Part 4

The poverty of the common people, and the avarice of others in better circumstances, have, in all places and at all times, been the chief causes by which the contagion has been propagated. The poor man, who dreads hunger more than death, cannot bear to see himself deprived of the pittance of property left him by a relation or friend, and accordingly endeavours to secure in secret all that he can; whilst the avaricious man, delighted with the thoughts of making a good bargain, buys what is offered for sale, regardless of the risk he runs of taking the contagion. There is but one effectual remedy for this evil, which, as long as it subsists, renders all precautions whatever of no avail. The remedy I mean is to allow a sum of money from the public treasury for the payment of the value of the goods which are burnt. In fact, the condition of those whose family is attacked with the plague is woful enough; deprived of their friends and cut off from all society, they have little else to expect but death: is it fit, then, that their situation should be rendered still more deplorable by having their goods taken from them and destroyed, without any compensation; and thus to have no other prospect left them but that of extreme indigence, in case of recovery? Let persons be appointed to appraise fairly the goods which are burnt, and pay for them accordingly; or, let the money be deposited in the hands of some banker, or of a committee chosen for that purpose, with the claimant's name, in order that if he recovers, it may be given to him, or in case of death, to his heirs. Not only those among the poor who are ill of the plague, but those also who are suspected of having the contagion, should be fed and maintained at the public expence; humanity, as well as the safety of the rest of the inhabitants, requires that this should be done. A sufficiently large sum should be appropriated to this purpose, in order that, in case of urgency, there may be no difficulties on this head. If every thing is arranged in this manner from the first appearance of the plague, the expences will not be very heavy, the contagion will be easily stopped, and the evil will be stifled in its infancy. When the disorder has ceased, all who have recovered from it, as well as those who have attended upon the sick, should remain shut up for some time until all doubts are removed as to their being capable of communicating the contagion, on mixing with the inhabitants again. Forty days (whence the term _quarantine_) are the usual probation; but although this space of time may be requisite for the complete purification of goods, it seems to be much longer than is necessary in the case of infected persons, or persons merely suspected of having the contagion[68]. Before those who have been performing quarantine are allowed to have communication with the rest of the inhabitants, they should be washed all over with vinegar, should put on new clothes (their old ones having been previously burnt, as well as their furniture, &c.) and have their houses well fumigated. Besides all this, it will further be proper to make a strict search for several months after, in order to be satisfied that the contagion is not concealed in any part of the town, and that nobody has locked up infected clothes or goods in chests, trunks, &c. or hidden them in any other places; for the plague might, when least apprehended, spring up again from such a source. The pestilential germ confined in clothes or bales of merchandise acquires a greater degree of virulence, and may in that manner be transported to very great distances, and be preserved for a great length of time. The deadly power of this poison is so much increased by being shut up in bales of goods closely packed and well defended from the air, that there are instances of persons who were seized with the most violent symptoms and suddenly killed, on opening them[69]. In the last century, a twelvemonth after the plague had ceased at Warsaw, _Erndtel_, who relates the following anecdote, passed through that town in order to attend the Court to Marienburgh and Dantzic: in the town of Langenfurt, a coachman's wife, being near the time of her lying-in, brought with her in the month of October a mattress on which some persons, who had died of the plague a year before, had lain. Having made use of it, she was soon seized with the same disorder, accompanied with inguinal buboes, and was shortly afterwards delivered; but an hæmorrhage from the womb coming on, she died, as well as the child. The husband, also, died soon after, having buboes and carbuncles; and many other persons caught the infection, which proved fatal to more than twenty of them. This contagion continued to manifest itself until the month of February, without, however, occasioning any more deaths, the persons belonging to the Court being dispersed in different villages and country seats. It ceased altogether in the beginning of March[70]. After the plague has spread itself and become prevalent, its progress is resisted with much more difficulty, and it threatens to become a general calamity. We must not, however, wholly despair; for if, on the one hand, the Magistrates and the Committee of Health exert themselves to the utmost, and on the other, the inhabitants are tractable, the evil may yet be suppressed, especially if the season be favourable. The first object of attention is, to prevent it from being carried into the neighbourhood and other places. To this end, it will be proper to make known in a printed declaration, that the disorder which rages is the plague; that the contagion does not exist in the air, and is only communicated by contact of the sick and infected goods: In this advertisement the inhabitants should be called upon to obey punctually the orders which may be given for the safety of the public at large, as well as of individuals; they should be warned against buying clothes or other effects which have been used; and dealers in second-hand goods and clothes should not be suffered to carry on their trade: Further, if the plague rages in one quarter of the town only, all communication between that part and the rest of the town should be immediately cut off.

