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University of California Berkeley 
 
 THE LIBRARY 
 
 OF 
 
 THE UNIVERSITY 
 OF CALIFORNIA 
 
 PRESENTED BY 
 
 PROF. CHARLES A. KOFOID AND 
 MRS. PRUDENCE W. KOFOID 
 
 M369473 
 
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T R E A /T r S E 
 
 ON THS ; 
 
 P L A G U E 
 
 A KB 
 
 YELLOW FEVER. 
 
 With an APPENDIX, containing 
 
 HISTORIES OF THE PLAGUE AT ATHENS IN THE TIME Off 
 
 THE PELOPOITNES1 AN WAR; AT CONSTANTINOPLE 
 
 IN THE TIME OF JUSTINIANJ AT LONDON IN 
 
 1665; AT MARSEILLES IN IJlQj &C. 
 
 BY JAMES TYTLER, 
 
 Compiler of the Medical Part of the Encyclopaedia Britannica. 
 
 Let every one, Phyfician or not t freely declare his own fentiments about if j 
 let him affign any credible account of its rife, or the cauies ftrong enoughj 
 in his opiniun, to introduce io terrible a fccne. 
 
 THUC v D: at 5, 
 
 Twas all the bufinefs then 
 To tend the Tick, and in their turns to die. 
 In heaps they fell. 
 
 Publijlied according to A El of Congrefs. 
 
 '. 
 
 SALEM: 
 
 PRfNTED EY JOSHUA CUSHfNC, FttA 
 
 B , M A C A N U I. T V , 
 
 1700 
 

 
 , 
 
CONTENTS. 
 
 PART FIRST. 
 
 Of the Afiatic or True Plague. 
 
 SECTION I. Page 
 
 Of the Plague in general. Inquiry into the Antiquity 
 of the Diftemper. Of the Plagues mentioned in the 
 Old Teftament. Hiftory of feveral remarkable 
 Plagues which, at various times ^ have deflated the 
 world. I 
 
 SECTION II. 
 
 Of the Countries wre the Plagueisfuppofedto originate. 
 The Influence of Climate in producing Difeajes 
 An d of the Moral Conduct of the Human Race in 
 producing and influencing the fame. 2 1 
 
 SECTION III. 
 
 Of Difeafe in general. The nature of the Plague as a 
 Difeafe considered. Of Contagion. Whether the 
 Plague is really Contagious or not. Medical Hif- 
 tory of the Diftemper. Inquiry into its Immediate 
 CaitfeS) and ^vhether an approaching Plague is indi- 
 cated by any vifible Signs. 74 
 
 SECTION IV. 
 
 Of the bejl Methods of Preventing the Plague. 302 
 
 SECTION V. 
 
 Of the Cure of the Plague. 347 
 
 PART SECOND. 
 
 Of the Yellow Fever. 
 
 SECTION I. 
 
 Hijiory of the Yellow Fever. 371 
 
 SECTION II. 
 
 Symptoms of the Yellow Fever, as described by various 
 authors. Comparifon between them and thofe of 'the 
 Plague t with an inquiry into the Caufes* Hiftory of 
 
 the 
 
CONTENTS. 
 
 Page 
 
 the Diftemper as it has appeared in various parts of 
 the United States fmce the year 1793. A difatfflon 
 of the quejtion, Whether the Yellow Fever is Con- 
 tagious or not. 382 
 
 SECTION III. 
 
 Methods of Prevention and Cure. 507 
 
 SECTION IV. 
 
 Remarkable Cafes. 534 
 
 APPENDIX. 
 
 N 1. 
 
 Account of the Plague at At hens , in the time of the Pelo- 
 ponnejian War ': From THUCYDIDES.* SMITH V 
 Tranjlation. 
 
 N II. 
 
 Account of the Great Plague in the time of JUSTI- 
 NIAN : By PROCOPIUS. 547 
 N III. 
 
 Account of the Plague at London in 1665 : Prom Dr. 
 HODGES and others. 548 
 
 N IV. 
 
 Account of the Plague at Marjeil/es in 1 720 : From 
 the Periodical Publications of the time. 554 
 
 N V. 
 
 Account of the Plague in Syria, Cyprus &c. From Dr. 
 PATRICK RUSSEL'J Treattfe. ibid, 
 
 N VI. 
 
 Remarkable cafe of a Remitting Fever at Bajforah in 
 1780. 
 
 N VII. 
 
 Set of Queries f unified by Doftors AIKIN and JEBB ; 
 and by Mr. HOWARD put to J ever at foreign Phy- 
 JicianS) during his tour ; with their Opinions con- 
 cerning the Plague. 565 
 
 A TREATISE 
 
TREATISE 
 
 ON THE 
 
 Plague and Yellow Fever. 
 
 PART FIRST. 
 
 'Of the Afiatic or True Plague, 
 
 SECTION I. 
 
 Of ike Plague in general. Inquiry into the Antiquity 
 cf the Difternper. Of the Plagues mentioned in the Old 
 Teftame'nt. Hi ft or y of fever al remarkable Plagues 'which , 
 at various times, have deflated the world. 
 
 AMONG the many difeafes which afflid the hu- 
 man race, we find ONE, upon record, fo irre- 
 fiftiblc in its progrefs, fo fatal in its attacks, and fo 
 entirely beyond the powers of medicine ; that, like the 
 ferpent Python^ the Leviathan, or the Mammoth, among 
 animals, it has 'generally been diflinguifhed by names 
 cxpreilive of its deftroying nature ; not, like other dif- 
 eafes, by any particular appellation derived from its 
 fymptoms. In the Hebrew language this diftemper is 
 ^xpreffed by the word which fignifies perdition >* in 
 
 Greek 
 
 * Thus t)r. Hodges; butCaimet informs us, that the Hebrews call by the 
 name of plagues all difeafes fent by way of punifhment o corre&i,an from 
 God i as the peftilt nee, tnfe^kioni the leproiy* jTutiden dfiJHhs t famines, ttflft* 
 
 B 
 
5, A TREATISE ON 
 
 Greek it is called loimos, from /no, to deftroy ; in Latin, 
 peftisy from peffundo, to overthrow ; and in Englifh, the 
 plague, from the Latin plaga^ a flrokc with a whip - 9 
 alluding to the common opinion, that it is a fcourge 
 from heaven, taking vengeance on mankind for their 
 fins. 
 
 Other diftempers, called by the general name of 
 Epidemics, have at different times infefted whole cities, 
 and even overfpread exteniive regions ; but thefe, 
 though fometimes very fatal, have always been found 
 ib much inferior to the (Jiftemper of which we treat, 
 that, on a comparifon, we may juftly fay, though epi- 
 demics have ilain their tkoufands, the true plague has 
 ilain its ten thoufands. In fpeaking of the deftruclive 
 ravages of epidemics, we may count the dead by tens, 
 by hundreds, or by thoufands ; but in the true plague, 
 always by thoufands, by myriads,* or by millions. 
 Procopius, when fpeaking of a plague which defolated 
 the world in his time, compares the number of the dead 
 to the fand of the fea; and Mr. Gibbon, who at- 
 tempts to fpecify, thinks they might amount to an hun- 
 dred millions;^ and I cannot help being of opinion, 
 that the deftruction generally bccafloned by violent 
 plagues, amounts to about one half of the population ; 
 
 the 
 
 pefts : in a wordt all calamities, whether public or private. Calmest Di&, 
 Vol. \\ f'ol. 412- Plaga. 
 
 Parkhurft derives the Greek term loimos, either from !u, as above, or frora 
 another deck werd fignifying to faint; the lame trom which the Englifh 
 word ed if ft has its origin j or it may be from the Hebrew lebem, toccniume. 
 
 A iric-ud obierves that * f we no where find the word perdition in our ver- 
 fion of the Old Teftament. We have, however, the word dejl>uEl'i<,n, which 
 is of a iimilar import; as, for inftance, in Prov. xv. i r. where the Hebrew 
 is abdun. In Rev. xvii. 8 & i i, we find the Englilh word perdition ; but as 
 we have no Hebrew verfion of the New Teftament, we may advert to the 
 ancient Syriac veriion. The Syriac being a filler dialeft of the Hebrew, dif- 
 fers, radically, but little from it. The Syriac of the two places referred to 
 above is ab-dna ; hence the word akaddonj vvhofe root is abd> and is the fame 
 with that of the Hebrew word above. 
 
 As to the word plague, we often find it in- the Old Teftament, but per- 
 haps never in that Ipecific fenfe in which the moderns ule it. The original 
 word, rendered plague, is pretty generally #/>, or its derivations ; as Exod, 
 xii. 13. ii. Sam. xxiv. 21, &c." On this lafi occafion, hawever, as the word 
 frftilenct had been ufed before, in the fame chapter, we can fcarce doubt 
 its having- been really feme kind of difeafe : and we know that modesa 
 plagues will fometimes deitroy as quickly as this is faid to have done, 
 
 * A myriad is generally fuppofcd to contain ten thoufaad. 
 fr Gibbon's Hiftcryi vol. iv. 
 
THE PLAGUE. 3 
 
 the reafons for which opinion will be given in the 
 courfe of this work. In all violent plagues, we hear of 
 the dead being left unburied ; of their being call into 
 pits, 8cc. But if we wi(h to make any grofs compari- 
 fon between the deftruclive power of the true plague, 
 and that of any other violent epidemic, we cannot, 
 perhaps, have a better inftance than that which took 
 place at BaiTorah (a city on the confines of Perfia) in 
 the years 1773 and 1780.* In the former of thefe 
 years that city was vifited by the true plague ; and in 
 the latter, by an epidemic remittent fever. The fever 
 was moft violent in its kind, and deftroyed twenty-five 
 thoufand in the city and neighbourhood ; but the true 
 plague, no fewer than two hundred and feventy-five 
 thoufand in the fame place. Suppofing the two com- 
 putations therefore to be equally exacl, we muft calcu- 
 late this plague to have been eleven times more deadly 
 than the epidemic. If therefore the ingenious claffifiers, 
 in modern times, have brought into alliance the plague 
 with other epidemic difeafes, and characlerifed the former 
 from the latter ; we may juftly fay, that they have fal- 
 len into the fame error with other naturalifls, who 
 characlerife the fuperior from the inferior; the lion 
 from the cat, not the cat from the lion. As to the 
 remedies applied in thefe difeafes, doubtful in epide- 
 mics, they fo univerfally fail in the true plague, that, 
 notwithftanding the improved ftate of medicine, we 
 may yet fay, it ftands among difeafes, in a great mea- 
 fure, like a giant without any champion to oppofe ; like 
 a poifon without any antidote. 
 
 In this unhappy predicament, the breaking out of 
 a, plague, in any city or country, proves a moft 
 diftreffing calamity, not only on account of the num- 
 bers deftroyed by the difeafe itfelf, but by reafon of 
 the bonds of fociety being loofed j fo that humanity 
 gives way to terror ; children are abandoned by 
 their parents, and parents by their children ; every 
 thing wears the appearance of ruin and defolation ; 
 while, in too many inftances, avarice urges on the 
 
 unprincipled 
 
 * Tranfaft, of Society for improving Medical Knowledge 
 
4. A TREATISE ON 
 
 unprincipled to rapine, or even to murder. Nor 
 are the cruel modes of prevention, fometimes prac- 
 tifcd even by the authority of the magiftrate, lefs 
 abhorrent to humanity, than the lawlefs outrages 
 of the thief or murderer. Inftances of all this will 
 appear in the courfe of the work ; the following are 
 fo remarkable, that I cannot help inferting them m 
 this place. In the great plague at Marfeilles, in 1720, 
 the town being almoft deferted, and few choofing to 
 venture into it, "three fea-captains, and fome hundreds 
 *' of failors, having the courage to enter the city, from 
 " the fea-fide, found therein a gang of murderers, who 
 * c made it their bufinefs to deflroy people feized with the 
 <c plague, and to plunder their houfes. The ringleader 
 * c of them,, named Roitanns, a gunfmith, was broken alive 
 < upon the wheel, and forty others were hanged. Rou- 
 <e anne owned that he had killed a thoufand perfons. 
 <c There were found, upon one of the murderers, jewels 
 <c to the value of more than thirty thoufand livres."* 
 During the time of this public calamity, four men,. who 
 came from Marfeilles to Aix, were fliot by order of 
 the parliament, left they mould have brought the infec- 
 tion along with them.-f Even this is not equal to what 
 Mr. Howard informs us was practifed in a hamlet of 
 Dalmatia, where, the plague having raged with fuch 
 violence, that only two or three remained ; the neigh- 
 bouring magiftrates ordered theie miferable furvivors to 
 be fhot. At fuch prices will people buy a precarious, 
 nay, an imaginary, fafety. In ihort, what Mr. Gibbon 
 fays of the fituation of people in the time of violent 
 earthquakes, will alfo, in a great meafure, hold good 
 in the time of peftilence, or any great publie calamity. 
 " Inftead of the mutual fympathy which might comfort 
 " and affift the diftreffed, they dreadfully experience 
 " the vices and paffions which are releafed from a fear 
 " of punifhment j the houfes are pillaged by intrepid 
 Cf avarice, revenge embraces the moment, and felects 
 " the victim : while "| vengeance frequently overtakes 
 
 * Political State for 1 720. + Political fhte, ibid. '* the 
 
 $ Mr. Gibbon, agreeably to the fubjeft on which he writes, particularifes 
 th mode of vengeaiice; fftyinp. * the earth frequently fwa//i>tvs ttp the af* 
 faffln,' 1 Ac. It is, hoped the lubftitution of the word vengeance, in general, 
 will not be deemed material alteration. 
 
THE PLAGUE, 5 
 
 the affaffin or ravifher in the confurnmation of his 
 
 crimes." 
 
 Whether the world hath been in the fame predicament 
 ever fince the human race began to multiply, or whe- 
 ther plagues have originated at fome remote period, 
 is a queftion not eafily determined. It is certain that, 
 as far as hiftories go, they give us accounts of plagues; 
 much kfs frequent indeed in very ancient times than in, 
 thofe which followed -, but the compafs of hiftorical 
 knowledge is narrow. There are no authentic hiftories. 
 of any nation previous to the termination of thofe of 
 the Old Teftament. Where facred hi^ory ends, pro- 
 fane hiftory begins. The fabulous period affords many 
 accounts of wars, heroes, giants, and monfters, but 
 fcarce any of plagues. Diodorus Siculus indeed makes 
 mention of a plague which happened in Greece, after 
 the flood of Deucalion ; and which, he fays, was occa- 
 fioned by the general corruption of vegetables, &c. 
 confequent on the flood. Deucalion's flood is fuppo- 
 fed to have been nearly cotemporary with the depar- 
 ture of the Ifraelites from Egypt ; fo that, if there is 
 any truth in the relation of Diodorus, it is not impro- 
 bable that fome of the Egyptian plagues might have 
 fpread into Greece. We are likewife told of a pe.fti- 
 lence at Athens in the time of Thefeus;* but all the 
 accounts of thefe times are fo uncertain, and fo much 
 involved in fable, that little or no dependence can be 
 placed on any of them. 
 
 The firft diftinc"t account we have of plagues of any 
 kind, then, is in the book of Exodus, where we are 
 told of many heavy judgments fent upon the Egyptians 
 becaufe of their difobedience. Before this, indeed, we 
 read of plagues fent on the king of Egypt, for having 
 taken Abraham's wife ; but as thefe fell only upon the 
 king and his houfehold, we cannot fuppofe any thing 
 like a general peftilence to have taken place among the 
 people. In like manner did it happen to Abimelech r 
 king of Gerar, on the fame account. All the women 
 belonging to the king's houfehold were rendered barren 
 
 for 
 
 * Uni7. Ilift. vol. vu 
 
6 A TREATISE ON 
 
 for a time ; but we hear of nothing happening to the 
 nation at large. Again, when Mofes and Aaron went 
 in before Pharaoh, they faid to him, " Let us go and 
 faeririce to the Lord our God ; left he fall upon us with 
 the fvvord, or with peftilence" This fhews indeed that 
 both Mofes and Pharaoh knew that fuch a thing as 
 pcjf-ilence exifted, or might exift ; but it cannot prove 
 that the difeafe we now call the plague or peftilence 
 commonly took place among nations in thofc days as 
 it has done fince. Even among the plagues inflicled 
 upon the Egyptians by the hand of Mofes and Aaron, 
 v;e find only two that can be fuppofed to have any 
 fimilarity to the difeafe we now call the plague ; viz. the 
 boil, and the deftmdion of their firft born. The former 
 may have been peftilential buboes ; the latter alfo may 
 have been the effecl of a moft malignant peftilence ; 
 fuch as, in the beginning of it, is faid frequently to kill 
 fuddenly, as by lightning ; but whether it was fo or not, 
 we cannot now determine. 
 
 In the hiftory of Job, who is fuppofed to have been 
 cotemporary with Mofes, we have a cafe more in point. 
 The boils, with which he was covered, are by Dr. Mead 
 fuppofed to have been the fmall pox ; though in the 
 true plague the body is fometimes covered with gangre- 
 nous puftules, conftituting a difeafe ftill more dangerous 
 and painful than the fmall pox; but whatever the 
 difeafe of Job was, we may reafonably conclude, that in 
 his time there was none limilar to it commonly exifting 
 among mankind. 
 
 After the departure of the Ifraelites from Egypt, we 
 find frequent mention of a plague as a difeafe common- 
 ly to be met with ; but it was always that of leprofy ; 
 thofe deftru<5tive plagues, which might be fuppofed to 
 refemble the difeafe we now call by that name, being all 
 miraculous. Concerning the prevalence of the leprofy 
 among the Jews, Diodorus fays that they " were driven 
 " out of Egypt as impious, and hateful to the gods ; for 
 " their bodies being overfpread and infected with the 
 :( - itch and leprofy, (by way of expiation) they got them 
 " together, and, as profane and wicked wretches, expelled 
 
 " them 
 
THE PLAGUE. f 
 
 f * them out of their coafts." This he tells us was a rea-' 
 fon given to one of the kings of Syria why he fhould ex- 
 terminate the Jews. In another place our author gives 
 the following account of the origin of the Jewiih nation. 
 " In ancient times there happened a great plague in E- 
 " gypt, and many afcribed the cauf of it to God, who 
 " was offended with them. For there being multitudes 
 <c of ftrangers of feveral nations who inhabited there, who 
 " ufed foreign ceremonies, the ancient manner of wor- 
 46 fliip was quite loft and forgotten. Hence the natural 
 ic inhabitants concluded, that unlefs the Grangers were 
 <c driven out, they mould never be freed from their 
 " miferies. Upon which they were all expelled," &cr- 
 He then tells us that feme of, them came into Greece 
 under the conduct of Danaus and Cadmus ; but the 
 greater part entered Judea, then quite defert aud unin- 
 habited. Their leader " was one Mofes., a very wife 
 and valiant man," &c.* 
 
 The allufion, in this laft paffage of Diodorus, to the 
 plagues of Egypt, mentioned in Exodus, is manifeft - y 
 and it is equally manifeft, that the Egyptians them- 
 felves, as well as the facred hiftorian, owned them to be 
 miraculous. Here, however, let it be remarked, that, 
 though thefe, and others inflicted on the Ifraelites, xverc 
 miraculous, we are not from thence to conclude that 
 they took place without the intervention of natural 
 caufes. On the contrary, in fpeaking of the plagues of 
 Egypt, we are told, that when the locufts came, " the 
 " Lord fent a ftrong eaft wind, all that day and all that 
 "night; and when it was morning, the eaft wind 
 " brought the locufts." In like manner " the Lord 
 " turned a mighty ftrong weft wind, which took away 
 " the locufts, and eaft them into the Red fea." Again, 
 when the fea itfelf was divided, " the Lord caufcd it to 
 go back by a ftrong eaft wind all that night." The 
 Egyptians were witneiTes to this ; but, as they did not 
 believe that the powers of nature had any fuperior, they 
 could never be induced to think that any of the 
 elements would take part in a difpute between two 
 nations, or favour the one more than the other, la 
 
 * Diodor. Sif. Frag. 
 
* A TREATISE ON 
 
 In difeafes inflicted on the human body, we are 
 allured that the powers of nature were as much employed 
 as in the miracles already mentioned. When it was 
 told David that the child born to him by Bathfheba 
 ihould die, the infant was feized with a natural diftem- 
 per, probably a fever, and died the feventh day. When 
 Hezekiah was informed that he fhould die, he did not, 
 any more than David had done, give himfelf up to 
 tfefpair ; but ufed, for his recovery, fuch means as were 
 in hfs power, viz. prayers to God ; from whom, by the 
 confthution of things under the Old Teftament, he 
 would receive a direct ar.fwer. And it is remarkable, 
 that though the anfwer was favourable, yet the difeafe 
 was not removed by any invifible power operating like 
 a charm, but by the ufe of a remedy. It is plain there- 
 fore that this difeafe was occafioned by one natural 
 power, and removed by another. The boil (for that 
 was the diftemper) was brought to maturity by a poul- 
 tice of figs, and the king recovered.* If then the 
 fcripture informs us, that even where the Deity himfelf 
 fpeaks, he has directed the ufe of a remedy, much more 
 ought we to be diligent in the ufe of fuch as our feeble 
 {kill can fuggeft, in thofe cafes where he leaves us en- 
 tirely to the exercife of our own judgments. To lit 
 down fupincly, in cafe of a dangerous diftemper, with d. 
 notion, that if God wills us to die we certainly (hall die, 
 /;/ any ufe of natural means ; and if he wills the contrary, 
 that we (hall as certainly recover, in any negleft of them ^ 
 is a conduct equally unfcriptural and abfurd. 
 
 In the books of Mofcs we find the Ifraelites, 
 in cafe of difobedience, threatened with the botch of 
 Egypt ; with terror, confumption, and the burning ague. 
 From the name of this laft we may reafonably iuppofe 
 it to have been the fame with the remitting fever of 
 the Eaft, which is attended with the mod intolerable 
 fenfation of burning in the bowels ; but whatever the 
 nature of thefe difeafes might have been, they certainly 
 were not very common in the world at that time, or 
 they would not have been threatened as extraordinary 
 
 judgments. 
 
 * Mead. 
 
THE PLAGUfi. 9 
 
 judgments. They were riot the fame with the pefti- 
 lence ; becaufe we find, that after they had been threa- 
 tened with fever, confumption> and extreme burning, 
 it is added; " I will make the pejlilence cleave unto 
 thee :" as if it had been faid^ that the peftilence, which 
 hitherto had appeared only oh extraordinary occafions, 
 ftiould then become endemi^ and never leave them. But, 
 On the whole, the firft account we have of any general 
 plague^ feems to be that which Was inflidted on the 
 jews on account of the fin of their king in numbering 
 the people. David was nearly cotemporary with the 
 Trojan war; and Homer, in the firft book of his Iliad, 
 informs us, that a plague likewife took place in the 
 camp of the Greeks $ and that too for the fin of their 
 king in carrying off the daughter of the prieft of Apollo* 
 and refufing to reftore her at the entreaty of her 
 father. 
 
 In comparing the account of the facred hiftoriari 
 With that given by Homer, we cannot help obfefving a 
 ftriking fimilafity between them. Both plagues were 
 inflicted on the people for the fin of their kings $ both 
 were miraculous ; the one continued three days, the 
 other nine. In both the Deity hifnfelf appeared : an 
 angel bfandifhed a drawn fword over Jerusalem ; and 
 Homer fays, that^ from the top of Olympus, Apollo 
 (hot his arrows into the Grecian camp. Lajftly, botti 
 were flopped in a fimilar mariner i David offered facri* 
 fkes to the true God ; and Agamemnon returned 
 Chryfeis, his captive, f.q her, father, the prieft of Apollo, 
 by whofe prayers and facrifices the plague was flopped . 
 Hence it feems not impoffible; that the ftory told by 
 Homer,' is only that or David, altered as he thought 
 mort proper for erilbellifriing his poem f and that this 
 was the firft remarkable plague in the world. 
 
 In the year 767 B. C. vte hear of a universal peffi- 
 lence ; but the imperfeft ftate of hiftory in thofe early 
 periods affords few accounts that can be depended 
 upon, either concerning that or any thing elfe.*, Till 
 after the foundation of Rome, indeed, authentic hiftory 
 
 fcarce 
 
 9 In the fubfc^ent ft^ion this plague will be more full/ treated of* 
 
 
 
io A TREATISE ON 
 
 fcarce commences; and it is not till the 279th year of 
 that city, that we hear of its being in any remarkable 
 degree infefted with a peftilerftial diforder.* The plague 
 we fpeak of is faid to have taken place about the year 
 469 B. C, which comes within 38 years of that of 
 Athens in the time of the Peloponnefian war. The 
 near coincidence of thefe dates, in times fo remote, and 
 when chronology was fo little fettled, tends to excite a 
 fufpicion' that both arofe from the fame infection. Of 
 its ravages at Athens we have an excellent account by 
 the hiftorian Thucydides,<f who was an eye witncfs of 
 what he writes. He fays, that according to report it 
 began in Ethiopia, from whence it came down into 
 Egypt, and thence into other countries. It is poflible, 
 therefore, that it might reach Italy fome time before it 
 came into Greece ; for it feems fcarce probable, that 
 fuch a very violent infection could have taken place in 
 Italy without being communicated to the neighbour ng 
 countries; whence we may reafonably conclude, that. 
 the firft plague at Rome, and that of Thucydides, were 
 the fame. At Rome, we are informed, it fvvvpt away 
 almoft all the flower of the youth who were able to 
 bear arms, the greateft part of the tribunes, and both 
 the confuls. The mortality was fo grcaf, that no place 
 of fepulture could be found for the dead bodies, but 
 they were thrown promifcuoufly into the Tiber. In 
 ihort, fo low were the Romans at this time reduced, 
 that the JEqui arid Volfci, two Italian nations with 
 whom they were almoft always at war, made an imme- 
 diate attack, in hopes of being eaiily able to carry the 
 city; but in this they were difappointcd. The Situa- 
 tion of Athens was truly deplorable ; being not only 
 engaged in a foreign war, but crowded with people from 
 the country; numbers dying daily in the ftreets, and 
 the furvivors giving themfelves up to all manner of 
 licentioufnefs.'j; . 
 
 * A plague is fpoken of in the time of Romulus ; but the accounts of this.* 
 and Tome others, are extremely obicure&nd 
 
 f See Appendix No. I. 
 
 .* See Thucydides's account at large, Appendix No, I, 
 
THE PLAGUE. U 
 
 As it feems probable that the fame infecYion defola- 
 ted both Rome and Athens, fo it feems not unlikely 
 that it was a continuance of the fame which deftroyed 
 the Carthaginian army in Sicily, while carrying on a 
 fuccefsful war againffc Dionyfius, tyrant of Syracufe. 
 The plague, as we are informed by the Univerfal Hif- 
 tory, was common in the Carthaginian territories, efpe- 
 cially thofe on the continent of Africa ; and this pefti- 
 lence broke out foon after the conclufion of the Pclo- 
 ponnefian war. As it originally came from Africa, it is 
 probable that it had never been quite extinguished 
 there; and the compilers of the Univerfal Hiftory 
 think it probable that the army might have brought 
 the feeds of it along with them into Sicily. But, what- 
 ever was the origin, the diftemper foon became fa 
 malignant, that the living were not fufficient to bury 
 the dead ; and thofe who attended the fick perifhed in 
 fuch a manner, that, after fome time, few dared to- 
 come near them. At firft they gave the dead a kind 
 of burial ; but in time the number became fo great, 
 and the furvivors fo few and weak, that an hundred and 
 fifty thoufind are faid to have rotted above ground. 
 " Juftin feems to intimate that almoft the whole Car* 
 tc thaginian army perifhed by the plague; and that in 
 " a, manner all at once, as it were in an inftant. Dio- 
 " dorus, however, informs us, that a confiderable body 
 " of Africans and Iberians furvived the dreadful calami- 
 <c ty. It is worth obfervation, that not a flngle perfon 
 " of thofe who attended the fick furvived.* 1 The mi- 
 ferable remains of this army, confiding at firft of more 
 than three hundred thoufand, were now attacked by 
 their enemies, whom they were no longer able to refift. 
 Their land forces were entirely defeated, and their fleet 
 was burnt : " the Gods themfelves, (fays Diodorus) 
 " when the mips were all in a blaze, and the flames 
 v< afcending above the mafts, feeming to deflroy the 
 " Carthaginians with lightning from heaven. " Fortv 
 
 - iD O -J 
 
 gallic's ftiil remained, and the unfortunate general was 
 now obliged to purchafe liberty to return with the few/ 
 he had left. But even thefe were treacheroufly 
 
 attacked 
 
i* A TREATISE ON 
 
 attacked by the tyrant's fleet, and feveral of them funk. 
 On his arrival at Carthage, he found the whole city not 
 only in mourning, but in defpair ; " the wretched in- 
 " habitants giving full vent to their grief, made the 
 " more ring with their groans and lamentations. In 
 ?* ftiort, a greater fcene of horror, except the fpot of 
 " ground where the Carthaginian army encamped be-* 
 c fore Syracufe, than Carthage now was, cannot well be 
 ?' conceived." This reception completed the defpair 
 of the unhappy general. Clothing himfelf in mean and 
 fordid attire, he joined with the reft in bewailing their 
 common calamities. After fome defperate exclama- 
 tions againft the gods, whom he accufed of partiality, 
 " The enemy, faid he, may rejoice at our mifery, but 
 *' have no reafon to glory in it. The troops we have 
 " loft did not fall by their valour, nor did they now 
 <c oblige thofe that arrived here to leave Sicily by force. 
 " We return victorious over the Syracufians, and are 
 " only defeated by the plague. As for the baggage 
 " found in our camp, this ought not to be looked upon 
 <c as the fpoils of a conquered enemy, but as moveables 
 " which the cafual death of their owners has left the 
 " Syracufians in poffeffion of." Having then gone on 
 to exprefs his grief for the lofs of his army, and declared 
 his intention not to outlive them, he (hut himfelf up 
 in his houfe, refufing admittance even to his own chil- 
 dren, and put an end to his life.* 
 
 Whether the unfortunate remains of this army 
 brought with them the infection to Carthage, and there 
 produced a n,ew fcene of defolation, we are not infor- 
 med ; but there feems to have been a very great tenden- 
 cy to peftilential diforders in the Carthaginian armies ; 
 for, in the time of the fiege of Syracufe by Marcellus, 
 plague broke out in the camp of the Carthaginians 
 iwho had come to affift the Syracufians. From them it 
 pa{Ted intotHe city itfelf, with fo much malignity, that 
 nothing was to be feen but heaps of dead and dying. 
 Jvlone durft receive or affift the fick, for fear of being 
 infefted by them $ and the bodies of the dead were, for 
 
 the 
 
 * Univ. Hift, vol. xvii. ' ' 
 
THE PLAGUE. i^ 
 
 the fame reafon, left unburied, to infect and poifon the 
 air with their putridity and corruption. Nothing was 
 heard, night and day, but groans of dying men - 3 and 
 the heaps of dead bodies continually prefented mourn- 
 ful objefts to the living, who expected every moment 
 the fame fate.* The infection reached the Roman 
 camp ; but we do not hear of its being conveyed, at 
 this time, either to Rome or Carthage. In the time of 
 the conteft with Jugurtha, however, a very terrible ca- 
 lamity took place in Africa. " According to Qrofius, 
 <c a great part of Africa was covered with locufts, which 
 *' deftroyed ail the produce of the earth, and even devour- 
 V ed dry wood. But, at laft, they were all carried by the 
 ." wind into the fea, out of which being thrown in vaft 
 " heaps upon the more, a plague enfued, which fwept 
 <c away an infinite number of animals of all kinds. In 
 6 Numidia only, perifhed eight hundred thoufand men j 
 " and in Africa Propria, two hundred thoufand -, among 
 " the reft, thirty thoufand Roman foldiers, quartered in 
 " and about Utica for the defence of the laft mentioned 
 " province. At Utica, in particular, the plague raged 
 " with fuch violence, that fifteen hundred dead bodies 
 " were carried out of one gate in a day."-j^ 
 
 From the time that the Romans finifhed their Afri-* 
 can wars, till they had accomplifhed moft of their con^ 
 quefts in Afia, their empire feems to have continued 
 free from this dreadful fcourge ; but foon after the 
 deftruclion of Jerufalem by Titus, fuch a violent infec- 
 tion feized on the city, that for fome time upwards of 
 twenty thoufand are faid to have died in it daily. 
 
 As the Roman arms were carried ftill farther to the 
 eaftward, and all the countries reduced, to the confines 
 of Periia, the plague feems to have become more com- 
 rnon among them. In the time of Marcus Aurelius, a 
 war was undertaken againft the Parthians, which was 
 carried on by the Romans with great fuccefs, and with 
 no lefs cruelty ; for, though the city of Sclcucia opened 
 its gates to the Roman general, he caufed the inhabi- 
 tants, |:Q the number of four hundred thoufand, to be 
 
 maflacred. 
 
 * Uiiiv. Hilt, vol. viii, t Id, yol. 
 
14 A TREATISE ON 
 
 mafTicred, Bat they foon paid dear for this cruelty, 
 by a dreadful peftilence, which broke out, according; 
 to the hiftorian Ammianus Mircellinus, in the very 
 city which they had d.Tolated, and was brought by 
 their army into Itily, fro-n whence it fpread through- 
 out the whole empire. Other hiftorians fay, that it 
 originated in Ethiopia, from whence it fpread into 
 E^ypt, and thence into the country of the Parthians. ' 
 We knov not how long the infection continued; only 
 that, fome years afterwards, when the emperor was 
 defeated by the Germans, the peftilence ftill raged to 
 fuch a decree, that fUves, gladiators, and even the ban- 
 ditti of Dilnmtia and Dardania, were enlifted for the 
 defence of the empire. It is certain that great havock 
 mufl haveibeen made by it, as we find that the barbari- 
 ans were encouraged to invade the empire on all fides, 
 and could fcarccly be repulfcd ; infomuch that hiftori- 
 ans compare this with the moft deftructive wars the 
 Romans had ever waged.* 
 
 Daring the time that the empire was overrun by the 
 northern barbarians, the plague frequently made its 
 appearance; which we fhill have occafion to notice 
 more particularly in the following fecYion ; but in thofe 
 times the deftruftlon by the fword was fo extraordinary, 
 that lefs mention is made by hiftory of any peftilential 
 diforder. In the time of Juftinian, however, about 
 fixty-n"v r e years after the final deftrudion of the weftern 
 empire, the moft violent plague recorded in hiftory took 
 place. Of this we have a particular account by Proco- 
 pms.-j- " The diftemper (fays Mr. Gibbon) arofe in the 
 " neighbourhood of Pelufium, on the Confines of Egypt, 
 4< between the Sarbonian bog and the eaitern channel 
 <e of the Nile. From thence, tracing, as it were, a 
 " double path, it fpread to the eaft, over Syria, Perfia, 
 " and the Indies, and penetrated to the weft, ajong the 
 <c coaft of Africa, and over the continent of Europe, 
 r< In the fpring of the fecond year, Conftantinople, dur- 
 <c ing three or four months, v/as vifited by this pefti- 
 ^ Icncc. Such was the corruption of the air, that the pel- 
 
 tileace 
 
 * Uftiv. Hift. vol. xv. -f See Appendix, No. IX. 
 
THE PLAGUE. 15 
 
 ** tilence was not checked, nor alleviated, by any differ- 
 " ence of feafons. The numbers that penfhcd in this 
 " extraordinary mortality have not been recorded ; only 
 " we find that, during three months, there died at Con- 
 " ftantinople five, and at lad ten thoufand a day. M my 
 " cities of the eaft were left vacant, and, in feveral dif* 
 " trids of Italy, the harveft and vintage withered on the 
 * 5 ground. The triple fcourge of war, peftilence and 
 * c famine affixed the fubjedh of Juftinian $ and his 
 <; reign is difgraced by a vifible decreafe of the human 
 '" fpecies, which has never been repaired, in fome of the 
 *' faireft countries of the globe."* 
 
 This plague broke out in the time of Juftinian, in 
 the year 541 or 542 of the chriftian era; and not only 
 ravaged Conftantmople in the time of Juftinian, but 
 returned with incrcafed violence during the reigns of 
 many of his fucceffors. In the time of Mauritius we 
 find the Avari, a barbarous nation to the north of the 
 Danube, driven back by the plague after they had crof- 
 fed that river to invade the Roman territories. The 
 reign of Phocas, fucceilbr to Mauritius, was ftill more 
 unfortunate. " Great numbers were fwept off, either 
 " by famine or peftilence; the earth refuftd her fruits 
 " in feafon ; the winters were fo fevere, that the feas 
 ft were frozen, and the fiih deflroyed." Phocas afcend- 
 ed the imperial throne in 603 ; but in the midft of 
 fuch confufion as then filled the world, we can fcarce 
 exped an accurate account of the time when this mofc 
 malignant pcfcilence ceafed. We can fcarcely fuppofc 
 it to have bfted two centuries ; but, in the reign of 
 Conilantine Copicnymus, which began in 742, we find 
 the difcempcr ftill raging, and the fame dreadful phe- 
 nomena of nature ftill continuing. The plague, we arc 
 now told, broke cut in Calabria in Italy; whence it foon 
 
 (bread 
 
 * Gibbon's Hift, vol. iv. Prccopius, in fpeaking of the numbers who died 
 in this extraordinary plague, compares them to the fand of the lea ; and af- 
 terwards expreiTes them by a phrafe which has been translated iv.-o hundred 
 millions. The phrafe is myriadxs myrladon nyriai. Mr. Gibbon, by drop- 
 ping the firft word* reftrits the lenfe to one hundred millions? which he 
 thinks not wholly inadniiflible; but the probability feems to be, thai Proco- 
 JMUS did not mean to fpecify the number, but to reprefent it as incalculable. 
 This is done by putting a comma, or iemicolon, after the firft word ; and we 
 may then read, that there perifhed myriad: ; a myriad of myriads. The grarr> 
 jttar is r&itied bf reading mjriades iuiteg4 of mjritfai. 
 
16 A TREATISE ON 
 
 fpread over Greece, Sicily, the iftands in the-#gean fea, 
 and at lafl reached Conftantinople; where it raged for 
 three years together, with fueh fury, that the living 
 were fcarce fufficient to bury the dead. The earth- 
 quakes* which accompanied or preceded this peftilence, 
 were fuch as had never been known in any age. In Sy- 
 ria and Falefline feveral cities were fwallowed up ; 
 others, entirely ruined ; and fome, if we may give credit 
 to Nicephorus, removed without any considerable da- 
 mage, fix miles and upwards from their former feats. At 
 the fame time happened an extraordinary darknefs, which 
 Jafted from the fourth of Auguftto the firft of October, 
 there being little or no diftindtion, during all that time, 
 between day and night.* During the reign of the fame 
 prince, there happened fuch an extraordinary froft, that, 
 at Conftantinople, both feas were frozen for an hundred 
 miles from the more ; the ice being covered with fnow 
 twenty cubits deep, and fufficiently ftrong to bear the 
 heavieft carriages. When the froft broke* mountains 
 of ice and frozen fnow, being driven by the wind 
 through the ftraits, did a great deal of damage to the walls 
 of Conftantinople. The month following, fevefal pro- 
 digies appeared, or were thought to appear, in the air 
 At the fame time a comet, which the Greeks called 
 EhcittSi becaufe it refembled a beam,- was feen for ten 
 days in the eaft, from whence it moved into the weft, 
 and fhone there for one and twenty days more. The 
 people were ftruck with terror and amazement at the 
 fight of the prodigies, and apprehended the laft day to 
 be at hand.-}- Dreadful earthquakes, ft&nge phenome- 
 na in the heavens, inundations, Sec. occurred in the 
 year 812, during the reign of Michael Balbus ; but no 
 remarkable plague is mentioned by the Greek hiftori- 
 ans,- till the year 1025, when a new train of calamities 
 took place. ' The plague broke out in Cappadocia, ra- 
 ging with fuch violence there, as well as in Paphlagonia 
 and Armenia, that the people were forced to abandon' 
 their, dwellings. A terrible famine followed ; after 
 which' the earthquakes again commenced with redou- 
 bled" 
 
 ' tfni*. Hiff. vol. xvii. * Ibid, 
 
THE PLAGUE. 17 
 
 bled fury : at Conftantinoplc they continued forty days 
 together; while people were terrified by a comet (proba- 
 bly a large meteor) which pafled with a dreadful noife 
 from north to fouth $ the whole horizon appearing to 
 be in a flame. 
 
 From thefe calamities the world, at lead that part of 
 it known to the Greek hiftorians, appears to have en- 
 joyed fome refpite till the year 1346. Indeed we may 
 now fay> as in the time of the invafion by the northern 
 barbarians, that the fword, and not the peftilence> 
 was the plague of thofe times, A rnoft violent and 
 univerfal peftilence, however, now took place j though, 
 for want of fuch hiftorians as Thucydides and Procopi- 
 us, we cannot here give a particular account of it. In 
 general we are told, that it began in the kingdom of 
 Cathay (the northern part of China) from whence it 
 gradually overfpread all the countries between that and 
 the weftern extremity of Aria. Invading, at laft, Con- 
 ftantinople, it proceeded from thence to Greece, Italy, 
 France, Africa, Germany, Hungary, Denmark, Britain 
 and Ireland. Thus, it feems to have been as extenlive 
 & contagion as ever appeared in the world. It is even 
 probable, that, from the remains of this contagion, 
 Europe hath been but very lately fet at liberty ; as we 
 hear, not long after, of plagues being very frequent in 
 different parts of that continent. In England it affu- 
 med fomewhat of a new form towards the end of the 
 Fifteenth century ; being then known by the name of 
 the Englifh Sweating Sicknefs. But, except in the 
 greater propeniity to iweat, the difeafe appears not to 
 have differed from the true plague. The fweating fick- 
 nefs firft ma.de its appearance in the army of Henry 
 VII, when he landed at Milford in 1483 ; and that 
 year invaded London, where it continued only from 
 the 2 1 ft of September to the end of October. It 
 returned in 1485, 1506, 1517, 1528 and 1551 ; fince 
 which time it has not been known in Britain. In 1517 
 it was extremely violent and mortal ; fometimes killing 
 the fick.in three hours; and fo general was the infec- 
 tion,- that, in fome places, one half of the inhabitants 
 
 D died. 
 
18 A TREATISE ON 
 
 died. In 1528 it alfo raged with great violence; th$ 
 fick fometimes dying in four hours. The lad attack, 
 in 1551, was alto very violent. In 1529 it appeared in 
 Holland and Germany, deftroying great numbers of 
 people ; but it hath not been obferved, at lead in any 
 remarkable degree, in thofe countries fince that time. 
 In the courfe of the lyth century, various parts of Eu- 
 rope have fufFered very much from the plague in its - 
 ufual form. Indeed (for reafons given in the fubfe- 
 quent fedion) we can fcarce fuppofe the peflilential 
 contagion ever to have ceafed entirely. In 1603, L n ~ 
 don was viiited with the plague ; and on this occafion 
 the pradice of fhutting up infeded houfes was firft 
 introduced.* In 1656 another plague took place in 
 the fame metropolis, but does not appear to have made 
 any violent attack. In Naples it raged that year with 
 great fury ; deftroying, according to feme accounts, 
 fifteen thoufand, according to others, twenty thoufand., 
 a day. But thefe accounts the author of the Journal 
 juft quoted, with great probability, fuppofes to have 
 been exaggerated. Others fay, that four hundred thou- 4 
 land Neapolitans were deftroyed by this infedion ; fo 
 that we muft at any rate believe it to have been very 
 violent. In the plague of London in 1665, immenfe 
 numbers perifhed ; and particular accounts were pub- 
 lilhed of this calamity ; of which an abridgment is 
 given in the Appendix to this work, No III. Since 
 that time i has not been known in Britain -, but other 
 parts of Europe have not been equally fortunate. In 
 the beginning of the eighteenth century it appeared in 
 feveral parts of the continent ; particularly in Copenha-^ 
 gen in the year 1711 $ where it committed great rava- 
 ges, as it had done at Dantzic two years before ; but in 
 1720 it appeared at Marfeilles in France, where it 
 raged with fuch fury as to deftroy fixty out of the hun- 
 dred thoufand fuppofed to be the whole population of 
 the place.-}* Since that time France hath been free 
 from the diftemper ; but in Sicily, the dominions of 
 the Ottoman Porte, and places adjacent, it hath been 
 
 felt 
 
 * Jtttrnal of the Plague Year. f See Appendix, No. IV. 
 
THE PLAGUE. 19 
 
 felt very feverely. In 1743 it was fuppofed to have 
 deftroyed two thirds of the inhabitants of Mefflna. A 
 particular account of its ravages was read before the 
 Royal Society of London by Dr. Mead. The follow- 
 ing is taken from Dr. Lobb's Treatife on the Plague. 
 M From the beginning of June to the end of July, of 
 " forty thoufand inhabitants, two thirds perifhed. The 
 " diforders in the city were incredible. All the bakers 
 " died, and no bread was baked for many days. The 
 " ftreets were full of dead bodies ; at one time from 
 " twelve to fifteen thoufand remaining in the open 
 " air : men, women and children, rich and poor, all toge- 
 " ther dragged to the church doors. The vaults being 
 "full, and the living not fufficient to carry the dead 
 " out of the city, they were obliged to put them on 
 f ' funeral piles, and burn them promifcuoufly. No- 
 * c thing was more (hocking than to fee people, far above 
 " the common ftations, go about begging for a loaf of 
 bread, when they could hardly walk, with their 
 " tumours upon them ; and few were in a flate to help 
 44 them. All thefe calamities did not hinder the moft 
 " execrable villanies, which were committed every mo 
 " ment ; and, though fo few furvived, the governor 
 6C was obliged to make feveral public examples/' 
 
 In the Turkilh dominions, though we have not read 
 of fuch extraordinary devaluations as formerly took place, 
 5'et we are allured that the peftilence rages there very 
 frequently. From 1756 to 1762 we have hiftories of it 
 by Dr. Ruffe 1 and others, the fubftance of which ac- 
 counts is given in the Appendix, No. V, In the time 
 of the great war between the Turks and Ruffians, it 
 found its way to Mofcow, which city it invaded in xyjl* 
 M. Savary fays, it was brought thither by infected mer- 
 chandife from the (lore houfes of the Jews ; and that 
 it carried off two hundred thoufand people. In the 
 fixth volume of the Medical Commentaries, however, 
 we are told that it was brought from the army by two 
 foldiers ; both of whom were carried into the military 
 hofpital, and both died. The aoatomift who diifected 
 their bodies died alfo. The infection quickly feized 
 
 the 
 
so A TREATISE ON 
 
 the hofpital, and thence the whole city. This happen- 
 ing in the beginning of the year, its progrefs was for 
 ibme time checked by the cold ; but its ravages be- 
 came greater as the fummer advanced. It raged moil 
 violently during the months of July, Augufl and Sep- 
 tember ; in which time there were inftances of its 
 deftroying twelve hundred perfons in a day. Twenty- 
 five thoufand died in the month of September ; in the 
 courfe of which month fcarce one in an hundred of the 
 Infected recovered. Only feventy thoufand, according 
 to this account, perifhed by the difeafe. The year 1/73 
 proved very fatal to BaiTorah ; where, as formerly men- 
 tioned, two hundred and feventy-five thoufand perifhed 
 in the fummer feafon, through the violence of the dif- 
 temper.* But in countries where the plague rages fp 
 frequently, and where there are few that make obferva- 
 tions with any accuracy, we cannot expect complete 
 hiftories of every attack made by it -, neither would the 
 limits of this Treatife admit of a detail of them, though 
 there were. We know, however, that fince the year 
 we fpeak of, the plague has ravaged Dalmatia, particu- 
 larly in the year 1784, when it almoil defolated the 
 town of Spalatro, deftroying three or four thoufand of 
 its inhabitants. Though fome countries therefore have 
 for a number of years remained free from the attacks 
 of this terrible enemy, yet there are others where it is 
 as it were ftored up, and from whence it may, on a 
 proper occafion, break forth as formerly, and once 
 more fpread ruin and defolation through the world. 
 
 SECTION 
 
 * An Englifh gentlemani who refidfed in Baflbrah at that time preferred 
 himfelf from the infedion by retiring to a mud-howfe, where he had no 
 communication with the inhabitants. Having a large quantity of Bengal 
 cotton, he fold it to the people to wrap their dead in. The price was put in 
 a baficet, which he hauled up by a rope to his ware-room ; lowering it again 
 with the proportionate quantity of cloth. In the courfe of the fummer he 
 had an account oiffiHnty thoufand winding flieets thus difpofed of 1 
 
 (Tmifact. ot a Society for improving Medical Knowledge.} 
 
THE PLAGUE. 21 
 
 SECTION II. 
 
 Of the Countries where the Plague is fuppofed to originate. 
 The Influence of Climate in producing Difeajes And 
 of the Moral Conduct of the Human Race in producing 
 and influencing the Jame. 
 
 IN confidering the origin of a calamity fo dreadful 
 and fo univerfal, we might reafonably fuppefe that 
 the fatal fpots which gave rife to it would long ago have 
 been marked out and abandoned by the human race 
 altogether. But this is far from being the cafe. In the 
 accounts already given of various plagues, they are al- 
 ways faid to have been imported from country to coun- 
 try, but never to have originated in that of the perfon 
 who wrote of them. If a plague arofe in Greece, we are 
 told it came from Egypt ; if in Egypt, it came from 
 Ethiopia ; and had we any Ethiopic hiftorians, they 
 would no doubt have told us that it came from the land 
 of the Hottentots, from Terra Auftralis Incognita, or 
 fome other country as far diftant as poffible from their 
 own. In fhort, though it has been a moft generally 
 received opinion, that plagues are the immediate effects 
 of the difpleafure of the Deity on account of the fins of 
 men ; yet, except David and Homer (already quoted) 
 we find not one who has had the candour to acknow- 
 ledge that a plague originated among his countrymen 
 on account of their fins in particular. In former times 
 Egypt and Ethiopia were marked out as the two great 
 fources of the plague ; and even as late as the writings 
 of Dr. Mead we find that the fame opinion prevailed. 
 The Doctor, who attempts to explain the caufes of the 
 plague, derives it entirely from the filth of the city of 
 Cairo, particularly of the canal that runs through it. 
 But later writers, who have vifited and refided in Egypt, 
 allure us that the country is extremely healthy, and that 
 the plague is always brought there from Con flan tinople. 
 It is true that Dr. Timone, in the Philofophical Tranf- 
 actions, No. 364, tells us, that it appears from daily 
 obfervation, as well as from hiftory, that the plague 
 
 comes 
 
2* A TREATISE ON 
 
 comes to Conftantinople from Egypt ; but the united 
 teftimonies of Savary, Volney, Mariti and Ruilel, who 
 all agree that Egypt receives the infection from Conftan* 
 tinople, muft undoubtedly preponderate. 
 
 4 The peftilence (fays M, Savary) is not a native of 
 * Egypt. I have collected information from the Egyp- 
 " tians, and foreign phyficians who have lived there 
 " twenty or thirty years ; which all tended to prove the 
 rc contrary. They have affured me that this epidemic 
 " difeafe was brought thither by the Turks, though it 
 ;c has committed great ravages, I myfelf faw the cara^ 
 * c velles of the Grand Signior, in 1778, unlade, according 
 " tocuftom, the fiiks of Syria at Damietta. The plague 
 :t is almoft always on board ; and they landed, without 
 " oppofhion, their merchandife, and their people who 
 :c had the plague. It was the month of Auguft j and, 
 " as the difeafe was then over in Egypt, it did not 
 <c communicate that feafon. The vefTels fet fail, and 
 ic went to poifon other places. The fummer following, 
 *'* the fhips of Conftantinople, alike infected, came to 
 " the port of Alexandria, where they landed their dif- 
 <c eafed without injury to the inhabitants. It is an ob- 
 ** fervation of ages, that if, during the months of June, 
 ** July and Auguft, infeded merchandife be brought 
 ic into Egypt, the plague expires of itfelf, and the peo- 
 * c pie have no fears ; and if brought at other feafon s, 
 *' and communicated, it then ceaies. A proof that it 
 fc is not a native of Egypt is, that, except in times of 
 " great famine, it never breaks out in Grand Cairo, nor 
 *' the inland towns, but always begins at the feaports 
 fs on the arrival of Turkifh vefll-ls, and travels to the 
 " capital ; whence it proceeds as far as Syria. Having 
 ** come to a period in Cniro, and being again intro- 
 ^ duced by the people of Upper Egypt, it renews with 
 w greater fqry, and fometimes (vveeps cff two or three 
 "hundred thoufand fouls; but always ftops in the 
 " month of June, or thofe who catch it then are eafily 
 "" cured. Smyrna and Conftantinople are now the 
 *' rchdcncc of this moft dreadful affliciion." 
 
 M. Volney 
 
THE PLAGUE. 13 
 
 M. Volney informs us, that the European merchants 
 tefiding at Alexandria agree in declaring that the dif- 
 eafe never proceeds from the internal parts of the coun- 
 try, but always makes its firft appearance on the fea- 
 coafts at Alexandria ; from thence it paifes to Rofetta, 
 from Rofetta to Cairo, and from Cairo to Damietta, 
 anc^through the reft of the Delta. It is invariably prece- 
 ded by the arrival of fome vefTel'from Smyrna or Conftan- 
 tinople j and it is obferved, that if the plague has been 
 violent during the fummer, the danger is greater for 
 the Alexandrians during the following winter. 
 
 To the fame purpofe, the Abbe Mariti fays, " The 
 " plague does not ufually refide in Syria, nor is this 
 <c the place where it ufually begins^ It receives this 
 " fatal prefent from Eo;ypt, where its ufual feat is 
 " Alexandria, Cairo or Damietta. The plague of 1760 
 " came at once from Cairo and Alexandria 3 to the 
 " latter of which it had been brought from Conftanti- 
 " nople. When it comes from that capital, as well as 
 " from the cities of Smyrna and Saloniea, it acquires a 
 " peculiar malignity ; and its activity never expands 
 " itfelf with more fury than in the plains of Egypt, 
 " which it overfpreads with incredible rapidity. It is 
 " obferved, that this plague, fo deftrudive to Egypt, 
 <J feldom attacks Syria ; but that the latter has every 
 " thing to dread from a plague hatched in the bofom 
 "of Egypt." 
 
 The teftimony of thefe three authors, who have all 
 been lately on the fpot, muft certainly have very great 
 weight, especially wheit corroborated by that of Dr. 
 Ruflel ; for which fee Appendix, No. V. But dill there 
 is fome difficulty. M. Savary informs us, that, except in 
 cafes of great famine ', the difeafe never bfeaks out in 
 Cairo ; which certainly implies that in cafes of famine 
 it does originate in the city itfelf; and Mariti, by fay- 
 ing that the Syrians have much reafon to dread a plague 
 hatched in the bo/om of Egypt, undoubtedly intimates 
 that plagues fometknes do originate in Egypt. Smyrna 
 and Saloniea likewife feem to come in for their fhare of 
 the blame ; and Dr. M'Bride, in his Practice of Phyfic, 
 
 informs 
 
24 A TREATISE ON 
 
 informs us, that fome parts of Turky are vifited by the 
 plague once in fix or feven years ; and M. Savary fays, 
 that Egypt is vifited with it once in four or five years ; 
 but if Egypt never receives it but from Turky, it would 
 feem that the plague could at leaft be no more frequent 
 than in that country ; or, if the fact be otherwife, that 
 the difeafe muft either originate in Egypt itfelf, or be 
 brought to it from fome other country than Turky. 
 Dr. Timone, in the paper already quoted,* tells us, 
 that the plague has taken up its refidence in Conftan- 
 tinople ; but that, though the feeds of the old plague 
 are fcarce ever wanting, yet a new infection is likewife 
 imported from time to time. Thus, in attempting to 
 find out the countries where the plague originates, we 
 are led in a circle. Conftaritinople accufes Egypt, and 
 Egypt recriminates on Conftantinople. Ethiopia, the 
 moft diftant and leaft known of thofe countries which 
 in former times had any connexion with the more civi- 
 lized parts of the world, for a long time bore the blame 
 of all ; but the Jefuit miffionaries who refided long in 
 Abyflinia (the ancient Ethiopia) do not mention the 
 plague as more common in that country than fome 
 others ; neither does Mr. Bruce, in the accounts he has 
 published, take notice of any fuch thing. Ethiopia 
 could not fpeak for itfelf, by reafon of the ignorance 
 and barbarity of its inhabitants; and Conftantinople is 
 now very much in the fame predicament. The invei- 
 tigation of this fubjecl therefore would require an accu* 
 rate account of the climates of thofe countries where 
 the plague is found to commit the greatcft ravages, and 
 a comparifon of them with thofe which are now ac- 
 counted the moft unhealthy in other refpects, and like- 
 wife a comparifon of the difeaies produced in the latter, 
 with the true plague. 
 
 The moft unhealthy climates now exifting (thofe 
 where the plague commonly rages excepted) are to be 
 met with in the hotteft parts of the world ; the Eaft 
 and Weft Indies, the waftes of Africa, and fome parts 
 of America. In all thefe, Dr. Lind, who has written a 
 
 trcatifc 
 
 * Philofoph. Tranfad. No. 364. 
 
THE PLAGUE* 25 
 
 treatife on the difeafes incident to Europeans in hot 
 climates, feems to lay the whole blame upon the heat 
 and moifture accompanying it. In the Eaft Indies 
 Bencoolen, in the ifland of Sumatra, is the moft un- 
 healthy of all the Englifh fettlements; but he informs 
 us, that by building their fort on a dry, elevated place, 
 about three miles from the town, it became fufficiently 
 healthy. Next to this, Bengal is moft fubject to lick- 
 nefs; for which heafligns the following reafon : " The 
 " rainy feafon commences at Bengal in June, and conti* 
 " nues till O&ober ; the remainder of the year is healthy 
 " arid pleafant. During the rains, this rich and fertile 
 " country is covered by the Ganges, and converted as it 
 " were into a large pool of water. In the month of Odto- 
 " ber,when the fbgnated water begins to be exhaled by 
 " the heat of the fun, the air is then greatly polluted by 
 " the vapours from theflime and mud left by the Ganges, 
 <e and by the corruption of dead fifh and other animals. 
 Difeafes then rage, attacking chiefly fuch as are lately 
 arrived. The diftempers are fevers of the remitting or 
 intermitting kind; for, though fometimes they may 
 " continue feveral days without fenfible remiffion, yet 
 " they have in general a great tendency to it. If the fea- 
 " fon' be very fickly, fome are feized with a malignant fe* 
 " ver, of which they foon die. The body is covered with 
 " blotches of a livid colour, and the corpfe, in a few 
 <c hours, turns quite livid and corrupted. At this time 
 Xfluxes prevail, which may be called bilious or putrid* 
 " the better to diftinguifh them from others which are 
 " accompanied with inflammation of the bowels. The 
 " ifland of Bombay has of late been rendered much more 
 * c healthy than it formerly was, by a wall built to prevent 
 <c the encroachments of the fea, where it formed a fait 
 *< marfh ; and by an order that none of the natives mould 
 " manure their cocoa-trees with putrid fifh. 
 
 " Batavia, the capital of the Dutch Eaft India do- 
 * c minions, is annually fubje<fl to a fatal and confuming 
 " ficknefs. Here the Dutch, in attempting to make this, 
 '* their capital in India, referable their cities in Europe, 
 " have adorned it with canals or ditches, interfering each 
 
 E other, 
 
 46 
 
s6 A TREATISE ON 
 
 " other, running through every part of it. NotwithftancJ- 
 
 " ing the utmoft care to keep thefe clean, during the 
 :< rainy feafon, and after it, they become extremely nox- 
 " ious to the inhabitants, but efpecially to flrangers. It 
 " has been remarked, that the ficknefs rages with the 
 ce greateft violence when the rains have abated, and the 
 " fun has evaporated the water in the ditches, fo that the 
 " mud begins to appear. This happened in 1764, when 
 " fome Britifh fhips of war had oceafion to flay for a little 
 :< time at Batavia. The flench from the mud was into- 
 " lerable ; the fever was of the remitting kind ; fome were 
 " fucHflenly feized with a delirium, and died in the firft 
 '' fit ; but none furvived the attack of a third. Nor was 
 " the ficknefs at that time confined to the fhips ; the 
 " whole city afforded a fcene of difeafe and death ; ftreets 
 "covered with funerals, bells tolling from morning to 
 " night, and horfes jaded with dragging the dead in her- 
 " fes to their graves. At that time a flight cut of the fkin, 
 " the leaft fcratch of a nail, or the moft inconfiderable 
 " wound, turned quickly into a putrid, fpreading ulcer, 
 " which, in twenty-four hours, confumed the flem, even 
 " to the bone. Beiides thefe malignant and remitting fe- 
 " vers, which rage during the wet feafon in the unhealthy 
 " parts of the Eaft Indies, Europeans, efpecially fuch as 
 " live intemperately^are alfo fubject to fluxes, and to an 
 " inflammation, or difeafe of the liver ; which lafl is almoft 
 " peculiar to India, and particularly to the Coromandcl 
 coaft." 
 
 In the fame work we have an extract from Mr. Ives's 
 
 ournal of a journey from India to Europe by land. 
 
 ic Gambroon in Perfia, fays he, is very unhealthful. 
 
 i; Few Europeans efcape being feized with putrid inter- 
 
 " mitting fevers, which rage from May to September, 
 
 " and are often followed with obftructions of the livr. 
 
 <c Various authors who have treated of Gambroon, do, 
 
 " as well as the prefent Englifh factory, impute its un- 
 
 " healthfulnefs, during the fummer months, to the nox- 
 
 c ious effluvia with which the air is contaminated, from 
 
 ' the great quantities of blubber fiih left by the fea up- 
 
 on the fhore, and which very foon 'become highly of- 
 
 4< fenfive. 
 
THE PLAdUE. 27 
 
 ** fenfive. In the rainy feafons, at the ifland of Karee, 
 " in the Perfian Gulf, intermitting fevers and fluxes are 
 " the ufual diftempers. On our arrival at Bagdad (fup- 
 " pofcd to contain 500,000 fouls) we found a purple 
 " fever raging in the city ; but though it was computed 
 " that an eighth part of the inhabitants were ill, yet the 
 " diftemper was far from being mortal. Here we were 
 cc informed that the Arabs had broken down the banks 
 " of the river near BafTorah, with a defign to cover with 
 " water the deferts in its neighbourhood. This, it feems, 
 " is the ufual method of revenge taken by the Arabs for 
 " any injury done them by the Turks at Bafforah ; and 
 " was reprefented to us as an aft of the moft (hocking 
 " barbarity, fince a general confuming ficknefs would 
 " undoubtedly be the confequence. This was the cafe 
 " fifteen years before, when the Arabs, by demolifhing 
 " the banks of this river, laid the environs of Bafforah 
 " under water. The ftagnating and putrefying water in 
 " the adjacent country, and the great quantity of dead 
 " and corrupted fifh at that time lying upon the fliore, 
 " polluted the whole atmofphere^ and produced a putrid 
 " and moft mortal fever, of which between twelve and 
 " fourteen thoufand of the inhabitants perimed ; and, at 
 <c the fame time, not above two or three of the Europeans 
 " who were fettled there efcaped. The effects of the 
 " violent heats we endured were, an entire lofs of appe- 
 " tite, a faintnefs and gripes, with frequent and bilious 
 " ftools ; which greatly exhaufted our ftrength. My 
 " ftomach was often fo weak, that it could receive only 
 6C a little milk. Several of us became feverifh through 
 *' the exceflive heat, and were obliged to have recourfe 
 " to gentle vomits, &c. Though we were furnilhed 
 *' with the moft ample conveniences for travelling, 
 Et which money, or the ftrongeft recommendations to 
 " the principal chriftians, as well as mahometan cheifs, 
 " could procure, and had laid in a quantity of excellent 
 " madeira, claret, and other provisions, &c. yet mod 
 " of us (offered in our conftitutions by this long and fa- 
 " tiguing journey.'* 
 
 On 
 
a s A TREATISE ON 
 
 On thefe climates in general Dr. Lind obferves, that 
 in well cultivated countries, fuch as China, the air is 
 temperate and wholefome; while the woody and uncul- 
 tivated parts prove fatal to multitudes accuftomed to 
 breathe a purer air. In all places alfo, near the muddy 
 and impure banks of rivers, or the foul mores of the fea, 
 mortal difeafes are produced from the exhalations, efpe- 
 cially during the rainy feafon. " There is a place 
 " near Indrapour, in Sumatra, where no European can 
 " venture to remain, or ileep one night on more, during 
 " the rainy feafon, without running the hazard of his 
 * c life, or at leaft of a dangerous fit of ficknefs ; and at 
 " Podang, a Dutch fettlement on Sumatra, the air has 
 <c been found fo bad, that it is commonly called the 
 <c Plague-Coaft. Here a thick, pefliiential vapour or fog 
 * c arifes, after the rains, from the marfhes, which de- 
 " ftroys all the white inhabitants." 
 
 In treating of the difeafes of Africa, the fame author 
 takes notice of thofe of Egypt ; which country, he fays, 
 is rendered unwholefome by the annual inundation of 
 the Nile, and being furrounded on three fides by large 
 and extenfive deferts of fand, by which means it is ex- 
 pofed to the effeds of that noifome vapour, which, dur- 
 ing the fummer months, arifes from fultry, hot fand. 
 He doth not, however, fay, that the true plague origi- 
 nates in this country, either from the inundation of the 
 Nile or any other caufe. On the climate of Egypt 
 I (hall once more quote M. Savary, who is a ftrenuous 
 advocate for its health inefs, and is at pains to confute 
 the opinion of Mr. Pauw, and others, who aiTert the 
 contrary. " Mr. Pauw (fays he) pretends, that at pre- 
 ic fent Egypt is become, by the negligence of the Turks 
 " and Arabs, the cradle of the peftilence ; that another 
 k6 epidemical difeafe, equally dreadful, appears here, by 
 :< the caravans of Nubia; that the culture of rice en- 
 ''genders numerous maladies ; that the want of rain 
 " and thunder occafions the air of the Thcbais to acquire 
 : * a virulence that ferments the humours of the human 
 * body, &c." " Thefe ailertions (M. Savary obferves) 
 " have an air of probability, which might impofe on 
 
 " people 
 
THE PLAGUE. 29 
 
 " people who have not lived in Egypt ; but Mr. Pauw 
 " has ventured opinions in his clofet, without the guid- 
 " ance of experience. In vallies, indeed, enclofed by 
 " high mountains, where the atmofphere is not conti* 
 " nually renewed by a current of air, the culture of rice 
 " is unwholefome, but not fo, near Damietta and Ro- 
 " fetta. The plains are nearly on a level with the fea ; 
 " neither hill nor height impedes the refrefhing breath of 
 " the north, which drives the clouds and exhalations off 
 " the flooded fields fouthwards, continually purifies the 
 " atmoiphere, and preferves the health of the people ; 
 " fo that the hufbandmen who cultivate the rice are not 
 " more fubjecl: to difeafes than thofe.who do not. The 
 " heats of the Thebais certainly furpafs thofe of many 
 " countries under the equator. Reamur's thermometer, 
 ** when the burning breath of the fouth is felt, fome- 
 <e times rifes to thirty-eight degrees above the freezing 
 " point,* often to thirty-fix. Were heat the principle 
 " of difeafes, the Said (Upper Egypt) would not be habi- 
 At table ; but it only feems to occafion a burning fever, 
 " to which the inhabitants are fubjecl: ; and which they 
 " cure by regimen, drinking much water, and bathing 
 " in the river : in other reipedls they are ftrong and 
 " healthy. Old men are numerous, and many ride on 
 " horfeback at eighty. The food they eat in the hot 
 " feafon contributes much to the prefervation of their 
 " health ; it is chiefly vegetables, pulfe and milk. In 
 " Lower Egypt, the neighbourhood of the fea, the large 
 " lakes, and the abundance of the waters, moderate the 
 " fun's heat, and preferve a delightful temperature. 
 " Strabo and Diodorus Siculus, who long lived here 9 
 " did not think the country unhealthy. There is, in- 
 * e deed, an unwholefome feafon in Egypt. From Febru- 
 " ary till the end of May, the fouth winds blow at in 
 " tervals, and load the atmofphere with a fubtile duft, 
 " which makes breathing difficult, and drive before 
 <c them pernicious exhalations. Sometimes the heat 
 " becomes infupportable, and the thermometer fudden- 
 ** ly rifes twelve degrees. The inhabitants call this fea- 
 
 "fon 
 
 * Water boils at eighty degrees of this thermometer. 
 
3 o A TREATISE ON 
 
 " Ton Khamfw, fifty ; becaufe thefe winds are moft felt 
 " between Eafter and Whitfuntide ; during which fea- 
 " fan they eat rice, vegetables, frefh fifh and fruit ; 
 " bathing frequently, and ufing plenty of perfumes and 
 " lemon juice ; with which regimen they prevent the 
 " dangerous effects of the Khamfin. But it muft not 
 " be fuppofed that this wind, which corrupts meat in a 
 " few hours, blows fifty days. Egypt would become a 
 " defert. It feldom blows three days together ; and 
 " fometimes is only an impetuous whirlwind, which ra- 
 " pidlypaffes, and injures only the traveller overtaken in 
 " the deferts. When at Alexandria a tempeft of this 
 " kind fuddenly arofe, driving before ittorreqts of burn- 
 " ing fand, the ferenity of the iky difappeared, a thick 
 " veil obfcured the heavens, and the fun became blood- 
 " coloured. The duft penetrated even the chambers, and 
 " burnt the face and eyes. In four hours the tempeft 
 " ceafed, and the clearnefs of the day appeared. Some 
 " wretches in the deferts were fuffocated, and feveral 
 f< I faw brought to appearance dead ; fome of whom, 
 " by bathing in cold water, were reflored to life." 
 
 The internal parts of the continent of Africa are but 
 little known. The northern parts, containing the States 
 of Barbary, are fufficiently healthy ; the middle parts 
 of the weftern coaft, known by the names of Negro- 
 land, Guinea, &c. are extremely unhealthy and perni- 
 cious to frrangers. Dr. Lincl informs us, that, at a 
 Pittance, this country appears in moft places fiat, cover- 
 ed with low, fufpended clouds; and on a nearer approach 
 heavy dews fall in the night time ; the land being 
 every morning and evening wrapped up in a fog. The 
 ground is clothed with a pleafant and perpetual ver- 
 dure, but altogether uncultivated, excepting a few 
 {pots, which are generally furrounded with forefts or 
 thickets of trees, impenetrable to refreshing breezes, 
 and fit only for the refort of wild beafts. The banks 
 of the rivers and rivulets are overgrown with bumes 
 and weeds, continually covered with flime, which lends 
 forth an intolerable fteach. All places however are 
 iiot equally unhealthy ; nor is any place equally un- 
 
 wholefome 
 
THE PLAGUE, 31 
 
 wholefoml5*at all times of the year. It is only with the 
 lainy feafon that the ficknefs commences. But as it 
 would be tedious, and not anfwer our prefent purpofe, 
 to enumerate thofe places which are healthy, and thofe 
 which are not, I (hall only extract from Dr. Lind's 
 work an account of one which feems to be as bad as 
 can well be imagined. It is called Catchou, a town be- 
 longing to the Portuguefe, and lituated in 12 degrees 
 N. lat. " I believe (fays the author of this^account) 
 " there is fcarce to be found on the whole face of the 
 " earth a more unhealthy country than this during the 
 " rainy feafon. We were thirty miles diftant from the 
 :( fea, in a country altogether uncultivated, overflowed 
 " with water, furrounded with thick, impenetrable 
 " woods, and overrun with Ilime. The air was vitiated, 
 " noifome and thick, infomuch that the lighted torches 
 ' c or candles burnt dim, and feemed ready to be extin- 
 u guifhed ; even the human voice loft its natural tone. 
 44 The fmell of the ground, and of the houfes, was raw 
 " and offenfive ; but the vapour arifing from the putrid 
 IC water in the ditches was much worfe. . All this, how- 
 " ever, feemed tolerable, in refpect of the infinite num- 
 *' bers of infects fwarming every where, both on the 
 " ground and in the air j which, as they feemed to be 
 :c produced and cherilhed by the putrefaction of the at- 
 u mofphere, fo they contributed greatly to increafe its 
 " impurity. The wild bees from the woods, together 
 " with millions of ants, overran and deftroyed the furni- 
 " ture ) while fwarms of cock-roaches often darkened 
 " the air, and extinguiihed even the candles in their 
 ;< flight ; but the greateft plague was the mufquetoes 
 t and fand-flies, whofe inceiTant buzz and painful flings 
 " were more infupportable than any fymptom of the fe- 
 <c ver. Befides all thefe, an incredible number of frogs, 
 " on the banks of the river, made fuch a conftant and 
 14 difagreeable croaking, that nothing but being accuf- 
 tomed to fuch an hideous noife, could permit the en- 
 " joy ment of natural fleep. In the beginning of Octo- 
 ' c ber, as the rains abated, the weather became very hot, 
 " the woods were covered with abundance of dead frogs, 
 
 "and 
 
3 z A TREATISE ON 
 
 " and other vermin, left by the recefs of the river ; all 
 " the mangroves and fhrubs were likewife overfpread 
 " with {linking flime." 
 
 No doubt thefe accounts are calculated to infpire us 
 with dreadful ideas of the countries mentioned in them. 
 What could be done by the putrefaction of dead ani- 
 mals and vegetables, certainly would be done here ; the 
 produce, however, was not the true plague ; not even 
 in Catchou - y but " a ficknefs which could not well be 
 " characterifed by any denomination commonly applied 
 " to fevers ; it however approached neareft to what is 
 " called a nervous fever, as the pulfe was always low, and 
 " the brain and nerves principally affected," 8cc. Cer- 
 tainly if in any country heat, moifture and putrefaction 
 could produce a plague, it would be in this* Yet, in all 
 the places we have mentioned, whether India, Arabia, 
 Egypt, or Guinea, (and we might go through the whole 
 world in the fame manner) we have not been able to 
 find either moifl heat or dry heat, even when aided by 
 putrefaction, infects, and naftinefs of all kinds (not juit- 
 ly chargeable upon any climate ,) I fay, we have not 
 found the united powers of all thefe able to produce a 
 plague. Nay, it is even doubtful whether climates can 
 produce thofe inferior difeafes above mentioned. Even Dr* 
 Lind, who appears to be fo willing to afcribe every thing 
 to climate, feems embarraffed in this refpect. " There 
 * c are many difficulties {fays he) which occur in afiigning 
 " a fatisfa&ory reafon, why in fome countries, as in thofe 
 " between the tropics, heavy and continual rains fhould 
 *' produce ficknefs ; while in other places, efpeciaily in 
 " the fouthern parts of Europe, a want of rain for two or 
 " three months in fummer brings on difeafes almofl fimi- 
 " lar. Upon this occafion (adds the Doctor) I cannot 
 *' help obferving, that there is hardly a phyfical caufc 
 " which can be afligned for the produce of any difeafe, 
 " that will not admit of fome exceptions : thus, not only 
 " the woods and moraffes in Guinea are tolerably heal- 
 " thy, with fome exceptions, in the dry feafon ; but a few 
 " inftances might be produced of towns furrounded with 
 " marines and a foggy air, where the inhabitants fufTer 
 
 "no 
 
e 
 
 THE PLAGUE. 33 
 
 no inconvenience from their fituation, even during the 
 rainy feafon. Do the impetuous torrents of water pour- 
 ed from the clouds during the rainy feafons, in tropical 
 countries, contain what is unfriendly to health ? Thus 
 much is certain, that the natives of fuch countries, efpe- 
 cially the mulattoes, avoid being expofed to thefe 
 rains as much as poffible, and when wet with them 
 " immediately plunge themfelves into fait water, if near 
 " it. They generally bathe once a day, but never in 
 " the frefli water rivers, when overflown with rains, 
 *' preferring at fuch times the water of fprings. Is the 
 " ficknefs of tbefe feafons to be afcribed to the intenfe 
 " heat of the then almoft vertical fun -, which frequent- 
 " ly, for an hour or two at noon, difpcls the clouds, and 
 r< with itsdircd beams inftantly changes the refreshing 
 " coolnefs of the air into a heat almoft infupportable ? 
 " Further : As the feafon of thofe fudden and terrible 
 tt ftorms, called the hurricanes, in the Eaft and Weft 
 c< Indies, and tornadoes on the coaft of Guinea, partly 
 ** coincides with that of the rains, do thefe dreadful 
 " tempefts in any meafure contribute to produce the 
 * 6 prevailing ficknefs at thofe times ? It was retnark- 
 '" able one year at Serlegal, that, in the beginning of the 
 [< rainy feafon, in the 'night fucceeding one of thefe tor- 
 r< nadoes, a great number of the foldiers, and two thirds 
 " of the Englifh women, were taken ill, this garrifon 
 " before having been uncommonly healthy. 
 
 " Laftly : Is it not more probable, as in thofe 
 rt countries the earth for fix or eight months in the 
 ' year receives no moifture from the heavens but what 
 tc falls in dews, which every night renew the Vegetation, 
 rt and reinftate the delightful verdure of the grafs, that 
 ' the furface of the ground in many places becomes 
 * hard and incruftated with a dry fcurf, which pens up 
 !C the vapours below, until, by the continuance of the 
 " rains for fome time, this cruft is foftened, and the 
 rs vapours fct free ? That thefe dews do not penetrate 
 " deep into the furface of the earth, is evident from the 
 l< conftant drynefs and hardnefs of fuch fpots of ground, 
 " in thofe countries, as are not covered with grafs and 
 
 F " other 
 
34 
 
 A TREATISE ON 
 
 " other vegetables. Thus the large rivers, in the dry 
 " feafon, being confined within narrow bounds, leave a 
 " great part of their channel uncovered, which, having 
 " its moifture totally exhaled, becomes a hard, dry cruft - 9 
 " but, no fooner the rains fall, than, by degrees, this 
 " long parched up cruft of earth and clay gradually 
 " foftens, and the ground, which before had not the 
 " leaft fmell, begins to emit a ftench, which in four or 
 <c five weeks becomes exceeding noifome j at which time 
 " the feafon of ficknefs commences.*' 
 
 From thefe quotations it muft certainly appear, that 
 the author himfelf is diffatisfied with his theory ; and 
 that, though in the outfet he thought heat and moif- 
 ture, affifted by the exhalations from putrid animal and 
 vegetable fubftances, fufficient to produce the diforders 
 of which he treats, yet, on a more minute inveftigation, 
 he is obliged to acknowledge, that fomething inexpli- 
 cable ftill remains. This he now wifhes to folve by un- 
 known properties in the water, by confined exhalations, 
 &c. But as the coniideration of thefe things belongs 
 properly to the next fection, I (hall here only remark, 
 that there hath not yet been given any fatisfaclory ac- 
 count of the origin of epidemic difeafes of what I call 
 the inferior kind, much lefs of the true plague, which 
 (lands above them all, as I have already faid, like the 
 fcrpent Python above other ferpents. 
 
 To what has been quoted from Dr. Lind, I fhall here 
 fubjoin the teftimony of Dr. Clark, who had an oppor- 
 tunity of obferving the epidemic difeafes which raged at 
 Bengal in 1768 and 1769. Thefe were, "the remittent 
 ;< fever and dyfentery, which begin in Auguft, and 
 L< continue till November. During the beginning of 
 ;c the epidemic, the fever is attended with extreme ma- 
 ; lignity and danger ; frequently carrying off the patient 
 ' in twelve hours -, and, if not flopped, generally proves 
 " fatal on the third or fourth day. In Auguft the re- 
 ' miffions are very imperceptible ; in October they 
 ' become morediftinct ; and, as the cold weather comes 
 " on, the fever becomes a regular intermittent. At 
 " that time, too, the putrid dyfentery begins to rage 
 
 " with 
 
THE PLAGUE. 35 
 
 " with the fever. Thefe difeafes were very fatal to ma- 
 " ny Europeans, particularly new comers, in 1768.. But 
 " in the year 1770, when there was a fcarcity of rice, 
 " it was computed, that about eighty thoufand natives, 
 " and one thoufand five hundred Europeans, died at 
 " Bengal. The ftreets were covered with funerals ; the 
 " river floated with dead carcafes ; and every place ex- 
 " hibited the moft melancholy fcenes of difeafe and 
 " death. During the fickly feafons at Bengal, the un- 
 " certainty of life is fo great, that it frequently happens 
 " that one may leave a friend at night in perfect health, 
 ** who (hall not furvive next day. There have been 
 " feveral inftances of perfons who have returned home 
 " in a ftate of perfect health from performing the lad 
 " duties to a deceafed friend, and have next day been 
 " numbered with the dead. But the cool, agreeable 
 " feafon, from December to March, is productive of no 
 " prevailing difeafes. The complaints to be met with 
 e( are in general the confequences, or remains, of the dif- 
 EC eafes of the former period. The complaints which 
 c the Europeans are fubjecl to in the dry months are, 
 " the cholera and diarrhoea. Fluxes and fevers are then 
 u feldom epidemic ; and, when they do happen, are not 
 " attended with much danger. 
 
 " At Batavia the rainy (eafon is from November to 
 " May, during which time malignant, remitting and 
 " continued fevers and the dyfentery rage with great fa- 
 " tality. Captain Cook, in his firft voyage, arrived 
 'here in October 1779; the whole crew, excepting 
 " Tupia, a native of Otaheite, being in the mod perfect 
 "health. But, in the courfe of nine days, they expe- 
 " rienced the fatal effects of the climate, and buried 
 " feven people at Batavia. On the 3d of December, 
 " the (hip left the harbour. At that time the number 
 " of fick amounted to forty ; and the reft of the (hip's 
 :c company were in a very feeble condition. When the 
 " (hip anchored at Prince's Ifland, in the Straits of 
 ' Sunda, the (icknefs increafed, and they buried twenty- 
 ic three perfons more in the courfe of about fix weeks. 
 " The Grenville Indiaman, which touched at thisifland 
 
36 A TREATISE ON 
 
 " in 1771, fuffered equally from the malignity of the 
 " air. A few were taken on board, when the (hip failed 
 " from Batavia, ill of a malignant fever j which fpread 
 " by contagion at fea, and carried off great numbers. 
 " I vifited feveral in this (hip, when fhe arrived at Chi- 
 " na, who were reduced to mere fkeletons, by the du- 
 " ration of the fever and dyfentery ; both of which were 
 " rnoft certainly propagated by contagion, 
 
 " Thofe parts of Sumatra lying immediately under 
 " the line are continually fubjedt to rain, and the 
 " ground near the fhore is low, and covered with thick 
 < trees and underwood. The heat being intenfe, noi- 
 " fome fogs arife, which corrupt the air, and render the 
 " country fatal to foreigners. The land of North 
 <c Ifland, which lies on this coaft, near the beginning of 
 " the Straits of Sunda, appears at a difbnce finely vari- 
 " egated ; but at the place where the wood and water 
 " are to begot it is low, and covered with impenetrable 
 " mangroves, and infefted with a variety of infects. It 
 " is here that moil of the Eaft India (hips take in wood 
 " for their homeward voyage. A Danifh fhip, in 1768, 
 " anchored in this ifland, and fent twelve of her hands 
 ;c on (liore to fill water ; where they only remained two 
 " nights. Every one of them was feized with a fever, 
 " whereof none recovered : but although the (hip went 
 " out to fea, none, except the twelve who went on 
 " more, were attacked with the complaint." 
 
 With regard to China, this author fays, that the 
 <c port of Canton is by no means fo healthy as is gene- 
 :< rally feprefcnted. The comparative degree of health 
 " which Europeans enjoy here has been afcertained from 
 " the inftances of the fupercargoes, which is, however, 
 " a very erroneous flandard. The generous and regular 
 ' way in which thefe gentlemen live, for the moil part, 
 :i exempts them from difeafes ; and, being but few in 
 rc number, no great mortality can take place among 
 " them. But feamen, who never obferve much regula- 
 :c rity in their way of living, who work hard in the 
 " day time, are but badly clothed, and not provided 
 ** again ft the damps and cold north-eailerly winds at 
 
 night, 
 
THE PLAGUE, 37 
 
 ft night, feldom fail to be affii&ed with the difeafes al- 
 " ready mentioned (fevers and fluxes.) Even the fac- 
 u tors of different nations, who refide here for any con- 
 fcC fiderable time, experience all the inconveniences pe- 
 " culiar to any fultry climate : florid health is a ftranger 
 " to their countenances ; their conftitutions are foon 
 <; weakened and enfeebled ; and they become fubject to 
 " habitual fluxes and other complaints, the ufual con^ 
 <; fequences of too great relaxation." 
 
 The climate of the fouthern part of China, according 
 to the fame author, is exceflively hot during the fum- 
 mer months. Even in September and October, when 
 the nights are cold, the days continue to be fultry. 
 The cold months are, December, January and February ; 
 ic and during this time the viciffitudes of the weather 
 " are more quick than in any other part of the world. 
 " When the wind is northerly, and the thermometer at 
 ic 46, upon a change of the wind to the fouth, it is next 
 " day up to 60 or 70. People who refide here are al- 
 " ways at a lofs with regard to their clothing ; one day 
 " finding a filk coat fufficient ; and the next, upon a 
 *' fudden change of wind, finding it neceflary to wear a 
 " flannel waiftcoat." 
 
 On the fubjecl: of climate, therefore, I muft conclude 
 with the following obfervations : Firft : That, as the 
 difeafes above mentioned are produced both in moift 
 and dry countries, in thofe in the torrid and thofe in 
 the temperate zone, they can neither be the offspring 
 cfmoiftureor drought, of heat or cold, of feptics or 
 antifeptics, but of fomething not yet difcovered. Se- 
 cond : That, upon fair inveftigation, it does not appear, 
 that ancient hiftorians have been able toafcertain the "ori- 
 gin of any plague whatever : they have univerfally af- 
 cribed it, to the anger of the Deity, while their own pride 
 would never allow it to have originated in any country 
 with which they were connefted. Third : It doth not 
 by any means appear, that the climates of thofe coun- 
 tries, where the plague is known to bemoft common, are 
 at all inferior to thofe already defcribed, excepting the ve- 
 ry circumfbnce of haying the plague frequently in them : 
 
 nay, 
 
3 8 A TREATISE ON 
 
 nay, in3eed, that they are equally bad. Nobody will 
 pretend to argue, that the climate of Afia Minor, of 
 Greece, of the Morea, or of any of the countries mo'ft 
 infefted with the plague, was, or is, worfe than that of 
 Catchou in Afriea, already defcribed ; yet it is certain, 
 that we have a number of teftimonies that the plague 
 has ravaged Afia Minor, while we have not one of its 
 vifiting Catchou. Ancient Greece, the Peloponnefus 
 (Morea) and Afia Minor, were accounted healthy and 
 fine countries ; and modern travellers aflure us, that 
 they have not degenerated in this refpect ; yet thefc 
 countries are defolated by the plague, while the un- 
 wholefome regions above defcribed are entirely free 
 from it, unlefs imported from fome other quarter. To 
 give this matter, however, as fair a difcuffion as poffible, 
 I ihall here confider the account we have of the climate 
 of BafTorah, given by the gentleman refiding there in 
 1780 ; whofe cafe, in the remitting fever, is given, Ap- 
 pendix, No. VI. " The overflowing of the Euphrates, 
 " and its waters flagnating in the defert, have always 
 " been accounted primary caufes of epidemical difeafes 
 " at BafTorah. The great floods from the melting of 
 " the fnow on the mountains of Diarbekir, the ancient 
 " AfTyria, happened in the year 1780, early in the 
 " month of May, when the heats in Perfia and Arabia 
 " begin to be exceflive. The defert, which reaches to 
 " the gates of Bafibrah, is, for many miles, incrufted 
 " with a furface of fait ; which, when mixed with the 
 " ftagnated waters, and expofed to the fun, produces 
 c< the moft noxious effluvia. As early as the 25th of 
 c May, the town was furroundecl by a fait marfh, the 
 [< heated fleam ariiing from which was, at times, almoft 
 :< intolerable ; but the canal that runs through a great 
 [C part of the city being filled with the bodies of ani- 
 " mals, and all kinds of putrid matter; and, at low 
 " tides, all thefe fubflances expofed to the fun, made 
 54 the air in the town fcarce fupportable ; and, being 
 " totally deftitute of police, the ftreets were in many 
 " places covered with human ordure, the bodies of 
 " dead dogs and cats, &c. which emitted a flench more 
 
 " difagreeable 
 
THE PLAGUE. 39 
 
 (C 
 
 difagreeable and putrid than any thing I ever experi- 
 " enced in my life. As to the degree of folar heat, it 
 " far exceeded what I conceived the human frame to be 
 * c capable of bearing. The fenfation under this heat 
 " was totally different from what I had ever experien^ 
 " ccd ; it refembled the approach of an heated fubftance 
 " to the body. The quickfilver, in Fahrenheit's ther- 
 <c mometer> rofe to between 156 and 162 degrees.* 
 " From the 3th of May I never faw it fo low as 156, 
 ** but generally between 158 and 160. After I left 
 " Bafforah I was told that it rofe ftill higher. In the 
 " cooleft part of the houfe, with the aid of every inven- 
 " tion to decreafe the heat, the quickfilver rofe to 115; 
 " but after I came away, I was informed that it rofe 
 " ftill higher, even at feven in the morning, the hour 
 " which we accounted the cooleft in the day. Once 
 <c the heat was faid to be fo intolerable, that no one 
 " could expofe himfelf to it long enough to obferve the 
 <c thermometer in the fun. Some of the oldeft inhabi- 
 <c tants of Bafforah faid that they never remembered to 
 " have heard of fuch a heat in any part of Perfia or 
 " Arabia. The natives of the country appeared more 
 c< alarmed at the heat than the Europeans : nothing 
 " could induce them to expofe themfelves to the fun 
 " after ten o'clock. I left Bafforah for Aleppo on the 
 <c 3bth of May. On our arrival at Zabira, the heat was 
 < fo intenfe, that even the Arabs funk under it." 
 
 From this account it was natural to expect that vio- 
 lent ficknefs would enfue. This was the opinion of the 
 inhabitants, and they were not deceived* The ficknefs, 
 however, was not the true plague, but a violent remit- 
 ting fever ; and even this did not originate in the city 
 itfelf, but was obferved to approach from Afia Minor, 
 ravaging Diarbekir, and keeping the courfe of the Ti- 
 gris, to Bagdad, where many died. From thence it 
 followed the courfe of the Euphrates to Bafforah, and 
 for about twenty miles lower. The oppofite, or Per- 
 fcan fhore, though within a few miles, was exempted, 
 
 and 
 
 * Spirit of wine boils at 175, 
 
4 o A TREATISE ON 
 
 and it did not fpread more than twenty miles into the 
 defert.* 
 
 I might now proceed to give an abftrad of what has 
 been faid of the power of climate in producing difeafes 
 on the Weftern Continent, and Weft India iflands; but 
 as this belongs more efpecially to the iecond part of this 
 Treatife, I fhall here pafs it over, as well as what Dr. 
 Smith has faid of the climate of Greece, in the Medical 
 Repofitory, and which he endeavours to prove to be limi- 
 lar to the climate of North America. But, before we 
 proceed to confider what difeafes may be produced by 
 climate alone, it is proper to difcufs the queftion, how 
 far man is naturally fubject to difeafes of any kind ? 
 Many, no doubt, will be apt to fuppofe this a very ab- 
 furd queftion; for as man is now, by nature, fubjecl: to 
 death, it feems to follow, that he is alfo naturally fubjecl: 
 to difeafe, as the means of bringing on death. But, 
 however plaufible this may appear, experience (hows, 
 that difeafe and death are not always connected. Ma- 
 ny people die of mere old age ; the powers of life being 
 exhaufted, and the fyftem fo far decayed, that the va- 
 rious parts of it can no longer perform their offices. On 
 the other hand, a difeafe deftroys by attacking fome 
 particular organ, and either totally confuming or alter- 
 ing it in fuch a manner, that itdifturbs the vital opera- 
 tions, while yet ftrong and vigorous. We may there- 
 fore compare the death of a perfon from mere old age to 
 the natural extinction of a candle when the tallow is 
 totally confumed ; and death from difecife, to the blow- 
 ing out of a candle while a part of it remains, and might 
 have burned for a confiderably longer time. Thus I 
 am inclined to confider all difeafes as merely accidental ; 
 and this with the greater certainty, becaufe, though, in 
 common with other believers in revealed religion, [ 
 think that death is the confequence of Adam's tranf- 
 greflion, yet I do not find that difeafe of any kind was 
 threatened except in cafes of pofttive tranfgreiTion, long 
 after the days of Adam. 
 
 Every 
 
 * Tranfa&ions of Society for improving Medical Knowledge, 
 
THE PLAGUE, 41 
 
 Every one allows, that, though fome difeafes are na- 
 tural, fome are likewife artificial $ but nobody hath at- 
 tempted to draw the line of demarcation between them. 
 Every thing is charged upon climate, heat, moifture, 
 drought, vapour, &c. and yet, upon examination, we 
 fhall find the utmoft difficulty in deriving a fingle difeafc 
 from the caufes we affign. No perfon in his fenfes will 
 fay that Adam, in confequence of eating the forbidden 
 fruit, became liable to the venereal difeafe. As little 
 can we fay for the gout, the ftone, or the dropfy 5 and 
 if we cannot particularize the difeafes to which he be- 
 came naturally liable, we have no right to fay that any 
 kind of difeafe became natural to him in confequence 
 of his tranfgreflion. If, therefore, death itfelf, ori- 
 ginally not natural to man^ did yet take place in 
 confequence of his moral conduct ; and if difeafes, 
 without number, have arifen among his pofterity, 
 though not natural to him in confequence of his firft 
 tranfgreffion, we have equal feafon to believe that thefc 
 difeafes have taken place among them in confequence 
 of their moral or rather immoral conduct, in totally de- 
 viating from the line prefcribed them by their Maker* 
 and following others of their own invention ; and this 
 will appear the more probable, when we confider, that, 
 long after mankind became fubject to death, we find 
 difeafes, particularly the peftilence, threatened as the 
 confequence of fubfequent tranfgreffions. 
 
 If* without taking fcripture into confideration, we 
 attend only to what may be gathered from profane hif- 
 tory, we find the teftimony of all the ancients concurring 
 in one general point, viz. that in times of great antiquity 
 men were more healthy, and even ftronger, than in the 
 times when thofe authors lived. This is taken notice 
 of by Homer, when comparing the ftrength of men in 
 the time of the Trojan war with thofe in his days, about 
 two centuries later.* Virgil, who lived in much more 
 
 modern 
 
 Vf A pond'rous ftone bold Helor heav'd to throw* 
 Pointed above, and rough and grofs below ; 
 Not two ftrong men th' enormous weight could raife 
 Such men as live ia thefe degenerate days. 
 
 Iliad, B, xii. 
 
 G 
 
42 A TREATISE ON 
 
 modern times than Homer, carries his ideas of the dege- 
 neracy of man much farther ; and informs us y that Tur- 
 nus, when fighting with ^Eneas, took up and threw a 
 .{lone which twelve men of that time could not have 
 lifted. Now, though we know that both thefe accounts 
 are fabulous, yet they perfectly coincide with the voice 
 of hiftorians of all nations ; for we are univerfally told, 
 that the firft inhabitants of countries were a brave, 
 hardy people, living according to the fimplicity of na- 
 ture, free from difeafes, and attaining to a good old age. 
 This is fo conformable to what is generally faid at 
 prefent, probably very often by rote, without regard to 
 rational evidence, that, were we fo inclined, ample room 
 might be found for declamation againft modern luxu- 
 ries, particularly the practice of drinking ardent fpirits, 
 as pernicious to health, and deftructive to the humaa 
 body. On this fubject, however, we may once for 
 all obferve, that, although we find ample evidence c-f 
 the baleful influence of thefe liquors in producing 
 other difeafes, yet we find none of their ever having 
 had any (hare in the production of an epidemic or ge- 
 neral diteafe among mankind. In ancient times ths 
 art of diftillation feems to have been unknown ; fo that 
 whatever mifchief was done in thofe days mud have 
 been done by wine, or other fermented liquors. In 
 modern times, though the ufe both of fermented liquors 
 and ardent fpirits is undoubtedly carried to excefs, yet 
 there is no evidence of their producing an epidemic, or 
 even making it more violent or general than it would 
 otherwife have been. Dr. Cleghorn, having fpoken 
 largely of the manner of living of the natives in Mi- 
 norca, proceeds thus : " I fhould nex-t give a circum- 
 <s ftantial account of the diet and way of life of the 
 46 Britifh foldiers in this ifland ; but as this would be a 
 ;c difagreeable ta/k, I fhall only oblerve, that the excefs 
 " of drinking is among them an univerfal vice, con- 
 " firmed into habit. But, however different the Spa- 
 " niards be from the Englilh, in their meat, drink, exer- 
 <c cife, affections of the mind, and habit of body j yet 
 " the health of both nations is equally influenced by 
 
 the 
 
THE PLAGUE. 43 
 
 *' the feafons. An epidemical diftemper feldom or 
 " never attacks the one clafs of inhabitants without 
 " attacking the other alfo ; and, furprifing as it may 
 " appear, it is neverthelefs true, that the peafants, 
 " remarkable for temperance and regularity, and the 
 " foldiers, who, without meat and clothes, frequently 
 <e lie abroad drunk, expofed to all weathers, have dif- 
 " eafes almoft fimilar, both as to their violence and 
 " duration." 
 
 There can be no doubt that excefs in drinking hath 
 put an end to the lives of many individuals ; and it hath 
 been obferved, that fuch as attempt to preferve them- 
 felves from the plague by the ufe of ftrong liquors, have 
 generally fallen facrifices to it ;* but this cannot prove 
 that fuch excefs would have brought on the diftemper 
 without fome other caufe. It hath been certainly 
 found, that excefs in drinking or eating, excefs in ve- 
 nery, exceflive fatigue by labour, watching, ffcudy, &c. 
 will all make an epidemic difeafe more violent when it 
 attacks a particular perfon ; but no experience hath yet 
 fiiown that the firft perfon feized with an epidemic 
 always fell under this defcription. All that can be faid 
 on the fubjecl is, that, by fuch exceffes as have already 
 been deforibed, the body is prepared for receiving the 
 difeafe, by an exhauftion, or evaporation (if we pleafe to 
 call it fo) of the vital principle ; as wood is prepared for 
 burning by the evaporation of its moifture - y but as 
 wood, however dry, will not burn without the contact 
 or application of fire, fo neither will the body, though 
 ever fo well prepared, be attacked by any epidemic, 
 unlefs the true caufe of that epidemic be alfo applied. 
 
 Thus we are ftill difappointed in our attempts to 
 difcover the origin of the plague. We have feen that 
 the moft unhealthy climates in the world do not pro- 
 duce it of themfelves ; neither can the conduct of any 
 individual bring it upon himfelf, without an unknown 
 fomethingi which nobody has yet found out. It was 
 this difficulty of finding out the natural caufe, which 
 certainly induced by far the greateft number of writers 
 
 on 
 
 * Sec Sec. IV, Preventives of the Plague, 
 
44 A TREATISE Otf 
 
 on the fubject to afcribe it to Divine Power -, and even 
 as late a writer as Dr. Hodges tells us, that he believes 
 in the to Theion, the "finger of God," in the plague, 
 as much as any body. As for thofe who have endea-* 
 youred to account for the origin of this diftemper from 
 an inquiry into natural caufes, and conclufions drawn 
 from the late experiments on air, they have totally failed j 
 as will be fully elucidated in the following fec~tion. 
 
 If then we are to believe that difeafes, efpecially thofe 
 called epidemics, among which the plague holds the 
 firft place, have arifen in confequence of a certain line 
 of conduct adopted by the human race, or have been 
 inflicted by the Deity as punimments on that account, 
 we are to look for their origin among thofe to whom the 
 Deity principally manifefted himfelf ; that is, the Jews, 
 and nations who interfered with them. Among the 
 Jews we hear of the firft general plague diftinctly men- 
 tioned ; viz. the three days peftilence of David, and to 
 which it is poflible that Homer alludes in his Iliad. 
 Next to this is the great plague of 767 B. C. faid to 
 have fpread all over the world. This coincides with the 
 time of Pu), king of Affyria ; who, having overthrown 
 the ancient kingdom of Syria, turned his arms againft 
 that of Jfrael 5 and no doubt extended his conquefts 
 among the eaftern nations, as we know very well the 
 Affyrian monarchs did. As the ten tribes, ever after 
 their feparation from the houfe of David , had in a man- 
 ner totally given themfelves up to idolatry, we are not 
 to wonder if the peftilence, fo frequently threatened by 
 Mofes, was very common, or, as phyficians term it, en- 
 demic, among them. Thus, whatever enemy invaded 
 the country, would almoft certainly carry the difeafe 
 along with them, and fpread it among the other nations 
 with whom they afterwards had any connexion. At 
 this time, or even before this, during the wars of Syria 
 with Ifrael and Judah, thi$ dreadful peftilence might 
 begin ; but, as to its being all over the world in any 
 particular year, I do not fee how it can be afcertained ; 
 becaute there are no general hiftories of the world iri 
 thofe early times. It appears more probable that this 
 
 general 
 
THE PLAGUE. 45 
 
 general peftilence took place at the time that Sennache- 
 rib's army was deftroyed. I have no doubt, indeed, 
 for the reafons already given, that the plague had in- 
 fe&ed Sennacherib's army before he went into Ethiopia. 
 In that country, in all probability, he would leave it ; 
 and, after his return to Judea, when the dreadful ca- 
 taftrophe befel him of an hundred and eighty-five thou- 
 fand of his men being deftroyed in one night, there can 
 be no doubt that the remains of his army would carry 
 with them the feeds of a moft malignant peftilence, 
 capable of fpreading definition far and wide. It is true, 
 we are not dire&ly told, in Scripture, that the AfTyrian 
 army was deftoyed by a plague, but that the angel of 
 the Lord deftroyed them$ but, as this exprefllon is 
 quite fimilar to what we read of the peftilence in Da- 
 vid's time, there can be but little doubt that the means 
 of deftru&ion made ufe of in both cafes were the fame. 
 Jofephus exprefsly fays, that Sennacherib ; s army was 
 deftroyed by a peftilence. Neither are we to conclude, 
 becaufe this peftilence was miraculous, that it therefore 
 certainly killed every one on whom it fell $ or that ijt 
 would not infeft thofe who came near the lick, as any 
 other difeafe of the kind would do. 
 
 From the fame fource may we derive the propenfity 
 in the Carthaginian armies to peftilential diforders 
 Carthage was a colony of Tyre ; and the Tyrians were 
 in clofe alliance with the Jews, during the reigns of 
 David and Solomon, and very probably afterwards ; fp 
 that from them the diftemper might be communicate4 
 in fuch a manner as to be almoft endemic ; and thus 
 hardly an army could be fent out but what would have 
 the infection with it, breaking out with violence now 
 and then, as occafional caufes tended to give life to the 
 contagion. It is impoffible, however, from the fource 
 juft mentioned to trace the plague of Athens, or the 
 firft plague in Rome j but it is very natural to fuppofe 
 that the violent one which raged in Rome, during the 
 reign of Titus, came from Jerufalem. That city had 
 fuftained a moft dreadful fiege, and the obftinate and 
 wretched inhabitants had endured fuch calamities a? 
 
 have 
 
4 6 A TREATISE ON 
 
 have fcarcely been recorded in the hiftory of nations. 
 Among thefe calamities was a peftilence, which, in all 
 probability, would be conveyed to Rome, and there 
 occaiion the deftruction already mentioned. 
 
 But what feems to render this account of the origin of 
 the plague more probable is, that the Jews are to this day 
 accufed of propagating the difeafe in thofe countries where 
 it is moil frequent. Baron de Tott is of opinion that the 
 plague in Conftantinople originates among the Jewifh 
 dealers in old clothes ; for thefe avaricious dealers, pur- 
 chaling the infected goods, fell them indifcriminately to 
 every one who will buy, and that without the leaft care ta- 
 ken to remove the infection from them ; by which means 
 k is no wonder to find the plague, as well as other difeafes, 
 diffeminated among them in great plenty. Dr. Ruflel 
 informs us, that the jews are moft liable to the plague, 
 the moft fearful of it, and the moft ready to fly from 
 the infection. The Abbe Mariti agrees in the fame 
 accufation againft this unfortunate people. " The 
 " Jews (fays he) purchafe at a low price the goods and 
 " wares which remain when moft of the family are de- 
 <e ceafed, and then (lore them up; which, when the 
 <c plague is over, they fell at a dear rate to thofe will 
 " buy, and thus propagate the peftilential poifon : again 
 " it kindles, and prefently caufes new deftruction. 
 " Thus this opprobrious nation, preferring gold to life, 
 '* fell the plague to muffulmen, who purchafe it with' 
 * f out fear, and ileep with it, till, renewed of itfelf, it 
 " hurries them to the grave." M. Volney, though he 
 does not mention the Jews in fuch exprefs terms as 
 Mariti and RuiTel, yet agrees as to the mode of its pro- 
 pagation in Conftantinople, and the reafon of its conti- 
 nuance in that city. " It is certain (fays he) that the 
 " plague originates in Conftantinople, where it is per- 
 " petuated by the abfurd negligence of the Turks, 
 <f which is fo great, that they publicly fell the effects of 
 t( perfons dead of the diftemper. The (hips which go 
 " to Alexandria never fail to carry furs and woolen 
 " clothes, purchafed on thefe occalions, which they ex- 
 *' f pofe to fale in the bazar of the city, and thereby fpread 
 
 " the 
 
THE PLAGUE. 47 
 
 ** the contagion. The Greeks who deal in thefe goods 
 " are almoft always the firft vi&ims." 
 
 Thus the account we have of the origin of the plague 
 at prefent is, that the city of Gonftantinople, having 
 been long and deeply infe&ed, the infection is ftored up 
 through the avarice of the Jewifh merchants, who buy 
 the goods and clothes of the infefted. The ftupidity 
 of the Turks allows thefe goods to be fold rn Conftanti- 
 nople, or exported freely to all parts to which their vef- 
 fels fail, particularly to Alexandria ; where the avarice 
 of the Greeks prompts them to buy without examination 
 or precaution, to the deftrudion of their own lives, and 
 of multitudes of others. Egypt being the principal place 
 of traffick, the plague is more frequent there than in 
 other parts of the empire. Syria is comparatively free 
 from it ; which M. Volney fuppofes to be owing to the 
 fmall number of veflels which come there dire&ly front 
 Conftantinople. 
 
 In this way we may, in a pretty plaufible manner, 
 account for the origin of this diftemper ; viz, that it 
 originally fell upon the Jews as a punifhment for their 
 iniquities ; that from the Jews it has been at different 
 times conveyed to other nations ; and, by a mixture of 
 thofe nations, has, at times, become general all over the 
 world. At laft it has, by the avarice of that people who 
 firft had been the occafion of its being introduced into 
 the world, become permanent in Conftantinople, whence 
 it is ft ill diifufed among different nations in proportion 
 to their dealings with that capital. 
 
 But it may now be faid, 'Allowing the pofitions 
 contended for to be true in their utmoft extent, how 
 comes it to pafs that the plague hath not been general 
 in every age and in every country ? Since the deftruc- 
 tion of Jerufalem, the Jews have been difperfed over all 
 nations : if nothing then were wanting to produce a 
 peftilence but Jews and old clothes, no age or country 
 ought to have been free from it ; neverthelefs it is cer- 
 tain that violent plagues take place only at particular 
 times, with long intervals between ; and of late the pef- 
 tticntial difpofition feems to have become much lefs 
 
 frequent 
 
48 A ^TREATISE ON 
 
 frequent than formerly ; the weftern parts of Europe* 
 particularly Britain, having been free from it for a great 
 number of years. There muft therefore be fome caufe, 
 different from what has yet been mentioned, by which 
 the infection is occafionally roufed from inactivity, and 
 excited to fpread defolation all around.' 
 
 That there are predifpofing caufes to epidemic dif- 
 orders, efpecially to the plague, the moft fatal of them 
 all, is not denied. Thefe prepare the body for receiving 
 the infection, but they will not, without that infection; 
 produce the diforder. Of thefe caufes fo many are to 
 be found in the conduct of mankind themfelves, that 
 we fcarcely need to look fgr them any where elfe. In 
 looking over the hiftories of plagues, we find them in 
 an efpecial manner connected with famines and wars. 
 The former fometimes take place in conference of the 
 failure of crops through natural caufes ; but, confidering 
 the general fertility of the earth, we mufl certainly ac- 
 count it owing to bad management, in fome refpedt or 
 other, that every country hath not as much laid up 
 within itfelf as would guard againft the confequcnces of 
 at leaft one or two bad crops. Yet we believe there is 
 not, at prefent, a country upon earth in this predica- 
 ment. If a crop fails any where^ the inhabitants muft 
 import largely, or they muft ftarve. This is the cafe 
 even in the fertile regions of the Eaft, where the earth 
 produces in exceffive abundance,* and there is little or 
 nothing of any kind of provifion exported to other 
 countries. A remarkable inftance of this occurred in 
 the plague at Aleppo, a hiftory of which is given by Dr. 
 Ruflel. He tells us, that the winter of 1756 proved 
 exceffively cold, which was followed by a famine next 
 year. This account is confirmed by Mr. Davves, in a 
 letter to the bifhop of Carlifle.*f He tells us, that in 
 the courfe of the winter many perifhed through cold ; 
 that the inhabitants were reduced to fuch extremities, 
 by the fingle failure of the crop in 1757, that women 
 
 were 
 
 * Herodotus fays, that in his time the province of Babylonia prodejj 
 commonly two hundred* and in plentiful years three hundred fold. 
 
 f Phiiof. Tranfaft. vol. liv. 
 
THE PLAGUE. 49 
 
 known to eat their own children as foon as they 
 expired in their arms with huoger ; and that human 
 creatures might be feen contending with dogs, and 
 fcratching for the fame bone with them in a dunghill. 
 A dreadful plague followed ; which, the two fucceeding 
 years, fwept off not fewer than fixty thoufand in the 
 city of Aleppo. 
 
 It is probable that in this cafe the famine either 
 produced the plague, or made it worfe than it would 
 have otherwife been ; and it is not denied that the cold 
 and bad feafon was the direct caufe of the famine. But 
 as little can it be denied, that had the people, or their 
 
 tovernors, been fo provident as to have laid up ftores 
 ifficient to fupply the country for one year, this famine 
 would not have been felt. As far, therefore, as the 
 plague was connected with the famine, we muft owa 
 that it was chargeable on the human race themfelves $ 
 not the fins of this or that particular perfon, but a ge- 
 neral deviation from the talk affigned them by their 
 Maker, viz. that of cultivating the ground ; and, in- 
 ftead of this, fpending their time in folly and trifling, 
 to fay no worfe. 
 
 But famines are occafioned not only by natural caufes, 
 but by wars ; in which mankind, acting in direct oppo- 
 lition to the laws of God and nature, deftroy and lay 
 wafte the earth, taking every opportunity of reducing 
 to extremity both thofe whom they call innocent and 
 thofe whom they call guilty. Thus vaft multitudes are 
 reduced to want, to defpair, and rendered a prey to grief, 
 terror, and every deprefling paflion of the human mind ; 
 they are expofed to every inclemency of the weather - 9 
 to the fcorching heats of the day, and the chilling damps 
 of the night j in ihort, to every thing that we can con- 
 ceive capable of predifpofing the body for the reception 
 of difeaies of the very woril kind. No wonder therefore 
 that war and peftilence go hand in hand ; and, by 
 taking a review of the hiftory of mankind, we fhall fee, 
 that, always at thofe times when the nations have been 
 moil actively employed in the trade of butchering one 
 another, then, or very foon after, they have been afflicted 
 
 H with 
 
50 A ^REATISE ON 
 
 with peftilence. To begin with the great plague of 767 
 B. C. which coincides with the rife of the Aflyrian em- 
 pire : Till this time, though there had been numberlefs 
 wars, yet they were carried on upon a much fmaller 
 fcale than now, when great empires were to be fet up, 
 and when the moft diftant nations were to be afiembled 
 in order to gratify the pride and ambition of an individual. 
 The AfTyrians, we know, penetrated into Ethiopia ; but 
 how far eaft or how far weft they went, we are not cer- 
 tainly informed. To their wars, however, we may with 
 reafon afcribe the defolations occaiioned by this firft 
 plague. From Thucydides's account of the plague at 
 Athens, it feems plain that it was occafioned 7 or at leaft 
 rendered more violent, by the wars of the Greeks with 
 one another at that time. Had the Carthaginian army 
 ftaid at home when they went to war with Dionyfius, 
 tyrant of Syracufe,* it is very probable that the pefti- 
 lence would not have broke out among them. The 
 like may be faid of the plague which broke out among 
 them in the time of Marcellus.-f* That in the time of Ju- 
 gurtha, indeed, is faid to have been occafioned by locufts $ 
 but, had not vaft bodies of men been collected together for 
 the purpofes of war, the plague could never have com- 
 mitted fuch ravages. The plague in the time of Titus 
 could not have been brought from Jerufalem, nor per- 
 haps would it have exifted there, had not Titus made 
 war againft that city ; and fo of others. 
 
 The plague which began in the reign of Juftinian, 
 as it was more violent than any recorded in hiftory, fo 
 it was preceded by wars equally unexampled. The 
 Romans had indeed for ages employed themfelves in 
 war ; but, by their conftant fuperiority to every adver- 
 fary, their empire had become fo amazingly extenfive, 
 that, whatever wars were carried on in the remote pro- 
 vinces, the great body of the empire always remained 
 at peace ; and this was the cafe even in their moft vio- 
 lent civil wars. On the acceifion of Alexander Severus ? 
 about the year 232, they began to encounter enemies fo 
 numerous and formidable, that all their power proved 
 infufficient to repel them. In the tenth year of Alex- 
 ander's 
 
 * See Sec, i, p, IQ. f Ibid* ]? * * 
 
THE PLAGUE. 51 
 
 ander's reign, the Perfians, having overthrown the an* 
 cient empire of the Parthians, turned their arms againft 
 the Romans, and, though frequently defeated at that 
 time with great ilaughter, renewed their incurfions in 
 the reign of Gordian, about the year 242, when they 
 were in like manner defeated and obliged to retire. As 
 thefe defeats, however, did not at all affect the ftrength 
 of the Perfian empire, the Romans ftill found them as 
 formidable enemies as ever ; while the Goths, Sarma*- 
 tians, Franks, and other northern nations, harafled them 
 in other parts. In the reign of Decius, who afcended 
 the throne in 249, they became extremely formidable, 
 infomuch that the emperor himfelf, with his whole 
 army, was at laft cut off by them. The confequence of this 
 was, that the empire was inftantly invaded in many 
 different parts, and, though the barbarians were at times 
 defeated, we never find that the empire regained its for- 
 mer tranquillity. The Perfians and Scythians, taking 
 advantage of the general confufion, invaded the provin- 
 ces next them, while the finifhing ftroke feerned to be 
 given to the Roman affairs by the defeat and captivity 
 of Valerian by the Perfians. 
 
 This difafter, as may well be imagined, produced an 
 immediate invafion by numberlefs barbarians, while 
 fuch. multitudes of pretenders to the imperial crown 
 were fet up, each afferting his claim by force of arms, 
 that the whole Roman territories were filled with blood- 
 fhed and flaughter. At this time Gallienus, the fon of 
 Valerian, was the law/id emperor, if indeed we may ap- 
 ply the word to the domination of fuch a monfter. His 
 mode of government may be imagined from the follow- 
 ing letter written to one of his officers in confequence 
 of a victory gained over an ufurper named Ingenuus, 
 " I fhall not be fatisfied with your putting to death only 
 " fuch as have borne arms againft me, and might 
 ** have fallen in the field : you muft in every city deftroy 
 c< all the males, old and young ; fpare none who have 
 ^ wifhed ill to me, none who have fpoken ill of me, the 
 f( fon of Valerian, the father and brother of princes. 
 < Ingenuus emperor ! Tear, kill, cut in pieces, without 
 
 " mercy ; 
 
ii A TREATISE ON 
 
 " mercy : you underftand me ; do then as you know 
 " I would do, who have written to you with my own 
 " hand." In confequence of this horrible order, not 
 a fingle male child was left alive in fome of the cities 
 of Moefia, where this inhuman tragedy was adted. 
 
 In the midft of this dreadful commotion, we find the 
 peftilence contributing its (hare to the common work of 
 defolation. In Alexandria in Egypt, fays Dionyfius, 
 bifhop of that place, " fury and difcord raged to fuch 
 " a degree, that it was more eafy to pafs from the eaft 
 " to the remoteft provinces of the weft, than from one 
 * c place of Alexandria to another. The inhabitants had 
 !< no intercourfe but by letters, which were with the 
 " utmoft difficulty conveyed from one friend to another. 
 " The port refembled the fhores of the Red Sea ftrewed 
 *' with the carcafes of the drowned Egyptians : the fea 
 " was dyed with blood, and the Nile choked up with 
 " dead bodies. The war was attended with a general 
 *' famine, and the famine with a dreadful plague, which 
 " daily fwept off great numbers of people, infomuch 
 " that there were then in Alexandria fewer inhabitants, 
 " from the age of fourteen to that of eighty, than there 
 " ufed to be from forty to feventy." It was not in 
 Egypt alone that this calamity prevailed. It raged with 
 great violence in Greece, and at Rome itfelf ; where, 
 for fome time, it carried off five thoufand perfons a day. 
 Many terrible phenomena of nature took place at the 
 fame time. The fun was overcaft with thick clouds, 
 and great darknefs took place for feveral days, attended 
 with a violent earthquake, and loud claps of thunder, 
 not in the air, but in the bowels of the earth, which 
 opened in feveral places and fwallowed up great num- 
 bers of people in their habitations. The fea, fwelling 
 beyond meafure, broke in upon the continent, and 
 drowned whole cities.* 
 
 At laft the civil commotions were fettled by the 
 accefiion of Claudius to the empire in 268. He found 
 the Roman force fo exhaufled, that, when marching 
 againft the Goths, he wrote to the fenate in the following 
 
 terms : 
 
 * Univ, Hid, vol. xvi. p p. 4331 435. 
 
THE PLAGUE. $3 
 
 terms : " If I fhould not be attended with fuccefs, you 
 " will remember that I fight after the reign of Gallienus. 
 " The whole empire is quite fpent and exhaufted, partly 
 " by him, and partly by the many tyrants who, during 
 " his reign, ufurped the fovereignty, and laid wafte our 
 *' provinces. We want even fhields, fwords and fpears.'* 
 In this miferable plight, however, he gained a mod 
 extraordinary victory; three hundred thoufand of the 
 enemy being killed or taken. But, while Claudius thus 
 carried on the work of death fuccefsfully againft the 
 barbarians, he was attacked from a quarter where he 
 could make no refiftance : a violent plague broke out in 
 his army, and carried off himfelf and a vaft number of 
 his men. 
 
 The dreadful defeat given to the Goths did not long 
 preferve the tranquillity of the empire. New invafions 
 took place, and new maffacres enfued. At laft, on the 
 acceffion of Dioclefian to the empire, it was thought 
 proper, on account of the prefent emergences, to divide 
 fuch wide-extended territories into four parts, to be 
 governed by four emperors of equal authority. By the 
 activity and valour of thefe, particularly of one of them, 
 named Galerius, the northern barbarians were reprefled, 
 and the Perfians reduced fo low, that they were obliged 
 to yield up a great part of their territories ; and it is faid 
 that their country might even have been reduced to a 
 Roman province, had the emperor fo inclined. We 
 know not whether, in his eaftern expedition, the Roman 
 army received any infection, nor do we hear of any 
 plague breaking out in it ; but we are told that Galerius 
 himfelf died of an uncommon diftemper ; an ulcer, 
 attended with mortifications, violent pains, and the pro- 
 duction of an infinite number of vermin, which devoured 
 and tormented him day and night. This diftemper, 
 however, feems rather to have been a cancer than a 
 peftilential diforder, as he laboured under it for more 
 than a year. After his death, dreadful wars continued, 
 both by reafon of the incurfions of barbarians, and the 
 contefts of thofe who enjoyed, or wifhed to enjoy, the 
 empire. The eaftern parts, however, had for fome 
 
 time 
 
54 A TREATISE ON 
 
 time kept free from peftilential contagion ; of which the 
 chriftian writers fay, that Maximin, who reigned there, 
 had made his boaft ; and, being a heathen, afcribed it 
 to the care he took of preferving the worfhip of the 
 gods. But, if this was really the cafe, he foon found 
 his gods unable to protect him ; for, foon after the ac- 
 ceflion of Conftantine the great, and his embracing 
 chriftianity, the dominions of Maximin were affli&ed 
 with famine accompanied with peftilence, and that at- 
 tended by fymptoms of a moil extraordinary nature ; 
 particularly ulcers about the eyes, which rendered mul- 
 titudes of thofe who were infected with the diftemper 
 totally blind. The chriftians did not fail to afcribe this 
 plague to the fins of Maximin ; but it muft be obferved, 
 that to his other fins he had added that of involving 
 himfelf in a violent war, during which the peftilence 
 broke out, and which probably was one of the caufes of 
 it* We may likewife obferve, that if the fins of Max* 
 imin brought on the plague, the piety of Conftantine 
 could not keep it off; fince we find that in the year 
 332, a confiderable time after the death of Maximin, 
 the territories of Conftantine were ravaged by a dreadful 
 plague, and the famine was fo fevere, that, at Antioch, 
 wheat was fold at four hundred pieces of filver per 
 bufhel. The diftemper which put an end to the life. 
 of Maximin himfelf was indeed fo extraordinary, that 
 we may reafonably excufe thofe who called it a judg- 
 ment fent directly from heaven. His eyes and tongue 
 are faid to have putrefied ; " an invifible fire was kindled 
 " in his bowels, which, being attended with unrelenting 
 " torments, reduced him in a few days to a perfect 
 " ikeleton ; his whole body was covered over with a 
 " kind of leprofy, and devoured by fwarms of vermin : 
 " he could not be prevailed upon to take any nourifh- 
 " ment, but greedily fwallowed handfuls of earth, as if 
 is he had hoped by that means to afluage his pains, and 
 " allay the hunger with which he was tormented with* 
 " out intermiffion,"* All this, we are told, was the 
 effect of poifon, which he had fwallowed in defpair, 
 
 after 
 
 * Univ. Hift, vol. xvJ 
 
THE PLAGUE. 55 
 
 after being defeated in battle $ but the fymptoms are 
 Unaccountable. 
 
 After the death of Conftantine, the empire being 
 again parted, civil diffenfions took place $ the northern 
 barbarians and Perfians renewed their incurfions, and at 
 length the battle of Murfa, between the emperor 
 Conftantius and an ufurper named Magnentius, 
 deftroyed fuch numbers that the empire no more 
 recovered its former ftrength. From this time therefore 
 the wars with the barbarians became more and more 
 violent; and, though frequently overcome, the advantage 
 was ultimately on their fide. In 361, the firft year of 
 the emperor Julian, the peftilence again made its appear- 
 ance. It was accompanied by many other grievous ca- 
 lamities : Dreadful earthquakes were felt in every 
 province j moft of the cities in Paleftine, Libya, Sicily 
 and Greece, were overturned. Libanius writes, that 
 not one city in Libya was left {landing, and but one in 
 Greece ; that Nice was utterly ruined, and Conftanti- 
 nople greatly damaged. The fea, in feveral places, broke 
 in upon the land, and deftroyed whole cities with their 
 inhabitants. At Alexandria, the fea, retiring during an 
 earthquake, returned again with fuch violence, that it 
 drowned feveral towns and villages in the neighbour- 
 hood. The earthquakes were followed by a famine, 
 and the famine by a peftilence. It was obferved by the 
 chriftian writers, that the famine feemed to follow Ju- 
 lian from place to place : and no wonder that it did fo ; 
 for he not only had always a large army along with him, 
 which confumed great quantities of provifion, but, at- 
 tempting to remedy the evil by fixing the prices of pro- 
 vifions, he rendered it much worfe, as the dealers in 
 corn were thereby tempted to convey it to other places,* 
 Indeed this emperor feems to have been inclined to pro- 
 duce famines wherever he went ; for, on his entering the 
 territories of the Perfians, with whom he was at war, he 
 wafted the country to fuch a degree, that he could neither 
 fubfift nor return ; while the enemy, imitating his exam- 
 ple, deftroyed all before him. The confequence was, 
 
 - that, 
 
 * Uniy, Hifl, vol. XVi, 
 
56 A TREATISE ON 
 
 that, by the time Julian was killed, the famine raged iit 
 the Roman camp to fuch a degree, that not a fingle per- 
 fon could have efcaped, had not the enemy mercifully 
 granted them peace. 
 
 Notwithflanding this difmal fituation, we hear of no 
 plague invading the camp of the Romans at that time. 
 The wars, however, continued with great violence $ and, 
 in the time of Valentinian, Valens and Gratian, became 
 worfe than ever. The dreadful ftate of the empire in 
 the time of Gratian is thus defcribed by St. Jerom : 
 " The whole country, from Conftantinople to the Julian 
 " Alps, has been fwimming thefe twenty years in Roman 
 " blood. Scythia, Thrace, Macedon, Dardania, Dacia, 
 " Theffaly, Achaia, both Epirufes, Dalmatia, both Pan- 
 " nonias, are filled with Goths, Sarmatians, Quadians, 
 " Alans, Huns, Vandals, Marcomans, &c. whofe avarice 
 " nothing has efcaped, whofe cruelty has been felt by 
 <c perfons of all ranks, ages and conditions." " What 
 " evils, (fays Gregory Nazianzen) have we not feen or 
 " heard of ! Whole countries have been destroyed with 
 " fire and fword ; many thoufand perfons of all ranks 
 " and ages have been inhumanly maflacred ; the rivers 
 " are ftill dyed with blood, and the ground covered with 
 " heaps of dead bodies/' 
 
 In the midft of fo great calamities, the peftilence, as 
 an evil of inferior nature, might in many cafes pafs un- 
 noticed by the hiftorians of the times ; neverthelefs, even 
 during that diftracted period, we find fome accounts of 
 it. In 384 we are told of a famine and plague at An* 
 tioch ; and, in 407, of one in Paleftine, faid to be occa- 
 iioned by multitudes of grafshoppers, which even ob~ 
 fcured the fun, and turned day into night. After hav- 
 ing done incredible mifchief, they were thrown by the 
 wind partly into the Red Sea, and partly into the Medi- 
 terranean ; whence being again caft afhore by the wavcs> 
 they putrefied, and occalioned a peftilence. Two yeats 
 after, when Rome had been firft belieged by Alaric the 
 Goth, the city was reduced to fuch ftralts, that human 
 flefh was publicly fold, and fome mothers are faid to 
 have devoured their children. This terrible famine was 
 
 occafioned 
 
f HE PLAGUE. 57 
 
 ccafioned by the uncultivated flate of the country, 
 which had lain wafte for feveral years, by reafon of the 
 wars, and the ports of Africa being blocked up by He- 
 raclianus left an ufurper fhould become emperor ; and 
 thus this loyal admiral, for fear that the people fhould 
 have a bad governor, determined rather that there 
 ihould be no people to be governed. Notwithftanding 
 this terrible famine, however, we hear of no peftilential 
 diforder taking place; not even after the taking of the 
 city by Alaric, when bloodfhed and maflacre were added 
 to the other calamities. 
 
 All this time the empire, by the incurfions of barba- 
 rians, by ufurpations, civil wars, and the general licen- 
 tioufnefs of the people, had been in a fituation not to 
 be defcribed. The invafion of the Hunns, a new and 
 more formidable enemy than they had ever experienced, 
 now completed the ruin of the Romans. The whole 
 weftern part of the empire became one continued fcene 
 of carnage and defolation. The common epithet be'- 
 flowed upon Attila, the king of thefe barbarians, was, 
 " The Scourge of GOD, the Deftroyer of Armies" As a 
 fpecimen of his behaviour, we fhall felect the account 
 of his taking of Aquileia in 452. That city, " being 
 " well fortified, and defended by the flower of the Ro- 
 " man troops, held out, in fpite of his utmoft efforts, for 
 " three months ; at the end of which it was taken by 
 " affault, pillaged for feveral days together, and laid in 
 " allies ; not a fingle houfe being left flanding, nor one 
 " perfon alive that fell into the enemy's hands. The 
 u cities of Trevigio, Verona, Mantua, Cremona, Brefcid 
 " and Bergamo, underwent the fame fate ; the barba- 
 " rians raging every where with fuch fury as can hardly 
 " be expreffed or conceived, and putting all to the 
 " fword, without diftin&ion of fex, age, or condition."* 
 Every one muft own that this was a very effectual 
 method of preventing the plague in thofe cities; It did 
 not, however, prevent that, or forne other difeafes, from 
 deftroying fuch numbers of the tyrant's troops, that he 
 was for that time prevented from taking Rome itfelf* 
 
 FVom 
 
 * Univ. Hift. vol. xvi, 
 I 
 
58 A TREATISE ON 
 
 From this time, to the total extinction of the weftern 
 empire, we do not hear of any remarkable infection 
 taking place. The barbarians Hill continued their wars 
 with one another, while the emperors of Conflantinople 
 were likewife at continual variance with the Perfians. 
 At laft, in the year 532, they concluded what they called 
 a perpetual or eternal peace, which lafted eight years / 
 Other treaties and truces were concluded ; notwithftand- 
 ing which, the war was almofl continual in the eaft ; 
 while, by the fecond conqueft of Italy, and the invafion 
 of the Gothic territories, new defolations overfpread the 
 weft. Thus, for a great number of ages, mankind had 
 been preparing themfelves for the dreadful peftilencc 
 _ which was about to enfue. Whatever infection could 
 be communicated to the air by multitudes of carcafes 
 rotting above ground had been done in an ample man- 
 ner. Whatever debility could be communicated to the 
 human frame by famine, expofure to the inclemency of 
 weather, by fatigue, terror, grief, and every thing that 
 can render life miferable, had alfo been communicated 
 by the moft powerful means. There only wanted fome- 
 thing to begin the calamity ; and this, whatever it was, 
 took place in the fifteenth year of Juftinian. Mr. Gib- 
 bon afcribes the origin of it to locufts , and its univer- 
 fality, to the general mixture of all nations, and the un- 
 rcftrained interconrfe they had with one another. " No 
 *" reftraints (fays he) were impoled on the frequent inter- 
 " courfe of the Roman provinces. From Perfia to 
 w France the nations were mingled by wars and emigra- 
 ,; <c tions $ and the peftilential odour, which lurks for years 
 " in a bale of cotton, was imported, by the abufe of 
 " trade, into the moft diftant regions. Procopius relates, 
 * c that it fpread always from the fea-coaft to the inland 
 *' countries : the moft fequeftered iflands and mountains 
 " were fucceffively vilited -, the places which had efcaped 
 *' the fury of its firft paffage, were alone expofed to the 
 " contagion of the enfuing year. In time, its malignity 
 " was abated and difperfed ; the difeafe alternately Ian- 
 5C guifhed and revived ; but it was not till the end of a 
 " ccikunitcus period of fifty-two years, that mankind re- 
 covered 
 
THE PLAGUE. 5f 
 
 Cl covered their health, or the air refumed its pure and 
 44 falubrious qualities." 
 
 Thus Mr. Gibbon endeavours to explain the caufes 
 of this plague from an alteration in the falubrity of the 
 atmofphere, without taking into confederation the dread- 
 ful commotions among mankind, above related. But, 
 now that we have noticed two very general infections, 
 one in 767 B. C. the other 1300 years after, we find 
 them both preceded and accompanied by wars uncom- 
 monly violent and deftructive. The great plague in the 
 time of Juftinian is faid by Mr. Gibbon to have con- 
 tinued only fifty-two years ; but this we muft under- 
 ftand of its firft and moft violent attack ; for it appears, 
 from the teftimonies produced in the former fedion, 
 that peftilential diforders, even very violent ones, con- 
 tinued at intervals for feveral centuries. Thus, from 
 the year 541 to 593, the fpace of fifty-two years is in- 
 cluded -, neverthelefs, in the time of Phocas, who began 
 to reign ten years after, the fame calamity continued ; 
 as did alfo violent wars with the Perfians and other bar- 
 barians. 
 
 The year 622 is remarkable for the flight of Maho^ 
 met from Mecca to Medina, from which time we may 
 date the rife of the empire of the Saracens ; a people 
 who, for defolation and deftru&ion, were perhaps never 
 equalled except by the Hunns and Moguls. In 630 the 
 impoftor himfelf died, after having juft united the Arabs 
 or Saracens, and fitted them for the work in which they 
 were to be employed. Their firft exploit was, to fall 
 upon the empire of Perfia, now weakened by its endlefs 
 wars with the Romans. This was conquered in two 
 years ; after which they broke into Paleftine, and con- 
 quered the provinces bordering upon Syria. In 634 
 they reduced Syria itfelf and Egypt. In 636 they took 
 and plundered Jerufalem. In 642 they conquered the 
 African provinces, and reduced fome of the iflands in 
 the Levant. With unabated fury they proceeded to 
 the eaft and weft ; laying fiege, in 668, to Conftantino- 
 pie itfelf, where they received their firft check by the 
 fhipwreck of their fleet, and the defeat of their army.- 
 
 Thus, 
 
fo A TREATISE ON 
 
 Thus, in the fpacc of 38 years, the immenfe trad of 
 country from the eaflern part of Perfia to the confines 
 of the Mediterranean Sea, with the northern coafts of 
 Africa, the whole including a fpace fcarce inferior to the 
 empire of Alexander the Great, was reduced under 
 fubjection to a race of favage barbarians, who knew on- 
 ly how to plunder, deftroy, and reduce other nations to 
 flavery, 
 
 In this manner Were the eaftern parts of the werld 
 prepared for a new infection, fuppofing the old one to 
 have been entirely gone off. The Saracens purfued 
 their good fortune, ravaged and conquered from India 
 to Spain, and from Spain were proceeding northward 
 through France, to extend their conquefts to the other 
 countries of Europe. But here, in 728, their fury was 
 flopped by Charles Martel, the father of Pepin, and 
 grandfather of Charles the Great. After a moft obfti- 
 nate and bloody battle, which lafled.feven days, and in 
 which the barbarians loft three hundred and feventy-fivc 
 thoufand men,* they were driven beyond the Pyrennean 
 mountains, and never after durft enter France. Thus 
 was one fury flopped, only to give place to another. 
 Charles, as ambitious and as cruel as the Saracens, having 
 in vain attempted the conqueft of Spain, reduced Italy 
 and Germany ; and, having dreadfully maffacred the 
 Saxons, and almoft exterminated the Hunns, fet up the 
 German Empire, and was crowned emperor of the 
 Weft in 8oq, 
 
 While the nations were thus deluging the earth with 
 blood, the peftilence made its appearance in the eaft, 
 attended with extraordinary phenomena. -f Some of thefe 
 are taken notice of by the Arabian hiftorians,and others are 
 fnentioned by them, concerning whjch the Greek hiftories 
 
 are 
 
 * M. Millot places this account among the exaggerations which ought not 
 to have a place in hiftory ;" but, as we have no evidence for or againft the fadt, 
 it was thought proper to let jt remain as related by the hiftorians of t-hofe 
 times. It is certain that in thofe days mankind allernbled for the purpofes 
 of bloodfhed and flaughter in prodigious numbers ; the deftru&ion was corn- 
 raonly in proportion tp the numbers aflernbled. The account is not more in- 
 credible than that of Tamerlane's filling up the harbour of Smyrna by 
 caufing each of his foldiers to throw a (lone into it. Such an army cbultf 
 have f pared the number in queftion. 
 
 t Set Sec, i. 
 
THE PLAGUE. 5i 
 
 are filent. In 636, particularly, we hear of violent ftorms 
 of hail throughout the Arabian Peninfula, and of Syria 
 being ravaged by epidemic diftempers. It would feem, 
 indeed, that the plague, during the whole of thefe hor- 
 rible periods, had never been extinguifhed j for in 671 
 they tell us that a celebrated Arab, named Ziyad, died 
 of the plague ; though neither Greek nor Arabian hif- 
 torians take notice of any remarkable peftilence as 
 raging at that time. We are told that this man was 
 attended by no fewer than an hundred and fifty phyfi- 
 cians.* " But, as the decree was fealed, and the thing 
 determined, they found it impoffible to fave him." This 
 diftemper was attended with fuch an excruciating pain 
 in his right hand, that the unhappy patient had re- 
 courfe to a cadi, or judge, to inform him whether he 
 might lawfully cut it off. The judge determined that 
 it was abfolutely unlawful to do fo ; notwithftanding 
 which, Ziyad refolved to proceed : but his heart failed 
 him when he favv the inftruments and cauterifing irons 
 to be employed in the operation ; for in thofe times of 
 barbarity and ignorance they knew no other method of 
 flopping blood but by a hot iron ; and therefore fome 
 of the phyficians in ancient times, when a limb was to 
 be cut off, ordered the incifion to be made down to the 
 bone with a red hot razor. But, to return to our fubjeft : 
 In Syria and Mefopotamia fwarms of locufls infefted 
 the earth about the year 679 ; but, as it feems extremely 
 probable that the plague was never out of the eaftern 
 regions, we cannot expect to hear much of it, unlefs 
 when extremely violent. That in the time of Conftan- 
 tine Copronymus feems to have extended over Arabia, 
 as we are told that theKhalif Yezid,whowas cotemporary 
 with Copronymus, died of the plague. We are alfo 
 told, that the earthquakes which affli&ed the territories 
 of the Greek emperors extended themfelves to the coun- 
 tries about the Cafpian Sea. In thofe ages indeed the 
 phenomena of nature appear to have been fo extraordi- 
 nary, that we can fcarcely account them any other than 
 jniraculous. Some of thefe have been defcribed in the 
 
 former 
 
 * Modern Univ. Hift. Arabia, 
 
6z A TREATISE ON 
 
 former fe&ion, on the authority of the Greek hiftorians : 
 the Arabians make mention of others fimilar. They 
 tell us, alfo, that once or twice it rained black Hones, and 
 that fome of thefe were fo inflammable, that an Arab 
 having attempted to make a fire with one of them in his 
 tent, it burft out into fuch a violent flame as confumed 
 the tent altogether.* This rain may be accounted for 
 from the explofion of a volcano ; but how fhall we ac- 
 count for the fun himfelf lofing his light ? a phenomenon 
 acknowledged even by Mr. Gibbon ; though that 
 author huddles things together in fuch a manner as 
 feems totally inconfiftent with the regular chain of 
 events. He tells us, that the dreadful plague, which 
 broke out in the time of Juftinian, was preceded by 
 comets, and mod violent earthquakes ; and that thefe 
 comets were attended with an extraordinary palenefs of 
 the fun. This may be ; but the word palenefs cannot 
 apply to the darknefs which lafled from the fourth of 
 Auguft to the firft of O&ober, and to which he feems 
 to allude, though it happened long after the time of 
 Juftinian ; neither can it be applied to what I am now 
 about to relate, viz. that in the year 782* a little after 
 funrife, the folar light was loft without an eclipfe, and 
 the darknefs continued till noon. It is impoflible to 
 read the hi (lories of thofe times without remembering 
 the words of our Saviour, that there mould be figns in 
 the fun and in the moon, diftrefs and perplexity of na- 
 tions, the fea and waves roaring, men's hearts failing 
 them for fear, &c. But, however the God of nature 
 might thus intimate to mankind his difpleafure with 
 their proceedings, it is certain they made no alteration 
 in their conducl. The Saracens, having conquered im- 
 menfe tracts of country, engaged in civil wars among 
 themfelves; the weftern nations, after having tried in 
 
 vain 
 
 * That fuch accounts are not to be looked upon as entirely fabulous, may be 
 gathered from what is related by Mr. Thornton in his travels through PaleJ- 
 tine, viz. that on the brink of the lake Aiphaltites he found numbers of 
 fmall Hack pebbles, which are foon fet on fire by being held in the 
 flame of a candle, and yield a fmoke intolerably (linking and ofJeniive ; but 
 have this remarkable property, that by burning they lofe nothing of their 
 weight, nor fuffer any diminution in their bulk. They are capable of taking 
 as fine a polifh as black marble, and are likewife faid to be met with of con* 
 ft&rable (ize in the neighbouring mountains," 
 
THE PLAGUE. 63 
 
 vain to deftroy each other, at lad united in a romantic 
 defign of conquering Paleftine from the Infidels ; while 
 the Turks, leaving their habitations about Mount Cau- 
 cafus, where, like the vultures of Prometheus, they had 
 for ages remained unfeen and unknpwn, precipitated 
 themfelvcs upon the Greeks and Saracens, and laftly, as 
 if all hell had broke loofe at once, the Moguls, from the 
 moil eafterly part of Afia, poured deftruction upon the 
 countries to the weft, even as far as Ruflia and Poland. 
 
 All thefe events took place in a few centuries. In 
 844 the Turks quitted Mount Caucafus, and fettled in 
 Armenia Major. In 1030 they fell upon the Saracen 
 empire, now divided among innumerable chieftains con- 
 tinually at war with each other. Among thefe was one 
 called the Sultan of Perfia, and another of Babylon. 
 The former being worfted, called in the Turks to his 
 afliftance. They fent him an auxiliary army of only 
 three thoufand men j and from this flender beginning has 
 arifen the vaft empire of the Ottoman Porte. The 
 three thoufand men were commanded by a general called 
 by the Greeks Tangrolipix, and by the Afiatics Togrul 
 Beg. Being a man of ability, the Sultan of Perfia, by 
 his affiftance, gbt the better of his adverfary ; but, refut- 
 ing to let the Turks depart, Tangrolipix with his army 
 withdrew to the defert of Carbanitis, where, being joined 
 by numbers of difcontented Perfians, he began to invade 
 the territories of the Saracens. The Sultan of Perfia 
 fent againft him an army of twenty thoufand men, whom 
 Tangrolipix furprifed and defeated, acquiring at the 
 fame time an immenie booty. The fame of his victory, 
 and his wealth, procured him bands of robbers, thieves, 
 and blackguards, from all the neighbouring countries ; 
 fo that he foon found himfelf at the head of fifty thou- 
 fand. Againft fuch a formidable force the Sultan of 
 Perfia marched in perfon ; but happening to lofe his 
 life in the engagement by a fall from his hoirfe, his men 
 threw down their arms and acknowledged Tangrolipix 
 to be Sultan of Perfia. 
 
 The new fuitan inftantly thought of deftroying other 
 fultans and potentates ; for which purpofe he opened a 
 
 paffagc 
 
64 A TREATISE ON 
 
 paffage for his countrymen from Armenia to Perfia; 
 The Sultan of Babylon was the firft vidtim ; after which 
 Tangrolipix turned his arms unfuccefsfully againft the 
 Arabians, but afterwards more fuccefsfully againft the 
 Greek emperors. The firft invafion by the Turks took 
 place in 1041 ; and in four hundred and twelve years 
 they became abfolute mafters of the empire. Though 
 unfuccefsful at firft againft the Saracens, they prevailed 
 greatly afterwards, and, by the time of the crufades, we 
 find them mafters of Paleftine, as well as feveral other 
 countries formerly conquered by the Arabs. From the 
 time of their firft invafion, in 1041, we may fay, the war 
 never ceafed ; and there is the greateft reafon to fuppofe 
 that the Greek empire would have been overthrown in 
 a very (hort time, had not the crufaders checked their 
 progrefs. The immenfe numbers with whom the bar- 
 barians had now to contend (amounting to no fewer 
 than feven hundred thoufand) threatened with deftruc- 
 tion the newly ere&ed empire of the Turks ; and had it 
 not been for the want of unanimity among the crufaders 
 themfelves, and the jealoufy of the emperors of Con- 
 ftantinople, they certainly would have overthrown it. 
 But, as matters went, all their labour was loft ; and they 
 only increafed the general carnage and defolation to an 
 extreme degree. The firft crufade was planned in 
 1093, publiihcd in 1095, and in March 1096 the firft 
 army fet out. In 1097 they began their conquefts, but 
 foon found it very difficult to keep them. The Turks 
 being at home, and united, had many advantages over 
 foreign invaders ; which the latter endeavoured to 
 counteract by drawing continual fupplies of frelh men 
 from Europe. Thus, for feveral centuries, the weftern 
 part of Afia was rendered a fcene of bloodfhed and defo- 
 lation. When they had contended for fomething more 
 than two hundred years, Jenghiz Khan, the Mogul, feems 
 to have formed the noble defign of deftroying the whole 
 human race at once, excepting only his own immediate 
 followers. His plan was, to exterminate man, woman 
 and child wherever he went, and to plant the countries 
 with his own people. It is impoffible to do juftice to 
 
 his 
 
THE PLAGUE. 65 
 
 liis exploits. Voltaire, fpeaking of the irruption of the 
 Moguls, faysj that the people fled every where before 
 themj like wild beads roufed from their dens by other 
 beads more favage than themfelves. In the Univerfal 
 Hiftory we are told, that he is fuppofed to have deftroyed 
 fourteen millions and an half of his fellow creatures. He 
 died in 1227, and left fucceffors worthy of himfelf. 
 Some of thefe proceeded eaftward, and fome weft ward. 
 The latter, under the conduct of a monjier named Hula- 
 kit, overthrew, in the year 1256, the remains of the 
 Saracen empire, by the taking of Bagdad. The mifera- 
 ble Khalif, coming forth to meet his conqueror, was 
 trampled under his horfe's feet, then fewed up in a fack, 
 dragged through the ftreets, and thrown into the river. 
 The Moguls who proceeded eaftward invaded China. 
 The Chinefe refilled with innumerable multitudes, and 
 battles were fought to which thofe of the prefent age are 
 mere fkirmifhes. The foldiers, overcome with third* 
 drank blood inftead of water ; hundreds of thoufands 
 fell on both fides, while human blood ran in dreams for 
 five or fix miles. At lad the fury of the Moguls was 
 dopped by the ocean ; for, having attempted the con- 
 queft of Japanj their fleet was wrecked, and an hundred 
 thoufand periihed. Like other great empires, alfo, pre- 
 tenders to the fovereignty darted up, and the whole was 
 parcelled out into a number of little dates, which, of 
 courfe, ceafed to be formidable. 
 
 The decline of the Mogul empire did not redore 
 peace to the world. The Turks continued their ravages j 
 the wedern nations continued their crufades. England* 
 which became a kingdom in 806, had been ravaged and 
 conquered by the Danes and Normans^ and likewife dif- 
 trefled by civil wars. At lad, having emerged from its 
 own difficulties, it began to inflict upon other nations 
 the miferics itlelf had endured. Wales and Scotland 
 became objects of the ambition of JJdward I* who had 
 already fignalized his valour in the crufade. The 
 WeKh were totally fubjugated, and the Scots overthrown 
 in the very bloody battle of Falkirk, where almod the 
 whole force of the country was deftroyed. The Scots, 
 
 K however, 
 
66 A TREATISE ON 
 
 however, were never totally fubdued. Robert Bruce 
 retaliated on the Englifh in the battle of Bannock-burn, 
 where two hundred thoufand Englifh were defeated by 
 thirty thoufand Scots. But Robert was not contented 
 with afferting the liberty of his country. Jealous of 
 his brother Edward, he fent him with an army to 
 conquer Ireland., We fhall not doubt of his valour, or 
 of the miferies he inflided, or was willing to inflid, upon 
 the people among whom he came. In dedroying them 
 he dedroyed his own army. They were reduced to the 
 mod dreadful ftraits by famine, infomuch that they 
 were obliged to feed upon the mod Joathfome matters, 
 their own excrements not excepted. 
 
 Being now arrived^at the beginning of the fourteenth 
 century, we fee that, from Ireland to China, mankind 
 had involved themfelves in one general work of de- 
 finition. Befides the wars, famines had been fo fre- 
 quent, that the eating of one another feemed to be but 
 a common affair. Indeed the hiftory of mankind would 
 tempt one to believe that they thought themfelves 
 brought into the world for no other purpofe but to de- 
 droy each other. As far back as the year 409, in the 
 time of the wars of the Vandals in Spain, a dreadful 
 famine took place, which, in 410, reduced many to the 
 neceffity of feeding upon human flefli ; parents devoured 
 their children, and the wild beads, being deprived of the 
 dead bodies which they ufed to feed upon, but which 
 were at this time devoured by the living, fell upon the 
 latter, and thus increafed the general dedrudion. Such 
 of the Romans as fled into drong holds and fortreffes,. 
 were in the end obliged to feed upon one another. To 
 thefe calamities the pedilence was added, which did not 
 fail to rage in its ufual manner. Famine and peftilence 
 had alfo ravaged the city of Rome when befieged by the 
 Goths under Vitiges, and under Totila. In this lad 
 liege the unhappy citizens were reduced to fuch draits, 
 that they confumed even the grafs which grew near the 
 walls, and were at kd obliged to feed on their own ex- 
 crements. We do not indeed hear, at this time, of any 
 particular indances of people feeding upon one another > 
 
 though, 
 
THE PLAGUE. 67 
 
 though, in fuch dreadful emergences, it is fcarcely to be 
 doubted that fome would have recourfe to this terrible 
 expedient in order to allay their hunger. But in the 
 famines which took place during the ravages of the Sa- 
 racens, Turks and Moguls, nothing feems to have been 
 more common. In 1066 a mod grievous famine took 
 place at Alexandria in Egypt, and throughout the whole 
 country. Three bufliels and a half of flour were fold at 
 eighty dinars, a dog at five, and a cat at three. The 
 Vifir, having waited on the Khalif, left his borfe at the 
 palace gate -, but, before he returned, the animal had 
 been carried off and eaten. Three men were hanged 
 for this theft, and their bodies ordered to be expofed 
 upon gibbets ; but next day they were found picked to 
 the bones, their flefli having been all cut off and de- 
 voured the preceding night. Bodies of men and women 
 were boiled, and their flefh. publicly fold. A violent 
 plague followed, which fwept away the greateft part of 
 the inhabitants. As the hellifh Moguls fpread defola- 
 tion wherever they advanced, fo their retreats were 
 equally formidable. 1111243, having advanced as far 
 as Aleppo in Syria, they found themfelves obliged to 
 retreat, and that for a very odd reafon, viz. that their 
 horfes were not well (hod. This, however, did not hin- 
 der them from deftroying every thing the earth pro- 
 duced, and dripping every man, nay, every woman, 
 they met, even of their clothes. The confequence was, 
 a terrible famine, fo that people were fain to fell their 
 children for fmall pieces of bread. 
 
 Such was the conduct of men, from one end of the 
 earth to the other, during the interval, if any interval 
 there was, between the plague in the time of Juftinian 
 and that of 1346. The peftilence, which had con- 
 tinually raged in one place or other, now overfpread the 
 whole world. At what time it began to decline we 
 know not j and, indeed, as the fame defolations and 
 maflacres continued, if thefe had any fhare in its pro- 
 dudion, it ought fcarcely to have declined at all. That 
 there was all this time little or no interval, appears from 
 what Dr. Rulh fays, vol. iii. p. 165, that between the 
 
 years 
 
68 A TREATISE ON 
 
 years 1006 and 1680, that is, in a period of 674 years, 
 the plague was fifty -two times epidemic all over Europe. 
 Suppofing the intervals between every general infeftion 
 then to have been equal, and the plague to have lafted 
 only one year at a time, it mult have recurred once in 
 twelve years. But the intervals were not equal; for 
 the Doctor tells us that it prevailed fourteen times in 
 the fourteenth century ; which gives an interval of lefs 
 than feven years ; and if the peftilence fo frequently over- 
 fpread the whole continent, we may be very fure that it 
 never was out of particular places of it. The Doctor 
 adds, " The ftate of Europe in this long period is well 
 known." We (hall alfo confider that of Afia. 
 
 The empire of the Moguls, which had fallen into 
 decay, revived under Tamerlane ; who, following the 
 example of Jenghiz Khan, had the epithet of the 
 dejhoying prince beftowed upon him by the Indians, on 
 account of his behaviour in their country. Building 
 his captives into walls with (tones and lime, pounding 
 them by thoufands in large mortars, was his common 
 practice ; while the Turks, proceeding weftward, wafted 
 every thing with fire and fword ; the chriftians all the 
 while continuing their mad crufades, and when driven 
 from one place endeavouring to eflablifli themfelvcs in 
 another. At laft the Turks and Tartars, or Moguls, or 
 rather their emperors, happening to quarrel, the battle 
 of Angora, in Galatia, decided (at the expenfe of fome 
 hundred thoufand lives) the difpute in favour of Tamer- 
 lane 5 but, as his empire ended with his life, the Turks 
 foon recovered from the blow they had received ; and, 
 by the taking of Conftantinople in 1453, put an end to 
 the terrible commotions which had prevailed in the eaft 
 for fo many ages. The crufades had alfo for fome time 
 been dilcontinued, and the world hath lince that time 
 been comparatively in a ftate of peace. 
 
 But, by fo much intercourfe with the Afiatics, efpe- 
 cially with the countries particularly fubject to the 
 plague, all Europe had been fo deeply infe&ed, that the 
 cli (temper could not but prevail for a long time, even 
 Chough it had not been kept up by the aimoft continual 
 
THE PLAGUE. 9 
 
 wars of the Europeans with one another, which was too 
 much the cafe. Dr. Sydenham informs us that before 
 Jiis time the plague commonly vifited England once in 
 forty years ; but by this we muft underfland a very vio- 
 lent infection ; for Dr. Rijfh tells us that plagues pre- 
 vailed in London every year from 1593^1611, and 
 from 1636 to 1649. The author of the Journal of the 
 Plague Year (1665) mentions a vifitation in 1656 ; and 
 Mr. Carey, in the beginning of his account of the plague 
 of London in 1665, fays, that the plague was almqft 
 continually among the difeafes enumerated in their bills 
 of mortality ; fo that we may fairly conclude it to have 
 been endemic in that city. Now let us fee how Eng- 
 land had employed itfelf. Jts kings, as well as many of 
 their fubje&s, had gone to the holy wars, as they called 
 them, and, by continuing in that devoted country 
 where moil probably the peftilence firft originated, it is 
 impoflible to fuppofe that fome of them did not receive 
 the contagion. Having caught the peftilence in the 
 koly war, they came home to diffufe it among their 
 countrymen, and to keep it up by 'profane wars, I fup- 
 pofe, both foreign and domeftic. Henry VII put an 
 -end to a very long and bloody contefl between the 
 houfes of York and Lancafter ; but he brought the 
 peftilence along with him, which raged violently during 
 the fifteenth and Sixteenth centuries. A moft violent 
 war, for half a century, on the continent of Europe, and 
 civil wars in England, would ftill continue to keep the 
 infection alive from 1600 to 1648, when a general peace 
 was concluded ; and from the fubfequent ftate of tran- 
 quillity, probably, after the violent attack in 1665, it 
 feems to have languifhed and died in England, as a 
 plant in a foil not natural to it. 
 
 But, though England has fince remained in peace, on 
 the continent it has been otherwife. In the beginning 
 of the eighteenth century, the heroic madnefs of Charles 
 XII feemed ready to confound the north, while the 
 glorious exploits of prince Eugene and the duke of 
 Marl borough appeared equally confounding to France. 
 Jn the midft of thefe grand atchievments, the peftilence 
 
 filently 
 
jo A TREATISE ON 
 
 filently claimed its (hare in the common work of de- 
 ftruction ; carrying oif upwards of two thoufand in a 
 week for fome time, in 1709, in the city of Dantzick, 
 and, in 1711, twenty-five out of fixty thoufand inhabi- 
 tants in Copenhagen. 
 
 The infection, however, feemed now to be retiring to 
 the place from whence it originally came. In 1666, or 
 foon after, it feems to have totally abandoned the ifland 
 of Britain; with the attack in 1711 it left the weflern 
 countries of the continent next to that ifland ; in 1713, 
 1714 and 1715 we are informed by baron Van Swieten 
 that it ravaged Auilria ; in 1721, or foon after, it aban- 
 doned France ; in 1743 it made its lad attack on Mef- 
 fina ; and in 1 784 we find it confined to Dalmatia and 
 the eaftern territories, where it has fo long reigned with- 
 out interruption. 
 
 From the view then which we have taken of the con- 
 duel: of the human race, and the confequences of that 
 conduct, we may reafonably conclude, that war will pro- 
 duce famine and peftilence, and that after all violent 
 wars a violent peftilence may be expected, efpecialiy if 
 the contending parties interfere with thofe nations 
 where it is moil frequent. Another piece of conduct 
 by which mankind expofe themfelves to peftilential con- 
 tagions is, the practice of cooping themfelves up in great 
 cities. Mr. Gibbon, fpeaking of earthquakes, fays, that 
 men, though always complaining, frequently bring mif- 
 chief upon themfelves. " The inflitution of great ci- 
 " ties (adds he) which enclofe a nation within the limits 
 " of a wall, almofl realifes the wifh of Caligula, that the 
 ** Roman people had but one neck. In thefe difaf- 
 ** ters (earthquakes) the architect becomes the enemy 
 " of mankind. The hut of a favage, or the tent of an 
 " Arab, is thrown down without injury to the inhabi- 
 * 6 tant ; and the Peruvians had reafon to deride the 
 < folly of the Spanifli conquerors, who with fo much 
 " coil and care erected their own fepulchres. The rich 
 " marbles of a palace are daihed on his own head, a 
 *' whole people is buried under the ruins of public or 
 *' private edifices, and the conflagration is kindled and 
 
 " propagated 
 
THE PLAGUE. 71 
 
 f< propagated by innumerable fires neceflary for the 
 " fubfiftence and manufactures of a great city." la 
 plagues, great cities are unquestionably as pernicious as 
 in earthquakes ; not indeed by reafon of the weight and 
 bulk of the materials, but the confinement of the peo- 
 ple within the fphere of infedion, and their continual 
 expofure to the caufes which prepare the body for re- 
 ceiving it. In fad, it has always been found that 
 plagues begin in cities; and were it not for the multi- 
 tudes that continually fly out of them there can be no 
 doubt that the mortality would be much greater than it 
 is. The intercourfe of many nations with one another, 
 the carrying from one end of the earth to the other of 
 goods capable of bringing with them the infedion, muft 
 alfo be fuppofed a very principal caufe of peftilence ; 
 but this laft will be more fully confidered in the next 
 fedion. At prefent we may conclude, that, the pefti- 
 lential contagion having originally fallen upon mankind 
 for their fins, it is ftill kept alive by the fame caufes ; 
 and, as far as we can conjecture, thefe fins are, the pro- 
 penfity to murder and deftroy which breaks forth in 
 war ; the vanity, pride and luxury which produces great 
 cities ; and the fame vanity, &c. joined with avarice, 
 which gives life to commerce. Add to all this the neg- 
 led of the cultivation of the earth,, which ought to be 
 the principal bufinefs of man. In confequence of this 
 neglect, immenfe tracts of it are ftill overrun with 
 woods, covered with ftagnant and noxious waters, or 
 lying in wafte and now uninhabitable deferts, fit only 
 for ferpents and the mod deftrudive animals. Thus the 
 very climate is changed from what it ought to be ; the 
 elements become hoftile to man in an extreme degree, 
 and the whole fyftem of nature, originally defigned to 
 give life and happinefs to the human race, is, through 
 their own mifcondud, changed into a fyftem of mifery, 
 difeafe and death. 
 
