B.
Questions relative to the Nature, Prevention,
and curative Treatment of the Plague.

The questions proposed by Prince Orlow to the physicians, and surgeons, were

1. In what manner is the contagion, which is making such great ravages in this place, propagated?

2. What are the symptoms which show that a person is infected with this disorder? In what respects does it differ from other malignant fevers, and what symptoms has it in common with them? How is the patient himself to know that he is attacked with this dreadful disorder, so as to be able to apply for help at the very beginning? How are those who are constantly with the sick, to know the disorder, so as to be put upon their guard against taking infection? And, lastly, how is the physician to be certain that it is the disease in question[57], in order that all possible means may be immediately employed to save the life of the patient?

3. Each of you is required to describe accurately the symptoms of this disorder through its whole course and under all its forms, noticing in what order the symptoms succeed each other, more especially what the symptoms are which accompany each crisis, and what those are which denote more or less danger: lastly, in what space of time, in what manner, and with what outward marks this contagious disorder terminates, whether it be in recovery or in death?

4. What are the medicines which have hitherto been administered in the different cases, in what doses, in what stage of the disorder, and with what success? The general result of these observations will determine which is the easiest and most successful method of cure.

5. What is it necessary for the patient to observe when he is taking the remedies, and when he is not; and what sort of regimen is best suited to promote the cure?

6. Lastly, each of you is required to make known, according to his own judgment and experience, what appear to be the best and surest methods by which individuals may escape this terrible scourge, and by which it may be checked, and if possible entirely eradicated; but these methods must be simple and easily put in practice.

My answers to these questions were as follow:

1. That this contagious disorder was propagated by touching the sick or dead bodies; by handling infected goods, such as clothes, furniture, and the like; by the patient’s breath; or by the air of a room, confined and loaded with effluvia from the bodies of the sick; but not at all by the common atmosphere[58]. Hence those who avoid all communication with the sick, and never meddle with infected things, remain free from the plague, although they live in the same territory or in the same town where it is making its ravages; whilst the poor, not shunning communication with the sick, and putting on infected clothes, which they buy cheap or get by inheritance, are continually exposed to the contagion, and are consequently those who are chiefly attacked by the plague[59]. Now, if the cause of the plague existed in the atmosphere, or that it was carried by it in a state of activity from one place to another, it should follow, that all the inhabitants of the same territory, or at least of the same town, rich as well as poor, should be equally attacked by it; but this is not the case. All, therefore, that can be attributed to the atmosphere, with regard to the plague, is, that according to its different temperature, it disposes the human body more or less to receive the contagion; and that according as its temperature is greater or less, it renders the pestilential miasm more or less violent, or even destroys it; which, indeed, seems to have been the opinion of other writers on this subject[60]. We have seen in the preceding narrative, that the cold of winter blunted, and as it were froze the pestilential virus, whilst the heat of summer rendered it more active and volatile; nevertheless, at both these seasons, the atmosphere was as healthy as usual.

2. That it was sometimes difficult to ascertain the existence of the plague on its first appearance; but that afterwards it was attended by certain marks, which distinguish it from every other disease. These characteristic marks are petechiæ, buboes, and carbuncles. When these occur in a disorder which is very rapid in its progress, is accompanied with fever (unless when it destroys suddenly) and is highly contagious, there can be no doubt that such a disorder is the plague[61].

To determine with certainty whether a disorder which prevails in any place is the plague, it must have all the symptoms which I have just described in one or more patients. These symptoms taken singly, do not constitute the plague; for many other disorders are equally rapid in their course; petechiæ appear in common putrid fevers; in some malignant fevers carbuncles are met with; buboes are produced by the venereal disease and scurvy; and some times, though very rarely, a crisis happens in putrid fevers by abscesses forming under the arm-pits; but these abscesses arise later in these cases than they do in the plague, and moreover they are not accompanied with buboes and the other symptoms which characterize the plague. The high degree of contagion by which the disorder is propagated from one person to another, enters necessarily into the definition of the plague; without it there is no plague. In a word, if there is a frequent communication, either by commerce or in consequence of war, with Turkey or Egypt, and some persons, or a great number of persons, are attacked with a disorder which corresponds exactly to the definition above given, it is certain that it is the plague.

