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THE LIBRARY 
 
 OF 
 
 THE UNIVERSITY 
 
 OF CALIFORNIA 
 
 PRESENTED BY 
 ( PROF. CHARLES A. KOFOID AND 
 MRS. PRUDENCE W. KOFOID 
 
 
 
 
(: i' 'i^^^ 
 
 V. 
 
 'i*" 
 
 •',*♦'. 
 
SUGGESTIONS 
 
 rOR THE 
 
 PREVENTION AND MITIGATION 
 
 OF 
 
 epiDemic auD i&esttlential SDiseases, 
 
 COMPr.EHENDING 
 
 THE ABOLITION 
 
 OF 
 
 QUARANTINES AND LAZARETTOS: 
 
 WITH 
 
 SOME OPPORTUx\E REMARKS 
 
 fPON THE 
 
 DAXGER OF PESTILENCE FROM SCARCITY. 
 
 INTENDED 
 
 TO SERVE AS AN INTRODUCTION TO A WORK, ENTITLED 
 
 RESEARCHES IN TURKEY, 
 
 CONCEKKING THE PLAGUE, ic. 
 
 BY CHARLES MACLEAN, M. D. 
 
 LECTliflER OS THE DISEASES OF HOT CM.MATES TO THK 
 UONOVRADLR EAST-lNmA COMPANY. 
 
 LONDON : 
 
 181 
 
L-ib ---_ 
 
 PREFACE. 
 
 VV e hear, every where, of pestilential diseases ; but we hear no 
 where, of their true cause. To dissipate the dreadful delusions, 
 which prevail upon the subject — rto assign their true cause, and to 
 promulgate an eiHcient method of cure, are the principal objects of 
 a work which I am preparing for publication, according to the 
 notice contained in the following pages. 
 
 But, in the mean time, it would not be justifiable in persons, 
 who, like myself, have given their attention to the subject, to remain 
 silent under the very alarming symptoms of progressive scarcity 
 which pervade the world, and when several countries are actually 
 afflicted with pestilence, arising in a great measure from that 
 source. 
 
 An article, which appeared in the public journals of the 15th 
 Instant, under the head of Vienna, of the S8th of December last, 
 has the following statement : " According to accounts from the 
 Turkish frontiers, there are still appearances of the plague in some 
 parts of Bosnia, Servia, and Bulgaria. In Moldavia it has spread so 
 much, that, in October last, few parts of the country were free 
 frcMTi it. In November, it even shewed itself at Jafry, the capital; 
 and as the symptoms became frequent there, all the Consuls left the 
 city, and, since that time, all intercourse "joitk the city is interrupted. 
 In Wallachia, they are more fortunate : that province has not only 
 remained free from the plague, but the harvest has been most abim~ 
 dant. The cordon which Austria has formed in the Buckowina 
 towards IMoldavia, and which has lately been so much strengthened, 
 'will suffice, -joe hope, to presence our frontiers from the infection.^* 
 
 To deprecate our having recourse, in the event of a pestilence in 
 this countr)', to measures so absurd and injurious, is, in pai't, the 
 object of this publication. 
 
 The effect of this melancholy delusion is to Increase mortality, 
 and to aggravate disease, at least in a fourfold degree, by obliging 
 
Preface. 44.^ 
 
 tlie people to remain exposed to the Influence of the atmosphere, 
 whicli is the principal cause of the disease, and by restricting ac- 
 cess to the means of subsistence, scarcity being its most powerful 
 auxiliary cause, as well as in various other ways, which cannot be 
 enumerated licre. 
 
 That the want of a regular and abund.mt supply of the meafts 
 of subsistence, is a very powerful cause of plague, in the countries 
 mentioned, shall be elsewhere shewn. It is seldom that an aflluent 
 native, at least among the Turkish population, and very rarely, 
 indeed, that an Englishman, is affected with plague in the Levant. 
 
 When, in the year 1758, a scarcity existed in England, which 
 was considered not real, but artificial, and which did not affect 
 other countries nearly in the same proportion as at present, it was 
 thought necessary, by Sir Richard Manningham, a pliysician of 
 London, to call the attention of the public to the dangers of an 
 impending pestilence : — " The plague of pestilence," says lie, 
 " may be much sooner produced in this nation, by an artificial fa- 
 mine, than by any infection of the plague itself from foreign parts.'" 
 
 It such apprehensions were justly entertained respecting the 
 effects that might have arisen from a scarcity which was only arti- 
 ficial, local, and temporary ; how much greater ought our appre- 
 hensions to be from a scarcity threatening to become real, general, 
 and of long duration ! 
 
 But whether famine arise from a real or artificial scarcity, or 
 fr-om a want of the means of procuring subsistence, or from a com- 
 bination of these circumstances, the cfFect is precisely the same ; 
 the pestilence ensuing would be also oi the same nature j and to 
 augment the abundance of the articles of subsistence, or of the 
 means of procuring them, would in all cases be the proper remedy. 
 
 Hence all measures which, in giving an artificial support to par- 
 ticular classes, tend to narrow the supply, or to keep up the price 
 of the necessaries of life, must operate directly against the welfare 
 of the great bulk of the community; and, under existing circum- 
 stances, augment the already afRicting miseries of the people. 
 
 Not only, therefore, should such measures be avoided, bul all 
 those means should be resorted to by which the abundance of the 
 articles of subsistence, and of the means of procuring them> can 
 be augmented, especially encouragement to importation, and the 
 establishment of public granaries : the former, as the most efficient 
 remedy against a real, the latter, against an artificial scarcity, 
 
 * Viile Discourse concerning the Plague, &c. titlr page. In ihc Preracf* 
 p. 1, hecallsit, " A most notorious artificial scarot}) : jor 'li!* known, " Ir 
 adds, " tfiat we have bread corn nicrr than enough iu our nation Ri the fall 
 sujiply of all the people." 
 
 iw35S393 
 
446 Preface, 
 
 To abolish, or if that be thought too much, to suspend quaran- 
 tine, is one of the means which 1 would recommend in order to 
 facilitate the importation of grain, flour, rice, Indian corn, or other 
 articles of subsistence, from countries supposed to be the seat of 
 those diseases for the prevention of which quarantines have been 
 established ; as the ports of the Black Sea, and of the Mediterra- 
 nean, and the West Barbary, on the Atlantic Ocean. In Egypt, and, 
 probably, in others of these countries, the harvest has been this year 
 particularly abundant. But if these sources were overflowing, and 
 the people of this country starving, they could not be rendered 
 available under the existence of the mischievous laws of quaran- 
 tine. 
 
 If the evil of scarcity should happily be only temporary, no ge- 
 neral detriment can arise from acting as if it were to be perma- 
 nent ; whilst, if it should prove permanent, by acting as if it were 
 only to be temporary, a great part of the community, either by the 
 direct efl^ect of famine, or through the intervention of a pestilence, 
 might be destroyed. 
 
 I shall probably be excused for hazarding these hints by all who 
 are duly impressed with the fact, that the times and circumstances 
 are of an aspect most serious, and require something much beyond 
 the application of palliatives and placebos. 
 
 In tracing to a papal stratagem the origin of the doctrine, to 
 which we owe so great a proportion of the mortality incidental to 
 epidemic diseases, no liberal Roman Catholic will, I am persuaded, 
 suspect me of wishing to disparage his religion. This would be 
 as unreasonable as it would be to impute to me a predilection for 
 the tenets of the Mahommedans or Hindoos, because I consider 
 their opinion of the non-existence of contagion, in epidemig 
 diseases, as beneficial and true. 
 
 ^ "■•.ijA'^^on> *> Bonveiie Street, Fleet street, 
 ', ,, , 22d January, lol?. 
 
SUGGESTIONS, 
 
 It has justly been remarked, by one of the most recent writers 
 upon the Turkish Empire, that « the experience of so many ages, 
 respecting the nature of the Plague, is Umited to a knowledge of 
 its symptoms, and of its fatal effects. ' " 
 
 A similar observation has been, witli equal truth, extended, by 
 an ingenious and candid writer, of much experience, among our- 
 selves, to epidemic maladies in general ; " We know no more of 
 epidemical diseases, or their causes," says he, " than the inhabit- 
 ants of Soldania.*" 
 
 These authors are only not correct, in that they have not gone 
 far enough. Relative to this most interesting and most important 
 subject of human research, involving, as it does, the fate of at least 
 a million of our fellow- creatures annually, our condition is much 
 worse than a state of absolute ignorance. We have unfortunately 
 wandered so long, and so far, into the regions of error, that, to 
 recover our lost way, has now become our first indispensable la- 
 bour. We must unlearn all that we have been hitherto learning : 
 we must transpierce mountains of consecrated delusion, before we 
 can even enter the right path of investigation. 
 
 It is, probably, not unknown to the public, that I last year^ em- 
 
 * " L'experience de tant de siecles, sur la nature de ce mal, se bornq 
 done a li connaissaiice des symptomes qui I'annoncent, ct de ses tiinestes 
 eftets." — Tubleuu General de VEmpirc Otiioman, par Mr. M. D'Ohsson, torn, 
 ii. §. vi. 
 
 * A Treatise on Tropical Disease?. By B. Moseloy, IM. D. 1th edit, 
 p. 638. 
 
 ^ In the autumn of 1815. 
 
448 Dr. Maclean on the Prei'cntion and Mitigation 
 
 ployed myself in investigating the Plague, and in treating cases of 
 that malady, in the Greek Hospital, near the Seven Towers, at 
 Constantinople. 
 
 So peculiar an experience, embracing also that of the progress, 
 and cure, of the disease, in my own person, will, perhaps, be ad- 
 mitted to confer upon my observations, respecting pestilential affec- 
 tions, a degree of authority, which they could not derive, either 
 from superior talents, or eminent station. 
 
 But I would not be understood, from thonce, to claim for my 
 doctrines any credit ; atid it were well for science if none were ever 
 accorded, beyond what is due to strict demonstration. All that I 
 request of the reader, is, that he will not refuse his assent to my 
 conclusions, unless he can shew them not to be logical ijiferences ; 
 or deny the correctness or my results, until he shall have ascer- 
 tained, that similar processes, conducted under similar circum- 
 stances, do not produce similar effects. 
 
 Epidemic diseases, from their greater number, as well as their 
 greater severity, naturally take precedence of all other maladies. 
 In proportion as they are more fatal, the discussions, which rehte 
 to them, are of superior importance. The subject even derives 
 additional solemnity from the profound ignorance of their nature, 
 which still continues to prevail : and they will be found, besides, 
 to possess an interest, derived from adventitious circumstances, 
 altogether singular and extraordinary, which distinguishes them 
 from every other human ailment. 
 
 Opinions, respecting their cause, which have arisen in the pro- 
 gress of society, and in Christian countries now almost universally 
 prevail, not only have the effect, by augmenting terror, and di- 
 minishing, or rendering precarious the means of subsistence, and 
 the attendance upon the sick, of increasing, in an almost incredible 
 ratio, mortality and disease ; but are, in many other respects, pro- 
 ductive of extensively injurious consequences to the best interests 
 of mankind. 
 
 And, wdiat may be regarded as still more singular and extra- 
 ordinary, these influential opinions are not only palpably erro- 
 neous, but of fraudulent origin, and of modern date. 
 
 The object, then, of the work which I contemplate, respecting 
 epidemic and pestilential diseases, and which is actually in a state 
 of forward preparation, is to promulgate principles, by the general 
 application of which, besides considerations of humanity and of 
 science, the population and the revenues of states mav be increased ; 
 or, what amounts to tiic same thing, their ordinary waste may be 
 dimhiishcd in a degree, which, pninaJaciCf might almost exceed 
 belief. 
 
of Epidemic and Pestilential Diseases, 449 
 
 But, as it would not be fitting, that results, which are tleomod 
 of such high importance, should be presented to the public in an 
 imperfect state ; and, as it may be yet some time before I am 
 enabled to complete my plan ; I conceive it may, in the interim, 
 be useful towards promoting discussion, by which alone truth can 
 be fully elicited, and finally established, to call the attention of the 
 public, by means of this notice of the fruits of my investigation, 
 to a subject no less remarkable for its importance, than for the neg- 
 lect with which it has hitherco been treated, and the consequent 
 obscurity in which it remains involved. 
 
 There arc, besides, in the actual state of the world, and esps- 
 eially of this country, some circumstances which lead me to think, 
 that it may possibly be of service that I should not delay to make 
 known at least some of the most prominent features of the results 
 of my investigation concerning epidemic diseases. 
 
 lliese are portentous times. Discontent and scarcity are 
 abroad ; and famine, with its usual concomitant, pestilence, vwy 
 follow. 
 
