Chapter IV: Part II (2)

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

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

CHAP. III.

_Of the Cure of the Plague._

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

_FINIS._

Footnotes:

[1] See the Dedication.

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

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

[4] Ibid. _p._ 113.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

[20] L. 6. v. 1234.

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

Et v. 1241.

Qui fuerant autem praesto, Contagibus ibant.

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

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

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

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

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

[26] Ibid. p. 118.

[27] Ibid. p. 117.

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

[29] The Sweating Sickness.

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

[31] Histor. l. ii.

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

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

[34] Vid. Hodges De Peste.

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

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

[37] Villani, loco citato.

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

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

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

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

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

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

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

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

[46] Lib. vi. v 1100.

[47] Rhas. et Avicen.

[48] Essay on Poysons, p. 178.

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

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

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

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

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

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

[55] Toulon, Traite de la Peste.

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

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

[58] Notitia Eccles. Diniensis.

[59] Histor. lib. lxii.

[60] Sydenham De Peste.

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

[62] Pag. 162. Edit. Lovan.

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

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

[65] Thuani Histor. lib. 5.

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

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

[68] Boccaccio Decameron. Giornat. prim.

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

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

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

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

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

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

[75] Hodges, De Peste.

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

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

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

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

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

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

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

[83] De Pestilent. cap. 21.

[84] Camden. Annal. Regin. Elizab.

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

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

[87] De Peste, c. 22.

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

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

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

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

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

[93] Notitia Ecclesiae Diniensis.

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

Transcriber's Notes:

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

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

Long "s" has been modernized.

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

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

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

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