PART FIRST. (continued 6)

The disappearance of the disease, while all the causes that we suppose capable of producing it remain in full force, is a demonstration that it depends on something entirely distinct from the human body, and from all those powers which perceptibly act upon it. It proves that this unknown power has only a temporary existence, coming to perfection at one season, and dying away in another; sometimes capable of being revived, and sometimes not. This corresponds entirely with what has been laid down concerning contagion itself, viz. that like other aerial vapours it is capable of decomposition, and remaining for an uncertain length of time in a dormant state; but that occasionally it may revive, and appear unexpectedly, as mofetes arise from lavas, or damps in mines. After a city has been thoroughly infected with a pestilential disorder, therefore, there can be no security against its re-appearance; it being impossible to know whether the contagion may not be still existing and capable of being revived by some unknown cause, though it has been dormant ever so long. In such cases it may with propriety be said to have arisen spontaneously, though, had it not been there at a former period, there could be no reason to think that it would have appeared at that time.

Dr. Russel next takes into consideration the plague at Marseilles in 1720, of which he says the accounts “are more full, and circumstances better authenticated, than most of the accounts of anterior plagues to be met with in books.” From the opposition to the doctrine of contagion at the time, he also supposes that the facts relative to its introduction would be severely scrutinized, and falsehoods detected: “but (says he) if, instead of such detection, the most material have been passed over in silence, and little more than hypothetical reasoning opposed to others, the main facts may be considered as established, if possible, more firmly than they were before.” These facts are stated as follows: “1. That the plague did not exist in France before the 25th of May, 1720. 2. That it was imported in goods from the Levant, by a ship which left the coast of Syria the beginning of February, and arrived at Marseilles the 25th of May. Two days after her arrival one of the sailors died; an officer of quarantine who had been put on board died on the 12th of June, and a cabin boy on the 23d. Some porters employed in opening the merchandise at the lazaretto also died about this time. Three others were taken ill in the beginning of July, with buboes in the groin and axilla. This alarmed the surgeon of the lazaretto; a consultation was held with two other surgeons on the 28th; the disease was unanimously declared to be the plague, and the three patients died next day: the surgeon of the lazaretto, with part of his family, and the priest who attended the sick, were also taken ill and died.”

From the lazaretto the disease made its way into the city, and began to appear about the 20th of June. By what means it was introduced is not directly said; but it seems to have been by smuggling infected goods. In the beginning of July it began to spread; but a kind of pause having taken place between the 12th and 23d, the physicians were reproached with having mistaken the distemper. During this supposed interval, however, it was discovered on the 18th of July that the disease had spread in a certain part of the city. A surgeon, employed to examine into the matter, declared the distemper to be the worm-fever; and about the 23d the council of health were informed of the death of fourteen persons in that quarter, and of several others falling sick. The surgeon still adhered to his opinion, but a physician declared it to be the true plague. About the end of the month it had got into the suburbs; four physicians declared it to be the true plague, but their report was not believed; they were insulted in the streets, and it was not until some of the inhabitants of better rank were taken ill, that the true state of the matter gained credit.

“Such (says Dr. Russel) was the rise of the plague at first, and its progress afterwards in the months of June and July; whence it appears, that persons on board the suspected ship, those employed in airing the goods, a surgeon and a priest, who attended the sick, were among the first infected; that the passengers from the several ships, all of which ships, the first excepted, brought foul patents, were, together with their baggage, admitted into the city, after preforming a quarentine of little more than eighteen days; that the distemper from the 20th of June till towards the end of July advanced very slowly, and sometimes seemed to pause; that it attacked chiefly the poorer sort of people, and was found in distinct quarters of the city; and lastly, that, during the first forty days, few or none of the infected recovered; a circumstance entirely consonant to what was observed in the beginning of the plague at Aleppo.”

Three other facts are mentioned by our author, viz. that the disease was evidently communicated by infection; that those who were careful to seclude themselves from all communication with the sick and with infected goods, were not infected; and lastly, that the disease, which began to rage violently in August, continued to do so through that and the following month, but declined fast in the months of October and November, and seemed to cease in the middle of winter. Some accidents happened in 1721, between the months of February and July, which gave occasional alarm; but the distemper did not spread, and ceased entirely after the summer solstice of that year.

To all this, however, objections have been made. 1. That the irregular seasons of the former year, a bad crop, and unwholesome aliment, had produced a malignant epidemic, all which, joined to the popular dread of contagion, were sufficient to produce the plague without any imported infection. To this Dr. Russel replies, that these positions, assumed as facts, had no existence; for which he refers to the publications of the times. 2. It was objected that there were instances of the plague in Marseilles before the 25th of May. These instances are only five in number, produced by M. Deidier, “who saw not the cases himself, yet (says Dr. Russel) from the very imperfect accounts he had been able to glean, he thought himself justified in declaring they bore all the marks of the true plague. Nothing (adds the Doctor) but extreme partiality to an hypothesis could have led any one practised in the plague, into such a declaration; the cases bearing every internal mark of belonging to a different class from the plague. I shall endeavour to show this in a few words.

“Of the five supposed infected patients, three recovered, two died, and all had eruptions. One who died had a parotis (the most ambiguous of all pestilential tumours) without any concurrence, so far as appears, of pestilential symptoms. The tumour had appeared six days before the woman’s death, but how long she had been sick remains unknown. The other died the 16th or 17th day, a very unusual period in the plague. She also had a parotis, which did not make its appearance till the 10th or 11th day of the disease. No pestilential symptoms whatever are mentioned. Of the three who recovered, one was very ill with a fever and carbuncle; but neither the invasion nor the duration of the disease are mentioned. Another had a carbuncle and a small tumour on the thigh; and the third (which bears the nearest resemblance to a very slight infection) had also a bubo in the thigh; but the tumours in neither of these patients are described in such a manner as distinguishes them from ordinary tumours; and the apothecary, who gives the account from memory, had in all likelihood never seen a pestilential bubo before.”

“Of the persons infected for some time after the arrival of the ships from the Levant, none had eruptions, and all perished after a few days illness; which agrees entirely with what was observed at Aleppo in the beginning of the plague: hardly any of the sick recovered, and the major part died in three or four days, without any appearance of buboes. Upon the whole, therefore, I think it very clearly established, that the plague did not exist in France before the month of May, 1720. Prior to M. Deidier, however, I find a M. Pons had endeavoured to prove that the plague was in Marseilles, not only before the month of May 1720, but even in the preceding year. I have not had an opportunity of examining that gentleman’s book.”

3. It is objected that the disease was not brought from the Levant by infected goods. “Captain Chataud’s vessel, supposed to have brought the infected goods, arrived with a clean patent, or bill of health, having left the coast of Syria before the plague broke out there; she consequently cannot reasonably be thought to have transported the plague, which was not in the ports from whence she came.”

To this Dr. Russel answers, that on commercial accounts the Turks carefully conceal the appearance of the plague from the Europeans. Should reports of accidents get abroad, they are variously and contradictorily represented, and pestilential marks and tumours fraudulently concealed. Though Chataud obtained a clean patent, the plague broke out soon after his departure, and three vessels with foul patents arrived at Marseilles a few days after Chataud. “To this (says Dr. Russel) it may be further added, that, notwithstanding his clean patent, persons acquainted with the Levant will think it far from improbable, that the plague might actually have been in Sidon when he sailed, though unknown to the magistrate, by whom the patents are granted. . . . A clean bill of health imports that the place has been free from plague, and all suspicion of plague, for a certain space of time; but the clean patents of the two first arriving from the Levant, after the cessation of the plague, are, according to Mr. Howard, deemed foul at Marseilles, and the passengers are obliged to perform a quarantine of thirty-one days. The French consuls lying under an obligation to insert in their patents a detail of circumstances, it must appear strange, when the condition of Syria at that time is considered, how Captain Chataud should have obtained a clean patent.”

Though this must certainly be deemed a sufficient answer to the objection, Dr. Russel goes on to give an account of what had happened the preceding year, when the plague had raged violently at Aleppo; and shows that, from the condition of the whole coast of Syria, a return of the plague was certainly to be expected; that the French consuls could not be ignorant of this, neither could the council of health at Marseilles be unacquainted with what had happened at Aleppo the preceding year. “The facility with which the patents seem to have been issued in Turky, and the partial indulgence of the council to Chataud’s ship, notwithstanding the very extraordinary mortality which had avowedly happened on the voyage, together with their easy confidence afterwards in the reports of the surgeon of the lazaretto, can only be accounted for from the prevailing influence of private commercial interest over a sense of official duty.”

Our author next proceeds to take notice of what happened during this ship’s voyage to Marseilles. On the 31st of January he left the coast of Syria with a clean patent, before the plague broke out. On the 25th of May he arrived at Marseilles, from Sidon, Tripoli and Cyprus. On the voyage, or at Leghorn, he lost six of the crew; but, by the certificates of the physicians of health at Leghorn, these died only of malignant fevers caused by unwholesome provisions. These last words in the Traite de la Peste are said to have been interpolated at Marseilles. At any rate, as Dr. Russel observes, they could relate only to those who died at Leghorn, not to the others, whom the physicians had not seen.