 Nor let me be reproached with endeavouring unnecessarily, to 
 excite alarm. If the danger be but imaginary, the speculation will 
 be harmless : the prophecy of the end of the world destroyed only 
 a few crazy tenements. But, if it should prove real, to anticipate, 
 if it (sinnot repel, is at least to break the force of the calamity. 
 
 My apprehension of the possibility of the occurrence of an epi- 
 demic disease in this country, arises from the prospect of a general 
 scarcity throughout Europe ; and the doubts that may rationally 
 be entertained, whether any measures within the compass of our 
 power may be adequate to obviate the consequences, in this re- 
 spect, of the varied and extensive evils which either exist, or are 
 impending. Let us not conceal from ourselves that it is not the 
 pressure of the present moment only against which we have to 
 guard. Considering, indeed, the deplorable state of the agricul- 
 tural prospects of this country as connected with those of some 
 other nations, and the unsettled state of all, it would be both un- 
 reasonable and pusillanimous not to anticipate, that, unless some 
 very material improvement speedily happen, upon which we have 
 no right to calculate, scarcity and distress, and consequently the 
 probability of famine and disease, may be even greater the next 
 and the following, than it is this year.' 
 
 The body being prepared by famine for falling into disease, 
 a slight deterioration of the atmosphere would be sufficient to 
 
 ' We hear alarming accKimls of scarcity t'roni almost every quarter : from 
 Sweden, hvvit/,erlarKl, Germany, France, and the Netlverlaud*. We/eel it at 
 home. Nor does the meshage of the American President, Mr. Maddison, to 
 V>oth Homes of Congress, which has just been received, give any promise of 
 a superabundance beyond the Atlantic. It is not by shutting ourey.es against 
 danger that we can hope to a\ ert it. 
 
4oO Dr. Maclean on the Prevention and Mitigation 
 
 b' 
 
 produce an epidemic malady. It consequently depends upon the. 
 casual diminution of the purity of the air, (and it is of the greatest 
 importance to note, that contagion can have nothing to do with 
 the matter,') whether we are to be afflicted with this additional 
 calamity. 
 
 When we become acquainted with the true causes, as well 
 principal as subordinate or collateral, upon which epidemic diseases 
 depend, and with the nature of the adventitious causes (the conse*- 
 quenccs of the belief in the doctrine of contagion) which multiply 
 their destructive eflects, we shall readily perceive the reason why 
 it would not be safe for any nation, even the most cultivated, and 
 consequently, other things being equal, the least liable to those 
 scourges, to consider itself as permanently exempt from the recur.- 
 rence of pestilential maladies.'' 
 
 In countries far advanced in civilization and culture, indeed, it 
 is seldom that the inferior or collateral causes of epidemic diseases, 
 as famine, Sec. occur with any considerable force; and, under 
 these circumstances, it requires the presence of the principal cause, 
 (which I shall prove, but, for the present, assume to be a deterio- 
 rated state of the atmosphere,) operating, in a high degree, to pro- 
 duce such pestilences as those which afflicted England in the 
 course of the seventeenth century. 
 
 Hence, for the last hundred and fifty years, although there have 
 been many obscure epidemics, as the bills of mortality enable me to 
 infer, which, however, have not been noted as such, we have, in 
 this country, remained exempt from any palpable or destructive 
 pestilence.^ And whilst it must be admitted, that the chances are, 
 according to the same principles, greatly in favour of the continuance, 
 with very rare interruption, of this happy exemption ; it is, howr 
 ever, no less obvious, that the subordinate or collateral causes 
 being, as at present, operating with unusual force, a slighter mea- 
 sure of the principal cause than under ordinary circumstances, 
 would be sufficient to produce the deprecated effect. 
 
 It is the part of wisdom to be prepared for every event. And 
 
 •It would seera as if medical writers had no other idea of the cause of 
 fever than coritagion, or niarsli miasma. When we come to investigate tlio 
 true cause of e|iide!nic diseases, the-re will be found to be almost equally 
 imaginary. It will, then, appear as absurd to talk of marsh rniasma, on the 
 rock of Gihra/tor, or on ioard a ship, as to talk, (ini/ uhere, of contagion. 
 
 ^ I am here obliged, fur the sake of illustration, to assume some things as 
 Known, which are only to be demonstrated in the work, aimounced in these 
 pages. And, in the mean time, I have to request that the reader will give 
 me credit for being able to prove what I deliberately assert. 
 
 ^ I shall shew, that noithtr thislongi.xcnjption, nor the repeated recurrence 
 of plague in the seventeenth century, have depended, in any degree, upon 
 the ^tate of our intercourse with Tuikry, or any other country, during these 
 pcrtodi re5,pcctively. 
 
of Epidemic and Pestilential Diseases. 4.71 
 
 if we arc properly prepared for that, whicli I have supposed possible, 
 by making ourselves acquainted beforehand with the true causes 
 of epidemic diseases, and with the appropriate measures to be pur- 
 sued for their alleviation, prevention, and cure, (conccnnng all of 
 which the most destructive errors continue to prevail,) 1 will ven- 
 ture to aflirm, that the mortality, to be apprehended from their 
 iBtrinsic severity, need not be contemplated with terror. 
 
 The peculiar nature of my experience, perhaps, may be deemed 
 to justify my speaking with some degree of confidence upon this 
 important subject : and it assuredly would not be, upon any 
 evidence short of demonstration, that I should permit myself to 
 assert, in the most unqualified terms, that with the exception of 
 those diseases, as small-pox and measles, which notoriously depend 
 upon that source, there is no fever, nor any general disease in 
 existence, that we know of, which is propagated by contagion.' 
 
 I have been led more at large into this train of observation, from 
 having repeatedly perused, in the public journals, advertisements 
 announcing the meeting of a soi-disant " Institution, for the cure, 
 and prevention, of confagicus fever, in the metropolis ;" and by 
 the desire to counteract the false and pernicious impression, that 
 might be made upon the public mind by an annunciation of this 
 nature, seeming to come from medical authority, if it were left 
 freely to operate, in the event of any casual increase of sickness, 
 in London, or others of our populous towns or cities. 
 
 But, it becomes of still greater moment, to endeavour to obviate 
 the effects of this delusion, if it be true, as is generally understood, 
 that the College of Physicians, who would of course be officially 
 consulted, upon the occurrence of an epidemic malady in the me- 
 tropolis, entertain, and would recommend measures conformable 
 to the same belief. 
 
 Of the destructive consequences of acting upon these erroneous 
 opinions, as well as that the opinions are erroneous, I rely that the 
 proofs, which I am enabled to adduce, will be found convincing, 
 and satisfactory. And, if so, it must be obvious, that if, in the 
 event of a pestilence, advice should be given to the Lord Mayor 
 and Aldermen of London, founded upon the errors deprecated, 
 (similaropinions have, if I be not misinformed, been recently com- 
 municated by the College to the Privy Council,) as was addressed to 
 their predecessors, in 1665, by the then College of Physicians, the 
 consequence would be, as it was at that period, to increase the 
 otherwise inevitable mortality, at least four-fold.* There would 
 be two hundred thousand deaths, instead of fifty thousand. 
 
 ' Typhus, upon wiiich the changes have been so incessantly rung by the 
 advocates tor contagion, will besliewn to be as incapable otpropagaluig itsell 
 as- gout or dropsy. 
 
 ^ Vide Directions for the Cure of the Plague, by the College of Physirians, 
 and Orders by the Lord Mayor and Aldermen of London, published I66j. 
 
452 Dn. Maclean on the Freaention and Mitigation 
 
 The advantages oF discussing and deciding the question respect- ' 
 ing their cause, whilst we are free from the terror and confusion 
 incidental to the presence of epidemic maladies, is rendered mani- 
 fest by a single consideration. During the plague of London in 
 3665, that of Marseilles in 1720, and indeed those of all other 
 cities, in which the belief in contagion has prevailed, a great pro- 
 portion of the sickness and mortality was obviously occasioned by 
 scarcity, from the impossibility of obtaining a regular and sufficient 
 supply of provisions, owing entirely to the influence of this UU" 
 founded belief. 
 
 The deaths in London, from pi. gue only, in 1665, were esti- 
 mated at one hundred thousand, upon grounds which there is no 
 good reason to consider as exaggerated, although the bills of mor- 
 tality did not state quite so many. The population being now 
 double of what it was at that period, a similar state of the atmo- 
 sphere being given, (for I shall prove that such was the cause of 
 that epidemic,) and the belief in contagion, with all its desolating 
 train of consequences, being operating with equal force, the mor- 
 tally would be double also. 
 
 Hence, it cannot fail to be of the most essential importance, in 
 the event of so calamitous an occurrence happening even in tire 
 smallest degree, that the public should be mad'e aware, that, inde- 
 pendent of all medical treatment, and of proper means of preven- 
 tion, three fourths at least of the mortality, which would otherwise 
 happen, may be obviated, merely by avoiding all the mistaken 
 Kveasures, which have been usually pursued, under similar circum- 
 stances, arising out of an hijpotkesis palpably erroneous. 
 
 That epidemic diseases do not depend upon contagion, then, 
 sJiall be demonstrated, by proofs, positive, negative, analogical, cir^ 
 cumstantial, and adnbsurdum. 
 
 With respect to the origin of this erroneous opinion, which was 
 altogether ukiiown to the ancient physicians, it may be considered 
 not a little curious, that it should have been lirst promulgated, as 
 ^ pious fraud, about the middle of the 16th century, by the legates 
 of Pope Paul III, at the Council of Trent ; and that it should have 
 since been propagated, and spread, and now exists, by faith, dread, 
 and fiction only. 
 
 The prepossession in favour of the ?/i/poiJ/rsis of contagion, arising 
 from the erroneous opinion entertained of its antiquity, being thus 
 destroyed, the question will be argued upon its proper merits. 
 
 To a papal stratagem solely, then, are we to attribute the destruc- 
 tion of lives, and the detriment to health, n\orals, medicine, com- 
 merce, navigation, the intercourse of nations, individual freedom, 
 military operations, the general consumer, and t^ic public revcnuq?. 
 
of Epidemic and Pestilential Diseases, 4.>S 
 
 which i shall shew to have been occasioned by the consequences, 
 directly or indirectly, of the hypothesis t)f contagion •, besides the 
 expenditure of immense sums of money, by all the nations of 
 Christendom, in institiUiiig and maintaining establi.shnieniSy that 
 essentially/ contribute to increase utoi-tulity and disease.'' 
 
 The destruction of lives, alone, depending upon the pernicious 
 measures founded upon them, I roundly esfimate at nearly a million 
 of persons annually, tliroughout tli^ world, since the period at 
 which they began to operate, in 154-7 ; not to speak of constitutions 
 ruined, and the miseries of poverty and want inflicted upon many 
 millions more. 
 
 Nor will it fail to be regarded as a singular phenomenon, that 
 the Turkish government alone, placed in the -vary focus of pesti- 
 lence, should have had the wisdom and forbearance, as I shall shew 
 it to be, to reject those fatal institutions, even when they were 
 strongly urged to adopt them by a neighbouring power." 
 
 ' Quarantine?, and other regulations of plague police, first established bj 
 the Venetian;;, are here ulludcd to. The plague having always been, as it 
 now is, a frequent visitor of the territories of" this state, they established, 
 about the middle ot the fit'ieenth centucy, an office, or coiuiril ofheait!i. 
 Afterwards, when tiiut disease had become contagious, by a decree of the 
 Pope, and the Council of Trent, (and all good Catholics were bound impli- 
 citly to believe tliis doctrine,) a similar office was established in almost every 
 village; and quarantine?, lazarettos, and other regulations of plague police, 
 multiplied along the banks of the Adriatic. They were adopted at Mar- 
 seilles, in 1669, probably inconsequence of the great plague of London, The 
 regulations of \'enice have served as models to Russia, Austria, and other 
 states. Of the origin and progress of the belief upon which they have been 
 founded, of its erroneousness, and of its numerous pernicious consequences, I 
 shall give a full and explicit history. 
 