 The account juft now given of the ways in which 
 mankind bring upon themfelves the plague, and other 
 difeafes ahnoft equally terrible, is fo conformable to the 
 opinions of the learned Di\ Mead, that I (hall conclude 
 
 this 
 
72 A TREATISE Otf 
 
 this fe&ion with a few extracts from his works. Of th 
 fmall pox he fays, that he fuppofes this ".to be a plague 
 " of its own kind, originally bred in Afrixra, and more 
 " efpecially in Ethiopia, as the heat is exceffive there ; 
 : ' and thence, like the true plague, was brought into 
 " Arabia and Egypt, after the manner above men- 
 " tioned" (i. e. by war and merchandife.) " Now (adds 
 " he) if any one thould wonder why this contagion was 
 if fo long confined to its native foil, without fpreading 
 ; * into diftant countries, I pray him to confider, that 
 " foreign commerce was much more fparingly carried on 
 ;< in ancient times than in our days, efpecially between 
 " Mediterranean nations j and likewife that the ancients 
 " feldom or never undertook long voyages by fea, as we 
 " do. And Ludolfus obferves, that the Ethiopians in 
 :< particular were ignorant of mercantile affairs. There- 
 " fore when in procefs of time the mutual intercourfe of 
 " different nations became more frequent by wars, trade 
 " and other caufes, this contagious difeafe was fpread 
 " far and wide. But, towards the end of the eleventh 
 " century, and beginning of the twelfth, it gained vaft 
 " ground by means of the wars waged by a confederacy 
 " of chriftain powers againft the Saracens, for the re- 
 ff covery of the Holy Land ; this being the only vifible 
 " recompenfe of their religious expeditions, which they 
 " brought back to their refpective countries/' Of the 
 true plague he fays, " It appears, I think, very plainly, 
 " that the plague is a real poifon, which, being bred in 
 v< the fouthern parts of the world, is carried by com- 
 " merce into other parts of the world, particularly into 
 " Turky, where it maintains itfelf by a kind of circu- 
 " lation from perfons to goods ; which is chiefly owing 
 " to the negligence of the people there, who are flupid- 
 " ly carelefs in the affair : that, when the conftitution 
 
 44 of the air happens to favour infection, it rages there 
 " with great violence ; that at that time, more efpecially,. 
 " difeafed perfons give it to one another, and from them 
 " contagious matter is lodged in goods of a foft, looie 
 " texture, which, being packed up and carried into other 
 
 45 countries, let out, when opened* the imprifoned feeds- 
 
 " of 
 
THE PLAGUE. 73 
 
 " of the contagion, and produce the difeafe whenever the 
 
 " air is difpofed to give them force ; otherwife they may 
 
 " be diffipated without any confiderable ill effects. The 
 
 <c air of our climate is fo far from being ever the original 
 
 " of the true plague, that moft probably it never produces 
 
 " thofe milder infectious diftempers, the fmall pox and 
 
 " meafles. For thefe difeafes were not heard of in 
 
 " Europe before the Moors had entered Spain ; and, as 
 
 " already obferved, they were afterwards propagated and 
 
 " fpread through all nations, chiefly by means of the 
 
 cc wars with the Saracens. The fweating iicknefs was 
 
 * c moft probably of foreign original. It began in the 
 
 " army with which king Henry VII came from France, 
 
 " and landed in Wales ; and it has been fuppofed by 
 
 " fome to have been brought from the famous fiege of 
 
 " Rhodes, three or four years before, as may be collected 
 
 " from one place of what Dr. Keyes fays in his treat ife 
 
 " on the difeafe. We had here the fame kind of fever 
 
 " in 1713, about the month of September, which was 
 
 ** called the Dunkirk fever, as being brought by our 
 
 " foldiers from that place. This, probably, had its origi- 
 
 " nal from the plague which broke out at Dantzick a 
 
 " few years before, and continued fome time among the 
 
 " cities of the north." 
 
 I now take leave, for the prefent, of this fubject, 
 which exhibits the conduct of mankind in fuch a dif- 
 agreeable view. Some, like M. Millot above quoted, 
 may be apt to fuppofe that many of the accounts are 
 exaggerated. But it is evident* that in our days it is 
 impoffible to determine any thing to be a falfehood, faid 
 to have happened in former ages, which is not abfolutely 
 contradictory to reafon. Every one of the accounts in- 
 ferted in this fection has found a place in the works of 
 hiftorians reckoned authentic, particularly in the Uni- 
 verfal Hiftory. All who believe the New Teftament 
 muft certainly believe, from the words of our Saviour, 
 that extraordinary things were to happen in the ages 
 fubfequent to his appearance. Can we then difcredit 
 the relations of thofc hiftorians who inform us that ex- 
 traordinary things have happened ? Modern hiftorians, 
 
 L making 
 
74 A TREATISE ON 
 
 making their own judgments the infallible meafure of wif- 
 dom, and the ftrength of nations now exifting the ulti- 
 mate meafure of human power, have endeavoured to 
 turn into ridicule every thing which does not precifely 
 accord with thefe two. In this the French are particu- 
 larly culpable ; accounting every thing to be incredible 
 which exceeds the powej of modern France to accom- 
 plifh, though they certainly do not know even the 
 extent of this power. Of fuch fcandalous vanity we 
 have a notable inftance in the works of prelident Goguet, 
 who pofitively determines that the walls of ancient Ba- 
 bylon, the pyramids of Egypt, and all the wonderful 
 works of Semiramis, Nebuchadnezzar, &c. were not 
 equal to the canal of Languedoc made by Louis XIV ! 
 
 SECTION III. 
 
 Of Difeafe in general. The nature of the Plague as a 
 Difeafe confidered. Of Contagion. Whether the Plague 
 is really Contagious or not. Medical Hi/lory of the Dif- 
 temper. Inquiry into its Immediate Caufes, and whether 
 an approaching Plague is indicated by any vifible Signs. 
 
 HITHERTO we have confidered the origin of the 
 plague entirely in a moral point of view. We 
 have feen, that, in conformity to the general opinion of 
 mankind, it may realonably be fuppofed to have been 
 inflicted upon mankind, the Jews particularly, for their 
 tranfgreffions ; that, having been once introduced, it 
 has been perpetuated, and fprcad from nation to nation, 
 and that in proportion to the degree of immorality of 
 a certain kind prevailing through the world. From 
 this it is naturally to be inferred, that, were the human 
 race to live at peace with one another, to difperfe them- 
 ielves over the face of the earth for the purpofe of 
 improving it by cultivation, and were they to be con- 
 tented with what the produce of each country affords, 
 there would be no plague among them. But we know 
 
 that 
 
THE PLAGUE. 75 
 
 that fuch a reformation is not to be expected, and we 
 mud take the world as we find it. The queftion then 
 is, By what means (hall individuals fecure themfelves 
 from being dedroyed by a plague which (hall happen to 
 invade any country ; or how (hall a perfon, already 
 infected with it, be redored to health ? For this purpofe 
 let us begin with confidering the nature of difeafe in 
 general, and of the plague particularly. 
 
 As to difeafe in general, phyficians have differed very 
 confiderably in their definitions; and, though many 
 have been given, few feem to be unexceptionable, that 
 of Dr. Fordyce feems to be among the cleared and 
 mod expreffive. " Difeafe (fays he) is fuch an al- 
 *' teration in the chemical properties of the fluids or 
 " folids, or of their organization, or of the action of 
 " the moving powers, as produces an inability or "diffi- 
 " culty of performing the functions of the whole or any 
 " part of the fyftem, or pain, or preternatural eva- 
 " cuation." But as this definition, however juft, cannot 
 be eafily underftood by fuch as are unaccuftbmed to 
 medical language, I fhall attempt the following ex- 
 planation of the animal economy, and the difeafes to 
 which it is fubject. 
 
 1. By nature our bodies are formed of certain folid 
 and fluid parts, operating upon one another in a man- 
 ner of which we know but little. Anatomifts have de* 
 fcribcd the ftructure of the human body and its parts in 
 a certain degree, but have always found themfelves 
 loft in an inconceivable minutenefs of texture. The 
 whole dructure of the human >ody, vifible and invifible, 
 is called its ORGANIZATION. 
 
 2. This organized body is acted upon by certain 
 powers refiding in the atmolphere, by which it becomes 
 endowed with LIFE. 
 
 3. The operation of thofe powers upon a well orga- 
 nized body conftitutes that agreeable and vigorous date 
 which we call HEALTH. 
 
 4. The operation of any other power, fubftituted in 
 place of the natural one, even upon a body perfectly 
 organized, produces a date very different from health ; 
 
 commonly 
 
76 A TREATISE ON 
 
 commonly attended with Come uneafy fenfations, and 
 which is called DISEASE. I fay it \scommonly attended 
 with uneafmefs, but not always ; for many perfons 
 within a few hours, nay, a few minutes, of their death, 
 have imagined themfelves quite recovered and well. 
 To illuftrate the meaning of what is faid of the fubfti- 
 tution of" any power inftead of the natural one : It is 
 natural for man to breathe air of a certain quality ; and 
 while he does fo he continues in health ; but let him 
 breathe the vapour of burning charcoal, or of fermenting 
 liquor, mixed in confiderable quantity with the air to 
 which he has been accuftomed, and he will very foon 
 find himfelf difeafed. Many other kinds of elaftic 
 fluids may be fubftituted inftead of the vapour juft 
 mentioned, all of which will in a fhort time produce a 
 difeafe in the mod healthy man. The ftate of a dif- 
 eafed body being very different from that of a found 
 one, the appearances are confequently very different. 
 The various appearances of difeafe in the human body 
 are called fymptoms of that difeafe, from a Greek word 
 fignifying appearance * 
 
 5. A difeafe proves mortal only by the PISORGANI- 
 z AT ION of the body. By diforganization I mean any 
 confiderable alteration in the ftrufture of the body, vi- 
 fible or invifible. The truth of this will appear from 
 a confederation of the method by which animals may be 
 recovered, after being to appearance dead by breathing 
 the vapour of charcoal, or fixed air in any other form, 
 viz. by plunging them in cold water. In a cave in 
 Italy a continual ftream of this kind of air ifTues from 
 the ground. It rifes but a fmall way, fo that a man 
 may iafely enter, becaufe his head is above the vapour - y 
 but, if he brings a (mail dog with him, the animal, in 
 confequence of breathing the pernicious fluid, falls down 
 as if dead, and would very foon die if left there. By 
 throwing it into a lake in the neighbourhood, (cold 
 water of any kind would anfwer as well) it recovers. In 
 
 the 
 
 * " Symptom (fays Dr. Fovdyce) is the Greek name for apptarance :" hu* t 
 from the ftriil etymology of the word* it ought rather to be tranflated accident. 
 The univcrfal confent of phylicians, however, has applied it to every appear- 
 ance produced in the human body by any diftempcr whatever* 
 
THE PLAGUE. 77 
 
 the difle&ion of fome unfortunate people, who have 
 been killed by breathing this pernicious fume, a mani^ 
 fed diforganization has been obferved, viz. a rarefaction 
 of the blood, and too great dilation, or even rupture, of 
 the fmall veflels. 
 
 6. A difeafe cannot always be cured by removing the 
 caufe which brought it on : it is necefiary alfo to repair 
 the injury done to the organization. This is exempli- 
 fied in the cafe of the dog juft mentioned. Taking 
 him out of the vapour is not fufficient for his recovery, 
 becaufe the organization of the body is injured ; the 
 cold water by contracting the veflels repairs the injury, 
 and the cure is completed. To the entire prefervation 
 of this organization it is probably owing, that people 
 have frequently recovered after being thought dead for 
 a long time.* ? 
 
 * Dr. Anthony Fothergill, in his prize differtation upon the fufpenfion ef 
 vital adlion, quotes fome experiments of Dr. JCite, in which he was able to 
 reftore to life animals that had been immerfed in water for eight, tea or 
 twelve minutes, though he acknowledges that this operation, though performed 
 with great attention, often failed ; while other animals, that had been 
 loager immerfed, recovered fpontaneoufly. He further adds, that if it be not 
 attempted before the convulfions of the animal ceafe, which on an average of 
 many experiments happens in about eleven minutes and a half, it will not be 
 Jufficient to renew the vital motions. But, " among the human fpecies 
 * (fays Dr. Fothergill) there are not wanting well authenticated instances of 
 fpontaneous recovery at an incomparably longer interval, and after every ex- 
 * ternal mark of life had disappeared. Such is the latent energy of the heart* 
 that it fometimes, after remaining feveral hours quiefcent, renews on a fudden 
 the feeret fprings of life, furmounts the barriers of the refitting blood, and 
 reftpres circulation with all the other fundions. Hence the unexpected re- 
 coveries from death-like fyncope brought on by fudden terror, or great effu- 
 ' fions of blood* evea after the funeral obfequies have been prepared. Hence 
 < fome perfons have accidentally been brought to life, even after interment, by 
 the rude motion produced in facrelegious attempts to wreft rings or brace- 
 *' lets from the apparently dead body." 
 
 Several iurprifmg inftances of the recovery of perfons fuppofed to be dead* 
 even of the plagud are given by Fabricius Hildanus ; to one of which Dr. Fother- 
 gill feerns to allude in the above quotation. Hildanus relates, that in the year 
 1357, when the plague raged violently at Cologne, a certain noble lady by 
 ame Reichmutb Adoleb, being feized with the difeafe, was thought to have 
 died, and was buried accordingly. Her hufband, out of affedion, would not 
 take off her wedding ring, which (he happened to have on her finger. The 
 undertakers being acquainted with this circumftance, next night came to the 
 church where fhe was buried, opened the fepulchre, and prepared to take off 
 the ring ; when to their utter aftonifhment ihe began to raife herfelf up in the 
 coffin. Struck with confternation they fled in the utmoft hafte, leaving to the 
 fortunate lady the Unthorn with which they lighted themfelves to the church* 
 and by means of which fhe now found out where fhe was, and after being 
 come to herfelf, returned to her own houfe. Here being known by her voice* 
 and the ring fhe wore, (he found admittace, and by means of a generous diet 
 gradually regained her health ; bringing her hulband afterwards three children, 
 and lurviving the accident many years. A 
 
73 A TREATISE ON 
 
 7. When the organization of the body is injured, the 
 acYion of the natural powers themfelves occafions unea- 
 linefs, and increafes the difeafe. The cure then is, to 
 fubilitute inftead of the natural power, as far as pof- 
 fible, the action of fome other power till the organiza- 
 tion is reftored ; after which the natural power muft be 
 again allowed to act, or a difeafe of another kind will 
 take place. This may be exemplified in a confumption 
 of the lungs ; where, that part being very much difor- 
 ganized, pure air renders the difeafe worfe ; and the 
 lick are relieved by mixing with the common atmo- 
 fphere fuch kinds of air or vapour as would prove per- 
 nicious to people in health. But, fuppofing this method 
 to be fuccefsful, and the confumption to be entirely 
 removed, it is plain that the ufe of the pure atmofphere 
 muft be refumed, or the impure air would bring on a 
 difeafe in the fame manner as on a healthy perfon. 
 
 8. The body is wafted in the natural operations of 
 life ; part of it pafiing off with the vapour of the breath, 
 part by infenfible perfpiration, &c. Hence it naturally 
 tends to diforganization and death, unlefs the wafte be 
 repaired. 
 
 9. This natural wafte of the body is repaired, and 
 health kept up, by the food and drink taken into the 
 
 ftomach - 10. Hence 
 
 A fecond inftance no lefs remarkable is of a woman of the name of NUolIe 
 LentilU> who, being fuppofed dead of the plague, had been thrown into a 
 pit with a great number of the bodies of others, dead of the fame diftemper. 
 After lying there a whole night, (he came to hcrfelf in the morning, but 
 neither knew at firft where (he was, nor, when (he did, could (he find any 
 means of efcaping, or extricating herfelf from the heap of dead bodies with 
 whicji me was opprefled. Being at a diftance from any houfe, her cries were 
 of no avail, and, in the mean time, having taker* no nourishment for four 
 days, fhe was fo tormented with hunger that Ihe eat part of the cloth which 
 covered her face. At laft, after remaining twenty-four hours in this dreadful 
 iituation, the pit being opened to bury fome other perfon, the exerted her ut- 
 moft endeavours in calling for afMance, and at laft was heard by thofe who 
 Hood round. Being taken up and brought home, (he prefently recovered, and. 
 lived feveral years after. 
 
 A third example is given by our author of one who, being carried to a church 
 to be buried, had his face previoufly fprinkled with holy water by a prieft. 
 But this was no fooner done than he (huddcred and opened his eyes in a 
 fright ; on which he was carried home, recovered, and lived eight years after. 
 Other examples might be brought, but thele are fum'cicnt to fhow what dread- 
 ful accidents may enfuc from early burials, and how cautious people ought ts 
 be in confining their friend* and relations to the duft from whence they 
 were taken. 
 
THE PLAGUE. 79 
 
 10. Hence arifes another fet of difeafes ; for as the 
 reparation of the wafte, juft mentioned, depends on the 
 proper action of the ftomach upon the food, and the 
 aflimilation of the latter with the fubftance of the body, 
 it is plain that this operation depends both on the 
 proper quality of the food, and the found flate of the 
 ftomach itfelf. 
 
 1 1 . The body is compofed of folids and fluids of dif- 
 ferent kinds, every one of which is fubject to difeafes 
 peculiar to itfelf; but, by reafon of the connexion of 
 the parts of the body with one another, it is impoflible 
 that any one can be very much difordered without af- 
 fecting all the reft. As the bond of connexion, how- 
 ever, is in many cafes totally invifible to us, furprifing 
 inftances frequently occur of one part being affected in 
 confequence of an injury done to another very diftant 
 from it. This connexion between all parts of the 
 body is called SYMPATHY. Dr. Gardiner of Edin- 
 burgh, in his obfervations on the animal economy, &c. 
 fays, that " the flomach is the principal feat of many of 
 " the mod remarkable fympathetic affections which 
 " happen in valetudinary flates of the body. Every 
 " diforder accompanied with fevere pain affects the fto- 
 " rnach, whilft this vifcus affects not only in i.ts dif- 
 " eafed ftate every part of the fyftem, but at other 
 " times the effects of healthful flimuli applied to it arc 
 " inftantly communicated to the reft of the body, as 
 " when we take food, wine, or medicine." Dr. Darwin 
 in his Zoonomia informs us that the ftomach is faid to 
 fympathize with almoft every part of the body - 9 but Dr. 
 Moore, in his medical iketches, tells us that the heart 
 poflcifes a greater (hare of fympathy than any other part 
 
 in the body, and next to it the ftomach .* rp, 
 
 12. -L ii e 
 
 * Dr. Gardiner, in his obfervations above quoted, gives the following cu- 
 rious anecdote. * An unmarried lady, of a healthy conftitution, has fuch a 
 
 peculiarity in the ttruiture of her nerves, that, though (he can, in general. 
 ' bear ftrong odours as well as molt people, yet (he cannot fuffer a rofe to be in 
 
 her holorn, or to hold it in her hand a few minutes, without becoming 
 1 faint, and having an inclination to vomit. Conferve of rofes, rofe-water, 
 ' and fimilar articles made from rofes, have more powerful effe&s upon her* 
 and ufually excite vomiting. Going into a room where any of her com- 
 paniona are wafhing with rofe-water, never fails to produce this cflcdt; #or 
 
 * docs (he recover of her indilpoCtion in lefs than two hours." 
 
So A TREATISE ON 
 
 12. The folid parts of the body are the bones, the 
 mufclcs, brain and nerves ; the fluids are, the blood, 
 and others produced from it. The bones are known to 
 every one -, the mufcles are the flefhy parts throughout 
 the whole body ; and the nerves are a kind of cords 
 feemingly originating from the brain, and from thenee 
 accompanying the blood veflels through all parts of 
 the body, 
 
 13. Much has been difputed about what is to be 
 accounted the primary part of the body, on which all 
 the reft depend ; and one clafs of diiputarits have at- 
 ranged themfelves on the fide of the blood, and the other 
 on that of the nerves. The difpute is like one about 
 the beginning of a circle. It cannot be decided, be- 
 caufe the blood cannot act without nerves, nor the 
 nerves without blood. I fpeak of the human body, 
 being aware that in fome animals the pofition may be 
 controverted. The following is a concife ftate of the 
 matter. 
 
 14. All the blood in the body paries through the 
 heart ; which has four cavities ; two called ventricles^ 
 and two auricles. Thefe, from their pofition in the body, 
 are called the right and left. The right ventricle com- 
 municates with the right auricle, as does alfo the left 
 ventricle with the left auricle ; but there is no commu- 
 nication between the right ventricle and the left, nor 
 between the right auricle and the left. Through thefe 
 cavities all the blood pafTes to every part of the body, 
 and returns from every part ; but, as in the former cafe, 
 we are here at a great lofs where to begin its motion ; 
 for this is precifely to find the beginning of a circle 
 As we muft begin fomewhere, however, we (hall do fo 
 with the right ventricle of the heart. This receives the 
 blood returning from all parts of the body, and propels 
 it into the right ventricle ; not the whole quantity at 
 once, for it cannot contain one half of it ; but by de- 
 grees. The auricle contracts as foon as it is full ; and 
 in the time that the auricle fills, the ventricle contracts, 
 fo that it may be empty, and ready to receive the blood 
 &ooi the auricle. By the contraction of the right ven- 
 tricle 
 
THE PLAGUE. 81 
 
 tricie the blood is driven into the pulmonary artery, and 
 pafles into the lungs; Here the artery branches into an 
 infinite number of fmall veflels much finer than hairs ; 
 and thefe again, Uniting into larger trunks, form at laft 
 the pulmonary vein, which brings back the blood to 
 the heart. The pulmonary vein is inferted into the 
 left auricle of the heart, which * as foon as it is filled with 
 blood, contracts, and expels the blood from it into the 
 left ventricle. From the left ventricle iffues a large 
 artery called the aorta, which by its branches fupplies 
 the whole body with the vital fluid. In all parts of the 
 body the arteries divide themfelves into innumerable 
 fmall branches, which terminate in veins equally fmall 
 as in the lungs ; but it has been difputed whether the 
 arteries and veins actually join each other in the form of 
 vefTelsj or whether the arteries depofit the blood in fmall 
 cells* from which the Veins fuck it up. The difpute is 
 of no confequence, nor can it be abfolutely decided, on 
 account of the exceeding fmallnefs of the veflels $ 
 though the microfcopical obfervations are rather favour- 
 able to the opinion of a continuation of veflels. The 
 veins from all parts of the body unite into larger veflels, 
 and thefe again uniting with one another, form at laft 
 one very large vein called the vena cava, which opens 
 into the right auricle of the heart, from which the cir- 
 culation goes on as already defcribed. The two ventri- 
 cles of the heart, and all the veins throughout the body, 
 are furnifhed with a kind of valves, which allow the 
 blood to proceed in the way of circulation^ but prevent 
 its returning in a cootrary direction* 
 
 15. The lungs, through which all the blood in the 
 body pafles, receive likewife the air which we draw in 
 every time we breathe. They confift of two large bo- 
 dies called lobes ; from their fituation called the right 
 and left. The air is conveyed into them by the wind- 
 pipe, called alfo the trachea^ and the afpera arteria. On. 
 entering the cavity of the breaft, the wind -pipe divides 
 into two large branches called the bronchi* -, one of 
 which goes to the right and the other to the left lobe of 
 the lungs. By the further divifion and fubdivifion of 
 
 M thefe 
 
8z A TREATISE ON 
 
 tbefe veflels the lungs are filled with an innumerable 
 multitude of little tubes, terminating in exceedingly 
 minute bladders or cells, which are the final receptacles 
 of the air fucked in when we breathe. Each of thefe 
 cells is furrounded with a kind of network of blood -vef- 
 fels exceedingly fmall, and confiding of very thin mem- 
 branes , fo that, in paffing through the lungs, the blood 
 is expofed as much as poffible to the action of the air. 
 
 1 6. It is a matter of great importance to find out 
 \vhat is the ufe of this expofure of the blood ; and 
 great difputes have taken place concerning it. In for- 
 mer times it was fuppofed that the blood received from 
 the air a vital fpirit, without which 'it would have been 
 totally incapable of performing its offices in the body* 
 Later phyliologifts endeavoured to explode this notion, 
 Dr. Hales particularly, by mewing that the circulation 
 of the blood through the lungs might be continued by 
 inflating and contracting them alternately by the fumes 
 of burning brimftone, endeavoured to prove that the ufe 
 of the air was only to give the lungs an opportunity of 
 dilating and contracting alternately, by which means 
 principally he thought the circulation might be carried 
 on. This continued to be the moft common hypothecs 
 as late as the time of Dr. Huxham. It was however 
 thought alto that by the comprefiion of the air the 
 blood was altered in its texture, its bulk, &c. Accord- 
 ingly Dr. Huxham tells us in the preface to his treatife 
 on air and epidemic difeafes, that " air fit for rcfpiration 
 " ought neither to be too hot, nor very cold ; for the 
 " ufe of the infpired air is to temperate the blood, which 
 *' would otherwife grow too hot, and putrefy,, as is evi- 
 " dent from the experiment of the moft excellent Boer- 
 ** haave made in a hot houfe ; for, if the air is more hot, 
 ** or even equally hot, as the blood of any animal, it cer- 
 *' tainly foon dies."* 
 
 17. The modern difcoveries in the competition of air, 
 have tended greatly to elucidate the ufe of this fluid in 
 the lungs, and its action on the blood in refpiration. 
 
 Dr. 
 
 * This certainly dees not hold good if we fappofe the heat of the atmof- 
 phere to be indicated by a thermometer ; for we are afiured that animals can 
 live ia a beat much Superior to that which raifes the mercury to 97. 
 
THE PLAGUE. 83 
 
 Dr. Prieftly firft determined it to be what he terms a 
 pkkgifticfrocefs, i. e. a procefs by which the parts of the 
 blood no longer proper to be retained among the reft, or 
 at lead fome of them, are carried off. That fomething is 
 carried off either from the* lungs themfelves, or from the 
 blood circulating through them, is evident ; for the air 
 which is taken into the lungs in a dry ftate, comes out 
 of them extremely moift, and loaded with vapour. An 
 efTential change is alfo made in the nature of the air it- 
 felf ; for it now affumes in a great meafure the nature 
 of what has been called fixed air, or the fume of char- 
 coal, or fermenting liquor, and thus becomes unfit for 
 being breathed a fecond time. This change is made by 
 the addition of fome terreftrial fubftance to the pure 
 atmofphere, which the latter volatilizes and carries along 
 with it.* 
 
 18. But, whatever may be carried off from the blood, 
 during its paflage through the lungs, fomething is cer- 
 tainly added to it, for the blood in the pulmonary artery 
 is of a dark red, but when it has undergone the action 
 of the air in the lungs, and returns by the pulmonary 
 vein, it is then of a bright fcarlet, which colour it retains 
 through all the arteries of the body, but lofes it on its 
 return through the veins. This fcarlet colour is com- 
 municated to blood in all cafes when expofed to the 
 air ; and Dr. Prieftley has obferved that it is aded upon 
 by the air even through a bladder ; much more then 
 rnuft it be fo through thofe very thin membranes which 
 form the coats of the fine pulmonary veflels. What 
 this fubtile matter is which the blood receives, (hall be 
 afterwards inquired into ; at prefent it is fuflicient to 
 take notice that it is abfolutely neceffary, for the pur- 
 pofes of life, that the blood mould pafs through the 
 lungs : for, as Dr. Huxham obferves, " we fee neither 
 *' nutrition, nor the motion of the mufcles, performed 
 
 by 
 
 * The difcoveries of modern chemifls have determined that the aerial fluid* 
 termed fxed air or carbonic acid, and which is nearly the fame with the va* 
 pour arifing from fermenting liquor, and is alfo largely contained in the fume 
 of burning charcoal, is not a fimple but a compound fubftance ; one part con* 
 fifting of the pure part of the atmofphere, or oxygene, the other of real char- 
 coal. The proportions, according to M. Chaptalj are i3>oz88 parts of char- 
 coal to 56,687 of oxygen. 
 
34 A TREATISE ON 
 
 by any blood that hath not paffed through the lungs { 
 *' this is obfervable from the coronary arteries* to the 
 *' ultimate ramifications of the aorta." As the previous 
 circulation of the blood through the lungs therefore is 
 abfolutely neccflary to the growth and life of the body, 
 and as the blood certainly receives fomething from the 
 air, we muft account this a proof, and no inconfiderable 
 one, that the air contains a vital fpirit, which it imparts 
 to the blood in the lungs. But, before we proceed farther 
 on this fubjecl:, it is proper to take fome notice of 
 
 19. The nerves. Thefe, which conftitute fuch a re- 
 markable and important part of the human body, are 
 white cords, of a foft pulpy fubftance, defended by a 
 tough fkin which goes along with them as far as they 
 can be traced. All the nerves either originate from the 
 brain, or terminate in it. The former doctrine hath 
 been generally adopted, and in conformity to that doc- 
 trine the following account of the nerves is laid down. 
 The brain is enclofed in the cavity of the fcull, but not 
 without the intervention of two membranes, called the 
 dura and pia mater, to prevent injury from the hard 
 bones, as well as for other purpofes. The brain is di? 
 vided into two lobes, the right and left. It is cornpofed of 
 two different kinds of fubftance, the outermoft called 
 the cortical, the innermoft the medullary fubftance ; the 
 latter feems compofed of fine fibres. The whole of the 
 rneduljary part of the brain terminates in a fubftance 
 called the cerebellum* very much refembling the brain, 
 but fmaller. The cerebellum terminates in another 
 fubftance refembling the medullary part of the brain, 
 called the medulla oblongata. The cerebellum lies in the 
 back part of the head, and the medulla oblongata under 
 it. The latter terminates in thefpinal marrow, extend- 
 ing from the lower and back part of the head to the 
 Jower extremity of the back borie, and is enclofed in the 
 hollow of that bone. The nerves proceed from thefe 
 four fubftances, viz. the brain, the cerebellum, the me- 
 dulla oblongata, and fpinal marrow. As they pafs to all 
 
 parts 
 
 * The name of the veflels by which the heart itfelf is fupplied 
 Thefe come from the aorta by the circuitous way of the lungs. 
 
THE PLAGUE. 85 
 
 parts of the body they accompany the arteries, dividing 
 with them into innumerable fmall branches ; but they 
 do not return with the veins $ fo that they feem not to 
 contain any fluid which goes and comes, or which circu- 
 lates like the blood. The nervous fluid, if any fuch 
 there be, feems to move conftantly one way, either to 
 the brain or from it. 
 
 20. Hitherto we have noticed only things which are 
 evident to our fenfes, and which the induftry of anato- 
 mifts has abundantly evinced ; but now our fubjedt ren- 
 ders it neceflary to ftep afide a little into the obfcure 
 regions of theory and conjecture. The mufcles, as we 
 have formerly faid, are the flefliy parts of the body ; and 
 by them all the motions of the body are performed. 
 The flefh is diflributed into diftinct portions, each of 
 which is enclofed in a membrane belonging to itfelf. 
 Each of thefe portions is a mufcle, and each mufcle has 
 a branch of an artery and the branch of a nerve belong- 
 ing to it. On both thefe the action of the mufcle de^ 
 pends ; for, if we cut the nerve belonging to a mufcle, 
 it immediately lofes all power of action ; and if we cut 
 the artery which accompanies the nerve, it does the 
 fame. As therefore the blood is found to receive Jome- 
 iking from the air, and as it lofes this when pafling 
 through the arteries, and as the nerves lofe their power 
 when the communication with the blood is cut off, it 
 feems extremely probable, that what is imbibed by the 
 blood in the lungs is taken up by the fine ramifications 
 of the nerves, and is no other than the immediate prin- 
 ciple of life and fenfation. Thus we will eftablifh a 
 doctrine directly oppofite to that commonly received ; 
 for, inftead of fuppofing that the nerves originate from 
 the brain, we are now led to fuppofe that they terminate 
 in it. Inftead of fuppofing that the fenfations originate 
 in the brain, we will be led to fuppofe that every fenfa- 
 tion originates in the organ appointed for that fenfation. 
 Thus we are confcious that our eyes, not our brain, are 
 the parts of our body which immediately perceive the 
 light -, our fingers, or any other parts of the body, feel 
 vyhat is applied to them -, and of confequence we have 
 
 reafon 
 
86 A TREATISE ON 
 
 reafon to believe that the animal fpirits^ nervous fluid, or 
 whatever we pleafe to call it, proceed from the furface 
 of the body inwards to the brain, not outwards from the 
 -brain to the furface of the body. The brain itfelf feems 
 to refemble a large collection or refervoir of water, in 
 which the fenfations, like fo many fmall dreams from 
 every part of the body, unite, and in which our intellec- 
 tual faculties refide in a manner totally inexplicable by 
 us. Thus far it feerned neceffary to theorife, in order 
 to form fome idea, however obfcured, of the connexion 
 between the nerves and our fenfitive and intellectual, or, 
 if we pleafe to call them fo, our fpiritual faculties. 
 
 21. In confequence of this very intimate connexion 
 between the blood and nerves, it is eafy to fee that any 
 injury done to the one may very greatly affect the other ; 
 and that a very flight, nay, to us imperceptible, change 
 in the organization of either, may produce the moft 
 grievous, and even incurable diforders throughout the 
 whole body, or in any particular organ. Let us now 
 confider a little farther the blood-veflels. 
 
 22. It hath been a queflion, whether in the firucture 
 of thefe veffels nature hath obferved an exact proportion. 
 For inftance, if the blood paffes by a kind of ftarts 
 through four cavities, as we are aflured that it does* it 
 feems natural to fuppofe that thefe four fhould be ex- 
 actly equal. This, however, hath been denied , and 
 fome, from its accommodating the human frame to 
 their theory, have fancied that they faw the ufe of fuch 
 difproportionate work. Dr. Huxham expreffes himfeli 
 in the following words : " Nor doth the air only refrige- 
 " rate the blood, but, by preventing its too great ebul- 
 " lition, and condenfing it, hinders it from burfting the 
 " vefTels. > This indeed is of exceeding great importance, 
 " if, with the very learned Helvetius, we fuppofe the capa- 
 u city of the right ventricle of the heart to be greater 
 *' than that of the left, and that the pulmonary arteries 
 <c are larger than the correfpondent veins ; for it thence 
 * { follows, that the blood ought to be considerably con- 
 4< denfed by the infpired air, that an equal quantity of 
 " blood may be received, in one and the fame time, by 
 
 <k the 
 
THE PLAGUE. 87 
 
 K the pulmonary veins and left ventricle of the heart, 
 "that is thrown off from the right ventricle, .and 
 " through the more capacious pulmonary arteries. This 
 " indeed many deny, afferting quite the contrary. It is 
 *' neceffary, however, that the aorta mould receive as 
 " much blood from the left ventricle of the heart, as is 
 " thrown off from the right ventricle through the pul- 
 " monary artery j and that in the very fame and equal 
 " time, or a fatal deluge would foon overwhelm the 
 " lungs, becaufe the contraction of each ventricle is 
 *' made at one and the fame time ; we always find 
 " therefore the aorta and pulmonary artery, in a natural 
 " ftate, equal on this account j alfo the capacity of the 
 " ventricles ought to be equal, that they may receive, 
 " in one and the fame fpace of time, equal quantities of 
 " blood," &c. 
 
 If any thing farther is necefTary upon this fubjeft, we 
 may ftill obferve, that if the blood were at all condenfed 
 by the air, it would be fo unequally, becaufe the air is 
 at fome times much colder than at others; and thus the 
 difproportion of the cavities of the heart to one another 
 could not fail of producing the mod difagreeable if not 
 fatal effects. We often fee what terrible confequences 
 enfue upon the enlargement of any part of an artery 
 near the heart ; and thefe would, fometimes at lead, be 
 felt by every individual.* 
 
 It is true, indeed, that this objection will in fome de- 
 gree hold, even though we fuppofe all the cavities of the 
 
 heart 
 
 * But there is a ftill more egregious blunder, and this the more furprifing 
 as it has been very general among phyiiologifis, viz. that when an artery 
 branches into two the capacity of the branches taken together is greater than 
 that ot the trunk. This would make the whole arterial fyftem one continued 
 tKeurj/M)* and, inftead ot promoting the circulation of the blood, would in 
 the moft effectual manner prevent it. In what manner an error fo extraordi- 
 nary In its nature could pals the mathematical phylicians of the laft oenturyt 
 I cannot imagine; but certain it is, that, in the year 1780 or 1781, the Edin- 
 burgh College were fchooied on this iubjedl by one of their own ftudents 
 named John Theodore Vander Kemp, a Dutchman. This gentleman foundt 
 by accurate menfuration, that when an artery divides, if the diameters of the 
 two branches are made the two ihorter (ides of a right-angled triangle, the 
 diameter of the trunk will be the hypothenuie ; and thus, as the areas of cir- 
 cles are to one another in proportion to thefquares of their diameters, the fum 
 of the areas of the two branches will be equal to the area of the trunk. On 
 looking into Blumenbach's phyfiology, 1 find the fame remark. 
 
 * An aneurifm is a preternatural enlargement of an artery. The blood 
 Magnates in that place, and at length eau through the fldh and fltin. 
 
88 A TREATISE Otf 
 
 heart to be equal, and the capacities of the blood veffefe 
 to be perfectly uniform throughout the whole body. 
 For, if we fuppofe the blood to be at all condenfed in 
 the lungs by the coldnefs of the atmofphere, it muft un- 
 doubtedly follow, that while paffing from them it occu- 
 pies lefs fpace than before it arrives at them. Hence 
 the pulmonary vein, the left auricle of the heart, the left 
 ventricle, the aorta, and all the reft of the arteries for a 
 confiderable way, muft be comparatively empty, even 
 though they receive as much fluid as fills the vena ca- 
 va, right auricle and ventricle of the heart, and pulmo- 
 nary artery. The equality which ought to prevail In 
 the fyftem, and which indeed cannot be difpenfed with, 
 ean only take place in thofe remoter branches of the ar- 
 teries in which the blood has reaffumed its former ftate 
 of dilation or rarefaction. 
 
 23. If we confider this matter attentively, we fhall 
 find it not a little myfterious. Every time we breathe" 
 out the air we have fucked into our lungs, a confiderable 
 quantity of moift vapour is breathed out along with it ; 
 but it has been proved by undeniable experiments that 
 the emiffion of aqueous vapour from any fubftance cools 
 it in proportion to the quantity of vapour emitted. 
 Every breath we draw, then, cools the lungs, and 
 confequently the blood, to a certain degree, and, as the 
 number of times that we breathe in a day is exceedingly 
 great, the cold produced by the evaporation ought to be 
 in proportion. But we fee that, notwithftanding all this 
 cooling, whether we breathe cold air or hot air, the 
 temperature of the body remains ftill the fame. The 
 air then, though conftantly carrying off the heat of the 
 body, does not cool it in the lead by its action on the 
 lungs. The only poflible way of folving this apparent 
 contradiction is, by fuppofing that the air, when acting 
 upon the blood in the lungs, leaves precifely as much 
 heat as it carries off, and therefore, though we breathe 
 ever fo long, we cannot by this means become either 
 hotter or colder. 
 
 24. To illuftrate this fubjeet, we might now enter 
 into an inquiry concerning the origin and caufe of 
 
 animal 
 
THE PLAGUE. 89 
 
 riimal heat ; but this will be touched upon hereafter. 
 We (hall here only take notice that the heat' of the body 
 is almoft univerfally allowed to proceed from the lungs. 
 It has likewife been demonftrated, that the air does in 
 fact contain an incredible quantity of heat, even when it 
 appears to us to be extremely cold. A certain pro^ 
 portion of this heat is feparated from it every time we 
 breathe; and if, either by the mixture of other fluids 
 with the air we breathe, or by any change in the organi- 
 zation of the body itfelf, a greater or fmaller proportion 
 of heat (liould be communicated to the blood, difeafe 
 muft enfue. 
 
 25. To fum up then what has been faid concerning 
 the blood and nerves : The whole mafs of fluid pafles 
 front the right fide of the heart to the lungs. In the 
 lungs it receives from the air fomething* neceftary to 
 the functions of life and fenfation, and purifies itfelf from 
 thofe matters which might prove pernicious. From 
 the lungs it pafles to the left fide of the heart, and 
 thence through the whole body. In its paflage through 
 the body, it is accompanied with nerves, which, taking 
 up from the arterial blood that vital fpirit received from 
 the air, convey it to all the organs of motion, of fen- 
 fation, and to the brain, where the whole powers of 
 perception being united form our intellectual faculties* 
 and, as far as our fenfes can perceive, the human fpirit 
 itfelf. The blood, thus deprived of its fpirit, is collected 
 from all parts of the body by the veins, and returned 
 to the right fide of the heart, from whence it is again 
 fent to the lungs> and the procefs carried on as before. 
 This hypothecs concerning the peculiar function of the 
 nerves I firft inferred in the ENCYCLOPAEDIA BRITA'N- 
 &ICA, fecond edition, under thearticle BLOOD, in the year 
 1778. It has been fince continued in the third Scots 
 edition, and from thence into the IriQi and American 
 editions. 
 
 26. It has already been obferved, that the body is 
 fubjected to a continual wafte. One fource of this 
 
 waftc 
 
 * It feems now to be proved beyond a doubt that thisfomet&lrrg fo long un- 
 known is that fluid called by Dr. JVieftley ttefkfogijiicaiit air, and by 
 JLavoifier exygcn. 
 
 N 
 
9 A TREATISE ON 
 
 wafte is the breath, by which a confiderable part pafles 
 off in vapour. A great quantity alfo pafTes off by the 
 pores of the fkin; frequently in a perceptible liquid 
 called fweat, hut oftener in an inviiible vapour from all 
 parts of the body, called injenfible perfpiration. The lat- 
 ter has been thought to be the great fource of wafte to 
 the human body ; and it is certain, that if any perfon in 
 health be weighed when he rifes in the morning, he will- 
 be found considerably lighter than when he went to bed. 
 The lofs of weight in this cafe proceeds not only from 
 the pores of the fkin, but from the lungs ; but though 
 phyficians have made a general allowance for both thefe, 
 I have not heard of any experiment by which we can 
 determine how much paffes off by the one, and how 
 much by the other, nor indeed does it appear eafy to 
 make fuch an experiment. Galen plainly overlooks the 
 perfpiration from the lungs entirely, " This excremen- 
 4C titious vapour (fays he) is expelled through fmall ori- 
 " fices, which the Greeks call pores, difperfed all over 
 " the body, and efpecially over the fkin, partly by fweat, 
 " and partly by infeniible perfpiration, which efcapes 
 cc the fight, and is known to few." Sanctorius, and the 
 fucceeding writers, have clafled both together indifcri- 
 minately ; allowing the difcharge to be ib great, that if 
 eight pounds of aliment be taken in, five of them pafs 
 off in this manner. In a fyftem of anatomy, publifhed 
 at Edinburgh in 1791, the author fays, that the dif- 
 charge by the fkin " is even much larger than this (the 
 " difcharge from the lungs we may fuppofe) iince it 
 5< not only throws off a quantity of the aliment, but 
 <c likewife what is added to the blood by inhalation^ 
 * c which, entering often in a very confiderable quantity, 
 " is thus again expelled/* The fame author likewife 
 fays, that the " perfpirable matter from the fkin is prin- 
 cipally water,'*' and that it iffues in fuch quantity as to 
 be feen in fubterraneous caverns evidently flying off 
 from the furface of the body like a denfe vapour. But 
 other phyfiologifls, particularly Dr. Blumenbach, inform 
 BS, that the matter of infenfible perfpiration is quite 
 &rnilar to the difeharge from the lungs, particularly con- 
 taining 
 
THE PLAGUE. 91 
 
 taining a great quantity of fixed air. The fame ac- 
 count is given 'in Chaptal's chemiftry, on the authority 
 of MeiTrs. Milly and Fouquet. This may be looked upon 
 as a valuable difcovery, efpecially in conjunct on with 
 that related by Drs. Beddoes and Girtanner, viz. that 
 the flefh of animals contains a quantity of oxygen. Dr. 
 Girtanner obtained a quantity of this air from the raw 
 flefti of animals, and fays that it may be repeatedly ob- 
 tained by expofing the flefh to the atmofphere, and 
 diftilling with a heat of 60 or 70 degrees of Reaumur's 
 thermometer (fomething below that of boiling water.) 
 Hence it is natural to conclude, that, as the difcharge 
 from the lungs purifies the blood from its ufelefs parts, 
 fo does the infenfible difcharge from the ikin purify the 
 folid parts from thofe particles which are no longer ufe- 
 ful. The probability of this alfo becomes greater by 
 considering, that in difeafes, when the quantity of mat- 
 ter to be thrown off is very great, the ikm becomes foul, 
 the teeth furred with black fordes, &c. all which difap- 
 pear as foon as the quantity of the offenfive particles is 
 reduced to its natural ftandard. As to any confiderable 
 quantity of aqueous vapour being difcharged this way, 
 unlefs in cafe of fweat, it does not feem probable ; for 
 in fueh a cafe our clothes would always be moift ; and 
 in the night time the accu. illation of moifture would 
 certainly be perceptible. The fw,at is entirely of a dif- 
 ferent nature from the infenfible perfu ration, and blood 
 and even fand has been known to iliue throu? * the ikin 
 along with it. (See the Anatomical Syftem above quoted.) 
 27. This very confiderable wafle of the body is re- 
 paired by the aliment taken into the ftomach. ?< the 
 mouth it is mixed with a confiderabie quantity of 
 the liquid called fativa, and in the ftomach with another 
 called the gaflric juice, wth which that organ always 
 abounds. From tha ftomach it pafTes into the intef- 
 tines,' where it is mixed A ith other two fluids ; one called 
 the pane reatic juice, the other the bile. This laft is of a 
 yellow colour, and i^ ibmetimes produced in enormous 
 quantities, infomuca that Dr. Wade, in his account 
 $f the fevers in Bengal, mentions fome patients who 
 
 have 
 
9* A TREATISE ON 
 
 have voided by ftool half a gallon of bilious matter 
 In one day. 
 
 28. In the ftomach principally the aliment undergoes 
 a certain change called digeftion\ by which it becomes 
 capable of being converted into the fubftance of the 
 body. Much has been inquired and difputed, to no 
 purpofe, about the nature of this change, and how it is 
 effected. One party has declared for attrition ; a fecond 
 for putrefaction ; a third for heat ; a fourth have fuppofed 
 that our meat was digefted by chewing ; as if, like the 
 lobfter, people had teeth in their ftomach ! and, laftly, 
 fome learned moderns, after much pains and trouble, 
 liave found out that it is digefted by Jolution. Dr. 
 Moore has fummed up the difcoveries concerning digeftion 
 in the following words : " The food, being previoufly 
 " divided and blended with the faliva and air by mafti- 
 " cation, (chewing) is fwallowed, and meets in the fto- 
 * c mach with the gaftric juice, whpfe diilblving power, 
 *' affifted by the natural heat of the place, is the princi- 
 <c pal agent in digeftion. The procefs is completed by 
 the pancreatic juice and bile, the nutritious parts of 
 <* the food being by this procefs converted into chyle 
 " for the fupport of the body, and the grolTer parts 
 * c thrown out/* 
 
 29. The infide of the ftomach and inteftines are full 
 of the mouths of innumerable fmall veffels, which con- 
 tinually fuck up from the aliment, as it pafles downwards, 
 the finer parts, in form of a white liquid, called chyle > 
 and from the whitenefs of their colour the veflels have 
 the name of laleals y from the Latin word lac^ milk. 
 After paffing through the fubftance of the ftomach and 
 inteftines, and running along the membrane called the 
 trtefentery, to which the inteftines are attached, the lac- 
 teals unite in a large refervoir called the thoracic du5l ; 
 and this again opens into a large vein on the left fide, 
 called \\vt fubclavian, which conveys the blood from half 
 the upper part of the body ; foon after terminating in 
 the vena cava, by which the chyle is conveyed to the 
 heart, thence to the lungs, and fo on in the common 
 
 courfe 
 
 * Moore's Medical Sketches. 
 
THE PLAGUE. 93 
 
 ourfe of circulation. The converflon of the chyle into 
 biood is called the procefs of fangulfication. 
 
 30. The blood, thus formed out of the aliment we 
 fwallo\#, is not one uniform fluid like water, but com- 
 pofed of three diftincl: fubftances ; one, which gives it 
 the red colour, and feems to be compofed of little round 
 globules ; another, quite colourlefs, but of a vifcid na- 
 ture, and which very foon coagulates, called the lymph ; 
 and a third, of a yellowifh colour, and retaining its flu- 
 idity much longer, called the ferum. A remarkable 
 property of this laft fluid is, that air can act through it 
 upon the blood -, for Dr. Prieftly found that a portion 
 of black blood affuifled a bright, florid colour from the 
 air, even though covered with ferum an inch deep. 
 When blood is drawn, the red globules are detained by 
 the lymph which coagulates, ad both together form 
 the red mafs called crafjamentum ; the ferum remaining 
 fluid, and retaining its name. 
 
 31. Befides thefe fluids, the blood either invifibly 
 contains, or is capable of being converted into, a great 
 many others -, for all the fluids in the body are feparated 
 from it, and all of them, the bile only excepted, front 
 the arterial blood, before it has loft that portion of its 
 fpirit which it imbibes from the air. When a fluid is 
 to be fecreted, fometimes it is done only by an infinity 
 of fmall veflels branching off from the arteries, and de- 
 pofiting the liquids which pafs through them in particu- 
 lar places ; and fuch are the fluids which moiflen the 
 infide of the body, and which are carried off by the 
 breath, or by fweat. But this feparation does not by 
 any means hinder the artery from terminating in its ufual 
 way in a vein, for in no cafe is the whole fubftance of 
 the bJood converted into any other liquid ; all of them 
 appear to be contained in it.. But the greateft number 
 of fluids are feparated by means of certain fubftances 
 called glands. Thefe are fmall round or oval fhaped 
 bodies; each of them enclofed in a membrane or fkin 
 which feparates it from the other parts, and each fur- 
 niilied with a fmall tube called the excretory duft, through 
 which the liquor feparated in the gland paffes to its 
 
 place 
 
94 A TREATISE ON 
 
 place of deftination. Each gland has aifo an artery and! 
 nerve, and a vein to bring back the blood after it has 
 parted with the fluid intended to be feparated. The 
 bile is feparated in the liver from the Blood of a large 
 vein called the vena portarum, formed by the union of 
 feme of the veins of the inteftines and mefentery. This 
 vein branches out through the liver like an artery, termi- 
 nating in other veins, wijich at laft bring back the bloo<J 
 to the heart. 
 
 32. As the human body 5s thus furnifhed with an 
 apparatus for feparating and carrying off, it is alfo fur- 
 BiQied with one for abforbing or taking in. All the 
 inward parts of the body are moift ; and the moifture is 
 furnilhed by the fin a 11 veffels above defcribed, and 
 which feparate part of the lymph from the blood. By 
 foch continual ieparatjon the cavities of the belly, 
 bread, brain, &c. would foon be filled with liquid, were 
 not fome means provided for carrying it off as fafl as it 
 is formed. The means in queftion are a fet of final! 
 veffels called lymphatics. Thefe " arife from the internal 
 ** furface of the bread, beily, and every cavity of the 
 " body -, they alfo pverfpread the whole external furfacc 
 tc of the body, and large lymphatic veffels are uiuallj 
 ts found clofe to the large blood veffels of the extrerm- 
 " ties, befidcs thofe fmall fuperficial ones which lie 
 i above the rnufcles in the cellular membrane (the fat 
 vc or rather the membrane containing it.) The large 
 '** vifcera generally have two fets of lymphatics, one 
 " lying on the furface of the vifcus, and the other 
 * c accompanying the blood veffels belonging to it. The 
 - faculty of abforption, though refu fed to the lymphatics, 
 " was afcribed by many anatomifts to common veins, 
 " and this opinion continued to prevail in fome degree, 
 *' until Hunter and Monro totally overturned it, 
 " exploding at the fame time the notion that any of the 
 * c lymphatics are continuations of arteries, and efUblifh- 
 ^ ing, beyond a doubt, that all are abforbent veffels."* 
 All the lymphatics terminate in the thoracic duel: ; fo 
 the liquid feparated by the exhalant arteries (fo the 
 
 veffel$ 
 
 * ^core's Medical Sketches, 
 
THE PLAGUE. $$ 
 
 Veflels are termed by which that fluid is feparated) is 
 again mixed with the blood, and again performs the 
 fame offices. 
 
 We' have now taken a review of the feveral parts of . 
 the human body, flight and fuperficial indeed, but fucii 
 as the limits of this work would allow, and fufficient to 
 furnidi to thofe entirely unacquainted with medical 
 matters forne general ideas on the fubj^ft. We have 
 feen that the body, in general, confifts principally of 
 four great parts, the blood-veflcls, the lymphatic veflfels, 
 the nerves, and the mufcles. Befides thefe we enumerate 
 the glands and membranes ; the former being nearly 
 allied to the blood-veflels, the latter apparently to the nerves. 
 The bones, having no concern with our prefent inquiry, are 
 Bot taken notice of. The flomach and inteftines, being 
 principally compofed of mufcular fibres, nerves, and 
 blood-veflels, muft be confidered as belonging to thefe 
 departments. Each of thefe large divilions has obtained 
 the name of fyftem ; and even the fubdivifion of the 
 blood-veflels into arteries and veins. Thus the arteries 
 of the body, taken collectively, are called the arterial fyf- 
 tem ; the veins the venous fyftem ; the brain and nerves the 
 nervous fyftem ; the mufcles the mufcular jyftem ; the lympha- 
 tics the lymphatic fyftem ; and the glands t\~\e glandular fyftem ; 
 &c. Thefe appellations have been given for the fake of dif- 
 tindlnefs and perfpicuity, but they have had a bad ten- 
 dency. Infignificant difputes have arifen concerning the 
 fuperiority of one fyftem to the other, and which is to be 
 accounted the primum mobile of. the body. By obferving 
 alfo the general ftrudure of the body in a more full and 
 ample manner than that of the parts which compofe it, 
 phyfkians have been apt to generalize too much in their 
 theories, and to fancy that from a few obvious laws they 
 might be able to explain the phenomena of difeafe in 
 alfnoft every poflible variety. To illuftrate this, let us 
 take the blood for an example. This to fight appears 
 an homogeneous fluid ; and Boerlriave and others have 
 afcribed difeafes to fome defedt or bad quality of the 
 blood. But this fluid confifts of three parts, each, as far 
 as we can perceive, eflentially diftinft from the other - g 
 
 viz. 
 
9 6 A TREATISE ON 
 
 viz. the lymph, ferum, and red globules. As each of 
 thefe happens to be difeafed, the cure muft be different ; 
 or if two happen to be difeafed, the medicines muft ftill 
 be varied. But, befides thefe general difeafes ariiing 
 from what, like the blood, is common to the whole 
 body, each component part of the body has an arterial 
 fyflem, a venous fyftem, a nervous and lymphatic 
 fyftem, &c. belonging to itfelf ; all of which, though 
 dependent on the body at large, have yet laws of their 
 own, in confequence of which any one of them may be 
 confiderably difeafed without much affecting the general 
 fyftem ; and this conftitutes what is called local difeafe. 
 Again : The parts of the body are fo connected with 
 one another, that the difeafe of one may mow itfelf in 
 another ; or it may affect the whole body in fuch a 
 manner as to produce a general difeafe j though Dr. 
 Rufh confiders this laft, at leail from injuries of the 
 vifcera, as a rare occurrence ;* but we certainly know 
 that general difeafes are very often followed by evident 
 difeafes of particular organs , and in thefe cafes it is im- 
 poflible to fay whether the general difeafe did not begin, 
 though imperceptible to us, in that very organ in which 
 we fuppofe it to terminate when the local difeafe was 
 come to fuch an height as to be evident to our fenfes. 
 In fome cafes it is plain that local injuries will bring on 
 mod violent difeafes of the whole fyftem. Thus a local 
 inflammation of the end of one of the fingers, by phy- 
 ficians called a paronyehia^ has been known to induce a 
 rnoft violent fever, nay, even to occafion death. Thefe 
 violent fymptoms end as foon as the fuppuratiorj is 
 completed ; fo that, were it not for the exceflive pain of 
 the inflammation, we might be apt to fuppofe that the 
 fever terminated in the fuppuration, whereas it evi- 
 dently was occafioned by the local difeafe, or the ten- 
 dency of the part to fuppurate ; the pain and inflam- 
 mation being neceflary preliminaries. Again : When 
 an intermittent fever is (aid to terminate, or to be fol- 
 lowed, by a hardnefs of the liver, we do not certainly 
 know whether an original difeafe of the liver might not 
 
 have 
 
 * Medical Isquiries and Obfervatrons, vol. ivi p. 133- 
 
THE PLAGUE. 97 
 
 have been the caufe of the intermittent. From a con- 
 lideration of all thefe things, viz. the extreme diverfity 
 of parts which compofe the human body, the ultimate 
 invifibility.of the ftrudure of each, the incomprehenfible 
 manner in which they are united, the equally inccmpre- 
 henfible dependence they have upon one another in fome 
 cafes, and independence in others, the numerous laws by 
 which they are governed, and which muft be very much 
 unknown to us, the invifible and incomprehenfible nature 
 of the powers which ad upon them, &c. &c. 1 fay, 
 when we coniider all thefe things, the boldeft theorifb 
 muft be humbled when he attempts to account for the 
 phenomena of difeafe in any one inftance. The excsf- 
 five difficulty in which we are involved is beautifully 
 defcribed by Dr. Ferriar when fpeaking of hyfterics ; 
 and obftacles equally infuperable by our theories will 
 undoubtedly be met with in any other diftemper. 
 " We are ignorant (fays he) by what laws the body pof- 
 " feffes a power of reprefenting the moft hazardous dif- 
 " orders, without incurring danger ; of counterfeiting 
 '* the greateft derangement in the circulating fyftem, 
 " without materially altering its movements ; of produ- 
 " cing madnefs, confcious of its extravagances; and of 
 " increafing the acutenefs of fenfation by oppreffing the 
 " common fenforium. In hyfterical affedlions all thefe 
 " appearances are excited, which are incompatible with. 
 " the reafonings of every fyftem-maker who has yet en- 
 ** deavoured to explain the inexplicable. Nature, as if 
 " in ridicule of the attempts to unmafk her, has, in this 
 ;< clafsof difeafes, reconciled contradictions, and realized 
 " improbabilities, with a myflerious verfatility, which. 
 " infpirts the true philofopher with diffidence, and re- 
 < duces the fyftematic to defpair." 
 
 Notwithftaading all thefe difficulties, however, phy- 
 ficians have theorifed, and that with fuch animofity, as 
 if all the arcana of nature had been laid open to every 
 proferTor who thought proper to invent or new-model a 
 lyftein ; though the conftant fucceflion of theories 
 might certainly have fliowa them the vanity of fuch 
 attempts. Some of thefe we muft now confider. 
 
 O JMedical 
 
98 A TREATISE ON 
 
 Medical theorifts have exerted their greateft abilities* 
 in explaining the nature of thofe general difeafes affect- 
 ing the whole body, denominated fevers; and which 
 are likewife called acute difeafes, from the violence with 
 which they fometimes attack, and the rapidity with 
 which they run through their courfe. Dr. Fordyce 
 fays, that fever will fometimes kill in five minutes from 
 the firft fenfation of uneafinefs. Ancient phyficians 
 have defcribed a number of fevers, which they fuppofed 
 to be of different fpecies, and accordingly have diflin- 
 guifhed by different names. Modern fyftem-makers 
 have added to the number ; fo that a bare detail of 
 the names which they have given to their divilions and 
 fubdiviiions, would conftitute a very formidable cata- 
 logue -, but the lateft practitioners are decidedly of 
 opinion that there is but one kind of fever, varying it- 
 felf according to circumftances. Dr. Rum declares 
 himfelf of this opinion in the mofl exprefs and positive 
 terms. " There is (fays he) but one fever. However 
 " different the predifpofing, remote or exciting caufes 
 <c may be, .... ftiJl, I repeat, there can be but one 
 ** fever ..... Thus fire is an unit, whether it be pro- 
 " duced by friction, percuffion, electricity, fermentation, 
 G or by a piece of wood or coal in a flate of inflam- 
 " mation."* 
 
 " I have faid that there is but one fever. Of courfe 
 " I do not admit of its artificial divifion into genera 
 " and fpecies ; a difeafe which fo frequently changes 
 " its form and place, fhould never have been defignated, 
 * { like plants and animals, by unchangeable characters. 
 " . . . . Much mifchiefhas been done by nofological 
 " arrangements of difeafes. They erect imaginary 
 <c boundaries between things which are of an homo- 
 geneous nature ..... They gratify indolence in a 
 phyiician, by fixing his attention upon the name of a 
 difeafe, and thereby leading him to neglect the vary- 
 <c ing (tare of the fyftem, &c."f 
 
 So much then having been faid and written upon the 
 difeafe in queftion, one might be apt to fuppofe that the 
 
 nature 
 
 ? Vol. iv p. 133. t Ibid. p. 149. 
 
 " 
 
THE PLAGUE. 99 
 
 nature of fever would have been thoroughly inveftigated, 
 and its caufes explained in the moft fatisfactory manner, 
 long before this time. Inftead of this, however, we find 
 it ftill like a word which every body ufes, and nobody 
 underftands. Dr. Fordyce, who has lately written a 
 treatife on the fubject, endeavours to prove that there 
 is not any fingle fymptom from the exiflence of which 
 we can certainly determine the prefence of this difeafe. 
 " Fever (fays he) has obtained its name in Greek, Latin, 
 " Arabic and Perfian, principally from the idea of heat : 
 " pur, in Greek fire; febris in Latin, from fervere, to 
 " burn," &c. This idea, he goes on to demonftrate, is 
 erroneous ; as the body of a feverifh patient frequently 
 finks the thermometer below the natural ftandard ; while 
 the patient fometimes finds himfelf cold when the ther- 
 mometer (hows him to be really hot, and hot while the 
 fame inftrument (hows him to be cold. Neither is cold, 
 followed by heat, a certain indication of the prefence of 
 fever, as many fevers begin without any previous fenfa- 
 tion of cold. Frequency of the pulfe alfo is no certain 
 fign ; and having difculTed this laft fymptom he con- 
 cludes thus. " If we examine the reftleffnefs, anxiety, 
 "{late of the tongue, head-ach, or any other of the 
 " fymptoms which often take place in fever, we ihall 
 " find that they alfo may be prefent when there is no 
 " fever, and abfent in a patient afflicted with this difeafe; 
 * 6 and therefore we cannot allow that there isanypatho- 
 |C gnomic fymptom of fever."* Dr. Rufh declines giving 
 any definition of fever ;-f but, with all due deference to 
 thefe two very experienced phyficians, we muft account 
 fuch extreme fcepticifm altogether erroneous. If fever 
 cannot be defined, it cannot be defcribed ; for a defini- 
 tion is no other than a fhort defcription. If again there 
 be no fingle fymptom by which the prefence of fever can 
 be known, it is impoffible that there can be any com* 
 bination by which it can be known, any more than we 
 can form an unit by any combination of cyphers. In 
 fact Dr. Fordyce himfelf is at laft obliged to acknow- 
 ledge 
 
 * A Patbognomic fymptom is one which being prefent certainly indicates the 
 prefence of a difeafe, and being abfenti the contrary, 
 t Vol. iv> p. 133. 
 
ioo A TREATISE ON 
 
 ledge that there is a certain fymptom with which fever gene- 
 rally begins ; and, by his infiftingupon it in various parts of 
 the work, we muft certainly be induced to fuppoie that 
 it was by this fign principally that he determined whether 
 his patients had a fever or not. " The firft appear- 
 " ance (fays he) which generally takes place is uneafinefs 
 <c and reftieffnefsj a general uneafinefs, the patient feel- 
 cc ing himfelf ill, but incapable of fixing on any particular 
 " part of the body. This uneafinefs affects the mind 
 *' at the fame time. Perhaps m this cafe it is the mind 
 
 * e that is firft affected Along with this uneafinefs 
 
 <c there is a reftleffhefs, the patient wifhing to change 
 <c his place or pofture frequently ; the mind cannot like- 
 *' wife reft upon one object ; it often wanders from one 
 " to another fubject. At the fame time there is a feel 
 * c of wearinefs which refifts the difpofition in the patient 
 <c to change his place and pofture, and refifts the dif- 
 <{ pofition of the mind to alter the object of its atten- 
 " tion, rendering the wifh for fuch changes ineffectual. 
 <c With thefe arifes an actual inability of exerting the 
 " mufcular powers, or performing any of the functions 
 <c of the body ; and alfo an a&ual inability of exercifing 
 <e the great faculties of the mind, the powers of percep- 
 " tion, memory, arrangement of ideas, and of the judg- 
 " ment, in the fame degree that they exifted in health. 
 * c The degree in which thefe take place is extremely 
 " different in the attacks o different fevers ; but thefe 
 ** appearances are very rarely abfent, although indeed 
 " they may alfo happen in other difeafes." 
 
 Dr. Rum accounts the laffitude with which fever 
 begins, one of the tranfient phenomena of it ; and this 
 with other phenomena he calls fymptoms. Such as are 
 more permanent and fixed, and which by other writers 
 have been reckoned different fpecies, he calls Jtates- 9 
 and of thefe he enumerates forty. Such as have any 
 relation to the plague are as follow. 
 
 i. The MALIGNANT ftate, known by attacking fre- 
 quently without a chilly fit, is attended with coma, a 
 depreffid, flow or intermitting pulfe, and fometimes by 
 
 a natural temperature or coldnefs of the fkin 
 
 This 
 
THE PLAGUE. xoi 
 
 This depreffed ftate of fever more frequently when left 
 to itfelf terminates in petechia?, buboes, carbuncles, 
 abfcefTes and mortifications, according as the ferum, 
 lymph, or red blood, is effufed in the vifcera or external 
 parts of the body. 
 
 2. The SYNOCHA, or common inflammatory ftate ; 
 attacking fuddenly with chills, fucceeded by a quick, 
 frequent and tenfe pulfe, great heat, third, and pains in 
 the bones, joints, breaft or fides. 
 
 3. The BILIOUS ftate of fever j known by a full, quick 
 and tenfe pulfe, or by a quick, full and round pulfe 
 without tenfion, and by a difcharge of green, dark co- 
 loured or black bile from the ftomach and bowels. 
 This ftate fometimes alTumes the form of an hedlic ; 
 the patient feels no pain in his head, has a tolerable ap- 
 petite, and is even able to fit up and do bufinefs. 
 
 4. The TYPHUS ftate; known by a weak and frequent 
 pulfe, a difpofition to fleep, a torpor of the alimentary 
 canal, tremors of the hands, a dry tongue, and, in fome 
 inftances, a diarrhoea. Sometimes it affumes fymptoms 
 of fynocha on the eleventh, fourteenth, and even twen- 
 tieth days. The common name of this ftate is the 
 nervous fever. 
 
 5. Intermiflions, or the INTERMITTING and RE- 
 MITTING ftates, occur moft diftindly and univerfally in 
 thofe which partake of the bilious diathefis. 
 
 6. The SWEATING ftate occurs not only in the 
 plague, but in the yellow fever, fmall pox, pleurify, 
 rheumatifm, hectic and intermitting ftates. 
 
 7. The FAINTING ftate; occurring in the plague, yel- 
 low fever, fmall pox, and fome ftates of pleurify. 
 
 8. The BURNING ftate. This is attended not only 
 with an intolerable fenfation of heat in the bowels, but 
 with a burning fenfation. excited in thofe who touch the 
 patient's ikin. It occurs moftly in the remitting fevers 
 of Afia. 
 
 9. The CHILLY ftate differs from a common chilly 
 fit by continuing four or five days, and to fuch a degree 
 that the patient frequently cannot bear his arms out of 
 bed. The coldnefs is moft obftinate in the hands and 
 
 feet. 
 
ioz A TREATISE ON 
 
 feet. A coolnefs only of the fkin attends in fome cafes, 
 which is frequently miftaken for an abfence of fever. 
 
 10. The INTESTINAL ftate ; including the cholera 
 morbus, diarrhoea, and cholic. 
 
 11, 12, 13,14, 15- The APOPLECTIC, PHRENETIC, 
 PARALYTIC, LETHARGIC and VERTIGINOUS ftateS. 
 
 1 6. The ERUPTIVE ftate ; including the fmall pox, 
 mealies, and other exanthemata of Dr. Cullen. 
 
 17. The H-^MORRHAGIC ftate; known by fluxes of 
 blood from various parts of the body. 
 
 1 8. The CONVULSIVE or SPASMODIC ftate. Con- 
 vulfions are frequently attendant on the malignant ftate 
 of fever. 
 
 19. The CUTANEOUS ftate; attended with various 
 eruptions on the fkin, particularly peteckia. 
 
 Theft include the moft remarkable varieties defcribed 
 by phylicians as different fpecies. From the fubfequent 
 account of the fymptoms of the plague, it will appear 
 that this (ingle diftemper monopolifes, as it were, the 
 fymptoms, at lead the moft dangerous and terrible, be- 
 longing to them all, Thofe nofologifts therefore who 
 fuppofe the ftates of fever above defcribed to be different 
 fpecies, inftead of faying that the plague belongs to one' 
 Jcind of fever, ought to fay that it is a complication of a 
 great many different kinds. But here a queftion arifes : 
 Do all the varieties of fever juft now defcribed, or do all 
 the other fevers defcribed by different authors, include 
 all the different modes by which the plague makes its 
 attack ? If fo, then we know that the plague really 
 partakes of the nature of fever, or may be accounted 
 the higheft degree of it. This is the opinion of Dr. 
 Rum ; for in his 4th vol. p. 153, he confiders the 
 different inflammatory ftates of fever, according to their 
 ftrength, in the following order, i. The plague. 2. 
 The yellow fever. 3. The natural fmall pox. 4. The 
 malignant fore throat, &c. To this I can have but 
 one objection, and to me it appears infuperable ; viz. 
 that the plague frequently deftroys without any fymp- 
 toni of fever; and, if fo, we muft certainly account 
 it a diftemper of another kind. To decide this 
 
 matter, 
 
THE PLAGUE, 103 
 
 matter, let us compare the fymptoms of the mod vio- 
 lent fever with what happens in times of violent pefti- 
 lence. We can fcarce imagine a fever more powerful 
 than that which deftroys in five minutes, and the follow- 
 ing is the defcription of it from Dr. Fordyce. " When 
 * c the firft attack of fever has been fatal, it has been 
 " claffed among fudden deaths, and all of thefe have 
 " been very erroneously called apoplexy, or fyncopy 
 " (fainting.) .... When the attack is fatal, it fometimes 
 * c kills in five minutes, fometimes it requires half an 
 * hour, feldom longer than that time. While the pa- 
 " tient is yet fenfible, violent head-ach with great fenfc 
 " of chillinefs takes place, the extremities become very 
 " cold, and perfectly infenfible ; there is great proftration 
 " of ftrength, fo that the patient is incapable of fupport- 
 * c ing himfelf in an erecl: pofture ; he becomes pale, his 
 " fkin is of a dirty brown, and he is foon infenfible to 
 " external objects ; the eyes are half open, and the cor- 
 " nea fomewhat contracted. If the patient goes off very 
 " foon, the pulfe is diminifhed, and at laft loft, without 
 " any frequency taking place -, but if it be longer before 
 " he dies, the pulfe becomes exceffively fmall .and fre- 
 4< quent ; all the appearances of life gradually fubfide, 
 " and the patient is carried off. Of this the author has 
 '* feen inftances, fometimes at the firft attack, oftener in 
 " the returns of the difeafe, although very few." 
 
 This no doubt is very terrible, and no plague what- 
 ever can exceed it. Indeed, when death is the termina- 
 tion, it fignifies little what the dijeafe is called. But the 
 queftion is not whether fever or plague is the moft dread- 
 ful, but whether they are the fame. Now, from the 
 above defcription, is is plain that fever never kills with- 
 out fome warning. In the prefent inftance, head-ach 
 and chillinefs give a certain, though fhort, warning of 
 the cnfuing cataftrophe ; but, in violent plagues, Dr. 
 Sydenham informs us, that people have been fuddenly 
 dcftroyed as if by lightning. Dr. Guthrie affures us 
 that in the laft plague at Mofcow he has feen foldiers 
 drop down fuddenly as if they had been ftruck by light- 
 ning, or by a mufket ball ; yet fome of thefe recovered 
 
 by 
 
104 A TREATISE ON 
 
 by bleeding and proper management ; but it is certainty 
 not unreafonable to fuppofe that many, who were not 
 thus taken care of, perifhed. Dr. Hodges fpeaks of the 
 contagion of the plague in the moft energetic terms. He 
 fays, " it is fo rare, iubtile, volatile and fine, that it in* 
 " finuates into, and refides in, the very pores and inter- 
 " ftices of the aerial particles. It is faid to be of a 
 il poifonous nature alfo, from its fimilitude to the nature 
 " of a poifon, fo that they feem to differ in degree only ; 
 " for the deadly quality of a peftilence vaftly exceeds 
 " either the arfenical minerals, the moft poifonous ani- 
 " mals or infects, or the killing vegetables ; nay, the 
 " peftilence feems to be a cornpofition of all the other 
 " poifons together, as well as in its fatal efficacies to ex- 
 
 ** eel them The contagion of the plague is 
 
 " more active than lightning, and in the twinkling of arx 
 " eye carries to a diftance putrefaction, mortification 
 " and death. As for the manner whereby it kills, its 
 * c approaches are generally fo fecret, that perfons feizecf 
 " with it fecm to be fallen into an ambufcade or a 
 
 " fnare, of which there feems to be no fufpicion 
 
 " In the plague of 1665, as in many others, people fro- 
 " quently died without any fymptoms of horror, thirft, 
 " or concomitant fever. A woman, who was the only 
 " one left alive of a family, and in her own opinion in per- 
 %< feet health, perceived upon her bread the peftilential 
 *' fpots, which (he looked upon to be the fatal tokens ; 
 " and in a very fhort fpace died, without feeling any 
 
 " other diforder, or forerunner of death A youth 
 
 <c of a good conftitution, after he had found himfelf fud- 
 <<>r 'denly marked with the tokens, believed at firft that 
 " they were not the genuine marks, becaufe he found 
 ** himfelf fo well ; yet he was dead in lefs than four 
 *' hours, as his phyfician had prognofticated. A fever, 
 44 however, did for the moft part fliew itfclf, and was 
 " always of the worft kind. Sometimes it feemed to re- 
 *' femble a quotidian, fometimes a tertian ; there never 
 44 was a total ceflation, but every exacerbation was worfe 
 6 > than before." In like manner the author of the 
 Journal of the Plague Year informs us that many, fup- 
 
 poling 
 
THE PLAGUE. 103 
 
 poitng themfelves, and fuppofed by others, to be in good 
 health, would fuddenly find themfelves feized with great 
 ficknefs, crawl to a bench, and inftantly expire. " Ma- 
 " ny (fays Dr* Hodges) in the middle of their employ, 
 ." with their friends and other engagements, would x fud- 
 " denly fall into profound, and often deadly fleeps." 
 
 It is needlefs to multiply examples : the above are 
 fufficient to fhow that the plague, when in its mod vio- 
 lent flate, kills fuddenly and imperceptibly, and that 
 like the bite of a vampire,* without producing any fen- 
 iible diforder. Jn a flate fomewhat inferior, it excites 
 the mod malignant fevers ; in one ftill inferior it pro- 
 duces fevers of a milder nature, and fo on until we find 
 it fo mild, that thofe infected with it are not even con- 
 fined to their bed. In all this inquiry, however, we find 
 the fecrecy and invifibility of the peflilence, fo often 
 mentioned in fcripture, ftill confirmed. Other diflem- 
 pers may " wade openly at noon-day," but this always 
 " walks in darknefs." 
 
 In one of the inferior flages of this diflemper the body 
 is affected with thofe eruptions named buboes and car- 
 buncles. Dr. Patrick Ruffel, in his treatife on the 
 plague at Aleppo, divides the fymptoms of the diflem- 
 per into fix clafTes. In the firfl there were no eruptions, 
 and all the patients of this clafs died. In the fecond, 
 and all the refl, there were buboes and carbuncles, But, 
 in the latter of thefe efpecially, it is worthy of remark, 
 
 that 
 
 * The vampire is a kind of bat of a very large fize, met with in feme 
 parts oi South America and in the Baft Indies. This vile creature delights 
 in human blood, and often attacks people in the night time in the rnoft infi- 
 Utous manner. A late traveller relates that at Surinam he was bit by one of 
 them, which fucked fo much of his blood that in the morning he found him- 
 felf exceedingly wesk and faint. He felt no pain, nor was fenfible of the 
 injury in any other way. The vampire commonly attacks the great to 
 making a wound fo exceedingly fmall that the perfon is not awaked by it ; 
 it then fucks till gorged with hlood, and, left the patient fhould awake, it- 
 keeps tanning him all the while with its large wings, the coolnefs oi which, 
 in that hot climate, promotes Deep. In this manner fome are faid to have 
 been destroyed. Captain Cook relates an humourous anecdote of one oi his 
 tailors, who being afhore at New Holland, and having wandered a little wajr 
 into the woods, returned in a fright, crying out that he had feen the devil I 
 Being afked in what fhape Satan had appeared, he aniwercd, < He was about 
 the iize of a one gallon keg, and very like it ; and if I had not been aftar'J, 
 I might have touched him." It was a vampire. The man, notwithftandin 
 his fright, had not exaggerated its magnitude. Peeple, though raiftakn and 
 ) sis not to be dilbelteved in every part of their relation, 
 
 p 
 
106 A TREATISE ON 
 
 that they appear neither as a foppuration, nor as a com- 
 mon mortification, but like the efchar formed by a cauf- 
 tic, which cna fcarcely be cut by a knife. This ap- 
 pearance is not to be met with in any other difeafe. In 
 many there are mortifications of various parts of the 
 body, but all thefe are foft, and feemingly corruptions 
 ef the flefh. When a perfon dies of any ordinary dif- 
 temper, the flefh foon corrupts and diflblves, but there 
 is no example of its turning to a hard efchar like that 
 made by a hot iron, or the cauftic with which iflues are 
 made. This ihews not merely a ceffation of life, but 
 the operation n f fome very a&ive power in the body, 
 like fire, tendii.g to deftroy the texture of it entirely, and 
 to reduce it to a cinder. This power feems alfo to 
 operate internally in the flefhy parts ; for when the 
 bodies of thofe were opened who died with the tok&ns y 
 as they are called by Dr. Hodges, upon them, the mor- 
 tification was always found much larger inwardly than 
 it appeared to be on the outfide. The tokens them- 
 felves are by Dr. Hodges called "minute diftinet blafls, 
 " which had their origin from within, and rofe up iu 
 5C little pyramidal protuberances, fometimes as fmali as 
 " pins' heads, at others as large as a iiiver penny ; hav- 
 " ing the peftilential poifon chiefly collected at their 
 bafes," &c. 
 
 That the plague was by the ancients reckoned a 
 difeafe of a nature different from all others, appears from 
 Galen, as quoted by Deuflngius. " What is called the 
 " peftilence is moft properly remarked by Galen not to 
 " be a genus of any known difeafe. For whatever dif- 
 " eafes and fymptorns are afTociated with the plague, 
 * c truly and properly fo called, the fame are wont to be 
 " called peftilential difeafes ; of which indeed there are 
 " an innumerable multitude, and thefe not always nor 
 *' every where the fame."* 
 
 In like manner Diemerbroeck, as quoted by Allen, 
 gives his opinion, that " The plague is fomething dif- 
 
 " ferent 
 
 * Non effe certi morbi genus* id quod pefilletts vocatur f re&iflime notatum a 
 
 Galeno eft (3 Epid. comm. 3. t. 20.) quicunque enim morbi ac fympto- 
 
 mata confociantur peftip veiae proprieque didXi ijdem morbi pejlilentti apellari 
 
 confuevere, quorum equidem innumerabilis exiftit cohors, acnon fcmpcrct 
 
 ubivis eadem. (D**^ d: P'Jte, S ( &. iilj 
 
THE PLAGUE, 107 
 
 cc ferent from a fever, and a fever is only a fymptom of 
 "it, as I have very of tin obferved ; and therefore fome 
 " very ill define the plague by a fever, lince a fever does 
 
 " not efientially belong to it A peftilential fe- 
 
 " ver, the companion of the plague^ is not occafioned by a 
 " peftilentiai venom, but by the mediation of putre- 
 " faction ; that is, it is not produced becaufe the hm- 
 " mours are infe&ed with the peftilent venom, but be- 
 " caufe the heart, being irritated, overwhelmed and 
 * c much weakened by the peftilent venom, can neither 
 " duly digeft and rarefy, nor govern and fufficiently dif- 
 " charge the infected humours ; which for this reafon. 
 " putrefy and acquire a preternatural heat, and fo excite 
 " a fever ; which by reafon of the forefaid fecondary 
 " caufe, is different and diftinct from the plague, and a 
 " fymptom of it. This is confirmed both by the max- 
 " ims and authority of the ancients and moderns, as 
 " well as by practice, and evident examples." 
 
 Thus it appears, both by fair reafoning by induction 
 from facts, and from the authority of the greateft phy- 
 ficians, that the plague is certainly a difeafe by itfelf, 
 and entirely diftinct from all others. Hence it follows, 
 that, though we could inveftigate the caufes of fever in 
 their utmoft extent, we might ftill be ignorant of the 
 true plague. That nothing, however, may be omitted, 
 let us now confider what phyficians have advanced on 
 this fubject, and what progrefs they have made in afcer- 
 taining the fources from whence fo many direful cala~ 
 mi ties are derived. 
 
 In an inquiry of this kind, or indeed concerning any 
 caufe whatever, it is plain that the nature of the effect 
 mud be firft und.erflood. Fever then being an effeft, 
 we mud begin with inveftigating its nature. But fever 
 itfelf is only manifeft by certain changes in the human 
 body. Before we can inveftigate the nature of fever, 
 therefore, we rnuft inveftigate the human body, and 
 that in a manner very different from what we did before. 
 We muft now confider the fources of life ; in what 
 manner the vital principle acts upon the body, and by 
 what means its motions can be difturbed, or how they 
 may be rectified when once difordered, &c. &c. 
 
 The 
 
io8 A TREATISE ON 
 
 The fyftems of medicine before the time of Boerhaave 
 are now fo generally exploded, that it is needlefs to take 
 any notice of them ; and the reputation of Boerhaave 
 himfelf in this way feems to be almoft expiring. His 
 doctrines, neverthelefs, merit fome attention, becaufe he 
 takes into account a principle overlooked by fucceeding 
 theorifts, viz. the coke/ion of the parts of the body. That 
 he did fo is evident, from his having written upon the 
 difeafcs of a weak and lax fibre, and the difeafes of a 
 ftrong and rigid fibre. In other refpects he followed in a 
 great meafure the mechanical phyficians of the former 
 century. He therefore took but little notice of the 
 nervous fyftem, as being lefs fubjecl:, or indeed to ap- 
 pearance not at all fubjecl:, to the known laws of me- 
 chanics. The blood was more manageable. The 
 xnicrofcopical difcoveries of Lewenhoeck furnifhed an 
 excellent foundation for his fyftem. This celebrated 
 obferver had difcovered, or fancied he had difcovered, 
 that the red part of the blood is compofed of globules. 
 Inaccurate indeed thefe globules mud have been, fince 
 ach of them was compofed of fix ; four touching one 
 another in the middle, with one above, and one below, 
 thus g. The ferum was faid to be compofed of fingle 
 globules, and by this attenuation it was fuppofed that the 
 fluid, inflead of red, appeared of a yellow colour. Still, 
 however, this was inefficient. Each of the yellow glo- 
 bules was difcovered (either by fancied obfervations or 
 by conjecture, it matters not which) to be compofed of 
 iix others, which, fingly taken, might conflitute the 
 lymph or fome other fluid > and thus, like the number 
 of the Beaft, we might go on by fixes to the end of the 
 chapter, and folve all the phenomena of nature. In. 
 juftice to the rnicrofcopifts, however, it mufb be obfer- 
 ved, that fome of them have given a much lefs fanciful 
 account of the ftruclure of the blood than Lewenhoeck. 
 Mr. Hewfon found it compofed of veficles, or fmall 
 bladder-like fubftances, with a black fpot in the middle, 
 Thefe veficles difiblved in pure water, but kept their 
 original form, which he fays was as flat as a (billing, 
 when a fmall portion of neutral fait was added to the 
 fluid. The (olid particles he fuppofed to be" produced 
 
 by 
 
THE PLAGUE. 109 
 
 by the lymphatic fyftem ; the black policies by the 
 fpleen. 
 
 The fuppofed obfervations of Lewenhoeck were of 
 confiderable ufe to Boerhaave in the forming of his 
 fyftem of medicine, though they feem not to have 
 accorded very well with his doctrine of lentor or vifcidity 
 in the blood. Bat, let this be as it willl, having laid it 
 <lown as the foundation of his theory, that the difeafes 
 of the body proceeded from too great a laxity of the 
 fibres, or from too great a rigidity of them, and a great 
 many from this lentor, his practice was accordingly di- 
 rected to fuch medicines as he imagined would remove 
 thele fuppofed caufes of difeafe. As the lentor of the 
 blood was one of his favourite fuppofitions, he was there- 
 fore perpetually at war with this imaginary enemy, and 
 dealt very much in faponaceous medicines with a view 
 to break it down. But here it is evident that this great 
 man w*as miftaken, even though we ihould allow the 
 cxiftence of lentor as much as he pleated. The vifci- 
 dity, lentor, or any other ftate of the blood, is an tffeft of 
 fomething. It is part of that ftate into which the body 
 is brought by the difeafe. The efforts of the phyfician 
 therefore ought to be againft that which produces the 
 lentor ; for, unlefs this be done, the caufe of the difeafe 
 muft perpetually counteract the medicines by producing 
 new lentor as faft as they deftroy it ; and befides, muft 
 have greatly the advantage of the phyfician, by being 
 already in pofleflion of the whole mafs of blood, while 
 the medicines can only enter it very gradually, and that 
 by the ftomach and lacteals, inftead of being inftantly 
 mixed with it, and exerting their power immediately 
 upon the fluid itfelf. 
 
 But befides this miftake, which is common to other 
 fyftems, Boerhaave's lentor has been denied, and that 
 upon fuch ftrong grounds that it is now univerfally ex- 
 ploded. Another fyftem quickly fucceeded, in which 
 every thing was managed by the nerves. This was 
 introduced by Hoffman, adopted, and perhaps improved, 
 by Dr. Cullen, under whofe aufpices it acquired fuch 
 a degree of celebrity, that for a long time it was danger- 
 ous 
 
no A TREATISE ON 
 
 ous to write or fpeak againft it ; and the perfon who had 
 the audacity to do fo underwent a kind of medical 
 profcription from the Edinburgh College and all its 
 iludents. According to this celebrated theorift, the 
 brain is that part of the body firft formed in the 
 embryo ; it may be feen with nerves proceeding from it 
 long before the heart or any blood-veffel belonging to it 
 is vifible. Hence we are to conclude that this part 
 is necelfary to the exiftence of every other part of the 
 body, though it doth not appear that they are effentially 
 neceflary to its exiftence. The fuperiority of the nerves 
 to all other parts being thus eftablifhed, the Doctor 
 undertook to prove that all other parts of the body 
 were formed from them j that the body is nourifhed 
 immediately from them, and in fhort that the whole 
 body is in fuch fubjection to the nervous fyftem, that, 
 except for the mere purpofe of diftending the vejOTels, we 
 can fcatcely know for what end the blood exifts; 
 iince the nerves car alter its confidence, or that of any 
 of the fluids fecretecl from it, by a mere affection of that 
 fyftem, without any thing either added to or taken from 
 the vital fluid. 
 
 Thus we were compelled to believe that all difeafes 
 at their firft origin are affections of the nervous fyftem, 
 from whence they are propagated through the whole 
 body. The Cullenian practice in acute difeafes, of which 
 the plague is the moft violent, was built upon a maxim 
 of Hoffman : " Atonia gignit fpafmos :" Atony produces 
 Jpafms. In explaining the nature of typhus fever, there- 
 lore, with which he claffcs the plague, the Doctor fup- 
 pofed that the contagion acted firft upon the nervous 
 iyftem, by producing therein a debility. The immedi- 
 ate effect of this debility is z fpafm, or preternatural con- 
 traction of the capillary veffeis, or extremely fmall arte- 
 ries. Hence the blood finds fome difficulty in circu- 
 lating, and the patient is feized with (hivering, and has 
 a fenie of cold. When this has continued for fome 
 time the iyftem begins to re-aEi againft its enemy ; the 
 m is reTolved, and, the reaction of the fyftem conti- 
 A , the action of the heart and arteries is augmented, 
 arid the body becomes warmer. Thus 
 
THE PLAGUE, in 
 
 Thus the coldnefs, fhivering, and confequent heat, 
 which conftitute thefirft attack of fever, are very plau- 
 fibly explained ; but in the mode of cure this learned 
 phytician fell into the fame miftake with Dr. Boerhaave ; 
 for though fpafm is undoubtedly, even according to htm- 
 felf, an effeft, he directs his medicines entirely againft it, 
 as if it were a caufe. Thus, forgetting what he had juft 
 before advanced, that the fpafm is occalioned by debili- 
 ty, he recommended the moft debilitating medicines 
 and regimen to cure people already too much debili- 
 tated ; and to fuch practice his enemies alledged that 
 many fell victims. The theory and practice, however, 
 ftill kept its ground ; and as great numbers of ftudents 
 were every year bred up in the belief of it at Edinburgh 
 College, who carried the principles of their teacher to all 
 parts of the world, it bade fair for becoming univerfaL 
 But, in the midft of this eclat, the whole fyftern received 
 fueh a rude (hock from the doctrines of John Browx, 
 though at that time not even M. D. as it hath not yet 
 recovered. 
 
 Though the author of the new fyftem contended, as 
 much as Dr. Cullen, for the fupremacy of the nerves, he 
 did not upon that foundation attempt to eftablifh his 
 practice. He confidered the living body as one machine, 
 the whole of which might be acted upon, and always was 
 acted upon by certain powers. It pofTefles a certain in- 
 explicable property called excitability, capable of being 
 augmented or diminifhed. Every power which aug- 
 ments the excitability he called z, jlimulus, the oppofitc 
 would have been a fedative ; but according to this 
 fyftem there is not any fedative, nor can there be one in 
 nature. The reafon is, that excitability itfelf has no 
 exiflence but in confequence of the action of certain 
 powers catted J?imu!ants. The total fubduction of thefe 
 reduces the excitability to nothing; of confequence no 
 power can act againft it in a ftate of non-exiftence. 
 What other phylicians call fedatives, therefore, accord- 
 ing to the new fyftem, are only weak Jlimulants. The 
 fallacy of fuch rcafoning is obvious ; but as it does not 
 affect the pra&ice, we ihall not fpend any time in con-' 
 lidering it further. On 
 
xi* A TREATISE ON 
 
 On the principles juft now laid down, the Brunonfan 
 fyftem divides all difeafes to which the human body is 
 liable into two great clafTes ; the one produced by too- 
 much excitement, the other by too little. The former 
 contains thofe difeafes by other phyficians called inflam- 
 matory ; the latter fuch as are called nervous, putrid, 
 or all in which the powers of life are too weak, and re- 
 quire to be fupported. This laft is fuppofed to be much 
 more numerous than the former ; and in the cure of 
 thefe it was that the founder of the fyftem appeared to 
 greater! advantage. A mod violent altercation took 
 place between Dr. Brown and the Edinburgh College ; 
 yet, notwithftanding all the influence of the profeflbrs, and 
 their unanimous oppofition to the new doctrines, they 
 found themfelves ultimately unable to refift a fingle mart 
 nnfupported either by wealth or reputation. The plau- 
 fibility of his fyftem, and its being obvious to every ca- 
 pacity, overcame every obftacle -, fo that even the prac- 
 tice of the Cullenians themfelves underwent confiderable 
 alterations. It is not, however, to be denied that the 
 fyftem hath been confiderably improved, or at leaft al- 
 tered, by fome of Dr. Brown's pupils, who have had the 
 advantage of ex te no" ve practice, and of vifiting many differ- 
 ent countries ; which the Dodtor himfelf never had. His 
 materia medica was befides exceedingly confined ; the 
 only medicines he had any great opinion of, being lauda- 
 num and ardent fpirits. The Peruvian bark he held in very 
 little eftimation, as being a weak ftimulus. He feems 
 to have been unacquainted with the virtues of mercury, 
 except in the venereal clifeafe, and moft probably would 
 Lave given laudanum in thole cafes of fever where mer- 
 cury is found by others to be fo efficacious. But this, 
 deficiency hath been abundantly fupplied by fome of 
 his followers. In a work entitled "The Science of 
 Life," publiflied by Dr. Yates'and Mr. M'Lean, prac- 
 titioners in the Eaft Indies, we find mercury exhi- 
 bited in prodigious dofes. As a fpecimen we fhall 
 felecl their third cafe, which was a dyfentery. On the 
 firft of September the pationt took two grains of calomel 
 and as much opium every two hours. This was con- 
 tinued 
 
THE PLAGUE, 113 
 
 tinned for two days. On the third, the dofe was 
 given every hour ; beiides which, he had half an 
 ounce of mercurial ointment with a drachm of ca- 
 lomel rubbed into his body. Next day the pills were 
 continued, and the quantity of ointment tripled by 
 thrice rubbing in. This was continued for three days, 
 at which time, an eruption on the ikm appearing, it was 
 feared he could not be falivated ; this eruption being a 
 iign that no falivation could be produced. - The fame 
 mode of treatment, however, was perlifted in. Septem- 
 ber 7th the calomel in the pills was augmented to 
 four grains ; the warm bath was ufed, and the ointment 
 continued; but at night twenty grains of calomel and 
 x of opium were given every two hours. At the fame time 
 two ounces of ointment, with four of calomel, were or- 
 dered to be rubbed in. Next day, though his puife 
 was almoft imperceptible, and his extremities cold, 
 66 the medicines were continued as far as circumftances 
 would admit;" with what view it is not faid, nor 
 indeed is it eafy to be difcovered. At one in the 
 morning, however, the patient died ; an event not at all 
 furprifing. Our authors excufe themfelves for this 
 failure by faying that the vifcera of the patient were 
 difeafed, as was evinced by the impoflibility of exciting 
 a falivation ; and " that when a patient is evidently in* 
 curable by the common practice, it becomes the duty 
 of the practitioner to depart from it*" 
 
 No doubt we may readily affent to both thefe afler* 
 tions ; but though a patient be evidently incurable by 
 the common practice, or by any other, there is no 
 necefiity for killing him, or for perfevering in a courfe 
 of violent medicines that evidently make him worfe. 
 The whole of this cafe indeed ftrongly militates againft 
 the doctrine of excitement ; for if mercury be fuch a 
 powerful flimulus to the powers of life in general, how 
 comes it^ to pafs that in the prefent cafe the unhappy 
 -patient, inftead of being in the imalleft degree excited, 
 was prodigioufly debilitated, and that from the very 
 firft time of taking the medicines. This will appear 
 from the following table, exhibiting the fymptoms of the 
 difeafc as they kept pace with the medicines taken. 
 
 DAYS 
 
A TREATISE ON 
 
 DAYS OF TH 
 MONTH. 
 
 Auguft 29 
 & pre ceding. 
 
 Sept. 
 
 4th 
 
 6th 
 
 MEDICINII TAK*N, 
 
 Ordinary dofes of 
 mercury and opi- 
 um. 
 
 Opium and mer- 
 cury, two grains 
 each, every two 
 hours ', befides opi- 
 ate draughts. 
 
 The opium and 
 mercury as before, 
 but now given eve- 
 ry hour ; half an 
 ounce of mercunal 
 ointment, with 60 
 grains calomel. 
 
 Pills as ufual. 
 Ointmt. thrice rub- 
 bed in, once with 
 120 grains of mer- 
 cury. 
 
 Medicines as be- 
 fore. 
 
 Medicines as be^ 
 fore. 
 
 SYMPTOM*. 
 
 Pills as before, 
 with four grains of 
 calomej. Mercury 
 in the ointment in- 
 creafed to half an 
 ounce. Warm bath. 
 At night an ounce 
 of mercurial oint- 
 ment, with two oun- 
 ces calomel. 
 
 Pain of bowels, 
 and frequent ftools, 
 growing worfe. 
 
 Still increafing. 
 
 Stools very fre- 
 quent, with violent 
 pain in- the bow- 
 els ; extreme third, 
 tongue furred, and 
 no fleep. 
 
 Vomiting during 
 the night. Tongue 
 brown and furred. 
 
 Violent pain in 
 bowels. 
 
 Extreme pain on 
 pre fling the arch 
 of the colon ; fre- 
 quent ftools, profufe 
 fweats, great dejec- 
 tion of fpirits. 
 
 Asyefterday. An 
 eruption on the fkin. 
 At night inceflant 
 ftools, with violent 
 pain in the belly j 
 profufe fweat. 
 
 Sth Pills, 
 
THE PLAGUE. 115 
 
 5th Pills, ointment ; Inceflant ftools, 
 ealomel as before, with violent pain; 
 Warm bath thrice, at night with blood. 
 At night two ounces Extreme debility, 
 ointment, with four 
 of calomel. 
 
 9th Medicines of the Stools innume- 
 fame kind, as many rable ; extremities 
 as could be taken. cold, pulfe fcarce to 
 
 be felt. 
 
 loth Death at one in 
 
 the morning. 
 
 From a confederation of this patient's fymptoms, in 
 comparifon with the quantity of mercury taken, it moil 
 evidently appears, that it acted in no other way than as 
 an irritating poifon ; affecting, with extreme violence, 
 the already difeafed inteftines, and, inftead of exciting 
 the vital powers of the whole fyftcm, manifestly deftroy- 
 ing them. Let it not be imagined, however, that this 
 cafe is fele&ed from the reft merely becaufe it was fatal, 
 or becaufe it affords an opportunity of finding fault with 
 the practice recommended in the book. It is the only 
 one in which the mercury had a fair trial ; and even 
 here it was not very fair, as being conjoined with a great 
 quantity of opium. In the other cafes, which termi- 
 nated favourably, the mercury was overpowered by fuch 
 horrible dofes of opium, that we cannot tell which me- 
 dicine had the greateft fhare in the cure; befides, that 
 in other cafes the patients were allowed the free ufe.of 
 wine, which we all know to be a powerful ftimulant and 
 cordial ; but it is not faid that the poor man, whofe cafe 
 is above related, had a fingle drop of wine, or any thing 
 elfe, except opium, to fupport him againft the action of 
 fuch a violent medicine. 
 
 On this cafe it is of importance flill to remark, that it 
 affords, in the ftrongefl manner, an argument againft 
 what our authors fay, p. 86, that " mercury acts by 
 *' fupporting the excitement of the whole body, it in- 
 " vigorates each particular part j and thus occafions, to 
 
 " a certain 
 
ii6 A TREATISE ON 
 
 * c a certain extent, the regeneration of thofe organs 
 * c which may have been injured by difeafe." In the in- 
 ftance adduced, there is no evidence of a ftimulus upon 
 any other part of the fyftein than the bowels, which 
 were already debilitated or difeafed in fuch a manner 
 that they could not bear it. The fyftem in general, 
 inftead of being excited, was funk and debelitated from 
 the very firft moment, until at lad the excitement ter- 
 minated entirely by the patient's death. But further ; 
 There is very little probability that mercury or any other 
 medicine whatever can prove a general ftimulus, and 
 that for the following reafons. 
 
 1. No medicine can affimilate with the fubftance of 
 the body. Medicines properly fo called are here alluded 
 to. Food or drink of any kind taken for the fupport of 
 the body while in health, however they may act medi- 
 cinally upon occafions, are excepted. 
 
 2. The body is compofed of many various fubftan- 
 ces, each differing in its nature from the other. The 
 nature of the medicine, whatever it may be, is uniform, 
 and cannot act upon fubftances of different kinds in an 
 uniform manner ; and without this there can neither be 
 an univerfal ftimulant, nor an univerfal debilitant. 
 
 3. All medicines, being incapable of affimilation with 
 the body, mufk be confidered, when taken into it, as fo- 
 reign matter ; and the introduction of them at any rate 
 is in fact the creating of a difeafe. This is evident from 
 multitudes of inftances where people by quacking with 
 thcmfeives, and taking medicines unneceffarily, have 
 deftroyed their health. 
 
 4. As every medicine has one peculiar nature, and 
 one mode of action in confequence of that nature, it 
 muft, when introduced into the body, where there are 
 fluids of various natures, act upon one of them more 
 than the reft ; and this may be called the chemical action 
 of that medicine upon the body. 
 
 5. In confequcnce of the chemical action of the medi- 
 cine, the mode by which it is expelled out of the body 
 will be different; for, as all medicines are extraneous 
 fubftances, they muft be fent out of the body as faft 
 
 as 
 
THE PLAGUE. 117 
 
 as poflible ; and it is their adion upon one particular 
 part which promotes their expulfion. Thus, if from 
 the nature of the medicine it ads in a certain way upon 
 the ftomach and bowels, it will vomit or purge, or per- 
 haps both 5 and by this adion it is expelled from the 
 body, along with whatever other matters happen to be 
 in the ftomach or inteftines ; and thus medicines do 
 good only accidentally ; for mere vomiting or purg- 
 ing are mod certainly difeafes ; but where noxious 
 matters exift in the bowels, and do not naturally excite 
 thefe operations, an emetic or purgative is unqueftiona- 
 biy ufeful. Here the authors of the Science of Life 
 reafon differently ; and it is worth while to refute their 
 argument, as being the foundation of fuch tremendous 
 pradice as nobody of common fenfe would choofe to be 
 the fuojed of. Of tartar emetic they fpeak in the 
 following terms. " That tartar emetic is a ftimulant of 
 <fc very high power, is evident from the fmall quantity of 
 " it which produces the ftate of indirect debility that 
 14 occafions vomiting. It. (hould be given in fuch a 
 <c manner as to increafe and to fupport the excitement. 
 " But this will be found difficult, as the duration of 
 " its adion feems to be even fhorter than that of opium. 
 " If its adion does not continue more than a quarter 
 * fi of an hour, might it not be repeated at fuch fhort 
 " intervals, and the dofes fo reduced as to allow the 
 e eftabli(hment of the indirect debility?" This is 
 arguing in a circle. They firft fuppofe that vomiting is 
 occafioned by indirect debility, that is, the weaknefs 
 produced by an exceffive ftimulus to the whole fyftem, 
 as in cafes of drunkennefs; and then, from the exiftence 
 of vomiting, they prove that a general ftimulus had 
 pre-exifted. The cafes, however, are widely different. 
 In cafes of drunkennefs, the perfon feels himfelf at firft 
 exhilarated, alert and adive, which fhowsthe exiftence 
 of a general ftimulus. But who has ever found himfelf 
 exhilarated by taking a dofe of tartar emetic ? Yet in a 
 general excitement it is abfolutely neceffary that this 
 exhilaration (hould take place, becaufe it is an infepa- 
 confequence of an addition of vital power, let it 
 
 come 
 
nS A TREATISE ON 
 
 come in what way it will. Thus we know that if a 
 perfon happens to be much exhaufted by fatigue and 
 abftinence, he will be exhilarated and his ftrength aug- 
 mented by a fingle mouthful of meat, as well as by a 
 glafs of wine. This fhows that both thefe are general 
 flimulants to the fyflem ; but what medicine have we 
 that will produce fimilar effects ? Perhaps opium, 
 comes the neareft in the whole materia medica ; but 
 the unealinefs it occafions in the flomach manifefts a 
 greater action upon it than the other parts ; for if the 
 whole body were equally excited, the withdrawing of the 
 flimulus, or its naturally lofing its force, could only 
 have the fame effect with falling or fatigue ; but the 
 debility of the ftomach, the confufion of the head, and 
 .other effects which attend a dole of opium, demonftrate 
 that it ads partially, and not equally over the whole 
 body. The Science of Life indeed fays that thefe effects 
 are owing to the improper omifTion of the medicine, or 
 not repeating the dofcs in due time. This may be ; 
 but no improper exhibition of food, or want of due re- 
 petition, will produce fuch f ymptoms ; which undoubt- 
 edly is a proof that food ftimulates the fyftem in one 
 way, and opium in another. 
 
 6. If any medicine could be found that acted as an 
 univerfal flimulus or exciter of the whole fyflem, it 
 .could not like others be expelled by any particular eva- 
 .cuation ; but, by deilroying the balance between the 
 force of the acting powers and the fubject on which they 
 act, would moft certainly kill, unlefs very powerful 
 means were uied to counteract its effect. The only 
 iVimulant we are acquainted with which acts equally on 
 the whole fyftem, and which can be readily exhibited as 
 a medicine, is that pure kind of air called by Dr. 
 Prieftley dephlogifticated, by Scheele empyrean^ and by the 
 French chemiits and their followers oxygen. The ex- 
 ,g powers of this air, when breathed inftead of the 
 .ordinary atmofphere, are aftonifhing. It not only aug- 
 ments the appetite, but the power of the mufcles, and the 
 inclination to ufe them ; fo that withodtany intoxication 
 .or delirium the perfon cannot refrain from action j and 
 
 it 
 
THE PLAGUE. n$ 
 
 it not only exhilarates the fpirits in an extraordinary 
 manner, but beautifies the face. Did the cure of dif- 
 eafes therefore, or any fct of them, depend on mere ex- 
 citation, no other medicine but oxygen would be necef- 
 fary. What effects it may have in difeafes of debility is 
 not yet afcertamed ; but to perfons in health it certainly 
 proves fatal : their bodies are unable to bear its powerful 
 action, and of confequence they wafte, and would die of 
 confumptions, if its effects were not counteracted. Nor 
 is this at all an eafy matter ; for Dr. Beddoes informs us 
 that, by breathing this air for a fhort time each day, only 
 for three weeks, he found himfelf in great danger of a 
 confumption, and was obliged to ufe much butter and 
 fat meat in his diet, befides giving up the ufe of the air 
 altogether, in order to get clear of its mifchievous 
 effects. 
 
 Another mode of {Simulating or exciting the whole 
 fyftem is, by putting into it a larger quantity of blood 
 than it naturally contains. This is entirely fimilar to 
 the breathing of oxygen; efpecially if arterial blood be 
 ufed, which has already imbibed its fpiritous part from 
 the atmofphere. In the laft century the transfufion of 
 blood was propofed not only as a mode of curing dif- 
 eafes, but of reftoring old people to youth ; and Dr. 
 M'Kenzie, in his Treatife on Health, quotes from the 
 memoirs of the Academy of Sciences feveral inftances of 
 the blood of brute animals being infufed into human 
 veins, without any inconvenience. It feems, however, 
 not only a bold but an unnatural atterript to ufe the 
 blood of beafts for fuch a purpofe ; and, however lavifli 
 mankind may be of their blood upon certain occafions, 
 it is to be feared that there are few who would be willing 
 to fpare any to relieve another from licknefs ; but indeed 
 little can be faid about the practice; as, on account of 
 fome bad confequences, or failures, it was forbidden by 
 the king of France, and by the pope's mandate in Italy, 
 and has now fallen into difufe. In a paragraph at the 
 end of Heifter's furgery (4*0 edition) it is aflerted that 
 the transfufion of blood was productive of madnefs. 
 Dr. Darwin, however, in his Zoonomia, ftill propofes 
 
 the 
 
120 A TREATISE Otf 
 
 the transfufion of blood as a remedy, and even defcribeS 
 a convenient apparatus for performing the operation, 
 In one part of his work he fays, " Might not the 
 transfufion of blood, fuppofe of four ounces daily, from 
 a ftrong man, or other healthful animal, as a fheep or an 
 afs, be ufed in the early ftate of nervous or putrid 
 fevers ?" In another place he mentions his having pro- 
 pofed it to a gentleman whofe throat was entirely clofed 
 up by an incurable fwelling, fo that he could fwallow no- 
 thing. This is a difeafe not very rare, and which always 
 muft be fatal ; becaufe the patients, though not affected 
 by any (icknefs, die of hunger ; and, to relieve them 
 from this miferable fituation, extraordinary attempts are 
 not only allowable but laudable. The Doctor propo- 
 fed to his patient, " to fupply him daily with a few 
 " ounces of blood taken from an afs> or from the ku- 
 " man animal, who is Jlill more patient and tradable., in 
 " the following manner : To fix a iilver pipe, about an 
 " inch long, to each extremity of a chicken's gut, the 
 " part between the two filver ends to be meafured by 
 " filling it with warm water ; to put one end into the 
 " perfon hired for that purpofe, fo as to receive the 
 " blood returning from the extremity ; and when the 
 " gut was quite full, and the blood running through the 
 " other filver end, to introduce that end into the veisi 
 " of the patient, upwards towards the heart, fo as to 
 c< admit no air along with the blood. And, laftly, 
 Ci to fupport the gut and filver ends on a water plate 
 " filled with water of 98 degrees of heat ; and, to mea- 
 " fure how many ounces of blood were taken away, to 
 " comprefs the gut from the receiving pipe to the deli- 
 " vering pipe." The gentleman defireci a day to con- 
 iider of this propofal, and then another ; after which he 
 totally refufed it, faying that he was now too old to 
 have much enjoyment of life, and that, being fo far ad- 
 vanced in a journey which he muft certainly accomplifh 
 fooner or later, he thought it better to proceed than re- 
 turn. The Dodor informs us that he died a few days 
 afterwards, feemingly very eafy, and carelefs about the 
 matter. One experiment of this kind I have been witnefs 
 
THE PLAGUE. 121 
 
 to; not indeed on a human creature, but on a calf. This 
 creature received into one of its jugular veins a confider- 
 able quantity of blood from the carotid artery of another, 
 nearly of the fame age (about a month, or little more.) 
 Jt was impoffible to fay any thing about how much was 
 transfufed ; only the bleeding was continued till the 
 animal which loft the blood began to fhew figns of faint- 
 nefs. The artery was then tied up, and the orifice in 
 the jugular vein clofed. The calf which had loft the 
 blood appeared very languid and faint, but lived a few 
 days in a drooping ftate ; when it either died of itfelf, or 
 was killed, as being fuppofed paft recovery. The other, 
 which had received the blood, appeared to be in every 
 refpect highly excited. It became playful, even in the 
 room where the operation was performed, its eyes afTu- 
 med a bright and mining appearance, and its appetite 
 was greatly increafed. Thus it continued. for about a 
 fortnight -, appearing all the time to be in high health, and 
 eating much more than ufual ; but at laft died fuddenly 
 in the night. From thefe effects on healthy fubjeds, how- 
 ever, we cannot infer what would happen in fuch as are 
 difeafed ; but it is plain that if the cure of difeafes were to 
 depend upon mere excitation, the means are in our power, 
 without any local irritation, which always muft take 
 place in fome degree by the ufe of ordinary medicines. 
 This path is not abfolutely untrodden : the pneumatic 
 practitioners of the prefent day have tried oxygen in 
 confumptions, and found it pernicious ; and Dr. 
 M'Kenzie Informs us that the transfufion of blood was 
 tried ineffectually in the fame. 
 
 7. As all the medicines ufually prefcribed at prefent 
 are only to be accounted partially ftimulant, or as acting 
 upon particular parts of the fyftem, we fee that fome 
 may promote one evacuation, and fome another 3 while 
 all produce fome change in the organization, which may 
 prove uieful or detrimental, may increafe the difeafe or 
 cure it, or may produce another, according to the judi- 
 cious or injudicious application. But for a knowledge 
 of all this we muft be indebted to experience : there is 
 not a theory on earth that can lead us a fingle ftep. 
 
 R Before 
 
122 A TREATISE ON 
 
 Before we difmifs the confideration of medical theories, 
 however, it will ftill be necefiary to give fome account 
 of the new fyftem as it hath branched out in various 
 ways : for though the fundamental principle is now 
 received by a great number of phyfkians, yet the fuper- 
 ftru6ture is exceedingly different from what Dr. Brown 
 himfelf erected ; and, indeed, from the very fame prin- 
 ciples we find conclufions made as directly oppofite to 
 one another as can be exprefled in words. Drs. Yates 
 and M'Lean, for inftance, at Calcutta in the Eafl Indies, 
 have concluded that the plague " is a difeafe of a very 
 high degree of exhauftion ;" which Dr. Brown would 
 have called debility. Dr. Rufli at Philadelphia, pro- 
 ceeding alfo upon the Brunonian principles, determines 
 it to be the mod inflammatory of all difeafes,* and 
 which Dr. Brown would have called a difeafe of excite- 
 ment. Thefe two doctrines are, in every fenfe of the 
 word, as diftant from one another as eaft from wed. 
 Let us then confider both, if any confideration can avail 
 us on the fubject. 
 
 By the ancients it was fuppofed that difeafes were 
 occafioned by fomething either bred in the body or re- 
 ceived into it, and that the power of nature produced, 
 during the courfe of the difeafe, a certain change in this 
 matter, called coElion, or concoRion ; which, ifwepleafe, 
 we may exprefs by the Englifh word cooking. The 
 matter of the difeafe, called alfo morbific matter, thus 
 cooked, was in a ftate proper for expulfion, and was 
 therefore thrown out by fweat, vomit, flool, &c. or it 
 might be expelled artificially, which could not have been 
 attempted with fafety before. Modern fyftems deny 
 the exiftence of morbific matter, and refolve all into an 
 affection of the nerves, according to Dr. Cullen by cer- 
 tain fedative caufes, but according to Dr. Brown by 
 an accumulation in fome cafes, and an exhauftion in 
 others, of the excitability or excitement of the body. 
 The Science of Life commences with ftating what they 
 luppofe to be an improvement of the Brunonian princi- 
 ples, and from which the following account of the ori- 
 gin 
 * See above) p. 102, 
 
THE PLAGUE. 123 
 
 gin of difeafes is extra&ed. " Upon the different dates of 
 " excitability depend all the phenomena of health and dif- 
 " eafe. There are three dates of the excitability, i . The 
 * ftate of accumulation; when a portion of the ufual 
 
 " ftimuli is withheld When a portion of the 
 
 " ufual flimuli is withheld, the excitability accumulates, 
 <c and the body becomes fufceptible of impreflion in the 
 vc direct ratio of the fubduction. This ftate conftitutes 
 " difeafes of accumulation, or of direct debility. 2. The 
 " middle ftate ; when the excitability is fuch that the ap- 
 " plication of the accuftomed degree of exciting powers 
 " produces tone or health. 3. The ftate of exhauftion. 
 * c When the application of ftimuli has been greater than 
 " that which produces healthy action, the excitability is 
 " exhaufted, and the body becomes lefs fufceptible of 
 " impreflion in the direct ratio of the excefs. This ftate 
 " conftitutes difeafes of exhauftion, or of indirect debility. 
 " The ftates of accumulation and exhauftion of the ex- 
 " citability, in their different degrees, conftitute all the 
 " difeafes to which living bodies are fubject." 
 
 Here the chime runs on the word excitability, which 
 is not defined. If we call this property/^/?, then we arc 
 only informed, that, as life is more or lefs vigorous, 
 the body enjoys a greater or fmaller degree of health ; 
 which we know without any medical instructor. If, in- 
 ftead of the accumulation and exhauftion of excitability, 
 we take the original doctrine of excitement and debility 
 laid do;vn by Dr. Brown himfelf, we are nothing better. 
 The whole theory is loft for want of the definition of a 
 (ingle word. As long as excitability remains an unknown 
 property, we can explain nothing by it. We may in- 
 deed vary our terms. We may call it nervous influence 
 with Dr. Cullen, or fenforial power with Dr. Darwin ; 
 but we mall (till be as much in the dark as ever; and 
 all that can be made out of our theories, when our lan- 
 guage is decyphered y muft be, that fometimes people are 
 well, and fometimes they are fick ! 
 
 Dr. Rulh, in his Treatife on the Proximate Caufe of 
 Fever, adopts in part Dr. Brown's fyftem pretty nearly 
 as the author himfelf laid it down. " Fevers of all 
 
 " kinds 
 
124 A TREATISE ON 
 
 " kinds (fays he) are preceded by general debility. This, 
 " debility is of two kinds, viz. dired and indirect. The 
 " former depends upon an abftracYion of ufual and 
 " natural ftimuli ; the latter upon an increafeof natural, 
 * 6 or upon the action of preternatural, ftimuli upon the 
 
 <c body Debility is always fucceeded by increafed 
 
 " excitability, or a greater aptitude to be acted upon by 
 
 "ftimuli The diminution or abftraction of one 
 
 ec flimulus is always followed by the increafed action of 
 " ethers." Here it is evident we are as much in want 
 of definitions as ever. We know neither what excitability 
 is, nor what debility is, and yet they are both held out 
 as the caufes, and proximate or immediate caufes, too, of 
 fymptoms produced by things quite obvious to our 
 fenfes. Thus cold and heat, with which we are daily 
 converfant, are only called the predifpofing caufes of fever ; 
 while debility and excitement, words to which we have 
 no meaning, are faid to be the proximate caufe. It 
 would certainly be better to throw away fuch words al- 
 together, and fay that cold, .heat, &c. caufe fevers, with- 
 out troubling ourfelves farther about the matter. 
 
 It remains now to take into confederation the pneu- 
 matic theories, founded upon the difcoveries made by 
 Dr. Black, Dr. Prieftley, Lavoifier, and others, concern- 
 ing various kinds of aerial fluids, or gafes? as they are 
 alfo called. Some of thefe, particularly that afterwards 
 called fixed air, were difcovered by Van Helmont. 
 Confiderable advances were made by a German chemifr, 
 named Mavow, in the laft century ; but his book had 
 fallen into fuch oblivion that his name was fcarce ever 
 mentioned, until his difcoveries were repeated, and ftill 
 greater advances made by others. Dr. Hales obtained 
 air from a great many different fubftances, but was un- 
 nb'e to afcertain any thing concerning its nature. Dr. 
 Black of Edinburgh laid the foundation of pneumatic 
 chemiftry, by difcoveri-ng that a certain fpecies of air is 
 capable of being abibrbecl by earths of different kinds, 
 and that many very heavy fubftances owe at leaft one 
 
 half 
 
 * Cat i$ a German word* or derived from on? j fjgnifyiog fpirit. The 
 word gbojl comes from the fame original. 
 
THE PLAGUE 125 
 
 half of their weight to this condenfed air. The difco- 
 very was accidental. Wifhing to obtain a very pure 
 and white lime, he had recour'fe to the fine white eartfi 
 called magnefia alba. Some of this he diftilled with a 
 heat fufficieiit to make the veflel red hot. Only a very 
 fmall quantity of water came over, but the magnefia had 
 loft almoft two thirds of its weight. This immenfe lofs 
 was found to arife from an emiffion of air during the 
 operation ; and by other experiments it was iikewife 
 found that the air might be transferred from one portion 
 of magnefia to another from which it had been previ- 
 oufly expelled ; that the exiftence of this fpecies of air 
 in certain bodies was the caufe of that fermentation 
 which takes place when any acid is poured upon them, 
 as vinegar upon chalk or potam. Hence if any of thefe 
 fubftances be deprived of its air, it will not any longer 
 ferment in this manner. It mud not be forgot, how- 
 ever, that when air thus unites itfelf with any terreftrial 
 fubftance it no longer has its former properties. It is 
 reduced exceedingly in bulk* and in proportion to this re- 
 duction only the body is increafed in weight; and therefore 
 though we fay that the air is abibrbed, we muft ftill re- 
 member that only one part of it is fo, and that by far 
 the lead coniiderable in bulk. A violent fire will always 
 expel the air again, and reflore it to its former bulk ; 
 and again the condenfation or abforption of the air is 
 always attended with the production of heat. This lad 
 property was not much attended to by Dr. Black, but 
 others have obferved it ; and the late Dr. Charles Web-* 
 fter of Edinburgh publifhed a theory in which he main^ 
 tained that condenfation was in all cafes the caufe of 
 of heat. But, however true it may be that condenfafe'ion 
 of any kind is followed or accompanied by heat, it is 
 evidently neceffary to know the caufe of the condenfation 
 alfo, other wife we make no advance in folid theory. 
 
 The aerial fluid, difcovered by Dr. Black, was one 
 of thofe mod commonly met with. He called it fixed 
 air, from its property of adhering or fixing itfelf to dif- 
 ferent bodies. It was found to be the fame- with that 
 which had been difcovered by Van Helmont, and by 
 
 hirn 
 
126 A TREATISE ON 
 
 him named gas fylveftre (fpirit of wood)* or the fume 
 of charcoal ; it was found to be the fame with the fleam 
 of fermenting liquor, and with that very frequent and 
 dangerous vapour, met with in coal mines, called in 
 Scotland the choke-damp. Like other difcoveries, this 
 was quickly pufhed beyond its proper bounds, and ap- 
 plied to the folution of phenomena which it could not 
 folve. Dr. M'Bride, particularly, fuppofed it to be the 
 bond of union between the particles of matter, or in 
 other words the principle of cohefion itfelf. , It was alfo 
 fuppofed to be the fubftance of thofe fcorching winds, 
 called famiel, met with in Ada and Africa, and which 
 fometimes prove fatal to travellers. The pernicious va- 
 pours called mofetes, which fometimes iffue from the old 
 lavas of Vefuvius in Italy, were likewife fuppofed to be 
 the fame j-j* but of this, particularly with regard to the 
 
 famiel, there feems to be no fufficient evidence. m, 
 
 The 
 
 * This muft be underftood. only of its general properties anil effedls ; for, 
 though the fume of charcoal poileilcs many of the apparent properties of 
 pure fixed air, it contains alfo a very coniiderable quantity of another kind 
 of gas . 
 
 f Many fabulous ftories have been related concerning the famiel. Even 
 fo late a traveller as Mr. Ives has adopted fome of thofe exaggerated accounts 
 which have been difcredited by thofe who have long refided in the coun- 
 tries where this wind is commonly met with. It is not peculiar to the de- 
 fcrts of Arabia, but is met with in all hot countries which are deftitute of 
 water. In the African deferts therefore it is common ; and Mr. Bruce de- 
 fcribes it by the name of Jim^m. It was preceded by whirlwinds of a ve- 
 ry extraordinary kind. In that vaft expanfe of defert (fays he) from W. 
 <* asul to N. W. of us, we faw a number of prodigious pillars of land at dif- 
 ** ferent diftances, at times moving with great celerity, at others walking on 
 " with a majefti'c flownefs. At intervals \ve thought they were coming in a 
 tl very few minutes to overwhelm us ; and fmall quantities of fand did adtu- 
 ' ally more than once reach us. Again they would retreat fo as to be almoft out 
 " of light ; their tops reaching to the very clouds.* There the tops often fe- 
 parated from the bodies; and thefe, once disjoined, difperfed in the air, 
 and did not appear more. Sometimes they were broken near the middle, 
 as if flruck with a large cannon fhot. About noon they began to advance 
 with cottilderable fwiftnefs upon us, the wind being very iirong at north. 
 Eleven of them ranged along fide of us at about the diflance of three 
 miles. The largeft oi them appeared to me at that diflar.ce to be about 
 
 ten feet diameter It was in vain to think of iiyir.g; the fwifteft 
 
 horfe or the fa.fted failing Ihip could be of no ufe to carry us out of this 
 danger; and the full periuafion of this rivetted me as if to the fpot where 
 I flood." At another time he faw them in much greater number, but of 
 f nailer fue. They began immediately after funrife, like a thick wood, 
 and almofl darkened the fun. His rays darting through them gave them 
 the appearance of pillars of fire. They now approached to the diftance of 
 two miles from our travellers. At another time they appeared beautifully 
 
 fpangled 
 
 N. B. In thefe fandy deferts , where it never rains, there arc ne clouds. 
 
THE PLAGUE. 127 
 
 The induftry of other experimenters did not long 
 leave theorifts without abundance of materials upon 
 which they might exercife their talents. It is impoffi- 
 ble in this place to aflign to each his proper rank in the 
 way of difcovery, or indeed to mention their names, 
 Dr. Prieftley has diftinguifhed himfelf far above the reft. 
 He not only repeated and improved Dr. Black's experi- 
 ments on fixed air , but likewife found out a number of 
 other kinds ; particularly that from animal fubftances in 
 a flare of putrefaction, which is fo pernicious to living 
 creatures, infects excepted ; for thefe laft will thrive 
 amazingly in air that would prove certain death to a 
 man. He alfo difcovered that this kind of air, and 
 fome others, were abforbed by vegetables, and thence 
 inferred the ufe of vegetables in purifying the atmofphere. 
 He even analyfed the atmofphere itfelf, and found that 
 
 it 
 
 fpangled with ftars. In Darwin's Botanic Garden we find a reafon affigned 
 for the appearance of thefe whirlwinds; viz. the impulfe of the wind on a 
 long ledge of broken rocks which bound the defert. By thefe the currents of 
 air which Oruck their fides were bent, and were thus like eddies in a ftream 
 of water which falls againft oblique obftacles. In the fame work we have 
 the following poetical description of them : 
 
 Now o'er their heads the whizzing whirlwinds breathe* 
 And the live defert pants and heaves beneath ; 
 Ting'd by the crimfon fun, vaft columns rife 
 Of eddying fands, and war amid the ikies* 
 In red arcades the billowy plains furround, 
 And whirling turrets ftalk along the ground." 
 
 Whether the fimoom is always preceded by thefe whirlwinds we know not ; 
 but Mr. Bruce mentions an extreme rednefs of the air, pointed out by his atten- 
 dant Idris, as the fure prefage. His advice was, that all of them, upon the 
 approach of the pernicious blaft, fhould fall upon their faces, with their 
 mouths on the earth, and hold their breath as long as pofiible, fo that they 
 might not inhale the deadly vapour. They loon had occafion to follow this 
 advice ; for next day Idris called out to them to fall upon their faces, for the 
 limoom was coming. * I faw (fays Mr. 15ruce) from the S. E. a haze corn- 
 " ing, in colour like the purple part of the rainbow, but not fo compreffed or 
 thick. It did not occupy twenty yards in breadth, and was about twelve 
 ** feet high from the ground. It was a kind of blufh upon the air, and it 
 moved very rapidly ; for I could fcarce turn to tall upon the ground, with 
 my face to the northward, when I felt the heat of its current plainly upon 
 my face. We all lay flat on the ground, as if dead, till Idris told us it 
 was blown over. The meteor, or purple haze, which I faw, was indeed 
 palled ; but the light air that flill blew was of heat fufficient to threaten 
 iutibcation. For my part, I felt diftin&ly in my bread that I had imbibed 
 a part of it; nor was I free of an afthmatic fcnfation till I had been fome 
 months in Italy, at the baths of Poretta, near two years afterwards." It 
 continued to blow for fome time, and in fuch a manner as entirely to ex- 
 hauft them, though fcarcely fufficient to raife a leaf from the ground. 
 
 The account given by Mr. Ives is, that it blows over the defert (of Syria) in 
 the months of July and Auguft, from the northweft quarter, and fometimes 
 
 continues 
 
128 A TREATISE ON 
 
 it confided of two different kinds of fluids, one of which 
 he called dephlogifticated, the other phlogi/licated air. 
 The former was found to fupport animal life for a time, 
 the latter to deflroy it inftantly. Their eflfeds upon 
 fire were the fame ; the former exciting the moft 
 vehement heat and bright flame, the latter extinguifh- 
 ing a^fire at once. 
 
 The fame of Dr. Prieftley's difcoveries quickly reached 
 the continent of Europe ; the French chemifts repeated 
 his experiments with improvements, as they thought ; 
 and indeed certainly made many curious difcoveries. 
 Lavoifier was particularly remarkable for his numerous 
 and accurate experiments ; but, by his changing entirely 
 the language of former chemifts, and fubftituting a fet 
 of new terms of his own invention, he certainly entailed 
 the greateft curfe upon the fcience it ever met with . 
 It belongs not to this tre'atife to give an account of his 
 fyftem farther than to fay, that, from the immenfe 
 
 proportion 
 
 continues with all its violence to the very gates of Bagdad, hut never affe&s 
 any body within its walls. Some years it does not blow at all, and in other;* 
 it comes fix, eight* or ten times, but feldom continues more than a few mi- 
 nutes at a time. It often pafles with the apparent quicknefs of lightning. 
 The fign of its approach is a thick haze which appears like a cloud ef duft 
 rifing out of the horizon, on which they throw themfelves with their faces on 
 the ground, as already mentioned. Camels are faid, inftindively, to bury 
 their nofes in the fand. As for the ftories of its diflblving the cohefion of the 
 body in fuch a manner that a leg or an arm may be pulled away from thole 
 who are killed by it, or that their bodies are reduced to a gelatinous fubftance, 
 we cannot by any means give credit to them. From its extreme quieknefs, 
 and luminous appearance, it would feem to be an electrical phenomenon im- 
 mediately preceding thofe vehement hot winds which all travellers agree in 
 likening to the vapour illuing from a large oven when the bread is newly ta- 
 ken out. Its eledtrical nature will be more probable from the account given 
 by Mr. Ives, that the Arabians fay it always leaves behind it a very fulphu- 
 reous fmell. Thefe particulars do not at all accord with the fuppoiltion of 
 its conlifting of fixed air. I have indeed been allured by a gentleman long 
 in the fervice of the EnglHh Eaft India Company, that the famiel cannot pals 
 over a rivec^ Hence probably it has been fuppofed to be a blaft of fixed air, 
 bccaufe this fpecies of gas is readily abforbed by water ; but wa know that 
 the fame thing would alfo take place with any quantity of eiedric matters 
 for water takes up this alfo much more completely than it does fixed air. 
 
 The mofttes are invifible, and kill in an inftant. They rife from old volca- 
 nic lavas, and, as it were, creep on the ground, and enter into houfes, fn that 
 they are very dangerous ; but, though they may probably con fill of fixed ai/, 
 \ve have not as yet any direct proof of it. It is not indeed eafy to imagine 
 why any lava fhould fuddenly emit a great quantity of fixed air, and then 
 as fuddenly ceafe; nor in what manner the ait thus emitted fhould contir.uj 
 unmixed with the atmofphere ; for fixed air will very readily mix in 
 manner, iniornuch that a large quantity of it being let looie in a i^o:\ 
 been found to vanilh entirely in lefsthan halt an hour. Sir William Ha;.'.~ 
 ton mentions * mofcte having got into the palace <?f th? king of Naples, 
 
THE PLAGUE. 129 
 
 proportion of condenfed aerial matter foiind in mod 
 terreftrial fubftances, he and his followers were led to 
 conclude, that different fpecies of air conftitute almoft 
 the whole of the terraqueous globe. Water particularly 
 they have abfolutely and moft pofitively determined to 
 be a compofition of two airs condenfed, viz. the dephlo- 
 gifticated and inflammable* which they call oxygen and 
 hydrogen. However, this doctrine is ftill oppofed by 
 Dr. Prieftley and fome others. 
 
 In the midft of fo much theory, and fo many new 
 and furprifing difcoveries, it would have been wonder- 
 ful indeed if the fcience of medicine had kept free from 
 innovation. It did not : the new chemiftry, with all 
 its formidable apparatus of hard words, was introduced, 
 and thus the ftudy of the fcience, already very difficult, 
 was rendered ftill more fo. In paffing this cenfure upon 
 the modern nomenclature ', as it is called, I arn fenfible 
 that I muft rank with the minority ; neverthelefs, I have 
 the fatisfaction of finding that I am not altogether fin- 
 gular. Dr. Ferriar, in the preface to his fecond volume, 
 complains, " that, with every attempt towards the for- 
 " mation of a fyftem, new applications of words are in- 
 " troduced, which, though defirable in the art of po- 
 " etry, are very inconvenient in pathological books, eipe* 
 " cialiy when this is done to give an air of novelty to 
 " old theories and obfervations. For, between the an- 
 " cient language, which practitioners cannot entirely 
 " reject, and the new dialect, which they cannot wholly 
 " adopt, the ftyle of medical books is reduced to a kind 
 " of jargon, that the author himfelf may pofiibiy under- 
 " (land, but which his readers find it very difficult to 
 " unriddle. Hence refults a neglect of medical litera- 
 " ture, and hence the pernicious habit of regarding as 
 " new whatever has not appeared in the publications of 
 " the hft half century." To the fame or a fimilar pur- 
 pofe, in the preface to his firfl volume, he cites Qijin- 
 tilian. *" Some have fuch a multitude of vain words, 
 that, while they are afraid of fpeaking like other people, 
 
 by 
 
 * Eft etiam in quibufdam turba inanium verborum. qui dum communein 
 loquendi morem reformidant, dudti fpecie nitoris, circumcum gmaia copioia 
 Joc^uacitate, qu dicere volunt. 
 
 s 
 
130 A TREATISE ON 
 
 by a kind of affected elegance, they confound every 
 thing they have to fay with their immenfe loquacity." 
 
 The pneumatic fyftem naturally arofe from a confi- 
 deration of the competition of the atmofphere we 
 breathe. Finding this fluid to be compofed of two 
 others, the one of which would preferve life for fome 
 time at leaft, and the other inftantly deftroy it, it be- 
 came natural to think that difeafes might be produced 
 by any considerable variation in the proportion of thefe 
 ingredients. An inftrument was foon invented by 
 which any confiderable variation in this refpect might 
 be difcovered j but upon trial this was found to be of 
 very little ufe. Dr. Prieftley himfelf tried, by means of 
 this inftrument, fome very offenfive air which had been 
 brought from a manufactory, and could find no remark- 
 able difference between it and that which was ac- 
 counted pure. Still, however, it was evident that by in- 
 creafing very much the proportion of one of the ingre- 
 dients, fome confiderable alteration might be produced, 
 which could not but be perceptible in the human body ; 
 and this led to the application of aerial chemiftry to dif- 
 orclers of the lungs. The mixture chofen for this pur- 
 pofe was pure dephlogiflicated (oxygen) with inflam- 
 mable air (hydrogen ;) and, though this has not been 
 known to effect a radical cure, it certainly has given 
 relief in many cafes. In fevers alfo the application of 
 fixed air (carbonic acid) hath been found advantageous $ 
 but with regard to oxygen and fome others we have not 
 yet a decided inftance of their good effects in any cafe. 
 Dr. Beddoes indeed is of opinion that it would be of 
 fervice in the fea-fcurvy ; but in this (whether his con- 
 jecture be right or wrong) the theory is certainly erro- 
 neous, as fhall prefently be evinced. 
 
 In confideririg the pneumatic fyftem it is evident that 
 modern chcm-ifts have fallen into the fame error with 
 their predeceffors y viz. of fuppofing that every thing 
 which by the force of fire or otherwife they could 
 produce, from any fubftance, previoufly exifted in it. 
 Hence, as from a piece of bone for inftance, a chemifl 
 can produce water, fait, oil and earth, it was fuppofed 
 
 thai: 
 
THE PLAGUE, 131 
 
 that thefe four were the principles or elements of the 
 bone. But this was falfe reafoning ; for if thefe were 
 really the chemical principles, they ought to have been 
 able to produce fome.kind of bony fubftance by mixing 
 -them together after they had been diftilled. But no 
 ftich thing could be done ;, and though we mould add 
 to the mixture the whole quantity of air emitted during 
 the diftillation, and which efcaped the notice of ancient 
 chemifts, our fuccefs would be no better. In like 
 manner, becaufe in certain circumftances oxygen is 
 obtained from the flefh of animals, it has been con- 
 cluded that it necefTarily exifts as an ingredient in their 
 bodies while living ; and that, if this kind of air happens 
 to predominate, the animal will be affected in one way, 
 or if hydrogen prevail, in another. But though we have 
 already quoted Dr. Girtanner with approbation as 
 having obtained oxygen gas from frefh meat, yet this 
 does not by any means prove to us that it exifts in flefli 
 as one of its component parts. Even in the Doctor's 
 experiment it was neceflary to expofe the flefh to the 
 atmofphere in order to procure the gas by diftillation; 
 which undoubtedly muft excite a ftrong fufpicion that 
 the air in queftion come? from the atmofphere itfelf ; and, 
 if this is the cafe, it is not reafonable to fuppofe that a 
 difeafe could be cured by any addition of oxygen to the 
 folid parts ; becaufe, though found flefh may have an 
 inclination to abforb this kind of air, we do not know 
 whether it would have fuch a property of abforption in a 
 clifeafed ftate. Indeed in the (curvy, which Dr. Beddoes 
 choofes as an example, experiment feems to determine 
 in favour of fixed air rather than any other. But let us 
 hear Dr. Girtanner himfelf, who has at large difcufTed 
 this fubject in two memoirs ; one upon the laws of 
 irritability, and another on the principle of irritatibility. 
 In thefe memoirs we find the Brunoman doctrine fet 
 forth with fuch filence in regard to Dr. Brown himfelf, 
 that forne have not fcrupled to charge Dr. Girtanner 
 with literary theft ; but this is a matter which belongs 
 not to us to confider : the theory may be very good, 
 whether ftolen or not. He changes the word excitabi- 
 lity, 
 
i$i A TREATISE ON 
 
 //>y, ufed by Dr. Brown, for irritability j but hath the 
 misfortune of not being able to tell us what he means 
 by it. He goes on, however, to diftinguim the three 
 Hates ot tone or health, accumulation, and exhaujlion y as 
 other Brunonians do. Health, he fays, in a fibre <4 con- 
 " fifts in a certain quantity of the irritable principle 
 " neceflary for its preservation. To maintain this ftate, 
 :c the action of the ftimulus muft be ftrong enough to 
 c carry off from the fibre the furplus of this irritable prin- 
 16 ciple, which the lungs and the circulation of the 
 " fluids are continually fupplying. For this a certain 
 c< equilibrium is neceflary between the ftimuli applied 
 " and the irritability of the fibre, in fine that the fum of 
 16 all the ftimuli acting upon it may be always nearly 
 " equal -, powerful enough to carry off from the fibre 
 <e the excefs of its irritability, and not fo ftrong as to 
 
 " carry off more than this excefs When the 
 
 " fum of the ftimuli acting upon the fibre is not great 
 " enough to carry off all its excefs of irritability, the 
 " irritable principle accumulates in the fibre, and then 
 " it is found in that ftate which I call the ftale of accu- 
 <c mulation > the irritable principle accumulates in the 
 " fibre, its irritability is augmented, and the ftimuli pro- 
 *' duce much ftronger contractions than when the fibre 
 " only retains its tone. .... When the fum of the 
 " ftimuli ading upon the fibre is too great, the fibre 
 " is deprived not only of the excefs of its irritability, but 
 <c alfo of fome portion of the irritable principle neceflary 
 " for the tone of the fibre ; or, more properly fpeaking, 
 " the fibre lofes more irritability than it receives, and, 
 s< of courfe, in a fhort time finds itfelf in a ftate of ex- 
 " hauftion ; and this exhauftion will be either temporary, 
 < or irreparable." 
 
 Here it is evident that we have nothing but Dr. 
 Brown's fyftem, without the leaft explanation to render 
 it more intelligible. A definition is ftill wanting. This 
 invifible and incomprchenfible property of irritability 
 ruins our whole fabric - 9 nor can the deficiency be fup- 
 plied by human art or ikill : of confequence we muft 
 abandon this part of the fyftem entirely, and come to 
 
 fomething 
 
THE PLAGUE, 133 
 
 fomething more cognizable by our fenfes. It is impof- 
 fiblc, however, to pafs over in filence the amazing inat- 
 tentiorj of the author, in imagining that on fuch unin- 
 telligible principles he could explain other phenomena. 
 " In the ftate of temporary exhaujlion (fays he) the fibre 
 " lofes its tone, and fails for want of irritability. The 
 " application of a itimulus while it is in this ftate will 
 " not make it contract. Provided the flimulus be not 
 " very ftrong, it will produce no effeft at all, but in a 
 " ihort time the irritable principle will accumulate afrefh 
 " in the fibre, and then it will again contraft. It is 
 " only by little and little that the fibre recovers its irri- 
 " tability. This truth, I dare venture to fay, is as new 
 " as it is ftriking. It unfolds a vaft number of phe- 
 " nomena hitherto inexplicable." Here we have no- 
 thing but the pompous declaration of a fad already 
 well known ; viz. that not only a fibre, but the whole 
 body, may be in a ftate of temporary infenflbility, and 
 yet recover either of itfelf or by the ufe of external means. 
 How many people have fallen into zfyncope, and yet re- 
 covered ! How many limbs have become paralytic, and 
 in time recovered their fenfe and motion ! Yet this is 
 all that we are informed of with fo much parade and 
 aflumption of novel ty. We know that when "a perfon. 
 is in a faint he is infenfible to ordinary ftimuli, though 
 very ftrong ones will roufe him ; but what can we infer 
 from this ? Nothing : only we fee it is fo. Does it avail 
 us any thing to be told that during the time of fainting 
 the irritability is exhaufted, and " in a fliort time the 
 irritable principle will accumulate afrefh;" in which 
 cafe the patient will no doubt recover, unlefs he happens 
 to be dead, which is the true meaning of an irreparable 
 exhaujlion of the irritability. 
 
 In fpeaking of the principle of irritability he exprefles 
 
 himfelf in the following manner. " I think that the 
 
 ;< oxygen isabforbed by the blood, and that the venous 
 
 6 blood is oxygenated in the lungs during refpiration. 
 
 The mod celebrated naturalifts and chemifts are of a 
 ;c different opinion : they think that the oxygen does 
 -" not combine with the venous blood. According to 
 
 " then?. 
 
134 A TREATISE ON 
 
 " them, this lad lofes carbon and hydrogen, and re- 
 -covers the bright colour natural to it, without abforb- 
 
 " ing any thing from the atmofphere After hav- 
 
 > ing a long time attended the phenomena of refpira- 
 ;< titin, and made many experiments upon this fubjecl:, 
 " Ithink it may be concluded that one part of the 
 " oxygen of the vital air combines with the venous 
 [< blood, of which it changes the black colour, and 
 '"makes it vermilion ;* the fecond part of the oxygen 
 " unites with the carbon contained in the carboriic-hy- 
 " drogen gas, which exhales from the venous blood, and 
 "forms Carbonic acid air ; a third part Unites with the 
 M carbon of the mucus, contained in great quantities in 
 Ci the lungs, and which is continually decompofmgj this 
 " part alfo forms carbonic acid air-; a fourth part of the 
 " oxygen combines with the hydrogen of the blood to 
 " form water." : 
 
 '' On this theory I (hall only obfervfc, that though I lay 
 claim to the former part, I allow the Doctor all the latter 
 part to hirhfeify particularly where he fpeaks- oi the 
 formation of water tqjbe exhaled dunrj-g refpiration. The 
 air in queftion confifts of two parts, like fixed air already 
 mentioned. One of thefe is capable -ot being attracted, 
 condenfed, or united witlvcertain fiibftances ; the other 
 vanifhes, leaving no other traces of -its. having ever ex- 
 ifted, but heat, greater qr leis according to circumftan- 
 ces. When the air is taken into the blood, one part of 
 it undoubtedly combines with fomething thrown out by 
 the lungs, and forms fixed air, of which our breath con- 
 tains r a conficlerable quantity. We know certainly that 
 the condenfable part of fixed air is formed cut of the 
 cond^nfable part of the oxygen, with certain additions. 
 As therefore great part of this condenfable oxygen is 
 thrown out in fixed air at every expiration, it is natural 
 to fuppofe that all of it is fo : at lead we cannot know 
 
 the 
 
 * Here Dr. Beddoes, from whofe publication this account of Girtanner's 
 npemoir is taken, has the following note: Dr. Goodwyn had proved thi* 
 before. Could Dr. Girtanner be ignorant of his experiments ?" In juftice 
 to myfelf, however, I muft obferve that this very do&rine had been pubiifn- 
 cjl in the ENC Y c LOP.ED.I A BRITANNICA long before either Dr. Goodwyn 
 or Dr. Girtanner had made any experiments on the fubjedl. It may ftill be 
 f\en under the article BLOOD, and reafons are there given for i'uppoiing that 
 'nly one part of the oxygen, vi?> the elaftic part, can be abforbed. 
 
THE PLAGUE. 135 
 
 the contrary without, a feries of very difjicult and tedious 
 experiments, which have never been made by Dr. Gir- 
 tanner or any body elie. But if the whole of this con- 
 deufable part b.e thrown out, none can enter the blood 
 by the breath ; and confequently whatever true oxygea 
 may afterwards be expelled from that fluid, muft be a 
 factitious iubftance, formed either during the artificial 
 procefs, ufed for diftilling it, or by a natural procefs in 
 the body itieif. It is not therefore at all probable that 
 the oxygen which fleili emits in diflillation can be de- 
 rived from the air by refpiration. 
 
 Another and more probable fource is the food and 
 drink we take ; al! of which are more or lefs impregna- 
 ted with air of different kinds, particularly fixed air. 
 This, we know, very readily condenfes, and certainly 
 will do fo when taken into the body. In this ftate it 
 not only may, but certainly will, pafs into the blood, 
 and through all the different parts of the body, until, 
 having accomplifhed its purpofe, whatever that maybe, 
 it is thrown out by infenflble perfpiration, as has been 
 already explained. 
 
 The conclusions drawn by Dr. Girtanner from his 
 experiments are, i. That the change of colour which 
 the blood undergoes during the circulation is not owing 
 to its combination with hydrogen air.* 2. The deep 
 
 colour 
 
 * Here it is neceflary to obferve, for the fake of accuracy and perfpicuity, 
 that, in the new chemiftry, the terms of which are now very generally adoptecU 
 the words oxygen ar*d hydrogen when mentioned by themfelves are not under- 
 ftood to lignity any kind of air, but what I have called the condenfable part 
 of the air. It the word air is added, then the whole fubftance of the fluid 
 is understood. But though this is the ftridt orthod@x language of the new - 
 chemiftry, it is impoffible to fay whether every one who adopts the terms be 
 fufficiently careful in this refped. Indeed this is one out of many inconve- 
 niences that might be pointed out which have arifen from this nomencla- 
 ture ; for thus the mere omiflion of a monofyllable, which may happen in 
 immberlefs inftances, totally perverts the meaning ot the author, and may 
 of courfelubjedi him to unmerited cenlure., Befides, it is not to be known, 
 unlefs the author tells us Co, that he detigns to obferve this ftridnefs, and 
 ot confequence we muft in multitudes of cafes be uncertain of the meaning of 
 vrhat wo read. Thus, in the prefent iaftance, when Dr. Girtanner fpe*ks of oxy- 
 gen, we know not certainly whether he means the air in fubftance, or only one of 
 its component parts. Probably he means the condenfuble or folid part. If he 
 does fo, there mull be a very material difference between his theory and that laid 
 down in the Encyclopaedia, and which is fupported throughout this treatife. 
 In the latter it is maintained that the comieniable part is thrown out by the 
 breath, being previoufly converted into fixed air, while the elaftic part enters 
 the vital fiuid communicating to it not only the red colour, but heat, and tha 
 principles of life and fenfation, as will be more fully explained in the fequel. 
 
136 A TREATISE Otf 
 
 colour of the blood in the veins is owing to the carbon it 
 contains. 3. That the vermilion colour of the arterial 
 blood proceeds from the oxygen with which the blood 
 is conjoined during its paffage through the lungs. 
 
 4. That refpi ration is a procefs exactly analogous to the 
 combuftion and oxydation of metals $ that thefe pheno- 
 mena are the fame, and to be explained in the fame manner, 
 
 5. That, during circulation, the blood lofes its oxygen, 
 and charges itfelf with carbonic hydrogen air, by means of 
 a double affinity. 6. That, during the diftribution of 
 the oxygen through the fyftem, the heat which was 
 united with this oxygen efcapes ; hence the animal heat. 
 7. That the great capacity of arterial blood for heat is 
 owing to the oxygen with which it is united in the 
 lungs. 
 
 On thefe proportions, which conftitute in a great 
 meafure the fundamental principles of the doctrine of 
 exygenation of the human body, we may remark, 
 
 i. Nobody can reafonably fuppofe that hydrogenair 
 is the caufe of the dark colour of the blood in the veins, 
 becaufe there is no fource from which it can be derived ; 
 and, befides, it is certain that no kind of air can exift in 
 its elaftic ftate in the blood, without deftroying the life 
 of the animal. Some experiments proving this are 
 given by Dr. Girtanner himfelf. It is true that an ae- 
 rial vapour, of the nature of fixed air, exhales from the 
 body by infenfible perfpiration ; but there can be no 
 doubt that this receives its elafticity only at the furface 
 of the body, and is expelled the moment it is formed. 
 It has indeed been proved, by undeniable experiment, 
 that no air of any kind exifts in the larger veins; be- 
 caufe a portion of a vein, included between two liga- 
 tures, being cut out, and put under the receiver of an air- 
 pump, does not fwell in the leaft when the air is ex- 
 haufted, which yet mud be the cafe, did the final left 
 quantity of elaftic air exift in it.* 2. When 
 
 * Hydrogen air is the fame with that by Dr. Prieftley called irfammabl* 
 ^ir. He alio difcovered the true competition of it. Having included a tew 
 grains of charcoal in the receiver of an air-pump* and exhaufted the air, he 
 heated it iq vacuo hy means of a Urge burning glafs. The charcoal was 
 entirely volatilized and converted into this kind of air. He found, however,, 
 that without loins i'mali portion of moifture this volatilization did not take 
 place. 
 
THE PLAGUE. 137 
 
 2. When the Doctor afferts that the dark colour of 
 the venous blood is owing to the carbon it contains, he 
 is in the firft place chargeable with the error of former 
 chemifts, who fuppofed that every thing which could be 
 extracted from any fubftance by fire, exifted previouflyin 
 it, in thatvery form in which it is extracted by the fire 5 
 and in the fecond place he fpeaks entirely at random, 
 without even a fhadow of proof. Nay, he himfelf tells 
 us, that he has repeated two of Dr. Prieftley's experi- 
 ments, which in the cleared manner demonftrate, that 
 neither the addition nor the abftraction of carbon, or 
 any thing elfe, give this dark colour to the venous 
 blood. " A fmall glafs tube (fays he) filled with arte- 
 " rial blood* of a bright vermilion, was fealed hermeti- 
 " cally,* and expofed to the light. The blood chan- 
 <e ged its colour by degrees, and in fix days became 
 " black as venous blood* The fame experiment was 
 " repeated, with this difference only* that the tube was 
 *' expofed to heat, and not to the light* The blood 
 " became black in a fhorter time." Jn thefe experi- 
 ments it is plain, that if the blood contained oxygen at 
 firft, it did fo at the laft $ the fame with regard to car- 
 bon. How came it then to pafsj that without either 
 evaporation of the former, or addition of the latter, the 
 change mould be produced ? If the oxygen imbibed by 
 the blood in the lungs was fufEcient to produce the red 
 colour, why did it not preferve it ? The cafe here is pre- 
 cifely fimilar to what happens with the calx of filver* 
 When that metal is diflblved in aqua fortis, and again 
 reduced to a folid form, it appears as a white powder, 
 and will preferve its colour if carefully kept from the 
 light ; but if a vial be filled with it, and expofed to the 
 fun, that fide on which the light falls will in a fhort 
 time become black, and this though the vial has been 
 ever fo carefully fealed. f- Formerly, chemifts had a me- 
 thod 
 
 * A glafs tube is fealed hermetically, by heating the open end or ends* 
 till they become foft, and then clofing them with a pair of pincers. 
 
 f Thus letters, or other characters, may be curioufly marked upon the calx 
 Within the vial, by cutting them out in paper, and then patting them on the 
 fjde to be expofed to the light. We may have them in this manner cither 
 dark upon a white ground, or white upon a dark ground. 
 
 T 
 
138 A TREATISE ON 
 
 thod of accounting for this appearance, as well as that 
 of the venous blood, by what they called the evolution 
 of phlogifton : but now that the very exiftence ofphlo- 
 gifton is denied, we are deprived of this refource. But, 
 whatever words we may ufe, it is plain that in neither 
 cife have we any ideas affixed to them which can make 
 the matter at all more intelligible than it was before. 
 But with regard to the blood, we are at a confiderable 
 lofs to underftand what the natural colour of it is ; and 
 indeed the queftion can only be determined by exa- 
 mining the blood of a fcetus which has never breathed. 
 If the arterial blood of fuch a fcetus be of a dark colour, 
 refembling that in the veins of a grown perfon, we muft 
 look upon this to be natural to it, and we may as well 
 inquire why a rofe is red, or an iris blue, as why the 
 blood is of a dark, and not of a bright red. But, if we 
 find this dark red change to a bright fcarlet in the arte- 
 ries, as foon as the child has breathed, we have as much 
 reafon to conclude that the air occafions this fuperioi" 
 rednefs, as that an acid is the caufe of a red colour in 
 the fyrup of violets, or an alkali of a green colour in the 
 fame. Experiments are yet wanting to determine this 
 matter. Mr. Hunter has obferved that " in fuch fre-* 
 " tufes as convert animal matter into nourifhment, they 
 " moft probably have it (the colour of the blood) influ- 
 " enced by the air, fuch as the chick in the egg, al- 
 " though not by means of the lungs of the chick, we 
 " find the blood, in the veins of their temporary lungs, 
 " of a florid colour, while it is dark in the arteries." 
 The probability therefore is, that the blood is naturally 
 dark ; by the claftic 1 principle of the oxygen that it is 
 rendered brighter , and that, this elaftic principle being 
 expended in the courfe of circulation, the fluid reaf- 
 fumes its original colour. 
 
 3. Though enough has already been faid to evince 
 that the fuperior rednefs of the arterial blood is derived 
 from oxygen gas, we (hall dill quote two inftances from 
 Mr. Hunrer's Treat ife on the Blood, which fet this 
 forth in the cleared manner; and thefe inftances are the 
 more remarkable, becaufe they demonftrate the pheno- 
 mena 
 
THE PLAGUE. 139 
 
 mena not of the dead, but of the living body, i . A gen^ 
 tleman in an apoplexy, who Teemed to breathe with 
 great difficulty, was bled in the temporal artery. The 
 blood flowed very flowly, and for a long time. It was as 
 dark as venous blood. He was relieved by the opera- 
 tion ; but, on opening the fame orifice in two hours, 
 the blood flowed of the ufual florid colour. 2. A lady 
 in an apoplexy was treated in the fame manner, and Mr. 
 Hunter obferved, that when Ihe breathed freely, the 
 blood from the temporal artery aflumed a bright red 
 colour ; but when her breathing was become difficult, 
 or when fhe feemed fcarce to breathe at all, it refumed 
 its dark colour, and this feveral times during the ope- 
 ration. 
 
