A Discourse on the Plague Part 4

ALTHOUGH the Methods taken in other Countries, as well as in our own, have generally been different from what we have here recommended; yet there are not wanting some Instances of extraordinary Success attending these Measures, whenever they have happened to be put in Practice.

THE Magistrates of the City of _Ferrara_ in _Italy_ in the Year 1630, when all the Country round about them was infected with the _Plague_, observing the ill Success of the Conduct of their Neighbours, who, for Fear of losing their Commerce, did all they could to conceal the Disease, by keeping the Sick in their Houses, resolved, whenever occasion should require, to take a different Method. Accordingly, as soon as they received Information, that one had died in their City of the _Pestilence_, they immediately removed the whole Family he belonged to into a _Lazaretto_, where all, being seven in Number, likewise died.

But though the Disease was thus malignant, it went no farther, being suppressed at once by this Method. Within the s.p.a.ce of a Year the same Case returned seven or eight Times, and this Management as often put a Stop to it. The Example of this _City_ was afterwards followed more than once by some other Towns in the same Territory with so good Success, that it was thought expedient, for the common Good, to publish in the _Memoirs_ of the People of _Ferrara_ this Declaration: _That the only Remedy against the Plague is to make the most early Discovery of it, that is possible, and thus to extinguish it in the very Beginning_[80].

NO less remarkable than this Occurrence at _Ferrara_, is what happened at _Rome_ in the _Plague_, I have taken Notice of before, in the Year 1657. When the Disease had spread itself among both Rich and Poor, and raged in the most violent Manner; the _Pope_ appointed Cardinal _Gastaldi_, to be Commissary General of Health, giving him for a Time the Power of the whole _Sacred College_, with full Commission to do whatever he should judge necessary. Hereupon he gave strict Orders, that no sick or suspected Persons should stay in their own Houses. The _Sick_ he removed, upon the first Notice, to a _Lazaretto_ in the _Island_ of the _Tyber_; and all who were in the same Houses with them to other _Hospitals_ just without the City, in order to be sent to the _Island_, if they should fall sick. At the same Time he took diligent Care to send away their _Goods_ to an airy Place to be cleansed. He executed these Regulations with so much Strictness, that no Persons of the highest Quality were exempted from this Treatment; which occasioned at first great Complaints against the _Cardinal_ for his Severity; but soon after he had general Thanks: for in two Months Time, by this means, he entirely cleared the City of the _Pestilence_, which had continued in it almost two Years. And it was particularly observed, that whereas before, when once the Disease had got into a House, it seldom ended without seizing the whole Family; in this Management scarce five out of an hundred of the sound Persons removed were infected[81].

I CANNOT but take Notice, that the _Plague_ was stopp'd at _Ma.r.s.eilles_ a full Fortnight by the same Measures, and probably might have been wholly extinguished, had not new Force been given it by the unseasonable Confidence of the Inhabitants upon this Intermission: which, we are informed, was so great, that they would not believe the _Pestilence_ had been at all among them, and publickly upbraided the Physicians and Surgeons for frighting them causlesly[82]. At this Time, no doubt, they must have neglected the Cautions necessary for their Security so much, as to leave us no room to be surprized, that the Disease should after this break out again with too great Violence to be a second Time overcome.

BUT, besides these Examples in foreign Countries, we have one Instance of the same Nature nearer Home. When the _Plague_ was last here in _England_, upon its first Entrance into _Poole_ in _Dorsetshire_, the Magistrates immediately suppress'd it, by removing the _Sick_ into _Pest-Houses_, without the Town, as is well remember'd there to this Time. A very remarkable Occurrence has greatly contributed towards preserving all the Circ.u.mstances of this Transaction in Memory. They found some Difficulty in procuring any one to attend upon the _Sick_ after their Removal: which obliged the Town to engage a _young Woman_, then under Sentence of Death, in that Service, on a Promise to use their Interest for obtaining her Pardon. The young Woman escaped the Disease, but neglecting to solicite the Corporation for the Accomplishment of their Engagement with her, three or four Months after she was barbarously hanged by the _Mayor_ upon a Quarrel between them.

I WOULD have it here observed, that as the Advice I have been giving is founded upon this Principle, that the best Method for stopping Infection, is to separate the _Healthy_ from the _Diseased_; so in small Towns and Villages, where it is practicable, if the _Sound_ remove themselves into _Barracks_, or the like airy Habitations, it may probably be even more useful, than to remove the _Sick_. This Method has been found beneficial in _France_ after all others have failed. But the Success of this proves the Method of _Removing the Sick_, where this other cannot be practised, to be the most proper of any.