 ^ Some account will be given of the representations, v.hich were made 
 upon the occasion here alluded to, by the Cabinet of Vienna, to the Turkish 
 Divan, through the medium of the Austrian Internuncio at Constantinople, 
 Baron Sturmer, proposing the establishment of Quarantines in various parts 
 of the Turkish dominions, as communicated to me by tlie venerable fatiier 
 <»f German physic, the justly celebrated Dr. Frank, counsellor of state, 
 and, first physician to their Imperial Majesties of Russia, wiio assisted to 
 draw up the regulations which were proposed for general adoption. 
 
 During the sitting of the Congress at Vienna, a memorial was presented 
 to that body, by the Philanthropic German Piiysician, Count Harrach, re- 
 commending that the Allied Powers should embrace the opportunity of their 
 assemblage, to obtain, by their conjoint representations, the consent of the 
 Turkish Government, to institute similar measures of plague police, in their 
 territories, with those entertained in other countries. Tiiis document shall 
 appear in the narrative of my researches, the benc-'olent author having, with 
 the liberality which distinguishes the true votary of science, favoured me 
 with a copy of it, knowing that my opinions upon the subject were diamet^i-^ 
 cally opposite to his own. 
 
 It is certainly very clear, that if the quarantines that exist are useful, they 
 should be generally extended, and the plan of Count Harrach acted upon; 
 whilst, if they are useless, or pernicioius, as I maintain, they should be 
 HhoIFv abolished. 
 
4.;4 Dr. Maclean on the Preteniion and Mitigation 
 
 By some persons, who have considered the subject superficially, 
 the frequent recurrence of plague in Turkey has been most ab- 
 surdly imputed to the want of these establishments ; since it will 
 be found, that, wherever they have been adopted, instead of pre- 
 venting, they have but increased mortality, and aggravated disease. 
 
 The establishments to which I here more particularly allude, are 
 quarantines, and lazarettos. But every other measure of separa- 
 tion, seclusion, restriction or regulation, which comes under the 
 denomination of plague police, should be considered as compre- 
 hended under the same head, and liable to the same objections. 
 
 Such are the measures, then, which I would most earnestly 
 «xhort my countrymen to reject, in the event of the occurrence, 
 under our present, or impending distresses, of an epidemic malady, 
 in whatever degree, among them j pledging myself, if they will 
 examine with attention, and without prejudice or prepossession, 
 the proofs and arguments which I shall offer for their perusal, to 
 shew to their entire satisfaction, and by the most irrefragable de- 
 monstration, that epidemic diseases never depend upon contagion. 
 
 And whilst the intelligence, that a demonstration is about to 
 appear, evincing that epidemic diseases never depend upon con- 
 tagion, may tend to obviate the apprehensions, which, upon the 
 occurrence, or even the rumour of the existence of such diseases, 
 never fail to arise from the supposed danger of 277/6'c/io7Z,- it may 
 also contribute, in no small degree, towards the same end, to be 
 Informed, that there are, in like manner, proofs in preparation, of 
 an efficient method of cure. 
 
 In the narrative of my proceedings at the Greek Hospital, near 
 the Seven Towers, besides some things, that will perhaps be 
 deemed both curious and new, with respect to the nature, cause, 
 prevention, and cure of plague, I shall have occasion to illustrate 
 the obstacles which have hitherto prevented or impeded the inves- 
 tigation of epidemic maladies. 
 
 An account will be rendered of my correspondence with the 
 Turkish Government, respecting the resumption of the investi- 
 gation, upon my recovery from the plague ; and their motives for 
 not wishing to encourage measures tending to repress the devas- 
 tations of that disease, as connected with religion, policy, and 
 avarice, will be explained. 
 
 From the whole of the details, it will be rendered manifest, that, 
 notwithstanding this disfavour, and the more active and dangerous 
 hostility of the inferior agents of the plague int-titutions, my in- 
 quiry has been attended with a very complete success. 
 
 In order to prevent misapprehension, or misrepresentation, I 
 think it right explicitly to declare, that, by complete success, I 
 would be understood to mean, that I have, by unequivocal pro- 
 
of Epidemic and Festikntia. Diseases, 4.55 
 
 cesses, invariably conducted by nmy personal agency, fully satisfied 
 myself, not only that plague does not depend upon contagion, but 
 that it is capable, by a mode of treatment, which I shall indicate, 
 of being cured, in the proportion of at least four cases out of five 
 of those presented, on or before the third day of the disease, in a 
 pestilence of ordinary severity : conclusions which I am ready at 
 any time to verify, in their full extent, to the satisfaction of others. 
 
 The system of depots for the reception of persons ill of the 
 plague, in order to disencumber their frightened relations, and 
 from whence they are transferred to the burying-ground, as exem- 
 plified in the practice of that near the Seven Towers, at which I 
 performed my experiments, shall be fully developed. "^ 
 
 The progress, symptoms, and treatment of the disease, in my 
 own person, shall be described. 
 
 And, finallv, an account will be given of the means by which I 
 have endeavoured to procure the immediate and general application 
 to public use, of the principles deduced from my experiments. 
 
 The general results of my researches concerning epidemic dis- 
 eases, may be thus summed up. 
 
 1. The nature of the obstacles which impede or prevent inves- 
 tigation, is explained ; and the path, which, to myself, was full 
 of thorns, rendered smooth to my successors. 
 
 2. The noted hypothesis of contagion is refuted. 
 
 3. Its fraudulent origin traced ; and, 
 
 4. Its destructive consequences shewn. 
 
 /)» The nature of epidemic diseases is illustrated, as dcducbd 
 from theii* phenomena, and the results of the operation of reme- 
 dies. 
 
 6. The doctrines concerning their cause, as laid down by Hip- 
 pocrates and the ancient physicians, are, in their great outlines, 
 but with certain modifications, adopted. 
 
 7. The means of prevention, and alleviation, are deduced from 
 the nature of the cause. 
 
 8. An efficient method of cure is ascertained. 
 
 9. It is assumed that a million of persons die annually of epi- 
 demic diseases throughout the world. 
 
 10. Of this mortality, it is computed that fifteen-sixteenths 
 are occasioned by the consequences of the belief in contagion j 
 the absence of the means of prevention, which depend upon a 
 knowledge of the cause j and the want of an efficient method of 
 cure. 
 
 11. Consequently, the result of the general renunciation of this 
 belief; of the general adoption of proper means of alleviation and 
 prevention ; and of the general application of an efficient method 
 of cure ; would be to save fiftecn-sixtccnihs of a million, or 
 
^•SjS Dr. Maclean^ ow the Freventim and Mitigation 
 
 937,500 lives, annually^ throughout the ^vorld : reducing the mor- 
 tality from a million to 62,500, or one-sixteenth. : J 
 
 In whatever degree these principles might be applied, the saving 
 of lives would be proportional. ,_ ,_ .y ^ 
 
 The grounds upon which this .computation has been made, shall 
 be duly assigned. It does not pretend to any thing like accuracy. 
 But whether it be excessive, or deficient, is imn\aterial, since thah: 
 oould not affect the validity of my general reasoning, or conclu- 
 sions. The only difference vyould be in respect to the quantum 
 of utility ; and it cannot be alleged, that, ^n this instance, its mini- 
 mv.m would not possess a su^cient degi'ee of importance. If the 
 proportions be even reversed, and the annual saving in lives, in- 
 stead of 937,500, be estimated at only 62,500, the object will not 
 cease to be worthy of being prosecuted. 
 
 12. From all which, it follows that it is an object of the highest 
 interest and importance, that a plan, upon a scale of suitable mag- 
 nitude, should ' be adopted, for the purposes of undeceiving the 
 multitude, in all countries, respecting the desolating belief in coh- 
 tagion ; of propagating a knowledge of the proper means of alle- 
 viation and prevention ; and of effecting the general application of 
 an efhcient method of cure, in epidemic and pestilential diseases. 
 
 Of Plague Police Estahlishme?its, 
 
 These Institutions being founded upon the doctrine of conta- 
 gion, are part of the destructive consequences of the belief in that 
 hypothesis alluded to, under the fourth of the foregoing general 
 heads, of the results of my researches. If this hypothesis were 
 disproved, all question respecting the merits of these institutions 
 would, of course, cease : but, whilst that object remains unac- 
 complished, it may, in the present state of knowledge respecting 
 epidemic diseases, tend greatly to elucidate the subject ; if, pre- 
 vious to coming in full collision with the whole mass of existing 
 prejudices, it be shewn, that, upon the principles of the advocates 
 for contagion themselves, 
 
 1. The laws of quarantine are absurd; 
 
 2. That plague police establishments are, in fact, inefhcient for 
 their object ; 
 
 3. That they are injurious to health, navigation, and com- 
 merce ; 
 
 4. And a source of great and pernicious expenditure. 
 Whether the measures which have been pursued, in order to 
 
 prevent the propagation of supposed infection, consist of seclu- 
 sion and conftuement, in a house, lazaretto, shi^, district, or town, 
 
of Epidemic and Pestilential Diseases. 45*1 
 
 tliey are all of the same nature, differing only in degree and manner 
 of restraint. Tlie shutting up of houses, in which there are per- 
 sons ill of the plague-, drawing lines of circumvallatioii, and cor- 
 dons of troops round cities, supposed to be infected j shooting the 
 sick J and other measures of similar barbarity, of which I shall cite 
 examples but too recent, are, I trust, already beginning to grow 
 obsolete. And let us also hope, that it will be but a very short 
 time before we see the detention of ships, goods, and persons, 
 tipon grounds which are either frivolous or chimerical, proscribed, 
 as unsuitable to the spirit and intelligence of the age. 
 
 All the regulations of plague police may be represented by the 
 general term 
 
 Quarantine. 
 
 Quarantine signifies the detention for forty days, as the term 
 Imports, in a state of exclusion from society, of persons, ships, 
 goods, &c. supposed to be capable of propagating, by contact or 
 contiguity, an infectious disease j forty days being presumed to 
 be the period at which that capability ceases. 
 
 Although the periods vary, being sometimes more, and some- 
 times less than forty days, the name remains the same. 
 
 As quarantine is a measure in perpetual operation, whether 
 there exist an epidemic disease or not, and even without the ru- 
 mour of one, It becomes a consideration of more importance, in so 
 far as its effects are distinct from those of other plague police 
 measures, than the regulations which are only enforced in the 
 event of actual pestilence. 
 
 Ahsurditi/ of the QiiarayUine Laxvs, even according to the 
 Doctrine if Contagion. 
 
 Were the laws of quarantine In other respects well-founded, we 
 might justly accuse them of having had more regard to the fears, 
 than to the permanent Interests of persons in liealth j whilst to the 
 sick they have been cruel, pernicious, or destructive. Plague, In 
 particular, has been assumed to be a disease necessarily fatal ; and 
 the measures which have been adopted upon its occurrence, have 
 been well calculated to justify the assumption. In resolving upon 
 means proper to arrest the progress of an evil, of which both the 
 nature and the cause have been equally misunderstood, it appears 
 as If the suggestions of alarm had been alone consulted. These 
 regulations, one would think, must have been made by men in high 
 
 NO. XX. Pam. VOL. X. 2 G 
 
45S Dr. Maclean on the FretJentiofi and Miiij^afion 
 
 to' 
 
 health, and never expecting that It might come to their turn to be 
 afflicted with sickness ; for they are the quintessence of abject fear 
 and base selfishness. By the very precautions employed against their 
 spreading, we find diseases, which might only be severe, rendered 
 almost certainly mortal ; and innocent or useful members, for 
 having the misfortune to be seized with a dangerous malady, lop- 
 ped off, like criminals, from the great body of society.' 
 
 That contagion is the cause of epidemic diseases, being, for the 
 sake of the argument, admitted, the object, at present, is to shew, 
 that the measures of plague police, enforced to prevent their 
 spreading, are, upon that supposition, not only detrimental, but 
 almost certainly destructive to the sick ; without being necessary, 
 or even conducive, to the safety of those in health. 
 
 Finding that the phsenomena of epidemic diseases could not be 
 accounted for by the hypothesis of contagion alone, the partisans of 
 that doctrine have been driven to the subterfuge of enlisting the 
 atmosphere as an auxiliary into their service. Accordingly, they 
 have generally admitted, that, " to the effect of contact, a certain 
 dispositio7i of the air is necessart/ ;" " for we often see," says one of 
 them, " infected persons arrive from other comwxxiqs, yet the disease 
 does not spread."^ 
 
 This is a fact, of which I am enabled to adduce some decisive 
 instances ; which, among other proofs, shall be employed to shew 
 that epidemic diseases do not depend upon contagion. In this num- 
 ber the celebrated Larnica cases shall not be forgotten, by which 
 Dr. Russel has succeeded in refuting the chief parts of his own 
 elaborate work ; and which Mr. Pym, as he wished durability to 
 his Bulamian invention, or permanence to quarantines and lazaret- 
 tos, committed a great oversight in so freely quoting. But my 
 purpose, at present, is to meet the advocates for contagion upon 
 their own ground. 
 
