A Discourse on the Plague

GRAND CAIRO is crouded with vast Numbers of Inhabitants, who for the most part live very poorly, and nastily; the Streets are very narrow, and close: it is situate in a sandy Plain at the Foot of a Mountain, which by keeping off the Winds, that would refresh the Air, makes the Heats very stifling. Through the midst of it passes a great Canal, which is filled with Water at the overflowing of the Nile; and after the River is decreased, is gradually dried up: Into this the People throw all manner of Filth, Carrion, &c. so that the Stench which arises from this, and the Mud together, is insufferably offensive[42]. In this Posture of things, the Plague every Year constantly preys upon the Inhabitants; and is only stopt, when the Nile, by overflowing, washes away this Load of Filth; the Cold Winds, which set in at the same time, lending their Assistance, by purifying the Air.

In Æthiopia those prodigious Swarms of Locusts, which at some times cause a Famine, by devouring the Fruits of the Earth, unless they happen to be carried by the Winds clear off into the Sea, are observed to entail a new Mischief upon the Country, when they die and rot, by raising a Pestilence[43]; the Putrefaction being hightened by the excessive Intemperance of the Climate, which is so very great in this Country, that it is infested with violent Rains at one Season of the Year, for three or four Months together[44]. And it is particularly observed of this Country, that the Plague usually invades it, whenever Rains fall during the sultry Heats of July and August[45], that is, as Lucretius expresses it, when the Earth is

Now if we compare this last Remark of the Intemperance of the Climate in Æthiopia, with what the Arabian Physicians[47], who lived near these Countries, declare, that Pestilences are brought by unseasonable Moistures, Heats, and want of Winds; I believe we shall be fully instructed in the usual Cause of this Disease. Which from all these Observations compared together, I conclude to arise from the Putrefaction so constantly generated in these Countries, when that is hightened and increased by the ill State of Air now described; and especially from the Putrefaction of animal Substances.

It is very plain, that animal Bodies are capable of being altered into a Matter fit to breed this Disease: because this is the Case of every one who is sick of it, the Humours in him being corrupted into a Substance which will infect others. And it is not improbable, that the volatile Parts with which Animals abound, may in some ill States of Air in the sultry Heats of Africa be converted by Putrefaction into a Substance of the same kind: since in these colder Regions, we sometimes find them to contract a greater Degree of Acrimony than most other Substances will do by putrefying, and also more dangerous for Men to come within the reach of their Action; as in those pernicious, and even poysonous Juices, which are sometimes generated in corrupted Carcasses: Of which I have formerly given one very remarkable Instance[48], and, if it were necessary, many more might be produced, especially in hydropic Bodies, and in cancerous Tumors. Nay more, we find animal Putrefaction sometimes to produce in these Northern Climates very fatal Distempers, though they do not arise to the Malignity of the true Plague: For such Fevers are often bred, where a large Number of People are closely confined together; as in Goals, Sieges, and Camps.

And perhaps it may not be here amiss to remark, that the Egyptians of old were so sensible how much the Putridness of dead Animals contributed towards breeding the Plague, that they worshipped the Bird Ibis for the Service it did in devouring great Numbers of Serpents; which they observed did hurt by their Stench when dead, as well as by their Bite when alive[49].

But no kind of Putrefaction is ever hightened in these European Countries to a degree capable of producing the true Plague: and we learn from the Observation of the Arabian Physicians, that some Indisposition of the Air is necessary in the hottest Climates, either to cause so exalted a Corruption of the forementioned Substances, or at least to enforce upon Mens Bodies the Action of the Effluvia exhaled from those Substances, while they putrefy. Both which Effects may well be expected from the sensible ill Qualities of the Air before described, whenever they continue and exert their Force together any considerable time.

What I have here advanced of the first Original of the Plague, appears to me so reasonable, that I cannot enough wonder at Authors for quitting the Consideration of such manifest Causes for Hidden Qualities; such as Malignant Influences of the Heavens; Arsenical, Bituminous, or other Mineral Effluvia, with the like imaginary or uncertain Agents.

This however I do not say with design absolutely to exclude all Disorders in the Air, that are more latent than the intemperate Heat and Moisture before mentioned, from a Share in increasing and promoting the Infection of the Plague, where it is once bred: for I rather think this must sometimes be the Case; like to what is observed among us in relation to another infectious Distemper, namely, the Small-Pox, which is most commonly spread, and propagated by the same manifest Qualities of the Air as those here described: Notwithstanding which, this Distemper is sometimes known to rage with great Violence in the very opposite Constitution of Air, viz. in the Winter during dry and frosty Weather. But to breed a Distemper, and to give force to it when bred, are two different things. And though we should allow any such secret Change in the Air to assist in the first Production of the Disease; yet it may justly be censured in these Writers, that they should undertake to determine the Specific Nature of these secret Changes and Alterations, which we have no means at all of discovering: Since they do not shew themselves in any such sensible manner, as to come directly under our Examination; nor yet do their Effects, in producing the Plague, point out any thing of their Specific Nature.

All that we know, is this, that the Cause of the Plague, whatever it be, is of such a Nature, that when taken into the Body, it works such Changes in the Blood and Juices, as to produce this Disease, by suddenly giving some Parts of the Humours such corrosive Qualities, that they either excite inward Inflammations and Gangrenes, or push out Carbuncles and Bubo’s; the Matter of which, when suppurated, communicates the like Disease to others: But of the manner how this is done, I shall discourse in the following Chapter.

CHAP. II.