WHEN the _sick Families_ are gone, all the Goods of the Houses, in which they were, should be _buried_ deep under Ground. This I prefer to _burning_ them: because, especially in a close Place, some infectious Particles may possibly be dispersed by the Smoak through the Neighbourhood; according to what _Mercurialis_ relates, that the _Plague_ in _Venice_ was augmented by burning a large Quant.i.ty of infected Goods in the City[83]. A learned Physician of my Acquaintance lately communicated to me the Relation of a Case, (given to him by an Apothecary, who was at the Place when the Thing happened) very proper to be here mentioned. The Story is this. At _Shipston_, a little Town upon the River _Stour_ in _Worcestershire_, a poor Vagabond was seen walking in the Streets with the _Small-Pox_ upon him. The People frightened took Care to have him carried to a little House, seated upon a Hill, at some Distance from the Town, providing him with Necessaries.

In a few Days the Man died. They ordered him to be buried deep in the Ground, and the House with his Cloaths to be burnt. The Wind, being pretty high, blew the Smoak upon the Houses on one Side of the Town: In that Part, a few Days after, eight Persons were seized with the _Small-Pox_. So dangerous is _Heat_ in all Kinds of pestilential Distempers, and so diffusive of Contagion. And moreover the Houses themselves may likewise be demolished or pulled down, if that can conveniently be done; that is, if they are remote enough from others: otherwise it may suffice to have them thoroughly cleansed, and then plastered up. And after this, all possible Care ought still to be taken to remove whatever Causes are found to breed and promote _Contagion_. In order to this, the _Overseers_ of the Poor (who might be a.s.sisted herein by other Officers) should visit the Dwellings of all the meaner Sort of the Inhabitants; and where they find them _stifled up too close_ and _nasty_, should lessen their Number by sending some into better Lodgings, and should take Care, by all Manner of Provision and Encouragement, to make them more _cleanly_ and _sweet_.

NO good Work carries its own Reward with it so much as this kind of _Charity_: and therefore, be the Expence what it will, it must never be thought unreasonable. For nothing approaches so near to the first Original of the _Plague_, as Air pent up, loaded with Damps, and corrupted with the Filthiness, that proceeds from _Animal Bodies_.

OUR _common Prisons_ afford us an Instance of something like this, where very few escape what they call the _Goal Fever_, which is always attended with a Degree of _Malignity_ in Proportion to the _Closeness_ and _Stench_ of the Place: and it would certainly very well become the Wisdom of the Government, as well with regard to the Health of the _Town_, as in Compa.s.sion to the _Prisoners_, to take Care, that all _Houses of Confinement_ should be kept as airy and clean, as is consistent with the Use, to which they are designed.

THE _Black a.s.sise_ at _Oxford_, held in the Castle there in the Year 1577, will never be forgot[84]; at which the _Judges_, _Gentry_, and almost all that were present, to the Number of three hundred, were killed by a _poisonous Steam_, thought by some to have broken forth from the _Earth_; but by a _n.o.ble_ and _great_ Philosopher[85] more justly supposed to have been brought by the _Prisoners_ out of the _Goal_ into _Court_; it being observed, that they alone were not injured by it.

AT the same Time, that this Care is taken of _Houses_, the proper Officers should be strictly charged to see that the _Streets_ be washed and kept clean from _Filth_, _Carrion_, and all manner of _Nusances_; which should be carried away in the _Night Time_: nor should the _Laystalls_ be suffered to be too near the City. _Beggers_ and _idle Persons_ should be taken up, and such miserable Objects, as are neither fit for the common _Hospitals_, nor _Work-Houses_, should be provided for in an _Hospital of Incurables_.

ORDERS indeed of this Kind are necessary to be observed at all Times, especially in populous Cities; and therefore I am sorry to take Notice, that in these of _London_ and _Westminster_ there is no good _Police_ established in these Respects: for want of which the Citizens and Gentry are every Day annoyed more ways than one.

IF these early _Precautions_, we have mentioned, prove successful, there will be no need of any Methods for _Correcting the Air_, _Purifying Houses_, or of _Rules for preserving particular Persons from Infection_: to all which, if the _Plague_ get head, so that the _Sick_ are too many to be removed (as they will be when the Disease has raged for a considerable Time) Regard must be had.

