought so difficult to explain the manner how _Goods_
retain the Seeds of _Contagion_, that some[54] Authors have imagined
_Infection_ to be performed by the Means of _Insects_; the _Eggs_ of
which may be conveyed from Place to Place, and make the Disease when
they come to be _hatched_. 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, the _Matter_ of _Contagion_ be 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.

WE all know how long a time _Perfumes_ hold 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 mostly _animal Juices_,
as _Mosch_, _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, as _Furrs_, _Feathers_, _Silk_, _Hair_, _Wool_,
_Cotton_, _Flax_, &c. the greatest part of which are likewise of the
_animal_ kind.

NOTHING indeed can give us so just a Notion of _Infection_, and more
clearly represent the manner of it, than _Odoriferous_ Bodies. Some of
_these_ do 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
by _Pestiferous_ Bodies; so that _Contagion_ is no more than the effect
of volatile offensive Matter drawn into the Body by our _Smelling_.

THE third Cause we assigned for the spreading of _Contagion_, was a
corrupted State of _Air_. Although the _Air_ be in a right State, yet a
sick Person may infect those who are very near him: As we find the
_Pestilence_ to continue sometimes among the _Crew_ of 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 the _Plague_ at _Genoa_ in the Year 1656. Eleven Persons put
to Sea in a _Felucca_, with design to withdraw themselves from the
_Contagion_, and retire into _Provence_; but one of them falling sick of
the _Plague_ soon 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 at _Genoa_ no more than one of them
survived[55].

HOWEVER in this Case the Malady does not usually spread far, the
_contagious_ Particles being soon dispersed and lost. But when in a
corrupt Disposition of the _Air_ the _contagious_ Particles 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.

IN general, a _hot Air_ is more disposed to spread _Contagion_ than a
cold one, as no one can doubt, who considers how much all kinds of
_Effluvia_ are farther diffused in a _warm Air_, than in the contrary.
But moreover, that State of _Air_, when unseasonable Moisture and want
of Winds are added to its Heat, which gives birth to the _Plague_ in
some Countries, will doubtless promote it in all. For _Hippocrates_ sets
down the same Description of a _Pestilential State_ of Air in his
Country, as the _Arabians_ do of the Constitution, which gives Rise to
the _Plague_ in _Africa_[56]. _Mercurialis_ assures us the same
Constitution of _Air_ attended the _Pestilence_ in his time at
_Padua_[57]: and _Gassendus_ observed the same in the _Plague_ of
_Digne_[58]. Besides, it is easy to shew how the _Air_, by the sensible
ill Qualities discoursed of in the last Chapter, should favour
infectious Diseases, by rendering the Body obnoxious to them.

INDEED other hurtful Qualities of the _Air_ are more to be regarded than
its Heat alone: for the _Plague_ is sometimes stopt, while the Heat of
the Season increases, upon the Emendation of the _Air_ in other
respects. At _Smyrna_ the _Plague_, which is yearly carried thither by
Ships, constantly ceases about the 24th of _June_, by the dry and clear
Weather they always have at that time: the unwholsome Damps being then
dissipated that annoy the Country in the _Spring_. However, the Heat of
the Air is of so much Consequence, that if any Ship brings it in the
Winter Months of _November_, _December_, _January_, or _February_, it
never spreads: but if later in the Year, as in _April_ or afterwards,
it continues till the time before mentioned.

BUT moreover, what was said before of some latent Disorders in the _Air_
having a share in spreading the _Plague_, will likewise have place in
these Countries; as the last _Plague_ in the City of _London_ remarkably
proves, the Seeds of which, upon its first Entrance, and while it was
confined to a House or two, preserved themselves through a hard frosty
_Winter_, and again put forth their malignant Quality as soon as the
Warmth of the _Spring_ gave them force: but, at the latter end of the
next Winter they were suppressed so as to appear no more, though in the
Month of _December_ more than half the _Parishes_ of the City were
infected.

A _corrupted State_ of Air is, without doubt, necessary to give these
contagious Atoms their full force; for otherwise it were not easy to
conceive how the _Plague_, 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 the
_Air_, and the restoring of it to a healthful State capable of
dissipating and suppressing the Malignity.

ON the other hand, it does not appear, that the _Air_, however
corrupted, is usually capable of carrying Infection to a very great
distance; but that commonly the _Plague_ is spread from Town to Town by
infected Persons and Goods: for there are numberless Instances, where
the _Plague_ has caused a great Mortality in Towns, while other Towns
and Villages, very near them, have been entirely free. And hence it is,
that the _Plague_ sometimes spreads from Place to Place very
irregularly. _Thuanus_[59] speaks of a _Plague_ in _Italy_, which one
Year was at _Trent_ and _Verona_, the next got into _Venice_ and
_Padua_, leaving _Vicenza_, an intermediate Place, untouched, though the
next Year that also felt the same Stroke: a certain Proof that the
_Plague_ was not carried by the _Air_ from _Verona_ to _Padua_ and
_Venice_; for the infected _Air_ must have tainted all in its Passage.
We have had lately in _France_ one Instance of the same Nature, when the
_Plague_ was carried at once out of _Provence_ several Leagues into the
_Gevaudan_. Usually indeed the _Plague_, 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 OWN it cannot be demonstrated, that when the _Plague_ makes great
Ravage in any Town, the Number of Sick shall never be great enough to
load the _Air_ with infectious _Effluvia_, emitted from them in such
Plenty, that they may be conveyed by the Winds into a neighbouring Town
or Village without being dispersed so much as to hinder their producing
any ill Effects; especially since it is not unusual for the _Air_ to be
so far charged with these noxious _Atoms_, 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 a
_Plague_ to avoid all Communication with the Diseased, is an effectual
Defence. However, I do not think this is often the Case: just as the
_Smoak_, with which the _Air_ of the City of _London_ is constantly
impregnated, especially in _Winter_, is not carried many Miles distant;
though the Quantity of it is vastly greater than the Quantity of
infectious _Effluvia_, that the most mortal _Plague_ could generate.

BUT, to conclude what relates to the _Air_, since the ill Qualities of
it in these _Northern_ Countries are not alone sufficient to excite the
_Plague_, without imported _Contagion_, this shews the Error of a common
Opinion, countenanc'd by Authors of great Name[60], that we are
necessarily _visited_ with the _Plague_ once 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 the _Pestilence_ is 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 last
_Plagues_ have 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.

THE _Air_ of our Climate is so far from being ever the Original of the
true _Plague_, that most probably it never produces those milder
infectious Distempers, the _Small-Pox_ and _Measles_. For these Diseases
were not heard of in _Europe_ before the _Moors_ had entered _Spain_:
and (as I have observed in the _Preface_) they were afterwards
propagated and spread through all Nations, chiefly by means of the Wars
with the _Saracens_.

MOREOVER, we are so far from any Necessity of these periodical Returns
of the _Plague_, that, on the contrary, though we have had several
Strokes of this kind, yet there are Instances of bad _Contagions_ from
abroad being brought over to us, which have proved less malignant here,
when our _Northern Air_ has not been disposed to receive such
Impressions.

THE _Sweating Sickness_, before hinted at, called _Sudor Anglicus_ and
_Febris Ephemera Britannica_, because it was commonly thought to have
taken its Rise here, was most probably of a foreign Original: and though
not the common _Plague_ with _Glandular Tumors_, and _Carbuncles_, yet a
real _Pestilence_ from 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 common _Plague_ in many of its
_Symptoms_, as _excessive Faintness_ and _Inquietudes_, _inward
Burnings_, &c. these _Symptoms_ being no where observed in so intense a
Degree as here they are described to have been, except in the true
_Plague_: And, what is much more, it was likewise a _contagious_
Disease.

THE first time this was felt here, which was in the Year 1485, it began
in the Army, with which King _Henry_ VII. came from _France_ and landed
in _Wales_[61]: and it has been supposed by some to have been brought
from the famous Siege of _Rhodes_ by the _Turks_ three or four Years
before, as may be collected from what Dr. _Keyes_ says 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 common _Pestilence_, which at those times raged in
_Italy_[63] as I find one of our Historians has long ago
conjectured[64]: and the others were very probably from a _Turkish_
Infection. 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 to _imported Contagion_;
because we are assured, that this Form of the Sickness was not peculiar
to our Island, but that it made great Destruction with the same Symptoms
in _Germany_, and other Countries[65].

I call this Distemper a _Plague_ with 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 common
_Plague_ itself (for few, who were destroyed with it, survived the
Seizure above one Natural Day) yet its going off safely with _profuse
Sweats_ in 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, than obstinate_ to _Remedies_; who
assigns this Reason for expressing himself thus, that _if the Patient
was kept warm with temperate Cordials, he commonly recovered_[66]. And,
what I think yet more remarkable, _Sweating_, which was the natural
_Crisis_ of this Distemper, has been found by great Physicians the best
Remedy against the common _Plague_: by which means, when timely used,
that Distemper may sometimes be carried off without any external
_Tumors_. 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 artificial _Sweat_, a natural _Sweat_ not excited by Medicines would
break forth exceedingly refreshing[67].