 4. Refpiration is not, as Dr. Girtanner fays, a pro- 
 cefs fimilar to the combuftion and oxydation (the calci- 
 nation) of metals. Some of thefe by calcination, and 
 all of them in the opinion of Dr. Girtanner, unite with 
 the condenfable part of the oxygen contained in the air, 
 while the elaftic part is diffipated in flame or heat. The 
 reverfe of this takes place in breathing ; for here the 
 elaftic part of the oxygen unites with the blood, and 
 makes it warm, while the condenfable part, uniting with 
 certain particles to be thrown off from the body, pafTes 
 away in fixed air. Thus the procefs of refpiration does not 
 refemble the calcination of a metal (at lead acccording 
 to our author's opinion of that operation) but rather the 
 inflammation of fome combuflible fubftance ; for in 
 both cafes a certain quantity of carbon is found to be 
 united with the bafis of oxygen in the atmofphere, and 
 thrown off from the place of combuftion ; and thus a 
 quantity of fixed air is produced from every burning 
 fubftance. Juft fo is it with refpiration. If the con- 
 denfable part of the oxygen combined with the blood, 
 then no fixed air could be produced ; or if any part of 
 the oxygenous bafe was abforbed, it muft certainly be 
 known by a proportional deficiency in the quantity of 
 fixed air produced. But there are no experiments made 
 with accuracy fufficient to determine this point. It is 
 true that many very able phyfiologifts, as Bprelli, Ju/in s 
 
140 A TREATISE ON 
 
 &c. have been of opinion, that part of the air is abfoN 
 bed hi refpiration ; but when we come to particulars no- 
 thing can be determined. Dr. Hales by experiment 
 found the quantity abforbed to be a Jixty-eighth part of 
 the whole quantity infpired ; but, on account of fuppofed 
 errors, he ftates it only at an hundred and thirty -fixth^wt. 
 Between thefe two the difference is fo enormous, that 
 we know not how to draw any conclufion from them. 
 The French chemifts are more decifive, and agree pretty 
 well with one another. Chaptal calculates it at three 
 hundred and fifty -three ^ and La Metherie at three hundred 
 andfixty, cubic inches in an hour. Allowing thefe ex- 
 periments to be juft, the next queftion is, what part of 
 the air is abforbed. Lavoifier fays, that it is the oxy- 
 genous bafe, or the fame with that which is abforbed in 
 the calcination of mercury. But how comes he to know 
 this ? Surely not in the fame way that he determines the 
 abforption of it by mercury. In the latter cafe he takes 
 a certain quantity of mercury, includes it in another 
 known quantity of oxygen air, and heats the metal by 
 means of a burning-glafs or otherwife : the confequence 
 is, that the air is abforbed, the mercury lofes its fluidity, 
 and is increafed in weight. The metal gains the whole 
 weight of the air abforbed ; and, by another procefs, all 
 the air and all the metal, or very nearly fo, may be ob- 
 tained in their original form. This experiment is fo 
 decifive, that nothing can be faid againft it with any (ha- 
 dow of reafon ; but who hath made, or who can make, 
 lirnilar experiments with the blood of a living man ? Such 
 experiments indeed might be made, if injenjible perfpira- 
 tion did not ftand in our way. Common atmofpherical 
 air is about eight hundred times lighter than water. A 
 cubic inch of diftilled water, according to Dr. Kirwan, 
 weighs two hundred and fifty -three grains and a quarter. 
 Oxygen air is fomewhat lighter than common air : we 
 fhall therefore fuppofe that fix hundred inches of it are 
 equal to an inch of water. If then the blood abforb 
 three hundred and fixty inches of air in one hour, it will 
 in twenty-four hours have abforbed eight thoufand fix 
 hundred and forty inches, equal in weight to fourteen 
 
 inches 
 
THE PLAGUE. 141 
 
 Inches of water and two fifths, which according to 
 Dr. Kirwan's eftimate is between feven and eight 
 ounces. But the quantity of matter infenfibly perfpired 
 in that time is fo much greater, that no calculation can 
 be made. Here is one mode of determining the quan- 
 tity of oxygen infpired totally impracticable in the hu- 
 man body, though quite eafy and practicable in the 
 cafe of mercury. The other mode of determining it 
 by the expulfion of oxygen from the blood is equally 
 impracticable. Dr. Girtanner indeed has expelled ox- 
 ygen from flefli; but we know not in what proportion, 
 nor can we determine whence it came. With regard to 
 this laft, indeed, there are two fources allowed by Drs. 
 Beddoes and Girtanner themfelves; viz. the abforption 
 of oxygen by the lungs, and the quantity taken in with 
 the aliment. A third fource was alfo manifeft from Dr. 
 Girtanaer's experiments ; viz. abforption from the at- 
 mofphere ; for, by expofure to the atmofphere, flefh, 
 which had once parted with its oxygen, became again 
 impregnated with it. In this cafe therefore we mud 
 acknowledge that the uncertainty of the abforption by 
 the lungs muft be extremely great. A certain quantity 
 of oxygen is undoubtedly thrown out in fixed air. How 
 are we to determine this quantity ? Certainly not by the 
 firft reverie that happens to occupy our imagination, 
 It is a problem, the folution of which miaft be attended 
 with the utmoft difficulty. We muft know, in the firft 
 place, how much oxygen was contained in the air infpi- 
 red. In the fecond place we muft know the quantity of 
 fixed air expired. In the third place we muft exactly 
 know the proportion of oxygen contained in the fixed 
 air thrown out by the breath. In the fourth place we 
 muft determine whether, by the cqnverfion of oxygen 
 into fixed air, any change is made in its bulk. For, if 
 this (hall be jfound to be the cafe, we fhould be led to 
 fuppofe an abforptjion or augmentation of air when no 
 {uch thing took place. This point therefore ought to 
 be determined with the utmoft accuracy. In the fifth 
 place we muft exactly know how much azote, Jepton, 
 phlogifticated ak is contained in the atmofphere infpired, 
 
 and 
 
6( 
 
 , A TREATISE ON 
 
 and likewife in that expired. In the fixth place, we 
 muil be allured that there are no other fluids in the at- 
 mofphere capable of being abforbed by the lungs, ex- 
 cepting oxygen and azote. Whether there are any 
 others or not, hath not been determined. From an 
 exprefiion of Dr. Fordyce, he would feem to be Ikeptical 
 on the fubject. " The atmofphere (fays he) is found 
 " to confift of various vapours, of which air, or, as it 
 " has been called, pure air, or refpirable air, (oxygen air) 
 " forms at prefent about a fourth. Gas (probably fixed 
 <c air) forms fome part ;>f but the greateft part confifts 
 " of one or more vapours, which, without any pofitive 
 quality, but from that indolence which makes mankind 
 in their refearches attempt to find a rejling place, have 
 4< been confidered by many chemifts as one individual fpecies, 
 " -under the names of phlogifticated air" &c. In the fe- 
 venth place we ought to know what quant ity of pure oxy- 
 gen, unconverted into fixed air, or whether any fuch, is 
 thrown out by the breath. That a quantity of this 
 kind of air is really thrown out, is probable, becaufe we 
 can blow up a fire with our breath, and by a blow-pipe 
 excite a moft jntenfe heat, capable of melting the moft 
 refractory metals, platina excepted. It is true that the 
 eolipile, by the mere converlion of water into fteam, will 
 blow up a fire alfo ; though, if the accefs of external air 
 be denied, the blaft of the eolipile will put the fire out. 
 Probably the breath would do the fame ; but even this 
 cannot be accounted a decifive proof of the oxygen be- 
 ing totally exhaufted ; for the moift vapour with which 
 the breath abounds may extinguifh the fire, even though 
 fome fmall quantity of oxygen fhould remain in it. It 
 is not, however, our bulinefs at prefent to enter minutely 
 into fuch difcuftions. From what has been already faid, 
 
 it 
 
 r It is now acknowledged that common atmofpherica! air contains a portion 
 of what Dr. Black and Dr. Prieftley have called fixed air ; but this portion is 
 fo fmall (not more than one fiftieth part, according to Dr. Anthony Fothergill's 
 Prize Diflertation, and none at a//, according to Dr. Beddoes) I fay, this 
 proportion is fo fmall, that we cannot fuppofe it to conftitute the quantity of 
 fixed air thrown out by the breath, which is very conliderable. Bolides, fixed 
 air, of all others, is the moft readily abforbed ; and, indeed, if we could admit 
 of abforption of any balis of air in the prefent cafe, it certainly ought to be 
 that of fixed air ; but where fuch a quantity is thrown out, we cannot w,el3 
 of any abibrjuion. 
 
THE PLAGUE. 143 
 
 it is evident, that the abforption of oxygen by the blood, 
 inflead of being indubitably eftablifhed, is of all things 
 the moft uncertain ; the requifites for determining it be- 
 ing abfolutely beyond the inveftigation of any perfon, 
 however accurate. We may indeed, with great labour 
 and trouble, determine that fome part of the air is ab- 
 forbed in breathing ; but what that part is, we are un- 
 able to difcover from any chemical inveftigation. The 
 opinion of the iimplicity of metals, and their being re- 
 duced to a calx by the adhefion of oxygen, has been 
 fo implicitly, and in a manner univerfally, received, that 
 it has given a new turn to phyfiology, fo that, by a kind 
 of analogical reafoning, the human body has been re- 
 duced to a mere chemical apparatus, the operations of 
 which may be calculated as we can do the event of ex- 
 periments in a laboratory. But, after a very long and 
 tedious conteft, Dr. Prieftley feems at laft to have over- 
 thrown this doctrine of oxygenation, even in the inani- 
 mate parts of the creation ; fo that we can much le(s 
 apply it to the doctrines of life and animation. His 
 experiments are publiflied in the third number of 
 the Medical Repofitory, volume II, and fully demon- 
 ftrate, that, though mercury abforbs oxygen dur- 
 ing calcination, this is not the cafe with all metals ; 
 that in many cafes the oxygen will unite with other 
 fubftances in preference to the metal, which laft is ne- 
 verthelefs reduced to a calx as though it had united with 
 the oxygen ; that in many cafes the addition of weight 
 gained by the calx is owing to mere water, &c. He 
 has likewife iliown that phlogifticated air (azote) is not 
 a fimple fubftance, as has been taught by the new che- 
 mifts, but confifts, as well as fixed air, of an union of 
 oxygen with carbon, or at leaft with the black matter 
 of burnt bones, with which he made the experiment. 
 Thefe aerial fluids therefore being fo eafily convertible 
 into one another, and the uncertainty of the changes in 
 bulk which may occur in confequence of thefe conver- 
 fions fo great, it is impoffible to fay whether a portion 
 of the atmofphere in fubftance, i. e. both oxygen and 
 azote, is abforbed, as phyficians formerly fuppofed ; or 
 
 whether 
 
i 4 4 A TREATISE ON 
 
 whether a portion of oxygen air alone be abforbed, as Dr. 
 Beddoes fuppofes ; or whether only the elaftic principle 
 itfelf is abforbed, and the diminution in bulk made in 
 confequence of the conversion of oxygen into fixed air ; 
 I fay, thefe matters depend on circumftances fo much 
 beyond the reach of our fenfes, that if we come to any 
 probable conclufion upon the fubjeet, it muft be by 
 analogical reafoning from other known facts, not from 
 experiments made directly upon the living body ; which, 
 in their own nature, muft, Iways be extremely vague and 
 uncertain. 
 
 5. That, during the circulation, the blood charges 
 itfelf with carbonic hydrogen air, is an affertion which 
 cannot be eafily admitted. It has already been obferved, 
 that, by the air-pump, venous blood does not appear to 
 contain any elaftic fluid whatever ; and it is alfo certain** 
 that animals cannot bear any quantity of air injected 
 into their veins. Dr. Girtanner himfelf tried feveral 
 kinds, and all of them proved fatal. Having injecteti a 
 considerable quantity of oxygen air into the jugular vein of 
 a dog, the animal raifed mod terrible outcries, breathed 
 very quickly, and with the utmoft difficulty -, by little 
 and little his limbs became fliff, he fell afleep, and died 
 in lefs than three minutes. On injecting into the vein 
 of another dog a fmall quantity of phlogifticated air, the 
 animal died in twenty feconds. With carbonic acid gas 
 (fixed air) a third dog died in a quarter of an hour. A 
 fourth was killed in fix minutes by nitrous air.* From 
 thefe experiments, had no others ever been made on the 
 fubject, it feems very probable, that no fpecies of air can 
 be fafely admitted into the blood in its elaftic ftate. If 
 any fuch therefore mould naturally be produced in the 
 body, it muft either be inftantly thrown out, or difeafe 
 muft enfue. Such objections to the Doctor's theory are 
 fo natural, that we might have thought he would have 
 forefeen and provided againft them, Inftead of this he 
 grounds the whole upon fuch ilender evidence as could 
 not be admitted in the moft trifling matter. " An in- 
 
 " cifion 
 
 * Nitrous air is that fuffbcating vapour which arifes when aqua fortis -is- 
 poured upon metals. When taken into the lungs It deltroys animal life more 
 quickly than any other fpecies. 
 
THE PLAGUE; 145 
 
 ^ eilion (fays be) wa? made in the jugular vein of a flieep, 
 " and the blood which came from it. was received into a 
 " bottle filled with nitrous air. When the bottle was 
 " half filled, it was clofed. The blood coagulated im- 
 " mediately, and a feparation of a great quantity of black- 
 " im ferum took place. The day after, on opening the 
 " bottle, a Very ftrong fmell of nitrous ether (dulcified 
 " fpirit of nitre) was perceived, the nitrous air having 
 " been changed in part into nitrous ether by the car- 
 " bonic hydrogen gas of the blood. This experiment 
 " proves, beyond a doubt, that the venous blood contains 
 " carbonic hydrogen air ; and that this air is not very in- 
 " timately mixed with it, but may be expelled with the 
 greateft eafe." 
 
 On reading the Doftor's account of this experiment, 
 it mud be very obvious, that, however decidedly he may 
 be of opinion that it proves beyond a doubt the exiftence 
 of hydrogen air in the venous blood, yet there is not one 
 folid reafon, from what he fays, for fuppofing any fuch 
 thing. How can any man determine from the mere 
 fmell offteep's blood taken out of the body of the animal j> 
 and mixed with a poifonous vapour, what is the compofi- 
 tion of human blood in the living body ? In the cafe 
 of any fubftance fufpefted to contain elaftic air, the air- 
 pump will always afford an experimentum cruets. But we 
 know that venous blood does not yield any elaftic vapour 
 by the pump : if inftead of bloody however, we mould 
 fill a portion of vein with beer, cyder, or other fermented 
 liquor, it would inftantly difcover, by its fwelling up, 
 that it really contained air in an elaftic ftate. If then 
 from the tumefa&ion of the vein when filled with fer- 
 mented liquor we conclude that the latter contains fixed 
 air, why fh-ould we not, from the non-tu'mefaelion of it 
 when filled with blood, con-elude that the vital fluid 
 contains no air ? If Dr. Girtanner was fo well allured 
 that the venous blood contains hydrogen air, he ought to 
 have expelled fome of it from a portion of the blood, 
 .noted, the difference between the blood which had loft 
 its air, and that which had not, and then, by adding the 
 air to it again, reftored the blood to it? former ftate 
 
 U Nothing 
 
146 A TREATISE ON 
 
 Nothing lefs then recompofition can prove the truth of & 
 chemical analyfis ; as divifion can only be proved by 
 multiplication, or multiplication by divifion. 
 
 From all that has been faid, we may fairly conclude, 
 that no proof can be brought fbfficient to prove the ex- 
 iltence either of oxygen air or any other fpecies of aerial 
 fluid, in its elaftic ftate, in the blood. Neither can we 
 prove that any part of the condenfable part of oxygen 
 air is received by the breath in the lungs. It is, how- 
 ever, probable that this condenfable part may be received 
 into the ftomach with our food - s that having pafTed 
 through the various channels of circulation, and arrived 
 at-laft at the furface, it there refumes its aerial nature by 
 combining with the fuperfluous heat of the body, and is 
 evaporated through the pores of the fkin by infenfible 
 perforation. The aerial vapour which pafles off by thefe 
 pores indeed has been difcovered to partake of the nature 
 c& fixed air ; but we know that this fpecies of gas always 
 contains the ban's of oxygen, being indeed compofed of it ; 
 and whether the oxygen be taken into the body in its 
 pure ftate or not, the refult would undoubtedly be the 
 fame ; for an union would be formed between it and 
 the carbonic particles to be thrown off from the body. 
 But thus we can never fuppofe the bafis of oxygen or 
 any other air to be a permanent part of the compofition 
 of our bodies ; nor can the quantity of it be augmented 
 by breathing any kind of air. The readied way to in- 
 creafe the quantity feems to be by drinking fermented 
 liquors. Thus, if the body is too hot, the fuperfluous 
 Leat will have a proper fubje6t to aft upon, viz. the con- 
 deniable part of the fixed air ; and hence we may per- 
 haps account for the very grateful and cooling fenfation 
 produced by drinking thefe liquors in fome difeafes. 
 With Fefpeft to the exiftence of carbon^ charcoal or hy- 
 drogen in the blood, it is probable that it exifts in equal 
 quantity at all times, being indeed the fundementai ma- 
 terial of the whole body, and probably only a modifica- 
 tion of that duft from whence man was originally taken. * 
 
 When 
 
 * In one of Dr. Prieftley's papers above quoted he fays, that c barceal is en- 
 tirely of vfgetab/e origin j but the converfion of vegetable into animal mat- 
 ter. 
 
THE PLAGUE. 147 
 
 When the blood therefore grows very black, when the 
 teeth are covered with a black fordes, the hands become 
 foul, &c. we may fay, indeed we too furely/^/, that, in 
 fuch cafes, there is a propenfity in the body to return to 
 its original ftate of diflblution ; but there is not one folid 
 reafon for fuppofing the proportion of its materials to be 
 varied ; that there is a collection of oxygen in one part, 
 hydrogen in another, or in mort that nature can admit of 
 any fuch difproportion taking place. 
 
 6. We muft noiv confider Dr. Girtanner's account 
 of the origin of animal heat, which is, that, " during 
 " the diftribiition of the oxygen through the fyftem^ 
 " the heat which was united with this oxygen efcapes ; 
 " hence the animal heat ;" and, " that the great capa- 
 *' city of the arterial blood for heat is owing to the oxygen 
 " with which it is united in the lungs." This leads us 
 to confider in a more particular rnanner the doctrine of 
 heat, a fubjed hitherto much lefs inveftigated than the 
 importance of the fubject requires. What little we do 
 know of this matter feems to be almoft entirely owing to 
 Dr. Black, who hath difcovered fome very remarkable 
 phenomena unknown to former philofophers. His dif- 
 tovery here, as in that of fixed air, was accidental. Mak- 
 ing experiments on the water of different temperatures, 
 he found that the mixture would always be an arithme- 
 tical mean betwixt the two quantities mixed. Thus, 
 
 on 
 
 ter, which we daily fee, is an undoubted proof that there cannot be any ef- 
 fential difference between them. Even the bones are undoubtedly produced 
 from vegetables in fuch animals as feed upon vegetable fubftances ; fo that 
 even the calcareous earth they contain is plainly of vegetable origin. We may 
 fay indeed that the calcareous particles had a previous exiftence in the vege- 
 tables ufed by the animal as food ; but we may fay the fame of the particles 
 of the blood, flefli, horns, &c. Befides, Dr. Prieftley has ihewn that every 
 particle ot charcoal may be volatilized into inflammable air, with as great ac- 
 curacy as any human experiment can be made; fo that in this eafe the calca- 
 reous particles, if any fuch there were, fhowed themfelves to be as much 
 charcoal as the reft. In the 74th volume of the Philofophical Tranfadions, 
 Mr. Watt has fhown, that dephlogifticated fpirit of nitre may be changed into 
 the fmoking and phlogiflicated kind by means of red-lead or magnefia alba t 
 as well as by charcoal ; of confequence there can be no effential difference 
 even there. In fhort, fo wonderful and multifarious are the transforming or 
 metamorphofing powers of nature, that every attempt to find out a fubftance 
 upon which thel'e powers cannot aft, will be found altogether vain, and 
 our beft conducted and mod plauiible experiments, made with a vie'w to dif- 
 cover the ultimate compolition or what we call the elements of bodies, will be 
 found mere inaccuracy, bungling and blunder. . 
 
A TREATISE ON 
 
 on mixing water at 50 degrees with an equal quantity 
 at IQO, the temperature of the mixture would be 75 
 degrees ; but if inftead of ufing water only he took fhow 
 or ice for one of the quantities, the mixture \vas no lon- 
 ger an arithmetical mean betwixt the two temperatures, 
 but greatly below it ; fo that a quantity of heat ftemed 
 to be totally loft and in a manner annihilated. His at- 
 tention was engaged by this unexpected, phenomenon, and, 
 profecuting his experiments, he found that, when wafer 
 was converted into ice, it really became warmer than it 
 was before j and, by keeping the fluid perfectly ftill 
 during the time that cold was applied, he was able to 
 cool it to 27 degrees of Fahrenheit's thermometer,, which 
 is five degrees below the freezing .point ; but on (bak- 
 ing this water fo cooled, it was'itiftantly converted in- 
 to ice, and the thermometer rofe to 32. Qn reverfing 
 the experiment he found that mere fluidity in water is 
 not fufficient to melt ice. A confiderabie degree of 
 heat is neceffary ; and even when this is previoufly gi- 
 ven to th'e water, the whole becomes as cold as ice by 
 the time that the iee is melted. The refult of his ex- 
 periments in fhort was this : Water, when frozen, ab- 
 forbs an hundred and thirty-five degrees of heat before 
 its fluidity can be reftored : that is, fuppofing a pound 
 of ice at the temperature of 32 to be mixed with a 
 pound of water at the temperature of 32, by adding 133 
 degrees, fo that the temperature of the water is augmen? 
 ted to 167, the ice will indeed be melted, but the tempe- 
 rature of the whole quantity of liquid will be reduced 
 to 32. In this cafe therefore the heat manifeflly affumes 
 two different modes of a6tion ; one in which it adb in- 
 ternally upon the fubftance of the body, without being 
 fenfible to the touch, while in its other date it hath no 
 effect iipon the internal parts, but afreets bodies on the 
 outfide. The former; (late therefore the Doctor diftin- 
 guifhed by the name of latent > the latter by that oi fen- 
 fible heat. 
 
 The fame theory was applied to explain the doctrine 
 of evaporation, and that'ih the moil decifiye and fatis- 
 factory manner. The Doctor found, that, in the 
 
 dift illation 
 
-THE PLAGUE. 149 
 
 diftiljation of water, much more heat was eommuni- 
 Ciited to that in the worm-tub of the ftill, than could 
 be fuppofed neceffary to raife the water diftilled to 212 
 degrees, which is the utmoft that water can bear. In 
 profecuting the experiment he found the quantity of 
 heat abforbed.by the water, when raifed into vapour, 
 truly furprifing; no lefs than a thoujand degrees; an 
 heat more than fufficient to have made the whole quan- 
 tity of fluid that came over red hot. Some objec- 
 tions, however, were made to this theory, even by the 
 Doftor's friends. Mr. Watt, particularly, though he 
 could not deny the theory derived from Dr. Black's 
 experiments, yet fuggefted one, which, had it proved 
 jfuccefsful, would have overthrown the whole. It was 
 this : Let water be diftilled in vacuo, where it boils with 
 a heat of 97 degrees, and the operation muft be carried 
 on with much lefs fuel, and with much greater eafe, than 
 in the common mode. It was faid that, in this experi- 
 ment, Dr. Black was equally concerned with Mr. Watt; 
 but, in a perfonal converfation with the Doctor himfelf, 
 he afiured me that he had no farther concern than fore- 
 telling that the experiment would not fucceed, which it 
 feems did not. The event was as follows : Mr. Watt, 
 determining at all events to try the experiment, caufecl 
 Jo be made a copper retort and receiver, joined together 
 in one piece. In the receiver he pierced a fmalj hole, 
 and, heating both retort and receiver, plunged the latter 
 into cold water. The confequence was, that a confide- 
 rable quantity of water entered the veflel, and was eafily 
 poured back into the retort, as a fubject for diftillation. 
 A fire being now applied, the water was foon raifed into 
 fleam, which filled both retort and receiver, and in a 
 great meafure expelled the external air. The fmall ori- 
 fice in the receiver being now clofed, and the receiver 
 itfelf plunged into cold water, the diftillation went on 
 in vacuo ; for ? as foon as any of the fteam was condenfed, 
 the fpace which it had occupied (according to Dr. 
 Black one thoufand and Jixty-Jix times more than the ori- 
 ginal water) was become abfolutely empty, and more 
 Jteam, rarefied, not by any quantity of fenfible heat, 
 
 but 
 
150 A TREATISE ON 
 
 but merely by that which it contained in a latent flats, 
 would occupy the place of the former. The event of 
 the experiment fliowed the truth of Dr. 'Black's theory. 
 The water boiled, and fteam was rarfed as well as if 
 accefs had been given to the air ; but with this difference, 
 that the upper part of the diftilling veflfel was never heat- 
 ed above what the hand could eafily bear. With the 
 water in the cooler it was quite otherwife. It became 
 hot as ufual, and, by the quantity of heat it received, 
 plainly demonftrated that the vapour, though deftitute 
 of moft of \\sjenjible -heat, yet contained an immenfe 
 quantity in a latent flate. The faving of fuel therefore 
 in the praclice of diftillation, which was Mr. Watt's ob- 
 ject in making the experiment, was quite trifling, and 
 not equal to the trouble of filling the retort with liquid. 
 The do&rine of latent heat thus eftablifhed, furnifhed 
 a folution of many phenomena which could not former- 
 ly be explained in a fatisfactory manner. Thus the 
 melting of all kinds of fubfbnces was found to be owing 
 to an abforption of heat, while their condenfation was at- 
 tended with the contrary. Fluidity in all cafes was ex- 
 plained on the fame principle ; and the more heat that 
 was -abforbed, the more fluid the matter became. Thus 
 water, when in a condenfed or folid (late, abforbs 135 
 degrees of heat before it becomes fluid. A thoufand de- 
 grees more convert it into vapour, and at laft, by paf- 
 jfing through the intenfe heat of a glafs-houfe furnace, it 
 is converted into a brilliant flame, and augments the 
 heat of the furnace to a great degree. Hence the prac- 
 tice in glafs-houfes of throwing water into the afh-hole, 
 the vapour of which, by pafling through the burning 
 fuel, makes the furnace much hotter than it was. In a 
 Jimihr manner were explained the phenomana of cryftal- 
 lization, the dudility of metals, the heat produced by 
 hammering them, and the hardnefs produced by the ope- 
 ration, as well as the operation of annealing, &c. One 
 other phenomenon, a very curious one, (hall be noticed, 
 on account of its being connected with the fubjecl of this 
 trcatife. It is this : Let a fmall veflel filled with vitri- 
 olic ether be put into a larger one of water, and-bot-h 
 
 included 
 
THE PLAGUE. 151 
 
 included in the receiver of an air-pump. On exhauft- 
 ing the air, the ether boils, and is converted into va- 
 pour, while the water freezes. This (hows that heat 
 does not always aft equally upon furrounding bodies, but 
 has a tendency to enter fome in preference to others ; 
 and from other experiments it appears, that this pro- 
 perty has a coniiderable connexion with the denlity of the 
 bodies concerned. 
 
 Thus one flep was gained,- and it was univerfally ad- 
 mitted that heat, in fome cafes, entered bodies, and in 
 others was thrown out of them ; but now the queflion 
 arofe, What is heat ; and by what laws is it regulated, 
 or from what fource is it derived ? Here Dr. Black 
 himfelf was at a lofs ; for, as he fuppofed cold to be a 
 mere non-entity, and only to confift in a comparatively 
 fmaller degree of heat, fome phenomena occurred which 
 would not eafily admit of folution upon fuch an hypo- 
 thefis. With thefe Dr. Black did not meddle much, 
 but others were bolder. Dr. Irving, Profeflbr of Che- 
 miftry at Glafgow, undertook to explain the whole myftery 
 of latent heat upon the lingle principle of attraction. 
 One of the moft puzzling phenomena in the way of Dr. 
 Black's theory had been, that in fome cafes heat and cold 
 feemed to repel each other, and a very remarkable in- 
 fiance of this was, that, in the morning, a little before 
 funrife, when the rays of light pafs through tl)e atmof- 
 phere, a little above the furface of the earth, the air then 
 becomes manifeftly colder than even at midnight. Dr. 
 Irving' s explanation of this was, that that the fun's rays 
 attracted heat from the atmofphere, and thus rendered it 
 colder. Such at lead was the explanation given in an 
 inaugural differtation by Dr. Cleghorn, one of Dr. Ir- 
 ving's fcholars ; for the Doftor himfelf delivered his 
 opinions only to them. In other cafes he fuppofed that 
 different fubftances had different capacities for receiving 
 heat , and, of confequence, mould the/0n, or rather 
 the infernal conjlitution, of the body be changed, the capa- 
 city of it tor receiving heat muflalfo be changed ; and as 
 an attra&ion fubfifts, or is fuppofed to fubfift, between 
 heat and all other fubftances, it is plain that while this 
 
 attraftion 
 
152 A TREATISE ON 
 
 attra&ion fubfifts, if the capacity of any fubftance for 
 receiving heat be augmented, it will imbibe much more 
 than it would have done had its former conftitution re- 
 mained. Thus water in its liquid ftate contains a cer- 
 tain quantity of heat; we may therefore fay that water 
 has a capacity for receiving heat equal to one to ten, or 
 what we pleafe. Vapour has a capacity for containing 
 heat ten times greater than water. Water therefore,- 
 when converted into vapour, will imbibe ten times the 
 quantity of heat that the water contains ; and, again, ori 
 being re-converted into water, the capacity becoming 
 what it was before, the fuperfluous quantity muft be 
 thrown out, as in Dr. Black's experiments. In like 
 manner, when a metal is melted by the fire, the capacity 
 of it for receiving heat is changed : of confequence a 
 great quantity is imbibed, and again expelled by the 
 change of capacity which takes place on its becoming 
 folid ; and thus, from the change of capacity^ in differ- 
 ent fubftances, every phenomenon was folved. 
 
 This db&rine of capacities did not give general fatis- 
 fadlion. Dr. Black himfelf faid of it, that it was nei- 
 ther probable, nor ingenious-* notwithftanding which, it 
 continued to be received, and even very generally adop- 
 ted. Dr. Crawford, fo well known for his writings on 
 this fubject, jias adopted the idea, and Dr. Girtanner, in 
 the paffage above quoted from him, appears to be of the 
 fame opinion. The dodrine, however, had feveral op- 
 ponents, among whom were the Monthly Reviewers. 
 In their account of N ichol Ton's Firft Principles of Che- 
 miftry, they exprefs themfelves in the following manner 
 " We only wiih, that, in the dodrine of heat, he had 
 " avoided, which he might eafily have done, Dr. Craw- 
 " ford's idea of bodies having different capacities for 
 *' heat. In the melting of ice, for inftancc, a quan- 
 " tity of heat is abforbed, without any increafe of the 
 ;< temperature, that is, without making the water fenfi- 
 " bly warmer than the ice before its liquefa&ion 5 which 
 
 " is 
 
 * Thefe words are to be found in the M. S. Copies of his ledures circulated 
 at Edinburgh. Dr. Black himfelr never pubHIhed any thing to the work! ujV- 
 on the tubjett. 
 
THE PLAGUE, ij 3 
 
 " is fa'id to be owing to the water having a greater ca~ 
 " pacify for heat, or being able to hold more of it, than 
 " the ice ; and, in like manner, when converted into 
 " vapour, its capacity is further increafed, or it can hold 
 " more ftilL This appears to us a very unchemical, and 
 " a very inadequate idea of the matter : for, admitting 
 " water to have a greater capacity than ice, how is 'the 
 " change from one ftate to the other to be effe&ed ? 
 " Can the properties which a body is found to poilefs, 
 " after a change has taken place, be afiigned as a caufe 
 " of the change icfelf ? Or will it be faid, that the heat 
 " firft enlarges the capacity, and then hides itfelf in that 
 <c capacity fo enlarged ? We mould think it much bet- 
 " ter to fay, confonantly with the phenomena of other 
 " combinations in chemiftry, that a certain quantity of 
 " heat, uniting with the ice, firft liquefies it, as a certain 
 <c quantity of acid only neutralizes an alkali $ that if 
 " any furplus quantity muft be introduced, that furplus* 
 " remianing free and uncombined, muft ad and be fen- 
 " fible as heat in the one cafe, and acid other $ and that 
 " different bodies require different quantities of heat or 
 " acid to be combined with them, for producing the 
 " changes in queftion."* 
 
 Thus the Reviewers, as well as others, reafoned a pri- 
 ori, and feveral facts were adduced to prove that no fuch 
 changes in capacity could take place* But however 
 ftrong the arguments adduced, or however plain the ex- 
 periments might be, little or no notice was taken of them, 
 and the enlargement or diminution of capacities has been 
 repeated, feemingly by rote, from one author to another, 
 without the leaft inquiry or inveftigation. Dr. Girtan- 
 ner indeed fays that " the oxygen united with the arte- 
 rial blood in the lungs" is the caufe of the great capacity 
 of the arterial blood for heat. But this is affigning a 
 very doubtful caufe for a very doubtful effect. He 
 ought to have proved in the firft place that arterial blood 
 really has this capacity ; for its being hotter than the 
 blood of the veins, only (hews that it parts with more 
 heat to furround ing bodies than venous blood does ; 
 
 X whict* 
 
 * Monthly Reywwi for 17901 p. lf$ 
 
r"54 < A TREATISE ON 
 
 which is a proof that it contains lefs heat, if there be any 
 difference, than that of the veins. But the truth is, that 
 the capacity for containing heat depends rteither on the 
 oxygenation nor hydrogenation of a fluid, but upon its 
 denfity. The more fluid and the more eafily expanfi- 
 ble into vapour that any fubftance is, ttie greater quan- 
 tity of heat it is capable of containing, and vice verfa. 
 This has been fully afcertained by Mr. William Jones, 
 an Englifh clergyman, whofe obfervations on the gene- 
 rally received fyftem of philofophy contain many parti- 
 culars worthy of attention. From his experiments it ap- 
 pears that a piece of red-hot iron, thrown into water, 
 imparts much lefs Jenjible heat to it, and isitfelfmuch 
 more effectually quenched, than by throwing it into an 
 equal quantity of quick- filver of the fame temperature 
 with the water. As the quick-filyer therefore becomes 
 much hotter to the touch than water does upon throw- 
 ing a piece of red-hot iron into it, and as the iron itfelf is 
 much more imperfectly quenched by the metal than by 
 the water, it follows that the latter is capable of contain- 
 ing much more heat than the former. But fuch experi- 
 ments^are not applicable to the blood. Though that of the 
 arteries may be fomewhat hotter than the venous blood, 
 yet the reafon is obvious. The heat is communicated 
 directly to the arterial blood in the lungs ; but during 
 the circulation a part of it evaporates, and the farther 
 cliftant any part is from the lungs, the more cool will 
 the vital fluid be, without regard to any alteration of 
 capacity , which indeed never can be fliown to exift. 
 
 But the moft decifive experiments againfl any fup- 
 pofed alteration in the capacities of bodies for contain- 
 ing heat are thofe lately tried by Count Rumford, and 
 related in the Philofophical Tranfactions for 1798. His 
 attention to this fubject was engaged by obferving the 
 great degree of heat acquired by a brafs gun during the 
 time of boring it,* and dill-more by the intenfe heat 
 (much greater than that of boiling water) of the metal- 
 lic chips feparated from it by the borer. From a confi- 
 
 deration 
 
 n 
 
 * Count Rumford was fuperimtendant of boring th <annon in the work- 
 fhops of the military hofpital at Munich- 
 
THE PLAGUED 155 
 
 deration of thefe things he was naturally led to the fol^ 
 lowing inquiries. " Whence comes the heat actually 
 *' produced in this mechanical operation ? Is itfurnifh- 
 < ed by the metallic chips which are feparated by the 
 " borer from the folid mafs of metal ? If this were the 
 " cafe, then, according to the modern doctrine of caloric, 
 " the capacity for heat of the parts of the metal fo redu- 
 " ced to chips, ought not only to be changed, but the 
 " change undergone by them be fufficiently great to ao 
 " count for #//the heat produced. But no fuch change 
 <c had taken place; for I found, that by taking equal 
 " quantities by weight of thefe chips, and of thin flips of 
 " the fame block of metal, feparated by means of a fine 
 " faw, and putting them at the fame temperature, that 
 " of boiling water, and putting them into equal quanti- 
 <e ties of cold water (that is to fay, at 59^- of Fahrenheit) 
 " the portion of water into which the chips were put, 
 " was not, to all appearance, heated either lefs or more 
 '* than the other portion in which the flips were put." 
 
 From this experiment, feveral times repeated with the 
 fame refult, Count, Rumford inferred, that the heat 
 could not poflibly have been furnimed at the expenfe of 
 the latent heat of the metallic chips. He then proceed- 
 ed to afcertain " hew much heat was actually generated 
 " by friction, when a blunt fteel borer being fo forcibly 
 " (hoved (by means of a ftrong fcrew) againft the bottom 
 " of the bore of the cylinder, [of the machine in ufe] 
 " that the preffure againft it was equal to the weight of 
 " about ten thoufand Ib. avoirdupois, the cylinder 
 " being turned round on its axis (by the power of horf- 
 " es) at the rate of about thirty-two times in a minute." 
 In this experiment the metallic duft or fcaly matter de- 
 tached from the cylinder by the borer weighed only 837 
 grains troy ; but, fays the author, " Is it poffible that 
 " the very confiderable quantity of heat produced in this 
 " experiment (a quantity which actually raifed the 
 " temperature of above 113 Ib. of gun-metal at leaft 70 
 ic degrees of Fahrenheit's thermometer, and which of 
 " courfe would have been capable of melting 6-J- Ibs. of 
 " ice, or making near five pounds of ice-cold water to 
 
 *' boil) 
 
i S 6 A TREATISE ON 
 
 " boil) could have been furnimed by fo inconfiderable a 
 " quantity of metallic duft, and this merely in confe- 
 " quence of a change of its capacity for heat ? As the 
 " weight of this metallic duft (837 grains troy) amoun- 
 " ted to no more than one 948th part of that of the 
 " cylinder, it muft have loft no lefs than 948 degrees of 
 " heat to have been able to raife the temperature of the 
 " cylinder one degree ; and confequently it muft have 
 " given off more than^^-^-v thoufand^ three hundred and 
 "Jixty degrees of heat to have produced the effects which 
 " were actually found to have been produced in this 
 " experiment." 
 
 It was next confidered whether the air did not con- 
 tribute to the generation of this heat ; and our author 
 determined that this could not be the cafe ; becaufe the 
 quantity of heat generated was not fenfibly diminifhed 
 when the free accefs of air was prevented. From ano- 
 ther experiment it appeared that the generation of the 
 heat was neither prevented nor retarded by keeping the 
 apparatus immerfed in water. Here the friction gene- 
 rated fo much heat, that in one hour the temperature of 
 the water furounding the cylinder was raifed from 60 to 
 107 degrees of Fahrenheit, In half an hour more it was 
 raifed to 142 ; at the end of two hours to 178 ; at two 
 hours 20 minutes to zoo ; and in two hours and a half 
 it boiled.* On the whole, Count Rumford concludes, 
 that " the quantity of heat, produced equably by the 
 " friction of the blunt borer againft the bottom of the 
 " hollow metallic cylinder, was greater than that produced 
 " equably in the combuftion of nine zvax candles, each 
 <c three quarters of an inch diameter, all burning at the 
 " fame time with a clear, bright flame." From all thefe 
 experiments, however, our author does not draw any cer^ 
 tain conclusion. " What is heat ? (fays he.) Is there 
 "any fuch thing as an igneous fluid ? Is there any 
 " thing that can with propriety be called caloric ? The 
 " heat produced, in the author's experiments, by the 
 " friction of two metallic furfaces, was not furnifhed by 
 " fmall particles of metal, detached from the larger folid 
 
 " on 
 
 *The quantity was two gallons and a quart, wine meafure. 
 
THE PLAGUE. 157 
 
 ** on their being rubbed together. It was not fupplied 
 " by the air, becaufe the machinery in three experiments 
 " was kept under water, and the accefs of atmofpherical 
 " air completely prevented. It was not furnifhed by the 
 " water which furrounded the machinery, becaufe this 
 * c water was continually receiving heat from the machi- 
 " nery and could not at the fame time be giving to and 
 "receiving heat from the fame body; and becaufe 
 " there was no chemical decomposition of any part of 
 <e this water." At laft he obferves, that the fource of 
 this heat, whatever it is, muft evidently be inexhauf- 
 tible, adding, that "anything, which any infutafed body, 
 * ; or fyftem of bodies, can continue to furnifh without //- 
 *' mitation, cannot poffibly be a material fubjlance ; and 
 * c it appears to me to be extremely difficult, if not quite 
 <c impofiible, to form any diftinct idea of any thing ca- 
 " pable of being excited and communicated, in the man- 
 * e ner the heat was excited and communicated in thefc 
 '" experiments, except it be MOTION." 
 
 On this laft paragraph, however, it is obvious to re- 
 mark, that the whole force of the argument refts upon 
 an injinuation, that the cylinder and borer were infulated, 
 or cut off from all communication with any other ma* 
 terial fubftance. Had this been the cafe, then no doubt 
 it would follow that an endlefs fupply of any thing mate- 
 rial could not be furnifhed by them ; but if, as Dr. 
 Boerhaave and many other learned and intelligent per- 
 ions have fuppofed, fire be an element universally pre- 
 fent, and which becomes fenfible to the touch only in 
 confequence of a particular mode of action, it will fol- 
 low, that no fubftance in nature can be infulated with 
 refpect to it ; but, in whatever place, and for whatever 
 length of time, any fubftance fhall be affected in fuch a 
 manner as to agitate this fluid, there we fhall perceive a 
 production of heat without limitation, even though heat 
 itfelf be no more than the action of a fluid efTentially 
 material, though invifible to us. 
 
 Confiderations of this kind occurred long ago to the 
 writer of this treatife, when by the nature of his employ- 
 ment it was neceflary for him to fpeculate upon thefe 
 
 fubjects* 
 
158 A TREATISE ON 
 
 fubjects. It could not then but appear to him that tru 
 theory of Dr. Black was far fuperior to any that had 
 been publifhed. The opinion, of thofe who fuppofed 
 fire to confift in the vibratory motion of the paticles of 
 folid bodies, feemed altogether untenable. It is impof- 
 fible to explain the phenomena of heat upon ordinary 
 mechanical principles, becaufe, with refpeft to all ter- 
 reftrial fubftances, heat conftantly appears as an agent > 
 while they are merely faffive ; and no man can explain 
 the nature of a caufe from its effect. Thus one of the 
 mod obvious effects of heat is expanjion, or enlargement 
 of bulk, in fu.ch bodies as are heated. But if from this 
 fact we infer that the parts of elementary fire are repul- 
 ,live of one another, our reafoning is certainiy erroneous. 
 In like manner, when we are not fenfible of heat, we 
 are not ^authorifed to conclude that it is not prefent ; 
 for Dr. Blak has demonftrated that it may be prefent 
 in very great quantity, though indifcoverable either by 
 our fenfes or by a thermometer. 
 
 - But, with regard to the theory publifhed by Dr. 
 Black himfelf, it is evident that,. though one part of it 
 refts on the folid bafts of experiment, the other is foun- 
 ded entirely upon hypothecs, and that too an hypothe- 
 lis which cannot admit of being proved by any experi- 
 ment, viz. that cold is a mere negative, and hath no real 
 exiftence in nature. Among many phenomena which 
 -militate againft this opinion, the following experi- 
 ment of M. Geoffrey feems to be the moft remark- 
 able. He took a (mall bafon filled with water, and fet 
 it on a fupport in the middle of a large tub of water, 
 in fuch a manner that the temperature of the water in 
 the tub might communicate itfelf to that -in the bafon. 
 This being afcertained by a thermometer placed in the 
 bafon, he threw a quantity of burning coals into the 
 tub. The effect of this, on the fuppofition that cold is 
 a mere privation of heat, ought to have been, that the 
 heat of the coals, communicated to the water in the 
 Jarge tub, would in a fhort time pervade the fmall ba- 
 fon, and affect the thermometer there. The latter 
 would therefore rife ; but inltead of this it fell feveral 
 
 degrees 
 
THE PLAGUE. 159 
 
 degrees before it began to rife ; for which it doth not 
 appear that any other reafon can be affigned than that 
 the cold is partly repelled by the heat of the coals, 
 and therefore, entering into the fmall bafon of water, it 
 caufes the thermometer to fink previous to its rif- 
 ing. To the fame purpofe we may urge the phenome- 
 non already taken notice of, viz. that the fun's rays, 
 when paffing at fome diftance above the furface of the 
 earth, cool the lower part of the atmofphere. The na- 
 tural folution is, that the heat of the fun partly repels 
 the cold downwards ; and as for the doctrine of attract- 
 ing heat from the atmofphere, Count Rumford has mown 
 that this does not happen in a cafe where we might with 
 much more probability expect it ; not to mention the 
 violence done to the common perceptions of mankind 
 by fuppofing the fun's rays, which are moft evidently 
 the fource of heat, to have any occafion to attract heat 
 from the atmofphere or any thing elfe. 
 
 Laftly, with regard to the capacities of bodies for con- 
 taining heat, the doctrine appears to involve a radical 
 error, of fuch enormous magnitude, that it is impoffible 
 to make any thing of it. This is no lefs than con- 
 founding the heat which flows out from bodies with 
 that which they contain as an effential part of their 
 compofition, and which they cannot emit without being 
 changed into fome other form. Thus the capacity of 
 aqueous vapour for containing heat, according to Dr. 
 Black, is 1000 degrees; yet without decompofing the 
 \ T apour it would have been impoffible to have known 
 this ; for vapour is often extremely cold to the touch, 
 and a thermometer immerfed in it will fink greatly. 
 In fliort, all that we can know about the capacity of 
 bodies for retaining heat is, that they either continue to 
 abforb it, or we may continue to force it into them, till 
 they be reduced to vapour. It is doubtful whether 
 they can receive more; for from the experiment with 
 Papin's digefter, formerly mentioned, it appears that the 
 additional quantity of heat, which the water was made 
 to receive, very quickly left it as foon as the fleam had 
 room to expand. 
 
 But, 
 
160 A TREATISE ON 
 
 But, to come to a conclufion upon this fubject : If 
 we will inveftigate the nature of heat, we muft do it as 
 in other cafes, viz. by making the igneous fluid, caloric^ 
 or what we pleafe to call it, the object of our fenfes ; for 
 we cannot reafon fairly, or indeed come to any rational 
 conclufion at all, by doing otherwife. In this invefti- 
 gation it is neceffary to attend to the particulars men- 
 tioned by Count Rumford. The fluid muft be om- 
 niprefent in its nature, infinite in its quantity* and equa- 
 ble, uniform and inceflant in its action 5 as far as thefe 
 epithets can be applied to any material being* There 
 are only two fluids which we know that can anfwer to 
 thefe characteriftics. " The one is the light of the fun, 
 which pervades all the celeftial fpaces ; the other the 
 electric fluid, which penetrates every terreftial fubftance* 
 Both of thefe produce heat, unlimited in quantity, as 
 well as in duration, provided their action be continually 
 kept up. The mode in which both produce heat is ex- 
 actly the fame, viz. by converging into a focus ; and 
 the greater the quantity, the greater is the heat, and that 
 without any limitation either as to intenfity or duration* 
 With regard to the folar rays, it has long been known 
 that by concentration they would produce heat ; never-^ 
 thelefs it was unaccountably doubted whether the rays 
 themfelves were the matter of heat. One objection to 
 this was, that on the tops of high mountains the air is 
 exceedingly cold, though the fun fhines very bright* 
 But this objection was founded upon an erroneous notion 
 that, wherever the matter of heat exifts, there we muft 
 feel it ; which doth not follow any more than that 
 wherever air exifts there we muft feel a wind blowing 
 upon us. Wind is air in motion, and ^keat is a more 
 fubtile fluid in motion. One demonftration of this is, 
 that, on the tops of the higheft mountains, a burning 
 Jens or mirror will fet fire to combuftible bodies as readi- 
 ly as in the vallies at the foot of them* Neither has 
 heat, properly fo called, and thing to do with air. The 
 focus of a burning-glafs will heat bodies in vacua as well 
 as in the open air 5 and Sir Ifaac Newton has obferved, 
 that if a thermometer be included in the vacuum of an 
 
 air-pump, 
 
THE PLAGUE. 161 
 
 air-pump, it will acquire the temperature of the room 
 nearly in the fame time that another will when included 
 in a fimilar glafs without any exhauftion. 
 
 The fcience of electricity is but of late date; and 
 moil violent and hypothetical difputes have taken, 
 place concerning the nature of the fluid. Its luminous 
 and burning properties naturally led a number of people 
 tofuppofe that it was elementary fire ; but this was op- 
 pofed by others with as much violence as if there had 
 been fomething criminal in the fuppofition. The op- 
 pofition, however, was founded upon the fame error with, 
 that about the folar light. It was imagined that wher- 
 ever elementary fire exiited, there heat mud be felt ; and 
 it was efpecially urged, that electricity, though it pro- 
 duced light, did not produce any heat, except when it 
 exploded with fuch violence as to penetrate the internal 
 fubftance of bodies, agitating their particles, and by this 
 Agitation producing heat. It has now, however, been 
 found, that the ele&ric aura, as it is called, when made 
 to converge in great quantity to the point of a needle, 
 will heat it to fuch a degree as to fet fire to gun-powder. 
 This (hows that heat is occafioned by the conver- 
 gence of this fluid to a focus, and to its divergence from 
 it. In the focal point, heat will always take place. 
 From the experiments of Haukfbee, Beccaria and Prieft- 
 ley, it likewife appears, that electricity will render tranf- 
 parent the moft opaque bodies, fuch as fealing-wax, 
 pitch, &c. which even the mod intenfe light of the fun 
 cannot do. As to the intenfity of the heat produced 
 by it, experiments have fhown, that it cannot be ex- 
 ceeded even by that of the moft powerful mirror. Glo- 
 bules of gold have been vitrified, platina melted, and 
 the moil infufible fubftances reduced to glafs, by means 
 of the electric (hock. From fo many evidences, there- 
 fore, it appears to me impoffible to conclude otherwife 
 than that the light of the fun and the eleftric fluid are 
 the fame thing; and, according to the different modes 
 in which they act, they produce the phenomena of heat 
 and light in all their varieties, befides a multitude of 
 other effects of which we cannot have any perception. 
 
 Y We 
 
162 A TREATISE ON y 
 
 We may indeed, if we pleafe, fuppofe that fome Other 
 thing exifts which is heat itfelf, and that the light or 
 eie&ric fluid fets in motion, attracts, repels, or ads 
 otherwife upon this unknown fornething ; juft as it 
 comes into our heads to fabricate our fyftem. But, until 
 our fenfes can difcover in fome way or other this hidden 
 fubftance, reafon will always fuggeil that it has no exif- 
 tence. We may fay that without fuch a fuppofition we 
 cannot folve the phenomena of heat. But do we ever 
 expect to folve thefe phenomena ; or do we know all 
 that the folar light and electric fluid can perform ? If 
 \ve do not know what they can do, neither do we know 
 what they cannot ; and the invention of other fluids 
 inuft be accounted not only chimerical but ufelefs. 
 
 But, to be more particular : on the fubject of heat 
 people have embarrafled themfelves more with philofo 
 phieal reveries than by any real difficulty, and rendered 
 the matter more ob feu-re than nature has made it. We 
 have already obferved, that by the convergence of light, 
 or of electricity, heat is always produced. Here we can 
 fee the mode in which the fluid acts, viz. firft by con- 
 verging, and then diverging. When the light falls upon 
 a folid body, it is evident, that if it be allowed to flow 
 out as eafily as it flows in, no internal agitation of the 
 parts/or of any fluid contained in them, can take place, 
 Tranfparent bodies therefore are never heated. Again, 
 if the light be not allowed to enter the fubftance of a 
 body, but is entirely reflected,- the body cannot be heat- 
 ed ' y and hence it is very difficult to melt a polifhed 
 metal even by a ftrong burning-glafs. M. Macquer's 
 burning mirror, which vitrified flints, could not melt 
 filver. But, when the light falls upon a body capable 
 of allowing it to enter its fubftance, at the fame time 
 that it cannot get out without difficulty, it is plain that 
 the force of the fluid will be exerted in order to over- 
 come that difficulty ;. the body will be expanded in all 
 directions - y tfte fluid will be thrown cut in the fame 
 manner, and the more that the internal action of the 
 light prevails over that power by which the parts of the 
 body cohere, the more will the phenomena of heat be 
 perceptible, 'Again, 
 
THE PLAGUE. 163 
 
 Again, let us fuppofe that the etherial fluid enters the 
 fubftance of any body capable of being dilated to a great 
 degree, it is equally plain that the action of the fluid 
 muft for fome time be directed only upon the internal 
 parts, and confequently will be imperceptible on the 
 outfide. This then is called latent heat ; and where the 
 prefTure on the outfide balances that on the infide no 
 heat will be perceptible to the touch. But by whatever 
 means this balance is broken, heat will inftantly be per- 
 ceptible ; and experiments (how that the balance may 
 be broken either by an increafe of cold or heat. Thus, 
 in the cafe of water, the internal preflure remains equal 
 to the external, until the fluid is cooled to a few degrees 
 below 32. The balance is then broken, and the inter- 
 nal action prevails ; a quantity of what is called fenfible 
 heat efcapes, and the water is converted into ice. Again, 
 at the temperature of 32, little or none of the water eva- 
 porates y but by the addition of heat, by which the in- 
 ternal action of the fubtile fluid we (peak of becomes 
 greater than the external, the water is converted into 
 vapour ; and it is remarkable that the fame effect takes 
 place on greatly augmenting the degree of cold ; for the 
 evaporation from ice, even in frofty weather, is found to 
 be very confiderable. 
 
 On the whole, from innumerable experiments it ap- 
 pears, that there exifls in nature a certain invifible fluid, 
 by the action of which, when diverging from a centre, 
 heat is produced in the central point. By a certain other 
 power this diverging force is limited, fo that in fome 
 cafes it is not perceptible beyond the furface of the body 
 in which it ads, and then it is called latent heat. In 
 other cafes it is perceptible in a certain degree, and the 
 degree in which it is perceptible hath been called the 
 temperature Gt fenfible heat of the body. On mixing dif- 
 ferent fubftances together it is found, that very often 
 the proportions between the external and internal actions 
 are varied. This has been already obferved, when giv- 
 ing an account of Dr. Black's difcovery of latent heat, 
 viz. that when fnow and warm water are mixed together 
 the temperature of the mixture differs very confiderably 
 
 from 
 
164 A TREATISE ON 
 
 from the arithmetical mean between the temperatures of 
 the two fubftances employed. Dr. Crawford profecuted 
 the experiment further, and found that there were few 
 fubftances which, on being mixed, did not (hew a tempe- 
 rature different from that of the arithmetical mean be- 
 tween the temperatures of the two originally employed. 
 This difference he unfortunately ufed as the foundation of 
 a rule for determinining the capacities of different fubftan- 
 ces for containing heat, and upon this erroneous princi- 
 ple has raifed a fuperftructure, which upon no occafion 
 can be of fervice to fcience, but muft always produce 
 obfcurity and confufion wherever it is introduced. 
 
 With regard to the power which fets bounds to the 
 expanfion of the fluid acting as heat, it is natural to 
 think that it can be no other than the fame fluid acting 
 in a contrary direction, or from a circumference towards 
 a centre ; and thus we (hall always find that the fame 
 fluid, by limiting its own operations, may produce thofe 
 phenomena which have been hitherto deemed fo diffi- 
 cult of explanation. In what manner this limitation is 
 in all cafes effected, or indeed in any cafe, we cannot' 
 pretend to explain. It is fufficient to obferve, that 
 wherever there is a perpetual efflux of any thing, there 
 inuft be alfo a perpetual influx at the fame time, and in 
 proportion to the one the other will be. Thefe two are 
 directly contrary to one another, and, as we fuppofe the 
 fluid to be univerfal, it is evident, that if any part of it 
 be put in motion in a particular direction, 1 the reft will 
 prefs. towards that part where the motion is, in order to 
 keep up the equilibrium. Hence we may eafily account 
 for the heat produced by percuffion or by friction. By 
 hammering apiece of iron, as Dr. Black juftly obferves, 
 the fluid is forced out from between the parts of the 
 metal. The emiffion of this fluid in all dire&ions is 
 heat itfelf -, and no fooner is one quantity thrown out than 
 another fupplies its place with great rapidity, and fo on, 
 until the preffure of the reft in fome way or other coun- 
 teracts the emiffion of any more, and the heat ceafes. 
 Tuft fo with. friction. The heat produced by it is al- 
 ways in proportion to the preffure employed. By this, 
 
 preffure 
 
THE PLAGUE. 165 
 
 greffure the parts of the two fubftances are forced into 
 Fuch clofe contad, that an agitation and emiffion of the 
 fluid pervading their fubftance takes place. This agi- 
 tation, as we have already noticed, is heat itfelf, and, as 
 long as the friftion is continued, more and more heat 
 will be produced, without any limitation, as Count Rum- 
 ford has obferved. 
 
 Some bodies have a greater difpofition than others to 
 emit this fubtile fluid ; and thefe we fay are naturally 
 of a warmer temperature than others. The temperature 
 is nothing elfe than the efflux of the fluid from them, 
 continually kept up by the a&ion of the furround- 
 ing fluid. By mixture with different fubftances the 
 temperatures of various bodies may be changed ; by 
 fome the influx, and by others the efflux, may be aug- 
 mented. In the former cafe we fay the body becomes 
 colder, in the latter hotter, than before ; and in not a 
 few cafes the agitation of the fluid becomes fo great that 
 the matter a&ually takes fire. In all thefe cafes, how- 
 ever, we can difcover nothing more than the bare 
 fad, that fo and fo is the cafe. We know that the 
 bodies do grow hot by the convergence of the etherial 
 fluid towards them, and its emiflion from them ; but 
 why it fhould converge or diverge we know not. 
 
 Thus much with regard to heat in general. We muft 
 next confider another fluid which has very generally been 
 accounted the fource and fountain of heat, viz. air. 
 This is indeed fo much the fource of heat in all our 
 operations, that it was natural to think it the only one ; 
 but experiments have now determined that air itfelf 
 is a mere creature of heat and light ;* for, by em- 
 ploying thefe in a proper manner, airs or gafes of all 
 kinds have been produced. Thus, by expofing water in 
 a glafs veflel for fome time to the rays of the fun, a 
 quantity of very pure oxygen air may be obtained ; by 
 concentrating the fun's rays upon charcoal, inflammable 
 air may be had ; and by diftilling, with a ftrong heat, 
 fubftances of various kinds, we may obtain a great va- 
 riety of aerial vapours. From all this we may reafona- 
 
 bly 
 
 * J>r. Prieftley thinks water is an tfftntlal in the compofition of air. 
 
,66 A TREATISE ON 
 
 bly conclude that heat, attached to fome other fub- 
 ffonce, diflblved in it in fuch a manner as to become 
 invifible, forms the fubftance of air. Heat therefore 
 being the agent in the competition of air, it is reafona- 
 ble to fuppofe that it is the agent in its decompoiition 
 alfo, or in its transformation from one fpecies to 
 another, of which the converfion of oxygen into fixed 
 air by combuftion is an inftance. When air is 
 taken into the lungs the blood is warmed by the 
 action of that invifible fluid, which has already given 
 eiafticity to the air. In confequence of a confidera- 
 ble quantity of this fluid being then converted from 
 a latent into a fenfible ftate, part of the elaftic principle 
 muft be loft, and the air diminiflied in bulk. The rea- 
 fon why this muft conftantly take place is, that part of 
 the heat evaporates from the furface of the body, during 
 the courfe of circulation. Were it not fo, the quantity 
 thrown out by the lungs would be exactly equal to that 
 which the blood received, and confequently there could 
 be no diminution between the bulk of the air expired 
 and that wliich was infpired ; but, on account of the 
 wafte juft mentioned, the blood muft always receive 
 fomewhat more than it gives out by the breath. Thus, 
 while the air we breathe continues the fame, and the or- 
 ganization of the body is not changed, the natural ope- 
 rations will go on fmoothly, and health will continue ; 
 but, as we have formerly obferved, by an alteration of 
 either of thefe, difeafe muft enfue ; and we muft now 
 endeavour, from the principles laid down, to examine 
 the mode in which epidemic difeafes, and particularly 
 the plague, may be produced. 
 
 The air is fo evidently conne&ed with human life, that 
 it has been from the earlieft ages accounted the fourcc 
 of peftilential difeafes, though, as none of the more ob^ 
 vious qualities of it, fuch as heat, cold, moifture, or 
 clrynefs, appeared to be conne&ed with them, they were 
 generally fuppofed to proceed from the action of fome 
 unknown natural caufe, or from that of the Deity him- 
 felf. Some, however, have alfo been of opinion that 
 plagues might originate from the obvious qualities of 
 
 the 
 
THE PLAGUE. 167 
 
 the air in conjunction with certain effluvia from putrid 
 vegetable or animal bodies. Thus, in feveral plagues 
 mentioned in ancient hiftory, we find fwarms of dead 
 locufts, grafshoppers, the carcafes of thofe flain in bat- 
 tle, crowded houfes, and filth of all kinds, affigned as 
 caufes. This opinion was adopted by Dr. Mead, and 
 he gives the following account of the origin of the 
 plague in Egypt. " Grand Cairo is crowded with in- 
 " habitants, who for the moft part live very poorly and 
 ** naftily ; the ftreets are narrow and clofe ; it is lituate 
 " in a fandy plain, at the foot of a mountain, which, 
 " by keeping off the winds that would refrefh the air, 
 " makes the heats very ftifling. Through the midfl of 
 " the city paffes a great canal, which is filled with water 
 s< at the overflowing of the Nile ; and, after the river 
 " decreafes, is gradually dried up : into this canal the 
 " people throw all manner of carrion, filth, &c. fo that 
 <c the flench which arifes from this and the mud toge- 
 " ther is infufferably offenfive. In this pofture of things, 
 " the plague every year preys upon the inhabitants, and 
 " is only flopped when the Nile, by overflowing, wafhes 
 " away this load of filth ; the cold winds, which fet in 
 " at the fame time, lending their affiftance by purifying 
 " the air." He then proceeds to account for the plagues 
 in Ethiopia in the manner above related, viz. by the 
 prodigious fwarms of locufts, which fometimes occafion 
 a famine by devouring the fruits of the earth, and, when 
 they happen to be caft by the winds into the fea, occa- 
 iion a peftilence j the putrefaction being heightened 
 by the intemperance of the climate, which here is 
 fo great that it is infefted with violent rains for three 
 or four months together ; and it is particularly obferved 
 of this country, that the plague ufually invades it when- 
 ever rains fall during the fultry heats of July and Au- 
 guft. He next takes notice of what the Arabians fay 
 of the origin of the plague in Ethiopia, viz. that it is 
 brought on by unfeafonable moiftures, heats, and want of 
 tvinds. But, whatever truth may be in the account 
 given of the Ethiopia plagues, the teftimonies already 
 produced in this treat ife are fufEcient to render it very 
 
 doubtful, 
 
168 A TREATISE ON 
 
 doubtful, at leaft, whether the plague ever does origi- 
 nate in Cairo, or any other place in Egypt. Befides, if 
 we once admit the exiftence of any thing as a caufe ade- 
 quate to the production of a certain effect, wherever that 
 caufe exifts the effect ought certainly to follow, unlefs 
 where we plainly perceive ibmething which prevents its 
 action. It is not fair reafoning to fay that the action of 
 the caufe is prevented by fomething unknown, for we 
 might as well fay that this unknown fomething is the 
 caufe originally, and acts only upon certain occafions, or 
 when it thinks proper. Now, if the filth of the canal 
 of Cairo be the caufe of the plague in that city, it ought 
 to recur annually at the feafon when that filth exifts in 
 greateft quantity, and in the moft putrid ftate. Never- 
 thelcfs we have the exprefs teftimony of Mr. Eyles Irwin, 
 that at the time he was in Cairo there had not been any 
 plague for feven years. The account he gives of it is a 
 kind of contraft to that above quoted from Dr. Mead. 
 " Mifir al Kaira, (ays he, or the City of Angwjti* fo called 
 " from the frequent vifits which it has received from the 
 " plague, but commonly called Grand Cairo by us, is iitu- 
 *' ated in iat. 30 degrees 3 minutes N. on an artificial 
 " branch of the Nile. Old Cairo nearly faces the river; 
 " but the new city is removed above a mile from it, and 
 " approaches to the range of mountains which runs 
 " through Upper Egypt, and abruptly breaks off here. 
 /' It is undoubtedly one of the fineft cities in the eaft; 
 "" which, from the prefent ftyle of architecture that reigns 
 " among the orientals, is but a faint commendation. 
 " The houfes are in general built of ftone, and, being 
 " elevated to feveral ftories, would make a grand ap- 
 " pearance, notwithstanding the inelegance of their 
 " ftructure, were not the effect deftroyed by the excef- 
 " five narrownefs of the ftreets. This is one of the 
 " caufes to which the ingenious Dr. Mead afcribes the 
 " birth of the plague in this capital ; but experience 
 " evinces that it arifes from foreign and adventitious caufes* 
 " There has not been a plague here the fe feven years -, which 
 " is rendered more remarkable by the commencement 
 " of the Ruffian war at the date of its ceilation. Nq 
 
 " one 
 
THE PLAGUE. 169 
 
 " one can account for this ; though a year feldom paf- 
 " fed by before without a vilit from it."* 
 
 From this it plainly appears, that, however thefe pu- 
 trid effluvia may concur with other circumftances in pro- 
 ducing the plague, they are by no means the only caufe; 
 otherwife not a fingle year could have pafled in Cairo 
 without a peftilence ; and the very fame thing we (hall 
 find to hold good in every other, let us choofe for a 
 caufe what we will. In order to inveftigate this matter 
 fully, we muft now confider what caufes have been af- 
 figned by phyficians for other epidemical difeafes; and 
 here, to avoid prolixity, we fhall chiefly confine ourfelves 
 to thofe enumerated by Dr. Fordyce as the caufes of 
 fever ; a gentleman whofe very extenfive experience 
 muft give the greateft weight to his teftimony.-j- The 
 principal caufes afiigned by him are, 
 
 i. Infe8iQH, or " a peculiar matter generated in the 
 " body of a man in fever, which is carried by the at- 
 " mofphere, and applied to fome part of the body of a 
 '< perfon in health, and which caufes fever to take place 
 " in him." That fuch a caufe exifts, he proves from ob- 
 ferving that " of any number of men, one half of whom 
 <c go near a perfon ill of a fever, and the other half do not, 
 " a greater number of the former will be infeded, in a 
 " fhort period afterwards, than in thofe who do not." 
 He fays he has known, in fuch circumftances, feven out 
 of nine infeded with the difeafe. This infedion is not 
 difcoverable by fmell or any other organ of fenfe ; nei- 
 ther can the greateft attention to cleanlinefs difarm it of 
 its malignity. Of this the Dodor fays that he has known 
 inftances; nay, of a perfon going into a room where a 
 fevenfh patient was, and bringing with him the infedion, 
 which was communicated to others in the room to which 
 he came. He owns, however, that by allowing the air 
 to ftagnate in which fevenfh patients are, the infedion 
 
 will 
 
 * Irwin's Voyage up the Red Sea, p. 335. 
 
 v At the time of writing his treatife Dr. Fordyce informs us, that he had 
 
 been *for upwards of twenty years one of the three phyfic4ans of Sr. 
 
 Thomas's Hofpital (in London) whofe walls have contained nearly four 
 
 ' thouland patients every year, where the proportion of fevers to other dif- 
 
 eaks is much greater than the general proportion," 
 
A TREATISE ON 
 
 will become extremely violent and fatal. This may na- 
 turally be fuppofed, even without having recourfe to 
 putrid effluvia ; becaufe, independent of thefe, the im- 
 perceptible infectious matter itfelf will undoubtedly be 
 accumulated in the atmofphere of the room, and act 
 more powerfully than it could have done had it been 
 partly carried off and diluted by attention to cleanlinefs 
 and ventilation. He alfo fays, that " when a number 
 " of pcrfonslive in afmall.fpaee, fuppofing even that they 
 " are kept as clean as poffible, it happens frequently that 
 " fever arifes in fome, often in many of them. It has 
 " been in this cafe fuppofed, and is extremely probable, 
 " that fome peculiar fpecies of matter is produced, capa- 
 " ble of producing fever, on being applied to the body." 
 
 2. Effluvia from -putrid animal or vegetable matters. 
 Of this our author feems to be lefs fully ascertained than 
 of the former, as he does not fay that he has obferved 
 any inftances of fevers arifing from this caufe ; and he 
 concludes by obferving that " either the caufe of fever, 
 " confiding of matter produced in the body of a perfon 
 " affected with thisdifeafe, feems probably different from 
 <c that produced by putrefaction, or might be generated 
 " without any putrefaction taking place." 
 
 3. Cold. Our author " is not difpofed to allow that 
 t; * fudden expofure to cold occafions fever to take place, 
 kC unlefs fome fymptom of the difeafe follows immediately. 
 " If a man had been fuddenly expofed to cold, and con- 
 " tinued in perfect health for twenty-four hours, the au- 
 *' thor would never allow that fever, or any other difeafe, 
 '"' was occafioned by it.. In this cafe (expofure to cold) 
 4 the evidence is much ftronger than in that of infec- 
 " tion ; for the author (Dr. Fordyce) has feen many 
 " inftances where, from expofare to cold, the commence- 
 "' ment of the attack was inftantaneous ; and many are 
 tc to be found in the records of medicine.' 1 
 
 4. Moljlitre. On thisfubjed the Doclor obferves, that 
 the application of water to the body is not a caufe of fe- 
 ver, unlel5 the air has particles of water floating in it , in 
 which cafe fever has eniued more frequently than in 
 ether cafes. Water may exifl in the atmofphere in 
 
 three 
 
THE PLAGUE. 171 
 
 three ftates. i. In fmall drops fufpended in it like duft 
 in water. 2. In vapour. In this cafe the tranfparency 
 of the air is not impaired, and a chemical combination, 
 as it is called, between the air and water takes place, 
 If the atmofphere be hot or denfe, it is capable of com- 
 bining chemically with a larger proportion of water. If 
 therefore the atmofphere mould in this manner be fatu- 
 rated with water, at any particular degree of heat or den- 
 fity, by diminiming either of thefe the vapour will be 
 condenfed, and the water reduced to the former ftate of 
 fufpenfion in fmall particles. 3. Water, heated to the 
 boiling point, emits a fteam, which combines chemical- 
 ly with the atmofphere, till the latter be faturated, after 
 which it aflumes the form of fmall particles ; and this 
 loft is the onlyjlate which has been found to produce fever. 
 
 Moifture will alfo produce fever when applied to the 
 body by wearing wet clothes. Thofe which imbibe or 
 part with heat moft flowly, are leaft apt to produce fevers 
 on being heated. The warmer the atmofphere, the more 
 liable people are to fevers from moifture. 
 
 It has been obferved, that moifture from marfhes, 
 
 ftagnating canals, or where the water runs very flowly, 
 
 is more apt to produce fevers than what proceeds from 
 
 the fea, lakes or rapid rivers. " This (fays the Do&or) 
 
 " has given occafion to fuppofe that fome other vapours 
 
 ec proceed from fuch marfhes befide water, and produce 
 
 " the difeafe. It certainly often happens, that a confi- 
 
 " derable degree of putrefaction takes place in marfhy 
 
 * c grounds, and more efpecially in warm climates ; but 
 
 " it is by no means to be concluded that moifture in the 
 
 " atmofphere always produces fever in confequence of 
 
 * c putrefaction. Putrefaction can only take place in ve- 
 
 " getable or animal fubftances. If water therefore, not 
 
 :c impregnated with either, mould be in fuch a fituation 
 
 :< as to produce moifture in the atmofphere, no putre^ 
 
 " faction can take place ; therefore, if fevers enfue, they 
 
 :c are certainly in confequence of moifture, not putrefac- 
 
 ; * tion. Many inftances of this may be brought, as in 
 
 " the war which took place in Flanders, between the 
 
 <6 tenth and eleventh year pf the prcfent century, an ar- 
 
 !' ray 
 
i 7 z A TREATISE ON 
 
 " my encamped upon fandy ground, in which water was 
 * found in digging lefs than a foot deep, and occafioned 
 " a great moifture in the air, which produced in a few 
 <c days numbers of fevers, although the army was per- 
 " fectly healthy before, and no more fevers were produ- 
 " ced on fhifting their ground. There are a vaft many 
 " other inftances of the fame thing having taken place. 
 " Befides, fever has often arifen immediately in perfons 
 " fitting in rooms, the floors of which had been juft 
 " moiflened with pure water." 
 
 5. Certain kinds of food. On this Dr. Fordyce ob- 
 ferves, that, though food of difficult digeftion undoubt- 
 edly produces a number of difeafes, he has never feen it 
 productive of fever excepting once. Dr. Girtanner re- 
 lates, that the emperor of Germany, having forced a 
 number of his fubjects to ferve as foldiers, and fent them 
 into an unwholfome part of Walachia, where he fed 
 them with a kind of pafte made of bread and water in- 
 ftead of meat, many of them died of the fcurvy. The 
 Doctor, however, does not afcribe this to any pofitive 
 caufe, but to three negatives^ viz. the abstraction of the 
 ftimulus of nutriment ', by feeding on the pafte juft men- 
 tioned ; of the ftimulus of oxygen in the corrupted at- 
 mofphere of Walachia ; and laftly of the nervous ftimuln$ % 
 the mod powerful of all ; the greateft part being engaged 
 by force againft their will. This corroborates what Dr. 
 Fordyce has faid, that bad food is very feldom the caufe 
 of fever ; for among fo many, who ufed the imperial 
 pafte juft mentioned, fome would certainly have been 
 affected by fevers, had it been capable of producing 
 them ; but, as it did not, it is rnoft evident that the 
 deficiency ofJHmuli is not the caufe of fever. 
 
 6. Pajfions of the mind. Thefe are looked upon by 
 Dr. Fordyce to be among the lefs frequent caufes of 
 fever, though it is certain that they have been produc- 
 tive of multitudes of difeafes, and even of fudden 
 deaths ; and Dr. Falconer, in his Prize Differtation, 
 afcribes to the paffions very confiderable effects in fe- 
 vers, and even in the plague itfelf. " Contagious fe- 
 " vers (fays he) afford ftrong inftances of the influence 
 
 ^ "of 
 
THE PLAGUE. 173 
 
 ** of mental affections, both as prophylactics and reme- 
 " dies. The plague is a, remarkable example, and the 
 " fame reafoning extends to other diforders of a febrile, 
 <c contagious nature. Fear, it is well obferved by Dr. 
 
 " Cullen, by weakening the body, and thereby increaf- 
 " ing its irritability, is one of the caufes which, concur- 
 * c ring with contagion, render it more certainly active, 
 " which he afcribes to its weakening effect on the body, 
 4C by which its irritability is increafed. ^Againft this 
 " therefore he directs the mind to be particularly forti- 
 " fied, which isbeft done by giving people a favourable 
 " idea of the power of prefervative means, and by de- 
 <c ftroying the opinion of the incurable nature of the 
 " diforder, by occupying the mind with bufinefs or la- 
 " bour, and by avoiding all objects of fear, as funerals, 
 " pafling-bells, and any notice of the death of particular 
 " friends. Even charms might be ufed with good effect, 
 < could we promote a ftrong prepoflTeflion of their effi- 
 " cacy, either by the confidence they infpire, or by their 
 < engrofling the attention of the mind. It is no lefs 
 "vCertain, that a ftudious regard to promote hope and 
 " confidence in recovery, is equally neceflTary for the 
 " cure as for the prevention of fuch diforders. We 
 " know that contagious fevers have a peculiar tendency 
 " to diminifh the energy of the brain, and of courfe to 
 " debilitate the whole fyftem ; and that this is efpecially 
 " the cafe with the plague, which produces the mod con- 
 " fid erable effects in weakening the nervous* fyftem or 
 " moving powers, and in difpofing the fluids to a general 
 " putrefcency ; and Dr. Cullen is of opinion that tothefo 
 cc circumftances, as the proximate caufes of the plague, 
 " regard ihould chiefly be had, both for the prevention 
 " and cure of this diforder. It muft therefore be highly 
 " neceflary, during the courfe of this difeafe, to attend 
 " to the fupport of the fpirits, as on thefe the vital prin- 
 <; ciples greatly depend ; and they can by no means be 
 " fo effectually kept up as by infpiririg a confidence of 
 
 < recovery." D ^ 
 
 * An intenfehead-ach, uncommon giddinefs, and afuddenlofs offtrength, 
 were the firft complaints of thofc who were feized with this diftemper." 
 
 (Ruflel on the Plague at Aleppo, p. 230 } 
 
i 7 4 A TREATISE ON 
 
 Dr. Zimmerman prefents us with a great number of 
 examples of the influence of the paflions in producing 
 difeafes, or death itfelf ; fome of the moft remarkable of 
 which follow. " All the paflions (fays he) when carried 
 -*' to excefs, bring on very formidable difeafes. Sorne- 
 " times they occafion death, or bring us at leaft into 
 **' imminent clanger. The moft reputable phyficians a- 
 " gree in opinion that terror may occafion apoplexy, and 
 " death ; and indeed they confider apoplexy as the moft 
 * c common effect of violent paflion. Without being 
 " carried to excefs, a paffion will fometimes occafion a 
 " difficulty of breathing, together with a fenfe of ftric- 
 4f ture in the bread, and an hefitation to fpeak ; the 
 " tongue remaining as it were immoveably fixed on the 
 " palate. Hyfterical and hypocondriacal affections are 
 ** fojmetimes the effects of grief in the mod healthy peo- 
 **' pie. Joy is much more dangerous to life than fudden 
 " grief. Sophocles died through joy at being crowned 
 " on account of a tragedy he had compofed in his old 
 " age. The famous Fouquet died on being told that 
 " Louis XIV had reftored him to liberty. The niece of 
 ?' the celebrated Leibnitz, not fufpedling that a philo- 
 " fopher would hoard up treafure, died fuddenly on 
 " finding under her uncle's bed a box containing fixty 
 " thoufand ducats. Violent anger has fometimes pro- 
 <c duced haemorrhages and fubcutaneous extravafations ; 
 " or, fome veflel of the brain being ruptured by thefe 
 tc tranfports, a fatal apoplexy has taken place. There 
 fi have been inftances of exceflive anger being fucceeded 
 <c by epilepfy, colic, or a violent degree of fever. Some- 
 " times it has occafioned an increaled flow of bile. In 
 " fome this produces vomiting ; in others it goes off 
 v; downwards, and caufes diarrhoea-; or being retained, 
 ws from a ftri<fture of the gall-ducts, will perhaps be ab- 
 v '* forbed, and occafion jaundice. In cafes where anger 
 '* has been fucceeded by extreme grief, obftructiohs have 
 %t taken place in the liver. The effects of terror are 
 ' iimilar to thofe of anger, but in general more violent. 
 ^ Sometimes exceflive terror feems to give tomenapreter- 
 
 ..atural ftrength, as is the cafe with madmen and drown- 
 
 ins 
 
THE PLAGUE. 175 
 
 <c ing perfons. In fome cafes it has not only excited im- 
 " mediate convulfions, but caufed them to return peri- 
 < odically. Fear has been faid to make the hair ftand 
 6f upright, and to contract the pores from which the hairs 
 6< iilue in tlie fame manner as cold does. There are in- 
 " fiances in authors even of the colour of the hair be- 
 " ing changed by exceflive fright. Philip V died 
 " fuddenly on being told that the Spaniards had been 
 " defeated, and, on opening him, his heart was found 
 " ruptured. Timid people are more liable than others 
 " to fall lick. A firmnefe of mind is one of the beft 
 <c prefervations againft contagion. Willis has very well 
 ** obferved, that they who fear the fmall-pox the moft 
 " are generally the firft to be attacked with it. Cheyne 
 " allures us that fear is extremely prejudicial in ali epi- 
 " demical difeafes. Dr. Rogers remarks, that fear con- 
 " ftantly increafes the ravages of a contagious difeafe. 
 " Rivinus attributed the propagation of the plague at 
 " Leipfic wholly to fear. The French phyfkians, who 
 *' wrote on the plague at Marfeilles, went fo far as to 
 " deny its being contagious, and afcribed its propaga- 
 " tion chiefly to fear." 
 
 As for the caufe of the plague itfelf, Dr. Fordyce fup- 
 pofes it to be produced by an infedion of a particular 
 kind. That which takes place in Syria and Egypt, he 
 fays, has only been clearly defcribed by Dr. RufTel; and 
 it cannot be gathered from the accounts whether this 
 may be originally produced without having been propa- 
 gated as the firft clafs of infections above mentioned are. 
 ** That difeafe (fays he) called the plague, which ravaged 
 <c this country (England) on .confidering the hiftories of 
 " the difeafe, feems to have been a, fever,* produced by 
 " infections of the firft clafs which have been enume- 
 ' rated." Dr. Moore has given an account of the ori- 
 gin of a plague, which, if it could be depended upon, 
 would decide the queflion concerning the origin of this 
 dreadful diftemper without previous infection. This 
 paffage- is extracted from the Hiftory of the Royal 
 
 Medical 
 
 * This is exprefsly denied by Br. Hodges, who had innumerable opportuni- 
 i'.ei o.f feeing the diftemper. 
 
176 A TREATISE ON 
 
 Medical Society for the years 1777 and 1778. " Dr. 
 " Mitchell, phyfician to the hofpital at Smyrna, ap- 
 " pears, according to a memoir of which he is ftie au- 
 " thor, fent by M. le Baron de Tott to the Medical 
 " Society to believe in the fpontaneity of the plague 
 " (or that it arifes of itfelf without any predifpofing 
 " caufe in the body) for proof of which he cites the 
 " following circumftance : A folitary fhepherd, having 
 " no communication with any body, fell lick while he 
 "was tending his flocks; he went into an inhabited 
 " part, where he communicated the plague with which he 
 " found that he was attacked. This circumftance would 
 " prove much, if it was certain that the Ihepherd had 
 " no communication with others ; if it were known how 
 " long, and with what precaution, he had been fecluded 
 " from company : but the proofs of thefe are too diffi- 
 " cult to be eftablifhed to allow of any conclufion to be 
 " draw from the fact. We are obliged therefore to ac- 
 " knowledge [it to be a doubtful matter] whether it is 
 " in fact a country that is the cradle of the plague ; 
 " what country this is, fuppofing that fuch an one ex- 
 " ids j or, finally, whether it fom'etimes appears fpon- 
 " taneoufly, and whether the firft whom it attacks be- 
 " comes the focus from whence it emanates." 
 
 Dr. Fordyce, in treating of the origin of fever, feems 
 inclined to think that it may arife without any predif- 
 pofing caufe ; and after having enumerated the various 
 caufes already mentioned, and fully confidered them, 
 gives it as his opinion, that *' there muft undoubtedly 
 be other caufes than thofe which give occafion to the 
 diieafe, but which are at prefent totally unknown" 
 In like manner Dr. Moore, fpeaking of the nervous 
 fever, fums up what may be known concerning the 
 caufe of it in the following words. " Upon the whole, 
 " we know that people of delicate, exhaufted and flckly 
 " conflitutions, and thofe whofe minds are iaddened by 
 " deprefling paflions, are greatly predifpofed to this dif- 
 <c eafe, the immediate feeds of which, we alfo know, 
 fcC may be generated in places where human effluvia are 
 " collected and confined. And this is the moft eflential 
 
 " part. 
 
THE PLAGUE, 177 
 
 <c part of qyr knowledge refpecting the caufe of this 
 " difeafe -, and even this little is difturbed with uncer- 
 " tainty : for we fometimes meet with inftances of peo- 
 " pie of robuft conftituiions, who are feized with the dif- 
 " eafe in all its malignity, when they are under no de- 
 " PT effing paffioHy when the difeafe is not epidemic, to 
 " whom we cannot trace it from any place where the 
 *: c human effluvia could be confined in any uncommon 
 :t degree, or from any perfon in the difeafe, of which 
 " perhaps there is no other perfon ill in the neighbour* 
 <c hood for feveral miles round ; and, in fhort, when we 
 " cannot connect it with any of the caufes fuppofed ta 
 c be the fources of the diftemper. On extraordinary. 
 5C occafions of this kind we have" nothing for it but to 
 { fuppofe that, notwithftanding the apparent vigour of 
 " the patient, his body has been peculiarly predifpofed 
 " to catch the infection, and that fome contagion, not 
 " forcible enough to infect any other perfon, has by fome 
 46 means, unobferved, been conveyed to him ; or, if fo 
 " many fuppofitions difpleafe, we may fuppofe at once 
 ;c that there is in forne cafes a fource of this fever which 
 :c has not been fufpected. For, although the numerous 
 [< obfervations that have been made give us the ftrongeft 
 " reafon to think that human effluvia produce this dif- 
 " eafe, we have no right to infer that it cannot arife alfa 
 " from fome other fource." 
 
 To the fame purpofe I fubjoin the very refpectable 
 
 opinion and teftimony of Dr. Patrick RufTel. " In fome 
 
 " epidemical diftempers, the fudden alternations of the 
 
 " air have conftant and manifeft influence ; in others, 
 
 !c though the influence of the air muft be equally ad- 
 
 ;4 mitted, it feems not to depend on fenfible alteration 
 
 14 or lucceflion in the common properties of the at- 
 
 4 mofphere, but on fome inexplicable combination, fome 
 
 (t occult > new, unknown quality. Amongft epidemics of 
 
 [c this laft kind muft be reckoned the plague 
 
 t Should ever that ftate of the air, without the concur- 
 <s rence of which the contagion of the peftilence never 
 cc fpreads, or ceafes to act, be difcovered, and afcer- 
 :c tained by unequivocal marks, the dread of the plague, 
 
 A a ^ universally 
 
178 A TREATISE ON 
 
 " univerfally prevalent, would be greatly 
 " more effectual means of prefervation would be found 
 * c out, and the application of them might fafely be li- 
 " mited to certain feafons. 
 
 " Experience in Turky, where, generally, no precau- 
 " tions are taken in the times of peftilence, clearly evin- 
 " ces, that, in a certain flare of the air, a communication 
 " with infeded places may fubfift without any material 
 <c confequence. The return of the plague at Aleppo 
 " happens at irregular periods ; the intervals are of con- 
 " (iderable, but unequal, length ; and in thofe the com- 
 44 merce with Egypt, Conftantiriople and Smyrna re- 
 " mains uninterrupted. In the intervals between 1744 
 * e 1760, and from 1762 fro 1780, the plague raged fc- 
 " veral times in the places now mentioned, without affect - 
 " ing Aleppo ; and even in two or three years fubfe- 
 " quent to 1762, though it was at Marafh, as well as 
 ce other places not far diftant, with which Aleppo has 
 " continual intercourfe, no inftances were difcovered of 
 cc communicated infection : if fuch happened, they muft 
 "have efcaped my utmoft vigilance ; and the daily 
 4 exercife of my profeffion led me to be very much 
 <c among the natives of all ranks. At the fame time I 
 " have reafon to fufpecl: that infected families from fome 
 *' of thofe places took refuge in Aleppo ; and J know, 
 <c with certainty, that not only fome merchants of that 
 " city, who happened to be at Marafh when the plague 
 " broke out there, returned to their families in the fum- 
 " mer of 1763, but that caravans of various merchandife 
 " arrived in the courfe of the fame fummer. 
 
 " I confider it therefore as an eftabliflied fact in the 
 " Levant, that commerce and intercourfe with infcded 
 <c towns is fometimes attended with no bad confequence. 
 " The fame thing may perhaps by aiTerted, without 
 " reftriftion, of all countries ; but till the figns indicat- 
 " ing a peftilential conftitution be afcertained, no parti- 
 " cular year can be declared exempt from danger. Pre- 
 "dictions founded on planetary conjunctions have been 
 " long exploded ; and figns derived from the known 
 " properties and alterations of the air, are almoft equally 
 
 " fallacious, 
 
THE PLAGUE. 
 
 " fallacious. The feafons concomitant with plagues in 
 " England, as well as elfewhere, have been very diffimi- 
 " lar ; and the fame vifible concurrence, ufually deemed 
 <c peftilential, has often, in the revolution of years, been 
 " obferved to return, in various countries, without pro- 
 " ducing the dreaded confequences. Upon the whole, 
 " from all I have been able to colled, the peftilential 
 " conftitution feems hitherto to be known nly from its 
 " effeds - y neither its approach nor its retreat can bepredicl- 
 " ed -, and its nature remains wrapped up in M y s x E R i o u s 
 
 DARKNESS." 
 
 Having thus feen, that, of the caufes commonly af- 
 figned for epidemical difeafes, not one can be accounted 
 certain and determinate, it now remains to confider one 
 more, and that is 
 
 Contagion. Though this has been generally account- 
 ed the fame with infe&ion, yet by fome it has been rec- 
 koned otherwife - 3 and indeed there feems to be a necefiity 
 for fuch a diftindion : for, though we mould prove ? 
 ever fo clearly, that a difeafe once communicated to one 
 perfon mould from that perfon be communicated to ano- 
 ther, yet the difficulty is to know from whence the firfl 
 perfon had it. This fource, if any fuch can be found, 
 is what we may with the greatefl propriety diftinguifh by 
 the name of contagion, and is the fenfe in which it fhall 
 for the future be ufed in this treatife, the matter commu- 
 nicated from one perfon to another being always called 
 infection. This indeed differs from what many celebrated 
 phyiicians have faid upon the fubjed ; but the diftinc- 
 tion certainly muft exift. Dr. Cullen fpeaks rather in- 
 diftin&ly upon the fubjed:. " We have fuppofed that 
 " miafmata are the caufe of intermittents, and contagions 
 <c the caufe of continued fevers, flridly fo named ; but 
 " we cannot with propriety employ thefe general terms. 
 ; The notion of contagion properly implies a matter arif- 
 " ing from the body under difeafe, miafma^ a matter 
 <c arifing from other fubftances. But, as the caufe of 
 " continued fevers may arife from other fubftances than 
 :c the human body, and may in fuch cafes be called a 
 *' mafaia, and, as other miafmata aifo may produce con- 
 
 ^ tagious 
 
iSo A TREATISE ON 
 
 " tagious diforde'rs, it will be proper to cliftinguifh the 
 * c caufe of fevers by ufing the terms marjli^ or human ef- 
 c< fluvia, rather than the general ones miajma^ or corita- 
 ghn." 
 
 From this -it is not very eafy to determine what the 
 Do&or means when he fpeaks offpecific contagions the 
 caufe of the plague. Dr. Ruffel plainly afcribes it to 
 human effluvia. " The plague (fays he) is a contagious 
 " difeafe ; that is, an emanation from a body difeafed^ paf- 
 " fing into one which is found, produces, in time, the 
 " fame difeafe," &c. There muft, however, undoubt- 
 edly have been fomething originally diftincl: from the 
 human body which gave rife at leaft to thefirft plague 
 that was in the world ; and fome plagues recorded in 
 hiftory are faid to have arifenin this way. Thus, Am- 
 mianus Marcellinus fays that the plague which broke out 
 in the Roman army in the time of Marcus Aurelius 
 arofe from a peftilential vapour confined in a golden cof- 
 fer dedicated to Apollo. Upon opening this, the-tonfa- 
 'gion diffuied itfelf all around, and the infection fpreading 
 from one to another, -produced an almoft univerfal pef- 
 tilence. Ammianus indeed is the only hiftorian who 
 relates this ; another account of its origin is given, p. 
 14, but whether we believe the account of Ammianus 
 or not (which indeed does not appear prbbuble) it is fuf- 
 ficient to fhow what were the received opinions at the 
 iiime. In like manner every one has heard of peftilen- 
 tial effluvia breaking out from the earth, from graves, &c. 
 fo that we certainly look upon this doctrine of contagion 
 as the canfe of difeafes to have been pretty generally re- 
 ceived. We are alfo informed by Dr. Mead, from M. 
 Villani, who wrote the -hiftory of thofe times, that the 
 ^great plague of 1346 began in China, where, according 
 to the report of fome Genoefe failors, it was occafioneS 
 by a great ball of fire that either burft out of the earth, 
 or : fell down from heaven. This is thought incredible 
 by Dr. Mead, and no doubt is fo, but it Ihows the ge- 
 neral opinion, that the original caufe or contagion which 
 produces a plague is diftincl from the infection which is 
 afterwards communicated from one to another. In the 
 
 French 
 
THE PLAGUE. iSr 
 
 French Encyclopedic, we have this account of the ball 
 of fire, or fiery vapour, without any comment. 
 
 As to the opinion of peftilential vapours arifing out of 
 the earth, though we are affured that people have been 
 fuddenly killed by explofions, probably of the electrical 
 kind, or by lightning ifTuing from under their feet, yet 
 we are not furniflied with any well authenticated ac- 
 counts of a -plague having arifen from any fuch caufe. 
 About -1:9 years ago a violent fever raged epidemically 
 through a (mall diftrift m the north of Scotland, which 
 was faid to Imve originated in the following manner. 
 Some young men having heard that a certain place in 
 'their neighbourhood had, in the time of a plague been a 
 burial ground, took into their heads to dig into it. 
 They did ib, and one of them immediately fell lick, but 
 -recovered. The father of two of the young men, exceed^ 
 ingly difpleafed at the conduct of his fons, and appre- 
 jienfi ve of the confequences, ^filled up the hole they had 
 dug hi the ground, foon after 'which he fell fkk and di- 
 ed, and the fever continued to rage in the neighbour- 
 hood for fome time. The mother df another of the par- 
 ties concerned alfo died, and boils broke out on various 
 |>arts of the bodies of the iick. This was the account 
 given in (bme of the newf-papers of the time, and had 
 the matter been thoroughly inveftigated and attefted, 
 would have been decifive in favour of peftilential conta- 
 gion 'being capable of taking up its refidence in the 
 earth. As it ftands at prefent, it can only draw our aN 
 tention to what may happen in another cafe, Ihould any 
 'finiilar one occur.* 
 
 With 
 
 * Though the writer of this Treatife was not at that time on the fpot 
 tvhere this event took place, yet he has as good evidence as any one can hava 
 of what has not fallen under his immediate infpedion, that thefe graves wera 
 opened, that the father of one of the young men died ; and the mother of 
 another, and one of the young men hirhfelf was taken ill, with the eruption of 
 fa/ils on fome parts of his body ; but whether there was any perfon previoufly 
 afFefted with fever in the neighbourhood from whom it might have been de- 
 rived, or any thing which might have ftrongly predifpofed thofe people to it, 
 is unknown. It is indeed no eafy matter to difcover who was the firft per- 
 Ton afteded with an epidemic, as no body choofes to own that either they, or 
 "griy of their relatives were the authors of mifchief, however involuntary, to the 
 "community. M. Chaptal, however, in his Elements of Chemiftry, has fome 
 'curious, as well as ufeful obfervations on the propriety of burying bodies in a 
 Tuflicient fpade and 'at a fufficietit depth j and on the accidents which may 
 
 arifq 
 
182 A TREATISE ON 
 
 With regard to epidemics occailoned by the action of 
 eledricity, we cannot indeed produce any inftance ; but 
 we have one of a diftemper more dreadful than even the 
 plague itlelf ; and that is of a perfon fuddenly ftruck by 
 an ele&ric flafh (generated either in his own body, or 
 in the room where he was) and by this ftroke reduced 
 to a moil deplorable condition, which foon ended in 
 death. The account (lands on the authority of Mr. 
 Jofeph Battaglia, furgeon at Ponte Bofio, who tranf- 
 mitted it to Florence, and is as follows. 
 
 " Don G. Maria Bertholi, a priefl refiding at mount 
 " Valere ir| the diftrid: of Livizzano, went to the fair 
 " of Filetto, on account of fome bufmefs which he had 
 " to tranfad, and after fpending the whole day in going 
 " about through the neighbouring country, in order to 
 " execute comrnifiions, in the evening he walked to- 
 <c wards Fenille, and flopped at the houfe of one of his 
 " brothers-in-law, who refided there. No fooner had he 
 " arrived, than hedeilred to be conduced to his apart- 
 ** ment, where he put a handkerchief between his fhoul- 
 " ders and his (hirt, and, when every body retired, he 
 " began to repeat his breviary. A few minutes after, a 
 " loud noife was heard in Mi\ Bertholi's chamber $ and 
 " his cries having alarmed the family, they haflened to 
 
 " the 
 
 arife from opening vaults and burying grounds. An inftance of this he gives 
 of the ground of a church in Paris being dug up, which emitted a naufeous 
 Vapour, affeding fcveral people in the neighbourhood. 
 
 From M. Chaptal's obfervations it appears, that bodies do not foon diflblve 
 in fuch a manner as to emit nodii'agreeable or noxious effluvia, when buried. 
 M. Becher, he fays, " had the courage to make obiervations during the courfe 
 * of a year upon the decompofition of a carcafe in the open air. The firft 
 ti vapour which riles, he fays, is fubtle and naufeous : fome days after, it has 
 ' a certain four and penetrating fmell. After the firft weeks the flcin be- 
 comes covered with a down, and appears yellowifti ; greenifh fpots are 
 formed in various places, which afterwards become livid and black ; a thick 
 glofey or mouldy fubftance then covers the greateft part of the body : the 
 fpots open and emit a fanies." In fuch as are buried the decompofi- 
 ioa is much more flow ; our author thinks four times at leaft. Accord- 
 ing to M Petit, a body buried at the depth of four feet is not decopi- 
 t>ofed in lefs than three years, avid, at a greater depth the decompofition 
 js ftiil more flow. This decompofitien is favoured by the prefence of wa- 
 ter, and likewiie by fome kinds of earth more than others. It has been 
 proved by Lemery, Geolfroy, and others, that argillaceous earths have very lit- 
 tle cffedl in this way : porous and light earths much more : the roots of vege- 
 tables alfo by abfovhing the putrid effluvia contribute greatly to the final dc- 
 ro'npofition of bodies buried in places expoled to the open air; but in church- 
 es and other covered places the cafe h vaftly diflcrent. Here, fays our 
 
 < author? 
 
THE PLAGUE. 183 
 
 " the fpot, where they found him extended on the floor, 
 " and furrounded by a faint flame, which retted to a 
 " greater diftance in proportion as it was approached, 
 " and at length difappeared entirely. Having conveyed 
 6f him to bed, fuch afliftance as teemed neceflary was 
 4C given him. Next morning I was' called, and after 
 " examining the patient carefully, I found that the tegu- 
 " ments of the right arm were almoft entirely detached 
 " from the flem, and hanging loofe, as well as the fkin 
 " of the lower part of it. In the (pace contained be- 
 " tween the moulders and the thigh, the teguments were 
 " as much injured as thofe of the right arm. The firft 
 " thing, therefore, to be done, was to take away thofe 
 44 pieces of fkin ; and, perceiving that a mortification was 
 " begun in that part of the right hand which had receiv- 
 " fed the greateft hurt I fcarified it without lofs of time ; 
 " but notwithftand' ,g this precaution, I found it next 
 " day, as I had fufpcdted the preceding evening, entirely 
 " fphacelous. On my third vifit, all the other wounded 
 " parts appeared to be in the fame condition. The pa- 
 " tient complained of an ardent thirft, and was agitated 
 " with dreadful convuliions. He voided by ftool bili- 
 " ous putrid matter, and was diftrefled by a continual 
 
 " vomiting. 
 
 author, is neither water nor vegetation ; and confequently no caufe which 
 can carry away, diflblve or change the nature of the animal fluids : and 
 ' I cannot but applaud the wifdom of government which has prohibited the 
 " burying in churches ; a pradlice which was once a fubjed of horror and in- 
 " fecYion. 
 
 * The decomposition of a body in the bowels of the earth can' never be dan- 
 gerous, provided it be buried at a fufficient depth, and that the grave be not 
 ' opened before its complete diflblution. The depth of the grave ought to be 
 * fuch that the external air cannot penetrate it ; that the juices with which 
 ' the earth is impregnated may not be conveyed to its furface ; and that the 
 ' exhalations, vapours, or gafes, which are developed or formed by decompo- 
 fition, Ihould not be capable of forcing the earth covering which detains 
 them. The nature of \he earth in which the grave is dug, influences all its 
 efiedts. If the ftratum which covers the body be argillaceous, the depth of 
 " the grave may be lei's, as this earth difficultly admits a pafifage -to gas and 
 vapour ; but, in general, it is admitted to be neceflary that bodies fhould be 
 buried at the depth of five feet to prevent all thefe unhappy accidents. It 
 " is likewife neceflary to attend to the circumftance, that a grave ought not to 
 ** be opened before the complete decompofition of the body. The term of de- 
 competition is various ; according to M. Petit of tkree years in graves of 
 ' four feet, and four years in thofe of fix feet. The pernicious cuftom which 
 < allows a fingle grave to families more or lefs numerous, ought therefore to 
 be fuppreiTed ; for, in this cafe the fame gave may be opened before the 
 time prescribed. It is likewile neceflaryi to prohibit burying m vaultsj or 
 ** even in t0ffias" 
 
184 A TREATISE ON 
 
 44 vomiting, accompanied with a violent /ever and de~ 
 44 lirium. At length the fourth day after a comatofe 
 " fleep of two hours, he expired. During my laft vilit, 
 " while he was funk in the lethargic fleep of which I have 
 " fpoken, I obferved with aftoniftiment, that putrefac- 
 44 tion had already made fo great progrefs, that his 
 44 body exhaled an infupportable fmell. I faw the 
 44 worms which iffued from it crawling on the bed 7 
 ce and the nails of his fingers drop of themfelves $ fo 
 : ' that I thought it needlefs to attempt any thing farther, 
 54 while he was in this deplorable condition. Having taken 
 " care to get every poflible information from the patient 
 44 himfeif, refpecting what had happened to him, he told 
 44 me, that he had felt a ftroke, as if fomebody had giver* 
 44 him a blow over the right arm, with a large clqb, and 
 44 that at the fame time, he had feen a fpark of fire attach 
 " itfelf to his (hirt, which in a moment was reduced to 
 44 afhes, though the fire did not in the leaft injure the wrift- 
 46 bands. The handkerchief which he had placed upon 
 " his moulders, between his fhirt and his fkin, was per- 
 44 fectly entire, without the leaft appearance of burning, 
 44 his drawers were untouched, but his night-cap was de- 
 44 ftroyed, though a fingle hair of his head was not hurt. 
 *' That this flame under the form of elementary fire, 
 < burnt the ikin, reduced the fhirt to afhes, and entirely 
 44 confumed the night-cap, without in the leaft touching 
 44 the hair, is a faft which I affirm to be true : befides, 
 44 every fymptom that appeared on the body of the de- 
 44 ceafed, announced fevere burning. The night was 
 44 calm, and the circumambient air very pure : no bitu- 
 ** minous fmell could be perceived in the chamber, nor 
 44 was there the leaft trace of fire or of fmoke. A lamp, 
 4< however, which had been full of oil, was found dry, 
 44 and the wick almoft in afhes. We cannot reafonably 
 " fuppofe this fatal accident to have been occafioned by 
 <c any external caufe ; and I have no doubt that if 
 " JVUffei were fcill alive he would take advantage of it 
 44 to fupport an opinion which he entertained, that light- 
 4W ning h fometimes kindled in the human body and 
 " deftroys it." 
 
 Another 
 
THE PLAGUE, 
 
 Another account, to the fame purpofe, is given in 
 Mr. Battaglia's paper. "On the 2ifl of April, 1781, 
 " the firft battalion of the brigade of Savoy fet out from 
 " Tortona, in order to go to Arti, when the weather was 
 " exceflively hot. On the 2zd, having made rather a 
 " forced march, the foldiers fuffered a great deal from 
 u the ardour of the fun, fo that, at the village of Serre, 
 " where they halted, one of them, named Bocquet, a 
 " man of twenty-five years-of age, whofe fkin being very 
 " hard and thick had not perfpired, fent forth a loud 
 " cry* which feemed to announce fome extraordinary 
 " commotion, and inftantly fell down- Mr. Bianet, 
 " furgeon major to the regiment, found the patient in 
 " convuliions. When he was carried to the hofpital 
 " the upper part of his body, to the thighs, appeared to 
 ic to be withered and black, and in a gangrenous ftate* 
 " Mr. Bianet employed fcarifications, but; without ef- 
 " feel: ; it was impoflible to make him fwallow any 
 " thing ; and it was found neceflary to abandon him to 
 " his difmal fate. His body foon exhaled a putrid 
 " fmell, and he died at the end of five hours. That his 
 " diforder might not be communicated to others, he 
 " was interred together with his clothes. Upon in- 
 * ; quiry, after his death, it was found that this man was 
 " addidted to the conftant ufe of fpiritous liquors, and 
 " that he had even drank of them to excefs upon the 
 march." 
 
 Other inftances there are, ftill more terrible, of people 
 actually taking fire and being confumed to alhes by 
 fome internal caufe ; but, as nobody was prefent either 
 at the beginning or during the continuance of thefe ex- 
 traordinary inflammations, nothing certain can be faid 
 about them. That fuch things, however, have hap- 
 pened, is certain, of which one of the moft remarkable 
 inftances is that of Signora Corn. Zangari, an Italian 
 lady. She retired to her chamber in the evening fome- 
 what indifpofed, and in the morning was found in the 
 middle of the room reduced to afhes, all except her face, 
 legs, fkull and three fingers. The ftockings and fhoes 
 flbe had on were not burnt in the leaft. The afhes were 
 
 B b light 
 
186 A TREATISE ON 
 
 light, and on preffing them between the fingers va- 
 nifhed, leaving behind a grofs, {linking moifture y 
 with which the floor was fmeared ; the walls and fur- 
 niture of the room being covered with a moift cineri- 
 tious foot, which had not only ftained the linen in the 
 chefts, but had penetrated into the clofet, as well as into 
 the room overhead, the walls of which were moiftened 
 with the fame vifcous humour. This lady had been 
 accuftomed to ufe a bath of camphorated fpirit of wine 
 when indifpofed. 
 
 Dr. Zimmerman, from the 64th volume of the Phi* 
 lofophical Tranfadions, relates the cafe of a poor wo- 
 man who perifhed in this miferable manner at Coventry 
 in England in the year 1772. " She fell out of bed, 
 cc and was found next morning burnt to death, though 
 " the fire in the grate had been fmall, and the furniture 
 "in the room had fuffered but little. Except one 
 " thigh and leg, there were not the lead remains of any 
 " fkin, veflels or vifcera ; and the greater part of the 
 " bones were completely calcined, and covered with a 
 " whitifh efflorefcence." 
 
 On thefe unfortunate people it has been obferved 
 that they were generally intemperate in the ufe of fpiritous 
 liquors. Of the poor woman at Coventry, whofe cafe 
 has been juft now related, it is faid, that fhe had been 
 in the pra&ice of drinking from half a pint to a quart 
 of rum every day, and this (he continued, notwithftand- 
 ing her being affected with jaundice and other complaints. 
 Mr. Wilmer, who communicated this cafe to the Roy- 
 al Society, concludes it with thefe words : " That her 
 " folids and fluids were rendered inflammable by the 
 " immenfe quantity of fpiritous liquors (he had drank, 
 " and when (he was fet fire to Ihe was probably foon 
 " reduced toadies." 
 
 On other cafes of a fimilar nature it has been re- 
 marked, that the miferable fufferers were " for the moft 
 " part advanced in years, remarkably fat, and had been 
 " much addicted to the ufe of fpiritous liquors, either 
 c * in their drink, or applied in friction to the body ; 
 " whence it has been concluded that thefe people pe- 
 
 " rimed 
 
THE PLAGUE. i&7 
 
 ** riQied by their whole fubftance fponraneoufly taking 
 " fire, the principaLfeat of which had been the entrails, 
 " or the epigaftric vifcera ; and that the exciting caufe 
 " was naturally found in the phlogifton of the hu- 
 " mours, called forth by that of the fpiritous liquors 
 " combined with them."* But folutions of this kind 
 cannot by any means be admitted. We have not the 
 ioialleft reafon to think that either the folid or fluid 
 parts of the bodies of hard drinkers are more inflammable 
 than thofe of other people ; neither is it credible that 
 any perfon could live with his body in fuch a flate. Be- 
 iides, the mod inflammable bodies will not begin to 
 burn unlefs fire actually be applied to them, while others 
 much lefs inflammable to appearance, will yet take fire 
 fpontaneoufly. Thus, even fpiritous liquors themfelves, 
 though they flame violently when thrown into a fire, or 
 when a burning body is applied to them, yet there is 
 not an inftance of fuch liquors taking fire of themfelves ; 
 nay, they cannot even be fet on fire by pouring them up- 
 on a red-hot iron, while, on the other hand, heaps of 
 wet vegetables, which we fhould think fcarce at all in- 
 flammable, do yet very frequently take fire fpontaneoufly. 
 The author lately quoted, however, juflly obferves that 
 M. Bartholi, the unfortunate prieft above mentioned was 
 plainly ftruck firft by electricity from without, a fpark of 
 fire attaching itfelf to his fhirt, and a faint flame furround- 
 ing his body ; fo that the fire did not feem to have 
 been generated in his body, but in the atmofphere. 
 There are inftances of people being furrounded with thefe 
 luminous appearances without being hurt j particularly 
 of a woman at Milan, whofe bed was furrounded with 
 a light of this kind. Mr. Loammi Baldwin, of this 
 country, was alfo furrounded by an electric light, while 
 railing a kite in the time of a thunder ftorm, and Dr. 
 Prieftley makes mention of a gentleman, who, after hay- 
 ing worked an electric machine for a long time in a 
 fmall room, perceived, on leaving it, a luminous vapour 
 following him. But the inftances moft to our prefent 
 purpofe are tome recorded in the Philofophical Tranfac- 
 
 . tions, 
 '* American Mufeuw, vol. xi, p, 148. 
 
i8S A TREATISE ON 
 
 tions, of luminous vapours coming from the fea, attach* 
 ing themielves to corn-ftacks, and fetting fire to them. 
 One of this kind is particularly mentioned inLowthorp's 
 Abridgement f the Tranfadlions, as having taken place 
 in Ireland, coming repeatedly from the fea, and fetting 
 fire to corn and hay, fo that the people were greatly 
 alarmed. At lad they found that it might be driven 
 off by making a great noife, and that it would avoid arty 
 fharp-pointed iron inftrument. Had fuch a vapour at- 
 tached itfelf to a human body, it is poflible that it might 
 have fet fire to it as well as to the flack of corn or hay. 
 Whether thefe accounts render the flory of the Genoefe 
 failors concerning the ball of fire occafioning the plague 
 of 1346 more credible; we leave the reader to judge. 
 They certainly (how, however, that the eleclric fluid will 
 fometimes interfere with the human body in a very ter- 
 rible manner, producing, where it does not kill inftan- 
 taneoully, fymptoms equal to thofe of the very worft 
 plague, as in the cafe of the prieft and foldier above 
 mentioned. 
 
 Another hypothecs concerning the origin of peftilen- 
 tial difeafes is that offwarms of little animals invifibly 
 exifting in the atmofpherc ; which, being taken into the 
 body by the breath, are fuppofed to corrupt or other* 
 wife vitiate the blood and other parts of the body, as we 
 fee in the plague and other epidemic diforders. This 
 hypothefis, fo generally exploded, and fo apparently im- 
 probable, feems to receive fome fupportfrom adifcovery 
 of an infect made by Mr. Henry Baker, F. R. S. and pub., 
 limed in his work entitled " The Microfcope made Ea- 
 fy." He called it the infecl: with net-like arms. " It 
 " lives (fays he) only in cafcades, where the water runs 
 " very fwift. Some of them being kept in a vial of water, 
 Cl mod died in two days, and the reft, having fpun them- 
 Ck felves tranfparent cafes, which were fattened either to 
 " the fides of the glafs, or to pieces of grafs put into it, 
 * feemed to be changed into a kind of chryfulis -, but 
 " before they affumed this form, they altered their fhape 
 ** (in a manner he reprefents by a figure.) None of them 
 " lived above three days ; and, though frefh water was 
 
 " given 
 
THE PLAGUE. 189 
 
 " given them two or three times a day, yet in a few hours 
 " it would ftink to a degree fcarce conceivable, and that 
 " too atfeveral yards diftance, though, in proportion to the 
 cc water, all the included infects were not more than as 
 " one to one million, an hundred and fifty thousand. This 
 " makes it probable that it is neceffary for them to live 
 " in a rapid ftream, left they mould be poifoned by the 
 " effluvia ifiuing from their own bodies, as no doubt 
 " they were in 'the vial." 
 
 From this account it is not difficult to conceive that 
 animals, though exceedingly fmall, may yet emit fuch 
 poifonous effluvia as will deftroy much larger ones ia 
 their neighbourhood. It will by no means be incredi- 
 ble that, had one or two fuch offenfive animals been 
 thrown into a jar containing gold-limes,* the whole of 
 thefe beautiful inhabitants would have perimed at once. 
 Let us fuppofe fuch a thing to have actually happened ; 
 that a malicious perfon had put them in over night, and 
 in the morning the proprietor of the fifties finds them all 
 dead, and the water ofTenfive to the laft degree. He 
 fends for a neighbouring philofopher, who, happening to 
 be ignorant of the exiftence of fuch animals, endeavours 
 to account for the phenomenon upon Come of the receiv- 
 ed principles of philofophy. How much theory would 
 here be wafted, and what endlefs difputes might enfue 
 without even a pqffibility of arriving at the truth ! Juft fo 
 it is with epidemic difeafes. The caufe is invifible, and, 
 until it becomes difcoverable by our fenfes, it can never 
 be known ; for, as has already been obferved, a caufe 
 never can be known merely by its effects, unlefs we have 
 feen it, or fomebody who has feen it gives us informa*- 
 tion. And this will certainly be found to hold good in 
 every inftance, even from the Supreme Caufe himfelf to 
 the diminutive infect juft mentioned. 
 
 Laftly, I fhall confider another pqffible fource of epi- 
 demics, which has besn hinted at by others. Allowing 
 
 that 
 
 * Thegold-fifk is a fmall fpecies of carp, brought originally from China. 
 They are adorned with the rnoft beautiful andrefplendent colours, and are fre- 
 quently kept in jars for pleafure. They fubfift entirely on the water, without 
 any other food. This is by Dr. Fordyce faid to be the cafe with all fifties, pro- 
 ictid the w*ter be impregnated with oxygen. 
 
i 9 o A TREATISE ON 
 
 that infectious matter proceeds from the body of a dif- 
 eafed perfon, as much muft iffue from a tingle patient 
 as is fufficient to bring the difeafe upon thoufands, and 
 with regard to the frnall-pox and fome other didempers 
 we certainly know that it is fo. This infection is diffi- 
 pated in the atmofphere, and intimately combined with 
 it, fo that it becomes imperceptiple and harmlefs ; but 
 we have no realbn to fuppofe that it is annihilated, of 
 cannot be re-produced in its priftine date. Water, 
 though perfectly diffolved, and to appearance deprived 
 of exigence in the air, may yet be precipitated from it> 
 and pour down upon us in deluges. What happens in 
 one cafe may happen in another. The infectious mat- 
 ter, diffolved in the air, may by fome natural caufe be 
 precipitated from it, overlhadowing whole regions, and, 
 if it be not powerful enough to produce the epidemic of 
 itfelf, may certainly predijpoje to it in fuch a degree^ 
 that the flighted additional caufe will bring it on. 
 
 Something indeed of this kind would feem really to 
 be the cafe, otherwife we cannot well conceive why there 
 fhould be fuch a diftincYion of difeafes. Thus the in- 
 fecYion of the fmall-pox is the fame all over the world. 
 The variolous matter will never produce the meafles in 
 any country, nor will the typhus produce a pleurify. 
 The plague manifeds itfelf to be the fame didemper in 
 all its various degrees of malignity,, though even this 
 dreadful difeafe is fometimes fo mild that it does not 
 confine the patient to his bed. There mud therefore be 
 iome certain conditution in the nature of the caufe 
 which produces fuch and fuch difeafes, as certainly as in 
 the feed of particular vegetables, which gives to each its 
 proper appearance and (hape. The caufe of the dif- 
 eafefo modified we may call, with Dr, Cullen, \\sfpecifte 
 tontagion. 
 
 Having thus treated fo largely upon contagion of 
 different kinds, it now remains to confider the objections 
 that have been made to the doctrine altogether. It is 
 indeed furprifing that in fo great a length of time, after 
 the world hath fo often and fo dreadfully fuffered from 
 violence of plagues, the iimple fact, whether it be 
 
 infe-cticus 
 
THE PLAGUE. 191 
 
 infectious or not, fhould not have been determined :. 
 nay, that it mould ilill be queflioned by phyikians of 
 no mean reputation whether fuch a thing as contagion 
 or infection can poj/ibly exijt. Dr. Mofely in his treatife 
 on tropical difeafes treats the whole doctrine of contagion 
 with the utmoft contempt ; calling it " a field for 
 " fpeculation, which has long amufed the pedantry of 
 " the tchools, and ihould never be entered into by prac- 
 " tical writers." Notwithstanding this, however, he 
 doth enter into it, and with fuch bad fuccefs, that in the 
 very firfb paragraph he is obliged to derive the caufe of 
 difeafes from the ftars ! " There are fome difeafes we 
 " know, (fays he) which follow the changes of the at- 
 " mofphere ; but there are others which make their 
 " revolutions, and vifit the earth, at uncertain periods; 
 " for which we can trace no caufe, depending on com- 
 " binations, in which, perhaps, the influence of the -planets 
 <c may have fome fhare." Here we have a ftill wider 
 field for fpeculation than even the fchools have given us $ 
 for the Doctor ought to remember that the influence of 
 a planet^ producing a difeafe, is as truly contagion as 
 the effluvia of a dunghill $ and if we have a wide field 
 to traverfe when tracing it through the earth, we have 
 one infinitely more extenfive in purfuing it through the 
 heavens. But we may be allured that planetary influ- 
 ence does not produce difeafes ; for, if it did, they would 
 in all times of peftilence overfpread the face of the earth, 
 as the influence of the planets, if they have any, cer- 
 tainly does. 
 
 The arguments ufed by this author againft terreftrial 
 contagion are, 
 
 i. "It has often happened that hundreds of men in 
 " a camp have been feized with the dyfentery, almoft 
 " at the fame time, after one fhower of rain, &c. Peo- 
 " pie under fimilar circumftances mult be fubjecl: to 
 " fimilar difeafes : and yet it often happens that dyfen- 
 " tery begins with a few people, and fpreads itfelf by 
 ' degrees until a multitude are affected." 
 
 This argument rather militates againft himfelf ; for, 
 if dyfentery or any other difeafe was occafioned by an 
 
 evident 
 
A TREATISE ON 
 
 evident general caufe operating upon perfons in fimilar 
 circumftances, all of them ought to be taken ill at once $ 
 but Dr. Mofely owns that they frequently are not. 
 There muft, of confequence* be fomething lefs evident 
 which determines the difeafe to particular perfons, while 
 the general caufe operates equally upon all. This lefs 
 evident caufe we call contagion. 
 
 2. " It is incredible that the fmelling a little human 
 " blood, that had ftood fome months in a phial, gave 
 " the man adyfentery mentioned by Pringle ; or that the 
 *' perfon Foreftus fpeaks of got the plague by only putting 
 u his hand into an old trunk ; or that the making an 
 " old feather-bed, which had lain by feven years, raifed 
 " a plague at Wratijlau, which deftroyed five thoufand 
 " perfons in twelve weeks, as related by Alexander Be- 
 ct ned ictus, &c.* Such things may be true, but, when 
 " probability is fhaken, reafon always inclines to fkep- 
 " ticifm." 
 
 Here our author mod evidently contradicts himfelf^ 
 for in the beginning of the paragraph he tells us that 
 the things related wtincY edible ? and in the end of it, that 
 they may be true. The argument, if it may be fo called, 
 is mere affertion. It is incredible that the fmell of putrid 
 human blood in a vial mould produce the dyfentery. 
 Why mould this be more incredible than that fmelling 
 to a charged vial fhould enfure an electric mock to the 
 perfon who did fo ? This is entirely a queftion refpecting 
 a matter of fact, not of fpeculation. The fame is the 
 cafe with the reft. It is not more incredible that, if the 
 infection of the plague was in a trunk, a man mould get 
 the plague by putting his hand in it, than that he fhould 
 be burnt if he put his hand into a trunk full of hot alli- 
 es. Before the Doctor decided in fuch a pofitive man- 
 ner, he ought to have proved that no infection could be 
 contained in a trunk ; but this, though the very point 
 in queftion, he takes for granted, firft telling us that the 
 contrary is incredible, and then that it may be true \ 
 
 3. " We obferve in camps and hofpitals, that thofe 
 tc people whofe dirty employments fubject them in a par- 
 " ticuiar manner to a depravation of 'their habits, feldom 
 
 " efcape 
 
THE PLAGUE. 193 
 
 ** efcape the prefent epidemic 5 and this gives rife to the 
 " vulgar expreflion, and very incorrect notion, of catching 
 " the difeafe. And we obferve that others from the 
 " flighted deviation from regularity lofe the power by 
 " which the body refifts difeafes, and they are alfo at- 
 " tacked. But thefe attacks are not to be attributed to 
 " infection : for thofe people who keep the vital and 
 " animal powers in uniform confederacy, by temperance 
 c< and calmnefsof mind (for fear, by lowering the vital 
 " energy, fubjects the body to difeafe) nourifhing diet, 
 " proper clothing and cleanlinefs, and keeping a free and 
 " regular paiTage for all excretions, are proof againft the 
 " aflaults of foul and peftilential air. Such people fel- 
 " dom fuffer even by the plague itfelf : while all around 
 " them perifh." 
 
 The firft fentence of the above paragraph is fo ob- 
 fcurely worded, that it is difficult to know the author's 
 meaning. I know not of any lawful employment fo dirty 
 that it neceflarily fubjects the perfon who practifes it to 
 a depravation of habit. The next afchbes every thing 
 to intemperance and fear * from which* it feems* we are 
 to infer that none but drunkards, cowards, and dirty* 
 naked ragamuffins, are ever feized with epidemic difeafes. 
 But of this we are able to bring a direct difproof. 1 fup- 
 pofe Dr. Mofely will not fay that the celebrated Prince 
 Eugene of Savoy was either a coward or a drunkard ; 
 that he had a dirty employment, wanted proper food of 
 clothes, or was deficient in perfonal cleanlinefs ; yet, 
 when in the marfhy parrs of Hungary* he was in danger 
 of death from an epidemic dyfentery* notwithstanding 
 that he was fo careful in refpect of diet* that he had 
 pure water brought him every day* probably from a 
 Goniiderable diftance. How came he to be affected by 
 the diftemper under fuch circumftances, while Count 
 Boueval, though as an inferior officer he probably enjoy- 
 ed fewer advantages., remained free from it, taking only 
 a ftnail quantity of Peruvian bark daily ? It is uncertain 
 whether the bark did really preferve him or not * but 
 the cafe of Prince Eugene plainly (hows that fobriety, 
 temperance, valour and cleanlinefs are not fufficient to 
 
 C c ward 
 
 \ 
 
( A TREATISE ON 
 
 ward off an epidemic difeafe, if people come in the way 
 of infection. 
 
 4. " It fhould follow, if contagion were fupported by 
 5< infefted bodies, that no perfon iliould ever efcape 
 '* infection (as at Oxford affixes in 1577*) who was 
 " within the fphere of its action - y and that thofe who 
 " were entirely fecluded from it, and free from all con- 
 " tiguity to infe&ed people, or fubftances, as the col leg- 
 " ers were in the town of Cambridge, when the plague 
 " was laft in England, (liould be exempt from it. 
 
 " Bat, in oppofition to this, Rhazes lived rzo years,, 
 s< and often pradtifed in plagues. Hodges remained in 
 " town, and attended the lick, during the great plague 
 " in 1665. Kaye was in the midil of pradice in the 
 ** fweating ficknefs in 1551, without any inconveniency. 
 " Procopius informs us, that during a terrible plague at 
 ** Conftantinople, in 543, which almoft deftroyed the 
 " whole city, no phyfician nor other perfon got the 
 " plague by attending^ drefiing or touching the fick. 
 
 ir John Pringle, from Stowe's Chronicle, gives the following account of 
 thefe aflizcs. ' On the 4th, $th and 6th days of July were the aflizes held 
 at Oxon, where was arraigned and condemned Rowland Jenkins, for ajedi- 
 ' ticus tongue ; at which time there arofe amidft the people fuch a damp, that 
 ' almoft all were fmothered. Very few efcaped that were not taken. Here 
 * died in Oxon three hundred perfons ; and fickened there but died in other 
 <* places, two hundred and odd. 
 
 The fcffions at the Old Bailey in Weftminfter, in 1650, proved alfo fatal 
 * to many ; of which Sir J'ohn alfo gives an account. I have been informed 
 "* (fays he) that at thofe Seffions, about a hundred were tried* who were all 
 kept in clofe places as long as the court fat ; and that each room was but 
 14 feet by n, and feven feet high. The bail-dock is alfo a frnall room 
 1 taken off one of the corners of the court, and left open at the top : in this, 
 
 * during the trials, are put fomeof the malefadtors who have been under the 
 ** clofeft confinemcRt. The hall in the Old Bailey is a room of only 30 feet 
 
 fquare. Now whether the air was moft tainted from the bar by fome prilbn- 
 ers then ill of the jail diftemper, or by tlie general uncleanlinefs of fuch, 
 ** perfons, is uncertain ; but it is probable that both caufes concurred. And 
 ' we may eafily conceive how much it might have been vitiated by the foul 
 fleams of the bail-dock, and of the two rooms opening into the court in 
 ' which the prifoners were the whole day crowded together till they were 
 brought out to be tried. It appeared afterwards, that thefe places had not 
 
 * been cleaned for lome years. The poifonous quality of the air was aggra- 
 vated by the heat and clofenefs of the court, and by the perfpiiabie matter 
 of a number of people of all forts, penned up for the moft part of the day 
 < without breathing the iYee air, or receiving any refreftiment. The bench 
 
 * conllfted of fix perfons, whereof four died, together with two or three of 
 the eounfel, one of the under fbcriffV, feveralofthe Middiefex jury, and 
 
 * others prefent to the amount of above forty ; without making allowance for 
 
 * th*fe of a lower rank, whofe death may not have been heard of ; and with- 
 out iocludiag any that did not (kken within a fortnight after the feflions. 1? 
 
 Cringle's Qbfervatioiisp. 329 & ieq.), 
 
THE PLAGUE. 1-95 
 
 *' Yet moft of the Capuchins, the Jefuits, the Recoilets, 
 " the Obfervantines, the Barefooted Carmelites, the 
 " Reformed Auguftines, all the Grand Carmelites, the 
 " Grand Trinitarians, the Reformed Trinitarians, the 
 " Monks of Loretto, of Mercy, the Dominicans, and 
 " Grand Auguftines, who kept themfelves fecluded in 
 " their feveral convents, and took every precaution to 
 " avoid the plague, while it raged at Marfeilles, perifhed 
 " by it. 
 
 " There are no epidemical nor contagious difeafes 
 " that attack every perfon who breathes the fame air* 
 " or that is in contact with the infection, elfe whole 
 " regions would be depopulated. The habit muft be 
 " graduated, or adapted, for the reception of a difeafe. 
 " In fome conftittitions of body the accefs is eafy, in 
 " fome difficult, in others impoflible. But where the 
 " .revelation of this myftery is to be found y none can tell" 
 
 Jn this, which our author feems to have defigned as 
 his grand argument, it is plain that the deficiency is as 
 great as in any of the reft. If we fuppofe the plague, or 
 any other epidemic difeafe, to arife from fome general 
 caufe,, let that caufe be contagion or any thing elfe, it 
 .ought to operate upon all who come within its fphere of 
 adion, as Dr. Mofely obferves of infeSlion. If experience 
 (hows that it does not, the argument will hold equally 
 againft a conftitution of the atmofphere, putrid effluvia, 
 heat, cold, or any thing elfe,; and in fad the Doftor 
 fairly gives up the point at laft, by refolving the whole 
 into an unreveakd myftery. With regard to what he 
 .fays about the plague at Marfeiiles getting into the con- 
 vents, of which he prefents us with fuch a catalogue,, it is 
 impoflible to know what precautions were ufed, and we 
 are allured that in Turky it is.thought neceflary for the 
 Europeans not only to guard againft a communication 
 with their own fpecies, but fome of the brute creation 
 alfo. Cats particularly are dreaded fo much, that a 
 general mafTacre of them commences among thofe who 
 ufe precautions, the favourites of that fpecies muft be 
 ifent to a diftance, and M. Volney mentions two mer- 
 chants who had fhut up their houies, and yet had the 
 
 plague 
 
j 9 6 A TREATISE ON 
 
 plague imported by a cat. In (hort, confidering that 
 infection is fuppofed to be altogether invifible and im- 
 perceptible, it is impoflible to fay how it may be convey- 
 ed, 'or to what extent it may occafionally act when once 
 brought into a country. Dr. Fordyceis of opinion that 
 the diftance at which infection may acl depends on the 
 difpofition of the air at the time ; and he obferves, that 
 a difference in this refpect is obfervable in the odoriferous 
 effluvia of vegetables. " If the air be loaded with moif- 
 * ? ture, they reach to a much greater diftance. Vapour 
 <c arifing from a field of beans, for inftance, or a pu- 
 <f trid ditch, is fenfible to the noftrils at a greater dif- 
 *< tance if the air is moift." He obferves indeed that this 
 has never been verified with regard to infection ; but as 
 it is evidently the cafe with putrid effluvia, which very 
 often accompany infection, we may reafonably conclude 
 that it is the cafe with the latter alfo. 
 
 Let us next take a view of what is advanced by the 
 authors of The Science of Life upon this fubject. 
 Mr. M'Lean, who puts his name to this part, informs us 
 of his conviction "that no general difeafe, which affects 
 ** a perfon more than once during life, can ever be com- 
 " municated by contagion ;" and he defines contagion 
 " a fpecific matter, generated in a perfon affected with 
 <c difeafe, and capable of communicating that particular 
 <c difeafe, with or without contact, to another." It 
 would here be no improper queftion, by what means he 
 comes to know that a contagious difeafe can affect a, 
 perfon only once. But even this queftion is unnecef- 
 fary. Dr. Guthrie gives an Account of a gentleman who 
 had the courage to inoculate himfelf for the plague, in 
 confequence of which he had the difeafe with the con^ 
 comitant fymptoms of buboes, &c. Here then we fee 
 the plague communicated by " a fpecific matter gene- 
 rated in a perfon affected " with the fame difeafe, i. e. 
 by contagion, according to Mr. M'Lean's own defini- 
 tion. The difpute therefore might ftop, as this fact 
 feems to be decifwe on the fubject ; but as he has at 
 great length inftfted upon the argument laft quoted from 
 J)r. Mofely, it feems neceflary to follow him a little far-r 
 tbcr. "If 
 
THE PLAGUE. f 197 
 
 " If a perfon (fays our author) be affefted wkh any 
 ** difeafe, it will neceflarily be communicated to every 
 c * other perfon who comes within the infectious diftance, 
 * c and is not at the fame time labouring under fome difeafe 
 " higher in degree. This proceeds upon a fuppofition 
 that his theory is abfolutely perfect and infallible ; which, 
 however plain it may appear to himfelf, will not proba- 
 bly be admitted by others without fome proof. Indeed 
 he himfeif afterwards adduces fome facts which decifive- 
 ly f overthrow it. " A child (fays he) here and thefre is 
 " exempted from fmall-pox, even though expofed to 
 " its contagion. " How comes this to pafs ? Thedifeafe, 
 we are told, is contagious, the child is expofed to the con- 
 tagion, and yet is not affected. In #//fuch cafes it would 
 be ridiculous to fuppofe the fubjects labouring under a 
 difeafe higher in degree than the contagion could pro- 
 duce. In numbers of inftances of this kind the children 
 ivere evidently in good health, and yet would perhaps be 
 feized at an after period when no more expofed to conta- 
 gion than they had been at firft. 
 
 " Small-pox, meafles, and other general difeafes, which 
 " occur only once during life, never difappear, until the 
 <c whole, of thofe who have been within the infectious 
 * c diftance, and were not at the time labouring under 
 *' fome difeafe higher in degree, have received the infec- 
 ^ tion. As thefe difeafes are very mild, children fome* 
 * c times refift the power of contagion from the fuperior 
 <e force of fome other difeafes, although they may be fo 
 " flight as to efcape common obfervation." 
 
 In this paragraph we have the favourite maxim of our 
 author repeated, twice indeed, without a fingle fact to 
 fupport it. Inftead of this we find hypothecs heaped 
 upon hypothecs, as the giants are faid to have heaped 
 mountains upon one another in order to get up to hea- 
 ven. He firft fuppofes that the infection of the fmall- 
 pox feizes on the whole of thofe on whom it falls. The 
 exceptions to this maxim he explains by another fuppo* 
 fition, viz. that the contagion of the fmall-pox is coun- 
 terafted by another difeafe. The fecond hypothecs is 
 fupported by a third, and that a very extraordinary one, 
 
 that 
 
V 9 8 A TREATISE ON 
 
 that the fmall-pox (a difeafe which has deftroyed innu- 
 merable multitudes) is very mild ; and this third by a 
 fourth, that the difeafes which counteracted the conta- 
 gion were fo flight as to efcape common obfervation. It 
 was incumbent on Mr. M'Lean to have pointed out 
 fome of thofe difeafes, and to have informed us how they 
 came to counteract, this contagion. But it is needlefs to 
 argue with one who writes fo extravagantly. Far from 
 the mode of rcafoning followed by Dr. Fordyce, who 
 decided from the majority of facts, our author deter- 
 mines every thing by his own preconceived opinions. 
 " That the power which occafioned difeafe at the Ox- 
 cc ford affizes (fays he) was not contagious matter, is 
 " proved by its producing diarrhoea in fome, while it 
 " produced fevers in others." But, if it was not conta- 
 gious matter, what kind of matter was it ? Or how 
 comes our author to know that thofe who were affected 
 by the diarrhoea were not Irkewife affected by fever ? 
 How many fevers are attended by diarrhoea, or how ma- 
 ny ceafe when diarrhoea comes on ! Jt would have been 
 equally conclufive to fay that the matter was not conta- 
 gious, becaufe fome died and fome recovered. 
 
 I (hall only take notice of one aCertion more, it being 
 'both tedious and unneceiTary to follow him through the 
 whole. " From -every record of epidemic and peftilen- 
 tial difeafes, it would appear, that they have their flated 
 *" periods of recurrence ; that thefe periods are fuch 
 ** months as are mod remarkable for vicifiitudes of the 
 " atmofphere .; that they become general only in thofe 
 " years in which thefe viciflitudes are extreme ; that 
 *' they do not occur in feafons when the heats or colds, 
 *' however intenfe, are equable ; nor in -years when the 
 ** (late of the atmofphere is tempered throughout ; and 
 * c that they 'uniformly ceafe with the eftablifhment of 
 tc an equable flate of the atmofphere, whether the wea- 
 ei ther be cold or hot. . . . In Aleppo, according to Dr. 
 " Ruire],the Europeans regularly (hut themfelves up in 
 ' re their houfes every ytar, at fome period between April 
 " and July j and the rich natives begin to adopt the 
 " fame plan, &c. . . . From this fact it appears, that 
 
 ^ f the 
 
THE PLAGUE. 199 
 
 the plague occurs at Aleppo, in a ftate more or lefs 
 mild, almoft annually, and that it commences and ceafes 
 at certain known periods. But it has been remarked 
 that, in its mod fevere ftate, this difeafe recurs only at 
 periods often years, or thereabouts : a regularity which 
 cannot, upon any known principle, be attributed to a 
 power of fuch cafual application as contagious mat- 
 
 ter." 
 
 In the beginning of this papagraph our author makes 
 a bold appeal to every record of epidemic arid peftilen- 
 tial diforders ; but here we may aik, Has he confulted 
 every record of thefe disorders ? That he has not, we may 
 readily believe - 9 but even thofe which are hinted at feern 
 either to have been very inaccurately confulte'd, or wil- 
 fully mifreprefented. To evince this I fubjoin the fol- 
 lowing abftradt of what Dr. Alexander Rufiel fays of 
 the plague in general, with the annotations of his bro- 
 ther, Dr. Patrick, takjen from Ruffei's Natural Hiftory 
 of Aleppo. 
 
 The inhabitants of Aleppo fuppofe that the plague 
 viiits them once in ten years, and that it is always im- 
 ported j and the moft fevere plagues are thought by 
 fome to come from Damafcus, while others contend 
 that they come from the northward. Dr. Alexander 
 RufTel thinks this popular opinion of the return of the 
 plague not altogether unfounded ; and he thinks it alfo 
 probable that it never invades Alepp without having 
 previoufly attacked either Damafcus or Khillis, Aintab, 
 Marafli or Uufa. He thinks that its appearance always 
 
 "is in one of the maritime towns of Syria ; if in Sidon,. 
 Byroot or Tripoli, Damafcus is commonly the channel 
 by which it reaches Aleppo ; but, if it (hows itfelf firft 
 at Scanderoon or Byafs, its approach is by the way of 
 Khillis or Aintab. 
 
 On this Dr. Patrick Ruflel obferves, that the account 
 of Aleppo being vifited only once in ten or twelve years- 
 is confirmed by. a letter from an Englifli gentleman, in 
 1719, who had refided there for 30 years. The dates 
 
 .of the plagues which Dr. Patrick had procured were, 
 1719, 1729 and 1733. Another began in 1742, and 
 
 terminated 
 
200 A TREATISE ON 
 
 terminated in 1744; from which time there was no 
 return trll 1757 or 1758, when it continued at Aleppo 
 till 1762, and did not entirely quit the country till 1764. 
 The plague of 1719 was faid to come from the north- 
 ward, but this appeared to want confirmation ; but all 
 accounts agree that it raged at Tripoli, Sidon, &c. two 
 months before it appeared in Aleppo. Egypt was ra- 
 vaged by the plague in 1728, as was alfo Byafs and the 
 neighbouring parts in the fame fummer; and next year 
 it appeared at Aleppo. In 1732 it raged at Sidon, Tri- 
 poli and Damafcus ; next year it feized Aleppo. 
 
 Dr. Alexander goes on to inform us, that the difeafe 
 never fprsads much in winter. It advances with the 
 fpring, comes to its height in June, declines in July, 
 and terminates in Augufb. " None (he fays) are ever 
 feized with in September and October, not even in the 
 plague of 1 742, which returned three years fuccefTively ;" 
 but Dr. Patrick fays that this was not confirmed by his 
 experience in 1760, though he owns that the diftemper 
 declines remarkably at that period ; and the natives are 
 greatly inclined to have it believed that the diftem- 
 per has totally ceafed, and to deceive the Europeans in 
 this refpect. The times at which the Europeans fliut 
 up and come out of their confinement ihow only the 
 increafe or decreafe of the difeafe, but not its beginning 
 or ending. The plague of 1719 made terrible havoc. 
 Europeans then iut up about the middle of March, 
 and kept confined till the middle of July. In 1729 
 they did not ihut up till the middle of May, and were 
 not confined above a month, the number of fick being 
 fmall. In 1733 they were confined from the middle of 
 March to the middle of July, but the diftemper was 
 lefs violent than in 1719. In 1742, the time of con- 
 finement much as in 1729. In 1743 Unit up April n, 
 and opened the middle of July. The plague violent, 
 but lefs fo than in 1733. In 1744 few (hut up, the 
 number of fick being inconfiderable. In 1760 they 
 fhut up on the 3Oth of June, and continued about a 
 month. In 1761 mut up May 28, rode out Aug. i, 
 and opened completely the loth of that month. In 
 
 1762 
 
THE PLAGUE. 201 
 
 1762 they were confined from the laft week in May to 
 the firft of Auguft. From 1762 to 1787, a larger peri- 
 od than ufual, the city was free from the plague. In 
 1787 it broke out among the Jews in the month of 
 April 5 increafed in May, raged violently in June, and 
 terminated in July. 
 
 From thefe accounts it appears, as Dr. Alexander 
 RufTel informs us 3 that the plague of one year differs 
 remarkably from that of another ^ but he fays, that, 
 at Aleppo, it is never attended with fuch fcenes of 
 horror as have been known in European countries j for 
 which Dr. Patrick afligns the following reafons : i. The 
 markets are cooftantly fupplied with provifions. 2. The 
 dread of the contagion is much lefs. 3. The fick are lefs 
 liable to be deferted by their attendants (but this, accord- 
 ing to his own obfervation, is not always the cafe) and 
 4. The regular, fpeedy interment of the dead prevents a 
 ipectacle far from uncommon in the European plagues, 
 and which of all others is the moft mocking to humanity. 
 
 " Extreme heat (fays Dr. Alexander) kerns to check 
 " the progrefs of the diftemper. July is a hotter month 
 " than June, and the feafon wherein the plague ceafes 
 " at Aleppo is that in which the heats are moft excef- 
 " five." His experience did not confirm a popular 
 opinion at Aleppo, and which has likewife been adopted 
 by many medical writers, that the moon has any influ- 
 ence on the diftemper. To have had the diftemper 
 once does not fecure a perfon againft future attacks. 
 Numbers of people who were alive when he left Alep- 
 po had it twice or oftener ; and he had inftances of fome 
 being infecled thrice in one feafon. Dr. Patrick Ruflci 
 has observations to the fame purpofe. 
 
 From this it appears, that the popular opinion at Alep- 
 po, which Mr. M'Lean wifhes to eftablifh as a certainty, 
 is by no means fo well founded that we can build any 
 theory upon it. The misfortune is, that, wherever a 
 theory is built upon any thing faid to be conftant and 
 invariable, a Jingle failure overturns the whole. Now, 
 in the dates of plagues above mentioned, the variations 
 are fo great that it is impofiible to draw any certain 
 
 D d conclufiou 
 
202 A TREATISE ON 
 
 eonclufion from them. In the firft: three inftances of 
 1719, 1729 and 1733 there is indeed a coincidence of 
 the firft two, but the laft falls fhort by no lefs than^tf 
 years. What then does Mr. M'Lean mean by his " ten 
 years, or thereabouts ?" Can thereabouts imply a differ- 
 ence of more than half? The Englifh gentleman's tefti-' 
 mony who refided 30 years in that country could extend 
 no further than to three plagues, and even thefe are not 
 mentioned. The fourth inftancein 1742 is deficient in 
 one year -, the fifth rn 1757 or 1758 exceeds by three or 
 four years, and the fixth from, 1762 to 1787 by no lefs 
 than fifteen years. 
 
 Aa anonymous writer in a Scots periodical publica- 
 tion entitled " The Bee," has partly adopted the above 
 opinion, but adds others for which he has not thought 
 proper to adduce any authority. " It vifits weft parts of 
 " AJia once in ten or twelve years, and carries off an 
 " eighth or tenth of the inhabitants. There have been 
 " plagues which have carried off one fourth of the inha- 
 " bitants. The farther eaft you go, the lefs frequent it 
 4C is every 2Oth, 4Oth, and, even at Bailorah, every 
 " 9th year ; but then this fcourge is moft dreadful, 
 * e The laft plague at Bafforah, which had not vifited the 
 <c city for 96 years, carried of more than nine tenths of 
 " the inhabitants.' 1 * It is aftonifhing that people will 
 write in fuch a manner as tofubject themfelves to endlefs 
 eriticifm on account of their incorififtency. The plague, 
 this writer fays, vifits moft parts of Afia once every ten 
 or twelve years, and yet it goes no farther eaft than BafFo- 
 rah ; a fpace fcarce equivalent to the twentieth part of 
 Afia ! Even in this fmall fpace, it varies from ten or 
 twelve, to twenty, forty, or even ninety years ; and, to 
 complete the whole, inftead of giving any inftance of the 
 periodical return of the plague at an interval of ninety 
 years, we have one of its difappearance for ninety-Jut 
 years ! 
 
 From all this it is evident, that no dependence can be 
 placed on fuch vague accounts with regard to the peri- 
 odical returns of the plague. Even the time of (hotting 
 
 up 
 
 * Bcei tol. xvui, p. 
 
THE PLAGUE. 1 203 
 
 cp the houfcs in Aleppo is not accurately related, for, 
 from the above abftraft it is plain, that they are fome- 
 times (hut up in March ; while Mr. McLean would 
 have us to believe that it is always between April and 
 July. It is needlefs to wade through a jumble of un- 
 fupported aflertions, which, being backed by no evidence, 
 fall to the ground of themfelves. " I will venture to af- 
 " Jert (fays he) that no perfon in perfed health ever 
 " was or can be expofed to the power of contagion, with- 
 <c out receiving the fpecific difeafe which that conta- 
 " gion produces ; excepting in fmall-pox, mealies, &c. 
 " when the perfon has previoufly had the difeafe." 
 How comes he to know all this ? Or, though our au- 
 thor ventures to aflert, mud we of neceflity venture to 
 believe ? When he afcribes the origin of epidemics, and 
 the plague itfelf, to the viciflitudes of the atmofphere, 
 not a fingle fact is adduced in fupport of his hypothefis 
 One very ftrange proof indeed he brings from Dr. Rum, 
 viz. that the latter had been informed by a gentleman 
 who refided in tropical countries, that, in the month of 
 July, feveral weeks before the yellow fever became ge- 
 neral, he had obferved a peculiar and univerfal fallownefs 
 of complexion in the countenances of the people of Phi L 
 ladelphia, fuch as he had feen in thofe of the more 
 fouthern countries before the appearance of bilious fevers 
 in them. Surely it is a very ftrange mode of argument 
 to tell us of the colour of people's countenances inftead 
 of the ftates or viciflitudes of the atmofphere, which we 
 are made to believe were the caufes of that change. 
 Another quotation is made from the fame author in 
 which a warm, dry, ftagnating air is conjeftured to have 
 been the caufe of difeafes ; but he does not even quote 
 Dr. Rum faying that it was the caufe of yellow fever, 
 much lefs of all epidemic difeafes. Refides, to fay that 
 any thing isoccafioned by z,Jlate> or viciffitude of the at- 
 mofphere, is fuch a vague mode of expreffion, that it 
 muft either mean nothing, or be contradictory to itfelf. 
 A ftate of the atmofphere we muft fuppofe to mean that 
 it continues for fome time either to be wet or dry ; a vi- 
 dj]itude> when it changes from one to the other. If an 
 
 epidemic 
 
204 A TREATISE ON 
 
 epidemic then is produced by zjtate, it cannot alfo be 
 produced by a viclffitude^ of the atmofphere : or, if fome 
 epidemics are produced by dates, and others by vicifii- 
 tudes, we ought to be informed which produce one kind, 
 and which another. But throughout the whole of this 
 diflertation we have neither diftin&nefs nor regularity, 
 nor indeed any thing but affertion, fupported only by an 
 imaginary theory. 
 
 Difmiffing at length therefore thefe conjeftural theo- 
 ries, let us endeavour to deduce from certain and un- 
 doubted fa&s the connexion between the ftate of the 
 body, and the operations upon it of other caufes, invifi- 
 ble indeed to our eyes, but difcoverable by our rational 
 faculties, and in fome meafure capable of being made 
 the obje&s of our fenfes alfo. 
 
 i. From the account given of the ftru&ure of the 
 human body, it undeniably follows, and has already been, 
 obferved, that all parts of it are fo conne&ed together, 
 that none can fuffer any very grievous injury without af- 
 fedingall the reft. 
 
 i. The life of man depends immediately on the air. 
 From this element the blood receives heat and a vital 
 fpirit diffufing itfelf from the blood along the nerves, 
 and thence expended in the operations of lifp and fen- 
 fat ion. 
 
 3. From undoubted experiments* it appears, that 
 this vital fpirit pofieifes in a great degree the properties 
 of elefitricity, infomuch that many fuppofe them to be 
 the fame. This is indeed denied by the celebrated 
 anatomift, Dr. Monro, but he allows that the nervous 
 fluid is fimilar to eleclricity, and it is certain that the 
 ele&rical fluid can affedl it in fuch a manner that we 
 may reafonably believe them to be the fame. 
 
 4. The air a&s upon the blood by the latent heat it 
 Contains. The air itfelf is compofed of fomething 
 volatilifed by heat. In fome cafes this is evidently a 
 terreftrial fubftance, as in that of inflammable air, or 
 hydrogen, which is formed of charcoal volatilifed by 
 iieat, with the addition of a little water. In the cafe of 
 
 oxygen, 
 
 * Thofe of Galvani and others on animal cleffr 
 
THE PLAGUE. 205 
 
 oxygen, or dephlogifticated air, the combination fecms 
 to be the matter of heat (which I mall hereafter diftin- 
 guifh by the name of the ethereal fluid) with water de- 
 prived of its carbonic principle. This coincides with 
 the opinion of Dr. Prieftley, who fays that the bafis of 
 dephlogifticated air feems to be dephlogifticated water. 
 But, let the bafis be what it will, the ethereal fluid which 
 volatilifes it is the agent -, the bafis is entirely paffive, and 
 only modifies or reftrains the action of the other fluid, 
 fo that it does not exert itfelf except in particular cafes. 
 Fixed air, or carbonic acid, is compofed of the bafe of 
 oxygen united with a certain portion of carbon, and the 
 whole volatilifed by the ethereal fluid. Phlogifticated 
 air, azote, or fepton, according to Dr. Prieftley, confifts 
 of the bafis of dephlogifticated air along with a certain 
 proportion of carbon different from that which produces 
 fixed air, volatilifed by the fame agent ;* and fo we 
 may determine concerning every other fpecies of air. 
 
 5. In certain cafes the ethereal fluid quits thofe fub- 
 ftances with which it is united : the air is then decom- 
 pofed, the fubftance into which the other fluid enters is 
 heated, or rendered more fluid than before (perhaps 
 both) while the bafis either unites itfelf to the moifture 
 of the lungs, or is thrown out by the breath. Whether 
 in any cafe the bafis can pervade the membranes, and 
 thus mix itfelf with the blood, notwithftanding the 
 pofitive affertions of Dr. Girtanner and others, is very- 
 doubtful, and does not admit of any pofitive proof. 
 
 6. The blood, being a fluid, muft be fubjecl to the 
 fame laws with other fluids. A certain quantity of 
 latent heat muft be contained in it, in order to give the 
 degree of fluidity naturally belonging to it. If this 
 quantity be augmented, the fluidity will be augmented, 
 and the blood will become thinner -, if it bediminifhed, 
 the contrary will take place ; and if we fuppofe a great 
 proportion of this latent heat to be abftradied, it is not 
 unreafonable to fuppofe that ibmething like a congelation 
 may take place, and the blood be changed into a folid 
 fubftance of fuch a nature as cannot any more be made 
 io refume its former qualities. 7, By 
 
 *See Medical Repofitory, voi ii, No. iii. 
 
A TREATISE ON 
 
 7. By augmenting the fenfible heat, the blood is af- 
 fected in the fame manner as any other fluid ; it fuffers 
 expanfion, by which the vefTels are dilated in proportion, 
 and, if this expanfion and dilation be carried to a cer- 
 tain length, a rupture of many of the fmall veflels, and 
 apoplexy, or fome other grievous difeafe, may enfue. 
 
 8. By breathing certain kinds of air, the fluidity, heat 
 and expanfion of the blood, and of confequence the di- 
 lation of the blood-veffels, are afTec~led. Thus, when a 
 perfon breathes a quantity of the fume of charcoal, 
 containing much fixed air, he feels himfelf affected with 
 pain and a fenfation of fulnefs in his head -, he becomes 
 flcepy, and, if the quantity be fufficiently great, he falls 
 into an apoplexy, and dies. From difledions it appears 
 that fuch as die in this manner have the capillary vefTels 
 greatly diflended, and even ruptured ; the heat of the 
 body is vaftly augmented, and even continues fome time 
 after death. Hence it is evident, that, by breathing 
 this kind of air, too much fenfible heat is conveyed to 
 the blood. In like manner when we breathe the fleam of 
 water, if any quantity of that fleam be condenfed in the 
 lungs, the whole quantity of latent heat contained in 
 that fleam difcharges itfelf upon the lungs, and increafes 
 the fenfible heat of the body ; and from this we may 
 iearn why on fome occafions our fenfations (hould fo ill 
 correfpond with the thermometer, and why a warm air 
 aim oft faturated with raoifture mould always appear 
 much hotter than a dry one, though the thermometer 
 (land at an equal height in both. Oxygen air feems 
 to convey to the blood a much larger quantity of 
 what we have called vital fpirit ^ than any other kind. 
 Whether this vital fpirit be the fame with the latent 
 heat of the blood, we know not ; but, as this kind of 
 air is evidently capable of fupplying the blood both with 
 latent and fenfible heat, it feems moft probable, that, 
 by breathing a confiderable proportion of it, both thefe 
 kinds of heat, as well as the vital fpirit itfelf, will be 
 augmented. In this cafe, wherever the air .naturally 
 contains a larger quantity of oxygen than ufual, the 
 blood ought to be more fluid, as well v as warmer, than 
 
 ufual, 
 
THE PLAGUE. 207 
 
 ufual, provided there be no evident caufe why it mould 
 be otherwife. Accordingly in warm climates it is al- 
 ways found that the blood is thinner and more fluid 
 than in fuch as are colder ; but at the fame time the 
 temperature of the body is colder than in other coun- 
 tries. Zimmerman tells ns, that, " at Curaffau, Euro- 
 peans gradually lofe their frefli colour and vivacity : 
 their natural heat even becomes three or four degrees 
 lefs than it was at their arrival." The reafon of this 
 laft, however, is evidently the exceffive perfpiration, 
 which is more than fufficient to carry off the fuperabun- 
 dant quantity of fenfible heat thrown into the body, 
 either by the rays of the fun, or by the fuperior quan- 
 tity of oxygen naturally exifting in the atmofphere ; for it 
 is now found, contrary to the opinions hitherto received, 
 that in the warmer climates the atmofphere contains a 
 larger proportion of oxygen than in the more tem- 
 perate.* 
 
 From this difcovery it appears, that, whatever maybe 
 the caufe of the frequency and violence of epidemics in 
 warm climates, it is not the want of oxygen. Nay, we 
 fhould rather be tempted to think that they were produ- 
 ced by too great an abundance of it ; and this the more 
 efpecially when we know that animals confined in oxygen 
 air are fuppofed to die of a burning fever ; and it is like- 
 wife known that this kind of air is prejudicial to con- 
 fumptive people, and even brings on the difeafe on thofe 
 
 who 
 
 * That this is the cafe with the atmofphere at Martinico is now determined 
 by a letter from Dr. George Davidion to Dr. Mitchell of New- York, inferted 
 in the Medical Repofitory, vol. ii, p. 279. With equal parts of nitrous and 
 atmofpheric air, there was an abforption of 67 parts out ofioo; but when 
 two parts of atmofpheric air were ufed to one of nitrous, the abforption was 
 only from $z to 58 parts ; with a mixture of iron filings and fulphur, upwards 
 of four tenths of the air were ablbrbed. Thefe experiments were attefted by* 
 a number of medical gentlemen who were prefent. In a letter fubjoined 
 from Dr. Chifholm, he lays, that, having made a trial with iron tilings and 
 fulphur, the abforption was forty parts ot an hundred, or exactly tour tenths* 
 with the eudiometer fifty-fix. It appears to rne (fays Dr. Chilholm) to be 
 a singular circumftance, that, although the ground on which the Ordnance 
 * Hofpital ftands is a perfect morals, partially drained, yet a refult almoft 
 exadily litnilar to that given by the experiments made with the eudiometer 
 * at my houie, fhould take place, with the fame inftrument and in circum- 
 " ftances very different. The proportion at the Ordnance Hofpital, I 
 think, has been 58 out of IQO, and at your houfe, a fituation leis fwampy, 
 ' and nearer the fea, it has been 67. An explanation of fo fingular a re(ult> 
 * in fituations ib different, is perhaps more to be wifhed than expe&ed." 
 
208 A TREATISE ON 
 
 who had it not before. From the experiments mention- 
 ed in the note, it feems probable that there are but few 
 even of fwampy places in hot climates, where oxygen 
 does not predominate; and in thefe the heat thrown in- 
 to the bloo l d muft ftill be augmented by that produced 
 from the quantity of vapour decompofed or condenfed 
 in the lungs, which, as the condenfation depends upon 
 unknown circumftances, can never be forefeen, or ever 
 prevented, but by a removal from the place. 
 
 With regard to other kinds of air, fuch as inflamma- 
 ble, phlogifticated air, &c. experiments are yet wanting 
 to determine their effects upon people who breathe them 
 habitually. The proportion in which they occafionall y 
 exift in the atrnofphere on particular occafions has not 
 been afcertained, and from the experiment made by Dr. 
 Prieftley with ofFenfive air taken from a manufactory, 
 as well- as from Dr. Chifholm juft mentioned, the proba- 
 bility is, that, even in the moft ofFenfive places, the pro- 
 portion of azote is by no means fo great to the oxygen 
 that we could fuppofe the excefs capable of producing a 
 diforder of any confequence, much lefs a violent epide- 
 mic. Fixed air is always produced in the putrefactive 
 procefs, and from its quality above mentioned of rarefy- 
 ing and heating the blood, might reafonably be fuppofed 
 to have fome (hare in producing epidemics, were it not 
 that this kind of air is fo readily abforbed by water, as 
 well as a number of other fubftances, that, except at the 
 very moment of emiffion, we can fcarce fuppofe it to 
 have any confiderable effect. 
 
 Mr. Watt in a letter to Dr. Beddoes gives an account 
 of a kind of air, feemingly more noxious than any yet 
 difcovered, which he produced by diftillation from flefb 
 and from wool. The effects upon himfelf were fo dif- 
 agreeable that he determined to make no more fuch ex- 
 periments, left he mould to his own hurt difcover a 
 mode of producing fome grievous difeafe. But we can- 
 not, from an artificial air of this kind, argue to a natural 
 one ; as the one produced by Mr. Watt was totally dif- 
 ferent from any fpecies of air naturally known. All that 
 we can fay is, that, as far as we can trace the connexion 
 
 between 
 
THE PLAGUE. 269 
 
 between our bodies and the different kinds of air which 
 may be breathed, the latter ad chiefly by the heat they 
 contain, and which they impart to the body in various 
 proportions ; by which means the latent or fenfible heat 
 of the blood, and confequently of the whole body, may 
 be occaiionally augmented or dirtliniflled. Thus the 
 body may be considerably altered in its cdnftitution, 
 and rendered more liable to difeafes than it was before $ 
 but (till it is found that difeafes continue to appear at 
 uncertain intervals, though all the catafes we are able to 
 difcover* or at lead all that are conftantly evident to our 
 fenfes, continue to operate without intefmiffion. Though 
 the obvious qualities of air and climate therefore may 
 fredlfpofe to an epidemic, we cannot affirm any thing 
 farther : the direct cdufe is always different* and hath 
 hitherto fo much eluded our refearches, that we can have 
 little hope of difcovering it, except by reaforiing from 
 facts lefs obfcure, 
 
 8. In all the operations of nature which we have ac- 
 cefs to inveftigate, the action of electricity is fo much 
 Concerned, that we can fcarce fuppofe it to be want- 
 ing in any of them. That it is concerned in preferv- 
 ing the health of the human body is likewife certain, 
 if it be the fluid which acts in the nerves, as rnoft pro- 
 bably it is. But whatever preferves health will alfo 
 bring on difeafe, if it be applied to that piirpofe ; and 
 we have already feen that this fluid is capable of bring- 
 ing on the moft dreadful fymptoms, viz. mortification 
 in its higheft ftage, fever, convulfions, bilious difcharges, 
 lethargy, &c. If it be capable of producing all thefe, 
 can we fay that it is not capable of producing thofe of 
 an inferior kind, or of varying difeafes and fymptoms 
 without end, according to the immenfe diverfity of its 
 action ? It may be laid that this difeafe was occa- 
 fioned by a violent flroke of electricity, fimilar to light- 
 ning 5 but how many people have declared, that, in the 
 beginning of fonie violent epidemics, they have felt a 
 fudden ftroke at the time of feizure ! Dr. Hodges 
 mentions this in the plague of 1665 at London, but 
 treats the accounts as effects of a diftempered imagina- 
 
 E e tion. 
 
210 A TREATISE ON 
 
 lion, Procopius relates the fame of the plague in his 
 time, viz. that many of the difeafed felt a uroke. It 
 is true that they faid fuch ftrokes were given by fpi- 
 rits in human fhape, in which we know they mud have 
 been deceived - y but, though they were miftaken in 
 fuppofing that they had been ftruck by a fpirrt, it does 
 not from thence follow that they felt no ftroke at all. 
 The people mentioned by Dr. Hodges did not fay that 
 they were ftruck by a fpirif, yet he treats their accounts 
 with as great contempt as though they had. Where 
 people have no intereft in deceiving, we ought certainly 
 to look with a favourable eye upon their teftimony - y for, 
 even although fome part of it fhould be incredible, we 
 have ftill reafon to believe that there is fome foundation 
 'for what they fay. Thus, the poor failor, fo much fright- 
 ened at the fight of a large bat in New Holland, was 
 certainly miftaken in faying that he had feen the devil ; 
 he was even miftaken in faying that he had horns ;* but 
 from all this it would have been doing him great injuftice 
 to fay that he had feen nothing. In like manner, when 
 numbers of people in Procopius's time faid that they 
 were ftruck by fpirits, when we find others in Dr. Hod- 
 gee's time faying that they were ftruck by fome invifible 
 agent, when we know that electricity can ftrike in an 
 i-nvifible manner, it certainly is more reafonable to con- 
 clude that violent difeafes fometimes do begin by an elec- 
 tric ftroke, than that all who faid they were ftruck in 
 this manner were madmen or liars. 
 