The other account is much less favourable. According to it, Chataud “left Sidon the 31st of January with a clean patent. The plague discovered itself there a few days after his departure. Having sustained some damage by bad weather, he put into Tripoli, where he embarked some merchandise; he took in also some Turks, passengers for Cyprus, together with their luggage. Soon after the ship had left Tripoli, one of these passengers fell sick and died. Two of the sailors employed to throw the corpse overboard desisted at the desire of the pilot, and the rest of the ceremony was performed by the other Mahommedan passengers; the ropes with which the body was lowered down, being by way of precaution thrown into the sea. Within a few days the two sailors who had handled the corpse were taken sick and died. At Cyprus the ship put her remaining passengers on shore, and made a very short stay. Soon after her departure from that island, a third sailor and the surgeon died of an illness of a few days duration. The captain, justly alarmed by these accidents, ordered the bedding and other things used by the deceased to be thrown into the sea; and kept himself carefully separate from the crew during the remainder of his voyage. Some time after this three more sailors fell sick, and, there being no surgeon on board, the vessel put into Leghorn, where the three sick men died, and the physician and surgeon of the lazaretto declared the disease to be a malignant pestilential fever.”

Our author considers the above account as a full proof of the plague being imported by Chataud’s vessel: he declines entering into the question about the possibility of importing contagion in merchandise. How this might take place has already been explained; and the present instance of its having been imported is as clearly proved as can be expected. A collateral proof, with regard to the contagion of the small-pox, we have from Dr. Huxham. A beggar, ill of that disease, approached a certain town in England, but was not suffered to enter, for fear of infection. The beggar died, and the infected clothes were burnt at some distance from the town; but the smoke being blown upon it by the wind, the small-pox in a short time made its appearance, beginning in that part upon which the smoke was blown. This clearly proves that one species of contagion may adhere to clothes, and is a very strong presumption that any other may do the same. It also shows that contagion, when once produced, is by no means easily destroyed; and consequently that all kinds of purification, even when used with the utmost care and diligence, are scarce sufficient to ensure safety.

It would now be superfluous to enter farther into the subject of the plague being communicated by infected goods, did not our author quote a work of Dr. Pye of London, in which the latter from the very Journal (which has been used as containing arguments in favour of contagion) makes inferences directly opposite. “The facts related in this journal (says Dr. Pye) seemed to me to make so clearly against the modern doctrine of contagion, that if this writer had not mentioned them as undeniable instances in his favour, I should not have thought there had been any persons here in England so dull of understanding, or so much blinded with prejudice, as to stand in need of having these facts put into a more obvious light: but, having this occasion, I shall consider them more largely than otherwise I would have done, and show that the porters, who died in the lazaretto at Marseilles, received no hurt or infection from the goods.

“To leave no room for objection, I shall take notice, that a guard of quarantine died on board Chataud’s ship the 12th of June; but, as this officer was no ways concerned either in unloading or opening the goods, he could receive no hurt from them; and besides, this must have been fourteen or fifteen days after the goods had been carried out of the ship into the lazaretto. Further, six of their men are said to die at Leghorn; but the town of Leghorn was not infected from thence, which would have been more likely if there had been any infection in the case, than that Marseilles should be afterwards infected.

“If any infection or infectious aura can be supposed to be packed up, and brought in goods, such infection or infectious aura must necessarily issue forth from them in greatest abundance, and with the greatest force, at the first opening or unpacking of them; and, as it must continue to fly off every moment, and be thereby continually diminishing, it is likewise certain, that in a very few days the goods must be in a great measure, if not entirely, cleared of it. Wherefore, if the porters could have been infected from the goods at all, it must have been at the first opening of them: but, even according to this journal, the porters that first fell sick were not taken ill before the 23d of June, whereas Chataud’s ship arrived the 25th of May preceding; so that the goods of that ship, in purifying which the porter first mentioned was employed, had been airing and purifying for twenty-six or twenty-eight days before this accident happened; and it cannot be conceived that after so long a time they should not have been entirely purged of all infection or infectious aura, if any could have been brought with them. Or if it can be supposed, which I think impossible, that any part might still be left, it must withal be supposed so much less than at first, as not to be capable of doing, those porters especially, the least hurt: to suppose otherwise would be to argue that the same man who some days before had received and borne a very great quantity and force without any injury, could then be killed by a quantity and force infinitely less.

According to the report of merchants, Frenchmen are not subject to the plague in Turky; and it cannot be conceived that so small a quantity of infectious air as can be packed up and brought in a bale of goods, should destroy them in France, or in an air and climate distant and different; when the whole atmosphere of the same infectious air is found not to injure them in very infected places, and wherein it is allowed to be bred and generated.”

Thus far Dr Pye.—Let us now hear Dr. Russel in answer.

“The death of the quarantine officer was mentioned in order to leave no room for objection; but still it may be objected that he has omitted the death of the sailor on the 27th of May, and asserted, in contradiction to the journal, that the former six sailors died at Leghorn. That Leghorn was more likely to be infected than Marseilles, is a strange notion. The ship had landed no goods there, nor had any intercourse with the shore; for the physician who visits the sick on board, remains at a distance from the ship, in a boat, and the dead bodies are sunk in the sea. As to the circumstance of the goods of Chataud’s vessel being all in the lazaretto before the 12th of June, it is a supposition to be attributed to Dr. Pye’s unacquaintance with matters of that kind; for it is impossible a ship which arrived the 25th of May should discharge the whole of her cargo in two or three days. The dispatch would have been miraculous, considering the ship lay near two leagues from the lazaretto, and was unloaded, and the boats navigated, by her own crew. It did not occur to Dr. Pye, that some time, previous to the vessels beginning to unload, is taken up in examination and other forms at Pomegue, and the council of health. The loss of six men on the voyage was an extraordinary circumstance, that required deliberation; and it appears that on the 29th, after the death of the sailor on board Chataud’s vessel, the council determined the quarantine of his cargo to be forty days, commencing from the landing of the last bale; which was double the time usually allowed for a ship with a clean patent. It is very probable, therefore, that the ship did not begin to unload till after the 29th of May, and possibly had not finished when the quarantine officer died, the 12th of June, who must have been taken ill two or three days before.

“In regard to the time requisite for the complete evaporation of the infectious aura, in what proportionate gradation its activity is impaired by ventilation, and the specific quantity required to produce effect on the human body, they are matters which I apprehend will not readily be admitted to be clearly and certainly known. That the first porters were not taken ill before the 23d of June, is very true; but that the goods had been airing and purifying for twenty-six or twenty-eight days, has been shown above to be an error. The Doctor also makes two other suppositions equally erroneous. The first, that the whole of the cotton contained in a number of bales is equally imbued with infectious aura; the second, that all the bales of a ship’s cargo are opened nearly about the same time. But, as the cotton contained in these bales may not only have been collected from different villages at different times, but packed up under various circumstances relative to the materials used for embalage, and the persons employed in embaling or steeving them; it may easily be conceived how the cargo of a ship, coming even from a place where the plague actually rages, may be only partially infected, or not infected at all. The warmest advocate for contagion never contended for every bale of a ship’s cargo being equally infectious. As to the airing of the bales, it is a laborious and a tedious process. Where there is a considerable number, it takes up several days to open and arrange them, goods of different kinds must be disposed separately, accounts taken, and the cordage, &c. laid up with care where it may be found again. The laborious part of these operations is performed by the porters, who also transport the goods from the water side to the enclosure where they are to be aired: and, as the days of quarantine do not begin to be reckoned till all the goods are landed, the porters for some days at the beginning are sufficiently employed in receiving and arranging the cargo, that being the business requiring the first dispatch. When these circumstances are considered, it will appear no extravagant supposition, that some of the last opened bales of Chataud’s cargo might still retain enough of infectious aura to infect the porter on the 23d of June. To set this retardment, almost unavoidable in the opening of bales, in a still clearer light, it should be observed, that, by the regulations at Marseilles, all suspected goods are subject to what is termed sereines; that is, a certain number of bales are taken out of the hold, and, being opened at both ends, are exposed to the air for two, three, or six days, by way of trial, in order to see if any signs of infection should appear among those employed in handling the merchandise. When these have been aired, more or less, according to circumstances, another parcel is opened and exposed to ventilation in like manner: so that, according to the burden of the ship, there may be several of these sereines, each of several days duration. In this manner, independent of accidental impediments from wind and weather, in sending the goods from the ship, it maybe supposed, were it at all necessary to make the supposition, that the porters, not only on the 23d of June, but on the 7th and 8th of July, were infected upon opening some new bales. As to the porter being infected by goods from another ship, Dr. Pye thinks it impossible, because the ship had been twelve days in port, and the goods must have been eight or nine days in airing and purifying: had he been acquainted with the practice of the sereines in quarantine, he would have been at no loss to make the accident agree exactly with his notion of the infectious aura. . . . The plain matter of fact, as it stands in the journal, is this, that six porters, employed in purifying suspected merchandise from the Levant, died of the plague; and their death was followed by that of the surgeon who attended them, and part of his family.”

