Chapter 4

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 _Æthiopia_ 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 _Primæ Viæ_ 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._

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 Sçavans, 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 aëre, 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 à Marseilles, pag. 6.

[19] Lib. 2. +Hoti heteros aph' heterou, therapeias anapimplamenoi, hôsper ta probata ethnêskon; kai ton pleiston phthoron touto enepoiei; eite gar mê theloien dediotes allêlois prosienai, apôllunto erêmoi, kai oikiai pollai ekenôthêsan aporia tou therapeusantos; eite prosioien, diephtheironto, kai malista hoi aretês 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 +prosanapimplêmi+ 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 +anapimplêmi+ 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 monê tôn nosôn malista tous plêsiazontas tois therapeuomenois prosanapimplêsi?+

[22] +Peri diaphoras pyretôn, 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 passé à Marseille pendant la derniere Peste.

[40] Vid. Serv. Comment. in Virgil. Æneid, 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, +Peripsêma hêmôn 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, +Hôs perikatharmata tou kosmou egenêthêmen, pantôn peripsêma+; for some of the best MSS. instead of +Os perikatharmata+, read +Hôsper+, or +Hôsperei 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. Æthiop. lib. i. c. 13. et D. August. De civitat. Dei, lib. iii. c. ult.

[44] Vid. Ludolf. Histor. Æthiop. 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. § 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 passé à Marseilles, _etc._

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

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

[55] Toulon, Traité 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._ Prælect. 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 avertendâ Peste, c. 10.

[82] Journal de ce qui s'est passé à 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 passé à 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.

End of Project Gutenberg's A Discourse on the Plague, by Richard Mead