AND I 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 of _September_, which was called the _Dunkirk Fever_, as
being brought by our Soldiers from that Place. This probably had its
Original from the _Plague_, which a few Years before broke out at
_Dantzick_, and continued some time among the Cities of the _North_.
With us this Fever began only with a Pain in the Head, and went off in
large _Sweats_ usually after a Day's Confinement: but at _Dunkirk_ it
was attended with the additional Symptoms of _Vomiting_, _Diarrhoea_,
&c.

TO return from this Digression: From all that has been said, it appears,
I think, very plainly, that the _Plague_ is a real Poison, which being
bred in the Southern Parts of the World, is carried by Commerce into
other Countries, particularly into _Turky_, 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 the _Air_ happens to favour
_Infection_, it rages there with great Violence: that at that time more
especially diseased Persons give it to one another, and from them
_contagious Matter_ is 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 of _Contagion_, and produce the Disease
whenever the _Air_ is disposed to give them force; otherwise they may be
dissipated without any considerable ill Effects. And lastly, that the
_Air_ does not usually diffuse and spread these to any great Distance,
if Intercourse and Commerce with the Place infected be strictly
prevented.

[Illustration]




PART II.

Of the Methods to be taken against the PLAGUE.




CHAP. I.

_Of preventing Infection from other Countries._


AS it is a Satisfaction to know, that the _Plague_ is 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.

THIS Caution consists of two Parts: _The preventing its being brought
into our Island_; and, if such a Calamity should happen, _the putting a
Stop to its spreading among us_.

THE first of these is provided for by the established Method of obliging
Ships, that come from _infected_ Places, to _perform Quarantaine_: As to
which, I think it necessary, that the following Rules be observed.

NEAR to our several Ports, there should be _Lazaretto's_ built in
convenient Places, on little Islands, if it can so be, for the Reception
both of Men and Goods, which arrive from Places suspected of
_Infection_: The keeping Men in _Quarantaine_ on board the Ship being
not sufficient; the only use of which is to observe whether any die
among them. For _Infection_ may be preserved 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 new _Quarantaine_ be begun every
time any Person dies; which might not end, but with the Destruction of
the whole Ship's Crew.

IF there has been any _contagious_ Distemper in the Ship; the _sound_
Men should leave their Clothes, which should be sunk in the Sea, the Men
washed and shaved, and having fresh Clothes, should stay in the
_Lazaretto_ thirty or forty Days. The reason of this is, because Persons
may be recovered from a Disease themselves, and yet retain _Matter_ of
_Infection_ about them a considerable time: as we frequently see the
_Small-Pox_ taken from those, who have several Days before passed
through the Distemper.

THE _Sick_, if there be any, should be kept in Houses remote from the
_Sound_, 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 the _Sound_, should
continue there thirty or forty Days.

I AM particularly careful to destroy the _Clothes_ of the Sick, because
they harbour the very _Quintessence_ of _Contagion_. A very ingenious
Author[68], in his admirable Description of the _Plague_ at _Florence_
in the Year 1348, relates what himself saw: That two _Hogs_ finding in
the Streets the _Rags_, 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 learned _Fracastorius_ acquaints us, that in his time, there being a
_Plague_ in _Verona_, no less than twenty five Persons were successively
kill'd by the Infection of one _Furr_ Garment[69]. And _Forestus_ gives
a like Instance of seven Children, who dy'd by playing upon Clothes
brought to _Alckmaer_ in _North-Holland_, from an infected House in
_Zealand_[70]. The late Mr. _Williams_, Chaplain to Sir _Robert Sutton_,
when Embassador at _Constantinople_, used to relate a Story of the same
Nature told him by a _Bassa_: that in an Expedition this _Bassa_ made to
the Frontiers of _Poland_, one of the _Janizaries_ under his Command
dy'd of the _Plague_; whose Jacket, a very rich one, being bought by
another _Janizary_, it was no sooner put on, but he also was taken sick
and dy'd: and the same Misfortune befel five _Janizaries_ more, who
afterwards wore it. This the _Bassa_ related 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. _Williams_ see there were _Turks_,
who allowed themselves in so much Freedom of Thought, as not to pay that
strict Regard to the _Mahometan_ Doctrine of Fatality, as the Vulgar
among them do.

IF there has been no Sickness in the Ship, I see no reason why the Men
should perform _Quarantaine_. Instead of this, they may be washed, and
their Clothes aired in the _Lazaretto_, as Goods, for one Week.

BUT the greatest Danger is from such _Goods_, as are apt to retain
Infection, such as _Cotton_, _Hemp_ and _Flax_, _Paper_ or _Books_,
_Silk_ of all sorts, _Linen_, _Wool_, _Feathers_, _Hair_, and all kinds
of _Skins_. The _Lazaretto_ for 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.

THIS may perhaps seem too long; but as we don't know how much time
precisely is necessary to purge the Interstices of spongy Substances
from _infectious Matter_ by 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
tender _Animals_ near to them, particularly little _Birds_: because it
has been observed in Times of the _Plague_, that the Country has been
forsaken by the _Birds_; and those kept in Houses have many of them
died[71]. Now if it should be found, that _Birds_ let loose among Goods
at the beginning of their _Quarantaine_, are obnoxious to the
_Contagion_ in them, it may be known, in good measure, when such Goods
are become clean, by repeating the Trial till _Birds_ let 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 the _Thought_, 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 are
_Plagues_ among Animals, which do not indifferently affect all kinds of
them, some being confined to a particular _Species_, (like the Disease
of the _Black Cattle_ here, a few Years since, which neither proved
infectious to other Brutes, nor to Men;) yet it has always been observed
that the true _Plague_ among 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 at _Grand
Cairo_, in the time of the _Plague's_ raging there, and carried them to
_Alexandria_. Upon opening one of the Bales of Wool in a Field, two
_Turks_ employed in the Work were immediately killed: and some _Birds_,
which happened to fly over the Place, dropp'd down dead.

HOWEVER, the Use of _Quarantaines_ is not wholly frustrated by our
Ignorance of the exact time required for this Purification: since the
_Quarantaine_ does at least serve as a Trial whether Goods are infected
or not; it being hardly possible that every one of those, who are
obliged to attend upon them, can escape hurt, if they are so. And
whenever that happens, the Goods must be destroyed.

I TAKE it for granted, that the _Goods_ should be _opened_, when they
are put into the _Lazaretto_, otherwise their being there will avail
nothing. This is the constant Practice in the _Ports_ of _Italy_. That
it is so at _Leghorn_, appears by the Account lately published of the
Manner, in which _Quarantaines_ are there performed: and I find, that
the same Rule is observed at _Venice_, from an authentic Paper, I have
before me, containing the Methods made use of in that City, where
_Quarantaines_ have been enjoined ever since the Year 1484; at which
time, as far as I can learn, they were first instituted in _Europe_. In
that Place all _Bales_ of _Cotton_, of _Camel_'s or of _Beaver_'s
_Hair_, and the like, are _ript_ open from end to end, and _Holes_ made
in them by the _Porters_ every 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 of
_Bermudas_ about the Year 1695; where, as the Account was given me by
the learned Dr. _Halley_, a Sack of _Cotton_ put 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 a _Contagion_ along with it, that the
Living scarce sufficed to bury the Dead. This Relation Dr. _Halley_
received from Captain _Tucker_ of _Bermudas_, Brother to Mr. _Tucker_
late Under-Secretary in our Secretary's Office.

INDEED, as it has been frequently experienced, that of all the Goods,
which harbour _Infection_, _Cotton_ in particular is the most dangerous,
and _Turky_ is almost a perpetual _Seminary_ of the _Plague_; I cannot
but think it highly reasonable, that whatever _Cotton_ is imported from
that part of the World, should at all Times be kept in _Quarantaine_:
Because it may have imbibed _Infection_ at 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 the _Infection_. At least,
it is found, that the Time employed by Ships in passing between _Turky_
and _Marseilles_, is not long enough for Goods to lose their
_Infection_: as appears not only from the late Instance, but also from
an Observation made in a certain _Memorial_, drawn up by the Deputy of
Trade at _Marseilles_[72]. _Marseilles_ is the only Port in _France_
allowed to receive Goods from the _Levant_, on Account of its singular
Convenience for _Quarantaines_, by Reason of several small _Islands_
situate about it. The _Ports_ of _France_ in the _Western Ocean_ having
had a Desire to be allowed the same Liberty, their Deputies presented,
in the Year 1701, a _Memorial_ to the _Royal Council of Trade_,
containing several Reasons for their Pretensions. To this the _Deputy_
at _Marseilles_ makes Reply in the _Memorial_ I am speaking of, in which
this Advantage of _Marseilles_ for _Quarantaines_ above 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 the _Plague_ in their Attendance upon Goods under
_Quarantaine_. Now if it be certain, that Goods have retained Infection
during their Passage from _Turkey_ to _Marseilles_; 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. Benedictus_ gives a very distinct Relation of a
Feather Bed, that was laid by seven Years on Suspicion of its being
infected, which produced mischievous Effects at the End of that great
Length of Time[73]. And Sir _Theodore Mayerne_ relates, that some
Clothes fouled with Blood and Matter from _Plague_ Sores being lodged
between _Matting_ and the Wall of a House in Paris, gave the _Plague_
several Years after to a Workman, who took them out, which presently
spread through the City[74].

