Part 1

AN

ACCOUNT

OF THE

PLAGUE

WHICH

_RAGED AT MOSCOW_,

IN

1771.

BY CHARLES DE MERTENS, M. D.

MEMBER OF THE MEDICAL COLLEGES OF VIENNA AND STRASBURG, FORMERLY IMPERIAL AND ROYAL CENSOR, AND CORRESPONDING MEMBER OF THE MEDICAL SOCIETY AT PARIS.

TRANSLATED FROM THE FRENCH, WITH NOTES.

_LONDON_:

PRINTED FOR F. AND C. RIVINGTON, NO. 62, ST. PAUL'S CHURCH-YARD.

1799.

PREFACE.

Histories of the Plague, exhibiting the modifications it undergoes in different climates, must at all times and in all places be acceptable, if not to the public at large, at least to that class of persons who make the art of medicine their study and employ: But, to a country situated like our own, histories of this terrible disorder occurring in the northern parts of Europe are more particularly interesting, by holding up to our view a picture of what it probably would be, whenever it should visit us again. Such a picture is presented to us in the history of the plague which depopulated Moscow and other parts of the Russian empire, in the year 1771, and which forms the subject of the following pages. What, at the present time, must give a greater degree of interest to such a subject, is the danger to which we are exposed of importing the pestilential contagion from America[1], on the one hand, and from Turkey and the Levant on the other: For, although the cold has, happily, suppressed for the present the pestilence which has been committing such dreadful ravages at Philadelphia and New York; yet is it to be feared that it may be retained in many houses, and lie dormant in various goods, ready to break out again, whenever it shall be favoured by the weather[2]: And no one who is acquainted with the nature of that contagion can deny the possibility of its importation from America into this country, either now or hereafter, by infected persons or infected merchandise. On the other hand, are we not threatened with a similar danger from the East? In executing the hostile operations which are going forwards in the Mediterranean, it seems scarcely possible for our fleets and armies to keep clear of contagion. No nation was ever long engaged in a war with the Turks, without taking the plague. In this respect they are as much to be dreaded by their friends as their foes. If, in the present contest, Italy, and France, and England shall escape this scourge, it will form an exception to past events, which all Europe must devoutly pray for.

Under these circumstances the Translator thought it would be useful to call the attention of the practitioners in medicine of this country, to the subject of pestilential contagion, by publishing the following Account of the Plague at Moscow in the year 1771. Besides the narrative of the rise and progress of the disorder, and the description of its symptoms and treatment, this account contains also a detail of the methods which were successfully employed in that city for checking and totally extinguishing the contagion; and in particular a detail of the means by which a large edifice, situated in the centre of Moscow, and containing about one thousand four hundred persons, was preserved from the pestilence during the whole of the time that it raged there.

This account is translated from a treatise republished in French, and originally written in Latin by Dr. Mertens, under the following title: "_Traité de la Peste, contenant l'Histoire de celle qui a régné à Moscou en 1771; par Charles de Mertens, Docteur en Medecine, &c. ouvrage publié d'abord en Latin[3]; actuellement mis en François, &c. à Vienne, 1784_." The author (who was physician to the Foundling-Hospital, at Moscow, and resided in that city during the whole of the time that the plague raged there) divides his treatise into four chapters; in the first of which he gives a history of the plague as it appeared at Moscow; in the second, he treats of the diagnosis; in the third, of the curative treatment; and in the fourth, of the precautions or methods of prevention.

So many works have been published on the plague, that whoever writes a regular treatise on this disorder cannot avoid repeating many observations that have been made by others before him. Hence, instead of dividing the present pamphlet into chapters and sections, and following the original word for word throughout; the translator has taken the liberty of extracting from the two last chapters those parts only which contain new observations, or which have an immediate reference to the narrative; which last he has translated entire, excepting half a dozen lines at the beginning, that seem to have been introduced by the author for no other purpose but that of quoting professor _Schreiber_'s[4] work on the plague, which broke out in the Ukraine in the years 1738 and 1739.

Besides the preface[5], and some other matters noticed in their respective places, the following topics of discussion have been omitted; viz. 1st. _the comparison between the plague and the smallpox_; 2d. _the reflexions on the inoculation of the plague_; 3d. _the precautions to be employed in wars with the Turks_; and 4th. _the precautions continually necessary in places exposed to the pestilential contagion_.

These topics have been omitted, because with regard to the first, as the smallpox and the plague agree in no other respect but in that of being propagated by contagion, a comparison between them seems to be quite unnecessary; because, as to the second, the inoculation of the plague is proved to be useless by the well-established fact, that the same person is susceptible of taking it several times[6]; and because with regard to the third and fourth points, they only lead to repetitions of general and particular precautions mentioned in other parts of the pamphlet, or suggest hints which do not apply to an insular situation like ours.

