Part 1

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AN ESSAY ON _Contagious Diseases_.

[Decoration]

AN ESSAY ON _Contagious Diseases_:

More particularly

On the _Small-Pox_, _Measles_, Putrid, Malignant, and Pestilential Fevers.

By _Clifton Wintringham_.

YORK:

Printed by _Charles Bourne_ for _Francis Hildyard_, and are to be Sold by _W. Taylor_, at the Sign of the _Ship_ in _Pater-noster-Row_ LONDON, 1721.

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THE PREFACE.

_The Design of this small Treatise being to deduce the Causes, and explain the_ Phoenomena _of some of the most Fatal Diseases which afflict Mankind, can stand in Need of no Excuse, whatever the_ _Performance it self may; and especially at a Time, when not only several of them Rage amongst us with uncommon Violence, but we are Daily threatned with the dreadful Calamity of a Raging Pestilence. I have endeavour'd to reduce these Diseases to the same Simplicity with Others, to speak Intelligibly of them, and show the real Changes in the Animal Oeconomy, from the Principles of the Modern Philosophy._

_The Learned Authors who have already wrote on this Subject, have rejected this Part of it, as being so easie and obvious as to need no Explanation. I doubt not indeed but this is their Case: But how easie soever it may be to explain these_ Phoenomena, _'tis not every one, conversant in the Practice of Physick, that will give himself the trouble to deduce them; and 'tis for such chiefly that this small Tract is designed; to_ _whom if it prove any way serviceable, I shall gain the End I proposed by it._

York, _June 1st_. 1721.

ERRATA.

Page 8. Line 20. before Contagion insert _a Pestilential_. Page 52. Line 17. read _Buboes_.

OF _Contagious Diseases_.

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CHAP. I.

_Contagious Diseases_ are generally defin'd by Physicians to be such, as are capable of being communicated to us by the Air, or the Effluvia of Morbid Bodies. When the Cause producing these Diseases is general, and not occasioned by the peculiar Qualities of particular Places, but brought from Abroad, they are stiled _Epidemic_.

The Causes therefore of these Diseases must either be generated in the Air, or produced from the Effluvia of Animal, Vegetable, or Mineral Substances floating in it. And consequently the Effects of the Contagious Particles must be extreamly various, according to the Qualities of the Bodies from which they are produced.

When any of these Causes is of so deleterious a Nature, as not only to be Infectious, but to destroy all or most of those that are affected by it, That Disease is called a Pestilence.

But before I proceed to examine the particular Properties and Effects of the Contagious Particles, it will be Necessary to Demonstrate the following Propositions.

PROP. I.

The Magnitude of the Particles of the Blood being increased, Obstructions will be formed in the Ramifications of the smaller Vessels, which will happen sooner or later, in Proportion to the increased Magnitude of the Particles, and the smallness of the Vessels.

_Demonstration._

Let the Canal A be an Artery of a middle Size, sending out the Branches C, D, E, F, G, H; Let the Dotts represent the increased _Moleculæ_ of the Blood, it is evident that these must be stopt some where or other in the Ramifications of the Vessels C, D, E, F, G, H, whenever the Diameters of the _Moleculæ_ exceed those of the containing Vessels.

PROP. II.

The Magnitude of the Particles of the Blood being increased, those Capillary Vessels nearest the Heart will be soonest obstructed, and _vice versa_; The rest in Proportion to the Velocity of the Blood, Diameters of the Canals, and their Distance from the Heart.

_Demonstration._

This is sufficiently evident from the foregoing; For the sooner those _Moleculæ_ arrive at the Capillary Vessels, the sooner those Vessels will be obstructed, and _vice versa_, and consequently _cæteris paribus_ the Capillaries of the Branches C, H, in the preceeding Figure, which are nearest the Heart, will be sooner obstructed than those of E, F.

PROP. III.

The Magnitude of the Particles of the Blood must be increased either by the Union of a greater Number of them than in a Natural State; Or by the Alteration of their Figure, by which their Surfaces become larger than before.