 If, then, to the effect of contact a certain disposition of the air 
 be necessary to the production of any disease, that disposition of 
 the air must not only form a part of its cause, but a part, ivithout 
 ivhich the effect cannot follow. 
 
 Consequently, to remove persons in health from that air, without 
 the aid of which, the disease, even according to the contagionists 
 themselves, cannot be produced by mere contact, must be the 
 
 ' It would not lie ])racticable here, without extentling these remarks much 
 beyond their intended hnuts, to enter uuo a distinct analysis of the effects 
 of eaeh separate nieasine of ])lague police. But those, to whom tlies? ohsetr 
 valions are particularly addressed, will be abie to distinguish to which mea-r 
 sure they are more especially applicable, when they do not embrace several, 
 or tlie whole. 
 
 * Vide Howard on the Trincipal Lazarettos o/Europ«, p. 33. 
 
of' Epidemic and Pestilential Diseases. 459 
 
 proper and efficient means of prevention : and to remove the sick, 
 must be a principal part of the method of cure. 
 
 It follows, no less clearly, that the continuance of persons in an 
 air viciously disposed, must be one of the most effectual means of 
 Tendering the healthy sick, and the diseases of the sick niortaU 
 And to detain them in it upon compulsion, which is the efl'ect of 
 all the usual measures of plague police, is, even admitting conta- 
 gion, little short of wilful murder. 
 
 Nor will the means usually resorted to upon such occasions, for 
 keeping the sick secluded, appear, according to the same doctrines, 
 to be either necessary or conducive to the safety of persons in health. 
 It is not contended by the most zealous advocates for contagion, 
 even those who have a direct interest in the permanence of the 
 belief, that its influence can extend beyond a fe\o paces. Raymond, 
 Physician to the lazaretto at Marseilles, and Desniollins, Surgeon, 
 say, that " infected persons are conversed with, without danger, 
 across a barrier, which separates them onli/ a Jexv paces."' 
 
 Giovanelli, Physician to the lazaretto at Leghorn, mentions yfi'<? 
 geometrical paces, as the greatest distance to which contagion can 
 extend.^ They, Physician to the lazaretto at Malta, says : " the 
 infection only extends some paces.''" And a Jew Physician of Smyrna 
 is of opinion, " that, in the greatest contagion, one may securely 
 see a patient at the distance of t'wo ells, if the chamber windows be 
 not all shut."* 
 
 Here we have it on the evidence of persons who cannot be sus- 
 pected of wishing to curtail its sphere of influence, that infection 
 never extends beyond a few paces. It would certainly be unrea- 
 sonable to reject evidence of this nature, coming from such a 
 quarter ; although, if the same persons were to assert that infection 
 is capable of being produced at the distance of one or two paces, 
 or at any distance, I should think it necessary to require proof. 
 But as I am now reasoning upon their own principles, I shall 
 adopt, as its basis, the greatest distance which they have themselves 
 assumed, being five paces. Five paces, then, according to the 
 doctrines of the contagionists, ensures safety as completely as five 
 hundred, or five thousand. 
 
 Thus, the healthy inhabitants of a town, district, lazaretto, or 
 vessel, might walk or tarry in perfect security at the distance of 
 five paces from the sick. There could, in such a case, be no pos- 
 sibility of the spreading of infection ; and the precaution of keepiKg 
 the sick at this distance from the rest of society duly enforced, 
 would infallibly, and at once, put an end to the propagation of any 
 
 ' Vide Howard on the Principal Lazarettos of Europe, p. 34. 
 
 - Ibid. s Ibid. ♦ Ibid. p. 35. 
 
460 Dr. Maclean on the Prevention and Mitigation 
 
 disease solely depending upon contagion, or, In as far as it might 
 in any degree depend upon such a source. 
 
 But the fact is, that a result of this kind has never been known 
 to happen, under the application of the precautionary measures in 
 question, in any epidemic disease. On the contrary, they will be 
 found to have commenced, run their course, and ceased,^ precisely 
 at the same periods, and in the same manner, where such institu- 
 tions have existed, and where they have not. 
 
 If this reasoning be correct, how greatly ought we to deplore 
 the existence of such regulations as those which follow i-. — 
 
 Ships, goods, and persons, are declared liable to quarantine 
 " coming from, or having touched at, any place from whence His 
 Majesty, with the advice of his Privy Council, shall have adjudged 
 and declared it probable, that the plague, or any other infectious dis- 
 ease or distemper, highly dangerous to the health of His Majesty's 
 subjects, jnay be brought ; and those having communication with, 
 or receiving any persons or articles from ships §o, qoming from, or 
 having touched at, such infected place," &c.' .. ,^ ,,."^l 
 
 " The places from whence the plague, or some other infectious 
 disease, may be brought into Great Britain, &c. are adjudged to be 
 any part of Turkey, or any port or place in Africa, within the 
 Straits of Gibraltar and the West Barbary, on the Atlantic 
 Ocean." * 
 
 But we find, that " although certain goods and ships, under par- 
 ticular circumstances, are made subject to certain fixed rates of 
 quarantine, yet it is farther provided, that goods specified in any 
 Order of Council, and ships, shall be made subject to quarantine.^ 
 The Privy Council may make such orders as they shall think neces- 
 sary upon emergencies. "■*■ 
 
 _ Thus it appears, that ships and goods coming from any part of 
 the world, and under any circumstances, may be subjected to such 
 restraints and detention as the Privy Council may choose to direct : 
 *' they may make such order as they shall think necessary upon 
 emergencies." 
 
 This unlimited authority has of course given rise to many injuri- 
 ous acts and regulations. If, for instance, a vessel meets with 
 another vessel, or a squadron, at sea, and is boarded by them, 
 although those so communicating have neither sickness, nor have 
 com.e from any place at which sickness existed at the time of their 
 departure, she is obliged to do quarantine. I knew a case of this 
 kind, in which a ship (the Sophia and Mary, of Bristol) was obliged 
 
 . ♦Rc: • 
 
 'Vide 45 Geo. III. cap. 10. sec. x. ; and Order io Council, 5th April, 
 1316, sec.i. 
 
 * \'ide Order in Council, 5th April, 1805. 
 
 ^ 54 Geo. III. cap. 10. sec. xi. ;> lb. sec. vii. 
 
of Epidemic and Pestilential Diseases. 461 
 
 ft) perform a quarantine of forty-two days at Malta, merely for 
 having been boarded by an Algcrine squadron off Lisbon. 
 
 The bare rumour of the existence of a plague in any part of the 
 Mediterranean, gives a pretext for the strict enforcement of quaran- 
 tine amongst the farthest nations of the North ; and the report of 
 a yellow fever in the West Indies, produces an increased vigilance 
 of the plague police establishments on the shores of the Baltic. By 
 the same rule, as the infection in these cases is supposed to be 
 brought in goods, and no one knows the period at which they cease 
 to be contagious, quarantine might, without more impropriety, be 
 enforced upon the arrival of East Indiamen from Bengal or China; 
 or rather ought, in consistency, to be enforced, when the report of 
 the existence of an epidemic has prevailed, at the time of their 
 sailing, in any part of these remote regions. 
 
 Considei'ing the matter merely in a view of commercial policy, 
 ■we may be allowed to regret, that, in conferring powers so arbitrary, 
 extensive, and undefined, the danger, against which it was intended 
 to provide, should have been so implicitly taken for granted ; and 
 that, in the absence of all correct knowledge respecting epidemic 
 diseases, no regular inquiry into the subject should have been 
 thought necessary, more than if their nature had been already per- 
 fectly understood. By regular inquiry, I do not mean the mere 
 official formality of ascertaining the individual or collective opinions 
 of men, who could not be supposed, without the gift of inspiration, 
 to know more of the nature of pestilential maladies, than they 
 might have found in the puerile traditions of the Catholics of the 
 Levant, and of Italy, transmitted through successive generations 
 unquestioned ; or in the absurd fables, respecting contagion, 
 invented by Fracastorius, in 1546, at the instigation of the Pope 
 and his Legates, and since quoted, as knowledge, by every succes- 
 sive writer upon the plague ;' but, a continued practical investiga- 
 tion. 
 
 Such, however, have been the tales, first fraudulently imposed 
 ■upon the world, in Italy, afterwards implicitly adopted by Mead, 
 and servilely copied by his successors, in England, which have 
 served as the foundation of our quarantine laws in this country. 
 Of the injury which they have occasioned to commerce and navi- 
 gation, some idea may be formed, from the following sweeping 
 clause, which it has been latterly judged expedient to introduce, 
 in order to protect our Levant trade against the competition of the 
 Dutch, and others, who were enabled, by the lenity of their quar- 
 antine laws, or an almost total disregard of them, to anticipate 
 
 ' Such is the story of the leather cap, by which f?5 Germans are said by 
 that author to have been successively infected in Italy; whicli, with lusuy 
 similar tales, I bhall endeavour to place in their true liglit. 
 
462 Dr. Maclean on the Prevention and Mitigation 
 
 and undersell us, with respect to Turkish commodities, in the 
 British markets : " Certain goods, wares, and merchandises, being 
 the growth, produce, or manufacture of Turkey, or of any place 
 in Africa, within the Straits of Gibraltar, or in the "West Barbary, 
 on the Atlantic Ocean, coming from any place in Europe, without 
 the Straits, or on the Continent of America, where there is not a 
 regular establishment for the performance of quarantine," are 
 declared subject to the same regulations as if coming directly from 
 the Mediterranean, or the West Barbary, on the Atlantic Ocean.' 
 The ships which bring them shall do quarantine, like those from 
 Turkey, with clean bills of health.^ 
 
 It can hardly be supposed, that to guard against contagion could 
 have been the design of this regulation ; since, with that view, it 
 would have been perfectly ridiculous. And although, with what 
 I understand to be its avowed object of protecting our commerce 
 against the rivalry of the Dutch, it may appear sornewhat less 
 irrational ; it would certainly have been still better, that such a 
 measure had not been rendered necessary. The more numerous, 
 complex, and rigid, are our quarantine regulations, the more will 
 our positive, as well as our relative advantages, with regard to 
 the commerce with the Levant, as I shall afterwards have occasion 
 more fully to explain, be diminished. 
 
 Of the different Kinds of Quarantine. 
 
 There are, in this country, six kinds of quarantine. 
 
 1. That performed, on account of actual pestilence, ox suspected 
 sickness, at the Isles of Scilly only, its period being 44 days. 
 
 A ship bound from Turkey, we shall suppose, arrives in England. 
 She has one, or a few sick persons on board. The disease is 
 immediately concluded to be contagious, or suspected^ which has 
 the same effect j although it would be difficult to conceive how 
 one or two sick persons, having an infectious disease capable of 
 being propagafed, as is supposed of plague, could make a long voy- 
 age, in daily or hourly contact with their messmates, without com- 
 municating the malady to all the crew. But there is probably no 
 instance in the annals of the trade between Turkey and this coun- 
 try, of the arrival of a vessel having, or having had, her whole 
 crew sick. Now, it is hardly possible to suppose, that any one 
 can have about him that potent and penetrating kind of contagion, 
 
 ' Vide Orders in Council, 5th April, 1805. 
 ■* Ibid. sect. v. and xlii. 
 
of Epidemic and FestUential Diseases. 4G3 
 
 imputed to the plague, without his communicating it to the whole 
 crew; although acliscasemay certainly affect a whole crew, scurvy 
 for instance, without being in the least contagious. 
 
 These trifling inconsistencies, however, being disregarded, qua- 
 rantine ensues. In the mode of performing it, one should suppose 
 that some regard might be had to the greatest infectious distance 
 (five paces) laid down by the lazaretto authoritic^s of the Levant. 
 But no ! neither five, nor five hundred, nor yet five thousand paces, 
 are deemed sufficient by the plague authorities, in this country, to 
 ensure safety. They do not consider themselves as secure from 
 infection, until this unfortunate ship and cargo, her crew and pas- 
 sengers, sick and well, articles enumerated, and articles not enu- 
 merated, as contagious, have fairly reached the rocks of Scilly !' 
 