3. For the answer to this third question, the reader has only to revert to the description of symptoms in note A of the Addenda. As for the prognosis, it is attended with great uncertainty in cases of the plague. In some instances, an indisposition apparently slight, is quickly followed by death; whilst others who seem to be on the point of death, recover[62]. In general, when the buboes suppurate well, and there is a separation of the eschars from the carbuncles, accompanied with an abatement of the other symptoms, a favourable prognostic may be given.

4. That hitherto medicine had done very little good, the disorder being so rapid in its course as not to allow time for the remedies to act; but that the Peruvian bark and mineral acids, in large doses, ought, in my opinion, to form the basis of the curative treatment.

From the preceding history of the plague it appears, that those who are attacked with this disorder are affected with nervous symptoms before the fever comes on, and that the fever itself is of a highly putrid nature, accompanied with marks peculiar to itself, and which distinguish it from all other fevers. The proportion of those in whom the plague appears under the form of an inflammatory fever, is very small: and this happens only in the beginning of the disorder, in plethoric subjects; and that in these instances, from being inflammatory it quickly becomes putrid. Thus there are two sets of symptoms in the plague, viz. those which depend on nervous irritation, and those which depend on the putrid condition of the blood. The first I call the nervous, and the second the putrid state.

In the first, or nervous state, the indication is to promote perspiration by warm acidulated drinks, such as infusions of tea and other herbs mixed with lemon juice or vinegar, camphorated emulsions, camphor julep with vinegar and musk, &c. If ever bleeding is proper, it is at this period, and in plethoric subjects.

In the second, or putrid state, vomits, the Peruvian-bark, and mineral acids are the most promising remedies. The violence and rapidity with which the disease runs its course, require that these medicines should be administered in powerful doses. In the month of September, a woman, aged twenty-four, was seized with head-ache, fever, and vomiting; shortly after, a bubo came out on the right groin, and another under the arm-pit on the same side, of the size of a hazel nut; the next day small petechiæ appeared over the whole body; she was weak and drowsy; the tongue was white and moist; the urine pale; and she complained of head-ache and oppression about the præcordia. After I had made her vomit by giving her twenty grains of ipecacuanha, I ordered her a very strong decoction of Peruvian bark, to a quart of which were added a drachm and a half of the extract of the same bark, a drachm of the acid elixir of vitriol of the London Pharmacopœia, and an ounce of syrup of marshmallow; she took three ounces of this mixture every other hour, and besides this, she also took four times in the day, half a drachm of Peruvian bark in powder. For her common drink, she had a decoction of barley, acidulated with spirit of vitriol. The buboes increased gradually, insomuch that in the space of a few days they were as large as walnuts; they continued in this state, without any signs of suppuration. The patient began to mend regularly, and at the end of a week, she was almost entirely recovered; she was then removed, in spite of all my remonstrances to the contrary, to the hospital, from which she was dismissed a short time afterwards, and came to see me, in perfect health.

By this mode of treatment I am persuaded that those who have the plague in its moderate and slow form, may be rescued from death. This is further confirmed by the cases of three children, one of whom was only a year old, and the two others still younger; each of them had a pestilential bubo in the groin, accompanied with fever and great debility. After they had taken the decoction of Peruvian bark, mixed with the extract, they got better; the buboes ripened and yielded a good pus. Two of these children got quite well; the third was carried off during his convalescence, by convulsions occasioned by the teeth. Although this happened in the month of December, when the disorder, being more mild, allowed many to recover; nevertheless these facts serve to establish the efficacy of the remedy, since the symptoms of the plague are always worse in children than adults, and its good effects were seen in all the three patients at the same time.