WHAT makes _Cotton_ so eminently dangerous, is its great Aptitude to
imbibe and retain any Sort of _Effluvia_ near it; of which I have
formerly made a particular Experiment, by causing some _Cotton_ to be
placed for one Day near a Piece of _putrefying Flesh_ from an amputated
Limb, in a Bell-Glass, but without touching it: for the _Cotton_ imbibed
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 of _putrefied Flesh_ from a sound Body,
this _Cotton_ had been thus impregnated with the Fumes of corrupted
Matter from one sick of the _Plague_; I make no doubt but it would have
communicated Infection. And the Experiment would have succeeded alike in
both Cases, if instead of _Cotton_, _Silk_, _Wool_, or _Hair_ had 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.

AS all reasonable Provisions should be made both for the _Sound_ and
_Sick_, who perform _Quarantaine_; so the strict keeping of it ought to
be inforced by the severest _Penalties_. And if a Ship comes from any
Place, where the _Plague_ raged, at the Time of the Ship's Departure
from it, with more than usual Violence; it will be the securest Method
to _sink_ all the _Goods_, and even the _Ship_ sometimes: especially if
any on Board have died of the Disease.

NOR ought this farther Caution to be omitted, that when the _Contagion_
has ceased in any Place by the Approach of Winter, it will not be safe
to open a free Trade with _it_ too soon: because there are Instances of
the _Distemper_'s being stopt by the Winter Cold, and yet the Seeds of
it not destroyed, but only kept unactive, 'till the Warmth of the
following Spring has given them new Life and Force. Thus in the great
_Plague_ at _Genoa_ about four-score Years ago, which continued Part of
two Years; the first Summer about _ten Thousand_ died; the Winter
following hardly any; but the Summer after no less than _sixty
Thousand_. Likewise the last _Plague_ at _London_ appeared 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 latent _Contagion_, 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.

BUT above all, it is necessary, that the _Clandestine Importing_ of
Goods be punished with the utmost Rigour; from which wicked Practice I
should always apprehend more Danger of bringing the _Disease_ than by
any other Way whatsoever.

THESE are, I think, the most material Points, to which Regard is to be
had in defending ourselves again _Contagion_ from other Countries. The
particular Manner of putting these Directions in Execution, as the
_Visiting_ of _Ships_, _Regulation_ of _Lazaretto's_, &c. I leave to
proper Officers, who ought sometimes to be assisted herein by able
Physicians.




CHAP. II.

_Of Stopping the Progress of the_ Plague, _if it should enter our
Country._


THE next 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.

THERE is no _Evil_ in the World, in which the great Rule of _Resisting
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 putting _this Maxim_ in
Practice.

AS the _Plague_ always breaks out in some particular Place, it is
certain, that the Directions of the _Civil Magistrate_ ought 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 on _Fire_, 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 severe _Discipline_, and even _Punishment_, rather than of a
_Compassionate Care_; which must naturally make the _Infected_ conceal
the Disease as long as was possible.

THE main Import of the _Orders_ issued out at these Times was[76]; As
soon as it was found, that any House was infected, to keep it shut up,
with a _large 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 such _Physicians_, _Surgeons_,
_Apothecaries_, _Nurses_, _Searchers_, &c. as were allowed by Authority:
And this to continue at least a Month after all the Family was _dead_ or
_recovered_.

IT is 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 and
Assistance; 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.

IF _Fear_, _Despair_, and all _Dejection of Spirits_, dispose the Body
to receive _Contagion_, 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.

NOTHING can justify such _Cruelty_, but the Plea, that it is for the
Good of the whole _Community_, and prevents the spreading of
_Infection_. But this upon due Consideration will be found quite
otherwise: For while _Contagion_ is kept nursed up in a House, and
continually encreased by the daily Conquests it makes, it is impossible
but the _Air_ should become tainted in so eminent a degree, as to spread
the _Infection_ into the Neighbourhood upon the first Outlet. The
shutting up Houses in this Manner is only keeping so many _Seminaries_
of _Contagion_, 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 a _Bale_ of infected _Goods_ unpack'd; the Poyson
will fly out, whenever the _Pandora's Box_ is opened.

AS these Measures were owing to the Ignorance of the true Nature of
_Contagion_, so they did, I firmly believe, contribute very much to the
long Continuance of the _Plague_, every time they have been practised in
this City: And no doubt, they have had as ill Effects in other
Countries.

IT is 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 thus _Shut 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 their
_Imprisonment_, 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
hideous _Shrieks_ of _Horror_ and _Despair_, quite _Distracted_, 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.

IN these 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].

AND it must be observed, that whenever popular Clamours prevailed so
far, as to procure some Release for the _Sick_, this was remarkably
followed with an Abatement of the Disease. The _Plague_ in 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, That _not 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 preceding _Plague_, _viz._
in the Year 1625, affords us another Instance of a very remarkable
Decrease upon the discontinuing to _shut up_ Houses. 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 this
_opening_ of the Houses was allowed of in the beginning of _September_:
and whereas the last Week in _August_, there died no less than four
thousand two hundred and eighteen, the very next Week the _Burials_ were
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].

SINCE therefore the Management in former Times neither answers the
Purpose of _discovering the Beginning_ of the _Infection_, nor of
putting a stop to it when _discovered_, other Measures are certainly to
be taken; which, I think, should be of this Nature.

THERE ought, in the first Place, _a Council of Health_ to 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 this _Council_ should 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.

INSTEAD of _ignorant old Women_, who are generally appointed _Searchers_
in Parishes to inquire what Diseases People die of, that _Office_ should
be committed to _understanding and diligent Men_: whose Business it
should be, as soon as they find any have dy'd after an uncommon Manner,
particularly with _livid Spots_, _Bubo's_, or _Carbuncles_, to give
Notice thereof to the _Council of Health_; who should immediately send
skilful Physicians to examine the suspected Bodies, and to visit the
Houses in the Neighbourhood, especially of the _poorer_ Sort, among whom
this Evil generally begins. And if upon their Report it appears, that a
_Pestilential Distemper_ is broken out, they should without Delay order
all the Families, in which the Sickness is, to be _removed_; the _Sick_
to different Places from the _Sound_: but the Houses for both should be
three or four Miles out of Town; and the _Sound_ People should be
_stript of all their Clothes_, and _washed_ and _shaved_, 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 the _Sick_, that they may
receive no Injury.

AS this Management is necessary with Respect to the _Poor_ and _meaner_
Sort of People; so the _Rich_, who have Conveniences, may, instead of
being carried to _Lazaretto's_, be obliged to go to their
Country-Houses: provided that Care be always taken to keep the _Sound_
separated from the _Infected_. And at the same Time all the Inhabitants
who are yet well, should be permitted, nay encouraged to leave the Town,
which, the thinner it is, will be the more healthy.

NO manner of _Compassion_ and _Care_ should be wanting to the
_Diseased_; to whom, when lodged in _clean_ and _airy_ Habitations,
there would, with due Cautions, be no great Danger in giving Attendance.
All Expences should be paid by the Publick, and no Charges ought to be
thought great, which are counterbalanced with the saving a Nation from
the greatest of Calamities. Nor does it seem to me at all unreasonable,
that a _Reward_ should be given to the Person, that makes the first
Discovery of _Infection_ in any Place: since it is undeniable, that the
making known the _Evil_ to those, who are provided with proper Methods
against it, is the first and main Step towards the overcoming it.

ALTHOUGH the Methods taken in other Countries, as well as in our own,
have generally been different from what we have here recommended; yet
there are not wanting some Instances of extraordinary Success attending
these Measures, whenever they have happened to be put in Practice.

THE Magistrates of the City of _Ferrara_ in _Italy_ in the Year 1630,
when all the Country round about them was infected with the _Plague_,
observing the ill Success of the Conduct of their Neighbours, who, for
Fear of losing their Commerce, did all they could to conceal the
Disease, by keeping the Sick in their Houses, resolved, whenever
occasion should require, to take a different Method. Accordingly, as
soon as they received Information, that one had died in their City of
the _Pestilence_, they immediately removed the whole Family he belonged
to into a _Lazaretto_, where all, being seven in Number, likewise died.
But though the Disease was thus malignant, it went no farther, being
suppressed at once by this Method. Within the Space of a Year the same
Case returned seven or eight Times, and this Management as often put a
Stop to it. The Example of this _City_ was afterwards followed more than
once by some other Towns in the same Territory with so good Success,
that it was thought expedient, for the common Good, to publish in the
_Memoirs_ of the People of _Ferrara_ this Declaration: _That the only
Remedy against the Plague is to make the most early Discovery of it,
that is possible, and thus to extinguish it in the very Beginning_[80].