 The sole precautions necessary in this case, even according to 
 the doctrines of the contagionists, would be to place the sick in 
 good air, with ample space, and suitable provisions and attendance, 
 having the interval of five paces between them and the rest of the 
 community, until death or recovery took place. 
 
 The passengers and crew in health, the ship and cargo should 
 then, according to the same doctrines, be kept in quarantine •, that 
 is, isolated at the distance of five paces or more from persons in 
 health, but only for the longest period, after being separated from 
 the sick, which the contagionists suppose to elapse between 
 receiving the infection and the appearance of the disease ; that is, 
 for three days : any farther period could have no object. 
 
 I beg it to be observed, that I am here again taking the doctrines 
 of the advocates for contagion as my text, and deducing from them 
 just inferences, in order to shew the absurdity, upon their oixin 
 principlesy of the precautionary measures adopted to prevent the 
 spreading of epidemic diseases. 
 
 Recommencement of Quarantine, 
 
 It is farther enacted, that if any death, suspected to arise from a 
 contagious disease, happen during any period of the quarantine, 
 it shall recommence.^ And thus, if a suspected death should take 
 place on the last day, the ship, crew, passengers, and cargo, must 
 submit to a farther detention of forty, or forty- four days ; and it 
 might even so happen that, from an unfortunate repetition of such 
 an occurrence, the detention might be prolonged until the ship and 
 
 ■ " Commanders, or masters of ships, having an actual pestilence on 
 board, are directed, if within the Straits, to proceed to some lazaretto in the 
 Mediterranean; if without the Straits, to proceed to the Scilly Isles." — Vide 
 45 Geo. 111. cup. 10. sect. xiii. 
 
 * Vide Ord. in Council, 6lh April, 1805, sect. xxix. 
 
464 Dr. Maclean on the Pre\)€ntion and Mitigation 
 
 cargo were rotten, or her crew and passengers dead.' Whereas, 
 by the immediate separation of the sick from those in health, upon 
 the arrival of the vessel, the whole of the time usually wasted in 
 quarantine, with the exception of the three days, might be saved, 
 and the whole of the loss upon the ship and cargo obviated. The 
 propriety of even this quarantine of three days, let it be recollected, 
 is only upon the principles of the doctrine of contagion. 
 
 Such a chain of accidents, it is true, may not often happen 5 but 
 the law is not, on that account, the less injudicious. If the evil 
 were of frequent occurrence, its immensity would alone demon- 
 strate the absurdity of the enactment, even to those who did not 
 immediately feel the injury. - ii" • 
 
 But it is so seldom, if ever, that quarantine is performed in 
 England, on account of suspected sickness, that, but for the prin- 
 ciple, the point would scarcely have been worthy of any, and, from 
 its consequences, does not appear to merit farther consideration. ■' 
 
 2. The second kind of quarantine is that performed by ships 
 having no suspected sickness, and bearing clean bills of health ; 
 that is, a certificate that there was no suspected sickness at the port 
 from whence they sailed, during their loading, or at the period of 
 their departure. The time is fifteen days, to which must be added 
 that occupied in discharging such parts of their cargoes as consist 
 of enumerated articles." Quarantine, under these circumstances, 
 is performed at different specified ports. 
 
 That a ship arriving in England, not only without any sickness, 
 but with a clean bill of health, should be required to do quarantine 
 for a single minute, seems to me to be a regulation without an 
 object ; especially when we reflect that all ships coming from 
 
 ' This would certainly be their fate, under the circumstances stated, if 
 plague were really contagious. All these regulations have been literally 
 copied from those of Venice, without considering that, even had their foun- 
 dation been correct, the difference of the circumstances of the two countries 
 would have required an essential difference in the application.of the prin- 
 ciples in detail. " When a person dies in any ©f these lazaretto^', unless the 
 Physician and Surgeon of the Office of Health declare that his death is 
 not owing to any contagious cause, and are very clear in their reports, 
 all those who are under quarantine are obliged to recommence it; and this 
 as often as there happens any suspected death." This, and other vexation*, 
 such as having no pay, sometimes give rise to mutinies among the crews 
 detained in quarantine. — Vide Howard' i Account of the Principal Lazarettos 
 of' Europe, p. 7. 
 
 '^ Ships furnished with clean bills of health shall, as well as the crews and 
 passengers, perform a quarantine of fifteen days from the date of the delivery 
 into the lazaretto, of such part of the cargoes as consist of the goods enume- 
 rated in class first and second ; or if there be no such cargo, from the 
 arrival of t!ie ships at their appointed stations. Vide Order in Council, Htk 
 April, 1805, sect. xii. 
 
of Epidemic and Pestiicniial Diseases. 46.5 
 
 Turkey perform more than a full quarantine at sea during the pas- 
 sage. Is it not a violation of all cORimoii sense, that we, who are 
 double the distance fromTurkty with someother countries, should 
 do double the quarantine ? It appears even more preposterotJS, 
 in proportion as we are more removed from the focus of supposed 
 infection, than the quarantine of eighty days, which used to he 
 perfonned at Venice, but is now considered superfluous, even 
 there. *< Formerly," says Howard, " when persons who had the 
 plague were brought from the city, (Venice), they were put, for 
 forty days, into a large room in the lazaretto, and afterwards into 
 another apartment, for the same time, before they were dis^ 
 charged.'" 
 
 The period now supposed sufficient for expurgation is forty days 
 from the commencement of the malady \ although there is no bet- 
 ter ground for this than mere hypothesis ; and forty min-utes, forty 
 hours, forty weeks, or forty years, would, in point of principle, 
 have been equally justifiable, or equally absurd. 
 
 The only danger that can be supposed to exist, under this species 
 of quarantine, is that which is presumed to depend upon the capa- 
 city of goods to receive, retain, and communicate infection. This, 
 as shall be presently shewn, amounts to nothing j but this quaran- 
 tine has the advantage over the two following kinds, that, with 
 precisely the same risk, it exacts only half the detention. 
 
 The following quarantines, although subject to difFerent periods, 
 are all performed upon grounds similar to each other, and similar 
 to the preceding. 
 
 3. A ship sailing from Turkey, with suspected bills of health, 
 commonly called touched patents ; that is, when a suspicion of 
 plague exists at the place of her lading or departure, but without 
 suspected sickness on board at the period of her arrival in England* 
 performs quarantine for thirty-four days at Stangate Creek only.* 
 
 4-. A vessel sailing without clean bills of health, that is, with a 
 certificate that the plague is understood to be actually existing at 
 the port of her lading or departure, but arriving without suspected 
 sickness in England, performs quarantine for forty-four days at 
 Stangate Creek only. This is at present, and has been for a long 
 time, by far the most frequent species of quarantine.* 
 
 » Vide an Account of the Principal Lazarettos of Europe, pp. 9 and IQ. 
 
 ^ " .Ships, &c. arriving with suspected bills ot health, (commonly called 
 touched patents, or bills,) shall respectively be subject to ten days less cjua^ 
 rantine than those without clean bills of health." Vide Ordir hi Council, 
 April 5, tms, sect. x\'u 
 
 5 Ships without clean bills of health, but having no suspected disease on 
 board, shall perform quarantine at Stangate Creek, and no xchcre else. — }'id$ 
 Order in Council, April '>, 1806, sect. xiv. xxxvij, and xxxix. 
 
4(56 Dr. Maclean o« the prevention and Mitigation 
 
 5. Goods, enumerated in class first ;ind second, brought to 
 England in ships that have already performed quarantine at any 
 of the lazarettos in the Mediterranean, are directed to perform a 
 farther quarantine of fifteen days.* 
 
 6. A similar quarantine is directed to be performed by goods, the 
 growth^ produce, or manufacture of Turkey, &c., coming from 
 any place in Europe, without the Straits, or on the continent of 
 America, where there is not a regular establishment for the per- 
 formance of quarantine, as if coming directly from the Mediter- 
 ranean," &c. 
 
 The last seems to be merely a politico-commercial regulation ; 
 and the preceding one to have been made to keep it in counte- 
 nance. 
 
 Upon what principle it has been decided that the Scilly Isles 
 are the proper station for ships having suspected sickness on board 
 to perform quarantine, or that Stangate Creek is the proper station 
 for ships having no sickness, I am equally at a loss to conjecture. 
 Nor can I forbear to contrast with these regulations the conduct of 
 the Turkish government, in the year 16G5, in freely and without 
 restriction admitting some of our ships into their harbours, after 
 they had been driven away, as suspected^ from several Christian 
 ports. I should be curious to know what measures our contagion- 
 ists, in their wisdom, would advise the Privy Council to adopt, if 
 It were ascertained that Turkish vessels had it in contemplation, 
 for purposes of commerce, to frequent our shores. It is probable, 
 I think, they would not consider themselves quite safe, if a quaran- 
 tine station were appointed for them nearer than the Orkneys. The 
 Mahomedans would not certainly hold intercourse with any nation 
 upon these conditions. And may we not find in quarantine a 
 solution, why the Turkish flag is so rarely, if ever to be seen 
 beyond the Straits of Gibraltar?^ 
 
 But, to return from what may appear to be a digression: if the 
 occasional detention of a ship, passengers, drew, and cargo, for 
 forty- four days, at the Scilly Isles, on account of the sickness of one, 
 or a few persons on board, and who might have been at once 
 removed, and the rest liberated, be, as I have shewn, both absurd, 
 and, as far as it operates, mischievous ; what ought we to think of 
 the detention, for the same period of time, of almost the whole 
 commerce of the Levant, without any sickness, and consequently, 
 without any assignable motive, at Stangate Creek ? For it is 
 
 ' Order in Council, April 5, 1805, sect, xliii. ^Ibid. 
 
 ^ It is singular that the opinion that plague docs not depend upon conta- 
 gfdn, has been imputed as an error to the Turks, as connected with their 
 ideas ot fatalism ; whilst the real error upon this subject has been regarded 
 as truth, and its fraudulent origin not observed. 
 
qfF.pidemk and Pestilential Diseases. 467 
 
 obvious that the want of a clean bill of health cannot in any view 
 of reason amount to a motive. There being no sickness, no ap- 
 prehension can be entertained of infection from persons : for, if 
 the crew of a ship could be supposed to go to sea, their persons 
 being loaded with infection, without the malady having actually 
 made its appearance, either the whole of it would be blown away 
 before tliey could make one fourth of the passage, or it would 
 remain entirely inoperative, from the absence of that disposition 
 of the air which is considered by the contagionists indispensable 
 to render it efficient. 
 
 As of late years very few vessels have arrived from Turkey with 
 clean bills of health, so nearly all the ships in that trade, belong- 
 ing to the United Kingdom, have been obliged to perform quaran- 
 tine ; that is, to lose one third of their time, without an object, 
 at Stangate Creek. And this, as it is of constant occurrence, and 
 the other (quarantine for suspected sickness, at the Scilly Isles) 
 but very rarely happens, comprehends almost the whole of the 
 evil. Indeed, it may reasonably be presumed to be alone sufficient 
 to arrest the progress of the trade of this country with the Levant; 
 and but for the destruction of that of France, in consequence of 
 the events of the war, would have probably, ere this, effected its 
 annihilation. It remains still to be seen, whether, upon the revival 
 of the trade of France with Turkey, in the event of the continu- 
 ance of peace between France and England, this will not actually 
 be the result. 
 
 I shall presently shew, from historical records, the pernicious 
 effects upon navigation and commerce which quarantine has actu- 
 ally produced in this country. But this seems to be the proper 
 place for saying a few words respecting clean, suspected, and 
 unclean bills of health. 
 
 Of Bills of Health, 
 
 A bill of health Is a document from the Consul at the port from 
 which a vessel sails. In any of the countries specified, purporting 
 either that, at the time of her sailing there was no plague, or sus- 
 picion of plague i that there were rumours of plague, but no actual 
 plague ; or that there was actual plague. The first are called clean 
 bills, the second suspected, and the last foul bills ; or, by a cour- 
 teous circumlocution, being without clean bills of health. 
 
 Although, there being no sickness on board, there does nof, upon 
 the supposition of contagion, appear to be any difference in the risk ; 
 vessels upon their arrival in England have, as we have seen, qua- 
 rantines allotted to them of very different periods, according to the 
 
468 Dr. Maclean on the Prevention and Mitlmtion 
 
 O' 
 
 specification of the bill of health with which they may be furnish- 
 ed ; that is, fifteen, thirty-foui', and forty-four days respective^Iy. 
 And if tlie detention of fifteen days be justly deemed a hardship, 
 where there is not the smallest shadow of risk, how much greater 
 is the hardship of being detained for thirty-four or forty-four days, 
 where the danger is equally chimerical ! For even according to 
 tlie doctrines of the contagionists, it is clear that there can be no 
 positive risk but in cases of suspected sickness. 
 