From this the reader will be able to judge how far the question is decided in favour of the fact that the plague at Marseilles was actually produced by imported contagion. It seems needless to follow our author through his investigation of those facts which his adversaries have misrepresented; for these must of course be in his favour; every misrepresentation by a disputant being plainly an abandonment of his cause. Indeed the argument against contagion at that time was properly but one, and is set forth in no stronger language now than formerly. Even as long ago as 1665 Dr. Russel quotes one Gadbury an astrologer stating the difficulty as strongly, and giving a solution of it as clearly, upon his principles, as the best modern theorists can do upon theirs. “If the pestilence, (says Mr. Gadbury) be infectious, and really catching in itself, it must be so equally to all persons that approach it, or that it approacheth; or else it must be infectious to some particular persons only. If it be infectious to all persons, or catching to all alike, then all persons, that come into the sight or within the scent of it, must necessarily be subject unto it. If not infectious unto all, but unto some particular persons only, I say then it ought not to be deemed or esteemed infectious at all, at least not any more infectious than are all other diseases, viz. small-pox, scurvy, pleurisy, ague, gout, &c. since (though the notion of infection be laid aside) there is not a person born into the world that hath not at some time of his life (as his nativity shall truly show) some one disease or other. Never was any person subject to violent diseases, as plague, &c. but had a violent nativity to show it, and e contra.”

The answer to this has been already given.—Let any other cause than contagion or infection be supposed, and the difficulty remains equally great. The probability is in favour of contagion, rather than a general disposition of the atmosphere, because in the latter case the disease would, contrary to experience, begin in a great many places at once; but the plague begins in such a secret manner that we scarce know whence it comes. Like fire, or a ferment in liquors, it diffuses itself far and wide, and lastly, like an immense inundation, the source of which is dried up, it seems to lose its power by extending too far, and dies away altogether. We cannot penetrate into the causes of those things, but, without any speculation at all, we can observe that the disease falls upon people of a certain constitution more than others, and this may be of use in preserving ourselves from it, as shall be explained in the next section.

It is still necessary to say something of the infection spreading from one person to another, and being kept off by refraining from communication with the diseased. This indeed naturally follows from its proceeding originally from the cotton: for as all the infected did not touch this cotton, there can be no other cause assigned from its spreading than by communication from one to another; and, therefore, if such communication was cut off, we should naturally think that the disease would not spread. But, in opposition to this, we have already quoted Dr. Moseley giving a long list of convents infected, though they kept themselves strictly shut up. Dr. Russel cites, in favour of prevention by shutting up, two certificates, one by the bishop of Marseilles, the other by the sheriff of the same place. To these he adds the testimony of M. Langeron, who was actively employed throughout the whole time that the plague continued, first as a commodore of the gallies, and afterwards as governor of the town and its dependencies. In opposition to these, however, he takes notice of two passages “in books of acknowledged authority,” which he is at pains to answer; the one is from the Journal already quoted, which says, “and what is unaccountable, those who have shut themselves up most securely in their own houses, and are the most careful to take in nothing without the most exact precautions, are attacked there by the plague, which creeps in no one knows how.” The other passage is taken from the Relation Historique, “that, in the height of the pestilence, the infection penetrated into places which had till then remained inaccessible; that monasteries and houses shut up in the most exact manner were no longer places of security.”

To the former of these our author answers, that “from the manner of stating the case, one would think that all these religious had been close shut up, without any communication with persons without doors; and this was certainly intended by an author who has made remarks upon it; but it will be found, upon looking into the beginning of the very paragraph cited, that the greatest part of them are represented as martyrs who had meritoriously exposed themselves. Of the twelve different orders mentioned on this occasion, the Grand Augustines only are said to have kept in their convent. But, supposing the Augustin convent to have been actually shut up, and in that state infected; it would by no means invalidate the instances brought of the preservation of the convents, the certificates concerning which were granted deliberately, after all was over; whereas the journal, written from day to day, marking circumstances rapidly as they occurred, the author, amongst various other affairs, had not always leisure or opportunity to examine minutely into circumstances. It is in this light I am inclined to consider the houses being infected which took in nothing without the most exact precautions; and the rather, because I met with several instances of the like kind at Aleppo, in the houses of the Christian and Jewish nations: but in the sequel it generally appeared there had been some improper communication carried on by the domestics, unknown to the family at the time.”

“That the atmosphere, in a city so dreadfully circumstanced as Marseilles, may become so highly tainted as to convey the plague into houses shut up, cannot confidently be affirmed to be impossible, by those who hold mediate contagion; and the concurrence of circumstances at that period in Marseilles, renders it highly probable that such accidents happened. But, in general, the pestiferous effluvia once emitted into the air, do not appear to operate at any great distance from their source; and M. Deidier asserts, that two monasteries (from their situation, one near a burial ground, the other near a pest-house) very dangerously situated, remained nevertheless untouched, which he thinks an argument against infection being conveyed by the air.”

From this long and contested account of the manner in which the plague was received into Marseilles, we see how very difficult it must be to come at a true state of facts, when a number of people think it their interest to misrepresent or conceal them. The limits of this treatise will not allow us to follow our author through the numerous details of misrepresentations and unfair methods which the adversaries of the doctrine of contagion have made use of to establish their opinion: neither shall we enter into any discussion concerning the origin of other plagues, as we should in them find the same opposite kinds of evidence without such documents for distinguishing the true from the false as Dr. Russel has produced in the case of Marseilles. A single fact only, mentioned by Mr. Howard in his Treatise on Lazarettos, shall be related, and which, if allowed to be fact, decides the question as effectually as a thousand.

“When the plague raged at London in 1665, it was conveyed to the remote village of Eyam near Tideswell in Derbyshire. In this place it broke out in September 1665, and continued its ravages upwards of a year, when two hundred and fifty of the inhabitants had died of it. The worthy rector, Mr. Mompesson, whose name may rank with those of Cardinal Borromeo of Milan, and the good bishop of Marseilles, at its breaking out, resolved not to quit his parishioners, but used every argument with his wife to quit the infected spot. She, however, refused to forsake her husband, and is supposed to have died of the plague. They sent away their children. Mr. Mompesson constantly employed himself, during the dreadful visitation, in his pastoral office, and preached to his flock in a field, where nature had formed a sort of alcove in a rock, which place still retains the appellation of a church. He survived, and the entries in the parish register relative to this calamity are in his own hand writing, viz.

In 1665, Sept. Died 6 1666, May Died 5

Oct. 22 June 20

Nov. 5 July 53

Dec. 7 Aug. 78

1666 Jan. 3 Sept. 14

Feb. 5 Oct. 17

March 2 Nov. 1

April 12

This plague is said to have arisen from a box of clothes sent from London while the distemper was at its height in that city. But whether this be admitted or not, it cannot well be supposed that in a small village there could either be a peculiar constitution of the air, collections of filth, immoderate heat, cold, or in short any general cause from which a plague could be supposed to arise, that would not have affected the country for a great way round. How then came this insulated spot to be so violently affected, except by contagion? No matter whether by clothes or any thing else. The very particular manner in which the numbers who died are recorded, leaves no doubt as to the fact of the distemper having been there; neither is it possible to account for its rise on any other principle than contagion.

Mr. Howard, previous to his going abroad, had been furnished, by Dr. Aikin and Dr. Jebb, with a set of queries relative to the plague, to be put to the physicians in the different countries through which he travelled. This commission he executed with great fidelity and exactness. The physicians to whom he proposed them were, Raymond of Marseilles, physician; Demollins of do. surgeon; Giovanelli, physician to the lazaretto at Leghorn; They, to do. at Malta; Morandi, physician at Venice; Verdoni, at Trieste; Jew physician at Smyrna; Fra. Luigi di Pavia, prior to the hospital of San Antonio at Smyrna. The questions proposed were as follow:

1. Is the infection of the plague frequently received by the French?

Though this was not asking in direct terms whether the plague is infectious or not, all to whom it was proposed seem to have viewed it in this light, Raymond of Marseilles only excepted, who answered directly, “Sometimes it is.” All the rest, except Giovanelli, agreed that it might be communicated by the touch, or by the breath. Verdoni gave an instance of its being communicated by a flower which three persons smelt at; two remained free, but the third sickened and died in twenty-four hours.

2. Does the plague ever rise spontaneously?

In this Verdoni alone answered positively in favour of the spontaneous rise of the plague. They spoke ambiguously.