_Demonstration._

This is evident from the Observations of _Lewenhoeck_ and _Malpighius_ on the perspirable and other ultimate Vessels, which are visible by the Microscope, and consequently larger than the Orifices of the Lacteals, which the best Glasses will not discover. Whence it will follow, that no Particle can pass this way into the Blood, which single can obstruct the Vessels, and consequently this Effect can only be produced by the Action of the Particles upon each other, _viz._ either by the Union of a greater Number, or some Alteration in their Figures, whereby their Surfaces become larger than before. Thus the Globules of the Blood as appears by the Microscope, are nearly of a Spherical Figure, which being the most capacious, as well as most apt to constitute a Fluid Body, by touching in the fewest Points The farther any Particles deviate from this Figure, the more likely they will be to obstruct the Vessels, and _vice versa_.

PROP. IV.

The Contagious Particles being admitted into the Blood, do there coagulate its Parts, and form _Moleculæ_ of a larger Size than ordinary.

_Demonstration_

The Force of the Heart and Cavities of the Canals being the same, when the Infection is first taken, as before, the Blood would pass with the same Facility thro' the Vessels as at other Times, and Obstructions could not be formed, were not the _Moleculæ_ thus increased; as our Senses show they are by the Eruption of Pustules in the Small-Pox, by the great Inflammations, Mortifications, Buboes, and Carbuncles in Malignant and Pestilential Fevers; and consequently the Contagious Particles do increase the Bulk of several of the constituent Parts of the Blood, by altering the Figures of its Particles, and forming _Moleculæ_ of a larger Size than in a Natural State.

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CHAP. II.

It has been the constant Observation of Physicians, as well ancient as modern, and confirm'd by numerous Instances, that a hot and moist Constitution of the Air, joyn'd with southerly Winds, was generally a Fore-runner of malignant and Pestilential Fevers. Thus _Hippocrates_ observes, that the Constitution of the Air preceeding that malignant Fever describ'd in the 3d Book of his Epidemics, 'was calm, moist, and southerly, and succeeded a hot, and dry Season; the Winter, calm, cloudy, rainy, warm, southerly; some Showers, and Northerly Winds about the Equinox; the Spring, calm and southerly, with great Rains; the Summer very hot, with little Wind, and much Rain about the Dog-days[a]. Some Authors led by the Title of this Book of his Epidemics, _viz._ [Greek: Katastasis Loimôdês], or the Pestilential Constitution, have imagin'd the Diseases here spoken of, to be the same with that terrible Plague describ'd by _Thucydides_, which taking its Rise in _Æthiopia_, and passing thence thro' _Lybia_ and _Ægypt_, miserably harass'd all _Persia_, _Phoenicia_, _Judea_, _Greece_, and _Coele Syria_, and was one of the most dreadful Calamities of this kind that ever appeared in the World. But whosoever will give himself the Trouble to compare the Symptoms of the Fevers here described by _Hippocrates_, with those related by that accurate Historian[b], who both had it himself, and visited many others in it, will find that there is not the least Similitude between them. The one being highly infectious, and not the least Appearance of Contagion in the other: _Galen_ also the best Interpreter of _Hippocrates_, in his Comment on this Book of his Epidemic's suspects, this Title to be spurious, tho' both he and others observe much the same Constitution of the Air to be the Fore-runner of these Diseases.

[a] _Hippoc._ Epidem. lib. 3. sect. 3. _Galeni_ Com. in hunc Loc. _Titi Lucret_, lib. 6.

[b] _Thucydides_ lib. 2.

[Sidenote: _What Places most Subject._]

Pestilential and Malignant Fevers, are likewise observ'd to be the most frequent in those Places where the Climate is hot and scorching, and especially when Rains fall in such Seasons of the Year. Thus in _Ægypt_ and some other Parts of _Africa_, if Rains fall during the Months of _July_ and _August_, the Plague usually breaks out the _September_ following[c].

[c] _Joan. Leon._ Hist. _Afric._ lib. 1. cap. 10. _Purchas_ Pilgrim. lib. 6. cap. 17. _Athan._ _Kircheri Scrutin. Pestis_, pag. 179.

This is still more remarkable in such Places, as not only are Situated in the forementioned Climate, but are likewise deprived of a constant Succession of pure and clear Air. An Instance of this we have in _Grand Caire_, which besides being subject to the common Disadvantages of the Country, (as are a Climate hot and scorching, a Situation low and flat, exposed chiefly to the warm Winds, their Water fetid and stagnating, being reserv'd in Vaults and Canals, which are Annually fill'd by the Overflowing of the River, the Air abounding with putrid Steams and Exhalations, arising from the Parts of Animals, Vegetables, and other Substances brought down and there deposited by the River), lies close under the Hill of the Castle, by which all Wind and Air is intercepted, which causes such a stifling Heat there, as ingenders many Diseases.[d]

[d] _Therenot_'s Travels, Part. 1. pag. 128.