AS to the _first_: _Fire_ has been almost universally recommended for this Purpose, both by the Ancients and Moderns; who have advised to make frequent and numerous _Fires_ in the Towns infected. This _Precept_, I think, is almost entirely founded upon a Tradition, that _Hippocrates_ put a stop to a _Plague_ in _Greece_ by this means. But it is to be observed, that there is no mention made of any Thing like it in the Works of _Hippocrates_. The best Authority we have for it, is the Testimony of _Galen_, though it is also mentioned by other Authors.

_Galen_, recommending _Theriaca_ against the _Pestilence_, has thought fit, it seems, to compare it to _Fire_; and, upon this Conceit, relates, that _Hippocrates_ cured a _Plague_, which came from _aethiopia_ into _Greece_, by purifying the Air with _Fires_; into which were thrown sweet-scented Herbs, and Flowers, together with Ointments of the finest Flavour. It is remarkable, that among the _Epistles_ ascribed to _Hippocrates_, which, though not genuine, yet are older than _Galen_, there is a _Decree_ said to be made by the _Athenians_ in Honour of this Father of Physicians, which, making mention of the Service he had done his Country in a _Plague_, says only, that he sent his Scholars into several Parts, with proper Instructions to cure the Disease. By which it should seem, that this Story of the _Fires_ was hardly or not at all known at the Time, when these _Letters_ were compiled. And _Sora.n.u.s_ may yet more confirm us, that it was framed long after the Death of _Hippocrates_: for _Sora.n.u.s_ only says in general, that _Hippocrates_ foretold the coming of the _Pestilence_, and took care of the Cities of _Greece_; without any mention of having used this particular Expedient.

_Plutarch_ indeed speaks of a Practice like this as commonly approved among Physicians, which he makes use of to ill.u.s.trate a certain Custom of the _Egyptians_: of whom he says, that they _purify_ the Air by the Fumes of _Resin_ and _Myrrh_, as Physicians correct the Foulness, and attenuate the Thickness thereof in Times of _Pestilence_, by _burning Sweet-Woods_, _Juniper_, _Cypress_[86] &c.

THIS I take to be the Sum of what can be learned from Antiquity in Relation to this Point; from whence we may see, that Writers have concluded a little too hastily for the use of _common Fires_ in this Case, upon the Authority and Example of _Hippocrates_, though we should allow the Fact as related by _Galen_: when it will not from thence appear that _Hippocrates_ himself relied upon them; since he thought it necessary to take in the a.s.sistance of _aromatic Fumes_. But as this Fact is not grounded upon sufficient Authority, so it is needless to insist long upon it. The Pa.s.sage I have brought from _Plutarch_ will better explain what was the Sentiment of those Physicians who approved the Practice. It seems they expected from thence to dispel the Thickness and Foulness of the Air. And no doubt but such evil Dispositions of the Air, as proceed from _Damps_, _Exhalations_, and the like, may be corrected even by _common Fires_, and the Predisposition of it from these Causes to receive Infection sometimes removed. But I think this Method, if it be necessary, should be put in Practice before the coming of the _Pestilence_. For when the Distemper is actually _begun_, and rages, since it is known to _spread_ and _increased_ by the _Heat_ of the _Summer_, and on the contrary checked by the _Cold_ in _Winter_; undoubtedly, whatever increases that _Heat_, will so far add Force to the Disease: as _Mercurialis_ takes notice, that _Smiths_, and all those who worked at the _Fire_ were most severely used in the _Plague_ at _Venice_ in his Time[87]. Whether the Service _Fires_ may do by correcting any other ill Qualities of the Air, will counterbalance the Inconvenience upon this Account, Experience only can determine: and the fatal Success of the Trials made here in the last _Plague_, is more than sufficient to discourage any farther Attempts of this Nature. For _Fires_ being ordered in all the _Streets_ for three Days together, there died in one Night following no less than four thousand (if we may believe Dr. _Hodges_:) whereas in any single Week before or after, never twice that Number were carried off[88]. And we find that upon making the same Experiment in the last _Plague_ at _Ma.r.s.eilles_, the Contagion was every Day spread more and more thro' the City with increas'd Rage and Violence[89].