 Bills of health, then, not being founded upon any probable 
 danger, arising from the existence of actual sickness among the 
 crew of a nature suspected to be infectious ; but upon the supposi- 
 tion of the possibility of an infection (itself not proved) being 
 capable of being communicated at some uncertain period, by some 
 unknown artificer, to some undescribed article of produce or 
 manufacture, regarded, upon some unintelligible principle, as 
 capable of receiving, retaining, and again communicating that in- 
 fection, upon some unexpected occasion, to living persons, must 
 be regarded as not only evidently absurd in their principle, but 
 even an insult to common sense. 
 
 Let us examine the practice. A single accident (the term used 
 to denote death) from the plague, or the report of an accident 
 occurring in some obscure quarter of the great cities of Smyrna or 
 Constantinople, whilst a ship is loading for England, is deemed 
 sufficient ground to refuse that ship a clean bill of health. ("We 
 have seen that even clean bills of health do not exempt from 
 quarantine.) But even this ground, such as it is, can never be a 
 matter of certainty. There are no means of ascertaining the truth 
 of these reports. The Consuls cannot themselves, nor any of 
 those immediately connected with them, if they were so inclined, 
 enter into personal inquiries, as this might subject them to quaran- 
 tine, or, as is supposed, to danger of infection. These reports 
 they are, therefore, obliged to take upon trust ; and as they are 
 often fabricated for purposes of commercial speculation, those who 
 give them credit are very liable to be deceived. Indeed, those to 
 whose department it belongs to grant bills of health, whilst they 
 have reason to believe the reports that are in circulation to be 
 fabricated, consider themselves as having no option, but to act 
 uponthem. Hence ships may be despatched without clean bills 
 of health, when there is neither plague, nor any suspicious sick- 
 ness y whilst those who have fabricated the reports upon which 
 they have been refused, may have been despatching cargoes by 
 circuitous routes, in order to arrive at our markets before our 
 own can have finished their quarantine ; and if this mischief can 
 even be in any degree remedied by protecting regulations, it must 
 
of Epidemic and Pesltkntlal Diseases. 469 
 
 still be at the price of additional restrictions upon navigation and 
 commerce, and enhancing the value of the commodities of the 
 Levant to the general consumer. 
 
 At Constantinople there are, at almost all periods of the year, 
 and in almost every year, straggling cases, or reports of cases, of 
 plague; whilst at Smyrna, the periods of its commencement and 
 cessation are more dist'inctly defined. A town must be free from 
 plague six weeks before clean bills of health can be issued. ' For 
 these reasons, although clean bills of health are sometimes issued 
 at Smyrna, it is very rarely, especially of late years, that they have 
 been granted at Constantinople. And this may be, in part, the 
 reason why the Smyrna rrtarket is better supplied with cargoes for 
 this part of the world ; why ships prefer going there to load j and 
 why so few English ships now resort to the Turkish capital. 
 
 It may also afford a sofUtion, to a certain extent, of the great 
 advantages, under the system of quarantine, which the French 
 Levant trade enjoys over that of Great Britain j advantages which I 
 shall endeavour to shew would be much less considerable, if no 
 quarantine were performed in either country. 
 
 But it is farther evident, from these observations, that without 
 reference to the question of infection, communicated from person 
 to person, unless the system of bills of health, together with that 
 of quarantines, be immediately abolished, which can alone prove 
 an efficient cure for so many and so great evils ; or, at least, if 
 some radical alterations be not made in the regulations respecting 
 them, the most insignificant flags of Europe will prev^ail over us 
 in the trade of the Levant. 
 
 Infection, as such, cannot he cornmimicated to, retained 
 by, or propagated from Goods. 
 
 It is upon the chimerical notion, as it now appears, that certain 
 goods, wares, and merchandises, therefore called susceptible, are 
 capable of receiving, retaining, and again communicating, at some 
 uncertain period, to the living body an infection capable of produc- 
 ing desolation and death among mankind, that both bills of health 
 in Turkey, and quarantines in England, are founded : for the 
 occurrence of suspected disease, as a ground of quarantine, is so 
 rare, if it ever happen, that, regarded in its effects, it is scarcely 
 worthy of consideration. ^ 
 
 ' Tlie reports respecting the cessation, as well as the commencement of 
 plague, arc equally suhject to uncertainty, even if the principle were correct 
 upon which bills of health are granted. 
 
 * There is not, as I am informed, an instance upon record, of a ship being 
 
4Y0 Dr. Maclean o/i the Pi^evention and Miti^atioji 
 
 O' 
 
 In arguing for the abolition of the system of bills of health and 
 quarantines, I trust it will be thought that it is treating the advo- 
 cates for contagion liberally to meet them upon their own ground. 
 Having, for the sake of the argument, admitted that epidemic dis- 
 eases may depend, according to their own notions of the matter, 
 ■partly upon specific contagion, capable, with the aidy however, of a 
 certain disposition of the atmosphere, of propagating itself from 
 one person to another ; it will even then appear, that neither by 
 facts nor by reasoning can the opinion be justified that such infec- 
 tion may be communicated from persons to goods, and from goods 
 again to persons. 
 
 If, to the effect of contact, a certain disposition of the atmos- 
 phere be admitted to be necessary to the propagation of infection, 
 even from one living body to another, is it not the height of human 
 absurdity to suppose that infection, as suclif and by virtue of its in- 
 herent powers, can pass from the living bodyinto inanimate mattery 
 upon which the air cannot be presumed to have a similar influence j 
 and that, after residing for some time in tins inanimate matter, it 
 can repass, still retaining its infectious qualities, into the living hu- 
 man body ? 
 
 In the Iicvant no one is afraid to touch the body of a person 
 dead of the plague.' This fearlessness must have arisen from ex- 
 perience and observation of the innoxiousnessof this species of 
 contact. If, then, the human body, which, in its living state, had 
 been supposed capable of propagating contagion to other living 
 bodies, be acknowledged by the advocates for that hypothesis to 
 have ceased, with the cessation of life, to possess that capability, 
 upon what ground can it be assumed that this faculty may be pos- 
 sessed or acquired by other inanimate substances .'' 
 
 Here, then, the whole of that extraordinary doctrine of articles 
 susceptible of contagion in the first degree, articles susceptible in 
 the second degree, and articles non-susceptible, upon which bills of 
 health, quarantines, and other regulations of plague police have been 
 founded, falls to the ground. 
 
 The positive facts which shew that goods do not propagate in- 
 fection, are even more unequivocal than those which relate to per- 
 sons. From the information which I obtained at Malta, and in 
 other places, I feel myself authorized in concluding, that persons 
 employed in the expurgation of goods in the lazarettos, have been 
 even less frequently affected by epidemic diseases, in proportion to 
 
 obliged to do quarantine at the Scilly Isles, on account of an actual pestilence 
 on board. Consequently, even according to the doctrines of contagion, qua- 
 rantine in this country can have no object. 
 • Vide an Account of the Principal Lazarettos of Europe, p. 25, note. 
 
of Epidemic and Pestilential Diseases. 471 
 
 their numbers, than some other classes of the community :' and 
 from such persons, when seized, an epidemic disease has never 
 been known to be propagated. 
 
 Neither have any instances been known of persons, who have 
 been seized whilst packing and unpacking goods, or stowing and 
 unstowing cargoes, (itself an event of rare occurrence,) communi- 
 cating their disease to others. 
 
 All the relations, then, of the propagation of infection in epide- 
 mic diseases, whether from the living body or inanimate matter, 
 with which the public have been deluded or amused, for two cen- 
 turies and a half, will be found to be of no higher authority than 
 that of the leather cap of Fracastorius, or the feather-bed of Bene- 
 dictus.^ 
 
 As infection, admitting it to exist in a state capable of being 
 propagated, with the help of a certain disposition of the air, accord- 
 ing to the contagionists, from one living body to another, cannot, 
 as has been shewn, be communicated from the living body to dead 
 matter, and again from dead matter to the living body, quarantine 
 jnust, upon their own principles, be in all cases not only super- 
 fluous, but pernicious. 
 
 The doctrine of tlie susceptibility of goods, then, upon which it 
 is founded, may be regarded as one of the most imaginary, delusive, 
 and destructive emanations of popular credulity, and pious fraud, 
 by which devastation has been spread over the face of our planet.* 
 But granting, for a moment, that infection may even be propa- 
 gated from persons to goods, and from goods again to persons, 
 what would be the consequences ? The consequences would be, 
 that the quarantines at present in use would be wholly inadequate 
 to their object ; and that no quarantine could ensure safety^ "doithout 
 being interminable I 
 
 > This fact is acknowledged, in his answers to iny queries, by the Presi- 
 dent of the College of Phvsicians (Froto- Medico) of that island, although 
 a firm believer in contagion. 
 
 * De Contagione, lib. iii. cap. 7. 
 
 ' De Pesie, cap. 3. — These tales, invented, as I shall shew, at the insti- 
 gation of the Pope and his Legates, during the Council of Irent, afterwards 
 became tlie principal foun(lali(»n for quarantines and lazarettos. 
 
 * Tor the fanciful classification here alluded to, see Order in Council, 
 April 5, 1805, sect. \xx. and xxxv. 
 
 In a manuscript, wi*h the perusal of which I was favoured at Constanti- 
 nople, by Mr. Julius C.tsar Kelli, a native of Leghorn, and for many years a 
 practitioner of medicine in the Levant, containing observations which he 
 had made during the plague at Salonica, in 1783, and at liiiisa, in i800, 
 1812, and 1813, I find it very gravely staled, that warm hread, jiastry, and 
 feathers, are roongst the articles mos< msccptib/r of infection; and that the 
 shaggy, or long-haired horse, is the on/t/ animal not susceptible ! 
 
472 Dr. Maclean o« ilie Pirvention and Mitigation 
 
 It must be quite obvious, that if infection exist in goods, no qua- 
 rantine c in avail that is not of a period somewhat longer than the 
 greatest duration of the capability of such goods to retain and com- 
 municate that infection. Thus, as the plague, we are told, spread 
 in Pans from rags, after having laiii several years in an old wall,* 
 several years \s the s/^or^^^^period for which rags ought to perform 
 quarantine. But, if infection can exist in rags for several years, 
 ■what certainty can we have that it may not continue to exist for 
 several ages, or for several centuries ? Again, a feather-beii, as we 
 are informed, having communicated infection at the end of seven 
 years ;^ seven years is the shmiest quarantine that feathers ought to 
 be made to perform. And what guarantee have we of safety even 
 at the end of that period ? If feathers be capable of retaining infec- 
 tion for seven years, how shall we ascertain whether they be not 
 capable of retaining it for seventy, or seven hundred years ? 
 
 The absurdity of these consequences, from the principles of the 
 contagionists, ought, I should think, to be quite Conclusive of the 
 argument. ' . - : 
 
 Continuing to reason upon the same groimdsj it may be proper, 
 after having shewn that the measures actually in use for the preven- 
 tion of epidemic diseases, are absurd, according to the doctrines 
 upon which they are founded, to inquire into the nature of those 
 means which would, upon the same prirtciples, be efficient, and 
 ought, if they were correct, to be employed. • • nJ-! .•') ir-.tt-iJiTii 
 
 The obvious method of preventing all fartMeFprbpa^ati6ri'ii>f a 
 disease, communicated in the manner supposed by the contagionists, 
 would be to remove the sick. This would of itself be sufficient, 
 since those affected could not, without the aid of the air, commu- 
 nicate the infection to others ; and persons in heialth, the conta- 
 gion being removed from them, could not be infected by the air 
 alone. 
 
 No species of quarantine, no period of confinement or seclusion, 
 could, according to these doctrines, be necessary, either in respect 
 to the sick, or to persons in health. ^ ''• ■■ 
 
 Even in cases where infection had taken place, but the disease had 
 not yet appeared, it would be sufficient, still acting upon the same 
 opinions, at the breaking out of the symptoms, to ren>ove- th$. -per- 
 sons afflicted, in the same manner as the other sick Ij^id been pre- 
 viously removed. - . ,- 
 
 But removal being rendered, by any circumstances, impractiga- 
 ble, it would be sufficient, for the safety of those in health, to kq^p 
 the suspected in quarantine for the longest supposed period bcLv»'€cn 
 
 ' Theodore Maycrnc Conseils centre la Peste, &e. p. 6il. ; i^M.^g-.- 
 * Alcxniider Benedictus, d? Teste, c. 5, 
 
cf Epidemic and Pestilential Diseases. 4.7S 
 
 the reception of infection, ai?d the appearance of disease; being, 
 according to the contagionists, three days ; and those actually la- 
 bouring uqd^r diseasj^, for the longest supposed period of the dura- 
 tion of the capability of propagating infection, being forty or forty- 
 two (lays from the cammencement of the diseasQ. 
 
 Thus it appears, that in no possible case can any measures of 
 restriction be necessary, according to the principles of the conta- 
 gionists themselves, taking them in their best defined form, ex- 
 cepting when the rempvaj of the sick from the noxious air, which, 
 together with cpntact, is supposed to produce the disease, becomes 
 impracticable ;-ra circumstance which can very rarely if ever 
 happen. 
 
 The measures, then, which obviously result from the doctrines of 
 contagion, as declared by its most experienced advocates, are almost 
 diametrically opposite to those which are now generally in use. 
 
 But, it would equiilly accord with the preceding opinions, as it 
 obviously follows from the principles of non-contagion, that both 
 those affected, and those in health, should, in all cases in which it 
 is practicable, be removed from the noxious atmosphere, as the 
 most efhcient mode of prevention, as well as an essential part of 
 the cure. 
 
 When, however, as most frequently, or almost always, happens, 
 the removal of persons in healrfi, as in large cities, is altogether 
 impracticable, other means of prevention become necessary, far dif- 
 ferent indeed from those vain attempts to purify the mass of a de- 
 teriorated atmosphere, which have usually been resorted to upon 
 such occasions. 
 
 These means sliall be considered in treating of the methods of 
 prevention founded upon the knowledge of the true cause of epi- 
 demic diseases. 
 
 Institutions of Plague Police are, in fact, inefficient 
 for their Object. 
 
 There cannot be a clearer illustration of the inefficiency, as to 
 their object, or of the perniciousness, in other respects, of the mea- 
 sures of precaution usually adopted against the propagation of epi- 
 demic diseases, than what happened in the plagues of London in 
 1625 and 1665 ; in both which instances, whilst the houses were 
 kept shut up, the disease continued to spread, and mortality to 
 increase ; and when they were allowed to be opened, mortality 
 decreased, and the disease ceased to spread. 
 
 NO. XX. Fax. VOL. X. 2 H 
 
474 Dr. Maclean, on tlie Prevention and Mitigation 
 
 On the former of these occasions, the houses were allowed to 
 be opened in the beginning of September. The deaths, from 
 plague, in the last week of August, amounted to 4218. The 
 next week they were diminished to SS^^ ; the week after to 2250 j 
 /and the third week to 1612.' These are undeniable facts. 
 
 In 1665, the circumstances were almost precisely similar : and 
 it was when the houses had been thrown open, and all other 
 measures of precaution abandoned in despair, that the malady 
 suddenly declined and ceased. These facts shall be distinctly 
 proved from historical records. "■ 
 
 Thus it appears, that, with the prohibition of intercourse, the 
 disease was aggravated and extended ; whilst, with its restoration, 
 it was mitigated and circumscribed. It would be incorrect, and 
 cannot be necessary, to argue, that these circumstances were in 
 the relation of cause and effect. But they clearly shew, that 
 measures of restriction have not the effect of arresting the progress, 
 or mitigating the severity, of pestilential maladies. 
 
 It is, indeed, evident, from the histories of the plagues which 
 have infested London since the year IS^T, as far as we have 
 authentic records, that at least three-fourths of the mortality ought 
 to be attributed to the restrictions by which the inhabitants were 
 confined to their houses, or, at any rate, to the town •, since, if 
 they attempted to depart, they were driven back, vi et wmis, by 
 the inhabitants of the neighbouring villages and country ; to 
 irregularity and deficiency in the supply of provisions, from the 
 dread of infection ; to the want of attendance upon the sick j and 
 to the other evils occasioned by the belief in contagion. 
 
 Gzs^Qn^ns, [Not itia Eccles. Z)/n2Vw5/s') relates, that, in a plague 
 which affected Digiie, in Provence, in 1619, out of ten thmisand 
 inhabitants, but fifteen hundred remained alive : and this mortality 
 he imputes to the citizens having been so closely confined, that 
 they were not suffered to go to their country houses : whereas, in 
 another pestilence, which broke out in the same place a year and 
 a half after, owing to the liberty being extended, there did not 
 die above one hundred persons. Without imputing more than 
 the due share of mortality to the operation of the restrictive 
 measures employed upon this occasion, it is obvious, !iot only 
 
 ' Vide the Shutting up of Houses, soberly debated, London, 1G65. — Mead's 
 J)iscourse, p. 37. 
 
 * It is a curious circumstance, that more information, of an applicative 
 nature, respecting llie plague of 1665, will be found in the journal of an 
 obscure saddler of Wiiitcchapcl, than ia all the writings of' the Medical 
 Taculty. 
 
of Epideimc and Pcstik'ntUU Diseases. 475 
 
 that they did not tend to stop the progress of the disease, 
 but that they must Iiave greatly aggravated its severity. And 
 it is strange that Mead, who quotes and applies these facts in a 
 difibrent sense, should not have felt how incompatible they are 
 with the doctrine of contagion. 
 
 Every one has read of the memorable plague of Athens, recorded 
 by Thucydides, in which the vigilance of the Peloponnesian besieg- 
 ers, serving in lieu of that of the plague guardians of modern 
 times, contributed to destroy so many of the unfortunate inhabit- 
 iir.ts ; and no one will contend that, if the Athenians could have 
 freely quitted their city, one fourth of the number would have 
 perished. 
 
 But of all the details respecting the ravages of pestilential mala- 
 dies to be found in history, those concerning the plague of Mar- 
 seilles, in 1720, are perhaps the most afflicting; where nearly half 
 the inhabitants of that ancient city perished, nine tenths of them, 
 I am persuaded, victims of the barbarous and cruel regulations by 
 ■which they were compelled to remain perpetually exposed to tlie 
 influence of the noxious atmosphere, which was undoubtedly the 
 tirst and principal cause of the disease ; famine and other collateral 
 causes, having, in the course of its progress, been superadded. 
 
 That contagion could have had no share in the production of 
 any of these pestilences, is evident, both upon the principle, which. 
 shaH be elucidated in my " Researches," that " diseases uohich 
 depend on contagion^ nev^ arise from other sources ; and that 
 diseases "which arise from other sources, never depend upon conla~ 
 gion /' and from the acknowledged inefficiency of all the measures 
 that have been adopted for checking tlie progress of epidemic 
 maladies. 
 
 Respecting that of Marseilles, we find the following article, 
 quoted under the head of Paris, in the Postman of August 6, 1720: 
 " The extraordinary council of health appointed by the Regent, 
 meet three or four times a week, and have taken the advice of the 
 most noted nhysicians of this city, about the most proper means for 
 preventing the spreading of the plague, si?ice lines, entrenchments, 
 and other precautions, cannot do it.'"' The walls of Marseilles 
 were not able to keep in, nor those of Aix or Toulon to keep out, 
 this malady; circumstances which, if it had depended upon con- 
 tagion, could not hive happened, since, in that case, even accord- 
 ing to the advocates of this doctrine, these places would have 
 afforded more than sufficient security. Infection can neither scale 
 walls, nor leap ditches. 
 
 I Vide Discourse concerning the Flj^ue, by Sir Ric.li:iid Manningham, 
 p. Jl. 
 
476 Dr. Maclean, on the Prevention and Mitigaiion 
 
 In Gibraltar, and many parts of Spain, as we are enabled to 
 infer from the materials published by Sir James Fellowes, and 
 other advocates for contagion, epidemic diseases have, since the 
 introduction and progress toward perfection of plague police 
 establishments, been even more frequent thau before. To impute 
 tliis increased frequency, indeed, to the operation of these institu- 
 tions, although such would be the obvious conclusion from the 
 doctrine of contagion, would be as inconsistent with truth, as to 
 impute to their absence the recurrence of pestilences in countries 
 where they do not exist. The fact is, that epidemic diseases 
 commence, pursue their course, and terminate at similar periods, 
 and in a similar manner, in all countries similarly situated, whether 
 tliese countries possess plague police establishments or not ; but 
 \vlth this difference, that where these establishments exist, they 
 never fail, in the precise measure of their activity, to increase 
 mortality, and to aggravate disease. i . 
 
 In 18 IS, for instance, the plague commenced, spread^ declined, 
 and ceased at similar periods, in Malta, where there are quarantines, 
 lazarettos, and other plague police regulations, of the most perfect 
 kind ; and in Wallachia, where there are none.* Gf the periods, 
 in regard to the latter, I was informed by the Prince of that country, 
 who is an intelligent Greek, and by the foreign Consuls, as well as 
 by several of the medical faculty, principally Germans, resident at 
 Bucharest. And these statements are the less liable to suspicion, 
 that my informants are all faithful believers in contagion. 
 
 It is not a little remarkable, and very much in point, that in the; 
 same year, upon the rumour of the plague having broken out at 
 Malta, the garrison of Gibraltar was put under rigid quarantine, 
 and remained so for two months ; notwithstanding which, the 
 disease commenced, ran its course, and terminated, in the same 
 manner as if no precautions whatever had been taken. ^ 
 . Considering these facts, it may be regarded as a curious phaeno- 
 menon in the history of the human mind, that the advocates for 
 contagion and quarantines should persevere, as they have recently 
 done in Spain and in Malta, in attributing the disappearance of 
 the malady at its usual season, to the vigilance and activity of the 
 police institutions. It shall be rendered manifest, that, excepting 
 in a view of mischief, it would have been precisely the same thing 
 whether they had been vigilant or asleep. 
 
 '' These institutions havo been brought, according to the existing idea?, 
 to the highest perrociion, at Odessa, under the government of the Duke I'.e 
 Richlieu ; and at Malta, by Lieutenant-General Sir Thomas Maitland. Put 
 they never have been, and never will be, able to prevent ihe spreading of 
 pestilence, when the circumstances occur that would otherwise produce it. 
 
 ' Vide a practical account of the Mediterranean fever, by W. Burnet, 
 M. D. p. 479. 
 
uf Epidemic mid Vestikntial Diseases. 47*7 
 
 The circumstances connected with the frequent recurrence of 
 t)ie plague in England during the century which preceded 1665, 
 ^6 well as those connected with the exemption which it ha'i 
 enjoyed from that malady during the century and a half which 
 have intervened, are equally in proof that the absence or the pre- 
 sence of that malady do not depend, in the smallest degree, upon 
 the state of our intercourse with Turkv-y, or any other country. 
 
 In the 73 years which preceded l(jG5, when there was very 
 little commerce or communication with the Levant, the plague 
 occurred seventeen times in England, allowing that of 1636 to 
 have existed, with intervals, twelve years. 
 
 During the fifty years which followed 166.'j, although the trade 
 and communication with the Levant must have been at least 
 quadrupled, whilst England still had no institutions of plague 
 police, and tlie disease continued to visit Turkey with undiminish- 
 ed frequency, it did not once occur in this country. 
 
 According to these data, however, if the disease had deperdcd 
 upon communication with Turkey, that is, upon infection from 
 goods, (for there have been no instances of the arrival of persons 
 actually labouring under disease of a pestilential nature,) the 
 plague, observing a similar rate of recurrence as in the 73 years 
 which preceded, would have appeared about fori^y-six times hx 
 England, from 166.1 to 1720. Its total exemption under such 
 circumstances, however, appears to me' to amount to fortv-six 
 good reasons against the existence of contagion in goods ; whilst 
 not one reason can be found in favour of the contrary opinion,' 
 now so generally acted, upon. - 
 
 Hence it woxild be as unreasonable to inrpute to- quarantine the 
 exemption of England from plague, during the century xvhich has 
 elapsed since its institution, as to impute it to any otiier regulation, 
 of which the existence happened to commence about the same 
 period; or as it would be lo attribute the frequent recurrence of 
 plague in Turkey to the want of these establishments. '"= .»'.. 5'''noj> 
 
 If such conclusions were correct, Spain, Gibraltar, -^Mahaj 
 Marseilles, the Ionian Islands, and the Venetian territories, all of 
 which are copiously supplied with these institutions, would never 
 have the plague •, whilst it would be constantly infesting Persia, 
 India, &c., which have not the benefit of these sovereign preven- 
 tives ; neither of which do we find to be the case. 
 