I Have been thus particular in tracing the Plague up to its first Origine, in order to remove, as much as possible, all Objection against what I shall say of the Causes, which excite and propagate it among us. This is done by Contagion. Those who are Strangers to the full Power of this, that is, those who do not understand how subtile it is, and how widely the Distemper may be spread by Infection, ascribe the Rise of it wholly to the malignant Quality of the Air in all Places, wherever it happens; and, on the other hand, some have thought that the Consideration of the infectious Nature of the Disease must exclude all regard to the Influence of the Air: Whereas the Contagion accompanying the Disease, and the Disposition of the Air to promote that Contagion, ought equally to be considered; both being necessary to give the Distemper full force. The Design therefore of this Chapter, is to make a proper Balance between these two, and to set just Limits to the Effects of each.

For this purpose, I shall reduce the Causes, which spread the Plague, to three, Diseased Persons, Goods transported from infected Places, and a corrupted State of Air.

There are several Diseases, which will be communicated from the Sick to others: and this not done after the same manner in all. The Hydrophobia is communicated no other way than by mixing the morbid Juices of the diseased Animal immediately with the Blood of the sound, by a Bite, or what is analogous thereto; the Itch is given by simple Contact; the Lues Venerea not without a closer Contact; but the Measles, Small-Pox, and Plague are caught by a near Approach only to the Sick: for in these three last Diseases Persons are render’d obnoxious to them only by residing in the same House, and conversing with the Sick.

Now it appears by the Experiments mentioned in the Preface, of giving the Plague to Dogs by putting the Bile, Blood or Urine from infected Persons, into their Veins, that the whole mass of the animal Fluids in this Disease is highly corrupted and putrefied. It is therefore easy to conceive how the Effluvia or Fumes from Liquors so affected may taint the ambient Air. And this will more especially happen, when the Humours are in the greatest Fermentation, that is, at the Highth of the Fever: as it is observed that fermenting Liquors do at the latter end of their intestine Motion throw off a great Quantity of their most subtile and active Particles. And this Discharge will be chiefly made upon those Glands of the Body, in which the Secretions are the most copious, and the most easily increased: such are those of the Mouth and Skin. From these therefore the Air will be impregnated with pestiferous Atoms: which being taken into the Body of a sound Person will, in the Nature of a Ferment, put the Fluids there into the like Agitation and Disorder.

The Body, I suppose, receives them these two ways, by the Breath, and by the Skin; but chiefly by the former.

I think it certain that Respiration does always communicate to the Blood some Parts from the Air: Which is proved from this Observation, that the same Quantity of Air will not suffice long for breathing, though it be deprived of none of those Qualities, by which it is fitted to inflate the Lungs and agitate the Blood, the Uses commonly ascribed to it. And this is farther confirm’d by what the learned Dr. Halley has inform’d me, that when he was several Fathom under Water in his Diving Engine, and breathing an Air much more condensed than the natural, he observed himself to breath more slowly than usual: Which makes it more than probable, that this conveying to the Blood some subtile Parts from the Air, is the chief Use of Respiration; since when a greater Quantity of Air than usual was taken in at a time, and consequently more of these subtile Parts received at once by the Blood, a less frequent Respiration sufficed.

As to the Skin, since there is a continual Discharge made thro’ its innumerable Pores, of the matter of insensible Perspiration and Sweat; it is very possible that the same Passages may admit subtile Corpuscles, which may penetrate into the inward Parts. Nay it is very plain that they do so, from what we observe upon the outward Application of Ointments and warm Bathings: which have their Effects by their finest and most active Parts insinuating themselves into the Blood.

It is commonly thought, that the Blood only is affected in these Cases by the morbific Effluvia. But I am of opinion, that there is another Fluid in the Body, which is, especially in the beginning, equally, if not more, concerned in this Affair: I mean the Liquid of the Nerves, usually called the Animal Spirits. As this is the immediate Instrument of all Motion and Sensation, and has a great Agency in all the glandular Secretions, and in the Circulation of the Blood itself; any considerable Alteration made in it must be attended with dangerous Consequences. It is not possible that the whole Mass of Blood should be corrupted in so short a Time as that, in which the fatal Symptoms, in some Cases, discover themselves. Those Patients of the first Class, mentioned in the beginning of this Discourse, particularly the Porters who opened the infected Bales of Goods in the Lazaretto’s of Marseilles, died upon the first Appearance of Infection, as it were by a sudden Stroke; being seized with Rigors, Tremblings, Heart-Sickness, Vomitings, Giddiness and Heaviness of the Head, an universal Languor and Inquietude; the Pulse low and unequal: and Death insued sometimes in a few Hours.

Effects so sudden must be owing to the Action of some Corpuscles of great Force insinuated into, and changing the Properties of, another subtle and active Fluid in the Body: and such an one, no doubt, is the Nervous Liquor.

It is not to be expected that we should be able to explain the particular manner by which this is brought about. We know too little of the Frame of the Universe, and of the Laws of Attractions, Repulsions and Cohesions among the minutest Parcels of Matter, to be able to determine all the Ways by which they affect one another, especially within animal Bodies, the most delicate and complicated of all the known Works of Nature. But we may perhaps make a probable Conjecture upon the Matter. Our great Philosopher, whose surprising Discoveries have exceeded the utmost Expectations of the most penetrating Minds, has demonstrated that there is diffused through the Universe a subtile and elastic Fluid of great Force and Activity. This he supposes to be the Cause of the Refraction and Reflection of the Rays of Light; and that by its Vibrations Light communicates Heat to Bodies: and, moreover, that this readily pervading all Bodies, produces many of their Effects upon one another[50].

Now it is not improbable that the Animal Spirits are a thin Liquor, separated in the Brain, and from thence derived into the Nerves, of such a Nature that it admits, and has incorporated with it, a great Quantity of this elastic Fluid: which makes it a vital Substance of great Energy. And a Liquor of this kind must be very susceptible of Alterations from other active Bodies of a different Nature from it, if they approach to and are mixed with it: as we see some Chemical Spirits upon their being put together, fall into a Fermentation, and make a Composition of a quite different kind.