 It may now again be afked, If the plagne, or violent 
 epidemics, be produced by ele&ric ftrokes, why are they 
 not much more frequently felt, or by what are thofe 
 milder difeafes produced which are not accompanied by 
 any fenfible ftroke ? Here we can be at no lofs to fay, 
 that whatever produces the higheft difeafe, may alfo pro- 
 duce the loweft. But, befides this argument, we have 
 politive evidence that commotions in the electric fluid 
 
 will 
 
 * In the account of this failor's fpeecfc a moft eflential part of tlie devil's 
 chara6ler was omitted. Th fpeech, according to Capt. Cook, was, that the 
 devil was about the fize of a one gallon keg, and very like it. He had horns 
 and wings ; and he was fo near, that, it I had ilOi b?en <*fear*d t I might 
 have touched him." (Sec p, 1051 n.) 
 
THE PLAGUE. 211 
 
 not only produce ficknefs, but very extraordinary 
 and feemingly miraculous effects upon inanimate bodies. 
 It has frequently been remarked that people are fick 
 during the time of earthquakes, when the electric mat- 
 ter is in violent agitation. This has been accounted 
 for from the motion of the earth, as the motion of a 
 iliip produces fea-ficknefs. But Dr. Hillary mentions 
 a flight earthquake in Barbadoes where people were af- 
 fe&ed with ficknefs and vomiting for fome hours after 
 the phenomenon had ceafed altogether; which undoubt- 
 edly mows, that a certain ftate of this fluid will diforder 
 the human body, independent of every other circurn- 
 flance, either of the heat or cold of the atmofphere, or 
 the oxygen, hydrogen or azote contained in it. Again, 
 we find that a certain ftate of the electric matter is not 
 only capable of producing very extraordinary effects by 
 itfelf, but alfo of communicating a power to the human 
 body to do the fame. A good number of years ago, a 
 powder-mill near London was blown up. The explo- 
 fion, as might be expe&ed, was violent and tremen- 
 dous ; but the mod remarkable circumftance was, that 
 the electric matter, for a great way round, was thrown 
 into unufual, though inviiible, commotions, which di- 
 covered themfelves by the rattling and breaking of chi- 
 na difhes though fitting apparently undifturbed upon 
 their flielves. This phenomenon did not fuddenly ceafe, 
 and, during the time of it, fome people appeared to be 
 infected by an electric contagion ; the power of breaking 
 china feemed to refide in their bodies, fo that if they ap- 
 proached or touched this kind of ware, it would inftantly 
 fly to pieces. Accounts of this extraordinary circum- 
 ftance were publifhed in many of the periodical works 
 of the time, particularly in Dodfley's Annual Regifter ; 
 and the fact feems to be eftablifhed beyond controverfy. 
 It proves that what has been advanced by Dr. Prieftley 
 concerning electrical operations, on a fmall fcale, holds 
 good alfo on a large one, viz. that the fluid, when once 
 fet in motion, is not eafily quieted. It eftablifhes the 
 fact, alfo, that by great explofions of gun-powder the 
 ledric matter is violently agitated ; and the confe- 
 
 quence 
 
A TREATISE ON 
 
 quence of thefe agitations we cannot know. It may be 
 faid, indeed, that in the operations of nature the ele&ric 
 matter is often violently moved without any ficknefs tak- 
 ing place ; neither in faft did any enfue at the time the 
 powder-mill in queftion was blown up. But it mud be 
 remembered, that, in the ordinary courfe of nature, if the 
 eleftric matter is moved, a receptacle is alfo provided 
 for it. In a thunder-ftorm, where immenfe difcharges 
 of ele&ricity are made from one cloud, there is another 
 cloud of an ele&ricity oppofite to the former ready to 
 receive them, or if not, the earth itfelf is frequently ftruck 
 In eruptions of volcanoes, the fmoke receives the ele<5tri- 
 city difcharged, and becomes charged with lightning of 
 a more dangerous kind than that of ordinary thunder- 
 ftorms j and Sir William Hamilton relates, that in the 
 great eruption of Vefuvius, in 1794, lightning of this 
 kind proceeded from the fmoke for no lefs a fpace than 
 f event ten days. But in artificial commotions of this flu- 
 id, where nattjre has not provided any receptacle, the 
 phenomena mud be qqite different ; and though we 
 may with fafety to ourfelves interfere with the operations 
 of fire and electricity to a certain degree, yet we may at 
 3aft roufe thefe terrible elements into fuch aftion as will 
 prove fatal to great numbers. Hence poffibly may arife 
 in part fome of thofe fickneiTes which take place after 
 battles, in violent lieges, Sec. An inftance of this is 
 faicl to have happened at Valenciennes, when laft be- 
 fieged by the Duke of York. A difeafe prevailed chief- 
 ly among women, children, and perfons of a weak con- 
 ftitution ; great numbers of whom died fo fuddenly that 
 it was at firft thought to be a plague, until it was found 
 not to be infedious. The blood was found greatly difr 
 folved, and the phyficians afcribed it to the monftrous 
 bombardment and cannonading which took place during 
 the fiege. Such was the account published in fome of 
 the newfpapers of the time, and from the fubfequent 
 confideration.s it will not feem improbable that fuch 
 things may take place. 
 
 From the experiments of Mr. Bennet (an Englilli gen- 
 tleman who has made feveral difcoveries in elediicity) 
 
 it 
 
r THE PLAGUE. 213 
 
 it appears, that we can neither brufh a piece of chalk, 
 open or (hut a book, or do feveral of the mod trifling 
 actions, without agitating this fubtile fluid in a percepti- 
 ble manner. It is well known that in fome cafes we 
 cannot flroke a cat's back without making the electric 
 matter vifible, and in fome pofitions, by putting our 
 fingers near the ears of the animal, very pungent fparks 
 will be received. If then we can neither open or (hut a 
 book, if we cannot ftroke a cat's back, or approach a 
 finger to her ear, without agitating the eleftric fluid, is 
 it reafonably to think we could burn a book, or kill a 
 cat, without doing the fame ? Certainly it is not. ^ If 
 we cannot burn a book or kill a cat without affefting 
 this fluid, it cannot be fuppofed that we can burn a 
 houfe or kill a man without producing a dill greater 
 commotion j and in proportion to the extent of our de- 
 vaftations, and the multitude of our maflTacres, the 5n- 
 vifible agitation of this element muft become flill greater 
 and greater. In all thefe tranfaftions it muft be rememr 
 bered that the fluid is forced out of its natural mode of 
 aftion $ for eleftric matter is made for the prefervation, not 
 the deftruftion, of life : but if, by long continued and ex- 
 tenfive application of its power to a contrary purpofe, we 
 in fome meafure pervert its a<5tion, no wonder that we 
 then feel the confequences of our own proceedings by its 
 partly turning its power againft the human race alto- 
 gether. 
 
 Again, the human body is not made for the habitation 
 of an infernal fpirit, but for one of a quite different 
 character, The boifterous paflions of fury, difcord and 
 hatred ought never to difturb the mind, which is made 
 for the habitation ,of endlefs peace and joy. The tumul- 
 tuous paffions are enemies to health -, and this is fo well 
 known to phyficians that they are very careful to prevent 
 their patients from being any way ruffled or difturbed by 
 violent paffions. It is true thefe paffions aft upon the 
 rational foul, which we may fuppofe to be diftinft frorn 
 that merely animal fpirit, probably no other than the 
 eleftric fluid, which runs along the nerves ; but experi- 
 ence fhows that each of thefe can aft upon the other ; a 
 
 diforder 
 
2i 4 A TREATISE ON 
 
 diforderin the body, particularly in the nervous fyftem, 
 will fometimes difturb the rational foul in fuch a man- 
 ner as almoft entirely to deprive it of all its faculties ; 
 while on the other hand a violent commotion in the 
 rational foul may at once extinguifli all the powers of 
 life, as has already been mown from Zimmerman. Now, 
 let any one confider what muft be the fenfations of thofe 
 who engage in war. Whatever pity or humanity may 
 be pretended, it is evident that in the day of battle all 
 thefe fenfations muft give way to horror and fury on the 
 part of the conquerors, and terror and difmay on that 
 of the vanquifhed. That thefe paffions never do entirely 
 fubfide, is evident from the treatment of conquered 
 countries and conquered people. When Jenghiz Khan 
 beheaded his prifoners by hundreds of thoufands, when 
 Tamerlane pounded them in mortars, when KhouliKhan 
 caufed thofe who offended him to be carried from place to 
 place, and a piece of flefh to be cut from their bodies at 
 each ftage, what muft have been the fenfations of thefe 
 mifcreants, and thofe whom they employed in fuch horrid 
 fcenes ? On the other hand, what muft be the fenfations 
 of thofe who fee their deareft relations torn from them 
 and Slaughtered or treated even worfe than if they were ; 
 themfelves driven from their peaceable abodes to wander 
 like beafts, while their cruel enemies exult in the mife- 
 ries they have brought upon them, and glory in doing 
 all the mifchief they can, and fpreading devaluation as 
 wide as poffible ? Thus, every paflion, inimical to health, 
 muft, on both fides, be carried to its utmoft height ; and 
 if thefe horrid fcenes overfpread a great part of the earth, 
 for hundreds of years together, is it any wonder that 
 plagues mould enfue ? If man, forgetting the dignity of 
 his nature, converts the habitation affigned him by his 
 Maker into a kind of hell, and himfelfinto a devil, can 
 we wonder that, in fuch circumftances, the fpirit of life, 
 originally appointed for his ufe, fhould become to fuch a 
 being the fpirit of death ? Dr. Mofeley feems to fpeak 
 Ilightly of Helmont for affigning moral caufes to fever j 
 hut if we confider the matter attentively it will certainly 
 fee found that the moral conduft of the human race in 
 
 genera} 
 
THE PLAGUE. 215 
 
 general has more connexion with the difeafes which be- 
 fal them, than we are perhaps willing to believe. 
 
 Mod authors fpeak of fome hidden, unknown and 
 unfearchable power in the atmofphere as the occafion 
 of plagues and other epidemics $ and, from what has 
 been already laid down, it feems by no means improba- 
 ble that this hidden power relides in the electric part of 
 it. But we know that electricity proceeds from the 
 earth, as well as from the air; fo that in fome countries 
 the evaporation of eleftric matter from the earth may 
 affeft the health of the inhabitants, as well as the con- 
 ftitution of the atmofphere. Hence fome fpots may be 
 naturally unhealthy, and incurably fo, independent of 
 either the perceptible or imperceptible properties of the 
 air ; their healthinefs may occafionally increafe or de- 
 creafe by means entirely beyond the reach of our invef- 
 tigation. Here then our inquiries muft flop. We may 
 indeed make a general conjecture that fuch differences 
 are produced by the action of the eledric matter ; but, 
 ualefs this adtion be pointed out, and fome connexion 
 traced between the iituation of the country and a parti- 
 cular mode of a&ion of the fluid, we may as well own 
 our ignorance at once. 
 
 9. From all that has been faid, then, we may con- 
 clude, that none of the obvious properties of the atmo- 
 fphere, or of any conftituent part of it, or of any varia- 
 tion in the proportion of its ingredients, can be account- 
 ed the caufe of epidemic difeafes ; that the hidden con- 
 ftitution of the atmofphere may with probability be 
 attributed to the agency of the eledqc fluid, and that 
 by the action of this fecret caufe, along with the other 
 more obvious properties of the air, fuch as heat or cold, 
 moifture or drynefs, &c. the human body may be fo 
 predifpofed to difeafes, that they will readily break forth ; 
 and that the condudt of mankind themfelves may 
 greatly contribute to this predifpofition ; the queftion 
 then is, fuppoling every thing to be thus laid, like a 
 train of gun-powder, what is the fpark which firft fets it 
 on fire. Does the difeafe arife fpontaneoufly in the firft 
 perfon affefted by it, or does it come from without ? 
 
 In 
 
216 A TREATISE ON 
 
 In anfvver to this we muft in the firft place obferve, 
 that the accounts of all plagues mentioned in profane 
 hiftory trace their progrefs from one place to another ; 
 whence the probability is, that at its origin the difeafe was 
 confined to a few, perhaps to a fingleperfon. In very few 
 cafes, however, has it been poffible to trace it to an in- 
 dividual ; and^ even when this has been done, the un- 
 fortunate individual is always faid to come from fome 
 other place. The inftance quoted from Dr. Moore is 
 perhaps the only one upon record where the plague 
 arofe fpontaneoufly in any perfon feparated from foci- 
 ety ; and from a fingle inftance little can be inferred. 
 In thofe terrible examples we have given of people be- 
 ing burned to death without any accident from terref- 
 trial fuel, the agent feems almoft certainly to have been 
 electricity. In the plague of Procopius, faid not to have 
 been infectious, the ftrokes complained of by many patients 
 feem to indicate an action of the fame fluid. The fame 
 in the plague at London, which was infectious, and 
 likewife of others. But, in cafes of plagues which are 
 not infectious^ another queftion arifes- By what means 
 do fuch difeafes fpread from place to place ? for even 
 this dreadful peftilence of Procopius did not over- 
 fpread the earth at once, but is faid to have begun at 
 Pelufium in Egypt. To this no anfwer can be giverL 
 To fuppofe an omniprefent contagion in theatmofphere, 
 proceeding either from contagion or any thing elfe, 
 cannot be admitted ; for upon this fuppofition the 
 whole world muft have been infected at once. The 
 caufe, whatever it was, plainly moved from one place to 
 another, or was fucceflively generated in different places. 
 Recourfe may be had to the precipitation of the contagi- 
 ous matter of former plagues from the atmofphere -, but 
 to account for this in fucceflion will be found very dif- 
 ficult ; and the fame difficulty will attend every other 
 folution which may be attempted. Mr. Gibbon indeed 
 cenfures Procopius for fuppofing it not to have been in- 
 fectious ; and perhaps the fpreading of the difeafe by 
 infection is the only way by which we can account, in 
 a fatisfadory manner, for the way in which it diffufed 
 
 itfeif 
 
THE PLAGUE. 217 
 
 itfelfover the world, which was, by firft infecting the 
 maritime places, and afterwards thofe which were more 
 inland $ always vifiting the fecond year thofe whom it 
 had fpared the firft. 
 
 10. Laftly, to form fome idea of the nature of conta- 
 gion, or infection, as it is more properly called, we mud 
 confider, that as the ethereal fluid, acting as heat, per- 
 vades the human body, fo doth it likewife under that 
 particular modification which we call electricity. Some 
 kinds of air, indeed moft of thofe with which we are ac- 
 quainted, feem to act by augmenting or diminifhing the 
 latent or the fenfible heat of the body. Such, when taken 
 in moderate quantity, may produce flight difeafes, as 
 head-ach, &c. and, when taken very largely, may even 
 put an end to life at once, either by rarefaction of the 
 blood and rupture of the fmall veflels, as is the cafe with 
 fixed air, or by opprefling the lungs entirely with their 
 bafis, which cannot be thrown out by the breath as in or-, 
 dinary refpiration. Others may affect the electricity of 
 it, or what in this treatife has been called the vital fpi- 
 rif, as well as the latent or fenlible heat. The confe- 
 quence of this will be difeafes of a more ferious nature ; 
 for upon this principle in all probability depend not on- 
 ly the fecretion and proper regulation of the nervous flu- 
 id, but what has been called the crajts, or proper coniif- 
 tence of the blood and other fluids. Hence it is pofli- 
 ble that fuch an inftantaneous (hock may be given to 
 the body, as will not only injure the organization in an 
 irreparable manner, but may be felt throughout the 
 whole body like an electric flroke, even though there be 
 no vifible fire, or fenfation of burning, as in the cafe of 
 the Italian prieft and others, who perifhed in fuch a mi- 
 ferabie manner. 
 
 Formerly all acute difeafes were fuppofed to depend 
 on morbific matter taken into the body, and abforbed 
 by the blood : the cure was thought to be accomplifhed 
 by the expulfion of this morbific matter from the body 
 by fweat, or fome of the other natural evacuations. 
 The doctrine was attended by many difficulties, and in 
 many cafes did not admit of a fatisfactory explanation. 
 
 F f It 
 
218 A TREATISE ON 
 
 It was therefore laid afide, and the debility or excite- 
 ment of the nervous fyftem arofe in its place. But this 
 new fyftem admitting of mlajmata and contagion, it was 
 plain that morbific matter flill kept its ground. With 
 a view, it would feem, to render the nervous theory more 
 complete, it has been found neceflary to deny the doc- 
 trine of contagion and infection entirely. This has been 
 done, wherever there was a poffibility ; but the pheno- 
 mena of the fmall-pox and mealies, as well as thofe arif- 
 ing from poifons, ftill militated ftrongly in favour of 
 morbific matter. To avoid the force of arguments 
 drawn from thefe fources, the doctrine of abforption was 
 denied, and contagions of all kinds were faid to act im- 
 mediately upon the nervous fyftem without affecting the 
 blood or other fluids. At laft the matter feemed to be 
 decided by the experiments of the Abbe Fontana on 
 poifons. He found that fome proved fatal by beingf 
 mixed with the blood, others by being applied to the 
 nerves, and others by being taken into the ftomach. 
 Even this did not give fatisfaction. It was contended 
 that the effects of poifonous bites were too quick to be 
 accounted fo/ on the principle of abforption ; that, after 
 the moft violent fymptoms had commenced, they might 
 be removed by cutting out the part affected ; and con- 
 fequently that, inftead of any abforption by the blood, we 
 were only to believe that the nervous fyftem was irritated. 
 
 " Poifons, (fays Dr. Girtanner) remedies, and, in ge- 
 <c neral, all furrounding bodies, acting only on the irri- 
 " table fibre, it follows that they act upon the fyftem in 
 44 a fimilar manner, and that every fubftance capable of 
 " producing the grcateft pomble effect upon the fibre, 
 " that is to fay, every fubftance capable of exhaufting all 
 cc the irritability both of the fibre itfelf and of the fyftem, 
 "in an inftant, asfoj: inftance, laurel water, or white ar- 
 
 fenic, is alfo capable of producing all the inferior de- 
 <c grees of action, either by acting on a fibre lefs irritable, 
 <c or by acting upon the fame fibre, but in a lets quanti- 
 4C ty. Laurel water, opium, white arfenic, ammoniac, 
 " are -of courfe both medicines and poifons capable 
 " of healing as w,ell as of producing, all maladies what/a- 
 
THE PLAGUE, 21$ 
 
 " ever, without exception* And this is confirmed by a 
 " number of experiments which I have made upon dif- 
 " ferent animals. Thir/rw/7; feems to me of the utmofl 
 " importance-, and the Abbe Fontana, who made more 
 " than fix hundred experiments to prove that ammoniac 
 < c is no remedy againft the bite of a viper, would have 
 " faved himfelf the trouble, had he known it. If, infteaci 
 " of applying the venom of the viper to fomany animals, 
 " and afterwards applying ammoniac to the wound, he 
 " had made a fingle comparative experiment, and appli- 
 <c ed ammoniac to a wound made by a lancet that was 
 " not poifoned, he would have found that ammoniac 
 " itfelf, applied in this manner, would have produced a 
 " difeafe exactly analogous to that caufed by the venom 
 " of" the viper ; and, confequently, fo far from removing 
 " the malady, mull necefikrily increafe it, by exhaufting 
 " the irritability of the fibre in a much lefs time than 
 " the venom of the viper by itfelf was capable of doing. 
 <c Mr. Fontana has made more than fix thoufand ex- 
 t periments upon the poifon of the viper; he employed 
 " more than three thoufand vipers, and caufed to be bit 
 " more than four thoufand animals ; and the conclufion 
 a he drew after this truly enormous number of obferva- 
 " tions was, that the poifon of the viper kills all animals, 
 " and produces the difeafe by its action on the blood. 
 " But why did Mr. Fontana neglect to make the de- 
 " cilive experiment, the experimentwn cruets of Bacon ? 
 ' 4 It is well known that frogs, and many animals with 
 " cold blood, live a long time without thq heart, and 
 " entirely deprived of blood. If therefore the poifon of 
 " the viper kills animals by its action on the blood, it 
 i( will not deftroy frogs without blood. But experiment 
 " contradicts this reasoning. The poifon of the viper 
 " will kill frogs without blood in as fhort a time as it 
 
 kills 
 
 * This is an afiertion fo extravagant* that is diffisult to imagine what 
 could induce any one to make it. Did our author ever hear that laurel water* 
 Sec. produced the venereal difeafe, the plague* yellow fever, gout, (lone, fmall- 
 pox, &c. &c. or to what patients and in what difeafes did he ever adminifter 
 this remedy with fuccefs ? I mean not to deny that thcfe fu^lances will cure 
 fame difeafes as well as produce others ; but fuch au unqualified expreffion 
 that they can not only produce but cure ail difeafes without exception, never 
 can be admitted. 
 
220 A TREATISE ON 
 
 " kills thofe animals who have not loft their blood. It 
 " is not therefore by its aclion upon the blood that the 
 " venom of the viper deftroys animals ; and thus does it 
 " happen that a fingle experiment frequently overturns 
 * c all tb&t fix thoufand other experiments have apparently 
 " eftablifhed. Ac-cording to my experiments, poifons 
 " operate upon the blood juft as they do upon the muf- 
 <c cular fibre, by depriving it of its principle of irritability, 
 " or of its oxygen. After having made this obfervation 
 " upon the experiments of Mr. Fonrana, I muft do him 
 " the juftice to add, that I have found all his experi- 
 c< ments very accurate, and that in all thofe which I have 
 " repeated, the refult has been exactly conformable to 
 " the account given by him ; it is in his concluiion only 
 <{ that he appears to be deceived." 
 
 On this I muft in the firft place obferve, that fince 
 philojophers and truth feem to be fo far diftant from each 
 other that even Jix thoufand experiments cannot bring 
 them together, it were greatly to be wifhed that in their 
 refearches they would pay a little more regard to huma- 
 nity. If the Author of Nature has fet man at the head 
 of the creation, if inferior animals muft patiently re- 
 lign their lives to preferve ours, are we therefore autho- 
 riled to torment and put them to death by thoufands 
 for every idle whim that comes into our heads ? After 
 Spallanzani, Fontana, Girtanner and a multitude of other 
 learned barbarians had cut in pieces, boiled alive, poifoned 
 and tortured thoufands of inoffenfive animals, new mafia - 
 cres it feems muft be made, and new tortures infiicled, 
 becaufe an experimentum crucis is ftill wanted ! If 
 knowledge is to be obtained only by fuch means as 
 thete, it certainly muft be derived from a very polluted 
 fource. 
 
 2. The experiment on which Dr. Girtanner builds 
 fo much is far from being above fufpicion. Though 
 we may cut the heart out of an animal, and let it bleed 
 as freely as poflible, yet we certainly overrate our abili- 
 ties if we fay that all the blood is taken out of it. The 
 more perfectly an animal is bled, the lefs irritability it 
 has j which gives a reafonable fufpicion, that, if all the 
 
 blood 
 
THE PLAGUE. 2*1 
 
 blood could be taken away, the irritability would ceafe 
 entirely. In frogs, and all other cold blooded animals, 
 the blood contains fewer red globules than in fuch as 
 are warmer ; the circulation is more languid than in 
 fuch as have warm blood, and, of confequence, the 
 blood will retain its irritability for a longer time, and it 
 will likewife be more difficult to deprive the body of all 
 its blood. In making this experiment, therefore, Dr. 
 Girtanner ought to have brought unexceptionable proofs 
 that he had deprived the frog of all the blood it con- 
 tained. But, as this was not done, we mail be realty to 
 fufpedt. that fome was left ; in which cafe we mould be 
 ftill.as uncertain as before whether the poifon a6ted on 
 the irritable fibre, or on the blood. But the decifive 
 experiment, or experimentum cruets, feems to have been 
 made by Fontana himfelf, by injeding a little of the 
 diluted poifon of the ticunas into the jugular vein of a 
 rabbit. Here the poifon was applied to the blood itfelf. 
 It could get at no other part of the fibre but the infide 
 of the vein, which is not accounted very irritable ; and 
 the quantity inje&ed was fofmall, that the Abbe thought 
 his experiment had failed ; yet the animal died as if by 
 lightning. The moment he turned his eyes towards it, 
 it was abfolutely dead, without difcovering the leaft 
 convuifive agony, or other fign of fome little life remain- 
 ing, generally obfervable for fome time in animals killed 
 by the common methods. On applying the fame poi- 
 ibn to a large nerve of another animal of the fame fpe- 
 cjes, no injury followed. 
 
 3. The difpute is of no confequence, and the experi- 
 ment will prove the fame thing whether we fuppofe the 
 poifon to aft upon the irritable fibre (the nerves and 
 mufcles) or upon the blood. The only important point 
 to be afcertained is, whether there be in nature any fub- 
 fiance which, applied to the internal parts of the body, 
 or to a wound, will inftantly diforder the whole in fuch 
 a manner as to bring on a violent difeafe which may 
 prove mortal in a fhort time. If any fuch there is, that 
 fubftance, whether folid or fluid, vifible or invifible, may 
 with propriety be called contagion ; and if any fuch proceeds 
 
 from 
 
222 A TREATISE ON 
 
 / 
 
 from the body of a difeafed perfon to one in health, the 
 vapour fo proceeding is infeftion. As to the mode of its 
 operation we are little concerned ; the fudden manner 
 in which people are affected (hows that poifons kill by 
 fuppreffing in a very (hort time the principle of life, 
 which feems to be analogous to electricity, or rather the 
 very fame with it ; neither is it more incredible that the 
 poifon of a ferpent mould kill by disturbing the natural 
 electricity of the body, than that the ftroke of a torpedo, 
 or electrical eel, iliould kill by the fame means. The 
 only difference is, that, in the cafe of poifons, the per- 
 nicious fubflance is introduced into the body itfelf ; in. 
 the torpedo, it comes with violence from without. The 
 former we may compare to the fiJent discharge of an 
 electrified jar by a point, the latter to its difcharge with 
 a violent flafh by a knob. But that in poiibnous bites 
 the blood is greatly affected, and that in a very fhort time, 
 we certainly know. There are fome kinds of ferpents 
 whofe bites are fo fuddenly fatal, that no cure can be 
 applied : one of thefe, called the fmall laharra, is men- 
 tioned by Mr. Bancroft in his Natural Hiftory of Gui- 
 ana. Mr. D'Opfonville, in his Philofophic Effays, takes 
 notice of one in the Eaft-Indies, which he calls the pot- 
 fon ferpent or ferpent poifon , which feems to be as bad as 
 the laharra mentioned by Bancroft. This too is but 
 fmall, viz. two feet long, and very ilender. Its fkin is 
 freckled with " little traits of brown, or a pale red, and 
 " contrafled with a ground of dirty yellow : it is moftly 
 " found in dry and rocky places, and its bite proves mor- 
 " tal in lefs than one or two minutes. In the year 1759, 
 * s and in the province of Cadapet, I law feveral in- 
 " ftancesof it; and, among others, one very fingular, 
 " in the mid ft of a corps of troops, commanded 
 " by M. de BuiTy. An Indian Gentoo merchant per- 
 " ceived a Mahometan foldier of his acquaintance 
 *' going to kill one of thefe reptiles, which he had found 
 " ileeping under his packet. The Gentoo flew to beg 
 " its life, protefting that it would do no hurt if it was 
 " not firft provoked ; pafiing at the fame time his hand 
 " under its belly, to carry it out of the camp; when 
 
 " fuddenly 
 
THE PLAGUE. 223 
 
 " fuddenly it twifted round, and bit his little finger; 
 " upon which this unfortunate martyr of a fanatic chari- 
 " ty gave a fhriek, took a few fteps, and fell down in- 
 " fenfible. They flew to his aflidance, applied the fer- 
 " pent-done, fire, and fcarifications, but they were all 
 " ineffe&ual j his blood was already coagulated* About 
 tc an hour after I faw the body as they were going to 
 f< burn it, and I thought I perceived fome indications 
 ct of a complete dijjblution of the blood." 
 
 The bite of the brulan or burning ferpent > according to 
 the fame author, is almoft as terrible. " This is nearly 
 " of the fame form with the laft, its fkin is not quite fo 
 " deep a brown, and is fpeckled with dark green fpots : 
 " its poifon is almoft as dangerous, but it is lefs active, 
 " and its effects are very different. In fome perfons it is 
 :< a devouring fire, which, as it circulates through the 
 ^ veins, prefently occafions death ; the blood difTolves 
 " into a lymphatic liquor refcmbling thin broth, with- 
 ** out apparently having pafled through the intermedi- 
 " ate ftate of coagulation^ and runs from eyes, nofe and 
 " ears, and even through the pores. In other fubjects 
 " the poifon feems to have changed the very nature of 
 * c the humours in diffolving them ; the fkin is chapped 
 " and becomes fcaly, the hair falls off, the members are 
 " tumefied, the patient feels all over his body the mod 
 " racking pains, then numbnefs, and is not long in 
 *' perifhing." 
 
 From thefe accounts it is plain that poifons do ope- 
 rate very powerfully on the blood ; and if they do fo in 
 one cafe it is reafonable to think that they do fo in all. 
 According to the degree of ftrength of the poifon, how- 
 ever, we are fure that the effects will be more or lefs vifi- 
 ble to us ; but, though we fliould not be able to per- 
 ceive any alteration whatever in the confidence or colour 
 of the vital fluid, we cannot pofitively fay that it has 
 
 not 
 
 * There muft certainly be feme error here ; for as he mentions a 
 of the blood fo loon afterwards, we fhould think it impoflible that any coagu- 
 lation would have taken place. Perhaps the word only imports that the 
 circulation was completely flopped. 
 
 + The blood certainly does not coagulate in the vcflels, in any cafe what 
 ever, unlcfc by injecting fomething into them. 
 
224 A TREATISE ON 
 
 not undergone any change ; for the fpirit which operates 
 in it is too fubtile for our obfervation. In the begin- 
 ning of almoft all difeafes, perhaps, blood drawn from a 
 vein will not be perceptibly different from that of a per- 
 fon in health , and Dr. Fordyce particularly takes no- 
 tice of this in fevers -, but as the difeafe goes on, an al- 
 teration becomes very perceptible, which gives juft 
 ground for fufpicion, that there had been fome altera- 
 tion from the very firft, though invifible to us. 
 
 After all our difputes, however, we fhall find that the 
 controverfy, though ultimately important, begins more 
 about words and trifles than any thing elfe. Dr. Brown 
 ufed the word excitability, Dr. Girtanner ufes irritability, 
 and the author of this treatife, the words vital fpirit and 
 electricity -, to exprefs fomething equally unknown to them 
 all. The only difference is, that Drs. Brown and Gir* 
 tanner fpeak of their excitability and irritability as a 
 kind of power effentially inherent in living bodies, acted 
 upon indeed by certain fubftances, but incapable of deriv- 
 ing any fupply from without ; the author of this treatife 
 confiders it only as a modification in the human body, 
 or an organization, if we pleafe to call it fo, of that fluid 
 which he believes to be univevfally diffufcd, under the 
 names of heat, light and electricity. Hence that por- 
 tion modified or organized in the human body muft be 
 tinder an entire and abfolute dependence upon the im- 
 menfe mafs of furrounding fluid, and, by any alteration 
 in the motions of it, mud be often very perceptibly af- 
 fected ; neverthelefs as this fluid was originally created 
 to preferve and not to deftroy human life, there is much 
 iefs danger from a natural than from an artificial com- 
 motion in it. In fome vifible bodies, fuch as poitons, 
 the fluid ads in fuch a manner as to counteract the ope- 
 ration of that part which is organized in the blood or 
 nerves, or both. Hence on the introduction of fuch 
 into the body the diforder flies like lightning through alf 
 parts of it, and in a very lliort time brings on death, 
 In thofe vapours properly called contagions, the oppofite 
 action'is Iefs violent, and therefore thediibrders they pro- 
 duce are in proportion. Hence fuch difeafes may either 
 
be 
 
 tin 
 
 THE PLAGUE. 22 
 
 promoted or retarded by the perceptible properties of 
 the atmofphere, which in poifons have little or no effect. 
 There is indeed a remarkable difference in the ftrength 
 of the poifon fecreted in the bodies of ferpents at certain 
 feafons of the year, or according to their food. M. 
 D'Opfonville obferves that the poifon of ferpents is in 
 general more powerful, the more they live in 'hot and 
 dry places, where they feed upon infeds that are full of 
 faline, volatile and acrimonious particles. But, notwith* 
 ftanding this difference in the ftrength of poifons accord- 
 ing to the circumftances of time and place, there is not 
 the leaft reafon to fuppofe that poifon of a given ftrength 
 would not produce the very fame effects, let the ftate of 
 the atmofphere be what it would. 
 
 If therefore we certainly know that there are fome 
 kinds of aerial vapours which when applied to the hu- 
 man body do exert a power directly oppofite to the vital 
 principle, there is no reafon to doubt that fuch vapours 
 may be confined among certain foft fubftances, fuch as 
 cotton, wool, &c. and remain there for an unknown 
 length of time, again exerting their malignant powers, 
 when a frefh object comes in their way. Befides, as all 
 kinds of air with which we are acquainted confift of a 
 balis united with the ethereal fluid and voiatilifed by it, 
 there is reafon to fuppofe that contagions themfelves are 
 formed in the fame manner. Some kinds of air alfo arc 
 very eafily decompofed, in which cafe the bafis attaches 
 itfeif to fome terreftrial fubftance, the ethereal fluid 
 which voiatilifed it diffufing itfeif around in an invifible 
 manner, but generally with a perceptible heat. Fixed 
 air affords a notable example of this ; for, by expofing it to 
 lime-water, or even dry lime, alkaline fait, volatile al- 
 kali, or common water, a decompofition of the air very 
 readily takes place, and its bafis is found to be attached 
 to thole fubftances. What happens to fixed air may 
 alfo happen to contagion. The bafis of it may have a 
 tendency to unite itfeif to cotton, or fuch like fubftan- 
 ces, and thus may not onlfnnfect them, but concentrate 
 itfeif to fuch a degree as to produce a difeafe much more 
 violent than that of the perfon who gave the infection ; 
 
 G g and 
 
226 A TREATISE ON 
 
 and fomething of this kind has even been obferved with 
 regard to infected cotton. But now another queftion 
 occurs : As fixed air, by being attached to terreftrial 
 fubftances, lofes its aerial property, why fhould the baiis 
 of contagious effluvia ftill retain its malignant quality 
 though in a ftate of decompofition ? Here we are again 
 helped out by analogy. Fixed air is known to be capa- 
 ble of refuming its aerial properties occafionally, from 
 caufes unknown to us, though we cannot fuppofe them 
 to be any thing elfe than the invifible adion of the 
 ethereal fluid fo often mentioned ; which, being guided 
 by laws unknown to us, we cannot poffibly comprehend. 
 The fact, however, is certain, that the bafis of fixed air 
 does very often quit the fubftances to which it is attach- 
 ed, and affume an aerial ftate in great quantity, and 
 with very mifchievous effects. Thus the old lavas of 
 volcanoes, if chemically tried will be found at all times 
 to contain great quantities of the bafis of fixed air, but it 
 is only at feme times that the mofetes which arefuppofed 
 to be the air itfelf, break forth.* In like manner the 
 ilrata under ground always contain great quantities of the 
 aerial bafis, but the damps in mines, which are certainly 
 known to confift moftly of fixed air, do not always ap- 
 pear , neither do they gradually accumulate, but come 
 fuddenly, fpreading unexpe&ed deftru&ion among thofe 
 who unfortunately come in their way. The fame may 
 take place with contagion. After remaining fome time 
 in a ftate of decompofition it may have a tendency to 
 become volatile again, or it may lie dormant entirely ; 
 and this laft will explain what is quoted from Dr. Ruf- 
 fel, p. 178, that fometimes commerce may be carried on 
 with infected places without danger. 
 
 Thus we fee that the difpute, originally begun about 
 a word, involves at laft a matter of the utmoft impor- 
 tance ; for, if it be found unreafonable to believe that 
 any fuch thing as contagion exifts or can exift, it follows 
 of courfe that it is allb unreafonable to take any precau- 
 tions againft it. Mr. M'Lean even goes a ftep beyond 
 thofe who deny the exigence of contagion -, for we find 
 
 him 
 
 * See p. nS| note. 
 
THE PLAGUE. 227 
 
 him alfo denying that putrid effluvia can produce epi- 
 demics ; according to which dodlrine, it feems, we may 
 not only fafely vifit places accounted the moft dangerous 
 on account of infection, but live in all manner of filth 
 and naftinefs with impunity. It is plain that no perfon 
 can ever prove that it is impoflible for contagion or any 
 thing elfe to have an exiftence. Indeed if nothing had 
 ever induced people to believe that it did exift, it would 
 have been fuperfluous to fay any thing about it. But 
 when we have innumerable teftimonies to the contrary ; 
 when the opinions of the greateft phyficians, as Dr. Lind, 
 Dr. Clarke, Dr. Mead, Dr. Sydenham, Dr. Fordyce, 
 Dr. Ruflel, &c. agree that not only the plague, but 
 every kind of fever, is infe&ious ; when we know from 
 the analogy of nature that, contagion may exift ; when 
 we know that there certainly are powers in nature able to 
 produce it ; is all this to be thrown afide merely on the 
 ftrength of a theory, and a theory too which can never be 
 proved ? for it is impoflible to prove the non-exiftence o 
 any thing, much lefs the impoffibility of its exiftence. 
 The lives of mankind are too precious to be fported 
 with on philofophical theories j and prudence will always 
 fuggeft, that wherever danger may at any time arife, 
 there it is proper to be on our guard. 
 
 Difmiffing at length the fubjed: of contagion in ge- 
 neral, we now enter upon the queftion, Whether doth it 
 appear from fair invefligation of teftimony, that the 
 plague has, at any time, been communicated by conta- 
 gion or not ? And here I fhall confine myfelf to what 
 has been adduced by Dr. P. RufTel on the fubjedt ; for, 
 if we find that the difeafe has only once been introduced 
 by contagion, it fignifies nothing though we were able 
 to prove, which we never can do, that it had been an 
 hundred times bred in feme other way. The matter is 
 of too great importance to allow even a chance of its im- 
 portation by the negled of the precautions neceflary to 
 prevent it. 
 
 Our author begins with obferving, that though the in- 
 feftious nature of the plague had been a queftion much 
 agitated in the fchools, " it was lefs to be expeded that 
 
 phyficians 
 
228 A TREATISE ON 
 
 " phyficians who had been engaged in practice among 
 " the infedted fliould have perfifted in the opinion that 
 ;t the difeafe was never communicated by contagion." 
 Such, however, has been the cafe. In 1720 forne French 
 phyficians laboured exceedingly to prove that the plague 
 which then raged at Marfeilles and throughout Pro- 
 vence arofe from corrupt humours bfed in the body in 
 confequence of irregularity in the feafons, and bad ali- 
 ment ; that it was fpread by the fame means, in concur* 
 rence with terror, grief, defpondence, or other debilitat- 
 ing affections of the mind ; but was neither bred nor 
 diifeminated contagion. Dr. Ruflel mentions in a note, 
 feemingly with furprife, that " fo late as the year 1778, 
 " Dr. Stoll of Vienna fliould have written exprelsly 
 " againft the doctrine of peftilentiai contagion." To 
 this profeflbr he thinks it a fuffictent anfwer to quote 
 the following palfage from Mr. Howard on Lazarettos. 
 " It muft appear very ftrange, that he fliould go back to 
 '* Livy's Roman Hiftory for proofs to eftablifli his point, 
 " totally neglecting all the facts concerning the nume- 
 " rous vifitations of the plague recorded in modern medi- 
 " cal books, or which had happened during his own 
 " time. I fuppofe profeflional men will lay very little 
 " ftrefs upon all that can be faid on peftilentiai difeafes, 
 " in general, which happened in wars and lieges two 
 " thoufand years ago, as applied to the plague properly 
 4C fo called, a difeafe then confounded with various 
 " others from which the accuracy of latter obferva- 
 " tions have fufficiently diftinguifhed it." 
 
 Dr. Ruflel complains of the French phyficians at 
 Marfeilles having made unfair reprefentations j particu- 
 larly that while they produce as irrefragable arguments 
 againft contagion their own efcape unhurt, amid circum* 
 fiances of fuppofed danger, they pafs ilightly over, or 
 omit all mention of numbers of the medical afliftants 
 whom they faw perifli in the exercife of their profefiion. 
 M. Dedier, however, who at firft oppofed the doctrine 
 of infection, at laft renounced his opinions fo far as to 
 allow that the difeafe might be communicated to dogs 
 by injecting peftiferous bile into their Veins ; and he 
 
 Jikewife 
 
THE PLAGUE. 229 
 
 :ewi(e admitted that it might be communicated from 
 one human creature to another, by drawing in for a con- 
 fiderable time the breath of a difeafed perfon, putting on 
 his ihirt, lying in the fame bed-clothes, and touching 
 the wounded parts of one's own body with hands embru* 
 ed with the fweat or blood of one infeded. He affirms, 
 however, that the atmofphere of a perfon in the plague 
 is no more to be dreaded than that of a venereal pa- 
 tient ; and that the touching or drefling of buboes or 
 carbuncles is not attended with any danger. He re- 
 ftrids the infedious quality of the humours to the bile ; 
 but the inoculation of a perfon by the matter of a pefti- 
 lential ulcer* undoubtedly decides this point againft 
 him. 
 
 On the fubjed of contagion Dr. Ruflel obferves, that 
 the vague manner in which the word has been ufed has 
 given rife to much confulion. Some, taking advantage 
 of the inaccurate mode of expreflion on this fubjed ufed 
 by Dr. Mead, attacked him with fophiftical nonfenfe. 
 The following may ferve as a fpecimen, from a pam- 
 plet entitled " Diftind Notions of the Plague, Sec. by 
 the Explainer" This explainer obferves, that, according 
 to Dr. Mead, " air- and his other caufes propagate and 
 " fpread contagion, not the plague ; and therefore either 
 " contagion and the plague are the fame, or elfe the 
 " plague is not confidered ; if the firft, then his caufes 
 " propagate the plague ; and the plague accompanies 
 *' the plague ; an excellent defence ! But, if the plague 
 " is out of the play, then contagioa accompanies no* 
 " thing*" From writers like this we certainly cau ex* 
 ped nothing. 
 
 The opinion of Dr. Cullen concerning contagion has 
 been already noticed, p. 179 ; but though he fuppofes 
 it to be a matter floating in the atmofphere, he obferves 
 that contagions are never " found to ad but when they 
 " are near to the fources from wherfce they arife ; that 
 ;v is, either near to the bodies of men, from which they 
 " immediately iflue, or near to fome fubftances which, 
 w as having been near to the bodies of men, are embu- 
 
 "ed 
 
 * Seep io4. 
 
A TREATISE ON 
 
 " ed with their effluvia, and in which fubftances thefe 
 " effluvia are fometimes retained in an adive ftate for a 
 " very long time. The fubftances thus embued with 
 " an adive matter may be c&lledfomites ; and it appears 
 " to me probable, that contagions as they arife from fo- 
 " mites, are more powerful than as they arife immedi- 
 " ately from the human body." This opinion concern- 
 ing the great power of contagion imbibed by certain 
 fubftances is conformable to what was above laid down 
 by reafoning a priori on the nature of contagion.* It 
 is doubted by Dr. Ruffel, but Dr. Lind adopts it, and 
 Van Swieten gives his opinion to the fame purpofe. 
 " I am convinced, that the body of the difeafed, kept 
 " exaclly neat and clean, is not fo liable to imprefs the 
 " taint, as his late wearing apparel, dirty linen, and un- 
 " cleanlinefs of any fort about him long retained in that 
 " impure ftate. I fay, thefe laft contain a more concen- 
 " trated and contagious poifon than the newly emitted 
 " effluvia or excretions of the fick." 
 
 With regard to the original caufe, our author obferves, 
 <c that the plague is bred or produced originally from 
 " vitiated human effluvia, is a matter which has by no 
 <c means been eftablifhed on proper authoriry." Setting 
 afide therefore inquiries of this kind, he thinks it fuffi- 
 cient to inquire whether the infection be not communi- 
 cated from a fick to a found perfon by immediate con- 
 tact ' y whether it be not alfo communicated at fome dif- 
 tance through the medium of the air ; and whether fub- 
 ftances of various kinds do not imbibe the infectious ef- 
 fluvia, and retain them for a confiderable time. So far 
 as thefe points admit of proof from the experience of 
 times paft, the queftion concerning peftilential contagion 
 will admit of a folution, independent of all theoretic rea- 
 foning whatever. 
 
 2. On the fubject of contagion people have been- 
 embarraiTed by confounding the true plague with other 
 malignant difeafes. This has been done, not only by 
 the ancients, but by fome moderns; and our author 
 quotes Dr. Pye, faying " that any epidemic licknefs, 
 
 " which 
 
 * See p. 2*6. 
 
THE PLAGUE. 231 
 
 H which rages with more . than ordinary violence, and 
 " which occafions extraordinary mortality amongft 
 " mankind, may be, and is, properly termed a pefti- 
 " lence, or the plague." By not attending to the pro- 
 per diftin&ions, in thefe cafes, circumftances belonging 
 to what are commonly termed malignant or peftilential 
 fevers will often come to be very improperly applied to 
 the true plague. 
 
 3. " It may be remarked, that thofe who contend 
 " in favour of contagion, from zeal for accumulating 
 " proofs, have collected a number of facts from hiftorical 
 " records of very unequal authority, and often with lit- 
 " tie critical ikill in difcrimination. Of this error their 
 " antagonifts availing themfelves, have felected from the 
 " mafs the inftances moil liable to doubt or objection, 
 " and have endeavoured, by their manner of arranging 
 " them, to place the whole in a ridiculous light ; while 
 " more important inftances are either evafively paft 
 " over, misftated in the reprefentation, or invalidated by 
 <c general declamation on the little credit due to hifto- 
 " rians in matters of phyfic, or the prejudices prevalent 
 ** in ancient times of ignorance, and on contradictions 
 " to be found in the arguments of thofe who fupport 
 cc the fyftem of contagion." 
 
 To this the Doctor adds the great quantity of hypo- 
 thetical reafoning which has been introduced into the 
 controverfy, and above all the unfair dealing of the 
 parties in carrying on the difpute, which has reduced 
 the matter from " a calm inquiry in purfuit of truth, 
 to a wrangling conteft for victory." Laftly he infifts, 
 that, had it not been for the mifreprefentations and 
 fmifter dealings of thofe who have written againft con- 
 tagion, " the queftion feems to have been properly re- 
 folved in the affirmative ;" and he complains greatly of 
 the conduct of the Montpelier phyficians in this refpect, 
 infomuch that "their misdating of circumftances, and 
 " the partiality fo evidently difcoverable in their narra- 
 ec tive of cafes, will ferve more effectually to remove 
 :< doubts on the fubject, than any arguments that could 
 w be ufed againft their hypothefis," 
 
 On 
 
2J s A TREATISE ON 
 
 On the fubjecT: of contagiou our author obferves, 
 that fome difficulties ilill remain ; but thefe, though 
 proper fubjects of future inquiry, " do not appear to be 
 " offeree fuiScient to invalidate facts already eftablifhed: 
 *' It is well known, that the fame perfon who has been 
 " inoculated two or three times for the fmall-pox with* 
 <c out effect, even in aa epidemic feafon, has afterwards 
 "received the infection upon repeating the operation 
 ** at a diftance of time when the difeafe was hardly fpo- 
 " radic. The caufe of this remains unknown ; but ig- 
 * c norance of it was never produced as an argument 
 
 " againfl the reality of variolous contagion If, 
 
 4< ofone hundred perfons expofed to the infection of 
 44 the plague by a near aproach to the fick, ninety 
 " (hou^d fall fick, mall human inability to affign fatis- 
 " factory reafons for the efcape of the other ten be con- 
 " verted into a pofitive proof againft the difeafe having 
 ** been caught by contagion ? If perfons retired from all 
 " commerce with the infected and their attendants, 
 <c breathing the fame air with the reft of the inhabitants, 
 " and nourished by the fame aliment, remain untouch- 
 *' ed during the ravage of the plague, as long as they 
 " continue fecluded, but, upon unguarded comcnunica- 
 4< tion, are taken -ill like others ; can any rational doubt 
 " be entertained about the caufe of their former fecu- 
 " rity ? Or if through flealth, or neglecl: of requifits 
 <c precautions, fubftances tainted by the lick ihould be 
 " conveyed into thefe fecluded retreats, and perfons 
 ** living temperately as before, ignorant of what had 
 " happened, and confequently in the midft of imaginary 
 " fecuritv, happen to be feized with the diftemper ; can 
 " it with any ihow of reafon be afcribed, not to conta- 
 44 gion, but to terror, or to colluvies in the flomach and 
 " bowels, produced by intemperance and bad aliment ? 
 <c The inftances here alluded to are not the creation of 
 " fancy -, but ftriftty confonant to repeated experience in 
 41 Turky ; to (ay nothing at prefent of what has been ob- 
 " ferved at Marfeilles and in various cities in Europe." 
 
 " But a greater difficulty than that of all perfons not 
 " being equally fufceptible of the infection ariies from 
 
THE PLAGUE. 233 
 
 * 6 the ceiTation of the plague, at a period when the fup- 
 " pofed contagious effluvia, preferred in apparel, furni- 
 <c ture, and other fomites, at the end of a peftilential 
 " feafon, muft be allowed to exift, not only in a much 
 " greater quantity than can be fuppofed to be at once 
 " accidentally imported by commerce, but in a ftate 
 " alfo of univerfal difperfion over the city : the fa<5r., 
 " however unaccountable, is unqueftionably certain $ 
 " the diftemper feems to be extinguifhed by fome caufe 
 " or caufes equally unknown as thofe which concurred to 
 * c render it more or lefs epidemical in its advance and at 
 *' its height. In Europe fomething may be afcribed to 
 * c the means employed for the cleanfing of houfes and 
 " goods fuppofed liable to retain the latent feeds of in- 
 " fe&ion ; but, at Aleppo, where the diftemper is left to 
 " take its natural courfe, aad few or no means of puri- 
 " fication are employed, it purfues nearly the fame pro- 
 " grefs in different years : it declines and revives in cer- 
 " tain feafons, and, at length, without the intervention 
 " of human aid, ceafes entirely." 
 
 On this we (hall remark in general, that the failure of 
 
 contagion in fome cafes to produce the ufual effe&s may 
 
 proceed from fome cpnftitution of the body, difpofing it 
 
 not to allow the caufe to produce its ufual effe&s at one 
 
 time, though at another, the conftitution may be fo far 
 
 changed as very readily to admit it. This opinion has 
 
 been very generally received among medical people, who 
 
 have, to this fingularity of conftitutioa given the name 
 
 of idiojyncrafy . It is, however laughed at by Mr. M'Lean. 
 
 ;t As the fad (lays he) cannot be denied, that a great 
 
 " majority have efcaped after contadt with perfons ill of 
 
 M difeafes fuppofed to be contagious, attempts may per- 
 
 c haps be made to account for it by fuppofing a certain 
 
 ' peculiarity of conftitution, which exempts from, or 
 
 :i difpofes to, difeafe. Is it the many who efcape that 
 
 * have this happy peculiarity of conftitution ; or the few 
 
 4 who are feized that are fo unfortunate as to poffefs it ? 
 
 ; The former are evidently too numerous to admit fucri 
 
 " an hypothecs. The property muft therefore, I con- 
 
 '* elude, by given to the latter. But a child here and 
 
 H h ' there 
 
234 A TREATISE ON 
 
 <; there is exempted from fmall-pox, although expofed 
 " to its contagion. In order to preferve a confiftency, 
 <c thisfaft muft be accounted for by the fame or another 
 peculiarity of conflitution. Peculiarities of conftitu- 
 tion, then, exempt from contagion in one cafe, and 
 difpofe to it in another ; and thus a term, which in 
 reality means nothing, may be made to account for 
 *' any thing. For my own part I confefs my inability to 
 " comprehend any other peculiarities of conjiitittion, or 
 " idiofyncrajies of 'habit ', than what are conftituted by the 
 " different degrees of health and difeafe ; the different 
 " ftates of the excitability." 
 
 In the fame manner that Mr. M'Lean argues with 
 regard to difeafe, let us argue concerning bodily ftrength. 
 Some men are able to lift a weight of 6 or 700 pounds, 
 but a great majority cannot lift above 300. Whence 
 proceeds the difference ? Is it the few who lift the great 
 weight that by nature have more ftrength, or is it the 
 rriany who can lift only the fmaller that by nature have 
 te/s f This is precifely his argument, and there needs no 
 other refutation than ftating it in this manner. What 
 he calls the ftates of excitability are as much idiofyncrajies 
 at the time as any thing elfe. Mr. M'Lean will not 
 deny that a perfon debilitated by certain caufes is more 
 liable to be feized with typhus fever than one who is not. 
 What does this proceed from, but that the body of Uie 
 one is prepared^ for the difeafe, is conftitutionally difpofed 
 to receive it, or has an idiofyncrafy of habit difpofing to 
 it, which the other has not ? It is true, that unlefs we 
 point out the circumftances which conftitute this iciio- 
 fyncracy we do nothing ; but Mr. M'Lean's fcheme, of 
 icfolving every thing into excitability, would forever pre- 
 vent us from doing fo f This is the great deficiency of 
 the Brunonian fyftem altogether ; for, by attending 
 only to the animal life of the bodyj he feems to have 
 abfolutely forgot that we had any thing in common with 
 vegetables. The bones, for inftance, or indeed any part 
 of the body, cannot be formed by the power which go^ 
 verns it after it was formed. The growth of the human 
 body is as ftrid vegetation as that of a tree ; and there- 
 
 f or ? 
 
THE PLAGUE. 
 
 fore we find that after the excitability is entirely gone, 
 after death has taken place for a confiderable time, the 
 body flili retains its form, and would do fo forever, did 
 not other powers interfere with it. Human life therefore 
 is a compound of the vegetable and animal life, the for- 
 mer being the bafis of the latter .$ and it is the vegetable 
 life which is much more commonly the fubject of difeafe 
 than the animal life. In vegetables we obferve an idio- 
 jyncracy of habit, as well as among animals. Some, even 
 of the fame fpecies, are much more vigorous than others, 
 and, among fome, difeafes are much more common than 
 others. In like manner among the human race fome 
 are ftrong, others weak ; in fome the blood is much more 
 confident, and coagulates on expofure to the air much 
 mere firmly than in others. Excitability, or excitement, 
 is common to all, and the degrees of it (though enume- 
 rated by Yates and IVTLean in a kind of thermometrical 
 icale) muft be merely imaginary, becaufe excitability is 
 not the object of our fenfes. The obvious properties of 
 the body itfelf, independent of any excitement whatever* 
 are principally to be confidered in medicine. Thefe 
 conftitute the peculiar conftitution, or the idiofyncracy of 
 habit, belonging to each individual. Yet, in defiance 
 of every consideration of thefe obvious properties, which 
 all have accefs to obferve, the new fyftem leads us only 
 to consider an invifible and unknown being called excita* 
 bility-. Hence difeafes peculiar to certain conftitutions 
 more than others are faid to be occafioned only by cer- 
 tain degrees of excitability common to all> or perhaps to 
 confift in thefe very degrees them&lves. Thus a pecu- 
 liar mode of practice has been introduced* in which al- 
 moft the whole materia medica is rejected. We have 
 already quoted Dr. Girtanner, faying that all difeafes 
 whatever may be cured, as well as produced, by only four 
 articles ; but in the following quotation he goes frill far* 
 ther. " The art of pharmacy and the fcience of pre- 
 " fcription will become iifelefs ; a phial of alcohol or 
 c laudanum will fupply the place of that enormous 
 s< quantity of drugs which crowd the fhops of apothe- 
 <4 caries. The trade of the druggift but hold -, if I 
 
 " continue 
 
A TREATISE ON 
 
 *< continue this prophetic language, I fhall only expofe 
 " myfelf to ridicule," &c. Reveries of this kind cer- 
 tainly deferve the moft fevere reproof. People may no 
 doubt amufe themfelves with theories as well as any thing 
 elfe, while thefe theories continue inoffenfive ; but when 
 the belief of them leads to a rejection of what has been 
 eftabliftied by the experience of many ages, they begin to 
 afifume a confequence which they originally had not. 
 We have already feen that a difbelief of the doftrine of 
 contagion leads people into a practice accounted danger- 
 ous by many, and which cannot be proved to be fafe. 
 A total rejection of medicines, the efficacy of which 
 have been attefted by thoufands', and which never can 
 be proved to have no efficacy, muft be attended with ftill 
 worfe confequences, as thus we (liould be deprived of 
 the means of curing thofe difeafes which our imprudence^ 
 in rejecting the former doctrine might have brought on/ 
 But, to return to the fubject of the plague. 
 
 The difappearance of the difeafe, while all the caufes 
 that we fuppofe capable of producing it remain in full 
 force, is a demonftration that it depends on fornething 
 entirely diftinct from the human body* and from all 
 thofe powers which perceptibly act upon it. It proves 
 that this unknown power has only a temporary exiftence, 
 coming to perfection at one feafon, and dying away in 
 another; fometimes capable of being revived, and fome- 
 times not. This corresponds entirely with what has 
 been laid down concerning contagion itfelf, viz. that 
 like other aerial vapours it is capable of decompofition, 
 and remaining for an uncertain length of time in a dor- 
 mant ftate -, but that occasionally it may revive, and ap- 
 pear unexpectedly, as mofetes arife from lavas, or damps 
 in mines. After a city has been thoroughly infected 
 with a peftilential diforder, therefore, there can be no fe- 
 curity again ft its re-appearance ; it being impofTible to 
 know whether the contagion may not be ftill exifting 
 and capable of being revived by lome unknown caufe, 
 though it has been dormant ever fo long. In fuch cafes 
 it may with propriety be laid to have znfen fpontaneoufly* 
 though, had it not been there at a former period* there 
 
 could 
 
THE PLAGUE. ' 237 
 
 could be no reafon to think that it would have appeared 
 at that time. 
 
 Dr. Ruffel next takes into confederation the plague at 
 Marfeilles in 1726, of which he fays the accounts " are 
 " more full, and circumftances better authenticated, 
 " than moft of the accounts of anterior plagues to be met 
 " with in books.'' From the oppofition to the do&rine 
 of contagion at the time, he alfo fuppofes that the facts 
 relative to its introduction would be feverely fcrutinized, 
 and falfehoods detected : " but (fays he) if, inftead of 
 " fuch detection^ the mod material haVe been pafled 
 " over in filence, and little more than hypothetical rea* 
 " foning oppofed to others, the main facts may be con- 
 " fidered as eftabliflied, if poflible, more firmly than 
 " they were before.'* Thefe facts are flated as follows t 
 '" i. That the plague did not exift in France before the 
 " 2th of May, 1720. 2, That it was imported in 
 " goods from the Levant^ by a fhip which left the coaft 
 " of Syria the beginning of February., and arrived at 
 " Marfeilles the 25th of May. Two days after her ar~ 
 Cs rival one of the fail ors died ; an officer of quarantine 
 " who had been put on board died on the isth of June, 
 " and a cabin boy on the 23d. Some porters employed 
 ct in opening the merchandife at the lazaretto alfo died 
 " about this time. Three others were taken ill in the be- 
 " ginning of July, with buboes in the groin and axilla. 
 " This alarmed the furgeon of the lazaretto $ a conful- 
 C tation was held with two other furgeons on the 28th; 
 " thedifeafe was unanimoufly declared to be the plague, 
 " and the three patients died next day : the furgeon of 
 " the lazaretto, with part of his family, and the prie(t 
 " who attended the fick, were alfo taken ill and died." 
 
 From the lazaretto the difeafe made its way into the 
 city, and began to appear about the loth of June. By 
 what mearts it was introduced is not directly faid ; but 
 it feems to have been by fmuggling infe&ed goods. In 
 the beginning of July it began to fpread ; but a kind of 
 paufe having taken place between the 1 2th and 23d, 
 the phyficians were reproached with having miftaken the 
 diftemper. During this fuppofed interval, however, 
 
 it 
 
A TREATISE ON 
 
 it was difcovered on the i8th of July that the difeafe 
 had fpread in a certain part of the city. A furgeon * 
 employed to examine into the matter, declared the dif- 
 temper to be the worm-fever ; and about the z^d the 
 council of health were informed of the death of fourteen 
 perfons in that quarter, and of feveral others falling fick. 
 The furgeon ftill adhered to his opinion, but a phyfician- 
 declared it to be the true plague. About the end of 
 the month it had got into the fuburbs ; four phyfieians : 
 declared it to be the true plague, but their report was 
 not believed ; they were infulted in the ftreets, and it 
 was not until fome of the inhabitants of better rank 
 were taken ill, that the true ftate of the matter gained- 
 credit. 
 
 " Such (fays Dr. RufTel) was the rife of the plague 
 " at firft, and its progrefs afterwards in the months of 
 "June and July ; whence it appears, that perfons on 
 " board the fufpected fhip, thofe employed in airing the 
 cc goods, a furgeon and a prieft, who attended the lick* 
 " were among the firft infected j that the pafTengers 
 " from the feveral mips, all of which (hips, the firft 
 " excepted, brought foul patents, were, together with 
 <c their baggage, admitted into the city, after preforming 
 " a quarentine of little more than eighteen days 3 that 
 " the diftemper from the 2Oth of June till towards the 
 Cc end of jaly advanced very flowly, and fometimes feem- 
 
 ed to paufe ; that it attacked chiefly the poorer fort of 
 
 people, and was found in diftinct quarters of the city ; 
 <; and laftly, that, during ike firft forty days, few or none ef 
 " the infected recovered $ a circumftance entirely confo- 
 <c nant to what was obferved in the beginning of the 
 " plague at Aleppo.'* 
 
 Three other facts are mentioned by our author, viz. 
 that the diieafe was evidently communicated by in- 
 fection ; that thofe who were careful to ieclude them- 
 felves from all communication with the fick and with in- 
 fected goods, were not infected > and laftly, that the 
 difeafe, which began to rage violently in Auguft, con- 
 tinued to do fo through that and the following month* 
 but declined faft in the months of O&obcr and Novem- 
 ber* 
 
 cc 
 
THE PLAGUE. 239 
 
 ber, and feemed to ceafe in the middle of winter. Some 
 accidents happened in 1721, between the months of 
 February and July, which gave pccafional alarm j but 
 the diftemper did not fpread, and ceafed entirely after 
 the fummer folftice of that year. 
 
 To all this, however, objections have been made. 
 
 1. That the irregular feafons of the former year, a bad 
 crop, and unwholefome aliment, had produced a malig- 
 nant epidemic, all which, joined to the popular dread of 
 contagion, were fufficient to produce the plague without 
 any imported infection. To this Dr. RufTel replies, 
 that thefe portions, afTumed as facts, had no exiftence ; 
 for which he refers to the publications of the times. 
 
 2. It was objected that there were inftances of the plague 
 in Marfeilies before the z^th of May. Thefe inftances 
 are only five in number, produced by M. Deidier, " who 
 " faw not the cafes himfelf, yet (fays Dr. Ruffel) from 
 " the very imperfect accounts he had been able to glean, 
 fc he thought himfelf juftified in declaring they bore all 
 " the marks of the true plague. Nothing (adds the 
 " Doctor) but extreme partiality to an hypothelis could 
 " have led any one practifed in the plague, into fuch a 
 " declaration ; the cafes bearing every internal mark of 
 " belonging to a different clafs from the plague. I fhall 
 " endeavour to fhow this in a few words. 
 
 " Of the five fuppofed infected patients, three reco- 
 < vered, two died, and all had eruptions. One who 
 fc died had a parotis (the moft ambiguous of all pefti- 
 *' lential tumours) without any concurrence, fo far as 
 '* appears, of peftilential fymptoms. The tumour had 
 " appeared fix days before the woman's death, but how 
 " long ike had been lick remains unknown. The other 
 *' died the i6th or i7th day, a very unufual period in 
 " the plague. She alfo had a parotis, which did not 
 " make its appearance till the loth or nth day of the 
 *' difeafe. No peftilential fymptoms whatever are men- 
 " tioned. Of the three who recovered, one was very ill 
 ** with a fever and carbuncle ; but neither the invafion 
 ^ nor the duration of the difeafe are mentioned. Ano- 
 " ther had a carbuncle and a fmall tumour on the 
 
 " thigh $ 
 
240 A TREATISE ON 
 
 " thigh ; and the third (which bears the neareft refem- 
 " blance to a very flight infe&ion) had alfo a bubo in 
 ** the thigh ; but the tumours in neither of thefe pa- 
 :i tients are defcribed in fuch a manner as diftinguifhes 
 " them from ordinary tumours ; and the apothecary, 
 " who gives the account from memory, had in all like- 
 " lihood never feen a peftilential bubo before." 
 
 " Of the perfons infefted for fome time after the ar- 
 fc rival of the (hips from the Levant, none had erup- 
 ;t tions, and all perifhed after a few days illnefs ; which 
 ;c agrees entirely with what was obferved at Aleppo in 
 16 the beginning of the plague : hardly any of the ficlc 
 " recovered, and the major part died in three or four 
 " days, without any appearance of buboes. Upon the 
 fi whole, therefore, I think it very clearly eftabhmed, 
 " that the plague did not exift in France before the 
 " month of May, 1720. Prior to M. Deidier, how- 
 " ever, I find a M. Pons had endeavoured to prove 
 " that the plague was in Marfeilles, not only before the 
 " month of May 1720, but even in the preceding year. 
 " I have not had an opportunity of examining that gen- 
 ^ tleman's book." 
 
 3. It is objected that the difeafe was not brought 
 from the Levant by in.fe&ed goods. u Captain Cha- 
 * e taud's veflel, fuppofed to have brought the infected 
 *' goods, arrived with a clean patent, or bill of health, 
 " having left the coaft of Syria before the plague broke 
 " out there ; (lie confequently cannot reaibnably be 
 * l thought to have tranfported the plague, which was 
 <4 not in the ports from whence (he came." 
 
 To this Dr. R.uffel anfwers, that on commercial ac- 
 counts the Turks carefully conceal the appearance of 
 the plague from the Europeans. Should reports of 
 accidents get abroad, they are variouily and contradic- 
 torily represented, and peftilential marks and tumours 
 fraudulently concealed. Though Chataud obtained a 
 clean patent, the plague broke out foon after his de^ 
 parture, and three veflel s with foul patents arrived at 
 Marfeilles a few days after Chataud. " To this (fays 
 " Dr. Ruffel) it may be further added, that, notwith- 
 
 {landing 
 
THE PLAGUE. 241 
 
 w (landing his clean patent, perfons acquainted with the 
 " Levant will think it far from improbable, that the 
 "plague might actually have been in Sidon when he 
 *' failed, though unknown to the magiftrate, by whom 
 " the patents are granted. ... A clean bill of health 
 " imports that the place has been free from plague, and 
 " all fufpicion of plague, for a certain fpace of time ; but 
 " the clean patents of the two firft arriving from the 
 " Levant, after the cefTation of the plague, are, according 
 " to Mr. Howard, deemed foul at Marfeilles, and the 
 " paflengers are obliged to perform a quarantine of thirty- 
 " one days. The French confuls lying under an obli- 
 " gation to infert in their patents a detail of circum- 
 " (lances, it muft appear ftrange, when the condition of 
 " Syria at that time is coniidered, how Captain Chataqd 
 " fhould have obtained a clean patent." 
 
 Though this muft certainly be deemed a fufficient 
 anfwer to the objection, Dr. Ruffel goes on to give an 
 account of what had happened the preceding year, when 
 the plague had raged violently at Aleppo $ and (hows 
 that, from the condition of the whole coaft of Syria, a 
 return of the plague was certainly to be expected ; that 
 the French confuls could not be ignorant of this, nei- 
 ther could the council 0f health at Marfeilles be unac- 
 quainted with what had happened at Aleppo the pre- 
 ceding year. " The facility with which the patents 
 " feem to have been iffued in Turky, and the partial 
 " indulgence of the council to Chataud's (hip, notwith- 
 " (landing the very extraordinary mortality which had 
 " avowedly happened on the voyage, together with their 
 cf eafy confidence afterwards in the reports of the furgeon 
 " of the lazaretto, can only be accounted for from the 
 " prevailing influence of private commercial intereft over 
 " a fen(e of official duty." 
 
 Our author next proceeds to take notice of what 
 happened during this (hip's voyage to Marfeilles. On 
 the 31(1 of January he left the coaft of Syria with a 
 clean patent, before the plague broke out. On the 2$th 
 of May he arrived at Marfeilles, from Sidon, Tripoli and 
 Cyprus. On the voyage, or at Leghorn, he loft fix of 
 
 li the 
 
-4s A TREATISE-^ON 
 
 the crew , but, by the certificates of the phyficians of 
 health at Leghorn, thefe died only of malignant fevers 
 caufedby unwho/efome provifions. Thefe laft words in the 
 Tralte de la Pefte are faid to have been interpolated at 
 -Marfeilles. At any rate, as Dr. Ruflel obferves, they 
 could relate only to thofe who died at Leghorn, npt t 
 the others, whom the phyficians had not feen. 
 
 The other account is much lefs favourable. Accord- 
 ing to it, Chataud " left Sidon the 3ift of January with 
 " a clean patent. The plague discovered itfelf there 
 " a few days after his departure. Having fuftained fome 
 ** damage by bad weather, he put into Tripoli, where he 
 " embarked fome merchandife ; he took in alfo fome 
 <c Turks, paflengers for Cyprus, together with their lug- 
 <c gage. Soon after the fhip had left Tripoli, one of 
 " thefe paflengers fell fick and died. Two of the failors 
 *' employed to throw the corpfe overboard defifted at the 
 " defire of the pilot, and the reft of the ceremony was 
 " performed by the other Mahommedan paflengers ; 
 " the ropes with which the body was lowered down, be- 
 " e ing by way of precaution thrown into the fea. With- 
 " in a few days the two failors who had handled the 
 <c corpfe were taken fick and died. At Cyprus the fhip 
 " put her remaining pafiengers on fhore, and made a 
 * 6 very fhort ftay. Soon after her departure from that 
 " ifland, a third failor and the furgeon died of an illnefs 
 <& of a few days duration. The captain, juftly alarmed 
 <c by thefe accidents, ordered the bedding and other 
 " things ufed by the deceafed to be thrown into the 
 "fea; and kept himfelf carefully feparate from the 
 " crew during the remainder of his voyage. Some time 
 " after this three more failors fell fick, and, there being 
 " no furgeon on board, the veflel put into Leghorn, 
 *' where the three fick men died, and the phyfician and 
 * e furgeon of the lazaretto declared the difeafe to be a 
 " malignant peftilential fever." 
 
 Our author coniiders the above account as a full 
 proof of the plague being imported by Chataud's vef- 
 fel : he declines entering into the queftion about the 
 fioffibility of importing contagion ^in merchandife. How 
 
 this 
 
THE PLAGUE. 243 
 
 this might take place has already been explained -, and 
 the prefent inftance of its having been imported is as 
 clearly proved as can be expected. A collateral proof, 
 with regard to the contagion of the fmall-pox, we have 
 from Dr. Huxham. A beggar, ill of that difeafe, ap- 
 proached a certain town in England, but was not fufFer* 
 ed to enter, for fear of infection. The beggar died, and 
 the infected clothes were burnt at fome diftance from 
 the town ; but the fmoke being blown upon it by. the 
 wind, the fmall-pox in a fliort time made its appearance* 
 beginning in that part upon which the fmoke was blown. 
 This clearly proves that one fpecies of contagion may ad- 
 here to clothes, and is a very ftrong prefumption that 
 any other may do the fame. It alfo (hows that conta- 
 gion, when once produced, is by no means eafily deftroy- 
 ed 5 and confequently that all kinds of purification, even 
 when ufed with the utmoft care and diligence, are fcarce 
 fufficient to enfure fafety. 
 
 It would now be fuperfluous to enter farther into the 
 fubject of the plague being communicated by infe&ed 
 goods, did not our author quote a work of Dr. Pye of 
 London, in which the latter from the very Journal (which, 
 has been ufed as containing arguments in favour of con- 
 tagion) makes inferences directly oppofite. " The facts 
 " related in this journal (fays Dr. Pye) feemed to me 
 " to make fo clearly againft the modern doctrine of con- 
 " tagion, that if this writer had not mentioned them as 
 " undeniable inftances in his favour, I fhould not have 
 " thought there had been any perfons here in England fo 
 " dull of underftanding, or fo much blinded with pre- 
 " judice, as to ftand in need of having thefe facts put 
 
 ' into a more obvious light : but, having this occafion, 
 " I {hall confider them more largely than otherwife I 
 " would have done, and fhow that the porters, whodi- 
 cc ed in the lazaretto at Marfeilles, received no hurt or 
 " infection from the goods. 
 
 " To leave no room for objection, I {hall take notice, 
 6 c that a guard of quarantine died on board Chataud's 
 
 :i mip the 1 2th of June j but, as this officer was no 
 *< ways concerned either in unloading or opening the 
 
 " goods, 
 
* 4 4 A TREATISE ON 
 
 " goods, he could receive no hurt from them ; and be a 
 " fides, this muft have been fourteen or fifteen days af- 
 cc ter the goods had been carried out of the (hip into 
 " the lazaretto. Further, fix of their men are faid to 
 " die at Leghorn ; but the town of Leghorn was not in- 
 " fefted from thence, which would have been more 
 <c likely if there had been any infedion in the cafe, than 
 " that Marfeilles fhould be afterwards infeded. 
 
 " If any infe&ion or infectious aura can be fuppofed 
 " to be packed up, and brought in goods, fuch infedion 
 " or infectious aura muft necefTarily ifiTue forth from 
 *' them in greateft abundance, and with the greateft 
 * c force, at the firft opening or unpacking of them $ and, 
 :c as it muft continue to fly off every moment, and be 
 " thereby continually diminifhing, it is likewife cer- 
 *' tain, that in a very few days the goods muft be in a 
 <e great meafure, if not entirely, cleared of it. Where- 
 " fore, if the porters could have been infe&ed from the 
 <e goods at all, it muft have been at the firft opening of 
 *' them : but, even according to this journal, the porters 
 *' that firft fell fick were not taken ill before the 23d of 
 * c June, Whereas Chataud's ihip arrived the 2th of May 
 " preceding ; fo that the goods of that mip, in purifying 
 <c which the porter firft mentioned was employed, had 
 <e been airing and purifying for twenty-fix or twenty- 
 " eight days before this accident happened ; and it cafi- 
 " not be conceived that after fo long a time they fhould 
 " not have been entirely purged of all infection or infec- 
 <c frous aura, if any could have been brought with them. 
 " Or if it can be fuppofed, which I think impoffible, that 
 " any part might ftill be left, it muft withal be fuppofed 
 " fo much lefs than at firft, as not to be capable of doing, 
 " thofe porters efpecially, the Jeaft hurt : to fuppofe 
 <c otherwife would be to argue that the fame man who 
 < fome days before had received and borne a very great 
 " quantity and force without any injury > could then be 
 " killed by a quantity and force infinitely lefs. 
 
 " According to the report of merchants, Frenchmen 
 " fire not fubjecl to the plague in Turky ; and it cannot 
 " be conceived that fo fmall a quantity of infectious air 
 
 4t as 
 
THE PLAGUE. 245 
 
 <e as can be packed up and brought in a bale of goods, 
 " fhould deftroy them in France, or in an air and cli- 
 " mate diftant and different ; when the whole atmo- 
 " fphere of the fame infe&ious air is found not to injure 
 " them in Very infeded places, and wherein it is al- 
 " lowed to be bred and generated." 
 
 Thus far Dr Pye.-~ -Let us now hear Dr. Ruffel in 
 anfwer. 
 
 " The death of the quarantine officer was mentioned 
 " in order to leave no room for obje&ion ; but ftill it 
 " may be objected that he has omitted the death of 
 " the failor on the 2jth of May, and aflerted, in con* 
 " tradition to the journal, that the former fix failors 
 " died at Leghorn. That Leghorn was more likely to 
 " be infefted than Marfeilles, is a ftrange notion. The 
 " fhip had landed no goods there, nor had any inter- 
 " courfe with the fhore , for -the phyfician who vifits 
 " the fick on board, remains at a diftance from the fhip, 
 " in a boat* and the dead bodies are funk in the fea. 
 " As to the circumftance of the goods of Chataud's vef- 
 " fel being all in the lazaretto before the i2th of June, 
 " it is a fuppofition to be attributed to Dr. Pye's un- 
 " acquaintance with matters of that kind ; for it is im- 
 " poffible a fhip which arrived the 25th of May fhould 
 " difcharge the whole of her cargo in two or three days. 
 * 6 The difpatch would have been miraculous, confider- 
 " ing the fhip lay near two leagues from the lazaretto, 
 " and was unloaded, and the boats navigated, by her 
 <c own crew. It did not occur to Dr. Pye, that forne 
 " time, previous to the veflels beginning to unload, is 
 " taken up in examination and other forms at Pomegug* 
 " and the council of health. The lofs of fix men on the 
 C voyage was an extraordinary circumftance, that re- 
 " quired deliberation ; and it appears that on the 29th, 
 " alter the death of the failor on board Chataud's vef- 
 ;c fel, the council determined the quarantine of his 
 41 cargo to be forty days, commencing from the landing 
 * c of the laft bale j which was double the time ufually 
 " allowed for a fhip with a clean patent. It is very 
 ?' probable, therefore, that tke fhip did not begin to 
 
 " unload 
 
246 A TREATISE ON 
 
 " unload till after the 2pth of May, and poffibly had 
 <c not finished when the quarantine officer died, the i2th 
 " of June, who muft have been taken ill two or three 
 " days before. 
 
 " In regard to the time requifite for the complete 
 " evaporation of the infedious aura, in what propor- 
 " tionate gradation its adivity is impaired by ventila- 
 " tion, and the Jfpecific quantity required to produce 
 " effect on the human body, they are matters which I 
 <c apprehend will not readily be admitted to be clearly 
 " and certainly known. That the firft porters were 
 " not taken ill before the 23d of June, is very true ; 
 " but that the goods had been airing and purifying for 
 " twenty-fix or twenty-eight days, has been mown above 
 " to be an error. The Dodor alfo makes two other 
 ** fuppofitions equally erroneous. The firft, that the 
 " whole of the cotton, contained in a number of bales 
 " is equally imbued with infedious aura ; the fecond, 
 " that all the bales of a fhip's cargo are opened nearly 
 " about the fame time. But, as the cotton contained 
 " in thefe bales may not only have been collected from 
 " different villages at different times, but packed up 
 * under various circumftances relative to the materials 
 ** ufed for embalage, and the perfons employed in em- 
 " baling or fteeving them ; it may eafily be conceived 
 tc how the cargo of a (hip, coming even from a place 
 " where the plague adually rages, may be only par- 
 " tially infeded, or not infeded at all. ^The warmeft 
 *' advocate for contagion never contended for every 
 " bale of a fhip's cargo being equally infedious. As 
 < e to the airing of the bales, it is a laborious and a 
 " tedious procefs. - Where there is a confiderable 
 " number, it takes up feveral days to open and arrange 
 " them, goods of different kinds muft be difpofed fepa- 
 *' rately, accounts taken, and the cordage, &c. laid up 
 " with care where it may be found again. The labori- 
 *' ous part of thefe operations is performed by the porters, 
 " who alfo transport the goods from the water fide to the 
 " enclofure where they are to be aired : and, as the days 
 4 of Quarantine do not begin to be reckoned till all the 
 
 ;" goods 
 
THE PLAGUE. 247 
 
 ft goods are landed, the porters for fome days at the be- 
 " ginning are fufficiently employed in receiving and ar- 
 " ranging the cargo, that being the bufmefs requiring the 
 " firft difpatch. When thefe circumftances are confi- 
 " dered, it will appear no extravagant fuppofition, that 
 " fome of the laft opened bales of Chataud's cargo might 
 " ftill retain enough of infectious aura to infect the por- 
 54 ter on the 23d of June. To fet this retardment, al- 
 " moft unavoidable in the opening of bales, in a ftill clear- 
 " er light, it mould be obferved, that, by the regulations 
 " at Marfeilles, all fufpected goods are fubject to what is 
 " termed fereines ; that is, a certain number of bales are 
 " taken out of the hold, and, being opened at both ends, 
 " are expofed to the air for two, three, or fix days, by 
 " way of trial, in order to fee if any figns of infection 
 " mould appear among thofe employed in handling the 
 * ; merchandife. When thefe have been aired, more or 
 ct lefs, according to circumftances, another parcel is 
 " opened and expofed to ventilation in like manner : 
 " fo that, according to the burden of the fhip, there may 
 " be feveral of thefe fereines, each of feveral days dura- 
 " tion. In this manner, independent of accidental im- 
 " pediments from wind and weather, in fending the goods 
 " from the (Lip, it maybe fuppofed, were it at all neceffa- 
 " ry to make the fuppofition, that the porters, not only 
 " on the 23d of June, but on the jth and 8th of July, 
 " were infefted upon opening fome new bales. As to 
 " the porter being infected by goods from another fliip, 
 " Dr. Pye thinks it impofiible, becaufe the fhip had been 
 " twelve days in port, and the goods muft have been 
 " eight or nine days in airing and purifying : had he 
 " been acquainted with the practice of the fereines in. 
 " quarantine, he would have been at no lofs to make the 
 " accident agree exactly with his notion of the infectious 
 " aura. . . . The plain matter of fact, as it ftands in 
 " the journal, is this, that fix porters, employed in pu- 
 " rifying fufpected merchandife from the Levant, died 
 " of the plague ; and their death was followed by that 
 " pf the furgeon who attended them, and part of his 
 " family." 
 
 From- 
 
248 A TREATISE ON 
 
 From this the reader will be able to judge how far the 
 queflion is decided in favour of the fact that the plague 
 at Marfeilles was actually produced by imported con- 
 tagion. It feems needlefs to follow our author through 
 his inveftigation ofthofe facts which his adverfaries have 
 mifreprefented ; for thefe mufl of courfe be in his favour; 
 every mifreprefentation by a difputant being plainly an 
 abandonment of his caufe. Indeed the argument againft 
 contagion at that time was properly but one, and is fet 
 forth in no ftronger language now than formerly. Eve*n 
 as long ago as 1665 Dr. RufTeFquotes one Gadbury an 
 aflrologer dating the difficulty as ftrongly, and giving a 
 folution of it as clearly, upon Us principles, as the ben; 
 modern theorifts can do upon theirs. " If the peftilence, 
 " (fays Mr. Gadbury) be infectious, and really catching 
 <c in itfelf, it muft be fo equally to all perfons that 
 " approach it, or that it approacheth ; or elfe it muft be 
 " infectious to fome particular perfons only. If it be 
 " infectious to all perfons, or catching to all alike, then 
 " all perfons, that come into the fight or within the fcent 
 " of it, muft neceffarily be fubjedl unto it. If not in- 
 " fedlious unto all, but unto fome particular perfons on- 
 < ly, I fay then it ought not to be deemed or efteemed 
 " infedtious at all, at leaft not any more infectious than 
 " are all other difeafes, viz. fmall-pox, fcurvy, pleurify, 
 " ague, gout; &c. fince (though the notion of infedfcion- 
 u be laid afide) there is not a perfon born into the world 
 " that hath not at fome time of his life (as his nati~ 
 *' vity (hall truly (how) fome one difeafe or other. Ne- 
 < c ver was any perfon fubjedl to violent difeafes, as plague, 
 " &c. but had a violent nativity to (how it, and e centra" 
 
 Theanfwer to this has been already given. Let any 
 other caufe than contagion or infection befuppofed, and 
 the difficulty remains equally great. The probability is 
 in favour of contagion, rather than a general difpofition 
 of the atmofphere, becaufe in the latter cafe the difeafe 
 would, contrary to experience, begin in a great many 
 places at once ; but the plague begins in fuch a fecret 
 manner that we fcarce know whence it comes. Like'fire, 
 or a ferment in liquors, it diffufes itfelf far and wide, and 
 
 laftly, 
 
THE PLAGUE. 
 
 laftly, like an immenfe inundation, the fource of which is 
 dried up, it feems to lofe its power by extending too far, 
 and dies away altogether. We cannot penetrate into 
 the caufes of thofe things, but, without any fpeculation 
 at all, we can obferve that the difeafe falls upon people 
 of a certain conftitution more than others, and this may 
 be of ufe in preferving ourfelves from it, as mall be 
 explained in the next fection. 
 
 It is ftill neceflary to fay fomething of the infection 
 fpreading from one perfon to another, and being kept off 
 $y refraining from communication with the difeafed. 
 This indeed natiirally follows from its proceeding origi- 
 nally from the cotton : for as all the infedled did not 
 touch this cotton, there can be no other caufe affigned 
 from its fpreading than by communication from one to 
 another ; and, therefore, if fuch communication was cut 
 off, we ihould naturally think that the difeafe would not 
 fpread. But, in oppofition to this, we have already 
 quoted Dr. Mofeley giving a long lift of convents infe&ed, 
 though they kept themfelves ftrictly fhut up. Dr. Ruf- 
 fel cites, in favour of prevention by fhutting up, two 
 certificates, one by the bifliop of Marfeilles, the other 
 by the fheriffof the fame place. To thefe he adds the 
 teftimony of M. Langeron, who was actively employed 
 throughout the whole time that the plague continued, 
 firft as a commodore of the gallies, and afterwards as 
 governor of the town and its dependencies. In oppo- 
 (ition to thefe, however, he takes notice of two pafiages 
 " in books of acknowledged authority," which he is at 
 pains to anfwer ; the one is from the Journal already quo- 
 ted, which fays, " and what is unaccountable, thofe 
 " who have fhut thernfelves up moft fecurely in their 
 " own houies, and are the moft careful to take in nothing 
 " without the moft exact precautions, are attacked there 
 " by the plague, which creeps in no one Jcnows how.'* 
 The other paffage is taken from the Relation Hiftorique, 
 " that, in the height of the peftilence, the infection 
 <c penetrated into places which had till then remained 
 " inacceffible ; that monafteries and houfes (liut up in 
 < c the moft exact manner were no longer places of fecu- 
 I* rity." K k To 
 
A TREATISE ON 
 
 To the former of thefe our author anfwers, that " from 
 " the manner of ftating the cafe, one would think that 
 " all thefe religious had been clofe fhut up, without any 
 " communication with perfons without doors; and this 
 " was certainly intended by an author who has made 
 " remarks upon it ; but it will be found, upon looking 
 <c into the beginning of the very paragraph cited, that 
 " the greateft part of them are reprefented as martyrs 
 " who had meritorioufly expofed themfelves. Of the 
 " twelve different orders mentioned on this occafion, 
 "the Grand Auguftines only are faid to have kept in 
 " their convent. But, fuppofing the Auguftin convent 
 " to have been actually ihut up, and in that ftate in- 
 " feded ; it would by no means invalidate the inftances 
 " brought of the prefervation of the convents, the cer- 
 " tificates concerning which were granted deliberately, 
 " after all was over ; whereas the journal, written from 
 " day to day, marking circumftances rapidly as they 
 " occurred, the author, amongft various other affairs, had 
 " not always leifure or opportunity to examine minutely 
 " into circumftances. It is in this light 1 am inclined 
 t to confider the houfes being infe&ed which took in 
 " nothing without the mod exact precautions ; and the 
 ** rather, becaufe I met with feveral inftances of the like 
 <c kind at Aleppo, in the houfes of the Chriftian and 
 " Jewifli nations : but in the fequel it generally appear- 
 " ed there had been fome improper communication car- 
 4C ried on by the domeftics, unknown to the family at 
 " the time. 
 
 " That the atmofphere, in a city fo dreadfully cir- 
 " cumftanced as Marfeilles, may become fo highly 
 " tainted as to convey the plague into houfes fliut up, 
 " cannot confiftently be affirmed to be impoffible, by 
 * thofe who hold mediate contagion - y and the concur- 
 " rence of circumftances at that period in Marfeilles, ren- 
 " ders it highly probable that fuch accidents happened. 
 cc But, in general, the peftiferous effluvia once emitted 
 " into the air, do not appear to operate at any great 
 ct diftance from their fource -, and M. Deidier afferts, 
 6C that two monafteries (from their Situation, one near a 
 
 " burial 
 
THE PLAGUE. 251 
 
 <c burial ground, the other near a peft-houfe) very dan- 
 cc geroufly fituated, remained neverthelefs untouched, 
 "which he thinks an argument againft infection being 
 " conveyed by the air." 
 
 From this long and contefted account of the manner 
 in which the plague was received into Marfeilles, we fee 
 how very difficult it muffc be to come at a true ftate of 
 fads, when a number of people think it their intereft to 
 mifreprefent or conceal them. The limits of this trea- 
 tife will not allow us to follow our author through the 
 numerous details of mifreprefentations and unfair me- 
 thods which the adverfaries of the doctrine of contagion 
 have made ufe of to eftablifh their opinion : neither 
 Ihall we enter into any difcuffion concerning the origin 
 of other plagues, as we fhould in them find the fame 
 oppofite kinds of evidence without fuch documents for 
 diftinguifliing the true from the falfe as Dr. RuiTel has 
 produced in the cafe of Marfeilles. A fingle fact only, 
 mentioned by Mr. Howard in his Treatife on Lazaret- 
 tos, fhall be related, and which, if allowed to be/<z<57, 
 decides the queftion as effectually as a thoufand. 
 
 " When the plague raged at London in 1665, it was 
 " conveyed to the remote village of Eyam near Tidefwell 
 " in Derbyshire. In this place it broke out in Septem- 
 " ber 1 665, and continued its ravages upwards of a year, 
 " when two hundred and fifty of the inhabitants had 
 " died of it. The worthy rector, Mr. Mompeflbn, 
 sc whofe name may rank with thofe of Cardinal Borro- 
 " meo of Milan, and the good bifhop of Marfeilles, at 
 " its breaking out, refolved not to quit his parifliiorters, 
 " but ufed every argument with his wife to quit the in- 
 *' fefted fpot. She, however, refufed to forfake her hu* 
 <c band, and is fuppofed to have died of the plague. 
 " They fent away their children. Mr. Mompeffon con- 
 " ftantly employed himfelf, during the dreadful vifita- 
 " tion, HI his paftoral office, and preached to his flock 
 *' in a field, where nature had formed a fort of alcove 
 " in a rock, which place ftill retains the appellation of 
 " a church. He furvived, and the entries in the parifh 
 " regifter relative to this calamity are in his own hand 
 writing, vis* In 
 
2 S z A TREATISE ON 
 
 In 1665,- Sept. : Died 6 1666* May Died 5 
 
 'Oct. 22 June 20 
 
 Nov, ,.5 July ,53 
 
 Dec. 7 Aug, 78 
 
 t66 Jan. 3 Sept. 14 
 
 Feb. 5 Oct. 17 
 
 March z Nov. i 
 
 April 12 
 
 This plague is faid to have afifen from a box of 
 clothes fentfrom London while the diftemper was at its 
 height in that city. But whether this be admitted or 
 not, it cannot well be fuppofed that in a fmall village 
 there could either be a peculiar confutation of the air, 
 collections of filth, immoderate heat, cold, or in fhort 
 any general caufe from which, a pi-ague could be fup- 
 pofed to arife, that would not have affected the country 
 for a great way round. How then came this infulated 
 fpdt to be To violently affe&ed, except by contagion ? 
 No matter whether by clothes or any thing elfe. The 
 very particular manner in which the numbers who 
 died are recorded, leaves no doubt as to the fa& of the 
 diftemper .haying been there ; neither is it poffible to 
 account for its rife on any other principle 'than con- 
 tagion. 
 
 Mr. Howard, previous to his going abroad, had been 
 furnimed, by Dr. Aikin and Dr. Jebb, with a fet of 
 queries relative to the plague, to be put to the phyfi- 
 cians in the different countries through which he tra- 
 velled, This comrnifilon he executed with great fide- 
 lity and exaclnefs. The phyficians to whom he pro- 
 pofed them were, Raymond of Marfeilles, phylicianj 
 DemoH'ms of do. furgeon j Giovanelli, phyiician to the 
 lazaretto at Leghorn; They, to do. at Malta ; Morandi, 
 phyfician at Venice ; fardom, at Triefle j Jew phyfi- 
 cian at Smyrpa ; Fra. Luigi dl Pavia, prior to the hof- 
 pital of San Antonio at Smyrna. The queflions pro-r 
 pofed were as follow : 
 
 i. Is the infedion of the plague frequently received 
 by the French ? 
 
 Though 
 
THE. PLAGUE. 253 
 
 Though, this was not asking in direct terms whether 
 the plague is infeftious or not, all to whom it was pro- 
 pofed Teem to have viewed it in this light, Raymond of 
 Marfeilles only excepted, who anfwered diredly, " Some- 
 times it is." All the reft, except Giovaneiii, agreed that it 
 might be communicated by the touch, or by the breath. 
 Verdoni gave an inftance of its being communicated by 
 a flower which three perfons fmelt at j two remained 
 free, but the third fickened and died in twenty-four 
 hours. 
 
 2. Does the plague ever rife fpontaneoufly ? 
 
 In this Verdoni alone anfwered positively in favour of 
 the fpontaneous rife of the plague. They fpoke ambi- 
 guoufly. 
 
 3. To what diftance is the air infecled ? How far 
 does actual contact, wearing infedl'ed clothes, or touch- 
 ing other things, produce the difeafe ? 
 
 To this queftion Verdoni anfwered in a manner feem- 
 ingly inconfiftent with his former anfwer j allowing not 
 only that the plague was infectious, but that infected 
 things might communicate the difeafe after an interval 
 of many years* All agreed that the ftrength of the in- 
 fection was greater or lefs according to circumftances ; 
 the diftance at which it could act was likewife uncertain. 
 Raymond faid that the fick might be fafely converfed 
 with, acrofs a barrier, at a few paces diftance ; the Jew 
 faid at two ells diftance, provided the chamber windows 
 be not all (hut. Giovanelli faid it had been proved that 
 the infection did not extend beyond five geometrical 
 paces. The touch of infected clothes, or drawing in 
 the breath of the fick, was looked upon by him an3 
 Fra. Luigi to be very dangerous. 
 
 4. What are the feafons in which the plague chiefly 
 appears ; and what is the interval between the infection 
 and the difeafe ? 
 
 To this it was anfwered by Raymond, that the two 
 folftices are the times in which it has leaft power. The 
 others agreed that hot and moift weather was favourable 
 to its ravages ; the fpring, fummer and firft month of 
 autumn are dreaded. Thefe circumftances, however, 
 
 rauft 
 
A TREATISE ON 
 
 muft be variable in different countries. As to the time 
 in which the infe&ion (hows itfelf, the anfwer was vari- 
 ous. According to They, it " fometimes a&s flowly, 
 fometimes like a Jlroke of lightning" According to 
 Verdoni, " the difeafe generally fhows itfelf at the in- 
 ftant of touch, like an eleflricalJJiock" Sometimes the 
 infection will be communicated from a fick perfon to a 
 found one, who without any difeafe may communicate 
 it to a fecond, and that fee end to a third, in whom alone 
 it would become a&ive. 
 
 The other queftions, relative to the fymptoms, pre- 
 vention and cure of the diftemper, will be taken notice of 
 in the courfe of the treatife. In the mean time having 
 difcuffed, with a prolixity almoft exceeding our bounds, 
 fuch preliminaries as feemed moft likely to throw fome 
 light on the nature of the diftemper, we (hall now pro- 
 ceed to the medical hiftory of the plague, as we find it 
 laid down in different authors. 
 
 Though this diftemper has moft frequently been ac- 
 counted a fever in the higheft degree, yet, as we have al- 
 ready noticed, it feems to be elfentially different.* The 
 teftimonies there quoted are fufficient to eftablifh the 
 fad ; and, were it needful, many others might be brought 
 from authors both ancient and modern. In the plague 
 faid to have taken place in the days of Romulus,-}* Plu- 
 tarch relates, that the people died without any ficknefs. 
 To this very ancient teftimony we fhall add that of Dr. 
 Patrick Ruffe], who clofes the account of his firft clafs 
 of patients with the following paragraph : " That the 
 " plague, under a form of all others the moft deftruc- 
 " tive, exifts without its charaderiftic eruptions, or 
 " other external marks reckoned peftilential, can admit 
 " of no doubt ; and it is to be regretted that mankind 
 ** have fo often, from the abfence of thefe, been betrayed 
 " into errors of fatal confequence on its firft invafion ; 
 *< at which early period human prudence can only be 
 <c exerted in the way of defence with any probability 
 " of fuccefs." 
 
 The 
 
 * See p, 102 ftf'1* f P. i9 note* 
 
THE PLAGUE. 255 
 
 The fymptoms of this fatal difeafe were fometimes a 
 ftidden lofs of ftrength, confufionor weight in the h.ad, 
 giddinefs at intervals, oppreffion about the pvsecordia, 
 deje&ion of fpirits, taciturnity, an anxious afpect, but 
 without any fymptoms of fever. In thefe, death enfued 
 within twenty -four hours ; fome were faid to have died 
 within a few hours, but our author faw none of thefe, 
 and is inclined to doubt the truth of the accounts, hav- 
 ing in feveral inftances, where this is faid to have hap- 
 pened, found upon inquiry that matters had been inac- 
 curately flated, and that the patients had really been ill 
 one or two days. 
 
 In others the diforder was more perceptible. In a 
 few hours the eyes became muddy, the furface of the 
 body cold, with drowfinefs, lethargy, and pain at the 
 heart. In the progrefs of the diftemper they frequently 
 loft the power of fpeech, the ikin feldom recovered its 
 warmth, or, if it did, it was only by irregular flufhings. 
 The pulfe fometimes remained nearly in its natural ftate, 
 but was, for the moft part, low and quick. They were 
 by turns delirious, confufed and fenfible, but the coma* 
 tofe difpofition was moft prevalent. Towards the 
 end they fuffered extreme inquietude. Vomiting in 
 fome occurred the firft night ; in others a diarrhoea 
 next day ; both accelerating the fatal period ; but 
 thefe fymptoms were lefs frequent than in fome of the 
 " other daffes. Buboes appeared only in a very few 
 " who furvived the third day. . . . The total abfence 
 " of buboes in fuch patients as perifhed fuddenly I have 
 " no doubt of, nor of their being in general very rare in 
 " others of this clafs ; though I fufpect that the buboes 
 " might fometimes have been concealed, where the dif- 
 " eafe ran out to the fourth or fifth day, and for the 
 " fame reafon that the reports concerning the ftate of 
 
 " the corpfe were fometimes not true It was 
 
 " very rare to find fufpicious marks of infection on the 
 
 " bodies [of thofe who died within 24 hours] 
 
 " Carbuncles were feldom vifible till the month of May, 
 " which was later than this form of the difeafe. It pre- 
 " vailed chiefly at the rife of the plague in 1 760, and 
 
 its 
 
A TREATFSE ON 
 
 ' its revival in the two Fucceeding years, decreafing, as 
 <c the diftemper fpread ; and though they were found 
 " difperfed in every ftage of the peftiicntial feafon, yet 
 " the number of this clafs was proportionably frnaU, 
 " compared with that of others. Petechiae, vibices, or 
 " broad, livid, roundifh fpots, occurred fometimes, but 
 " were not common, and the two latter were feldom vi- 
 fible till after death." 
 
 This account of the moft malignant form of the pefti- 
 lence differs considerably from that of Dr. Hodges, who 
 leems to think that the tokens, as he calls them, very 
 generally were to be found on the bodies of thofe who 
 died fuddenly. He mentions indeed a young man who 
 was fuddenly feized with a violent palpitation of the 
 heart, and thus continued till his death, which took 
 place in a few hours. In this cafe the Doctor fuppofed 
 that there might be a carbuncle broke out on the heart. 
 Dr. Ruflel has confidered the defcription of the tokens 
 given by Dr. Hodges, and compared it with that of 
 others called by Diemerbroeck macula mortis, fpots or 
 tokens of death ; and by this companion it appears that 
 the former has fpoken fomewhat indiftinctly on the fub- 
 jec"l, confounding two different kinds of eruptions to- 
 gether. Dr. Hodges, however, as we have already feen 
 (p. 10) aflerts, in his Lcimologla^ that the tokens rife from 
 within, and are broadeftat their bafes, where he alfo fup- 
 pofes the peftilential poifon chiefly to lie; To the fame 
 purpofc, in his Letter to a Perfon of Quality he fays, 
 " The tokens have their original' and rife from witbin, 
 " and afterwards externally fhow themfelves; which is 
 " evident, becaufe the bafis of them is larger than their 
 " outward appearance, and the internal parts are found 
 " very often fpotted, when there is no difcoloration 
 " vifible on the {kin." Dr. Ruflel, after quoting Die- 
 inerbroeck, makes the following obfervations : " The 
 " author (Diemerbroeck) is diffufe on this fubjecl:, and 
 " thinks it a miftaken though prevalent. notion, that the 
 " macula? are merely fuperficial in the {kin, proceeding 
 " from putrefaction, ebullition, &c. in the blood or hu- 
 <* mours : on the contrary he affirms, they arife from the 
 
 " internal 
 
THE PLAGUE. 257 
 
 " internal parts, even the periofteum, broad at the bafe, 
 " and tapering to their termination in the ikin, being 
 " produced by the extinction and extravafation of the vi- 
 " tal fpirits. Now (fays Dr. RutTel) this anfwers exact- 
 " ly to one fpecies of the tokens defcribed by Hodges, 
 " which therefore may be reckoned the fame with the 
 " macula mortis., and was probably the only one obferved 
 " at Nimeguen," &c. On the fame fubjed he quotes 
 a book entitled Medela Peftis, in which the author fays 
 that by careful direction the tokens may be traced half* 
 way deep in the flefh, and fome, in the mufcles of the 
 bread, have been followed by the incilion knife even to 
 the bone* By the directions given by authority to the 
 fearchers in 1665, they were ordered to look narrowly for 
 thefe tokens, which were defcribed as " fpots arifing on 
 " the fkin, chiefly about the breaft and back, but fome- 
 " times alfo in other parts. Their colour is fomething 
 " various, fometimes more reddifh, fometimes inclining 
 " a little towards a faint blue, and fometimes a brownilh 
 " mixed with blue $ the red ones have often a brownifh 
 f( circle about them, the brownifh a reddim." 
 
 On the fubjed of tokens Dr. Hodges further ob- 
 ferves, that they differed alfo in their degrees of hard- 
 nefs, fome being eafily penetrated with a needle or 
 penknife, while others, more callous or horny, were 
 penetrated with more difficulty. They fo ftrongly 
 refembled warte, that they could fcarce be diftingu'fhed 
 from them 5 and Dr. Hodges himfelf was often obliged 
 to have recourle to a needle for this purpofe. They 
 feemed hard to the touch, not unlike kernels under the 
 fkin, the fuperfices being fmooth. " When 1 eflayed 
 to prove fome of them (fays he) I found them almo/l 
 impenetrable" Another very remarkable circumfbnce 
 relative to them was, that they were often quite infen- 
 fible, and this cliftinguithed them from the carbuncle, 
 which is always very painful. Hodges alfo remarks, 
 that a quick fenfibility in the ikin was always a good 
 fign, and thofe that went no farther than the ikin would 
 fometimes Hough off. 
 
 if 1 Along 
 
258 A TREATISE ON 
 
 Along with thefe tokens we can fcarce doubt that 
 petechi* and vibices made their appearance. The for- 
 mer, even in the inferior degrees of the d idem per, were 
 dangerous, the latter always fatal, never appearing till 
 the patient is within a few hours of death, fometimes in- 
 deed not till death has taken place. Of the petechi Dr. 
 Ruflel (ays, that for the moft part they predicted death, 
 but not without exception. Such as he obferved were 
 round, fomewhat fmaller than a recent flea-bite. They 
 were diftincl, few in number, and fcattered irregularly 
 about the bread and maftoid mutcles. When they did 
 not appear till the approach of death, they were from 
 the fird livid, or very duiky ; but if they appeared early, 
 they were of a lefs deep colour, changing afterwards to 
 livid. Hodges fpeaks of them as deeper coloured than 
 the fpots of maiignant fever, not fixed in any particular 
 fpot, fometimes few, but commonly very numerous ; the 
 colour fometimes red or purple, fometimes yellow, and 
 fometimes livid or black. From Gotwald, RuiTel quotes 
 a defcription of thefe fpots, which he divides into four 
 fpecies. i. Redd ifh, like flea-bites, foon growing brown 
 or black j appearing on all parts of the body except the 
 face, 2. In the form of lentils, fpreading like the former 
 all over the body; ruddy at fird, but in 24 hours growing 
 dark orafh-coloured. 3. Large brown fpots, fcattered 
 here and there, fometimes intermixed with the lentil kind. 
 4. Not unlike the meafles, fpreading all over the body, 
 riling afterwards in fmall blifters without any matter, 
 vanifhihg about the fifth day. Ruflel alfo takes notice 
 of a fpecies of petechias which were very numerous, con- 
 fluent, and of a dark red or dufky colour and irregular 
 figure. Thefe were fometimes remarked in the inter- 
 dices of the former. Such inflances occurred but rarely. 
 
 The vibices were much larger than the petechi^. 
 Gotwald fays that they covered the face as high as the 
 nofe, and from thence fpread to the forehead, disfiguring 
 the patient in a frightful manner. They did not appear 
 till a ihort time before death. Often they appeared un- 
 expectedly, (hooting up like lightning from the bread 
 to the face, in fpots of various colours, blue, green, brown 
 
 and 
 
THE PLAGUE. 259 
 
 and yellow. Diemerbroeck defcribes them as oblong 
 fpots of a livid or black colour, like ftrokes drawn with a 
 pen ; fometimes they were larger, the biggeft refembling 
 the ftrokes of a whip. Ruffe 1 takes notice of a kind of 
 marbled appearance which took place at the height of 
 the difeafe, or a few hours before death ; the colours be- 
 ing a faint blue, and darkifh red, both more or lefs ob~ 
 (cure at times, but never bright. It was not permanent, 
 vaniming in one place, without leaving any trace, and 
 returning at fhort intervals. " The fkin in various pla- 
 " ces was fometimes deformed by narrow ftreaks of red- 
 " dim purple, or livid colour. When fuch took pofTef- 
 " fion of the face they gave a frightful appearance to the 
 cc countenance, and frequently made fuch an alteration 
 <c in the features, and fo completely difguifed the patient, 
 " as to render him hardly knowable by his acquaintance. 
 " A ftreak nearly of the fame kind was fometimes obferv- 
 " ed darting from the edges of the buboes and carbun- 
 " cles. The vibices or weals were much longer and 
 xc broader, and more exactly refembled the marks left in 
 " the fleihy parts by blows or ftripes ; they were found 
 " chiefly on the thighs, buttock, and back, and made 
 " their appearance feveral hours before death, in feme 
 " cafes, but in others not till after. Large blue or pur- 
 " pie fpots, the macula magn<e of authors, were fome- 
 <c times obferved with or without the vibices, a little 
 " while before the patient expired, but moil commonly 
 c< were difcovered only on the corpfe. Their figure in 
 <c general was round, fometimes irregular." 
 
 Whether all theft mortal figns appeared on fuch as 
 died very fuddenly of plagues, and were by the Englifli 
 writers confounded under the general name o^ tokens y 
 cannol certainly be determined. Dr. RufTel faw none 
 who died within the twenty-four hours, and few who di- 
 ed within thirty hours, fo that we cannot from him ex- 
 pect any particular account of the fituation of thofe who 
 died fuddenly. In general, however, he fays, that " in 
 . cc the mod deftrudive forms of the plague, the vital 
 " principle feems to be fuddenly, as it were, extinguish- 
 ^ ed> or elfe enfeebled to a degree capable only for a fliort 
 
 " while 
 
260 A TREATISE ON 
 
 " while to refiftthe violence of the difeafe ; in the fub- 
 u ordinate forms, the vital and animal functions, vari- 
 " oufly affected, are carried on in a defective, diforderly 
 " manner, and denote more or lefs danger accordingly." 
 It teems probable therefore that in thofe who are fudden- 
 ly killed, the fame effects take place in a fhort time which 
 are obferved to take place after a longer fpace in thofe 
 who die gradually, buboes only excepted, which require 
 for their formation a longer time than is allowed to the 
 patient to live. Internal mortifications, or rather efchars, 
 are therefore to be fufpected, and directions have evinced 
 that this was really the cafe ; but befides thefe there 
 was an appearance obferved in the plague at Marfeilles 
 which is not taken notice of by former phyiicians ; viz* 
 a preternatural enlargement oif the heart. M. Deidier 
 on that occafion communicated an account of nine dif- 
 fections, but of thefe only one had died without erup- 
 tions. This was a woman of 40 years of age, who lived 
 till the third day. In her the mediaftinum* was torn 
 ** towards the upper part ; the pericardium of a livid co- 
 *' lour 5 the heart larger than in its natural {late, by the 
 < c fweilingof its ventricles j full of thick, black blood. 
 (C The liver was alfo very large, and of a livid colour, witli 
 " a carbuncular puftule on the fide of the gall-bladder, 
 ^ which was filled with very black bile." In others 
 who had eruptions, and who of confequence we muft 
 fuppofe to have lived longer, the enlargement of the 
 heart was (till more remarkable. In one who lived 
 eleven days, the heart was of double the bignefs, having 
 fcarce any blood in the ventricles, whofe cavities were 
 filled each with a large polypus, that on the right fide 
 having dilated the auricle to the breadth of four inches. 
 The liver alfo was larger than ordinary, and the gall- 
 bladder full of a black and green bile. The appearances 
 were much the fame in all the reft ; but, as the time 
 
 they 
 
 * The Mediaftinum is a membrane by which the cavity of the bread is lon- 
 gitudinally divided. The tearing of it in any difeafe feems altogether unac- 
 countable* unlefs we fuppofe an extraordinary lols of cohefion to have taken 
 place without any mortification. The pericardium is a membrane (unround - 
 ing the heart, and in a naturaj ftate contains fome water, condeiifed from va- 
 pour after death. 
 
THE PLAGUE. 261 
 
 they fuftained the difeafe is not mentioned, we cannot 
 determine whether the enlargement of the heart took 
 place at the very firft, or was only an adventitious fymp- 
 tom after the fever had come on. Dr. Ruflel takes 
 notice that fuch patients as he attended complained 
 greatly of their heart. " A fenfe of oppreffion about Jhe 
 " praecordia (fays he) which the fick were at a lofs to 
 " defcribe, was, in one degree or other, a conftant at- 
 * c tendant on the plague, except in very flight cafes of 
 " infection ; and where it came on early, or perfifted in 
 t( a high degree, was always a dangerous fymptom. 
 " The fick fhowed how feverely they fufFered by their 
 " perpetually changing their poflure, in hopes of relief; 
 " but, when aflced where their pain lay, they either an- 
 " fwered haftily they could not tell, or, with a fixed, wild 
 ." look, exclaimed kulbi ! kulbi! (my heart ! my heart !) 
 " This anxiety increasing as the difeafe advanced, ter- 
 " minated at length in mortal inquietude, the patient, 
 " for many hours, in the laft ftages, inceflantly writhing 
 " his body and limbs as if in agony. Though pain at 
 " the heart was often conjoined with the fymptom juft 
 " mentioned, and by the fick feemingly blended together, 
 " it appeared to be different, and to exift feparately. 
 " They often exclaimed as in the other, my heart ! my 
 " heart ! pointing alfo towards the fcrobiculum cordis, 
 <e but then would add eujam kulbi ^ my heart pains me ; 
 " or naar fi kulbi, my heart is on fire.'* This laft pain 
 the Doctor fuppofes might have its feat in the upper ori- 
 fice of the ftomach ; the extreme anxiety may be ac- 
 counted for from the enlargement of the heart ; but as 
 neither of thefe fymptoms took place in fuch as died in 
 a very fliort time, we muft be apt to confider this enlarge- 
 ment not as any primary and efTential fymptom of the 
 difeafe, but as one which takes place when the vital pow- 
 ers are able tooppofe for fome confiderable time the caufe 
 of the difeafe. 
 
 In his account of the origin of the plague, Dr. Ruf- 
 fel takes notice of the opinion that, at the communica? 
 tion of the infection, the fick were fometimes fenfible of 
 having received it. This has been obferved by Dr Lind 
 
 in 
 
A TREATISE- ON r 
 
 in malignant fevers ; it has alfo been obferved in plague?, 
 as we have Teen from Dr. Hodges, Verdoni, and others ; 
 but RufFel fays he never faw any inftance of this. He 
 owns, however, that he has feen inftances of the difeafe 
 quickly fucceeding a panic fear of being infected. " In 
 " cafes (fays he) where the difeafe was not difcovered to 
 " be the plague, till upon the eruption of buboes after 
 " two or three days, I have known feveral perfons who 
 " had, till then, without the leaft fufpicicn, frequented 
 " the fick, ftruck fuddenly with a panic, and imagine 
 " themfelves ill. They felt (hooting pains in their 
 " groins, confufion in the head, and a loathing. Though 
 4C in fome thefe complaints were merely imaginary, and 
 " foon vanifhed, in others they proved real ; the fymp- 
 c< toms increafing, and being followed by eruptions. In 
 * c fuch cafes I fufpe&ed the latent infection to have 
 " been excited by terror." 
 
 In the inftance formerly quoted from Dr. Guthrie at 
 Peterfburg, we have a notable example of this fudden 
 feizure by a ilroke. His information was derived from 
 the phyfician-general of the Ruffian army. This gen- 
 tleman allured him, that " he had feen men, in appa- 
 *' rent good health, inftantaneouily drop down, as if (hot 
 " by a mufket ball, by the fudden action of the peftife- 
 " rous miafma, and upon duty again in 24 hours, per- 
 *' fectly recovered by the operation of a flrong vomit." 
 Whether or not thefe mtnfe/t any ftroke at the inftant 
 cf their falling we are not told : poffibly it might be 
 only a fyncope very common in the plague, which took 
 place at the very firft invafion. RulTel informs us, that 
 '< the fudden lofs of ftrength, and diftu/bance of the 
 fc functions attributed to the brain and heart, are rec- 
 *< koned, in a particular manner, fymptoms of the plague. 
 " In their higheft degree they diftinguifh the meft fatal 
 * forms of thedifeaS ; and, under different modifica- 
 " tions, adhere to all its varieties. . . . The early ap- 
 <e pearance of faintnefs was very remarkable in the 
 Ci plague," &c. 
 
 Thus we fee that the plague attacks without fever in 
 two different modes- 5 one, by attacking and deftroying 
 
 the 
 
THE PLAGUE. 263 
 
 the folid parts of the body, the other, without any dif- 
 organization of the body, attacking the vital principle 
 itfelf, or rather the blood, from which this principle is 
 derived, fo that a temporary fufpeniion of all the func- 
 tions enfues. The analogy between the caufe of pefti- 
 lence and thofe vifiblefubftances called poifiws, is very re- 
 markable in fome things, though in others it totally fails. 
 In the Medical Repofitory * we have a differtation upon 
 this analogy by Dr. Edward Miller. He obferves, that 
 this analogy has been generally overlooked, chiefly on 
 account of the invifible nature of the aerial poifon, and 
 the fuddennefs of death from poifons, more frequently 
 than from peftilential diieafes. This he accounts for 
 from the largenefs of the dofe of poifons compared with 
 that of contagion ; " but (fays he) by diminifliing the 
 " quantity to an appropriate amount, thefe noxious fub- 
 " fiances (the poifons) may be made to exhibit the 
 * s courfe, duration, and nearly all the phenomena, of 
 " what is called a malignant fever. But, above all, the 
 " attention of phyficians has been diverted from this 
 " analogy between miafmata and poifons, by the febrile 
 " part of the character which generally belongs to pefti- 
 ct lential diieafes, and which, in common apprehenfion, 
 " is conftantly connected with them. Yet thefe difea- 
 < fes are by no means univerfally accompanied with what 
 " is ftrictly called fever. There is often a degree of 
 " virulence in the Afiatic plague, in the yellow fever, 
 - ec and in all the other forms of peftilential and malignant 
 <( difeafes, which altogether tranfcends the procefs of fe- 
 " ver, and extingniilies life in a more fummary manner. 
 " In the worft cafes both of poifon and peftilence, the fe- 
 " brile part of the fymptoms excites little attention." 
 
 Our author does not fay in what this virulence con- 
 fifts. In the cafes of thofe who die with the tokens upon 
 them, the caufe is plainly within the body ; the deftroy- 
 ing power acting witli greateft efficacy below the fkin in 
 the foft fubftance of the flefli. Where the patient is 
 fuddenly feized in the manner defcribed by Dr. Guthrie, 
 the caufe feeius to be fomething foreign to the body 
 
 fuddenly 
 
 * Vol. ii, p, 403, 
 
164 A TREATISE ON 
 
 fuddenly inhaled, the effects being fimilar to thofe of 
 fixed air when drawn in by the breath, and of confe- 
 quence eafily expelled by a vigorous adtion of the powers 
 of the fyftem. Guthrie obferves, that, in filch cafes, it 
 feems " as if the contagious matter exifted in a very 
 loofe ftate in the firft pafiages at the beginning of the 
 difeafe." 
 
 In the production of thofe tokens mentioned by Dr. 
 Hodges, we know that there muft have exifted in the 
 body a certain caufe capable of totally deftroying the 
 parts, and reducing them to an hard efchar, fimilar to 
 that produced by fire or by a cauftic. As we are unac- 
 quainted with any thing capable of producing this effecl: 
 but fire, we can attribute the origin of thefe tokens to 
 nothing elfe but the emiflioh of the latent heat of both 
 the folids and fluids which compofe thefe parts, and 
 their confequent tranfmutation into an hard, and as it 
 were charred, fubftance. That fuch an emifiion of la- 
 tent heat does in fome cafes take place is evident from 
 the production of a great quantity of fenlible heat when 
 certain fubflances are mixed together. Thus, upon 
 mixing. together oil of vitriol, oil of turpentine and 
 ftrong fpirit of nitre, the whole mixture will take fire 
 and burn violently, though two of the ingredients, viz. 
 oil of vitriol and fpirit of nitre, are by themfelves inca- 
 pable of being inflamed. In like manner if ftrong fpi- 
 rit of nitre be poured upon oil of cloves or faflfafras, the 
 mixture will burft out into a violent flame. Water 
 poured upon quick lime occafions great heat, and feems 
 in great part to be converted into a folid fubftance ; 
 for only a fmall part evaporates, and the flaked lime 
 falls into a powder to appearance perfectly dry, and 
 from which the moifture cannot be expelled without a 
 very violent fire. In this cafe Dr. Black is of opinion 
 that the heat comes from the water, which, as we have 
 already feen, contains a great quantity of it in a latent 
 ftate. But, according to his experiments, the emifiion 
 of 135 degrees of heat is fufficient to reduce water to a 
 ftate of folidity ; and the heat of lime when flaking is 
 fo much fuperiorto this, that (hips have frequently been 
 
 fet 
 
THE PLAGUE. 265 
 
 fet on fire by it. We muft therefore either fay that 
 water in certain circumftances can part with much more 
 than 135 degrees, or that the lime itfelf emits part of 
 the heat it contains. This laft indeed feems to be the 
 more probable fuppofition of the two ; for though 
 fluids contain more heat in proportion to their bulk than 
 folid bodies, we have no reafon to fuppofe that the lat- 
 ter contain none at all : on the contrary the experiments 
 formerly mentioned, efpecially thofe made by Count 
 Rumford, mow that they are furnifhed with an almoft 
 unlimited quantity, 
 
 The caufe of the moft violent kind of plague then we 
 muft fuppofe to be fomething received into the body, 
 which in a certain time, probably fooner or later ac- 
 cording to the ftrength of the contagion, difpofes to an 
 irregular emiffion of its heat, which coming by a kind of 
 explofions, or, as Dr. Hodges calls them, blafts y produce 
 thofe efchars which have been called tokens, and feem to 
 be no other than partial combuftions, by which the parts 
 affected are reduced to a ftate of charcoal, or nearly fo. 
 
 In affigning this caufe for the moft deadly kind of 
 plague, we muft naturally afk the queftion, how can all 
 this take place without any pain ? for of thofe who died 
 in this manner, many felt neither pain nor uneafinefs till 
 within a few moments of death. This can only be 
 accounted for by the fudden and perfeft deftruction of 
 the parts, which did not allow time for any fenfation of 
 pain to take place; and indeed in the application of 
 caufttc for an ifiue, the patient often feels but little pain. 
 It is impofiible to avoid perceiving a very ftrong con- 
 nexion between this kind of plague and the dreadful 
 cafes of fpontaneous combuftion related p. 182 >i86. 
 In the cafe of the prieft indeed the fire feeras to have 
 come from without, though even this cannot be afcertain^ 
 ed beyond a doubt ; but in thofe who were abfalutely 
 confumed to allies, it feems equally probable that it may 
 have arifen from within ; and as none of the unfortunate 
 perlons feem to have made any noife or ftruggle, the 
 prieft alone excepted, it feems probable that the firft 
 hac} deprived them of all fenfation, and that, not- 
 M m withftanding 
 
266 A TREATISE ON 
 
 withftanding the terrible ideas with which fuch extraor- 
 dinary occurrences mud have infpired thofe who faw 
 them, the fufferers may. have died without feeling any 
 pain. The prieft feems to have felt nothing after the 
 firft ftroke. 
 
 Should this caufe be admitted (indeed whether it is 
 admitted or not) we fee that it is in vain to attempt to 
 folve the phenomena of peftilence by the doctrine of fti- 
 muli, excitement or debility. There is no degree of fti- 
 mulus, fire exepted, which can convert part of the body 
 into an hard efchar, neither can it be done by any de- 
 gree of debility or exhauftion. Befides, the irregular 
 manner in which thefe efchars are fcattered up and down, 
 Ihows that the caufe has not acted from a regular diffu- 
 flon all over the body, but in a number of infulated 
 fpots, between which the connexion can by no means 
 be traced. In all peflilential eruptions indeed the action 
 of fire feems to be very perceptible. Gotwald mentions 
 his having obferved in two patients what he calls papulx 
 ardentes " burning pimples," which Dr. Ruffel fuppofes 
 to be a modification of carbuncularpuftules. Gotwald 
 calls them alfo fire-bladders, and fays that they were as 
 broad as a /hilling,. of an irregular fhape, and the ikin 
 feemed as \tjhrivelled with fire. The carbuncle itfelf ap- 
 proaches much to the nature of the efchar, and is attended 
 with violent heat in the adjacent parts. Gotwald, who 
 gives an account of the plague at Dantzic, diftinguifhes 
 the carbuncle into four kinds, (to be afterwards defcrib- 
 ed.) Of thefe he fays in general, that they all burn very 
 violently at firft, &c. 
 
 From all thefe accounts it feems plain, that in the 
 plague there are partial difcharges of heat, from Jome 
 caufe, upon various parts of the body ; and that, in ma- 
 ny inftances, this heat deftroys the texture of the parts 
 entirely. When this is done inftantaneofly the patient 
 feels no pain, but if more gradually, the pain is excef- 
 live, as in the cafe of buboes and carbuncles -, which the 
 Journalift of the plague year in London informs us 
 were attended with fuch horrid pain as to make the pa- 
 tients cry out in a lamentable manner. This extraordi- 
 nary 
 
THE PLAGUE. 267 
 
 nary heat muft either come from, without or within, and 
 we have all the reafon in the world to believe that it 
 comes from within. Mr. Hunter, in his Treatife on the 
 Blood, informs us that in a local inflammation there is 
 always an increafe of heat in the inflamed part. Should 
 this heat arife, as it probably does, from an emiflion of 
 part of the latent heat, we may conclude, that fuch a 
 quantity might be emitted, as entirely to change the 
 texture of the parts. Thus mortifications or deftruc- 
 tions of thofe parts may enfue, of all kinds, from the 
 mild pus to the peftilential efchar. 
 
 In the effects of peftilential contagion we obferve, if 
 not a fuperiority, at lead a different mode cf afiion from 
 what takes place in poifons. All thefe feem to act by 
 diflblving the blood, or infecting it in fuch a manner that 
 it fupplies no fufficient quantity of animal fpirits ; of 
 confequence, the creature foon faints and dies. In the 
 plague, the blood .does not appear to be much affected, 
 neverthelefs it emits, in various places, certain explofions 
 which convert the parts into an efchar. Poifons always 
 feem to produce the petechise or purple fpots which 
 fometimes appear in the plague. In Dr. Miller's Trea- 
 tife, already quoted, we find, among the fymptoms occa- 
 fioned by arfenic, " red or dark fpots appearing on -the 
 " ikin, and rapid putrefaction, which renders fpeedy in- 
 " terment neceffary." Herein it differs from the plague, 
 for the bodies of fuch as die of that diftemper are not 
 more liable to fpeedy putrefaction than others. Of the 
 vegetable poifons he alfo obferves, that, " after death, 
 " fometimes before, livid fpots are obferved on the body, 
 " the appearance of the blood is dark and diflblved, and 
 " putrefaction fpeedily takes place." Of animal poi- 
 fons " The bite of the poifonous ferpents is generally 
 <fi followed by tumour, and livid colour of the part bit- 
 " ten, extravafation of dark coloured blood into the ad- 
 " jacent cellular membrane, naufea and vomiting, fud- 
 :c den proftration of ftrength, paralyfis of the limbs, con- 
 ** vulfions, yellownefs of the ikin, haemorrhages, &c. 
 " Livid appearances of the body, a dark coloured and 
 ^ diflblved ftate of the blood, and a rapid putrefaction, 
 are obferved after death/' From 
 
268 A TREATISE ON 
 
 From all thefe accounts, however, it is plain, that, 
 whatever may be the analogy between the adlion of poi- 
 fons and malignant fevers, they do not in any manner 
 operate like the contagion of the true peftilence. Of 
 this the conftant effect is to produce buboes, carbuncles, 
 and other eruptions, refembling much more the effects 
 of fire than any thing elfe ; or, if the patient is cut off 
 without the appearance of thefe, fiinilar effects are obferv- 
 ed on the internal and vital parts. Dr. Miller's conclu- 
 fion feems therefore liable to exception ; in which he 
 fays, " that only the lighter cafes of peftilence are unlike 
 " the effects of poifon, but that, in proportion to the de- 
 " gree of malignity, the refemblance grows ftronger." 
 It doth not appear that any poifon hath produced one of 
 the characteriftic fymptoms of the true plague, or any 
 thing but what is common to animals dying of various 
 difeafes, the red fpots on the fkin only excepted. 
 
 In the eighth volume of the Philofophical Tranfactions 
 abridged by Martyn, we have an account of a number 
 of experiments by M. Deidier and others, made upon 
 dogs into whofe veins he injected, or poured into wounds 
 made in the miferable animals, the bile of people dead of 
 the plague at Marseilles. tc The confequence was, 
 ** that they became melancholy, drowfy, and without 
 <c caring to eat. All of them died in three or four days, 
 <e with the efiential marks of the true plague, declared 
 ft by buboes, carbuncles, and gangrenous inflammations 
 * c in the vifcera, in the fame manner as in the human 
 " carcafes from whence the bile was taken." 
 
 The poifonous bile affected the creatures differently 
 according to the vicinity of the place of injection to the 
 heart. In the jugular vein it killed them in twenty- 
 four hours, injeded in the quantity of a drachm to two 
 ounces of water. In this fhort time were brought on 
 gangrenous inflammations, the heart was (luffed with 
 thick and black blood, the liver was fwelled, and the 
 gall-bladder full of green bile. This fhows a very ef- 
 fential difference between the action of the peftilential 
 poifon and that of others ; the former, in fome parts of 
 the body at leaft, coagulates^ the blood 5 the latter, in 
 ail parts, difiblves it. In 
 
THE PLAGUE. 269 
 
 In the crural vein (the vein of the leg) the effects 
 were lefs violent, In about an hour they became heavy. 
 In the former cafe they inftantly became drowfy. In 
 the fecond experiment they contracted fuch a loathing 
 for food, that they would neither eat nor drink any 
 thing after the injection was made. On the third day 
 there appeared confiderable tumours under the axilla 
 (the fore leg I fuppofe) and on their thighs, about three 
 inches from the wound. The wound itfelf turned 
 to a gangrene, and t*he creatures died ufually on the 
 fourth day. 
 
 In another experiment the animal had convulfive 
 motions all over immediately after the injection, followed 
 by a lethargy. Next day a carbuncle appeared on the 
 great pectoral mufcle on the right fide. On the third, 
 a bubo appeared on the thigh, and the fame day the dog 
 died. From the time of the injection he had neither 
 eat nor drank. On diffection the fore part of the bread 
 under the teguments was found entirely gangrened, 
 the inward parts and vifcera full of black clotted blood, 
 the outward furface of the lungs was all purple, the heart 
 was fwelled as big again as ufual, and the four cavities 
 x were full of black clotted blood. The bile of this dog, 
 injected into the crural vein of another, produced fimi- 
 lar fymptoms, only the latter eat a little boiled meat, 
 which he vomited up again in two hours. He died the 
 third day, with the fame fymptoms of the plague as 
 the others. 
 
 The bile of people who died of ordinary malignant fe- 
 vers was muh lefs powerful. A quantity (not mentioned 
 how much, but probably a drachm) mixed with four 
 ounces of warm water, was partly injected into the ju- 
 gular vein of a dog, and a comprefs foaked in the reft 
 of -the liquor applied to the wound. He appeared heavy 
 and ileepy, and would neither eat nor drink till the third 
 day, when he did both willingly. On the fourth day 
 the comprefs fell off, the wound was found to be dimi- 
 niflied one half, and healed by degrees, the dog reco- 
 vering perfectly. In another experiment with the bile of 
 a patient who had died of a malignant fever, the dog not 
 
 only 
 
270 A TREATISE ON 
 
 only had about^a drachm of it put into a wound in his 
 thigh, but was made to fwallow fome of it; notwith- 
 flanding which he was not feized with any diftemper, 
 and the wound healed in fifteen days. This bile was as 
 black as ink, in great quantity, and very thick. In the 
 other fubjects it was of a deep green. In another expe- 
 riment, with the fame bile applied on a comprefs, the 
 dog likewife efcaped without any apparent diforder ; 
 but in a third, the animal died in twenty-three hours, 
 though at firft he had iliown no fign of being affected, 
 only that he feemed to be thirfiy, and drank with grec- 
 dinefs. On opening him his heart was found flill to 
 beat with violence, and, after the beating ceafed, no 
 biood was to be found in it, either in the auricles or 
 ventricles. " This liquor, crowded together in the great 
 " veffels, appeared of a lively red* and very fluid, with- 
 " out any of thofe concretions that we conftantly ob- 
 " ferved in thofe who died of the plague. Here ap- 
 " peared neither external nor internal marks of the 
 * c plague." The bile of a perfon who had died of an 
 eryfipelas, injected into the crural vein of a dog, pro- 
 duced no bad effect. A dog was killed by half a drachm 
 of Hungarian or blue vitriol injected into the jugular 
 vein. He died in univerfal convulfions : the heart was 
 full of grumous blood, reduced to a kind of thick pap, but 
 without any clots. The bile, applied to two wounds 
 in another dog, produced no bad effect. 
 
 From other experiments it appealed that even the 
 peftilential poifon itfelf, taken into the ftomach of dogs, 
 did not produce any deleterious effects. " A dog of 
 " the Hofpital of the Mail in Marfeilles, who followed 
 t the furgeons when they went to drefs the fick, ufed 
 ic greedily to fwallow the corrupted glands, and the 
 * { dreffings charged with pus which they ufed to take off 
 " the plague fores : he licked up the blood that he found 
 <c fpilt on" the ground in the infirmary; and this he did 
 < e for three months, being always gay, brifk, well, full 
 " of play, and familiar with all comers." The health and 
 hrifknefs of this unfortunate dog proved his ruin, by 
 making him the fubjcct of philosophical experiment, 
 
 A drachm 
 
THE PLAGUE. 271 
 
 A drachm of the peftiferous bile inje&ed into the crural 
 vein, killed him in four days. He had a confiderable 
 haemorrhage from the wound the night before he died, 
 and he had alfo a difagreeable fmell both while living 
 and after he*'was dead. Two other dogs, which had 
 fwallowed a quantity of peftiferous bile, became heavy 
 and melancholy, refufed their food, and fhowed other 
 figns of diforder ; but all thefe went off in a fliort time, 
 and no figns of the diftemper appeared. 
 
 Thefe experiments induced M. Deidier to fuppofe 
 that the contagion of the plague lay only in the bile ; 
 but the following experiment (hows that the blood was 
 equally infe&ed, and capable of communicating the 
 difeafe, and that of the mod malignant fpecies. It was 
 made by M. Couzier, phyfician to the infirmary at Alais, 
 and in the Philofophical Tranfa&ions we have the 
 following account : " I took a quantity of blood from 
 " a perfon dead of the plague, and mixed it with warm 
 " water, which mixture I attempted to inject into the 
 " crural vein of a dog, but the end of the fyringe being 
 ** too large to enter the vein, the experiment did not fuc- 
 u ceed. This made me refolve to try to lay fome of the 
 " fame infected blood upon the wound. This I accord - 
 " ingly did, and covered it with a dreffing, which the 
 <c dog got off in the night. I found the next morning 
 " that the dog had licked the wound, and that he refuf- 
 " ed his food. Towards night he began to bemoan 
 " himfelf, and gave figns of an approaching death. The 
 <c next morning I found him dead, the wound being con- 
 " fiderably fwelled and gangrened, and the edges round 
 " the fwelling were likewife gangrened. 
 
 " Upon opening the body, we found the liver fome- 
 " thing larger than ufual, with fpots of a livid purple, as 
 " in the bodies of perfons dead of the plague. In the 
 c ftomach was found a quantity of black coagulated 
 cc blood, of the fize of a hen's egg. This in all likeli- 
 " hood was what he had fwallowed upon licking the 
 ^ wound. The heart was very large, with a black gru- 
 ; * mous blood in the ventricles, and the auricles were 
 <f turned blackifh and gangrenous." 
 
 This 
 
27^ A TREATISE ON 
 
 This laft experiment naturally brings to remembrance 
 tbofe of Dr. Home at Edinburgh, in which he inocu- 
 lated the meafles by means of the blood of patients ill 
 of that diforder. From the accounts he has given in his 
 treatiie entitled Medical Fa<5hand Obfervations, we can. 
 have little doubt that his experiments fucceeded, how- 
 ever others may have failed. One thing, however, is ve- 
 ry obvious, viz. that if we mean to communicate a dif- 
 eafe by means of the blood, we muft ufe a much greater 
 quantity than if we make the experiment with the mat- 
 ter of an abfcefs. The cafe of contagious difeafes feems 
 to be the fame as in fermenting liquors. With a fmall 
 quantity of yeaft we can eafily induce fermentation in any 
 proper liquor, but, if we ikim off the yeaft, and ufe only 
 the pure fermenting liquor, we muft ufe a much greater 
 quantity ; and to inattention to this circumftance we 
 may with probability afcribe the difficulty which Dr. 
 Home himfelf met with in introducing the difeafe, and 
 the total want of fuccefs in others. In M. Couzier's ex- 
 periment a confiderable quantity muft have been ufed, 
 as he fays that in the dog's ftomach it equalled the fize 
 of an hen's egg. A much fmaUer quantity of matter 
 taken from a peftilential abfcefs is capable of producing 
 the difeafe in a human body, as is evident from the cafe 
 formerly quoted of that gentleman who inoculated him- 
 felf for the plague, and of which Dr. Guthrie gives the 
 following account : " ThiswasMathiasDegio,oneofthe 
 " furgeons of the hofpital at Buchareft, a building appro- 
 <c priated to the cure of the plague in the Ruffian army. 
 " He, perceiving the gentlemen of hisprofeffionr0#d?w#^ 
 ' ' in a manner to death, if punctual in the dif charge of their duty* 
 " had the reiblution to inoculate himfelf for the plague, in 
 ' the full confidence of its efficacy, and ever afterwards 
 ' found himlelf invulnerable, whilft his companions 
 " around him were falling viclims to its fury. He pro- 
 " duced the difeafe by inferting, with the point of a 
 * c lancef, under the epidermis of his arm, matter from a 
 " peftlferous abfcefs, and followed the cold regimen ob- 
 
 " ferved 
 
 * This, among innumerable other inftancss that might be brought, is z 
 proof of the infe3i.eus nature of the plague* , 
 
THE PLAGUE. 273 
 
 " ferved in the (mall-pox, as he had imitated its mode 
 " of inoculation. On the fourth day of the pundture 
 16 the fever declared itfelf, and he, being perfectly devoid 
 " of fear, got through the difeafe without feeling more 
 " inconvenience than if it had been that which he imi- 
 " tated. He drank freely of cold water, with vinegar, 
 " or a little wine, and kept generally out of doors. This 
 " beverage was the only thing that had the appearance 
 " of medicine, 5 ' &c. 
 
 From a careful attention to all theie hiftories, it is 
 plain that the plague is naturally an eruptive difeafe, as, 
 in all the animals in which it was artificially brought on, 
 eruptions took place, provided the life of the creature 
 was fufficiently prolonged to allow them to come out. 
 Dr. RufTel fays, that, from his diary, he noted down 
 the cafes of two thoufand [even hundred patients, all of 
 whom had eruptions of one kind or other. In this it 
 agrees with the fmall-pox, which Dr. Mead juftly con- 
 fiders as an inferior kind of plague. In the latter, 
 however, the eruptions feem to refemble thofe called by 
 Dr. Hodges the tokens, only that the caufe which pro- 
 duces them is lefs violent in its nature ; but why the 
 eruptions of the fmall-pox fliould be in diftinc~t puftules, 
 and not one continued boil all over the body, is un- 
 doubtedly inexplicable on any theory whatever. The 
 fame is true of the plague. No man can explain why 
 the tokens, for inftance, inftead of being colle&ed into 
 one great efchar, are difperfed into fmall diftinct pieces; 
 or why, inftead of buboes in the groin and armpit, or 
 inftead of carbuncles indifferent parts of the body, there 
 fhould not be a (ingle one equivalent in bulk and power 
 to them all. This appears fimilar to the phenomena of 
 rain, hail or fnow, which fall in diftincl: drops, fluid or 
 congealed, or in flakes, inftead of being equally diffufed 
 all over the fpot on which they fall. In the latter cafe 
 we fay that the phenomenon is occafioned by eleftricity : 
 v. r e may fay the fame, if we pleafe, of the fmall-pox and 
 plague, with equal emolument. 
 
 From the accounts we have juft now quoted, it ap- 
 pears that there is between malignant fevers and the 
 
 N n true 
 
2'74 A TREATISE ON 
 
 true peftilence a very efiential difference -, the latter 
 tending to thicken the bloody the former to make it 
 thinner. In this refpect therefore the poifons feem to 
 refemble malignant fevers very confiderably ; for M. Fon- 
 tana obferved that by mixing animal poifons with blood 
 drawn from a vein, it was prevented from coagulating. 
 In the inftance above related where a dog died in con- 
 fequence of bile injected into his veins from one who 
 died of a malignant fever, the blood was found extremely 
 fluid. In forne who died of the hofpital fever. Sir 
 John Pringlc informs us, that fuppurations had taken 
 place in the brain ; but in the true plague the tendency 
 to mortification always prevailed above every thing. 
 
 Laftly, that the plague proceeds from too great a 
 quantity of heat, either emitted from the body itfelf, or 
 fome how introduced into it, feems to be pretty plain 
 from the effect it has of augmenting the venereal appe- 
 tite to an almoft inconceivable degree. This was taken 
 notice of in the plague of Marfeilles, and indeed in many 
 others. Ruffel quotes two remarkable paffages to this 
 purpofe ; one in a plague at Genoa, the other in Medina. 
 *' Amidft fo many dreadful fears and terrors, amid fo many 
 " fetid and putrefying bodies, amid the (bricks, the fighs 
 "'-and the groans of the fick, what would you have 
 *' expected ? That the people, ftruck with dread and 
 *' horror, remained fad, modeft and quiet. You are 
 <c miftaken. They fung, played on inftruments, danced* 
 <c intrigued, and Genoa never was feen fo (bamelefs, 
 <b debauched, and diforderly. I have faid before, that 
 <c God in this plague gathered in a harveft for heaven ; 
 " but it feemed to be alfo a vintage for the lafcivious of 
 " of the earth. If not fo, how came fo many marriages 
 " to be celebrated in the Lazaretto of Confolation, and 
 * f that fo many women, without (bedding a tear for the 
 " death of their hufbands, immediately entered into new 
 " engagements ? One day, in particular, five marriages 
 " were performed, four of the bridegrooms being buriers 
 " of the dead, and dreffing themfelves and their brides 
 " in clothes dripped off from the bodies of the deceafed." 
 On the plague of Medina he quotes the following extract 
 
 of 
 
THE PLAGUE. 275 
 
 of a letter written by a gentleman who refided in that 
 city during the plague in 1743. " It has always been 
 " obferved, that, after every plague, thofe who recover 
 * c are addi&ed in an extraordinary degree to lewdnefs 
 " and incontinence, which was furprifingly vifible at 
 " Meffina, and carried to fuch a degree of frenzy and 
 " befliality, that many were known to violate the bodies 
 " of dead virgins !" 
 
 That an extraordinary propensity to venery may be 
 produced by introducing into the body a quantity of 
 heat, admits now of a kind of dernoHftration from a fad: 
 mentioned by M. le Roy concerning phofphorus.* This 
 fubftance is exceedingly apt to take fire on the application 
 ofafmall degree of heat, and even by flight friction. 
 It is now introduced into the materia medica> and is 
 found to be a very powerful medicine, though dangerous 
 on account of its inflammability, the heat and air con- 
 tained in the human ftomach being fornetimes fufficient 
 to fet it on fire. The taking fuch a fubftance into the 
 body therefore feems not much different from taking 
 actual fire into it ; and indeed M. 1'e Roy mentions the 
 cafe of a woman who had taken only a fingle grain, and 
 who he fays had been recovered, by fa from a putrid 
 fever, but died fuddenly from fome imprudence. In 
 this woman the whole fubftance of the body was found 
 luminous upon direction, and the hands of the operator 
 continued luminous even after being wafhed. M. le Roy, 
 having taken three grains of this fiery fubftance, found 
 himfelf extremely incommoded by it for fome hours, 
 and was obliged to drink great quantities of very cold 
 water. Next day he found his mufcular powers ama- 
 zingly increafed, and had an almofl infupportable venereal 
 irritation. This we fee was the confequence of throwing 
 into the body a quantity of heat from without ; but if 
 the body itfelf emits that heat which it invifibly con- 
 tains, the effects muft be the fame as though an extrane- 
 ous quantity had been thrown into it. Neither are we 
 to imagine that the quantity of heat contained in our 
 bodies is fmall or inconfiderable -, for we have already 
 
 feen 
 
 * Meraoires de Societe Medicale, &<? 
 
A TREATISE ON 
 
 feen that beat confifts in the efflux from any fubftance, 
 of an invifible and moft fubtile fluid, in all diredions, 
 When this flux is gentle, the heat is moderate, but in 
 proportion to the adivity of the difcharge, the tempe- 
 rature becomes hotter and hotter, and if very violent, 
 the cohefion of the parts is diflblved entirely, and the 
 fubftance is faid to be on fire. There is required there- 
 fore only fome caufeto begin the emiffion of this fluid ; 
 for as loon as this begins, the immenfe quantity with 
 which we are furrounded, will fupply more in abundance,* 
 and continue fo t6 do, as long as the original caufe 
 fubfifts, or until the fubftance can no longer bear the 
 power which operates upon it. 
 
 From this view of the caufes of the plague, and from 
 the fads which have been laid down concerning it, we 
 cannot help perceiving a very ftrong (imilarity between 
 the plagues mentioned in the Old Teftament and thofc 
 which ftill exift in the world. In one of the paflages 
 formerly quoted it is called an inflammation^ an extreme 
 bnrninv> and from the teftimonies of different authors 
 above quoted, it is plain that the difeafe ftill deferves the 
 name beftowed upon it in the facred writings. From 
 the account given of its proximate caufe, it is plain that 
 plagues of all degrees of intenfity may take place, from 
 abfolute accenfion of the body, and its redudion to a(h- 
 es, to the mildeft ftate of the difeafe, in which the pa- 
 tient is not confined to his bed ; and all this from the 
 {ingle principle of emiffion of heat from the body rtfelfc 
 It likewife appears that there may be either in the body 
 itfelf, or in the element which furrounds it, fuch a con- 
 ftitution as will difpofe that element which is the natu- 
 ral and immediate preferver of our life, fuddenly to at- 
 tack and deftroy it, of which the cafe of the Italian prieft 
 is a moft remarkable inftance. In other cafes, fuch as 
 
 the 
 
 * If we confider the compofition of the atrtiofphere which furrounds us, we 
 rnuft acknowledge that by far the greater part of it confifts of fire and elcdric 
 fluid, the latter being properly the element in a comparatively quiefeent ftate. 
 In deflagrating dephiogifticated and inflammable air, the mixture has fome- 
 times ihrunk up into a three hundredth part of its bulk ; which ftiows that of 
 thefe airs two hundred and ninety-nine parts are fire, the fingl remaining 
 part only being earthi water* or fome iolid matter which we call the bajis of 
 
THE PLAGUE. 277 
 
 the Italian lady, and the woman at Coventry, the body 
 itfelf teems to have given out its heat, though this could 
 not be done without a concurrence of the furrounding 
 ethereal fluid. In a ftage ftill lower, the body is partial* 
 ly confurned, or rather partly charred into a kind of cin- 
 der, as where the tokens are produced > and when the 
 caufe ads with ftill lefs violence, a fever is produced. 
 In the Old Teftament we find thefe different kinds of 
 plagues very diftindly mentioned. In fome cafes the of- 
 fenders died by actual fire, which either ftruck them 
 from without, or was kindled within their bodies. In 
 others, they feem to have died by that very deadly kind 
 of plague of which we have already faid fo much, which 
 kills in a few hours. This was probably the plague 
 which deftroyed the army of Sennacherib, and this in 
 the tenth chapter of Ifaiah is by fome thought to have 
 been prophefied of under the title of a burning like the 
 burning of a fire. 
 
 Of thefe things I the rather take notice, as I perceive, 
 in a late oration, not only the doctrine of the plague be- 
 ing propagated by contagion feverely ridiculed, but the 
 fcripture itfelf treated in a moft indecent and fcanclalous 
 manner. " In the ear Heft ages of the world (fays he) 
 <4 when ignorance and fuperftition led men to attribute 
 " all extraordinary phenomena to the direct agency of 
 " fupernatural beings, peftilence was fuppofed to be 
 " immediately imported from heaven. This is the opi- 
 " nion which appears to have prevailed among the an- 
 *' cient Hebrews, and may be ranked at the head of the 
 " catalogue of abfurdities on this fubjeft. Thedomi- 
 * e nion of prejudice over the minds of that ignorant and 
 " obftinate people appears in this inftance particularly 
 ;t ftriking. Such was the depth of their blind bigotry 
 ' in favour of the healthfulnefs of the globe they inha- 
 * bited, that they would feem to have coniidered it as 
 " even fuperior to that of the celeftial regions. Hence, 
 " unwilling to believe that their favourite earth could 
 * { give origin to an evil fo dreadful as the peftilence, they 
 " imported the feeds of this calamity from the more un- 
 ff healthful climate of heaven ] !" 
 
 In 
 
278 A TREATISE ON 
 
 In this extraordinary paragraph we find the matter fo 
 much mifreprefented, that every veftige of truth is fwal- 
 lowed up in it. The Hebrews believed that they were 
 tinder the immediate infpeftion and government of the 
 Deity ; a doftrine which, however our author may dif- 
 believe, he cannot difprove. But, notwithftanding this 
 immediate infpe&ion and government, the Deity never 
 did bring upon them any plague but by the intervention 
 of natural caufes. The agents which he had originally 
 created were fufficiently able to execute his purpofes. 
 The Creator never employed any power but what al- 
 ready exiiled in the world, and the power that he gene- 
 rally did employ was fire. This agent he directed to 
 exert its force in fuch degrees as he pleafed, and againft 
 whom he pleafed. It is a miftake to think that miracles 
 were immediately the effects of fupernatural power. They 
 were all accomplished by the very powers which exift in 
 the world at this moment, only thefe powers were by the 
 Creator at particular times directed to act in a manner 
 that they would not have done had they been left to the 
 mechariifm of their own nature. When we read there- 
 fore of people being confumed by fire from the Lord, 
 there was neither importation of fire from heaven nor 
 any where elfe -, the element exerted its power on thefe 
 particular perfons, either by lightning proceeding from the 
 cloud which reprefented the Deity, or their bodies 
 threw out the latent heat which they contained, and 
 confumed of themfelves. That in cafes of this kind 
 there was no importation fuppofed, is evident from an ex- 
 preffion ufed about bringing water from the rock. It is 
 not faid that the water fell from the ftars, or came down 
 with the tail of a comet, but that the rock gave out the 
 water which it previously contained. At the prefent 
 day the lame powers exift, and fometimes produce the 
 iame effects that they did in former times, with this dif- 
 ference, that now, having no intelligent agent to inter- 
 fere with their natural mode of action, they exert their 
 force indifcriminately, and as the mechanifm of their na- 
 ture happens to be ftimulated, they deltroy every thing 
 proiuifcoufly before them. In all this I cannot perceive 
 
 the 
 
THE PLAGUE. 279 
 
 the fmalleft abfurdity, or any thing but what a rea- 
 fonable man may indeed mujl believe, if he makes ufe of 
 his reafon. As to the caufes which Dr. Caldwell fo much 
 infifts upon, viz. filth and corruption, it is extremely 
 probable that (while the Ifraclites were in the wildernefs) 
 thefe had no exiftence. By their law they were enjoin- 
 ed fuch frequent ablutions, that their bodies muft always 
 have been perfectly clean. Human excrements were 
 not allowed to lie above ground. The offals and dung 
 of their facrifices were carried to a diftance, and they were 
 exprefsly told, that they muft not allow of any unclean- 
 nefs in their camp, left God fhould turn away from them 
 and abhor them. Add to all this the great heat and 
 drynefs of the defert in which they wandered, which 
 would quickly parch up and carry off the moifture from 
 any dead carcafes or putrefying matters that might be 
 allowed to remain notwithftanding the injuctions to the 
 contrary. Indeed if we confider the drynefs of the cli- 
 mate where thefe people were, and that they were con- 
 ftantly attended by a large ftream of water, it is difficult 
 to conceive any fituation upon earth more healthy than 
 that of the Jews in the wilderneis. If plagues therefore 
 came upon them, it is difficult to fay how they could 
 have happened according to the ordinary courfe of na- 
 ture ; and, if not according to this, it muft have been by 
 an alteration of it, or by miracle. 
 
 The plague, as has already mentioned, in its very fe- 
 vere ftate appears moft commonly in the beginning of 
 an epidemic feafon, and is neither very common nor 
 very infectious. The moft common mode in which it 
 invades the patient is with the fymptoms of a malignant 
 fever; and of cafes of this kind Dr. RulTel has made 
 up his five claffes of patients, the firft or deadly kind 
 having been already defcribed. In his fecond clafs, the 
 next in malignity to the fatal kind, the difeafe made its 
 attack with a flight (hivering, fucceeded by fever with 
 giddinefs, vomiting, head-ach, and fometimes loofenefs. 
 In the night the fever increafed, the thirft was exceflivc, 
 and the patient, haraffed by the vomiting, &c. pafled a 
 very unquiet night, frequently with delirium or coma. 
 
 Towards 
 
2 8o A TREATISE ON" 
 
 Towards morning- the fever abated, the fick recovered 
 their (enfes if delirium had taken place, but if coma, it 
 continued through the day, and the remiffions were lefs. 
 Throughout the firft day, and part of the fecond, the 
 pulfe was full and ftrong, but on the fecond it began to 
 alter, and fome of the characteriftic figns of the difeafe 
 to appear. The principal of thefe was a certain mud- 
 dinefs in the eyes, which fometimes took place even on the 
 firfl day. This is by our author accounted a fymptom very 
 difficult to be defcribed, and, though he recounts the de- 
 fcriptions given by feveral authors, none are found ade- 
 quate to the real appearance. " It refembled (fays he) 
 ft fome what the dull, fixed eye obfervable in the lafh ftage 
 " of malignant fevers; but the dullnefs was different, 
 <c muddinefs and luftre being ftrangely blended together. 
 " It continued with little alteration in the remiffions, 
 "and even where the patient appeared fenfible and 
 " compofed it did not increafe in the febrile exacerba- 
 " tions, but the eyes acquired a rednefs that added 
 " wildnefs to the look, which abating or going off in 
 " the remiffions, the muddinefs remained behind. It 
 <e was this which contributed chiefly in competing that 
 " confufion of countenance which I mail not attempt 
 " to defcribe, but which enabled me to pronounce with 
 * c tolerable certainty whether the difeafe was or was not 
 " the plague, though not independently of other fymp- 
 " toms. When this muddinefs difappeared or abated, 
 " it was conftantly a favourable fign. After a critical 
 " fign it often difappeared fuddenly, but where there 
 " was a fucceffion of fweats, or where no vifible crifis 
 " happened, its difappearance was flow and gradual." 
 
 Along with this muddinefs the patient had a peculiar 
 confulion of countenance ; the pulfe quick and equal, 
 or low and flattering, but rarely intermittent ; the ex- 
 ternal heat moderately feverifli, at other times intenfe, 
 with irregular fluftings, with pain at the heart, or op- 
 preffions "about the prsecordia ; burning pain at the pit 
 of the ftomach, and inceffant inquietude. When to 
 thefe iymptoms were added a faltering in the tongue, 
 lofs offpeech, while the fur face of the body became 
 
 cold 
 
THE PLAGUE. 281 
 
 cold and damp with clammy fweat, death was inevita- 
 ble. In the evening of the fecond day all the fymp- 
 toms became worfe^ and in the morning the patient 
 appeared to lie quiet more from his ftrength being ex- 
 haufted than from any change to the better. When 
 the vomiting had ceafed, however, there was frequently 
 fuch a remiffion on the third day as gave the attendants 
 great hopes of a favourable event - 9 but thefe hopes were 
 always fallacious and of (hort duration. Sometimes 
 where vomiting, loofenefs or haemorrhage had preceded, 
 the patient died on the third day : at any rate, none of 
 this clafs recovered^ whether the difeafe was left to itielf, 
 or treated with medicine. The appearance of buboes 
 was of no confequence, for they never came to matu- 
 rity, and the little advances they made neither accele- 
 rated nor retarded the termination of the difeafe, which 
 happened fometimes on the third, but more frequently 
 on the fifth or fixth day. 
 
 The third clafs of patients were equally unfortunate 
 with the other two. "The difference between the 
 " fecond and third confided in the abfence of vomiting 
 " at the beginning, the later acceffion of coma and other 
 ;t bad fymptoms, and a flight tendency to perfpiration, 
 tc which very rarely occurred in the fecond. . . . From 
 " the fecond or third night the courfe of fymptoms in \ 
 ;t both clafles varied very little, and the termination of 
 " the difeafe was in both the fame : it may be added 
 " they reigned together through all the periods of the 
 ' peftilential feafon, but were mod prevalent in itsaug- 
 ' { ment $ for at its height, and in its decline, they gave 
 " place to varieties of the difeafe lefsdedructive." 
 
 The fourth clafs was the mod numerous of all. Its 
 
 didinetive marks were, " the continuance of the inflam- 
 
 ' matory or febrile fymptoms with lefs interruption than 
 
 ' in the other, a pulfe more condantly fudained, or foon 
 
 ;< recovering itfelf when hurried in the exacerbations; 
 
 :; the length and vigour of the exacerbations decreafing 
 
 ' in the advance of the difeafe ; and, above all, the 
 
 :c prevalent tendency to a favourable difcharge by the 
 
 " fkin, with the critical fweats on the 3d, 5th, or fub- 
 
 O o fequejit 
 
A TREATISE ON 
 
 " fequent days. . . . Vomiting was a concomitant Iti 
 " about one fourth of the fick. The fever, for the 
 * moil part, was very moderate the firft night, very 
 " rarely accompanied with delirium, and almoft never 
 ** with the comatous difpofition. . . . The buboes and 
 " carbuncles commonly made their appearance the firft 
 " day ; but it was not unufual to fee a fucceffive erup- 
 " tion of thefe in the courfe of the difeafe. . . . The 
 " morning fweat, on the third day, in fome cafes proved 
 ** completely critical, but more commonly produced 
 " only a remirlion fo favourable as to encourage the ex- 
 * c pedlation of a more favourable crifis on the fifth -, but* 
 '"' where the patient neither fweat on the third, nor a 
 t fenfible remiffion took place on that day, fome degree 
 <c of danger was always to be apprehended. . . . After 
 " the fweat on the fifth, the fubfequent exacerbations 
 " proved flrghter and flighter, and the buboes for the 
 *' moft part advancing favourably, little or no fever was 
 " left remaining after the beginning of the fecond week, 
 " except perhaps fymptomatic heats occafioned by the 
 *' eruptions." In this clafs the patients fometimes ap- 
 peared only to have a flight attack, and yet at laft 
 were feized with mortal fymptoms, while others who 
 feemed to be much worfe at firft yet happily recovered 
 and did well. In general the fevere peflilential fymptoms 
 did not come on till a confiderable time after the attack. 
 To the fifth clafs our author refers all cafes of flight 
 infeclion, wherein the more formidable fymptoms of 
 peftilence never concurred, and ell the infected recovered* 
 " The accefs here was often attended with fo little ap- 
 " parent diforder, that the eruptions gave the firft alarm ; 
 " and the fever which came on afterwards was frequently 
 " fo flight as not to confine the fick to the houfe. Others 
 " found themfelves indifpofed for two or three days, 
 " but were not fenfible of any febrile heat whatever. 
 " But in this clafs the difeafe did not always invade 
 " thus infenfibly. The febrile fymptoms, efpecially the 
 ic firft three days, fometimes run pretty high ; and the 
 " fever afterward, in nocturnal exacerbations particularly, 
 " run out to the end of the w<ek or longer ; but, as 
 
 " there 
 
THE PLAGUE. 283 
 
 " there was no concurrence of alarming fymptoms, and 
 " the exacerbations, terminating for the mod part in 
 " fweats, gradually diminimed in force after the third or 
 " fourth night, it was not difficult in the worft cafes to 
 " foretel the event at that period, nor neceffary in others 
 " to defer the decifion fo long." 
 