3. To what distance is the air infected? How far does actual contact, wearing infected clothes, or touching other things, produce the disease?

To this question Verdoni answered in a manner seemingly inconsistent with his former answer; allowing not only that the plague was infectious, but that infected things might communicate the disease after an interval of many years. All agreed that the strength of the infection was greater or less according to circumstances; the distance at which it could act was likewise uncertain. Raymond said that the sick might be safely conversed with, across a barrier, at a few paces distance; the Jew said at two ells distance, provided the chamber windows be not all shut. Giovanelli said it had been proved that the infection did not extend beyond five geometrical paces. The touch of infected clothes, or drawing in the breath of the sick, was looked upon by him and Fra. Luigi to be very dangerous.

4. What are the seasons in which the plague chiefly appears; and what is the interval between the infection and the disease?

To this it was answered by Raymond, that the two solstices are the times in which it has least power. The others agreed that hot and moist weather was favourable to its ravages; the spring, summer and first month of autumn are dreaded. These circumstances, however, must be variable in different countries. As to the time in which the infection shows itself, the answer was various. According to They, it “sometimes acts slowly, sometimes like a stroke of lightning.” According to Verdoni, “the disease generally shows itself at the instant of touch, like an electrical shock.” Sometimes the infection will be communicated from a sick person to a sound one, who without any disease may communicate it to a second, and that second to a third, in whom alone it would become active.

The other questions, relative to the symptoms, prevention and cure of the distemper, will be taken notice of in the course of the treatise. In the mean time having discussed, with a prolixity almost exceeding our bounds, such preliminaries as seemed most likely to throw some light on the nature of the distemper, we shall now proceed to the medical history of the plague, as we find it laid down in different authors.

Though this distemper has most frequently been accounted a fever in the highest degree, yet, as we have already noticed, it seems to be essentially different.99 The testimonies there quoted are sufficient to establish the fact; and, were it needful, many others might be brought from authors both ancient and modern. In the plague said to have taken place in the days of Romulus,100 Plutarch relates, that the people died without any sickness. To this very ancient testimony we shall add that of Dr. Patrick Russel, who closes the account of his first class of patients with the following paragraph: “That the plague, under a form of all others the most destructive, exists without its characteristic eruptions, or other external marks reckoned pestilential, can admit of no doubt; and it is to be regretted that mankind have so often, from the absence of these, been betrayed into errors of fatal consequence on its first invasion; at which early period human prudence can only be exerted in the way of defence with any probability of success.”

The symptoms of this fatal disease were sometimes a sudden loss of strength, confusion or weight in the head, giddiness at intervals, oppression about the præcordia, dejection of spirits, taciturnity, an anxious aspect, but without any symptoms of fever. In these, death ensued within twenty-four hours; some were said to have died within a few hours, but our author saw none of these, and is inclined to doubt the truth of the accounts, having in several instances, where this is said to have happened, found upon inquiry that matters had been inaccurately stated, and that the patients had really been ill one or two days.

In others the disorder was more perceptible. In a few hours the eyes became muddy, the surface of the body cold, with drowsiness, lethargy, and pain at the heart. In the progress of the distemper they frequently lost the power of speech, the skin seldom recovered its warmth, or, if it did, it was only by irregular flushings. The pulse sometimes remained nearly in its natural state, but was, for the most part, low and quick. They were “by turns delirious, confused and sensible, but the comatose disposition was most prevalent. Towards the end they suffered extreme inquietude. Vomiting in some occurred the first night; in others a diarrhœa next day; both accelerating the fatal period; but these symptoms were less frequent than in some of the other classes. Buboes appeared only in a very few who survived the third day. . . . The total absence of buboes in such patients as perished suddenly I have no doubt of, nor of their being in general very rare in others of this class; though I suspect that the buboes might sometimes have been concealed, where the disease ran out to the fourth or fifth day, and for the same reason that the reports concerning the state of the corpse were sometimes not true. . . . It was very rare to find suspicious marks of infection on the bodies [of those who died within 24 hours]. . . . Carbuncles were seldom visible till the month of May, which was later than this form of the disease. It prevailed chiefly at the rise of the plague in 1760, and its revival in the two succeeding years, decreasing as the distemper spread; and though they were found dispersed in every stage of the pestilential season, yet the number of this class was proportionably small, compared with that of others. Petechiæ, vibices, or broad, livid, roundish spots, occurred sometimes, but were not common, and the two latter were seldom visible till after death.”

This account of the most malignant form of the pestilence differs considerably from that of Dr. Hodges, who seems to think that the tokens, as he calls them, very generally were to be found on the bodies of those who died suddenly. He mentions indeed a young man who was suddenly seized with a violent palpitation of the heart, and thus continued till his death, which took place in a few hours. In this case the Doctor supposed that there might be a carbuncle broke out on the heart. Dr. Russel has considered the description of the tokens given by Dr. Hodges, and compared it with that of others called by Diemerbroeck maculæ mortis, spots or tokens of death; and by this comparison it appears that the former has spoken somewhat indistinctly on the subject, confounding two different kinds of eruptions together. Dr. Hodges, however, as we have already seen (p. 10) asserts, in his Loimologia, that the tokens rise from within, and are broadest at their bases, where he also supposes the pestilential poison chiefly to lie. To the same purpose, in his Letter to a Person of Quality he says, “The tokens have their original and rise from within, and afterwards externally show themselves; which is evident, because the basis of them is larger than their outward appearance, and the internal parts are found very often spotted, when there is no discoloration visible on the skin.” Dr. Russel, after quoting Diemerbroeck, makes the following observations: “The author (Diemerbroeck) is diffuse on this subject, and thinks it a mistaken though prevalent notion, that the maculæ are merely superficial in the skin, proceeding from putrefaction, ebullition, &c. in the blood or humours: on the contrary he affirms, they arise from the internal parts, even the periosteum, broad at the base, and tapering to their termination in the skin, being produced by the extinction and extravasation of the vital spirits. Now (says Dr. Russel) this answers exactly to one species of the tokens described by Hodges, which therefore may be reckoned the same with the maculæ mortis, and was probably the only one observed at Nimeguen,” &c. On the same subject he quotes a book entitled Medela Pestis, in which the author says that by careful dissection the tokens may be traced half-way deep in the flesh, and some, in the muscles of the breast, have been followed by the incision knife even to the bone. By the directions given by authority to the searchers in 1665, they were ordered to look narrowly for these tokens, which were described as “spots arising on the skin, chiefly about the breast and back, but sometimes also in other parts. Their colour is something various, sometimes more reddish, sometimes inclining a little towards a faint blue, and sometimes a brownish mixed with blue; the red ones have often a brownish circle about them, the brownish a reddish.”

On the subject of tokens Dr. Hodges further observes, that they differed also in their degrees of hardness, some being easily penetrated with a needle or penknife, while others, more callous or horny, were penetrated with more difficulty. They so strongly resembled warts, that they could scarce be distinguished from them; and Dr. Hodges himself was often obliged to have recourse to a needle for this purpose. They seemed hard to the touch, not unlike kernels under the skin, the superfices being smooth. “When I essayed to prove some of them (says he) I found them almost impenetrable.” Another very remarkable circumstance relative to them was, that they were often quite insensible, and this distinguished them from the carbuncle, which is always very painful. Hodges also remarks, that a quick sensibility in the skin was always a good sign, and those that went no farther than the skin would sometimes slough off.

Along with these tokens we can scarce doubt that petechiæ and vibices made their appearance. The former, even in the inferior degrees of the distemper, were dangerous, the latter always fatal, never appearing till the patient is within a few hours of death, sometimes indeed not till death has taken place. Of the petechiæ Dr. Russel says, that for the most part they predicted death, but not without exception. Such as he observed were round, somewhat smaller than a recent flea-bite. They were distinct, few in number, and scattered irregularly about the breast and mastoid muscles. When they did not appear till the approach of death, they were from the first livid, or very dusky; but if they appeared early, they were of a less deep colour, changing afterwards to livid. Hodges speaks of them as deeper coloured than the spots of malignant fever, not fixed in any particular spot, sometimes few, but commonly very numerous; the colour sometimes red or purple, sometimes yellow, and sometimes livid or black. From Gotwald, Russel quotes a description of these spots, which he divides into four species. 1. Reddish, like flea-bites, soon growing brown or black; appearing on all parts of the body except the face. 2. In the form of lentils, spreading like the former all over the body; ruddy at first, but in 24 hours growing dark or ash-coloured. 3. Large brown spots, scattered here and there, sometimes intermixed with the lentil kind. 4. Not unlike the measles, spreading all over the body, rising afterwards in small blisters without any matter, vanishing about the fifth day. Russel also takes notice of a species of petechiæ which were very numerous, confluent, and of a dark red or dusky colour and irregular figure. These were sometimes remarked in the interstices of the former. Such instances occurred but rarely.