If therefore we allow the Effluvia or Exhalations from a corrupted Mass of Humours in a Body that has the Plague to be volatile and firey Particles, carrying with them the Qualities, of those fermenting Juices from which they proceed; it will not be hard to conceive how these may, when received into the nervous Fluid of a sound Person, excite in it such intestine Motions as may make it to partake of their own Properties, and become more unfit for the Purposes of the animal Oeconomy. But of this more in another Place.

This is one means by which the Plague, when once bred, is spread and increased: but the second of the forementioned Causes, namely, Goods from infected Places, extends the Mischief much wider. By the preceding Cause, the Plague may be spread from Person to Person, from House to House, or perhaps from Town to Town, tho’ not to any great Distance; but this carries it into the remotest Regions. From hence the trading Parts of Europe have their principal Apprehensions, and universally have recourse to Quarantaines for their Security. The Universality of which Practice is a strong Argument, that Merchandize will communicate Infection: for one cannot imagine, that so many Countries should agree in such a Custom without the most weighty Reasons. But besides, there is not wanting express Proof of this, from particular Examples, where this Injury has been done by several sorts of Goods carried from infected Places to others. Some of these I shall hereafter be obliged to mention; at present I shall confine my self to three Instances only. The first shall be of the Entrance of the Plague into Rome in the Year 1656, which we are assured was conveyed thither from Naples by Clothes and other Wares from that Place, brought first to Port Neptuno, and carried from thence to the Neighbouring Castle of St. Lawrence: which after having been kept some time there, were conveyed into Rome[51]. The second Instance I shall take is from the Account given us of the Entrance of the Plague into Marseilles[52]; which being drawn up with great Exactness, may be the more rely’d on. It appears indisputably by this Account, that the Mischief was brought thither by Goods from the Levant. For the first, who had the Distemper, was one of the Crew of the Ship, which brought those Goods: the next were those, who attended upon the same Goods, while they were under Quarantaine; and soon after the Surgeon, whom the Magistrates of Marseilles appointed to examine the Bodies of those, who died.

This Relation, if duly consider’d, is, I believe, sufficient to remove all the Doubts any one can have about the Power of Merchandize to convey Infection: for it affords all the Evidence, the most scrupulous can reasonably desire. Possibly there might be some Fever of extraordinary Malignity in Marseilles, such as is commonly called Pestilential, before the Arrival of these Goods: But no such Fever has any indisputable Right to the Title of Pestilence, as I have before shewn. On the contrary, these two, the real Pestilence, and such Pestilential Fevers, must carefully be distinguished, if we design to avoid all Mistakes in reasoning upon these Subjects.

Some such Fever of uncommon Malignity, I say, might perhaps be in Marseilles before the Arrival of these Goods. There might likewise perhaps be an Instance or two of Fevers attended with Eruptions, bearing some Resemblance to those of the Plague: for such I my self have sometimes seen here in London. But it is not conceivable, that there should be any Appearance of the true Plague before that time: for it was full six Weeks from the time of the Sailor’s Death, which had given the Alarm, and raised a general Attention, before the Magistrates received Information of any one’s dying of the Plague in the City. And I believe it was never known, that the Plague, being once broke out, gave so long a Truce in hot Weather.

The Plague, which has this present Year almost depopulated Messina, affords a third Instance of the same kind. By an authentic Relation of it, published here[53] we are informed, that a Genoese Vessel from the Levant, arrived at that City; and upon notice given that a Sailor, who had touched some Cases of Cotton Stuffs bought up at Patrasso in the Morea, where the Distemper then raged, was dead of the Plague, in the Voyage; the Ship was put under Quarantaine: during which time the Cotton Stuffs were privately landed. The Master and some Sailors dying three days after, the Vessel was burnt. These Goods lay for some time concealed, but were soon after publickly sold: upon which the Disease immediately broke out in that Quarter where they were opened; and afterwards was spread through the whole City.

I think it not improper, for the fuller Confirmation of the present Point, to give a Relation communicated to me by a Person of unquestionable Credit, of the like Effect from Goods, in respect to the Small-Pox; which Distemper is frequently carried in the Nature of the Plague both to the East and West-Indies from these Countries, and was once carried from the East-Indies to the Cape of Good Hope, in the following manner. About the Year 1718, a ship from the East-Indies arrived at that Place: In the Voyage three Children had been sick of the Small-Pox: The foul Linen used about them was put into a Trunk, and lock’d up. At the Ship’s Landing, this was taken out, and given to some of the Natives to be washed: Upon handling the Linen, they were immediately seized with the Small-Pox, which spread into the Country for many Miles, and made such a Desolation, that it was almost dispeopled.

It has been thought so difficult to explain the manner how Goods retain the Seeds of Contagion, that some[54] Authors have imagined Infection to be performed by the Means of Insects; the Eggs of which may be conveyed from Place to Place, and make the Disease when they come to be hatched. But as this is a Supposition grounded upon no manner of Observation, so I think there is no need to have recourse to it. If, as we have conjectured, the Matter of Contagion be an active Substance generated chiefly from animal Corruption; it is not hard to conceive how this may be lodged and preserved in soft porous Bodies, which are kept pressed close together.

We all know how long a time Perfumes hold their Scent, if wrapt up in proper Coverings: And it is very remarkable, that the strongest of these, like the Matter we are treating of, are mostly animal Juices, as Mosch, Civet, &c. and that the Substances, found most fit to keep them in, are the very same with those, which are most apt to receive and communicate Infection, as Furrs, Feathers, Silk, Hair, Wool, Cotton, Flax, &c. the greatest part of which are likewise of the animal kind.