Next to a detail of all the events which took place during the raging of the plague at Moscow, the translator has especially aimed at a full and accurate delineation of the symptoms. In doing this, he has taken the pains to compare the description given by Dr. _Mertens_, with those of two other writers on the same subject; viz. _Orræus_ and _Samoïlowitz_. Thus he flatters himself that all the different types and modifications which the plague assumes in the Northern parts of Europe, are here developed in such a manner, as to enable those who have never seen the disorder, to detect it on its first appearance, or in its early progress, should this country have the misfortune to be visited by it again.

_January 2, 1799._

AN

ACCOUNT

OF THE

PLAGUE AT MOSCOW.

In 1769 war broke out between the Russians and Turks. The year following intelligence was received that the Turks had carried the plague into Wallachia and Moldavia, where it was making great ravages; and that in the town of Jassy a number of Russians had been carried off by a disorder, which, on its first appearance, was called by some of the faculty, a malignant fever; but which the most eminent physicians in the place declared to be the plague. _Baron Asch_, first physician to the army, sent an account of this disorder in a letter, written in German, to his brother, a physician at Moscow, who showed it to me. The following is a translation thereof: "It attacks people in different ways. Some are slightly indisposed, complaining for several days of a headach, sometimes very violent, at other times less so, and now and then ceasing altogether, and then coming on again. The patients are affected with pains in the chest, and particularly in the neck; they gradually become languid and dejected, with something like intoxication and drowsiness. They have a particular taste in their mouths, which soon turns to a bitter; at the same time they have an ardor urinæ. To these succeed chilly and hot fits, and, lastly, all the symptoms which characterize the plague. The disease sometimes terminates favourably by perspiration, before the appearance of exanthemata, buboes, or carbuncles. The contagion is sometimes more rapid and more violent in its action; in that case the infected are suddenly seized after making a hearty meal, after a fit of anger, or too much bodily motion, with head-ach, nausea, and vomiting; the eyes become inflamed and watery (_larmoyans_), and pains are felt in those parts of the body where buboes and carbuncles are about to appear. There is no great degree of heat. The pulse is sometimes full and hard; sometimes small, soft, and scarcely perceptible; it often intermits, and, what should be particularly noticed, it is often feeble. These symptoms are accompanied with lassitude, a white tongue, dry skin, urine of a pale yellow colour, or turbid, but without sediment; frequently with a diarrhoea, which it is difficult to stop; and, lastly, with delirium, buboes, carbuncles, and petechiæ[7]."

The following summer this disorder spread into Poland, and committed great havoc there; from thence it passed to Kiow, where it destroyed four thousand souls. Immediately on its appearance at the last-mentioned place, all communication between that town and Moscow was cut off; guards were stationed on all the great roads, and all travellers were ordered to perform quarantine for several weeks.

At the end of November 1770, the anatomical dissector, at the military-hospital in Moscow, is attacked with a putrid petechial fever, which carries him off in three days. The attendants upon the sick[8] of this hospital dwelt with their families in two rooms separate from the wards. In one of these rooms they fall ill one after the other, till, at length, all of them, to the number of eleven, are seized with a putrid fever, accompanied with petechiæ; buboes and carbuncles appear in some of them; and most of them die between the third and fifth day. The attendants occupying the other room are seized in like manner with the same disorder.

On the 22nd of December, we are required to meet at the Board of Health. The first physician to the military-hospital states the circumstances, which I have just related, the truth of which is confirmed by the evidence of three other physicians, who farther report, that fifteen among the attendants, including their wives and children, had fallen victims to this disorder since the end of November; that five still continued ill of it; but that it had not yet shown itself in any of the hospital-wards. Eleven physicians were present at this consultation, and we all agreed that the disorder under consideration was the plague, except Dr. _Rinder_, state-physician[9], who had visited the sick, several times, in company with Mr. _Schafonsky_, and who pronounced it to be merely a putrid fever; an opinion which he maintained both in conversation and by writing.

This hospital stands out of the town, near the suburb inhabited by the Germans, from which it is separated by a small stream, called the Yausa. We advised that it should be immediately shut up, and that guards should be placed round it, in order to cut off all communication; that all the attendants upon the hospital-invalids should be removed, together with their wives and children, to a detached situation, care being taken to separate the infected from the healthy; and, lastly, that all the clothes and furniture, not only of those who were dead, but likewise of those who still survived, should be burnt.

The cold had set in later this year than usual; the weather was very damp and rainy until the end of December, when a hard frost came on, and continued through the remainder of the winter.