That these may justly be esteem'd the Causes of the greater Frequency of these Diseases in this Place, than others in the same Climate, appears from their being so rarely known in those Places, which tho' equally hot, enjoy an Air free from Vapours.[e] Thus in _Numidia_ and some other Parts of _Africa_, the Plague is scarce to be found once in a hundred Years, and hardly at all in the Land of _Negroe_.[f]

[e] _Piso_ Hist. _Ind._ & _Brasil_.

[f] _Purchas_ Pilgrim. lib. 6. cap. 13.

[Sidenote: _Several Causes of the Plague._]

The other Observations of the Causes of these Fevers, may be reduced to such as arise from the Stinks of stagnating Waters in hot and close Weather, to some putrid Exhalations of the Earth, to the Parts of Animals and Vegetables putrifying in the open Air, or the taking of corrupt & unwholsome Nourishment.

Of the first kind was that at _Selinis_, occasioned by the stinking Exhalations of the stagnating Waters adjacent, which the discerning _Empedocles_ removed by scouring its Ditches from their Filth, by a fresh Current of Water drawn from two Rivers in the neighbouring Country[g].

[g] _Plutarchi_ Lib. [Greek: peri polypragmosynês].

To the second Class may be reduced that Pestilential Fever, which the same great Philosopher check'd at _Agrigentum_, by stopping the Mouths of some neighbouring Mountains, whose pernicious Fumes had infected the adjacent Country[h]; As also that mentioned by _Ammianus_ _Marcellinus_, which broke out in _Seleucia_, and over-ran a great Part of _Greece_, _Italy_, and _Parthia_, and took its Rise from the opening of an old Vault in the Temple of _Apollo_.

[h] _Diog. Laert._ in Vit. Emped.

To the Third belong, such as are occasioned by the Parts of Vegetables and Animals, especially those of Men, putrifying in the open Air. As was that mention'd by _Livy_, which over-ran a great Part of _Italy_, and owed its Rise to the dead Bodies of the _Romans_ and _Fidenates_ left unburied in the Field of Battle[i]. Analogous to this was that which from the same Cause appeared in _Germany_, _Anno 1630_; And likewise that mentioned by _Ambrose Parree_ from the same Cause; as also that mentioned by _Diodorus Siculus_, occasioned by great Quantities of Locusts driven by Winds into the Sea, and thence cast up in Heaps on the Shore. To this likewise must be reduced those Malignant and Pestilential Fevers, which so frequently attend Camps and Seiges, especially in the hot Eastern Countries, whose numerous Armies frequently feel the dismal Effects of these stinking Fumes: As do likewise the vast Caravans of the _Mahometans_ in their Annual Pilgrimages to _Mecca_.

[i] _Tit. Livii_ Hist. _Roman._

To the last belong those Pestilential Fevers, which take their Rise from a preceeding Famine, as was that in _Judea_ in the time of _Herod_[k], in which the Product of the Ground being consumed by the great Heat, and long Drought of the preceeding Summer, the poorest sort of People were obliged, thro' the Scarcity of Provisions, to make use of such Food as afforded unwholesome and putrifying Juices.

[k] _Joseph_. Antiq. _Judæor_. lib. 15. cap. 12.

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CHAP. III.

The Changes wrought in the Animal Oeconomy from the above-mention'd Causes, may be reduced to such as depend either on the Increased Heat of the Air join'd with its Humidity; Or to such as are produced from the particular Qualities of the putrid and Contagious Particles floating in it; Or to the united and complicated Effects of all together.