NO less remarkable than this Occurrence at _Ferrara_, is what happened
at _Rome_ in the _Plague_, I have taken Notice of before, in the Year
1657. When the Disease had spread itself among both Rich and Poor, and
raged in the most violent Manner; the _Pope_ appointed Cardinal
_Gastaldi_, to be Commissary General of Health, giving him for a Time
the Power of the whole _Sacred College_, with full Commission to do
whatever he should judge necessary. Hereupon he gave strict Orders, that
no sick or suspected Persons should stay in their own Houses. The _Sick_
he removed, upon the first Notice, to a _Lazaretto_ in the _Island_ of
the _Tyber_; and all who were in the same Houses with them to other
_Hospitals_ just without the City, in order to be sent to the _Island_,
if they should fall sick. At the same Time he took diligent Care to send
away their _Goods_ to an airy Place to be cleansed. He executed these
Regulations with so much Strictness, that no Persons of the highest
Quality were exempted from this Treatment; which occasioned at first
great Complaints against the _Cardinal_ for his Severity; but soon after
he had general Thanks: for in two Months Time, by this means, he
entirely cleared the City of the _Pestilence_, which had continued in it
almost two Years. And it was particularly observed, that whereas before,
when once the Disease had got into a House, it seldom ended without
seizing the whole Family; in this Management scarce five out of an
hundred of the sound Persons removed were infected[81].

I CANNOT but take Notice, that the _Plague_ was stopp'd at _Marseilles_
a full Fortnight by the same Measures, and probably might have been
wholly extinguished, had not new Force been given it by the unseasonable
Confidence of the Inhabitants upon this Intermission: which, we are
informed, was so great, that they would not believe the _Pestilence_ had
been at all among them, and publickly upbraided the Physicians and
Surgeons for frighting them causlesly[82]. At this Time, no doubt, they
must have neglected the Cautions necessary for their Security so much,
as to leave us no room to be surprized, that the Disease should after
this break out again with too great Violence to be a second Time
overcome.

BUT, besides these Examples in foreign Countries, we have one Instance
of the same Nature nearer Home. When the _Plague_ was last here in
_England_, upon its first Entrance into _Poole_ in _Dorsetshire_, the
Magistrates immediately suppress'd it, by removing the _Sick_ into
_Pest-Houses_, without the Town, as is well remember'd there to this
Time. A very remarkable Occurrence has greatly contributed towards
preserving all the Circumstances of this Transaction in Memory. They
found some Difficulty in procuring any one to attend upon the _Sick_
after their Removal: which obliged the Town to engage a _young Woman_,
then under Sentence of Death, in that Service, on a Promise to use
their Interest for obtaining her Pardon. The young Woman escaped the
Disease, but neglecting to solicite the Corporation for the
Accomplishment of their Engagement with her, three or four Months after
she was barbarously hanged by the _Mayor_ upon a Quarrel between them.

I WOULD have it here observed, that as the Advice I have been giving is
founded upon this Principle, that the best Method for stopping
Infection, is to separate the _Healthy_ from the _Diseased_; so in small
Towns and Villages, where it is practicable, if the _Sound_ remove
themselves into _Barracks_, or the like airy Habitations, it may
probably be even more useful, than to remove the _Sick_. This Method has
been found beneficial in _France_ after all others have failed. But the
Success of this proves the Method of _Removing the Sick_, where this
other cannot be practised, to be the most proper of any.

WHEN the _sick Families_ are gone, all the Goods of the Houses, in which
they were, should be _buried_ deep under Ground. This I prefer to
_burning_ them: because, especially in a close Place, some infectious
Particles may possibly be dispersed by the Smoak through the
Neighbourhood; according to what _Mercurialis_ relates, that the
_Plague_ in _Venice_ was augmented by burning a large Quantity of
infected Goods in the City[83]. A learned Physician of my Acquaintance
lately communicated to me the Relation of a Case, (given to him by an
Apothecary, who was at the Place when the Thing happened) very proper
to be here mentioned. The Story is this. At _Shipston_, a little Town
upon the River _Stour_ in _Worcestershire_, a poor Vagabond was seen
walking in the Streets with the _Small-Pox_ upon him. The People
frightened took Care to have him carried to a little House, seated upon
a Hill, at some Distance from the Town, providing him with Necessaries.
In a few Days the Man died. They ordered him to be buried deep in the
Ground, and the House with his Cloaths to be burnt. The Wind, being
pretty high, blew the Smoak upon the Houses on one Side of the Town: In
that Part, a few Days after, eight Persons were seized with the
_Small-Pox_. So dangerous is _Heat_ in all Kinds of pestilential
Distempers, and so diffusive of Contagion. And moreover the Houses
themselves may likewise be demolished or pulled down, if that can
conveniently be done; that is, if they are remote enough from others:
otherwise it may suffice to have them thoroughly cleansed, and then
plastered up. And after this, all possible Care ought still to be taken
to remove whatever Causes are found to breed and promote _Contagion_. In
order to this, the _Overseers_ of the Poor (who might be assisted herein
by other Officers) should visit the Dwellings of all the meaner Sort of
the Inhabitants; and where they find them _stifled up too close_ and
_nasty_, should lessen their Number by sending some into better
Lodgings, and should take Care, by all Manner of Provision and
Encouragement, to make them more _cleanly_ and _sweet_.

NO good Work carries its own Reward with it so much as this kind of
_Charity_: and therefore, be the Expence what it will, it must never be
thought unreasonable. For nothing approaches so near to the first
Original of the _Plague_, as Air pent up, loaded with Damps, and
corrupted with the Filthiness, that proceeds from _Animal Bodies_.

OUR _common Prisons_ afford us an Instance of something like this, where
very few escape what they call the _Goal Fever_, which is always
attended with a Degree of _Malignity_ in Proportion to the _Closeness_
and _Stench_ of the Place: and it would certainly very well become the
Wisdom of the Government, as well with regard to the Health of the
_Town_, as in Compassion to the _Prisoners_, to take Care, that all
_Houses of Confinement_ should be kept as airy and clean, as is
consistent with the Use, to which they are designed.

THE _Black Assise_ at _Oxford_, held in the Castle there in the Year
1577, will never be forgot[84]; at which the _Judges_, _Gentry_, and
almost all that were present, to the Number of three hundred, were
killed by a _poisonous Steam_, thought by some to have broken forth from
the _Earth_; but by a _noble_ and _great_ Philosopher[85] more justly
supposed to have been brought by the _Prisoners_ out of the _Goal_ into
_Court_; it being observed, that they alone were not injured by it.

AT the same Time, that this Care is taken of _Houses_, the proper
Officers should be strictly charged to see that the _Streets_ be washed
and kept clean from _Filth_, _Carrion_, and all manner of _Nusances_;
which should be carried away in the _Night Time_: nor should the
_Laystalls_ be suffered to be too near the City. _Beggers_ and _idle
Persons_ should be taken up, and such miserable Objects, as are neither
fit for the common _Hospitals_, nor _Work-Houses_, should be provided
for in an _Hospital of Incurables_.

ORDERS indeed of this Kind are necessary to be observed at all Times,
especially in populous Cities; and therefore I am sorry to take Notice,
that in these of _London_ and _Westminster_ there is no good _Police_
established in these Respects: for want of which the Citizens and
Gentry are every Day annoyed more ways than one.

IF these early _Precautions_, we have mentioned, prove successful, there
will be no need of any Methods for _Correcting the Air_, _Purifying
Houses_, or of _Rules for preserving particular Persons from Infection_:
to all which, if the _Plague_ get head, so that the _Sick_ are too many
to be removed (as they will be when the Disease has raged for a
considerable Time) Regard must be had.

AS to the _first_: _Fire_ has been almost universally recommended for
this Purpose, both by the Ancients and Moderns; who have advised to make
frequent and numerous _Fires_ in the Towns infected. This _Precept_, I
think, is almost entirely founded upon a Tradition, that _Hippocrates_
put a stop to a _Plague_ in _Greece_ by this means. But it is to be
observed, that there is no mention made of any Thing like it in the
Works of _Hippocrates_. The best Authority we have for it, is the
Testimony of _Galen_, though it is also mentioned by other Authors.
_Galen_, recommending _Theriaca_ against the _Pestilence_, has thought
fit, it seems, to compare it to _Fire_; and, upon this Conceit, relates,
that _Hippocrates_ cured a _Plague_, which came from _AEthiopia_ into
_Greece_, by purifying the Air with _Fires_; into which were thrown
sweet-scented Herbs, and Flowers, together with Ointments of the finest
Flavour. It is remarkable, that among the _Epistles_ ascribed to
_Hippocrates_, which, though not genuine, yet are older than _Galen_,
there is a _Decree_ said to be made by the _Athenians_ in Honour of this
Father of Physicians, which, making mention of the Service he had done
his Country in a _Plague_, says only, that he sent his Scholars into
several Parts, with proper Instructions to cure the Disease. By which it
should seem, that this Story of the _Fires_ was hardly or not at all
known at the Time, when these _Letters_ were compiled. And _Soranus_ may
yet more confirm us, that it was framed long after the Death of
_Hippocrates_: for _Soranus_ only says in general, that _Hippocrates_
foretold the coming of the _Pestilence_, and took care of the Cities of
_Greece_; without any mention of having used this particular Expedient.
_Plutarch_ indeed speaks of a Practice like this as commonly approved
among Physicians, which he makes use of to illustrate a certain Custom
of the _Egyptians_: of whom he says, that they _purify_ the Air by the
Fumes of _Resin_ and _Myrrh_, as Physicians correct the Foulness, and
attenuate the Thickness thereof in Times of _Pestilence_, by _burning
Sweet-Woods_, _Juniper_, _Cypress_[86] &c.