In addition to our joint report, _Field-Marshal Count Soltikoff_, governour-general of the place, consulted me in private, and desired to know what steps I thought adviseable under the present circumstances. On a subject pregnant with so much danger to the public at large, I did not hesitate to communicate my sentiments in the most unreserved manner. Accordingly I put into the governor's hands a paper, wherein I laid great stress upon the necessity of employing every possible precaution with regard to the hospital, where I affirmed, that the plague had appeared among the attendants, as before mentioned; I added, that it would be necessary to make strict enquiries to ascertain, whether the contagion was concealed in any part of the town, and that, wherever it should be discovered, the same precautions, as in the case of the hospital, should be adopted: that, for the same purpose, it would be further necessary to desire the physicians and surgeons, whenever they should perceive any unusual or doubtful symptoms in their patients, to give immediate notice thereof to the Board of Health; and to order the police-officers to appoint a consultation of physicians, whenever several persons should fall ill in the same house. I remarked, however, that there would be great difficulties in the business, if the contagion existed in other parts of the town besides the hospital; but, I added, that, even in this case, we might hope to eradicate the evil when the frost should set in, provided speedy and proper measures were resorted to.

We wished that what had passed on this subject should not transpire; but the rumour of the plague having broke out at Kiow, some months before, had produced such an effect upon the minds of the public, that the precautions which were adopted, with regard to the military-hospital, threw the whole city into the greatest alarm. All attempts to dissipate the fears of the inhabitants were fruitless.

After some days, however, when it was known that only seven persons in the hospital itself were ill of the disorder, and that the rest remained free from infection, the public fell into the opposite extreme, and thinking themselves in perfect security, the grandees, nobles, merchants, common people, in a word, all the inhabitants, except the governour and a few others, ceased to give themselves any further trouble about the means of prevention.

This idea of security, which was countenanced by the before-mentioned state-physician, Dr. _Rinder_, continued until the month of March. The medical consultations ceased. In spite of all our efforts to the contrary, every kind of precaution was neglected in the city; it was only at the military-hospital that, by order of the Empress, the means of prevention were still observed; in consequence whereof the plague was entirely suppressed there, after twenty-four persons had been seized with it, only two of whom recovered[10]. Six weeks after the death of the last of them, all their clothes, beds, &c. together with the house, to which they had been removed, and which was built of wood, were burnt. The hospital was opened again at the end of February.

The generality of mankind judge of things by events only; and will never believe that the plague is among them, until they have certain proof thereof in the number of funerals[11]. It is owing to this and other mistaken notions, that the plague is not put a stop to in the beginning; at which period it may be compared to a spark which might easily be extinguished, but which, if left to itself, bursts out into a conflagration which nothing can resist.

The opinion which went to assure the inhabitants that they were safe from the plague, was very generally believed, as in such cases almost always happens[12]. It only remained for us to console ourselves with the consciousness of having discharged our duty faithfully, and to the best of our abilities. Would to God that the business had stopped here, and that what afterwards took place had not confirmed the truth of our assertions. We should not then have beheld the dreadful destruction of so many of our fellow-creatures, nor have witnessed the most horrid of all public calamities.

On the 11th of March we are again convened at the Board of Health. In the centre of the town there was a large building used for manufacturing clothing for the army; three thousand persons were employed in it, nearly a third part of whom, of the most necessitous class, occupied the ground-floors; the rest, after working there the whole day, returned in the evening to their respective homes, in different parts of the town. Dr. _Yagelsky_, at that time second physician to the Military Hospital, whom the Governor-General had sent to the manufactory in the morning, brings word that he had found several patients, (eight to the best of my recollection) labouring under the same disorder, (accompanied with petechiæ, vibices, carbuncles, and buboes) which he had seen three months before at the military hospital; and that on seven dead bodies which he had examined, he had perceived similar appearances. On enquiring of the workmen in the manufactory, in what manner, and how long this disorder had made its appearance among them, he was told that a woman who had a swelling in her cheek, had betaken herself to one of her relations who lived in the manufactory, and had died there; and that, from that time, one or other of them was every day taken ill of the disorder. They further stated, that from the period above-mentioned to the present day, they had lost one hundred and seventeen persons, including the seven dead bodies not yet interred. This account given by Dr. _Yagelsky_, was corroborated by two other physicians, who had been sent the same day to examine the patients and dead bodies.