WHAT has been said of _Fires_, is likewise to be understood of _Firing of Guns_, which some have too rashly advised. The proper Correction of the Air would be to make it _fresh_ and _cool_: Accordingly the _Arabians_[90], who were best acquainted with the Nature of _Pestilences_, advise People to keep themselves as _airy_ as possible, and to chuse Dwellings exposed to the Wind, situate high, and refreshed with running Waters.

AS for _Houses_, the first Care ought to be to keep them _clean_: for as _Nastiness_ is a great Source of _Infection_, so _Cleanliness_ is the greatest Preservative; which shews us the true Reason, why the _Poor_ are most obnoxious to _Contagious Diseases_. It is remarked of the _Persians_, that though their Country is surrounded every Year with the _Plague_, they seldom or never suffer any Thing by it themselves: and it is likewise known, that they are the most _cleanly_ People of any in the World, and that many among them make it a great Part of their Religion to remove _Filthiness_ and _Nusances_ of every Kind from all Places about their Cities and Dwellings[91].

BESIDES this, the _Arabians_ advise the keeping Houses _cool_, as another Method of their _Purification_, and therefore, to answer this End more fully, they directed to strew them with _cooling_ Herbs, as _Roses_, _Violets_, _Water-Lilies_, &c. and to be washed with _Water_ and _Vinegar_: than all which, especially the last, nothing more proper can be proposed. I think it not improper likewise to _fume_ Houses with _Vinegar_, either alone or together with _Nitre_, by throwing it upon a _hot Iron_ or _Tile_; though this be directly contrary to what modern Authors mostly advise, which is to make Fumes with hot things, as _Benzoin_, _Frankincense_, _Storax_, &c. from which I see no reason to expect any Virtue to destroy the Matter of _Infection_, or to keep particular Places from a Disposition to receive it; which are the only things here to be aimed at. The _Smoak_ of _Sulphur_, perhaps, as it abounds with an _acid Spirit_, which is found by Experience to be very _penetrating_, and to have a great Power to repress _Fermentations_, may promise some Service this way.

AS hot Fumes appear to be generally _useless_, so the Steams of _Poisonous Minerals_ ought to be reckoned _dangerous_: and therefore I cannot but dissuade the use of all _Fumigations_ with _Mercury_ or _a.r.s.enic_. Much less would I advise, as some have done, the wearing _a.r.s.enic_ upon the _Pit_ of the _Stomach_ as an _Amulet_: since this Practice has been often attended with very ill Consequences, and is not grounded upon any good Authority, but probably derived from an Error in mistaking the _Arabian_ Word _Darsini_, which signifies _Cinnamon_, for the _Latin de a.r.s.enico_, as I have formerly shewn[92].

THE next thing after the _Purifying of Houses_, is to consider by what Means particular _Persons_ may best defend themselves against _Contagion_: for the certain doing of which, it would be necessary to put the _Humours_ of the _Body_ into such a State, as not to be alterable by the _Matter of Infection_. But since this is no more to be hoped for, than a _Specific Preservative_ from the _Small-Pox_; the most that can be done, will be to keep the Body in such Order, that it may suffer as little as possible. The _first Step_ towards which, is to maintain a good State of Health, in which we are always least liable to suffer by any external Injuries; and not to weaken the Body by Evacuations. The _next_ is, to guard against all _Dejection of Spirits_, and _immoderate Pa.s.sions_: for these we daily observe do expose Persons to the more common _Contagion_ of the _Small-Pox_. These Ends will be best answered by living with Temperance upon a good generous Diet, and by avoiding _Fastings_, _Watchings_, _extreme Weariness_, &c. _Another_ Defence is, to use whatever Means are proper to keep the _Blood_ from _Inflaming_. This, if it does not secure from _contracting Infection_, will at least make the _Effects_ of it less violent. The most proper Means for this, according to the Advice of the _Arabian_ Physicians, is the repeated Use of _acid Fruits_, as _Pomegranates_, _Sevil Oranges_, _Lemons_, _Tart Apples_, &c. But above all, of _Wine Vinegar_ in small Quant.i.ties, rendered grateful to the Stomach by the Infusion of some such Ingredients as _Gentian Root_, _Galangal_, _Zedoary_, _Juniper Berries_, &c. Which Medicines by correcting the _Vinegar_, and taking off some ill Effects it might otherwise have upon the Stomach, will be of good Use: but these, and all other hot _aromatic_ Drugs, though much recommended by Authors, if used alone, are most likely to do hurt by _over-heating_ the Blood.