The vibices were much larger than the petechiæ. Gotwald says that they covered the face as high as the nose, and from thence spread to the forehead, disfiguring the patient in a frightful manner. They did not appear till a short time before death. Often they appeared unexpectedly, shooting up like lightning from the breast to the face, in spots of various colours, blue, green, brown and yellow. Diemerbroeck describes them as oblong spots of a livid or black colour, like strokes drawn with a pen; sometimes they were larger, the biggest resembling the strokes of a whip. Russel takes notice of a kind of marbled appearance which took place at the height of the disease, or a few hours before death; the colours being a faint blue, and darkish red, both more or less obscure at times, but never bright. It was not permanent, vanishing in one place, without leaving any trace, and returning at short intervals. “The skin in various places was sometimes deformed by narrow streaks of reddish purple, or livid colour. When such took possession of the face they gave a frightful appearance to the countenance, and frequently made such an alteration in the features, and so completely disguised the patient, as to render him hardly knowable by his acquaintance. A streak nearly of the same kind was sometimes observed darting from the edges of the buboes and carbuncles. The vibices or weals were much longer and broader, and more exactly resembled the marks left in the fleshy parts by blows or stripes; they were found chiefly on the thighs, buttock, and back, and made their appearance several hours before death, in some cases, but in others not till after. Large blue or purple spots, the maculæ magnæ of authors, were sometimes observed with or without the vibices, a little while before the patient expired, but most commonly were discovered only on the corpse. Their figure in general was round, sometimes irregular.”

Whether all these mortal signs appeared on such as died very suddenly of plagues, and were by the English writers confounded under the general name of tokens, cannot certainly be determined. Dr. Russel saw none who died within the twenty-four hours, and few who died within thirty hours, so that we cannot from him expect any particular account of the situation of those who died suddenly. In general, however, he says, that “in the most destructive forms of the plague, the vital principle seems to be suddenly, as it were, extinguished, or else enfeebled to a degree capable only for a short while to resist the violence of the disease; in the subordinate forms, the vital and animal functions, variously affected, are carried on in a defective, disorderly manner, and denote more or less danger accordingly.” It seems probable therefore that in those who are suddenly killed, the same effects take place in a short time which are observed to take place after a longer space in those who die gradually, buboes only excepted, which require for their formation a longer time than is allowed to the patient to live. Internal mortifications, or rather eschars, are therefore to be suspected, and dissections have evinced that this was really the case; but besides these there was an appearance observed in the plague at Marseilles which is not taken notice of by former physicians; viz. a preternatural enlargement of the heart. M. Deidier on that occasion communicated an account of nine dissections, but of these only one had died without eruptions. This was a woman of 40 years of age, who lived till the third day. In her “the mediastinum101 was torn towards the upper part; the pericardium of a livid colour; the heart larger than in its natural state, by the swelling of its ventricles; full of thick, black blood. The liver was also very large, and of a livid colour, with a carbuncular pustule on the side of the gall-bladder, which was filled with very black bile.” In others who had eruptions, and who of consequence we must suppose to have lived longer, the enlargement of the heart was still more remarkable. In one who lived eleven days, the heart was of double the bigness, having scarce any blood in the ventricles, whose cavities were filled each with a large polypus, that on the right side having dilated the auricle to the breadth of four inches. The liver also was larger than ordinary, and the gall-bladder full of a black and green bile. The appearances were much the same in all the rest, but, as the time they sustained the disease is not mentioned, we cannot determine whether the enlargement of the heart took place at the very first, or was only an adventitious symptom after the fever had come on. Dr. Russel takes notice that such patients as he attended complained greatly of their heart. “A sense of oppression about the præcordia (says he) which the sick were at a loss to describe, was, in one degree or other, a constant attendant on the plague, except in very slight cases of infection; and where it came on early, or persisted in a high degree, was always a dangerous symptom. The sick showed how severely they suffered by their perpetually changing their posture, in hopes of relief; but, when asked where their pain lay, they either answered hastily they could not tell, or, with a fixed, wild look, exclaimed kulbi! kulbi! (my heart! my heart!) This anxiety increasing as the disease advanced, terminated at length in mortal inquietude, the patient, for many hours, in the last stages, incessantly writhing his body and limbs as if in agony. Though pain at the heart was often conjoined with the symptom just mentioned, and by the sick seemingly blended together, it appeared to be different, and to exist separately. They often exclaimed as in the other, my heart! my heart! pointing also towards the scrobiculum cordis, but then would add eujani kulbi, my heart pains me; or naar fi kulbi, my heart is on fire.” This last pain the Doctor supposes might have its seat in the upper orifice of the stomach; the extreme anxiety may be accounted for from the enlargement of the heart; but as neither of these symptoms took place in such as died in a very short time, we must be apt to consider this enlargement not as any primary and essential symptom of the disease, but as one which takes place when the vital powers are able to oppose for some considerable time the cause of the disease.

In his account of the origin of the plague, Dr. Russel takes notice of the opinion that, at the communication of the infection, the sick were sometimes sensible of having received it. This has been observed by Dr. Lind in malignant fevers; it has also been observed in plagues, as we have seen from Dr. Hodges, Verdoni, and others; but Russel says he never saw any instance of this. He owns, however, that he has seen instances of the disease quickly succeeding a panic fear of being infested. “In cases (says he) where the disease was not discovered to be the plague, till upon the eruption of buboes after two or three days, I have known several persons who had, till then, without the least suspicion, frequented the sick, struck suddenly with a panic, and imagine themselves ill. They felt shooting pains in their groins, confusion in the head, and a loathing. Though in some these complaints were merely imaginary, and soon vanished, in others they proved real; the symptoms increasing, and being followed by eruptions. In such cases I suspected the latent infection to have been excited by terror.”

In the instance formerly quoted from Dr. Guthrie at Petersburg, we have a notable example of this sudden seizure by a stroke. His information was derived from the physician-general of the Russian army. This gentleman assured him, that “he had seen men, in apparent good health, instantaneously drop down, as if shot by a musket ball, by the sudden action of the pestiferous miasma, and upon duty again in 24 hours, perfectly recovered by the operation of a strong vomit.” Whether or not these men felt any stroke at the instant of their falling we are not told: possibly it might be only a syncope very common in the plague, which took place at the very first invasion. Russel informs us, that “the sudden loss of strength, and disturbance of the functions attributed to the brain and heart, are reckoned, in a particular manner, symptoms of the plague. In their highest degree they distinguish the most fatal forms of the disease; and, under different modifications, adhere to all its varieties. . . . The early appearance of faintness was very remarkable in the plague,” &c.

Thus we see that the plague attacks without fever in two different modes; one, by attacking and destroying the solid parts of the body, the other, without any disorganization of the body, attacking the vital principle itself, or rather the blood, from which this principle is derived, so that a temporary suspension of all the functions ensues. The analogy between the cause of pestilence and those visible substances called poisons, is very remarkable in some things, though in others it totally fails. In the Medical Repository102 we have a dissertation upon this analogy by Dr. Edward Miller. He observes, that this analogy has been generally overlooked, chiefly on account of the invisible nature of the aerial poison, and the suddenness of death from poisons, more frequently than from pestilential diseases. This he accounts for from the largeness of the dose of poisons compared with that of contagion; “but (says he) by diminishing the quantity to an appropriate amount, these noxious substances (the poisons) may be made to exhibit the course, duration, and nearly all the phenomena, of what is called a malignant fever. But, above all, the attention of physicians has been diverted from this analogy between miasmata and poisons, by the febrile part of the character which generally belongs to pestilential diseases, and which, in common apprehension, is constantly connected with them. Yet these diseases are by no means universally accompanied with what is strictly called fever. There is often a degree of virulence in the Asiatic plague, in the yellow fever, and in all the other forms of pestilential and malignant diseases, which altogether transcends the process of fever, and extinguishes life in a more summary manner. In the worst cases both of poison and pestilence, the febrile part of the symptoms excites little attention.”

Our author does not say in what this virulence consists. In the cases of those who die with the tokens upon them, the cause is plainly within the body; the destroying power acting with greatest efficacy below the skin in the soft substance of the flesh. Where the patient is suddenly seized in the manner described by Dr. Guthrie, the cause seems to be something foreign to the body suddenly inhaled, the effects being similar to those of fixed air when drawn in by the breath, and of consequence easily expelled by a vigorous action of the powers of the system. Guthrie observes, that, in such cases, it seems “as if the contagious matter existed in a very loose state in the first passages at the beginning of the disease.”