[Sidenote: _Effects of a hot and moist Air._]

The Alterations produced in the Body from a greater Heat continually surrounding it, provided it be not Excessive, are a Rarefaction of the Juices, and Relaxation of the _Fibres_ on the Surface of the Body, and greater Derivation of the Fluids that way. Whence proceeds a large Evacuation of the perspirable Matter. This being continued in a greater Proportion than in a Natural State, will gradually deprive the Blood of its Aqueous and Spirituous Parts, and leave the remaining serous Part more stock'd with acrid and pungent Salts, and the Gross, Terrestrious, Oleaginous, and Viscous Particles more firmly united by their nearer Approach, and stronger Cohesion to each other. This greater Heat or Quantity of Fiery Particles, continually surrounding the Body, will necessarily insinuate it self into, and unite with the Saline, Sulphureous, and other Particles, in the same manner as we see it does with other Substances, both Solid and Liquid[l]; And likewise by increasing the Velocity of the Circulation and Attrition of the Particles against each other, render them on these Accounts also more Volatile, Pungent and Stimulating, and consequently the Blood will consist of Particles more gross and inspissated or coagulated, and likewise of those of a more acrid and pungent Disposition than in a natural State.

[l] _Boyl_'s Experm. Nov. de Pond, Ignis & Flam. _Newtoni_ Optic. Quæst. 21 & 22.

The Blood being in this depraved Condition, the rest of the Animal Juices must degenerate in Proportion thereto, and the Nervous Fluid, as it consists of the most volatil and subtil Parts, be extreamly acrid and pungent, as well as unequal in its Texture and Fluidity, from the more viscous Parts contain'd in it.

[Sidenote: _Putrid Fevers how produced._]

This then being the State of the Blood and other juices of the Body, it is easy to perceive how from very Slight, and otherwise trivial Occasions, a Fever of a very Malignant Nature may be produced. Thus the perspirable Matter from a slight Cold taken being retained, or the Vessels any otherwise filled by Irregularities in Diet, or others of the Non-naturals, the Weight of the moving Fluid will be increased, and the Circulation be more languid and slow. Whence the intestine Motion of the Particles of the Blood being diminished, the viscous Parts will cohere more strongly and in greater Quantities than before, and obstruct the Capillary Arteries, especially in the Extremities, and a Coldness, Stretching, Yawning, Torpor, _&c._ necessarily succeed, the constant Attendants of a beginning Fever; All which will bear a Proportion to the Quantity retain'd, and the Viscosity of the moving Fluid.

These Disorders will necessarily be increased on account of the Air's Spring being weakned by its Heat, the Vessels of the Lungs being less inflated, and the Globules of the Blood less broken and divided, and the more especially in a humid Air, Heat and Moisture necessarily relaxing the Tone of the Fibres and Vessels, and rendring them less Springy and Elastic. Hence then the Quantity of Spirits being diminish'd, and their Motion more slow, the Contraction of the Heart and other Muscles will be more weak and languid, and being stimulated by the Acrimony of the Circulating Liquors, must contract more frequently than in a Natural State; The Consequence of which is Weakness, Faintness, Thirst, and Dejection of Spirits.

These and the preceeding Symptoms will necessarily continue, 'til such time as the gross and viscous Matter, being shook and loosen'd by the Action of the Capillary Vessels, is washed away into the Veins by the force of the Circulating Fluids, and there continues its Course with the rest, 'til it be either attenuated and secreted, or lodged again in the Capillaries to excite new Disorders.

[Sidenote: _Malignant Fevers._]

Now if to this evil Disposition of the Air be added a number of pungent stimulating Particles, whether bred in the Body or floating in the Air, and thereby communicated to the Blood, which are apt to coagulate the Animal Juices, so as to form _Moleculæ_ of such Shapes and Sizes as more firmly obstruct the Capillary Vessels, and at the same time stimulate and corrode the nervous Parts; It will necessarily happen, that the preceeding Symptoms must be highly exasperated, and a Fever of a much worse Nature produc'd.

Hence then must follow a violent Hurry and Colluctation of the Fluids, the Viscid and coagulated Parts of the Blood in some Parts obstructing the Circulation of the Juices, and the Acrid, Volatil, and Fiery Parts, rarefying and dissolving others of the more Liquid, to the greatest degree of Pungency and Volatility imaginable.

Hence it is easy to perceive how the Motion of the Blood must necessarily be in some Parts more languid, by the Cohesion of the more Viscous parts, in others quicker, join'd with a pungent and stimulating heat, from the increased Velocity and Acrimony of the moving Fluid, and the various Actions of the Particles upon each other, and their Impulses on the containing Vessels; As also how these are capable of almost infinite Variations, in Proportion to the different Quantities and Qualities of the constituent Particles. Hence then appears the Reason of that wandering and uncertain Heat and Coldness, in different Parts of the Body at the same time. Hence appears the Reason of that great Inquietude and Anxiety, of those uncertain and partial Sweats, Watchings, Tremors, stretching Pains of the head, and the like, as will be more fully shown hereafter.