Nothing indeed can give us so just a Notion of Infection, and more clearly represent the manner of it, than Odoriferous Bodies. Some of these do strangely revive the animal Spirits; others instantaneously depress and sink them: We may therefore conceive that, what active particles emitted from any such Substances do, is in the like way done by Pestiferous Bodies; so that Contagion is no more than the effect of volatile offensive Matter drawn into the Body by our Smelling.

The third Cause we assigned for the spreading of Contagion, was a corrupted State of Air. Although the Air be in a right State, yet a sick Person may infect those who are very near him: As we find the Pestilence to continue sometimes among the Crew of a Ship, after they have sailed out of the Infectious Air wherein the Disease was first caught. A remarkable Accident of this Nature is recorded to have happened in the Plague at Genoa in the Year 1656. Eleven Persons put to Sea in a Felucca, with design to withdraw themselves from the Contagion, and retire into Provence; but one of them falling sick of the Plague soon after they had imbarked, infected the rest; insomuch that others being taken ill, and dying in their turns, they were not admitted any where, but were forced to return from whence they came: and by that time the Boat arrived again at Genoa no more than one of them survived[55].

However in this Case the Malady does not usually spread far, the contagious Particles being soon dispersed and lost. But when in a corrupt Disposition of the Air the contagious Particles meet with the subtile Parts generated by that Corruption, by uniting with them they become much more active and powerful, and likewise of a more durable Nature; so as to form an infectious Matter capable of conveying the Mischief to a greater distance from the diseased Body, out of which it was produced.

In general, a hot Air is more disposed to spread Contagion than a cold one, as no one can doubt, who considers how much all kinds of Effluvia are farther diffused in a warm Air, than in the contrary. But moreover, that State of Air, when unseasonable Moisture and want of Winds are added to its Heat, which gives birth to the Plague in some Countries, will doubtless promote it in all. For Hippocrates sets down the same Description of a Pestilential State of Air in his Country, as the Arabians do of the Constitution, which gives Rise to the Plague in Africa[56]. Mercurialis assures us the same Constitution of Air attended the Pestilence in his time at Padua[57]: and Gassendus observed the same in the Plague of Digne[58]. Besides, it is easy to shew how the Air, by the sensible ill Qualities discoursed of in the last Chapter, should favour infectious Diseases, by rendering the Body obnoxious to them.

Indeed other hurtful Qualities of the Air are more to be regarded than its Heat alone: for the Plague is sometimes stopt, while the Heat of the Season increases, upon the Emendation of the Air in other respects. At Smyrna the Plague, which is yearly carried thither by Ships, constantly ceases about the 24th of June, by the dry and clear Weather they always have at that time: the unwholsome Damps being then dissipated that annoy the Country in the Spring. However, the Heat of the Air is of so much Consequence, that if any Ship brings it in the Winter Months of November, December, January, or February, it never spreads: but if later in the Year, as in April or afterwards, it continues till the time before mentioned.

But moreover, what was said before of some latent Disorders in the Air having a share in spreading the Plague, will likewise have place in these Countries; as the last Plague in the City of London remarkably proves, the Seeds of which, upon its first Entrance, and while it was confined to a House or two, preserved themselves through a hard frosty Winter, and again put forth their malignant Quality as soon as the Warmth of the Spring gave them force: but, at the latter end of the next Winter they were suppressed so as to appear no more, though in the Month of December more than half the Parishes of the City were infected.

A corrupted State of Air is, without doubt, necessary to give these contagious Atoms their full force; for otherwise it were not easy to conceive how the Plague, when once it had seized any Place, should ever cease but with the Destruction of all the Inhabitants: Which is readily accounted for by supposing an Emendation of the Qualities of the Air, and the restoring of it to a healthful State capable of dissipating and suppressing the Malignity.

On the other hand, it does not appear, that the Air, however corrupted, is usually capable of carrying Infection to a very great distance; but that commonly the Plague is spread from Town to Town by infected Persons and Goods: for there are numberless Instances, where the Plague has caused a great Mortality in Towns, while other Towns and Villages, very near them, have been entirely free. And hence it is, that the Plague sometimes spreads from Place to Place very irregularly. Thuanus[59] speaks of a Plague in Italy, which one Year was at Trent and Verona, the next got into Venice and Padua, leaving Vicenza, an intermediate Place, untouched, though the next Year that also felt the same Stroke: a certain Proof that the Plague was not carried by the Air from Verona to Padua and Venice; for the infected Air must have tainted all in its Passage. We have had lately in France one Instance of the same Nature, when the Plague was carried at once out of Provence several Leagues into the Gevaudan. Usually indeed the Plague, especially when more violent than ordinary, spreads from infected Places into those which border upon them: which probably is sometimes effected by some little Communication infected Towns are obliged to hold with the Country about them for the sake of Necessaries, the Subtlety of the Venom now and then eluding the greatest Precautions; and at other times by such as withdraw themselves from infected Places into the Neighbourhood.

I own it cannot be demonstrated, that when the Plague makes great Ravage in any Town, the Number of Sick shall never be great enough to load the Air with infectious Effluvia, emitted from them in such Plenty, that they may be conveyed by the Winds into a neighbouring Town or Village without being dispersed so much as to hinder their producing any ill Effects; especially since it is not unusual for the Air to be so far charged with these noxious Atoms, as to leave no Place within the infected Town secure: insomuch that when the Distemper is at its Highth, all shall be indifferently infected, as well those who keep from the Sick, as those who are near them; though at the beginning of a Plague to avoid all Communication with the Diseased, is an effectual Defence. However, I do not think this is often the Case: just as the Smoak, with which the Air of the City of London is constantly impregnated, especially in Winter, is not carried many Miles distant; though the Quantity of it is vastly greater than the Quantity of infectious Effluvia, that the most mortal Plague could generate.