THIS I take to be the Sum of what can be learned from Antiquity in
Relation to this Point; from whence we may see, that Writers have
concluded a little too hastily for the use of _common Fires_ in this
Case, upon the Authority and Example of _Hippocrates_, though we should
allow the Fact as related by _Galen_: when it will not from thence
appear that _Hippocrates_ himself relied upon them; since he thought it
necessary to take in the Assistance of _aromatic Fumes_. But as this
Fact is not grounded upon sufficient Authority, so it is needless to
insist long upon it. The Passage I have brought from _Plutarch_ will
better explain what was the Sentiment of those Physicians who approved
the Practice. It seems they expected from thence to dispel the Thickness
and Foulness of the Air. And no doubt but such evil Dispositions of the
Air, as proceed from _Damps_, _Exhalations_, and the like, may be
corrected even by _common Fires_, and the Predisposition of it from
these Causes to receive Infection sometimes removed. But I think this
Method, if it be necessary, should be put in Practice before the coming
of the _Pestilence_. For when the Distemper is actually _begun_, and
rages, since it is known to _spread_ and _increased_ by the _Heat_ of
the _Summer_, and on the contrary checked by the _Cold_ in _Winter_;
undoubtedly, whatever increases that _Heat_, will so far add Force to
the Disease: as _Mercurialis_ takes notice, that _Smiths_, and all those
who worked at the _Fire_ were most severely used in the _Plague_ at
_Venice_ in his Time[87]. Whether the Service _Fires_ may do by
correcting any other ill Qualities of the Air, will counterbalance the
Inconvenience upon this Account, Experience only can determine: and the
fatal Success of the Trials made here in the last _Plague_, is more than
sufficient to discourage any farther Attempts of this Nature. For
_Fires_ being ordered in all the _Streets_ for three Days together,
there died in one Night following no less than four thousand (if we may
believe Dr. _Hodges_:) whereas in any single Week before or after, never
twice that Number were carried off[88]. And we find that upon making
the same Experiment in the last _Plague_ at _Marseilles_, the Contagion
was every Day spread more and more thro' the City with increas'd Rage
and Violence[89].

WHAT has been said of _Fires_, is likewise to be understood of _Firing
of Guns_, which some have too rashly advised. The proper Correction of
the Air would be to make it _fresh_ and _cool_: Accordingly the
_Arabians_[90], who were best acquainted with the Nature of
_Pestilences_, advise People to keep themselves as _airy_ as possible,
and to chuse Dwellings exposed to the Wind, situate high, and refreshed
with running Waters.

AS for _Houses_, the first Care ought to be to keep them _clean_: for as
_Nastiness_ is a great Source of _Infection_, so _Cleanliness_ is the
greatest Preservative; which shews us the true Reason, why the _Poor_
are most obnoxious to _Contagious Diseases_. It is remarked of the
_Persians_, that though their Country is surrounded every Year with the
_Plague_, they seldom or never suffer any Thing by it themselves: and it
is likewise known, that they are the most _cleanly_ People of any in the
World, and that many among them make it a great Part of their Religion
to remove _Filthiness_ and _Nusances_ of every Kind from all Places
about their Cities and Dwellings[91].

BESIDES this, the _Arabians_ advise the keeping Houses _cool_, as
another Method of their _Purification_, and therefore, to answer this
End more fully, they directed to strew them with _cooling_ Herbs, as
_Roses_, _Violets_, _Water-Lilies_, &c. and to be washed with _Water_
and _Vinegar_: than all which, especially the last, nothing more proper
can be proposed. I think it not improper likewise to _fume_ Houses with
_Vinegar_, either alone or together with _Nitre_, by throwing it upon a
_hot Iron_ or _Tile_; though this be directly contrary to what modern
Authors mostly advise, which is to make Fumes with hot things, as
_Benzoin_, _Frankincense_, _Storax_, &c. from which I see no reason to
expect any Virtue to destroy the Matter of _Infection_, or to keep
particular Places from a Disposition to receive it; which are the only
things here to be aimed at. The _Smoak_ of _Sulphur_, perhaps, as it
abounds with an _acid Spirit_, which is found by Experience to be very
_penetrating_, and to have a great Power to repress _Fermentations_, may
promise some Service this way.

AS hot Fumes appear to be generally _useless_, so the Steams of
_Poisonous Minerals_ ought to be reckoned _dangerous_: and therefore I
cannot but dissuade the use of all _Fumigations_ with _Mercury_ or
_Arsenic_. Much less would I advise, as some have done, the wearing
_Arsenic_ upon the _Pit_ of the _Stomach_ as an _Amulet_: since this
Practice has been often attended with very ill Consequences, and is not
grounded upon any good Authority, but probably derived from an Error in
mistaking the _Arabian_ Word _Darsini_, which signifies _Cinnamon_, for
the _Latin de Arsenico_, as I have formerly shewn[92].

THE next thing after the _Purifying of Houses_, is to consider by what
Means particular _Persons_ may best defend themselves against
_Contagion_: for the certain doing of which, it would be necessary to
put the _Humours_ of the _Body_ into such a State, as not to be
alterable by the _Matter of Infection_. But since this is no more to be
hoped for, than a _Specific Preservative_ from the _Small-Pox_; the most
that can be done, will be to keep the Body in such Order, that it may
suffer as little as possible. The _first Step_ towards which, is to
maintain a good State of Health, in which we are always least liable to
suffer by any external Injuries; and not to weaken the Body by
Evacuations. The _next_ is, to guard against all _Dejection of Spirits_,
and _immoderate Passions_: for these we daily observe do expose Persons
to the more common _Contagion_ of the _Small-Pox_. These Ends will be
best answered by living with Temperance upon a good generous Diet, and
by avoiding _Fastings_, _Watchings_, _extreme Weariness_, &c. _Another_
Defence is, to use whatever Means are proper to keep the _Blood_ from
_Inflaming_. This, if it does not secure from _contracting Infection_,
will at least make the _Effects_ of it less violent. The most proper
Means for this, according to the Advice of the _Arabian_ Physicians, is
the repeated Use of _acid Fruits_, as _Pomegranates_, _Sevil Oranges_,
_Lemons_, _Tart Apples_, &c. But above all, of _Wine Vinegar_ in small
Quantities, rendered grateful to the Stomach by the Infusion of some
such Ingredients as _Gentian Root_, _Galangal_, _Zedoary_, _Juniper
Berries_, &c. Which Medicines by correcting the _Vinegar_, and taking
off some ill Effects it might otherwise have upon the Stomach, will be
of good Use: but these, and all other hot _aromatic_ Drugs, though much
recommended by Authors, if used alone, are most likely to do hurt by
_over-heating_ the Blood.

I CANNOT but recommend likewise the Use of _Issues_. The properest Place
for them I take to be the inside of the Thigh a little above the Knee.
Besides, the smoaking _Tobacco_, much applauded by some, since it may be
put in Practice without any great Inconvenience, need not, I think, be
neglected.

BUT since none of these Methods promise any certain Protection; as
_leaving_ the Place infected is the surest _Preservative_, so the next
to it is to avoid, as much as may be, the _near Approach_ to the _Sick_,
or to such as have but _lately recovered_. For the greater Security
herein, it will be adviseable to avoid all _Crouds of People_. Nay, it
should be the Care of the _Magistrate_ to prohibit all unnecessary
_Assemblies_: and likewise to oblige all, who get over the Disease, to
_confine_ themselves for some time, before they appear abroad.

THE Advice to keep at a Distance from the _Sick_, is also to be
understood of the _Dead Bodies_; which should be _buried_ at as great a
Distance from Dwelling-Houses, as may be; put _deep_ in the Earth; and
_covered_ with the exactest Care; but not with _Quick-Lime_ thrown in
with them, as has been the Manner abroad: For I cannot but think that
_This_, by _Fermenting_ with the putrefying Humours of the Carcases, may
give rise to noxious Exhalations from the Ground. They should likewise
be _carried out_ in the _Night_, while they are yet fresh and free from
_Putrefaction_: Because a Carcase not yet beginning to corrupt, if kept
from the Heat of the Day, hardly emits any kind of Steam or Vapour.