In the beginning, when only a few families have become infected, the public safety requires that they should be sent out of the town, or at least removed to some detached building, so as to be deprived of all further intercourse with the rest of the inhabitants; but this should be done in a humane and soothing manner, and with as little inconvenience as possible to these unfortunate persons. When the calamity, however, has arrived at such a pitch, that great numbers are attacked with the disorder, and that it has spread itself over every part of the town; we can no longer hope to eradicate it entirely by these precautions. At this period it would be cruel and unfeeling to add to the sufferings of so many afflicted families, by forcing away the sick from the healthy, by depriving the father of the presence of his children, the wife of the attentions of her husband, and the old man of the comfort of his family. Under such circumstances, we should only aggravate the evil, by compelling the sick to conceal their illness. Besides, it is impossible to find buildings sufficiently large and convenient for such a vast number of patients. Nevertheless, every exertion must be made to stop the progress of this terrible disorder, which propagates itself by contagion, in every direction.

In this melancholy situation what adds to the distress is, that it is difficult to contrive measures which shall on the one hand be consistent with the humanity with which the unfortunate sufferers should be treated, and on the other, with the public safety. If you drag from their houses the fathers of families, mothers, and children, and thrust them into hospitals, you rob them of the only consolation which is left them, you heap misery upon misery, and plunge them into despair, from which it is impossible for them to recover. On the other hand, although the contrary plan may seem more humane, it is nevertheless equally cruel and fatal to the public at large to neglect all precautions, and to let the contagion take its own course; for in that case many towns and whole provinces would become a prey to the pestilence. We must, therefore, take the mid-way between these two extremes.

Let an hospital with the houses near it, or a whole suburb[71], be appropriated for the reception of the poor who are seized with the plague; let every thing which is requisite for their support and cure be provided there; and let them repair thither of their own accord, and not be brought by compulsion. Let other persons be allowed to remain with them, provided the infected houses have a common mark upon the doors, by which they may be distinguished from the rest, in order that sound persons who enter them may be put upon their guard. Let the Board of Health circulate printed directions how the uninfected are to manage when they approach the sick, warning them to keep the doors and windows open, to avoid the breath of the infected, and the effluvia from their bodies and excrements; to sprinkle the rooms frequently with vinegar; and to avoid, as much as possible, touching with their bare hands either the bodies of the sick or infected goods; or if they have touched them, to wash their hands immediately with vinegar.

Physicians, surgeons, and nurses, must be appointed to take care of the impested, and have handsome salaries allowed them[72].

The Magistrates should take care that the dead bodies do not remain unburied longer than is absolutely necessary for determining the disease by which life was destroyed.

Those who are employed in burying the dead should be protected from the contagion, by having cloaks and gloves of oil-cloth, which should be frequently washed with vinegar; and that they may not touch the dead bodies with their hands, they should be provided with hooks and other instruments for lifting them up.

The burying-grounds should be out of the town, and at some distance from the high-roads; the corpses should be thrown into deep trenches, and be immediately covered over with a thick layer of earth, not only to prevent the effluvia that would otherwise arise from them, but also to secure them from dogs and crows.

Although, as I have before remarked, the atmosphere at Moscow, even when the plague was at its height, was not at all vitiated, and by no means contagious, not only in the winter but also in the middle of summer, when the heat is as great as in any other parts of Europe, excepting such as lie immediately to the south; yet, if a great number of bodies dead of the plague are suffered to lie unburied and putrefy, they may impregnate the air with their effluvia to such a degree as to render the atmosphere (otherwise incapable of propagating the contagion) infectious, especially in summer, and thereby cause it to spread inevitable destruction to the neighbourhood. It is well known that the carcases of all animals in a state of corruption fill the surrounding atmosphere with effluvia that are accompanied with an intolerable stench, and that these effluvia, though they do not produce the plague, are nevertheless the cause of putrid, malignant fevers. Accounts are given by several authors of such-like epidemic diseases being produced by the fætor exhaled from the dead bodies left on the field of battle, or from the bodies of animals putrefying in stagnant waters or on the banks of rivers. Among others, _Forestus_, (Lib. 4. Obs. ix. Tom. 1.) gives the history of a very malignant epidemic, occasioned by an enormous fish of the whale kind, which lay corrupting on the sea-shore. But how much more pernicious effects must the putrefaction of bodies dead of the plague have, since in this disorder the simple effluvia from the sick are so fatal to persons in health?

(The observations which follow on the airing of goods, on quarantine, &c. coincide so much with those that are to be found in every treatise on the plague, that they are omitted by the Translator.)

C.