But before I proceed to explain the Nature of a Fever truly Pestilential, it will be necessary to observe, that notwithstanding the foremention'd putrid Disposition be generally a Prelude to a Pestilential Constitution of the Air, yet it has never that I know of been observ'd, that these Causes alone at their first Onset, produced a real Plague or Pestilential Contagion, without the Concurrence of some preceeding Infection, either brought from abroad, or gradually augmented from the increased Putrifaction of the Air, and Poisonous Steams of Morbid Bodies.

Thus the putrid Air of Camps in hot Countries is frequently found to produce Pestilential Fevers, but this never happens at their first Onset; The Diseases first appearing being Fluxes, Putrid, and afterwards Malignant Fevers; which being exasperated and propagated by the Virulent Effluvia of Diseased Bodies, and the increased Putrifaction of the Air, grow up gradually to those of a Pestilential, and exceedingly infectious Disposition.

[Sidenote: _Of Putrifaction & Fermentation._]

Now Putrifaction being only a kind of Fermentation, wherein the Particles of a putrifying Body are put into an intestine Motion, and by their Action and Attrition broken and divided, and since all fermenting Substances do emit vast Quantities of small separable Parts, it will necessarily follow, that the most subtil and active Particles of the Purifying Body will be elevated into the Air, and float in it.

[Sidenote: _Effluvia from putrified Bodies what._]

These Effluvia consist of the finest and most volatil saline and oleaginous Particles, highly attenuated and set at Liberty from the gross Oil and Terrestrious Part, as appears from the Distillation of such Substances, all which afford great Quantities of a pungent and volatil Salt. It is likewise observable, that the subtil Oleaginous Particles being specifically lighter, as well as more easily attenuated and divided than those of a Saline Nature, will be thrown off in greater Proportion in the beginning of the Fermentation or Putrifaction than the heavier Salts will be, which must either be more attenuated and volatilised, or require a greater force to raise them into, and sustain them in the Air than the former, and consequently the greatest Emission of these saline Particles will be after the Fermentation has been for some time continued; As we find it happens in all fermenting Liquors, as Wine, Beer, Cyder, and the like. All which emit, during the Fermentation, greater Quantities of Particles of an active attenuated Oil or Spirit for some time, than of a Saline Nature, which requiring a longer time in order to attenuate them, are not raised till the former are in a manner quite exhaled, as appears from collecting the Steams of fermenting Liquors, and of those which are turn'd sower by Distillation, and consequently the Exhalations arising from putrifying Bodies will after some time consist mostly of Saline Particles highly attenuated and volatilised, and those not wrapt up and sheathed in the Oily ones, and thereby render'd innocuous, and often useful to the Body, but naked and exceedingly acrid and poignant.

How unfit an Air stock'd with these kind of Particles is for Respiration, appears from several of Mr. _Boyl_'s Experiments on Animals, shut up with putrified Air in the Receiver, most of which with incredible Inquietude die sooner than in _Vacuo_, as also from the pernicious Effects of the Steams of Vaults, Mines, the _Grotto de Cane_, and such like. But besides this Inaptitude of such Air to expand the Pulmonary Vessels, these minute and pungent Particles may be considered as so many _Stimuli_ or Lancets, acting upon and penetrating the Coats of the Stomach, Lungs, and other Vessels. On which Account they are not only capable of creating great Disordes, as Inflamation, Pain, Sickness, Anxiety, Vomiting, _&c._ in the Stomach and Nervous Parts; But likewise being carried immediately into the Blood, will there stimulate the ultimate Vessels, ferment, dissolve, or coagulate the circulating Juices according to the particular Qualities and Quantity of the Contagious Particles. Nor is it unlikely, that from the various Action of the Particles upon each other, and their different Combinations in a stagnating Air, Particles may be formed of Qualities vastly differing from, and in their Force almost infinitely exceeding those of their Primogenial Salts and first Principles, as in Sublimate, some Preparations of Antimony, _&c._ Instances of which those versed in Chymistry are no Strangers to.

[Sidenote: _Infectious Particles how produced._]