But the cure of the plague by the mineral acids and Peruvian bark, is only to be expected when the disease appears under its less violent forms. In a great number of instances (where the disease has been more violent) these remedies have been prescribed, not only without effecting a cure, but even without retarding death for a moment. Various other medicines, such as theriaca (which has been so improperly cried up in the plague) camphor, dulcified spirit of nitre, &c. have in like manner failed; so that we are compelled to acknowledge, that the plague (under its more violent forms) is of such a malignant nature as not to yield to any medicines with which we are yet acquainted, howsoever well adapted they may, à priori, seem to be for getting the better of this disorder. From analogy and the preceding facts, I am inclined to place more reliance upon the Peruvian bark and acids, given in large doses, than upon any other remedy; joining with them, to obviate debility, camphor, elixir of vitriol, wine, and blisters. Some were relieved by gentle emetics, such as ipecacuanha. A surgeon who had brought with him from England a great quantity of James’s Powder, prescribed it to several patients; but I never heard that it answered better than ipecacuanha or other emetics[63]. Purgatives, even of the most gentle sort, were hurtful; they brought on a diarrhœa which it was scarcely possible to check, and which weakened the patients exceedingly. I consider bleeding to be very improper in the plague; nevertheless I would not forbid it entirely, where the disease, in plethoric subjects, assumes an inflammatory form, and is accompanied with phrenitis; which, however, was seldom the case in the plague at Moscow[64].

5. That during the convalescence, wine, malt-liquor, kuas (the small beer of Russia) light vegetable food[65], and above all fresh air, were proper and necessary. The same diet which is suited to putrid fevers is equally suited to the plague. Nothing answers better for raising the drooping spirits and recruiting the strength of the weak and convalescent, than well fermented malt liquor, or wine and water.

6. That as to checking its progress and entirely eradicating the pestilence, that, in the present extended state of the disorder, would be attended with much difficulty; but that whatever tended to lessen the communication between the sick and healthy, and to prevent the latter from coming in contact with infected clothes, furniture, &c. would contribute to this end; and that I hoped the frost would not only weaken the contagion, but in a great measure destroy it.

When physicians of science and probity declare that they are convinced of the existence of the plague in any place, it is incumbent on the magistrates, without paying any regard to the contrary opinions of other practitioners, to take the necessary precautions for preserving the health of the public, by removing, as soon as possible, all infected persons, as well as those who are under suspicion of being infected, out of the town, to a house standing by itself, and to surround the building with guards, in order to cut off all communication. As it is of great importance in the beginning of the plague to suppress it in secret, an infected family may be removed in the night-time, without giving rise to any suspicions concerning the disorder; which if it has, as yet, appeared only in this family, may be thus extinguished, without exciting a general alarm[66]. But when several families have become infected, it is then no longer possible to keep it a secret from the public, since the precautions which it is necessary to employ must make it known. In such a case, the impested, as well as all those who have dwelt under the same roofs with them, must be cut off from all further communication with the rest of the inhabitants. The clothes and furniture belonging to the sick (excepting such things as are of a hard and solid texture, which it will be sufficient to wash with vinegar) must be burnt. The goods that are thrown into the fire must not be touched with the hands, but be taken hold of by tongs and poles furnished with hooks at the end[67]; in the same way, the dead bodies are to be put into the carts, that carry them to the burying-grounds. Persons who may be relied on, should be appointed to see that all these directions are strictly complied with. The relations and friends of the sick should be persuaded to burn the clothes and other effects which they may at different times have received; and the health of such friends and relatives should be well watched by the physicians.

A Board of Health, composed of some persons of rank, two or three physicians, and as many of the principal citizens, should regulate, under the authority of the magistrates, all matters relative to the health and safety of the inhabitants. This Board or Committee should divide the town into quarters or districts, in each of which they should appoint a physician to visit the sick; they should enjoin the inhabitants to apprize them whenever any individual in a family is taken ill; and they should order that no person be buried until the corpse shall have been examined by one of the faculty, and a note be given certifying the disorder of which the person died. If there should not be a sufficient number of physicians, the surgeons may be employed in this business.

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

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

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

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

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

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

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

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

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

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

C.
Of the Antipestilential Fumigating Powders.

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

D.
Of Preservative Remedies.

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

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

E.
Of the means by which the Foundling-hospital
at Moscow was kept free from the Plague.

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

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

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

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

THE END.

FOOTNOTES: