A Discourse on the Plague by Richard Mead (early readers txt) 📕

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 passing 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 pass 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 pass 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 passing the Line by Permission.

This I take to be a more effectual Method to keep the Infection from spreading, than the absolute refusing a Passage 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 Gassendus[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 assigns this, as the principal 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 illustrated by many Instances of ill Effects from the Neglect of this Caution in Times of the Plague. I shall mention two, which happen’d among us during the last Plague. I have had occasion already to observe, that the Plague was in Poole. It was carried to that Place by some Goods contained in a Pedlar’s Pack. The Plague was likewise at Eham in the Peak of Derbyshire, being brought thither by means of a Box sent from London to a Taylor in that Village, containing some Materials relating to his Trade. There being several Incidents in this latter Instance, that will not only serve to establish in particular the Precepts I have been giving, in relation to Goods, but likewise all the rest of the Directions, that have been set down, for stopping the Progress of the Plague from one Town to another; I shall finish this Chapter with a particular Relation of what passed in that Place. A Servant, who first opened the foresaid Box, complaining that the Goods were damp, was ordered to dry them at the Fire; but in doing it, was seized with the Plague, and died: the same Misfortune extended itself to all the rest of the Family, except the Taylor’s Wife, who alone survived. From hence the Distemper spread about and destroyed in that Village, and the rest of the Parish, though a small one, between two and three hundred Persons. But notwithstanding this so great Violence of the Disease, it was restrained from reaching beyond that Parish by the Care of the Rector; from whose Son, and another worthy Gentleman, I have the Relation. This Clergyman advised, that the Sick should be removed into Hutts or Barracks built upon the Common; and procuring by the Interest of the then Earl of Devonshire, that the People should be well furnished with Provisions, he took effectual Care, that no one should go out of the Parish: and by this means he protected his Neighbours from Infection with compleat Success.

I have now gone through the chief Branches of Preservation against the Plague, and shall conclude with some general Directions concerning the Cure.

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