In the production of those tokens mentioned by Dr. Hodges, we know that there must have existed in the body a certain cause capable of totally destroying the parts, and reducing them to an hard eschar, similar to that produced by fire or by a caustic. As we are unacquainted with any thing capable of producing this effect but fire, we can attribute the origin of these tokens to nothing else but the emission of the latent heat of both the solids and fluids which compose these parts, and their consequent transmutation into an hard, and as it were charred, substance. That such an emission of latent heat does in some cases take place is evident from the production of a great quantity of sensible heat when certain substances are mixed together. Thus, upon mixing together oil of vitriol, oil of turpentine and strong spirit of nitre, the whole mixture will take fire and burn violently, though two of the ingredients, viz. oil of vitriol and spirit of nitre, are by themselves incapable of being inflamed. In like manner if strong spirit of nitre be poured upon oil of cloves or sassafras, the mixture will burst out into a violent flame. Water poured upon quick lime occasions great heat, and seems in great part to be converted into a solid substance; for only a small part evaporates, and the slaked lime falls into a powder to appearance perfectly dry, and from which the moisture cannot be expelled without a very violent fire. In this case Dr. Black is of opinion that the heat comes from the water, which, as we have already seen, contains a great quantity of it in a latent state. But, according to his experiments, the emission of 135 degrees of heat is sufficient to reduce water to a state of solidity; and the heat of lime when slaking is so much superior to this, that ships have frequently been set on fire by it. We must therefore either say that water in certain circumstances can part with much more than 135 degrees, or that the lime itself emits part of the heat it contains. This last indeed seems to be the more probable supposition of the two; for though fluids contain more heat in proportion to their bulk than solid bodies, we have no reason to suppose that the latter contain none at all: on the contrary the experiments formerly mentioned, especially those made by Count Rumford, show that they are furnished with an almost unlimited quantity.

The cause of the most violent kind of plague then we must suppose to be something received into the body, which in a certain time, probably sooner or later according to the strength of the contagion, disposes to an irregular emission of its heat, which coming by a kind of explosions, or, as Dr. Hodges calls them, blasts, produce those eschars which have been called tokens, and seem to be no other than partial combustions, by which the parts affected are reduced to a state of charcoal, or nearly so.

In assigning this cause for the most deadly kind of plague, we must naturally ask the question, how can all this take place without any pain? for of those who died in this manner, many felt neither pain nor uneasiness till within a few moments of death. This can only be accounted for by the sudden and perfect destruction of the parts, which did not allow time for any sensation of pain to take place; and indeed in the application of caustic for an issue, the patient often feels but little pain. It is impossible to avoid perceiving a very strong connexion between this kind of plague and the dreadful cases of spontaneous combustion related p. 182–186. In the case of the priest indeed the fire seems to have come from without, though even this cannot be ascertained beyond a doubt; but in those who were absolutely consumed to ashes, it seems equally probable that it may have arisen from within; and as none of the unfortunate persons seem to have made any noise or struggle, the priest alone excepted, it seems probable that the first attack had deprived them of all sensation, and that, notwithstanding the terrible ideas with which such extraordinary occurrences must have inspired those who saw them, the sufferers may have died without feeling any pain. The priest seems to have felt nothing after the first stroke.

Should this cause be admitted (indeed whether it is admitted or not) we see that it is in vain to attempt to solve the phenomena of pestilence by the doctrine of stimuli, excitement or debility. There is no degree of stimulus, fire exepted, which can convert part of the body into an hard eschar, neither can it be done by any degree of debility or exhaustion. Besides, the irregular manner in which these eschars are scattered up and down, shows that the cause has not acted from a regular diffusion all over the body, but in a number of insulated spots, between which the connexion can by no means be traced. In all pestilential eruptions indeed the action of fire seems to be very perceptible. Gotwald mentions his having observed in two patients what he calls papulæ ardentes “burning pimples,” which Dr. Russel supposes to be a modification of carbuncular pustules. Gotwald calls them also fire-bladders, and says that they were as broad as a shilling, of an irregular shape, and the skin seemed as if shrivelled with fire. The carbuncle itself approaches much to the nature of the eschar, and is attended with violent heat in the adjacent parts. Gotwald, who gives an account of the plague at Dantzic, distinguishes the carbuncle into four kinds, (to be afterwards described.) Of these he says in general, that they all burn very violently at first, &c.

From all these accounts it seems plain, that in the plague there are partial discharges of heat, from some cause, upon various parts of the body; and that, in many instances, this heat destroys the texture of the parts entirely. When this is done instantaneosly the patient feels no pain, but if more gradually, the pain is excessive, as in the case of buboes and carbuncles; which the Journalist of the plague year in London informs us were attended with such horrid pain as to make the patients cry out in a lamentable manner. This extraordinary heat must either come from without or within, and we have all the reason in the world to believe that it comes from within. Mr. Hunter, in his Treatise on the Blood, informs us that in a local inflammation there is always an increase of heat in the inflamed part. Should this heat arise, as it probably does, from an emission of part of the latent heat, we may conclude, that such a quantity might be emitted, as entirely to change the texture of the parts. Thus mortifications or destructions of those parts may ensue, of all kinds, from the mild pus to the pestilential eschar.

In the effects of pestilential contagion we observe, if not a superiority, at least a different mode of action from what takes place in poisons. All these seem to act by dissolving the blood, or infecting it in such a manner that it supplies no sufficient quantity of animal spirits; of consequence, the creature soon faints and dies. In the plague, the blood does not appear to be much affected, nevertheless it emits, in various places, certain explosions which convert the parts into an eschar. Poisons always seem to produce the petechiæ or purple spots which sometimes appear in the plague. In Dr. Miller’s Treatise, already quoted, we find, among the symptoms occasioned by arsenic, “red or dark spots appearing on the skin, and rapid putrefaction, which renders speedy interment necessary.” Herein it differs from the plague, for the bodies of such as die of that distemper are not more liable to speedy putrefaction than others. Of the vegetable poisons he also observes, that, “after death, sometimes before, livid spots are observed on the body, the appearance of the blood is dark and dissolved, and putrefaction speedily takes place.” Of animal poisons—“The bite of the poisonous serpents is generally followed by tumour, and livid colour of the part bitten, extravasation of dark coloured blood into the adjacent cellular membrane, nausea and vomiting, sudden prostration of strength, paralysis of the limbs, convulsions, yellowness of the skin, hæmorrhages, &c. Livid appearances of the body, a dark coloured and dissolved state of the blood, and a rapid putrefaction, are observed after death.”

From all these accounts, however, it is plain, that, whatever may be the analogy between the action of poisons and malignant fevers, they do not in any manner operate like the contagion of the true pestilence. Of this the constant effect is to produce buboes, carbuncles, and other eruptions, resembling much more the effects of fire than any thing else; or, if the patient is cut off without the appearance of these, similar effects are observed on the internal and vital parts. Dr. Miller’s conclusion seems therefore liable to exception; in which he says, “that only the lighter cases of pestilence are unlike the effects of poison, but that, in proportion to the degree of malignity, the resemblance grows stronger.” It doth not appear that any poison hath produced one of the characteristic symptoms of the true plague, or any thing but what is common to animals dying of various diseases, the red spots on the skin only excepted.

In the eighth volume of the Philosophical Transactions abridged by Martyn, we have an account of a number of experiments by M. Deidier and others, made upon dogs into whose veins he injected, or poured into wounds made in the miserable animals, the bile of people dead of the plague at Marseilles. “The consequence was, that they became melancholy, drowsy, and without caring to eat. All of them died in three or four days, with the essential marks of the true plague, declared by buboes, carbuncles, and gangrenous inflammations in the viscera, in the same manner as in the human carcases from whence the bile was taken.”

The poisonous bile affected the creatures differently according to the vicinity of the place of injection to the heart. In the jugular vein it killed them in twenty-four hours, injected in the quantity of a drachm to two ounces of water. In this short time were brought on gangrenous inflammations, the heart was stuffed with thick and black blood, the liver was swelled, and the gall-bladder full of green bile. This shows a very essential difference between the action of the pestilential poison and that of others; the former, in some parts of the body at least, coagulates the blood; the latter, in all parts, dissolves it.

In the crural vein (the vein of the leg) the effects were less violent. In about an hour they became heavy. In the former case they instantly became drowsy. In the second experiment they contracted such a loathing for food, that they would neither eat nor drink any thing after the injection was made. On the third day there appeared considerable tumours under the axilla (the fore leg I suppose) and on their thighs, about three inches from the wound. The wound itself turned to a gangrene, and the creatures died usually on the fourth day.

In another experiment the animal had convulsive motions all over immediately after the injection, followed by a lethargy. Next day a carbuncle appeared on the great pectoral muscle on the right side. On the third, a bubo appeared on the thigh, and the same day the dog died. From the time of the injection he had neither eat nor drank. On dissection the fore part of the breast under the teguments was found entirely gangrened, the inward parts and viscera full of black clotted blood, the outward surface of the lungs was all purple, the heart was swelled as big again as usual, and the four cavities were full of black clotted blood. The bile of this dog, injected into the crural vein of another, produced similar symptoms, only the latter eat a little boiled meat, which he vomited up again in two hours. He died the third day, with the same symptoms of the plague as the others.