 Plague Police Establishments arc injurious to Healthy 
 Navigation, and Commerce. 
 
 Since to produce disease must be the obvious and necMsary^' 
 
478 Dr. Maclean, on the Prevention and Mitigation 
 
 consequence of detention and confinement, under circumstances 
 calculated to depress the mind or deprive the body of its usual 
 exercise, it cannot be necessary to cite proofs of the insalubrity of 
 quarantme, or other measures of plague police. They are to be 
 found in the most ordinary laws of life. Howard used to com- 
 plaia of constantly experiencing headache during his visits to the 
 Jazarettos and hospitals. ' 
 
 My business, at present, is rather with the effect of these insti- 
 tutions upon navigation and commerce. 
 
 Perhaps the best mode of estimating the effect of quarantine 
 upon commerce and navigation, is to compare those of France and 
 England with Turkey at several periods. 
 
 Previous to 1669, when there was no quarantine in either 
 country, the Levant trade of England, as we learn from Anderson's 
 useful work upon commerce, was superior to that of France. 
 
 From 1669 to 1720, quarantine being established in France, 
 hwt not in England, our Levant commerce still continued to pre- 
 ponderate. 
 
 From 1720 to 1785, quarantine existing in both countries, the 
 trade of England regularly declined ; so that from 1760 to 1785, 
 the average annual exports were not quite equal to one-fourth of 
 those of the twenty years preceding 1720, nor the imports to one 
 half. ^ 
 
 During the same period the trade of France with Turkey regu- 
 larly increased ; so that its exports, in 1787, were to those of 
 Englandj in 1785, as fifteen and a half; and its imports as ten and 
 a half to one. ^ 
 
 The state of our Levant commerce, from the breaking out of 
 the war, a few years afterwards, to the present period, as there 
 was no competition, can afford no data. 
 
 As the remedies which were attempted to be applied to these 
 evils all failed of success, we may presume, that the causes to 
 which they had been imputed were not the right ones. 
 
 Under the persuasion that our inferiority might depend upon 
 the limitations under which our Levant trade was conducted, 
 although these limitations existed in an equal or greater degree 
 
 ' Vide an account of the Principal Lazarettos of Europe, p. lOG. 
 
 * Vide And. Com. Vol. IV. passim. — Tiie difference seems so surprising, 
 that I cannot but apprehend, that I must have committed some errors in my 
 deductions from liie duta of Mr. Anderson : but, if I have, the reader will, I 
 daresay, believe that it was not wilful : and I shall be much obliged to any 
 one who will enable me to correct any error of importance into which 1 may 
 have fallen. 
 
 ' In 1787, the exports and imports of France to Turkey amounted each 
 to about a million sterling. — Vide. And. Com. V^ol. IV. p. C57. 
 
of Epidemical and Pestilential Diseases. 479 
 
 when our commerce surpassed that of France, an act of parliament 
 was passed in ITS*, by which every subject of Great Britain, 
 desiring to become a member of the Turkey Compnny, was 
 directed to be admitted, within thirty days after making such 
 request, paying for such admission twenty pounds for the use of 
 the Company, and no more.' 
 
 Notwithstanding this enlargement, the trade continued to 
 decline from 115^ to 1785, more rapidly than before ; and as 
 there appears to be no reason to doubt that this state of decay 
 would have continued progressive, it is more than probable that, 
 but for the intervention of the French war of the Revolution, anH 
 the destruction of the French commerce of the Levant, ours would, 
 ere this, have been wholly annihilated. 
 
 Amongst the palliatives resorted to in mitigation of this evIJ, 
 was a law, passed in 1759, to prohibit Britishsubjects from ex- 
 porting French broad-cloth to Turkey, and from importing raw 
 silk from Leghorn into Great Britain.'' 
 
 A duty was also laid, in 1781, upon cotton and cottonwool, im- 
 ported into this kingdom in foreign ships or vessels, during the 
 then existing hostilities.^ 
 
 But these protecting laws, as they did not touch the main cause 
 of the evil, were, as might be expected, wholly unavailing. 
 
 From the moment of the establishment of the quarantine laws 
 in England, our Levant commerce began and continued to decline, 
 until the Turkey trade of France also fell into our hands. This 
 coincidence clearly indicates these laws as the main cause of 
 the evils. It is both so obvious and so adequate, that there can be 
 no necessity to look for any other ; and if we do not, by its re- 
 moval, apply the proper remedy, it is not difficult to foresee, that 
 as France is about to resume her rivalry, perhaps with more ad- 
 vantages than before, it will not be long before she regains her 
 superiority. 
 
 Although there can be no doubt that quarantine operates inju- 
 riously to commerce and navigation in France, and in every other 
 country in which it has been adopted, as well as in England ; yet 
 it must be observed, that neither the inconvenience nor the expense 
 of doing quarantine at Marseilles, when it is even of the same 
 duration, can be near so great aS at the Isles of Scilly, or in Stan- 
 gate Creek, or in Milford Haven. And hence the advantages en- 
 joyed by France, from the situation of Marseilles, when there 
 were no quarantines in either country, must be now greatly in- 
 hanced by the different operation of those establishments in each. 
 
 • And. Com. Vo!. III. p. 29?, 3. 
 
 * W. Vol. 111. p. 317, 8. ^ Id. Vol. IV. p. 398. 
 
430 Dr. Maclean, o« the Prevention and Miti}iatioii 
 
 o 
 
 It Is evident, that from proximity merely, vessels may go from 
 Marseilles to Smyrna, embracing the intervals in which that plac« 
 is known to be free from plague, and from rumours of plague ; 
 and after having supplied themselves with all that the demand re- 
 quire^ of the commodities of the Levant, may return at seasonable 
 periods, subject only, for the most part, to the short detention re- 
 quired under clean bills of health, whilst by far the greatest num- 
 ber of our vessels, not having the same facilities of embracing the 
 most favourable seasons, are placed under the circumstances 
 which subject them to the performance of the long quarantine of 
 forty-four days. 
 
 This constitutes a very great difference in respect to the injury 
 which the trade of each country suffers from those regulations. 
 But there is a further circumstance, which is also much against us 
 in this comparison. Marseilles being the most conveniently situ- 
 ated point in France for the centre of Levant commerce, the mer- 
 chandize of these countries, after suffering, generally, no farther 
 detention at that port than the period of the shortest quarantine, 
 are promptly transmitted to all the other parts of the kingdom ; 
 whilst ours, by being consigned to Stangate Creek, is doomed, 
 after having performed the longest period of quarantine, to the 
 farther detention of a circuitous navigation, arising from the inap- 
 propriate situation, excepting for the port of London, of that 
 place. 
 
 With respect to the comparative disadvantages to which our Le- 
 vant commerce is exposed by the quarantine ' laws, and of their 
 positive mischiefs, which are both great and numerous, I shall, 
 for the present, only observe, without insisting upon incidental 
 expenses, the tear and wear of ships, the wages of crews, or the 
 waste or destruction of cargoes, that the detejition merely must 
 either have the effect of diminishing the profits, on the commerce 
 and navigation to the Levant, by one-third, or of inhancing, in the 
 same ratio, the price of the commodities of that country to the 
 general consumer, since, but for this detention, vessels would 
 make at least three voyages, where they now make only two. 
 
 The severity with which, even under the least unfavourable 
 circumstances, the effects of quarantine are felt by the commercial 
 community, is well evinced by the following circumstance. The 
 Council of Commerce, established by the French King in 1700, 
 presented a memorial to that King's council, in which, among 
 other things, they represent that, " It would be more advantageous 
 for France to permit her ports on the ocean to carry on this trade 
 directly to the Levant, without being obliged, ever since the year 
 
 * It was not my intention here to do more than merely to inditate thcui. 
 
of Kpidcmical and F€!itHeiiti(ti Diiease^. 431 
 
 1CG9, to unlade at Marseilles, on their return, under pretrnc^ of 
 preventing their bringing in the plague v which has obii^^ them 
 to relinquish that trade entirely." .>';;t.,u .'UMf ^j.t .j r>j . v^o.;^ 
 
 How much more heavily the disadvantage's of these Vtjgufaftlons 
 have weighed upon the cpmnierce of England, where, from Itsl 
 greater distance from the seat of the supposed infectrort', the pre-f' 
 text was still more unreasonable, I have already had occasion tbi 
 shew. 1>* 3<iiVfcil joa ,i;«9*fc^v mo io .><' 
 
 .,-.,».. .. '<■- . ..^-. <■ ^ldfc■^iJOV£i Jitiv. 
 
 (^ til ii) fi.' 1 iij(du2 rbirhv 
 
 Plague Police Eslahlishments are a Source qf^edt^aVid ■ 
 pernicious Expenditure. 
 
 Previous to ISOOi' gliips without clean bills of health were not 
 admitted to entry in these kingdoms, unless after having per- 
 formed quarantine in one of the principal foreign lazarettos (we 
 had then none of our own,) in the Mediterranean. This regula- 
 tion has existed since the first introduction of quarantine into this 
 country, in 1720. From that period to the year 1800, quarantine, 
 with clean bills of health, was performed in England, in old ships 
 of war, called floating lazarets j and the expense borne by his Ma-: 
 jesty's government. 
 
 In 1800, it being deemed expedient to remove the restrictions 
 mentioned, an act, (39 and 40 Geo. III. c. 80,) was passed, au- 
 thorizing ships to enter without clean bills of health ; appropri-^ 
 ating the sum of 65,0001. from the consolidated fund, for the esta- 
 blishment of a land lazaret at Chetney Hill, and imposing a ton- 
 nage duty upon the shipping employed in the Levant trade, to 
 reimburse the cost of Chetney Hill, and to provide for the future 
 expenses of quarantine, as well afloat as on shore.* , ;';, 
 
 In 1805, this sum having been found insufficient, another aict 
 was passed, to make further provision, and to confirm the act of 
 1800 in all its conditions. 
 
 ' Vide And. Com. Vol. HI. p. 7. 
 
 * Experience of the comparative disadvantages arising to our commerce 
 tVom the performance of quarantine, with foul hills of health, in the Medi- 
 terranean, and, perhaps, the difliculty of procuring access to the foreign 
 lazarettos in war time, after Franco had extended her conquests, pointed out 
 the e>:pedieni;y of transferring them to England: and, were these institu- 
 tions useful, this measure would certainly have been an improvement. Its 
 propriety was pointed out several years before it was carried into effect, in 
 an able letter, addressed by the merchants of Smyrna, to Mr. Howard, and 
 inserted at page 27 of his Account of the Principal Lazarettos of Europe. 
 But if my conclusions be just, this transfer can now on!y be regarded as liie 
 improvement of an cnror. 
 
482 Dr. Maclean, on the Pi^eve?itwn and MitigatioUy cJt. 
 
 Under the authority of these acts upwards of 250,0001. have, 
 since 1800, been levied upon the trade of the Levant. The land 
 lazaret remains still unfinished. And, after an expense has been 
 incuri'ed of between one and two hundred thousand pounds, in 
 the purchase of lands, and the erection of works, doubts liave 
 even arisen respecting the healthiness of the situation. 
 
 Here, then, is a direct expense of from 16,0001. to 20,0001. a 
 year entailed on the public for an object that is not simply useless, 
 but injurious ; for whether it be paid in the first instance by a 
 duty on the Levant trade, or otherwise, the amount always comes 
 ultimately from the pockets of the consumer. 
 
 This is an ascertained expenditure. But we know not how 
 much has been advanced out of the consolidated or other funds, 
 to support the quarantine establishments in this country, beyond 
 what has been reimbursed by the tonnage duty levied upon the 
 trade. 
 
 This is properly a subject of official inquiry, and the truth may 
 be easily ascertained. 
 
 To the amount expended upon quarantine establishments at 
 home, we have now to add that which is required for those of 
 Malta, Gibraltar, and such as have recently devolved to us in the. 
 Ionian islands. The whole united cani(ot fall short of a hundred 
 thousand pounds a year, and may possibly exceed two. 
 
 "Were the expense indeed twenty times as great, there is no 
 doubt that if these establishments could be shewn to be unequivo- 
 cally useful, it ought and would be cheerfully borne. But as it 
 has, I think, been proved, that whether contagion do or do not 
 exist, they are insufficient for their object, and otherwise injurious, 
 it follows that if the expense were only one twentieth part of the 
 "actual amount, it ought to be forthwith discontinued. 
 
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