I CANNOT but recommend likewise the Use of _Issues_. The properest Place for them I take to be the inside of the Thigh a little above the Knee.

Besides, the smoaking _Tobacco_, much applauded by some, since it may be put in Practice without any great Inconvenience, need not, I think, be neglected.

BUT since none of these Methods promise any certain Protection; as _leaving_ the Place infected is the surest _Preservative_, so the next to it is to avoid, as much as may be, the _near Approach_ to the _Sick_, or to such as have but _lately recovered_. For the greater Security herein, it will be adviseable to avoid all _Crouds of People_. Nay, it should be the Care of the _Magistrate_ to prohibit all unnecessary _a.s.semblies_: and likewise to oblige all, who get over the Disease, to _confine_ themselves for some time, before they appear abroad.

THE Advice to keep at a Distance from the _Sick_, is also to be understood of the _Dead Bodies_; which should be _buried_ at as great a Distance from Dwelling-Houses, as may be; put _deep_ in the Earth; and _covered_ with the exactest Care; but not with _Quick-Lime_ thrown in with them, as has been the Manner abroad: For I cannot but think that _This_, by _Fermenting_ with the putrefying Humours of the Carcases, may give rise to noxious Exhalations from the Ground. They should likewise be _carried out_ in the _Night_, while they are yet fresh and free from _Putrefaction_: Because a Carcase not yet beginning to corrupt, if kept from the Heat of the Day, hardly emits any kind of Steam or Vapour.

AS for those, who must of necessity attend the _Sick_; some farther Directions should be added for their Use. These may be comprehended in two short Precepts. _One_ is, not to _swallow their Spittle_ while they are about the _Sick_, but rather to _spit_ it out: _The other_, not so much as to _draw in their Breath_, when they are very near them. The reason for both these appears from what has been said above concerning the Manner, in which a sound Person receives the Infection. But in case it be too difficult constantly to comply with these _Cautions_, _washing_ the _Mouth_ frequently with _Vinegar_, and _holding_ to the _Nostrils_ a _Sponge_ wet with the same, may in some measure supply their Place.

THIS is the Sum of what I think most likely to stop the Progress of the _Disease_ in any Place, where it shall have got Admittance. If some few of these Rules refer more particularly to the City of _London_, with small Alteration they may be applied to any other _Place_. It now remains therefore only to lay down some Directions to hinder the Distemper's spreading from _Town_ to _Town_. The best Method for which, where it can be done, (for this is not practicable in very great Cities) is to cast up a _Line_ about the _Town infected_, at a convenient Distance; and by placing a _Guard_, to hinder People's pa.s.sing from it without due Regulation, to other Towns: but not absolutely to forbid any to withdraw themselves, as was done in _France_, according to the usual Practice abroad; which is an unnecessary Severity, not to call it a Cruelty. I think it will be enough, if all, who desire to pa.s.s the _Line_, be permitted to do it, upon Condition they first perform _Quarantaine_ for about twenty Days in _Tents_, or other more convenient _Habitations_. But the greatest care must be taken, that none pa.s.s without conforming themselves to this Order; both by keeping diligent _Watch_, and by _punishing_, with the utmost Severity, any that shall either have done so, or attempt it. And the better to discover _such_, it will be requisite to oblige all, who travel in any Part of the Country, under the same Penalties, to carry with them _Certificates_ either of their coming from Places not _infected_, or of their pa.s.sing the _Line_ by Permission.

THIS I take to be a more effectual Method to keep the _Infection_ from spreading, than the absolute refusing a Pa.s.sage to People upon any Terms. For when Men are in such imminent Danger of their Lives where they are, many, no doubt, if not otherwise allowed to escape, will use Endeavours to do it secretly, let the Hazard be ever so great. And it can hardly be, but some will succeed in their Attempts; as we see it has often happen'd in _France_, notwithstanding all their Care. But one that gets off thus clandestinely, will be more likely to carry the Distemper with him, than twenty, nay a hundred, that go away under the preceding Restrictions: especially because the _Infection_ of the Place, he flies from, will by this Management be rendered much more intense.