 " All the infeded had buboes or carbuncles, and very 
 " often both eruptions concurred in the fame fubjed. 
 C Perfons not confined by indifpofition were often, by 
 " the inguinal buboes, prevented from walking abroad. 
 " The carbuncles conftantly formed the black cru/t,* and 
 "then fuppurated ; the buboes in one third of the fick 
 " difperfed. The difperfion of the buboes was never 
 " obferved to be attended with bad confequences, not- 
 " withstanding the general negled; of purging in the 
 " decline of the difeafe ; indeed very few had recourfe 
 " to remedies, topical applications excepted, uralefs per- 
 " haps a bleeding at the beginning, where the febrile 
 " fymptoms ran high. This clafs was nearly as numerous 
 " as the fourth, but began to predominate rather later^ 
 " and reigned moft of all in the decline of the plague 
 "in 1762." 
 
 The fixth clafs mud be omitted, as containing dubi- 
 ous, anomalous and extraordinary cafes. We fhall 
 therefore proceed to confider the accounts of the plague 
 given by other phyficians, which, without queftioning 
 the accuracy of Dr. Patrick RufTel in relating what hs 
 has feen, may ferve to throw fome light on the fubjecT:, 
 by relating what others have feen. Dr. Alexander Ruf- 
 fel, in his Natural Hiftory of Aleppo, gives the Follow- 
 ing defcript ion of it. " The diftemper in itfelf is the 
 " moft lamentable to which mankind are liable. The 
 " torments of heat, thirft and pain frequently unite in 
 :< fome patients ; an unfpeakable dejection and languor 
 <c in others ; and even thofe who efcape with life do 
 ic not ceafe to fuffer from painful and putrid ulcers, the 
 :< painful remains of the difeafe. The defertion of rela- 
 " tions, of friends, and of domeftic fervants, the want 
 
 " often 
 
 This is in favour of what has already been obfervedi that the 
 Sruptiona in all cafes &owe4 
 
284 A TREATISE ON 
 
 " often of the common necefifaries of life, and the diffi- 
 " culty of procuring medical afliftance, are circumftances 
 " likewife which aggravate (the miferies of the lick, and 
 " contribute greatly to augment the general horror. 
 
 " But, as nodifeafe incident to mankind is in its na- 
 " ture more terrible and definitive, fo none is more dif- 
 " ficult to obferve. Its fymptoms are fcarcely in all re- 
 " fpeds alike in any two perfons, and even vary extreme- 
 /" ly in the courfe of an hour in the fame fubjedl. The 
 " difeafe, attended in the beginning with fymptoms not 
 " highly alarming, often ends fatally in a few hours ; 
 " while the moft formidable attacks, by a fudden and 
 " unexpected alteration, fometimes terminate happily. 
 
 " The firft complaints of thofe feized with this diftem- 
 " per, were, in general, a coldnefs or fhivering ; ficknefs ; 
 " a vomiting of large quantities ofporraceous bile, which 
 " often had a very oifenfive fmell ; anxiety, or an inex- 
 *' preflible uneafinefs about the pit of the ftomach ; pairt 
 ** in the back or loins ; an intenfe hefid-ach ; uncom- 
 " mon giddinefs, and a fudden iofs of ftrength. Some 
 44 were fenfible of a fharp Ihooting pain darting at inter- 
 <c vals into the parotid, axillary or inguinal glands. To 
 " thefe fymptoms fucceeded a violent fever ; in which, 
 " while the fick complained of extreme inward heat, 
 " their fkin, externally to the touch felt little hotter 
 *' than ufual. Sometimes this hea became general and 
 " intenfe ; at other times particular parts only were af- 
 * c feded ^ but it feldom continued long in the lamede- 
 " gree,. having feveral unequal remiflions and exacerba- 
 ** tions in a day. In thefe exacerbations the face became 
 " florid, but would often from a deep fcarlet change to 
 " a livid colour, like that of a perfon almoft flrangled ? 
 f and, again fuddenly changing, it would afTume a ca- 
 *' daverous palenefs. The eyes, foon lofing their natural 
 * { luftre, acquired a kind of muddinefs ; and the coun- 
 f c tenance of moft of the fick v^as ghattly and confufed 
 <c beyond defcription. The pulfe at the beginning was 
 " fomewhat quicker and lower, but in other refpects va- 
 " ried little from the natural (tate. Within a few hours 
 * f it commonly increafed in quicknefs and ftrength, but 
 
 " feldom 
 
THE PLAGUE. 285 
 
 ** feldo$n remained the fame for an hour, nay fcarcely 
 " many minutes together ; inceffantly varying, both as 
 " to ftrength and quicknefs, and without any manifeft 
 " correfpondence with the other febrile fymptoms. 
 
 46 In fuch as complained of pains darting eitikr into 
 " the parotids, the arm-pits, or the groins* afmall hard, 
 " deep-feated tumour, with external difcoloration of 
 fc the fkm, was difcovered by the touch in the part, and 
 " thefe were the incipient peftilential buboes. 
 
 " The appearances now defcribed were thofe of the 
 " diftemper on the firft day, till evening, when the fick 
 " always fufTered a fevere exacerbation, in which the 
 " heat both internal and external became exceffive ; 
 " and, as they generally were by that time delirious, it 
 " was often with difficulty that they would be kept 
 " within doors ; they were greatly difpofed to talk, but 
 **" faltered fo in their fpeech, that what they faid was 
 " hardly intelligible, the tongue having hared with the 
 -" other organs in the general debility. The exacerba- 
 '* tion lafted the moft part of the night ; but the heat, 
 " delirium, and inquietude abated towards morning, and 
 " a manifeft remiffion took place. Some recovered their 
 " fenfes entirely, fome partially, and then complained of 
 " intenfe head-ach, or of pains from the buboes ; it was 
 " ufual in this interval alfo that thofe who had carbun- 
 <c cles began to complain of burning pain in thefe fejy 
 " eruptions. The morning remifiion was commonly of 
 ** very (hort duration ; the rigours, anxiety and delirium 
 44 foon returning more violent than before, attended with 
 " a ftrong and frequent fubfultus tendinum. Thefe fe- 
 " brile fymptoms did not increafe regularly as the day 
 " advanced ; but went away and returned at intervals 
 " leaving (hort but alarming intermiffions ; for each 
 :c exacerbation furpafled that which preceded it either 
 c in violence or duration. In the evening the pulfe 
 ** could hardly be counted, by reafon of its depreffiori 
 " and quicknefs ; the patient became comatofe, and the 
 ;< refpiration was quick, laborious, and interrupted. 
 : The buboes which, fome hours before, feemed mant- 
 * c feftly to advance, often fubfided, and fometimes al- 
 
 " moft 
 
286 A TREATISE ON 
 
 " mofl entirely difappeared ; the carbuncles, mortifying 
 " at the top, refembled a great efchar. made by a cauf- 
 " tic : and at this period alfo livid or black fpots, of 
 " various dimenfions, often were found fcattered univer- 
 " fally on the body. 
 
 " Under thefe circumftances, dreadful as they feem- 
 " ed, fome hope of recovery ftill remained ; for, though 
 " many of the flck died on the third day, feveral had a 
 " favourable crifis on that day, by a profufe fweat ; fome 
 te ftruggled to the fifth day, a few to the feventh, and, 
 :4 here and there one, even to the eleventh j before 
 " any critical alteration took place. Where a copious 
 '' fweat happened on the third day, if it did not prove 
 " perfectly critical, it at lead always considerably abated 
 * the fever ; which, in that cafe, was generally to- 
 " tally removed by a fecond, though lefs profufe fweat, 
 " on the fifth : and then befides weaknefs the chief re* 
 " mains of the difeafe confided in the pain of the erup-r 
 " tions. 
 
 " Nothing could be predicted with refpecl to the 
 " event of the difeafe from the manner of its invafion 3 
 cc thofe who had the mod favourable efcape having been 
 * c often in the beginning attacked with as alarming 
 *' fymptoms as others were who died in a few hours, 
 " Sometimes the febrile paroxyfm,^ which had fet in 
 <c with fuch formidable violence, diffoived in a few 
 ^ hours, and left the patient languid indeed, and weak 
 *' in an extreme degree, but free from other complaints 
 " except the pain arifmg from the bubo, which from 
 *' that period increafing in fize, and advancing favoura^ 
 " bly to maturation, was, in many cafes, ready to open 
 " in twelve or fifteen days : the patient all the while, 
 u except the firft day, walking about as ufual. Great 
 " numbers happily efcaped, not only in the manner juft 
 " defcribed, but likewife where the buboes never ad- 
 " vanced ; for thefe tumours, fo far from coming always 
 " to maturation in fuch as recovered, very often dif- 
 4< cuffed without any bad confequence. Carbuncles 
 " often began to digeft before the termination of thefe- 
 <c ver in a critical fweat. 
 
THE PLAGUE. 287 
 
 tc All the infe6ted had buboes, except fuch as expired 
 ** fuddenly, or furvived the firft attack a few hours only. 
 " Inftances of this dreadful kind were more particularly 
 " obferved in March 1743. The fick were feized in the 
 " ufual manner ; but the head-ach, vomiting, and pain 
 " about the praecordia, increafmg every moment, proved 
 " fuddenly mortal, or terminated within a few hours in fa- 
 " tal convulfions." Dr. Patrick RuiTel obferves, that fuch 
 inftances of fudden death were very rare in the plague 
 of 1760, 1761 and 1762; and in thefe they happened 
 only in the winter, or early in the fpring. In fuch fud- 
 den deaths few had any appearance of buboes ; but in 
 general the armpits and groins, or the inlide of the arms 
 and thighs, became livid or black, and the reft of the 
 body was covered with confluent petechia*, livid puftules 
 being here and there interfperfed : but all thefe appear- 
 ances were more efpecially obferved after death. 
 
 In the plague of 1760, vibices as well as livid and 
 black fpots were. frequently found on the corpfe, but 
 not conftantly. They were always fufpicious in con- 
 junction with other circumftances, but their abfence 
 was no proof, though frequently urged as fuch, that the 
 diftemper was not the plague. The vibices fometimes 
 appeared feveral hours before death, but the livid fpots 
 feldom or never. 
 
 The tongue in feme was quite moift, and continued 
 to be like that of a healthy perfon throughout the dif- 
 eafe ; in others, white at firft, then yellow ; at laft 
 black, and covered with a dry, foul fcurf or fur. The 
 thirft was generally very great, but never conftant ; re- 
 turning at regular intervals, and never appearing to cor- 
 refpond with the danger of the fever. Sometimes it 
 was fo little that the patient could not be prevailed 
 upon to drink a fufficient quantity. The appearance of 
 the urine was equally variable, and afforded no certain 
 prognoftic ; being feldom alike in any two patients in 
 the fame ftage of the diftemper, and varying in the fame 
 patient every day. The vomiting commonly ceafed 
 after a few hours, excepting where the fick were in- 
 duced by thirft to load their ftomach, in which cafe it 
 
 always 
 
288 A TREATISE ON" 
 
 always returned. Sometimes the patients were coftrve, 
 in others a diarrhoea took place, but in moft the dif- 
 charges were natural. No critical folution by urine or 
 ftool Teemed ever to take place. A few cafes of haemor- 
 rhages from the note and uterus were obferved; and if 
 they happened after the fecond day, were foon followed 
 by a plentiful fweat, which commonly proved critical ; 
 " a circumftance different from what has been ufually 
 " obferved in the plague at other places. 
 
 " From the preceding account of the plague it will 
 <c readily be conceived that nothing oan be more diffi- 
 " cult than to form any judgment or prognoftic of the 
 " event of the dife-afe ? in which, as it is juftly remarked 
 " by Morellus, our fenfes and our reafon deceive us, the 
 " aphonfnis of Hippocrates are erroneous, and even 
 * c Hippocrates (as I am inclined to think) might have 
 " erred in his judgment." 
 
 Innumerable other hiftories of the diftemper might be 
 given, but the following, it is hoped, will be fufficienty 
 along with what has been already detailed, to (how that 
 the plague in former ages was the fame as at this day. 
 In the terrible plague which broke out in the time of 
 Juftinian, the diftemper fometimes began with deliri- 
 um, and the patient inftantly dtfpaired of life ; but 
 more generally people were furprifed by the fudden 
 coming on of a flight fever ; fo flight that no danger 
 was apprehended either from the ftate of the pulfeor co- 
 lour of the body. This, however, was quickly follow- 
 ed, fometimes even on the fame day, fometimes on the 
 fecond or third, by buboes or parotids (fwellings behind 
 the ear) which when opened were found to contain a 
 black coal^ or efchar, of the fize of a lentil. If thefe 
 fwellings fuppurated kindly, the patient recovered, but 
 if not, a mortification enfued, and death was the confe- 
 quence, commonly on the fifth day. Black puftules or 
 carbuncles, covering the body, were figns of immediate 
 death, as was likewife a vomiting of blood in weak con- 
 flitutions ; for this terminated in a mortification of the 
 bowels. Pregnant women generally perifhed, but wo- 
 men were lefs fufceptible of the infe&ion than men ; 
 
 and 
 
THE PLAGUE, 289 
 
 and young perfons were in more danger than old. Ma- 
 ny, who recovered, loft the ufe of their fpeech, and fuch 
 were not fecure from a relapfe. 
 
 In the laft plague at Mofcow, the fymptoms were va- 
 rious, according to the perfons, conflitution and the wea- 
 ther ; in general, head-ach, giddinefs, iliivering, lofs of 
 ftrength, flight fever, ficknefs and vomiting, rednefs of 
 the eyes, white and foul tongue* with a dejeded counte- 
 nance, buboes and carbuncles appearing on the fecond or 
 third day, but feldom on the fourth* The buboes were 
 feated chiefly in the glandular parts, the armpits and 
 groin, but fometimes made their appearance in the neck, 
 cheeks, See. Sometimes thefe fuppurated perfectly, and 
 then they proved beneficial, but not otherwife. Some- 
 times they fuddenly difappeared, after having attained 
 the fize of walnuts ; and this retrocefllon was always fup- 
 pofed to be a fign of approaching death. Sometimes 
 they neither fliowed any fign of inflammation nor were 
 painful, and in fuch cafes afforded no relief. Similar 
 fwellings fometimes occured in the parotid glands, but 
 they were never equally beneficial with the buboes. 
 Carbuncles were gangrenous fpots on the fkin, refembling 
 a burn, with black, livid or red veficles, bordered with 
 an inflammatory ring, and foon terminating in a hard, 
 black efchan The anthrax is more promi nent, penetrating 
 deeper into the adipofe membrane, and attended with 
 more pain and inflammation. The difeafe was likewife 
 attended with petechiae fimilar to thofe in putrid fevers, 
 but larger j alfo with vibices, which refembled the mark 
 of a whip, and were confidered, as well as the petechise, 
 as mortal figns. No diftincl: account of the pulfe could 
 be given ; as, after the difeafe became general, phyficians 
 did not choofe to feel the pulfes of their patients but 
 through a glove or tobacco-leaf. Worms called teretes 
 were frequently clifcharged both upwards and downwards. 
 Women with child generally fuffered abortion, and were 
 carried off by an uterine haemorrhage.* 
 
 According 
 
 * Bonetus relates, that in 1676 in a malignant fever at Borgo di Safia, th* 
 patients difcharged live worms by the mouth, and adds that they were foonef 
 killed by wine than any thing. 
 
2 9 o A TREATISE ON 
 
 According to Sydenham, the plague begins with 
 chiliinefs and fhivering, like the fit of an intermittent, 
 fucceeded in a little time by violent vomiting and op- 
 prefiion at the bread, accompanied with its common, 
 fymptoms. Thefe continue till the difeafe proves mor- 
 tal, or the kindly eruption of a bubo or parotis difcharges 
 the morbific matter. Sometimes, though rarely, the 
 difeafe is not preceded by any fever ; the purple fpots, 
 which denote immediate death, coming out even while 
 perfons are abroad about their bufinefs. But this hardly 
 ever happens but in the beginning of a very fatal plague, 
 and never while it is on the decline, or in thofe years 
 in which it is not epidemic. Sometimes fwellings ap- 
 pear without having been preceded either by a fever or 
 any other considerable fymptom 5 but he conceives that 
 fome flight and obfcure fhivering always precedes the 
 feizure. 
 
 Mariti, in his travels through Cyprus, &c. fays that 
 the plague of 1760 began with lofs of appetite, pain in 
 the (boulders, head-ach extremely violent, delirium, 
 vomiting, with a moft excruciating pain in that part 
 where the tumour by which the plague is character'* fed, 
 is about to break forth. Death often took place on the 
 third day, and very few lived beyond the thirteenth. 
 
 The Abbe's definition of what he calls the plague, and 
 which feems to be the pe/Ulenttal bubo of the phyficians, 
 is fomewhat ft'ngular. " The plague (fays he) is an ob- 
 ** long tumour, fhaped like a pumpkin, which is at firft 
 " of a flefht colour ; but it gradually becomes red, and 
 * e at length blueifh ; and this is a fign that the difeafe 
 " is incurable. If it continues red, and a little after in- 
 <e dines to yellow, it is a fign that a fuppuration will 
 " take place : the fwelling is then opened, and the pa- 
 r tientis fometimes cured." 
 
 According to our author, the fymptoms of the plague 
 do not appear till fifteen days after the infection is re- 
 ceived ; and this is the reafon of a law which fubjects to 
 a proof of twenty days every perfon fufpected of being 
 difeafed. In this plague it was obferved that people of 
 the foundeft conflitutions were the moft fubject to. it, 
 
 and 
 
THE PLAGUE. 291 
 
 and the leaft capable of refitting it, On the other hand, 
 it appeared to fpare weak and delicate perfons, whole 
 cure, in cafe of an attack, was much lefs difficult. A 
 greater number of Moors than of any other nation were 
 attacked by it ; and when once they were feized, their 
 cafe was abfolutely defperate. Thofe who had recovered 
 from the difeafe were lefs liable to a fecond attack, but 
 were not abfolutely fafe. " I have known fomc (fays 
 " our author) who have been ill feven times, and have 
 ec died of it at laft." 
 
 Dr. M'Bride informs us that in the plague which 
 raged at Marieilles and the adjacent places in 1720, 
 people on their firft feizure feemed as if intoxicated with 
 drink ; they loft the power of their limbs entirely, and 
 became fo deje&ed that they gave themfelves over to 
 defpair from the very firft attack. Along with the bi- 
 lious vomitings and purgings which generally took place 
 on the fecond day, quantities of fmall worms like afca- 
 rides were thrown off. The more plentiful thefe evacu- 
 ations were, the more falutary ; for thofe who vomited 
 and purged but little funk down, oppreffed with the 
 difeafe, and died before the fourth day, covered with 
 livid blotches and petechiae , thofe who had the largeft 
 evacuations had alfo the moft plentiful eruptions of bu- 
 boes and parotid abfceffes. When thefe appeared, the 
 patients rofe, walked about, and became remarkably 
 hungry ; the heat and thirft fubfided, but the face con- 
 tinued pale and languid, the pulfe hard and frequent. 
 On the fixth, feven th, or eighth day, if the fuppuration 
 flopped, and the humours went back, then came on op- 
 preflion, difficulty of breathing, furious delirium and 
 convulfions, which ended in death. When carbuncles, 
 or biles, with mortified Houghs, appeared in different 
 parts of the body, either alone or accompanied with the 
 glandular fwellings, the patients fcarcely ever efcaped. 
 In great numbers of people tumours appeared without 
 any previous febrile fymptom, and, in a few cafes, went 
 off by refolution ; in others they continued inafchirrous 
 date ; but it was beft vvfyen the tumours came to fuppu- 
 ration. 
 
 Theft 
 
29* A TREATISE ON 
 
 Thefe are the moft remarkable fymptoms of this fatal 
 difeafe, which have been recorded by the phyficians of 
 greateft eminence who have written upon the fub- 
 je<5t. It remains ftill to give fome particular defcription 
 of the buboes and carbuncles, which are fuppofed to 
 Conftitute in a particular manner the chara&eriftic figns 
 of the diftemper. Of thefe the following account, given 
 by Dr. Alexander Ruflel, feems to be fufficientiy clear 
 and explicit. 
 
 Only a very few, and fuch as died fuddenly, were 
 exempted from buboes, but only about one half had 
 carbuncles. In the latter plagues their proportion was 
 ftill frnaller ; but they feldom appeared earlier than in 
 the months of April or May. In 1742 and 1743, the 
 buboes often appeared on the firft commencement of the 
 diftemper, fometimes not till twelve hours after , in a 
 few inftances not till two or three days ; but in 1744 
 they were fometimes the firft fymptoms of the difeafe. 
 The buboes were generally folitary, the inguinal and 
 axillary more frequent than the parotid. " The in- 
 <l guinal bubo for the moft part was double ; that is, 
 " two diftinct glands fwelled in the fame groin. The fu- 
 <e perior, which in fhape fomewhat refembled a fmall 
 " cucumber, lay obliquely near the large veflels of the 
 " thigh, lower than the venereal buboes are ufually found, 
 " and it was that which commonly came to fuppuration ; 
 *' the inferior was round, and in fize much fmaller. I 
 " once met with a cafe in which an axillary bubo divided 
 " in like manner into two parts, one of which got under 
 " the pe<5toral mufcle, the other funk deeper into the 
 " armpit : both grew painful and inflamed, but that in 
 c< the armpit only fuppurated." 
 
 The bubo was at firft a fmall hard tumour, painful 
 but not inflamed externally. Thefe indurated glands 
 were deeply feated, fometimes moveable, at others more 
 or left fixed, but always painful to the touch. Some- 
 times they would increafe to a confiderable fize in a few 
 hours, with intenfe pain, then fuddenly fubfide ; and 
 thefe changes would take place feveral times in twenty- 
 four hours. " An exacerbation of the peftilential fyntp- 
 
 " toms 
 
THE PLAGUE. 293 
 
 " toms immediately upon the decreafe of the bubo, fome- 
 " times prompted me to imagine it owing to the retro- 
 " ceffion of the tumour ; but this did not happen fo 
 " conftantly as to make me think it was fo in reality. 
 " The buboes, as far as I could learn, never advanced 
 " regularly to maturation till fuch time as a critical 
 " fweat had carried off the fever. In ten, twelve, or 
 " fifteen days, from the firft attack, they commonly 
 " fuppurated -, having been all along attended with the 
 *' ufual fymptoms of inflammatory tumours. But I 
 " have known them fometimes, nay, frequently, difappear 
 (e foon after the critical fweat, and difcufs completely 
 ft without any detriment to the patient. At other 
 " times, though grown to a pretty large fize, the tumour, 
 " about the height of the difeafe, would fink and morti- 
 " fy, without any fatal confequences ; for, as foon as 
 " the criiis was complete, the mortification flopped, and 
 *' the gangrened parts feparating gradually, left a deep 
 " ulcer, which healed without difficulty. I met with 
 " no inftance of a bubo in which fever did not either 
 " precede or follow the eruption." 
 
 On the fubject of carbuncles, Dr. Patrick Ruflel ob- 
 ferves, that " there are certainly varieties in them, but 
 " perhaps thefe varieties have been unneceffarily multi- 
 " plied, from the fame eruption having been viewed in 
 " different ftages of its progrefs ; for all of them fooner 
 " or later are covered with a black efchar." Dr. Alex- 
 ander Rufiel describes them as follows : " The carbun- 
 " cl.es were commonly protruded the fecond day of the 
 " difeafe $ and though the mufcular and tendinous parts 
 " were more efpecially affected, no part whatever could 
 " be faid to be free of them. The carbuncle at firft re- 
 i{ fembled an angry confluent pock in its inflammatory 
 :t ftage, but was attended with intenfe, burning pain, 
 ; * and furrounded by a circle of a deep fcarlet hue, which 
 ic foon became livid. By a progrefs very rapid, it then 
 * fpread circularly, from the fize of a iilver penny to an 
 :c inch and an half, two inches, nay, even three inches, 
 " diameter ; and the fupervening gangrene often pene- 
 ;" trated deep intp the fubftance of the parts affe&ed. 
 
 <e la 
 
294 . A TREATISE ON 
 
 " In fuch of the fick as recovered, the gangrene ufually 
 " ceafed fpreading on the third day ; and, a day or two 
 " after, figns of fuppuration were obferved at the edge of 
 " the black cruft, the feparation of which, advancing 
 *' gradually, was completed rather in lefs time than that 
 " of the efchar in iffues made by cauftic. In cafes where 
 ** the patient died, I was informed (for I faw none of 
 M thofe cafes myfclf) that a quantity of ichorous matter 
 "oozed from beneath the efchar, which remained itfdf 
 *' fhrivelled and hard, without any favourable figns ef 
 * c feparation or cligeftion.*'* 
 
 Dr. Alexander Ruffel alfo defcribes another kind of 
 puftule, which he fays appeared in a fmall number of 
 the fick, but which his brother Dr. Patrick had no op- 
 portunity of obferving in 1760. It had no livid ordif- 
 coioured circle furrounding it, but was filled with lauda- 
 ble pus ; and, when dry, the cruil fell off, as in the dif- 
 tinc*t fmall-pox. This was looked upon as a favoura- 
 ble fymptorn, all who had it happening to recover. 
 
 We have now detailed, at confiderable length, the 
 fymptoms of the plague as mentioned by authors of great 
 eminence. To give a detail of all that has been fa id 
 
 upon 
 
 ? I>r. Gotwald, formerly quoted, defcribes four varieties of carbuncles* the 
 *' differences between which feem to be pretty diftin&ly marked. i. One 
 " kind rifes pretty high, is of a dark brown colour, the cuticle appearing as 
 *' if it were burnt, and it is furrounded with a lead-coloured circle. In the 
 * beginning it is no bigger than a pea, but, if not prevented, foon grows to 
 the fize of a crown piece; inwardly it ismoifter than the reft, and may be 
 more eafily feparated. Its feat is generally in the fleihy parts, as on the 
 Ihoulders, neck, hips, arms and legs. 2. The fecond lie a iitlie deeper* 
 and do not rife fo high ; the efchar in the middle is entirely dark and 
 alh-coloured, full of fmall chops, as if it would burft by too great drynefs : 
 it has a ftrong lead-coloured circle, behind which the found f3e(h looks red 
 and fhining. Jt eats into the fiefh round about it, and takes deep root : it 
 generally fixes in the moft flefhy parts, as the buttocks, calves, &c, 3. The 
 third is not very large at firft ; it appears like a blood fvvelling, not lo dark 
 < as the former, with a wrinkled {kin; as it increafes, fmall blifters arife in 
 the middle, and form an efchar, in little clutters, which, as an ingenious 
 phyfician obferved, were fmall carbuncles. They commonly are fituated 
 * in membranous and tendinous parts about the knees, toes, and behind the 
 * ears, &c. 4. The fourth is the moft curious, as Purman, in his treatife on 
 the plague, has well obforved. Sitonius calls them pale, livid, ulcerous 
 papulae : they appear with a high.yellowifh blifter, which leems full of cor- 
 ruption : the circle round it is fnft red, then of an a(h colour : the blifter 
 loon falls, and, with the carbuncle, appears fcarce fo big as a pepper corni 
 continually eating deeper and wider. They are feated upon the cartilaginous 
 < or griftly parts. Gotwald found them near the pit of the itcmach, upon 
 " the cartilago enfiformis and fhort ribs. All the four take root and burn 
 ?* very violently at firft, but the two former moft of all." 
 
HE PLAGUE. 295 
 
 upon this fubjeft would be impoffible > neither indeed 
 can it be thought necefTary in the prefent treatife. 
 Whatever may have been omitted or too flightly men- 
 tioned in this fe&ion, will naturally be confidered when 
 we come to treat of the cure. It now therefore only re- 
 mains to fay, whether the approach of a plague may be 
 known by any vifible figns, fo that people might in 
 fome meafure prepare thernfelves for the enfuing ca- 
 lamity. 
 
 Were we in pofleffion of an accurate and authentic 
 hiftery of the world, this queftion might be very eafily 
 decided j but the uncertainty of ancient records, the 
 mutilated ftate of thofe which we do poffefs, the diverfity 
 of opinions among mankind, and the unhappy difpolition 
 to rtnfreprtjsnt) fo common in all ages, render it very dif- 
 ficult to fay any thing upon the fubject. If the theory 
 hinted at in this fedion (that plagues arife from fome 
 commotion in the electric fluid) can be allowed to have 
 any foundation in nature, then it ought to follow, that 
 the forerunners of peftilence would be fome electric 
 phenomena ; and* from a perufal of the firft and fecond 
 lections of this work, it will appear that fuch an opinion 
 is not altogether unfounded.* 
 
 The appearance of immenfe numbers of infects has 
 likewife been accounted a fign of approaching peftilence ; 
 but if we fuppofe their appearance to be a jfr#, we can 
 fcarce imagine their putrefaction to have been a caufe, of 
 peftilence. In the eaft we are informed by Dr. Ruflel 
 that the inhabitants of Aleppo account the appearance of 
 infects, and even eclipfes, as prefaces of the plague. They 
 fuppofe alfo that the ftiilnefs of frogs is a fign of pefti- 
 lence ; but the fame author informs us that all thefe 
 figns failed in 1760. Violent earthquakes and famines 
 feem to be more certain figns, though even thefe are 
 not always to be depended upon ; it being evident 
 from hiftorical accounts that peftilence has fometimes 
 preceded, and fometimes followed, earthquake and fa- 
 mine. Mr. Gibbon, however, afcribes to the above- 
 mentioned caufes 5 viz. infects, earthquakes, and even 
 
 comets, 
 
 See p, p. 6ii <a. 
 
296 A TREATISE ON 
 
 comets, the dreadful plague which took place in the 
 reign of Juftinfon. At leaft, all thefe preceded it; but 
 perhaps the infefts were only meant to be accounted the 
 caufe of the plague. The caufe of the infefts muft remain 
 in obfcurity. According to him, " In a damp but 
 C flagnating air, this African fever is generated from 
 " the putrefaction of animal fubflances, and efpecially 
 " from the fwarms of locufts, not lefs deftru&ive to 
 mankind in their death than in their lives." 
 
 This dreadful plague was preceded by comets and 
 moft violent earthquakes. A remarkable comet appear- 
 ed in 536, fuppofed to be the great one obferved by Sir 
 Ifaac Newton in 1680. This, we are told by aftrono- 
 mers, revolves round the fun in a period of 575 years ; 
 but the failure of aftronomical predictions in the return 
 of the expected comets of 1759 and 1789, mew the 
 futility of fuch calculations. Another comet appear- 
 ed in 539, and thefe comets were attended with an 
 extraordinary palenefs of the fun. Mr. Gibbon obferves, 
 that earthquakes, which he calls a fever of the earth, 
 " raged with uncommon violence during the reign of 
 " Juftinian. Each year is marked by the repetition of 
 " earthquakes of fuch character, that Conftantinople has 
 4t been lhaken above forty days ; of fuch extent, that 
 " the (hock has been communicated to the whole fur- 
 *' face of the globe, or at lead of the Roman empire, 
 " An impulfive or vibrating motion was felt ; enormous 
 " chafms were opened, huge and heavy bodies were dif- 
 " charged into the air, the fea alternately advanced and 
 " retreated beyond its ordinary bounds, and a mountain 
 " was torn from Liburnia, and thrown into the waves* 
 " where it protected as a mole the new harbour of Bo- 
 " trys in Phenicia." 
 
 According to Dr. Sydenham the plague at London in 
 1665 was preceded by a very cold winter ; the firft con-> 
 tinued till fpring and went off fuddenly towards the end 
 of March. Peripneumonies, pleurifies, quiniies, arid 
 other inflammatory diforders, then made their appear- 
 ance, along with an epidemic fever of a particular kind, 
 which did not yield to the remedies fuccefsful in other 
 
 epidemics. 
 
THE PLAGUE. 297 
 
 epidemics. About the middle of the year the plague 
 began, and increafed in violence till the autumnal equi- 
 nox, when it began to abate, and by the enfuing fpring 
 was entirely gone. Our author fays that the plague fei- 
 dom rages violently in England but once in thirty or 
 forty years ; but fince his time, which is upwards of a 
 century, no plague hath appeared. He fuppofes the 
 plague and other epidemics to depend on fome fecret 
 conftitution of the air* but pretends not to fay what that 
 conftitution is. But, befides this conftitution, he is of 
 opinion that there muft be another circumftance, viz. 
 the receiving the effluvia or feminium From an infected 
 perfon. Thus he fuppofes that a {ingle infected perfon 
 is fufficient to poifon a whole country ; the general mafs 
 of atmofphere being infected by the breath of the difea- 
 fed and the effluvia of the dead bodies. u Thus (fays he) 
 " the way of propagating this dreadful difeafe by infec- 
 " tion is rendered entirely unnecelfary ; for though a 
 <c perfon be mod cautioufly removed from the infected* 
 " yet the air received in by breathing will of itfelf be 
 " fufficient to infect him, provided his juices be difpofed 
 *' to receive the infection. I much doubt, if the difpo- 
 " iition of the air* though it be peftilential, is of itfelf 
 " able to produce the plague ; but the plague being at- 
 "'ways in Tome place or other, it is conveyed by peftiien- 
 " tial particles, or the coming of an infected perfon from 
 <c fome place where it rages, to an uninfected one, and 
 '" is not epidemic there, unlefs the conftitution of the air 
 * c favours it. Otherwife I cannot conceive how it fhould 
 " happen, that, when the plague rages violently in one 
 " town in the fame climate, a neighbouring one fhould 
 " totally efcape it, by ftrictly forbidding all intercourfc 
 *' with the infected places $ an inftance of which we had 
 cs fome few years ago when the plague raged with ex- 
 s treme violence in mod parts of Italy ; and yet the 
 ^ Grand Duke, by his vigilance and prudence) entirely 
 *' prevented its entering the borders of Tufcany." As 
 to the nature of the difeafej when once produced, Dr. 
 Sydenham is of opinion that it is altogether inflammato^ 
 ry i for which he gives the following reafons : i. The 
 
 Qjq, colour 
 
.298 A TREATISE ON 
 
 colour of blood taken away that refembles that ih pleu- 
 ritic and rheumatic diforders. 2. The carbuncles re- 
 ferable the mark of an actual cautery, q. The buboes 
 are equally difpofed to inflammation with any other tu- 
 mours that come to fuppuration. 4. The feafon of the 
 y^ar may be adduced in proof of this ; for between fpring 
 and fummer, inflammatory diforders, as pleurifies, quin- 
 fies, &c. are common. 
 
 Before we put an end to this fection, it may now be 
 proper to fay a few words by way of apology for thfe 
 many apparent digreffions from the fubject which have 
 appeared in it. In the firft place, then, the work being 
 intended 'for general infpedtion, and not merely for me- 
 dical readers, it became abfolutely neceflary to intro- 
 . duce a number of things which for medical readers 
 would have been totally fuperfluous. It was to be fup- 
 pofed that the book might come into the hands of fome 
 who had not read any thing concerning the ftructure of 
 the body, who had not heard of any of the fyftems of 
 medicine now prevalent, or the different doctrines they 
 contain. It was impoffible to write in an intelligible 
 manner for fuch people without giving fome few hints 
 concerning all thefe fubjects : the fame confederation 
 made it necefTary to enter pretty largely into the difco- 
 veries concerning the compofition of the atmofphere 
 and various kinds of elaftic fluids, concerning heat, &c. 
 In doing this the writer was under a necefllty either to 
 adopt fome of the doctrines he took notice of, or to 
 animadvert upon them. If he has ventured freely to 
 give his fentiments, it is not with a view to eftablifii a 
 theory of his own, but to direct the attention of the 
 reader to thofe natural agents which feem to be at 
 prefent too much overlooked, principally becaufe they 
 are lefs acceflible to our fenfes, and of confequence lefs 
 fubject to experiment, than others. If therefore in this 
 trcatife it is fuggefted that the atnvofphere acts on the 
 human body by its internal or latent heat, and by its 
 'electricity, as well as by its other properties j if the 
 writer is inclined to believe that thefe are in fact the 
 n:oft powerfulparts of it 5 that we never can act with- 
 out 
 
THE PLAGUE. 299 
 
 put them, and that in fhort our life and health are in 
 immediate dependence upon them ; I fay, that none of 
 all thefe things are in opposition to any fad: hitherto 
 difcovered, either of the medical kind or any other. 
 On the other hand, in all ages phyficians have fought 
 for foine conftitution in the air, inexplicable, and per- 
 petually unknown, to which difeafes might be alcribed 
 that could not be fuppofed to originate from any of its 
 ordinary properties. To explore this conftitution is as 
 great a defideratum at the prefent moment as two thou- 
 fand years ago ; and any attempt to inveftigate it, or a 
 conjecture relating to it, cannot be fuppofed inconfif- 
 tent with any thing already difcovered and afcertained. 
 There are many things which fead us to think that 
 electricity is very much concerned in difeafes, and 
 and among the reft we muft account the new difcovery 
 of Dr. Perkins's metallic conductors a very notable 
 proof of it; Thefe, when firft ufhered into the world, 
 were made by many a fubject of ridicule ; but the evi- 
 dence in favour of their efficacy, both in America and 
 in various parts of Europe, feems now to be decifive in 
 their favour; and, if they act at all, it is almoft impof- 
 fible to fuggeft any other principle than that of electri- 
 city to which their efficacy can be owing. No doubt 
 it is difficult to draw the line properly betwixt credulity 
 and fkepticifm, but where credible teftimony determines 
 any thing to have actually happened, or where folid rea- 
 foning gives room to fuppofe any thing to be probable, 
 it never can be invalidated by any argument a priori 
 formed againft the pqffi-bility of fuch a thing taking place. 
 In page 128 it is faid, that M. Lavoifier, by introdu- 
 cing the new chemical nomenclature, " has entailed the 
 greateft curfe upon the fcience it ever met with." An 
 apology for this bold affertion is abfolutely necefTary, 
 and the quotation made from Dr. Ferriar may be deem- 
 ed inadequate, or perhaps mifapplied. In paffing this 
 cenfure on the nomenclature I wrote from experience. 
 The new nomenclature, inftead of promoting my improve- 
 ment in chemiftry, hath had a direct contrary tendency, 
 inftajice of the inconvenience and ambiguity ariflng 
 
 from 
 
A TREATISE ON 
 
 from it is given p. 135, when fpeaking of Dr. Girtan- 
 ner's theory. But a much more remarkable example is 
 to be met with in the review of Dr. Monro's Chemi- 
 cal Treatife, where we find him cenfured for the very 
 fame ambiguity taken notice of with regard to Dr. Gir- 
 tanner, u He might have obferved (fay the reviewers) 
 " the diftindion between the hydrogen and inflamma- 
 " b!e air, and between the oxygen and pure air 5 as well 
 " as between the azote and impure air : he has men- 
 " tioned thefe as fynonimous, whereas they are terms 
 "' that exprefs bafes, or fubftances in a concrete fiate 
 " (what I have called the condenfable part) and the com- 
 *' pounds of thefe fubilances and heat, when they af- 
 " fume the form qfgafes or elaftic fluids." (Monthly 
 Rev. for 1790, p.. 26.) 
 
 That the terms invented by Lavoifier and others have 
 not been received with perfect unanimity by the che- 
 niifts of the prefent day, is evident from Dr. Pearfon's 
 " Tranflation of the New Chemical Nomenclature," 
 which is not only ^tranjlation, \>\&& vindication of it. In 
 the courfe of his work he quotes the tranflator of the 
 Chemical Dictionary faying, that, " from the zeal of 
 " reforming language, fuch a number of reformers may 
 " arife, that our ears will not be lefs ftunned, nor our 
 " underftandings lefs perplexed, than if we were expo- 
 " fed to the clamour of Babel, or the thaw of ivords of 
 <c Sir John Mandeville." To this Dr. Pearfon replies, 
 that there is no reafon to fear any fuch bad confequences. 
 ^ The diftinguilhed fuperiority of a fyPcem produced by 
 " a De Guy ton, a Lavoifier, or a Eergman, would furely 
 " fupercede the work of perfons of inferior ability" It 
 is impoffible to know the perfons here defignated, unlefs 
 the Doctor points them out. If he choofes to call him- 
 fe/fone of them, we can have no objection. He cer- 
 tainly has diffented, in one article, from " the fyftem 
 produced by De Guy ton, Lavoifier and Bergman," and 
 {his is with regard to the word azote. This is the term 
 announced to us as the moft proper for denoting a certain 
 kind of air. But Dr. Pearfon determines nitrogen to be 
 fnore proper. Even this has not given entire fatisfae- 
 
 tiorv 
 
THE PLAGUE, 
 
 tion, for Dr. Mitchell has adopted the vtotifabton in 
 preference to both azote and nitrogen. Thus, inftead of 
 the original phrafe phlogi/Kcated #/V, ufed by Dr. Prieft- 
 ley, we have four ; for as long as the works of Dr. Prieft- 
 ley remain, the original term will be ufed by fome, while 
 with others it will be fo much difufed that perhaps they 
 will not underftand it when it happens to occur. Nor 
 are corrections of this kind all that we have to fear. Pro- 
 feffor Wiegleb, who has written a Syftem ofChemiftry 
 in quarto,' has therein changed almoft all the nomencla- 
 ture invented by Lavofier. Inftead of it he gives a no- 
 menclature of his own, in which he makes very much 
 ufe of the termination cratla^ from a Greek word fignify- 
 Ing ftrength j thus, inftead of faying the acid of fluor, 
 we are to fay fluoricratia. I muft confefs that to me 
 the perpetual repetition of this termination has a very 
 ridiculous appearance $ but the misfortune is, that in 
 the cafe of nomenclatures we have no choice. We can- 
 not choofe one and reject another : good or bad, we 
 muft take both ; and were an hundred new ones to arife, 
 we muft be condemned to learn them all. Nor is even, 
 this the word. Wiegleb's fcholars, for inftance, accuf- 
 tomed to the language of their teacher, will be apt to 
 put it into their writings, perhaps without proper expla- 
 nation ; and < thus fuch writings muft be unintelligible 
 both to old and new chemifts : and thus it will be with 
 as many others as choofe to invent new chemical terms. 
 
 Were this a proper place for entering into a difcuffion 
 of Lavoifier's nomenclature, it might eafily be mown 
 that the terms are not more proper than thofe which 
 preceded them ; but no real inconvenience can arife from 
 the propriety or impropriety of a mere name. It is the 
 resemblance of the terms to one another, and the facility 
 with which miftakes may be made, that gives juft ground 
 of complaint. Nor is it any juft reafon to accufe a per- 
 fon of want of judgment or careleflhefs becaufe he hath 
 miftaken thefe terms. We fee that even Dr. Monro has 
 not attended to every circumftance ; and if a man of 
 Jiis experience and accuracy hath been inaccurate in this 
 f efpejft, what is to be expected from others ? How 
 
 eafily 
 
3 oz A TREATISE ON 
 
 eafily may the words fulfate, fulfite., fulphwet and fulpJiure, 
 be miftaken for one another, either in writing or con- 
 verfation ! Yet a miftake of this kind would totally 
 pervert the meaning of the perfon who ufed it. The 
 fcripture finds fault with thofe who make people offend- 
 ers for a wordy but here we are in danger of being 
 made offenders for a letter. In fhort, taking into ac- 
 count the inconveniences ariiing from this nomencla- 
 ture itfelf, the numberlefs corrections and amendments 
 (no matter whether real or imaginary) to which it may 
 be fubjecled, and the number of others totally different 
 from it which may arife, I cannot help looking upon 
 the introduction of it into chemiftry as an evil of the 
 firil magnitude $ an evil which cannot be remedied by 
 any art, but muft continually become worfe and worfe. 
 
 SECTION IV. 
 
 Of the left Methods of Preventing the Plague. 
 
 THESE methods may be claffed in the following 
 manner : i. Thofe moft proper for avoiding 
 the infection, fuppofing the difeafe to be infectious. 
 2. The proper mode of refilling or removing thofe local 
 caufes which may give rife to it, OF may co-operate with 
 the infectious matter in giving greater force to the dif- 
 eafe, fhould it happen to be introduced ; and, 3. The 
 bed method of preparing the body for refitting peftilen- 
 tial attacks, fhould we happen to be fo fituated that no 
 external method of defence could be ufed. 
 
 With regard to the firft of thefe intentions the flying 
 from places infected has been fo univerfally recommend- 
 ed, and fo generally received, that the precept has been 
 made up into the following proverbial Latin diftich ; 
 
 Hoec tria tabificam tollunt adverbia peftera 
 Mox, longe, tarde, cede, recede, redi." 
 
 Thefe tuerds prevent the plague's itrfefliotes paint 
 Co quick, Jty far>Wflow return again. 
 
 This maxim hath been put in execution in all -ages,, 
 often with fo little regard to humanity that it can-i 
 
 not 
 
THE PLAGUE. 3*J 
 
 ftot by any rneans : be recommended 'without very con- 
 fiderable limitation. The reparation of theflck from all 
 promifcous intercourfe with the found, in times of pefti- 
 lence, feems to be dictated by common fenfe ; but 'this 
 tnay be done without killing them, or leaving'them to 
 expire in the miferable ftate to which they are reduced by 
 the difeafe. Mr. Howard -informs us that in feme places 
 (hips which have the plague on board are chafed away and 
 burnt ; and iriftaftces of cruelty with regard to infected 
 individuals halve been formerly mentioned. Dr. Mer- 
 tens is of opinion that cutting off all the communication 
 between the infe&ed and healthy is the only means 
 of preventing the difeafe from fpreading. The good of 
 this practice was obferved in one of the hofpitalsat Mof- 
 cow. All the avenues to it were fhu't up, but one which 
 was ftrictly guarded, and every fufpedted article prohi- 
 bited from entering. Infe&ed clothes and utenfils were 
 burned, and the houfes where the fick had lived were 
 purified by the fumes of vinegar and gun-powder. 
 
 In this mode of prevention it is of the utmoft confe- 
 quence to afcertain the diftance to which the contagion 
 extends ; in the next place to know whether by means 
 of clothes, cotton Or other kinds of merchandife it may 
 be imported from one place to another ; and in the third 
 place how long "the infection may remain in thefe kinds 
 of goods , fo that people may know when the danger is 
 over. As to the diftance, it feems to be generally agreed, 
 that it is but ftnall. Some of the anfwers to Mr. How- 
 ard by the phyficians of whom he inquired, have been 
 already related. Of the infection of the plague he fpeaks 
 in the following manner : 
 
 " In my opinion this diflemper is not generally to be 
 cc taken by the touch, any more than the gaol-fever or 
 " fmali-pox ; but either by inoculation, or by taking 
 " in with the breath the putrid effluvia which hover 
 IC round the infected body; and which, when admitted, 
 " fet the whole mafs'of blood into fermentation, and 
 " fometimes fo fuddenly and violently as to deftroy its 
 " whole texture, and to produce putrefaction and death 
 <* in 48 hours. Thofe effluvia' are capable of being 
 
 <c carried 
 
3 o 4 A TREATISE ON 
 
 " carried from one place to another, upon any fubftancci 
 " where what is called /cent can lodge $ as upon wool, 
 " cotton, &C; and in the fame manner that the fmell of 
 <c tobaco is carried from one place to another." 
 
 " The infection in the air does not extend far from 
 <c the infected object, but lurks chiefly (like that near 
 " carrion) to the leeward of it. I am fo affured of this, 
 " that I have not fcrupled going, in the open air, to 
 " windward of a perfon ill of the plague to feel his pulfe. 
 <c The rich are lefs liable to the plague than the poor* 
 " both becaufe they are more careful to avoid infection, 
 " and have more large and airy apartments, and becaufe 
 -" they are more cleanly, and live on better food, and 
 " plenty of vegetables , and this I fuppofe is the reafon 
 <c why Proteftants are lefs liable to this diftemper than 
 ." Catholics during their times of fading, and likewife 
 " why the generality of Europeans are lefs liable to it 
 16 than the Greeks, and particularly Jews. 
 
 " It is remarkable that, when the corpfe.is cold of a per- 
 " fon dead of the plague, it does not infect the air bjr 
 " any noxious exhalations. This is fo much believed 
 " in Turky, that the people there are not afraid to han- 
 " die fuch corpfes. The governor of the French hof- 
 " pital at Smyrna told me, that, in the laft dreadful 
 <c plague there, his houfe was rendered almoft intolerable 
 " by an ofFenfive fcent ; efpecially if he opened any of 
 " thofe windows which looked towards the great burying- 
 ce ground, where numbers every day were left unburied ; 
 " but that it had no effect on the health of himfelf or 
 . family." 
 
 It is likewife a matter of the utmoit importance to 
 .afcertain the time at which the difeafe is introduced into 
 any town or diftrict. Dr. Caneftrinus, in a treatife on 
 this diftemper, publimed at Saltzburg, complains greatly 
 of the diflenfions among phyficians concerning the na- 
 ture of the diftemper, owing to which its exiftence is 
 frequently denied, and thus its ravages are propagated 
 immenfely beyond the limits which might otherwife 
 circumfcribe them. Of this he gives the following re- 
 markable inftance ; " In the year 1770 a difeafe witk 
 
 <c uncommon 
 
THE PLAGUE. 305 
 
 " uncommon fymptoms prevailed at Bodrogh in Up- 
 *' per Hungary, which carried off a number of perfons 
 " in a ftiort time. A phyfician of the county of Zem- 
 " plin was fent to inquire into the nature of the malady. 
 " He reported that the difeafe was of a fufpicious na- 
 <c ture, having a great refemblance to the plague. His 
 " report was received by the nobility and health-officers 
 " with indignation, as if untrue. Another was fent, 
 " who, without hefitation, pronounced the difeafe an 
 " epidemic fcurvy. In the mean time the difeafe, be- 
 " ing left to itfelf, fpread wider, and raged with fuch 
 " violence as to carry off feventeen perfons in one houfe. 
 " The nature of the difeafe now becoming apparent, 
 " proper meafures were taken, and the infe&ed fepa- 
 " rated from the found, by which means the difeafe was 
 "confined within a fmall diftrift.*" With regard to 
 the infeftion of the difeafe, or contagion, as it is com- 
 monly called, he exprefles himfelf as follows : " The air 
 " is not capable of diffufing the contagion to any con- 
 " iiderable diilance from the infe&ed fubjeft unimpaired 
 " in its power, but, like other poifonous matter, it is 
 " capable of dilution in the atmofphere, fo as to be 
 " rendered at length innoxious. The contagion of the 
 " plague will be entirely prevented from fpreading if all 
 " accefs to, and all intercourfe with, the fick be ftridly 
 " prohibited : whence the following forms a fafe and 
 " infallible prophylactic of the difeafe : 
 
 Mox, longe* tardd cede f recedet redi. 
 Go quick, fiy far, and flow return again.*' 
 
 <c No change in the habit takes place previous to the 
 < aftion of the contagion, but the body is from the firft 
 " equally fufceptible of it as of the itch, or any other 
 st infedious difeafe. Whilft the plague ceafes in the 
 ;c civilized parts of Europe fpontaneoufly, or by human 
 " precautions, its revival is prevented, from the care that 
 < is bellowed in purifying or deftroying every infedled 
 < fubftance. In the eaft, on the contrary, this precau- 
 " tion is totally neglected ; whence it is probable that 
 ** the difeafe is not reproduced anew, but that it is per- 
 
 " petuated 
 
 * Medical Review, vol. iii, p. 257* 
 
 Rr 
 
;o6 A TREATISE ON 
 
 " petuated by the former fomes, as happens with us in 
 " the fmall-pox. The matter producing the ordinary 
 " epidemics is widely diffufed in the atmofphere, and 
 " capable of infecting through a widely extended (pace. 
 " The peftilential poifon, on the contrary, is confined 'to 
 <c the vicinity of the affected body, and becomes fo dilute 
 " at the diftance of a few paces only as to be incapable of 
 " further action. Hence it appears that the plague is 
 " much eafier avoided than epidemic diforders. The 
 " more abundant the contagious matter is, the further 
 " probably is the power of its infection carried. This 
 " is the reafon that the mere feparation of the lick and 
 " fufpected from the healthy is fo much more efficacious 
 " in deftroying it at its commencement than at a later 
 " period. To reftrain epidemics within bounds is impof- 
 " fible - 3 but with the contagion of the plague, it is cer- 
 " tain that it can be confined by art to a narrow fpot." 
 Of the truth of this laft aflertion our author gives a 
 remarkable, inftance in his own practice about the time 
 that the plague flopped at Bodrogh. Having been 
 fent into Caflbvia, along with two other phyficians, they 
 were informed by the furgeon of the lazaretto, that an 
 unufual difeafe had broken out in the diftrict of Zboina, 
 which had fuddenly proved fatal to many. On inquiry 
 it was found that it had come from Bodrogh in the 
 following manner: Two young men, returning from 
 the vintage at Tokay, ilept a night in an infected houfe, 
 and ftole fome clothes belonging to thofe who had died 
 of the plague. He who carried the clothes died by the 
 way : his father carried home the bundle, kept them 
 unpacked for fome weeks, but having at laft worn them, 
 he and all his family fell victims to the fame difeafe. 
 The peflilcnce began to fpread, and {hewed an appear- 
 ance of great malignity. Our author did not hefitate 
 to declare its true nature, and in confequence of his 
 declaration all communication was cut off between the 
 adjacent countries and the infected fpot, by a cordon of 
 the military. The infected were feparated from fuch as 
 were only fufpected, and thefe laft from the found : 
 three infected houfes were deftroyed by fare, and other 
 
 means 
 
THE PLAGUE. 307 
 
 means (to be afterwards related) were ufed with a view 
 to deflroy the contagion itfelf. Thus the difeafe was 
 prevented from fpreading ; and none but fuch as had 
 been previously fufpected werefeized. 
 
 To the fame purpofe the Abbe Poiret thinks it an 
 eafy matter to extinguifh the plague entirely. He was 
 a witnefs to the ravages of the difeafe in Barbary, and 
 thinks it the mod eafily avoided of any diftemper ; but 
 the misfortune is, that there are many,things in their own 
 nature very eafily accomplifhed, which the inattention 
 or perverfenefs of mankind render utterly im practicable. 
 Such, it is to be feared, is the extinction of the plague 
 by the means juft mentioned; for though thefe means 
 might be enforced in a country diflricl; or fmall town, 
 yet, where the peftilence enters a large and populous city, 
 there are fo many modes of concealing its exiftence, and 
 the unknown intercourfe of the lick with the found 
 muft be fo frequent, that it feems fcarce poffible to pre- 
 vent the malady from fpreading, 
 
 In London, whether it arofe from a neglect of ufing 
 the precautions for too long a time, or from any other 
 caufe, cannot well be known ; but the attempts of the 
 magistrates to feparate the lick frem the found cer- 
 tainly were not attended with any good confequence. 
 " The confirmation (fays Dr, Hodges) of thole who 
 " were thus feparated from all fociety, unlefs of the in- 
 " fefted, was inexpreffible, and the difmal apprehenfions 
 " it laid them under made them but an eafier prey to the 
 " devouring enemy. And this feclufion was on this 
 " account much the more intolerable, becaufe, if a frefh 
 " perfon was feized in the fame houfe but a day before 
 " another had finifhed the quarantine, it was to be per- 
 " formed over again ; which occafioned fuch tedious 
 " confinements of lick and well together, as fometimes 
 :t caufed the lofs of the whole. Moreover, this fhuN 
 ;c ting up of infected houfes made the neighbours fly 
 " from theirs, who might otherwife have been a help to 
 :< them on many accounts ; and I verily believe that 
 " many who were loft might have been alive, had not 
 ?- the tragical mark upon their doors driven proper affif* 
 
 tanco 
 
A TREATISE ON 
 
 " tance from them. And this is confirmed by the exatn- 
 " pies of other peftilential contagions, which have been 
 " obferved not to ceafe until the doors of the fick were fet 
 :c open^, and they had the privilege of going abroad." 
 The iJoclor fets forth alfo the arguments on the other 
 fide ; but whatever might have been the advantages of 
 a feparation of the fick from the healthy, if conducted 
 in a manner lefs capable of hurting the feelings of hu- 
 manity, it is evident that in the London plague the 
 methods attempted to prevent the difeafe at Jeaft did 
 no good. 
 
 In countries where the plague generally prevails, and 
 the Europeans are united in the opinion that it is necef- 
 fary to feparate themfelves from the natives, the method 
 of (hutting up is attended with the mod falutary effects, 
 as has been attefted by almoft every traveller who has re- 
 iided there for any time. Accidents among them are 
 very rare, though not altogether without example. At 
 Alexandria in Egypt, M. Volney tells us, that as foon 
 as the plague makes its appearance the European mer- 
 chants fhut themfelves up in their khans and have no 
 communication with the reft of the city. Their provi- 
 fions are depofited at the gate of the khan, and received 
 there by the porter, who takes them up with iron tongs, 
 and plunges them into a barrel of water provided for the 
 purpofe. If it is neceffary to fpeak to any one, they 
 keep at fuch a diftance as to prevent touching with their 
 clothes, or breathing on one another ; by which means 
 they preferve themfelves from this dreadful calamity, un- 
 lefs by fome accidental neglect of thefe precautions. 
 Some years ago a cat, which paffed by one of the terraces 
 into the houfes of the French merchants at Cairo, convey- 
 ed the plague to two of them, one of whom died. This 
 flate of imprifonment continues for three or four months, 
 during which time they have no other amufement than 
 walking in the evening on the terraces, or playing at 
 Cards. 
 
 The doctrine of predeftination, and ftill more the bar- 
 barifm of the government, have hitherto prevented the 
 Turks from attempting to guard againft this deftruetive 
 
 difeafe ; 
 
THE PLAGUE. 309 
 
 difeafe : the fuccefs, however, of the precautions taken 
 by the French, has of late begun to make fome impref- 
 fion upon many of them. The Chriftians of the country 
 who traffic with the French merchants, would (hut 
 themfelves up like them ; but this cannot be done 
 without permiffion from the Porte. A lazaretto was 
 fome years ago eftablifhed at Tunis ; but the Turkifli 
 police is every where fo wretched, that little can be hoped 
 for from thofe eftabliihments, notwithftanding their ex- 
 treme importance to commerce and the fafety to the 
 Mediterranean flates. The very laft year afforded a 
 proof of this ; for as violent a plague as ever was known 
 broke out there. Jt was brought by vefTels coming 
 from Conftantinople, the mailers of which corrupted 
 the guards, and came into port without performing qua- 
 rantine. Water carriers have never been attacked by it* 
 Mariti fays, that in the ifland of Cyprus, and on the 
 continent of Syria, every European, on the flighted ap- 
 pearance of the plague, after taking the neceflary precau- 
 tions, (huts himfelf up with his family. The Mahome- 
 tans alone, more intrepid, go abroad as ufual, converfe 
 with each other, give fuch affirmance to each other as may 
 be neceflary, and often fly to the relief of a Chriftian 
 when deferted by his friends. This arifes from their be- 
 lief in predeftination. The Mahometans of Syria, how- 
 ever, lefs familiarized with this fcourge, make ufe of 
 fome precautions, which were augmented in 1760. 
 They publifhed an ordonnance forbidding every veflel 
 attacked by the plague to enter their ports : but their 
 vigilance in this refpeft was fo remifs, that it was not fuf- 
 ficient to prevent the contagion. The governor of Acre 
 checked the progrefsof this plague, by giving the inha- 
 bitants the means of retiring from its ravages ; and thefe 
 means, though abfolutely contrary to the dogmas of the 
 Mahometan religion, were eagerly embraced. The Eu- 
 ropeans became their models ; and the governor, after 
 deriving from them every neceflary information, (hut 
 himfelf up, after their example, together with his nume- 
 rous family. The mufti alone, being the protedor of 
 the Mahometan law, cannot imitate a condudt which 
 
 that 
 
A TREATISE ON 
 
 that law condemns. Inftead of (hutting himfelf up in 
 a prudent confinement, he thundered forth againft this 
 new method, reproached the governor for his conduct, 
 and, having treated him as an impious perfon, threatened 
 him with all the vengeance of Heaven. The governor, 
 however, only laughed at this pious folly of the mufti, 
 and fent a detachment of foldiers to impofe on him a 
 fine of two hundred and fifty fequins, for having dared 
 to afcribe to him, in matters of religion, an ignorance, 
 from every fufpicion of which his age ought to have fe- 
 cured him. 
 
 In the time of plague, the proper precautions are,, to 
 iliut one's felf clofely up, and to receive no provifions or 
 other things, except thofe on which the plague has no 
 influence. The people of Syria, however, in 1760, ad- 
 mitted every kind of provifions without fear, but not 
 without ufing certain precautions. They did not receive 
 warm bread ; ftefh of every kind was thoroughly waflied, 
 and milk was drained through a linen cloth, in order to 
 free it from the fmalleft particle of animal hair. All 
 kinds of pulfe were foakecl in water, and they abftained 
 from peaches, apricots, and other fruits which are covered 
 with a downy rind. Fowls were cooked out of the houfe, 
 for fear that fome fmall feather might adhere to them. 
 Flowers were altogether profcribed. Letters were open- 
 ed by the perfon who brought them ; and they were never 
 read until they had been fteeped long enough in vine- 
 gar to be purified without effacing the writing. Every 
 thing was received into the houfe by means of a rope of 
 herbage fufpended from a window. The governor em- 
 ployed every precaution which he thought likely to guard 
 him from the contagion ; and, by (hutting himfelf clofely 
 up, he fet an example which the reft of the Mahometans 
 did not neglect to follow. Befides this rue caufed the 
 ilreets to be cleanfed ; and carried his vigilance fo far as 
 to forbid the caravans which arrived from Damafcus, 
 where the plague fwept off four or five thoufand 
 people every day, to enter the city. He obliged them to 
 fubmit to a proof of eight days without the walls, and 
 cftablifhed regulations of the fame kind refpecting veffels 
 
 coming 
 
 
THE PLAGUE. 311 
 
 coming from Alexandria orDamietta. One precaution 
 taken in the time of plague is, to prevent cats from enter- 
 ing houfes : an open war is therefore declared againft 
 thefe animals ; and, wherever they are found, they arc 
 knocked on the head with large clubs. This is a cru- 
 elty abfolutely neceffary ; for there is no vehicle that will 
 convey the infection with more certainty or rapidity than 
 the hair of cats. Rats and mice multiply in confe- 
 quence of their deftru&ion ; but there is no inftance of 
 their ever having propagated the plague. This difeafe, 
 when it attacks men, (pares quadrupeds and birds. The 
 furs of the one, and the feathers of the other, however, at- 
 tract and communicate the infection. People ought 
 particularly to keep from goats and fheep ; from horfes 
 and oxen little is to be apprehended. 
 
 All thefe precautions were fometimes ineffectual. 
 The French at Acre, who there, as well as throughout 
 Syria, are collected into one quarter, ufed every precau- 
 tion that could be thought of, yet, on the 3Oth of March, 
 1760, five of them were infedted. They belonged to 
 the hofpital of the Holy Land, and the monks were in- 
 ftantly ordered to (hut themfelves up. They did fo - 9 
 and eight of them died, one only efcaping. 
 
 Mr. Howard likewife gives particular accounts of the 
 precautions ufed in feveral different countries through 
 which he travelled. In Malta two kinds of quarantine 
 are performed ; one for fhips with clean bills, the other 
 for thofe with foul. The former lafts 18 days.* The 
 crews and patTengers are allowed to buy provifions, and 
 converfe by means of enclofures with (lone pods and 
 palifadoes. A letter received from a Turkifh (hip was 
 taken by a pair of iron tongs, dipped in vinegar, put into 
 a cafe, and laid for about a quarter of an hour on a wire 
 grate under which ftraw and perfumes had been burnt ; 
 after which the letter was taken out and opened by one 
 of the directors, In this ifland (hips with foul bills muft 
 perform quarantine eighty days ; but, at the end of 
 forty, may change their ftation. The different kinds of 
 goods are feparated and placed in proper order under 
 
 cover. 
 
 * At Aleppo 20. (Ruffe!.} 
 
A TREATISE OM 
 
 cover. The cottons are taken out of the bags contain- 
 ing them, and placed on rows of piles on boards, laid on 
 ftone pillars about 1 8 inches from the floors; and, in 
 repacking them they are flung over a man who gets in- 
 to the bags, and treads down the cotton ; the confe- 
 quence muft be the expofing him to great danger, iliould 
 any infe&ion remain. 
 
 Mr. Howard took a voyage to Venice in a fhip with 
 a foul bill, on purpofe to know every thing relative to 
 the performance of quarantine. " A meflenger (fays 
 ' he) came in a gondola to conduft me to the new 
 " lazaretto. I was placed, with my baggage, in a boat 
 " faftened by a cord ten feet long to another boat in 
 " which were fix rowers. When I came near the land- 
 " ing place the cord was loofed, and my boat was pufh- 
 " ed with a pole on the fhore, where I was met by the 
 " perfon appointed to be my guard. Soon after un- 
 " loading the boat, the fub-prior came and fliowed me 
 " my lodging ; a very dirty room, full of vermin, and 
 c: without table, chair or bed. That day and the next 
 " morning I employed a perfon to wa(h my room ; but 
 ^ c this did not remove the offenfivenefs of it, or prevent 
 " that conftant head-ach which I had been ufed to feel 
 " in vifiting other lazarettos and fome of the hofpitals 
 " in Turky. My guard fent a report of my health to 
 ** the office, and, on the reprefentation of our conful, I 
 " was removed to the old lazaretto. Having brought 
 " a letter to the prior from the Venetian ambaflador at 
 " Constantinople, I hoped now to have had a com- 
 ;e fortable lodging. But I was not fo happy. The 
 " apartment, confifting of an upper and lower room, was 
 " no lefsdifagreeable and ofFen five than the former. I 
 et preferred lying in the lower room, on a brick floor, 
 " where I was almoft furrounded by water. After fix 
 " days, however, the prior removed me to an apartment 
 " in fome refpedb better, and confifting of four rooms. 
 " Here I had a pleafant view ; but the rooms were 
 " without furniture, very dirty, and nolefs offenfive than 
 " thefick wards of the word hofpital. The walls of my 
 " clumber, not having been cleaned perhaps for half a- 
 
 " century^ 
 
THE PLAGUE, 313 
 
 '* Century, were faturated with infection. I got them 
 ** waflied repeatedly with boiling water, to remove the 
 *' offenfive fmell, but without any effect. My appetite 
 *' failed, and I concluded I was in danger of the flow 
 " hofpital fever. I propofed whitewafhing my room with, 
 " lime flaked in boiling water, but was oppofed by 
 " ftrong prejudices. I got this, however, done one 
 ** morning through the affiftance of the Britifh conful, 
 *' who fupplied me with a quarter of a bufhel of frefh 
 " lime for that purpofe. The confequence was, that 
 n my room was immediately rendered fo fweet and frefh, 
 " that I was able to drink tea in it in the afternoon, and 
 '* to lie in it the following night. On the next day the 
 " walls were dry, as well as fweet j and in a few days I 
 ** recovered my appetite. This room was lime-whited in 
 " November, and in a very rainy feafon. In the fol- 
 " lowing March, in complaining to the under fheriifs in 
 " Newgate of their inattention to the elaufe which or- 
 " ders this in the ac> of parliament for fecuring the 
 ' health of prifoners, their excufe was, that they were 
 " afraid of dampnefs/' 
 
 An health-office was eftablifhed at Venice in 1448, 
 in the midft of a very deftructive peftilence. The old 
 and new lazarettos are both built on little iflands, fur- 
 rounded not only by canals, but high walls. They 
 have only a ground floor, and one over it, and are di- 
 vided and fubdivided into a great number of apart- 
 ments, each having an open court in front, with plats of 
 grafs, which is not fuffcred to grow too high $ nor are 
 any trees fuffered to grow within this diftrict, or a good 
 way from it. The internal government is managed by 
 a prior, who muft not be related to the magiftracy nor 
 any of its minifters. He muft have no intereft nor con- 
 cern in (hipping nor in trade. He muft fee all the 
 gates and doors'of the apartments locked every evening 
 by funfet ; he takes the keys into his pofTeffion, and 
 fufprs them not to be opened before funrife ; and, in 
 cafe of any fufpicion of infection, the gates muft be kept 
 conftantly locked, and opened only for necefTary occur- 
 rences in prefence of the prior. He muft not fuffer 
 
 S s dogs. 
 
314 A TREATISE ON 
 
 dogs, cats, &c. to lodge in the lazaretto. He muft 
 neither buy nor fell, nor fufTer others to do fo, within the 
 lazaretto. , No filling boats or other frnall craft to come 
 within a certain diftance, or keep communication with 
 thofe performing quarantine. Provifions are received 
 by poles feven or eight feet long, and the money dipped 
 in vinegar and fait water before it is received. The prior 
 and his fubftitute muft carefully avoid touching either 
 goods or paifengers in quarantine, and for this purpofe 
 they keep a cane to make thofe who approach them 
 keep their proper diftance -, but if by an unfortunate ac- 
 cident they fhould be contaminated, they muft perform 
 quarantine. Any perfon malicioufly touching them is 
 liable to punifhment. 
 
 Ships are ftrictly forbid to ufe any ropes but fuch as 
 are tarred. Wool, filk, cotton-wool, woollen and linen 
 clothes, and furs especially, are accounted the moft dan- 
 gerous goods. Animals with long hair are fubjeft to full 
 quarantine ; but fhort haired ones purged by fwimming 
 afhore ; feathered animals, by fprinkling with vinegar 
 till wet. 
 
 The celebrated Dr. Mead, though an enemy to the 
 cruel mode of abandoning the iick, or treating them 
 with any kind of harflirieis, was perfectly ienfible of the 
 neceffity of ufing every precaution for preventing pefti- 
 lential contagion from being imported. In his opinion 
 it is not fufficient that fliips fhould perform quarantine, 
 *' the only ufe 'of this being to obferve whether any die 
 " among them. For infection may be preferved fo long 
 " in clothes among which it is once lodged, that as 
 " much, nay, more of it, if ficknefs continues in thefhip, 
 ** may be brought on fhore than at the beginning of the 
 " forty days, unlefs a new quarantine be begun every 
 * { time any perfons dies ; which might not end but with 
 " the definition of the whole {hip's crew." He is there- 
 fore of opinion that lazarettos ought to be eftabiiihed on 
 frnall iflands near the fea-coaft ; and in this Mr. How- 
 ard agrees with him. The latter recommends the laza- 
 retto at- Leghorn as the beft in Europe. Dr. Mead alfo 
 very much infifts on the utility of deftroying the clothes 
 
 of 
 
THE PLAGUE. 315 
 
 of the fick, becaufe, fays he, they harbour the very ef- 
 : fence of the contagion. He quotes in favour of this opi- 
 nion what Boccaciofays he faw&t Florence in 1348 ; 
 viz. that two hogs, finding in the ftreets the rags which 
 had been thrown out from off a poor man dead of the 
 difeafe, after fnuffling upon them, and tearing them with 
 their teeth, fell into convulfions, and died in two hours. 
 This is one of the things which Dr. Mofeley looks upon 
 to be incredible. It is indeed very marvellous, and 
 ieems to be contradicted by M. Deidier's account of the 
 dog at Marfeilles who fwallowed with impunity the filthy 
 pus and peftilential matter adhering to the drefiings of 
 plague fores : but, when a perfon of credit informs us 
 that he/aw any thing, we fcar.ce know how to contradict 
 him. The evidence of peftilential contagion adhering 
 to clothes, does not depend on fuch accounts. That 
 lately quoted from Dr. Caneftrinus is decifive on the fub- 
 ject ; and he informs us that one of the methods ufed 
 by himfelf to ftop the plague in Zboina,, above mentioned, 
 was, the burning of the clothes of infected perfons. He 
 fays that the peftilential contagion refembles that of the 
 fmall-pox, in being of a fixed nature ; and that all who 
 ftudiouily avoided communication with the fick, or with 
 whatever fomes might carry the contagion, efcaped it al- 
 together. " That the contagion of the plague (fays he) 
 " may lie dormant for a conliderable time, and be car- 
 " ried to a great diftance by the medium of packages, &c. 
 " and again revive with its former violence, is proved by 
 " various circumftances. Chenot relates, in his treatife 
 " on the plague which raged in Tranfylvania, that the 
 <c infection was revived a whole year after it had difap- 
 " peared ; and other fimilar inftances are adduced." If 
 this revival happened from infefted clothes or foft goods, 
 it Ihows them to be dangerous in the extreme ; but of 
 this we have not any direct proof, neither indeed is fuch a 
 belief quite confident with what takes place in all plagues, 
 viz. that the clothes of the infe&ed are worn by the found, 
 without producing any reinfection. In the great plague 
 at London, for inftance, where an hundred thoufand pro- 
 bably perifhed, and a much greater number muft have 
 
 been 
 
A TREATISE ON 
 
 been infefted, we cannot fuppofe that all the clothes be- 
 longing to fuch an immenfe multitude were burned, or 
 never made ufe of again. It is of neceffity therefore 
 that we fuppofe the peftilential contagion to become 
 effete, and to lofe its virulence, after fome time -, and 
 this feems to be very much haflened by expofure to the 
 atmofphere. The doing of this, however, by obliging 
 people to pqt their naked arms into bales of fufpeded 
 goods, has fuch an appearance of cruelty, that Dr. Mead 
 has propofed to judge of the prefence or abfence of infec- 
 tion by allowing little birds to fly about among them j 
 *' becaufe (fays he) it has been'obierved, in times of 
 " the plague, that the country has been forfaken by 
 " the birds ; and thofe kept in houfes have many of 
 cc them died." But, though he fays this upon very 
 great authority, no lefs than that of Diemerbroeck, yet 
 we can by no means look upon the fad: to be abfolutely 
 determined. Dr. RufTel indeed fays that the defertioa 
 of the birds is looked upon by the Turks to be the ^8 
 of an approaching plague; but this failed in 1760. 
 Thucydides fays that birds of prey deferted the territory 
 of Athens during the great plague in his time; and he 
 fuppofes them to have been poifoned by feeding upon 
 the bodies of fuch as died of the difeafe. It is poffible 
 that fuch food might be difagreeable to them, but no 
 proof is brought of any of them having been actually, 
 poifoned by it. As for birds kept in houfes, it is poffible 
 that in a time of general- calamity they might have been 
 neglected, and died for want of proper food, &c. Dr. 
 Mead alfo quotes an inftance which cannot be credited in 
 a confiftency with undoubted teftimonies that peftilential 
 contagion does not extend but for a very little way. 
 Upon opening an infected bale of wool in the field near 
 Cairo, cc two Turks employed in the work were immedi- 
 ately killed, and fome birds which happened to fly 
 over the place dropped down dead.'' Such accounts 
 have arifen from a fuppofition" that the whole mafs of 
 atmofphere was violently infected ; but this would be to- 
 tally inconfiftent with the life of any human creature, 
 and we may well put down this, as that^f, peftilential in- 
 fection 
 
THE PLAGUE. 317 
 
 fe&ion arifing from cities like a cloud, as merely chime* 
 rical.* It is too well known that peftilential contagion, 
 inftead of foaring in the air, keeps very near the ground. 
 We now come to the fecond mode of prevention, viz. 
 removing thefe local caufes which, in the opinion of 
 fome, may produce a plague in any country, and, in that 
 of others, may increafe or fet in a&ion the contagion 
 previoufly exifting. Thefe caufes have been enumerated 
 by the late Dr. Smith,-}* in a D ffcrtation on the pefti- 
 lential Difeafes which at different times appeared in the 
 Athenian, Carthaginian and Roman armies, in the neigh^ 
 bourhood of Syracufe. They are, i. The climate and 
 feafon. ^. The fituation of the armies; and, 3. Their 
 condition. The climate of the iiland of Sicily in gene- 
 ral he obferves is extremely pleafant at fome feafons of 
 the year ; in the neighbourhood of Syracufe particularly 
 ftorms are fo infrequent during the former part of the 
 year, that the fun is never obfcured for a whole day, 
 f ven in the month of January, however, the weather is 
 warm, and as the feafon advances the heat becomes in* 
 fupportable. In autumn it is rendered fornewhat unplea- 
 fant and unhealthy by the frequent rains and chillnefs of 
 the evenings. But, in particular places, during the hot- 
 ted feafon, nothing can exceed its unhealthinefs. Ac* 
 cording to Barichten, " the Icaft flagnant water is fuffi- 
 C4 cient, in the heats of fummer, to poifon the atmo- 
 " fphere : its effects on the countenances of the poor 
 " people who live in its vicinity are evident ; and 3, 
 " ftranger who travels through the ifland in this feafon 
 " ought to avoid ever paffing a night near them." De 
 Non fays, that " as foon as the fun enters the Lion, this 
 " country becomes the houfe of death : fevers of the 
 
 " jnoft 
 
 * About the mouth of the river Gambia in Africa, after the annual inunda- 
 tion of the river, the putrefadion of the mudt mixed with animai and vegetable 
 Jubftances, becomes fo great, that the birds maHifeft their difguft by foaring to 
 an immenfe height in the air. This is a natural confequence of the levity of 
 putrefa6live vapours compared with the common atmofphere As thefe vapours, 
 however, are compofed of feveral kinds of gales, it is pofTible that fome may 
 deicend, while others afcend ; and thus the contagious part, tending to the 
 earth, may violently affed the people who are confined among it, while the 
 birds eicape ; b,ut there is ftill wanting fome pofitive evidence that ever th$ 
 true plague did arifefrom this caufe. 
 
 f Med. Repofitory vol. ii, p, 367, 
 
3 i8 A TREATISE ON 
 
 " mod: malignant kind feize on the imprudent or un- 
 " fortunate wretch that fpends a night near them (ponds 
 u and marfhes) and few efcape with life when attacked 
 " by fo virulent a diforder." 
 
 To the poifonous effluvia of thefe marfhes the Doclor 
 attributes, in an efpecial manner, the plagues which took 
 place in the armies. In the fecond year of the Pclo- 
 ponnefian war, the Athenian army was encamped, as we 
 .are told by Thucydides, " upon marfhy and unvvhole-* 
 fome ground .j" and that fuch kind of encampments will 
 produce dtfeafes in an army is well known. In the time 
 of Dionyfius, when the Carthaginian army under ImilcQ 
 fuffered fo dreadfully, or rather was totally deftroyed, 
 his camp was fituated on an eminence between two 
 moraffes, the heat at that time being exceflive. Han- 
 nibal, the predecefTor of Imilco, had alfo loft great part 
 of his army by a plague, though he had been encamped 
 in a healthy fituation ; but, in order to raife a wall 
 which fhould overlook the city, he had taken the ma- 
 terials of the tombs found in the common burial place, 
 the city at that time containing two hundred thoufand 
 inhabitants. " From the uncovering and difturbing of 
 " fo many dead bodies (fays our author) arofe a terrible 
 < peftilence, which carried off immenfe numbers of the 
 ** Carthaginians, and amongft the reft the generalhim- 
 *' felf." To the unhealthy fituation of the armies alfo 
 the Do&or afcribes the plague which took place in the 
 Roman and Carthaginian camps in the time of the fe- 
 cond punic war ; and the Carthaginians fuffered moft, by 
 reafon of their being nearer to the marfhes. The ftate 
 of mind, the cleanlinefs of the perfon, Sec. alfo muft be 
 taken into account ; and our author ihows that neither 
 of tbefe could be fuppofed favourable to the Car-* 
 thaginians. 
 
 That perfonal cleanlinefs, and breathing pure air, 
 fhould contribute to the health of individuals, or to any 
 number of them collected into camps or cities, feems to 
 be agreeable to reafon and common fenfe ; neverthelefs 
 we find that this has been denied, and even Dr. Canef- 
 trinus fays that " in the plague of Lyons and Marfeilles 
 
 "it 
 
THE PLAGUE. 319 
 
 " it was obferved, that the moft populous parts of thefe 
 ** cities, where the Jlreets were narrow and filthy ', fuifered 
 *' /efs from the difeaie than thofe which were more airy 
 c * and clean. At the time of the plague in London in 
 " the time of Charles II, the phyficians advifed that all 
 " the privies ihould be opened and expofed y the fetid 
 " odour from which having pervaded the city, the plague 
 * was flopped ! Is it from this caufe (the author afks) 
 c< that the plague has feldomer vifited Spain, the towns 
 " of which are intolerably ofTenfive from their want of 
 " cleanlinefs ?"* 
 
 This certainly feems a very ftrange doctrine, never- 
 thelefs the fact that Spain is but little fubjeft to the 
 plague feems undeniable, and as it is no lefs certain that 
 the towns are exceflively filthy, it would feem that 
 cleanlinefs is not effectual in preventing it. But, how- 
 ever agreeable the fmell of human excrements may be to 
 the Spaniards, or to the Englim phyficians in former 
 times, it feems to be lefs fo at prefent. " I am perfuaded 
 " (fays Dr. Ferriar) that mifchief frequently arifes from. 
 " a practice common in narrow back ftreets of leaving 
 " the vaults of privies open. I have often obferved 
 **' that fevers prevail moft in houfes expofed to the efflu* 
 " via of dunghills in fuch fituations." In Spain the 
 opinion feems to have been but lately eradicated ; for 
 fome years ago, an order having been iifued by govern- 
 ment that the ftreets of Madrid fhould be kept fomewhat 
 cleaner, the people were fo much exafperated at being 
 threatened with the lofs of the favoury odour, that a re- 
 bellion had almoftenfued, and the phyficians declared the 
 frnell of human excrements to be the moft vvholeforne 
 thing in the world. } 
 
 That 
 
 * Medical Review, vol, iil, p. 263. 
 
 t Ir feems, however, of late, that at ieaft the city of Madrid is kept clean. 
 Swinburne fays, f peaking of the palace at Madrid, To the weft it has the 
 < town, ihe three principal ilreets of which terminate in the Pravo. Thefe 
 < are three noble openings, excellently paved, and clean even to a nicety f 
 " indeed fo are moft of the ftreets of Madrid fince the edi6l for paving and 
 cleaning them.* The foreigners that refided here before that time, fhuddet 
 at the very recolleciion of its former filth. Some of the natives regret the 
 * old itink& and naftincfs ; as they pretend that the air of Madrid is fo fub- 
 
 til 
 * Dillon has a like rsmark in his Travels through Spain." 
 
A TREATISE ON 
 
 That the confinement of human effluvia, along with; 
 heat and want of water, will produce a malignant fever^ 
 is certain from the example of the unfortunate people 
 confined in the Black Hole at Calcutta. In this cafe 
 the diftemper feems to juftify the opinion that plague 
 may be artificially produced, perhaps mere than any 
 other upon record 5 for Dr. Ferriar informs us that it 
 was attended with eruptions refembling thofe of the true 
 plague. In this cafe, however, the confinement was 
 beyond example in any fituation which can be fuppofed 
 incident to a city or camp. There is no country in the 
 ivorld where the inhabitants arc equally numerous with 
 thofe of the empire of China, its population at prefent 
 being eftimated by Sir George Staunton at three hundred 
 and thirty -three millions , a number equal to one third of 
 the fuppofed inhabitants of the whole globe ; of confe- 
 quence the cities muft be immenfely crowded with in- 
 habitants ; yet it remains free from plagues. Human 
 effluvia therefore, in the moft populous ftate in which 
 mankind can exift in fociety, are not able to taint the 
 atmofphere of a country or city. The following is Dr. 
 Clark's account of that celebrated empire: "The 
 " whole empire of China is reprefented to be extremely 
 <c delightful ; the foil rich, the air pure, and the indui- 
 " try of the inhabitants aftoniming. As it produces 
 *' every luxury and necefTary of life, it is jufrjy efteerned 
 <f * one of the moft fertile countries in the world. As the 
 " Chinefe prohibit emigration, and feldom or never en- 
 " a e * n war > t ^ e ^ T country is extremely populous.- 
 6C Every river maintains a proportion of inhabitants ade- 
 '* quate to the land, whofe families live continually in* 
 cc boats, without having any other place of refidence, 
 kC Their number of people lays them under the necef- 
 
 " fity 
 
 til as to require a proper mixture of grofler effluviat to prevent its pernicious 
 1 etfefts upon theconftitunon. The extremes of cold and heat are. aftonifhing 
 ' in this place, and the winds fo fearching, that all the Spaniards wear lea-- 
 
 * them under waiftcoats, to preferve their chefts ; for they pervade every 
 other kind of clothing " 
 
 The former filthineis of Madrid, together with its being fiturated in a cli- 
 mate expoied to the viciffitudes of extreme heat and cold, and its exemption 
 from the plague under thofe circumftances, certainly prefcnts a moft folid ob- 
 jeftion to the theory of the domeftic origin of plague. To the fame purpofr 
 lee below the remarks on the climate of China, 
 
THE PLAGUE. 321 
 
 11 flty of carrying induftry to the greateft height ; for 
 *' otherwife their country* fertile as it naturally is, would 
 " be infufficient to maintain the inhabifants. Every 
 " inch of land is cultivated ; no forefts nor woods, nor 
 ** even a fingle tree, is fuffered to obftruct the labours 
 " of the hufbandman. Canals are cut every ,where to 
 ' water the fields, and marfhes are manured for the 
 " cultivation of rice. By thefe means health and plenty 
 " are> in a great meafure, the portion of its inhabitants 
 * c through all the feafons of the year. The only terrible 
 " and fatal difeafes to which they feem to be fubjed; 
 " are the fmall-pox and leprofy. 
 
 But, though our author determines in general that 
 the air of China is pure, this cannot apply to every part 
 of it without exception. On the contrary he describes 
 in the following manner Wampoa, a village about four- 
 teen or fixteen miles below the city of Canton, on Can- 
 ton river : " It is the ufual ftation of all European 
 " fhips in this river. On one fide the land is low^ 
 1 marfhy, and covered with water, forming fwamps fit 
 ri only for the cultivation of rice. The extent of thefe 
 :c fwamps is confiderable ; the tide rifes high, and over- 
 te flows great part of them ; but the interfedion of the 
 " rivers renders them more pure than they would other- 
 *' wife be, and confequently the air is much healthier 
 " than one could expect from the unfavourable afpeft." 
 
 In like manner Canton city he fays " is built on a 
 
 cc very extenlive plain, and is large and populous. Here 
 
 " the government allow the Englifh, Dutch^ French^ 
 
 4 Danes and Swedes feparate factories on the banks 
 
 :< of the river. The city, though paved, is very wet in 
 
 c rainy weather ; and the water makes its way under 
 
 '* the fa-ftories ol the different nations every tide. The 
 
 ' houfes are built with bricks; the apartments are in 
 
 ic general final 1, and not very lofty, and the ground 
 
 ' ftories are very damp. When the bufmefs of the fea- 
 
 p< fon is over, the fupercargoes remove to Macao, a 
 
 ' Portuguefe iiland, fubjecl: to the Chinefe government,, 
 
 ; The city of Macao is fituated on a rifing ground ; 
 
 " the whole ifland is dry, rocky and barren ; it is, how- 
 
 T t ever, 
 
322, A TREATISE ON 
 
 " ever, plentifully fupplied with provifions by the Chi- 
 " nefe ; and, though the air is very fultry, yet it is to- 
 " lerably healthy." 
 
 From the preceding account it is plain, that the 
 caufes which operate in the production of plagues and 
 epidemic difeafes in other countries, though they exift 
 in China, do not acV there with equal efficacy. At 
 Wampoa the marfhes in the neighbourhood muft, in the 
 hot feafon, emit noxious effluvia as well as any where 
 elfe, and there can be no certainty that the overflowing 
 of the tide is fufficient to put a flop to their malignant 
 influence. At Canton the water penetrates below the 
 floors of the houfes, and we have feen from Dr Fordycc* 
 that in other countries the fprinkling of a floor with clean 
 water, and the encampment of an army upon ground 
 where water was found at a fmall depth below the fur- 
 face, were fufficient to produce fevers -, yet here it is not 
 fo. In this city alfo the inhabitants are numerous, and 
 the apartments fmall j fo that neither the perfpiration of 
 multitudes, nor the moid exhalations from water ftag- 
 nating in the ftreets, nay, under the houfes themfelves, 
 are able to produce the difeaies in queftion. Again, at 
 Macao the fultry heat of the air has as little effect as the 
 reft. 
 
 Laftly, in Pekin, the capital, the population and the 
 crowd areimmenfe. According to Sir George Staunton^f- 
 the city is about one third larger than London ; but, as 
 lie fuppofesj it to contain three millions of inhabitants, 
 the population muft be twice and a third-part as great as 
 that of London in proportion to its bulk. " The low 
 4t houfes of Pekin (fays he) feem fcarcely fufficient for fo 
 u vaft a population j but very little room is occupied by 
 " a Chinefe family, at leaft by the middling and lower 
 " clafies of life. In their houfes there are no fuperfluous 
 " apartments. A Chinefe dwelling is generally fur- 
 " rounded by a wall fix or feven feet high. Within 
 46 this enclofure, a whole family of three generations, 
 *' with all their refpe&ive wives and children, will fre- 
 
 " quently 
 
 * Sec p.p. J/TI 172. t Authentic Account of an Ernbafiy fee* vol. ii> p. 34* 
 $ib.p. 39* 
 
THE PLAGUE. 323 
 
 " quently be found. One fmall room is made to ferve 
 " for the individuals of each branch of the family, fleep- 
 " ing in different beds, divided only by mats hanging 
 " from the ceiling. One common room is ufed for 
 
 eating.' 
 
 Where difeafes are prevalent, circumftances of the 
 kind juft mentioned would certainly be urged as evident 
 canjes of them ; but in China we fee that fcmethittg dif- 
 arms fuch caufes of their power. People, however, fel- " 
 dom want a falvo for any thing. u The crowds of 
 " people, at Pekin (fays our author) do not prevent it 
 " from being healthy. The Chinefe indeed live much 
 " in the open air, increafing or diminifhing the quan- 
 " tity of their apparel according to the weather. The 
 " atmofphere is dry, and does not engender putrid dif- 
 " eafes ; and excefles productive of them are feldom 
 i committed." But, if the dry air at Pekin contributes 
 to the health of the people, why does not the moid air 
 of Canton produce difeafes ? Befides, in this empire 
 there are multitudes of people who live entirely upon 
 the water, in a kind of houfes conftru&ed upon junks, - 
 employed in carrying grain from place to place, or for 
 other purpofes.* Sir George Staunton computes the 
 number of inhabitants on a branch of a fingle river 
 to be no lefs than an hundred thoufand. What then 
 muft they be throughout the whole empire ! Yet thefe 
 people, though continually expofed to moifture, as well 
 as to an almofl inconceivably crowded (ituation, are yet 
 no more fubject to epidemics than others. Our author 
 does not fpecify the excejjes which produce diforders. 
 Intemperance in drinking no doubt is one of them ; but 
 Dr. Patrick Ruffel exprefsly fays, that he never faw an 
 iaftance of the plague being brought on by intem- 
 perance. 
 
 Laftly, with regard to living in the open air, Mr. 
 M'Lean has afcribed to the viciffitudes of this ele- 
 ment the principal if not the only caufe of epidemics. 
 ;i A fact worthy of notice (fays he) is, that aged perfons 
 " and children are both feldomer and lefs feverely at- 
 
 " tacked 
 
 * Authentic Account* #c. vol. i> j>. 230. 
 
3 2 4 A TREATISE ON 
 
 " tacked by epidemics and peftilential diforders than 
 " the young and middle aged, and women feldomer and 
 " lefs feverely than men. Now, if contagion was the 
 " fource of thefe difeafes, the cafe would be exactly re- 
 * c verfed. Old people, women and children, being more 
 " in the way of contagion, would be more frequently 
 " and more feverely attacked. But the young and mid- 
 <c die aged, being more expofed to the <vic(ffitudes of the 
 " atmofphere, the principal fource of thofe difeafes, they 
 " are confequently more feverely attacked. It has been 
 " a puzzling queflion to folve why old people and chil- 
 " dren are iefs expofed to plague, &c. but the folution 
 " will be no longer difficult if it fhould be proved that 
 " thefe difeafes are always produced by certain ftates or 
 " viciffitudes of the atmofphere, together with the appli- 
 ^ cation of other powers co-operating in the production 
 " of indirect debility." In the country we fpeak of, 
 however, this folution fails in a manner almoft as evident 
 as can be imagined. " The removal of the embaffy, 
 " (fays Sir George Staunton) was a difappointment to 
 <c feveral perfons belonging to it, who had made arrange-. 
 * c meats for paffing the winter at Pekin. Judging of its 
 " temperature by the latitude of the place, a few minutes 
 " under 40 north, they were not aware of the violent 
 " effect of the great range of high Tartarian mountains, 
 ** covered perpetually with fnow, upon that capital, 
 *' where the average degree of the thermometer is under 
 " twenty in the night during the winter months, and 
 * c even in the day time is confiderably below the freezing 
 " point. The ufual inhabitants were guarded againft 
 " cold, not only by habit, but by an increafe of clothing 
 " in proportion to its intenfcnefs, confiding of furs, wool- 
 * c len clothes and quilted cottons. They are not accuf- 
 " tomed to the prefence of fire. They have no chim- 
 * neys, except to kitchens in great hotels. Fires, on 
 "'which Englifhmen chiefly depend againft fuffering by 
 " the fharpnefs of the atmofphere, could not well anfwer 
 - c that purpofe in houfes which are fo conllriicted as to 
 ?< admit the external air almoft on every fide. Stoves 
 <fi - are^ however, common in large buildings. Thefe 
 
 u ftoves 
 
THE PLAGUE, 325 
 
 '* ftoves are fituated frequently under the platforms on 
 " which the inhabitants fit in the day time, and reft at 
 *' night. The worft weather experienced in that capi- 
 " tal might be confidered as mild by the Tartars, com- 
 *' ing from a climate flill more rude ; but other foreign- 
 " ers are laid to feel themfelves lefs comfortable at Pekin 
 " in the winter than in the fummer, though the heat is 
 " then raifed to the oppofite extreme. In both they 
 " feem to require a feafoning. Several individuals of the 
 " embajjy fell ill during their flay ; and all did not recover. 
 *' The human frame feems calculated for the hotteft 
 * c rather than the coldeft atmofphere, and to exift at 
 ** the equator rather than the pole." 
 
 Here we are involved in difficulties much greater than 
 before. It appears that even the fine climate of China 
 is healthful only to its own inhabitants. They can bear 
 the vicijfitudes of the air, which Europeans cannot. The 
 prevention of plagues or mortal difeafes then muft con- 
 (id in fome mode of living by which people can accom- 
 modate themfelves to the country which they inhabit, 
 and without which every other precaution will be inef- 
 fectual. The difeafes with which the attendants of the 
 ambaffador were feized could not be owing to any flo- 
 venlinefs or dirtinefs in their lodgings or food, or to 
 want of apparel ; nor were they more expofed to the 
 inclemencies of the air than others ; only they were in a 
 flrange country, where that inexplicable constitution of 
 the elements acted upon them in a manner different 
 from what it did on the natives, and, while it was 
 friendly to the latter, proved pernicious to the former. 
 But there was a time when even China was as unhealthy 
 as other countries; for the great plague in 1346 began 
 in the northern part of it. We have feen, in a former 
 fcction, that this was preceded by the moft dreadful and 
 violent wars throughout the whole Afiatic continent. 
 Since the ceiTation of thefe violent wars the Chinefe have 
 (laid at home, and applied themfelves to the arts of peace, 
 particularly to agriculture, which they have carried, we 
 may fay, to itsutmoil perfection. This feems therefore 
 to be the true method of removing all thofe local caufes 
 
 which 
 
326 A TREATISE ON 
 
 which produce epidemics, or at leaft of preventing them 
 from doing hurt , and, without attention to the natural 
 duties and occupations of man, it is to be feared that all 
 artificial modes of prevention will be found not only pre- 
 carious but ineffectual. 
 
 Dr. Smith in the differtation above mentioned ob- 
 ferves, that " it may be doubted whether any moral 
 " caufe would be fufficieat to protect, for a long period,, 
 " an unaccuftomed refident in a marfhy fituation from 
 " the ufual confequences." This is no doubt very pro- 
 bable ; but, from the example of Lord Macartney's at- 
 tendants in China, it appears equally probable that it 
 snakes little difference whether the country be marfhy 
 or not. Dr. Lind has many excellent obfervations upon 
 the fubject of unhealthy countries, and gives particular 
 directions for ftrangers how to act, when obliged to 
 cxpofe themfelves to the inclemencies of the weather; 
 but none of thefe being effectual in preventing the ac- 
 cefs of the true peftilence, we muft ftill adhere to the 
 old Latin adage already quoted, p. 302. Flight feems 
 to be the moft effectual method. To avoid migrations 
 to thofe countries where it ufually rages, and, if it 
 were poflible to perfuade the inhabitants of fuch coun- 
 tries, to imitate the example of Chinefe induflry, in- 
 Head of allowing the greater part of the territories they 
 poffefs to lie wafte, would in all probability gradually 
 lefien both the frequency and violence of this terri- 
 ble difeafe. Migrations of large bodies of people, 
 cfpecially for the purpofes of war, are greatly to be 
 dreaded. If a few Englifhmen, poffeffed of every thing 
 neceffary, could not keep their health at Pekin, what 
 muft have been the probable confequence of landing an 
 army of an hundred thoufand, with a view to conqueft ? 
 Or what could we expect if the Chinefe were to "pour 
 forth by millions" into other countries in order to con- 
 quer them ? Dr. Lind takes notice that even of the firft 
 Portuguefe adventurers to Africa, fuch as efcaped the 
 firft ftcknefs continued afterwards to enjoy good health* 
 He likewife obferves that many who left Britain, after be- 
 ing feaforjed to the countries to which they went, chofe 
 
 rather 
 
THE PLAGUE, 327 
 
 rather to remain abroad fox life, than to run a new rifk 
 by going back to their own country. It is not there- 
 fore fo much the greater unhealthinefs of the country to 
 which we go, as the change, which is to be dreaded. If 
 therefore great bodies of men will employ themfelves in 
 conftant rambling from one country to another, no 
 wonder that difeafes break out among them, unknown, 
 either in the countries they have left, or thofe to which 
 they go. 
 
 We come now to the third mode of prevention, viz, 
 
 that of destroying the infection after it has begun to 
 
 exift. This is varied according to the nature of thofe 
 
 things which we fuppofe to be infected. The general 
 
 notion of infection taking place in the atmofphere has 
 
 been already fpoken of; but the uncertainty of this 
 
 hypothefis, and the apparent impoffibility 'of altering a 
 
 conftitution of the atmofphere, muft certainly leave 
 
 very little room for hope in this cafe. It hath, however, 
 
 been attempted by various methods. Hippocrates 
 
 adopted the opinion that all difeafes were produced by 
 
 the air, and from him it was borrowed by Lucretius, as 
 
 we are informed by the annotator on Creech's Tranfla- 
 
 tion of that author. " In his book de Flatibus (of 
 
 <l winds) fays the annotator, after a long narration of 
 
 " the effects that the air produces, he at length falls on 
 
 " the fubject of difeafes, all of which he affirms to be 
 
 " bred and generated in the bodies of animals by means 
 
 " of the air. Firft (fays he) I will begin with the moft 
 
 " common fevorous difeafe, which accompanies, in a 
 
 " manner, all difeafes whatever. For there are two forts 
 
 " of fevers, one that is promifcuous, and common to 
 
 " all, and is called the plague ; the other, by reafon of 
 
 " unhealthful diet, is peculiar only to fuch as ufe that 
 
 " diet ; but of both thefe kinds of fevers the air is the 
 
 " fole author and caufe, for the common fever or plague 
 
 <k happens alike to all, bccaufe they all breathe the fame 
 
 " air : and it is certain that the like air, being alike min- 
 
 " gled in like bodies, mud beget like fevers." In confe- 
 
 quence of his theory, this great phyficianadvifed to have 
 
 recourfe to fire as a purifier of air in times of peftilence. 
 
 But 
 
3*8 A TREATISE ON" 
 
 But experience doth not warrant the fuccefs of this me- 
 thod; neither indeed can we fuppofe that it could befuc- 
 cefsful, unlefs people were able to kindle fuch fires as 
 would abforb the whole atmofphere of a country. This 
 method was tried in London without the leaft fuccefs j 
 nay, feemingly with bad effect ; for, the very night the 
 fires were lighted, more than four thoufand people died $ 
 and, a few days after, an end was put to the experiment 
 by fuch violent rains as extinguifhed all the fires at once/ 
 
 The burning of infected clothes has already been 
 taken notice of 5 but though this muft certainly prevent 
 any new infection from arifing from thefe clothes, it will 
 not prove that the infection may not evaporate dur- 
 iag the time of burning, and, being volatilized even be- 
 yond its natural pitch, by the heat, may do mifchief at 
 a greater diftance than could have happened had they 
 been let alone. The inftance, formerly quoted from 
 Dr. Huxham, of the fmall-pox being diffeminated by 
 the fmoke of burning infected clothes, if not a proof \ af- 
 fords at lead a ftrong prefumption, of the danger of fuch 
 a practice. The only way of perfectly enfuring fafety 
 in fuch a cafe would be to burn them by the fea-fide, 
 when the wind blows from the more, Were the fmoke 
 allowed to pafs over land, and great piles burnt at once, 
 it is impoffible to fay how far the contagion might be 
 carried.* 
 
 Another mode of purification isbyexpofing fufpected 
 goods to heat, to the vapour of vinegar, &c. fumigating 
 with gun-powder, fulphur, &c. and on this principle 
 various powders of fumigation have been invented, 
 fome of which are faid to have been very fuccefsful in 
 Ruffia ; and the compofition of one is given by Dr. 
 Alexander Rufiei in his Natural Hiftory of Aleppo ; 
 but all thefe are undervalued by Dr. Guthrie,-}* who calls 
 the practice of fumigation or fmoking, an " inadequate 
 and ineffectual ceremony." Dr. Mitchel, alfo difcom- 
 mends them, faying that they are adviled " without any 
 " proof that thefe deftroy peftilential matter, arid while, 
 
 " at 
 
 * In the time of the great fire at London, in 1666, aftes are faid 
 been carried to iixteen miles diftance. 
 
 f Duncan's Med. Comment, vol. viiii p. $$9 f 
 
THE PLAGUE. 
 
 " at the fame time, it is certain that they diminish niofe 
 " or lefs the wholefomenefs of the atmofphere with 
 " which they are mingled."* Of late the vapours of 
 pure nitrous acid (the nitric, according to the new no- 
 menclature) has been recommended* with the boldeffi 
 appeal to experience ; but the confideration of this na- 
 turally belongs to the fecond part of this work, where we 
 ihall have occafion alfo to confider the theory of the 
 feptic acid. In the mean time we miift go on with lomei 
 farther account of the different modes of fumigation. 
 
 " There is no better corrective (fays Allen from Die- 
 " merbroeck-f ) of a peftilential air, than fire ; as much 
 " experience has taught us* Hippocrates fubdued and 
 " extinguifhed that famous plague, which came amongft 
 " the Grecians from Ethiopia ; for he commanded great 
 " fires to be kindled throughout the whole city, efpe- 
 " cialiy in the night time, to purge away the pollutions 
 " of the ain It is believed that a fire made with juni- 
 " per-wood or am, tends much to correct the venomous 
 '* corruptions of the air. The kindling of fulphur and 
 " gun -powder purify the air, and drive away its corrup- 
 " tions $ fo does the burning of amber, pitch, frankin- 
 " cenfe, &c. fo do the fumes of vinegar raifed with red- 
 54 hot irons, or bricks." According to Etmuller* " Hip- 
 " pocrates drove away that famous plague in Greece by 
 u the ufe of fulphur j the fumes of it are very much 
 u commended to correct the air^ and make drink more 
 <c wholefome ; it prevents all manner of corruptions and 
 * c alterations, as well as the putridinous alteration of the 
 " blood. In a great degree of malignity, the fhirt and 
 cc clothes may be impregnated with the fume of 
 " fulphur." 
 
 Here we have accounts of a difeafe^ called that famous 
 plague, driven away by two different methods j and, to 
 complete our dilemrria^ Dr. Carieftrinus tells us that the 
 plague at Athens is faid to have been ftaid " by fprinkling 
 the ftreets with wine." What an expenfive remedy* 
 when the odour of privies was afterwards found to an^ 
 
 fwer 
 
 * Med, Repof. vol. ii, p. 433. f Synopfis, vol. i, p. So. 
 
 Uu 
 
33 c> A TREATISE ON 
 
 fwer as well ! " Whilftthe plague was raging at 
 " kow, an earthquake* happened on the very day that it 
 " began to decline. In this cafe did any vapour iflue 
 " from the earth deftrudtive of the peililential conta- 
 " gion ? or did former noxious exhalations ceafe in 
 " confequence of the convulfion of the earth P-f* Sor- 
 " bait relates, that, in the time of the vintage in the 
 " neighbourhood of Mofelle, the plague ceafed like a 
 " miracle, while the muft was in a fermenting ftate. 
 " At Vienna likewife it was obferved that, during and 
 " at the clofe of the vintage, the difeafe manileftly de- 
 " clined , which may have been owing to the great 
 " quantity of fixed air in the atmofphere." . 
 
 To this our author adds, that " places adjoining td 
 46 fpice-fhops have generally remained free from infec- 
 " tion 5 and, in the plague of London, all thofe em- 
 " ployed in fhipbuilding efcaped the difeafei Smiths 
 * c alfo and cooks remained un infe&ed." M. Volney 
 tells us that, in Egypt, water-carriers are exempted - 9 
 and Baldwin, that oilmen are in the fame happy pre- 
 dicament ; while on the other hand Allen quotes Boer- 
 haave faying, that " Foreftus, Diemerbroeck, the French, 
 " English, and Germans, obferved, that all dealers in 
 " foap, wafhers, and all who by their bufinefs ufed foap, 
 * nay, who only. f wore flirts %va(}>ed with foap, prefently 
 " died of the plague.'* 
 
 From fo many and fo difcordant opinions, the only 
 conclufion we can draw is, that, when once a peftilence 
 has invaded a country, there is not any poffibility of 
 operating upon the contagion in fuch a manner as to 
 deftroy it. If the plague ceafes, it muft do fo naturally, 
 
 and 
 
 * Earthquakes, as we have already feen, might be accounted rather zjign 
 or caufe of the beginning of peftilence, than of its departure. A great quantity 
 of eledricity in the atmofphere'has accordingly been enumerated among the 
 gns of an approaching peftilence. Thus in Burnet's Thefaurus, p. 699, we 
 find among the previous figns of a plague, plurima et fere continua nodlurna 
 iulgora, 'fine pluviis et tonitiuis, ccelo non nubiloio exiftante." Very much 
 and almoft continual lightning at night, without rain or thunder ; the Iky m 
 the mean time not being covered with clouds. 
 
 f Before we can attach any degree of probability to either of thefe fuppo- 
 jfitionsi it muft be proved that plagues arife out of the earth. But thisr thougfe 
 as plaufibie as w*ny other hypothfesi is not yet Supported by any J 
 proofi 
 
THE PLAGUE, .331 
 
 and we cannot accelerate this ceflation. This is -entirely 
 conformable to the opinion of Dr. Patrick Ruffel. 
 Speaking of the decline of the plague at Marfeilles, and 
 the vigorous exertions of the magiftrates to put a flop 
 to it, he fays, " The caufes now enumerated might no 
 " doubt have fome effed:, but a more powerful and 
 " general caufe had begun long before to reftrain the 
 " havock of the peftilence, which had declined vifibty 
 " in the month of September, and in thofe of OCtober, 
 " November and December declined with a rapidity 
 " not afcribable to the exertions of the mod vigorous 
 " police. This caufe is generally fuppofed to be fome 
 " change in the conftitution of the air ; but which has 
 " hitherto been defined with no better fuccefs tha.n that 
 " peculiar (late of the atmofphere which, in conjunction 
 " with contagion, is abfolutely neceflary to render the 
 <e plague epidemical." 
 
 Dr.Ruffel takes notice of the methods of extinguifli- 
 ing contagion already mentioned, by kindling fires, &c. 
 and difapproves of them. We fhall not therefore fpend 
 more time in confidering whether or not there is any 
 probability of eradicating or mitigating the violence of 
 a plague when once it is introduced. However this 
 may be impracticable in fo large a fpace, it feems that it 
 certainly may be done in fmailer fpaces, (hips for in- 
 ftance ; or, if not with the true plague, at leaft with ma- 
 lignant and infectious fevers. Dr. Trotter, in his Me- 
 dicina Nautica, has laid down methods for accomplifli- 
 ing this, and expreiles the higheft confidence in their 
 fuccefs. He adopts the doctrine of contagion, of which 
 he gives the fame definition that in this treatife is given 
 of infetlion, viz. " Something propagated from difeafecl 
 41 bodies, or from fubfbances that have been in contaCfe 
 :< with them, producing a limilar difeafe in other per- 
 <{ fons* the propagation of contagion, as well as its 
 '" reception into the healthy body. A more aggravated 
 <c degree of malignity will generate a greater quantity of 
 " infeClion, and, as it may be confined in a larger or 
 *' fmailer fpace, it will be lefs or more noxious. A fe- 
 
 " ver 
 
 * Mcdicina Nautica, p. i7 *'/<! 
 
33* A TREATISE ON 
 
 ver may be called malignant, when, with the fymptoms 
 f of debility, there is a cadaverous fmell arifmgfrom the 
 ^ body, an unufual foetor of the breath, ftools, and other 
 * c excretions, the tongue black and parched, the eye 
 *' dufky or yellow, the countenance bloated and dejefted, 
 " and the fkin fallow. In approaching a fick bed of this 
 " kind, a perfon not much accuftomed to fuch vifits 
 " will be very liable to receive the infedion ; and the 
 " unpleafant fmell will be much fooner perceived than, 
 " by the phyfician or other attendants. We conclude 
 ct that a malignant typhus is more apt to generate con- 
 " tagion, becaufe ilight cafes are found not to extend 
 " to others, even though no mode ot precaution has been 
 " ufed. The difeafe itfelf is incapable of generating in- 
 " feiftion, till after a certain period ; but this period is 
 " uncertain : it feems to depend on the nature of the 
 C fymptoms, whether they are mild or malignant. Wt 
 ^ are ajfured of this f aft , from a timely feparation having 
 * e prevented the farther progrefs ; and by this means ALONE, 
 " / apprehend, we eradicate contagion in SHIPS, or ANT 
 " WHERE ELSE. In the fmall-pox* the difeafe feems 
 * c incapable of infedling another perfon before the fecond 
 <c or third day of the eruption. With the meafles it is 
 " otherwife. The difeafe may be propagated at the 
 * e moft early ftage of the eruption ; and, if I was to be aU 
 cc lowed to conjediure on the fubjet, I would fay, that 
 " the contagion is the offspring of the catarrh (the cough 
 <c and hoarlenefs refembling a cold) which accompanies 
 V. the meailes. 
 
 ". Subftances imbued with the exhalations from in- 
 ? e . feded bodies, if not expofed to the air, have their pow- 
 <c ers of communicating the difeafe increafed ; or, ia 
 " other words, the in left ion from fomites (infeded cotton, 
 " clothes, &c.) is faid to become more virulent than it 
 *' was when firft feparated from the body. " I am 
 
 * In the plague, Dr. R,ufiel,has obferved, that thofe who die in a very fho* 
 time are much lefs ready to communicate infe<5Hon, than tliofe who live lon- 
 ger He aHb takes notice! that * the plaigue though a contagious difeafe, is 
 not equally contagious in every period of the peftilential feafon. In the 
 " beginning thofe frequenting the fick often, efcape unhurt* or one only* out 
 " of feveral, 'is infeded. The efcape of perfons employed about the fick", 
 proves a frequent eaufe of mifleading the popular opinion of the difeafci and 
 has in many inftances occa^ioHed much mifch:sf by er^ou^asing th.e ncdec^ 
 M, of due precautions till too late.'* 
 
THE PLAGUE. 333 
 
 * e I am of opinion, with others, that the exhalations or 
 * c excretions of the fick are the vehicles of contagion. It 
 " is thefe which impregnate the atmofphere with nox- 
 *' ious matter : they affect in like manner bed-clothes, or 
 " apparel, and every thing that can imbibe them, when 
 " in contact with the difeafed body. When bed-clothes, 
 " or body-linen, but particularly filk or woolen cloth, 
 " have been expofed to thefe exhalations, and then heap- 
 " ed together for a length of time, the noxious efflu- 
 " via are, as it were, multiplied, and will more certainly 
 s; infect others than they did at firft. The bales of goods 
 " which brought the plague to Marfeilles, and affected 
 " the people that opened them fo fuddenly, had their 
 *' virulence increafed by not being duly ventilated. 
 * c When the jail-fever was brought into court by the 
 " prifoners at Oxford affizes, and more lately at the 
 * ' Old Bailey, the fever was propagated from the clothing 
 " of the prifoners j no doubt, from being confined in 
 " impure, ill-aired cells, this infection became more vi- 
 " rulent. The highly concentrated flate of contagion, 
 " in the bales of goods, could only have been brought 
 " to that degree of virulence from the clofenefs of the 
 *' package : it cannot be fuppofed that human beings 
 " could have put them together otherwife. The nurfes 
 *' of hofpitals know well, as Dr. Lind tells us, that there 
 f " is mod danger of catching a fever when they pile 
 " heaps of bed-clothes or body-linen together for a 
 " few days, before it is carried to the wafh-hpufe. The 
 *' wafher-women at Hailar have alfo told me the fame 
 <c thing. They know when a dangerous fever is in the 
 " hofpital by the bad fmell of the, clothes : this makes 
 " them air them abroad, till the fmell is gone, and then 
 " they can wafhthem with fafety. But, if it happened, 
 * c from the hurry, that this could not be done, or if it 
 " was negleded by deftgn, many of them were feized 
 " with the iicknefs. The porters and people employed 
 " in cleaning and fumigating the blankets and beds at 
 " Haflar are well acquainted with this fact, and they 
 V meafure the danger by the badnefs of the fmell. This 
 f c ought to inftruft every body to ftand to windward of 
 
 thefe 
 
334 A. TREATISE ON 
 
 " thefe infe&ed fubftances when they are opened ; as 
 4t the current of air would then carry it the other way. 
 " In one of the courts of juftice, the people who flood 
 " between the priibners and a window, into which the 
 * e wind blew, efcaped the infection, while thofe on the 
 " other fide were fufferers. 
 
 " In the fummer of 1 793, while the Oreftes brig, com- 
 f< manded by Lord Auguftus Fitzroy, lay at Plymouth, 
 " (lie was anchored very near and to leeward of an 
 " army tranfport, which had on board a very malignant 
 ** fever among the foldiers. While the foldiers were 
 *' moved on deck, to go on fhore to the hofpital, the 
 " crew of the Greftes, from curiofity, walked on deck to 
 " look at them. Such was the concentrated ilate of 
 ** the contagion among the clothing and bedding of 
 ** thefe troops, on bringing them from below, that 
 ** eighteen people belonging to the brig were quickly 
 " feized with the fame fever, the infection of which 
 *' had been conveyed by the current of wind. It did 
 <c not, however, extend much farther in the Oreftes, 
 < 6 from the attention of her commander. But this 
 *' ought to be a caution for fhips to keep clear of thofe 
 4C that have fevers on board, as a virulent CONTAGION 
 ^ may be conveyed to a confiderable diftance. 
 
 " Dr. Lind is inclined to think that wafhing the 
 ** bed-linen in hot water, even when firit fhifted, is aN 
 *' tended, with much riik ; and that the noxious matter 
 < c may be volatilized by the heat of the water, and affect 
 ' the woman. For this purpofe he has recourfe to his 
 *' favourite procefs, of fumigation, to infure the wafher- 
 < woman. The heat of his fumigating furnace would 
 " no doubt dry the linen, and exhale any moifture ; but 
 *- c our pra&ice in the Charon (the hofpital (hip) was, to 
 ** plunge everything as it came from the bed into a tub of 
 *' hot water kept ready on purpofe. The linen waswafh- 
 <c eel -and dried immediately after. We had in that hof- 
 ^ pital many malignant cafes of typhus, and fome deaths^ 
 ** yet no infection was ever fpread there." 
 
 Our author next proceeds to inquire into the caufe of 
 this exceffive concentration cf the infectious matter in 
 
THE PLAGUE. 
 
 fotnites, or clothes, bed-clothes, bale-goods, &c. The 
 mod plaufible reafon, he fays, that could for fome time 
 be affigned for this, " was, the generation of animalcula ; 
 < the cotton or woollen clothing was faid to ferve as a 
 " nefl for the corpufcles to multiply ; and thus the con- 
 " tagiou was thought to increafe feven fold." This 
 theory had an effect on the practice of phyficians, both as 
 to the prevention and cure of fevers fuppofed to proceed 
 from thence. Our author looks upon the hypothecs to 
 be chimerical, becaufe none of thefe animalcules have 
 ever been made vifible by the bed microfcopes. But 
 there is no neceflity for fuppofing the animalcules to be 
 invifible to the naked eye. They may creep on the 
 ground, or fly in the air, without being obferved by us. 
 Mr. Baker's difcovery.of the infect which not only poi- 
 foned eleven hundred thonfand times its bulk of water, 
 but infected a much greater bulk of air, with its effluvia,* 
 ihows that fuch a thing may bepoffibk} and in dubious 
 matters bare poffibility ought always to produce in- 
 quiry. If the perfpiration of human bodies when con- 
 fined becomes noxious, why may not that of a multi- 
 tude of infects be fo too ? There is no necefltty for 
 fuppofmg that an infect muft be fwallowed, or inhaled 
 by the breath, before it can do hurt. What Dr. Trot- 
 ter fays of the variolous contagion emitted from the 
 human body will apply equally to infects. " What has 
 been called the infenfible perfpiration (lays he) which 
 arifes from the furface and the lungs, we have a right 
 to believe carries with it in folution a portion of the 
 " variolous matter which charges the atmofphere with 
 <s the contagion of fmall-pox, even in fuch quantities as 
 " to impregnate the clothing of attendants and vifitors ; 
 " by which means it has been frequently carried to fa- 
 " milies and villages many miles diftant from its fource.'* 
 The fmallnefs of fiza of infects can be little objection 
 here. A fkunk is but a fmall animal, yet it fpreads its 
 odour farther than an hundred difeafed human bodies 
 could propagate the plague.^ On 
 
 * P. 189. 
 
 t Here, I hope, it will not be thought unreafonable to digrefs a little in 
 favour of the fenfations of humanity, which on all occafions ought to prcdo- 
 
 " 
 
33 6 A TREATISE O& 
 
 On this fubject, however, we may remark, that ttougfc 
 -the nurfes and attendants on hofpitals meafure the degree 
 of infection by the fmeil, yet people afe by no means 
 fafe in approaching patients about whom no fmeil can 
 be perceived. We have already feen, from Dr. For- 
 dyce, that what may be called the pure infection of fe- 
 vers is not perceptible by any of our fenfes -, and there 
 are examples of very offenfive fmells iffuing from difeafed 
 bodies without any contagion enfuing. Dr. Trotter 
 tells us, that " a patient in typhus was fent from the 
 " Venerable to the hofpital fhip, with a fostor about 
 " him, that exceeded any thing of the kind that ever 
 " came within the Doctor's knowledge. After being 
 " wafhed and fhifted, it ftill continued, and was per- 
 " ceived at a confiderable diftance. He died in a few 
 " days, yet nobody was infected from him, either rn his 
 " own fliip, or in our hofpital. There was probably 
 " fome peculiarity of conftitution here." In M. Dei- 
 dier's experiments, above related* the dog which eat 
 the dreflings of the plague fores, after being infected -with 
 the diieafe, emitted a very difagreeable odour, but we 
 do not find that the odour was in any way infectious. 
 In the Encycloped. Britan. art. Me$. Hydrophobia, we 
 find an account of an hydrophobic patient (and a pa- 
 tient who recovered) in whom the blood drawn from a 
 vein was as black as ink, and flunk abominably, yet this 
 flench was attended with no bad confequence. There 
 is therefore no effcntial connexion between offenfive 
 fmells and contagion ; yet, as they are fometimes united^ 
 the abfence of the frnell ought not to encourage us rafhly 
 to go into fufpicious places, neither ought the prefence 
 of it to deter us from venturing where we have otherwife 
 good reafon to do fo. Having 
 
 initiate in our minds. Birds are the natural enemies of that hateful clafs of 
 beings we call infci* y and which in general are the natural enemies of 
 man. In proportion to the havock we make among the former, the latter will 
 multiply upon us whether we will or not. The wanton indifcrimJnate and 
 I may add provoking, deftru&ion exercifed among this ufefal as well as 
 beautiful and agreeable part of the creationi muft certainly be fometimes at- 
 tended with bad confequences. Though birds feed on many different kinds 
 of inledts, yet there are exceptions. If then we totally exterminate a fpecjes 
 of birds, is it not probable that a fpecies of infeils might appear, the mifchief 
 done by which we could not be able to counteract ? Qterc, Is it not pof* 
 that the H'Jpan fy may have made its appearance from this caufe i 
 
"THE PLAGUE. 337 
 
 Having given up the doctrine of animalcula, the 
 t)odtor goes on to explain the do&rine of concentrated' 
 contagion in a manner very fimilar to that given in this 
 treatife, viz. from the decompofition of fome kind of 
 gas. " The foetor of the breath (fays he) perfpirable 
 " matter, &c. evidently demonftrate that they differ from 
 " the healthy ftate. The fmell, to our fenfes, comes very 
 " near what is called fulpkur ate d- hydrogenous gas. Some 
 " of the fluids within the body would feem to be in fome 
 " degree in a ftate of a&ual decompofition ; unlefs we can 
 " fuppofe the mucous glands of the lungs fecreting a fluid 
 * fi that taints the expired air in this manner. The decom- 
 " pofition of the fat, which fometimes difappears very fud- 
 " denly in fevers* may give fome ground for the fuppofi- 
 " tion that a large portion of thefe exhalations are com- 
 u pofed of hydrogenous gas. But, whether we can go thus 
 " far or not, what is feparated from the body> it is plain, 
 " is more difpofed to decompofition than when the 
 ;t body is in health. Now this procefs will ftill go on, 
 " whether expofed to the atmofphere or not, with this 
 "difference, that, by expofing fubftances which have 
 " imbibed the exhalations of the difeafed to a free air, 
 " the noxious gafes will be diflipated as quickly as they 
 " are evolved j while, on the other hand, by laying the 
 <c clothes in a heap, packing them firm in a cheft, ot 
 " making up cloth into fmall bales, the gafes are con- 
 " centrated into a fmall fpace ; and woe to the man 
 " who firft infpires them. . . . Now this does not hold 
 " out an idea that the powers of contagion are multiplied, 
 " as by generation ; for that would be to fay, that thefe 
 " gafes are tkewfelves what we call the matter of infec- 
 1C tion. I would only go fo far as to aflert that they are 
 ;< the vehicles of it, till more certain experience fhall 
 " determine farther." 
 
 With refpect to fumigations with nitrous acid, our au- 
 thor repeatedly declares that he has no confidence in 
 them ; nay, he brings inftances where they feemed to have 
 bad efteds. But as the difpute about fumigation has no 
 connexion with the true plague, nitrous acid having 
 never been ufed as a preventive for it, we fhall defer any 
 
 X x farther 
 
338 A TREATISE ON 
 
 farther conlideration of it to the fecond part of this treatife, 
 to which it naturally belongs. 
 
 We come now to the fourth and lad mode of preven- 
 tion, viz. a coniideration of thofe means by which an 
 individual, without ieparating himfelf from fociety, and 
 who is daily obliged to have communication with the- 
 fick, may yet fecure himfelf againft infe&ion. Here the 
 means recommended are extremely various, and fome of 
 them fo oppofite, that we can fcarce avoid fufpecYmg them 
 all. The misfortune is, that though a perfon ihould go, 
 without fear, among the fick, though he ihould con- 
 ftantly take a medicine, and Ihould never have the dif- 
 temper, yet we cannot fay whether the medicine did 
 preferve him or not. Were it pofiible to know the 
 particular conftitution of the body which dtfpofed fome 
 to refift the attack of the difeafe, attempts might be 
 made to bring the conftitutions of others to the fame 
 ftandard ; but unfortunately our ignorance here is fo great, 
 that any attempt to alter the conftitution of the body 
 has generally proved unfortunate even in other difeafes. 
 Dr. Lind informs us, that the firft Portuguefe adven- 
 turers in Africa, having obferved, that " fuch as had 
 " the good fortune to efcape a fit of ficknefs or death, 
 *' foon after their arrival, enjoyed afterwards a pretty 
 " good ftate of health, thence concluded, that the blood 
 " of fuch perfons had been entirely changed by the diet 
 **' of tne country. Upon this erroneous principle they 
 " adopted a mofh fatal method of feafoning people to 
 " thefe unhealthy climates. They, by fmall .quantities, 
 tf frequently repeated, took away as much blood as they 
 * c fuppofed to be contained in the body, and thus they 
 <fc reduced the patient to a ftate of extreme weaknel's." 
 
 From its being obferved that people of delicate con- 
 ftitutions are kfs liable to the plague than others, fuch 
 a miftake probably has alfo been made with regard to 
 this diftemper, but with equally bad fuccefs. Alien 
 tells us from Diemerbroeck, " Phlebotomy, though migh- 
 " tily cried up by many of the ancient and modern 
 " phyficians, yet we reject it altogether, as very dangerous 
 " and detrimental -, for it appeared by experience that 
 
 " thofe 
 
THE PLAGUE. 339 
 
 '** thofe 'who made ufe of it for prevention's fake were 
 " feized with the plague foon after bleeding, wherefore 
 " we forbad it to all." This may feem furprifing, as we 
 find bleeding fo much recommended by Sydenham as 
 a remedy ; but by others it is equally reprobated ; nay, 
 Dr. Hodges tells us that he never knew but one who 
 recovered from the difeafe after the ufe of it. Iffue 
 feem more likely, if not to prevent^ at lead to render the 
 difeafe more mild if it mould attack. They are recom- 
 mended by Diemerbroeck, and RuiTel fpeaks of them as, 
 " by fome authors, reprefented as aiaioft infallible." 
 He cannot, however, recommend them from his own 
 experience, having never feen them opened for the pur- 
 pofe of preventing the plague ; and he juftly obferves, 
 that when habitual on any other account, they may per- 
 haps iofe their effect in this. " Multitudes (fays he) of 
 " both fexes at Aleppo had iffues in their arms, it being 
 " there a very common remedy in a variety of chron,ic 
 " diforders : but, notwithftanding thofe outlets, nurri- 
 " bcrs perifhed ; and I did not remark that thofe who 
 " had them were in any degree lefs liable than others to 
 be infected." 
 
 Tobacco has been recommended as an excellent pre- 
 fervative, particularly by Diemerbroeck, who writes with 
 a kind of enthufiafm in its favour. " Being called 
 " (faid he) to vifit a patient afflicted with the plague, as 
 " foon as I entered his chamber I felt a mod offenfive 
 " fmell of excrements (for he had a diarrhoea) with 
 <c which I was greatly affeded. Leaving the houfe 
 " after a very fhort vifit, I indantly found myfelf feized 
 " with giddinefs, naufea, and lineafinefs at the heart; fa 
 " that 1 had no doubt of my having caught the pedilen- 
 " tial contagion. Laying afide all bufinefs, therefore, I 
 ' immediately returned home, and fmoked five or fix 
 " pipes of the bed tobacco ; by the ufe of which all the 
 " above-mentioned fymptoms fo totally vanifhed, that 
 " I felt not the lead uneafinefs any more. Then, being 
 tc again defirous to go abroad and vifit other fick peo- 
 :e pie, I took a drachm of theriaca, and from thence- 
 *< forward was in perfect health. The fame thing hap- 
 
 " pened 
 
34$ A TREATISE ON 
 
 " pened to me three or four times during the time of 
 * c this peftilence ; and without lofs of time, according 
 " to the quantity of infection I fuppofed that I had 
 " taken in, I had recourfe to the more plentiful ufe of 
 " tobacco, by which my health was reftored. 1 always 
 " looked upon tobacco to be an excellent preventive 
 " remedy, and its fmoke I have fometimes found ufeful 
 " to myfelf even in an incipient attack of the difeafe,*'* 
 He then proceeds to inform us of a report that in a vio-. 
 lent plague at London all the dealers in tobacco were 
 exempted. At Nimeguen, however, they were not fo 
 fortunate ; yet of the family of the principal tobacco 
 merchant (Thomas Peters, an Englifhman) which was 
 very large, none were infected, excepting only one fer- 
 vant maid, and (he quickly recovered, 
 
 On this remedy Dr. Ruflel makes the fame remark as 
 on the iffues. " The cuftom of fmoking (fays he) is 
 " univerfal among both men and women at Aleppo. 
 " This too, from its being habitually practifed, might 
 <c perhaps lofe part of its prophylactic virtue : at the 
 *' fame time thofe who ufe it as a prefervative muft 
 " always be fuppofed in fome degree accuftomed to it, 
 " otherwife the violence of its operation on moft per- 
 f< fons, on their firft beginning to fmoke, might prove 
 * c hurtful. It fhould further be obferved, that the to- 
 " bacco commonly ufed in Syria is much milder than 
 <<? the American, and that the oriental fmokers feldom OF 
 * c never fpit." 
 
 It hath been obferved that the plague is flopped ei- 
 ther by great heat or great cold, but more readily by the 
 former than the latter. " It has generally been fuppofed 
 " (fays Dr. Caneftrinus) that the cold of winter was 
 <e deftru&ive of contagious matter ; but various inftan- 
 " ces of the contrary may be colleded. The plague in 
 " Tranfylvania continued through the very fevere froft 
 c< in 1709. On the contrary it has been found, that 
 cc excefiive heat has extinguifhed, or at lead diminiilied, 
 i; peftilential difeafes. Daring the plague at Aleppo 
 " the weather was unufually hot ii^ the beginning of 
 
 " July, 
 
 Diemcrbroeck, Hilt. 17, lib. 4. 
 
THE PLAGUE. 341 
 
 July, and it was remarked that the difeafe declined 
 confiderably ; and in general Dr. Ruflel obferved, 
 that the plague ceafed at the hotted feafon of the 
 year. The plague at Ockzacow, which raged in the 
 years 1738 and 1739, began in the month of April, 
 and continued with violence till July, when it de- 
 clined confiderably, and entirely ceafed in the month 
 of September ; in February of the year following it 
 4C re-appeared, and totally ceafed in July." 
 
 From thefe fads we might be led to fuppofe that a 
 warm regimen, or occafionally expofing the body to 
 great heat, might be advantageoufly ufed by way of 
 prevention ; but Dr. RmTel juftly obferves, that the hu- 
 man frame, " could it fupport fuch an application of fire 
 " and fmoke as is neceflary to expel or deflroy contagion 
 " from infected fubftances, would probably receive little 
 " benefit from it, if infected ; nor could thofe in health 
 " fuflain, without prejudice, the heat and denfe fmoke 
 " which is probably required for the perfect extinction 
 " of the infedlious effluvia floating in the confined at- 
 " mofphere of a morbid body." He is of opinion, 
 however, that fome kinds of fumigations may be of ufe, 
 and he mentions fome of thefe, but fays that the per- 
 fumes ordered by the college are perhaps as proper as 
 any, though their forms might be rendered more fimple. 
 Heat alone can fcarce be thought very proper for pre- 
 vention, and, when the difeafe is once begun, is faid to 
 be detrimental. Dr. Guthrie quotes Baron Afh faying, 
 that f * in heated rooms the difeafe is ungovernable : it 
 is only in free air that it is to be treated." But of late 
 a difcovery has been made of a furprifing power in 
 heated oil of removing this difeafe, infomuch that, if we 
 can believe what has been published of it, we muft fup- 
 pofe it to be little lefs than a fpecific. So great indeed 
 has been the confidence put in this method, that, by 
 order of the Academy of Sciences at Liibon, it has been 
 tranflated into Arabic, French and Portuguefe.* " The 
 " method was firft propofed by George Baldsvin efq. 
 *- c agent for his Britannic Majefty, and conful-general at 
 
 " Alexandria, 
 
 * Annals of Medicine for 17971 p. 373. 
 
342 A TREATISE OK 
 
 " Alexandria. He communicated his method to Lewis 
 " de Pavia, chaplain and agent to St. Anthony's Hof- 
 " pital at Smyrna ; who, after five years experience, 
 " pronounces it to be the moft effectual remedy hitherto 
 "' made ufe of in the hofpital of which he has had the 
 " management for twenty-feven years* Immediately 
 ic after a perfon is perceived to be infected with the 
 * c plague, he muft be taken into a clofe room ; and, over 
 *' a brazier of hot coals, with a clean fponge, dipped in 
 " warm olive oil, his body muft be very brifkly rubbed 
 " all over ; for the purpofe of producing a profufe fweat. 
 " During the fridion, fugar and juniper berries muft be 
 " burned in the fire, which raife a denfe and hot fmoke^ 
 M that contributes to the efYe&. The friclion ought 
 * ; not to be continued more than four minutes, and a 
 " pint of oil is enough to be ufed at each time. In ge- 
 t: neral the firft rubbing is attended by a very copious 
 ^ perfpiration ; but, fhould it fail of this effed:, the ope- 
 " ration may be repeated, firft wiping the body with a 
 ic warm, dry cloth - y and, in order to promote perfpira- 
 " tion ftill farther, the patient may take any warm fu- 
 *' dorific drink, fuch as elder-flower water, tea, &c. It 
 " is not neceflary to touch the eyes ; and other tender 
 66 parts of the body muft be touched gently. Every 
 " pofTible precaution muft be made ufe of to prevent 
 " the patient from taking cold, nor muft the linen be 
 c< changed till the perfpiration has entirely fubfided. 
 <c The operation fiiould be repeated once a day, until 
 " evident fymptonis of recovery begin to appear. If 
 " there are already tumours on the body, they (hould be 
 " gently and more frequently rubbed, till they appear 
 " to be in a ftate of fuppuration, when they may be 
 54 drefTed with the ufual plafters. The operation ought 
 *' to be begun on the firft appearance of the fyrnptoms 
 " of difeafe ; if negleded till the nerves and the mafs 
 ^iof blood are affedfced, or a diarrhoea has commenced, 
 ** little hopes can be entertained of a cure ; but ftill 
 * the patient (hould not be defpaired of, as, by an af* 
 ^ fiduous application of the means propofed, fome few 
 " have recovered, even after diarrhoea had com- 
 
 <c menced. 
 
THE PLAGUE. 345 
 
 " menced. During the firft four or five days the pa- 
 " tient muft obferve a very abftemious diet ; the au- 
 " thor allows only a fmall quantity of vermicelli, lim- 
 " ply boiled in water. Nor mull any thing be taken 
 "'for thirty or forty days, except very light food, as, he 
 " fay g, an indigeftion in any ilate of the diforder might 
 " be dangerous. He does not allow the ufe of wine 
 " till forty days. There is no inftance of the perfon' 
 " rubbing a patient having taken the infection. He 
 " fhould previoufly anoint himfelf all over with oil, and 
 " muft avoid receiving the infected perfon's breath into 
 " his mouth or noftrils. The precaution to be ufed in 
 " all circumftances is that of carefully anointing the 
 " body, and living upon light and eafily digeftible food. 
 " Mr. Baldwin obferves, that among upwards of a 
 " million of people carried off by the plague in Upper 
 " and Lower Egypt, in the fpace of four years, he could 
 <; not difcover a fingle oilman, or dealer in oil/* Lif- 
 bon, Jitly> 1797. By Royal Pernriffion. 
 
 With regard to diet, and the ufe of fpiritous liquors, 
 opinions, as may well be imagined, have been very dif- 
 cordant. Alien quotes Diemerbroeck advifing poor peo- 
 ple to take two or three fpoonfuls of the befl white wine 
 vinegar every morning, which he looked upon to be one 
 of the bed prefervatives : he recommends alfo the fre- 
 quent application to the noftrils of a fpunge dipped m 
 treacle vinegar. With regard to himfelf he fays that his 
 principal care was to avoid uneafy paffions of the mind ; 
 and that when he found himfelf any way difturbed by 
 thefe, he cheered his heart by three or four glailes of 
 wine : his common drink was beer, and alfo white wine, 
 fmall, or moderately ftrong, which fometimes he drank 
 to cheerfulnefs, but never to drunkennefs. Dr. Patrick 
 Ruffel alfo fays, that " a glafs of generous wine, or any 
 '' other cordial more agreeable to the choice, may be 
 : taken before dinner, in cafe of languor, or bppreffiori 
 " at the ftomach, from fatigue, foetor, or apprehenfion. 
 *' I found a rummer of old hock v&y agreeable oti fitch occa- 
 " fans" Allen goes on to inform us from Diemerbroeck, 
 that, "-as to diet, it is advifeable in a peflilential difpo- 
 
 4< iition 
 
344 A TREATISE ON 
 
 ** fition to ufe temperance, which very much contributes 
 " to the prefervation of health - y but all fudden changes 
 " are dangerous ; wherefore it is moil dangerous fudden- 
 " ly to alter the ufual rule of diet. It is very ill in the 
 " plague to go abroad with an empty ftomach t hog's 
 " flefli is looked upon to be very pernicious : all fweet 
 " things are to be avoided : wine moderately made ufe 
 " of is good, but the abufe of it very dangerous. Mer- 
 " curialis teftifies, that among the Patavians and Vene- 
 " tians, moft of the tipplers died, who thought to driver 
 " out the plague with ftrong wines.'* Mr. Howard in- 
 forms us, that a perfon in high ftation at Conftantinople, 
 attributed his recovery entirely to the ufe of green tea, 
 others to brandy. He alfo mentions a Mr. Hare, mafter 
 of a merchant velTel at Senegal, who, during the preva- 
 lence of a malignant fever there, was very much expofed 
 to the infection, and who out of humanity waited upon 
 a negro, whom nobody would go near. He took no 
 medicines, neither did he tafte either fpiritous or ferment- 
 ed liquors, and was the only European that entirely ef- 
 caped the contagion.* 
 
 Thefe accounts feem to evince that little or nothing 
 is to be expected from a change of diet. This is an at- 
 tempt to change the conftitution of the body, and can- 
 not be expected to 1 fucceed any more than bleeding. 
 There is a certain quantity, and a certain fpecies, both 
 of food and drink, different in different perfons, neceiTary 
 to preferve health, and thofe who require both in larger 
 quantity or better quality than others, are no more to be 
 charged with intemperance than thofe who are fupport- 
 ed by the fmalleft quantity of the coarfeft fare. In 
 times of danger, therefore, thofe who have been accuf- 
 tomed to fpiritous liquors ought not to give them over ; 
 neither ought thofe to begin the ufe of them who have 
 not ufed them before. From the account formerly 
 given of the ftructure of the human body, it appears to 
 be furnifhed with an apparatus for exhaling or throwing 
 out a perfpirable matter as well as for inhaling or taking 
 
 in 
 
 * The opinion of thofe phyficians whom Mr, Howard consulted upon this 
 fubjed are given at large in the APPENDIX* 
 
THE PLAGUE. 345 
 
 in one equally fubtile. How far the fkin may be able 
 to inhale or rather imbibe furrounding effluvia, may be 
 doubted ; but with the lungs there cannot be any doubt; 
 and the effluvia taken into them muft unquestionably 
 affect the blood, and of confequence the vital principle, 
 almoft without any rhedium. To deprive the body of 
 its due portion of nourifhment therefore is to throw a 
 temptation in its way (if I may ufe the expreflion) to ab- 
 forb any thing ; and the fame effect muft enfue from 
 any other mode of debilitating it, either by intemperance, 
 terror, or the like ; and hence to vifit infected places 
 while under any fuch debility muft be very imprudent. 
 Dr. RufTel agrees that it is a general and rational pre- 
 cept, never to go abroad fading. For thofe who can- 
 not eafily bear fatigue without eating between breakfaft 
 and dinner, fome light food may be proper* at an inter- 
 mediate hour, in order to avoid going into the chambers 
 of the fick with an empty ftomach in the forenoon. 
 ~ f ' In fuch circumftances (fays he) after a long and 
 " fatiguing morning, I have often found myfelf difagree- 
 " ably affected in my latter vifits, and have been fenfi- 
 tc ble of flight giddinefs, and of the appetite flagging at 
 " dinner, as if fomething lay on the ftomach. I have 
 " known others much more ftrongly affected in this 
 " manner, and confequently much more alarmed. In 
 ct fuch cafes much no doubt may depend on the fancy; 
 * e but in thofe times the power of the imagination 
 cc requires management. So intimately is it connected 
 " with the accidental ftate of the body, that the fame 
 " rifk, from which a man Ihrinks in a ftate of languor 
 l< and fatigue, he will encounter undauntedly after a 
 " temperate meal : the ftrange, unufual fenfations, which 
 ic amount almoft to a perfuafion of having caught the 
 " infection, will often, like the phantoms of a vilion, 
 ; vanilh after a few glaffes of wine.* Whether any 
 
 " flight 
 
 * This Jo&rtne of foncy, or imaginatien, ought undoubtedly, as Dr. Ruflel 
 fays of the imagination itfelf, to be under fome management. The indifcri- 
 rninate ufe of the word has been carried to fuch a length as in a manner to 
 fuperfede a!l evidence, teftirnony, argumentation or reafon. With fome it is 
 iafficient to difcredit the moft pofitive teftimony (even upon oath) if they 
 
 take 
 
 y v 
 
346 A TREATISE ON 
 
 " flight degree of real infection can be thus diffipated^ 
 " I lliall not take upon me to determine ; is is fufficient 
 cc for the prefent purpofe to indicate the means of re- 
 * e draining thofe alarming fenfations which, when aggra- 
 " vated by imagination, are apt to deprefs the fpirits, 
 <c and,, according to the general opinion, to reduce the 
 " human body to that relaxed, inhaling flate peculiarly 
 * c fufceptible of contagion." 
 
 As to other modes of precaution, the Doctor advifes 
 that fuch as are about the fide " mould guard the mouth 
 " and noftrils with vinegar, avoid drawing in the breath 
 " while clofe to the bed fide, or fwallowing their fpittle 
 " while in the infected chamber. Before they approach 
 " the bed in order to examine the eruptions, the bed- 
 " clothes ought to be removed, to give time for the 
 " difperfion of a confined fleam which immediately dif- 
 <c covers itfelf to the fenfes ; and it will be advifable 
 " to dip the hands in vinegar before examining the 
 "parts. On coming out of the chamber it will alfo 
 " be proper to rinfe the mouth, and wafli the hands, 
 *' with vinegar, plain or camphorated." He advifes alfo' 
 
 to 
 
 take it into their heads that fuch a thing cannst be ; which by the bye is as 
 ftrong an evidence of ignorance as any man can give. If imagination is given 
 as a cau/e t the extent and nature of its powers ought to be ascertained ; but 
 who has done this ? On the contrary 1 may fay that not one in five hundred 
 who makes ule of the word would be able to define it. But the molt curi- 
 ous mode of reasoning ufed by thefe imaginary gentlemen is, if they are afked, 
 How do you prove that fuch a thing is the effedt of imagination ?" they arc 
 ready to anfwer, " I can indeed bring no proof that it is i'o, but how do you 
 prove that it is not ?" Here the imaginaries have not reafon fuflicient to (how 
 them that they ought to bring a proof, and not thofe who fay they faw or felt 
 any thing. Bat, waving this, fenfe is the higheft faculty in our nature; i- 
 s iatien as well as reaftn are inferior to it ; becaufe neither the one nor tho 
 other can be converfant except about the objedls of fenfe. If any perfon 
 therefore fays that \\tfees or that he feels- any thing, nobody can, with any 
 ihadow of reafon, fay that he neither faw norfei't any thing. If one man fees 
 what another cannot fee, while the fuppofed objed is eaiily within reach of 
 the eyes of either, then th* one who cannot fee it has a right to'fufpect that 
 theobje<ais imaginary; but, if the perlon himfelt feels any flight pam or 
 uheafmefs, and that fhould go off in a Hiort time, after drinking a glafs of 
 \\'ine, there is as little reaion to fuppofe that the pain was imaginary, as that 
 the drinking of the wine was imaginary. In Dr. Ruflel's cafe, though his 
 ftrength was in general fufficient to refift the contagion in which he was im- 
 rnerfed, yet w:.en that ftrength began to decay, it was no wonder that he 
 found the contagion beginning to invade : a few glafies of wine gave vigour 
 to the fyftem, and enabled it to repel the attack. Had he been much fo- 
 tiRued with bodily labour, and found himielf greatly relieved by a few 
 glatVes of wine, furely he would not fuppofe that his former fatigue was mere- 
 ly imaginary. Juft fo muft it be in the former caie j the one has no more to 
 i]o with imagination than the other. 
 
THE PLAGUE. 347 
 
 to fumigate the clothes with nitre, fulphur, and juniper 
 fcerries, burnt on a red-hot iron. 
 
 " Upon returning home it may be advifable to mift 
 " clothes immediately, hanging thofe taken off upon 
 " lines in a fmall chamber, to be again fmoked, and af- 
 <c terwards aired. - The mouth and hands ought once 
 " more to be well warned, and the hair might be fumi- 
 " gated with a little nitre and fulphur, by means of a 
 " pipe, fo as not to incommode the lungs. 
 
 One other mode of prevention, not of the difeafe, but 
 of incurring danger from it, is inoculation. This is 
 greatly recommended by Baron Aili above mentioned, 
 and not only for the plague among the human fpecies, 
 but for that among cattle, which frequently deftroys 
 great numbers of thofe necelfary animals. The cafe of 
 Mathias Degio related p. 272, (hows the practicability 
 and the fafety of it. The only folid objection that can 
 be made to it is, that thofe who have once had the plague 
 are not fecure from having it a fecond time, or oftener. 
 Yet, if we confider the extreme fatality of the difeafe 
 \vhen it attacks in the natural way, and that the number 
 of thofe who have the plague only once is much greater 
 than of thofe who relapfe, this practice will certainly be 
 found to merit confideration, and, unlefs fpme objec- 
 tion to it be difcovered greater than any that has yet 
 appeared, feems likely to be advantageous to the human 
 face in general. 
 
 SECTION V. 
 
 the Cure of the Plague. 
 
 FROM what has already been laid down in a former 
 .fection concerning the nature of this diftemper, it 
 appears, in its word and moft deadly form, to confift in 
 the fudden breaking forth of a kind of hard mortifica- 
 tions, or rather efchars, like thofe made by fire, in dif- 
 ferent parts of the body. When thefe happen to fall 
 
 upoij 
 
343 A TREATISE ON 
 
 upon any of the vital parts, it is evident that no cure 
 can be applied. When fuch efchars difcover themfelves 
 in abundance on the external parts, it is likewife obfer* 
 ved that the patient certainly dies ; whether from the 
 fame taking place inwardly, or from nature not being 
 able to bear the lofs of fubftance, and to feparate fo ma- 
 ny deep efchars, is uncertain : but this kind, which aN 
 tacks without fever, has always been reckoned abfolutely 
 incurable. When the tendency to internal mortifica- 
 tion is lefs, and the fiery blafts, if we may fo call them, 
 approach the furface, fo that buboes or carbuncles begin 
 to appear, there is then fome hope that the patient may 
 recover. Even here, however, the cafe mud be confi- 
 dered as very doubtful, and we have feen that in Dr. 
 RuffoPs three firft clafles of patients not one recovered ; 
 neverthelefs, as we are not always able to diftmguifh 
 with certainty whether the patient is altogether beyond 
 the power of medicine or not, excepting where the 
 tokens formerly mentioned appear, this kind only is 
 here diftinguifhed by the name of the fatal or inevitably 
 mortal kind of plague. In all cafes, where there is time 
 allowed, medicine ought to be employed ; but, as in 
 other difeafes, different theories have bred fuch a con- 
 tradiction of opinions, that it is with no fmall difficulty 
 we can judge which has any probability of fuccefs. In 
 this uncertainty, however, we muft look upon thofe who 
 have recently had an opportunity of feeing the difeafe as 
 fuperior not only to thofe who have only read of it, but 
 even to the moft celebrated ancient phyficians who have 
 written upon the fubjecl:. Thofe who have had the beft 
 and lateft opportunities of feeing the diftemper are Drs. 
 Alexander and Patrick RufTel at Aleppo, and the phy- 
 ficians to the Ruffian army when the plague raged in it 
 in 1770, &c. 
 
 Dr. Alexander RufTel begins with obferving that 
 " the difcordant opinions of medical writers concerning 
 
 :e the method of treating the plague are innumerable. 
 
 ' In regard to bleeding and other evacuations, they 
 <c maintain opinions diametrically oppofite; fome recom- 
 <<r mending them as indifpenfably requifite, others decry- 
 
 " ing 
 
THE PLAGUE. 349 
 
 " ing them as invariably pernicious ; while both parties, 
 " with equal confidence, appeal to experience. But, in 
 " a difeaie wherein reafon is often perplexed, and expe* 
 <c rience itfelf fallacious, it is greatly to be lamented that 
 " nature is not more, and opinion lefs, confulted. 
 
 " No traces of any fatisfactory method of cure are to 
 " be met with among the natives at Aleppo. The Ma- 
 " hommedans, holding the plague to be a penal curfe in- 
 " flifted by Almighty God on a finful people, have lefs 
 " faith in the efficacy of medicine in that difeafe than 
 " any other : and, as the chief of thofe who practife 
 " phyfic are either Chriftians or Jews, not armed with the 
 " doctrine of predeftination, and confequently apprehen- 
 :c five of contra&ing the infection, they (the phyficians) 
 * c endeavour to confirm the vulgar notion of the inuti- 
 " lity of their art in the plague, with a prudential view 
 " of evading the danger of being forced to vifit the fick, 
 " Hence the greateft part of the infected are either left 
 " to ftruggle with the difeafe without any affiftance 
 " from medicine, or are under the neceffity of fubmit- 
 " ting to the diredlion of the meaneft andmoft ignorant 
 *' of mankind/' 
 
 The whole pra&ice of the native phyficians confifts 
 in bleeding, let the ftage of the diftemper be what it 
 will, and afterwards attempting to raife a fweat with the 
 infignificant remedy of a few grains of bezoar mixed 
 with the diftilled water of fcorzonera. On the fubject 
 of evacuations our author remarks, that bleeding, even 
 very plentifully, was always ufeful in the beginning, but 
 as conftantly prejudicial after the firft day. Vomiting 
 was equally ufeful at the fame period ; with mere warm 
 water, if that would anfwer the purpofe, but if not, fmall 
 drops of ipecucuanha or fal vitrioli might be added. 
 Violent cathartics were hurtful, but an emollient clyfter 
 or laxative of manna and cream of tartar were not only 
 fafe but ferviceable. " On the fecond day of the dif- 
 * v eafe (fays the Doctor) where the remillions of the 
 *' fymptoms were tolerably diftinct, I have frequently 
 ** and fuccefsfully given an infufion of fenna with manna 
 c * and cream of tartar ; and it is a fact confirmed to 
 
 " me 
 
350 A TREATISE ON 
 
 tc me by repeated experience, that a purgative of this 
 " lenient kind, given after the critical fweat, was the 
 " moft effectual means of promoting the fuppuration of 
 " the buboes. 
 
 " The natural crifis of the difeafe was always by the 
 if fkin. When a copious fweat could be procured by 
 <c art, it was likewife of fervice ; but the attempt, if 
 " made the firft day, was attended with two material 
 *' inconveniences : the firft, that the common diapho- 
 ** retic medicines, if given in the ufual dofe, if they 
 u failed in their operation, threw the patient into a 
 i flame, and greatly augmented all their fymptoms ; 
 *' the fecond, that, though they produced the defired 
 " effcd, it was neceffary to keep up the fweat a much 
 ** longer time than moft people of that country could 
 " be perfuaded to endure ; and, if the fweat was prema- 
 M turely checked by expofure to the air, all the fymptoms 
 u were either exafperated, or (what was often the cafe) 
 * c a diarrhoea was induced, which, though at firft it might 
 *' feem to relieve, yet generally proved fatal in the 
 " end/' 
 
 Contrayerva and valerian, faffron, the compound 
 powder of contrayerva of the Edinburgh College, are 
 recommended as fudorifics ; given in fmall dofes every 
 four hours, with acidulated diluent drinks. Thefe me- 
 dicines were occafionally joined with anodynes, among 
 which fyrup of poppies was reckoned preferable to opi- 
 um. In cafes of diarrhoea, Venice treacle or diafcor- 
 dium were joined with the diaphoretics. Neither bark 
 nor fnakeroot could have a fair trial, on account of the t 
 prejudices of the people : and on this occafion our au- 
 thor oblerves, that " the phyfician who would obtain a 
 < ready compliance with his dirc6tions, in that country, 
 " muft as feldom as poflible offend the palates of his 
 " patients with naufeous remedies ; for, whatever may 
 " be the confequence, they will often rather choofe to 
 <c incur diftant though great rifks, than avoid them by 
 <c fubmitting to prefent inconveniences.'* Nitrous me- 
 dicines were found ineligible on various accounts : 
 i . They did -not, as in other difeafes, allay heat. 2. The 
 
 ficfc 
 
THE PLAGUE. 351 
 
 fick could not bear them in ordinary dofes without lan- 
 guor and dejection. 3. They were apt to bring on a 
 diarrhoea. The following is an epitome of our author's 
 practice : 
 
 1. Bleeding from ten to twenty ounces as foon as 
 poflible after the feizure. The quantity feldom ex- 
 ceeded fixteen ounces, and even this is greatly above 
 what is taken in any other difeafe in that country. 
 
 2. After bleeding, where the naufea was confiderable, 
 the fiomach was cleanfed with warm water ; or, if that 
 failed, with ipecucuanha or fait of vitriol. It was of 
 fuch importance to have both thefe evacuations per- 
 formed early, that our author inftructed mod of his ac- 
 quaintance how to act if they mould be infected. 
 
 3. A gentle anodyne fucceeded the vomit. If by it 
 the ftomach was not quieted, an ounce of diafcordium, 
 or 15 drops of laudanum, were added to the faline 
 draught of Riverius. 
 
 4. Small dofes of cordial and diaphoretic medicines, 
 with a very fmall quantity of antirnoniated nitre, were 
 exhibited every four hours ; the fick were encouraged 
 to drink freely of a decoction of fcorzonera roots and 
 barley, or fpring water moderately acidulated with fpi- 
 rit of vitriol. A mixture of the acid with fyrup of vio- 
 lets was kept ready to be added to plain water. All the 
 drink was given warm if the patient would be prevailed 
 upon to take it fo- 
 
 5. In the winter the fick were removed into more airy 
 lodgings than thofe in which they ufually flept, and the 
 air of the room was warmed or corrected by a moderate 
 fire. In fummer only the windows oppofite to the pa- 
 tient's bed were ordered to be (hut ; but even this re- 
 ftriction was not univerfally complied with ; many in- 
 fifting upon fetting all the windows open in the day 
 time, and ileeping on the houfe top at night. 
 
 6. In cafe of faintnefs and unealinels, a cordial, com- 
 pofed of fome of the limple diftilled waters, tinctures of 
 iaffron and valerian, alkermes, and fpirit of vitriol, was 
 ufed with advantage and great refrefhment to the fick. 
 This with plenty of acidulated drinks was the chief pre- 
 fcription for infected children, Under 
 
352 A TREATISE ON 
 
 Under the above treatment, a fweat often broke out 
 on the fecond or beginning of the third day ; after which 
 the fick were covered up, and the fweat encouraged as 
 long as they could be perfuaded to bear it. By this firft 
 fweat, efpecially if it happened on the fecond day, the 
 patient was never freed from the fever, though greatly 
 relieved. It was therefore neceffary to continue the 
 iame medicines, in order, by a more plentiful fweat, to 
 procure a perfect crifis. Where the fweat was fuppofed 
 to be fufficiently copious, and had greatly mitigated the 
 fymptoms, a mild cathartic was given in the morning, 
 though fome degree of fever ftill remained ; the other 
 medicines not being intermitted during its operation. 
 An anodyne was given in the evening. 
 
 In cafe of an exacerbation of the fymptoms or the 
 depreflion of the buboes, as fometimes happened on the 
 fecond or third day, it was ufeful to apply a blifter juft 
 below the tumour. A blifter to the head was ufeful in 
 cafes of coma and debility of the tongue. The natives 
 were exceedingly averfe to the ufe of blifters ; but, having 
 obferved that fome who had been judged pad recovery 
 had neverthelefs ftruggled through, apparently from the 
 ufe of blifters, they at'laft came into fome degree of cre- 
 dit. Cataplafms, competed of garlic, bread and vine- 
 gar, were advantageoufly applied to the foles of the feet. 
 Thefe, as well as blifters, were ufeful in cafes of coma , 
 alfo emollient laxative clyfters. The dofe of the alexi- 
 pb armies was increafed, and acidulated drinks, in frnall 
 quantities at a time, given frequently. 
 
 To the buboes it was cuftomary to apply fuppurative 
 cataplafms ; but, as thefe could not, where the patient 
 was defirous of walking, be eafily kept on, a diachylon 
 gum plafter was fubftituted, with the addition of a few 
 cantharides, or a little euphorbium, if a greater ftirnu- 
 Jus was judged neceffary. In moft cafes the buboes were 
 left to open of themfelves ; the natives being afraid of 
 the lancet or cauftic, and fometimes operators being 
 wanting. No bad confequence enfued on their being 
 left to open of themfelves, nor was any particular treat- 
 ment neeefiary. Where they mortified, the treatment 
 
 was 
 
THE PLAGUE. 
 
 was the fame as in carbuncles, and though, after the fe- 
 paration of the gangrened parts, the ulcer often remain- 
 ed wide and deep, yet they healed kindly and in a fhort 
 time. 
 
 Sometimes the carbuncles were fcarified, but oftener 
 not; The beft dreflings were pledgits of yellow bafilicon, 
 with a fmall proportion of oil of turpentine, or fome- 
 times tincture of myrrh> with an emollient cataplafm 
 over all. 
 