But, to conclude what relates to the Air, since the ill Qualities of it in these Northern Countries are not alone sufficient to excite the Plague, without imported Contagion, this shews the Error of a common Opinion, countenanc’d by Authors of great Name[60], that we are necessarily visited with the Plague once in thirty or forty Years: which is a mere Fancy, without Foundation either in Reason or Experience; and therefore People ought to be delivered from such vain Fears. Since the Pestilence is never originally bred with us, but always brought accidentally from abroad, its coming can have no relation to any certain Period of Time. And although our three or four last Plagues have fallen out nearly at such Intervals, yet that is much too short a Compass of Years to be a Foundation for a general Rule. Accordingly we see that almost fourscore Years have passed over without any Calamity of this kind.

The Air of our Climate is so far from being ever the Original of the true Plague, that most probably it never produces those milder infectious Distempers, the Small-Pox and Measles. For these Diseases were not heard of in Europe before the Moors had entered Spain: and (as I have observed in the Preface) they were afterwards propagated and spread through all Nations, chiefly by means of the Wars with the Saracens.

Moreover, we are so far from any Necessity of these periodical Returns of the Plague, that, on the contrary, though we have had several Strokes of this kind, yet there are Instances of bad Contagions from abroad being brought over to us, which have proved less malignant here, when our Northern Air has not been disposed to receive such Impressions.

The Sweating Sickness, before hinted at, called Sudor Anglicus and Febris Ephemera Britannica, because it was commonly thought to have taken its Rise here, was most probably of a foreign Original: and though not the common Plague with Glandular Tumors, and Carbuncles, yet a real Pestilence from the same Cause, only altered in its Appearance, and abated in its Violence, by the salutary Influence of our Climate. For it preserved an Agreement with the common Plague in many of its Symptoms, as excessive Faintness and Inquietudes, inward Burnings, &c. these Symptoms being no where observed in so intense a Degree as here they are described to have been, except in the true Plague: And, what is much more, it was likewise a contagious Disease.

The first time this was felt here, which was in the Year 1485, it began in the Army, with which King Henry VII. came from France and landed in Wales[61]: and it has been supposed by some to have been brought from the famous Siege of Rhodes by the Turks three or four Years before, as may be collected from what Dr. Keyes says in one Place of his Treatise on this Disease[62]. Besides, of the several returns which this has made since that time, viz. in the Years 1506, 1517, 1528, and 1551, that in the Year 1528 may very justly be suspected to have been owing to the common Pestilence, which at those times raged in Italy[63] as I find one of our Historians has long ago conjectured[64]: and the others were very probably from a Turkish Infection. If at least some of these Returns were not owing to the Remains of former Attacks, a suitable Constitution of Air returning to put the latent Seeds in Action before they were quite destroyed. It is the more probable that this Disease was owing to imported Contagion; because we are assured, that this Form of the Sickness was not peculiar to our Island, but that it made great Destruction with the same Symptoms in Germany, and other Countries[65].

I call this Distemper a Plague with lessened Force: because though its carrying off thousands for want of right Management was a Proof of its Malignity, which indeed in one respect exceeded that of the common Plague itself (for few, who were destroyed with it, survived the Seizure above one Natural Day) yet its going off safely with profuse Sweats in twenty four Hours, when due care was taken to promote that Evacuation, shewed it to be what a learned and wise Historian calls it, rather a Surprize to Nature, than obstinate to Remedies; who assigns this Reason for expressing himself thus, that if the Patient was kept warm with temperate Cordials, he commonly recovered[66]. And, what I think yet more remarkable, Sweating, which was the natural Crisis of this Distemper, has been found by great Physicians the best Remedy against the common Plague: by which means, when timely used, that Distemper may sometimes be carried off without any external Tumors. Nay besides, a judicious Observer informs us, that in many of his Patients, when he had broken the Violence of the Distemper by such an artificial Sweat, a natural Sweat not excited by Medicines would break forth exceedingly refreshing[67].

And I cannot but take notice, as a Confirmation of what I have been advancing, that we had here the same kind of Fever in the Year 1713, about the Month of September, which was called the Dunkirk Fever, as being brought by our Soldiers from that Place. This probably had its Original from the Plague, which a few Years before broke out at Dantzick, and continued some time among the Cities of the North. With us this Fever began only with a Pain in the Head, and went off in large Sweats usually after a Day’s Confinement: but at Dunkirk it was attended with the additional Symptoms of Vomiting, Diarrhœa, &c.

To return from this Digression: From all that has been said, it appears, I think, very plainly, that the Plague is a real Poison, which being bred in the Southern Parts of the World, is carried by Commerce into other Countries, particularly into Turky, where it maintains itself by a kind of Circulation from Persons to Goods: which is chiefly owing to the Negligence of the People there, who are stupidly careless in this affair. That when the Constitution of the Air happens to favour Infection, it rages there with great Violence: that at that time more especially diseased Persons give it to one another, and from them contagious Matter is lodged in Goods of a loose and soft Texture, which being pack’d up and carried into other Countries, let out, when opened, the imprisoned Seeds of Contagion, and produce the Disease whenever the Air is disposed to give them force; otherwise they may be dissipated without any considerable ill Effects. And lastly, that the Air does not usually diffuse and spread these to any great Distance, if Intercourse and Commerce with the Place infected be strictly prevented.

PART II.

CHAP. I.

This Caution consists of two Parts: The preventing its being brought into our Island; and, if such a Calamity should happen, the putting a Stop to its spreading among us.

The first of these is provided for by the established Method of obliging Ships, that come from infected Places, to perform Quarantaine: As to which, I think it necessary, that the following Rules be observed.

Near to our several Ports, there should be Lazaretto’s built in convenient Places, on little Islands, if it can so be, for the Reception both of Men and Goods, which arrive from Places suspected of Infection: The keeping Men in Quarantaine on board the Ship being not sufficient; the only use of which is to observe whether any die among them. For Infection may be preserved so long in Clothes, in which it is once lodged, that as much, nay more of it, if Sickness continues in the Ship, may be brought on Shore at the end than at the beginning of the forty Days: Unless a new Quarantaine be begun every time any Person dies; which might not end, but with the Destruction of the whole Ship’s Crew.