AS for those, who must of necessity attend the _Sick_; some farther
Directions should be added for their Use. These may be comprehended in
two short Precepts. _One_ is, not to _swallow their Spittle_ while they
are about the _Sick_, but rather to _spit_ it out: _The other_, not so
much as to _draw in their Breath_, when they are very near them. The
reason for both these appears from what has been said above concerning
the Manner, in which a sound Person receives the Infection. But in case
it be too difficult constantly to comply with these _Cautions_,
_washing_ the _Mouth_ frequently with _Vinegar_, and _holding_ to the
_Nostrils_ a _Sponge_ wet with the same, may in some measure supply
their Place.

THIS is the Sum of what I think most likely to stop the Progress of the
_Disease_ in any Place, where it shall have got Admittance. If some few
of these Rules refer more particularly to the City of _London_, with
small Alteration they may be applied to any other _Place_. It now
remains therefore only to lay down some Directions to hinder the
Distemper's spreading from _Town_ to _Town_. The best Method for which,
where it can be done, (for this is not practicable in very great Cities)
is to cast up a _Line_ about the _Town infected_, at a convenient
Distance; and by placing a _Guard_, to hinder People's passing from it
without due Regulation, to other Towns: but not absolutely to forbid any
to withdraw themselves, as was done in _France_, according to the usual
Practice abroad; which is an unnecessary Severity, not to call it a
Cruelty. I think it will be enough, if all, who desire to pass the
_Line_, be permitted to do it, upon Condition they first perform
_Quarantaine_ for about twenty Days in _Tents_, or other more convenient
_Habitations_. But the greatest care must be taken, that none pass
without conforming themselves to this Order; both by keeping diligent
_Watch_, and by _punishing_, with the utmost Severity, any that shall
either have done so, or attempt it. And the better to discover _such_,
it will be requisite to oblige all, who travel in any Part of the
Country, under the same Penalties, to carry with them _Certificates_
either of their coming from Places not _infected_, or of their passing
the _Line_ by Permission.

THIS I take to be a more effectual Method to keep the _Infection_ from
spreading, than the absolute refusing a Passage to People upon any
Terms. For when Men are in such imminent Danger of their Lives where
they are, many, no doubt, if not otherwise allowed to escape, will use
Endeavours to do it secretly, let the Hazard be ever so great. And it
can hardly be, but some will succeed in their Attempts; as we see it
has often happen'd in _France_, notwithstanding all their Care. But one
that gets off thus clandestinely, will be more likely to carry the
Distemper with him, than twenty, nay a hundred, that go away under the
preceding Restrictions: especially because the _Infection_ of the Place,
he flies from, will by this Management be rendered much more intense.
For confining People, and shutting them up together in great Numbers,
will make the Distemper rage with augmented Force, even to the
increasing it beyond what can be easily imagined: as appears from the
Account which the learned _Gassendus_[93] has given us of a memorable
_Plague_, which happened at _Digne_ in _Provence_, where he lived, in
the Year 1629. This was so terrible, that in one _Summer_, out of _ten
thousand_ Inhabitants, it left but _fifteen hundred_, and of them all
but _five_ or _six_ had gone through the _Disease_. And he assigns
_this_, as the principal Cause of the great Destruction, that the
Citizens were too closely confined, and not suffered so much as to go to
their Country-Houses. Whereas in another _Pestilence_, which broke out
in the same Place a Year and an half after, more Liberty being allowed,
there did not die above _one hundred_ Persons.

FOR these Reasons, I think, to allow People with proper _Cautions_ to
remove from an infected Place, is the best Means to suppress the
_Contagion_, as well as the most humane Treatment of the present
Sufferers: and, under these Limitations, the Method of _investing_
Towns infected, which is certainly the most proper, that can be advised,
to keep the Disease from spreading, will be no Inconvenience to the
Places _surrounded_. On the contrary, it will rather be useful to them;
since the Guard may establish such _Regulations_ for the Safety of
those, who shall bring Provisions, as shall remove the Fears, which
might otherwise discourage them.

THE securing against all Apprehensions of this Kind, is of so great
Importance, that in _Cities_ too large to be invested, as, for Example,
this City of _London_, the _Magistrates_ must use all possible Diligence
to supply this Defect, not only by setting up _Barriers_ without their
City, but by making it in the most particular manner their Care to
appoint such _Orders_ to be observed at them, as they shall judge will
be most satisfactory to the Country about.

THOUGH Liberty ought to be given to the _People_, yet no sort of _Goods_
must by any means be suffered to be carried over the _Line_, which are
made of _Materials_ retentive of _Infection_. For in the present Case,
when _Infection_ has seized any Part of a Country, much greater Care
ought to be taken, that no _Seeds_ of the _Contagion_ be conveyed about,
than when the Distemper is at a great Distance: because a _Bale of
Goods_, which shall have imbibed the _Contagious Aura_ when pack'd up in
_Turky_, or any remote Parts, when unpack'd here, may chance to meet
with so healthful a Temperament of our Air, that it shall not do much
hurt. But when the Air of any one of our Towns shall be so corrupted,
as to maintain and spread the _Pestilence_ in it, there will be little
Reason to believe, that the Air of the rest of the Country is in a much
better State.

FOR the same Reason _Quarantaines_ should more strictly be enjoined,
when the _Plague_ is in a bordering Kingdom, than when it is more
remote.

THE Advice here given with respect to _Goods_, is not only abundantly
confirmed from the Proofs, I have given above, that _Goods_ have a Power
of spreading _Contagion_ to distant Places; but might be farther
illustrated by many Instances of ill Effects from the Neglect of this
Caution in Times of the _Plague_. I shall mention two, which happen'd
among us during the last _Plague_. I have had occasion already to
observe, that the _Plague_ was in _Poole_. It was carried to that Place
by some _Goods_ contained in a _Pedlar's Pack_. The _Plague_ was
likewise at _Eham_ in the Peak of _Derbyshire_, being brought thither by
means of a Box sent from _London_ to a Taylor in that Village,
containing some Materials relating to his Trade. There being several
Incidents in this latter Instance, that will not only serve to establish
in particular the Precepts I have been giving, in relation to Goods, but
likewise all the rest of the Directions, that have been set down, for
stopping the Progress of the _Plague_ from one Town to another; I shall
finish this Chapter with a particular Relation of what passed in that
Place. A Servant, who first opened the foresaid _Box_, complaining that
the Goods were damp, was ordered to dry them at the Fire; but in doing
it, was seized with the _Plague_, and died: the same Misfortune
extended itself to all the rest of the Family, except the Taylor's Wife,
who alone survived. From hence the Distemper spread about and destroyed
in that Village, and the rest of the Parish, though a small one, between
two and three hundred Persons. But notwithstanding this so great
Violence of the Disease, it was restrained from reaching beyond that
Parish by the Care of the Rector; from whose Son, and another worthy
Gentleman, I have the Relation. This Clergyman advised, that the _Sick_
should be removed into _Hutts_ or _Barracks_ built upon the _Common_;
and procuring by the Interest of the then Earl of _Devonshire_, that the
People should be well furnished with Provisions, he took effectual Care,
that no one should go out of the Parish: and by this means he protected
his Neighbours from Infection with compleat Success.

I have now gone through the chief Branches of _Preservation_ against the
_Plague_, and shall conclude with some general Directions concerning the
_Cure_.




CHAP. III.

_Of the Cure of the Plague._


IT appears, from what has been said in the beginning of this Discourse,
that the _Plague_ and the _Small-Pox_ are Diseases, which bear a great
Similitude to each other: both being _Contagious Fevers_ from _Africa_,
and both attended with certain _Eruptions_. And as the _Eruptions_ or
_Pustules_ in the _Small-Pox_ are of two Kinds, which has caused the
Distemper to be divided into two Species, the _distinct_ and
_confluent_; so we have shewn two Sorts of _Eruptions_ or _Tumors_
likewise to attend the _Plague_. In the first and mildest Kind of the
_Small-Pox_ the _Pustules_ rise high above the Surface of the Skin, and
contain a digested _Pus_; but in the other, the _Pustules_ lie flat, and
are filled with an indigested _Sanies_. The two kinds of critical
_Tumors_ in the _Plague_ are yet more different. In the most favourable
Case the _Morbific Matter_ is thrown upon some of the softest _Glands_
near the Surface of the Body, as upon the _inguinal_, _axillary_,
_parotid_, or _maxillary_ Glands: the first Appearance of which is a
small Induration, great Heat, Redness, and sharp Pain near those Glands.
These _Tumors_, if the Patient recover, like the _Pustules_ of the
distinct _Small-Pox_, come to a just Suppuration, and thereby discharge
the Disease. In worse Cases of the Distemper, either instead of these
_Tumors_, or together with them, _Carbuncles_ are raised. The first
Appearance of them is a very small indurated _Tumor_, not situate near
any of the fore-mention'd Glands, with a dusky Redness, violent Heat,
vast Pain, and a blackish _Spot_ in the middle of the _Tumor_. This
_Spot_ is the beginning of a _Gangrene_, which spreads itself more and
more as the _Tumor_ increases.