 Dr. Patrick RufTel complains that, in Turky, phy- 
 fkians are laid under fuch reftraints, by popular preju- 
 dices, that they are fometimes obliged to remain almoft 
 paflive fpeftators of the difeafe. The natives are fond 
 of bleeding, and will at any time let blood in the hot 
 ftages, when the febrile fymptoms run high. About two 
 thirds of the infected were bled at the arm ; but from 
 the rapid progrefs of the difeafe, and the quick tranfition 
 to the low, languid (late, few were bled more than once, 
 and that ufually within the firfl forty hours. The time 
 of bleeding was ufually the firfl night, or fome time ori 
 the fecondday ; but fometimes not till the third. Where 
 the operation was repeated, it was ufually on the third, 
 fometimes on the fifth* and even on the fixth ; he has 
 even met with inftances wherein the patient was three or 
 four times bled, the laft being as late as the feventh day. 
 In his own practice he ufually advifed one bleeding at 
 the beginning, except in the very young, aged, or infirm; 
 On the firft day, if not forbid by circumftances, bleed- 
 ing was ordered by way of precaution 5 but on the fuc- 
 ceeding days it was regulated by the ftate of the pulfe^ 
 and other fymptoms. Where the infection was flight, 
 and the febrile fymptoms moderate, or did not come on 
 till fome days after the eruptions, it was wholly omitted. 
 The quantity of blood taken away feldom exceeded 
 eight or ten ounces. Cupping was ufed by the natives, 
 but never ordered by Dr. Ruffel. Children were fca- 
 rified in the legs. He feldom had an opportunity of 
 examining the blood drawn from a vein ; but, in fuch 
 cafes as occurred* the general appearance was little dif- 
 ferent from that of healthy blood ; the craflaraenturh 
 
 Zz was 
 
A TREATISE ON 
 
 was fometimes of a darkifh colour, but never fizy or 
 refolved. 
 
 With regard to the propriety or impropriety of bleed- 
 ing, or at leaft the fuccefs attending it, we can bed judge 
 from the hiftories of cafes given by Dr. Ruffel at the 
 end of his work. Of thefe there are an hundred and 
 twenty, with fome fupernumeraries, giving an account of 
 the cafes of the attendants, &c. Of thefe, fixty-five 
 were bled ; forty died, and twenty-five recovered. 
 
 Of thefe hundred and twenty cafes at large, fifty-fe- 
 ven recovered, as many died, and the event of fix was 
 unknown. This would tend to give us fome confidera- 
 ble idea of the Doctor's fuccefs ; but, when we take into 
 account the time of the year in which thefe cafes were 
 treated, the matter will appear in a quite different light. 
 Twenty-feven took place moftly in the earlier part of the 
 feafon, and were of confequence more violent than the 
 others ; and, of thefe, twenty-one died, five recovered, 
 and the event of the other cafe was uncertain. Of the 
 reft only thirty-fix died, and fifty-four recovered. Such 
 an excefiive difproportion cannot be afcribed to the me- 
 dical treatment, but to the nature of the difeafe itfelf, 
 growing milder as it extended wider. In many of thefe 
 cafes it is not mentioned whether the patients took any 
 medicines or not ; neverthelefs, as it muft always be fup- 
 pofed that a phyfician would prefcribefomething for his 
 patient, it muft alfo befuppofed that all took medicines, 
 excepting where we are exprefsly told that they did not. 
 The cafes in which he mentions the medicines employed 
 were the following : 
 
 i. A young man of 2O,fuddenly felzed, was bled large- 
 ly^ had a vomit of ipecacuanha, which brought off a 
 quantity of bile, but without putting a ftop to the natu- 
 ral retchings. Some diaphoretic medicines were given,, 
 which did not remain on hisftomach, and he did not 
 fweat. Thefe were flopped by a draught of juice of 
 lemons and alkaline fait taken in the act of effervefcence. 
 Sinapifms were applied to the feet, and he died the third 
 jiight at midnight. 
 
 2, A 
 
THE PLAGUE. 355 
 
 *, A widow lady about 40, of a thin, delicate habit, 
 in whom the difeafe came on gradually, was bled on the 
 third day, and took diaphoretic medicines and acidula- 
 ted cordials till the 9th. She died on the i ith. 
 
 3. A Jewifli rabbi, between 30 and 40, of a thin, 
 fpare habit, was bled on the zd day, and died early on 
 the morning of the 4th. 
 
 4. A Jewifli boy, between feven and eight years old, 
 of a pale, unhealthy complexion, was repeatedly purged, 
 and had fuppurative cataplafms applied to the buboes 
 without efTed. He recovered flowly. Dr. Ruffel was 
 not called till the feventh day of the difeafe, and we are 
 not informed when the purgatives were adminiftered. 
 
 5. A Jewifli lad of 14, healthy and florid, was vifited 
 on the third day. He had already been fcarified in the 
 legs, and bleeding was ordered ; but, as he became faint, 
 only a fmall tea-cupful could be taken away. The 
 blood, after two hours, was found to have a foft and 
 loofe texture, fomewhat blackifli on the furface ; but 
 the quantity of ferum was not greater than ufual. It 
 had appeared of a blackifli colour at firft. He had a 
 vomit, draughts with fpiritus mindereri ; afterwards a 
 diaphoretic mixture and acidulated cordial, and fina- 
 pifmsto the feet. On the feventh day he fweated copi- 
 oufly, and was much relieved, but foon relapfed. On 
 the roth he fweated early in the morning, and had a 
 temporary relief, but foon became worfe than ever. On 
 the eleventh he had three ftools of black blood. One 
 of thefe, kept for the Doctor's infpection, confided of 
 about three tea-cupfu]s, without any factor ; the others 
 were " inconfiderably fmall." Some tin&ure of bark 
 was now added to his ufual mixture. On the 1 5th he 
 had a purging potion which operated five times, had an 
 opiate at night, and tincture of bark with elixir of vitriol 
 was ordered twice a day. Next day he was quite free of 
 fever, and quickly recovered. 
 
 6. A Jew of a thin, fpare habit, who took no me- 
 dicines, died on the fixth day. His wife, of a delicate 
 frame, and fix months gone with child, was bled in the 
 arm, had " proper drinks" directed for her, brought 
 
 forth 
 
356 A TREATISE ON 
 
 forth a child in the agonies of death, and expired on the 
 lixth day. They were extremely poor, and Dr. Ruffel 
 fays of the houfe they inhabited, that it "was one of 
 thofe miferable dwellings which he had always confider- 
 ed as one of the receptacles of contagion." It did not, 
 however, appear to be fo ; for, though there were other 
 fix in the family, only one of them was infected, who 
 died in ten days. 
 
 7. A youth of a delicate conftitution, a French na- 
 tive of Aleppo, was vifited on the morning of the third 
 day. He had a carbuncle on his neck, which had been 
 miftaken for an ordinary inflammation, and a phyfician 
 who had previoufly vifited him applied a galbanum 
 plafter, ordering alto fome nitrous medicines ; but the 
 plafter giving much pain, it was changed for a common 
 poultice. Live pigeons were applied to the feet. On 
 the fourth he had a diaphoretic medicine, and his drinks 
 were acidulated with fpirit of vitriol. The fymptoms 
 increafing, finapifms were applied to the feet, but with- 
 out effeclb. Cataplafms of garlic were applied next 
 night ; he had two copious black ftools, not very foetid, 
 and two bilious ones in the morning of the fixth. By 
 thefe ftools he was greatly weakened, and was ordered a 
 cordial with diafcordium. He had another ftool, and 
 became much worfe. Cataplafms were applied without 
 fTed, and he died on the feventh day. This patient 
 had a great number of eruptions ; but, though fix peo- 
 ple attended him conftantly, none of them were in- 
 feted. 
 
 $. A Jewifh girl of nine years old, of a delicate frame, 
 and fprightly difpofition, was vifited on the 4th day. 
 The ufual regimen and medicines were ordered, but fhe 
 could not be prevailed on to take any thing befides an 
 acidulated cordial. Palm-oil was externally applied to 
 a carbuncle near the corner of the mouth, about an inch 
 long, and the third of an inch broad. This leemed to 
 eafe the pain, but did not prevent it from fpreading. 
 The face was alfo ftrangely disfigured by three or four 
 ftreaks of a pale red colour, mooting up on each fide 
 from the cheeks towards the temples. The gangrene 
 
 fpreacj 
 
THE PLAGUE, 357 
 
 fpread rapidly, and ihe died on the evening of the tenth 
 <lay. 
 
 9. A ftout, healthy Armenian youth, about 20, was 
 vifited on the firft day, and took a vomit of ipecacuanha, 
 which brought up a good deal of bile. An anodyne was 
 given at night, but without effect. He took no medi- 
 cines afterwards but an acidulated cordial. On the 
 third he eat a quantity of cherries, and drank fome iced 
 water. He died on the fourth. Here the infection 
 fpread violently, only one out of fix in the fame houfe 
 efcaping the difeafe. Three died. 
 
 10. An Armenian woman in the feventh month of 
 her pregnancy. She was bled the firft day, had after- 
 wards diaphoretic bolufes, but did not fweat. On the 
 third day me was delivered of a dead child, and feemed 
 much better, but died at night. After death the body 
 was entirely covered with purple marks. 
 
 1 1. A boy was bled and had an alexipharmic mixture 
 the firft day. A diarrhoea came on, and diafcordiutn 
 was added to the mixture without fuccefs. He died 
 the third night. The infection was violent, only one 
 in the houfe efcaping. 
 
 12. A Jew of middle age and grofs habit of body 
 was bled on the fecond day. He was vifited on the 
 fifth, had diaphoretic powders, and finapifms were or- 
 dered without fuccefs. He died on the 6th. 
 
 13. A Chriftian youth of 17, taken fuddenly, was vi- 
 fited on the fecond day. A cataplafm was applied to the 
 groin ; he had a vomit of ipecacuan, and a diaphoretic 
 draught with nitre and diafcordium at night, but did 
 not fweat. Next day he had acidulated drinks, a mix- 
 ture with fweet fpirit of nitre, and a fmall proportion of 
 nitre itfelf. On the fourth, he had two ftools, of a 
 reddifli colour like blood, after which he became 
 much worfe. In the night he had two other ftools, 
 which feemed to lower him. Throughout the day a 
 larger portion of nitre had been added to his mixture, 
 and three tea-cupfuls of blood were taken away, with- 
 out the Doctor's knowledge, by cupping. On the fifth 
 the nitre was omitted i he was ordered an aftringent cor- 
 dial, 
 
358 A TREATISE ON 
 
 dial, but it was not given ; however, the diaphoretic 
 medicines were continued, and he had three loofe {tools* 
 which funk him greatly. Next day he feemed paft re- 
 covery ; lying motionlefs, infenfible, his breathing quick, 
 laborious and interrupted ; the ikm not cold, but the 
 feverifh heat gone, and his countenance ghaftly. From 
 this lethargic ftate the women attempted frequently to 
 roufe him, by applying vinegar to his noftrilSj calling 
 him loudly by his name, and fuch like means, by which 
 they fometimes fucceeded ; but, though he opened his 
 eyes, and gave figns of fenfe, he could not be prevailed 
 on to drink ; and he remained filent. He would then, 
 for fome time, writhe his body as in mortal agony, and 
 again relapfe into lethargy. This dreadful paroxyfm, 
 however, began to wear off about noon ; and at night 
 he was lefs difturbed than ufual. On the feventh day 
 he was manifeftly better ; he had a loofenefs, with gripes, 
 for which the white decoction was ordered ; and he had 
 tincture of bark thrice in twenty-four hours. On the 
 iixteenth day the fever was entirely gone. The Doctor 
 obferves that this patient fweated much lefs than was 
 ufual with thofe who recovered. 
 
 14. A Chriflian boy about 17 was vifited on the 
 4th day, having taken forne abforbent powders on the 
 2d from another phyfician. The family would allow 
 no other medicines to be given, except a few grains of 
 bezoar, and he died next day. 
 
 15. An Italian, a man about 40, of a grofs habit of 
 body, and addicted to drinking, but who, finding him- 
 felf fomewhat indifpofed, had for two or. three days lived 
 temperately, was vifited on the fecond day of his illnefs, 
 had a diaphoretic mixture, and a laxative medicine, 
 without relief. In the night between the 5th and 6th 
 he had fome retchings to vomit. Next day he com- 
 plained of a pain at the pit of the ftomach, had a vomit 
 of ipecacuanha, which brought off a conliderable quan- 
 tity of bile by vomit and ftool, but without any appa- 
 rent relief. He had two foetid flools, and was ordered 
 a cordial with volatiles. On the yth his pulfe was ex- 
 ceedingly funk;, and his extremities had been as cold as ice 
 
 but 
 
THE PLAGUE. 359 
 
 but with very little alteration in the eyes or countenance 
 The patient did not know that thefe parts had loft their 
 heat; and, notwithftanding this change, the fenfation 
 (till remained in them. He died on the afternoon of 
 the 8th day. This patient had no eruptions. 
 
 1 6. A Chriftian merchant about 50, of an atrabilious 
 habit, and fubjedt to the haemorrhoids, on being taken 
 ill drank immoderately of cold water. He was viftted 
 next day. In the afternoon about ten ounces of blood 
 were taken away, and, as his pulfe rofe after the opera- 
 tion, he loft, by Dr. Ruflel's order, fix ounces more. 
 Three ounces were afterwards taken away by cupping, 
 and about as much more was accidentally loft by the 
 loofening of the bandage of the arm ; fo that about 24 
 ounces were taken away in all. Next day he got a few 
 drops of Carmelite water, a kind of fpiritous cordial, 
 which he vomited, had a blifter and fmapifms applied, 
 and died between 10 and 11 at night. He had no 
 eruptions. 
 
 17. An Armenian youth was vifited on the morning 
 of the third day, was bled, and had a faline draught 
 every four or five hours. On the fifth he was removed 
 into a more airy chamber, and had Huxham's tindure 
 of the bark. He died on the ninth day. 
 
 1 8. A young lady of French extraction, of a thin, 
 {lender make, was vifited on the morning of the fecond 
 day. On the third fhe had diaphoretic powders, and 
 loft a few ounces of blood by cupping, without the 
 Doctor's knowledge ; fhe had a diaphoretic mixture, 
 and died on the fixth day. 
 
 From thefe accounts it is eafy to fee, that, in violent 
 cafes of the plague, medicine can do little or nothing. 
 Such cafes generally occur in the earlier months of the 
 feafon, though they may take place, and do take place 
 in great numbers, at any time. In the beginning of 
 the feafon the patients are almoft all attacked in this 
 violent manner, and very feldom recover, whether they 
 take medicines or not. It being then an eftablifhed 
 fad:, that as the epidemic feafon advances the difeafe 
 grows, milder, and many more continue to recover of 
 
 themfelves 
 
360 A TREATISE ON 
 
 themfelves than did fo at firft, we are naturally led to 
 fuppofe that a multitude of thofe who recovered after 
 taking the medicines would have done the fame without 
 them. Little therefore needs be faid of the immenfe 
 number of prefcriptions found in authors who have 
 written upon the plague, as it may generally be fuppo- 
 fed that at certain times thefe would have been ineffec- 
 tual, and at others they were ufelefs. The following is 
 an epitome of Dr. Patrick Ruffel's practice : 
 
 1. Bleeding as early as poflible, feldom repeated, 
 except where manifeftly indicated by circurnftances. 
 
 2. Vomiting, if fpontaneous, was encouraged by warm 
 water. If the patient was affected by naufea, vomiting 
 was provoked by warm water or camomile tea, aflifted 
 by a feather. If a bitter tafte in the mouth was com- 
 plained of, ten or fifteen grains of ipecacuanha were 
 given. The times of remiflion were laid hold of for 
 thofe remedies. 
 
 3. Where fpontaneous vomiting continued too long, 
 a faline mixture was given, fometimes with opiates and 
 external applications. 
 
 4. The ftomach being fettled, mild fudorifics were 
 given in fmall dofes, every five or fix hours. In the 
 beginning, nitre was joined with contrayerva, but where 
 it occafioned loofe (tools, was left off. Spiritus .minde- 
 reri and faline mixture were alfo given as fudorifics. 
 
 5. In cafe of diarrhoea, dilution was firft prefcribed 
 and then the white decoction. Laxative medicines 
 were feldom admitted by the friends of the patient, 
 Diafcordium and opiates were ufed in- cafes of obftinate 
 diarrhoea. 
 
 6. In the advance of the diftemper it was found more 
 eligible to give the fudorifics at fhorter intervals, when 
 occafion required, than to augment the dofe, which was 
 apt to occafion difguft, and a rejection of medicine entire- 
 ly ; confequences which alfo attended an attempt to 
 heighten the power of the medicines themfelves. The 
 general defign was to make their operation coincide with 
 the periodical determination to the fkin naturally occur 
 ring in the difeafe. 
 
 7. The 
 
THE PLAGUE. 361 
 
 7. The fudorifics exhibited hav ; ng but fmall power 
 by themfelves, it was found neceffary to affift them by 
 dilution, as well as in every other method which could 
 be attempted. If the patient was not naturally inclined 
 to drink, he was encouraged to it by offering agreeable 
 liquids, either hot or cold at the perfon's option. 
 
 8. The diet was the fame as in other acute diftempers. 
 No animal food ftronger than chicken broth was allowed * 
 the reft confifted of farinacea and leguminous vegetables. 
 " It was certainly neceffary (fays our author) to a cer- 
 " tain degree, to fupport nature by proper food ; but to 
 " force it upon a naufeating ftomach feems to have been 
 " irrationally recommended ; and a where attempted^ 
 " which the over care of the nurfes frequently did, ufual- 
 " ly excited vomiting. I fornetimes wifhed to give 
 " wine, but a religious bar lay in the way of Mahomme- 
 " dans, and a prejudice againft it, in all fevers^ rendered 
 " it equally inadmiffible among the Chriftians and Jews." 
 
 9. For oppreffion at the prsecordia, mild cordials, aci- 
 dulated drinks and cool airwere found ufeful. Through- 
 out the difeafe accefs of cool air to the chamber was 
 conftantly allowed, and, where the chamber itfelf was not 
 fufficiently airyj the bed was removed to the houfe top. 
 Towards the height of the exacerbations^ however, when 
 there happened to be the leaft appearance of moifture on 
 the ikin, the fick were kept moderately covered up from 
 the chin downward. 
 
 10. After the height, and through the decline of the 
 difeafe, the bark in fubftance, or Huxham's tincture* 
 were given inftead of the ordinary fudorifics; 
 
 In the plague which took place in the Ruffian army, 
 the greatetl confidence feemBto have been put in vomits. 
 The difeafe commonly began with a dull pain in the 
 head, refembiing that produced by the fumes of char- 
 coal, accompanied with fhivering, univerfal weaknefs, 
 Sec.* On the firft appearance of thefe a vomit was gi- 
 ven, working it off with acid drinks, " If the naufea 
 " and bitter tafte in the mouth was not removed by 
 
 " the 
 
 * Duncan's Med, Comment, vol. viii, p, 
 
 Aaa 
 
*' 
 
 362 A TREATISE ON 
 
 " the firft, they gave a fecond, and fometimes a third or 
 4C fourth ; nay, they fometimes, if the fymptoms were 
 *' very urgent, gave two or three in the fpace of twelve 
 <c hours, as there is no time to be loft in this difeafe $ foe 
 fc they did not find this fpecies of evacuation fubject to 
 the fame inconvenience with purges, which a man in 
 the plague is unable to fupport ; nay, they are even 
 dangerous, though he bears brifk vomits, and a repe- 
 tition of them, when the nature of the cafe requires it. 
 " The ftomach being thus cleanfed, they gave every 
 " morning a powder compofed of twenty grains of rhu- 
 ;c barb, mixed with as much flower of brimftone, and 
 " three grains of ipecacuanha, exhibiting alfo, every 
 " hour, five grains of pure nitre mixed with two grains 
 " of camphor j and, if coftive, a laxative clyfter was 
 * c given every evening, compofed of decoction of camo- 
 ic mile, wine vinegar, with or without foap, according 
 " to circumftances. 
 
 " The head, temples and buboes were frequently 
 " wafhed with warm vinegar, and the laft urged to fup- 
 " puration with emollient cataplafms ; but, in cafe they 
 *' were found to baffle all attempts to bring them for- 
 " ward, they were then fcarified or extirpated, and the 
 ** patient ordered to drink plentifully of lime-tvatcr. 
 " Bark was given after- evacuation, joined to the flower 
 *' of brimftone in the proportion of one ounce of the 
 " former to a drachm of the latter, divided into fixteen 
 " powders, and taken in twenty-four hours. When de~ 
 * c lirium came on, blifters were applied to the legs and 
 " arms, and camphor given largely. Vegetable and 
 ** mineral acids were given indifcriminately ; but they 
 " found the vegetable kind fometimes remain on the 
 * ftomach when the other was thrown up ^ and of the 
 "'latter they preferred the vitriolic. Acidulated drinks 
 " were given in quantity through the whole difeafe, and 
 " the food confided of acidulated water-gruel, and fruit 
 " when they could procure any. The air of the room 
 44 was kept charged with acetous vapours, as much as 
 w poffi-ble, and it was remarked, that, while the bitter 
 " tafte remained, there was little hope of the difeafe 
 <c abating. According 
 
THE PLAGUE. 363 
 
 According to Baron Am, " the plague does not de- 
 " pend upon any conftitution of the air, but is com- 
 " municated only by contact, and they had repeatedly 
 " fucceeded in fupprefling it in different divifions of the 
 14 army, by the immediate feparation of the infcded 
 ** with their attendants, and burning -every thing be- 
 " longing to them, or that they had touched. They 
 " found the greateft advantage in keeping the foldiers 
 " ignorant of its exiftence till fuppreffdd ; for by this 
 " means they preierved their peace of mind, and health 
 " of body -, and they found an exact military difcipline 
 " the beft prefervative againft the difeafe. For the cure 
 " of thofe infected they found the cold regimen, a free 
 e< circulation of aii\, vegetable and mineral acids, ipeca- 
 " cuanha, rhubarb and bark, to be the propereft reme- 
 w dies. That, to purify the air in hofpitals appropriated 
 " for their reception* gun-powder was found mod effi- 
 " cacious, probably from the commotion given to the 
 *' air in explofion, over and'above its action in common. 
 " with other fumes. To refift infection, courage and 
 *' fortitude of mind is neceifary, as confirmation and 
 " terror feem to prepare the body for the reception of" 
 " the difeafe/* 
 
 Dr. Sydenham feemed to have as great an opinion of 
 bleeding, -as the Ruffian phyficians of vomits. Con- 
 fidering the plague as merely inflammatory, he lays the 
 whole Itrength of the cure upon bleeding, which he 
 greatly prefers to any other remedy. The quantities he 
 took away were very confiderable j and he gives an 
 inftance of a patient who died from not having enough 
 taken away. He alfo informs us, that, during the civil 
 wars in England, the plague raged in fcveral places. 
 Being accidentally brought to Dunftar cattle in Somer- 
 fetftiire, a furgeon, who had travelled much in foreigru 
 parts, applied for leave to give the garrifon what affif- 
 tance he could. This being granted, he bled them, 
 every man as he flood, without diftinction, till ready to 
 drop down ; the blood was fuffered to flow down upon 
 the ground, fo that no account could be taken of the 
 , They were then ordered to lie in their tents $ 
 
 and, 
 
364 A TREATISE ON 
 
 and, though no kind of remedy was given after bleeding, 
 every one recovered.* Notwithftanding his opinion of 
 bleeding, however, this celebrated phyfician was obliged 
 to attempt the cure by fweating, which he fays he pre- 
 ferred to bleeding on account of its not weakening the 
 patient fo much, nor hazarding the reputation of the 
 phyfician ; yet he fays it is prejudicial in young people 
 where the powers of life are ftrong. His improved 
 method therefore was, firft to bleed moderately, if no 
 fwelling had appeared, by which means a fweat would 
 be more fafely and eafily raifed. The bleeding is to be 
 performed in bed, after which the patient mud be 
 covered up with the bed-clothes, and a piece of flanel 
 applied to the forehead. This laft expedient, he fays, 
 contributes more to the raifing of a fweat than one 
 would imagine. If no vomiting enfued, he adminif- 
 tered fudorific medicines internally. But, if the fto~ 
 mach cannot retain any thing, he propofes to begin the 
 fweating merely by the weight of the clothes, and now 
 and then throwing part of the fheet over the face. The 
 fweat being thus begun, the vomiting, however violent, 
 generally ftops, and the medicines will be retained, fo 
 that as plentiful a perfpiration as we can defire may be 
 excited. An inftance of his fuccefs in this way he gives 
 in an apothecary who applied to him in behalf of his 
 brother. A fweat being propofed, the apothecary told 
 him that he had given him feveral ftrong fudorifics, all 
 of which had been thrown up ; but the Doctor, having 
 firft fweated him moderately by the bed-clothes, after- 
 wards gave him a large dofe of Venice treacle ; which 
 operating powerfully, he recovered from the difeafe* 
 He advifes the fweat to be kept up without inrermiffion 
 for twenty-four hours ; a fmaller time being inefficient 
 
 to 
 
 * Dr. Power whowrotCt in 17321 the Ancient Phyjlclan's Legacy* had lodged 
 his foldiers in a church in which thofe who died ot a plague had been buried. 
 An hundred and eighty of the foldiers were leized either with petechizc or 
 buboes. He ordered them all to be bled in fuch quick fucccffion, that the arm 
 of the firft was not bound up till the blood flowed from the laft. Thus every- 
 one loft about an hundred ounces (upwards of three quarts.) He then orderecj 
 them water acidulated with fpirit of vitriol for their drink; and by this 
 treatment all recovered excepting eightt wl>o would not refrain from fpiritous 
 liquors. I'his was tranfaded in Peru": but in feurope the plague will fcarce 
 pear bleeding to a few ounces. (Sauvages.) 
 
THE PLAGUE. 365 
 
 to remove the difeafe, and a ftoppage of the perfpiration 
 certainly attended with a return of the bad fymptoms. 
 On this occafion he cenfures Diemerbroeck and others 
 for advifing to flop the fweat on every flight occafion. 
 The linen is to be allowed to dry on the patient's body, 
 he muft take all his liquids warm, and continue the ufe 
 of a diluting fluid. Sage poflet drink is what he recom- 
 mends. Next morning the cure was finiflied by a 
 purge of fenna, tamarinds, &c. Where a fwelling ap- 
 pears, he diredls to forbear bleeding even in fuch as are 
 not apt to fweat, leaft the patient fliould die fuddenly 
 from a return of the morbific matter into the vefTels. 
 Bleeding, however, might be ufed with fafety even in 
 this cafe, provided a fweat was inftantly to be raifed ; 
 and thus he thinks the fwelling might be difperfed per- 
 haps with more fafety than by waiting for its fuppura- 
 tion. 
 
 This may be accounted an epitome of the mod ap- 
 proved modern pra&ice in peftilential cafes. The Ruf- 
 fian phyficians above quoted feem to fpeak with moft 
 confidence of their fuccefs. They, however, " lay great 
 " ftrefs upon diftinguilliing the plague from the worft 
 <5 kind of malignant fever in hot countries ; and it is 
 " not without reafon, as bad confequences have attended 
 " the confounding of them on the breaking out of the 
 " plague. I am credibly informed that the great havock 
 " made in Mofcow was principally owing to this cir- 
 " cumftance ; for it obtained fome time before it was 
 ' difcovered by gentlemen unacquainted with the dif- 
 " eafe, and before they would acknowledge its exiftence, 
 " although fomc veteran army practitioners recognifed 
 " its appearance under one of its forms, and endea- 
 " voured to alarm their brethren, but in vain, for a 
 time."* 
 
 From this it is natural to conclude, that, when the 
 difeafe was once fairly difcovered and attacked by the 
 powers of medicine, it could not make much refiftance ; 
 yet Dr. Mertens, fpeak ing of this very plague, fays, that 
 to the rapidity of the diftemper, and many in^ 
 
 ducements 
 
 * Duncan's Med- Comment, vol. viii, p. 359. 
 
3 66 A TREATISE ON 
 
 ducements to conceal it, little can be faid cf remedies 1$ 
 the plague. He divides the diftemper into two kinds, 
 the nervous and putrid ; the former " comprehending 
 ** merely that degree of confufion and difturbance given 
 ** to the nervous fyftem on the firft introduction of the 
 * c miafma, and the latter commencing at .the time the 
 * c miafma begins to operate upon the blood and other 
 " fluids by aflirnilating them to their own putrid na* 
 u ture." In the nervous ftate the miafma has fome? 
 times been carried off by fweat, gentle diaphoretics, 
 camphorated emulfions, juleps of camphor and muik. 
 Gentje emetics, particularly ipecacuanha, were found 
 ttfeful ; but James's powder (which was imported from 
 England in great quantity) did not anfwer any good 
 purpofe. In the putrid ftate, the bark and rninera} 
 acids were ufeful 5 purgatives were hurtful, blood-let- 
 ting inadvifable, and fcarifying the carbuncles, rccom* 
 mended by almoft every writer, attended with no good 
 
 Few of the modern travellers who have vifited the 
 countries in which the plague is frequent, being verfed 
 in medicine, have faid much about the cure of it. Ma<? 
 yiti only fays, that, in the iiland of Cyprus, infected pa* 
 tients were allowed no other diet than pure water, panada, 
 yice, tea, &c. Some thought to ward off the difeafe by 
 drinking ftrong liquors, but thefe almoft always fell victims 
 to it. Whatever their methods were, indeed, they muft 
 certainly have been very ineffectual, fince the fame author 
 informs us that, in the plague of 1759, in many parts 
 of that iiland there were not a fufHciency of inhabitants 
 left to cultivate the ground. 
 
 Diermerbroeck, whofe name juftly ranks high among 
 thofe who have written on the plague, trufh moftly to 
 fudorific medicines. Bleeding, 'according to him, is 
 abfolutely to be avoided, as well as purging and vomit- 
 ing. He directed firft that the chambers of the iick 
 {hould be kept clean, and the air purified three or four 
 times a day by fumigations, and that the fick fhould 
 take (in the beginning, the firft, fecond, or third day) 
 draught + and being well covered with blankets 
 
 plentiful 
 
THE PLAGUE. 367 
 
 plentiful fweats were promoted for two or three hours or 
 more (always having a regard to the patient's ftrength.) 
 If the patient did not fweat ealily, bags filled with hot, 
 dry fand were applied to the feet, armpits and groin. 
 If the fide were not eafed by the firft fweat, it was 
 repeated in a few hours ; but if, after the fecond 
 fweat, the fever and other fymptorns ftill increafed, it 
 was the word fign. After ten or twelve hours, and 
 on the following days, they were repeated four or five 
 times as occafion required. Ekfides this he directed apo- 
 zems, antidotes, Spc. which, as it is mod probable they 
 had no effect in removing the difeafe, it is neediefs to 
 trouble the reader with.* That 
 
 * As it might by forae be deemed an afFroat offered to the wifdom of an* 
 tiquity, mould we pafs over in filence the opinions of the more ancient phyr 
 Cdans, I (hall in this note give a fhort account of fome of their moft remarka- 
 ble modes of pjra&icc, as they are recorded in Burnet's Tb'faurus. 
 
 i. Foreftus, in many refps a refpe&able author, recommends an antidote 
 composed of equal parts of rue, figs and almonds, beat into a pulp in a Hone 
 mortar with a wooden peftie till united (which is not very eafily done) into an 
 uniform mat's, adding as much fyrup of citrons with vinegar as would render 
 it loft, with a little powdered fait put in iaft- The efficacy of this he tells us 
 he experienced in faimfelf as well as all his family as a preventive ; himfelf 
 taking in the morning the bigaefs of a fmall nutmeg of this, made up into A 
 eonfe&iort with the ancient theriac, mithridate, Armenian bold terrafigll- 
 lata, &c. 
 
 In his regular practice (for the abov muft be accounted quackery) he advifes 
 bleeding within the firft twelve, or at molt twenty-four, hours ; fuch as were 
 bled afterwards he fays died. If performed in feven or eight hours after the 
 commencement of the difeafe the cure went on the better. Where bleeding 
 was inadvifable he<ifed cupping with fcarifications, finifhing the cure with 
 fweating and cordials. He remarks that where black tumours or efchars, len- 
 til mapedi appeared, the difeafe always proved mortal without a fingle eijt- 
 ception. Theie were fmall. like a grain of black pepper and therefore called 
 by the vulgar ptppercwrn ; undoubtedly the tokens of Dr. Hodges. 
 
 4 Hildanus, allb a refpec^able writer has an high opinion of iffues as a 
 preventive. He fays he never knew but one or two (and thole of a very bad 
 habit of body) who had iilues in their legs and aims that periihed in the 
 plague, and fays that he has known its efficacy as a preventive not only in 
 himfelf but many others. He fays he kept two ifiues in his own body, one 
 in the left arm, the other in the right leg. (See above p. 33.9-) To the fame 
 purpofe Mercurialis relates that he never knew but one, and he was a prieftt 
 who died of the plague having an ilfue He fays allb that he had inquired 
 of many other phylicians, who all gave a limilar teflimony According to 
 him, in the plague at Laufanne, all who were attacked by vomiting or loofe- 
 nefs, and almoft all who were bled, fell viciims to the difeafe. 
 
 As preventives he advifes amulets made up of arfenic powder of toatft, and 
 other things. Tiicfe are to be hanged round the neck in times of plague, and 
 are undoubtedly of great virtue (maximum ad prafervatUntm -vim bttberf^ non 
 fft quod dut>i tct !} This remedy he fays he had from his preceptor Gcfmas 
 Slotanutt a very celebrated iurgeon. 
 
 Brine of pork is another preventive, which he never tried himfelf, but aflcs 
 Sennertus about it. Jt was recommended to Hildanus by a lawyer of his 
 acquaintance The brine is firft to be boiled in a kettle* and well fcimmed, 
 
 till 
 
A TREATISE ON 
 
 That a free perfpiration is the natural cure of the 
 plague, feems to be allowed by almoft all writers of credit. 
 Dr. Ruflel fays, " Of all excretions, that by the ikin 
 *' would feem to be the moil materially important in' 
 " the plague. Where the fkin remains perpetually dry, 
 *' or where fhort and precipitate fweats are attended 
 " with no favourable alteration, danger is always to be 
 " apprehended. On the other hand, fweats, at certain 
 
 " period* 
 
 till it becomes clear, poured into earthen vefiels, and kept fhut up from the air 
 for a twelvemonth ; after which it was fit for ufe. A draught of this was 
 given to people infeded with plague, and operated by fweat, ttool or vomitt 
 or perhaps both by vomit and Itool. The patient was to abftain from drink 
 for fosne hours after. The brine of anchovies is recommended by Sam. For- 
 inius, as ufeful in the plague at Montpelierin 1630. 
 
 3. The fame author (Formius) tells us of a mafi and his wife and wife's 
 iifter, in Montpelier, who, being taken with the plague, fwalloWed a foludort 
 of their own excrements in urine, jlrained through linen elth, and thus got 
 clear of the diftemper. It produced exceffive vomiting and purging. Dr. 
 "Ruffel mentions one of his patients, who, he fufpeded, had got a dole of be- 
 zoar in urine. 
 
 4. Johannes Helmontius fays, that to his certain knowledge (me confcio) 
 llibtrnus Butlerus cured fome thoufands of the plague, at London ; though 
 unhappily our author got only part of the fecret, and which is to the following 
 purpofe. " Reordered me to fufpend by the legs before the fire, a large toad 
 o* taken in the afternoon in the month of June 9 putting below him a cake of 
 
 yellow wax. At lengtk, after three days fufpenfion, the toad vomited 
 
 earth, and fome walking Infffts (iniedis ambulantes) viz. files with fhining 
 wings of a greenilh colour, as if gilt : the toad died immediately after this 
 evacuation, nor did it take placet notwithflanding his fufpenfion till the 
 * third day. He (Butlerus) then told me that I had medicine enough for cur- 
 ** in %f ert y iboufand people infeded with the plague, and promifed to (how me 
 * the rnyftery of the matter (rei cardinem) but oeiag iuddenly fent into ba- 
 nifhment he departed." The beft part of the lerret being thus loft, it is 
 needlefs to trouble the reader with any further account of experiments made 
 \vith other toads roafted alive, powdered and made up into troches, &c. pre- 
 fuming that thefe could not equal the value of the original receipt. I proceed 
 therefore, 
 
 5. To the antidote of the celebrated Avenzoar, who drove avvay the plague 
 by thefmeJl of the urine of an be goat ; and MereuriaJis fays that in th'ehouie 
 ot a moft reverend canon in Hungary, he faw a large he goat kept for this 
 purpofe. 
 
 6. From fuch horribly difgufting remedies we certainly turn with pleafur* 
 to the elegant tablets prepared fo: tne Emperor Maximilian II. Thefe were 
 compoied of Armenian bole? prepared pearl, prepared coral, prepared emeralds, 
 prepared jacind, gold-leaves (ingredients in a medical view equally efficaciout 
 with chalk or oyfter Ihells) along with a little ambergreafe and fome other in- 
 gredients of little value, as medicines, and made into tab-lets with conferve of 
 
 roles. It is needlefs to fpend time in commenting on fuch ridiculous 
 
 remedies; fuffice it to fay, that the intention of all rational pradtice both 
 ancient and modern has been to effed a cure by fweating. From the inftance 
 related by Sydenham, as well as that of Dr. Power above mentioned, it feemsy 
 that if theexad time in which the dileafe begins could be known, it might b<5 
 carried off by profufe blood-letting ; but as this for the melt part cannot be 
 difcovered, it is certainly better to wait, even though the event ftiould net 
 prove favourable, than to run the rifle of killing the patient iiiftantly by aa 
 ignorant etfoit to fave him. 
 
PLAGUJE, 369 
 
 f * periods of the difeafe, appeared clearly critical in a 
 " greater or lefs degree. They were followed by a 
 ** manifeft alteration for the better, and by their repeti- 
 * $ tion the fever was- carried entirely off, or reduced to 
 " fymptomatic exacerbations, feemingly dependent on 
 " the eruptions." He adds, that he never obferved 
 blood exude through the pores, nor did he obferve the 
 fweat to be remarkably offenfive ; or in any degree fo 
 remarkable as in fome eruptive fevers, particularly in the 
 fmall-pox before eruption, Dr. Hodges, however, fays 
 that in the plague of London fweats were fometimes ex- 
 tremely acrid and foetid ; and that they were met with 
 of various colours, fuch as purple, green, black, or blood- 
 coloured. 'Sometimes it was cold, though the patient 
 Was tormented with intolerable inward heat and drought ; 
 and would continue even after death ; but he was of 
 opinion that fweat is the natural crifis of the dif- 
 temper. 
 
 Befides thofe fymptoms of the plague which have been 
 enumerated, there are others, particularly haemorrhages 
 and convulfions, with which it is fometimes attended. 
 Thefe it has in common with the yellow -fever, and 
 tnerefore are confidered in the fecond part of the work* 
 I now conclude this part with a fhort retrofpect of the 
 principal fads which to me feem to be the refult of the 
 inveftigation. i. That the plague is of an unknown 
 (I believe it of divine) original. 2. That in the coun- 
 tries on which it firft was fent, it ftill remains, and from 
 them has always been propagated to others, without a fin- 
 gle well attefted inftance to the contrary. 3. That the 
 means by which the diftemper ufually has been propagated 
 are war and commerce. 4. That the difeafe differs from all 
 others in having a more violent tendency to inflamma- 
 tion, infomuch that it approaches to adtual accenfion ; 
 nay, that the extraordinary inftances of fpontaneous 
 burning we read of are to be accounted only the 
 higheft degree of this difeafe. 5. That the immediate 
 or proximate caufe of the plague is a tendency in the 
 blood and other fluids to difcharge upon certain parts 
 the latent heat they contain, in fuch quantity as to de- 
 
 B b b ftroy 
 
370 A TREATISE ON 
 
 ftroy thefe parts entirely, and to convert them into s 
 kind of coaly fubftance. 6. That this tendency de- 
 pends on a certain inexplicable aftion of the external 
 atrnofphere, particularly of the elementary fire contained 
 in it,, and of which it principally confifts.* 7. The ap- 
 proach of a plague cannot be foretold, either from the 
 eonftitution of the atmofphere, earthquakes, ftorms, or 
 any other natural phenomena. 8. The plague is an 
 eruptive difeafe, and it is known to be fo by the certain 
 death of all in whom eruptions do not appear ; a tenden- 
 cy to eruption being always obferved where life remained 
 long enough. 9. The contagion of the plague diffufes 
 itfelf from a fmall fpace all around, leffening in violence 
 the farther it is diffufed. In its moft concentrated (late it 
 hath proved invincible by medicine ; in its mild ftate it 
 requires none ;-f fo that in the plague the medical powers 
 are found of lets avail than in any other acute diftemper. 
 10. The natural cure of the plague is by perfpiration or 
 fweat, and this perhaps is the only evacuation which 
 ought to be kept in view, as having a falutary tendency, 
 by thofe who attend the iick. \ 
 
 * Thefe two iaft conelufions (though I believe them myfelf) are propofetf 
 o nly as probable conjedures, which as yet 1 fee nothing to contradict. 
 
 t See p. 282. 
 
 % The operation of oil fo much recommended by Mr. Baldwin is faid to b$ 
 l>y producing fweat. (See above p. 341 .) 
 
 END OF THE FIRS<T PART, 
 
 PART 
 
A 
 
 TREATISE 
 
 ON THE 
 
 Plague and Yellow Fever. 
 
 PART SECOND. 
 
 Of the Yellow Fever. 
 
 WE now come to treat of a difeafe, Jefs fatal indeed 
 than the Afiatic plague, but yet fo deadly in its nature 
 in the Weftern World, that it has of late been con- 
 founded with the former,, and attempts made to prove 
 that they are both to be considered only as degrees 
 of the fame difeafe, and that both have been re- 
 corded by hiftorians indifcriminately under the com- 
 mon appellation of plague or peftilence. To invefti- 
 gate this matter candidly, and to (how that there is 
 a real and eflential difference between the two, as 
 far as we can credit tefli monies drawn from the moft 
 refpe&able writers, fhall be the work of the follow-, 
 ing part of this treatife. 
 
 SECTION I. 
 
 Hi/lory of the Yellow Fever. 
 
 THE diftemper now under consideration has been 
 commonly diftinguifhed by two different names; 
 one of which is the Yellow Fever, the other the Black 
 Vomit. Both of thefe are taken from fymptoms fo re- 
 markable 
 
A TREATISE ON 
 
 markable (though not occurring in every cafe) that, 
 had the difeafe exifted in ancient times, we can fcarce 
 think but fome of the hiftorians of antiquity would have 
 taken notice th^t in fucb a plague thofe who died gene- 
 rally became yellow, or that they had a continual vo- 
 miting, of black matter, which could not be flopped. 
 Black or bilious vomitings are indeed mentioned, though 
 not as the principal fymptom, but the yellow cqlour is 
 not once taken notice of. Dr. Hodges indeed men? 
 tions a {ingle inftance of a patient who became all over 
 of agreen colour ; but as a change of colour is not taken 
 notice of in the plague as a general fymptom, either by 
 him or by any other writer, we muft conclude that this 
 diftemper (the yellow fever) has been obferved only in 
 modern times. 
 
 When Columbus firft vifited the Weft India iflands, 
 
 we hear nothing of his having found fuch a difeafe ex- 
 
 ifting there ; nor does it appear that it was known. 
 
 among the many Spanifh adventurers who fuccceded 
 
 him, and who fubdued fuel) imrnenfe tracts on the 
 
 Southern Continent. Soon after the fettlemerit of fome 
 
 of the Weft India iflands, however, by other European 
 
 nations, this difeafe began to rnake its appearance, 
 
 though at what time is ftill uncertain. Dr. Hillary 
 
 fays, that, " as we have no accounts of this difeafe in the 
 
 ancients, nor even in the Arabian writers, who lived and 
 
 pracYifed in the hot climate, we muft give \tfome name ;" 
 
 and he calls it the putrid bilious fever. " From the beft 
 
 41 and moft authentic account (adds he) that I can ob- 
 
 " tain, as alfo from the nature and fymptoms of the 
 
 " difeafe, it appears to be a difeafe that is indigenous * 
 
 " to the Weft India ifiands and the continent of Ame- 
 
 " rica which is fituatec} between the tropics, and moft 
 
 i( probably to all other countries within the torrid zone. 
 
 " But I cannot conceive wjiat were the motives which 
 
 " induced Dr. Warren to think that this fever was firft 
 
 " brought from Paleftine to Marfeilles, and from thence 
 
 " to Martinique, and fo to Barbadoes, about thirty-feven 
 
 " years fince (1721 or 1722.) A better inquiry woulc} 
 
 " have 
 
 * Naturally belonging to the climate. 
 
THE YELLOW FEVER. 373 
 
 ave informed him, that this fever had frequently ap^ 
 f< peared, in this and the other Weft India iflands, many 
 " years before : for feveral judicious pra&itioners, who 
 f< were then, and are now, living here, whofe bufmefs 
 " was, vifiting the fick the greateft part of their life 
 " time, fome of them alrnoft eighty years of age, remem- 
 " ber to have feen this fever frequently in this ifland, 
 " not only many years before that time, but many years 
 " before that learned gentleman came to it." 
 
 To the fame purpofe Dr. Mofely fays, " Warren, 
 <l though he lived at Barbadoes in 1 739, fuppofes it never 
 " appeared in that ifland till about the year 1721, and 
 <c that it was then brought frorrr Martinique in the Lynn 
 " man of war. He fays the fecond appearance of it 
 f there was in 1733, and that it then came alfo from 
 
 ' Martinique. He undertakes to (how, that it is a 
 " difeafe of Afiatic extract ; and fays, that a Provencals 
 " fleet arrived at Port St. Pierre in Martinique, from 
 " Marfeilles, on board which were feveral bales of Le- 
 :c vant goods which were taken in at Marfeilles from a 
 " fhip juft arrived from St. Jean D'Acre (probably the 
 " Ptolemais of the ancients.) Upon opening thefe bales 
 " of goods at Port St. Pierre, this diftemper immediately 
 " (hewed itfelf ; many of the people were inftantly feiz- 
 :l ed, fome died almoft fuddenly, others in a few days, 
 
 * and fome lingered longer ; and the contagion, ftill 
 " fpreading, made great havock at the beginning. He 
 " fays he had this account from Mr. Nelfon, an Englif}^ 
 " furgeon, who was feized with the difeafe at Marti* 
 " nique, and died of it a few days after his arrival at Bar- 
 * c badoes. He fays, it is very probable that the fame 
 " fever, or one of very near refemblance and affinity, 
 
 5 may firft have been carried among the American Spa- 
 : niards (among whom it is now endemic) in fomewhat 
 :e a like manner ; and that poflibly fome peculiar quali- 
 
 ' ties in the air and climate might have foftered and 
 ** maintained it there ever fince." 
 
 Dr. Mofely at once concludes the whole of this ac- 
 count to be fabulous, but whether fabricated by Dr. 
 Warren or the fjur&eon, he does not fay. He then ap- 
 
 peatf 
 
37 4 A TREATISE ON 
 
 peals to Dr. Towne, who wrote before Warren, in 
 1776, but takes no notice of this chimerical origin of the 
 yellow fever, but confiders it as an endemical difeafe in 
 the Weft Indies. Hillary's opinion already given is alfo 
 quoted. 
 
 The next evidence is that of Mr. Hughes, who, though 
 not a medical man, has written on the firft appearance 
 of the yellow fever in Barbadoes in the following terms j 
 pr. Gamble remembers that it was very " fatal here in 
 *' the year 169 i, and that it was then called the new dif- 
 4< temper, and afterwards Kendalls fever, the pe/ti/entiat fe~ 
 * c ver, and the bilious fever. The fame fymptoms did 
 * 6 not always appear in all patients, nor alike in every 
 * c year when it vifited us. It is moft commonly rife and 
 " fatal in May, June, July and Auguft, and then moftly 
 * c among ftrangers ; though a great many of the inhabi- 
 cv tants, in the year 1696, died of it j and a great many 
 ^ at different periods fince." 
 
 As to the firft appearance of the difeafe in the Weft 
 India iflands we have no accounts which have been 
 deemed fuffidently authentic, though indeed it muft be 
 ponfeffed that the doubts feem to be derived as much 
 from an attachment to theory as to the inveftigation of 
 truth. st The endemial caufus, or yellow fever, (favs Dr. 
 " Mofely) which is the terror of Europeans newly arri- 
 * fc ved in the Weft Indies, is called by the French la maladi 
 * 6 de Siam. Monfieur Pouppe Defportes, who practifed 
 " phyfic at St. Dominique ftom 1732 to 1748, and who 
 ^ bad more experience, and has written from better in-* 
 ic formation on the difeafes of that colony, than any of 
 * his countrymen, fays that this fever was fo called from 
 ^ its being firft taken notice of in the iiland of Mir- 
 * c tinique at a time when forne vefiels were there froin 
 * Siam. This account, though probably true enough 
 " as to the time of its being firft obferved in the French 
 4C colonies, is extremely incorrecl: in other refpects : for 
 ic M. Dcfportes has not only admitted a fuppofition that 
 * the difeafe originated among thefe Eaft Indian ma- 
 ^ riners, but calls it peftilential, and fays that the Euro- 
 ^ peans are almoft thq only vidlims to it. 
 
THE YELLOW FEVER. 375 
 
 " The generality of the French writers fay that it was 
 
 * brought directly from Siam, in a merchant (hip, and 
 " communicated to the people of Martinique, whence 
 " the contagion was carried to St. Dominique, but that 
 " failors were the only people attacked by it, whence it 
 " was called lafievre matelotte" 
 
 This account feems to carry no improbability in it 5 
 neverthelefs Dr. Mofely rejects it upon grounds that are 
 very far from being indifputable. " The French writ- 
 
 * ers (fays he) have not been at the trouble to confider 
 " that a difeafe brought from Siam in the Eaft Indies, in 
 " a (imilar latitude to the Weft India iflands, would be 
 " moft likely to affect the natives, living in a climate 
 4 * fimilar to that in which the difeafe originated, rather 
 " than the Europeans of fo different a temperament of 
 " body." But this argument would prove too much ; 
 for if. the difeafe would be moft likely to affecl: the natives 
 in a climate Jimllar to that in which the difeafe origi- 
 nated, furely it would be ftill more likely to attack the 
 natives in that very climate in which the difeafe did ori- 
 ginate, and that Europeans would be free. But the very 
 reverfe is the cafe. The difeafe, according to Dr. Mofe- 
 ley himfelf, originates in the Weft Indies ; and yet Eu- 
 ropeans, especially thofe newly arrived, are particularly 
 objects of its vengeance. 
 
 " But (adds our author) the fact is, that "this dif- 
 ** eafe never attacks either white or black natives of hot 
 " climates ; neither was it brought from Siam 5 and 
 <c though it is poflible, from the heat of the climate, that 
 4C it may frequently appear there, or in any other tro~ 
 <c pica! country (though BARRERE fays it is unknown 
 t at Cayenne] no hiftory of that country that I have yet 
 " met with mentions fuch a difeafe ; notwithftanding 
 " what many writers have boldly advanced to the con- 
 " trary." 
 
 Here it is evident we have no argument, but a par-- 
 cel of affertions, the firft of which contradicts what he 
 had juft before quoted from Mr. Hughes. For the 
 latter informs us that in 1696 a great many of the 
 inhabitants died of it as well as (hangers. His not 
 
 meeting 
 
376 A TREATISE ON 
 
 meeting with it in any hiftory of Siam is not a proof of 
 its non-exiftence in the country,, neither indeed does he 
 himfelf think that it is fo, as he tells us that it may poffi- 
 bly appear there, or in any other tropical country. 
 
 In Sauvages's Nofology we find the plague diftinguifhed 
 Into a number of different fpecies^ among which there is 
 one called the plague of Siam. This, he fays, was in the 
 year 1685 brought from Siam to Martinico, in the (hip 
 called the Orlflame. This feems to have been t\\e yellow 
 fever, and the fymptomsare confidered in the following 
 fection. This date agrees exactly with what Mr. 
 Hughes fays in the place above quoted, that it was violent 
 in Barbadoes in the year 1691, when it went by the 
 names of the new fever, and Kendafs fever. Both thefe 
 names imply that the difeafe had been but lately known, 
 and that it was by no means a native of the climate. 
 It muft either have been imported therefore from fome 
 other country, or it muft have originated in confequence 
 of the fettlement of fome Europeans in a climate fo 
 diffimilar to their own, while fome of them ftiJl continued 
 to ramble from one country to another, occafionally vifit- 
 ing all, without taking up their refldence in any. 
 
 Martinique feems to have been the firft place where 
 this diftemper made its appearance ; and from thence 
 it feems quickly to have extended itfelf to St. Domin- 
 go and Barbadces. Its farther progrefs, however, can- 
 not be traced, nor can we tell exactly what time it firfl 
 entered the continent. Whether the true plague was 
 ever imported into the Weftern Continent cannot at 
 prefent be afcertained, neither can we tell what difeafes 
 the Indians were fubject to before the arrival of the Eu- 
 ropeans. The Spaniards, who firft arrived, are allowed 1 
 to have been lefs fubject to the plague than other na- 
 tions,* but they were quickly followed by thofe who had 
 no fuch exemption. Sebaftian Cabot difcovered the' 
 North American Continent for Henry VII of England, 
 very foon after, if not before Columbus difcovered the' 
 Southern Continent for the king of Spain. This was 
 a very fufpieious time ; for Henry VII himfelf had in* 
 
 troduced 
 
 * Seep'. 3*9* 
 
THE YELLOW FEVER. 377 
 
 traduced the (Wearing ficknefs into England only thir- 
 teen years before ;* and in thofe days the plague feems 
 never to have been eradicated ; fo that it is by no means 
 impoflible that thefe firft adventurers might have com- 
 municated to the Indians with whom they had any 
 communication, the feeds of difeafes totally unknown to 
 them before. Certain it is; that the North American 
 Indians were fubjecl to epidemics before the fettlement 
 of any Englifh colonies among them. Hutchinfon in 
 his Hiftory of Maflachufetts takes notice of the Indians 
 having been greatly weakened by an epidemic, which 
 was attributed to an unfavourable feafon, in confequence 
 of which they were obliged to feed upon unripe fquafhes, 
 fruits, &c. We know not the nature of the diftemper, 
 though* from the circumftance juft mentioned, we 
 may not unreafonably conjecture it to have been of the 
 peftilential kind. That epidemics ftill continue among 
 thefe people we alfo know from the teftimony of Capt. 
 Carver, who found one of their towns deferted, and the 
 inhabitants fied into the woods, on account of an epide- 
 mic diforder j but what the nature of it was he does not 
 inform us.-}- Mr 
 
 * See p. 17. 
 
 f In Belknap's Biography we have a more particular account of this 
 lence, as it is called* and which, if the relations there given are to be credited* 
 certainly determines the difeafe in queftion to have been the yellow fever. 
 The account is to the following purpofe : Lord Arundel, of Wardour, had 
 employed a captain Weymouth to fearch for a N. W. paffage to India. Jrt 
 this he failed, but falling in with a river, fuppofed to be either the Kennebeclc 
 or Penobfcot* he brought from thence five of the natives* with whom he land* 
 ed at Plymouth in July 1605. Three of the Indians were taken into tho 
 family of Sir Ferdinando Gorges ; and from thefe many particulars were ob- 
 tained refpefting their country, which being eagerly attended to by Gorges* 
 he formed a plan of advancing his fortune by a thorough difcovery of the 
 country. Two veRels were accordingly fitted out ; one of which failed* but tho 
 other brought fuch information as gave encouragement to attempt the found- 
 ing of a colony. Two of the natives who had been brought to England were 
 fent back, and 45 perfons were left on the continent to begin the fettlement ; 
 but thefe, having undergone great hardships, quitted the place in 1608. Gor- 
 ges, however was not difcouraged. He fent out one of his fervants, by name 
 Richard If'tnts^ and fome others, whom he hired to ftay in the country all 
 winter. 
 
 Mr. Vines and his companions were received by the Indians with great 
 * hofpitality, though their' refidence among them was rendered hazardous ; 
 " both .by a war which raged among thenn and by a peftiience which accom- 
 " panied or fucceeded it. 
 
 This war and* peftiience are frequently fpoken of by the hiftorians of 
 New England, as remarkable events, in the courfe of Providence, which 
 
 " prepared 
 
 Ccic 
 
'57? A TREATISE ON 
 
 Mr. Webfter, in his eighth letter to Dr. Carrie orr 
 the lubject of peftilential difeafes, quotes from the 
 Doctor's letter to Mr. Wynkoop, of October ^th, -1797, 
 the following paflages : " Thomas Story and Jofeph 
 " Gough relate, that a malignant fever prevailed in 
 ' Philadelphia in 1699, introduced from the Weft 
 " India iflands. . . . Dr. Mitchill afcribes the yellow 
 " fever as it appeared in Virginia in 1741 and 47 to 
 " fpecific contagion, and mentions that it had been 
 :c twice imported into Virginia by his Majefty's (hips of 
 " war. Dr. Leamy (Lining) in the Phyfical Eiiays in 
 ' Edinburgh, informs us, that the yellow fever which 
 " has prevailed at different periods at Charlefton, South 
 fc Carolina, was always traced to fome infected perfon 
 " recently from the Weft Indies. In 1741 it was in- 
 *' troduced by acheft of wearing apparel which had be- 
 
 " longed 
 
 *' prepared the tvay for the eftabliftiment of an European colony. Concerning 
 ** the war, we know nothing more than this, that it was begun by the Tar- 
 ** ratenes, a nation who relided eaftward of Penobfcot. Thefe formidable 
 " people furprifed the bafhaba, or chief fachem, at his head quarters, and de- 
 ** ftroyed him with all his family; upon which all the other fachems wh 
 were fubordinate to him quarrelled among themfelves for the fovereignty ; 
 ** artd in thefe difTenfions many of them as well as of their unhappy people 
 perilled. Of what particular kind the peftilence was, we have no. certain* 
 information ; but it ieems to have been a diforder peculiar to the Indians, 
 "** for Mr. Vines and hs companions, who were intimately converfant with 
 1 them, and frequently lodged in their wigwams, were not in the leaft de* 
 gree affe&ed by it, though it fwept off the Indians at fuch a prodigious rate 
 - * that the living were not able to bury the dead, and their bones were found 
 feveral years after, lying about the villages where they had refided., Tho 
 extent of this peftrlence was between Penobfcot in the eaft, and Narraganfet 
 * in the weft. Thefe two tribes efoaped, whilll the intermediate people wero 
 wafted and deftroyed." 
 
 This diftemper appears to have raged among the Indians in the year 1616. 
 The following particulars are further given in Belfcnap's Biography, vol. ii, 
 p. 208 : Hitherto they (the Englith colonifts) had not feen any of the na- 
 tives at this place. The mortal peftilence which raged through the country, 
 four years before, had almoft depopulated it. One remarkable circumftance 
 attending this peftilence was not known till after this fettlement was made. 
 *< A French fhip had been wrecked o Cape Cod. The men were faved, with 
 * their provifions and goods. The natives kept their eye on them* tilt they 
 ** found an opportunity to- kill all but three or four, and divide their goods. 
 " The captives were fent from one tribe to another, as Daves. One ot them 
 learned fo much of their language, as to tell them that God was angry with 
 <* them for their cruelty, and would deftroy them, and give their country to 
 another people. They anfwered that they were too many for God to kill'. 
 * He replied* that if they wee ever fo raanyi God had may ways to kill 
 
 " them* 
 
 * <* The Pawkunnawkutts were a great people heretofore. They lived to 
 the caft and northeaft of the NarraganfittSi and their chief fachem held do- 
 
THE YELLOW FEVER; 379 
 
 F longed to a perfon who died of it from Barbadoes." 
 Thefe quotations are made by Mr. Webfter with a 
 view to difpute the contagious nature of the difeafe, 
 Here they are introduced only to (how if poflible the 
 time that the difeafe firft entered the United States ; 
 and the introduction of it into Philadelphia in 1,699 
 (though we are not fureif even this was its firft -appear- 
 ance, flill correfponds extremely well with the date of its 
 introduction into Martinique mentioned by Sauvages. 
 Dr. Lining fays it had been four times epidemic in 
 Charlefton before the time that he wrote; viz. in 173 z> 
 1739, 1745^ and 1748. Hence we may conclude, that 
 this fever, on the northern part of the continent of 
 America, has been nearly coeval with the fettlement of 
 the Britifh colonies there; for we cannot fuppofe that 
 we have accounts of the very firft time that it made its 
 
 appearance 
 
 " them, of which they were then ignorant. When the peftilence came among 
 ** them (a new dlfeafe^ probably the yellow fever) they remembered the 
 Frenchman's words ; and when the Plymouth iettlers arrived at Cape Cod 
 " the few furvivors imagined that the other part of his prediction would foort 
 be accomplished. Soon after their arrival, the Indian priefts or powows 
 .** convened, and performed their incantations in a dark fwamp three days 
 r< fucceflively, with a, view to curfe and deftroy the new comers. Had they 
 <* known the mortality which raged among them, they would doubtlefs have 
 rejoiced in the fuccefs of their endeavours, and might very eafily have taker* 
 advantage of their weaknefs to exterminate them. But none of them were 
 " feen till after the licknefs had abated ; though fome tools, which had beea 
 ** left in the woods, were miffing, which they had ilolen ia the night," 
 
 minion over divers other petty fagamores ; as the fagamores uppn the ifland 
 of Nantuckett, and Nope, or Martha's Vineyard, of Nawfett, of Manna- 
 *< moyk, of Sawkattukett, Nobfquafitt, Matakees, and feveral others, and 
 ' fome of the Nipmucks. Their country, for the moft part, falls within 
 * the jurifdidtion of New Plymouth colony. This people were a potent na- 
 ' tion in former times, and could raife, as the moft credible and ancient In- 
 " diaus affirm, about three thoufand men- They held war with the Narra- 
 f ganfitts, and often joined the Manachufetts as friends and confederates 
 . againft the Narraganfitts. This nation, a very great number of them, were 
 *' iwept away by an epidemical and unwonted foknefs, an. i6iz and 1613* 
 . about feven or eight years before the Englifh firft arrived in thofe parts to 
 fettle the colony of New Plymouth. Thereby Divine Providence made way 
 * for the quiet and peaceable fettlemcnt of the Englifh in thofe nations* 
 What this difeafe was, that fo generally and mortally fwept away, not only 
 thefe but other Indians, their neighbours, I cannot well learn. Doubtlefs 
 it was fome peftilential difeafe. | have dilcourfed with fome old Indians* 
 that were then youths> who fay, that tke bodies all over were exceeding yel- 
 *t Jo-u> (defcribing it by a yellow garment they Ihowed me) both before they 
 died, and afterward. 
 
 " The Maffachufetts, being the next great people northward, inhabited 
 principally about that place in Maliachufetts bay, where the body of the 
 . ng!itfi now dwell. Thefe were a numerous and great people. Their chief 
 
 ftchens 
 
A TREATISE ON 
 
 appearance any where. Numbers of individuals would 
 probably be affedted with it, and their cafes pafs unnoti- 
 ced, till the general malady attracted the public atten- 
 tion . 
 
 In the Spanifh dominions it feems to hava been other- 
 ttife. Dr. Mofeley quotes Don Ulloa faying that c: th* 
 " vamito prieto, or black vomit, was unknown at Cartha- 
 ^ gena, and all along the coaft, till the years 1 729 and 
 * c 1730, In 1729 Don Domingo Juftiniani, commodore 
 '* of the guarda coftas, loft fo conliderable a part of his 
 * c (hips' companies at Santa Martha, that the furvivors 
 ^ were ftruck with aftonifhment and horror at the 
 " havock made among their comrades. In 1730, when 
 rt the galleons under Don Manuel Lopez Pintado came 
 a to Carthagena, the feamen were feizcd with the fanae 
 * c dreadful mortality's and fo fudden were the attacks cf 
 
 " the 
 
 ** faehem held dominion over many other petty governors ; as thofe of Wee- 
 ** chagafkas, Neponfitt, Punkapaog, NpnantUm, N-alhavvay, fome of tht 
 84 Nipmuck people, as far as Pocowitacuke, as the old men of MaiTachufettS 
 ** affirmed. This people couldi in former times* arm for war about threfc 
 * thoufaad men, as the old Indians declare. They were hi hoftiiity very of- 
 ** ten with the Narraganfitts, but held amity for the moft part with the Paw- 
 111 kunnawcutts, who lived on the fouth border, and with the Pawtucketts, who 
 4 * inhabited on their north and nortfaeaft limits. In an. 1611 and i6rj thefe 
 " people were alfo forely fmitten by the hand of God with the fame Miteafe 
 41 before mentioned : which deftroyed the moft of them, and made room for 
 ** the Englifh people of Mallachufetts colony, which people this country, and 
 the next called Pawtuckett. There are not of this people left at this day 
 l above three hundred men> befides women and children. 
 
 " Pawtucfcett is the fifth and laft great fachemfnip of Indians. Their coun- 
 tl try lieth north and northeaft from the MaflTachufetts, whole dominion reach- 
 * eth fo far as the Englhh jnrifdicliori,^or colony of the Maflachufetts, doth 
 * now extend, and had under them feveral other fmaller fagamores; as the 
 Pennakoisks, Agawomes, NaamkeekSi Pafcatawayes, Accomintas, and others. 
 * They were alfo a confid'erable people heretofore, about three thoufand men 
 ' and held amity with the people of Maflachufetts. But thefe alfo were al- 
 moft totally deftroyed by the great ficknefs before mentioned ; fo that at 
 * this day they are not above two hundred and fifty men, befides women and 
 children. This country is now inhabited by the English uader the govern- 
 rnent of Ma^ichufetts." (Gookin's Hiftorical Collections of the Indians 
 in New England.) 
 
 The following was communicated to Benjamin Baflfet, efq. of Chilmarkt 
 by Thomas Cooper, a half blooded Indian, of Gay Head, aged about fixty 
 years ; and which, he fays, he obtained of his grandmother, who, to ufe his 
 'own expreflion, was a ftout girl v/hen the English came to the ifland : " Before 
 the Englifh came among the Indians, there were two diforders of which 
 tkey generally died, viz. the confumption and the yellow fever. The latter 
 they could always lay. in the following manner : After it had raged and fwep 1 * 
 off a number, thofe who were well, met to lay it. The rich, that is, fuch 
 < as had a canoe, (kins, axes, &c. brought them ; They took their feat in a 
 circle, and ail the poor fat around without. The richeft then propofed to 
 
 < begu; 
 
THE YELLOW FEVER. 382 
 
 " the difeafe, that perfons, walking about one day, were 
 '* the next carried U> their graves. Unhappily, after all 
 (( the experiments of the furgeons of the galleons, and 
 " phyftcians of the country, no good method of treat- 
 " ing the difeafe has been difcovered > no fpecifk for 
 ft curing it." 
 
 This fatal difeafe, however common in the fouthern 
 and warm part of the continent of America, feems not 
 to have exerted its power in the more northern and 
 temperate climates till the year 1793. Since that time 
 its ravages have beert too well known to require an 
 enumeration here. To defcribe the fymptoms, inquire 
 into the caufes, and the means of prevention and cure, 
 is a work of more importance, and to this we muft 
 now proceed. 
 
 4 begin to lay theficknefs; and, having in his hand fomeihtng in fhaperefem*- 
 1 bling his canoe, {kin, or whatever his riches were, he threw it up in the air ; 
 
 * and whoever of the poor without could take it, the property it was intended 
 
 * to refemble became for ever transferred to him or her. After the rich had 
 ? thus given away all their nioveabJe property to the poor, they looked out the 
 ' handfomeft and moft fprightly young man HI the affembly, and put him 
 1 into an "entire new wigwair,, built of every thing new for that purpofe. 
 
 * They then formed into two files at a fmall diftance from each other; one 
 1 (landing in the fpace at eaeh end put fire to the bottom of the wigwam orj 
 1 all parts, and fell to finging and dancing Prefently the youth would leapt 
 out of the flames, and fall down to appearance dead. Him they convmitted 
 
 * to the care of five virgins, prepared for that purpofe, to reftore to life again. 
 The term required for this would be uncertain, from fix to f&rty-efght hours, 
 during which time the dance muft be Kept up. When he was reftored he 
 
 * would tell, that he had been carried in a large thing high up in the air, where 
 he came to a great company of white people, with whom he had interceded, 
 1 hajrd to have the diftefnper laid, and generally, after much perfuafion, would 
 obtain a promife, or anfwer of peace, which never failed of laying the 
 
 JM diftemper." 
 
 The following is extracted from Prince's Chronological Hiftory of Ne\v 
 England, p. 46 : " This winter (1617) and thefpring enfuing, a great plague 
 * befals the natives in New England, which wafteth them exceedingly; and 
 * fo many thoufands of them die, that the living are not able to bury them* 
 and their fkulls and bones remain above ground at the places of their habi~ 
 * tations for feveral years after. 
 
 By Capt. Dermer's letter of Dec. ay, 1619, in Purchas, and of June 30* 
 1620, in Gov. Bradford, compared with Gov. Bradford's own account, it 
 f feems that the Narraganfitts in the weft, and Penobfcots in the eaft, efcapcd 
 f this plague, or that it raged only in the countries lying between them* -and 
 * ? prepared' the way for another people." 
 
 SECTION 
 
A TREATISE ON 
 
 SECTION. II. 
 
 Symptoms of the Yellow Fever, as described by various au- 
 thors. Comparison between them and thofe of the Plague, 
 with an inquiry into the Caufes. Hiftory of the Diftemper 
 as it has appeared in various parts of the United States 
 fince the year 1 793. A difcuj/ion of the quejlion Whether 
 the Yellow Fever is Contagious or not. 
 
 OF all. thofe who have attempted to give an account 
 of. this fatal difeafe, none appear to have exceeded 
 Dr. Mofeley, either in his accuracy in enumeration, of 
 pcrfpicuity in defcription, of the fymptoms. According 
 to him the yellow fever is a fpecies of the kaufos of Hippo- 
 crates, Aretceus and Galen j that is, the febris ardens or 
 cdufus, aggravated by climate, incidental only to thegrofs, 
 inflammatory and plethoric at any feafon of the year, to- 
 tally different from the remitting bilious fever to which 
 all habits of body are fubjecT: in hot climates, particular- 
 ly after rains, and in the fall of the year. .The caufus, 
 feldom feen in the temperate climates of Europe, never 
 appears there with the violent fymptoms which attend it 
 in hot climates. <c Whether in the latitudes (fays he) fo 
 * c mild as thofe of Spain, Greece, Italy and the Archi- 
 <s pelagan iflands, the caufus has ever been attended with 
 " black vomiting, as in the Weft-Indies, I cannot tell. 
 " Lomrnius mentions the vomiting of blood, and void* 
 " ing black liquid ftools and blac urine. Critical and 
 Ci fymptomatical yellownefs of the {kin in the caufus are 
 " enumerated by Hippocrates among its fymptoms., and 
 Lommius mentions the danger of that appearance be- 
 *' fore the feventh day. The affinity of the fymptoms, 
 5C progrefs and termination of a caufus in Europe to 
 cc thofe of the yellow fever in the Weft-Indies, excepting 
 %i the black vomiting, leaves no room to doubt that the 
 f difference of climate conftitutes all the difference that 
 ; is found between them." 
 
 For thefe reafons Dr. Mofeley adopts the name of en- 
 caufus , and he takes notice that many difficul- 
 ties 
 
THE YELLOW FEVER. 383 
 
 tics have arifen to young pradtitioners, and to ftrangers 
 in the Weft-Indies, from the various names improperly 
 given to it from its ultimate and not from its primary 
 fymptoms. Some calls it a burning bilious fever ; War- 
 ren, a putrid bilious fever ; but, though they have d if- 
 puted about their terms, Dr. Mofeley thinks that nei- 
 ther of them have proved whether bile be the caufe or the 
 effe<ft of the difeafe. To call it the black vomit or the 
 yellow fever, he thinks alfo improper, as a ftranger would 
 not know the difeafe until fome of thefe fymptoms appear ; 
 both of which are generally fatal, and neither of them 
 conftant. 
 
 The Weft-India caufushe fays is no more putrid than 
 the fmall-pox, or any other acute difeafe ; which may, 
 after it has patted its inflammatory ftate, change to pu- 
 trefaction, and end in death with an extraordinary diflb- 
 lution of the fluids. The difeafe is in truth an inflam- 
 matory one in the higheft degree poffible ; accompanied 
 with fuch fymptoms in a greater extent as attend all in- 
 flammatory fevers, and moft ftrikingly the reverfe of any 
 difeafe that is putrid, or of one exacerbation. It obeys 
 no feafon of the year, and attacks fuch people, and un- 
 der fuch circumftances, as are feldom the objects of pu- 
 trid difeafes, viz. all who are of an inflammatory diathe- 
 lis, and do not perfpire freely. 
 
 This diftemper attacks failors in the Weft-Indies 
 more than any other fet of men, even of new comers. 
 For this the Dr. affigns as a reafora, that they eat, drink, 
 and fleep, fo much at fea, ufe no exercife, and are 
 always of grofs habit of body. To this he adds the heat 
 and dampnefs of harbours, generally in the neighbour- 
 hood of marfhes, and their expofure to land winds at 
 night ; the labour they endure on board veflels in port, 
 and the carelelThefsand excefTes frequently committed by 
 thefe people after long voyages. 
 
 When a ftranger newly arrived feels a fudden iofs of 
 ftrength, with a continual defire of changing his pofition 
 without finding reft in any, we may expect a caufus. If 
 he has expofed himfelf to any of the caufes juft mention- 
 ed, the probable cohfequences would be, that on the 
 
 morrow 
 
384 A TREATISE ON 
 
 morrow he would feel an heavinefs, laffitude, opprefliorj 
 and lofs of appetite.* Next day, or perhaps within 
 twelve hours from the firft indifpofition, the violence of 
 the difeafe commences with faintnefs, generally giddi- 
 nefs of the head, with a fmall degree of chillnefs and 
 horror, but never any rigor. Thefe fymptoms are fuc- 
 ceeded by a high fever, great heat, and ftrong beatings 
 of the arteries, particularly thofe of the temples and ca- 
 rotids ; iluihings of the face, gafping for cool air ; tongue 
 white tinged wilh yellow, after the retchings have com- 
 menced ; exceflive third ; rednefs, heavinefs,, and fenfa- 
 tions of burning in the eyes ; heavinefsand darting pains 
 in the head, fmall of the back, and often down the 
 thighs ; the pulfe generally full and ftrong, but fome- 
 times quick, low, and vaccillating ; the {kin hot and dry y 
 though -fometimes it has a partial and momentary moif- 
 ture. There is a ficknefs of ftornach from the begin- 
 ning ; retchings fucceed immediately after any liquid is 
 fwallowed, which bring up bilious matter. There is an 
 anxiety with ftriflure, forenefs, and intenfe heat about 
 the prsecordia ; great reftleffnefs, heavy refpiration, figh- 
 ing, urine deep coloured and in fmall quantity. 
 
 Thus the fever goes on during its firft ftage, which 
 conftitutes the inflammatory period^ and continues from 
 twenty-four to lixty hours. The fecond, which our au- 
 thor calls the metaptofis, is comparatively mild, and is an 
 Intermediate ftate between the inflammatory and gangre- 
 nous ftages. In this there is an abatement of many of 
 the former fymptoms, and a kind of deceitful tranquillity, 
 accompanied, however, with a perturbation, if the patient 
 Should hapiien to ileep. There now appears a yellow 
 tinge in the eyes, neck and breaft -, the heat fubfides, 
 fometimes accompanied with chiilnefs, but never with 
 that kind of rigor, which, when it happens, terminates 
 the difeafe by fweat, or by copious bilious evacuations, 
 upwards or downwards. The retchings increafe and be- 
 come porraceous : the pulfe flags,, but is fornetimes high, 
 
 and 
 
 * M This (fays the Doftor) is the time to eitinguifli the difeafe ; but fiuro^- 
 * peans and North Americans generaily negledt it* as they are not accuftome<l 
 at home to have recourfe to nsedicineon the firft moment of incUfpo&UQn-"' 
 
THE YELLOW FEVER. 38$ 
 
 and fometimes foft ; the /kin moid and clammy ; urine 
 of a dark faffron colour, and in fmall quantity ; the 
 tongue in fome cafes is dry, hdrd, and difcoloiired, in 
 others furred and moid the head is confiifed, fome- 
 times with delirium, with a gloffinefs of the eyes. This 
 ftage of the difeafe continues fometimes only for a few 
 hours, at others from twelve .to forty-eight, feldom 
 longer, and too frequently the difeafe hurries on rapidly 
 from the firft to the third ftage, which is the gangrenous 
 or fatal ftate. Now the pulfe finks, intermits, and be- 
 comes unequal, fometimes very quick ; the vomiting 
 becomes frequerit with great draining and noife. The 1 
 rnltter difcharged is now in greater quantity, appearing 
 like the grounds of coffee, or of a flate coloiir, and the 
 ftomach can retain nothing : the breathing is difficult, 
 the tongue black, the fweats cold arid clamrriy, the eyes 
 yellow and funk ; there is a yellownefs round the moutH. 
 and temples, and foon after over the whole body. The 
 deepening of the yellow colour, with an aggravation of 
 the other fyniptbms, is a forerunner of death. There is 
 a deep refpiratiori, fubfultus tendinum, a cdnvulfive 
 kind of fighing ; the urine is quite black, and fometimes 
 totally fupprefied. There is a death-like coldnefs of the 
 hands, feet and legs, While the Heat ftill remains about 
 the ftomach ; the patient is delirious; and druggies to get 
 up in bed ; he trembles, his fpeech falters ; blood oozes 
 from the mouth arid rioftnls, forrietimes frorri the corners 
 of the eyes and ears a black bloody cruor is difcharged 
 both by vomit arid dool : livid fpots appear on differ- 
 ent parts of the body, particularly the pr&cordia ; hic- 
 cup, muttering, coma, and death, folldw in quick 
 fuccefiion. 
 
 The affecting cafe ofcnpt. Mawhood, who died on the 
 
 fourth day of the difeafe; at Port-Royal in Jamaica, in 
 
 the year 1780, exhibits a dreadful piclufe of this difeafe 
 
 5n its lad dage. " When I entered the room, (fays Dr. 
 
 ; Moieley) he was vomiting a black, bloody cruor, and 
 
 " he was bleeding at the nofe. A bloody ichor was 
 
 < oozing from the corners of his eyes, and from his mouth 
 
 '' and gums. His face was befmeared with blood, and 
 
 -D d d " with 
 
A TREATISE ON 
 
 " with the dullnefs of his eyes it prefented a mod diftref- 
 " fing contraft to his natural vifage. His abdomen was 
 " fwelled and inflated moft prodigioufly. His body was 
 <c all over of a deep yellow, interfperfed with livid fpots. 
 <c His hands and feet were of a livid hue. Every part of 
 " him was cold, excepting about his heart. He had a 
 " deep, ftrong, hiccup, but neither delirium nor coma; 
 *' and was, at my firft feeing him, as I thought, in his 
 " perfect fenfes. He looked at the changed appearance 
 " of his fkin, and exprefTed, though he could not fpeak^ 
 <c by his fad countenance, that he knew life was foon to 
 *' yield up her citadel, now abandoning the reft of his 
 " body. Exhaufted with vomiting, he was at laft fuf- 
 ** focated.with the blood he was endeavouring to bring 
 * c up, and expired." 
 
 The fymptoms juft now enumerated generally take 
 place in thofe who die from the third to the feventh day 
 of the difeafe. But in this, as in other fevers, the fymp- 
 toms vary conflderably according to the conftitution of 
 the patient,, and habit of the body. In fome it begins 
 neithej with chillnefs, <aintnefs, nor flufhings of the face. 
 Sometimes the pulfe is much depreffed and not quick - 9 
 and in fultry weather, and damp fituations, where the 
 inflammatory ftate has been only of a few hours duration, 
 the w<?tap/0/fr has been fo, rapid, that the black vomiting 
 and the mortified ftate have unexpectedly appeared, and 
 have ended the patient in 24, 36 or 48 hours. But our 
 author fays that he never faw or heard of an inftance of 
 what Lind fays, that the black vomit may attack a man 
 when newly arrived, without any previous complaint ; 
 or of that mentioned by the fame author, viz. " an 
 uneafy itching fenfation, commonly in the legs ; and 
 upon pulling down the ftockings, ftreams of thin-dif- 
 iblved blood followed, and a ghaftly yellow colour quick- 
 ly diffufed itfclf all over the body.'" 
 
 In fome cafes the difeafe is much more mild. There 
 are inftances where it has been protracted to the eighth, 
 ninth or tenth day j and others where it has never paflcd 
 from the inflammatory ftage ; but being checked, 
 though not extinguiihed, it has been lengthened out, and 
 
 at 
 
THE YELLOW FEVER. 
 
 at laft converted into a remittent of great duration, mod 
 difficult of cure, and tedious of recovery. 
 
 According to our author, the ftomach feems to bear 
 the principal burden of the difeafe, and accordingly, after 
 death, appears to have been principally affeded. Great 
 heat is perceived near the prsecordia during all the ftages 
 of the difeafe, and pain and uneafinefs are complained 
 of when thofe parts are prefied with the hand. After 
 death, livid fpots appear over the whole body, particu- 
 larly about the prsecordia. On difTedion, the ftomach, 
 in fome part or other, is generally found mortified, 
 efpecially if the black vomiting has continued long, and 
 the livid fpots have appeared before death. Frequently 
 the upper part of the duodenum is in a gangrenous ftate, 
 and always bears the marks of inflammation, let the dif- 
 eafe have been of ever fo fhort a duration. 
 
 Though both liver and gall-bladder muft be very 
 much affeded in this difeafe, yet Dr. Mofeley is of 
 opinion that nothing can be depended upon from an 
 infpedion of them after death. Some fymptoms there 
 are in common with inflammations of the liver, but 
 none of thofe which diftinguifh it from other difeafes. 
 It never terminates in fuppuration of the liver as, the 
 hepatitis fometimes does, though it is frequently carried 
 off by an enormous fecretion of bile. " Diffedions 
 44 (fays the Dodor) have never difcovered any certain 
 " and uniform appearance in the liver of thofe who have 
 " digd of this difeafe. In hot climates a found ftate of the 
 " liver is never to be expeded after death, whether the 
 4i difeafe has been acute or chronical. Of the latter clafs 
 " of difeafes it is almoft always either the feat, or the 
 " origin.'* 
 
 Dr. Lining, in a letter to Dr. Whytt at Edinburgh, 
 publifhed in the Phyfical and Literary EfTays, defines 
 the difeafe, to be " that fever, which continues two or 
 " three days, and terminates without any critical dif- 
 8C charge by fweat, urine, ftool, &c. leaving the patient 
 " executively weak, with a fmall pulfe, eafily depreflible 
 " by very little motion, or by an ered pofture ; and 
 " which is foon fucceecled by an ideritious (jaundice) 
 
 " colour 
 
38S A TREATISE ON 
 
 " colour in the white of the eyes and the ikin ; vomiting, 
 <c haemorrhages, &c. and thofe without being accom- 
 " panied with any degree of a febrile pulfe and heat." 
 
 In the four times in which he mentions it to have 
 been epidemic at Charlefton, our author fays, that none 
 of the years (excepting 1739, the fummer and autumn 
 of which had been remarkably rainy) were either warmer 
 or more rainy (and forne of them lefs fo) than the fum- 
 rners and autumns were in feveral other years in which 
 there was not one inftance of any one being feized with 
 it. The fubjects were whites of both fexes, efpecialiy 
 ftrangers lately arrived, from cold climates, Indians, Mif- 
 tees, Mulattoes of all ages, excepting young children, 
 and of thofe only fuch as had formerly efcaped the in- 
 feclion. Negroes were not liable to it. 
 
 Thofe affected with the fever, for a day or two pre- 
 vious to the attack generally complained of head-ach, 
 pain in the loins and extremities, but principally in the 
 knees and legs, debility and laffitude ; but fome were 
 taken ill fuddenly without any warning. The fymptoms 
 were, Havering ; frequent, full, hard and ftrong pulfe ^ 
 though fometimes fmall and hard, and in others foft and 
 frnall -, but towards the end of the fever it became fmal- 
 ler, harder, and lefs frequent. Sometimes there was a 
 remarkable throbbing in the hypochondria an'd carotids, 
 the former caufing in fome a tremulous motion of the 
 xvhole abdomen. The heat was about 102 of Fahren^ 
 heit, and nearly equal over the whole body ; fome had 
 frequent returns of chillinefs without any diminution of 
 temperature of the body. " In a few there happened fo 
 " great a remifiion of the heat for fome hours, when at the 
 " fame time the pulfe was, foft and lefs frequent, and the 
 " ikin moift, that one from thefe circumftances might 
 " reafonably have' hoped that the fever would only 
 <c prove a remittent or intermittent. About the end of 
 c the fccond day the heat began to abate." Here Dr. 
 Mofeley takes notice that when the fever abates, fome, 
 who have miftaken the bilious remittent for the caitfus* 
 ipcak of remiffions which do not happen in this fever. 
 " Tliis circumftance of the endemial caufus (fays he) 
 I believe, has never been mentioned before." Dr. 
 
THE YELLOW FEVER. 
 
 Dr. Lining goes on to inform us, that the ftin was 
 rarely dry in this difeafe, there being generally a propen- 
 fity to fvveat. " On the firft day the fweating was com- 
 " monly profufe and general, on the fecond it was more 
 " moderate ; but on both thofe, there happened frequent 
 <c and fhort remifllons of the fweatings, at which times 
 <J the febrile heat increafed, and the patient became more 
 " uneafy. On the third day the difpofition to fweat 
 " was fo much abated that the /kin was generally dry ; on- 
 ic ly the forehead and backs of the hands continued moid." 
 A great defpondency and proftration of ftrength took 
 place from the firft attack. On the firft day they ge- 
 nerally dozed much, but were afterwards very watchful. 
 Qn the fecond day the pains in the head, loins, &c. of 
 which they had complained before the attack, and which 
 were fometimes very acute in the forehead, generally 
 went off. Many on the firft day were a little delirious, 
 but afterwards not until the recefs of the fever. 
 
 The blood had no inflammatory cruft ; in warm 
 weather it was florid like arterial blood, and continued in 
 one foft homogeneous like mafs, without any feparation of 
 the ferum after it was cold. When there was any fepa- 
 ration, the crafTamentum was of too loofe a texture. 
 
 This difeafe was not attended with any remarkable 
 thirft ; but, on the third day, as the fever began to lef- 
 fen, or rather, fays the Doctor, as the fulncfs of the pulfe, 
 heat and difpofition to fweat, began to abate, a riaufea, 
 vomiting, or frequent Teachings to vomit, came on efpe- 
 cially after the exhibition of either medicines or food. 
 A very few had a vomiting, either bilious or phlegmatic, 
 on the firft day. The whole febrile ftate was attended 
 with an obftinate coftivenefs. 
 
 Thefe were the principal fymptoms with which the 
 febrile ftate was attended, and which generally went off 
 on the third day, or in feventy-two hours from the firfi; 
 attack, without any lalutary crifis, and was foon fuc- 
 ceeded by the fecond f>adium 9 as our author calls it ; a 
 ftate, though without a fever, much more terrible than 
 the former. The fymptoir.s now were, 
 
 i. 
 
A TREATISE ON 
 
 i. The pulfe, though hard and fmall, became lefs fre* 
 quent ; very little more fo than in health. Soon after 
 it became much flower, and very foft ; this foftnefs re- 
 maining while any pulfe could be felt. In many it gra- 
 dually fubfided, till it became fcarce perceptible ; nei- 
 ther could it be fupported by any of the ordinary means 
 ufed for that purpofe. After this the yellow fuffufion, the 
 vomiting, delirium, reftlefsnefs, &c. increaferf to a great 
 degree. Sometimes the pulfe would recover its flrength, 
 but only for a (hort time. 
 
 a. The heat did not exceed the natural, and was ftill 
 farther diminifhed as the pulfe funk ; the fkin became 
 cold, and the face, bread and extremities acquired fome- 
 fhing of a livid colour, There was no great thirft, though 
 the fick had a great inclination for drong liquors. 
 
 3. The vomiting or reaching to vomit increafed, and 
 in fome were fo conftant, that neither medicines nor ali- 
 ment of any kind could be retained. Some vomited 
 blood, others only what was laft exhibited, mixed with 
 phlegm, while others had what is called the black vomit. 
 But this, though its general appearance is black, appears 
 not to be entirely fo, but owes its colour to a great num- 
 ber of black ilakey fubdances. Thefe are by our author 
 fuppofed to be the bile mixed with the mucus of the 
 ftornach, or adhering to it. He founds his opinion 
 upon obfervations from dilTection, where the mucus of 
 the domach was always found abraded, and the bile in 
 its cyftis black, and ibmetimes very vifcicl. This change 
 In the ftate of the bile he has always obferved in fuch as 
 died of this difeafe, and likewife thatthe blood ws very 
 fluid, and the verTels of the vifcera much diftended. In 
 one cafe he found the bile of the confidence of turpentine, 
 and carbuncles or gangrenous fpecks on the ftomach. 
 
 The reaching to vomit continued a longer or fhorter 
 time, according to the date of the pulfe ;. an increafe of 
 fulncfs of the pulfe being attended with an abatement of 
 the reaching, and the contrary. 
 
 In this date the patients were extreme ly unquiet, even 
 their fkep being frequently attended with dejection of 
 (pints and debility. This lad fymptom was fo excef- 
 
 five 
 
TfiE YELLOW FEVER. 391 
 
 five that if the patient was only raifed up in bed, or fome- 
 times if the head was only raifed from the pillow, while 
 a little drink was given, the pulfe funk immediately, and 
 became fometimes fo fmall, that it could fcarce be felt ; 
 they became cold, the fkin became clammy, the deliri- 
 um increafed, their lips and fkin, efpecially about the 
 neck, face and extremities, as well as the nails, acquired 
 a livid colour. The reftleffnefs and tofling were fo great, 
 that it was fometimes fcarce pofiible to keep the fkk in 
 bed, though, even in this ftate, they made no particular 
 complaint, and if asked how Jiiey did, the reply was, 
 far y^ well. 
 
 A yellownefs in the eyes became now very obfervable, 
 and this was foon diffufed all over the body ; but in 
 forne, this colour did not appear until a little before 
 death, when it fpread furprifingly quick, efpecially 
 about the bread and neck. Along with thfs were a 
 number of frnall fpots of afcarlet, purple or livid colour. 
 Thefe appeared principally about the neck and breaft. 
 
 Some were obftinately codive, others the contrary, 
 with large, liquid and black (tools, but others were re- 
 lieved by moderate ftools, even though black. In forne 
 they refembled tar, in fmotfthnefs, tenacity, colour and 
 confidence. 
 
 In this difeafe there was fuch a putrid diflblution of 
 the blood that hemorrhages took place from almoft all 
 parts of the body. In , women the menftrua flowed, 
 fometimes in great quantity, even at irregular periods. 
 Blood flowed alfo from the eyes, nofe, mouth and ears, 
 and from thofe parts where bliders had been laid on. 
 " Nay, (fays our author) in the year 1 739 or 1745, there 
 " were one or two inftances of an haemorrhage from the 
 " fkin, without any apparent pun&ure, or any lofs of the 
 " fcarf-fldn/* The urine was pale while the patient was 
 not yellow, but a deep faffron colour when the yellownefs 
 had come on. Sometimes it was turbid, at others 
 blood/, and the quantity of blood was always in propor- 
 tion to the dafe of the pulfe ; diminifhing as the pulfe 
 became more full, and increafing as it became weaker, 
 
 In 
 
A TREATISE ON 
 
 In the third ftage, which always terminated in 
 the pulfe was exceedingly fmall and Unequal, though foft } 
 the extremities were cold, clammy and livid ; the face and 
 lips in fome flufhed, in others they were of a livid colour ; 
 the livid fpecks increafed fo faft, that in fome the whole 
 bread and heck appeared livid ; the heart palpitated 
 ftrongly ; the heat about the prscordia was greatly in- 
 created, refpiratidn became difficult, with frequent figh- 
 irig ; the patient became anxious and extremely reftlefs, 
 the tweat flowed from the face, neck and breaft, blood 
 from the mouth or nofc-jor ears, ami in fome from all to- 
 gether ; the deglutition became difficult, hiccup and fub - 
 fultus tendinum came on, the patient picked the bed- 
 clothes, was comatous or conftantly delirious. In this 
 terrible (late fome continued eight; ten or twelve hours 
 before they died, even after they had been fo long fpeech- 
 lefs, and without any perceptible pulfation of the arteries 
 and wrifts \ whereas in all other acute difeafes, death 
 follows immediately after the pulfe in the wrifts ceafes, 
 When the difeafe was very acute, violent convulfions 
 feized the unhappy patient, and quickly brought this 
 ftadium to its fatal end. After death the livid blotches 
 increafed faft, efpecially about the face, neck and breaft, 
 and the putrefaction began very early, or rather increafed 
 very quickly. In hot weather, and when the fymptoms 
 at Srtt were very violent,' there was little difference to be 
 obferved between the ffodia, tl-.e whole tragedy being 
 completed in lei's than forty-eight hours. 
 
 On this difeafe in general Dr. Lining remarks, that 
 the infection was increafed by warm, and lefTened by 
 cold, weather. In hot days the violence of the fymp- 
 toms were augmented to fuch a degree as fometimes to 
 become fatal to thofe who, in nlodcrate weather, feemed 
 to be in no danger; while, on the other hand, in cold 
 days, fome who had been in great danger were apparent- 
 ly faved from the jaws of death. The difeafe was alfo 
 more fatal to thofe who lay in fmall chambers without a 
 proper ventilation, to fuch as were of an an athletic 
 an(3 full habit, to ilrangers, natives of a cold climate, 
 inr! to fuch as were moft afraid of it, as well as to thofe 
 
 who 
 
THE YELLOW FEVER. 39$ 
 
 who had previoufly overheated therhfelves by exercife in 
 the fun, or by exceffive drinking of ftrong liquors. It 
 proved alfo moft certainly fatal to valetudinarians, or to 
 iuch as had been previoufly weakened by any difeafe. 
 
 Dr. Lind obferves that " a yellow colour of the fkiii 
 " is obferved not only in common agues, but likewife 
 " in other fevers ; fometimes denoting, as in contagious 
 *' fevers, their malignant nature, at other times, as ia 
 " fome Weft Indian fevers, an univerfal diflblution of 
 " the blood and humours ; and frequently this fymptom 
 " accompanies gentle difcharges of the bile, and a dif- 
 " eafed liver." In fpeaking of the difeafesih the Weft 
 Indies, he mentions fome fevers, which he derives from 
 ftagnated air, " of fuch a maligrlant nature, that the 
 " people after being there a few days are fuddenly feized 
 " with violent vomitings, head-achs, deliriums, 8tc. and 
 " in two or three days more the whole body putrefies, 
 " and the diflblved mafs of blood iflues from every 
 " pore. . . . On confidering the yellow fever particu- 
 " larly he. is of opinion that the remarkable diflblutiort 
 " of the brood, together with the tendency to putrefac- 
 " tion in the whole body, the black vomit, and other 
 " chara&eriftic fymptoms, are often accidental though, 
 " fatal appearances in fevers of the Weft Indies. They 
 " proceed, according to him, in fuch as are newly arrived, 
 " fometimes from a grofs habit of body, exceffive drink- 
 " ing of fpiritous liquors, and from being afterwards 
 " overheated in the fun ; but the intenfe heat and un- 
 " healthfulnefs of the air does much more frequently 
 " produce all thofe fymptoms. This fever was once 
 " fuppofed to have been firft carried into the Weft In- 
 " dies by a (hip from Si am : an opinion truly chimerical -, 
 " as (imilar diieafes have made their appearance, not only 
 " in the Eafl Indies^ but in fome of the fouthern parts of 
 " Europe, during a feafon when the air was irttenfely 
 41 hot and unwholefome. This happened in the months 
 " of September and October 1764, wheh exceffive heat 
 " and want of rain for forrie months gave rife to violent 
 " epidemic bilious difeafes, refembling thofe of the Weft 
 */ Indies, in the city of Cadiz in Spain, of which ari 
 
 E e e " hundred 
 
-94 A TREATISE ON 
 
 " hundred perfons often died in a day. At this time 
 " the winds blew moftly from the fouth, and after fun- 
 " fet there fell an unufual and very heavy dew. The 
 " difeafe began with alternate heats and chills, naufea, 
 " pains of the head, back and loins, and at the pit of the 
 :( ftomach. Thefe fymptoms were often followed, in 
 4 lefs than 24 hours, with violent Teachings, and a 
 :c vomiting of green and yellow bile, the fmell of which 
 " was very offenfive. Some threw up an humour as 
 c black as ink, and died foon after, in violent convul- 
 :c fions and in a cold fweat. The pulfe was fometimes 
 " funk, fometimes quick, but often varying. After the 
 " firft day, the furface of the body was generally either 
 " cold,, or dry and parched. The head-ach and ftupor 
 c< often ended in a furious delirium, which quickly 
 " proved fatal. The dead bodies having been examined 
 <c by order of the court of Madrid, the ftomach, meten- 
 " tery and inteftines were found covered with gangre- 
 :c nous fpots. The orifice of the ftomach appeared ta 
 " have been greatly affected, the fpots upon it being 
 ** ulcerated. The liver and lungs were both of a putrid 
 " colour and texture. 
 
 " The ftomach contained a quantity of an atrabilious 
 " liquor, which, when poured on the ground, produced 
 "' afenfibleeffervefcence ; but, when mixed with fpirit of 
 " vitriol, a violent ebullition enfued. The dead bodies 
 " turned fo quickly putrid, that at the end of fix hours their 
 " fteneh was intolerable, and in fome of them worms 
 " were already found lodged in the ftomach. His Ma- 
 " jefty's fhip the Tweed being at that time in Cadiz bay, 
 " feveral of her men were taken ill when on fliore, but, 
 "by being carried on board, all of them recovered. 
 " Neither did the black vomit or any other deadly 
 " fymptom of that fever make its appearance in any of 
 " the fhips. The dread of this diftemper forced many 
 " people of fadiion to retire into the country, where they 
 < remained in perfect fafety." 
 
 Dr. Lind further remarks, that in the yellow fever it 
 is a bad fign if the ikin is very dry and rough ; " and the 
 " longer it continues in this ftate, the greater is the dan- 
 
THE YELLOW FEVER, 395 
 
 <s ger, as fuch patients feldom recover, though the pulfe 
 " may give hopes, and the other fymptoms alfo be flat- 
 <c tering; for many haveagood pulfe in this fever a little 
 " before death," He alfo quotes Dr. Bruce, an eminent 
 phyfician of Barbadoes, whofe account of the difeafe is to 
 the fame -purpofe. He fays it may come on at any 
 feafon of the year, but that the fymptoms are mod 
 fevere when there is great heat joined with moidure. 
 The blood, even in the beginning of the difeafe, is of 
 a florid red colour, and as it were rarefied ; the crafla- 
 mentum fcarcely cohering -, the ferum of a clay-co- 
 Joured yellow. It fometimes finifhes its courfe in 24 
 hours. 
 
 The account given by Dr. Hillary correfponds alfo 
 very much with that already given, the fubjects of the 
 difeafe are the fame with thofe already mentioned. He 
 has feen it at all feafons of the year, but it is word in a 
 hot feafon, efpecially if it was preceded by moid and 
 warm weather. " Blood, taken even at the beginning 
 " of the difeafe, is often of an exceeding florid red colour, 
 66 much rarefied and thin, and without the lead appear- 
 " ance of fizinefs ; and the craflamentum, when it has 
 " dood till it is cold, will fcarce cohere, but fluctuates ; 
 " the ferum is very yellow. . . . On the fecond or third 
 " day the blood is much more dilTolved, the ferum 
 " more yellow, and the craflamentum Ioofe 5 fcarcely 
 " cohering, but undulates like fizy water when fhaken, 
 " and fometimes has dark, blackifn fpots on its furface., 
 * c fhowing a drong gangrenefcent diathefis. ... In the 
 " latter dage of this fever the blood is fo attenuated 
 " and diflblved, that we frequently fee it flowing not 
 u only out of the nofe and mouth, but from the eyes, 
 " and even through the very pores of the ikin ; alfo 
 " great quantities of black, half-baked, half-mortified 
 " blood is frequently voided, both by vomiting and 
 " dool, with great quantities of yellow and blackifh pu- 
 " trid bile, by the fame ways ; and the urine, which 
 *' was before of a high icteritious colour, is now almoft 
 " black, and is frequently mixed with a quantity of half- 
 " cjiffolved blood. . . . Soon after death the body ap- 
 
 " pears 
 
A TREATISE ON 
 
 c * pears much fuller of livid, large, blackifh, mortified 
 " fpots, particularly about the praecordia and hypocon- 
 " dres, efpecially the right ; which parts feem to be, 
 " even from the firft feizure, the principal feat of this 
 " terrible difeafe. And upon opening the bodies of 
 c< thofe vyho die of it, we generally find the gall-bladder 
 " and biliary ducts filled with a putrid blackifli bile, 
 " and the liver and ftomach, and adjoining parts, full of 
 " blackifh and mortified (pots, and fometim.es. gan- 
 " grenes, in thofe, as alfo in feverai other parts of the 
 " body. And the whole corpfe foon putrefies after 
 <c death, and can be kept but a few hours above 
 " ground." 
 
 Dr. Jackfon, in defcribing the yellow fever of Jamai- 
 ca, acknowledges the difficulty of characterising the dif- 
 eafe, even though he is of opinion that it " poffeffes fome 
 " chara&eriftics of its own, different from thofe of any 
 " other." In a note at the end of his work, he ob- 
 ferves the impropriety of calling it the yellow fever; 
 becaufe that yellownefs fometimes does not appear at all ; 
 and in no one cafe does it ordinarily (how itfelf till the 
 latter ftages. " I know alfo (fays he) that moft of the 
 <c practitioners of Jamaica confider it only as an aggra- 
 " vated fpecies of the remittent, the common endemic 
 " of hot climates. It appeared to me, I muft confefs, in 
 <c a different light. . . . U may not, however, be im- 
 " proper here to take notice of the opinion of Dr. Mofe- 
 <c ley, who has endeavoured to perfuade us that it is no. 
 " other than the katifos, or ardent fever, of the ancients. 
 " e But the yellow fever of the Weft Indies is, by Dr. 
 ** Mofeley's own confefiion, in fome meafure peculiar 
 <c to ftrangers newly arrived in tropical climates. The 
 " kmtfos, we are infornried, made its appearance in the 
 e< iflands of the Archipelago, and on the coafts of the 
 ' contiguous continents, indifcriminately among men 
 " and women, natives and foreigners : in fact it has not, 
 cc as far as I can perceive, any claim to be conlidered as a 
 " diftinct difeafe. If I rightly underfland Hippocrates, 
 l or the defcription of the ftill more accurate Aret^us, 
 * c kaiifos in reality is only an accidental condition of the 
 
 " common 
 
THE YELLOW FEVER. 397 
 
 ** common endemic of the country, where the force of 
 " the fever is chiefly exerted upon the ftomach and ali- 
 " mentary canal. In this manner it appears frequently 
 ** in Jamaica, and in the fouthern provinces of America. 
 " In the hot months of fummer, it appears occafionally 
 <e in every climate ;. and is not necefiarily accompanied 
 " with, nor does it depend upon, a general inflammatory 
 " diathefis of the fyftern for its exiftence." 
 
 The Doctor divides this difeafe into three fpecies : 
 I. Where " figns of putrefaction are evident at a very 
 " early ftage, which is generally rapid in its courfe, and 
 " which cafually terminates in black vomiting. Yel- 
 " lownefs feldom or never fails to make its appearance in 
 " the prefent inftance ; and perhaps it is the only one 
 " which, ftrictly fpeaking, can be called the yellow fever. 
 " 2. A form of fever which has either no remiffions, or 
 " remiffions which are fcarcely perceptible ; in which 
 ci figns of nervous affection are more obvious than fymp- 
 " toms of putrefcency ; and in which yellownefs and black 
 " vomiting are rare occurrences. 3. Another form, in 
 " which regular paroxyfms and remiffions cannot be tra- 
 " ced j but in which there are marks of violent irritation, 
 " and appearances of inflammatory diathefis in the ear- 
 " Her ftage, which give way, after a fhort continuance,. 
 " to figns of debility and putrefcency, to which yellow- 
 " nefs frequently fucceeds, or even fometimes the fo 
 *' much dreaded vomiting of matter of a dark colour. 
 " The difeafe in thefe three forms appears to be in reality 
 " one and the fame. The difference of the fymptoms 
 " probably arifes from very trivial or very accidental 
 " caufes. It is in fome meafure peculiar to ftrangers 
 " from colder regions foon. after their arrival in the Weft 
 6C Indies, and may generally be diftinguiflicd from the com- 
 " mon endemic of the country, not only by a total want of 
 " paroxyfms and remiflions, but likewife by a certain ex- 
 " preffion of the eye and countenance, with fomething un- 
 " ufually difagreeable in the feelings, of which words 
 " convey only an imperfect idea." 
 
 The fymptoms enumerated by Dr. Jackfon are in 
 general the farne with thofe already taken notice of, 
 
 He 
 
A TREATISE OM 
 
 He mentions likewife a degree of confufion frequently 
 joined with grimnefs, difficult to be defcribed in words, 
 but which a perfon acquainted with the appearances of 
 the difeafe immediately recognifes as one of its dif- 
 tinguifhing marks. v In the fecond ftage he fays, that no 
 fweat or moifture was now obfervable on any part of the 
 body : the ftate of the fkin impreffed the idea as if it 
 were not pervious to any degree of perfpiration, and heat 
 gradually tbrfook the furface and extremities : the tongue 
 became moift, and at the fame time frequently clean about 
 the edges ; the gums became redder, more fpongy, and 
 {bowed a greater difpofition to bleed i vomiting was 
 troublefome : the matter thrown up was ropy, in large 
 quantity, and abounding with villous or mucous flakes 
 of a darker colour. The circulation in the extreme 
 vefFels became gradually more languid ; the natural heat 
 retired from the furface of the body, which was now dry 
 and impervious ; the pulfe returned nearly 1 " to its ordinary 
 itate, or became flow, full and regular ; the yellownefs 
 increafed faft, fo that the whole body was frequently 
 yellow as an orange, or of as deep a colour as the fkin of 
 an American favage : anxiety was inexpreiTible ; vomit- 
 ing was irreftrainable, and the vomiting of a matter like 
 the grounds of coffee at laft made ifcs appearance. This 
 matter was often as black as foot, where the progrefs of 
 the crifeafe had been rapid ; while it was not only lefs 
 intenfely black, but often tinged with green, where the 
 difeafe had been more flow and gradual. The number 
 of villous or mucous flakes, in the matter difcharged by 
 vomit, increafed as the difeafe advanced, and with them 
 were joined ftreaks of blood, which feemed principally to 
 come froai the throat and gums. As the difeafe advanced, 
 the vomiting became more frequent, but was'feldom ac- 
 companied with any violent retching. Quantities of 
 liquor were difcharged, fo enormous that it was often 
 difficult to imagine whence they came, after which the 
 patient enjoyed fome refpite, till a iimilar collection was 
 made. As foon as the matter difcharged by vomit ac- 
 quired this dark and footy colour, the belly generally 
 became loofe, the ftoqls being black, fmpoth, and not 
 
 unlike 
 
THE YELLOW FEVER. 399 
 
 tsnlike tar or molaiTes ; the tongue became clean, the 
 gums putrid ; haemorrhages, or rather cozings of blood, 
 were fometimes obferved in different parts of the body, 
 while livid blotches made their appearance on the belly 
 and infides of the thighs. The pulfe, which during the 
 latter ftages of the diftemper could fcarcely be diftin- 
 guiihed from that of aperfon'in health, became at laft 
 irregular, quick, or intermitting ; foon after which coma 
 or convulfions clofed the fcene. Sometimes the yellow- 
 nefs fucceeded the black vomiting. In thefe the vo- 
 miting began unexpectedly, or without much previous 
 affedion of the ftomach : the colour was commonly in- 
 tenfely black ; the patient turned yellow almoft in an 
 inftant, and died in a very fliort time. When any one 
 recovered from this deplorable fituation, of which there 
 were forne few inftances, the termination was not by 
 any regular crifis. The black vomiting ceafed, fome- 
 times apparently in confequence of treatment, fome- 
 times evidently of its own accord : but a vomiting of 
 a ropy, glutinous matter continued for a great length of 
 time, together with an extreme irritability of the fto- 
 mach, and a very peculiar (late of the fkin j which fome- 
 times did not recover its natural fmoothnefs and unc- 
 tuofity for feveral weeks. 
 
 The difpofition to faint, fo common in the yellow 
 fever, is fuppofed by Dr. Jackfon to arife from a kind of 
 torpor in the nervous fyftem, rather than the ufual caufes 
 of fainting. For this opinion he affigns as a reafon, that 
 44 the patient was often able to ftand upright for fome 
 " time, and even to walk to a conliderable diftance ; 
 " and, when at laft overcome, was obferved to fall down 
 " in a torpid, rather than a fainting, {late." 
 
 In diffcdions our author obferved that the omentum 
 and all its appendages were in a dry and parched ftate, 
 and of an uncommon dark grey colour. But, along 
 with this dark grey colour, and want of uRcluofity and 
 moifture, ufually met with in the abdomen, the ftomach 
 and inteftines had a dirty yellow appearance, were highly 
 putrefied, and much diftended with wind. The liver 
 and fpleen were generally enlarged in fize ; the former 
 
 of 
 
4od A TREATISE ON 
 
 of a deeper yellow than any of the other abdominal 
 vifcera ; while the texture of the fpleen was often lefs 
 firm than natural. The bile was ufually black and 
 thick, like tar or molaires ; the blood-veflels of the liver 
 bearing marks of uncommon diftenfion. A quantity of 
 black fluid, fimilar to that ejected by vomit, was found 
 in the ftomach, which fluid our author fays pofitively 
 derived its blacknefs from the bile, the flakes obferved 
 to float in in being parts of the villous coat of the fto- 
 mach abraded. He denies that the black colour of the 
 matter vomited is owing to blood, as many authors have 
 fuppofed. He fays that the paffage of the bile might 
 be eafily traced from the gall-duel: into the pylorus. 
 
 This being in the Doctor's opinion the only true kind 
 of yellow fever, we fhall not follow him through the 
 defcription of the other two fpecies, but proceed to con- 
 fider that remarkable and exceflively fatal diftemper 
 which appeared in the year 1793, firft in the Weft In- 
 dia iflancls, and then on the American continent. Dr. 
 Chiiholm, who has defcribed the diftemper very particu- 
 krly^ derives it from the coaft of Africa, and gives the 
 following account of its origin on the authority of a 
 Mr. J. Paiba, " one of the adventurers in the Boullam 
 " fcheme ; and who, defpairing of fuccefs, left the coaft 
 " of Africa in a veflel called the Hankey. This veflel 
 " failed from England in April 1792 with (lores and 
 44 adventurers for the intended colony at Boullam. The 
 " people were all in good health : that part of the coaft 
 fcC of Africa on which they touched is remarkable for its 
 44 healthinefs ; only it is deftitute of water except what 
 44 can be procured by digging temporary wells on the 
 44 beach, and which is brackilh, and confequently un- 
 " wh'olefome. The ferocity of the negroes who inhabit 
 44 that part of the continent prevented them from being 
 44 accommodated on (hore, fo that they found themfelves 
 46 obliged to remain on board the Hankey for nine 
 44 months. As the rainy feafon came on almoft imme- 
 " diately after their arrival on the African coaft, they 
 44 attempted to flicker themfelves by raiiing the iides of 
 44 the veflel feveral feet, and covering it with a wooden 
 
 44 roof- 
 
THE YELLOW FEVER. 401 
 
 *' roof.' 1 Thus were upwards of two hundred perfons, 
 among whom were many women and children, con- 
 fined in fuch a manner as muft be fuppofed capable of 
 producing fevers of a bad kind, if they could be produced 
 by fuch caufes. Accordingly a malignant fever did 
 break out ; the veflel was not ventilated, nor were the 
 bed-clothes, &c. of the fick deftroyed ; from whence 
 Dr. Chifholm concludes that the infection remained 
 on board the veflel. The Doctor then proceeds to give 
 the following account of the veflel after her departure 
 from Boullam :* " Capt. Coxe, finding the water at 
 " Boullam unwholefome, proceeded with his fhip to 
 "Biflao, where there is a Portuguefe fettlement, fora 
 " fupply. The fhip was navigated by about twelve fea- 
 " men, moft of whom had not experienced ficknefs, and 
 " had probably been procured from Sierra Leone : at 
 C any rate they were then taken on board for the firft 
 " time. Of thefe, before the return of the Hankey to 
 " Boullam, nine died ; and the remainder, with the 
 " captain, were reduced to a deplorable ftate. The 
 " time for which the Hankey was chartered being ex- 
 :t pired, Mr. Paiba, with his family, intended to return 
 <c to England in her ; but as no feamen could be pro- 
 " cured they put to fea, having on board the captain, fick, 
 '* and only the mate, Mr. Paiba and two feamen to navi- 
 " gate the fhip. With much difficulty they arrived at 
 " St. Jago, where they fortunately found the Charon 
 lt and Scorpion fhips of war. Capt. Dodd of the for- 
 ** rner, humanely rendered them every fervice in his 
 i power, and on leaving them put two men of each fhip 
 ;t on board the Hankey. With this aid they proceed- 
 * c ed to the Weft Indies ; a voyage to England being 
 impracticable in their wretched ftate. On the third 
 " day after leaving St. Jago, the men they procured 
 '* from the (hips of war were feized with the fever, which 
 4 had carried uff three fourths of thofe on board the 
 : Hankey at Boullam; and, having no afliftance, two 
 " of the four died : the remaining two were put on 
 
 " board 
 
 * Chiftiolm's Eflay on the Malignant Peftilential Fever, p, 86. 
 Fff 
 
40* A TREATISE ON 
 
 " board here in the moft wretched (late poffible, Capt. 
 " Dodd, on his arrival at Barbadoesfrom the coaftof Afri- 
 " ca, was ordered to convoy the homeward -bound fleet of 
 " merchantmen. In the execution of his orders he came to 
 " Grenada on the zyth of May, and, hearing of the 
 *' mifchief which the Hankey had been the caufe of, 
 " mentioned that feveral of the Charon*s and Scorpion's 
 " people were fent on board the Hankey at St. Jago> ta 
 lt repair her rigging, cc. that from this circumftance,. 
 cc and the communication which his barge's crew had 
 " with that fbip, the peftilence was brought on board 
 "both ihips; and that of the Charon's crew thirty 
 <c died, and of the Scorpion*s, about fifteen. The Han- 
 " key arrived at the port of St. George's (in Grenada) on 
 " the i Qth of February, in the moft diftrelTed fituation, 
 * 4 and for a few days lay in the bay, but was afterwards 
 C brought into the careenage. From this period are we 
 ** to date the commencement of a difeafe before, I be- 
 " lieve, unknown in this country, and certainly un- 
 <{ equalled in its deftruclive nature." 
 
 This account of the introduclion of the fever (which 
 however is by Dr. Chifholm accounted very different 
 from the yellow fever above defcribed) is fo clear and 
 diftinft, that, at firft reading, it commands our belief. 
 It hath not, however, met with uaiverfal approbation ; 
 and even the /<?&*, for which both parties appeal to Mr. 
 Paiba and capt. Dodd, vary from one another in a fur- 
 prifing manner. Dr. Trotter, in his Medicina Nautica, 
 ^. 328, gives the following account : " Dr. Chifliohn 
 " tells us, that the fhips of war on the African ftation, 
 * c having fent men to affift the Hankey, after numbers 
 " had perifhed from the fever, received the infection by 
 C{ means of this communication, and that in the Charon 
 *' thirty died, and fifteen in the Scorpion. Capt. Dodd, 
 " who at that time had his broad pendant in the Cha- 
 * e ron, now commands the Atlas of 98 guns in the fleet 5, 
 " Mr. Smithers, the furgeon, is at prefent in the For* 
 < midable, a fecond rate, alfo in the fleet ; from them I 
 <c have copied the following narrative of their tranfac- 
 " tions with the Hankey : 
 
 When 
 
THE YELLOW FEVER. 
 
 403 
 
 " When the fquadron under commodore Dodd 
 *' came to St. Jago in 1793, the Hankey lay there in 
 " great diftrefs for want of hands ; having buried above 
 " one hundred perfons, men, women and children, from 
 " the time (he had been at Bulam. The fever was now 
 " overcome : Mr. Smithers faw two men that had lately 
 u recovered. He left a quantity of bark. The Charon 
 <c and Scorpion fent two men each to ailift in navigating 
 " her to the Weft Indies. The Hankey at this port 
 < was cleaned, wafhed with vinegar, and fumigated. N& 
 "fever appeared in either of the men of war, in confe- 
 " quence of this communication ; they arrived at Gre- 
 " nada in perfect health, but did not go into the fame 
 .*' part of the ifiand to which the Hankey went. The 
 ** Charon, at this harbour received fome feamen from 
 " the merchant ihips then taking in cargoes for England $ 
 * c (he had afterwards fourteen cafes of yellow, fever, of 
 " which one died : but it is remarkable that the Scor- 
 " pion did not bury a fingle man during the whole voy- 
 <c age.* It is probable from thefe facts, that the Han- 
 *' key did not import the infection that produced the 
 Ci Grenada fever , for, after the dijeafe was worn out, (he 
 " had a paffage to make to the Weft Indies of many 
 " hundred leagues. It is alfo doubtful how the effects 
 " left in the Hankey could produce the fever, for the 
 " bedding was thrown away, and what clothing remained 
 " had been aired, and probably had fcarcely been in 
 * c contact with the body after being fick. J> 
 
 The difcordance between this and the foregoing ac- 
 count is abundantly evident. Dr. Chifholm's account 
 of the bedding, &c. is alfo very different. " Our lieu- 
 * c tenant governor, Ninian Home, efq. fome time after 
 " the difeafe became epidemic, informed me, that, in 
 :c confequence of the information he had received of 
 " the clothes, &c. of the victims of the fever at Boul- 
 " lam being ftill on board the Hankey, he ordered Capt. 
 s ' Coxe to be brought before him and fome gentlemen 
 44 of the council. He then acknowledged, that all the 
 " effects of thofe who had died were then on board his 
 
 " (hip, 
 * To this is fubjoined the attention f M r. Smithers with refpefl to the Charon* 
 
404 A TREATISE ON 
 
 " (hip, and faid that he would not deftroy them,<unlef$ 
 " he was indemnified for the lofs he might fuftain, 
 1 c fhould the heirs of the deceafed call on him for thofe 
 cc effects. Every argument was ufed to induce him to 
 <c deftroy the articles, but the only one which influences 
 <c a man of this defcription, indemnification ; and he of 
 < courfe carried the feminium of the difeafe to England," 
 It was this confideration which induced the governor to 
 write to the fecretary offtate, and in confequence of his 
 reprefentation thevefTel was obliged to perform quaran- 
 tine in England, a circumftance which Dr. Trotter 
 mentions without approbation. 
 
 Thus far the matter of faft feems to be Very much 
 obfcured ; and the more we inveftigate, the more we are 
 involved in darknefs. In the Medical Repofitory, vol. i, 
 p. 484, we find the following fevere cenfure paffed upon 
 Dr. Chimolm by the late Dr. Smith of New York : 
 " It belongs to another part of this paper to aflign the 
 " probable motives of Dr. Chifholm for maintaining 
 " that the fever was imported into Grenada : certain it 
 " is that he avowed a different opinion to Mr. Paiba, to 
 " whom he freely declared, that he could by no means 
 " trace the difeafe to the Hankey , and that he believed 
 " it to be of local origin, owing to the unhealthy condi- 
 " tion of the careenage, and the particular prevailing 
 " winds : and, to confirm this notion, he informed 
 " Mr. Paiba that a fimilar difeafe, from the fame caufe, 
 " though in a lefs degree, had exifted in St. George's 
 <{ fome years before." 
 
 This was plainly giving Dr. Chimolm the lie ; which, 
 whatever might have been the confequence between the 
 two parties, abfolutely fuperfedes, to any impartial and 
 unconcerned perfon, the evidence of both, at Jeaft as far 
 as regards the origin of this difeafe. It is not, however, 
 to be fuppofed that Dr. Chifholm would pafs fuch a cen- 
 fure unnoticed. He did accordingly reply in a letter to 
 Dr. Smith, who had fent him a copy of the Repofitory, 
 with a letter inviting him to defend what he had faid. 
 Dr. Smith died before this letter reached him, but the 
 principal part has appeared in the Medical Repofitory, 
 
 voh 
 
THE YELLOW FEVER. 405 
 
 vol. ii, p. 285. In this Dr. Chifliolm retracts what he 
 had faid concerning the mortality on board the Charon 
 and Scorpion (hips of war. " I have lately received 
 " (fays he) from a gentleman of the navy here, a log- 
 " book of the Charon, kept by one of her officers during 
 " the voyage in queftion. In this I find, that no fick- 
 " nefs took place in either of thefe (hips in confequence 
 " of this interview. A log-book is unqueftionable 
 " evidence, and I therefore admit it." As to the more 
 ferious part of the charge, viz. that Dr. Chifliolm had 
 wilfully rnifreprefented matters, the Dodor replies, that 
 the narrative publifhed by him was in general fuch as he 
 had from Mr.Paiba ; not indeed in manufcript, as Dr. 
 Smith ftated his to have been, but in converfation; and 
 that this convocation took place expreflly with a view 
 to elucidate the caufe of the fever, which he (Dr Chif- 
 holm) could not account for by any reafoning from 
 local caufes, but heard it very generally afcribed to in- 
 fection from the Hankey. Mr. Paiba was introduced 
 to Dr Chifliolm at the requeft of the latter by the Hon. 
 Samuel Mitchill now (the letter is dated Sept. 6th 1768 
 probably 1798) the fenior member of the council of 
 Grenada. " Mr. Mitchill (fays the Doclor) brought 
 *' Mr. Paiba to my houfe, and was prefent during the 
 " greateft part of the time the converfation continued. 
 * ; 1 found Mr. Paiba very willing to give me every infor- 
 <e mation in his power relative to the ftate of the Bu- 
 " lama or Boulam colony, and of the fliip Hankey ; 
 " but I found him ftrongly difinclined to fall in with the 
 " univerfally received opinion, that that fliip introduced 
 *' the difeafe. The particulars I have given, are thofe 
 " Mr. Paiba related to me in this converfation ; and, in 
 * c order to be correct, I immediately, after Mr. Paiba 
 " left me, committed them to paper. Mr. Paiba pro- 
 " mifed to favour me with a written account ; and in 
 *' order to direct that gentleman's attention to the points 
 " I confidered as of moft importance, I drew up a fet of 
 " queries, and Mr. Mitchill charged himfelf with the 
 " delivery of it. A copy of thefe I have now in my 
 " pofleflion, and a flight attention will exhibit my view 
 
 "in 
 
4 otS A TREATISE. ON 
 
 " in framing them, and foow the doubts refpeding.. the 
 " nature of the epidemic which fuggefted them. Al- 
 46 though I repeatedly, through Mr. Mitchill and Mr. 
 cc Palmer, the gentlemen with whom Mr, Paiba refided 
 " in the country, renewtd my requeft to have this pro- 
 " mife fulfilled, Mr. Paiba left the liland without gra- 
 " tifying it. If no other ftrong proof exifted of fome- 
 " thing peculiar in the fever which at that time prevail- 
 * : ed, the circumftance of my formally applying to Mr. 
 " Paiba ; for information relative to the ftate of the 
 " Hankey, and of taking the trouble to obtain an inter- 
 * c view with him, prefents an evidence as conclufive as 
 " can well be required by reafonable men. But the be- 
 " lief of the infection of the Haukey was univerfat, nor 
 cc was it by any means confined to thofe whole intereft 
 " might have been affedled by the profperity of an in- 
 *' fant colony on the coaft of Africa/' 
 
 Another charge againft Dr. Chifholm is, that he falfi- 
 fies the date of the Hankey's .arrival at Grenada ; and 
 which in Dr Smith's paper is brought forward in the fol- 
 lowing words : " In p. 91 the Doctor remarks, thaj:, ' in 
 sc the fhort fpace of time from the beginning of March 
 <c to the end of May, 200 of about 500 failors, who 
 <c manned the iliips in the regular trade, died of this 
 ** fever.* By this it appears that the fever in queftion 
 ^ broke out as early as the beginning of March. The 
 * 4 difingenuoufnefs of this author is particularly evident 
 *' from this quotation, if the period of the commence* 
 $< ment of the difeafe be correctly ailigned : and that it 
 *' is fo is probable from the difficulty of concealing the 
 " fact ; as there muft have been thoufands of witneifes 
 ^ to the progrefs of the fever. When therefore it was 
 fc thought proper to fix the odium of introducing the 
 <c difeafe upon the Hankey (a project of which Dr. 
 *' Chifholm feems originally to have had no idea) it be- 
 " came neceffary for him to fix an earlier dale to her 
 " arrival. Now, that the Hankey did not arrive till 
 cc towards the latter end of March, is verified by the 
 " concurring teftimony of Mr. and Mrs. Paiba, and of 
 M Mr. Bell, of this city (New York) who happened to 
 
 "be 
 
THE YELLOW FEVER. 
 
 ** be in Grenada about that time, and was perfonal- 
 <fi ly acquainted with Mr. and Mrs. Paiba in that 
 " ifland." 
 
 In anfwer to this Dr. Chifholm repeats his declara^ 
 tion that the Hankey arrived at Grenada on the i8th 
 of February, and not on the I9th of March, as Dr. 
 Smith (fuppofed 911 the authority of Mr. Paiba) had 
 ftated. In proof of this he produces an inconteftible 
 evidence, viz. an extract from the St. George's Gazette 
 in Grenada, of date ipth of February, which begins 
 thus : " By the (hip Hankey of London, arrived here 
 ytfterday from the ifiand of Boulam on the coaft of Afri- 
 ca, we are informed," &c. The remainder of the ex- 
 tract contains an account of the exceffive mortality on 
 board the fhips $ which, as it may perhaps be exagge- 
 rated, it is needlefs to tranfcribe. 
 
 The next thing of confequence is the deftru&ion of 
 the bed-clothes and effects of the deceafed ; of which 
 Dr. Smith fays, '* Before the Hankey put to fea, all 
 " the bedding of the fick was thrown overboard or de- 
 4C ftroycd ; the (hip was warned from ftem to ftern, both 
 " above and below, with fait water ; and the purifica* 
 " tion was completed by fumigating her with tar, pitch 
 " and gun-powder. In this clean condition they bade 
 *' farewel to Bulama on the azd of November, 1792 $ 
 '< but, in attempting to pafs through the channel near 
 " to the entrance into the open fea, in a dark and foggy 
 " night, they got aground on a fand-bank, upon the 
 " north fide of the iSand of Formofa or Warang, be- 
 " longing to the Bijugas, who are reprefented as canni-* 
 <s bals. The extreme terror excited by this accident 
 " was not calculated to improve the health of the peo- 
 " pie on board the Hankey ; fo that, yvhen it became 
 14 necefTary to take meafures for their fecurity and de- 
 cc liverance, only four men were found in a condition to 
 GC do duty, and all of thefe had intermittents. With 
 ' them, however, and his lady, Mr. Paiba fet off, in an 
 :c open boat, for Biflao, to obtain afliftance from the 
 ' Portuguefe fettlement. Thither he arrived, rowing 
 " though rains and fogs, in a leaky boat, after being out 
 
 " two 
 
A TREATISE ON 
 
 " two nights and a day ; and having obtained fuch help 
 <e as he could, returned to the Hankey, got her off, and 
 "carried her to Biflao. On the paflage there eight per- 
 " fons died who belonged to this (hip. At Biifao they 
 " refitted, and the Hankey was a fecond time purified as 
 " completely as /Jie had been before leaving Bulama." 
 
 In anfwer to all this Dr. Chiftiolm again declares, " that 
 <c the bedding and effects of the deceafed were preserved 
 " on board the Hankey, and conftituted the feminium 
 * c of the infection. Capt. William Liddle, of the (hip 
 " General Mathew, faw them on board ; and it was in 
 <c confequence of that gentleman's reprefentation that 
 " the lieutenant governor, Mr. Home, entered into a 
 " ftrict inveftigation of the matter ; the general refult of 
 " which I have given ; and the authenticity of it may be 
 " depended on. Capt. Liddle is now refident in Lon- 
 " don, and Mr. Byles, the governor's fecretary, is now 
 " reiident commiffary at Grenada ; and thefe gentlemen 
 * will readily teftify to the truth of my (latement. The 
 "* deftructive articles I have mentioned were not throivn. 
 *' overboard till the Hankey arrived in Grenville Bay, 
 " when they were deftroyed at the requeft of Mr. Prend- 
 " foot, the gentleman who chartered the (hip for Eng- 
 " land. 
 
 Dr. Chiftiolm is likewife charged with having mif- 
 ftated the cafe of ajjfapt. Remington, faid to be the firft 
 who fuffered by the fever in Grenada. The words in 
 Dr. Chifholm's Eflay are, " A Capt. Remington, an in- 
 44 timate acquaintance of Capt. Coxe's, was the firft per- 
 " fon who vifited the Hankey after her arrival in St. 
 " George's bay. This perfon went on board of her in the 
 C evening after (lie anchored, and remained three days ; 
 " at the end of which time he left St. George's, and pro- 
 " ceeded in a drogher (a coafting veflel) to Grenville 
 *' bay, where his (hip, the Adventure lay. He was feiz- 
 <e ed with the malignant peftilential fever on the paflage ; 
 ** c and the violence of the fymptoms increafed fo rapidly, 
 " as, on the third day, to put an end to his exiftence." 
 In oppofition to this Dr. Smith gives the follwing ftate- 
 jnent from Mr. Paiba : " He (Capt. Remington) had 
 
 " beca 
 
THE YELLOW FEVER* 409 
 
 a been all day and all night coming from Grenville bay* 
 ** and had been wet through. He Hept on board in his 
 " clothes j and went in an open boat the next day back 
 46 to his fhip : enough to kill any one in that climate.'* 
 Dr. Chiiholm replies " that the above ftatement is not 
 " correct, nor founded on fact ; Dr. Chifliolm's evidence 
 " for what he faid was founded on the information of 
 " captains ofveffels, who knew all the circumftances of 
 " his vifit to the Hankey ; and of Dr. Stewart, an emi- 
 " nent practitioner, who attended him at Grenville bay* 
 " when he landed there. Laftly, that the idea of his 
 " having returned to Grenville bay in an open boat, is 
 " abfurd ; nothing of the kind having been ever at- 
 " tempted.** 
 
 From this tedious account it is plain that the evi- 
 dence relative to the importation of the fever into Gre- 
 nada by the Hankey is quite contradictory, and fubver- 
 live of itfelf, becaufe we are unable to judge between 
 the two difputants. A further confideration of it would 
 lead us entirely from the fubject of this treatife, into an 
 endlefs difpute about which of the two parties had fpo- 
 ken the truth. Setting aiide therefore the whole of the 
 evidence on both fides as inefficient, we fliall now pro- 
 ceed to give an account of the fymptoms of the diftem- 4 
 per as defcribed by Dr. Chifholm, and to which defcrip- 
 tion there has never been any objection made. 
 
 In the moft violent kind of this fever, according to 
 our author, " the patient, without any previous com- 
 :c plaint, fuddenly becomes giddy ; he lofes his eye-fight j 
 c; everything feerns to move round him with inconceiva- 
 * ble velocity ; h falls down almoft infenfible, and in 
 " that (late remains near half an hour, or upwards* 
 " Daring this paroxyfm the body feels cold, and is over- 
 " fpread with cold iwcat, which iflues from every pore 
 " in aftonifliing abundance. On his recovery the cold 
 " goes off, and is inftantly fucceeded by intenfe heat, and 
 * 4 quick, fmall, hard pulfe j the head achs dreadfully, 
 :e particularly the fore part ; generally accompanied with 
 " pain in the right fide and at the pr^ecordia. The lad, 
 " however, has never been acute, and may rather be cal- 
 G g g " led 
 
4 io A TREATISE ON 
 
 * c led oppreffion than pain. The eyes are much inflamed; 
 cc watery, protruded, and wildly rolling ; the face much- 
 " fluihed ; much heat is felt at the pit of the ftomach, 
 " and that organ feems to be confiderably affected by 
 " the frequent retching and vomiting which then come 
 " on. The patient foon after complains of intolerable 
 " pains in the (mail of his back and in the calves of his- 
 *' legs ; but the latter appears to be moft violent. Dur~ 
 " ing twelve, eighteen, twenty-four or thirty-fix hours, 
 " thefe fymptoms continue increafing, except the quick- 
 " nefsand hardnefsof the pulfe, which does not change 
 :c materially during that time ; and are then fucceeded 
 cc by general coldnefs, cold fweat, a greater or lefs degree 
 <c of coma and delirium, or a ftate very much refembling- 
 Cft intoxication. Life in this ftate is lengthened out to 
 " fixty or ninety hours from the firft attack. A fhort in- 
 " terval of reafon then takes place ; the patient confiders 
 <c hirnfelf better, and is, fora moment, flattered with the 
 " profpect of recovery : but a fit as fudden and unex- 
 <{ peeled as the firft comes on, during which he foams g 
 " at the mouth, rolls his eyes dreadfully, and throws, 
 <c out and pulls back his extremities in quick fucceffion. 
 " In general the patient expires in this fit j but fome 
 " have recovered from it, and continued rational for a 
 <c few hours longer, when a fecond fit has carried them 
 off." 
 
 This, without much deviation, was the general pro- 
 grefs of the worft kind of the fever. In fome, however, 
 a comatofe difpofition fhowed itfelf from the very firft ; 
 in others the difeafe began with fliort convulfive fits in 
 frequent fucceffion, followed by conilan.t delirium and 
 cold clammy fweat, without any intervening heat. In 
 a few cafes the firft fymptoms were coldnefs and fhiver- 
 ing, as in other fevers. 
 
 The diftinguiihing fymptoms were the uncommonly 
 fudden attack, the remarkably acute pain in the loins and 
 calves of the legs, the watery, inflamed and rolling eye, 
 flufhing of the face, tendency to coma, the pain general- 
 ly confined to the forehead, and the peculiar caft of the 
 delirium, during which the looks and actions of the pa* 
 
 tient 
 
THE YELLOW FEVER. 412 
 
 tient very much refembled thofe of a perfon intoxicated. 
 It was never furious in any other way than by making 
 efforts to get out of bed ; and thefe in a few inftances 
 rofe fo high that the patients got up, dreffed themfelves, 
 and walked out a confiderable way before they could be 
 overpowered. " The ftrength during the delirium is 
 " to appearance furprifingly great, for it is frequently 
 " neceffary to ufe the united efforts of two or three men 
 *' to keep the patient in bed. This is, however, no more 
 " than a fpafmodic affection of the mufcles ; for in re- 
 " ality the powers of the fick in this difeafe are reduced 
 " to the extreme of debility, as is feen in the convalef- 
 -" cent ftate." 
 
 The moft unequivocal characteriftic of this difeafe, 
 liowever, according to our author, rs the appearance of 
 a kind of petechise, but which look rather like red or li- 
 vid patches than what is commonly underftood by that 
 word. They were always the forerunners of death. 
 In a few very violent cafes the body was almoft of a livid 
 or black colour, but they were generally feated on the 
 neck, (boulders and breaft. Vibices alfo, like thofe iti 
 the plague, defcribed p. 258, fometimes made their ap- 
 pearance, and were alfo a fatal prefage. 
 
 Haemorrhage occurred much more frequent and pro* 
 fufe in this than in any other acute diftemper our author 
 had met with. <c In feveral inftances, the immenfity of 
 " blood difcharged has evidently been the more imme- 
 " diate caufe of death. The robuft, plethoric and groft 
 " habits have been the moft fubject to it. It has taken 
 " place from the noftrils, mouth, anus, and urethra; 
 " fometimes from the canthi (corners) of the eyes ; but 
 C never, I believe, from the ears or pores of the fkin. 
 " The moft profufe difcharge has been from the noftrils 
 < and anus, and has frequently, amounted to three or 
 " four pounds at a time; the ftools having been on thofe 
 ts occafions entirely compofed of pure blood. Towards 
 " the clofe of life, the blood thus difcharged has appeared 
 " granulous, or like ichor, with a fediment of a black 
 * c gritty fubftance, and has been fo extremely offenfive 
 * as to oblige all the attendants to keep at a confiderable 
 
 " diftance 
 
4 i2 A TREATISE ON 
 
 " diftance till the hemorrhage ceafed. Hemorrhage 
 " however, has never been critical, nor has it in any 
 cc inftance permanently relieved the head-ach or pain in 
 " the breaft or fide, . . . Nearly about the period that 
 thefe profufe difcharges came on, a rawnefs was felt on 
 " the whole of the interior furface of the nofe, and on 
 " feveral parts of it little ulcers formed $ on thers, 
 " fmall efchars, which were remarkably itchy, but on 
 ' being touched, or an attehipt made to detach them 
 * c from the membrane of the nofe, were very painful, and 
 " bled. Thefe difappeared in proportion to the patient's 
 *' recovery j and I have reafon to fufpect, that, when 
 " the iffue of the difeafe was fatal, thefe little efchars 
 *' became gangrenous." 
 
 In this diftemper there was always a tendency to coma 
 after the firft two days ; and after the third, it certainly 
 came on. On examining the heads of two who died 
 convulfed after having been comatofe for fome time, a 
 great quantity of ferum was found in the brain j and, on 
 narrowly infpecYmg the^eyes of thofe who were after- 
 wards feized with coma, the pupil was found manifeftly 
 dilated. 
 
 A remarkable fymptom unnoticed in any other fever 
 is taken notice of by our author ; viz. an affection of the 
 tefticles. " About the end of the fecond day the pa- 
 :c tient began to complain of a violent pain in thefe parts, 
 " accompanied with a contraction of the fpermatic cord, 
 " and a drawing up of the tefticles towards the abdo- 
 * c minal ring. On examination they appear very much 
 " leflened in fize, are drawn up coniiderably towards the 
 " abdomen, and the fcrotum appears at the fame time 
 " remarkably flaccid and empty. The furfacs of the 
 " fcrotum becomes foon after very painful, and an exco- 
 " riation takes place, chiefly at the mofl defcending 
 <c part, from which a confiderable quantity of very offen- 
 * 6 five purulent matter iflues : at the fame time a fimilar 
 " difcharge from the urethra takes place, which ceafes 
 " with the difeafe when the event is favourable, or be~ 
 61 comes ichorous and bloody, and infufferably fcetid 
 t when death is the confequcnce. In cafes which ter^ 
 
 ** minate 
 
THE YELLOW FEVER. 413 
 
 * ruinate favourably, the whole of the fcrotum, in a few 
 *' days, is covered with a cruft of hardened pus, which, 
 *' in the convalefcent flate, comes away very eafily by 
 * c means of a warm bath. The thicknefs of this coat 
 " may be about the fourth of a line ; and, when fepara- 
 <c ted, it much refembles moiftened parchment. In 
 " fatal cafes, this affection of the fcrotum always termi- 
 " nates in gangrene a few hours before death." 
 
 Another remarkable fymptom is the change of voice 
 to a (brill, foft and low found when compared with the 
 natural tone, at the fame time that the fyHables are more 
 diftinguifhed, and the words are flrangely lengthened out 
 in a drawling and whining manmer. This change of 
 voice affords a pretty certain prognoflic ; every altera- 
 tion towards the natural tone being an almoft certain 
 fign of a favourable change* and the contrary if the 
 voice becomes farther removed from it. 
 
 The pains felt in this fever were in a great meafurc 
 peculiar to it, and feem to have been of a fpafmodic na~ 
 jture. In the head the pain fi\ot from the forehead, to 
 which it was confined, invariably towards the bottom 
 of the orbits, where it was generally exquifite. Some- 
 times it extended to the temples, where 'there was al- 
 ways a throbbing ; but in no cafe did it extend to the 
 back part, or over the whole head. This pain extended 
 alfo to the balls of the eyes, which were protruded, and 
 feemed ready to flart from their orbits, with an inflam- 
 mation externally, and a fenfation of pain internally,, 
 rendering the admiflion of light intolerable. In the 
 legs the pain had its feat at the top of the great tendon^ 
 immediately below the calf, and in the point where it 
 was feated a gnawing fenfation was felt, occafioning ex- 
 quifite torture, with an involuntary contraction of the 
 limb 3 ib that, on the whole, our author concludes that 
 this pain much refembles the cramp, differing only ii* 
 being more permanent. 
 
 With regard to the pulfe, our author obferves, that 
 in this difeafe " it never intermits. Even at the ap- 
 " proach of death it has not intermitted, but has gene- 
 *' rally been remarkably tremulous, and fo flow as to 
 
 beat 
 
A TREATISE 
 
 t beat no more than thirty times in a minute. On the 
 " whole, it has not been found quicker than 130, or 
 " flower than 30, in a minute." In violent cafes the 
 pulfe was hard, quick and final 1, but fometimes full ; 
 and when it was fo it was a good fign. It was however 
 fubject to exceffive variations ; and it frequently hap- 
 pened, " efpecially in the robuft, that, after the firft 
 *' ftage, flaming and chillnefs have often alternated in 
 ** lefs than a minute; and that, although the fkin felt 
 * c confiderably warm, the pulfe has been no more than 
 " 52 ; but that, even when the low ftate came on, ia 
 * c which there was always a difagreeable coldnefs of the 
 * { furface, it has been as quick, and nearly as full, as 
 <4 during the preceding febrile ftage, although unaceom- 
 " panied with thirft, or any other evident fymptom of 
 * c the exiftence of fever." 
 
 In the ftate of delirium, Dr. Chifholm obferves, that, 
 whatever was the fubjecl: of the patient's raving thoughts, 
 he was always ftrongly under the impreflion of fear ; 
 and a word from the phyfician always reduced him to 
 implicit obedience, however reftlefs he might have been 
 before. During this ftate he complained of no pain, 
 even from blifters, nor was he fenfible of the operation 
 of laxative medicines. On being aiked about his fitu- 
 ation, he always anfwered that he was very well, and 
 fenfible of no pain, as in the yellow fever already de- 
 fcribed. It is obfervable, however, that the yellow co- 
 lour, fo remarkable in the former, feldom took place in 
 the Boulam fever; but indeed this fymptom, as has for- 
 merly been noticed, is by no means a chara&eriftic ei- 
 ther of the one difeafe or the other ; but Dr. Chifholm 
 obferves " that in fome protracted cafes on fhore, and in 
 " fome among the failors, which might have been a 
 " combination of the peftilential and yellow fevers, this 
 " fymptom appeared about the 5th, jth or pth day." 
 
 Befides the petechise and vi bices, already mentioned, 
 Dr. Chifliolm takes notice of two other forts of erup- 
 tions, which appeared about the lips : the one was fuch 
 as frequently appears at the termination of the common 
 remittents., and was favourable ; the other refembling 
 
 fpots 
 
THE YELLOW FEVER. 415 
 
 {pots made by the fine black pencil of a painter, all 
 round the mouth, but efpecially the upper lip, and cer* 
 tainly affording a fatal prognoftic. 
 
 This difeafe was attended with a fuppreffion of urine, 
 a violent pain above the os pubis, a fcalding in the ure- 
 thra, a fenfe of fulnefs, without any vifible fwelling, a 
 contraction and diftortion of the penis ; the urine gene- 
 rally of a deep red, fornetimes brownifh, green, very 
 often bloody, and in a few cafes much inclining to black, 
 and of an oily confiftence. Its fmell was generally very 
 offenfive. All the excretions were exceedingly offenfive, 
 but the faeces moft remarkably fo towards the latter end 
 of the difeafe; for in the beginning they had no re- 
 markable fcetor. The fick were almoft univerfally 
 coftive, which our author fuppofes to have arifen from a 
 fufpenfion of tone in the inteftinal canal ; for by excit- 
 ing action in the fibres a large evacuation generally en- 
 fued. The colour of the feces varied from yellow, or 
 a yellowifh white, to black; and from a confiderable 
 degree of thicknefs, to the exact appearance of coffee- 
 grounds. The matter dilcharged by vomit alfo varied 
 from porraceous to black, and refembling coffee badly 
 boiled. 
 
 In this difeafe, as in the plague defcribed by Thucy^ 
 dides, mod other difeafes degenerated into it, or partook 
 of its nature. Dyfenteries fuddenly flopped, and were 
 immediately fucceeded by the fymptorns of peftilentiai 
 fever. A remarkable inftance of this is given in twenty- 
 feven recruits, who had been feized with dyfentery, in 
 confequence of being expofed to rain, receiving the in- 
 fection in the hofpital to which they were carried. The 
 medicines exhibited with a view to cure the dyfentery 
 feemed to be attended with furprifing effect ; but in a 
 fhort time fymptorns of peftilentiai fever came on, even 
 in a few hours after thofe of dyfentery had difappeared. 
 In like manner catarrhal complaints foon changed their 
 nature. Convalefcents from other difeafes, fuch as la- 
 boured under chronical complaints, particularly rheuma- 
 tiftn and inflammation of the liver, were particularly 
 fubject to it. " The puerperal fever became malignant, 
 
 "and 
 
4 iS A TREATISE ON 
 
 11 and of courfe fatal ; and even among pregnant negfo 
 ** women, who might otherwife have had it in the ufual 
 " mild degree peculiar to that defcription of people, many 
 " were reduced to a very dangerous iituatbn by it. In 
 " fhort, every difeafe in which the patient was liable to 
 ** infection, fooner or later affumed the appearance, and 
 " acquired the danger, of the peftilential fever.'* 
 
 This fever was faid to be propagated from Grenada 
 to others of the Weft India iflands, and to the United 
 States, where in the fame year, 1793, it raged with great 
 violence in Philadelphia. Without entering into any 
 inquiry at prefent concerning the truth of this report, or 
 the origin of the fever itfelf, let us fee whether from the 
 fymptoms enumerated by Dr. Rum, who hath written a 
 very lengthy difTertation upon the difeafe, it wajs the 
 fame with the Boulam fever already defcribed. Accord- 
 ing to him the fever in 1 793 was frequently preceded by 
 " coftivenefs, a dull pain in the right fide, defect of ap- 
 '* petite, flatulence, perverted tafte, heat in the ftomach, 
 46 giddinefs or pain in the head, a dull, watery, brilliant, 
 " yellow or red eye, dim and imperfect vifion, hoarfe- 
 46 nefs, or flight fore throat, low fpirits, or unufual viva- 
 t{ city, a moifture on the hands, a difpofition to fweat at 
 * s nights, or after moderate exercife, or a fudden fup- 
 
 " preffion of night fweats On entering a fick 
 
 " room the phyfician was firft ftruck by the connte- 
 " nance of the patient. It was as much unlike that 
 ** which is exhibited in the common bilious fever, as the 
 ** face of a wild animal is unlike that of a domeftic one. 
 " The eyes were fad, watery, and fo inflamed in fome 
 " cafes as to referable two balls of fire. Sometimes they 
 " had a mod brilliant or ferocious appearance. The 
 " face was fuffufed with blood, or of a dufky colour, and 
 " the whole countenance was dufky and clouded. After 
 " the loth of September, when the determination of 
 " blood to the brain became univerfal, there was a pre- 
 " ternatural dilation of the pupil. Sighing attended in 
 ** almoft every cafe. The fkin was dry, and frequently 
 
 " of its natural temperature The pulfe at the 
 
 44 beginning of the attack was fometimes full, tenfe and 
 
 " quick, 
 
TH YELLOW FEVER. 4 i 7 
 
 ^ quick, but frequently weak ; fometimes fo low that 
 " it could not be perceived without prefling the wrifls ; 
 " and fometimes it had no preternatural quicknefs. Iri 
 " many it intermitted after the fourth or fifth, and fome- 
 " times after the fourteenth ftroke. In fome it was ex- 
 " tremely flow ; even as low as thirty ftrokes in a mi- 
 :c nute. The pulfe was alfo tenfe and chorded. The 
 " flow intermitting pulfe was obferved more frequently 
 " in children than adults, and fuppofed to proceed frorn 
 " a colledtion of water in the brain. Imprefled witH 
 " this idea, I requefted Mr. Coxe, one of my pupils, to 
 " aflift me in examining the ftate of the eye. For two 
 " days we difcovefed no change in it ; but on the third 
 u day after we began to infpect the eyes, we both per- 
 " ceived a preternatural dilatation bf the pupils in different 
 " patients j and we feldom afterwards faw an eye in 
 *' which it was wanting. In Dr. Say it was attended 
 * e with fquinting, a fymptom which marks a high de- 
 " gree of a morbid affection of the brain. Had this 
 " flownefs or intermiflion of the pulfe occurred only af- 
 :c ter ligns of inflammation of congeftion had appeared 
 " in the brainy I fliould have fuppofed that it had been 
 4 derived wholly from that caufe ; but I well recollect 
 " having felt it Several days before I could difcover the 
 lead change in the pupil of the eye. I am forced 
 " therefore to call in the operation of another caufe, to 
 *' aflift in accounting for this ftate of the pulfe, and this 
 " I take to be a fpafmodic affection^ accompanied with 
 *' preternatural dilatation or contraction of the heart. 
 " Lieutaud mentions this fpecieS of pulfe in feveral pla- 
 " ces, as occuring with an undue enlargement of this 
 " mufcle. Dr. Ferriar defcribes a cafe, in which a low, 
 ' c irregular, intermitting and hardly perceptible pulfe 
 <4 attended a morbid dilatation of the heart. .... 
 " After the loth of September this undefcribable orfulky 
 1(1 pulfe became lefs obfervable, and^ in proportion as 
 " the weather cooled, it difappeared. It was gradually 
 :< tucceeded by a pulie fiiil^ tenfe, quick, and as frequent 
 " as in pleurify or rheumatifm. It differed, however, 
 ** from a pleuritic or rheumatic pulfe, in imparting a 
 
 H h h " very 
 
418 A TREATISE OH 
 
 " veiy different fenfation to the fingers. No two ftrokes 
 " feemed to be exactly alike. Its adion was of a hob- 
 
 ' bling nature. . . . It was an alarming fymptom. , . 
 " The pulfe mod frequently leffened in its fulnefs, and 
 <c became gradually weak, frequent and imperceptible 
 
 e before death ; but I met with feveral cafes in which it 
 ** was full, active, and even tenfe, in the laft hours o 
 " life. 
 
 " Hemorrhage? occurred in the beginning of the 
 " diforder, chiefly from the nofe and uterus. Sometimes 
 " only a few drops of blood diftilled from the nofe. As 
 " the difeafe advanced, the difcharges of blood became 
 " univerfal. They occurred from the gums, ears, fto- 
 ic mach, bowels, and urinary pafTages. Drops of blood 
 " iffued from the inner canthus of the left eye of Mr. 
 " Jofiah Coates. Dr. Woodhoufe attended a lady who 
 
 c bled from the holes of her ears which had been made 
 " for ear-rings. Many bled from the orifices which had 
 " been made in performing venefection, feveral days af- 
 M ter they appeared to have been healed , and fome from 
 " wounds in veins made in unfuccefsful attempts to draw 
 " blood. Thefe laft were very troublefome, and in fome 
 " cafes precipitated death. . . . 
 
 " I was furprifed to find fo few marks of hepatic af* 
 " feclion. I met with but two cafes in which the pa- 
 " tient could lie only on the right fide. Many com- 
 *' plained of a dull pain in the region of the liver, but 
 " very few complained of that forenefs to the touch,. 
 " about the pit of the ftomach, which is taken notice of 
 " by authors, and which was univerfal in the yellow fe- 
 " ver of 1762. In proportion as the cool weather ad- 
 " vanced, a preternatural determination of the blood 
 " took place to the brain and lungs. Many were affect- 
 " ed with pneumonic fymptoms, and fome appeared ta 
 *' die of fudden cffufions of blood or ferum in the lungs, 
 " . . . The difeafe feldom appeared without nauiea or 
 " vomiting. In fome cafes they both occured for fe- 
 <c veral days, or a week, before any fever took place. 
 " This was more frequently the cafe where the difeafe 
 " was taken by exhalation from the putrid coffee > than by 
 
 ^ jwtayon. 
 
" 
 
 THE YELLOW FEVER; 419 
 
 - 
 
 " tontagion. The ftomach was fo extremely irritable as 
 "to reject drinks of every kind. Sometimes green or 
 " yellow bile was rejected on thefirft day of the difon 
 " but I much oftener faw it continue for two days with- 
 " out difcharging any thing from the ftomach, but the 
 " drinks which the patient had taken. If the fever in 
 " any cafe came on without vomiting, or if it had been 
 checked by remedies that were ineffectual to remove it 
 altogether, it generally appeared or returned on the 
 " 4th or 5th day of the diforder. I dreaded this fymp- 
 " torn on thofe days y for, though it was not always the 
 " forerunner of death, yet it generally rendered the reco- 
 " very more difficult and tedious. In fome cafes the 
 <c vomiting was more or lefs conftant from the beginning 
 *' to the end of the diforder, whether it terminated in 
 " life or death. The vomiting which came on about 
 : the 4th or 5th day was accompanied with a burning 
 ;c pain in the region of the ftomach. It produced great 
 *' anxiety and toffing of the body from one part of the 
 * bed to another. In fome cafes this painful burning 
 " occured before any vomiting took place. Drinks were 
 " now rejected fo fuddenly as often to be difcharged 
 4S over the hand that lifted them to the head of the pa- 
 *' tient. The contents of the ftomach were fometimes 
 ;c thrown up with a convulfive motion which propelled 
 :t them in a ftream to a great diftance, and in fome ca- 
 " fes all over the clothes of the by-ftanders. ... On 
 " the firft and fecond days many puked from half a 
 ct pint to nearly a quart of yellow or green bile. In 
 " four (three of whom recovered) the bile, even at this 
 " time, was black. On the 4th or 5th day a matter re- 
 " fembling coffee-grounds was difcharged. . . . Many 
 " recovered in whom this fymptorn appeared. Towards 
 " the clofe of the difeafe there was a difcharge of a deep 
 :( or pale-coloured black matter, with flaky fubftances 
 " frequently fwimming on the top of it." 
 
 A quantity of grumous blood, dark coloured on the 
 outfide, was frequently difcharged by vomit towards the 
 end of the difeafe; and, along with all the difcharges 
 fcomjhe ftomach, there was occafionally a large worm, 
 
 and 
 
A TREATISE ON 
 
 and frequently large quantities of mucus and tough 
 phlegm. Our author fuppofes the black blood and 
 coffee-coloured matter to be different from that which 
 conftitutes the true black vomit. This laft he fuppofes 
 to arife in fome cafes from matter formed in confequence 
 of a mortification of the flomach. 
 
 The bowels were generally coflive, fometimes with 
 extreme pain, tenefmus, and mucous and bloody dif* 
 charges. Sometimes the difeafe came on with diarrhoea, 
 principally in thofe who had weak bowels. Sometimes 
 there was a tendon of the abdomen, with pain in the 
 lower part of it. Flatulency, chiefly in the ftomach, was 
 almoft univerfal in the diforder throughout all its ftages. 
 
 The colour and confidence of the fceces was various 
 according to the mode of treatment the patient had un- 
 dergone. Where they were fpontaneous, or brought 
 away only by gentle purgatives, their appearance was 
 natural ; but when the patient was ftrongly purged, they 
 were dark-coloured, foetid, and in large quantity. The 
 colour was fometimes green, fometimes olive. Their 
 foetor was proportioned to the time they had been de- 
 tained in the bowels. In one cafe, where tonics had 
 been ufed, and the patient had no ftool for feveral days, 
 a purge produced fuch an exceffively foetid difcharge, 
 that the fmell produced fainting in an old woman who 
 attended. Their acrimony was fo great that the re<flum 
 was excoriated, and an exteniive inflammation fometimes 
 produced round its extremity. In fome cafes the ftools 
 were as white as in the jaundice. Large round .worms 
 were frequently difcharged with them. 
 
 The urine in this difeafe was fometimes plentiful and 
 high-coloured, fometimes clear, and fometimes turbid ; 
 fometimes difcharged with a burning pain, as in a go- 
 norrhoea y fometimes it was fupprefled ; and in one cafe 
 the patient voided feveral quarts of limpid urine juft 
 before he died. 
 
 Many were relieved on the firft day by fweats, fome- 
 times fpontaneous, and fometimes produced by diluting 
 drinks, or (Irong purges; fometim-es of a yellow colour, 
 and offeniive fmell. Sometimes they were cold, though 
 
 the 
 
THE YELLOW FEVER, 421 
 
 tfre pulfe was full at the fame time. In general, how- 
 ever, the fkin was dry, and there were but few inflances 
 of the difeafe terminating by fweat after the third day. 
 In fome there was a great difcharge of mucus from the 
 throat, occafioning an almoft conftant hawking and 
 fpitting ; and thofe always recovered. 
 
 In this fever, as in that of Boullam, and in the true 
 plague, people fometimes fell down fuddenly in apo- 
 plexy, fyncope or univerfal convulfions. Some had 
 numbnefs and immobility of their limbs. Some had a 
 coma (a continual fleepinefs) or an obflinate wakeful- 
 nefs ; the latter chiefly attended a (late of convalefcence. 
 In fome the diftemper began with a violent cramp in 
 the legs or arms. The laft Itage was attended with a 
 ftrong hiccup, which was a very dangerous fymptom, as 
 indeed it is in all fevers. In fome cafes there was a de- 
 ficiency of fenfibilty, in others too much, fo that the 
 mere motion of the limbs was attended with pain. 
 
 In this, as in the Boullam fever, the patient often ma- 
 nifefled a confiderable degree of ftrength, even without 
 any delirium. One of Dr. Rufh's patients flood up 
 before a looking-glafs, and fhaved himfelf, the day on 
 which he died. A delirium, however, was common, 
 alternating in fome cafes with the exacerbations and re- 
 wijjions of the fever, but in fome continuing without 
 intermiffion to a few hours before death. Some had 
 maniacal fymptoms, without any appearance of fever ; 
 but in many the underflanding was not impaired 
 throughout the whole courfe of the difeafe. 
 