If there has been any contagious Distemper in the Ship; the sound Men should leave their Clothes, which should be sunk in the Sea, the Men washed and shaved, and having fresh Clothes, should stay in the Lazaretto thirty or forty Days. The reason of this is, because Persons may be recovered from a Disease themselves, and yet retain Matter of Infection about them a considerable time: as we frequently see the Small-Pox taken from those, who have several Days before passed through the Distemper.

The Sick, if there be any, should be kept in Houses remote from the Sound, and, some time after they are well, should also be washed and shaved, and have fresh Clothes; whatever they wore while sick being sunk or buryed: And then being removed to the Houses of the Sound, should continue there thirty or forty Days.

I am particularly careful to destroy the Clothes of the Sick, because they harbour the very Quintessence of Contagion. A very ingenious Author[68], in his admirable Description of the Plague at Florence in the Year 1348, relates what himself saw: That two Hogs finding in the Streets the Rags, which had been thrown out from off a poor Man dead of the Disease, after snuffling upon them, and tearing them with their Teeth, they fell into Convulsions, and dy’d in less than an Hour. The learned Fracastorius acquaints us, that in his time, there being a Plague in Verona, no less than twenty five Persons were successively kill’d by the Infection of one Furr Garment[69]. And Forestus gives a like Instance of seven Children, who dy’d by playing upon Clothes brought to Alckmaer in North-Holland, from an infected House in Zealand[70]. The late Mr. Williams, Chaplain to Sir Robert Sutton, when Embassador at Constantinople, used to relate a Story of the same Nature told him by a Bassa: that in an Expedition this Bassa made to the Frontiers of Poland, one of the Janizaries under his Command dy’d of the Plague; whose Jacket, a very rich one, being bought by another Janizary, it was no sooner put on, but he also was taken sick and dy’d: and the same Misfortune befel five Janizaries more, who afterwards wore it. This the Bassa related to Mr. Williams, chiefly for the sake of this farther Circumstance, that the Incidents now mentioned prevailed upon him to order the burning of the Garment: designing by this Instance to let Mr. Williams see there were Turks, who allowed themselves in so much Freedom of Thought, as not to pay that strict Regard to the Mahometan Doctrine of Fatality, as the Vulgar among them do.

If there has been no Sickness in the Ship, I see no reason why the Men should perform Quarantaine. Instead of this, they may be washed, and their Clothes aired in the Lazaretto, as Goods, for one Week.

But the greatest Danger is from such Goods, as are apt to retain Infection, such as Cotton, Hemp and Flax, Paper or Books, Silk of all sorts, Linen, Wool, Feathers, Hair, and all kinds of Skins. The Lazaretto for these should be at a Distance from that for the Men; and they must in convenient Warehouses be unpack’d, and exposed, as much as may be, to the fresh Air for forty Days.

This may perhaps seem too long; but as we don’t know how much time precisely is necessary to purge the Interstices of spongy Substances from infectious Matter by fresh Air, the Caution cannot be too great in this Point. Certainly the time here proposed, having been long established by general Custom, ought not in the least to be retrenched; unless there could be a way found out of trying when Bodies have ceased to emit the noxious Fumes. Possibly this might be discovered by putting tender Animals near to them, particularly little Birds: because it has been observed in Times of the Plague, that the Country has been forsaken by the Birds; and those kept in Houses have many of them died[71]. Now if it should be found, that Birds let loose among Goods at the beginning of their Quarantaine, are obnoxious to the Contagion in them, it may be known, in good measure, when such Goods are become clean, by repeating the Trial till Birds let fly among them receive no hurt. But the Use of this Expedient can be known only by Experience. In the mean time, I own I am fond of the Thought, in compassion to poor Labourers, who must expose their Lives to danger, in the attendance upon this Work: and tho’ I am well aware that there are Plagues among Animals, which do not indifferently affect all kinds of them, some being confined to a particular Species, (like the Disease of the Black Cattle here, a few Years since, which neither proved infectious to other Brutes, nor to Men;) yet it has always been observed that the true Plague among Men has been destructive to all Creatures of what kind soever.

A very remarkable Story, lately communicated to me by a Person of undoubted Credit, is too much to the purpose to be here omitted. The Fact is this. In the Year 1726, an English Ship took in Goods at Grand Cairo, in the time of the Plague’s raging there, and carried them to Alexandria. Upon opening one of the Bales of Wool in a Field, two Turks employed in the Work were immediately killed: and some Birds, which happened to fly over the Place, dropp’d down dead.

However, the Use of Quarantaines is not wholly frustrated by our Ignorance of the exact time required for this Purification: since the Quarantaine does at least serve as a Trial whether Goods are infected or not; it being hardly possible that every one of those, who are obliged to attend upon them, can escape hurt, if they are so. And whenever that happens, the Goods must be destroyed.

I take it for granted, that the Goods should be opened, when they are put into the Lazaretto, otherwise their being there will avail nothing. This is the constant Practice in the Ports of Italy. That it is so at Leghorn, appears by the Account lately published of the Manner, in which Quarantaines are there performed: and I find, that the same Rule is observed at Venice, from an authentic Paper, I have before me, containing the Methods made use of in that City, where Quarantaines have been enjoined ever since the Year 1484; at which time, as far as I can learn, they were first instituted in Europe. In that Place all Bales of Cotton, of Camel’s or of Beaver’s Hair, and the like, are ript open from end to end, and Holes made in them by the Porters every Day, into which they thrust their naked Arms, in order that the Air may have free Access to every part of the Goods. That some such Cautions as these ought not to be omitted, is clearly proved by the Misfortune, which happened in the Island of Bermudas about the Year 1695; where, as the Account was given me by the learned Dr. Halley, a Sack of Cotton put on Shore by Stealth, lay above a Month without any Prejudice to the People of the House, where it was hid: but when it came to be distributed among the Inhabitants, it carried such a Contagion along with it, that the Living scarce sufficed to bury the Dead. This Relation Dr. Halley received from Captain Tucker of Bermudas, Brother to Mr. Tucker late Under-Secretary in our Secretary’s Office.