BUT, besides the Agreement in these critical Discharges, the two
Distempers have yet a more manifest Likeness in those _livid_ and _black
Spots_, which are frequent in the _Plague_, and the Signs of speedy
Death: for the same are sometimes found to attend the _Small-Pox_ with
as fatal a Consequence; nay, I have seen Cases, when almost every
_Pustule_ has taken this Appearance. Moreover, in both Diseases, when
eminently malignant, Blood is sometimes voided by the Mouth, by Urine,
or the like[94]. And we may farther add, that in both Death is usually
caused by Mortifications in the _Viscera_. This has constantly been
found in the _Plague_ by the Physicians in _France_: and I am convinced,
from Accounts I have by me, of the Dissection of a great many, who had
died of the _Small-Pox_, that it is the same in that Distemper.

THIS Analogy between the two Diseases, not only shews us, that we
cannot expect to cure the _Plague_ any more than the _Small-Pox_, by
_Antidotes_ and _Specific Medicines_; but will likewise direct us in the
Cure of the Distemper, with which we are less acquainted, by the Methods
found useful in the other Disease, which is more familiar to us.

IN short, as in the _Small-Pox_, the chief Part of the Management
consists in clearing the _Primae Viae_ in the beginning; in regulating the
Fever; and in promoting the natural Discharges: so in the _Plague_ the
same Indications will have Place. The great Difference lies in this,
that in the _Plague_ the Fever is often much more acute than in the
other Distemper; the Stomach and Bowels are sometimes inflamed; and the
Eruptions require external Applications, which to the _Pustules_ of the
_Small-Pox_ are not necessary.

WHEN the Fever is very acute, a cool _Regimen_, commonly so beneficial
in the _Small-Pox_, is here still more necessary. But whenever the Pulse
is languid, and the Heat not excessive, moderate Cordials must be used.

THE Disposition of the Stomach and Bowels to be inflamed, makes
_Vomiting_ not so generally safe in the _Plague_ as in the _Small-Pox_.
The most gentle _Emetics_ ought to be used, none better than
_Ipecacuanha_; and great Caution must be had, that the Stomach or Bowels
are not inflamed, when they are administer'd: for if they are, nothing
but certain Death can be expected from them: otherwise at the beginning
they will be always useful. Therefore upon the first Illness of the
Patient it must carefully be considered, whether there appear any
Symptoms of an Inflammation having seized these Parts: if there are any
Marks of this, all _Vomits_ must be omitted; if not, the Stomach ought
to be gently moved.

THE _Eruptions_, whether _glandular Tumors_, or _Carbuncles_, must not
be left to the Course of Nature, as is done in the _Small-Pox_; but all
Diligence must be used, by external Applications, to bring them to
_Suppurate_. Both these _Tumors_ are to be treated in most respects
alike. As soon as either of them appears, fix a _Cupping-Glass_ to it
without _scarifying_; and when that is removed, apply a _suppurative
Cataplasm_, or _Plaster_ of warm Gums.

IF the _Tumors_ do not come to _Suppuration_, which the _Carbuncle_
seldom or never does; but if a thin _Ichor_ or Matter exudes through the
Pores; or if the _Tumor_ feel soft to the Touch; or lastly, if it has a
black _Crust_ upon it, then it must be _opened_ by _Incision_, either
according to the length of the _Tumor_, or by a _crucial Section_. And
if there is any Part _mortified_, as is usually in the _Carbuncle_, it
must be _scarified_. This being done, it will be necessary to stop the
Bleeding, and dry up the _Moisture_ with an _actual Cautery_, dressing
the Wound afterwards with _Dossils_, and _Pledgits_ spread with the
common _Digestive_ made with _Terebinth. cum Vitel. Ov._ and dip'd in a
Mixture of two Parts of warmed Oil of _Turpentine_, and one Part of _Sp.
Sal. Ammon._ or in _Bals. Terebinth._ and over all must be put a
_Cataplasm of Theriac. Lond._

THE next Day the Wound ought to be well _bathed_ with a _Fomentation_
made of warm _aromatic_ Plants with Spirit of Wine in it; in order, if
possible, to make the Wound digest, by which the _Sloughs_ will
separate. After this the _Ulcer_ may be treated as one from an ordinary
_Abscess_.

FARTHER, in the _glandular Tumors_, when they suppurate, we ought not to
wait, till the _Matter_ has made its way to the outer Skin, but to open
it as soon as it is risen to any Bigness: because these _Tumors_ begin
deep in the Gland, and often mortify, before the Suppuration has reached
the Skin, as the Physicians in _France_ have found upon dissecting many
dead Bodies.

THIS is the Method in which the _Plague_ must be treated in following
the natural Course of the Distemper. But the Patient in most Cases runs
so great Hazard in this way, notwithstanding the utmost Care, that it
would be of the greatest Service to Mankind under this Calamity, if some
artificial Discharge for the corrupted Humours could be found out, not
liable to so great Hazard, as the natural Way. To this Purpose _large
Bleeding_ and _profuse Sweating_ are recommended to us upon some
Experience.

DR. _Sydenham_ tried both these Evacuations with good Success, and has
made two very judicious Remarks upon them. The _first_ is, that they
ought not to be attempted unless in the Beginning of the Sickness,
before the natural Course of the Distemper has long taken Place:
because otherwise we can only expect to put all into Confusion without
any Advantage. His _other_ Observation is, that we cannot expect any
prosperous Event from either of these Evacuations, unless they are very
copious: there being no Prospect of surmounting so violent a Malignity
without bolder Methods than must be taken in ordinary Cases.

AS for _Bleeding_, by some Accounts from _France_, I have been informed,
that some of the Physicians there have carried this Practice so far, as
upon the first Day of the Distemper to begin with bleeding about twelve
Ounces, and then to take away four or five Ounces every two Hours after.
They pretend to extraordinary Success from this Method, with the
Assistance only of cooling _Ptisanes_, and such like Drinks, which they
give plentifully at the same Time. Such profuse Bleeding as this may
perhaps not suit with our Constitutions so well as with theirs; for in
common Cases they use this Practice much more freely than we: Yet we
must draw Blood with a more liberal Hand than in any other Case, if we
expect Success from it. I shall excuse myself from defining exactly how
large a Quantity of Blood is requisite to be drawn, for want of
particular Experience: but I think fit to give this Admonition, that, in
so desperate a Case as this, it is more prudent to run some hazard of
exceeding, than to let the Patient perish for want of due Evacuation.

AS for _Sweating_, which is the other Method proposed, it ought, no
doubt, to be continued without Intermission full twenty-four Hours, as
Dr. _Sydenham_ advises. He is so particular in his Directions about it,
that I need say little. I shall only add, that _Theriaca_, and the like
solid Medicines, being offensive to the Stomach, are not the most proper
_Sudorifics_. I should rather commend an Infusion in boiling Water of
_Virginia Snake-Root_, or, in want of this, of some other warm
_Aromatic_, with the Addition of about a fourth Part of _Aqua
Theriacalis_, and a proper Quantity of Syrup of Lemons to sweeten it.
From which, in Illnesses of the same kind with the _Goal Fever_, which
approaches the nearest to the _Pestilence_, I have seen very good
Effects.

WHETHER either of these Methods, of _Bleeding_, or of _Sweating_, will
answer the Purpose intended by them, must be left to a larger Experience
to determine; and the Trial ought by no means to be neglected,
especially in those Cases, which promise but little Success from the
natural Course of the Disease.

_FINIS._

[Illustration]




Footnotes:

[1] See the Dedication.

[2] _Vide_ Huet. De rebus ad eum pertinentibus, _pag._ 23.

[3] Observations sur la Peste de Marseille, p. 38, 39, 40.

[4] Ibid. _p._ 113.

[5] _Vid._ Philos. Transactions No. 370.

[6] Le Journal des Scavans, 1722. _pag._ 279.

[7] _Vid._ Dissertation sur la Contagion de la Peste. A Toulouse 1724.

[8] _Vid._ Mechanical Account of Poisons, _pag._ 24.

[9] Vid. Philos. Trans. No. 372.

[10] _Vid._ Lettre de Messieurs _Le Moine_ et _Bailly_.

[11] Astruc, Dissertation sur la Contagion de la Peste. A Toulouse,
1724. 8o.

[12] _Diemerbroek_ De Peste, _p._ 120.

[13] In these Words, _Where it can be done_.

[14] _Vid._ the _Gazettes_ of the Years 1665. _and_ 1666.

[15] Celsus de Medic. in Praesat. Morbos ad iram deorum immortalium
relatos esse, et ab iisdem opem posci solitam.

[16] Libr. De morbo sacro; et libr. De aere, locis, et aquis.

[17] Observat. et Reflex, touchant la Nature, etc. de la Peste de
Marseilles, pag. 47. et suiv.

[18] Journal de la Contagion a Marseilles, pag. 6.