 In this difeafe the pains in almoft every part of the 
 body were very diftrefTing. In thofe cafes, however, 
 " where the fyilem funk under the violent smprefllon of 
 the contagion, there was little or no pain." In other 
 cafes the patients were diftrefTed with pains in their head, 
 particularly affecling the eyeballs. Sometimes it ex- 
 tended from the back down the neck. A pain was felt 
 in the ears, as if they were drawn together by firings. 
 The fides, flomach, liver and bowels were all afTeded. 
 A burning pain in the flomach was fometimes fo excef- 
 fiye that the patient fhrieked out violently. The back 
 
 was 
 
A TREATISE ON 
 
 was often the feat of violent pain, which fometimes ex- 
 tended from the back to the thighs ; and the arms and 
 legs were fometimes affected in fuch a manner that one 
 patient faid his limbs felt as if fcraped with a (harp 
 inftrument. 
 
 The thirft was generally moderate, but fometimes 
 otherwife ; and, when exceffive thirft came on in the 
 laft ftage of the diforder, it was a dangerous fymptom. 
 Water was preferred to all other drinks. The appetite 
 for food returned much fooner in this than in other 
 fevers, and was excefiively keen. Coffee was relifhed in 
 the remiflions, in every ftage of the diforder. Wine was 
 difliked, but malt-liquors were agreeable. In fome 
 cafes the recovery was attended with a great propenfity 
 to venery, as in the true plague, but in an inferior de- 
 gree. 
 
 In fome cafes the difeafe was attended with buboes 
 and glandular fwellings. " Imet with three cafes (fays 
 " our author) of fwellings in the inguinal, two in the pa- 
 <c rotid, and one in the cervical glands : all thefe patients 
 " recovered without any fuppuration of their fwellings. 
 *' They were extremely painful in one cafe, in which no 
 *' rednefs or inflammation appeared. In the others there 
 :t was confiderable inflammation, and but little pain. 
 
 " Several cafes of carbuncles, fuch as occur in the 
 <c plague, came under my notice. They were large, hard 
 " fwellings on the limbs, with a black apex, which, upon 
 ^ being opened, difcharged a thin, dark-coloured, bloody 
 " matter. From one of thefe malignant fores an 
 * a haemorrhage took place, which precipitated the death 
 a of an amiable lady. A large and painful anthrax on 
 ** the back fucceeded a favourable iffue of the fever in 
 " another patient. I met with a woman who (bowed 
 " me the marks of a number of fmall boils on her face 
 * c and neck, which accompanied her fever. . . . Not- 
 <c withftanding the difpofition to cutaneous eruptions in 
 " this diforder, it was remarkable that blifters were much 
 ** lefs difpofed to mortify than in the common nervous 
 " fever. Such was the infenfibility of the fkin in fome 
 ** people, that blifters made no imprefiion upon it. ... 
 
 "In 
 
THE YELLOW FEVER. 423 
 
 v In every cafe of this diforder which came under my 
 ** notice, there were evident remifllons or intermifiions 
 <c of the fever, or fuch fymptoms as were fubftituted for 
 fever." 
 
 The yellow colour rarely appeared before the third 
 day, and generally about the fifth or feventh day. The 
 eyes were not always affected with this colour. Some- 
 times it appeared firft on the neck and breaft ; and in 
 one cafe it appeared behind the ears and on the crown 
 of the head, which had been bald for fome years. It 
 varied in the deepnefs of the tint, and fometimes difap- 
 peared altogether 5 but, though fome cafes of great 
 malignity and danger appeared without any yellownefs, 
 it was always a dangerous fymptom when it appeared early. 
 The caufe of this yellownefs is by our author fuppofed 
 to be an abforption and mixture of the bile with the 
 blood. 
 
 After death the body .appeared of a deep yellow 
 colour, fometimes a few minutes after death ; fome- 
 times it was purple or blacky and in one cafe yellow 
 above, and black below, the middle. In fome it was 
 pale, as in common difeafes, and many died with a 
 placid countenance as in natural fleep. In fome the 
 body grew cold foon after death, in others not till fix hours 
 afterwards, and in like manner fiiffnefs occurred fome* 
 times in one hour, in others not till fix. Where eva- 
 cuations had been procured, fymptoms of putrefcence 
 were longer in making their appearance than in thofe 
 who had ufed no medicines for that purpofe. Many 
 difcharged large quantities of black matter from the 
 bowels, others, of blood from the nofe, mouth and 
 bowels. 
 
 i The morbid appearances of the internal parts of the 
 " body (fays the Doctor) as they appear by difledtioa 
 " after death, from the yellow fever, are different indif- 
 44 ferent countries and in different years." Dr. Mitchill, 
 in his hiftory of the yellow fever in Virginia, in 1737 and 
 1741, informs us, that, in a female flave of forty, the 
 gall-bladder was outwardly of a deep yellow, but with- 
 in, full of a black, ropy, coagulated atrabitis (black bile) 
 
 obftruding 
 
424 A f REAtlSE ON 
 
 obftructing the biliary ducts. It was fo thick, that if 
 retained its figure when the gall-bladder was opened, 
 It more refembled bruifed and mortified blood than bile, 
 though it would (lain a knife or probe of a yellow colour. 
 Two thirds of the iiver on its concave furfaee were of a 
 deep black colour, and round the gall-bladder it feemed 
 to be mortified and corrupted. A vifcid bile, like that 
 juft defcribed, was found in the duodenum near the gall- 
 bladder. The villous coat being taken off, the other 
 parts were found red and inflamed. The whole was lined 
 with a thick fur or ilime. The omentum was fo much 
 walled, that nothing but its blood-veifels could be per- 
 ceived. The ftomach appeared to be diftended or fwel- 
 }ed, lined like the duodenum, containing a quantity of 
 bile even blacker than that in the bladder. It was in- 
 fiamed both on the outiide and infide. The lungs were 
 inflated and all full of black or livid fpots ; and on thefe 
 fpots were fmall blifters like thofe of an eryiipelas or 
 gangrene, containing a yellow humour. The blood-vef- 
 fels in general were empty ; only the vena portarum 
 feemed full and diftended as ufual. On cutting the 
 found part of the liver, the lungs or the fpleen, blood 
 iffued freely. 
 
 Dr. Mackittrick found the liver fphacelated, the gall- 
 bladder full of black bile, and the veins tinged with a 
 black fluid blood. In all cafes the ftomach, duodenum 
 and ilium were remarkably inflamed. The pericardium 
 contained a vifcid yellow ferum, and in larger quantity 
 than ufual. The urinary bladder a little inflamed 3 the 
 lungs found. 
 
 Dr. Hume, of Jamaica, found the liver enlarged and 
 turgid with bile, and of a pale yellow colour ; the fto- 
 mach and duodenum fometimes inflamed j and, in one 
 cafe, the former had black fpots of the fize of a crown- 
 piece. He had feen fome bodies in which there was no 
 appearance of inflammation of the ftomach, though the 
 patients had been afflicted with exceflive vomiting. 
 
 Dr. Lind's account is given p. 394. 
 
 Drs. Fhyiic and Carthrall, of Philadelphia, found the 
 brain in a natural ftate $ the vifcera of the thorax per* 
 
 feftly 
 
Ttffe YELLOW FEVER. 42$ 
 
 feftly found ; the blood in the heart and veins fluid, 
 Similar in its confidence to the blood of perfons who 
 have been hanged, or deftroyed by electricity. " The 
 * ftomach and' beginning of the duodenum are the parts 
 " that are moft difeafed. In two perfons, "who died of 
 "' the difeafe on the 5th day, the villous membrane of 
 " the ftomach, efpecially about its fmaller end, was found 
 ** highly inflamed ; and this inflammation extended 
 " through the pylorus into the duodenum fom-e way* 
 " The inflammation here was extremely fimilar to that 
 " induced in the ftomach by acrid poifons, as by ar- 
 " fenic, which we have once had an opportunity of fee- 
 " ing in a perfon deftroyed by it. The bile was of its 
 cc natural colour, but very vifeid." 
 
 In others the ftomach was fpotted with extravafated 
 blood ; and it contained, as well as the inteftines, a black 
 liquor like that which had been vomited and purged be- 
 fore death. The gentlemen were of opinion that this 
 muft have been a fecretion from the liver, as a fluid of 
 the fame kind was found in the gall-bladder, of fuch an 
 acrid nature that it inflamed the operator's hands, arid 
 the inflammation lafted fome days. The liver was of its 
 natural appearance, or nearly fo. Thefe difle&ions were 
 made early in the feafon ; and at that time Dr. Rufh is 
 of opinion that the' difeafe 'was not attended with any 
 congeftion in the brain, though it was fo afterwards ; 
 and accordingly we are informed that Dr. Annan at- 
 tended a diflcdion at Bufh-hill, in which the veflels of 
 the brain were remarkably turgid. Dr. Rufh, however, 
 is likewife of opinion, that the morbid appearances in 
 the brain may ceafe after death, as well as the fuffufion 
 of blood in the face difappears after the retreat of the 
 blood from the extremities of the veflels in the iaft mo- 
 ments of life. tc It is no new thing for morbid affections 
 >s of the brain to leave either -flender or no marks of dif- 
 t eafe after death. Dr. Quin has given a difledion of 
 ;t a child that died with all the fymptoms of hydrocepha- 
 " ius internus, and yet nothing was -4iftingui (lied in the 
 * brain but a flight turgefcence of the blood-veflels. 
 :t Pr, Girdleftone fays, that no injury appeared in the 
 
 Hi *' brains 
 
426 A TREATISE ON 
 
 " brains of thofe perfons who died of the fymptomajic 
 " apoplexy which occurred in a fpafmodic difeafe which 
 " he defcribes in the Eaft Indies ; and Mr. Clark in- 
 " forms us that the brain was in a natural ftate in every 
 *' cafe of death from puerperal fever, notwithflanding it 
 * c feemed to be affefted in many cafes foon after the at- 
 tack of the diforder." 
 
 With regard to the ftate of the blood in this diftem- 
 per, Dr. Rum fays, that when drawn from a vein, it was, 
 " i. In the greateft number of cafes, denfe, and of a 
 " fcarlet colour, without any feparation into craiTamen- 
 "turn and ferum. 2. In many cafes it did feparate in* 
 Cfi to crafiamentum and yellow ferum. 3. In a few ca^ 
 <c fes the ferum was of a natural colour. 4. There were 
 " many cafes in which the blood was as fizy as in pneu- 
 " mony and rheumatifm. 5. In fome inftances the 
 " blood was covered with a blue pellicle of fizy lymph, 
 " while the part which lay in the bottom of the bowl 
 " was diflblved. In two cafes the jymph was mixed 
 " with green ftreaks. 6. It was in a few inftances of a 
 " dark, colour, and as fluid as molaffes. Both this and 
 " the 5th kind of blood occurred chiefly where bleeding 
 " had been omitted altogether, or ufed too fparingly, in 
 " the beginning of the diforder. 7. In fome patients 
 " the blood in the courfe of the difeafe exhibited nearly 
 C all the appearances which have beea mentioned, 
 " They were varied by the time in which the blood was 
 " drawn, and by the nature and force of the remedies 
 " which had been ufed in the diforder/' 
 
 From this account of the different appearances of the 
 blood, it appears to have varied at the very firft attack 
 from an healthy ftate, and to have gradually deviated 
 from that ftate more and more, as the difeafe advanced. 
 Dr. Rufli fays,* from Dr. MitchuTs Hiftory of the Yel- 
 low Fever in Virginia, in 1741, that cc blood drawn 
 " from a vein was always diffolvecL The fame ftate of 
 " the blood was obferved in many perfons who had been 
 " expofed to the .contagion, who difcovered no other 
 *' fymptom of the difeafe." In p. 70 Dr, Rufh 
 
 gives 
 
 * Account of tie Bilious Remitting Fever, &c. p. i$. 
 
THE YELLOW FEVER. 4*7 
 
 gives his own opinion in the following words : " I fhal! 
 fay, hereafter, that the blood was feldom diflblved 
 in this fever;" and p. 73, fpeaking particularly of the 
 blood, he enters into an argumentation againft the 
 putrefcency of that fluid. "It* 1 (the blood) fays he, 
 " has been fuppofed to undergo a change from a healthy 
 " to a putrid ftate ; and many of the fymptoms which 
 " have been defcribed, particularly the haemorrhages and 
 *' eruptions on the fkin, have been afcribed to this fup- 
 " pofed putrefaction of the blood. It would be eafy to 
 " multiply arguments to prove that no fuch thing as 
 " putrefaction can take place in the blood ; and that 
 " the fymptoms which have been fuppofed to prove its 
 " exiftence are all effects of a fudden, violent and rapid 
 " inflammatory action, or preffure upon the blood-vef- 
 *' fels ; and hence the external and internal hsemorrha- 
 " ges. The petechise on the lurface of the fkin depend 
 " on the fame caufe. They are nothing but effufions 
 " of ferum or red blood, from a rupture or preternatu- 
 " ral dilatation of the capillary vefTels. The fmell emit- 
 " ted from perfons affected with this difeafe was far from 
 " being of a putrid nature $ and, if this had been the 
 " cafe, it would not have proved the exiftence of putre- 
 " faction in the blood ; for a putrid fmell is often dif- 
 ** charged from the lungs, and from the pores in fweat^ 
 " which is wholly unconnected with a putrid, or per- 
 ** haps any other morbid, ftate of the blood. There are 
 " plants which difcharge an odour which conveys to the 
 f nofe a fenfation like that of putrefaction ; and yet 
 :c thefe plants exift at the farne time in a ftate of moft 
 " healthy vegetation : nor does the early putrid fmell of 
 " a body which perifhes with this fever prove a putrid 
 k change to have taken place in the blood before death 
 *' All animals which die fuddenly, and without lofs of 
 " blood, are difpofed to a fpeedy putrefaction. This 
 *' has long been remarked in animals that have been kil* 
 * c led after a chace, or by lightning. The poifon- 
 " ous air called fame!, which is defcribed by Chardin, 
 <c produces, when it deftroys life, inftant putrefaction. 
 **' The bodies of men who die of violent pafllons, or af 
 
 " ter 
 
42$ A TREATISE ON 
 
 " ter (Irong convulfions, or even after great ihufcukr 
 " exertion, .putrefy in a few hours after death. The 
 " healthy ftate of the body depends upon a certain (late 
 * c of arrangement in the fluids. A derangement of thefe 
 " fluids is the natural confequence of the violent and ra- 
 :c pid motions, or of the undue preflure upon the folids, 
 " which have been mentioned. It occurs in every cafe 
 " of death from indirect debility, whether it be induced 
 " by the exceffive ftimulus of contagion, by the volatile 
 ;t vitriolic acid which is fuppofed toconftitute the deftruc-r 
 " t\ve famiel wind,* or by violent commotions excited in 
 :t the body by external or internal caufes. The practice a- 
 '' moiig fifhermen in feme countries of breaking the heads 
 '' of their fi(h as foon as they are taken out of the water, 
 ^ in order to retard their putrefaction, proves the truth 
 " of the explanation I have given of its caufe foon after 
 * c dearth. The fudden extinction of life in the fim pre- 
 " vents thofe convulfive or violent motions which induce 
 <c fudden dif organization in their bodies. j[t was re- 
 " markable that putrefaction took place mod fpeedily 
 <c after death from the yellow fever, where the commo~ 
 " tions of the fyftem were not relieved by evacuations. 
 " In thofe cafes where purges and bleeding had been 
 c< uied it was much flower. There is a fact mentioned 
 " by Dr. Ferriar, from Dr. Hamilton, late profeffbr of 
 " anatomy at Glafgow, which may feem at firft to milU 
 * c tateagainft the facts I have mentioned. He lays that 
 <c he had obferved that bodies which were brought into the 
 " diffecting room that had pe tech is on them were 
 " longer in putrefying than any others. The fevers of 
 " which the poor (the common fubjects of direction) 
 " die, are generally of the low nervous kind. Great di- 
 c; -t eft debility is the characterise of thofe fevers. The 
 ' petechi^e which occur in them appear in the laft flage 
 this direct debility. They are the effect, not of 
 " too much impetus in the blood, as in the yellow fever, 
 " but of a defect or total abfence of it in the laft hours of 
 " life. The flow progrefs of the body to putrefaction 
 
 " after 
 
 ^ce p. 126, n. where an account is given of the famie!> and another hy- 
 concerning its nature. 
 
THE YELLOW FEVER, 429 
 
 
 
 ** after death, in the inftances mentioned by Dr. Ha- 
 " milton, feems to depend upon the fame caufe as that 
 " to which I have afcribed it in thofe cafes of death, 
 <c from the yellow fever in which evacuations had been 
 " ufed, viz. direct debility. In the former cafes this 
 " flownefs of putrefa&ion is induced by nature, in the 
 " latter by art. The effects of debility from both caufes 
 " are, notwithftanding, the fame." 
 
 From this long detail, in which the author's meaning 
 feems rather involved in pbfcurity, we may gather that in 
 the fever of 1 793 the blood had no determinate appear* 
 ance, but that, according to the action of the vafcular 
 fyftem, it was fizy or otherwife. This pofition, which 
 in my opinion is the* meaning of the pafiage juft now 
 quoted, is not fupported by any facts. It is mentioned in- 
 deed that the blood in feme was fizy, in others quite fluid, 
 but as the cafes in which it was fo are not particularly re- 
 lated, we do not know whether the action of the veflels 
 was ftronger in thofe where the blood was fluid than where 
 it was not. Certain it is, that the blood may be made 
 fiuid by certain fubftances mixed with it, without any 
 action of the. veflels at all. The poifon of the ticunas, 
 as well as all other animal poifons, renders the blood flu- 
 id, yet this will kill inftantaneoufly when injected into a 
 vein, before the veflels have time to act in fuch a man- 
 ner as could, be fuppofed to change the texture of any of 
 the fluids.* Or if this flill will not fatisfy, we are aflured 
 that the poifon of ferpentsj as well as many other fub- 
 ftances, which are not poifons, when mixed with the 
 blood taken out of the body, will prevent it from coagu- 
 lating. Granting, therefore, what hath not been proved, 
 that the greater the action of the veflels, the more fluid 
 the blood will be, yet we cannot know whether this flu- 
 idity be o.ccafioned by the action of the veflels, or the 
 action of the veflels by the tendency to fluidity in the 
 blood. But it matters not which of the two is caufe or 
 effect : the queftion is, Whether in the yellow fever does 
 the ultimate effort of the difeafe tend to produce any 
 alteration in the texture of the blood to fluidity, or other- 
 wife ? 
 
 * See p. 221223, 
 
43* A TREATISE ON 
 
 wife ? This can be known only from confidering the 
 fymptoms which take place in -the laft ftage of the dif- 
 order, and from dirfe&ions. Now, from the concur- 
 rent teftimoniesofall the writers quoted in this treatife* 
 it appears that towards the end of the difeafe there is 
 iuch a tendency to diffblution, that the whole body feems 
 ready to fall down into a putrid mafs ; or at leaft into 
 what is commonly called fo, whether with ftrict propriety 
 of language or not, fignifies little. In (hort, the differ* 
 ence between the plague and yellow fever feerhs to be 
 entirely of the fame kind with that taken notice of in 
 thi;; treatife, p. p. 269, 270, where the bile of a perfon 
 dying of a malignant fever was injecled into the veins of 
 a dog. Here the blood was very fluid. In capt. Maw- 
 hoods cafe (p. 385) the blood flowed from his nofe, eyes 
 and gums, befides what he difcharged by vomit. Dr, 
 Lining (p. 389) attefts a fimilar tendency to difTolu- 
 tion in the blood in a moft remarkable manner. See 
 alfo Dr. Lind's opinion to the fame purpofe, p. 393, Dr 
 Hillary's, p. 395, Dr. Jackfon's account, p. 399, Dr.Chif- 
 holm's, p. 411 ; and laftly, Dr. Ru(h*s own teilimony 
 concerning the haemorrhages from aii parts, lately quoted. 
 As we have formerly feen, that in the plague there 
 was no fuch tendency to diffolution, but rather to co- 
 agulation, in the blood, it was thence concluded that the 
 immediate caufe of the fyrtiptoms of plague is a tenden- 
 cy in the bldod to throw out the latent heat it contains, 
 by which means the parts on which thefe difcharges. fall, 
 are burnt up to a kind of cinder. In the yellow fever 
 the ieverfe takes place. The blood has a tendency to 
 abforb heat, and if it does fo it muft of courfe become 
 thinner, for this is the nature of all fluids, and indeed it 
 is abundantly manifeft that fluidity in all cafes is an 
 t:ffe6t of the abforption of heat.* In confequence of 
 this abforption, the bcxly towards the hitter end feels cold,, 
 the heat feems to retire from the extremities towards the 
 vital parts, and the veffels contracting and lofing their 
 power by reafon of the abftraclion of fenfible heat, the 
 e c cafes entirely fome time before death. Dr. Hux- 
 
 ham 
 
 *Seep. 550. 
 
THE YELLOW FEVER. 431 
 
 ham takes notice of this excefiive coldnefs in the limbs 
 taking place in a lady who died of a malignant fever, and 
 likewife that an intolerable ftench iffued from her body 
 for fome time before her death, though kept clean with 
 all poffible care. As the plague therefore is the higheft 
 of all inflammatory difeafes, fo the yellow fever feems to 
 be the higheft of the malignant clafs. 
 
 It may be objected, however, that as haemorrhages, 
 petechise, black vomiting, and convulfions, fometimes 
 take place in the plague, we cannot from the exiftence 
 of fimilar fymptoms in the yellow fever, conclude that 
 they are different difeafes. But, with regard to the fird, 
 it mud be obferved, that an hemorrhage may enfue 
 from a rupture of veflels as well as from an oozing of 
 blood in confequence of an acrimonious thinnefs of 
 blood. It is indeed to be queftioned, except in cafes 
 where blood is difflharged by the pores of the fkin, whe- 
 ther any haemorrhage takes place but by a rupture of 
 veflels. In an healthy fubjecl:, hemorrhages very fre- 
 quently take place from the nofe where the blood is of 
 a very proper confidence j and Dr. Ruflel fays that he 
 had occafion to fee hemorrhages from the nofe and ute- 
 rus only , that in the advanced dages of the difeafe 
 though the blood was paler and of a thinner confidence, 
 the haemorrhage was feldom profufe. It was, however, 
 of very bad omen ; mod of the cafes in which it appear- 
 ed having terminated fatally. 
 
 That towards the end of this difeafe the blood fhould 
 begin toabfoib the heat which it had before thrown out, 
 is not wonderful. A tendency to diiTolution very pro- 
 bably does in all cafes take place in a greater or lefler 
 degree ; but we have not any reafon to fuppofe that in 
 the true plague hemorrhages ever are as frequent, vio- 
 lent, or attended with fuch an apparent tendency to 
 putrefaction, as in the yellow feVer, and confequently we 
 muft fuppote that there is {omefpect/lc difference between 
 the date of the blood in the one difeafe and in the 
 other. 
 
 Convulfions, though very frequent in the yellow fe- 
 ver, yet, according to Dr, Ruflel, were very rare attend- 
 ants 
 
432 A TREATISE ON 
 
 ants on the accefs of the peftilential fever. Even hic- 
 cup was feldom obferved, and fneezing not once. How- 
 ever, he fays that convulfive motions of the limbs were 
 frequently obferved in the courfe of the difeafe ; but 
 this is far froin what Dr. Chifholm fays of the Boullam 
 fever, where the patient expired in a violent convuMive 
 fit ; or what Dr. Rufli fays of the fever of 1793, in 
 which the patient fometimes fell down in universal con- 
 vulfions. In fhort, the abfence, or much lefs frequency, 
 of nervous fymptoms in the plague, feems to conftitute 
 another fpecific difference between the two. 
 
 With regard to black vomiting, it is neither peculiar 
 to the plague nor yellow fever. Dr. Miller* has mown 
 that it may be occalioned by almofl any kind of acrid 
 poifon taken into the ftomach. In proof of this he 
 quotes from Sauvages the cafe of a man who died in 
 confequence of taking a drachm of wrnte arfenic inftead 
 of cream of tartar, in whofe ftomach was found, on dif- 
 fedlion, a black liquor which depofited a fediment like 
 powdered charcoal. Tl> villo.us coat of the ftomach was 
 likewiie abraded. For other cafes of the fame kind he 
 refers to Wepfer de cicuta aquatica, Morgagni, &c. Ano- 
 ther cafe of poifon by arfenic occurred in New- York 
 hoipital, in which the patient had a'black vomiting. In 
 another cafe in which corrofive mercury was fwallowed 
 by miftake, the patient, after being to appearance in a 
 fair way of recovery, began to vomit a dark-coloured 
 matter, and died in a day or two. The agaricus cly- 
 peatus, a kind of poifonous mufhroom, brought on bili- 
 ous ftools, locked jaw, vomiting, delirium, oppreffion of 
 the breaft, fighing, anxiety, great proftration of ftrength, 
 yellownefs on fome parts of the ikin, and death on the 
 fixth day. On diflecYton the ftcmach was found to be 
 inflamed, the duodenum diftended with flatus, and the 
 gall-bladcler full of green and black bile. 
 
 But the principal diftinctions between the plague and 
 yellow fever feem to be the eruptive nature of the former, 
 and the propenfity in the latter to attack ftrangers new- 
 ly arrived from colder climates ; alfo in being more eafi- 
 
 }j 
 
 * Med. Repofitory, vol. ii; p. 4^. 
 
THE YELLOW FEVER. 433 
 
 ly checked by cold than the plague. It has already 
 been remarked from Dr. Ruffel, that of two t houf and f even 
 hundred patients, whofe cafes he noted, every one had bu- 
 boes. Thefe, however, were not all the cafes he faw ; 
 for he mentions fome that had no eruptions j but frorri 
 this it is impoflible to avoid drawing the conclufion, 
 that eruptions are the true chara&eriftics of the plague. 
 Of thefe two thoufand feven hundred, eighteen hundred 
 and forty-one had buboes in one or both groins ; five 
 hundred and fixty-nine had them in the arm-pit ; two 
 hundred and thirty-one had parotids $ four hundred and 
 ninety, carbuncles ; and feventy-four, fpurious buboes. 
 Now, in all the number of cafes of fever which Dr. Rufh 
 attended in 1793, he had only two with buboes, and 
 one parotid ; and as to the carbuncles they do not 
 anfwer the defcription of thofe in the former part of this 
 work.* It is impoflible therefore that any more clear 
 line of diftin&ion can be drawn between the plague and 
 yellow fever, The following table, however, exhibiting 
 at one view the fymptoms of the plague, the yellow 
 fever* fever of Boullam, and fever of 1793, will perhaps 
 fet this matter in a ftill clearer light. 
 
 From a mere infpedton of the detail of fymptoms in 
 this table, the difference between the feveral diftempers 
 is obvious. It is evident that none of them can with 
 any kind of propriety be called higher and lower degrees 
 of the reft. The plague is efientially different from the 
 other three, which feem indeed to be nearly allied ; the 
 Boullam fever being only attended with more violent 
 and malignant fymptoms. We ought now to enter 
 into a particular inquiry concerning the origin and na- 
 ture of thefe fevers; but, as a knowledge of this is in 
 fome meafure dependent on the queftion, whether or 
 not they are contagious, we (hall in the firft place 
 prefent the reader with the following extrad from a 
 French treatife, in which the queftion feems to be han- 
 dled in an agreeable and judicious manner, and then 
 make another attempt, by an inveftigation of matter of 
 
 facl, 
 
 * See p. 257. 
 
 Kkk 
 
A TREATISE ON 
 
 fad:, to determine whether the difeafe has ever been ex- 
 cited by imported contagion or not : 
 
 " A very important queftion is whether this difeafe 
 ' is contagious. The greater part of the American phy- 
 6C ficians are of opinion that it is, and are perfuaded that 
 " it is brought from the Weft Indies, by the fhips which 
 " arrive here in the beginning of every fummer. It is 
 " even from that opinion, and on their vigorous reprefen- 
 :c tations, that quarantines have been eftablilhed, which 
 " every veflel from the Weft Indies is obliged to perform 
 * during 10 and fometimes 20 days at Fort Mifflin, fe- 
 " veral miles diftance from Philadelphia. This forma- 
 " lity, fo troublefome to navigation, was obferved this 
 ' c year (1798) with more feverity than ever it was ; but 
 * c without anfwering any good purpofe for the veiTcls ^ 
 " for very few (hips' companies appeared taken with the 
 " yellow or putrid fever. Neverthelefs the epidemic,. 
 " whatever name it affumes, raged this year in Phila- 
 c delphia with more fury than even in 1793. Befides, 
 c if the quarantine was a fure prefervative, if almoft all 
 * the fhips* crews coming from the Weft Indies brought 
 < ihs yellow fever with them, why fhould not CHARLES- 
 " TON, NORFOLK, ALEXANDRIA, BALTIMORE, Bos- 
 " TON and SALEM, where no quarantines are performed, 
 < be affefted with the contagion, as well as New York 
 "and Philadelphia? The American phyikians are fo 
 " convinced that the yellow fever is contagious, that they 
 " fcrupulou/ly prohibit perfons in health from all com- 
 " munications with thofe difeafed ; they order frequent 
 " waterings in the ftreets and about the houfes where 
 cc the fever has manifefted itfelf, and aromatic fumiga- 
 * tions. They even order the clothes of tho/e who have 
 tc fallen by it to be burned, as is pradifed with refpect 
 " to thofe who die with the plague. It muft be confef- 
 " fed that their precautions, in this refpecl:, have in 
 " fome fort been juftified, on feeing all the individuals 
 " of one family fuccedively taken with it, and often at 
 44 the (lime time, their neighbours, and fo on, to a num- 
 " ber of people who might be authorifed to attribute 
 " their misfortunes only to their vicinage with the firft 
 " viftims. <; Neverthelefs, 
 
THE YELLOW FEVER. 435 
 
 * c Neverthelefs, if this diftemper was as contagious as 
 *' certain phyficians pretend, why fhould they not be the 
 " firft to be taken with it , they who fee, examine and 
 " touch many patients every day ? Why fhould not 
 " thofe who nurfe them day and night, who continually 
 " breathe thofe putrid miafrnata ; why fhould not thofe 
 " who attend the hofpitals, thofe who daily carry 30 or 
 ** 40 coffins to the grave, be taken with it ? We do not 
 *' hear, however, that the phyficians, furgeons, nurfes and 
 " fextons have enlarged the funeral lift more than any 
 " other clafs. of citizens. Some doubtlefs have fallen, 
 * c and perhaps they owed their death to their frequent 
 " communications with the fick ; but would the epi- 
 * c demic have fpared them in any other condition, more 
 " than a number of unfortunate people who are neither 
 ** phyficians nor nurfes ? 
 
 " Another particular not lefs remarkable is, that the 
 * ( yellow fever feems hitherto to have fpared the French- 
 " men who have refided in the Weft India colonies, the 
 " greateft part of whom have neverthelefs ftaid in New 
 " York and Philadelphia during the y How fever, and 
 "have lived in the midft of the contagious air which 
 " proves fo fatal to the Americans. The refult of all 
 *' this is, that, notwithftanding four years' experience, 
 " notwithftanding the public and private refearches and 
 " difcuffions which took place between the phyficians 
 " and philofophers of the American continent, there is 
 " ftili much uncertainty on the nature of the diftemper 
 " which fo rapidly depopulates New York and Philadel- 
 < phia. Every opinion, every fyftem, prefents palpable 
 u contradidions, and is liable to objections which it is 
 <c difficult, not to fay impoffible, to anfwer in a fatisfac- 
 " tory manner. If the difeafe be contagious, why are 
 " not the phyficians, the nurfes, the fervants of the hof- 
 <c pitals, taken fooner than perfons v/ho have no fort of 
 " communication with the fick ? 
 
 " If it be not contagious, how happens it that the na- 
 54 tives of every age and fex, many of which, the women 
 <c and children efpecially, live in a pretty fober manner, 
 " and feldom drink any of thofe liquors fo liable to in* 
 " flame the blood, are taken with jt, and fall, in fpite of 
 
436 A TREATISE ON 
 
 " all the efforts of medicine ? How happens it that the 
 c Europeans and Frenchmen who have never been in 
 " the colonies are attacked like the Americans, whilft 
 " the planters in the Weft Indies are fpared ? 
 
 " On the other hand, if, as the French phyficians pre- 
 ie tend, this is nothing elfe than the malignant putrid 
 " fever, often prevalent in Hifpaniola, how happens it 
 ;c that thofe medicines and that mode of treatment 
 " which were fo frequently fuccefsful in the colonies have 
 * no fort of fuccefs when adminiftered to Americans, 
 " and feldom with Europeans ? Why is this fever at- 
 :< tended, in its very firft ftage, with vomitings of blood, 
 :c bile, black fpots, purples and other alarming fymptoms, 
 :c which they frequently have at Hifpaniola ? How 
 " comes it that the Weft India planters, who, while 
 >l they refided in the colonies, had frequent attacks of 
 :c putrid and often inflammatory fevers, enjoy the mod 
 *' blooming health ever fince they have been on the 
 :c American continent ? And why are they not taken 
 ; with thofe putrid and inflammatory fevers, at a time 
 c when thofe who have given them an afylum are the 
 " daily victims of it ? Finally, if we muft attribute the 
 c epidemic to no other caufe than the immoderate heat 
 c of the fummer, which is really greater here for two or 
 ; * three months than at Hifpaniola, where a land and 
 fc fea breeze tempers its violence, why does it not flop 
 " its ravages when the heat moderates ? We have ob- 
 " ferved in the epidemics of New York and Philadel- 
 : phia, that they were lefs deftructive in the burning 
 " dog-days than in the months of September and Oc- 
 " tober, when the mornings, evenings and nights begin 
 " to be cool, and even cold enough to allow people to 
 fc go clothed as warmly as in winter. 
 
 " We have now a recent and (hiking example that it 
 :c is not heat only which caufes the epidemics ; fince 
 :c there were only, in the month of September, three or 
 <c four days of great heat. The reft were very cool. It 
 " may even be (aid that from the 22d it was cold, efpe- 
 " cially on the 28th and 2pth, when a violent north 
 " wind obliged many people to have a fire. The num- 
 
 " ber 
 
THE YELLOW FEVER* 437 
 
 " her of deaths never were, however, fo numerous as they 
 ** have been fincc the 2oth of September. The funeral 
 <c lift, which in July and Auguft amounted to 40 per day, 
 " reached on the aoth of September to 78, the zzd, 68, 
 "** the 23d, 71, the 24th, 63, the 25th, 80, the 26th, 
 " 77, the 27th, 96, the 28th, 106, the 29th, 76, and 
 " from the 29th at twelve o'clock, to the ift of Odo- 
 ** ber, fame hour, the number was i 70 ; a number as 
 (f prodigious as it is frightful : we could not therefore 
 " even flatter ourfelves that the fevereft frofts of the end 
 tf of Odtober would difpel the epidemic, did not expe- 
 <c rience afford us that comforting hope. 
 
 " What then is the phyfical caufe of this fcourge, 
 " which all human prudence and fcience are unable to 
 * f avert ? The miniflers of religion will not fail to af- 
 tf cribe it to celeftial wrath, and to advife prayers, faft 
 <! and charity to appeafe it. Thofe pious practices can- 
 " not affurediy do harm ; but the philofophical obferver, 
 *? who does not conceive that Philadelphia and New 
 " York fhould have excited the Heavenly wrath more 
 ^ than thofe of other cities of the continent, willfeek for 
 " more natural caufes, and will examine whether they 
 ^ fhould not be attributed to fome local and peculiar 
 *i vice of thofe two unfortunate cities, and perhaps to 
 " the temperament, the diet, the mode of life, of their 
 " inhabitants. Refpe&ing this, we do not find, in the 
 <c localities of New York and Philadelphia fufficient 
 ^ reafons, nor in the conftitutions or mode of life of their 
 ** inhabitants fufficient variations, to mark them as the 
 *- c victims of the yellow fever ^ while the inhabitants [of 
 * c other places] are free from it. 
 
 * c I am however inclined to think that New York and 
 C{ Philadelphia, more than any other cities, contain 
 <c caufes of corruption or putridity, occafioned by their 
 4f fize and the extent of their commerce, which, added 
 <c to the high mode of life of the Americans, may be 
 ** thefource of the calamity which now affects them. 
 
 ^ In effect, we obferve that in thefe two cities the 
 " epidemic has conftantly manifefted itfelf in thofe parts 
 *? which are not only the mod commercial, but alfo 
 
 " where 
 
A TREATISE ON 
 
 " where the common finks of the city meet ; where the 
 " houfes, inhabited by the poorer clafs of people, being 
 " fmaller, and more crowded together j where the (lores 
 <c contain mod provifions liable to fermentation and pu- 
 " tridity j where the (hipping crowded in the wharf: 
 *' render the water ftagnant ; where immenfe quantities 
 " of dirt and litter are brought from every quarter for 
 " the purpofe'of filling up new wharves and other places 
 " defigned to be taken from the fea, to enlarge lands 
 " to buiid upon ; finally, where the water ufed to drink 
 " does not reach the pumps of the lower part of the 
 " city until it has filtrated through the burying-grounds 
 " and privy-houfes of the upper parts, moft of which 
 44 have no walls, and are never emptied. 
 
 " Let us add to all thofe caufes of infection the dead 
 " dogs, cats, pigs, and rats, which are thrown into the 
 *' common (inks and docks, the rotten fi(h, and the pri- 
 " vies, which in feveral houfes, efpecially at New York, 
 * 4 are nothing but tubs, which are emptied weekly on 
 " the fea more, and we (hall have lefs reafon to won- 
 44 der at the putrid exhalations which iffue on the eaftern 
 " part of New York, and at Philadelphia on that part 
 44 contiguous to the Delaware, and which are capable of 
 cs infecting the whole atmofphere, and to impair the 
 " health of thofe who live in it. If the people who 
 " dwell in thofe parts are not fcrupulouily fober, if they 
 * c frequently indulge in the ufe of fpiritous liquors, if 
 " they feed on fuch food as is generally known to be 
 " unhealthy, is it to be wondered that, with fuch a 
 " mode of life, their blood ihould be more difpofed to 
 44 inflammation and to be diffolved and corrupted, ir> 
 " the midft of an air already corrupted and loaded with 
 44 deftrucYive miafmata ? 
 
 " Now every man knows that thofe who live conti- 
 " guous to the river at New York, and the Delaware at 
 " Philadelphia, moftly failors, Shipwrights, truckmen, 
 44 labourers, tavernkeepers, &c. feldom trouble them- 
 4C felves about the quantity of their foods and drinks, 
 fi but indulge copiouily in the ufe of ftrong liquors, of 
 44 which an aftonifhing confumption is made in thofe 
 
 4 * parts, 
 
THE YELLOW FEVER. 439 
 
 * f parts. They are not in other refpedh more careful as 
 *' to cleanlinefs in their narrow and low houfcs. There, 
 " in a hole called a bedroom, and on a feather-bed half 
 " rotted, in a heap of rags half devoured by infeds (till 
 " more difgufting, two and fometimes three individuals, 
 *' covered with fweat, often drunk, fleep, and ftill in* 
 <( creafe the filth by their ftiameful and dirty mode of 
 " life. Shall we find it ftrange that thofe infeded haunts 
 " mould (hed forth in the morning a mephitic air, ca~ 
 " pable of fuffbcating the moftrobuft and vigorous men ? 
 " Shall we wonder that thofe who breathe this peftilen- 
 " tial gaz are fuddenly feized with a fever ? in itfelf perhaps 
 " not very dangerous, if it were treated in a fuitable 
 " manner. But what is their method of treating it ? 
 " They do not even know the name ofpfifan, ftill lefs 
 " the ufe of anodynes, nor that of fall of nitre + nor of 
 * c camphor, fo proper to prevent putridity. Punch, 
 " made with rum ; water mixed with gin and molalfes ; 
 " a fort of foup made with Madeira wine ; fifh ; raw oyf- 
 " ters, &c. thefe are their firft medicines. If their wives or 
 " friends go to confult the apothecary, he advifes the 
 " caftor-oil, or the famous calomel pills or powders, whofe 
 " virtues the quacks extol for every difeafe. Finally, 
 " if the fever increafes, the doctor is called, who admi- 
 * c nifters a light puke of 12 or 15 grains of tartar eme- 
 " tic, a plenty of laudanum to procure fleep, and who, 
 " feeing the cafe defperate, withdraws, faying that he 
 " was called too late 1* " Although 
 
 * In Dr. Rufh's account of the fever of 17931 we tind the following remarks 
 a the French mode of practice, to which it feems remarkable that our author 
 has given no anfwer : "I proceed with reludlance to inquire into the com* 
 < parative fuccefs of the French practice. It would not be difficult to decide 
 upon it from many fadts that came under my notice in the city ; but I Ihalt 
 " relt its merit wholly upon the returns of the number of deaths at Bum-hill. 
 
 This hofpital. after the aad of Septemberi was put under the care of a 
 French phyiician, who was aflifted by one of thephyficians of the city. The 
 1 kofpital was in a pleafant and airy fituation ; it was provided with all the 
 ' neceiTaries and comforts for fick people that humanity could invent, orlibe- 
 rality lupply. The attendants were devoted to their duty, and cleanlinefs 
 
 * and order pervaded every room in the houfe. The reputation of this hof- 
 
 * pital, and of the French phyfician> drew patients to it in the early ftage of 
 the diforder. Of this I have been afiured in a letter from Dr. Annan, who 
 4 was appointed to examine and give orders of admiflum into the hofpital to 
 fuch of the poor of the diftridt of Southwark, as could not be taken care of in 
 their own houfes. Mr. Olden has likewife informed me, that moftofthe 
 
 patients who were fent to the hofpital by the city committee (of which he 
 
 was 
 
440 A TREATISE ON 
 
 c Although the inhabitants of the other parts of the 
 * city who are in better circumftances follow a mode of 
 " life more regular, feed on more wholefome aliment, 
 * ' and are much more cleanly in their houfes (except how- 
 " ever feather -beds and lower bedrooms] it is neverthelefs a 
 4< fact that they are much inclined, the men efpecially, to 
 " eat fait meat, meat half cooked, green fruit, and ftilt 
 " more to drink fpiritous wines. Several of them allow 
 ** themfelves an immoderate ufe of the latter between din- 
 * ner and tea-time, the ftrength of which, added to that of 
 *' the higK-fpiced food, and liquors, muft neceffarily in- 
 4t creafe in their blood that fermentation already exci- 
 " ted by the heat of the feafon. Now, lhall we not 
 " concede that bodies thus predifpofed ought to be 
 < more fufceptible than others of the impreffion of the 
 " corrupted mialmata which are conftantly exhaled from 
 * c every thing that furrounds them j from the common 
 " fewers, the wharves or the docks ; from the dirt and 
 ** litter of the alleys and lanes - 9 from the fulphureous 
 * bilge-water of fhips ; from the cellars and from the 
 " fiores ; in fhort, from thofe houfes which contain fick, 
 * c dying and dead perfons ? 
 
 Here the author, after ftating objections on both 
 fides, feems at laft to determine that the difeafe is pro- 
 duced by putrid effluvia. The difpute on this fubject, 
 however, hath continued fo long, that we can by nor 
 means expect to fettle it in this treatife. At firfh view 
 one would think that nothing could be more eafy than 
 to determine whether the difeafe arofe foon after the ar- 
 lival of foreign veflels, or in places which had no con- 
 nexion with maritime affairs. But when we come to 
 particulars there is fuch a ilrange difagreement and con- 
 tradiction 
 
 * was a member) were in the firft ftage of the fever. With all thefe advan- 
 
 * tages, the deaths, between the zzd of September and the 6th of November* 
 ' amounted to 448 out of 807 patients who were admitted into the hofpitaj 
 4 within that time. Three fourths of ail the blacks (nearly zo) who were pa- 
 tients in this hofpital, died. A lift of the medicines prefcribed there may be 
 
 * feen in the minutes of the proceedings of the city committee. Calomel and 
 ' jalap are not among them. Moderate bleeding and purging with glauber 
 
 * laltsi I have been informed* were ufed in fome cafes by the phyiicians of 
 this hofpital. The proportion of deaths to the recoveries, as it appears i* 
 the minutes of the committee from whence the report is taken> it> truly m*- 
 
 * lancholy !" 
 
THE YELLOW FEVER. 44* 
 
 tradiClion concerning fads, that we are in every inftance 
 driven back into the wide field of theory and argumen- 
 tation. One inftance of this we have already had in the 
 cafe of the Boullam fever faid to be imported by the 
 Hankey. Let Us now try another. Dr. Currie of Phi- 
 ladelphia, in a letter to Mr. Wynkoop of date October 
 loth, 1797, fays that the fever at New- York, of 1795, 
 was proved " by unqueftionable faCts," to have been in- 
 troduced from Port au Prince by the brig Zephyr ; and 
 for a proof of this he refers to a letter of the health 
 committee of New York to the governor, dated Sep- 
 tember 8th of that year. From this letter it appears 
 that Dr. Treat viiited this vefTel on the 28th of July, 
 where he found three men ill of what he called a bi- 
 lious remitting fever , and the body of one who died 'that 
 morning. Two days after, the DoCtor was taken ill, 
 and died in eight days, with unequivocal fymptoms of 
 yellow fever. On the 25th, four perfons from on board 
 the (hip William, from Liverpool, which arrived feveral 
 weeks before (the crew of which till this time had beeri 
 healthy) were taken ill of fever, and died with fimilar 
 fymptoms in feven days. Nothing can be more direCt 
 than this evidence, yet it did hot give fatisfaCtioh. 
 
 The faCt was impugned by the late Dr. E. Smith, in 
 a letter to Dr. Buel,* who produces fuch evidence as, 
 in his opinion, " eftablilhes it beyond a Contradiction, 
 " that neither Dr. Treat nor any other perfon con- 
 *' traCted a fever, fuch as prevailed in New York in 
 " 1795, from any lick or dead man, or any thing elfe 
 " connected with the veflel in queftion." 
 
 The evidence brought forward is the declaration and 
 depofition of capt. Bird. In a letter to Dr. Dingley^ 
 the captain " thinks it his duty to contradict the report" 
 that Dr. Treat " caught thedifeafe of which he died ori 
 board the Zephyr." He contradicts it by a depofition, 
 that " the mate and one mariner had the fever and ague 
 " feventeen days on Chore, and came on board with the 
 
 ** fame difeafe ; and the captaift himfelf had a dyfen- 
 
 i 
 
 * Webfter's Colicaion, p. yf, 
 
 Lii 
 
44* A TREATISE ON 
 
 " tery on his arrival in New York ; and John Wheeler, 
 " aged 1 6 years, died on the day of the arrival of the brig 
 C in New York, by worms craw/ing up into fas throat, and 
 " choking him. He was fewed up in a piece of canvafs, 
 " and ready to be committed to the deep, when Dr. 
 " Treat came on board, who defired the captain to have 
 " the canvafs opened, that he might infped: the body ; 
 " and he only cut the canvafs over the face, but did not 
 " make any other examination of the body." 
 
 How far this proves captain Bird's affcrtion, that Dr, 
 Treat did not catch the difeafe on board the Zephyr, the 
 reader will judge. It is, however, inconfiftent with the 
 plan of this treatife to enter into an examination of con- 
 tradictory evidence concerning matters of fact. Ac- 
 counting z& nothing, therefore, all that has been faid, by 
 either part\> concerning the brig Zephyr, let us proceed 
 to other teftimonies. 
 
 In a collection of/afts and obfervaticns by the College 
 of Phyiicians, published la ft year, we find the following 
 remarkable accounts tending to prove that the difeafe 
 was introduced by the fhip Deborah, from Port au 
 Prince and Jeremie ?in St Domingo: i v In a letter 
 from Dr. Stevens to Dr. Griffiths it is dated, that " the 
 " yellow fever prevailed in almoft all the fea-port towns 
 " in the French part of Hifpaniola, particularly at Cape 
 " Nichola Mole, where it raged fo violently that it 
 " obliged the Britifli to abandon the poft Iboner than 
 " they intended. About the fame time it appeared in 
 ** the harbour of St. Thomas, and was fo deftructive to 
 " foreigners, that it obtained the name of th ptqrve" 
 The Doctor faw feveral cafes of it in St. Domingo, 
 during the months of Auguft and September, 1798, and 
 " thele were entirely confined to American jcamen, while 
 <c the native inhabitants of the city were totally exempt 
 *- from it." 2. From thrs very fickly coaft arrived the 
 Deborah on the eighth of July. 3. On the izth of 
 Auguft John Lewis, mate ot the Deborah, informed D\\ 
 Currie, that the veflel had loftfeven perfons with fever on 
 board during her paffage, and one by accident ; and 
 that flx had been employed as a tranfport in the BritiJJi fer* 
 
 vice 
 
THE YELLOW FEVER. 443 
 
 *uite previous to her taking in her cargo atjeremie. 4. Mr. 
 Thomas Town informed Dr. Wittar, that, on the firft 
 of Auguft, 1798, he was told by Alexander Philips, of 
 Water ftreet, that he (Mr. Philips) had brought up 
 two or three tick people from the Deborah, in one or 
 two boats. Some of them he had brought to his own 
 houfe; and one was dead. Philips himfelf was fick at 
 the fame time, and died a day or two after. 5. Mr. 
 Purdon informed Dr. Currie that he had a fimilar ac- 
 count from Mr. Philips, whom he faw on the firft or fe- 
 cond of Auguft in apparent good health, and that he 
 died on the Saturday following. 
 
 All this, and further evidence feemingly equally ftrong, 
 was fet afide with the greatefl facility by bringing coun- 
 ter-evidence, particularly that of Mrs. Philips, who de- 
 nied that there were any fick people in the houfe ; and 
 by bringing inftances 'of the fever exifting in town before 
 the veffel arrived. It is needlefs therefore to trouble the 
 reader with any further difcuffion of this evidence more 
 than the reft. As the ancient Britons, in their letter to 
 Aetius, lamented that the barbarians drove them to the 
 fea, and the^ drove them back to the barbarians, fo 
 may we lament, in the prefent inveftigation, that the 
 uncertainty of theory drives us to faffs, and the uncer- 
 tainty of fuppofed fads drives us to theory. Still, how- 
 ever, we (hall not defpair. The introduction of a difeafe 
 into a large city is much more difficult to be traced than 
 in a fmaller one. In the year 1 794 the difeafe appeared 
 in the town of New Haven in Connecticut. Dr. Mon- 
 fon of that place informs us, that it appeared on the loth 
 of June, when Mrs. .Gorham, reiiding on the Long 
 wharf, was vifited by Dr. Hotchkifs, who found her af- 
 fected with fymptbms of the yellow fever. In three days 
 her complaints fuddenly vanifhed, and flie was fuppofed 
 to be in a fair way of recovery, but the fame evening fhe 
 vomited matter refembling coffee-grounds, and died next 
 day. On the fame day that Mrs. Gorham died, Dr. 
 Monfon vifited her niece, a girl of eight years of age, who 
 had ftaid a week with her aunt, and was taken ill 
 three days before. The day after the Doctor faw 
 
 her 
 
444 A TREATISE ON 
 
 her fhe was fuddenly relieved as her aunt had been, 
 but in a few hours vomited matter like coffee-grounds^ 
 and died next day. Thefe and fome other fimilar cafe$ 
 having alarmed the feledt men, inquiry was made, when 
 ' it appeared, that, in the beginning of June, capt. 
 c Truman arrived from Martinico, in a floop that was 
 " infe&ed with the contagion of the yellow ferer ; that 
 " this veflel lay at the wharf, within a few rods of Mrs. 
 " Gqrhams refidence ; that (he had on board a cheft of 
 " clothes which had belonged to a mariner who died 
 " of the yellow fever in Martinico ; and that his cheft 
 " was carried into Mr. Auftin's ftore, and opened in 
 " prefence of Capt. Truman, Mr. Auftin, Henry Hub- 
 " bard, and Polly Gorham : the three laft died in a 
 " fhort time after their sxpofure to the contents of the 
 " cheft. Hence it is highly probable that Mrs. Gor- 
 " ham caught the difeafe from the infected floop or 
 " clothing. Mr. Auftin's ftore (lands within three or 
 c< four rods of Mr. Gorham's houfe ; and no perfon in 
 " town was known to have the yellow fever previous to 
 ** capt. Truman's arrival." 
 
 In his further account of this fever Dr. Monfon (hows 
 that it was contagious in the higheft degree, and that 
 Mr. Gqrham*s hou.fe proved a kind of feminary from 
 whence the difeafe fpread itfelf. " June 26 (fays he) 
 " Ifaac Gorham loft an infant child with the yellow fe- 
 " ver ; and foon after his fon and daughter were affecled 
 <c with it : the former died. Solomon Mudge died 
 " on the 30th ; Jacob Thomfon's negro woman on the 
 cc ift of July ; Archibald McNeil on the 9th ; Polly 
 " Brown on the 3d of Auguft ; John Storer, jun. and 
 " John Hide, on the 8th \ and widow Thornton on the 
 " roth. Jacob Thornton's negro wonpan, Solomon 
 c< Mudge, John Storer, jun. and John Hide, had vi- 
 f( fited Mr. Gorham's houfe a few days before their ill- 
 <c nefs ; Polly Brown and Mrs. Thornton nurfed in Mr. 
 " Gorham's family ; and Archibald M'Neil nurfed 
 " Solomon Mudge. Elias Gill died on the I2th of 
 " Auguft, and Samuel Qrifwold's wife on the 7th : 
 " the former vifited Mr. Gorham's houfe, the latter 
 t( purfed in his family. " There 
 
THE YELLOW FEVER. 445 
 
 & There were a number of perfons who caught the 
 t* difeafe at Mr. Gorham's houfe, and recovered. 
 
 " Mrs. Thomfon, on the firft day of her illnefs, was 
 " moved half a mile from Mr. Gorham's, into George^ 
 *' ftreet. Luther Fitch caught the difeafe from Mrs. 
 " Thomfon, and communicated it to his fervant maid. 
 * c Both recovered. Mr. Fitch lives in College-ftreet, 
 " nearly three quarters of a mile diftant from Mr. Gor- 
 " ham's houfe. 1 could trace the difeafe throughout 
 " the town. No perfon had the yellow fever unlefs in 
 " confequence of attending the fick, or of being expofed 
 " by nqrfes, infected houfes, clothing, or furniture. 
 
 " J have inquired of feveral aged perfons in this town 
 " relative to the yellow fever, whether they knew of its 
 rc having ever been here previous to June 1794, and 
 "there is but a (ingle inftance; the fads relating to 
 :c which are thefe : In the year 1743 a tranfient perfon, 
 '5 by fhe name of Nevins, who came from the Weft In- 
 " dies, lodged at the houfe of Nathaniel Brown, an inn- 
 " keeper in this city. The man was taken very fick in 
 " the night, and died fhortly afterwards ; and his body 
 *' was very yellow after death. Mr. Brown's wife fickened 
 " in a fliort time, and died of the fame complaint, which 
 f* was at that time fuppofed to be the yellow fever. 
 
 " lam credibly informed that feveral perfons at Mill-' 
 " river, in Fairfield county, and alfo at New London, 
 " died with the yellow fever in Auguft and September, 
 c< 1795. It was propagated there by infeded perfons 
 ' from New York. 
 
 <c Capt. John Smith died in this town, the 2oth of 
 " Auguft, 1795. He caught the difeafe in New York, 
 " and communicated it to one of his negro fervants." 
 
 On the whole, Dr. Monfon concludes, " that the yel- 
 e low fever is feldom or never generated in this country, 
 " and that it is always imported from abroad. An ob- 
 tc jeftion to the idea of its being generated in this coun- 
 <c try is, that it was never known in the interior of this 
 " ftate, or of the United States, fo far as I can learn. 
 f? Had it ever appeared in Connecticut before the year 
 * G 1743, and June 1794, we fliould undoubtedly have 
 
446 A TREATISE ON 
 
 u had fome record of the fact. There is no fuch 
 " record, and no perfon remembers to have heard of 
 * c fuch a difeafe, but at thefe periods, prevailing in any 
 " part of the ftate. There are numbers of aged perfons 
 " in New Haven who remember the putrid ulcerous fore 
 * 6 throat, fmall pox, meafbs, dyfentery, &c. raging here 
 " with great mortality, but have no recollection of any 
 " yellow fever. Hence we may rationally conclude that 
 " it never did appear in this ftate but in the years 1743 
 " and 1794. 
 
 " It is evident, from facts before mentioned in this 
 " letter, that the yellow fever was propagated in no other 
 <c way than by contagion, and that this is a fpecifa con* 
 *' tagton* and no more diverfified, in its operation on the 
 *' human fjftem, than that of the fmall pox and 
 " meafles. 
 
 " If the citizens of large commercial cities were atten- 
 " tive in tracing the origin of the yellow fever, on its 
 <c firft appearing among them, they would often find 
 4 * that the difeafe was imported. In fome inftances it 
 " would be extremely difficult to difcover the origin. 
 *' But the mifchief lies in this ; that the inhabitants of 
 " fuch cities, whenever a contagious difeafe makes its 
 " appearance among them, endeavour to fupprefs all 
 <s rumour of it, from an apprehenfion of alarming the 
 ^ country, and injuring their commerce ; unwilling 
 ** to believe that there is evil in the city, till the dileafe 
 ** fpreads in every direction. Then, indeed, when it is 
 " too late, they are felicitous in the ufe of means to ar- 
 ^ reft its progrefs. As it extends itfelf flowly at firft, 
 " feafonable exertion might both detect its fource, and 
 " prevent its increafe ; but when it is difTufed through 
 " a city, it fpreads with rapidity, and it is no longer pof- 
 *< fihlc to difcover where it began. But as, whenever 
 ** the yellow fever has appeared in the United States, 
 " it has always been in fca-port towns, and originated 
 <e near wharves, docks, and warehoufes, there feems to 
 " be high probability that the difeafe is imported." 
 
 The evidence here feems fo ftrong, that no counter- 
 evidence that can be brought appears likely to invalidate 
 
 it. 
 
THE YELLOW FEVER. 447 
 
 it. The coincidence of the commencement of the fever 
 with the arrival of the (hip hath not been denied, as in 
 other cafes ; and, though it has been attempted to prove 
 that a fever might have arifen from the quantity of pu- 
 trid or putrefcent matters at that time in the town, yet 
 the circumftances of thofe who were prefent at the open- 
 ing of the cheft of clothes being taken with the fever, 
 and thofe who were fuk of it in fo many cafes infecting 
 one another, cannot by any means be overthrown. But 
 the fact is, that even thofe who contend mod violently 
 againft importation, do yet allow that it may in fome ca- 
 fes be fo ; but they contend that if proper care be taken 
 it will not fpread. Dr. Smith in his letter to Dr. Buel 
 fays, " that infection may be brought into any place 
 " from abroad ; that, under certain circumftances of the 
 46 place where it is introduced, it becomes very deftruc- 
 " tive ; but that, when thefe circumftances do not ex- 
 " ift, however the perfon immediately affected, if it be 
 " introduced by a Tick perfon, may fuff.T, it is harmlefs 
 " fo far as the general health of that place is concerned. 
 " If the fubject were viewed in this light, as moft af- 
 " furedly it ought to be, the queftion of importation or 
 " non-importation would (ink into its merited iniignifi- 
 " cance." But, with due refpect to the memory of Dr. 
 Smith, this mull furely be accounted a very inconfide- 
 rate mode of reafoning. In the inftance he fpeaks of, 
 that of the Zephyr lately mentioned, he allows that Dr. 
 Treat might have caught the difeafeon board the veffel,* 
 " but (fays he) zsno other perfon is known to have been 
 " infected by that veffcl, and as the Doctor communi- 
 " catc-d it to no perfon, the advocates for importation 
 " would not be greatly benefited by the conceffion." 
 Surely we muft look upon the life of Dr. Treat himfelf 
 to have been a matter not entirely infignificant, and if 
 he caught the fever by going on board, a number of others 
 who went in full confidence of the impqffibility of im- 
 portation, might have done the fame. As far therefore 
 as the prevention of fuch accidents can be accounted a 
 matter of importance, it is alfo of importance to believe 
 
 the 
 
 Webfter's CoHeSion, p. 9$. 
 
A TREATISE ON 
 
 the do&rine of imported contagion. It is true, Df; 
 Smith, in the paiTage juft quoted, adds immediately af- 
 ter, that " no fuch conceffion (with regard to Dr. Treat) 
 isneceflary ;" but, in p, 104, he does make an ample con- 
 ceffion, as we have feen, viz, that the contagion may not 
 only be imported, but, under certain circqmftances, bevc^ 
 tya&iveanddeftruElive. The queftion therefore fefts here : 
 Can we at all times promife that, with the utmcft care 
 that can be taken, the circumstances of a place may not 
 be fuch as to give activity to an imported contagion ? In 
 the nature of things ifc is impoffible that the docks, 
 wharves, ftreets and alleys of a large town can be abfo- 
 lutely clean. It is equally impoffible that all men can 
 be advifed to be temperate, cleanly, and neat in their 
 lodgings ; and we are unable to determine how far peo- 
 ple may deviate from the rule of right in thofe refpects 
 without danger. Before any theory of this kind could 
 be fupported, it would beabfolutely neceflHry to bring 
 an unequivocal proof that yellow fever had been in one 
 inftance at lead produced by local caufes; but this can- 
 not be done. Among the Hottentots, the dirtied peo- 
 ple in the world, no fuch difeafe exifts. Among the 
 peafants of Poland, who likewife live in a very dirty 
 manner, their mode of life is faid to produce not a fe- 
 ver, but a difeafe of the hair, called the plica Polonica; 
 In the Medical Repofitory, vol. i, p. 276, Dr. Mitchilf 
 of New York describes a difeafe called elcphantiafi$ y lik- 
 traa, or f curvy, occafioned by loathfome, putrefying diet, 
 fuch as rotten fifh, filh -livers and roe, fat and train of 
 whales and fea-dogs, congealed four milk, with little or 
 no vegetable provifions, and by expofure to wet and 
 cold. This difeafe prevails in Iceland, in the Ferro 
 iflands, in two diftricbs of Sweden, and in Madeira; yet 
 this difeafe is not the yellow fever, though it is faid to 
 make the pcrfon affli&ed with it more like " a putrefy- 
 ing corpfe than a living man." The cold feems to be 
 affigned as a reafon why the difeafe does not affume a 
 febrile form ; bat, however this may hold with Iceland, 
 it cannot with Sweden, where the fummer is fo hot, that 
 the fun has been (aid to fet forefts on fire* This is pro- 
 bably 
 
f tf E YELLOW FEVER. 449 
 
 Bably a fable ; but we are affured by Pontoppiddan, in 
 his Natural Hiftory of Norway* a country to the full as 
 cold as Sweden, that in fummer the heat is very great. 
 His expreffion is, that it is enough to " make a raven 
 gape." As to Madeira, where the climate is warm, there 
 can be no fuch objection. But a particularity of this dif- 
 eafe is, that it is infectious. Suppofing then that by any 
 means it fhould be exalted into a fever, have we any rea- 
 fon to imagine that in fuch a cafe it would lay afide its in- 
 fed ious property ? Surely not. If this then is the cafe with 
 a difeafe produced by the fame cauftfs with the yellow 
 fever, we have the very fame reafon to fdffrpofe that the 
 latter is infectious, as that the former would be fo if it 
 could lay afide its prefent form, and aflume that of fe- 
 ver. Another proof that mere dirtinefs cannot at all 
 times produce a diftempef, or even propagate its infec- 
 tion, may be deduced from the fixth cafe quoted p. 355 
 from Dr. RuiTel, where he fays that a poor Jewifh fami- 
 ly lived in a place fuch as he had always confidered as 
 one of the receptacles of contagion, yet only one in fix 
 of thofe who remained in it was taken with the plague. 
 In all cafes of plague, or of violent epidemic di (orders, 
 it has indeed been obferved that the poor were more 
 fubjecl: to an attack than the rich. This was fo remark- 
 able in the plague of London in 1665 that Dr. lodges 
 fays it was called the poor's plague ; and Dr. Ferriar tells 
 us from Diemefbroeckj that in fome parts of Italy it was 
 cuftomary in the beginning of a peftilence to drive out 
 the poor ; and likewife that this cruel expedient was ufed 
 at Marfeilles. The bad fuccefs of the experiment at this 
 lad place, however, fhows that people of any defcription, 
 and in any circumftances, may be attacked. A very 
 probable caufe, entirely diftinft from any mode of living, 
 may be affigned in this cafe, viz. that the poof are more 
 expofed to infection than others, both from their cir- 
 cumftances and therr rafhnefs ; for it will be evident to 
 thofe who converfe with the moft uninformed people of 
 any country, that the TurkiQi notion of predeftination 
 is far from being confined to Mahometans. It is not* 
 however, denied, that dirtinefs, as well as other local 
 
 M m m caufes, 
 
453 A TREATISE ON 
 
 caufes, may do much hurt, and oceafion the fpreading oi 
 a difeafe which otherwife would not fpread ; becaufe 
 uncleannefs of all kinds feems to be the proper vehicle 
 of infection, in which it appears to delight to take up its 
 abode. In the Medical Extracts, voh ii, p. 174, we 
 have from Goldfmith the following anecdote concerning 
 the concentration of peflilential infe&ion in- the plague 
 of London : 
 
 " A pious and learned fchoolmafter, who ventured to 
 EC ftay in the city during the plague, and took upon him- 
 " felf the humane office of viliting the tick and dying who 
 ' had been ddlbrted by better phyficians, averred, that, 
 *' being once called to a poor woman, who had buried 
 c her children of the plague, he found the room where 
 " Ihe lay fo little, that it cou-ld fcarce hold the bed on 
 " which {he was ftretched. However, in this wretched 
 41 abode, befide her, in an open coffin, her hufband lay, 
 *' who had fbrae time before died of the diftemper, and 
 " whom me foon followed. What (hewed the peculiar 
 *' malignity of the air, thus fuffering from human miaf- 
 " mata or effluvia,, was, that the contagious fteams had 
 * c produced fpots on the very wall of their wretched 
 ** apartment. And Mr. Boyle's own ftudy, which was 
 <c contiguous to a peft-houfe, wasalfo fpotted in the fame 
 " frightful manner." This mows not how infection may 
 be produced^ but how it may be concentrated in fuch 
 miferable apartments. The appearance on the walls 
 brings to remembrance what is faid in the book of Le- 
 viticus concerning the appearance of the Icprofy in walls 
 and clothes. 
 
 But, fuppofing we fliould allow that dirtinefs may- 
 bring on a yellow fever (and it is plain that this cannot 
 be proved) we have, in the cafe of the Bufbridge Jndia- 
 inan, a dtmorflration that cleanlinefs cannot keep it off.* 
 This veilel failed from England for the Eaft Indies, in 
 the year 1792, much about the fame time that the 
 Hankey failed for the coaft of Africa. She had on 
 board 264 people in all, viz. 109 belonging to the (hip's 
 company, 130 recruits, and 25 pailengers. She had 
 
 very 
 
 * Annals of Medicine* vcJ. 3> p. 166. 
 
THE YELLOW FEVER. 451 
 
 very boifterous weather at firft fetting out, but crofled 
 the equator on the 26th of May, where the weather was 
 fultry, with heavy mowers of rain. The difeafe now 
 made its appearance firft among the recruits, and in a 
 fortnight fpread among the fhip's company. It was com- 
 mon for fix or feven to be attacked with it daily from 
 the commencement ; " and in thefpace of twelve weeks 
 " almoft every perfon in the fhip not only had laboured 
 " under it, but many had fuHcred repeated relapfes." 
 For fevcral weeks the weather was hot and fultry j but, 
 when in the vicinity of the Cape of Good Hope, they 
 experienced a reverfe, and were driven by a ftorm as 
 high as S. lat. 42. Here the thermometer indicated a 
 temperature only 13 above froft, but no material change 
 in the difeafe took place. Afterwards, when returning 
 into the warm latitudes, they experienced the fultry heats 
 of the Atlantic without any change either for the better 
 or the worfe, and this for no iefs a fpace than three 
 months. 
 
 As to the origin of the difeafe, Mr. Bryce the furgeon,, 
 though inclined to afcribe it to contagion, could not 
 trace it to any origin of that kind, as the veflel had been 
 fix weeks at fea before it appeared. It " could not be 
 " afcribed to want of air or cleanlinefs, as every poffible 
 " attention had been ufed to preierve thefe : the different 
 " apartments were thoroughly cleaned and fumigated 
 " with wetted gun-powder ; the decks were fprinkled 
 " with boiling vinegar; and the windfalls were attentive- 
 " ly kept in order at each hatchway. Mr. Bryce is in- 
 " clined to conjecture that a peculiar combination in the 
 " circumftances of diet, lituation, and date of the atmo- 
 " fphere, may have given rife to this calamity. But the 
 " fame combination of circumftances fo frequently takes 
 " place without any fever, that it appears much more 
 " probable the difsafe had its origin either from an 
 " imported fomes, or from a femes generated in fome indi- 
 " in dual in the fliip, from whence it was afterwards 
 <c propagated to others by contagion"' The difeafe pro- 
 duced on Aboard the fhip was not contagious to the 
 people on board another veflel with whom they had 
 
 communication, 
 
45* A TREATISE ON 
 
 communication, nor to the people afhore among whom 
 the convalefcents were put, nor to new pafiengers taken 
 on board the veflel in the Eaft Indies ; circumftances 
 certainly not a little furprifing. 
 
 It doth not therefore appear, that, without the inter- 
 vention of fome other caufe, mere dirtinefs can produce 
 the yellow fever. Let us next fee what can be done by 
 confinement, want of air, or, as it has been lately called, 
 abftra&ion of oxygen. On this, however, we muft ob- 
 ferve, that in all cafes where people are allowed to 
 breathe, their lungs muft be filled with the due quantity 
 of fame elaftic fluid. If the fluid they breathe contains 
 a fmailer quantity of oxygen, it muft contain a greater 
 quantity of famething elfe. If adifeafe therefore is pro- 
 duced, it muft be occafioned by the prefence of that 
 other fluid, as well as by the abfence of oxygen. Now, 
 in confined air, we know that not only the oxygen is di- 
 minifhed, and confequently a larger proportion of azote or 
 fepton mixed with it, but in addition to this increafed 
 proportion of azote, there is alfo a pofitive augmentation 
 of the deleterious part of the atmofphere by the effluvia 
 from the bodies of thofe who are confined. Theie ef- 
 fluvia, as we have feen, p. 90, contain a great quantity 
 of fixed air. Others have mown that they contain alfo 
 azote 5 and it may be fo; but ftill we are fure that the 
 fixed air predominates. Befides this, from the breath 
 we know that a great quantity of aqueous moifture pro- 
 ceeds. Experiments on the aftion of thefe different 
 kinds of fluids are yet in an imperfeft (late, yet fome 
 important fa<5ts relating to them are known, i. Oxy- 
 gen breathed in great proportion produces an augmen- 
 tation of heat, and proves an univerfal ftimulant. See p. 
 1 1 8. By itfelf it quickens the pulfe-.* 2. Pure fixed air 
 breathed by itfelf deft roys life with the circumftances of 
 increafed heat, rarefadtion of the blood, and rupture of 
 the veflTels. See p. 206. 3. The circumftances attend- 
 ing death by breathing azote are not particulaly record- 
 ed j 
 
 * In the Medical Extracts we find it recorded, that a young gentleman 
 having breathed pure oxygen for feverai minutes, hispuUei which was before 
 64, foon beat i3o ( in a minute. 
 
TH YELLOW FEVER. 453 
 
 ed j but we know that by breathing an atmofphere low- 
 ered by it the contumptive fever is not increafed, but 
 diminished , and there is an account in the Medical An- 
 nals of a perfon who was perfectly cured of a confumf> 
 tion by the fmell of the bilge-water of a {hip. 4. It has 
 formerly been 0iown, from Dr. Black's experiments, that, 
 when the vapour of water is condenfed in the body, a 
 great quantity of heat muft be thus communicated to 
 it. In confined air therefore there is a diminution of 
 the oxygen which produces heat ; but there is an aug- 
 mentation of the fixed air and of the aqueous moifture 
 which increafes it ; fo that, on the whole, the balance 
 muft be confidered as in favour of the augmentation of 
 heat in the human body ; not to mention the quantity 
 of fenfible heat continually added to the atmofphere by 
 that which evaporates from the body. This pofition, 
 however, doth not (land upon the uncertain ground of 
 theory j it is confirmed by the following remarkable 
 facl: : Commodore Billings, who commanded a Ruffian, 
 expedition fitted out by the late emprefs, found, in his 
 travels through the northeaftern part of Afia, that the 
 cold of the atmofphere exceeded not only what was 
 known in other climates, but even what moft people had 
 been able to produce by freezing mixtures. Dr. Gu- 
 thrie informs us that he was unable to produce a greater 
 degree of cold than 36 below o of Reaumur, though af 
 fifted by 20 below o of natural cold, and the power of 
 all the freezing mixtures he knew. u How much then 
 " (fays he) was I furprifed to hear Mr. Billings aflert, 
 " that fome fpirit thermometers which he had with him, 
 " graduated according to Reaumur's fcale, were often as 
 c low as 40 below the freezing point of water, that is, 
 e 8 deg. below the freezing point of mercury. And 
 <c once or twice he obferved them at 42 deg. below the 
 " freezing point of ynickfilver* " During 
 
 * This account is taken from the Annals of Medicine for 1 798, and appears 
 in a letter from J>r. Gutfciic at Peterfburg to Dr. Duncan at iidinburgh- It 
 is drawn up with fuch ajlonijhing inaccuracy, that we may well be furprifed 
 how the one phyfician fliould write, and the other print it. There feerns in 
 the firft place to have been a miftake of Reamur's thermometer for Fahren- 
 heit's. But even this will not reftify the account. The xero or (o) on Reau- 
 ?nur's fcile is the freshing point qf water ; on Fahrenheit's it is the ccld PFO- 
 
454 A TREATISE ON 
 
 " During this fevere cold (probably 42 below o of 
 * Fahrenheit) the Nomade TchurJki (a wandering na- 
 " tion on the northeaftern extremity of th Afiatic con- 
 " tinent) who were conducing him along the coaft of 
 " the Frozen ocean, in fledges drawn by rein-deer, en^ 
 " camped every night on the frozen fnow in low tents, 
 " which they quickly formed with the fkins of rein-deer, 
 cc fpreading fome of them on the furface of the fnow, on 
 " which they all ilept ; and he aiTured me, that, fo far 
 " from fufTering from cold during the night, the heat 
 " was fo exceffive in thefe fur tents, where from ten to 
 " fifteen ilept together, according to itsdimenftons, that 
 " no one could bear even a fliirt j but all lay in a vio- 
 *< lent perfpiration, naked as they were born, till dawn 
 " of day, without the aid of fire, excepting a train-oil 
 " lamp, which lighted each tent." 
 
 From this account it feems pretty evident, that, by 
 the accumulation of animal effluvia, a heat may be com- 
 municated to the atmofphere greater than that of the 
 human body. We cannot fuppofe the heat of the tent 
 which put the people in a violent perfpiration to have 
 been lefs than 90 of Fahrenheit ; and, fuppofing the tem- 
 perature of the external atmofphere to have been at a 
 medium 30 below o, there mud have been a genera- 
 tion of 120 degrees of heat ; but the heat of the human 
 body does not exceed 97 degrees, and it cannot com- 
 municate more heat than it has. But we muft fuppofe 
 the tents to have been capable, had they been filled to 
 the top, of containing twice the number who did fleep 
 in them. They could communicate to the air therefore 
 
 only 
 
 ctuced by a mixture of fait and fnow, 32 degrees below the freezing point of 
 water. The freezing point of quickfilver has been fixed at 39, 39^ 0140 
 degrees below the cold produced by fait and fnow. When the themometer 
 therefore fell to 40 deg. below the freezing paint of water, it was only eight 
 degrees below the cold of fait and fnow, and not equal to the congelaT 
 lion of mercury by more thaix thirty degrees. The difference between this 
 and f<,rty-ti+>o degrees below the freezing point of quicklilver is enormous 
 and incredible. It indicates a degree of cold hitherto unobferved on the face 
 y>f the earih, and fcarccly equalled by the lateft experiments made at Hudfon'e 
 .here, by means of vitriolic acid and fnow, the thermometer was made 
 jo indicate a degree of cold 40 degrees below the freezing point of quicklilver. 
 5 he inaccuracy and confufion of this account, however* does not aifeft the 
 autnt p.-m relative to Mr. Billings'* journey. 
 
THE YELLOW FEVER. 455 
 
 only one half of 97 degrees, or 48-^- ; the remaining 
 714 therefore muft been derived from the breath and 
 perfpiration of the body.* 
 
 Let us now attend to the confequences which muft 
 naturally and undeniably follow from this fad:. If, in 
 fuch a violently cold climate, the effluvia of fifteen hu- 
 man bodies could produce a heat fufficient to induce a 
 violent perfpiration, what would they not have done had 
 they been in a climate where the heat of the atmofphere 
 was upwards of an hundred degrees greater, or between 
 70 and So above o of Fahrenheit ? Perhaps this was 
 never thoroughly tried except in the black hole at Cal- 
 cutta. Here an hundred and forty-fix men and one 
 woman were enclofed in a dungeon only 18 feet fquare, 
 and confequently affording fcarce eighteen inches fquarc 
 to each. This happened in a very hot climate, in the 
 month of June ; fo that we cannot fuppofe the tempera- 
 ture to have been lefs than 80 of Fahrenheit. 
 
 On being confined in this manner, the vital powers 
 endeavoured, by a moft profufe perfpiration, to fend off 
 the fuperfluoiis quantity of heat thrown into the body. 
 This was exactly what took place with Dr. Guthrie ; but, 
 in the cafe of the black hole, there was, befides the 
 quantity of heat produced by the warmth and per- 
 fpiration of the body, an hundred and ten degrees more to be 
 added, on account of the natural heat of the atmofphere. 
 For we cannot fuppofe the heat at Calcutta, inafultry 
 evening in the month of June, to have been lefs than 
 80, which added to 30, fuppofed to be the temperature 
 among the Tchutfki, makes 110. The perfpiration 
 was extremely profufe, and was foon accompanied with 
 exceffive thirit; nature being unable to fupply fuch a 
 quantity of liquid, or this liquid to carry off the heat from 
 the body. The want of pure air began then to be felt 
 by a difficulty of breathing ; and Mr. Holvvcll, having in 
 defpair retired fr.om the window, found the difficulty of 
 breathing increafe, attended by a palpitation of the heart. 
 Aroufed by his Offerings, he returned and was relieved 
 
 by 
 
 * Here no account is made of the heat that the very cold fnow upon which 
 tliey lay m(t have ablbrbed, which we know muft have been very confidera- 
 bJe, though it cannot be calculated. 
 
456 A TREATISE 
 
 by drinking fome water, and having air at the 
 The difficulty of breathing diminifhed, and the pal- 
 pitation ceafed ; but, finding the thirft not to be quench- 
 ed by water, he fucked his fhirt-fleevesj which were wet 
 with fweat, and endeavoured as much as poflible to catch 
 all of it that he could. The tafte was foft and agreeable, 
 A pungent ft earn was now felt like fpifit of hartfhorn. 
 A number had died, and Mr. Holwell, once more ren- 
 dered defperate, retired from the window, and lay down 
 upon a bench, where he foon loft all fenfe. Next morn- 
 ing only 23 furvived, of whom Mr. Holwell was one. 
 He revived on being brought out ta the frem air, but 
 was inftantly feized with a putrid fever, as well as all 
 the reft of the furvivors. In this fttuation they were 
 obliged to walk, loaded with fetters, to the Indian camp ;- 
 at night they were expofed to a fevere fain* and the day 
 following to a fultry fun ; yet, notwithftanding this ill 
 treatment, they all recovered ; having an eruption of 
 large and painful both all over the body. Mr. Holwell,- 
 however, faid that he never afterwards enjoyed good 
 health. 
 
 Another melancholy proof of the bad confequences 
 refulting from a want of frefh air we have in the evi- 
 dence given by Dr. Trotter, when the queftion con- 
 cerning the flave trade was agitated before the Britifh 
 Houfe of Commons. He depofed that the ilaves were 
 confined 16 hours out of 24, and permitted no exercife 
 while on deck. They were kept in rooms from 5 to 6 
 feet high, imperfeclly aired by gratings above, and fmall 
 fcuttles in the fides of the (hip, which could be of no 
 life at fea. The temperature of thefe rooms was often 
 above 96 of Fahrenheit, and the Doclor fays that he 
 never could breathe in them, unlefs juft under the hatch- 
 way. ' I have often (fays he) obferved the flaves draw- 
 " ing their breath with all the laborious and anxious 
 " efforts for life which are obferved in expiring animals 
 " fubjecled by experiment to foul air, or in the exhaufted 
 " receiver of an air-pump. I have often feen them, 
 " when the tarpaulings have been inadvertently thrown 
 " over the gratings, attempting to heave them up, cry- 
 
 " ing 
 
THE YELLtiW FEVER: 457 
 
 ** ing out, in their own language, c We are fufFocated i* 
 *' Many I have feen dead, who, the night before, had 
 " fhown no figns of indifpofition; fome alfo in a dying 
 *' ftate* and, if not brought up quickly on the deck, 
 " irrecoverably loft. Hence, in one ihip, before her ar- 
 *' rival in the Weft Indies, out of 650 ilaves, more than 
 " 50 had died, and about 300 were tainted with the 
 " fea fcurvy." 
 
 A third example of the effects of want of air, though 
 conjoined with other caufes, may be reckoned the cafe 
 of the Hankey, formerly related. The people there 
 were not indeed confined as much as in the black hole, 
 but it is iaipofiible to fuppofe that there could be a pro- 
 per circulation of air, and the length of time the paffen- 
 gers were confined might be equivalent to the violence 
 of the caufe in the cafe of the black hole. In the lat- 
 ter, however, the difeafe produced was not the yellow 
 fever, but feems to have been a kind of non-defcript 
 eruptive one, more refembling the fmall pox, or rather 
 Job's diftafe^ than any other. From Dr. Chifholm's ac- 
 count of the Boullam fever alfo, it feems to have been 
 more of an eruptive nature than the common yellow fe- 
 ver ; fo much, that Dn Chimolm is of opinion that it 
 partook u in no fmall degree of the nature of the true 
 plague." He fays that in it he " did not obferve car* 
 t uncles on any who died ; but that iw many who reco- 
 vered they were numerous, large, and very troublefome." 
 He confidered them alfo as a critical difcharge^ and the 
 enly one in this fever ; but in the plague they certainly 
 are not ; neither is it at all probable that they were of 
 the fame nature with the peftilential carbuncles. 
 
 In p, 207 of this treadle it is inferred, from fome ex- 
 periments of Dr. Davidion and Dr. Chifhoim, that the fe- 
 vers in warm climates are not owing to a deficiency of 
 oxygen in the atmofphere ; but in a treatife on the 
 yellow fever in Dominica by Dr. Clarke, we have other 
 experiments, which, if they can be depended upon, cer- 
 tainly overthrow that doctrine, or at lead render it very 
 dubious. 'Dr. Clarke endeavoured to afcertain the puri- 
 ty of the air by Mr, Schcele's apparatus, and which was 
 
 N n n likewifc 
 
45? A TREATISE ON 
 
 likewife ufed by Dr. Davidfon, viz. filling gallipots witfs 
 flowers of fulphur and iron filings well mixed and moid- 
 ened, and putting thefe upon a Hand under a glafs vef- 
 fel, which was placed on a ftool in a pail of water. The 
 glafs veflel was marked and divided on the outfide,and, 
 alloxvance being made for the fpace occupied by the 
 gallipot, the water rofe only one fifth in the glafs veffel, 
 after {landing 24 hours. When the difeafe abated, it 
 rofe near one fourth ; and upon many trials afterwards 
 it never rofe above one fourth. When the emigrants 
 fled towards the mountains, where the air is very pure, 
 they always avoided an attack of fever, or foon recover- 
 ed if in a convalefcent ftate. This is fimilar to what is 
 ilated by Van Swieten concerning the plague at Ocza- 
 kow, viz. that the atmofphere was fo loaded with fome 
 kind of vapour, that in certain parts of the town polifh- 
 ed fword-blades were turned black. This feems to have 
 indicated a great prevalence of inflammable or hepatic 
 air, or both, in the atmofphere - y but it is extremely doubt- 
 ful whether this could produce a fever, much lefs the 
 true p/ague. In Dr. Clarke's experiments it were to be 
 wifhed that he had examined the nature of that part of 
 the atmofphere which was left after the abforption cf 
 the oxygen. It is by no means probable that at any 
 rate the addition of a fifth part of azote could have ren- 
 dered the air fo unwholefome ; and befides, we are en- 
 tirely at a lofs whence to derive fuch an immenfe quanti- 
 ty ; for certainly the quantity of air which furrounds us, 
 even for a few miles extent, is fo great, that any confi- 
 derable alteration in its compofition could not take place 
 without a very evident caufe. The probability there- 
 fore is, thaj the experiments did not give an accurate 
 flatement of the quantity of oxygen contained in the at- 
 mofphere. Experiments on this fubjecl: mud always 
 be uncertain ; and of all the modes of trying the qua- 
 lities of the air,, perhaps that with fulphur and iron fil- 
 ings is mod liable to variation. It may vary, from the 
 nature of the fulphur,* from the cleannefs or the impu- 
 rity 
 
 * If fulphur be zjimple fubftanee, as the newchemifts pretend, there ougbt 
 never to be any variation in its properties, except what arlfes from mere impu- 
 rity* 
 
THE YELLOW FEVER. 
 
 rity of the iron filings, or laftly from the accuracy of 
 the mixture. It is alfo a misfortune in this cafe, that 
 though a great abforption proves the exiftence of a large 
 quantity of oxygen in the atmofphere, yet a fmall one 
 does not prove the contrary ; for it is more reafonable 
 to fuppofe that we have failed in our experiment, than 
 that the conftitution of the atmofphere has changed. 
 Dr. Clarke's experiments therefore cannot prove an7 
 thing, until more accurate methods of inveftigating 
 thefe things be found out. 
 
 We muft now proceed to inveftigate a third caufe af- 
 figned for the production of fever, and that is the putre- 
 faction of animal and vegetable fubftances. This hath 
 been very much infifted on. Dr. Rum afcribes the fe- 
 ver of 1 793 to the exhalations of putrid coffee, but allows 
 alfo the diftemper to have been contagious, and fays, 
 that " for feveral weeks there were two fources of infec- 
 66 tion, viz. exhalation and contagion. The exhalatioa 
 " infected at the diftance of three or four hundred yards, 
 " while the contagion infected only acrofs the ftreets. 
 " The more narrow the ftreet, the more certainly the 
 " contagion infected. Few efcaped it in alleys. After 
 * 6 the I5th of September the atmofphere of every ftreet 
 <c was loaded with contagion ; and there were few citi- 
 " zens in apparent good health, who did not exhibit one 
 " or more of the following marks^of it in their bodies : 
 cs i. Yellownefs in the eyes, ana fallow colour on the 
 ic ikin. 2. Preternatural quicknefs in the pulfe. 3. Fre- 
 " quent and copious difcharges by the ikin of yellow 
 " fweats. 4. A fcanty difcharge of high-coloured or 
 *' turbid urine. . A deficiency of appetite, or a pre- 
 " ternatural increafe of it. 6. Coftivenefs. 7. Wake- 
 " fulnefs. 8. Head-Ach. 9. A preternatural dilata- 
 
 " tion 
 
 rity ; but the following is a remarkable inftance to the contrary: Dr. Craw- 
 ford (brother to the celebrated Adair Crawford) informed me, that for his oil 
 of vitriol works at Lifburn, in Ireland, he had purchafed five tons of fulphur 
 produced from copper mines in the iiland of Anglefey. The fulphur looked 
 well, and was not more impure than what he commonly ufed ; but t on trial* 
 the produce of acid fell fo much Ihort of what fee had been accuftomed to 
 receive, that it would not afford the expenle of manufa&uring. An experi- 
 jrient on fuch a large fcale could not be erroneous. If fulphur is a fimple fub- 
 flance, the fa<3 is unaccountable : if it is compofed of phlogifton and acid, an 
 OTcr proportion of the former will esfjly account for it. 
 
4 6a A TREATISE ON 
 
 " tion of the pupils Many country people who 
 
 " fpent but a few hours in the flrcets in the day, in attend* 
 " ing the markets, caught the difeafe, and fickened and 
 " died after they returned home ; and many others, when; 
 " bufmefs compelled to fpend a day or two in the city 
 " during the prevalence of the fever, but who efcaped 
 " an attack of it, declared that they were indifpofed 
 fc during the whole time with languor or head-ach." 
 
 Thus, according to our author, the fever of 1793 fa* 
 gan from putrid effluvia, and was continued by contagion. 
 But many attempts have been made to prove that 
 putrid effluvia alone both begin and continue it. The 
 limits of this treatife would not allow (even were it but 
 beginning) of a particular account of all that has been 
 faid upon the fubjccl: ; neither indeed is it needful. A 
 {ingle well attefted inftance would decide the matter j 
 but we have already feen the difficulty of procuring that 
 inftance on either fide. Certain it is, that we have in- 
 ftances of the yellow fever arifing where it is not pretend- 
 ed that there was any confiderable collection of putrid 
 matters. In the Medical Repository, vol. ii, p. 149, we 
 find an account of the yellow fever appearing " in a coun- 
 * c try village, near a frefh river, on low marjky ground, feven, 
 " miles from Portland, fo that no fufpicion could arife 
 JJ of the difeafe being imported. Several other cafes of 
 <e yellow fever occur^d in different parts of the coun- 
 " try. 1 * This ftands on the authority of Dr. Jeremiah 
 Barker of Portland, fo that there can be no doubt of its 
 authenticity ; and though it cannot prove that the yel- 
 low fever may not arife from putrid effluvia, yet it cer- 
 tainly (hows that it may arife without them. It 
 does the fame with marfli effluvia; for though we may, 
 in the cafe of the village, fuppofe that the rnarfliy ground 
 on which it (lands occafioned the difeafe there, yet what 
 fhail we affign as the caufe of its being difperfed in dif- 
 ferent parts of the country, where there were neither 
 marfhes nor rotten beef? The proofs indeed of animal 
 effluvia being the caufe of yellow fever are fo equivocal, 
 that Dr. Davidfon* fuppofes putrid vegatabk matters to 
 
 be 
 
 * Medical Repof, vol. I, p, 170* 
 
THE YELLOW FEVER, 461 
 
 fee more aftive in this way than the former. For this 
 fuppofuion he gives as a reafon, that Dr. Rufh has ob- 
 ferved, that butchers, and thofe who lived in the neigh- 
 bourhood of fhambles, fcavengers, grave diggers, and 
 others of (icnilar employments, efcaped the yeilow fever 
 in Philadelphia. Thefe, the Doctor juftly obferves, were 
 niore expoled to what he calls the gazeous oxyd of azote, 
 than any other ciafs ; and he likewife takes notice, that 
 failors, who during long voyages feed on putrefcent food, 
 which might be (uppofed to produce a great quantity of 
 this acid, are thence fubjecl: tofcurvy, a difeafe not only 
 different from fever, but entirely oppolite to it. This 
 exemption of people converfant amons; the dead has been 
 ,alfo taken notice of by Dr. Mitchiil,* who brings as 
 an argument againft the contagious nature of the difeafe,, 
 that " feven men belonging to the alms-houfe of New 
 5C York were employed, during the whole of the fickly 
 " feafon of 1798, in putting the perfons dead of the 
 ?c plague (yellow fever) into coffins, and though they 
 " handled in the courfe of their fervice upwards of Jive 
 " fe^/m/ corpfes, in different ftages of putrefaction, and 
 " though they were much incommoded with the pefti- 
 " lential quality of the -air in the rooms they entered, and 
 cc frequently were obliged to vomit, not one of them was 
 " fo much indifpofed, during the whole feafon, as to 
 ^ difcontinue his employment/* This is no dgubt a 
 very remarkable fad, but in the prefent inftance it 
 proves too much ; for if, from it, we conclude that the 
 difeafe is not contagious, we muft alfo conclude that 
 it cannot be produced by putrid animal fubflances. 
 Yet in the very next fentence Dr. Mitchill affurds Dr. 
 Currie, <c that exhalations from corrupting beef and fifh 
 ^ have excited ficknefs as malignant, and as deadly, as 
 <;< any which has occurred." If exhalations from putre- 
 fying beef and fifh have produced this (kknefs, why did 
 not exhalations from putrefying hitman bodies do the fame ? 
 and if we are allured that the latter did not, we have as 
 little reafon to fuppofe that the former did; unlefs we 
 cftablifh a difference between the corrupting flefh of one 
 
 anirnal 
 
 * Medical Repof,, vol. U> 
 
462, A TREATISE ON 
 
 animal and of another, which no experience hath coun- 
 tenanced in the leaft. 
 
 The exemption of thofe employed in burying the dead, 
 even in the true plague, is obfervable. Dr. Caneftrinus 
 fuppofed it might be owing to the ufe of garlic, which 
 they were wont to bruife and rub their hands, face and 
 bread with, and likewife to chew, before they entered 
 into an infected houfe ; but this cannot be fuppofed a 
 very powerful antidote. Dr. Rufli is of opinion that 
 grave diggers efcaped in Philadelphia by the circum- 
 ftance of their digging in the earth ; and he fays alfo 
 that fcarce an inftance was heard of thofe employed in 
 digging cellars being attacked with the difeafe. " There 
 * c leems to be Something (fays he) in the frefh earth, 
 " which attracts, or deftroys, by mixture, contagion of 
 every kind. Clothes infected by the fmall pox are 
 *' more certainly purified by being buried underground 
 " than in any other way. Even poifons, are rendered 
 " inert by the action of the earth upon them. Dogs 
 " have long ago eftablifhed this fact, by fcratching a 
 " hole in the ground and burying their limbs or nofes 
 fc in it, when bitten by poifonous Tnakes. The pra&ice, 
 " I am told, has been imitated with fuccefs by the 
 <c fettlers upon new lands in feveral parts of the United 
 ' States/' 
 
 This reafon is very plaufible for the exemption, of 
 fuch as work in the ground, from contagion ; but it can- 
 not do for fc avengers and butchers, who by the nature 
 of their employment are frequently expofed to fleams 
 from the vileft matters. We may, on the contrary, de- 
 rive ffom thence a very ftrong argument that thefe 
 fleams are by no means eflentially connected with con- 
 tagion. We have already feen from Dr. Forclyce (p. 
 169 of this treatife) that contagion or infection is not 
 the object of fenfe. Dr. Rufh, though he doth not 
 abfolutely fay that the contagion of the yellow fever 
 hath no ftnelJ, yet informs us, that " the fmell of the 
 ic contagion, as emitted from a patient in a clean room, 
 " was like tfeat of the fmall pox,* but in moft cafes of 
 
 a lefs 
 
 * Accoujlt of the Bilious Yellow Fev>p. i7 
 
THE YELLOW FEVER. 463 
 
 <e a lefs difagreeable nature. Putrid fmells in fick 
 ec rooms were the effects of a mixture of the contagion 
 " with fome filthy matters. In fmall rooms, crowded 
 " in fome inflances with four or five fick people, there 
 " was an effluvium that produced giddinefs, ficknefs at 
 <c the ftomach, a weaknefs of the limbs, faintnefs, and, 
 " in fome cafes, a diarrhoea. The contagion adhered 
 " to all kinds of clothing. It was in no inftance commu- 
 " nicated by paper." From fo great authority we may 
 certainly conclude that, according to the befl observation, 
 there is an effential difference between the contagion of 
 a difeafe and the effluvia of a putrefying carcafe ; and 
 that, though the latter may be the vehicle of the for- 
 mer, and may increafe its virulence, either by being partly 
 affimilated to its nature, or by affording it a proper nidus 
 for concentrating itfelf ; yet that originally the one is 
 not the other ; and, though contagion may bring on a 
 fever without putrid effluvia, yet putrid effluvia cannot 
 do fo without contagion. With regard to pure conta- 
 gion, I fliall here, to the evidences already produced, 
 fubjoin the teftimony of Dr. Davidfon, formerly quoted. 
 " I muft declare* (fays he) I have feen the difeafe evi- 
 " dently propagated in this way (by contagion ;) but in 
 " many inftances it could not be traced- I have known 
 " three cafes of the fever brought on by perfons bathing 
 * c in the fea along fide the veflel, fome diftance from the 
 <c (liore, and neglecting to dry themfelves properly af- 
 ^ tervvards. The feminia of the difeafe were here pre- 
 ff fent, and, like the ele&rical jar charged, required 
 " only the approach of a conductor." This (hows an 
 amazing fubtilty and diffufibility ir^the contagion, 
 fcarcely indeed credible, if it were not known to be 
 equally fubtile in other cafes. In the correfpondence 
 between Dr. Haygarth, of Chefter in England, and Dr. 
 Waterhoufe,, profeflbr of medicine at Cambridge near 
 Bofton, the latter informs us, from Dr. Rand, that by 
 burning, in a field near Charleftown, the bedding, fur- 
 niture, &c. belonging to a perfon who had been ill of 
 the fmall pox, the people who lived in the wake of the 
 
 fmoke 
 
 f Med. Repof. vol. i* p, 171. 
 
464 A 
 
 fmoke proceeding from it were attacked with the (mail 
 pox, and the difeafe fpread. This is fimilar to an ob- 
 fervation formerly quoted from Huxbam ; but the fol- 
 lowing are much more remarkable : " A veffel arrived at 
 " Charleftown from Lifbon, laden with fait, and lemonS 
 
 [C in boxes.* A perfon had the frnall pox on board, 
 u and the fmall pox officers would not fuffer the lemons 
 " to be fold, without being fir ft unpacked and the paper 
 
 * furrounding each lemon taken oft. Thefe papers were 
 :t kept by themfeivcs in. a ftorehoufe for fevera! weeks j 
 " and after this, by order of the overfeers.? they were 
 
 1 brought out and burnt ; when, of two children play.* 
 :c ing round the fire, one, named Manning, took the 
 " diforder, and broke out at the ufual time. . . . 
 
 " Dr. Rand was called to a lady, whom he found hot 
 " and feverifh with a violent pain in her head and back ; 
 '* but he had no fufpicion of the frnall pox. He bled 
 
 e her, and a Mrs. Brandon held the veffel to receive the 
 '* blood, forne of which fpirted on her hand and arm. 
 " Next day the fmall pox appeared on the lady who 
 lt was bled ; and (he was of courfe immediately feparated 
 ;t from Mrs. Brandon ; notwithstanding, in twelve or 
 " founeen days, Mrs. Brandon was feized with the 
 11 fmali pox, and died. Several other perfons prefent 
 " were alfo liable to the infection, yet no one took the 
 " difeafe but this woman, who flood over the blood 
 :e while it was running, and received fome on her arm, 
 " except Mrs. Benjamins, to whom the bafon of blood 
 " was handed over the bed, who alfo took the fmall pox 
 ;c fom the effluvia of the blood. The fame phyfician 
 " was called to Tne child of Manning (who was fuppofed 
 *' to have taken the fmall pox from the burning of 
 " lemon- papers as aforefaid ,) he found the child bleed- 
 " ing at the nofe in its mother's lap, who was then in 
 " the ninth month of her pregnancy. The next day 
 " the fmall pox appeared on the child, and it was of 
 " courfe immediately feparated from its mother and all 
 44 the family ; neverthelefs, in about fourteen days the 
 cs mother was feized with the diforder, and not long 
 
 " after 
 
 * Haygatt!l>'s Sketch of t Flan to exterminate Gafual Small^PojCi vel. n, p> *7* 
 
THE YELLOW FEVER. 
 
 " after delivered of a dead child, which child had dtftinS 
 " eruptions over its whole body" 
 
 Thefe facts are of the utmoft importance in determine 
 ing the nature of contagious difeafes. In conjunction 
 with others, they ihow that fuch difeafes originate in 
 the blood, and from thence are communicated to the 
 reft of the body* They (how alfo, that the contagion 
 is in all cafes truly fpecific, and immutable. Thus the 
 contagion of the fmall pox, whether exifting in the mat- 
 ter of a puftule, in the fmoke of burning clothes or pa- 
 per, or in the effluvia of blood, is invariably the fame, 
 and never produces any other difeafe. It is the fame 
 whether applied to the human body, or to that of a brute 
 animal ; of which we have a remarkable inftance in the 
 Medical Repofitory, vol. i, p. 258. " A peafant of the 
 " county of EfTex, in England, feeing a great many 
 " children carried off by the natural fmall pox, was de- 
 " firous of inoculating his two boys $ one nine, and the 
 " other twelve years old. Not being able to employ a 
 " furgeon, he collected the fcabs of a child then fick of 
 " the difeafe, powdered them, and fprinkled the powder 
 " upon flices of bread and butter. The two fons ate 
 " them, and gave a bit to the houfe-dog. They had a 
 46 mild fmall pox, and got well without any remarkable 
 " accident. The dog remained fick for two or three 
 " days, drank a great deal, and refufed to eat ; on the 
 " fourth he had a very decided variolous eruption : on 
 * c the ninth the puftules were full ripe t and dried up and 
 < fell off like thofe* of the two children. An Englifh 
 " author fays he has feen the fame epidemic in a flock 
 " of fheep, the greater part of which were infedted, and 
 ; * communicated it to two cows, one of which died. 
 4< The fypmtoms that manifefted themfelves in thefe 
 *' animals in the courfe of the difeafe were in every refpe& 
 : * the fame as in the human fpecies." 
 
 This inftance, partly quoted in the former part of this 
 treatife,likewife is a ftrong proof of the contagion of fmall 
 pox being fir ft communicated to the blood ; for, by 
 (wallowing it along with the aliment, it would, in the 
 common courfe of digeftion, be abforbed by the lacte- 
 
 O o o als a 
 
4'66 A TREATISE ON 
 
 als, and enter the blood with the chyle. The experi- 
 ments with dogs made by M. Deidier, of which an ac- 
 count is given p. 268, (how that the contagion of the 
 plague is equally fpecific with that of the fmall pox ; 
 and we fee that it acted in all cafes in which it was tried 
 by being mixed with the blood. Being thus firft mixed 
 with the blood, it is plain that the contagion muft have 
 palled from this fluid to all the other parts of the body * 
 and, if difeafed blood is capable of communicating its 
 difeafe to all the found parts of the body in which it 
 circulates, we muft own that this ftrongly corroborates 
 Dr. Waterhoufe's fufpicion, " that the blood is capable 
 of producing the infection before the difeafe is fo far 
 advanced as to be apparent on the furface." If the dif- 
 eafe originates in the blood, the latter mould indeed 
 feem more capable of communicating it at firft than 
 afterwards -, becaufe we muft fuppofe that the difeafed 
 parts would be thrown off to the furface, and fo pafs off 
 altogether. On this fubject Dr. Waterhoufe alfo quotes 
 the opinion of Dr. Holyoke of Salem, " who, for his 
 "learning, profeffional abilities and integrity, isjuftly 
 ** efteemed one of the firft pbyficians in this country, 
 * c and whofe extenfive practice has afforded him ample 
 ** experience in the fmall pox." He writes to Dr. Wa- 
 terhoufe, " that, although he has reafon to believe that 
 " an infe&ed perfon feldom gives the difeafe till after 
 " the eruption is confiderably advanced, yet. there are 
 " facts which make it probable that it is fometimes 
 " communicated earlier." 
 
 In the fame letter Dr. Waterhoufe gives other inftan- 
 ces of the inconceivable fubtilty of variolous contagion, 
 no lefs remarkable than thofe already mentioned. One 
 is of Dr. Brattle, who, having vifited patients infected 
 with the frnall pox, " ufed the common precaution of 
 * covering his clothes with a loofe gown, &c. but neg- 
 " lefted his wig. In confequence of this frnall neglect, 
 " after riding fix miles on horfeback, he gave the difeafe 
 " to a perfon in a room through which he patted, where 
 " he did not ftay to fit down.'* Another is, if poflible, 
 dill more remarkable : " David Anthony, efq. one of 
 
 the 
 
THE YELLOW FEVER. 467 
 
 ** the overfeers of the fmall pox in Rhode Mand, after 
 ** going in* tne hofpital, and ufing the common pre- 
 " cautions, neglected tofmok-ekis wig. In his way home, 
 c< two miles from the hofpital, he called at the houfe of 
 " his daughter. He did not difmount, but fat on his 
 " horfe, and talked to her through an open window; 
 * l and, at the common period (by which we ufually un- 
 " derftand about fourteen days) me took the difeafe 
 " and died. Many fuch inftances, adds the Doctor, 
 " could I relate, where wigs have given the infection, 
 " after being expofed to the open air during the paflage 
 " of feveral miles." 
 
 From all this it appears how difficult a talk they 
 undertake who contend for the domeftic origin of the 
 yellow fever, without contagion. In all cafes they muft 
 have recourfe to fomething vifible and obvious to the 
 fenfes. Thus putrid beef, putrid fifh, ponds of water, 
 marines, &c. are all eafily feen, and we are able to prove 
 their abfence as well as their prefence. But we certainly 
 know that the yellow fever has arifen where none of 
 thofe fuppofed caufes have exifted, as in the Bufbridge 
 Indiaman ; and, on the other hand, all the fuppofed 
 caufes have exifted without the production of any fever. 
 Of this laft Dr. Chifholm, in the conclufion of his de- 
 fence againft Dr. Smith, gives the following remarkable 
 inftance ;* " During a confiderable part of the years 
 " 1776 and 1778 my duty led me very much to refide 
 " in New York; and during my refidence, particularly 
 *' in the fumrner and autumn of 1778, which were re- 
 <x markably hot, and infulferably fo in the lower ftreets 
 ** of New York, no difeafe of a very alarming nature, and 
 " none which aflumed the form of an epidemic, appeared 
 *' among the troops or inhabitants. The fmell from all 
 " the (hips, and from thofe in particular delineated by 
 " Dr. Seaman (who has written a treatife on the fub- 
 *' ject) was in the higheft degree offenfive. The police 
 ** at that time was by no means ftrict : putrid fubftan- 
 ** ces of every defcription were accumulated in the flips, 
 
 "and 
 
 Mcd. Repf, vol. ii, p, 231. 
 
A TREATISE ON 
 
 " and in many parts of the city unconne&ed with 
 " wharves, and yet no difeafe was the confequence." 
 
 Some particulars above related may perhaps appear, 
 to thofe who deny the exiftence of contagion, in rathef 
 a ludicrous point of view. It is indeed too common 
 for people to laugh at what they cannot anfwer ; but if 
 we confider the inftantaneous and inexplicable action of 
 the poifon of ferpents, and in how little time they pro- 
 duce a mortal diforder, or even death itfelf ; when we 
 confider that contagion is only a volatile poifon, and 
 that it for the moft part takes up an incomparably lon- 
 ger time to bring on death than the bites of fome veno- 
 mous animals ; we cannot be furprifed that a quantity 
 of this" volatile matter inconceivably lefs than that of 
 animal poifon fhould be capable of bringing on the dif- 
 order ; for the length of time may be fuppofed to make 
 up for the deficiency of quantity. Yet, if we confider 
 the extreme activity of fome animal poifons, the wonder 
 at the fmall quantity of contagion neceffary to produce 
 a deleterious effect will in a great meafure ceafe. In the 
 former part of this treatife it has been obferved, from 
 Dr. Mead, that the whole quantity of poifon emitted 
 by a viper, when it bites> does not exceed the bulk of a 
 good drop. An ordinary drop from a vial weighs half a 
 grain, fo that we cannot fuppofe a large drop to be more 
 than a whole grain. But there are inftances in which 
 effects equally deleterious are occafioned by the bites of 
 animals the whole bulk of which is fcarcely equivalent 
 to that of the poifon of the viper. In the northern cli- 
 mates of the Old World, fpiders do not grow to any re- 
 markable bulk, yet the bite of the poifonous fpider of 
 Ruflia is as mortal as that of the rattlefnake.* The 
 effect of the furia infernalh of Linnaeus is dill more to 
 our purpofe. It is an infect found in the forefts of Ke- 
 mi in Lapland, and likewife in Sweden and Ruffia ; and, 
 if we can give credit to Mr. Pennant, in fome of the Weft- 
 em Iflands of Scotland. This infect falls down out of the 
 air, and, if it happens to light upon any uncovered part 
 of the human body, it almoft inftantly penetrates down 
 
 to 
 
 * See Medical Annals, vol. Hi, p. 4*9. 
 
THE YELLOW FEVER. 
 
 to the bone, occafioning the moft excruciating pain, and 
 death in a quarter of an hour ^ Now, fhould we fup- 
 pofe the whole body of this infect to be poifon, as it is 
 probable that it is not, it is fo minute, that though the 
 whole were volatilized into contagion, it might be well 
 fuppofed to adhere to a wig* or even a more diminutive 
 part of the clothing; and, conlidefing the virulent ef- 
 fecls of even this fmall quantity of contagion when con- 
 centrated, it would eafily follow by fair calculation, that 
 a very minute proportion of even this/wtf// quantity might 
 bring on a dangerous difeafe. 
 
 Laftly, it may be urged on the fide of contagion that, 
 when a velfel arrives from a fickly country, it is no proof 
 that (he has not brought a difeafe with her, that the peo- 
 ple aboard are in health. There is abundance of evi- 
 
 clpnce 
 
 * The following account of the poifonous infers of Raffia, extracted from 
 )r. Guthrie's letter to Dr. Duncan (Med. Annals, vol, iii, p. 396) may be not 
 unacceptable to the reader : I have lately feen (fays Dr Guthrie) a woma* 
 * l with her hand and arm in a moft violent ftate of irritation, from the lodge- 
 *' ment of the lumbricus melitenfis, a worm not much thicker than a horfe- 
 *' hair, which had entered her thumb whilft at work in a marfhy fpot, and 
 i* was, when I faw her, a day after the accident, on its way up the arm, with 
 * 4 excruciating pain. I muft own that I ihoald not have known the nature 
 11 of the difeafe, if a fellow-peafant had not immediately declared that 
 ' it was produced by trre dangerous worm ; which many of thefe people aro 
 ** acquainted with to their colt, as an inhabitant of the ftagnant pools and 
 ' marfties in that diftrid, about fixty verfts to the fouthweft of Peterfburgh. 
 ' I muft farther acknowledge, that I was happy to hear the patient was to> 
 * be irrftantly tranfported to another village, where a famous operator lived* 
 *' well fkilled in the art of extracting the venomous infed ; as I fhould cer- 
 ' tainly have gone very awkwardly to work if 1 had been obliged to operates 
 ** though the iimple peafaftts perform it with fuccefs and fafety, gradually 
 * winding the worm round a quill, till the whole animal be extracted ; a work 
 ' of much patience and perfever&nce. I was very forry that duty obliged me 
 44 to be in town the fame evening, a drive of lixty verfts. It was therefore 
 * impoflible for me to accompany the patient, though I was very defuous of 
 *' witnefiing this village-operation. 
 
 But Ruflia is. peftered with a ftill more dangerous worm ; the furia infer- 
 * nalis. It is ftill fmaller than the former, not being thicker than a human 
 ' hair. This infernal infedt, from its extreme lightnefc, is often carried up 
 into the air, with the duft, by whirlwinds; and, if it unfortunately falls on 
 ' thfc uncovered part of a man or beaft, it enters the flefh in an inftant, and 
 M foon proves mortal, if a remedy be not quickly applied. 
 
 " Our new vice-governor of Peterfburg lately came down from Siberia? 
 c where he was commandant of a fort. He tells me, that in the diftril of 
 l Nerchinfk, where he commanded, the peafants, as well as their cattle, ar* 
 often deftroyerl by an infedt falling upon them. To prevent this accident 
 " from proving fatal, the part is inftanly fcarified, and rubbed with a mix> 
 J ture ot fnuif and fal ammoniac. 
 
 This I am convinced muft be the furia infernalis ; more efpecially as he 
 aflured me, that the infeft was fo very minute, that none of the peafants 
 4* had ever feen it >vhen it fell upon thcnij and that they had no idea of its 
 
A TREATISE ON 
 
 dence that very dangerous maladies may be communica^ 
 ted by thofe who do not labour under the fame. The 
 prifoners at the Oxford aflizes were not fick at the time 
 they communicated a dreadful diftemper to thofe around 
 them. Dr. Brattle and Mr. Anthony were in perfect 
 health when they communicated the contagion of the 
 fmall pox, yet the effect was not lefs fatal. In fhort> 
 contagion being a power certainly known to exift, though 
 invifible and imperceptible, it is impoffible ever to prove 
 that it is abfent j neither after the contagion of any 
 difeafe has once got into a country can we beaffured that 
 it may not revive. The experience, we may fay, of the 
 whole world teflifies that it does adhere particularly to 
 clothing. Dr. Land thinks it may adhere to the timbers 
 
 of 
 
 nature and form. But one eireumftaace of his, recite*?, alxaoft 
 " my belief ; that the carcafe of an animal killed by this in led is aim oft a* dan- 
 " gerous as the infedl itlelf . This phenomenon I cannot account for in any 
 f other way but by fuppoSng, as the accident always happens in the hot monthf 
 ** of the year r that a high degree of putridity is produced by the venomou* 
 w worm, when the cafe proves fatal. 
 
 I informed the vice-governor of the manner in which the Dalecar}ian pea- 
 ; fants in Sweden treat the accident, in order that he might cosjrsuakate their 
 ** mode of cure to his Siberian acquaintance! which is merely applying to the 
 * part affected a piece of fweet card. The infed poffibiy prefers this to flefa, 
 i and leaves th one for the other. I asn however, much afraid that this fim- 
 ' pie remedy will feklom be at hand in Raffia, as the peafauts areunac^uaiaW 
 61 ed with the ui'e of rennet* but prepare a four curd by means of heat, through* 
 t out the whole empire ; evidently taking its origin in the Tartar Koumis 
 Q< and (hewing them te be a people f Scythian extra&ioa. They like wife: 
 * ieparate butter from milk by heat, inftead of the churn ; a curioas circum- 
 w ftance, prob^bJy unknown to you before. 
 
 ' Thefe two dangerous infects are, however, not all which threaten th$ 
 < life of man in this empire : the foutheyn provinces are infefted with a thirds 
 < the bite of which is as mortal as that of tke deadly rattlefnake, if the parj 
 <*-be not inftantly tcarifted, and rubbed with frefti butter. This >s a fpecies 
 of era-b-fpider, 4he phalangium acaroides, refembiing the tarantula, but ra- 
 i ther thinner and (mailer. 5t however kills and devours that forinidabla 
 .fpider in a few minutes, which, wfeea compared whh ii is an innocenj 
 t animal. 
 
 Your acquaintaace, Mrs. Guthrie, lateJy seturntd from a toar on accottnX 
 a of health, along the north ihore of the Black Sea. Amg much important 
 c and curious information, (lie gave me fome account of the care employed 
 for the bite of this mortal fpider, which finds maa? lurking-places among 
 the rmed buildings of th anaient Cheilbnef us Taurica, r Crimea, laid* 
 * waftc ia tlw laft Tuifc(h war. It is a curiows fai, that anital oil coun- 
 -< teracls the venom of the fpider tribes, as vegetable oils do the venom 
 * of ferpents. 1 fufpedt, however, that either of them would counteract both 
 ** poifons ; indeed, I think we have a proof of animal oil a&ing woaderfulljr 
 on ferpents, in the anecdote related by Bruce, when the deadly ceraftes, of 
 j* viper of the Nile, turned away its head from the oiiy breaft of She prime 
 <* mmifter of Fenaar, when he csielefsty teok it up in his hand, and applies* 
 it to his naked bofom, to Ihew Mr. Bruce how innocent it was ta men of his 
 \* eok>ur> v;kofe very Q,in tkkencd tfee ans>al> 
 
THE YELLOW FEVER. 471 
 
 of iliips ; and there is the greateft reafon to believe that 
 it may alfo adhere to the walls of apartments in houfes. 
 The appearance of fever therefore without any new im- 
 portation cannot prove that it has not arifen from con- 
 tagion. But it is now time to date the evidence on the 
 oppofite fide. 
 
 In Webfter's Collection we find the domeftic origin 
 of yellow fever fupported by Drs. Valentine Seaman, 
 and E. H. Smith of New York ; and by Drs. Taylor 
 and Hansford, and Dr. Ramfay of Norfolk. Dr. W. 
 Buel of Sheffield has alfo given an account of a fever., 
 but fo unlike that of which we treat, that what is faid 
 of the one cannot be applicable to the other. 
 
 The arguments ufed by Dr. Seaman are, i. Several 
 perfons were infected, who had taken the utm oft care to 
 avoid all communication with the fick, who had not 
 been for feveral weeks out of their houfes, or within 
 eighty feet of an infected perfon. ^. The nurfes and at- 
 tendants in fome places were infected, but in others ge- 
 nerally efcaped. Neither did the difeafe fpread into the 
 country, as was reported ; the Doctor having inquired 
 into thefe reports, and found them groundlefs. 3. Dr. 
 Lining fays in his letter to Dr. Whytt,* " If any perfon 
 from the country received it in town, and fickened on 
 his return home, the infection fpread no further, not 
 even to one in the fame houfe."-}- 
 
 Several other arguments of the fame negative kind are 
 adduced, which, being not eflentially different from thofe 
 already quoted, it is needlefs to detail. The following 
 are rather of a different nature : 4. Some contagions 
 are propagated by contact only, others at a diftance ; but 
 at any rate we may fuppofe that contact will propagate 
 contagion more readily and more powerfully than any 
 other mode that can be imagined. Yet multitudes of 
 difiections have been made, and thofe who made 
 them are ftill alive. 5. " Specific and ackowledged con- 
 " tagions all feem to arife from themfelves only : hence 
 
 4S it 
 
 * Seep. 387. 
 
 t The fame phyfician, in the very letter quoted by Dr. Seaman, fays that 
 all the times this fever had appeared in Carolina, the origin of it was evi- 
 dently traced to fome reflel arrived from the Weft Indies, 
 
A TREATISE Otf 
 
 96 it would be almoft as hard for me to believe that tns 
 *' fiphylis, fnaall pox, or meafies, could be produced 
 " from any other caufe than their own proper virus, ob- 
 * fc tained from perfons affected with the like difeafe, as 
 " it would be for me to conceive of the formation of a 
 *' plant without its having received its feed, or radical^ 
 " f r om one of the fame nature.* Contagions feem to 
 * c fix in the foil of our bodies, and there feed, as natu- 
 " rally and regularly as vegetables do on the earth. But 
 " the yellow fever has been produced from other caitjes 
 " than -contagion.^ Does it not then admit of a doubt, 
 " whether it can pojjefs a power of propagating itfelf ?" 
 7. Contagions refpedt no perfons, but all of every clime 
 and colour are equally attacked with them ; but the 
 yellow fever is known to attack fome much more readily 
 than others. 8. Contagious difeafes generally have a deter- 
 mined time of invafion after an expofure to their caufe : 
 but the advocates for contagion in the yellow fever can- 
 not be confined in this manner. " Their doctrine re- 
 44 quires that it (the contagion of yellow fever) be per* 
 " m it ted to act at any time between that of the expofure 
 " and the fixteenth day ; otherwife it would not em* 
 '* brace cafes enough to give it a currency." 9. " Con- 
 tagions 
 
 * Arguments of this kind involve us in an endlcfs difpute fimilar to thsft 
 relative to the equivocal generation of plants and animals ; that is, the 
 production of plants without a feed, and animals without parents. As fome 
 difeafes are confetted to arife from fome kind of feed, we are puzzled to ac- 
 count for the origin of the firjt difeafe of that kind. Neverthelefs, as their 
 difeafes do exift, the difficulty anting from a confederation of their origin Is 
 overlooked. In the yellow fever, which is not t fo long (landing, the orig'm 
 is more dilated. #ut it is iikewife undeniable, that fome contagious diftem- 
 pers (the itch particularly) though capable of being propagated by contagion, 
 may yet arife from want of cleanlinefs, and living on particular kinds of food. 
 May not this alfo be the caie with the yellow fever ? And is it not the iafe 
 and rational way to acl as though it might not only be produced at home, but 
 iinported from abroad ? 
 
 t This is the very point in queftion ; but our author, inftcad of enumerat- 
 ing the fads by which his petition may be fupported, relers to Dr. Lind, whofe 
 evidence (hall be afterwards confidered. 
 
 J No greater latitude, or very little more, is required by the advocates for 
 the t.ontagious nature of the yellow fever than Dr. Seaman muft allow in a 
 diftemper which he himfelf owns to be contagious. It is well known, on the 
 caftern continent at leaft, that a gonorrhoea will come on at any time between 
 the firft and fifteenth day after the infection is received. Dr. Guthrie fup- 
 poles the time intervening between the reception of peftilential contagion. and 
 the appearance of the fymptoms to be four days; and I>r. Chiftiolm thinks 
 that in the Boullam fever it is fomewhat flbort of two days : but it is plain 
 that much muft depend on the quantity of couta^ioni and t&e predifpofitws. 
 of the body to receive it. 
 
THE YELLOW FEVER, 473 
 
 " tagiohs act more or lefs at all places and feafons, fim- 
 " ply of themfelves, without the aid of any particular 
 cc circumftance of air or climate ; but the fupporters of 
 " the yellow fever being contagious are obliged, by the 
 ''force of the foregoing obfervati'ons, to acknowledge their 
 " imaginary fondling to be but a half -formed monjler^ and 
 u perfectly inactive without being aflifted by the con- 
 " currence of a predifpofing conftitution of the air. 
 " (Rufh on yellow fever.) This, fever exifts only in 
 " warm weather : hence its caufe in this city (New 
 " York) was perfectly extinguished by the frofty nights 
 cc in the loth month. It is confined moftly to low fitua- 
 " tions in thick-fettled places ; otherwife our almshoufe 
 " and the furrounding country would have fadly experi- 
 " -cuced its deleterious effects." 
 
 This argument merits a particular confederation, as 
 involving a queftion of very great importance, namely^ 
 concerning the conftitution of the atmofphere^ which 
 we have had occafion formerly to fpeak of, and which is 
 by fome thought to be fufficient of itfelf to produce epi- 
 demics, without the intervention of any other caufe. 
 This conftitution of the atmofphere is, it is true^ fome- 
 thing unknown ; and, when people appeal to it, it is only 
 in other words owning their ignorance ; but the neceffity 
 of recurring to fome caufe imperceptible by our fenfes 
 has in all ages been obvious. So much indeed has been 
 faid in this treatife on the caufes of plague (which may 
 apply alfo to yellow fever)* that more would be fuper- 
 fluous, even if our limits would admit of it. The di- 
 lemma (and it is equally infoluble let iis fay what we 
 will) ftands thus : If the yellow fever is produced by the 
 effluvia of marfhes, by putrid fteams, or by any thing 
 elfe, how comes it to pafs that it has been fo frequent in 
 the United States fince the year 1792 in comparifon of 
 what it was for 30 years before ? Have the American, 
 cities all at once become finks of filth and naftinefs ? 
 Have the feafons been changed, or have the inhabitants 
 given themfelves up at once to fwinifh intemperance, and 
 
 gluttony, 
 
 * See p. 1 66, & feq. 
 
 PPP 
 
474 A TREATISE ON 
 
 gluttony, devouring, like favages, their meat half-rotten, 
 half-roafted or half-boiled ? From fome declamatory 
 publications indeed one might be apt to think that the 
 authors certainly meant to bring fuch accufations againft 
 them. But it undoubtedly will be found an hard mat- 
 ter to prove that the general cleanlinefs of the country 
 is inferior to what it was, or that the people are lefs vir- 
 tuous than they were before. Befides, has not the vigi- 
 lance of the magiftrate, ever fince 1793, been exerted to 
 the utmoft to procure a removal of thofe nuifances from 
 which the difeafe might be fuppofed to arife ? Yet their 
 effotfs have not availed ; for it is confeffed that the at- 
 tack in 1798 was the moft fevere ever experienced. 
 Jf cold could have exterminated the difeafe, certainly 
 the three laft winters have been abundantly fufficient to 
 do fo ; yet it is certain that cafes of the fever did appear 
 in the end of December laft, when the cold muft cer- 
 tainly have been deemed fufficrently intenfe to put a 
 ftop co putrefaction of every kind. No wonder then 
 that people, unable to fee the caufes of thefe things, 
 fliould have recourfe to fomething invifible, which they 
 called the conftitntion of the aimofpJiere. On this fubjec"* 
 Dr. Haygarth of Chefter makes the following objections 
 to the commonly "received opinions concerning epidemic 
 cenftituiions of the atmofphere :* 
 
 " i. Dr. Odier of Geneva, in a letter to Dr. Hay* 
 " garth., writes thus : c I believe it would not be difficult 
 46 to prove that the (late of the atmofphere is in no re- 
 " (peel; the caufe (of the regular epidemics of that city;) 
 " for the villages and towns which furround it do not 
 *' experience the fame epidemic all years as Geneva, al- 
 " though they are (ituated under the fame heavens, and 
 ie expoted to the fame viciffitudes of atmofphere.' 2. Sy- 
 *' denham conjectures that fome effluvia, iiTuing from 
 " the bowels of the earth, produce epidemics. Were 
 *' this true, it might advance one ftep towards a folution 
 " of the difficulty by difcovering a local difference in the 
 " atmofphere. But it has never yet been pretended that 
 * any fuch vapour was perceived. Yet every part of 
 
 " the 
 * Sketch of a Plan to exterminate Cafual Small Pox. 
 
THE YELLOW FEVER. 475 
 
 4 * the earth muft be capable of furni (hing it ; as no por- 
 " tionofthe whole habitable globe has been difcovered 
 " where the air could not propagate the frnall pox. . . . 
 *' 3. Hence we may fafely conclude, that the flight varia- 
 " tions of the fame climate, and the fame feafun, muft 
 " be altogether infignificant and nugatory. What im- 
 44 portant difference of atmofphere can be fuppofed to 
 " exift for weeks or months together in two neighbour- 
 " ing villages, or in the adjacent ftreets of the fame 
 ec town ? This remark is plainly applicable to the pro- 
 " pagation of the plague and other infectious diftempers. 
 <c Yet the lateft and moft refpe&able authors continue 
 " to be mifled by this groundlefs hypothecs." 
 
 Obje&ions of this kind do not folve the difficulty. 
 The exceffive difparity of feafons with refpect to the 
 fpreading of epidemic difeafes, the long cefTation of them 
 at fome times, and their fudden revival, as if with re- 
 doubled fury, at others, indicate the operation of fome 
 caufe invifible to us ; but whether that caufe refides in 
 the earth or in the air, cannot eafily be known. As 
 contagious matter feems to operate by being received 
 with the air into the lungs, it would feem rather probable 
 that the ultimate caufe of epidemics refides alfo in the 
 air. Dr. Haygarth complains that the vapour arifing 
 from the earth, fuppofed to produce epidemics, mould 
 be invifible -, but the contagion of the fmall pox, or of 
 any other infectious diforder, is equally fo. It muft, he 
 fays, be difFufed all over the earth. The electric fluid is 
 fo; it ifTues from the earth in every part of its furface, 
 as is demonftrated by the common experiments of elec- 
 tric machines ; and there are the ftrongeft reafons to be- 
 lieve that it ifTues at fome times and in fome places in 
 much greater abundance than others. But enough has 
 been faid on this fubjed ; we muft now confider mat- 
 ters a little more obvious. 
 
 Though it is not eafily feen in what manner the pro- 
 portion of the ingredients which compofe the atmofphere 
 can be changed, and we are unable to difcover the ope- 
 ration of the more fubtile fluid contained in it, yet we 
 are certain that its conftitution muft be different in dif- 
 ferent 
 
476 A TREATISE ON 
 
 ferent parts of the world. Iflands, from their being 
 furrounded on all fides by the fea, muft of confequence 
 have an atmofphere considerably different from that of 
 the internal parts of continents, where the air always 
 pafles over large tracts of land. Hence the continent of 
 America, being fituated between the two vaft oceans 
 called the Atlantic and Pacific, muft poflefs a conftitu- 
 tion of atmofphere considerably different from that of 
 the Eaftern. Of confequence, the difeafes of Europe 
 and Afia, when tranfplanted to America, or to the 
 American iflands, will probably, fooner or later, afiume 
 a type different from that which they had in their own 
 country. Dr. Waterhoufe has taken notice of this in 
 his letter to Dr, Haygarth, and thinks that it may hold 
 good even in the fmall pox. " May not the fmall pox 
 " (fays he) operate differently in the two countries? It 
 " has certainly had a different appearance, and required a 
 " fomewhat different treatment, almoft every time it has 
 " come among us. That the difference in thevirulency 
 " of the fmall pox, obferved at different periods, when 
 " epidemic here, may be attributed to a peculiar con- 
 " ftitution of the atmofphere, no one feems to doubt ; 
 " and why may not the difference, fo reafonably to be 
 " expected between the atmofphere of your ifland and 
 " this continent, allow us to fuppofe that there is fome 
 c - difference in the facility of receiving the infection ?** 
 This is alfo an important confideration, and may throw 
 fome light on the caufe, as well as the mode of preven- 
 tion, of this difeafe. 
 
 Laftly, Dr. Seaman attempts to difprove the authen- 
 ticity of fome cafes which have been brought as pofitive 
 proofs of the difeafe having been received by infection. 
 Thefe belong not to us to confider ; it being impofiible, 
 by reafon of the invihble nature of contagion, to deter- 
 mine from a fimple confederation of any patient's cafe 
 whether it was infectious or not. Dr. Fordyce has laid 
 clown the proper rule for judging in fuch cafes.* One 
 only of the inftances brought by Dr. Seaman therefore 
 vye ihall mention, and that, not becaufe it proves any 
 
 thing, 
 
 * See p. i 9. 
 
THE YELLOW FEVER. 477 
 
 fhing, but on account of its fingularity. " Daniel Phoe- 
 # nix, city-treafurer of New York, is fuppofed without 
 " doubt to have taken his complaints from contagion: 
 " the corporation, fome time paft, having iffued into cir- 
 ** culation, for the accommodation of the inhabitants, 
 " a great number of paper penny bills, it has been con- 
 " eluded that he muft have received contagion through 
 fc ' f the medium of fome bundles of thefe bills, which he 
 " opened, that had been nearly worn out, to be exchang* 
 *' ed, and which he opened and examined to afcertain 
 " their amount fome days after he had received them.'* 
 The Dodor allows that he might have been infected by 
 the bills, but afcribes it to putrid effluvia.'* 
 
 Dr. Smith, in his letters to Dr. Buel, infills much on 
 the vitiated ftate of the atmofphere, and is at fome pains 
 to defcribe the perfons who were moft fubjedt to it. 
 Thefe, in 1795, were for the moft part foreigners ; un- 
 der which denomination the Doftor comprehends thofe 
 who came from other ftates, from the Weft Indies, and 
 from Europe, or who had not been many months or 
 years fettled in the city. The number of citizens who 
 fullered he does not fuppofe to have exceeded one in 
 feven ; but he remarks, that, both among foreigners and 
 citizens, the feverity of the difeafe fell chiefly on the 
 poor. This mixture of different nations he accounts, 
 and with great probability, one of the caufes of the dif- 
 
 temper, 
 
 * Dr. Seaman having at laft, as he thinks, completely overthrown his ad- 
 yerfaries, and ranked himfelf with the more conjiderate and reafonable part of 
 the community, likens thofe who differ from him to fuch as beljeve.in ihcfoiuer 
 'ef imagination to mark the child in the womb ; and which he is of opinion that 
 the women of America would not disbelieve, though all the phyficians on the 
 continent weae to unite in perfuading them to the contrary. On this fubjedfc 
 the writer of this treatife is happy at having it in his power to declare himfelf 
 pf the fame opinion with the ladies, and to offer, in fupport of their opinion 
 ?nd his, the following fa<5l. A pregnant woman, having been employed in 
 dyeing fome cotton yarn, and rinfed it, after it had got the colour, in cold 
 water, threw it, while wet and cold, about her neck. It touched the (kin on 
 the back part of the neck, and part of her arm. The woman ftarted, fhivered, 
 and inftantly faid that her child would be marked. It happened exa<Uy ac- 
 cording to her predidtion. The back part of the neck, and correfponding 
 part of the arm to that which the cotton touched, being covered with purple 
 fpots in the child, exaclly fimilar to what might have been made by drops of 
 the purple liquid in which the yarn was dyed falling upon theflcin. Of this 
 fadt I am as certain as of my own exiftence; having been prefent when the 
 cotton was dyed, having heard the lyoman call out as above relatedi and feei* 
 tlo child after it was born t and particularly infpec^ed the marks. 
 
A TREATISE ON 
 
 temper. In confirmation of it he quotes Dr. Blane, on 
 the difeafes of feamen, remarking, " that it fometimes 
 " happens that a fhip, with a long-eftabhftied crew, fhall 
 " be very healthy ; yet if Grangers are introduced among 
 " them, who are alfo healthy, ficknefs will be mutually 
 " produced. " The fame obfervation is made by Dn 
 Rufh, who, befides a general reference to the hiflory of 
 difeafes, adds the following remarkable fad : " While 
 (i the American army at Cambridge, in the year 1775, 
 " confided only of New England-men, whofe habits 
 " and manners were the fame, there was fcarcely any 
 66 ficknefs among them. It was not till the troops of the 
 * c eaftern, fouthern and middle ftates met at New York 
 " and Ticonderoga, in the year 1776, that the typhus 
 " became univerfal, and fpread with fuch peculiar mor- 
 ce taltty in the armies of the United States." 
 
 This confirms the obfervation made in the former 
 part of this treatife, when fpeaking of the Englifh em- 
 baffy to China. It may likewife with probability be 
 afligned as one reafon why large manufactories are gene- 
 rally fo unhealthy. In them there always is a collection 
 of people from many different and diftant parts ; and 
 what holds good on a large fcale mud alfo do fo on a 
 fmaller one. But this does not difprove the dodtrine 
 of contagion, but rather confirms it ; for, if the difcor- 
 dant effluvia rifing from healthy bodies of different con- 
 jkitutiom can generate a difeafe, much more may we fup- 
 pofe the effluvia from fick perfons capable of continuing 
 and propagating it. 
 
 Now, let us confider the account, imperfedt as it is a 
 which we have been able to colledt concerning the ap- 
 pearance of the yellow fever on the Weftern Continent, 
 We have feen (p. 377, n.) that, at the time the plague 
 was in England, five of the Americans were tranfported 
 to that country , two of whom,, after flaying fome time 
 in England, were fent back, with other Grangers, to 
 America. This firft colony having failed, another was 
 fent ; the Indians went to war among themfelves, and 
 the yellow fever is fuppofed to have made its appear- 
 ance. Here a fufpicion naturally arifes, that a ilight 
 
 peftilentia! 
 
THE YELLOW FEVER. 479 
 
 peftikntial taint had been imported by fome of thefe 
 ftrane^ers, and that what would have been the true 
 -plague in Europe or Ada, by reafon of the peculiar con- 
 flitution of the atmofphere in the New World, there be- 
 came the yellow fever. The fame may be faid of the 
 original importation of it into Martinico. Sauvages 
 exprefsiy fays it was the plague which was imported. 
 Mofeley and others deny that any fuch difeafe as the 
 yellow fever exifts in Siam ; and indeed it feerns at 
 any rate to be a new difeafe. It feems poffible that 
 difeafes may change their nature ; and Dr. Ferriar has 
 given a diflertation on the converiion of difeafes. As 
 therefore the true plague never made its appearance in 
 America or the Weft Indies, it feems not unreafonable 
 to fuppofe that thefe countries are incapable of receiving 
 it, but that the peftilential poifon, when tranfported to 
 the Weftern Continent, may aflume a different, and in 
 many refpecls an oppofite, nature ; the two difeafes be- 
 ing thus like the oppofite poles of a magnet, fcarce agree- 
 ing in any thing but the common work of deftrudtion. 
 
 It is needlefs to fpend time in attempting to invefti- 
 gate the caufe of this difeaie appearing at different peri- 
 ods. That of 1793 has been the mod remarkable and 
 the moft deftrudlive ; the difeafe having never fince that 
 time ceafed its ravages. Previous to its appearance at 
 Philadelphia that year, Dr. Rufh obferves, that, " du- 
 " ring the latter part of July, and the beginning of Au-> 
 " guff, a number of Aediftreffed inhabitants of St. Do- 
 " rningo, who had efcaped the deftruction of fire and 
 " fword, arrived in the city. Soon after their arrival the 
 " influenza made its appearance, and fpread rapidly 
 " among the citizens." The yellow fever quickly fol- 
 lowed ; for on the 5th of Auguft the Doctor mentions 
 his being called to his firft patient. To the fame pur- 
 pofe we are informed by Dr. Clarke that " the fever made 
 " its appearance in Dominica about the i5th of June, 
 " 1793, a few days after the arrival of a great number of 
 * c French emigrants. They were not lick, and the fever 
 " had not made its appearance in Martinique when they 
 " left it. From the 1 ift of July to the ift of Oftobcr it 
 
 " was 
 
480 A TREATISE ON 
 
 " was computed that eight hundred emigrants, including 
 * e their fervants and flaves, were cut off by this fever $ 
 " and about two hundred Englifh, including new com- 
 66 ers, failors, foldiers and negroes, all fell victims to it 
 " in the fame fpace of time. Few new corners efcaped 
 * c an attack, and few recovered. It fpared neither age 
 " nor fex among the Europeans and emigrants ; and not 
 " only the people of colour from the other iflands, but the 
 * c new negroes who had been lately imported, were all 
 " attacked. Such as had been long on the ifland 
 " efcaped."* 
 
 Thefe fads feem to point out one of the caufes, and 
 very probably a principal caufe, of this dreadful diftem- 
 per. They fhow very evidently that there is a connex- 
 ion between war and difeafes. It has formerly been at- 
 tempted to point out a natural connexion between the 
 horrid practices of men, on thefe occafions, and the 
 production of difeafe. Thefe inveftigations, however 
 chimerical they may be reckoned, are yet fupported by 
 many fadts, which undoubtedly prove that mankind 
 cannot always maltreat and torment one another with 
 impunity. The affair of the Black aflizes, and Old Bai- 
 ley fefFion, in 1750, (hows, that by confinement and 
 bad ufage the human body, without being apparently 
 deprived even of health, may become poifonous to thofe 
 around it, and produce dreadful difeafes. In like man- 
 ner the inhabitants of St. Domingo, having been put to 
 the moil dreadful diftrefs, becari^ properly fitted for 
 fpreading deftru&ion whereever they went.-j- It is even 
 probable that, in proportion to the degree of diftrefs fuf- 
 fered by thefe people, the difeafe communicated by 
 them will be malignant; nay, that new difeafes may 
 ipring up, which cannot be treated with fuccefs by any 
 
 method 
 
 * Medical Review, vol. iv. 
 
 f Dr. Mofeley who has written at fome length on the interruption given ta 
 military operations by difeafes, gives an account of general falling's expedi- 
 tion in 1780, where the Englifh troops, confined in the caftle of St. Juan, in 
 an unhealthy fituation on the river Nicaragua, were cut off by difeafes ; but 
 thefe were riuxes and intermittents. He doth not mention the yellow fever 
 among them. He tells us indeed that the troops under general Garth brought 
 the jail fever along with them, and that thofe who returned to Jamaica were 
 ha raffed with obftinate intermrtteuts t with dianliceaf d/fentery, or paifcfui 
 enlargements of the liver and fpleen. 
 
THE YELLOW FEVER, 481 
 
 thcthod yet known to phyficians. With regard to the 
 difeafe in queftion, it Teems plainly to have from fome 
 caufe or other received an additional malignity. Dr. 
 Chifholm fays that what he calls the Boullam fever was 
 fappofed in Grenada to have been the common yellow 
 fever of the Weft Indies engrafted on the jail fever. Dr. 
 Lind, Dr. Jackfon, and even Dr. Chifholm himfelf, 
 agree that the former is not infectious : but from what 
 has been already faid the evidence feems to prevail in 
 favour of the opinion that the latter is fo. Should we 
 then allow that two kinds of this fever might exift at 
 the fame time, in one city, the difficulty would be at 
 once removed. But this has been reckoned by many, 
 particularly by Dr. Ruth, as totally inadmiffible ; and 
 indeed it is a maxim confonant to general experience* 
 that two epidemics cannot exift in one place at the fame 
 time, or that two difeafes can fcarcely exift at once in 
 the human body. This however muft be underftood, 
 principally at leaft, of acute difeafes, or fuch as affect the 
 whole fyftem ; for if any difeafe of a particular part (hall 
 take place^ it does not feem impoflible that a fever may be 
 fuperadded to fuch local difeafe. The following confi- 
 derations may perhaps throw fome light on the fubjecl: : 
 It appears from the experiments of Dr. Adair Craw- 
 ford, that, when animals are icnmerfed in hot water, the 
 blood drawn from a vein is of a florid red colour. la 
 fummer it is likewife obferved to be of a more florid co- 
 lour than in winter. If heat thus gives a more bright 
 red to the blood, it undoubtedly alfo makes it more 
 fluid, and in proportion to its fluidity it will likewife be- 
 come acrimonious 5 though this acrimony is not necef- 
 fariiy connected with a florid colour, as the blood of 
 the arteries is not more fo than that in the veins. In 
 the yellow fever, however, the blood fometimes, towards 
 the end of the difeafe, becomes endowed with extreme 
 acrimony. Dr. Smith, in one of his letters to Dr. Buel, 
 obferves, that " blood drawn in the fever of 1795 was 
 " remarkably wanting in florid ity ; efpecially what was 
 " evacuated towards the clofe of the difeafe, whether by 
 44 art, or fpontaneous effufion. In one inftance it feemed 
 
 q *' endowed 
 
4^2 A TREATISE ON 
 
 " endowed with a cauftic quality, and affected a lancet 
 <c fo as to leave a permanent difcolouration and inequality 
 " on its furface." He obferves alfo, nay, confiders it as 
 demon/hated, that the yellow fever is not a difeale of vaf- 
 cular debility, and he fays that it is attended with an 
 afton ifl-ung fluidity, or, as it is called, dlffblution of the 
 blood. Every one therefore who comes from a cold to 
 a warm climate muft in fome degree or other have his 
 blood liquefied, and in a certain proportion rendered 
 more acrimonious than before. This acrimony may be 
 undoubtedly augmented by certain caufes, and by none 
 more probably than immoderate drinking of fpiritous 
 liquors. Every one therefore who comes from a cold 
 country to a warm one, efpecially where the air is alfo 
 moift, may confider himielf as already difeafed, at leaft 
 in comparifon with what he was when at home. For 
 the blood is now expofed to a greater degree of heat, 
 and confequently is about to abforb, or rather may be 
 confidered as in the ad of abforbing, more, and con- 
 fequently of changing from a thicker to a thinner or 
 more fluid ftate; the latter being the natural fituation 
 of the blood in warm countries. Dr. Rufh, in his in- 
 quiry into the proximate caufe of fever, has accounted 
 for the diffolved appearance of the blood in malignant 
 fevers to a tendency in the blood -veflels to paralytic affec- 
 tion. He fays that " it (the diffolution of the blood) 
 " begins in the veins, in which mufcular action is more 
 " feeble than in the arteries. This has been proved by 
 " Dr. Mitchill in his account of the yellow fever in Vir- 
 *' ginia in 1741. He found the blood to be diffolved 
 <c when drawn from the veins, which, when drawn from 
 " the arteries of the fame perfons, exhibited no marks 
 " of diffolution." This, as the Doctor obferves, " is a 
 fadl of great importance;" only we muft remember, 
 that, in every thing relative to the human body, when 
 we find two phenomena contlantly accompanying each 
 other, it is extremely difficult for us to determine which is 
 caufe or effccl:. Instances of this often occur ; and in the 
 prefent cafe the dilemma is as great as any other. Though, 
 from the teftimony of Dr. Mitchill, we cannot doubt 
 
 " that 
 
THE YELLOW FEVER. 485 
 
 that in yellow fever the diffolution begins in the veins; 
 and though it is likewife extremely probable that this 
 diffolution is attended with a paralytic tendency, we 
 cannot know whether the diffolution is the caufe of the 
 paralytic tendency, or the paralytic tendency the caufe of 
 the diffolution, The point, however, is of no impor- 
 tance. We fee that in warm climates the blood of 
 a perfon newly arrived has a natural tendency to dif- 
 folution, and of courfe the veins to the paralytic af- 
 fection juft mentioned. The liver therefore, which 
 is fupplied with blood by a large vein branched out 
 like an artery, and terminating in other veins to car- 
 ry back the blood from the former,* muft be much 
 more affe&ed than any other part of the body ; and this 
 indeed feems a very probable reafon why all thofe who 
 come to warm countries become much more inclined to 
 bilious complaints, which denote an affection of the 
 liver, than they were before. This hepatic affection 
 may very probably be greatly augmented, in new comers, 
 by various caufes. One of thefe is hard labour under a 
 greater heat than they have been accuftomed to ; a 
 fecond, that in the Weft India iflands they have not 
 accefs to that plentiful fupply of fermented liquor, a- 
 bounding infixed air, which they had at home. This, 
 though not generally taken notice of, is far from being a 
 matter of little confequence ; for, though emigrants from 
 Britain and Ireland have been for the mod part accuf- 
 tomed to drink fpiritous liquors, yet fermented malt 
 liquors certainly conflitute the principal part of their 
 drink. The total want of thefe, and the fubftitution of 
 ardent fpirit and water, muft certainly be detrimental, 
 even though they keep within the bounds of moderation, 
 and much more if they do not. Dr. Mofeley relates,-}- 
 from Dr. Irving, that, in a bad kind of intermittent 
 which broke out among the troops in fervice on the 
 Spanifh main in 1780, " nothing was fo grateful as Lon- 
 >' don bottled porter. Wine was neither fo much defired 
 : by the fick, nor fo Serviceable in corroborating and 
 *' keeping up the powers of the ftomach $ which, like 
 
 " the 
 
 * Seep. 94. f Treatife on Tropical Difeafes, p, 173. 
 
484 A TREATISE ON 
 
 ** the reft of the body, was foon reduced, from the 
 " flighted indifpofition, to the loweft ftate of debility." 
 A third caufe is no doubt their frequently dr.inking too 
 freely of fpiritous liquors, perhaps hot of the bed qua? 
 lity ; and which, as they are neither conjoined with the 
 fixed air nor with the mucilage which as it were invif- 
 cate and blunt their force in malt liquors, cannot fail of 
 exerting their deleterious properties in a very remarka- 
 ble manner. 
 
 From thefe and other caufes there muft neceiTarily 
 arife a predifpofition to hepatic difeafes j and this pre- 
 di(polition cannot be removed until the blood has af- 
 fumed the ilate of fluidity proper to the climate in which 
 they are, and the body has acquiefcecl in the change. 
 They are then faid to bz feafoned to the climate ; and it 
 is feldom that this feafoning takes place without a dif- 
 eafe ; indeed fo feldom, that the firft illnefs which hap- 
 pens to feize them after their arrival is called the feafon- 
 ing. Dr. Trotter indeed gives a very different account 
 of this feafoning. He considers thole who come from 
 a cold to a warm climate as having a redundancy both 
 of excitement and excitability, and fays that " to wear 
 " out tlds accumulated excitability by flow and gentle gra- 
 " dations is the grand explanation of the word feafoning : 
 ;C it is thefecret which conftitutes the only difference be- 
 " tween the inhabitants of England and Jamaica. The 
 ;? yellow fever of the Weil Indies therefore, as it appears 
 :c in the body of a raw European, is a difeafe of the 
 c utmqft excitement, in a conftitution of accumulated exci- 
 e t ability ; where a tenfe fibre and denfe blood permit it 
 ; to be carried to the higheft pitch of inflammatory 
 " tendency ; which, from the nature of the animal eco- 
 " nomy, ipeedily e;:hautls the powers of life, even in a 
 :c day or two, inducing putrefaction and death." 
 
 Explanations of this kind may edify thole who un- 
 (dcrftand them j but, though we (hould declaim ever fo 
 much about excitement and excitability, it is plain, 
 that, in every one who comes from a cold country to a 
 warm one, the liver is affected in a manner that the reft 
 of the body is not. In feme confutations, or from ex- 
 citing 
 
THE YELLOW FEVER. 485 
 
 citing caufes in any conftitution, this affeftion of the 
 !iver may be augmented, and no doubt at lad produce 
 a bilious fever, which may be varied in a number of 
 ways, accopding to the nature or the energy of thefe 
 paufes. The pure bilious fever, being of itfelf properly 
 a local affection, may not be contagious ; and we find it 
 generally agreed among phyficians that the common 
 yellow fever of the Weft Indies is not infectious. Ne- 
 verthelefs, it feems by no means improbable that from 
 certain circumftances contagion may be joined with it, 
 and it may then fpread and infeft, even as the moft 
 deadly plague. Dr. Crawford relates, that, in the year 
 1770, a new kind of fever broke out in the Middlefex; 
 Indiaman, of which many died. It is not faid that the 
 difeafe was contagious ; but, on opening the bodies of 
 fome who died, the liver was found enlarged, and of a 
 more florid colour than it ought to be. It cannot be 
 deemed impoflible that contagion, even that of the true 
 plague, might be mixed with this fever, which (as 
 the affection of the liver was probably the original 
 difeafe, might have been accounted little other than 
 fymptornatic) would then have afTumed very malignant 
 fymptoms. 
 
 We might now fay that we have got to the end of 
 our fubject. Having fo amply difcuffed the queftion 
 concerning contagion, and dated the principal part of 
 the evidence againft it, it feems proper to conclude the 
 Section with a (hort hiftory of the difeafe in the malig- 
 nant form it has affumed in the United States lince the 
 year 1792. Still, however, it is neceiTary to fay fome- 
 thing further of one or two of the caufes which have 
 teen commonly affigned as neceflarily inducing this 
 difeafe. Thefe are, i. Extreme heat, and, 2. Marfh 
 effluvia. The effect of the former has already, been 
 partly confidered as a predifponent caufe of yellow fever t 
 but it doth not appear that merely from this caufe the 
 difeafe has ever been produced. It hath indeed been 
 obferved by very intelligent phylicians, that in Virginia 
 the remitting fever has often been brought on by mere 
 expofure to the fun, Dr. Oliver of Salem hath obli- 
 gingly 
 
4 S6 A TREATISE ON 
 
 gingly informed me, that he has " in more than one in* 
 lance been feized with that difeafe after riding in the 
 fun;** and that an eminent practitioner in Virginia had 
 informed him that he had alfo more than once fuffered 
 in the fame way. Drs. Taylor and Hansforth obfervc* 
 that, when the remitting fever proves mortal, it is gene- 
 sally attended by ficknefs and perpetual vomiting $ 
 which is the termination of the yellow fever. The above 
 (evidence is decifive with regard to heat being able to 
 produce a remittent, but cannot exactly apply to the 
 yellow fever, which has no remifllons, Two failors in- 
 deed, lately brought from a coafting veHel to the Salem 
 hofpital, were attacked with violent fymptoms of yellow 
 fever without having been, as is faid, expofed to any in- 
 fection. But evidence of this kind cannot be fuppofed 
 to be incontrovertible. We have already feen the diffi- 
 culty of afcertaining fa&s ; and if it is difficult to prove 
 that contagion has been received, it muft be ftiil more 
 Ib ta prove that it has not. The perfons in queftion had 
 both worked during a very hot day in a veffefs hold, 
 they afterwards fat expofed in the damp air of the evening 
 on the deck until 10 o'clock at night, and then ilept 
 in the veiTePs cabin with the windows open. One of them 
 was feized in the night with a naoft violent pain,, and the 
 other on the morning fucceeding. It is faid that about 
 II months fince this vefFel was at New York, and that a 
 perfon on board had the yellow fever ; it is alfo alleged 
 that the veffel was not purified., and that the beds re- 
 mained on board. It has therefore been by fome con- 
 jectured that the difeafe might have been derived from 
 this fource. 
 
 Dr. Ramfay, in a letter to Dr. Come of Philadelphia, 
 cenfures Dr. Lining for faying that the yellow fever was 
 imported into South Carolina. " The greater yellow- 
 nefs of the fkin (fays he) appears to be the only circum- 
 ftance in which it differs from the bilous remittent fe- 
 vers of hot climates, or very hot feafons of any climate/' 
 Our author alfo cenfures Dr. Lind of Haflar,* who, he 
 
 fays, 
 
 * If phyficians cenfure one another at this rate* how 
 T&Q gives a tras ftate ct the mattes 
 
THE YELLOW FEVER. 487 
 
 fays, has been milled by the tnifreprefentatwns of Dr 
 Warren and others. He alfo gives into the opinion that 
 coatagion acts only by contact, or at a very little dif- 
 tance ; but this fubjed we cannot enter farther into at 
 prefent. If we can believe Dr. Mofeley, the fure crite- 
 ,rion by which the yellow fever may be diftinguifhed 
 from any other is, that the former hath no remif- 
 iions.* If folitary cafes of it appear in Carolina and the 
 fouthern States every year, this will not prove that the 
 difeafe was generated in the country, any more than that 
 the plague was generated in London, becaufe it appear- 
 ed there for many years fucceflively. 
 
 But, if the heat of the fun cannot produce the true 
 yellow fever, it can kill fuddenly without any fever 
 whatever. This is faid by Dr. Mofeley to be lefs fre- 
 quent in the Weft India iflands than on the eaftern and 
 weftern continents. He fays that he has felt as great 
 inconvenience from the fun's heat at Venice, Naples, 
 Rome, Montpelier, and in Virginia, as in the Weft In- 
 dies ;-}- but he concludes that the tranjitions from heat 
 to cold are more pernicious to the human body than any 
 continued heat, however violent. 
 
 With regard to the effluvia of marfhes, it is not deni- 
 ed that they produce fevers, but thofe fevers are of the 
 intermittent or remittent kind. Dr. Smith indeed, in 
 the flrft volume of the Medical Repository, labours to 
 prove that the plague defcribed by Thucydides was not 
 
 efientially 
 
 * This pofition of Dr. Mofeley is not univerfally received. The meaning 
 of the word rem!jfien certainly is a temporary abatement* and implies & 
 recurrence, of the lame fymptoms which originally took place. Dr. Mofeley 
 defcribes the yellow fever as beginning with one kind of fymptoms which 
 fuddenly ceaie and are fucceeded after a certain interval by others of a quite 
 liiterent kind ; and he claims the difcovery as his own. If he be right in 
 this description, the jellow fever is certainly net a remittent ; if otherwife* 
 it rrtuft be difficult to eftablifh any true diftin&ion between them. 
 
 i At Stralburg, in Germany; our author fays that he faw a man who had 
 been an idiot for more than a year from a ftroke of the fun. The 8th of July 
 1707 was ib hot in England that many people died at their work, and many 
 horlcs and oxeu were killed by the fun's rays. In 1743, eleven tboufand peo- 
 ple periihed from the Z4th to the *5th of July in the ftreetsof Pekinin China. 
 On the joth of July, 1705, the heat at Montpelier was fo great, that eggs were 
 roafted by it, Chalmers, in his account of the weather and difeafes of South 
 Carolina, fays, that he has feen a beef-fteak, laid on a cannon for twenty 
 jninutes, deprived ofits juices, and overdone by the exceffive force <*f the 
 fun's rays, 
 
483 A TREATISE ON 
 
 effentially different from the fevers which fometimes pre- 
 vail in North America, and that it had its origin from 
 marfli effluvia and the ravages of war. That this dif- 
 temper was not the plague defcribed by Ruflel we may 
 gather from a fingle cireumftance : for Ruffel tells us 
 that freezing never occurred in the plague defcribed by 
 him,* while Thucydides fays that it was one of the com- 
 mon fymptoms of his. Neither does the defcription of it 
 (Appendix No. i) at all agree with any of the accounts 
 of the yellow fever we have. The climate of Attica no 
 doubt was variable, and may in this refpect refemblc 
 that of North America ; but fo is the climate of China, 
 yet no fuch difeafes are there produced The Doctor 
 concludes that the diftemper originated from /0f<?/caufes ; 
 but the difficulty we find in proving fu:b o-igin of dif- 
 eafes in our own days, and in the country where we re- 
 fide, muft certainly make us look upon the proofs which 
 can be brought for the local origin of a difeafe which 
 happened two thoufand years ago, and in a diftant 
 country, as very equivocal. The following extract from 
 the Paris Medical Memoirs may be adduced as a proof 
 of the intrinfic power of marfh mud to produce fevers,, 
 It is contained in a paper written by Dr. Perkins of Bofton. 
 " A farmer was in the practice of fpreading, upon about 
 " thirty acres of tan-Jy fome new murfh mud, from O&o- 
 " her to April annually, to increafe the fertility of the 
 * c foil. In the fummer of the third year, thofe inhabi- 
 ** tants who lived to the northward and eaftward of the 
 " place were attacked with a very malignant fever, which 
 " generally proved mortal. What is a proof that the 
 ct marfli mud was the caufe of the difeafe is, its extent, 
 * 6 which was not more than a mile and an -half from the 
 " farmer's houfe, in the direction of the fouthcrly and 
 " wefterly winds. Perhaps had this marfli mud been* 
 " wafhed by plentiful rains, the danger would have 
 * been lefs. Something like it happened to the inhabi- 
 &c tants of the marfhes in Eofi SnJfany, (les marais fitues 
 * c a 1'eft dans le Sudberg) where the paffage for the wa- 
 44 ters was too deep, and too confined. In regular fea- 
 
 " forts 
 
 * See the Table* 
 
THE YELLOW FEVER. 489 
 
 " fons they were attacked with fimple intermittent fevers; 
 " but, after wet feafons, there prevailed among them ma- 
 " lignant fevers, and very obftinate remittents. Since 
 " the marfhes have been drained, the inhabitants are no 
 " longer fubject to fevers, and are as healthy as thofe of 
 " others places. We know that there are local epi- 
 " demies, which are produced by a low, wet, and rich 
 " foil ; fuch are, probably, thofe which prevail in the 
 " lower part of New York, which, according to the in- 
 " formations obtained by Mr. Perkins, is more unheal- 
 " thy towards the end of the fummer than the other part 
 " of the city, and whofe inhabitants are fubject to difeafes 
 *' of a putrid car aft ere. 
 
 " It appears, from feveral obfervations, that the moft 
 " mortal epidemic fevers are not commonly produced 
 *' by caufes operating immediately : the caufe often ex- 
 " ifting feveral months before the difeafe even appears." 
 