Indeed, as it has been frequently experienced, that of all the Goods, which harbour Infection, Cotton in particular is the most dangerous, and Turky is almost a perpetual Seminary of the Plague; I cannot but think it highly reasonable, that whatever Cotton is imported from that part of the World, should at all Times be kept in Quarantaine: Because it may have imbibed Infection at the Time of its packing up, notwithstanding no Mischief has been felt from it by the Ship’s Company. And the length of Time from its being pack’d up to its Arrival here, is no certain Security that it is cleared from the Infection. At least, it is found, that the Time employed by Ships in passing between Turky and Marseilles, is not long enough for Goods to lose their Infection: as appears not only from the late Instance, but also from an Observation made in a certain Memorial, drawn up by the Deputy of Trade at Marseilles[72]. Marseilles is the only Port in France allowed to receive Goods from the Levant, on Account of its singular Convenience for Quarantaines, by Reason of several small Islands situate about it. The Ports of France in the Western Ocean having had a Desire to be allowed the same Liberty, their Deputies presented, in the Year 1701, a Memorial to the Royal Council of Trade, containing several Reasons for their Pretensions. To this the Deputy at Marseilles makes Reply in the Memorial I am speaking of, in which this Advantage of Marseilles for Quarantaines above the other Ports, is much insisted upon: and, to evince the Importance thereof, it is declared in express Words, that many Times Persons have been found in that Place to die of the Plague in their Attendance upon Goods under Quarantaine. Now if it be certain, that Goods have retained Infection during their Passage from Turkey to Marseilles; it is too hardy a Presumption to be admitted in an Affair so important as this, that they must necessarily lose all Contagion in the Time of their coming to us, because the Voyage is something longer. But besides this, there are some few Instances of Goods, that have retained their Infection many Years. In particular, Alex. Benedictus gives a very distinct Relation of a Feather Bed, that was laid by seven Years on Suspicion of its being infected, which produced mischievous Effects at the End of that great Length of Time[73]. And Sir Theodore Mayerne relates, that some Clothes fouled with Blood and Matter from Plague Sores being lodged between Matting and the Wall of a House in Paris, gave the Plague several Years after to a Workman, who took them out, which presently spread through the City[74].

What makes Cotton so eminently dangerous, is its great Aptitude to imbibe and retain any Sort of Effluvia near it; of which I have formerly made a particular Experiment, by causing some Cotton to be placed for one Day near a Piece of putrefying Flesh from an amputated Limb, in a Bell-Glass, but without touching it: for the Cotton imbibed so strong a Taint, that being put up in a close Box, it retained its offensive Scent above ten Months, and would, I believe, have kept it for Years. If, instead of the Fumes of putrefied Flesh from a sound Body, this Cotton had been thus impregnated with the Fumes of corrupted Matter from one sick of the Plague; I make no doubt but it would have communicated Infection. And the Experiment would have succeeded alike in both Cases, if instead of Cotton, Silk, Wool, or Hair had been inclosed in the Vessel: Animal Substances being the most apt to attract the volatile Particles, which come from Bodies of the same Nature with themselves.

As all reasonable Provisions should be made both for the Sound and Sick, who perform Quarantaine; so the strict keeping of it ought to be inforced by the severest Penalties. And if a Ship comes from any Place, where the Plague raged, at the Time of the Ship’s Departure from it, with more than usual Violence; it will be the securest Method to sink all the Goods, and even the Ship sometimes: especially if any on Board have died of the Disease.

Nor ought this farther Caution to be omitted, that when the Contagion has ceased in any Place by the Approach of Winter, it will not be safe to open a free Trade with it too soon: because there are Instances of the Distemper’s being stopt by the Winter Cold, and yet the Seeds of it not destroyed, but only kept unactive, ’till the Warmth of the following Spring has given them new Life and Force. Thus in the great Plague at Genoa about four-score Years ago, which continued Part of two Years; the first Summer about ten Thousand died; the Winter following hardly any; but the Summer after no less than sixty Thousand. Likewise the last Plague at London appeared the latter End of the Year 1664, and was stopt during the Winter by a hard Frost of near three Month’s Continuance; so that there remained no farther Appearance of it ’till the ensuing Spring[75]. Now if Goods brought from such a Place should retain any of the latent Contagion, there will be Danger of their producing the same Mischief in the Place, to which they are brought, as they would have caused in that, from whence they came.

But above all, it is necessary, that the Clandestine Importing of Goods be punished with the utmost Rigour; from which wicked Practice I should always apprehend more Danger of bringing the Disease than by any other Way whatsoever.

These are, I think, the most material Points, to which Regard is to be had in defending ourselves again Contagion from other Countries. The particular Manner of putting these Directions in Execution, as the Visiting of Ships, Regulation of Lazaretto’s, &c. I leave to proper Officers, who ought sometimes to be assisted herein by able Physicians.

CHAP. II.

As the Plague always breaks out in some particular Place, it is certain, that the Directions of the Civil Magistrate ought to be such, as to make it as much for the Interest of infected Families to discover their Misfortune, as it is, when a House is on Fire, to call in the Assistance of the Neighbourhood: Whereas, on the contrary, the Methods taken by the Publick, on such Occasions, have always had the Appearance of a severe Discipline, and even Punishment, rather than of a Compassionate Care; which must naturally make the Infected conceal the Disease as long as was possible.