_Of the Antipestilential Fumigating Powders._

The houses and rooms of persons infected with the plague are purified by firing gunpowder in them. At Moscow we employed with success a powder, called _antipestilential_, of which sulphur and nitre formed the basis; some bran and other vegetable substances, such as abrotanum, juniper-berries, &c. together with certain resins, were added; but in my opinion these resins are totally useless, and only increase the expence[73]. The acid vapours let loose on burning nitre and sulphur together, remain a long time suspended in the air[74]. The greater or less strength of these powders depends on the proportion of sulphur and nitre to the other ingredients. After burning the rags or other litter which may be found in the rooms, they are fumigated by throwing one of these powders on a chafing-dish or pan of coals, the doors and windows being shut, to keep in the smoke and vapour for a sufficient length of time. This vapour is hurtful to the lungs, and produces suffocation; hence the person who throws the powder upon the burning coals should get out of the room as fast as possible. This process is repeated three or four times in the space of twenty-four hours for several days together; after which the doors and windows are thrown open.

D.

_Of Preservative Remedies._

We shall content ourselves with abridging, rather than translating at full length, what the author offers on this head. Among other preservatives, _issues_ are taken notice of. The author himself had one made in his left arm, which he kept open for a twelvemonth; but he is inclined to attribute his exemption from infection rather to his having avoided the contact of the sick and infected goods, than to this remedy. It appears that four surgeons at the principal pest-hospital died of the plague, notwithstanding they had all of them issues. Hence their preservative virtues may be questioned; yet as they have been recommended by others, and are attended with little inconvenience, he thinks it would be proper for those who are obliged to go among the infected, to have one made in the arm or leg, or both.--_Sweet spirit of nitre_ was esteemed an excellent preservative by some; they took twenty or thirty drops of it upon a lump of sugar several times a day. Others took, with the same intention, the _Peruvian bark_ under different forms; but as they all kept out of the way of the contagion at the same time, the preservative powers of these remedies remain very doubtful. The common practice of carrying _camphor_ in the pocket or sewed in the lining of the clothes, has nothing to recommend it. In like manner the _smoking of tobacco_, though it has been so strongly recommended by _Diemerbroeck_ and others, is by no means a certain protection against the contagion. The Turks, says Dr. _Mertens_, are continually smoking their pipes; and yet great numbers of them are swept off by the plague every year. This reflection was not sufficient to do away the prejudice in its favour, so difficult is it to destroy a received opinion, howsoever false it may be. While the plague was raging at Moscow, many Russian gentlemen and foreigners had recourse to the smoking of tobacco, as an infallible preservative. Those who were accustomed to the pipe, smoked oftener, whilst others gradually brought themselves to bear it, until they saw some among the foreigners of the lower class carried off by the plague, in spite of the use of this remedy. The master chimney-sweeper at the foundling-hospital, who had formerly served in the Prussian army, had so much faith in the smoking of tobacco, that he was always seen with a pipe in his mouth from morning to night; and boasted that by this means he should be proof against the plague. Disregarding all other precautions, even when the disorder was at its height, (viz. the month of September) he got over the fences in the night-time, in order to go and see his wife and children who were in the town. He was immediately seized with head-ach and vomiting, and the next day he had a bubo in the groin and under the arm-pit, accompanied with great debility and fever. He died at the end of forty-eight hours. His apprentice, twelve years of age, had a large flat bubo under the armpit, and followed him soon after.

From the account published by Count _Berchtold_ at Vienna, in 1797, it would appear that the best preservative method is that recommended by Mr. _Baldwin_, the British Consul at Alexandria. It consists simply in anointing the body all over with olive oil. According to the same account, friction with warm oil is not only a preservative, but also a curative remedy. See the second volume of _Duncan_'s Annals of Medicine.

E.

_Of the means by which the Foundling-hospital at Moscow was kept free from the Plague._

I shall now give a particular account of the means by which the Foundling Hospital was kept free from the plague, during the whole time that it raged at Moscow; in the last six months of which it swept off so many thousands of inhabitants. From this account it will easily be seen how possible it is in times of pestilence, to keep one's self, one's family, and whole buildings, not only private but public, free from infection.

The Foundling Hospital[75] is situated in the middle of the city, at the conflux of the Yausa and the Moscua. It occupies a space of ground, at that time only inclosed by a hedge six feet high, whose circumference measures nearly a French league. On this has been erected a building which might easily be made to contain five thousand foundlings. That part of it which was finished in 1769, contained one thousand children and three hundred adults; the rest, consisting of masters, servants, workmen, and soldiers, who amounted to nearly one hundred, lived in houses built of wood adjoining the stone edifice and standing within the inclosure. This inclosure had three gates.