In a Memoir addressed to the Governor-General and the Senate (by whom we had been called together) we renew our declarations, that this disorder is the plague[13]; and we advise them to remove out of the town all the persons dwelling in the manufactory, taking care to separate the sick from the healthy; that they should order the clothes and furniture of the dead and infected to be burnt; and that the strictest search should be made to find out whether the contagion existed in any other part of the city. The inhabitants are again seized with a panic; and they now too well perceive the consequences of their neglect of the precautions recommended. We were thirteen physicians at this meeting[14], two of whom, who three months before had agreed with us that the disease which broke out at the military hospital was the plague, now said that the present disorder was not the plague, but a putrid fever; an opinion which they enforced in a separate conference with the Senate. These two physicians (Drs. _Kuhlmann_ and _Schiadan_) who still differed from us in opinion, had been led into their error, by observing that the number of deaths in the town was not greater than usual, but rather less than in the preceding years, and that there were very few people ill.

Some days after, being summoned to meet the other physicians and surgeons at the senate, where each of us was required to deliver our sentiments explicitly, I affirmed, in the most solemn manner, that I was thoroughly convinced that the disease under consideration was the plague; ten of my colleagues were of the same opinion, and the two others before mentioned still maintained the contrary[15]; nevertheless, they admitted the propriety of adopting precautions against a disorder, which, though not the plague, was of a contagious nature.

The first day (the 11th of March) is spent in deliberations. The infected building is shut up, and guards are placed there, to prevent any person from going in or coming out. Several make their escape through the windows, and the rest are removed out of the town during the night, the uninfected to the convent of St. Simon, and the infected to the convent of St. Nicholas, one of which is distant six, and the other eight versts[16]; from Moscow. These convents are surrounded with high walls, and have only one entrance. As it was discovered that some had died among the workmen who lived in their own houses, these were taken to a third convent, situated in like manner out of the town. Orders were given to the surgeons who had the care of all these people, to transmit daily to the Board of Health a list of the sick and dead. A committee of physicians was appointed to regulate every thing concerning the treatment of the sick, and the keeping of those who were performing quarantine free from infection; and great attention was paid to the interment of the dead. Drs. _Erasmus_ and _Yagelsky_ (now no more!) were entitled to great praise for the manner in which they acquitted themselves in this business. When any one of those who were under quarantine was taken ill, he was put in a separate room, and kept there until the symptoms of the plague shewed themselves, when he was conveyed in a carriage, by persons hired for that purpose, to the pest-house, viz. the convent of St. Nicholas.

The public baths, where the people are accustomed to go, at least once a week, were shut up. The town was divided into seven districts, to each of which one physician and two surgeons were appointed, for the purpose of examining all the sick as well as the dead bodies; in which business police-officers were joined with them. It was forbidden to bury the dead within the city; proper places for burying-grounds were fixed upon at some distance from the town. It was ordered, that whenever any one of the common people should be seized with the plague, he should be sent to the hospital of St. Nicholas, and that, after burning his clothes and furniture, those who had been living in the same apartment should be detained for the space of forty days in some buildings appropriated to that purpose out of the town; that if the like occurrence should happen in the house of a principal inhabitant or person of rank, all the servants who had been in the same room with the patient should perform quarantine, and that the master, together with all his family, should remain shut up in his own house for the space of eleven days. All this was sanctioned and passed into the form of a law by a resolution of the Senate. General _Peter Demitrewich de Yeropkin_, not more distinguished by his birth and valour than by his polished manners and humane disposition, was appointed by the Empress, Director-General of Health.

Notwithstanding what had happened, the number of those who were convinced that the plague had reached Moscow, was as yet inconsiderable. Dr. _Orræus_, physician to the army, who had visited impested patients at Jassy, was now passing through Moscow in his way to Petersburgh, and was requested to examine the sick and dead bodies before mentioned, which he accordingly did, and declared, that the disorder was exactly like that which, a short time before, had proved so destructive in Moldavia and Wallachia; that it was, in fact, the plague. This was further confirmed by Dr. _Lærch_, who was just returned from Kiow, where he had remained during the time that the plague raged there.

The weather continued very cold until the middle of April, in consequence of which the contagion became more fixed and inactive, attacking only those who dwelt with the infected. In the pest-house, the daily number of deaths did not exceed three or four; and of the manufacturers who were performing quarantine only about the same number fell ill.

According to the reports of the physicians, surgeons, and police-officers, the town appeared to be healthy. Almost every body believed that the physicians who had called the disorder the plague, had imposed upon the public; others entertained doubts on the subject. Things went on in this way until the middle of June, during which time nearly two hundred persons had died at the hospital of St. Nicholas. The number of sick and dead diminished daily there, in so much that, for a whole week, although the weather was very warm, not one fell ill of the disorder, and there only remained in the hospital a few convalescents. No further vestige of the disorder could be traced in the town.