For confining People, and shutting them up together in great Numbers, will make the Distemper rage with augmented Force, even to the increasing it beyond what can be easily imagined: as appears from the Account which the learned _Ga.s.sendus_[93] has given us of a memorable _Plague_, which happened at _Digne_ in _Provence_, where he lived, in the Year 1629. This was so terrible, that in one _Summer_, out of _ten thousand_ Inhabitants, it left but _fifteen hundred_, and of them all but _five_ or _six_ had gone through the _Disease_. And he a.s.signs _this_, as the princ.i.p.al Cause of the great Destruction, that the Citizens were too closely confined, and not suffered so much as to go to their Country-Houses. Whereas in another _Pestilence_, which broke out in the same Place a Year and an half after, more Liberty being allowed, there did not die above _one hundred_ Persons.

FOR these Reasons, I think, to allow People with proper _Cautions_ to remove from an infected Place, is the best Means to suppress the _Contagion_, as well as the most humane Treatment of the present Sufferers: and, under these Limitations, the Method of _investing_ Towns infected, which is certainly the most proper, that can be advised, to keep the Disease from spreading, will be no Inconvenience to the Places _surrounded_. On the contrary, it will rather be useful to them; since the Guard may establish such _Regulations_ for the Safety of those, who shall bring Provisions, as shall remove the Fears, which might otherwise discourage them.

THE securing against all Apprehensions of this Kind, is of so great Importance, that in _Cities_ too large to be invested, as, for Example, this City of _London_, the _Magistrates_ must use all possible Diligence to supply this Defect, not only by setting up _Barriers_ without their City, but by making it in the most particular manner their Care to appoint such _Orders_ to be observed at them, as they shall judge will be most satisfactory to the Country about.

THOUGH Liberty ought to be given to the _People_, yet no sort of _Goods_ must by any means be suffered to be carried over the _Line_, which are made of _Materials_ retentive of _Infection_. For in the present Case, when _Infection_ has seized any Part of a Country, much greater Care ought to be taken, that no _Seeds_ of the _Contagion_ be conveyed about, than when the Distemper is at a great Distance: because a _Bale of Goods_, which shall have imbibed the _Contagious Aura_ when pack'd up in _Turky_, or any remote Parts, when unpack'd here, may chance to meet with so healthful a Temperament of our Air, that it shall not do much hurt. But when the Air of any one of our Towns shall be so corrupted, as to maintain and spread the _Pestilence_ in it, there will be little Reason to believe, that the Air of the rest of the Country is in a much better State.

FOR the same Reason _Quarantaines_ should more strictly be enjoined, when the _Plague_ is in a bordering Kingdom, than when it is more remote.

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

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

CHAP. III.

_Of the Cure of the Plague._

IT appears, from what has been said in the beginning of this Discourse, that the _Plague_ and the _Small-Pox_ are Diseases, which bear a great Similitude to each other: both being _Contagious Fevers_ from _Africa_, and both attended with certain _Eruptions_. And as the _Eruptions_ or _Pustules_ in the _Small-Pox_ are of two Kinds, which has caused the Distemper to be divided into two Species, the _distinct_ and _confluent_; so we have shewn two Sorts of _Eruptions_ or _Tumors_ likewise to attend the _Plague_. In the first and mildest Kind of the _Small-Pox_ the _Pustules_ rise high above the Surface of the Skin, and contain a digested _Pus_; but in the other, the _Pustules_ lie flat, and are filled with an indigested _Sanies_. The two kinds of critical _Tumors_ in the _Plague_ are yet more different. In the most favourable Case the _Morbific Matter_ is thrown upon some of the softest _Glands_ near the Surface of the Body, as upon the _inguinal_, _axillary_, _parotid_, or _maxillary_ Glands: the first Appearance of which is a small Induration, great Heat, Redness, and sharp Pain near those Glands.

These _Tumors_, if the Patient recover, like the _Pustules_ of the distinct _Small-Pox_, come to a just Suppuration, and thereby discharge the Disease. In worse Cases of the Distemper, either instead of these _Tumors_, or together with them, _Carbuncles_ are raised. The first Appearance of them is a very small indurated _Tumor_, not situate near any of the fore-mention'd Glands, with a dusky Redness, violent Heat, vast Pain, and a blackish _Spot_ in the middle of the _Tumor_. This _Spot_ is the beginning of a _Gangrene_, which spreads itself more and more as the _Tumor_ increases.

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

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

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

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

THE Disposition of the Stomach and Bowels to be inflamed, makes _Vomiting_ not so generally safe in the _Plague_ as in the _Small-Pox_.

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

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

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

Sal. Ammon._ or in _Bals. Terebinth._ and over all must be put a _Cataplasm of Theriac. Lond._

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

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