The bile of people who died of ordinary malignant fevers was much less powerful. A quantity (not mentioned how much, but probably a drachm) mixed with four ounces of warm water, was partly injected into the jugular vein of a dog, and a compress soaked in the rest of the liquor applied to the wound. He appeared heavy and sleepy, and would neither eat nor drink till the third day, when he did both willingly. On the fourth day the compress fell off, the wound was found to be diminished one half, and healed by degrees, the dog recovering perfectly. In another experiment with the bile of a patient who had died of a malignant fever, the dog not only had about a drachm of it put into a wound in his thigh, but was made to swallow some of it; notwithstanding which he was not seized with any distemper, and the wound healed in fifteen days. This bile was as black as ink, in great quantity, and very thick. In the other subjects it was of a deep green. In another experiment, with the same bile applied on a compress, the dog likewise escaped without any apparent disorder; but in a third, the animal died in twenty-three hours, though at first he had shown no sign of being affected, only that he seemed to be thirsty, and drank with greediness. On opening him his heart was found still to beat with violence, and, after the beating ceased, no blood was to be found in it, either in the auricles or ventricles. “This liquor, crowded together in the great vessels, appeared of a lively red, and very fluid, without any of those concretions that we constantly observed in those who died of the plague. Here appeared neither external nor internal marks of the plague.” The bile of a person who had died of an erysipelas, injected into the crural vein of a dog, produced no bad effect. A dog was killed by half a drachm of Hungarian or blue vitriol injected into the jugular vein. He died in universal convulsions: the heart was full of grumous blood, reduced to a kind of thick pap, but without any clots. The bile, applied to two wounds in another dog, produced no bad effect.

From other experiments it appeared that even the pestilential poison itself, taken into the stomach of dogs, did not produce any deleterious effects. “A dog of the Hospital of the Mail in Marseilles, who followed the surgeons when they went to dress the sick, used greedily to swallow the corrupted glands, and the dressings charged with pus which they used to take off the plague sores: he licked up the blood that he found spilt on the ground in the infirmary; and this he did for three months, being always gay, brisk, well, full of play, and familiar with all comers.” The health and briskness of this unfortunate dog proved his ruin, by making him the subject of philosophical experiment. A drachm of the pestiferous bile injected into the crural vein, killed him in four days. He had a considerable hæmorrhage from the wound the night before he died, and he had also a disagreeable smell both while living and after he was dead. Two other dogs, which had swallowed a quantity of pestiferous bile, became heavy and melancholy, refused their food, and showed other signs of disorder; but all these went off in a short time, and no signs of the distemper appeared.

These experiments induced M. Deidier to suppose that the contagion of the plague lay only in the bile; but the following experiment shows that the blood was equally infected, and capable of communicating the disease, and that of the most malignant species. It was made by M. Couzier, physician to the infirmary at Alais, and in the Philosophical Transactions we have the following account: “I took a quantity of blood from a person dead of the plague, and mixed it with warm water, which mixture I attempted to inject into the crural vein of a dog, but the end of the syringe being too large to enter the vein, the experiment did not succeed. This made me resolve to try to lay some of the same infected blood upon the wound. This I accordingly did, and covered it with a dressing, which the dog got off in the night. I found the next morning that the dog had licked the wound, and that he refused his food. Towards night he began to bemoan himself, and gave signs of an approaching death. The next morning I found him dead, the wound being considerably swelled and gangrened, and the edges round the swelling were likewise gangrened.

“Upon opening the body, we found the liver something larger than usual, with spots of a livid purple, as in the bodies of persons dead of the plague. In the stomach was found a quantity of black coagulated blood, of the size of a hen’s egg. This in all likelihood was what he had swallowed upon licking the wound. The heart was very large, with a black grumous blood in the ventricles, and the auricles were turned blackish and gangrenous.”

This last experiment naturally brings to remembrance those of Dr. Home at Edinburgh, in which he inoculated the measles by means of the blood of patients ill of that disorder. From the accounts he has given in his treatise entitled Medical Facts and Observations, we can have little doubt that his experiments succeeded, however others may have failed. One thing, however, is very obvious, viz. that if we mean to communicate a disease by means of the blood, we must use a much greater quantity than if we make the experiment with the matter of an abscess. The case of contagious diseases seems to be the same as in fermenting liquors. With a small quantity of yeast we can easily induce fermentation in any proper liquor, but, if we skim off the yeast, and use only the pure fermenting liquor, we must use a much greater quantity; and to inattention to this circumstance we may with probability ascribe the difficulty which Dr. Home himself met with in introducing the disease, and the total want of success in others. In M. Couzier’s experiment a considerable quantity must have been used, as he says that in the dog’s stomach it equalled the size of an hen’s egg. A much smaller quantity of matter taken from a pestilential abscess is capable of producing the disease in a human body, as is evident from the case formerly quoted of that gentleman who inoculated himself for the plague, and of which Dr. Guthrie gives the following account: “This was Mathias Degio, one of the surgeons of the hospital at Bucharest, a building appropriated to the cure of the plague in the Russian army. He, perceiving the gentlemen of his profession condemned in a manner to death, if punctual in the discharge of their duty 103 had the resolution to inoculate himself for the plague, in the full confidence of its efficacy, and ever afterwards found himself invulnerable, whilst his companions around him were falling victims to its fury. He produced the disease by inserting, with the point of a lancet, under the epidermis of his arm, matter from a pestiferous abscess, and followed the cold regimen observed in the small-pox, as he had imitated its mode of inoculation. On the fourth day of the puncture the fever declared itself, and he, being perfectly devoid of fear, got through the disease without feeling more inconvenience than if it had been that which he imitated. He drank freely of cold water, with vinegar, or a little wine, and kept generally out of doors. This beverage was the only thing that had the appearance of medicine,” &c.

From a careful attention to all these histories, it is plain that the plague is naturally an eruptive disease, as, in all the animals in which it was artificially brought on, eruptions took place, provided the life of the creature was sufficiently prolonged to allow them to come out. Dr. Russel says, that, from his diary, he noted down the cases of two thousand seven hundred patients, all of whom had eruptions of one kind or other. In this it agrees with the small-pox, which Dr. Mead justly considers as an inferior kind of plague. In the latter, however, the eruptions seem to resemble those called by Dr. Hodges the tokens, only that the cause which produces them is less violent in its nature; but why the eruptions of the small-pox should be in distinct pustules, and not one continued boil all over the body, is undoubtedly inexplicable on any theory whatever. The same is true of the plague. No man can explain why the tokens, for instance, instead of being collected into one great eschar, are dispersed into small distinct pieces; or why, instead of buboes in the groin and armpit, or instead of carbuncles in different parts of the body, there should not be a single one equivalent in bulk and power to them all. This appears similar to the phenomena of rain, hail or snow, which fall in distinct drops, fluid or congealed, or in flakes, instead of being equally diffused all over the spot on which they fall. In the latter case we say that the phenomenon is occasioned by electricity: we may say the same, if we please, of the small-pox and plague, with equal emolument.

From the accounts we have just now quoted, it appears that there is between malignant fevers and the true pestilence a very essential difference; the latter tending to thicken the blood, the former to make it thinner. In this respect therefore the poisons seem to resemble malignant fevers very considerably; for M. Fontana observed that by mixing animal poisons with blood drawn from a vein, it was prevented from coagulating. In the instance above related where a dog died in consequence of bile injected into his veins from one who died of a malignant fever, the blood was found extremely fluid. In some who died of the hospital fever, Sir John Pringle informs us, that suppurations had taken place in the brain; but in the true plague the tendency to mortification always prevailed above every thing.

Lastly, that the plague proceeds from too great a quantity of heat, either emitted from the body itself, or some how introduced into it, seems to be pretty plain from the effect it has of augmenting the venereal appetite to an almost inconceivable degree. This was taken notice of in the plague of Marseilles, and indeed in many others. Russel quotes two remarkable passages to this purpose; one in a plague at Genoa, the other in Messina. “Amidst so many dreadful fears and terrors, amid so many fetid and putrefying bodies, amid the shrieks, the sighs and the groans of the sick, what would you have expected? That the people, struck with dread and horror, remained sad, modest and quiet. You are mistaken. They sung, played on instruments, danced, intrigued, and Genoa never was seen so shameless, debauched, and disorderly. I have said before, that God in this plague gathered in a harvest for heaven; but it seemed to be also a vintage for the lascivious of of the earth. If not so, how came so many marriages to be celebrated in the Lazaretto of Consolation, and that so many women, without shedding a tear for the death of their husbands, immediately entered into new engagements? One day, in particular, five marriages were performed, four of the bridegrooms being buriers of the dead, and dressing themselves and their brides in clothes stripped off from the bodies of the deceased.” On the plague of Medina he quotes the following extract of a letter written by a gentleman who resided in that city during the plague in 1743. “It has always been observed, that, after every plague, those who recover are addicted in an extraordinary degree to lewdness and incontinence, which was surprisingly visible at Messina, and carried to such a degree of frenzy and bestiality, that many were known to violate the bodies of dead virgins!”