[19] Lib. 2. +Hoti heteros aph' heterou, therapeias
anapimplamenoi, hosper ta probata ethneskon; kai ton pleiston phthoron
touto enepoiei; eite gar me theloien dediotes allelois prosienai,
apollunto eremoi, kai oikiai pollai ekenothesan aporia tou
therapeusantos; eite prosioien, diephtheironto, kai malista hoi aretes
ti metapoioumenoi.+ The beginning of this Passage, as it here stands,
though it is found thus in all the Editions of _Thucydides_, is
certainly faulty, +therapeias anapimplamenoi+ being no good
Sense. The Sentence I shall presently cite from _Aristotle_ shews that
this may be rectified only by removing the Comma after +heterou+,
and placing it after +therapeias+, for +prosanapimplemi+
in _Aristotle_ absolutely used signifies _to infect_. With this
Correction, the Sense of the Place will be as follows: _The People took
Infection by their Attendance on each other, dying like Folds of Sheep.
And this Effect of the Disease was the principal Cause of the great
Mortality: for either the Sick were left destitute, their Friends
fearing to approach them, by which means Multitudes of Families perished
without Assistance; or they infected those who relieved them, and
especially such, whom a Sense of Virtue and Honour obliged most to their
Duty._

The Sense here ascribed to the word +anapimplemi+ is confirmed
yet more fully by a Passage in _Livy_, where he describes the Infection
attending a Plague or Camp Fever, which infested the Armies of the
_Carthaginians_ and _Romans_ at the Siege of _Syracuse_, in such words,
as shew him to have had this Passage of _Thucydides_ in view; for he
says, _aut neglecti desertique, qui incidissent, morerentur; aut
assidentes curantesque eadem vi morbi repletos secum traherent_. Lib.
xxv. c. 26.

[20] L. 6. v. 1234.

  ----nullo cessabant tempore apisci
  Ex aliis alios avidi contagia morbi.

Et v. 1241.

  Qui fuerant autem praesto, Contagibus ibant.


[21] Sect. I. +Dia ti pote ho loimos mone ton noson malista tous
plesiazontas tois therapeuomenois prosanapimplesi?+

[22] +Peri diaphoras pyreton, Bib. 1.+

[23] De Peste, c. iv. annot. 6.

[24] Evagrii Histor. Eccles. l. iv. c. 29.

[25] Gastaldi De avertenda et profliganda Peste, p. 117.

[26] Ibid. p. 118.

[27] Ibid. p. 117.

[28] See Bills of Mortality for the Year 1665.

[29] The Sweating Sickness.

[30] Nat. Hist. l. vii. c. 50.

[31] Histor. l. ii.

[32] Histor. Ecclesiast. l. iv. c. 29.

[33] De Bello Persico, l. ii. c. 22.

[34] Vid. Hodges De Peste.

[35] Vid. Istorie di Matteo Villanni, l. I. c. 2.

[36] Mezeray Hist. de France, Tom. i. p. 798.

[37] Villani, loco citato.

[38] Vid. Huet. Histoire du Commerce des Anciens, p. 88.

[39] Relation Historique de tout ce qui s'est passe a Marseille pendant
la derniere Peste.

[40] Vid. Serv. Comment. in Virgil. AEneid, l. iii. v. 57.

[41] This was a kind of _Expiatory Sacrifice_, as the _Scape-Goat_ among
the Jews, _Levit._ xvi. And the Wretches thus devoted to dye for the
Sins of the People were called +Katharmata+, _Purgations_. Vid.
Aristophan. in Plut. ver. 454. et in Equit. ver. 1133. et Scholiast.
ibid. _Suidas_ adds that when the Sacrificed Person was cast into the
Water, these Words were pronounced, +Peripsema hemon genou+, _Be
thou our Cleansing_. And I observe, by the by, that the Apostle _Paul_,
1 _Corinth._ iv. 13. alluding very probably to this wicked Custom, makes
use of both these Words, where speaking of himself in the plural number,
he says, +Hos perikatharmata tou kosmou egenethemen, panton peripsema+;
for some of the best MSS. instead of +Os perikatharmata+, read +Hosper+,
or +Hosperei katharmata+; that is, _We have been looked upon as Wretches
fit only to be Sacrificed for the Public good, and cast out of the World
by way of Attonement for the Sins of the whole Society._

[42] Vid. Le Brun Voyage au Levant, c. 38.

[43] Vid. Ludolf. Histor. AEthiop. lib. i. c. 13. et D. August. De
civitat. Dei, lib. iii. c. ult.

[44] Vid. Ludolf. Histor. AEthiop. lib. i. c. 5. et Comment.

[45] J. Leo Hist. Afric. lib. i.

[46] Lib. vi. v 1100.

[47] Rhas. et Avicen.

[48] Essay on Poysons, p. 178.

[49] Cicero de Nat. Deor. lib. i. Sec. 36. speaking of these Birds, says:
_Avertunt Pestem ab Aegypto, cum volucres angues ex vastitate Libyae
vento Africo invectas interficiunt atque consumunt; ex quo fit ut illae
nec morsu vivae noceant, nec odore mortuae._

[50] Newton's Optics, Qu. 18 to 24.

[51] Gastaldi, De Peste, p. 116.

[52] Journal de ce qui s'est passe a Marseilles, _etc._

[53] Vid. The London Gazette, July 23, 1743.

[54] Kircher, Langius, _&c._

[55] Toulon, Traite de la Peste.

[56] _Hippocr._ Epid. l. iii. That _Hippocrates_ describes here the
Constitution of Air accompanying the true _Plague_, contrary to what
some have thought, _Galen_ testifies in his Comment upon this Place, in
libr. De Temper. l. i. c. 4. and in lib. De differentiis Febr. lib. i.
c. 4.

[57] Vid. _Mercurial._ Praelect. De Pestilent.

[58] Notitia Eccles. Diniensis.

[59] Histor. lib. lxii.

[60] Sydenham De Peste.

[61] Vid. Caium, De Febr. Ephemer. Britan. and Lord _Bacon_'s History of
_Henry_ VII.

[62] Pag. 162. Edit. Lovan.

[63] Vid. Rondinelli Contagio in Firenze, et Summonte Histor. di Napoli.

[64] Lord _Herbert_'s History of _Henry_ VIII.

[65] Thuani Histor. lib. 5.

[66] Lord _Verulam_'s History of _Henry_ VII.

[67] Vide Sydenham, De Peste, An. 1665.

[68] Boccaccio Decameron. Giornat. prim.

[69] De Contagione, l. iii. c. 7.

[70] Observat. l. vi. Schol. ad Observ. 22.

[71] Diemerbroeck, De Peste, l. 1. c. 4.

[72] Memorials presented by the Deputies of the Council of Trade, in
_France_, to the Royal Council, Pag. 44 and 45.

[73] Alex. Benedict. De Peste, cap. 3.

[74] In a Paper of Advice against the _Plague_, laid before the King and
Council by Sir _Theod. Mayerne_ in the Year 1631. _MS._

[75] Hodges, De Peste.

[76] Vid. _Directions for the Cure of the_ Plague _by the_ College _of_
Physicians; _and Orders by the_ Lord Mayor _and_ Aldermen _of_ London,
_published_ 1665.

[77] Vid. a Journal of the Plague in 1665. by a Citizen. London, 1722.

[78] Discourse upon the Air, by _Tho. Cock_.

[79] Vid. The shutting up Houses soberly debated, _Anno_ 1665.

[80] Muratori governo della Peste, lib. I. c. 5.

[81] Cardin. Gastaldi, De avertenda Peste, c. 10.

[82] Journal de ce qui s'est passe a Marseilles, &c. p. 9, 10, 11.

[83] De Pestilent. cap. 21.

[84] Camden. Annal. Regin. Elizab.

[85] Lord _Verulam_, Natural History, Cent. 10. Num. 194.

[86] Plutarch lib. de Isid. et Osir.

[87] De Peste, c. 22.

[88] Hodges, De Peste, pag. 24.

[89] Journal de la Peste de Marseilles, pag. 19. et Relation Historique
de tout ce qui s'est passe a Marseilles pendant la derniere Peste, pag.
77.

[90] Rhazes, De re Medica, lib. 4. c. 24. & Avicenn. Can. Med. lib. 4.
c. 1.

[91] Gaudereau Relation des Especes de la Peste que reconnoissent les
Orientaux.

[92] Mech. Account of Poisons, Essay III.

[93] Notitia Ecclesiae Diniensis.

[94] Vid. Observ. et Reflex. sur la Peste de Marseilles, p. 333.




Transcriber's Notes:

In the original text, the Preface is printed in italics. For ease of
reading, non-italicized text in this section is represented by =text=.

In the remainder of the text, passages in italics are indicated by
_underscore_.

Long "s" has been modernized.

The original text includes Greek characters. For this text version these
letters have been replaced with +transliterations+.

The following misprints have been corrected:
  "Phsician" corrected to "Physician" (page 4)
  "that that" corrected to "that" (page 50)
  "Qarantaine" corrected to "Quarantaine" (page 92)
  "the the" corrected to "the" (page 95)

Other than the corrections listed above, inconsistencies in spelling and
hyphenation have been retained from the original.






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