In the month of July, as soon as I found that the plague had spread itself in the town, I requested the Governors of the hospital to order all the gates to be shut, excepting that where the porter lived; and not to suffer any person to come in or go out, without permission from the principal inspector. I further requested them to lay in a large stock, from places not yet infected, of flour, cloth, linen, shoes, and other necessaries. In the month of August, when the plague was raging with great fury, it was no longer permitted for any one to enter but myself. Persons who lived out of the enclosure were hired to purchase all the necessaries of life, and to carry letters. I gave the porter some written directions, in which I put down every thing he was to allow to enter, and under what precautions. The butcher threw the meat into large tubs filled with vinegar, from which it was afterwards taken out by the under-cook. I prohibited the admission of furs, wool, feathers, cotton, hemp, paper, linen, and silk; but I allowed sugar-loaves to be received, after taking off the paper and packthread. Letters were pricked through with a pin and afterwards dipped in vinegar, and dried in the smoke produced by burning juniper-wood. The inhabitants of the building were allowed to speak to their relations and friends, who stood at a certain distance out of the gate[76]. Being obliged to purchase two hundred pair of boots and shoes, in the month of October; I ordered them to be immersed for some hours in vinegar, and afterwards dried.

I visited all the sick in the house twice every day; the sound were examined by two surgeons night and morning, who informed me whenever they found any of them indisposed. Whenever any symptoms occurred in a patient which appeared to me doubtful, I kept such patient apart from the rest, until I was satisfied the disorder was not the plague. In this manner I detected the plague seven times among the soldiers[77] and workmen belonging to the Foundling Hospital; but as I separated them on the first appearance of the symptoms, they none of them infected the others, except the master chimney-sweeper, who gave it to his apprentice. After the month of July, we ceased to admit any more foundlings or pregnant women. I proposed to the Governors to hire, in the mean while, a house for this purpose in the suburbs, which was not determined upon until the month of October[78]. At this time there still continued to die in the town above a thousand persons in a day. I had the children who were brought to this quarantine-house, stripped to the skin; after which their clothes were burnt, their bodies washed all over with vinegar and water, and new clothes put upon them. I kept them for the space of a fortnight in three rooms detached from the rest; if, after that time, no signs of the plague appeared among them, they were put (having previously changed their clothes) each in the order in which he finished this first term of probation, in the common dwelling-rooms of the quarantine-house; here they remained another fortnight, before they were removed to the Great Hospital. I visited every day these children and the lying-in women[79]. One infant was brought with a pestilential bubo, and two others, during the time of their quarantine, had the plague with buboes, as mentioned in a former part of this treatise. By putting them in separate rooms along with their nurses, the contagion was prevented from spreading[80]. I had thus the happiness of rescuing from death about one hundred and fifty children[81], brought to the quarantine-house after the month of October. In the Spring of 1772, every thing was restored to its former footing.

THE END.

FOOTNOTES:

[1] Whatever doubts might have been entertained, as to the real nature of the yellow fever, on its first appearance in North America, I believe almost all physicians are now agreed that it is the plague, with such modifications as are easily referable to difference of climate and different mode of living.

[2] This can hardly fail to be the case until the American government shall have recourse to some of those vigorous measures for eradicating the contagion which are mentioned in the following pages.

[3] In a work, entitled Observationes de Febribus putridis, de Peste, &c. published at Vienna, in 1778.

[4] _Schreiber_ Observat. et Cogitat. de Pestilentia quæ 1738 & 1739, in Ukrania grassata est.

[5] The author's preface or introduction is wholly controversial. It consists of a reply to Mr. _Samoïlowitz_, who had attempted, in a very illiberal manner, to detract from the merit of the author's publication. This reply is accompanied with copies of the certificates and testimonials received from the lieutenant of the police, the governours of the Foundling-Hospital, the lieutenant-general of Moscow, Count Pànin, the privy counsellor de Betzky, &c. relative to his advice and exertions during the time of the plague. These vouchers completely refute his adversary's charges; but as they and the rest of the preface present no facts relative to the history or treatment of the disorder, they cannot be interesting to any but the author's friends, and are therefore omitted.

[6] Notwithstanding this, Mr. _Samoïlowitz_ contends strenuously for the inoculation of this disorder, in a pamphlet entitled "Memoire sur l'Inoculation de la Peste, &c. Strasbourg, 1782."

[7] See Addenda, Note A.

[8] In military hospitals men perform the office of nurses. Tr.

[9] Literally physician to the city. The Russian government appoints a physician to every principal town of the empire.

[10] _Orræus_ states, that of the whole number, which consisted of thirty, twenty-two died, five recovered, and three escaped infection. _Descriptio Pestis_, p. 26. Translator.