That an extraordinary propensity to venery may be produced by introducing into the body a quantity of heat, admits now of a kind of demonstration from a fact mentioned by M. le Roy concerning phosphorus.104 This substance is exceedingly apt to take fire on the application of a small degree of heat, and even by slight friction. It is now introduced into the materia medica, and is found to be a very powerful medicine, though dangerous on account of its inflammability, the heat and air contained in the human stomach being sometimes sufficient to set it on fire. The taking such a substance into the body therefore seems not much different from taking actual fire into it; and indeed M. le Roy mentions the case of a woman who had taken only a single grain, and who he says had been recovered, by it, from a putrid fever, but died suddenly from some imprudence. In this woman the whole substance of the body was found luminous upon dissection, and the hands of the operator continued luminous even after being washed. M. le Roy, having taken three grains of this fiery substance, found himself extremely incommoded by it for some hours, and was obliged to drink great quantities of very cold water. Next day he found his muscular powers amazingly increased, and had an almost insupportable venereal irritation. This we see was the consequence of throwing into the body a quantity of heat from without; but if the body itself emits that heat which it invisibly contains, the effects must be the same as though an extraneous quantity had been thrown into it. Neither are we to imagine that the quantity of heat contained in our bodies is small or inconsiderable; for we have already seen that heat consists in the efflux from any substance, of an invisible and most subtile fluid, in all directions. When this flux is gentle, the heat is moderate, but in proportion to the activity of the discharge, the temperature becomes hotter and hotter, and if very violent, the cohesion of the parts is dissolved entirely, and the substance is said to be on fire. There is required therefore only some cause to begin the emission of this fluid; for as soon as this begins, the immense quantity with which we are surrounded, will supply more in abundance,105 and continue so to do, as long as the original cause subsists, or until the substance can no longer bear the power which operates upon it.

From this view of the causes of the plague, and from the facts which have been laid down concerning it, we cannot help perceiving a very strong similarity between the plagues mentioned in the Old Testament and those which still exist in the world. In one of the passages formerly quoted it is called an inflammation, an extreme burning; and from the testimonies of different authors above quoted, it is plain that the disease still deserves the name bestowed upon it in the sacred writings. From the account given of its proximate cause, it is plain that plagues of all degrees of intensity may take place, from absolute accension of the body, and its reduction to ashes, to the mildest state of the disease, in which the patient is not confined to his bed; and all this from the single principle of emission of heat from the body itself. It likewise appears that there may be either in the body itself, or in the element which surrounds it, such a constitution as will dispose that element which is the natural and immediate preserver of our life, suddenly to attack and destroy it, of which the case of the Italian priest is a most remarkable instance. In other cases, such as the Italian lady, and the woman at Coventry, the body itself seems to have given out its heat, though this could not be done without a concurrence of the surrounding ethereal fluid. In a stage still lower, the body is partially consumed, or rather partly charred into a kind of cinder, as where the tokens are produced; and when the cause acts with still less violence, a fever is produced. In the Old Testament we find these different kinds of plagues very distinctly mentioned. In some cases the offenders died by actual fire, which either struck them from without, or was kindled within their bodies. In others, they seem to have died by that very deadly kind of plague of which we have already said so much, which kills in a few hours. This was probably the plague which destroyed the army of Sennacherib, and this in the tenth chapter of Isaiah is by some thought to have been prophesied of under the title of a burning like the burning of a fire.

Of these things I the rather take notice, as I perceive, in a late oration, not only the doctrine of the plague being propagated by contagion severely ridiculed, but the scripture itself treated in a most indecent and scandalous manner. “In the earliest ages of the world (says he) when ignorance and superstition led men to attribute all extraordinary phenomena to the direct agency of supernatural beings, pestilence was supposed to be immediately imported from heaven. This is the opinion which appears to have prevailed among the ancient Hebrews, and may be ranked at the head of the catalogue of absurdities on this subject. The dominion of prejudice over the minds of that ignorant and obstinate people appears in this instance particularly striking. Such was the depth of their blind bigotry in favour of the healthfulness of the globe they inhabited, that they would seem to have considered it as even superior to that of the celestial regions. Hence, unwilling to believe that their favourite earth could give origin to an evil so dreadful as the pestilence, they imported the seeds of this calamity from the more unhealthful climate of heaven!!”

In this extraordinary paragraph we find the matter so much misrepresented, that every vestige of truth is swallowed up in it. The Hebrews believed that they were under the immediate inspection and government of the Deity; a doctrine which, however our author may disbelieve, he cannot disprove. But, notwithstanding this immediate inspection and government, the Deity never did bring upon them any plague but by the intervention of natural causes. The agents which he had originally created were sufficiently able to execute his purposes. The Creator never employed any power but what already existed in the world, and the power that he generally did employ was fire. This agent he directed to exert its force in such degrees as he pleased, and against whom he pleased. It is a mistake to think that miracles were immediately the effects of supernatural power. They were all accomplished by the very powers which exist in the world at this moment, only these powers were by the Creator at particular times directed to act in a manner that they would not have done had they been left to the mechanism of their own nature. When we read therefore of people being consumed by fire from the Lord, there was neither importation of fire from heaven nor any where else; the element exerted its power on these particular persons, either by lightning proceeding from the cloud which represented the Deity, or their bodies threw out the latent heat which they contained, and consumed of themselves. That in cases of this kind there was no importation supposed, is evident from an expression used about bringing water from the rock. It is not said that the water fell from the stars, or came down with the tail of a comet, but that the rock gave out the water which it previously contained. At the present day the same powers exist, and sometimes produce the same effects that they did in former times, with this difference, that now, having no intelligent agent to interfere with their natural mode of action, they exert their force indiscriminately, and as the mechanism of their nature happens to be stimulated, they destroy every thing promiscuously before them. In all this I cannot perceive the smallest absurdity, or any thing but what a reasonable man may indeed must believe, if he makes use of his reason. As to the causes which Dr. Caldwell so much insists upon, viz. filth and corruption, it is extremely probable that (while the Israelites were in the wilderness) these had no existence. By their law they were enjoined such frequent ablutions, that their bodies must always have been perfectly clean. Human excrements were not allowed to lie above ground. The offals and dung of their sacrifices were carried to a distance, and they were expressly told, that they must not allow of any uncleanness in their camp, lest God should turn away from them and abhor them. Add to all this the great heat and dryness of the desert in which they wandered, which would quickly parch up and carry off the moisture from any dead carcases or putrefying matters that might be allowed to remain notwithstanding the injunctions to the contrary. Indeed if we consider the dryness of the climate where these people were, and that they were constantly attended by a large stream of water, it is difficult to conceive any situation upon earth more healthy than that of the Jews in the wilderness. If plagues therefore came upon them, it is difficult to say how they could have happened according to the ordinary course of nature; and, if not according to this, it must have been by an alteration of it, or by miracle.

The plague, as has already mentioned, in its very severe state appears most commonly in the beginning of an epidemic season, and is neither very common nor very infectious. The most common mode in which it invades the patient is with the symptoms of a malignant fever; and of cases of this kind Dr. Russel has made up his five classes of patients, the first or deadly kind having been already described. In his second class, the next in malignity to the fatal kind, the disease made its attack with a slight shivering, succeeded by fever with giddiness, vomiting, head-ach, and sometimes looseness. In the night the fever increased, the thirst was excessive, and the patient, harassed by the vomiting, &c. passed a very unquiet night, frequently with delirium or coma. Towards morning the fever abated, the sick recovered their senses if delirium had taken place, but if coma, it continued through the day, and the remissions were less. Throughout the first day, and part of the second, the pulse was full and strong, but on the second it began to alter, and some of the characteristic signs of the disease to appear. The principal of these was a certain muddiness in the eyes, which sometimes took place even on the first day. This is by our author accounted a symptom very difficult to be described, and, though he recounts the descriptions given by several authors, none are found adequate to the real appearance. “It resembled (says he) somewhat the dull, fixed eye observable in the last stage of malignant fevers; but the dullness was different, muddiness and lustre being strangely blended together. It continued with little alteration in the remissions, and even where the patient appeared sensible and composed it did not increase in the febrile exacerbations, but the eyes acquired a redness that added wildness to the look, which abating or going off in the remissions, the muddiness remained behind. It was this which contributed chiefly in composing that confusion of countenance which I shall not attempt to describe, but which enabled me to pronounce with tolerable certainty whether the disease was or was not the plague, though not independently of other symptoms. When this muddiness disappeared or abated, it was constantly a favourable sign. After a critical sign it often disappeared suddenly, but where there was a succession of sweats, or where no visible crisis happened, its disappearance was slow and gradual.”