The main Import of the Orders issued out at these Times was[76]; As soon as it was found, that any House was infected, to keep it shut up, with a large red Cross, and these Words, Lord, have Mercy upon us, painted on the Door; Watchmen attending Day and Night to prevent any one’s going in or out, except such Physicians, Surgeons, Apothecaries, Nurses, Searchers, &c. as were allowed by Authority: And this to continue at least a Month after all the Family was dead or recovered.

It is not easy to conceive a more dismal Scene of Misery, than this: Families lock’d up from all their Acquaintance, though seized with a Distemper which the most of any in the World requires Comfort and Assistance; abandoned it may be to the Treatment of an inhumane Nurse (for such are often found at these times about the Sick;) and Strangers to every thing but the melancholy Sight of the Progress, Death makes among themselves: with small Hopes of Life left to the Survivers, and those mixed with Anxiety and Doubt, whether it be not better to die, than to prolong a miserable Being, after the Loss of their best Friends and nearest Relations.

If Fear, Despair, and all Dejection of Spirits, dispose the Body to receive Contagion, and give it a great Power, where it is received, as all Physicians agree they do; I don’t see how a Disease can be more inforced than by such a Treatment.

Nothing can justify such Cruelty, but the Plea, that it is for the Good of the whole Community, and prevents the spreading of Infection. But this upon due Consideration will be found quite otherwise: For while Contagion is kept nursed up in a House, and continually encreased by the daily Conquests it makes, it is impossible but the Air should become tainted in so eminent a degree, as to spread the Infection into the Neighbourhood upon the first Outlet. The shutting up Houses in this Manner is only keeping so many Seminaries of Contagion, sooner or later to be dispersed abroad: For the waiting a Month, or longer, from the Death of the last Patient, will avail no more, than keeping a Bale of infected Goods unpack’d; the Poyson will fly out, whenever the Pandora’s Box is opened.

As these Measures were owing to the Ignorance of the true Nature of Contagion, so they did, I firmly believe, contribute very much to the long Continuance of the Plague, every time they have been practised in this City: And no doubt, they have had as ill Effects in other Countries.

It is therefore no wonder, that grievous Complaints were often made against this unreasonable Usage; and that the Citizens were all along under the greatest apprehensions of being thus Shut up. This occasioned their concealing the Disease as long as they could, which contributed very much to the inforcing and spreading of it: and when they were confined, it often happened that they broke out of their Imprisonment, either by getting out at Windows, &c. or by bribing the Watchmen at their Doors; and sometimes even by murdering them. Hence in the Nights, people were often met running about the Streets, with hideous Shrieks of Horror and Despair, quite Distracted, either from the violence of the Fever, or from the Terrors of Mind, into which they were thrown by the daily Deaths they saw of their nearest Relations.

In these miserable Circumstances, many ran away, and when they had escaped, either went to their Friends in the Country, or built Hutts or Tents for themselves in the open Fields, or got on board Ships lying in the River. A few also were saved by keeping their Houses close from all communication with their Neighbours[77].

And it must be observed, that whenever popular Clamours prevailed so far, as to procure some Release for the Sick, this was remarkably followed with an Abatement of the Disease. The Plague in the Year 1636 began with great Violence; but leave being given by the King’s Authority for People to quit their Houses, it was observed, That not one in twenty of the well Persons removed fell sick, nor one in ten of the Sick died[78]. Which single Instance alone, had there been no other, should have been of Weight ever after to have determined the Magistracy against too strict Confinements. But besides this, a preceding Plague, viz. in the Year 1625, affords us another Instance of a very remarkable Decrease upon the discontinuing to shut up Houses. It was indeed so late in the Year, before this was done, that the near Approach of Winter was doubtless one Reason for the Diminution of the Disease, which followed: Yet this was so very great, that it is at least past dispute, that the Liberty then permitted was no Impediment to it. For this opening of the Houses was allowed of in the beginning of September: and whereas the last Week in August, there died no less than four thousand two hundred and eighteen, the very next Week the Burials were diminished to three thousand three hundred and forty four; and in no longer time than to the fourth Week after, to eight hundred and fifty two[79].

Since therefore the Management in former Times neither answers the Purpose of discovering the Beginning of the Infection, nor of putting a stop to it when discovered, other Measures are certainly to be taken; which, I think, should be of this Nature.

There ought, in the first Place, a Council of Health to be established, consisting of some of the principal Officers of State, both Ecclesiastical and Civil, some of the chief Magistrates of the City, two or three Physicians, &c. And this Council should be intrusted with such Powers, as might enable them to see all their Orders executed with impartial Justice, and that no unnecessary Hardships, under any Pretence whatever, be put upon any by the Officers they employ.

Instead of ignorant old Women, who are generally appointed Searchers in Parishes to inquire what Diseases People die of, that Office should be committed to understanding and diligent Men: whose Business it should be, as soon as they find any have dy’d after an uncommon Manner, particularly with livid Spots, Bubo’s, or Carbuncles, to give Notice thereof to the Council of Health; who should immediately send skilful Physicians to examine the suspected Bodies, and to visit the Houses in the Neighbourhood, especially of the poorer Sort, among whom this Evil generally begins. And if upon their Report it appears, that a Pestilential Distemper is broken out, they should without Delay order all the Families, in which the Sickness is, to be removed; the Sick to different Places from the Sound: but the Houses for both should be three or four Miles out of Town; and the Sound People should be stript of all their Clothes, and washed and shaved, before they go into their new Lodgings. These Removals ought to be made in the Night, when the Streets are clear of People: which will prevent all Danger of spreading the Infection. And besides, all possible Care should be taken to provide such Means of Conveyance for the Sick, that they may receive no Injury.