 The other arguments ufed by Dr. Smith in his letters 
 to Dr. Buel proceed upon the ftate of the city, the mode 
 of living, &c. and the condition, of moft of the emi- 
 grants, their bad accommodations, and efpecially their 
 abufe of fpiritous liquors. The neglect of bathing is 
 alfo much complained of, and a cemparifon made with 
 the conduct of the French in this and other refpects, 
 greatly to the advantage of the latter. 
 
 Drs. Taylor and Hansforth confider the difeafe which 
 took place in Norfolk in Virginia as only an higher de- 
 gree of the common remittent fever which ufually pre- 
 vails, and afcribe it to the long-continued heat, putre- 
 fcence, &c. ' Some French mips were faid to have 
 brought the difeafe, but thefe arrived " fo long before 
 the difeafe appeared, that (the Doctors think) it would 
 be abfurd to fuppofe even a poffibility of its being de- 
 rived from them/' Mr. Webfter adds, in a note, that 
 the French corvettes, three of which fquadron were 
 taken by the Thetis, capt. Cochran, " anchored in 
 " Hampton Roads, May i8th. The fever did not 
 " appear in Norfolk till Auguft. captain Cochran's 
 " crew, however, took the fever from the French prifoners, 
 *>' and twelve of them died before the Thetis reached 
 
 R r r Halifax," 
 
49* A TREATISE ON 
 
 " Halifax." This is certainly a fufpicious circum- 
 fiance. 
 
 Dr. Ram fay, in his letter to Dr. Mitchill concerning 
 the fame diitemper, obferves that it was confined almoft 
 entirely to foreigners, of whom he gives a very unfa- 
 vourable account. The fituation of the town, putre- 
 fcence, &c. are likewife brought in for a (hare, as well as 
 the feafon, which had been uncommonly warm. 
 
 Thefe are the principal evidences that have been 
 brought for and againft the origin of the difeafe which 
 fince 1792 has raged with fuch violence in the United- 
 States. Innumerable pieces have appeared in the Newf- 
 papers on both fides of the queftion, the moft remarka- 
 ble of which are the letters of Mr. Noah Webfter to Dr. 
 Currie. Thefe, however, we cannot now confider, as we 
 cannot expect indeed that they fhould contain any thing 
 elte than a fuller detail of what has already been fet forth. 
 Mr. Webfter betides, in his letters, owns that he is not a 
 medical man ; nay, that he had not " read above three op 
 four medical books." I hope therefore the reader will 
 xcufe the preference given in this treatife to the writings 
 and arguments of thofe who are acquainted with medi- 
 cine both by reading and practice. The difpute between 
 the College and Academy of medicine can be fettled only 
 by themfelvcs ; the only fafe line of conduct feems to be 
 to admit both doctrines, and to take every method of 
 preventing the introduction of the difeafe, whether fup- 
 pofed to be generated or imported. 
 
 Whether the diftemper which has fo fatally prevailed 
 iince the year 1793- be naturally connected with the 
 troubles in Europe and the Weft Indies or not, it is cer- 
 tain that it has been cotemporary with them. In New 
 York the difeafe appeared in 179-1, but we are not fur- 
 niihed with any particular accounts of it at that time; 
 nor does it appear to have made any great ravages, either 
 on the continent or the Weft India iflands,. till 1793. 
 At this time the war raged in Europe with fury; the 
 French royalifts were every where driven out, and dif- 
 trefed in every poflible way. Defolation and flaughter 
 prevailed at St, Domingo, while an unbounded inter- 
 
 courfe 
 
THE YELLOW FEVER. 
 
 courfe took place between the United States and all thofe 
 nations who were involved in the calamities refult- 
 ing from the unbridled paffions of man excited to 
 their utmoft pitch of ferocity. In the midft of this gene- 
 ral commotion the fever broke out in the Weft India 
 inlands, appearing firft in the ifland of Grenada. We 
 have feen, that, according to Dr. Chifliolm, this difeafe 
 was brought to Grenada in the Hankey, from the coaft 
 of Africa, on the i8th of -February. About the middle 
 of April it began to appear on land. In the beginning 
 of May it reached a detachment of the royal artillery 
 lying at a diftance from the focus of infe&ion, " but 
 " (fays Dr. Chifholm) by the communication which the 
 " gunners in Fort George had with the 45th regiment^ 
 " and the predifpodtion of the men to receive the infec- 
 " tion as far as that could be induced by excefles in 
 " drinking, and other irregularities." About the firft of 
 June the difeafe began to appear among the negroes of the 
 eftates in the neighbourhood of the town, but never at" 
 tacked them with the fame violence that it did the 
 white people. During the months of May, June and 
 July, it appeared indifferent parts of the country $ being, 
 as our author fuppofes, carried thither by infected per- 
 fons. From Grenada, the Doctor fays, the difeafe 
 fpread to the iflands of Jamaica and St. Domingo, and 
 from the latter to Philadelphia, " by veffels on which 
 " the infection was retained by the clothes, more efpe- 
 t cially the woollen jackets, of the deceafed failors." 
 
 This account of the origin of the fever at Philadelphia^ 
 as we have already feen, is inadmiffible by thofe who 
 deny the contagious nature of the difeafe ; but as the 
 latter have never given any diftioct account of its rife, or 
 fhown why it fliould firft appear in one ifland and then in 
 another, inftead of beginning in them all at once, we 
 muft adhere to that of Dr. Chifliolm, till we are furnifh- 
 ed with a better. 
 
 In Philadelphia it has already been obferved, that Dr. 
 Rum was called to his firft patient on the 5th of Auguft ; 
 but Mr. Carey mentions a child of Dr. Hodges *' as 
 probably the firft victim ;" who was taken ill on the 
 
49* A TREATISE ON 
 
 a6th or zyth of July. This fame month the unfortu- 
 nate fugitives had arrived from Cape Francois; and we 
 have already feen, from Dr. Clarke, that the arrival of 
 fome of their fellow-fufferers in Dominica had the fame 
 dreadful attendant. Whether the diforder is to be 
 afcribed to the arrival of thefe people in either place, the 
 reader will judge. Other vefTels are charged with having 
 imported the fame; but, facts being difputed, we can- 
 not enter into the controverfy. 
 
 The difeafe began in Water-ftreet, to a particular 
 part of which, near to that where the fufpe&ed mips lay, 
 it was for fome time confined, but did not excite public 
 alarm till about the i9th of Auguft. From this time to 
 the 25th of the month the attention of the citizens was 
 fo much aroufed 3 that they began to move into the coun* 
 try ; and on the zzd, the city commiiTioners were pe- 
 remptorily ordered by the mayor to keep the city clean, 
 On the 26th the College met, and addreffed the citizens 
 on the fubject ; recommending fuch means of prevent- 
 ing the fpreading of the ficknefs as to them feemed moft 
 proper. Among thefe were, to avoid any intercourfe 
 with the infected, to live temperate, keep their minds 
 eafy, and to avoid fatigue. Lighting of fires was par- 
 ticularly difapproved of; but the burning of gun- 
 powder, and the fleams of vinegar and camphor, were 
 recommended for infected rooms, and forulingon hand- 
 kerchiefs, and in fmelling-bottles. 
 
 In confequence of this addrefs alfo the bells were flop* 
 ped from tolling* the conftant noife of which had greatly 
 contributed to increafe the public alarm. The people, 
 who had been in ufe to light large fires in the corners of 
 the ilreets, being forbid on the zpth by proclamation to 
 do fo, had recourfe to firing of guns ; which was at lad 
 carried to fuch excefs, that it alfo was prohibited by 
 proclamation on the 4th of September. 
 
 Notwithflanding all thefe precautions, the diftemper 
 continued to increafe in fuch a manner as to produce the 
 moft dreadful terror and difmay. " Indeed (fays Mr. 
 " Carey) it is not probable that London, at the laft ftage 
 " of the plague, exhibited ftronger marks of terror than 
 
THE YELLOW FEVER. 493 
 
 " were to be feen In Philadelphia, from the 26th or 27th 
 " of Auguft, till pretty late in September." This pro- 
 duced fcenes of diftrefs unparalleled till this time in the 
 city, and of which many inftances are to be met with 
 in Mr. Carey's account. It cannot, however, be doubt- 
 ed that the violence of the diftemper, its contagious na- 
 ture, and the confequent danger of vifiting the metro- 
 polis, were greatly exaggerated. Thus terror was ftruck 
 throughout all the adjacent dates. At Chefter-towo, 
 in Maryland, a meeting was held, on the loth of Septem- 
 ber, in confequence of which the Eaftern more line of 
 ilages was quickly flopped. On the nth of the fame 
 month it was ordered by the mayor of New York that 
 the names of all (uch perfons as had arrived or fhoulci 
 arrive from Philadelphia or other plac^, by land or water, 
 that were or fliould be fick, mould be reported to him, 
 that thofe who were fick of infe<5tious difeafes might be 
 removed out of the city. Next day the governor pro- 
 claimed that all veflels from Philadelphia fhould ap- 
 proach no nearer than Bedlow's iiland, about two miles 
 from the town, till licenfe was given. But thefe precau- 
 tions not being deemed fufficient, a night watch was efta- 
 blilhed, and next day an addrefs was publifhed by dele- 
 gates, purporting the infufficiency of all that had been 
 done, and again calling upon their fellow-citizens to exert 
 their utmoft vigilance in detecting the fugitives from Phi- 
 ladelphia. Various other refolutions were pafTed in New 
 York ; and throughout the whole continent fuch mea- 
 fures were taken as feemed moil likely to profcribe the 
 unhappy Philadelphians, and to prevent their having 
 any place of refuge from the ficknefs they fo much dread- 
 ed. On the i ft of October, however, the inhabitants 
 of Springfield, in New Jerfey, pafled a refolve, offering 
 their town as an afylum for the people of Philadelphia, 
 and directing an hofpital to be provided for the recep- 
 tion of fuch as might fall fick. Similar refolutions were 
 paired by the inhabitants of Elizabethtown, and Elkton 
 in Maryland. 
 
 The diftemper in the mean time arrived at the moft 
 dreadful height in Philadelphia, and almoft all thofe 
 
 who 
 
494 A TREATISE ON 
 
 who could take the charge and burthen of public af- 
 fairs were abfent. An hofpital had been eftablifhed at 
 Bufb Hill, bat, for want of fuperintendence, had fallen 
 into fuch diforder, that the poor chofe rather to deny 
 their illnefs than to be fent to it. On the 15th of Sep- 
 tember, however, Stephen Girard, a native of France, 
 and a wealthy merchant, together with Peter Helm, a 
 native of Pennfylvania, offered their fervices as fuper- 
 intendants. By their exertions the credit of the hofpital 
 was foon retrieved, and fuch numbers demanded adrnit- 
 tanc, that it became neceflary for each candidate to pro- 
 cure a certificate from a phyfician, that the patient really 
 laboured under a malignant fever. In a fhort time the af- 
 fairs of the city went on, in every refped, with as much 
 regularity as could be expected ; but the mortality increaf- 
 ed throughout the month of September, and the three firft 
 weeks of October. Great hopes were entertained from 
 fome cold and rainy weather in the end September; but 
 they proved iiluftve, and the difeafe became even more 
 fatal than before, till the 2 6th of Oclober, when it fud- 
 tknly ceafed, as Mr. Carey fays, with hardly any rain, 
 and a very moderate degree of cold. " That day (adds 
 " he) was as warm as many of the moft fatal ones in the 
 " early part of the month. To account for this is per- 
 " haps above our power. In fact, the whole of the dif- 
 * c order, from its firft appearance to its final clofe, has fet 
 " human wifdom and calculation at defiance." During 
 the time of this calamity Mr. Carey computes thsLtfev&f* 
 teen thoufand left the city, and/owr thoufand and thirty- 
 one perifoed. 
 
 This city fuffered another attack in 1794, but far lefs 
 fcvere than before. In 1795 and 1796 the difeafe feems 
 fcarcely to have made its appearance ; but in 1 797 it reviv- 
 ed, and, in 1 798, broke out with greater fury than even in 
 1793. No particular hiftory hath been pubiifhecl of 
 this iaft fevere attack. We knew only ir* general, that, 
 though a much greater number of the inhabitants fled 
 out of town in 1 798 than in 1 793, the number of deaths 
 was almoft P.?. great ^ being efti mated at three thou- 
 i eight hundred and forty-one. Great difputes, 
 
 as 
 
THE YELLOW FEVER. 495 
 
 as has been obfervcd, have taken place concerning the 
 origin of thefe difeafes ; on which we (hall only further 
 remark, that if, after fuch repeated and dreadful experi- 
 ence of the bad effects of allowing putrid matters to ac- 
 cumulate, fuch quantities could be collected as to pro- 
 duce the very fatal ficknefs of laft year, it argues a moft 
 unaccountable, and indeed incredible, infenfibihty on the 
 part of the people, as well as remifsnefs on that of the 
 rnagiftrates ; and this perhaps may be accounted as 
 ftrong an argument in favour of contagion as can be 
 adduced. 
 
 That fuch a violent diftemperfhouldceafe all at once, 
 is indeed not to be expected 3 and we have already 
 heard of its again appearing in the city. Fear has been 
 very juitly excited, there and in other places ; but it is 
 to be hoped that the remarkable coolnefs of the feafon 
 will operate favourably in preventing any very violent 
 attack for this year. 
 
 New York has alfo fuffered very confiderably from 
 this difeafe. Here it appeared in 1791, in the autumn, 
 and in a part of the town remarkable for its vicinity to a 
 collection of filth. In 1792 it made no progrefs ; and 
 in iy93> though fome died of it who fled from Philadel- 
 phia, it did not fpread. In 1794 it returned with con- 
 fiderable violence, and with ftill greater in 1795. In 
 the hiftory of this difeafe by Dr. Seaman,* he takes no- 
 tice that in July and Auguft an unufual number of per- 
 Tons differed from drinking cold water, and fome fell 
 down and died in the ftreets ; but the Doctor fuppofes 
 this to have happened rather through the exceflive heat 
 of the fun than the drinking of water. As the difeafe 
 came on, all others gave way to it, even " the common re- 
 mitting bilious fever ;"-f- and in the month of July fome 
 cafes occurred. We have already had occafion to take 
 notice of the death of Dr. Treat, who was taken ill on the 
 22d of July ; but before that time, on the 6th of the 
 fame month, Dr. Seaman fays that, in conjunction with 
 this gentleman, he had vifited a patient " affected with 
 " 4lJ the full-marked and decided fymptoms of an highly 
 
 " malignant 
 * Med, Rcpof, vol. i, p, 316. f Webfter's 
 
496 A TREATISE ON 
 
 " malignant yellow fever."* The difeafe continued to 
 gain ground in Auguil, and became extremely violent 
 in that and the following month ; but, according to our 
 author, the low ground in the foutheaft part of the city 
 tvas the " grand centre of the calamity, diffufing its 
 " effeds like diverging rays, aiding, by its mod power- 
 " fill influence, different fecondary centres, already fmok- 
 " ing hot, to flame out its peftiferous operations." In 
 this part of the town five hundred died in three months. 
 
 The attack at this time did not aroufe the people to 
 a proper fenfe of their danger. As formerly, the origin 
 of the difeafe in 1795 had been attributed to the filth of 
 the city. Next year it was attributed to the fame, and fo 
 in 1797 and 1 798. This laft year, particularly, it is faid 
 to have originated partly from great quantities of putrid 
 beef and fifh, collected for exportation, and which could 
 not be exported. In Mr. Hardy's account of this fever, 
 it is calculated that there died in 1798 two thoufand 
 and eighty-fix ; but that, if it were taken into the ac- 
 count how many left the town and died in the country, 
 the number would amount to between two thoufand 
 four hundred, and two thoufand five hundred. 
 
 It is not in Philadelphia and New York alone that 
 this dlftemper has prevailed. BoRon, Newburyport, 
 Portftnouth, Portland, and even detached fpots in the 
 country, to which it is not poffible to trace any infec- 
 tion, have felt its ravages. At Salem alfo, where the 
 difeafe was never known before, twenty-one cafes in- 
 cluding fome doubtful ones appeared in 1798; and of 
 thefe, ek-ven proved fatal. In 1796, when it prevailed 
 in Newburyport, it was fuppofed to have been in- 
 troduced by a vefTel from the Weft Indies ; and, ac- 
 cording to Dr. Coffin, the opinion would have been 
 incontrovertible, had not a large quantity of fifh-gar- 
 bage been collected at the place where the veiTel 
 landed ; fo that, though the difeafe fpread from that 
 place, it could not be known whether it proceeded from 
 
 the 
 
 * This proves that Dr. Treat tvai tut the firft perfon who fuffered by 
 this difeafe, but it will not prove that the difeafe w*s not imported by Capt. 
 Bird's veffel ; for the fever fpread in the vicinity of the veffdj not of th 
 AJmftwwfc* where the iiift patient was carried. 
 
THE YELLOW FEVER. 497 
 
 the veffcl, or the fifti, or both. It feems now unfortunate- 
 ly to be the cafe, that where this difeafe once gets foot- 
 ing it cannot eafily be eradicated. If we fuppofe it always 
 to be imported, the continual intercourfe with the Weft 
 India iflands will account for this ; but the extreme dif- 
 ficulty, or rather jmpoflibility, of procuring an account 
 of faro or even a fingle fadl: which cannot be contro- 
 verted, renders every thing that can be faid upon the 
 fubject uncertain and precarious. In the cafe of New 
 London particularly, where 8 1 perfons were deftroyed 
 by it lad year, neither importation nor collections 
 of filth could be affigned as the caufe - y neverthelefs it 
 began near a wharf ; but Mr. Holt, in his account of 
 the difeafe, thinks it was moft probably owing to the 
 mere heat and drynefs of the feafon. On the other 
 fide of the queftion, however, we muft ftill infert Dr, 
 Brackett's account of the origin of the difeafe at Portf- 
 mouth, in anfwer to a letter from Dr. Oliver of this 
 place. 
 
 " The yellow or peflilential fever made its firft appear* 
 " ance at Portfmouth, about the firft of Auguft laft. 
 " Eight or ten days before that time a vefiel arrived here 
 " from Martinico, and brought a French family (four 
 " or five in number.) This veiTel, before me left the 
 " Weft Indies, had two failors taken fick (as the cap- 
 " tain informed me) one of whom died on the pafTage 
 " home ; the other was on the, recovery when the vefiel 
 " came into this port. 
 
 " There was not, nor had not been for a long time 
 * 5 before, any fever in this town. Two or three days 
 ;c after, I heard that one or two men, who were labourers 
 " (and probably had been on board, as they lived nigh 
 4 where the vefiel lay at the wharf) died fuddenly with. 
 '* fever, but am uncertain whether with yellow fever, as 
 " I never law them. The firft of Auguft, the owner, 
 " whole houfe was about four or five rods diftant from 
 ' the veflel,- had a child of four or five years of age ta- 
 " ken lick ; the next day I vifited it, and two days af- 
 " ter he died. The fymptoms appeared like a cholera 
 " morbus^ fick ftomach, and frequent puking of black 
 
 S s s bile, 
 
495 A TREATISE ON 
 
 " bile. The day before he died a brother of his, fifteen 
 " years old, was taken ill, and had much the fame fymp- 
 " toms, only greater inflammation and diftrefs. He was 
 " blooded freely, took calomel, bark, &c. He diecj 
 " five days after hefickened. Between the 8th and the 
 " 20th of Auguft, four or five of the other children and 
 " fervants were taken with the fame fymptoms, and re-. 
 " covered. On the fixteenth day, a daughter* feventeen 
 C years of age, was taken down with the fame difeafe 5 
 ;c (he was treated in the fame manner! with bleeding^ 
 " mercury, warm bath, bark, &c. and died on the pth 
 u day. This patient had a great difcharge of blood 
 " from her mouth and gums far three days before (he 
 " died. One or two more of the family had it after^ 
 " wards, and recovered. All thefe patients took thein-i 
 " foclion, I believe, about the fame time/ Many others 
 " in that neighbourhood had the fever during this 
 " time, about one half of whom died : out of forty-fix 
 " patients I loft fifteen. If I could procure a forenefs of 
 " the fauces, by administering calomel in fmall dofes s 
 " and rubbing it in the gums, or by frictions on the legs 
 " and arms with mercurial ointment, the third or fourth 
 " day, I was fure of their recovery* 
 
 " How many died of this difeafe in the whole, I have 
 " forgotten j as, through fatigue, and debility of body 
 " and mind, I kept no notes ; I think rather more than 
 " half of thofe who had it. The fever agreed in every 
 <c fymptom, almoft,with that defcribed by Dr. Rulhand 
 " others. The contagion did not appear to be propa- 
 " gated, as the largeft number who had the difeafe were 
 " (eized in the month of Auguft, and lived in the ftreets 
 " only which communicated with the wharf where the 
 *' veffel lay, and the beach where (lie was graved. Thefe 
 " ftreets are in the higheft part of the town, and always 
 * e efteemed the moft healthy, and as free of putrid flab-? 
 " ftances as any in it. In the months of September and 
 " October the fever was followed by dyfentery, and 
 " fpread through almoft every part of the town and its 
 " environs. There has been no cafe of fever or ciyfen- 
 fmce Jaft fall ; this place, during th^e winter, and 
 
 <c fumnier 
 
YLLOW FEVER, 
 
 e * fummer thus far, has been uncommonly healthy ; and 
 <c it appears likely to continue fo, if the committee of 
 " health fhould not be remifs in their duty. Thus> 
 <c without any comments, I have endeavoured to give 
 cc you a ihort hiftory of the peftilential fever, as it ap- 
 " peared here laft fummer. The ideas, you may com- 
 " municate to the author of the book intended to be 
 " published." 
 
 The following letter from Dr. Warren, which he 
 obligingly fent to two phyficians-in Salem, gives an ac- 
 curate account of the diftemper which prevailed in Bof- 
 ton laft year-: 
 
 " I mould immediately have anfwered your favour of 
 " laft month, but for a wifll to give you as complete an 
 <e account of the caufes and mortality of the late epi* 
 c; demic as could be colle&ed. 
 
 " There were a number of fufpe&ed caufes, which, 
 " though concealed during the prevalence of the difeafe, 
 " it was hoped would be developed after the agitation of 
 " the public mind had entirely fubfided ; and I was in ex- 
 " pe&ation that fome regular returns would have been 
 c< made of the numbers who had paffed through the dif- 
 * c eafe, and of thofe who had died with it, fo that fome 
 * 4 eftimate might be formed of its malignity and morta- 
 *' lity 3 but fuch returns have not yet been made, and it 
 " is therefore impoffible to obtain any fatisfa&ory evi- 
 " dence on thofe heads. I fuppofe the number of 
 " deaths to have been rather fhort of two hundred^ 
 * c but this is only a rude guefs, and fhould not be 
 " relied on in forming any confequential deduftions 
 <fc on the fubjeft. I (hall, however, now offer fuch an 
 " account of the diforder as my prefent materials have 
 *' enabled me to prepare. 
 
 " The firft unequivocal appearance of the malignant 
 * c fever, in the town of Bofton, was on the loth of July 
 " 1798 (though one family had been attacked with a 
 " fever, attended with unufual fymptoms, as early as the 
 tc middle of June ; but, as no other inftances occurred 
 t{ for fo long a time, of an alarming nature, fome doubts 
 " may perhaps bejuftly entertained of the identity of the 
 
 " affedion.) 
 
A TREATISE ON 
 
 " affection.) Three or four cafes only, I believe, hap* 
 
 " pened between this and the latter end of the month. 
 
 " The two firft of thefe were young men employed in 
 
 " (lores directly oppofite to each other, on Green's 
 
 " wharf, near the Town-dock. A few days after, three 
 
 " or four perfons were feized with the fame complaint, 
 
 " whilft following their refpective occupation in Mar- 
 
 cs ket fquare, on the eaft and fouth (ides of Faneuil Hall, 
 
 " or the Market-houfe. In the beginning of the 
 
 " month of Auguft feveral perfons were taken fick in 
 
 " the fame neighbourhood, chiefly young men between 
 
 " 1 6 and 24 years of age, whilft employed in (lores and 
 
 " counting houfes there fituated. The (lores in Mer- 
 
 " chant's row, extending from the Market to State- 
 
 <c ftreet, were more efpecially vifited with the difeafe, 
 
 " and, in the courfe of the fame month, a family at the 
 
 " bottom of State-ftreet, and feveral perfons at Oliver's 
 
 *' dock, were taken fick. At this place a kind of bafon 
 
 " is formed between a point of the town project ing from 
 
 " Fort hill, and the Long wharf, which is conftantly re- 
 
 " ceiving the offals of fifh, and other animal fubftances, 
 
 <; which from its fituation could not be wafhed off by 
 
 " the waters contained in it. This fpot is remarkable 
 
 * c for having been the refidence of mod of the perfons 
 
 " firft attacked with the bilious remittent fever of 1796. 
 
 ic To the latter end of this month the number of fick 
 
 *\ continued to be increasing ; but the attacks were prin- 
 
 <c cipally confined to the above-mentioned quarters, till 
 
 " at length the difeafe appeared on the fouth fide of 
 
 " Fort hill, at fome diftance to the fouthward of Oli- 
 
 " ver's dock, leaping, as it were ? over the fummit of the 
 
 " hill, without lighting upon the inhabitants on the 
 
 " north of that eminence. The fatality of the difeafe 
 
 " was here probably greater than in any part of the town 
 
 *' of equal population ; and it was nearly the laft place 
 
 " in which it difappeared. Very few families who re- 
 
 ct maincd in their own houfes upon the hill efcaped its 
 
 " attack ; and the progrefs of the difeafe, in all the pla- 
 
 " ces above mentioned, feemed to have been arrefted 
 
 ** only by means of the evacuation of the buildings by 
 
 u the 
 
THE YELLOW FEVER. 501 
 
 w the people who inhabited them. In the latter end of 
 " Auguft, and through the month of September, many 
 " perfons were taken fick in Fore-ftreet, which runs 
 " northerly from Market or Dock fquare, along the 
 " heads of the wharves, on the eaftern fide of the town. 
 
 " Through the whole period of the ficknefs fcarcely a 
 " perfon was taken ill who had not refided, or been in 
 ** daily employment, in the vicinity of thefe places. The 
 " fubjects of the difeafe were generally natives of the town, 
 " chiefly in the prime of life, and in the vigour of health. 
 " I recollect no inftance of any French inhabitants be* 
 " ing affailed by it, and have heard of only one or two 
 " inftances of the blacks being affected with it. 
 
 " That the fever was in a degree contagious, I cannot 
 " entertain a doubt 5 but that it was not fo in a very 
 " high degree, I am as fully perfuaded, from the number 
 ** of cafes in which there was reafon to believe it could 
 " not have been taken .in that way. In moft in- 
 <c ftances, where contagion might have been fufpedled, 
 " the fubjects were fo fituated that they might have re- 
 *' ceived it from the fame fource as thofe with whom they 
 " had communicated. I cannot learn that any evidence 
 " has been furnifhed of infection from the fick who had 
 " been removed into the country, though there were 
 " many inftances of fuch removals, under the moft ma- 
 '* lignant forms which it affumed. 
 
 " The fever was generally ufhered in by a chill, but I 
 <{ think by no means equal to that which commonly 
 " precedes fevers of the ardent kind, nor in proportion 
 <f to the violence of its fubfequent periods. In a fhort 
 " time the rigors were fucceeded by exceffive heat ; the 
 " pulfe, which had been fmall and contradled, became 
 " hard and full ; the refpiration laborious from violent 
 " opprefiion at the firobiculus cordis ; the tongue af- 
 - iu ned a whitiQi caft ; the eyes became highly infla- 
 " med, while the pains in the head, back, and legs, were 
 fi intolerably fevere. To thefe fymptoms fucceeded 
 <c nauf?a, and vomiting fometimes of a highly bilious 
 *' matter, feldom attended with diarrhoea, but often 
 ** with a burning at the ftomach, tendernefs of the ab* 
 
 * c domen s 
 
A TREATISE CM 
 
 cc domen, parcity of urine ; and, in one inftance, a dy* 
 " furia, with a great proportion of blood at each evacu- 
 " ation of that fluid. 
 
 " Thefe appearances ufually continued about 4$ 
 cc hours, after which they often fuddenly gave place to a 
 " very different train of fymptoms. The pulfe funk 
 " aftonifhingly, and became intermittent $ the heat and 
 " pains entirely fubfided ; and the patient fuppofed 
 " himfelf to be out of danger. From a perfect poffeflion 
 " of all his intellectual faculties, with a ferenity of mind, 
 " which in no other difeafe, I believe^ is fo generally ob- 
 " ferved to accompany its lad ftages, on or about the 5th 
 " day from the acceffion of the fever* he fell into a ftate 
 '* of infenfibility, and thence funk gently into the arms 
 *' of death. In others this change was lefs rapid ; the 
 ** pulfe became gradually fmaller, the diftreffing fymp* 
 " toms ilowly abated, a coldnefs of the extremities took 
 " place, and continued for feveral days before death, ac- 
 <c companied with clammy fvveats, often without any 
 " perceptible pulfe in the wrifts, for feveral hours before 
 " the fatal termination. The tongue feldom became 
 cc much coatedj to the laft. Delirium was by no means 
 <c generally attendant ; and a yellownefs of the ikin was 
 et far from being univerfal ; fometimes, however, this 
 " appearance was obferved within the three firft days ; 
 " often on the fourth and fifth ; and I was induced to 
 i coniider it as an accident, rather than a conftituenfe 
 " character of the difeafe. 
 
 " The black vomit, as it has been ufually called, 
 66 though in my opinion by no means to be coniidered ad 
 " a pathognomic fign of the difeafe (as I have frequently 
 *' feen it take place in other acute fevers, efpecially the 
 " puerperal) was very frequently attendant on the laft fta- 
 '' ges of the diforder; very few recovered after this cir- 
 " cumftancehad taken place^ in one perfon, however, who 
 6< had it in the moft alarniing form, together with an in* 
 44 termjtteut pulfe, coldnefs of the extremities, fmgultus, 
 " and every ufual mark of immediate diffolution, a moil 
 " unexpected recovery happily difappointed the pofitivc 
 " prognoftic'sof his phyficians* As the cure advanced, th 
 
 *' fkin 
 
THE YELLOW FEVER, 503 
 
 *' ikin in this inftance became extremely yellow, and 
 " tinued fo for many weeks after the fever had fubiided ; 
 " the biliary duels having been completely obftruded, and 
 *' confequently the alvine evacuations of a clayey colour, 
 " and with much difficulty procured. Frequent repeti- 
 " tions of rhubarb and calomel in large dofes, the conti- 
 " nuance of the mercurial medicine in fmall dofes, fo as 
 " to keep up a continual ptyalifm, and a laxative diet, 
 * c reftored him to perfect health. 
 
 " For the difcoveries which were made on difle6ting 
 " the bodies of fome of thofe who died with the difeafe, 
 " I beg leave to refer you to a publication m the Bofton 
 " Centinel, made during the prevalence of the diforder 
 " in this place, and fubfcribed by Dr. Ifaac Rand, fen. 
 5< Prefident of the M- Medical Society, and myfelf/* 
 (For thefe difcoveries fee the table, facing p. 434. 
 
 " We had heretofore treated our patients agreeably 
 " to the method pracYifed at Philadelphia in 1793, with 
 " bleeding in moft inftances, and a&ive purges of jalap 
 " and calomel, or Rochelle falts. The difeafed ftate of 
 <s the liver, the known effects of mercury in hepatitis, 
 * e and the recolledtion of the fuggeftions contained in. 
 <c Dr. Rum's publication on the yellow fever, together 
 * c with thofe of feveral other celebrated writers on the 
 " fame fubjeft, induced us to enter immediately on the 
 *' ufe of calomel in fmall dofes, as recommended in our 
 " paper above referred to. 
 
 " In my own pradice I now ufually commenced the 
 4C treatment by bleeding from ten to fixteen ounces, and 
 <4 followed it by a dofe of between ten and fifteen grains 
 " of calomel with between twenty and twenty-five 
 6C grains of jalap, or an ounce of Rochelle falts, or more, 
 " according to the conftitution. Immediately after the 
 " operation of thefe medicines I began with the ufe of 
 <s calomel in fmall dofes, in pills of a grain, every hour, 
 " aqd fometimes of 3 grains every two hours. Within 
 ^ the fir ft twenty-four hours, but fcarcely ever after, I 
 *' found occafion frequently to repeat the bleeding, and 
 ^ it is worthy of remark, that in fcarcely a fmgle inftance 
 *' was this operation performed without almoft inftanta- 
 
5 o 4 A TREATISE ON 
 
 " neous relief; although in moft cafes, a few hours af- 
 " ter, there was a recurrence of the fymptoms. The 
 <c blood for the moft part was dark. In three cafes there 
 * c was no feparation of ferum from the coagulated mafs 
 " at the end of forty-eight hours. In two of thele (and 
 " they were the only cafes in which I obferved it) a firm 
 " buff was formed on its furfacej and all three died of 
 " the difeafe. 
 
 " The calomel was often continued through the whole 
 " courfe of the fever ; and ptyalifm was ufuaily brought 
 *' on within three or four days : though fometimes up- 
 * c wards of 200 grains were given, at the rate of a grain 
 " every hour, without any fpeciflc effect on the faiivary 
 " glands. In proportion as the forenefs of the mouth ad- 
 <c vanced, the fymptoms univerfally gave way ; and in 
 " every patient, two only excepted, this effect of the re- 
 <f medy was a fure pledge of recovery. In this exception 
 ** were comprehended two perfons of the fame family, a 
 '* father and daughter, both of whom had furviveo the 
 " I4th day of tae difeafe, had copious hemorrhages from 
 <c the mouth (a circumftance which alfo attended on ma- 
 <c ny who recovered) and died in a ftate of apparent pu- 
 " t refaction. 
 
 " The purgative medicines were generally repeated 
 M every fecond day j or an enema of water gruel was ad- 
 " miniftered occasionally, if the bowels were conftipa- 
 " ted ; but if otherwife, and the calomel paffed off by 
 '* thofe emunctories, opium was combined with it in 
 *' fufficient quantities to reftrain the difcharge. The 
 " evacuations which took place from the inteflines, dur- 
 <c ing the ufe of the mercury, were almoft univerfally of 
 " a remarkably dark colour, generally approaching to a 
 *' deep green, but by no means remarkably foetid. 
 " When Ipontaneous, they were often obferved to be of 
 " the colour and confiftence of water gruel. 
 
 " In cafes of very laborious refpiration, which was fre- 
 <f quently in an extreme degree diftreffing, efpecially af- 
 ^ ter the firft 36 or 48 hours had elapfed, blifters, ap- 
 " plied either to the cheft or extremities, had a favoura- 
 <* ble effect i on the latter, they were moft ufeful in the 
 
 " advanced 
 
<c 
 
 THE YELLOW FEVER. 505 
 
 advanced ftages of the difeafe, by exciting to a&ion 
 the debilitated veflels, and by reftoring circulation and 
 warmth to the parts. In the fame intention, wine, 
 fnake-root, and the bark, were fometimes ufed with 
 advantage. 
 
 " The diet was generally of the lighted and moft cool- 
 Ing nature ; barley-water, apple-water, and fpruce- 
 beer, were generally both grateful and falutary. The 
 warm bath was often exhibited with apparent fuccefs, 
 efpecially in the beginning of the difeafe, and when a 
 copious fweat had been induced by it. The cold bath 
 was alfo reforted to by fome refpedtable practitioners, 
 and perhaps, under fome circumftances, with good ef- 
 fe&s ; but I have no reafon to think it was generally 
 advantageous. 
 
 " Upon the whole, I believe that the moft efficacious 
 remedy, and the only one to be relied on, is mercury. 
 " It is certain that, as far as my obfervation has extend- 
 <c ed, under no other method of treatment did fo many 
 " recover ; and there were but few inftances of a fatal 
 " termination, when it had been adminiftered from the 
 " commencement of the fever. 
 
 " Various have been the caufes affigned to this difeafe. 
 " That its origin wasdomeftic, I have not a (ingle doubt, 
 u No inftance of the arrival of any veflel from the warm- 
 " er latitudes, with this ficknefs on board, has been dif- 
 " covered ; and it is believed that the local caufes are 
 <c fufficiently numerous to account for its exiftence. At 
 " moft of the places, where its ravages have been made, 
 ft very large quantities of putrid fubfrances had been for 
 " fome time accumulating. The offals from the fifh 
 " market, as well as damaged fre(h and falted fldi to an 
 ce immerife amount, had been thrown into the dock. A 
 :< very great number of raw hides had been imported, 
 * c and ftored in places contiguous to thofe in which bufi- 
 ft nefs was constantly going on. The influence of a 
 l< continued heat through the fummer, to a degree fcarce- 
 ;< ly before known in this country, had rendered thefe 
 " articles highly putrid ; and from the fame caufe fe- 
 ft verai articles of proyifion, fijch as barrelled beef, &c. 
 
 T 1 1 " which 
 
A TREATISE ON 
 
 " which had been prepared for exportation, but, by rea- 
 *' fon of the reflraints laid on our commerce, retained in 
 *' (tore, had become tainted. The effects of thefe were 
 '* in ibme inftances inconteftibly evinced ; three lads, 
 " who had been employed in repacking be^f, were at 
 " about the fame time feized with thedifeafe in its mod 
 " fatal form ; and a perfon, who had purchafed fome of 
 tf< the hides at a low price, immediately after their remo- 
 " val fell a facrifice to his folly. 
 
 " Two or three thoufand of the inhabitants removed 
 " into the country, and began to return about the mid- 
 * 6 die of October, when the decline of the difeafe jufli- 
 " fied the meafure."* 
 
 SECTION 
 
 * The following fa<3s in confirmation of the importation of the yellow 
 fever were communicated in a letter from an eminent pra&itioner in New 
 Haven to a gentleman of the fame profeflion in this town. They came to hand 
 too late to be inferted otherwife than in a note, the meet being already pre- 
 pared for prei's : 
 
 A child was reported to have died of worms, and the parents were indulged 
 in the common ceremonies of burial : but the truth wasi that the difeafe had 
 been the black vomit. The confequence was, a very extenfive fpread of the 
 contagion. In lefs than a week fix out of eight of the bearers were taken 
 with th fever, and thefe were young perfons from different parts of the towiv 
 * As to the fuppofitions (fays the gentleman) with refpecl to local caufes ort- 
 * ginating the difeafe, I conceive there is no occafion to feek for any other 
 than what was contained in the cheft (p. 444) which was a blanket and 
 * clothing taken off the corpfe of one who had died of the fever in the Weft 
 Indies, and without the leaft formality of cleanfmg put down into a clofe 
 ' cheft, and brought to New Haven, and lodged in Auftin's ftore. Now it 
 appears to me (thefe facts, well afcertained) as idle to inquire after other 
 caufes, as it would, fuppofe it were the infection of the fmall pox brought 
 in a cheft, and a number of perfons who had infpeclcd the cheft to be taken 
 <* down with it. Would in fuch a cafe, mankind have racked their invea- 
 
 tions to have investigated other inducing caufes ? Surely not As to 
 
 local putrefying f ubftances, there was nothing but what has been common 
 < to the place, where the fever made its firft appearance, for many years in dry 
 i fummers. 
 
 I might revert to the introdudlion of the fever by importation at Chatham 
 on Connecticut river ; at Providence, Rhode liland ; in which the importa-, 
 tion was as evident as at New Haven. In fhort, there is fcarcely a place on 
 the continent, where this fever has made its appearance, but what it may 
 be traced to ap imported origin. There have been but two or three excep- 
 tions which I have heard of." 
 
 The following particulars relative to the difeafe at Portfmouth may like- 
 wife be deemed authentic, as communicated by a refpeclable gemlemaq 
 (though not of the medical profeffion) in that place: Moft men of jtidg- 
 < ment and information on the fubjed fuppofe it was imported laft year in 
 a (hip of Mr. Sheafe, which arrived from Martiflico about the aoth of July, 
 * One man had died on board this fhip in the Weft Indies : all the reft arrived 
 f * in health ; but the difordej: made its appearance in a few days afterwards. 
 * Mr. Sheafe loft three of his his own family. He lived within a ftone' 
 w throvy of the wharf where his fhip Jay, and the fever fpread in the neigh- 
 bourhood. 
 
THE YELLOW FEVER. 507 
 
 SECTION III. 
 
 Methods of Prevention and Cure. 
 
 IN the yellow fever, as in the plague, where an attack 
 is frequenly made with fuch violence as to bring on 
 death in twenty-four hours, or even a ftill fhorter time, 
 it is plain that much more dependence muft be placed on 
 
 prevention 
 
 bourhood. Mr. Plummer, in the next houfe to Mr. Sheafe's, died about th6 
 loth of Auguft ; Mifs Parker, in the fame houfe, four days afterwards ; and 
 Mifs Smith, who had lived nearly oppofite, removed to Berwick, and was 
 * there feized and died about the lame time. It is worthy of remark, that 
 this was always thought the moft healthy part of th the town." 
 
 As a contraft to thefe evidences, we fubjoin the following epitome of part of 
 Dr. Rum's addrefs to the citizens of Philadelphia on the origin of the yellow 
 fever, &c.* In this addrefs, the Doclor confiders it as indifputable that the 
 difeafe is, in all countries, the offspring of putrid vegetable and animal exha- 
 lations ; but it prevails only in hot climates and in hot fea Ions. In Phila- 
 delphia it arifes, i. From the docks ; and hence, in New York, it has got the 
 name of the dock fever. 2. From the foul air of (hips. 3. From the com- 
 mon fewers. 4. From the gutters. 5. From dirty cellars and yards. 6. Pri- 
 vies. 7. Putrefying mailes of matter lying in the neighbouring part of the 
 city. 8. Impure pump water. 
 
 Thedifeaie is eonfidered by the Doflor as an higher degree of biliofcs fever. 
 He anfwers the objedion by Dr. Chifholm (fee p. 467.) where he ipeaks of 
 the fever not being produced in 1778, when it was left in a more filthy ftate 
 fey the Britifh army than it has been at any timefince." To this he anfwers 
 that for the production of the difeafe three things are necefiary. i. Putrid 
 exhalations. 2. An inflammatory conftitution of the atmofphere, and. 3. Art 
 exciting caufe, fuch as great heat, cold, fatigue, or intemperance. The con- 
 ftitution of the atmofphere, however, he looks upon to be the principal caufe 5 
 as without this conftitution mild difeafes would be produced, but along with 
 it they become very malignant. " The peftilemial conftitution of the air 
 in the United States began in 1791. It prevailed in Charlefton in 17921, 
 " and it has been epidemic in one or more of the cities or country towns of the 
 United States every year fmce. ... It has not been confined to the fea- 
 ports. It has prevailed fiace the year 1793 in many of the villages of New 
 Englandi and of the fouthern ftates. On the Genefee river it has become 
 " fo prevalent as to acquire the name of the Genefee fever. The bilious fevers 
 which prevailed in all the above places before the year 1793 were of a mild 
 < nature, and feldom mortal. They have lately di ("appeared* or are much di~ 
 minimecl ; and have been fucceeded by a fever which frequently terminates 
 in death in five days, with a yellow fliin and black vomiting." Thefe 
 circumftances are fupported by undeniable teftimony. 
 
 In ani'werto thequeftion Can the yellow fever be imported ?" Our author 
 
 anfwers as follows : I once thought it might; but the foregoing fadts au- 
 
 thorife me to atlett, that it cannot, fo as to become epidemic in any city or 
 
 country. There are but two authorities on which the belief nf this difeafe 
 
 being imported refts. Thefe are Dr. Lining's and Dr. Lind's. The for- 
 
 met fays it was imported into Charleston in 1732, 1739, 1745 and 1748. The 
 
 latter lays it was conveyed into Philadelphia, where it afterwards became 
 
 epidemic, by means of the clothes of a young man who died in Barbadoes. 
 
 in No circumftances of fhips or names are mentioned with thefe afl'ertions to 
 
 *s entitle them to credit, and from the facility with which vague reports of 
 
 * Printfft In i 739. tfc 
 
5 o$ A TREAtlSE ON 
 
 prevention than the efforts of the mod fkilful phyficiatl 
 after the difeafe has once begun j for, in fuch violent at- 
 tacks, medicines, thoiigh ever fo powerful, have not time 
 to act. In countries therefore where this terrible difeafe 
 exifls, the firft confideration neceffary for every individual 
 is, whether he is one of thofe likely to be attacked by it. 
 Now, from the general teftimony of thofe who have feen 
 this fever, it appears that fuch as are newly arrived, the 
 young, and in other refpecls the healthy and ftrong, the 
 laborious, and the intemperate* are moft liable to be at- 
 tacked. Dr. Naffy of Philadelphia feems a/one to afford 
 an exception to the general teftimony. Speaking of the 
 caufe of epidemics j after having afcribed them to fome 
 conftitution of the atmofphere, he fays, " If the air is 
 " not infected, difeafes cannot be epidemic; and this is 
 " fo, indeed, though it only attacks the natives. What 
 " can be the caufe of that corruption of the air ? For 
 " what reafon are the natives, and thofe inured to the 
 " clinaate of Philadelphia, a&* infected with the prevail- 
 " ing difeafe, while foreigners efcape it ?" Dr. Chif- 
 holm particularly points out thofe who, in 1793, were 
 moft liable to the Boullam fever. Thefe were, u i. Sai 
 " lors * more efpecially the robuft and young ; thofe 
 " lead accuftomed to the climate -, and thofe moft given 
 
 " to 
 
 " the foreign origih of this difeafe have been admitted and propagated by phy* 
 ' ficians in other countries, there is reafon to believe the afiertions of thofe 
 ' two phyficians are altogether without foundation. The College of Phyfi- 
 cians of Philadelphia, after two weeks inveftigation, : were unable to difcover 
 any ihips, clothes, or fick perfon, that could have introduced the difeafe in- 
 " to Philadelphia in the year 1793^ The Academy of Medicine have clearly 
 proved, by many documents, that the difeafe was not imported in the years 
 1797 and 1798. The origin of a few cafes, reported by Dr. Griffitts and 
 < 4 other members of the College of Phyficians, which have lately appeared in 
 ' our city, has in vain been fought for from a prize floop or the Ganges. Two 
 affidavits of Meftieurs Hill and Ingerfol prove that fhe had been healthy in 
 the Weft indies, and that no perfon had been lick on board of her during 
 her voyage, nor after her arrival in our port. Equally unfuccefsful have 
 5 been the attemps to derive thofe cafes from beds and blankets infedled by 
 ' the fever of lad year. In Bofton, Connecticut, New York, Baltimore, Nor- 
 " folk and Charleston, both phyficians and citizens have long ago rejected the 
 < c opinion of the importation of the fever. Some phyficians fuppofe it pofljble 
 for the contagion of this fever to adhere to the timbers of (hips that have 
 failed from Weft India ports, and that it may be propagated from them to a 
 ' whole neighbourhood, although houfes.and even ftreets, interpofe between 
 them. This opinion is too abfurd to ftand in heed of refutation. Indeed 
 every thing that relates to the importation of this lever is contrary to reafon 
 and fadts It is an error, fubftituted in the room of a belief that all peftileu* 
 * tial difeafes were derived from the planets." 
 
THE YELLOW FEVER. 509 
 
 w to drink new rum. 2. Soldiers ; more efpecially 
 " recruits from Europe ; and the mod intemperate. 
 <c 3. White males in general lately arrived ; more efpecial- 
 ( ly young men from Europe. 4. All other white males; 
 " more efpecially the lower clalTes ; and of them the 
 " moft intemperate ; thofe debilitated by recent ficknefs. 
 " 5. White, females, more efpecially thofe conneft- 
 " ed with the (hipping ; and thofe lately from Europe. 
 " 6. People of colour, from Muftees to Cabres. 7. Ne* 
 * c gro men ; more efpecially failors and porters. 8. Ne- 
 " gro women ; more efpecially haufe wenches. 9. Chil- 
 " dren ; more efpecially thofe of colour." It is cer- 
 tain, however, that, when the diftemper rages with great 
 violence, natives as well as foreigners are liable to be at- 
 tacked. We cannot fuppofe that all who perifhed at 
 Philadelphia in 1 793 and 1 798 were foreigners. Though 
 the latter therefore have the greatefl occafion to fear* 
 the natives muft not think themfelves abfolutely fecure ; 
 neither are foreigners to be terrified in fuch a manner as 
 if they could not efcape. With refpect to the general 
 modes of prevention, then, to which it is the bufinefs of 
 every individual to attend, the following things are to be 
 taken into confederation : 
 
 1. Every one who comes from a cold to a warm cli* 
 mate may be affured that on his arrival the temperature 
 of his body is higher by three or four degrees than that 
 of the native inhabitants. 
 
 2. In this fituation he muft confider himfelf as necef- 
 farily about to undergo a change of conftitution ; and 
 fuch change he may likewife be affured will beft be made 
 by the gradual operations of nature ; concerning which 
 we know fo littl'e, that it does not feem advifeable to ufe 
 any artificial method of promoting or accelerating it. 
 
 3. As the voyage from the Eaftern continent muft 
 have taken up a confiderable time, and as the mode of 
 living on fea muft have been very different from that to 
 which he was formerly accuftomed, we muft confider the 
 conftitution as already in fome degree altered from what 
 it was when the perfon firft went on board. 
 
 4, This 
 
A TREATISE ON 
 
 4. This alteration will be greater or lefs according t6 
 circumftances. If the veflel has been much crowded 
 with paflengers ; if the weather has been ftormy, fo that 
 he has been expofed to damp ; if they have had little 
 water, or of bad quality ; if their provifions have been 
 bad, or if there has not been a fufficient fupply of frefli 
 air in the place where he flept; the body mud be con- 
 fidered as already predifpofed to difeafe, which the new 
 climate will fcarcely fail of bringing to maturity. 
 
 5. Every one muft confider that mode of living to 
 which he has been accuftomed the greateft part of his 
 life as natural to him. Any confiderable deviation from 
 it, efpecially if fudden, would be of bad confequence, 
 even in his own country ; much more muft it be fo in 
 another. As much as poflible therefore he ought to 
 conform his mode of life in the new country to what it 
 was in the old, adhering only to the rules of temperance. 
 
 6. It has already been obferved, that we muft take in- 
 to account the time that the perfon has been at fea, and 
 the difference between his mode of life during his voyage* 
 and that to which he was formerly accuftomed. This 
 difference confifts in one particular in having lived for 
 fome weeks entirely upon fait provifions. To thefe he 
 has been in fome meafure accuftomed ; and therefore it 
 muft be reckoned injudicious to give up the ufe of fait- 
 ed meat at once for fuch as is frem. In facl, this mode 
 of abandoning fait meat for frem has been reckoned by 
 the heft phyficians one of the caufes by which the dif- 
 eafe is brought on. Drs. Taylor and Hansforth exprefs 
 theunfelves in the following manner on thisfubject : " It 
 ti has been noticed by feveral medical writers, that frefli 
 * c meats, and particularly beef, in fouthern climates, ap- 
 " parently generate fluxes and other malignant difeafes." 
 Or. Ramfay, aifo, fays of thofe who were moftly afFeclcd 
 with the yellow fever in Norfolk, that, " being foreign* 
 " ers, they dealt lavifhly in beef, filll, and all kinds of 
 <fc irelb food. Obferve, this beef was driven perhaps from 
 t one to two hundred miles before killed, then expofed in 
 " a hot market to vend ; that, by one o'clock, their din- 
 <s mg hour, I always did, and do, believe it muft have 
 
 " been 
 
THE YELLOW FEVER. 
 
 *' been tainted. Obferve, the fifli were all dead by break 
 *' of day, and brought by land from twenty to twelve 
 
 " miles hard drinkers of fpirits moftly * 
 
 " One or two natural born citizens were the whole, out 
 *' of upwards of two hundred and twenty, who, in the 
 " fpace of fix weeks, fell vi&ims to this difeafe. The 
 " natives live chiefly on falted meats and fowls, or other 
 " kinds of poultry, which are killed but a little time 
 " before dreffing." It is unfortunate that among the 
 emigrants from cold countries there is a general preju- 
 dice againft fait, as highly inflammatory ; and many <3if- 
 eafes are imputed to the ufe of it where it is undoubt- 
 edly entirely innocent. In very cold climates indeed it 
 has with great reafon been fuppofed to produce the 
 fcurvy ; and the Tchutiki, who conducted capt. Bil- 
 lings through their frozen regions, informed him that 
 fait was poifon in their climate ; throwing away, with 
 marks of abhorrence, a quantity he had brought with 
 him from his frigate. We cannot indeed argue from 
 fait being pernicious in a cold climate that it is medi- 
 cinal in a warm one, but we mall foon fee that it has 
 been recommended in the plague, and may not impro- 
 bably be ufeful in the yellow fever. At any rate the 
 pradice of the natives ought in this refpeCt to be a rule for 
 emigrants, rather than any theories they may have laid 
 down previous to their leaving their own country. 
 
 7. In like manner thofe who newly arrive in a warm 
 climate ought to avoid as much as poflible the ufing of 
 violent exercife in a heat greater than that to which 
 they have been accuftpmed, and by all means to avoid 
 intemperance in fpiritous liquors. We are not how- 
 ever to imagine from this that fuch as have been accuf- 
 tomed to drink fpiritous liquors are all at once to give 
 over the ufe of them, and live a life of abftinence. On 
 this fubjccl Mr. Hardie, in his account of the malignant 
 fever of 1795, has the following judicious obfervation : 
 " It has often been faid, that temperance was the beft 
 <c prefervative againft infection. The obfervation, in 
 c< general, is certainly juft; but it may, and during the 
 f< late calamity has, been carried too far. For my "part, 
 
A TREATISE ON 
 
 " from what has come under my own knowledge, I have 
 kc no hefitation in afferting, that to perfons who had 
 " been accuftomed to live freely, nothing could be more 
 " dangerous than to become remarkably abftemious 
 " upon the appearance of this diforder. Perfons of the 
 K above defcription mould, in my opinion, have conti- 
 ** nued to live in their ufual manner; by which means 
 " they would have been more likely to repel infec- 
 * c tion, or if infeded, they would have more ftrength to 
 " refift the attack. But, whilft I confider abflinence in 
 " fuch a fituation as highly improper, a ftate of intern- 
 " perance is certainly more fo ; for, were it neceffary, I 
 " could mention the names of feveral individuals, who 
 " whilft in a ftate of intoxication were attacked with the 
 " fever, and in two days after were tenants of the grave. 
 c The fate of fuch people might be pronounced almoft 
 *' with certainty : they were feized with fymptoms of a 
 " peculiarly malignant nature, and their death feemed 
 " unavoidable/* 
 
 On the fubjecT. of vegetables much declamation has 
 been ufed. Jf we give heed to fome, it might almoft be 
 fuppofed that all diieafes incident to human nature are 
 owing to the ufe of animal food. The following pa- 
 ragraphs from Webfter's Collecliion may ferve as a fpeci- 
 men : " We fhall not repeat the obfervations which we 
 " have heretofore made, upon the averfenefs the Ame- 
 " ricansfeel for foup and reftorative broths, on their eating 
 " their meat running with blood, with fcarcely any bread, 
 * c and plenty of heavy potatoes, the only vegetables which 
 " are feen on their tables ; whilft the French always give 
 '* the preference to vegetables, and efpecially to thofe 
 " which are light and wholefome. But we cannot help 
 " obferving, that, in the months of May, June and July, 
 ** the ftreets and markets were fecn in the morning fur- 
 " nifhed with an immenfe quantity of fruits, the moft 
 " part of which are either green or unripe. In the even- 
 " ing all thofe fruits have difappeared and have been 
 '* eaten -, hence bloody fluxes, dyfenteries and bad 
 " chyles, which unwholfome food muft undoubtedly 
 v produce. 
 
 " 
 
THE YELLOW FEVER. 513 
 
 * s The city of Naples contains about four hundred 
 tk thoufand inhabitants -, of whom thirty or forty thou- 
 " fand are faid to belorig to the clafs of beggars. In that 
 " climate the rains prevail, with little intermiflion, for 
 '" three months, from February to May. From May to 
 * e September, a drought, equally fevere, and fcarcely allay- 
 " ed in many years by a (ingle plentiful rain, renders 
 " the heat almoft intolerable. The wages of a labourer 
 " not exceeding eight pence this currency a day, and 
 " meat being rarely had in their markets for lefs than 
 "four pence the pound, and vinous liquors in the fame 
 " proportion, the mafs of population is excluded from 
 " any (hare of thefe luxuries; of confluence they fup- 
 " port themfelves on vegetables, roots, fallads, fruits, &c* 
 " and dilute their food, and animate their fpirits^ with 
 " water and lemonade. Yet this city has, for a great 
 " number of years, known no general difeafe. And for 
 <c ten years no febrile difeafe, of any fort, was common 
 " among them. They alfo pay great attention to per- 
 " fonal cleanlinefs. Fadh of this fort are very important, 
 " and form the beft comment on the difcordant opinions 
 " of our phylicians." 
 
 As a contraft to thefe the reader may take the follow- 
 ing quotation from the Medical Extracts : 
 
 " One gentleman excepted, fays Dr. Shebbeare, and I 
 :< never faw a gentleman or lady who wholly abftained 
 " from animal food look like other people $ nothing is 
 " fo eafy to diftinguifh as a vegetable man by his phyfi- 
 " ognomy, the fitted appellation by which they can be 
 <c diitinguidied ; he neither moves, talks nor looks like 
 " other people ; his face conveys a declaration of his 
 " whole body being out of order, by the lifelefs infipidi- 
 " ty which is in it, as his converfation does of his mind 
 " being difturbed, his whole time being taken up in 
 " recounting to the world his manner of living, hisfeel- 
 ; ings, his weak ftomach, his difturbed deep, &c. . . 
 " If he pretends to have fpirits, it is no more than a cef- 
 46 tain equability of a lifelefs, inanimate date, like that 
 * of the dormoufe among animals, or the yew tree in 
 " winter among vegetables,'* &c. (Medical Extracts, 
 vol. x. p. 234.) U u u On 
 
A TREATISE ON 
 
 On the. fubjeft of vegetable and animal food we Snd 
 the following obfervations in Willich's Lectures on diet, 
 Sec. " In the primitive ages, people fubfifted chiefly on 
 i plants and fruits. Even to this day many nations, the 
 
 * Bramins, for inftance, abftain from the ufe of animal 
 " food. The ancient Germans alfo, who were fo renown- 
 K ed for their bodily ftrength^ lived upon acorns, wood- 
 "apples, four milk, and other productions of their then 
 " uncultivated foiL la the prefent mode of life, here (in 
 " England) as well as on the continent, a great proper- 
 " tion of She poorer clafs of country people almoft en- 
 ;c tirely fubfift on vegetables. Although thefe people 
 "'duly digeft their vegetable aliment, and become vi- 
 " gorous^-yet it is certain that animal food would anfwer 
 " thefe purpofes much better. Hence, in countries 
 " where the labouring clafs of people live principally up- 
 " on animal food, they far escel in ftrcngth and dura- 
 *< bility." 
 
 On the fobjeft of diet we (hall take notice only of 
 one article more, and that is 7 the ufe of warm diluting 
 liquors. Thefe are commonly three in number, viz". 
 tea, cof&e and chocolate. Abundance of declama- 
 tions have been ptablifhed againft the ufe of thefe, particu- 
 larly the firft f but the daily experience of multitudes 
 fhows that its ufe, in moderation, is perfectly innocent. 
 Indeed when people go to exceis with this, as well as any 
 thingclfe, bad effedts niuft certainly enfue, Zimmer- 
 man* mentions a Dutch phyiician (Bontikoe) who main- 
 tained that tea ought to be drank in the quantity of ens' 
 or two linn drsd cups a day F But fuch ridiculous excef- 
 ies muft make any thing deflrucYive to health ; and ac- 
 cord ingly this practice, being oppofed by Boerhaave, 
 foon fell into difufe. Ccffee has the fame exhilarating 
 rirlue as tea, but muft be considerably different in its 
 
 qualities, 
 
 * This aatlwjr relates the following curious anecdote concerning tea-drink- 
 ing : ' \Ve had a gentleman in Switzerland, who in every refpet knew how 
 
 to aiVume the tone of majefty. He was to!d one day that nothing elevated 
 the dignity of a king fo much as when every thing around him had a pale 
 look. This intimation was fufficient for him. He directed all his fcrvants 
 to be blooded once a month, and obliged each of them to iwallow fifty difhes 
 of tea every day." Tea is laid to produce a cadaverous hue in the nerfon who 
 driiiks it after bloodletting. ? 
 
THE YELLOW FEVER. 515 
 
 qualities, as having in it a portion of empyreumatic oil 
 extra&ed by the toafting, and therefore a change from 
 tea to coffee in fuch as come into a warm country feems 
 to be improper. Chocolate differs confiderably from 
 both, poff-ffing no exhilarating virtue, or only in a fmall 
 degree, but is more nutritive, and in South America 
 conftitutes a confiderable part of the food. On coming 
 into warm climates it is obvious that the increafed per- 
 fpiration muft be (applied by a considerable quantity of 
 diluting liquids: and. foch of thefe as the perfon has 
 been moft accuftomed to ought to be preferred. For 
 the reft, diluted malt liquors feem preferable to fpirits 
 and water. Cyder, though very agreeable when frefh, 
 is apt .to become vapid, and even get a putrefcent taint. 
 Perhaps a plain infufion of malt, of late found fo ufeful 
 at fea, might alfo prove beneficial at land, where proper 
 fermented liquors cannot be had, 
 
 Thefe modes of prevention are obviously derived 
 from the circumftances which attend every emigrant 
 from a cold to a warm country. The indication 
 mud be, to -keep themfelves as cool as poffible, with- 
 out debilitating the body. It was formerly a cuftom 
 to ufe bleeding and purging when people arrived iu 
 warm latitudes; but this pradice fell into difufe, per- 
 haps without fufficient realoR. Dr. Ruflh attefts the 
 efficacy of thefe remedies as preventives when figns 
 of the difeafe appeared. " During the exigence of the 
 " premonitory fymptoms (fays he) and before patients 
 " were con-fined to their rooms, a gentle purge, or the 
 <l lofs of a few ounces of blood, in many hundred in- 
 " fiances prevented th>e formation of the fever. I did 
 * c not meet with a fingk exception to this remark/' As 
 mercury is found to be one of the beft remedies, if not 
 the only one, that can be depended upon for curing the 
 difeafe after it is onre formed, it is natural to think that 
 it would act as a preventive; and accordingly we find, 
 in Dr. Walker's account of the yellow fever in Jamaica, 
 an inftance to our purpofe. When the fort of Omoa 
 was taken from the Spaniards, a great quantity of 
 q^ickfdver was carried off by the Epglifla. One {hip 
 
516 A TREATISE ON 
 
 was loaded with it, and, the vefiels containing it being 
 broken by the (hot of the fhip which captured her, a 
 number of men were employed in collecting it with their 
 hands into buckets. Not one of thefe men was in the 
 lead affected with iicknefs, though a moft malignant 
 fever raged among the reft. Preventives of fuch a 
 powerful nature, however, could not well be adopted 
 without the advice of a phyfician ; it being evidently 
 dangerous for any perfon unacquainted with medicine to 
 tamper with hirpfelf in this way. 
 
 When the difeafe happens to get into a town, it then 
 becomes an object for every perfon to avoid the danger ; 
 and for this Dr. Chifliolm has given fuch inftructions as 
 feem to be quite fufficient for any individual, and may 
 be very eafiiy reduced to practice. His obfervations 
 may be fummed up as follows : i. To avoid going into 
 infected houfes. 2. If this cannot be done, to avoid 
 going into the chamber ofthefick. 3. If neither of 
 thefe is practicable, to avoid a near approach to the fick 
 perfon. 4. To avoid drawing in his breath, or that 
 peculiar fmell which ifTues from the bodies of the fick; 
 and not to touch the bed-clothes. By neglecting this the 
 perfon becomes affected with naufea : flight rigors and 
 head-ach fucceeci in a few hours by the difeafe. 5. Not 
 to touch the patient's body cr his wearing apparel, or 
 fuffer the effluvia from either to be blown upon the body. 
 The diftance at which the contagion acts is by Dr Chif- 
 holm fuppofed not to exceed ten feet ; but Dr. Lind 
 thinks it may extend to fifty or fixty feet ; but this 
 muft depend very much upon circumftances. The on- 
 ly thing that can be done in fuch cafes is to keep at as 
 great a diftance as pofjible. As to the preventives com- 
 monly recommended, fuch as vinegar, camphor, garlic, 
 cc. we have no accounts of their having ever been effi- 
 cacious in any cafe ; and there is not the leaft reafon to 
 think that they can be fo. 
 
 To purify rooms or ihips from the infection they have 
 received, it has formerly been obferved that fumigations 
 with the acid of nitre have been recommended. Ac- 
 cording to the theory of Dr, Mitchili of New York, 
 
 however, 
 
THE YELLOW FEVER. 517 
 
 however, this mode of prevention muft not only be ufe~ 
 jefs but pernicious. The reafon is, that according to 
 this gentleman the difeafe is produced by the very acid 
 in queftion. His reafoning is fhortly this : Putrid fub- 
 ftances evolve various forts of air, two of which by com- 
 bination form the acid of nitre. Neither of thefe by 
 themfelves are capable of producing fever, though in 
 conjunction they are. Their combination is the acid 
 of nitre, which the Do&or thinks is always that which 
 produces putrefaction. Dr. Girtanner has related an 
 experiment which feems to confirm this opinion, viz. 
 that, having inje&ed fome nitrous air into the jugular 
 vein of a dog, the animal died in a fliort time, and upon 
 opening him his lungs were found of a greenifh colour 
 and partly putrid. Dr. Beddoes adds, in a note, that 
 the green colour is a (ign of the exiftence of nitrous acid a 
 not of putridity ; but, notwithftanding this, Dr. Gir- 
 tanner might ftili have been in the right, as we cannot 
 fay that the exiftence of nitrous acid is incompatible 
 with putridity. But there is not any occafion to enter 
 into a difcuffion of the queftion, as the matter feems to 
 be determined by facts which cannot be overthrown. 
 Dr. Carmichael Smyth, in a treatife on the jail fever, 
 confiders the difeafe as proceeding from putrefaction, and 
 " particularly the putrefaction of tht perjpirabfo matter?* 
 when there is not a renewal of the application of air to 
 carry it off." With regard to Jpecific contagions he 
 thinks they can neither be carried off nor blunted, but 
 by expofure to the open air or to a dream of water ; 
 but with putrid contagions he believes that they may be 
 deftroyed by the mineral acids in a ftate of vapour. The 
 pernicious qualities of the fumes of fulphur prevented 
 him from making any trials with that fubftance ; but 
 to nitre there was no fuch objection, and he therefore 
 proceeded in the following manner ; the fubjects of his 
 trial being the prifon wards at Winchefter, where the 
 Spanim prifoners were kept, and among whom a typhus 
 fever was making rapid progrefs : Having divided the 
 
 wards 
 
 * If this be chiefly ccmpofed of fixed air and azote, as has been faid inp, 
 4&, it fo difficult to fee how putrefaction can take place in it. 
 
A TREATISE ON 
 
 wards into four parts, he removed the prifoners into three 
 of them, took out of the fourth divifion all the ham* 
 mocks and bedding, and had them thoroughly cleaned 
 out. The hammock pofts were well waflied with dilu- 
 ted fj>irit of fait. The wards, when dry, were clofely (hut 
 up, and pots placed in them at different diftances, con- 
 taining from half a pound to a pound of nitre, which 
 was deflagrated by an iron heater put into each pot.* 
 The wards were then mut up for fome hours, and when 
 opened, were expofed to a free ventilation. The procefs 
 was repeated twice or thrice, after which the prifoners 
 were likewife cleaned ; their old clothes, bedding, &c. 
 taken away, were replaced by others, and none of thefe 
 were afterwards feized with the fever. 
 
 A much more decifive experiment was afterwards 
 made at Sheernefs on board the Union hofpital (hip, 
 where there were upwards of two hundred people fick of 
 a very malignant fever. Previous to the fumigation all 
 the parts and fcuttles were ihut up. " Sand which had 
 <c been heated in an iron pot was then fcoopecl into 
 " earthen pipkins, into each of which was put a fmall 
 " tea-cup containing about half an ounce of vitriolic 
 " acid ; to which after it had acquired a proper degree 
 *' of heat an equal quantity of nitre in powder was 
 f gradually added, and the mixture flirred with a glafs 
 " fpatula, until vapour arofe from it in confiderable 
 " quantity. The pipkins were then carried through 
 " the wards by the nurfes and convalefcents who kept 
 " walking about with them in their hands, occafionally 
 *' c putting them under the cradles of the fick, and in 
 *' every corner where any foul air was fufpecled to lodge, 
 * c thus the fumigation was continued, until the whole 
 " fpace between decks, fore and aft, was filled with the 
 " vapour, which appeared like a thick haze." 
 
 The firft fumigation was performed in about three 
 hours ; the vapour fubfided in about an hour, when the 
 ports and icuttles were thrown open for the acimifiion of 
 
 frefli 
 
 * It is not cafy to undcrftand this. Nitre cannot deflagrate or burn, unlefr. 
 :t be mixed with charcoal, lulphuri or foine inflammable i'ubftance. The iron 
 heater could only expel ths wuteri with a fmail proportion ot acid. 
 
THE YELLOW FEVER. 519 
 
 frcfli air. Mr. Menzies, the operator, perceived that even 
 by this firfl; fumigation the air was confiderably fweetened ; 
 and on repeating the operation next day, which {now 
 that the people were more expert) took up only an hour, 
 fuch a change was made as the nurfes and attendants 
 were very fenfible of, and, beginning to put confidence 
 in the remedy, approached the cradles of the fick with 
 lefs fear. The experiment was further carried on by 
 Mr. Baffin, to whom Mr. Menzies refigned the office of 
 conducting it ; and from repeated trials it appeared that 
 the fumigation effectually counteracted the influence of 
 the contagion, though numbers of patients, labouring 
 under the mod malignant fevers, were received from the 
 Ruffian fliips of war. 
 
 The good effects of nitrous vapour ufed in this way is 
 alfo confirmed by Mr. David Paterfon, now furgeon in 
 Montrofe in Scotland. The trial took place in the pri- 
 fon wards at Forton. The operation was performed in 
 the manner above related, and with fuch fuccefs, that a 
 ward 57 feet long, 10 feet and an half high, and 20 feet 
 broad, was filled in a quarter of an hour, only by 
 means of three pipkins. The good effeds were extreme- 
 ly obvious, and Mr. Paterfon obferved that in the wards 
 which had been fumigated at night there was an agreea- 
 ble fmell next morning ; and by this fmell he was able 
 to difcover whether the operation had been properly per- 
 formed or not. The fame author gives feveral cafes in 
 which the good effects of the pure acid vapour of nitre 
 in cleanfing putrid ulcers was manifeft. A third tefti- 
 rnony of the efficacy of this vapour is given in a letter 
 to Dr. Garthfliore of London from Mr. James M'Gre- 
 gor, furgeon to the 88th regiment, in the ifland of Jer- 
 iey. The difcafe was a typhus fever, winch had formerly 
 proved very cltftru&ive ; but, while the acid vapour 
 was ufed, only one out vifixty-fix cafes proved fatal. Mr. 
 M'Gregor is not only of opinion that the nitrous fume 
 prevented the contagion from acting fatally, but that it 
 deftrov-cd it altogether, fo that no more cafes appeared. 
 Mr. Paterfon made trial of different acids, but had not 
 completed his experiments : we are informed, however, 
 
 in 
 
520 A TREATISE ON 
 
 in the Medical Extracts, that in the year 1795, neaf 
 about the time that the lad experiments were made up- 
 on the Union hofpital fhip, Morveau in France had em* 
 ployed, for the fame purpofe, oxygenated muriatic acid* 
 in the form of air or vapour, with which he purified 
 the infected hofpital at Dijon ; and the fame method 
 was afterwards extended to the different military hofpi- 
 tals by a decree of the National Aflembly. 
 
 This mode of prevention teems to be eftablifhed on 
 as fure a tefiimony as any thing can be ; but what can 
 befaid that will not be difputed ? Dr. Trotter has 
 argued in the moft ftrenuous manner that fuch fu- 
 migation is not only ufelefs, but pernicious. " The 
 " whole prefervative means (fays he) are comprifed in 
 " the immediate removal of the lick ; cleanlinefs in per- 
 " fon and in clothing ; fires to keep the people warm in 
 " the winter feafon ; avoiding cold and moifture, fatigue 
 cc and intoxication ; and keeping the fhip dry and pro- 
 " perly ventilated.'* To thefe he alfo thinks it would 
 be expedient to add a band of mufic in order to keep up 
 the fpirits of the people ; but, with regard to any thing 
 elfe, he thinks that " a phyfician of a fleet, though arm- 
 " ed with a diploma, and with the chemiftry of the ele- 
 " ments at his fingers' ends, will find that very little has 
 " been left for him to do ; \vhtk-r Ms doctrine of pro 
 " phylactics (preventives) bttkzvinegar of the four thieves 9 
 " or the fumigations of modern phyficians, under the 
 " fcientific appellations of fulphureous gas, muriatic acid 
 " g^s > or nitrous gas." The Doclcr was fo zealous 
 againil thefe noxious fumigations, that he wrote to Evan 
 "Nepean, efq. at the Admiralty upon the fubjed. His 
 argument was, that every poffible method was taken on 
 board of veffels to expel azote or mepliilic air, by opening 
 ports, fcutties, &c. and putting do'vn windfalls, &c. 
 " This azote is the biife of the nitrous acid : they only 
 " diffcrr in the degrees of combination with oxygen, or 
 " what was formerly called dephiogifticated air : and in 
 
 " proportion 
 
 * Perhaps this vapour may be as efficacious as the other in defraying con- 
 tagion, but its fmell is fo extremely oifenfive and dii agreeable to the lungs* 
 that on this account nitrous vapour feems much preferable. 
 
THE YELLOW FEVER. 521 
 
 * 8 proportion to the quantity it attracts of this principle 
 et it is called azote, azotic gas, nitrous gas, nitrous acid, 
 " nitric acid. In ihort, Dr. Smyth's preventive is the 
 5< very fubdance that every intelligent officer is hourly 
 " employed to drive from the decks of his Majedy's 
 " ihips."* This letter was t ran fm it ted to the commiflion- 
 ers for the fick and wounded for their report. The an- 
 fwer of the commiffioners was to the full as learned as 
 the Doctor's letter ; but they confidered the experiments 
 of Dr. Smyth and others as quite decifive upon the 
 fubjecl, fo that Dr. Trotter was obliged to fubmit. The 
 matter therefore being determined by fuch high autho- 
 rity, we rnuft take leave of the fubjed:, and proceed .to 
 confider the mode of preventing the difeafe from getting 
 entrance into any town, or of eradicating it when once 
 it has got in. 
 
 Among thefe the enacting and dridtly enforcing qua- 
 rantine laws certainly hold the firfl place. But thefe 
 belonging entirely to the magidracy and police of the 
 place cannot be the fubjecl: of any difcuffion here. The 
 fuccefs of thefe has been fo great in other countries, that 
 Dr. Willich informs us " that fome of the mod ingeni- 
 " ous practitioners of Italy and Germany are, at this 
 " moment, employed in a ferious attempt wholly to ex- 
 " tirpate this contagion (the fmall pox) from the conti- 
 " nent of Europe ; an objedt which has formerly been 
 " accompliihed in the cafes of the plague and leprofy."-f- 
 Perhaps, then, it is no improbable fuppofition, that, by 
 a drift obfervance of quarantine laws* and attention 
 to cleanlinefs, the yellow fever may be eradicated at leaft 
 from the northern dates, whofe climates are lefs conge- 
 nial to it than the fouthern. 
 
 Dr. Chifliolm informs us that the general plan of pre- 
 vention made ufe of in Grenada confids in the dedruc- 
 tion of all fmall wooden buildings ; obliging the inhabi- 
 tants to build with done or brick 5 to make fpacious 
 ftreets ; to have the rooms of the houfes as large as poffi- 
 ble< ; dables, neceffaries, &c. at a didance 3 and certain 
 
 places 
 
 * Medicina Nauticai p. 329. t WUlichj p. ij. 
 
 X x x 
 
.A TREATISE ON 
 
 places appointed as receptacles for filth, to which it mufl: 
 be carried every morning ; flaughter-houfes at a dif- 
 tance from the town, &c. with a number of other parti- 
 culars relative to cleanlinefs which it is needlefs to enu- 
 merate here ; not forgetting the quarantines, lazaret- 
 tos, &c. without which he does not think any activity 
 on the part of the people can avail. 
 
 Dr. Rum, who is an enemy to quarantines, recom- 
 mends to the people of Philadelphia the following par- 
 ticulars : " i. Let the docks be immediately cleaned, 
 " and let the accumulation of filth in them be prevent- 
 " ed in future, by conveying water into them by a paf- 
 " fage under the wharves, or by paving them with large 
 " flag ftones inclining in fuch a manner towards the 
 " channel of the river as that the filth of the ftreets mail 
 " defcend from them (after it falls into the docks) into 
 " the river. This method of paving docks has been 
 " ufed with fuccefs in the city of Breft. 2. Let every 
 " (hip that belongs to our port be compelled by law to 
 " carry a ventilator. Let all fuch (hips as are difcovered 
 <c to contain foul air in their holds be compelled to dif- 
 " charge their cargoes- before they reach our city, and 
 " let the mips in port be compelled to pump out their 
 " bilge water everyday. 3. Let the common fewers be 
 " warned frequently with dreams of water from our 
 " pumps. Perhaps an advantage would arife from 
 " opening them, and removing fuch foul matters as 
 ."dreams of water .are unable to wafli away. 4. Let 
 " the gutters be warned every evening in warm weather. 
 " By frequently warning the fbreets and pavements the 
 " heat of the city would be leffened, and thereby one 
 " of the predifpofing caufes of the fever would in fome 
 * c meafuic be obviated. 5. The ut mod care mould be 
 " taken to remove the filth from the yards and cellars of 
 " every houfe in the city. Hog-flies mould be forbid- 
 " den in yards, and the walls of cellars fhouid be white- 
 " v/amed two or three times a year, and their floors 
 " mould be conftantly covered with a thin layer of lime. 
 61 White warning the outfide of houfes in fickly itreets 
 " would probably be ufeful. 6. Lef the privies be emp- 
 
 " tied 
 
THE YELLOW FEVER. 523 
 
 ** tied frequently ; and let them be constructed in fucli 
 " a manner as to prevent their contents from oozing 
 st through the earth fo as to contaminate the water of 
 " the pumps. 7. Let all the filth be removed from the 
 " neighbourhood of the city, and let the brick kiln and 
 " other ponds be filled up from time to time with the 
 " earth which is obtained in digging cellars. 8. In the 
 " future improvements of our city, let there be no more 
 " dwelling houfes erected in alleys. They are often the 
 " fecret receptacles of every kind of filth. 9. The pre- 
 " difpofition of our citizens to be affected by the remote 
 " and exciting caufes of the yellow fever would be very 
 " much leflened by their living fparingly upon frefli 
 <c animal food, and chiefly upon broths and frefli vegeta- 
 " bles, rendered favoury by fpices and a fmall quantity 
 " of falted meat, during the fummer and autumnal 
 <c months. A conftant attention (liould be paid at the 
 * c fame time to bodily cleanlinefs." 
 
 Thefe are the modes of prevention which feem to be 
 the moft obvious and neceflary, as well as approved by 
 the beft judges. It appears, however, that in certain 
 cafes neither human fkill nor care can prevent or cure 
 the diforder. The number of phyficians who have fal- 
 len victims to this difeafe are too manifeft proofs of 
 this.* Indeed, when we confider that it is the nature 
 of the diftemper firft of all to attack the vital parts, and 
 that this attack may commence with little or no pain, 
 
 it 
 
 * Dr. Rufh pathetically laments the lofs of Dr. Nicholas Way, who had 
 been his intimate friend. In a poem called the Political Greenboufe we find 
 fome account of the death of Drs. Smith, Cooper and Scandella, whoalfo pe- 
 ri/hed ; and the fates of Drs. Smith and Scandella were con neded with one 
 another. Dr. Cooper of Philadelphia was feized with the difeafe in that city. 
 A friend who attended him fickened during his attendance, and Dr. Cooper, 
 before he had thoroughly recovered, attended in his turn the friend who had 
 taken care of him. A relapfe enfued, and the Doftor died. Dr. Smith was 
 intimate with Dr. Scandella of Venice, who had come from thence to Ameri- 
 ca, and was at New York during the time of the fever in 1 798. Intending to 
 return to Europe, he waited, there for the Englifli packet boat ; but, being in- 
 formed that a foreign lady in Philadelphia, for whofe daughter he had an at- 
 tachment, was fick of the yellow fever, he returned to that city ; but could 
 Sot lave either mother or daughter from the cruel difeafe. On Seandella's 
 corning to New York the fecond time he could find no body that would re- 
 ceive him as a lodger. In this forlorn fituation he wrote to Dr. Smith, who 
 inftantly gave him an invitation to his houle. Here he was feized with the 
 fever, and was attended by Dr, Smith, until the latter alfo fell lick. A friend 
 who lived in the houfe attended firft Pr, Scandella, and then Dr. Smith, UK. 
 til both died. 
 
524 A TREATISE ON 
 
 it is evident that an attack may be begun before we 
 think of a preventive, and may, as it were in a moment, 
 prevail in fuch a manner as to be entirely beyond the 
 reach of medicine, before even a medicine is thought 
 tteceffary. In every cafe therefore, where the yellow fe- 
 ver prevails, an attention to health becomes as neceflary 
 as procuring the means of fubliftence. Every precau- 
 tion muft be ufed, and when we have done fo we are 
 not even then fecure. We are ignorant of the natural 
 caufes which produce it ; they are invifible to our 
 fenfes, and incomprehenfible by our understandings. 
 Safety then can only be expected from the protection of 
 that Being to whom all natural caufes are known, and 
 to whom all muft yield obedience. In fhort, w^ may 
 fum up the whole in the well known fentence, " He that 
 will fov& life, and fee good days, let him refrain his TONGUE 
 from EVIL, and his LIPS that they /peak no GUILE. Let 
 him efchew EVIL and do GOOD ; let him fee k PEACE, and 
 enfue it" A very ftrange receipt indeed, we will fay ; 
 but how often have we tried it ? 
 
 The cure of the yellow fever hath been attempted in 
 various ways, according to the theories laid down by 
 different phyficiana concerning its nature. Dr. Cullert 
 conficiers it as of the nature of typhus fever,* and of con - 
 fequence would have treated it with antimonials ; moft 
 probably with his favourite remedy, tartar emetic. Dr. 
 Rufh, from his opinion that it is the highefl degree of 
 inflammatory fever, recommends powerful evacuants, and 
 large blood-letting, in 1793, and 1797, though he feems 
 to have altered his fentirnents in 1798. Dr. Brown, 
 who would have confklered it as a difeafe of debility, 
 would of courfe have prefcrihed opium and other 
 ftimulants ; and laftly, on the theory of Dr. Mitchill, 
 that the difeafe proceeds from an acid, remedies of 
 a nature directly oppofite, viz. alkalies, ought to be 
 ufeful. It is not the defign of this treatife to enter 
 into any consideration or comparifon of the practice 
 of different phyficians, but to point out at once, to 
 thofe who are not phyficians, the remedies which have 
 
 been, 
 
 * Typhus Idleroides, 
 
THE YELLOW FEVER. 
 
 been, by general confent, accounted mod efficacious j 
 and in this refpect there is now a furprifing unanimity 
 among gentlemen of the medical profeffion. Thofe 
 which hold the firft rank are, 
 
 i. Mercury. In the ufe of this medicine the phyfi- 
 cians of the Wefterri world have certainly excelled thofe 
 of the Eaft. In a paper in the Medical Repofitory, vol. 
 i, p. 500, Dr. Holyoke of Salem fays that the practice of 
 giving mercury was firft introduced into New England 
 about 60 or 70 years ago,* by a phyfician from Scot- 
 land, a difciple of the celebrated Pitcairn. In 1734 or 
 1735 it was ufed fuccefsfully in a very malignant difeafe 
 called the throat diftemper, and which he thinks was of 
 the fame genus with the malignant ulcerous fore throat 
 treated of by Huxham. About 45 years ago it was com- 
 monly ufed in pleurilies and other inflammatory difor- 
 ders ; and, ever fince the year 1751 or 1752, it has been 
 ufed by Dr. Holyoke himfelf. In Europe, however, 
 the cafe was exceedingly different ; mercury being there 
 generally reckoned pernicious in fuch diforders, from a 
 notion of its being inflammatory, or diflblving the blood. 
 Thus, on the appearance of the Boullam fever in Grena- 
 da, Dr. Chifholcn found hicnfelf exceedingly at a lofs 
 what to do, and he feems to have invented, rather than 
 to have been previoufly inftruRed in, the mercurial prac- 
 tice. His fuccefs, however, was very great, provided he 
 could raife a falivation ; but in order to do this he was 
 frequently obliged to give much larger dofes than he had 
 ever done before, or had any notion of doing. In p. 
 i 59 he mentions one patient who took 400 grains before 
 the falivary glands were affected. He tells us, however, 
 p. 271, that, on the re-appearance of the fever in 1794, he 
 gave the medicine in much larger dofes than before ; be- 
 ginning with mercury without any previous evacuations 
 which he had ufed the year before, and with fuch fuc- 
 cefs that he did not lofe a fingle patient ; fo that he 
 profeffes himfelf almoft ready to pronounce it infallible 
 in curing the difeafe. The practice of giving mercury 
 is confirmed by Dr. Rufh, and indeed by fo many 
 
 other 
 
 * The Dolpr's letter is dated December, 1797. 
 
5 z6 A TREATISE ON 
 
 other phyficians, that it is fuperfiuous to quote them. 
 Dr. Nafly, formerly mentioned, again ftands almoft fin- 
 gular in condemning the medicine, becaufe it difTolves 
 the blood ; but it is impoffible that any theory, however 
 plaufible, can (land againft well attefted facts. Dr. Ruih 
 is indeed very much of opinion that it is eafily practica- 
 bk for people to cure themfelves of this diforder, dread- 
 ful as it is, provided they take it in time. But by this we 
 xnuft underftand, that the very moment the perfons feels 
 uneafinefs he muft apply a remedy, and not trufl to na- 
 ture, in any cafe whatever. When the yellow fever pre- 
 vails, every one who feels the flighteft diforder may be 
 afTured that his diforder partakes of its nature, and ought 
 immediately to have recourfe to a mercurial purge* 
 Dr. Rulli fays alfo that bleeding fhould be firft perform- 
 ed. The many difputes, however, concerning the effi- 
 cacy of this laft remedy, muft make any perfon hefitate 
 at the application of it without medical advice, efpecial- 
 ly as a mercurial purge may be fafely taken without it. 
 
 2. 'Blood-letting. This was, by Dr. Rufh, confidered 
 as the capital remedy in 1793 ; but Dr. Chiiholm, who 
 made trial of it in the Boullam fever, found that it could 
 not be ufed with any degree of fafety. Dr. Jackfon 
 lays it is frequently neceffary in the Jamaica fever, but 
 it was feldorn of ufe to repeat it. Dr. Walker fays it 
 increafed the debility in the fame fever of 1793, 94 and 
 9. Dr. Mofeley recommends it in the yellow fever of 
 the Weft Indies, but only in the firft ftage, and fays that 
 the injudicious performance of this operation, when the 
 fecond ftage has come on, has given occafion to the 
 opinion that a patient cannot bear two bleedings. Dr. 
 Coffin found it ufeful at Newburyport in 1796, in the 
 beginning of the difeafe, and fays it may fometimes be 
 repeated. Repeated bleedings are recommended by Dr. 
 Ouviere of Philadelphia, who fays they are not to be 
 omitted even in fat and weak habits. This is confirmed 
 by the editor of the Medical Repofitory, vol. i, p. 92, 
 who fays it was ufecl with fuccefs at the hofpital in New 
 York in 1796, " at repeated times, to the amount of 
 ** from 24 to 175 ounces, and in forne cafes feveral times 
 
 " performed 
 
THE YELLOW FEVER. 
 
 <c performed after the fixth day of the difeafe, to the 
 " great relief of the lick." Dr. Bruce recommends it in 
 the iiland of Barbadoes in the robuft and plethoric,* 
 Dr. Hillary fays that in the fame ifland it is always abfo- 
 lutely necefTary, and that it may even be repeated once* 
 but that a third bleeding was feldom necefiary. Dr. 
 Wright, in the fame ifland, found the " lancet not onlf 
 unneceffary but dangerous in the extreme." Dr. Clarke, 
 in Dominica, found it generally very pernicious, and a 
 fures us " that there was not a fingle inftance of an emi- 
 " grant recovering who had been bled in this difeafe, la 
 " the firfl 24 hours indeed it was admiflible in the young 
 * { and athletic feized a fhort time after their arrival, but 
 " after that time, or at mod after 36 hours, it will al- 
 " ways be found prejudicial, if not fatal." It was not 
 tried by Dr. Bryce on board the Bufbridge. It is re- 
 commended by Dr. Currie in his treatife on bilious fe- 
 vers. 
 
 It is needlefs to take up time with a detail of more 
 pinions. From thofe already recited it is natural to 
 conclude that the fever in fome places, and at fornc 
 times, differs very much from others. This is conform- 
 able to the opinion of Dr. Currie, who fays, that the 
 bilious fever " is amazingly influenced in its afpect and 
 aptoms by the foil, fituation, climate, feafon, and 
 " by the preceding and prefent ftate of the atmofphere, 
 " and the cuftomary mode of living of the inhabitants/* 
 The utility or even fafety of blood letting then feems to 
 depend on circumftances which can be only known* 
 and that perhaps with difficulty, at the time ; nor can its 
 fuccefs in one feafon be a fufficient argument for the ge- 
 neral practice of it in another. 
 
 3. Vomits have generally been found dangerous. Dr, 
 Mofeley, Dr. Rufli, and indeed almoft all who have prao 
 tifccl in this difeafe, fay, that they cannot be ventured 
 upon without extreme caution. Dr. Chifholm, in imi- 
 tation of the Ruffian practice in the true plague, at- 
 tempted the cure of the Boullam fever by vomits ; 
 but, as one half of thofe to whom they were exhibit- 
 ed 
 * Lind on hot climates. 
 
A TkEAf ISE CiW 
 
 ed died of the difeafe, he did not think there was 
 encouragement to proceed. Perhaps as preventives they 
 might be ufeful, as it feems probable indeed that any 
 thing muft be which tends to cleanfe the alimentary 
 canaL 
 
 4. Purgatives are found extremely ufeful, both as pre- 
 ventives and medicines. There are innumerable inftan- 
 ces where an incipient attack of the difeafe has been carri* 
 ed off by a brifk purge. Dr. Chifholm was able to remove 
 the flighter cafes of Boullam fever by purgatives. He 
 ufed at firft glauber falts with two grains of tartarifed 
 antimony, which generally proved emetic as well as pur- 
 gative ; but he afterwards ufed with advantage the bet- 
 ter purging falts, rendering the folution palatable by the 
 addition of lime juice and fugar. But in all violent ca- 
 fes he would depend on nothing but mercury. 
 
 5. Stimulating medicines . The ftimulants commonly 
 ufed on the Brunonian plan, viz. opium, bark, tc. are uni- 
 verfally owned to be pernicious. In a letter from Dr- 
 Sayres to Dr. Currie,* the former fays, that " bark, 
 " wine, and a number of the common ftimulants, were 
 " given on the firft appearance of debility taking place; 
 " but with little fuccefs. Finding the common round 
 " of medicine ineffectual in the advanced ftate of the 
 " difeafe, I determined (fays Dr. Sayres) to ufe a different 
 " mode of treatment. In three cafes of adults, two of 
 " which had the black vomiting, and the third was in a 
 " gore of putrid blood from the mouth and nofe, Ifor- 
 " bid medicine, and directed very cold water and bran- 
 " dy mixed ftrong, to be given as freely as poffible. It 
 " had the happy effect of checking the vomiting in two 
 <c cafes, when the ftomach had rejected every kind of 
 " mild drink, &c. and, by continuing that practice al- 
 " moft fo as to produce high intoxication, for two or 
 " three days, thefc two cafes were recovered almoftfrom 
 " a ftate of death. The third was apparently much 
 " benefited for three days ; but, beinginahigh putrefcent 
 " ftate when I faw him, and having loft a very confider- 
 " able quantity of blood from the mouth, nofe, &c. he 
 
 " died 
 * Memoirs of Yellow Fever, p. 137, 
 
THE YELLOW FEVER, 529 
 
 died on the ninth day/' In the Boullam fever Dr. 
 'biiholm ufed the Anguftura bark in twelve cafes, eight 
 >f whom recovered ; but, though it was greatly fuperior 
 to the Peruvian bark, he did not think proper to truft 
 to it in violent cafes. 
 
 6. Alkaline remedies. Thefe have been recommend- 
 ed on the fuppofition that the yellow fever is occafioned 
 by an acid. Their efficacy is attefted by Dr. Jeremiah 
 B u'ker of Portland, who fays that they afforded more re- 
 lief than any others, and that all the cafes accompanied 
 with yellownefs ended favourably, but one. The alka- 
 line remedies " would actually alleviate the diftrefiing 
 " pain and anguifh at the ftonaach, which would not 
 " yield to opiates. The morbid excitement too was evi- 
 " dently under the controul of alkalies $ the febrile dif- 
 " turbance appeared to be in a direct ratio to the degree 
 " of virulence in the deleterious caufe."* We have not 
 any particular details of cafes, nor any form of exhibition 
 pointed out. In a dy (enteric fever indeed he fays that 
 he ufed a mixture of a quarter of an ounce of fait of 
 wormwood with a pound of lime water ; the dofe from 
 one to two ounces every hour, once in fome cafes every 
 half hour, or oftner, in an infufion of camomile.^ Cal- 
 cined oyfler flielis were fometimes given from 40 to 60 
 grains. 
 
 7. Cooling medicines, external and internal. The good 
 effects of cold water applied to the body in fevers has 
 long been known. Dr. Jackfon obferves that it was firft 
 introduced at Rome in the infancy of the Methodic 
 feet, and attained afterwards a high degree of celebrity, 
 its reputation was highly raifed by a cure performed on 
 the emperor Auguftus ; but foon after funk by the 
 death of Marcellus, the prefumtive heir to the empire, to 
 whom it had been improperly prefcribed. It was foon after 
 prefciibcd again, and greatly ufed by Galen; and after 
 him was in (till greater favour with the Arabian phyfi- 
 clans ; but, fiace the revival of literature, has been much 
 
 neglected 
 
 * Medical Repof. vol. ii f p. 149. 
 
 i In this mixture the fixed air in the alkaline fait would iaftantly deftroy 
 the virtues of the lime water by precipitating the lime. What is fold for fait 
 9f wormwood is neither more nor leis than common peail alh, 
 
 Yyy 
 
530 A TREATISE ON 
 
 negle&ed till of late. In the fever of Jamaica, after the 
 fatal fymptoms were removed, Dr. Jackfon fays, that the 
 tone and vigour of the fyftem was beft reftored by cold 
 bathing, " which (fays he) I am induced to confider as 
 " the moft important remedy in the cure of the fevers 
 " of the Weft Indies, and perhaps in the cure of the 
 " fevers of all hot climates. Though it might not ab- 
 " folutely cut fhort the courfe of the difeafe, yet it fel- 
 " dom failed to change the fatal tendency of its nature." 
 Even in the latt ftage of the yellow fever, where the pa- 
 tient feems at the utmoft extremity, our author tells us 
 that he has alternately employed warm and cold bathing 
 with the greateft fuccefs. He has even wrapped the 
 body in a blanket foaked in water in which a large por- 
 tion of fait had been diffolved, or which had been fteep- 
 ed in brandy or rum, enjoining the liberal ufe of wine, 
 or more powerful cordials. Dr. Wright alfo mentions 
 the cold bath with approbation ; but, as it cannot be ve- 
 ry generally depended upon, its ufe ought never to fu- 
 peffede that of other remedies, efpecially mercury ; and 
 indeed *tvs may be faid of every th'ng elfe ; for though 
 by the ufe of the remedies already mentioned the difeafe 
 has fometimes b<,en fuhdued, yet the fuccefs has never 
 been fo great bur that every one under an attack of the 
 yellow fever muft be coufidered as in very corifiderable 
 danger. 
 
 In the ufe of cooling medicines, taken internally, we 
 muft have a particular regard to the ftate of the ftomach, 
 which is exceffively irritable; and it is furpnflng that 
 this irritability is of fuch a nature that, though it will 
 certainly reject the mikleft drinks or medicines, it may 
 yet retain others feemmgly much more acrid, as has al- 
 ready been obferved in the cafe of Dr. Sayres's patients. 
 AS long ago as the time of Diemerbroeck >i folution of 
 common fait in vinegar was recommended in the plague. 
 Since that time it has been found extremely ufeful in the 
 cryfentery ; and, as in this difeafe the bowels are likewife 
 man extremely irritable ftate, it would feem from ana- 
 Jogy that the fame medicine might be ufeful alfo in the 
 yellow fever. Dr. Wright of Jamaica (who attefts the 
 
 efficacy 
 
THE Y-ELLOW FEVER. 53* 
 
 efficacy of the medicine in dyfentery, belly-ach, remit- 
 tent fever, and putrid fore throat) gives the following 
 improved method of preparing it : " Take of lime or 
 cc lemon juice three ounces; of marine fait as much as 
 " the acid can diffolve; of any fimple diftilled cordial 
 " water one pint ; and of loaf fugar a fufficient quan- 
 " tity to fweeten it. The dofe of this mixture muft be 
 " proportioned to the age and fex of the patient, and to 
 " the violence of the difeafe. A wine glafsful may be 
 " given to adults every two, four or fix hours." 
 
 8. Medicines proper for relieving tfo moft urgent fimp- 
 toms of the difeaje. The moft diftrefling fymptoms at- 
 tending the yellow fever are, head-ach, vomiting, pain 
 in the ftomach,and pains in the back, loins and limbs. 
 Blifters were tried by Dr. Chifholm to mitigate the pain 
 in the head. " I have (fays he) bliftered the whole head, 
 " and the infide of each thigh, at once, in feveral cafes, 
 " without producing the leaft change in that or any 
 " other fymptom. I have had recourfe to this remedy 
 " to leffen pain, to remove irritability of the ftomach, 
 " and to raife the vital powers in the low, comatofe ftage, 
 " but always except in two cafes without fuccefs." In 
 one a blifter to the fcrobiculus cordis completely remo- 
 ved the irritability ; the other cafe is related in the next 
 fection. Another practitioner found a blifter applied to 
 the forehead of remarkable ufe in four cafes; but Dr. 
 Chifholm fuppofes them to have been of the lefs violent 
 kind. Others have alfo found them occafionally ufeful; 
 fo that, though dependence cannot be placed upon 
 thefe remedies, it feems improper to reject them entirely. 
 But the moft effectual method of allaying the irritability 
 of the ftoniach was by the exhibition of vitriolic sether. 
 Dr. Chifholm adopted the medicine on the recommenda- 
 tion of M. Poiflbnier, and found it to anfwer the cha- 
 racter given of it by him. Dr. Chifholm gave about a 
 tea fpoonful in half a glafsful of* cool water, after which 
 the patient continued undifturbed about two hours, when 
 the dofe was repeated. Sometimes, though feldom, the 
 ftomach was thus enabled to bear the bark, but other- 
 wife the rether was given every three hours. If the 
 
 ftomach 
 
53* A TREATISE ON 
 
 ftomach retained the bark after the fir ft dofe, tether was 
 then given only once in five or fix hours. Jther, fays 
 he, given in the manner I have mentioned, is extremely- 
 grateful to the patient ; it occafionsan agreeable warmth 
 along the oelophagus, and gently ftimulates the ftomach. 
 This effect, however, does not continue long ; but the 
 frequent production of it at length gives it permanency. 
 It appears to act as a tonic, an antifeptic, and an agree- 
 able ftimulant ; a warm glow overfpreads the furface ; 
 and thirft, naufea and opprefiion, often have fled be- 
 fore it. 
 
 Thefe are the remedies moft approved, and which may 
 with moft reafon -be expected to fucceed in the cure of 
 the difeafe, where it is within the power of medicine, But 
 there are certain cafes in which medicines of the ordi- 
 nary kind cannot act. Sometimes, at the very beginning 
 of the difeafe, all the three ftages of it feem to commence 
 at once, or to be mingled in fuch a manner that medi- 
 cines have not time to exert their force. Again, in the 
 laft ftage, Dr. Jackfon compares the attempts to overcome 
 the torpor of the fyftem by medicine, to that of attempt* 
 ing to revive a dead corpfe. " I have, however (fays he) 
 "Teen inftances of fuch unexpected recoveries from the 
 " moft hopelefs ftate in fevers, that I feldom totally def- 
 " pair as long as life remains." It is evident, however, 
 that the remedies employed muft be different, according 
 to the different times of the difeafe. In the beginning 
 it is probable that by bleeding to an extreme degree, 
 fothat the greater part of the mafs of blood was taken 
 away, the difeafe might be fubdued at once, and the 
 patient recover, as has been already mentioned of the 
 plague, p. 363. But the idea of death feems to be fo 
 firmly connected in the human mind with the lofs of a 
 great quantity of blood, that very little hopes can be en- 
 tertained of any good being done in this way. It feems 
 indeed owing to this invincible affociation of ideas that 
 the enemies of Dr. Rufh have found means to load him 
 fo much and fo undefervedly with reproach. Another 
 method, lefs exceptionable, though probably alfo lefs effi- 
 cacious, is by injections into the veins. But what are we 
 
 to 
 
THE YELLOW FEVER. 533 
 
 to inject ? Here, to the difgrace of experimenters, let it 
 be recorded, that fuch has been their innate propenfity 
 to cruelty, that though we know a number of fubftances 
 which, injected into the veins of an animal, will certainty 
 lull it, yet we fcarce know one which can be injected 
 with even a -probability of doing good. In the Medical 
 Extracts indeed we find it related that at Guadaloupe a 
 phyfician had cured the moil inveterate difeafes by in- 
 jecting certain remedies into the veins. But what thefe 
 remedies were we know not. In the fame paragraph in- 
 deed it is faid that alarming fyrnptoms from the bite of 
 a viper were removed by injecting diluted /pint of hartf- 
 horn into the blood. As the bite of a viper is attended 
 with a diflfolution of the jMood, and yellownefs of the 
 fkin, we may thence derive fome faint hope that fuch an 
 injection might alfo be ufeful in defperate cafes of the 
 yellow fever 5 but, till further experiments are made, we 
 can fay nothing more on the fubject. 
 
 Laftly, when the difeafe has proceeded fo far that the 
 blood flows out from all parts of the body, and it is evi- 
 dent that the patient muft die were it only from the loft 
 of that fluid, then, if ever, the once celebrated remedy 
 >f the transfufion of blood may be of ufe. An account 
 of this remedy has been given in the former part of this 
 work. It muft be evident that human blood ought to 
 be preferred to that of a 'brute creature ; but the danger 
 incurred by one who iliould lofe a quantity of blood fo 
 near to a perfon capable of giving the febrile infection 
 muft certainly be very great. Neverthelefs, there are 
 cafes in which the death of a beloved object infpires 
 more horror than the thoughts of any perfonal danger, 
 or even death itfelf, to the perfon who beholds it. In fuck 
 cafes no doubt there are many that would run all rifks ; 
 and, mould any cafe prove fuccefsful, no doubt the 
 perfcm who had the courage to make the experiment 
 would find ample recompenfe in faving a perfon he lov- 
 ed from death, and in eftablifhing a truth of fuch .im- 
 portance to the world in general.* SFCTTOM 
 
 * From the accounts of the rnoft eminent praflitioners it appears that th 
 fiver of 1798 differed considerably in its nature from that of 1795. Jn Phila- 
 delphia 
 

 534 A TREATISE ON 
 
 SECTION IV. 
 
 Remarkable Cafes. 
 
 SO many cafes have been enumerated in the courfe of 
 this work, that little more remains to be done io 
 that way. The following are given, not merely on ac- 
 count of their Angularity, or to give inftances of furpri- 
 iing and unexpected recovery, but to elucidate fome 
 points of doctrine hinted at before, and not fufficiently 
 
 tfelphia particularly there were many cafes that could not bear the ftroke of 
 a lancet. In Bofton it fecms to have partaken more of the nature of the true 
 plague than in other places and other years. The difTecttons of Drs. Rand 
 and Warren manifeft a difference between the effeds of it on the body at that 
 time, and what they were in former years. Buboes, carbuncles, or what were 
 thought to be fo, and petechia?, were obferved here, at* well as in New York. 
 One remarkable cafe, related in the next fecVion, (hows a difpofnion to ind*~ 
 -rathn^ very uncommon in the yellow fever, though fo common in the true 
 plague that in the former part of this trcatife it is taken for the chara&eriltic 
 mark of the difeafe. None of thof* efchars called token*, however* were in 
 any cafe obferved. The difeafe here bore bleeding much better than at Phi- 
 ladelphia ; but mercury was always the moft efficacious remedy, where a fa- 
 Jivatiou could be raifed The warm bath was uleU ia fome cafes with fuccefs* 
 Large evacuations were ufeful, and fome patients bore three or four bleedings* 
 with repeated dofes of jalap and calomel. The ditiemper is by one gentleman 
 ftyled a novel difeafe, and differing etlcntia-lly from other bilious complaints. 
 2n one cafe the patient died of apoplexy ; and another would probably have 
 ihared the fame fate, had it not been for timely bleeding. The black vomit 
 was almoft inevitably attended with death. The matter evacuated was 
 thought to be extra vafated blood from veffels in fome cafes mortified. The 
 yellow colour was judged merely accidental ; but Dr. Lind's opinion of its 
 arifmg from a diflblution of the blood feems now to be universally abandoned, 
 and the colour is fuppofed to arife from a fuifufion of bile, owing either tc 
 the obftru&ron of the dudls, or too great fecretiofl. 
 
 The names of the gentlemen upon whole authority the above fa^s ftand; 
 cannot be mentioned, as permiffion for fo doing has not been obtained. Their 
 authenticity, however, can be prov&d by undeniable documents. 
 
 The origin of the fever at Bofton ha:>, as ufual, been difyuied ; but the com- 
 Tiion opinion is that it was generated. It now appears, however, that, though 
 there are very ftrotig reaibns for fuppofoig. it to have originated in the place, 
 there are others equally ftrong for believing that it was imported. It is af- 
 certained thai a velfel OH board which perfons had died with the yellow fever 
 Jay in the neighbourhood ef the family ftrft leixed with the diieafe in 1798*. 
 On the other hand, there were inftances of many that were fciz^d with the 
 diftemper who had not even left their houfes for months previous to the con- 
 tagious period. This year (1799) there have been unqueftionable proofs of 
 the importation of the fever from the Havana. The quarantine* however* 
 Jas kept the infection from fpreading; though the ftate of the atmofpher* 
 Jias been much lefs favourable to the difeafe than laft year and his there- 
 fare no doubt contributed to prefer ve the health of the people* 
 
 Vt* 
 
THE YELLOW FEVER. 
 
 535 
 
 i. Spontaneous burning. In the former part of this 
 treatife feveral extraordinary inftances of this kind are 
 given ; but a doubt was fuggefted whether the fire was 
 
 produced 
 
 We have been favoured with the following lift of thofe afFeSed with the 
 difeafe this year at ilewburyport : 
 
 When taken. 
 Oflytaway June 28. 
 March 28. 
 
 Sol. Haflcel July j. 
 His nephew 4- 
 
 Duggins 5. 
 
 Tho's Norwood 6. 
 
 Tho's Nor'd jun. 6 
 
 Robert Lord 6. 
 
 Stephen Tilton 6. 
 
 Paine 7. 
 
 Herbert 7. 
 
 Walleigh 7. 
 
 Mifs Dole 9. 
 
 Sally Wood 10 
 
 James Wood xi. 
 
 Widow Waite n. 
 Wm. Thompfon n 
 
 Jona. Pearfon 13. 
 
 Danl. Favour jun. 15 
 Goodhue 15. 
 
 Rev. Mr. Milton 15. 
 Mary Dunn 15. 
 
 Giles Parfons 16. 
 
 Sol. Currier 
 Sam. Currier 
 Creaty 
 Mrs. Wood 
 Sally Edwards 
 
 Her brother 
 
 1-6. 
 18. 
 
 19. 
 r 9 . 
 
 Remarks. 
 
 A feaman on board the veflel. 
 do. 
 
 On board while her cargo was difcharging, &c. 
 
 do. 
 
 JPrefent when the ballaft was thrown out, atfb 
 I on board. 
 
 } Worked in a hatter's friop about 16 rods from the 
 veflel when graving, the wind blowing all or 
 ) moft of the time from the veflel towards the {hop* 
 
 Worked on the wharf where the veflel was hauled in. 
 
 Loaded and flowed the veflel for another outward 
 bound voyage. Thefe men lived at Amelbury. 
 
 Worked in a tailor's {hop, by Norwood's hatter's 
 
 do [(hop. 
 
 r Along fide the veflel, and filled the old bread 
 
 1 caflcs for her outward voyage. He alfo lived neas 
 
 ( the wharf. 
 
 C Doubtful whether her diforder was the fever. Lrv 
 { ed at the bottom of the wharf. 
 
 < Lived at the bottom of the wharf, & was along 
 } tide of the veflel. 
 
 I Kept a ftoie near the wharf, & was along fide 
 { the veflel. 
 
 Worked near the bottom of the wharf. 
 
 On board tke fchooner, and trimmed the fugar cafks. 
 
 Vifited thefick at Norwood's. 
 
 Lived at Norwood's. 
 
 < Handled the bags of money that came in the 
 } veflel, and counted it. Was along fide of the vefleJU 
 
 On board the fchooner. Helped to haul her in. 
 On board. Helped to difcharge the ballaft. 
 On board when the veflel was difcharging her carga, 
 Widow of James Woodi above mentioned. 
 Lived with Jamos Woed. 
 
 Lived oppou'te, & often in, Wood's houfe during 
 the ficknefs. 
 
 *Ibofe marked -whb after ijks recovered. 
 
 The fever unequivocally the fame which prevailed in this town In 1796* 
 * and in Bofton and Portfmouth the laft fummer. 
 
 ' The veflel fuppofed to have introduced the difeafe was the fchooner 
 Sa!ly jofeph Gunnifon matter, which arrived at Bartlett's wharf on the 
 ' morning or the agth of June laft, after a pafiage of 18 days, from St. Tho- 
 44 rnas's where the yellow fever prevailed and was very mortal, with 17 
 * tierces of lugar, and ca(h in bags. She difcharged her cargo before one 
 4 o'clock on the day of her arrival. In the fame afternoon her ftone ballaft, 
 taken on board at St. Thomas's was thrown on deck. On the firft of July 
 (he was moved to a wharf 10 rods below, and her ballaft was thrown on a 
 pier wholly covered with water. This ballaft was covered with a vifcous 
 iubftance, which adhered to the fingers, and was very offenfive to the peo- 
 
5.36 A TREATISE ON 
 
 produced internally ', or externally. The following ac- 
 count, from the Medical Extracts, determines the mat- 
 ter. The circumftance took place in England, in the 
 year 1613, One Hitchill, a carpenter, came home from 
 his work as ufual, without being fenfible of any indifpo- 
 fition, and went to bed. In the night time, or early in 
 the morning, his wife awaked and found him dead by her 
 fide. His body was fo hot that it could not be touch- 
 ed, and he continued burning internally for three days. 
 No flame appeared on the outfide, only an hot fleam if- 
 ibed from his body ; and we are not told what was the 
 ultimate effect of the fire, or whether his body was con- 
 fumed to allies or not. In the fame work we are told of 
 a woman who was found dead in her room in the morn- 
 ing, and confumed to allies, her very bones being calci- 
 ned to whitencfs. The floor on which me lay was very 
 little burned. This laft cafe, however, is not fo directly 
 in point as the former, which feems decifive with regard 
 to the internal origin of the fire. 
 
 2. M. 
 
 pie working on the pier. On the fame day me was hauled in between the 
 two wharves, and gravedi and removed back to Bartjett's wharf, where (he 
 was loaded with lumber for another voyage, on which (he failed the 
 i ith of July. 
 
 It is ftili queftioned whether this fever was imported, or generated in the 
 town. You will find that all who have had it have benconneded with that 
 vefiel. or lived or worked near where (he lay, or vifited the Tick near the place 
 " where the vellel was graved. And undoubtedly there were many perfons 
 alike connecled and firuated who did not take it, although the inhabitants 
 ** living near the wharf very foon moved away. It is laid that there is an ol<i 
 i diftil-houie near the bottom of the wharf, which has not been ufed tor 
 many years, and that the tubs and cifterns are replete with putrid exhala- 
 tions. I do not know that this fa& has been verified. It is aiib faid that 
 back of the ftore uled by the deceafed Jonathan Pearibn> were brewers', foap 
 4* boilers' and tallow-chandlers' works which had aU been ufed in the la(U 
 * i'pring. This is true ; but I do not know that it is evident that any putrid 
 * fubftances were formed there. Dr. Vergnies informs me that there was one 
 cafe ot the yellow lever 2 days before the veflTel arrived. In my mind the 
 weight of evidence in favour of the importation greatly preponderates. In 
 ** 1796 the evidence was very unequivocal that the fever was generated. 
 
 Juft before the veflel arrived we had fome very warm weather, and the 
 " heat was oppreflive to the feelings. The thermometer two afternoons was 
 at 90 deg Perhaps it may not be unufeful to mention that calomel was 
 given liberally. All who recovered were falivated. All who could not be 
 falivated died: and unfortunately fome who were evidently falivated died. 
 Since forming rny table I find that a Mrs. Plummer who lived near th 
 wharf will die.* Her cafe for the firft fcvcn days was fuppo&d to be an 
 intermirent fever ; then it aflumed the fymptoms ot the yellow fever. Site 
 was taken an the nth July. 
 
 " * This patient is now dead ^' 
 
THE YELLOW FEVER. 537 
 
 2. M. D'ObfonviHis cafe of the plagtte. In the for- 
 mer part of this treatiie it has been find that heat de- 
 ftroyed the plague , but, on the authority of the Ruffi n 
 phyficians, that the difeafe could not be treated in hot 
 rooms. The following cafe, however, Ihows that even 
 expofure to a burning fun in a defert, to the cold air of 
 night, and to the mod injurious ufage, cannot always 
 render fatal an attack even of the moft dreadful diftern- 
 per in the world. M. D'Obibnville had undertaken a 
 journey over land to the Eaft Indies, in order to execute 
 an important commiffion from the French government, 
 in 1761, the very time when the plague raged violently 
 in the eaft. He defcribes his cafe in the following 
 words : <k 1 felt the firft fymptoms of the plague two fmall 
 " days journey from Aleppo, when I had entered the 
 ' c defert j and at night, when going to reft, complained 
 ** of a general uneafinefs and heavinefs of the head. In 
 " the morning the fever was known to be inflammato- 
 " ry j and from that time I had no longer any fleep. 
 " The third, the fever and head-ach became more vio- 
 '' lent, two buboes began to rife on my left fide, my 
 ''' tongue was fwelled, and of a brown violet colour. The 
 " fourth and fifth days, fores began to appear on my 
 " loins, the fpine of my back, and the fcrotum ; fome 
 " of which were as large as the palm of my hand, and 
 >c their colour at firft was a red purple. I was obliged, 
 c however, to rife, like other paff ngers, at two in the 
 " morning, and travel on horfeback till eleven. Unable 
 ic to fwallow any thing but a little water, abandoned by 
 :c my Chriftian fervant, who durft not come near me, 
 tc and attended by an Arab, that 1 could not underftand, 
 ;c the violence even of my illnefs, and a little fortitude, 
 :t had hitherto contributed to fupport mej but my 
 >s weaknefs increafed hourly, and 1 could no longer fit 
 my horfe, when an Armenian lady, named Tcheremani, 
 '' determined to ride him herfelf, and with the utmoft 
 ' humanity gave up her camel to me, on which was a 
 ' kind of litter. On the fixth day the fymptoms all 
 >s appeared aggravated ; at one moment my pulfe beat 
 i; v/ith an aftonifliing quicknefs, and fire feemed to run 
 
 Z z z 
 
538 A TREATISE ON 
 
 " through my veins ; and the next, my blood was 5n- 
 " tercepted in its courfe, a moifture covered my fore- 
 ;< head, and 1 felt myfelf fainting, though without being 
 " delirious, or lofing my fenfes." 
 
 The caravan having arrived at a fmall. ruined village 
 named Soccun, in the defert, it was refolved to leave M. 
 D'Obfonville to his fate, his cafe being confidered as def- 
 perate ; and indeed he fays he was left alone at his own re- 
 queft. A fmall horde of Arabs relided in that village, 
 though ruined, and our patient was configned to the care 
 of a religious perfon called zmoullak. This gentleman, like 
 too many others, did not choofe to [ewe God for nought ', 
 and therefore demanded fifty piaftres in filver, beiides 
 fome effects, in recompenfe for the charity which he was 
 about to extend to the unhappy traveller. Having re- 
 ceived thofe, and the caravan being gone, the moullah 
 and his wife in the night time laid M. D'Obfonviile 
 acrofs an afs, and carried him about a mile into the de- 
 fert, where they left him to fhift for himfelf. Happily, 
 however, either through accident or defign, thefe religious 
 devils had depofited their prey near fome water, which 
 undoubtedly, as he dill retained his fenfes, was the means 
 of preferving his life. " It was there (fays he) that, ex- 
 " tended upon the earth, with no other fiiccour than a 
 " little water, nature laboured to expel the poifon by 
 " which I was opprefTed. One of the buboes burft of 
 " itfelf j the peftilential fores, which appeared firft of a 
 "' red purple, became yellowiih, then brown, and laftly 
 " black. Thefe parts then becoming gangrenous, form- 
 " ed hard and thick fcabs, which, kernelling and falling 
 " away from the quick fiefh, left very deep ulcers. This 
 " was the fird epocha of health ; an abundant fuppura- 
 " tion began, and the fever almoft immediately left 
 
 me." 
 
 Having remained alone in the defert for eight or ten 
 days, he was found by chance by fome Arabian women, 
 who brought him to their place of rciklence, wafhed his 
 fores with water, brought him dried herbs for his bed, 
 and gave him barley bread, butter and curds for his 
 food ) endeavouring beiides by their fongs to comfort 
 
 him. 
 
THE YELLOW FEVER. 
 
 Iilm, and alleviate his diftrefs as much as poffible. With 
 thefe women he remained twenty days, reduced to an 
 extremity of weaknefs by reafon of the difcharge from 
 the fores. At lad, having learnt a few Arabic words, he 
 prevailed upon two of the hufbands to conduct him to 
 Aleppo, about feven days journey diftant. He was now 
 mounted aftride on a camel (a very hard trotting ani- 
 mal) and by forced marches accomplifhed the journey 
 infix days, when he appeared before the conful, the 
 European marchants, and a crowd of people, in a condi- 
 tion without example ; almoft naked, with five running 
 buboes, the little covering he had foul, infe&ed with 
 ulcers as long as the palm of the hand, which had eaten 
 away the flefli, and in fome places difcovered the bones, 
 having befides two holes in the fcrotum. From this 
 miferable condition he recovered in a month. It would 
 feem that in fome cafes the human body, as well as mind, 
 rifes fuperior to every indignity ; and that in proportion 
 to the degree of injury and opprefiion is the tenacity of 
 life, as well as energy of fpirit. 
 
 3 . Remarkable cure of the plague by expofure to cold and 
 ivet. M. Savary relates that the captain of a veffel in- 
 formed him that, having touched at Conftantinople 
 when the plague was raging there, fome of his failors 
 caught the diftemper ; two died fuddenly, and by af- 
 iifting them he was infected. " I felt exceflive heat 
 " (fays he) which made my blood boil ; the difeafe feized 
 " my head, and I perceived that I had only a few mo- 
 " ments to live. The little remaining reafon I had 
 " taught me to attempt an experiment. I laid myfelf, 
 " quite naked, all night on the deck - 5 the heavy dews 
 " that fell penetrated to my very bones ; in a few hours 
 " I could breathe freer, and ray head was better ; my 
 " agitated blood became calm, and, bathing the morning 
 " after in the fea, 1 was perfectly cured." 
 
 4. Extraordinary effeft of FEAR in rendering the con- 
 tagion of the SMALL POX effeftual* " A very beauti- 
 " ful girl, twenty-five years of age, fervant to captain 
 4 * Morton, had never had the fmall pox, and had the 
 
 " moft 
 
 9 Haygar&'s Sketch, vol. ii, p. 405. 
 
:< 
 
 540 A TREATISE ON 
 
 " mod dreadful apprehenfions of that difeafe. On the 
 " twentieth of Januarv, 1791, about four in the after- 
 *' noon, flie was (landing near the kitchen fire, when 
 ;c a joiner in the neighbourhood came to the door, which 
 :c is about fixteen feet from the fire place where the girl 
 <c ftood. Mrs. Morton found fault with the man for 
 " not coming fooner to finim fome work, and he ex- 
 <c cufed himfelf by faying his apprentice was ill of the 
 :c fmall pox, which had delayed him. The girl imme- 
 <c diately clafped her hands, and exclaimed, God forgive 
 ** you, but I will lay my death to you. From that mo- 
 ment (lie became chilly, then hot and reftlefs. She 
 pafil-d a very bad night, frequently exclaiming, God 
 * c forgive Caider, he has killed me ; meaning he had 
 <c given her the final! pox. In the morning of the 
 " twenty-ill (I I was fent for, and found her very hot, with 
 *' a quick pulfe, great ficknefs and anxiety. I ordered her 
 " an emetic, and aflured her flic did not need to be in 
 " the leaft alarmed, as file could not poffibly have 
 " caught the difeafe. She iecmed to be convinced that 
 ** her fears were ground leis ; but next day, the twenty- 
 " fecond, a violent rafli appeared ; on the twenty-third 
 " the fmall pox came out, of the word kind I had ever 
 <c feen, and flie died on the ninth day from the eruption." 
 5. Inefficacy if FEAR to render the contagion of \ EL- 
 LOW FEVER effectual. Dr. Rufh mentions a young 
 woman fo exceedingly fearful of the difeafe, that (lie was 
 troublefonie to all around her. Afterwards (he hap- 
 pened to be under the neceffity of attending Jeven per- 
 fons ill of the fever, and yet efcaped unhurt. This 
 (hows that fear (and the fame may be laid of any pre- 
 difpofing caufc) is not always fuificient to produce the 
 difeafe. The foregoing cafe is fo extraordinary that 
 Dr HUygarth is of opinion that the patient muft have 
 been previoufly infected ; but of this there is no evi- 
 dence ; and it is bad reafoning to endeavour to eftablifli 
 a fact by our own ignorance. The only argument that 
 is or can be ufcd in fiich cafes is, " I cannot underftand 
 how fuch a thing could have happened, therefore it has 
 not been fo." 
 
 6. 
 
THE YELLOW FEVER, 54* 
 
 6. "Boullam fe-ver cured by a blifter* The patient was 
 a tradefman in St. George's, Grenada, and had " all the 
 *' fymptoms of the difeife except the febrile heat. A 
 *' blifter was applied between the moulders, without ad- 
 * c miaiftering any medicine previoufly except .the folu- 
 <c tion (mentioned p. 530) which operated very mode* 
 <c rately. The effect WAS wonderful ; the difcharge was 
 " uncommonly large, blavk, and foetid in an intolerable 
 " degree; and the indent this took place the patient 
 < became better; and fooo ifter, without the ufeof any 
 t other remedy, recovered." 
 
 7 . Yello w fever of Birbadoes cured fa vomiting . j The 
 patient was a young man, about twenty-four years of 
 age, furgeon to a Guinea (hip. Being a lover of fpiritous 
 liquors, he had been drunk three days and nights fuccef- 
 lively, and in that condition had run races with the fai- 
 lors on the fhore, in the heat of the mid day fun. The 
 lad night he ilept in the open air under a tamarind tree, 
 and in the morning was feized with the fever, attended 
 with the mod violent reaching to vomit, infomuch that 
 lie could fcarcely anfwer yes or no to the questions afked 
 him by the Doctor. Sixteen ounces of blood were taken 
 away, which was very florid, thin and difiblved. He was 
 directed then to drink warm water to cleanfe his ftomach, 
 which he did to the amount of three gallons, which he 
 difcharged, together with immenfe quantities of yellow 
 and blackifh bilious matter. He then took a grain and 
 an half of opium, and ilcpt fomc hours, after which a 
 dole of manna and tamarinds carried off by ftool a good 
 deal more of bilious matter, and, with the help of fomc 
 elixir of vitriol, mint and fnakeroot tea, he recovered in 
 a (hort time. 
 
 Dr. Rufh, in a letter publifhed in the neivfpapers 
 lad year, after regretting the inefficacy of bleeding and 
 purging, fufpects " that death occurred from thcftagna- 
 ** tion of acrid bile in the gail-bladder, or its adherence 
 " to the upper bowels, as mentioned by Dr. Mitchell 
 "in 1 741, "which he propofes to evacuate by drong 
 
 emetics 
 
 ** Chiflwlm's Effayi p. 1*9. i Hillary's Obfervations> p. 37^. 
 
542 A TREATISE ON 
 
 emetics and purgatives, fo as to occafion an artificial 
 cholera morbus ; and he greatly commends this mode 
 of practice. " Vomits (fays he) are old remedies in the 
 ** yellow fever of the Weft Indies. I gave them on the 
 " firft day of the difeafe in the year i793> and always 
 " without fuccefs. They uniformly did harm when 
 " given in the beginning of the fever in its worft grade, 
 w Tn 1797. The reafon of this failure in their efficacy 
 " I now perceive was becaute they were given before, the 
 <c violent morbid action in the fyftem was reduced or 
 " moderated by bleeding and purging. After this- 
 " change is introduced in the difeafe they are perfectly 
 ce fafe. The time for exhibiting them (houid be regu- 
 C 1'ated by the pulfe and other fymptoms. In moderate 
 ** cafes of the fever they are as proper in its firft ftage. 
 " as on the 4th day* As there is a bliftering point in all 
 * c fevers, fo there 'appears to be an emetic point in the 
 " yellow fever. It may occur on the fecond, and it 
 c< may be protracted to the fixth or feventh day of the 
 * c difeafe. I have not given the medicine I have men- 
 " tioned in any cafe where the patient complained of 
 " pain or burning in the ftomach ; but I have confidered 
 a naufea, and a moderate degree of puking, as no ob- 
 " ftacle to its ufe ; for Dr. Phyfic has taught me by his 
 " diffections that thefe fymptoms may exift without the 
 " leaft inflammation in the ftomach, and that they have 
 been abfent where the ftomach has appeared after 
 a death to have been highly inflamed . 
 
 " The cure of the fever ihould not reft upon a fingle 
 * dofe of the medicine. I have given two dofes of it io 
 " a day in feveral cafes, and have given it in one cafe 
 " every day for three fucceflive days. 
 
 " It has often been rem-arfeed, that no two epidemics 
 " are exactly alike. They vary not only in different 
 " climates, but in the fame climate in different years. 
 " They even vary with the changes of the weather in the 
 "famcfeafon. The fever of 1797 differed in fevera* 
 " particulars from the fever of 1793 ; and the psefenfc 
 epidemic differs materially from both. In many of 
 " the cafes I have feen it qxceeds the fever of laft year ^n 
 
 w its 
 
THE YELLOW FEVER. 543 
 
 its malignity. Thefe variations in difeafes call for 
 correfponding changes in our practice." 
 8. Extraordinary cafe of yellow fever at Rofton in 1 798. 
 The fubject of it* was a female of about 24 years of 
 age, in the 9th month of pregnancy. I faw her on 
 Monday the 1 7th of September. She had then a fmaU 
 but painful hardnefs on the left parotid gland, which 
 had commenced fome days before, and foon extended 
 to the lips and neighbouring parts. The centre of the 
 tumour refembled that of the incifion of an arm 
 about the time of the eruption of the fmall pox 
 after inoculation, exhibiting a hard, florid, (hining 
 appearance. I recommended an emollient poul- 
 tice, hoping to procure fuppuration ; but, though 
 they were repeated fteadily, not the lead evidence 
 of matter could be produced ; and upon each vi- 
 fit I found the tumour had extended in a rapid and 
 formidable degree. I was called up in the courfe of 
 the night to her, and found her almofl fuffocated from 
 the preflure of the tumour on the trachea ; for it had 
 now extended itfelf to all the mufcles and glands of 
 the neck and face. I changed the poultice for an em- 
 brocation of the faturnine preparations, which were re- 
 peated till about 10 o'clock of the following morning, 
 when (he was taken in travail, and foon delivered of 
 a healthy male child. For a few hours after her de- 
 livery (he appeared fomething better, but in the night 
 <c flie grew worfe, and about 12 o'clock I was called to 
 " her, when (he appeared to be expiring. At the requeft 
 " of her friends I entered my lancet into the tumour 
 <c the length of the inftrument -, but, as I had expect- 
 " ed, not the lead particle of matter flowed, and the 
 " parts were as hard as a fchirrus. She continued how- 
 " ever in agony till 3 o'clock of the day, and then 
 " expired." 
 
 9. Two cafes of fpontaneous origin of yellow fever : from 
 the Medical Repofitory, vol. ii, p. 333. " At Salem 
 " (Mailachufetts) there was a general prevalence of 
 
 " health 
 
 * The attending phyfician's, name is not mentioned* having no permiffioa 
 to do ib. 
 
 <e 
 
A TREATISE 
 
 *' health at that feafon ; though feveral cafes of yellow 
 ec fever, and fome of them fatal ones, occurred. Dr. 
 " Oliver very judicioufly inclines to the belief that the 
 <c exemption of this town from the ravages of yellow 
 " fever is owing, ift, to the remarkably clean ftate of 
 " the town ; and, zdly, to the houles being placed at 
 " luch diftances as to admit of free ventilation. It was 
 " obfervable that the yellow fever had a fpontaneous 
 * c origin in two different places of the town, where putrid 
 *' matters had been fufferrd to accumulate, and proved 
 <c fatal to two perfons in different families ; thefe unclean 
 *' fpots forming exceptions to to the generally purified 
 " flate of the town." 
 
 10. Cafe of fever produced by the effluvia of putrid beef. 
 This took place in the federal garnfon on Governor's 
 liland.* The fubject was a foldier, who had been ex- 
 cufed from duty on account of a violent and obftinate 
 gonorrhoea. On removing him into a lodging without 
 the garnfon he was feized with fymptoms of fever, and 
 on the commencement of thefe the gonorrhce.i ceafed. 
 For four days the fever increafed, and was attended at 
 hft with vomiting, hiccup and delirium. From the 
 firft commencement of the difeafe the phyfician had 
 been fenfible of a very offenfive fmell in the patient's 
 room. Being allured that this was not owing to want of 
 cleanlinefs, he caufed fearch to be made under it, and in 
 the cellars found three barrels of beef fo putrid that it 
 was with difficulty they could be removed, on account 
 of the ftench. Oa removing them, however, the patient 
 rapidly recovered, though till then he had conftantly 
 grown worfe. 
 
 * Medical Repofitory, vol. i, p. sio. 
 
 END OF THE SECOND PART. 
 
APPENDIX. 
 
 N I. 
 
 Account of the Plague at Athens., in the time of the PC- 
 
 lop onnefian War : From THUCYDIDES . S M i T H'J> 
 
 Tranflation. 
 
 THE Peloponnefians and their allies, who had made an incurfion into 
 Atticai with two thirds of their forces, had not been many days there 
 before a ficknefs began firft to appear among the Athenians, fuch as was re- 
 ported to have raged before this in other parts, as about Lemnos and other 
 places. Yet a plague ib great as this, and Ib dreadful a mortality, in human 
 memory could not be paralleled. The phyficians at firft could adminifter no 
 relief, through utter ignorance ; nay, they died the falter, the clofer their at- 
 tendance on the fick ; and all human art was totally unavailing. Whatever 
 i'upplications were offered in the temples, whatever recourfe to oracles and 
 religious rites, all were infignificant : at laft, expedients ef this nature they 
 totally relinquifned, overcome by calamity. It broke out firft, as it is faid, in 
 that part of Ethiopia which borders upon Egypt ; it afterwards fpread into 
 Egypt and Libya ; and at length, on a fudden, fell on the city of the Athe- 
 nians. The contagion fhewed itfelf firft in I'iiaeus; which occafioned a re- 
 port, that the Pcloponnelians had caufed poifon to be thrown into the wells ; 
 for, as yet, there were no fountains there. After this it fpread into the upper 
 city, and then the mortality very much, increafed. Let every one, phyfician 
 or not, freely declare his own fentiments about it ; let him affign any credible 
 account of its rife, or the caufes ftrong enough, in his opinion, to introduce fo 
 Terrible a fcene. I (hall only relate what it actually was, and as, from an in- 
 formation in all its fymptoms, none may be quite at a lofs about it if< ever it 
 ftiould happen again, I (hall give an exact detail of them ; having been lick of 
 it my 1 elf, and feen many others afflicted with it. 
 
 This very year, (430 B. C.) as is univerfally allowed, had been, more than 
 any other, remarkably free from common diforders; or, whatever difeafe? 
 had already feized the body, they ended at length in this. But thofe wlio en- 
 joyed the moft perfecl health were fuddenly, without any apparent caufe* feized 
 at firft with head-achs extremely violent, with inflammations and fiery rednefs 
 in the eyes. Within, the throat and tongue began inftamly to be red as blood ; 
 the breath was drawn with difficulty, and had a noifome fmell. The 
 fymptoms that fucceeded thefe were, fneezing and hoarienefs ; and not long 
 after, the malady defcended to the breaft, with a violent cough; but, wheu 
 once fettled in the ftomach, it excited vomitings, in which was thrown up ali 
 that matter which phyficians call difcharges of bile, attended with exceffive 
 torture. A great part of the infected were fubject to fuch violent hiccups. 
 without any di (charge* as brought upon them Itrong convulsions, to fome but 
 of a fhort, to others of a very long continuance. The body, to the outward 
 touch, was neither very hot nor of a pallid hue, but reddifh, livid, marked all 
 over with little puftules and fores ; yet, inwardly, it was fcorched with fuch 
 exceffive heat that it would not bear the flighteit covering of the fineft linen 
 upon it, but muft be left quite naked, They longed for nothing fo much. 
 as- to be plunging in cold water; and many <?t thofe. who were not pro*' 
 
 4 A perly 
 
APPENDIX, 
 
 perly attended threw themfelves into wells, hurried by a th'uft not to fc 
 extinguifhed ; and, whether they drak much or little, their torment ftill 
 continued the fame. The reftletthefs of their bodies, and an utter inabili- 
 ty ofcompoling themfelves to fleep, never abated for a moment And thd 
 body, fo long as the diftemper continued in its height, had rib vifible wafte 
 but withllood its rage to a miracle ; fo that moft of them perifhed within feven 
 or nine days by the heat that fcorched their vitals, though their ftrength was 
 not exhautted ; or, if they continued longer, thedifternpsr fell into the belly 
 cauftng violent ulcerations ot the bowels, accompanied with, an inceflant flux, 
 by which many, reduced to an excefftve weaknefs, were carried off. For the 
 malady, beginning in the head, and fettling firit there, funk afterwards 
 gradually down through the whole body. And whoever go fafe through all 
 its moft dangerous ftages, yet the extremities of their bodies ftiil retained the 
 marks of its violence. For it ihot down into their privy members, into 
 their fingers and toes, by lofing which they efcaped with 1'Te. Some thera 
 were who loft their eyes, and fome who, being quite recovered, had at once 
 totally loft all memory, and quite forgot not only their mod intimate friends* 
 but even their own felves. For, as this diiiemper was in general virulent be- 
 yond exprelfion, and its-every part more grievous than had yet fallen to the lot 
 of human nature ; fo, in one particular inftance, it appeared to be none of the 
 ratural infirmities of man, fince the birds and hearts that prey on human flefh 
 either never approached the dead bodies, of which many lay about uninterred 
 or certainly perilhed if they taftcd. One proof of thia is then the total difap- 
 pearance of fueh birds; for not one was to be feen, either in any other place,. 
 or about any of the carcafes. But the dogs, becaufe of their conftant familiarity 
 with man, afforded a more notorious proof of this event. 
 
 The nature of this peililential diibr'der was in general (for I have purpofely 
 omitted many of its varied appearances, or the clrcumftances particular to 
 ibmeof the infededin contradiftindlion to others) fuch as hath been defcribed. 
 None of the common maladies incident to human nature prevailed at that 
 time ; or, whatever diforder any where appeared, it ended in this. Some died 
 merely for want of care; and fome with all the care that could poffibly be 
 taken; nor was any one medicine difcovered from whence could be promifeci 
 any certain relief; fince that which gave eafe to one was prejudicial to another. 
 Whatever difference there was in bodies in point of ftrength, or in point of 
 weaknefs, it availed nothing ; all were equally fwept away before it, in fpite 
 of regular diet, and ftudied prescriptions. Yet the moft a fiecl ing circumftances 
 of this calamity were, that dejection of mind which conftantly attended tho v 
 firft attack ; for the mind finking at once into dtfpair, they loon gave them- 
 felves up without a ftruggle ; and that mutual tendernefs in taking care of one 
 anothe 1 * which communicated the infediion, and made them drop like iheep. 
 Thib latter cafe can fed the mortality to be fo great. For, if fear withheld 
 them from going near one another, they died for want of help ; fo that many 
 houles became defolatc for wan? of needful attendance ; and if they ventured, 
 they were gone. This was moft frequently the cai'e of the kind and compaf* 
 fionale Sur.h yerfons were a'f'amed, out of 'A feltnh concern for themfelves, 
 entirely to abandon their friends 5 when their menial fervants, no longer able 
 to endure the groans and lamentations of the dying, had been compelled to fiy 
 from fuch a weight ot calamity. But thofe, efj>ecia;ly, who had fafely gone 
 through it, took pity on the dying and the lick, becaufe they knew by them- 
 felves what it really was and were now fe<;ure in themfeivcs ; for it never 
 j'eized one a Jeeond time fo as to be mortal. Such were looked upon as quite 
 happy by others, and were themfelves at firft overjoyed in their late efcape* . 
 and the groundlefs hope that hereafter no diftemper would prove fatal to them. 
 Betides this rciguing calamity, the general removal from the country into the 
 city was a heavy grievance, more particularly to thofe who h.icJ been necelfi- 
 tated to come thither. For, as they had no houfes, but dwelled all the fum- 
 jner time in booths, where there was fcarce room to breathe, the pefiiience 
 deftroyed them with the utmort diforder, fo that they Jay together in heaps, 
 the dying upon the dead-, and the dead upon the dying. Some were tumbling 
 over one another in the public ftreets, or lay expiring about every fountain* 
 whither they had crept to afTuage their extraordinary thirit. The temples, 
 
 to 
 
APPENDIX. 547 
 
 In vvliich they had ereaed tents for their reception, were full of the bodies 
 which had expired there. For, in a calamity fo outrageouily violent, and uni- 
 verfal defpair, things facred and holy had quite loft their diftindlion. Nay* 
 all regulations obferved before in matters of fepulture were quite confounded* 
 iince every one buried where he could find a place. Some, Whole fepuichres 
 were already filled by the numbers which had periftied in their own families, 
 were fnamefully compelled to feize thofe of others. They furprifed on a fud- 
 len the piles which others had built for their own friends, and burned their 
 dead upon thm ; and fome, whilft one body was burning on a pile, tofled 
 another body they had dragged thither upon it, and went their way. 
 
 Thus did the peftilence firft give rife to thofe iniquitous ads which pre- 
 vailed more and more in Athens. For every one was now more eafily indu- 
 ced openly to do what for decency they did only covertly before. They faw the 
 ftrange mutability of outward condition ; the rich entirely cut off, and their 
 wealth pouring fuddenly on the indigent and neceflitous ; fo that they thought 
 it prudent to catch hold off'peedy enjoyments an<l quick gufts of pleafurej 
 perfuaded that their bodies and their weai h. might be their own merely for 
 the day. Not anyone continued refolute enough to form any honeft or gene- 
 rous dsfign, when fo uncertain whether he mould live to effed it- What- 
 ever he knew could improve the pleafure or latisfaclion of the prefent mo- 
 ment, that he determined to be honour and intereft. Reverence of the gods, 
 crof the laws of fociety, laid no reftraints upon them; either judging that 
 piety or impiety were things indifferent, fmce they faw that all men peri(hed 
 alike; or, throwing away every apprehenfion of being called to account for 
 their enormities, (ince juftice might b^ prevented by death; or rather, as the 
 heavieft judgment to which man could be doomed was already hanging 
 over their heads, fnatching this interval of pleafure before it fell. 
 
 N e II. 
 
 dc count of the Great Plague In the time 0/*JusTiNiAN : 
 By FROCOPIUS. 
 
 r T^HIS was a plague which almoft confumed mankind ; of which Procopitis 
 JL concludes there was no other caule than the immediate hand of God 
 himfelf For it neither came upon one part of the world alone, nor in one 
 feafon of the year; whence fubtile wits (as he faith) might make pretenfions. 
 It afRided the whole world? and all conditions of men, though of never fo 
 contrary a nature and difpofition ; fparing no confutation nor age. The dif- 
 ference of men as to their places of dwelling, diet, complexions, inclinations? 
 &c. did no good in this diieafe. Some it took in fummer, fome in winter* 
 and others in other feafons. It began among the Egyptiins in Pelufium, and 
 fpread to Alexandria, with the reft of Egypt, one way, and the other to thofe 
 parts of Paleftine which border upon Egypt. From thence it travelled to the 
 utmoft bounds of the world, as by fet journies and ftages, making deftrucliott 
 its only butinefs, and fparing neither iiland> cave, nor top of -mountain, where 
 mankind inhabited ; for, if it leaped over a country, returning afterwards* 
 it left it no caule to rejoice above its fellows It began ftill at the fea coaft, 
 and thence went to the inland parts In the fecond year of its progrefs it 
 arrived at Conftautinople, about the middle of the fpring, where it was the 
 fortune ol Procopius then to refide. Apparitions of fpirits, in all fhapes hu- 
 man, were feen by many, who thought the man they met ftruck them in 
 fome part of the body ; and fo foon as they faw the fpirit they werefeized with 
 the difeafe At firft when they met them they repeated divine names, and 
 lied into churches, to no purpofe. Afterwards they were afraid to hear thetr 
 friends call them, locking themfelves up in their chambers, and (topping their 
 ears. Some dreamed they faw fuch lights ; others that they heard a voice 
 tell them they were enrolled among the number of thofe appointed to die. 
 
 But 
 
545 
 
 APPENDIX. 
 
 T?ut moftr without warning, became feverifh fuddenly : thdr bodies changed 
 not colour, nor were hot ; the fever being fo remils till evening, that neither 
 the patient nor phyiician. by his pulfe, could apprehend any danger. Yet to 
 fame the fame day, to others the next, or many days after, arofe a bubo, ei- 
 ther in the groin, the armpit, under the ear, or in other parts. Thefe were 
 the general fyrnptoms which happened alike to'al! the vifited peribrife. 
 
 There were others different ; whether made fo by the diverlity of bodies, 
 or by the will and pleafure of him that fent the diftemper, our author cannot 
 fay. Some were feized with drowfinefs and numbering, others with a (harp 
 diftracYion. The flumberers forgot all things : if they were looked to, fomc 
 would eat ; fome, that were negledted, flarved to death. Thofe who were 
 diftra&ed were vexed with apparitions ; crying there were men to kill them ; 
 and running away ; being fo troublefome and unruly that their keepers were 
 pitied as much as they themfelves. No phyfkian or other caught the difeafe 
 by touching tick or dead bodies ; many ftrangely continuing free, though they 
 tended and buried infected perfons, and many catching it they knew not how, 
 and dying inft mtly. Many leapt into the water, though not from thirft ; and 
 fome into the fea. Some, without flumbering or madnefs, had their bubo 
 gangrened, and died with extreme pain ; which doubtiefs alfo happened to 
 thofe who had the phrenfy, though, being not themfelves, they underftood it 
 rot. Some phyficians hereupon, conceiving the venom and head of the dif- 
 eafe to lie in thofe plague fores, opened the dead bodies, and, fearching the 
 fores, found an huge carbuncle growing inward^ Such whole bodies were 
 f pot ted with black pimples, the bignefs of a lentile, lived not a day. Many 
 died vomiting blood. Some that were given over by the moft eminent phy- 
 ficians unexpectedly recovered ; others, of whofe recovery they thought them- 
 felves perfedtly fecure, fuddenly perifhed. No caule of this ficknefs could 
 be reached by man's reafon. Some received benefit by bathing, others it 
 hurt. Many died for want of relief, others efcaped without it. In a word, 
 no way could there be found of prefervation, either by preventing the fick- 
 nefs, or of mattering the difeafe, no caule appearing either of their falling lick 
 or recovery. Women with child, who were vilitcd, certainly died; fome 
 xnifcarrying, fome fairly delivered, and perilling with their children. Three 
 women only were fafely brought to bed and recovered, their children dy- 
 ing ; and one died whole child had the hap to live. Such as had their fores 
 great, and running plentifully, efcaped ; the violence of the carbuncles be- 
 ing thereby afluaged ; and this was the moft certain fign of health. Such 
 whofe fores ftaid as they firft arofe, underwent ths miferable accident for- 
 merly mentioned. Some had their thighs withered, when the fores rofe 
 upon them and did not run. Some efcaped with diminifhed tongues, and 
 lived ftammering, or uttering founds without diflindion, all their days. In 
 Conftantinoplc the peftilence lifted four months ; raging three months with 
 all extremity. In the beginning few died more than ufual. Then, growing 
 liotter and hotter, it came to live, and at laft to ten thoufand every day. At 
 firft they buried their dead carefully.; but at length all came to confufion, 
 and many lay long unburied ; fervants were without mailers ; rich men had 
 none to attend them. In the afrl idled city little was to be feen but empty 
 Iioufes, no trade going, or ihops open. 
 
 N III. 
 
 Account of the Plague at London in 1665 : From Dr. 
 HODGES and others, 
 
 IN the beginning of September 1664 the people of London firft became 
 alarmed by a report of the plague being broke out in Holland, where it 
 raged violently the former year. The United Provinces had received it from 
 fome place in the Levant, and, certain accounts having been received of the 
 
 dJfteropei 
 
APPENDIX. 549 
 
 iiftemper being in Holland, feveral councils were held by government with a 
 view of concerting means for preventing its introdudlion into Britain Thefe 
 Mvere held privately, and it does not appear that any thing was poiitively de- 
 termined upon ; but thus the knowledge that 1'uch a diftemper exifted in 
 Holland was fupprefifcd, and the public tears diflipated until the beginning 
 of December ; when two, fuppofedtobe Frenchmen,* in Long-acre, or rather 
 the upper end of Drury lane, died with fuch fufpicious fymptoms that the 
 people ot the houfe endeavoured to conceal the diftemper of which they died. 
 The fecretaries of (late, however, having got intelligence of the matter, cauf- 
 ed their bodies to be infyeded, when it became evident they had died of the 
 plague. This produced a general alarm ; Dr. Hodges fays, that hereupon 
 forne timorous neighbours, under apprehenfions of a contagion, removed in- 
 to the city of London ; who unfortunately carried along with them the pefti- 
 lential taint ; whereby that difeafe, which was before in its infancy, in a fa- 
 ' mily or two, fuddenly got ftrength, and i'pread abroad its fatal poifon ; and* 
 < merely for want of confining the perfons firft feized with it, the whole city 
 < was irrecoverably infected/' The author of the Journal, however, fays 
 that the public fear again fubfided, though it had been ftill farther railed by 
 the death of another pertbn in the fame houfe about the latter end of Decem- 
 ber ; but, as no more died for fix weeks, no farther notice was taken of it un- 
 til the 1 2th of February, when one died in another houfe, but in the fame 
 parifh. Soon after this an increafewas obferved in the weekly lift of burials 
 at St. Giles's parith, which augmented the general alarm fo much that few 
 cared to pafs through Drury lane or the fufpeded ftreets, unleis upon very 
 urgent bufinefs. In a fhort time a like augmentation was perceived in the 
 "bills of the adjoining parithes, and indeed all over the town. The Journal 
 informs us that the ufual number of burials within the bill of mortality was 
 from 240 to 300 ; but from the 2oth of December to January 24th they had gra* 
 dually arifen from 291 to 474. This feems incontinent with what he had be- 
 fort faid of the alarm having ceafed till the I2th of February ; but we (hall 
 take his own words. "This laft bill (474) was really frightful; being a 
 ' greater number than had been known to have been buried in one week fmce 
 4t the preceding vifitation of 1656. However, all this went off again, and the 
 41 weather proving cold, and the froft, which began in December, continuing 
 *' very fevere, even till near the end of February, attended with (harp though 
 * moderate winds, the bills decreafed again, and the city grew healthy, and 
 41 every body began to look upon the danger as good as over ; only that ftill 
 the burials in St. Giles's continued high. From the beginning of April efpe- 
 41 daily, they ftood at 25 each week, till the week from the i8th to thr 
 zjth, when there were buried in St. Giles's parifh 30 ; whereof were two 
 ' of the plague, and eight of the fpotted fever, which was looked upon as thr 
 fame thing ; likewile the number that died of the ipotted fever on the 
 whole increafed ; being eight the week before, and twelve the week above 
 " named." 
 
 Thus a new and ftill greater alarm was produced, which was yet farther 
 
 augmented by the fpreading of the diftemper. The journalift fays indeed 
 
 that only a few were fet down in the lifts as having died of the plague ; the 
 
 remainder of the. deaths being charged to other diitempers; and accordingly 
 
 one week, when the mortality bilKwas high, and only 14 charged to the plague f 
 
 lie fays, this was all knavery and collufion ; for in St. Giles's parifli they 
 
 1 buried 40 in all; whereof it was certain that moft of them died of the 
 
 1 plague, though they were fet down of other diftempers; and though ths 
 
 number ot all the burials was not increafed above 32, and the whole bill 
 
 * being but 385, yet there were 14 of the fpotted fever, as well as 14 of the 
 
 * plague; and we took it for granted upon the whole that there were 50 died 
 < of the plague that week. The next bill was from the 23 d of May to the 
 ^oth, when the number of the plague was 1 7 ; but the burials in St. Giles's 
 
 were 53 ; a frightful number, of whom they fet down but nine of the 
 j but, on examination more ilritUy by the juftices of the peace, and 
 
 * a* 
 
 * jfwr&l of th: Plague Tear, 
 
55* APPENDIX. 
 
 * at the lord mayor's requefl, it was found there were aa more who were yeaLV 
 dead of the plague in that parifh, but had been fet down of the fpotted fe- 
 ver, or other diftempers, befides other* concealed." 
 
 The account given by Dr. Hodges is fomewhat different from the above. 
 He informs us that " a very hard froft began in December, and continued 
 three months, which feerncd greatly to diminim the contagion, and very 
 " few died during that feaion ; though even then it was not totally extinguith- 
 ed." The journalift fays that in this interraiffion of the plague there was 
 a difficulty which he could not well get over. The firft perfon who died of 
 the plague he fays (p. 334) was on December aoth, or thereabouts, 1664, though 
 he had told us before (p. ^} that it was the end of November, or beginning 
 of December the fame year. But after this (continues he) we heard no more 
 of any perfon dying of the plague* or the diftemper being in that place, till 
 * the ^th of February, which was about feven weeks after ; and then one more 
 '* wa> buried out of the lame houfe : then it was hufhed and we were per- 
 *' fcclly eafy as to the public for a great while, for there were no more enter- 
 *' ed in the weekly bill to be dead of the plague,, till the zzd of April Now 
 the queition feems to be thus : Where lay the feeds of the infection all 
 * this while ?* How came it to ftopfo long, and not to ft^p any longer ? Either 
 " the diftempsr did not immediately come by contagion from body *o body* 
 ' or, if it did, then a body may continue to be infected without the difeal* 
 * difcovering itfeif many days, nay, weeks together. It is true there 
 * was a very cold winter, and long froft, which continued three raontks ; and 
 this, the Doclors fay, might check the infection ; bur then the learned mull 
 * allow- me to fay that if, according to their notion* the difeafe was, as I 
 ' may fay, only frozen up, it would, like a frozen river, have returned to its ufu- 
 * al force and current when it thawed ; whereas the principal recefsof the in- 
 fection, which was from February to April, was after the froft was broken f 
 " and the weather mild and warm. But there is another way of folving all 
 this difficulty* which I think my own remembrance of the thing will fup- 
 ** ply ; and that is, the fact is not granted, namely, that thqre died none in 
 ' thofe long intervals, viz. from the zoih of December to the gth of February, 
 * and from thence to the 2id of April. The weekly bills are the only evi- 
 *' dence on the other fide, and thofe bills were not of credit enough, at lealt 
 ' with me, to fupport an hypothefis, or determine a queftion of fuch impor- 
 tanceas this : for it was cur received opinion at that time, and I believe 
 upon very good grounds, that the fraud lay in the parifh officers, fearchers, 
 a< and pcrfons appointed to give account of the dead, and what difeafes they di 
 r ed of; and, as people were veiy loth at firft to have the neighbours believe 
 their houfes wereinfeded. fo they gave mouey to procure, or ptherwife pro- 
 * cured, the dead perfons to be returned as dying of other diftempers ; and this, 
 fi I know, was pradtifed afterwards in many places ; I believe I might fay inalJ 
 places where the difiempercaine i as might be feen by the vaft increafe of 
 * the numbers placed in the weekly bills under other articles of difeafes, 
 < during the time of the infedion. For example, in the months of July and 
 Auguil, when the plague was coming on to hs highdt pitch, it was very 
 ordinary to have from 1000 to 1200, nay to almoft 1500, a week, of other 
 *< diftempers : not that the nun)bers ot thofe diftempers were really increafed 
 to fuch a degree ; but the great number of families and houfes where really 
 * the infection- was, obtained the favour to have their dead returned of other 
 difte<n;->ers, to prevent th-e Hunting up of their houfes." 
 
 The difeafe continued to advance, but with fuch intervals and remiffions as 
 frequently gave hopes of its disappearing entirely. Neverrhelefs, about the 
 beginning at May ihe inhabitants began to leave the ity in great numbers. 
 Thejournaliftj for his own part, vras irrefolute; and fometimes would have left 
 the city with the reft, had it not been for the imponlbiJity of finding an horfe; 
 for, (fays he) though it is true that all the people did not go out of the city 
 ** of London, yet I may venture to fay that in a manner all the horfes did ; 
 * lor there was hardly a horfe 10 be bought or hired in* the whole city for fom* 
 * weeks." Many fled on foot, carrying with them foldiers* tents, in which 
 they il^pt in the fields, ir being then warm weather, and no danger of taking 
 cold. This way ot living \vs.& alio ii.rniliar in fome degree by reafon of the 
 
 wars 
 
APPENDIX. $ji 
 
 which had preceded; multitudes of thofe who had fervedin them being 
 
 at that time in London. This our author greatly approves of as a method of 
 preventing the infedtion from fpreading, and thinks that, had it been more 
 generally practifed,much lei's damage would have been done in the country 
 than happened at the time from this dreadful diftemper. 
 
 Early in June the court thought proper to remove to the city of Oxfordt 
 whither the infedtion did not reach. The people ftill continued to remove 
 during the whole month of July, though infmaller numbers than before ; but 
 in Auguft the multitude of fugitives fo increased that, fays our author, I be- 
 gan to think there would be noiie but magiftrates and fervants kft." Hein- 
 fotmsui allb that at the bieaking out of this plague the city was unufually full 
 of people ; vatt numbers who had ferved in the wars, or who, in times of trou- 
 ble, had been friends to royalty, had flocked into it on the reiteration of 
 Charles II, in hopes of reaping fome fruit of their former labours aud fuller- 
 ings ; fo that on the whole he fuppofes there muft have been upwards of an 
 hundred thoufand people more than ufual in the city. Indeed, if we are to 
 believe that, on a representation of the ftate of the poor to the lord mayor, it 
 appeared that there were an hundred thoufand ribband weavers in Spittle- fields* 
 we muft look upon the population of London at that time to have been incredi- 
 bly great; and when the journalift computes the number of thofe who fled 
 only at two hundred thoufand, we muft certainly iuppofe it te have been 
 greatly underrated. 
 
 As the plague continued to become more and more violent, the magiftrates 
 thought proper to take fome means tor feparating the infefted from the 
 healthy ; but unhappily their mode of procedure was fuch as infpired both the 
 inlsded and uninfected with the utmoft terror. The houfes were marked with 
 a red crofs, fubfcribed with the words LORD, HAVff ME&CY UPON vs !** 
 in large letters. They were continually guarded, day and night ; and none 
 were allowed accefs to the Tick, to give them either food or medicines, ex- 
 cepting thofe who guarded them | nor were the lick themfeivcs allowed to go 
 abroad until foity days after their recovery. But, though the diitemper 
 continually advanced, it did not get to its fuli height until the months of Au- 
 guft and September. Before this time it feemed to fly from place to place 5 
 4p that great hope* were entertained, though always without foundation, of 
 its total removal; but now it invaded the whole city. Four or five thoufand 
 <iiedin a week; once eight thoufand ; and in the month ot September, for 
 iometitne, twelve thouiand a week died. The city was reduced to the ex- 
 tremity of diftrefs. 
 
 The author of this journal had the courage not only to remain in the city 
 during the whole time of the infedtion, but even took many folitary walks to> 
 the houfeofhis brother, who had removed imo the country, in order to pre- 
 lerve his goods from being ftolen. At fir! t he went every day, but afterwards 
 only once or twice a week. He tells us alib that lie took many walks out of 
 cunofity; and, though he generally came home frighted and terrified, he 
 could not reitrainhimielf. In thofe walks (fays he) I had many difmai 
 
 Series before my eyes ; as particularly of perfbns falling dead in the ltreets 
 terrible ihrieks, and fcreamings of women, who, in their agonies, would 
 throw open their chamber windows, and cry out in a difmal, fuprifing manner, 
 
 It is fcarce credible what dreadful cafes happened in particular families 
 every day; people in the rage ot the diftemper, or in the torment of their 
 
 fwellings, which was indeed intolerable, running about raving and diftradted i 
 and oftentimes laying violent hands upoji themfelves, throwing themielves 
 
 out at their windows, ihooting themielves, &c. mothers murdering their 
 own children, in their lunacy ; fome dying of mere grief as a paffion ; fome of 
 
 fright and furpriie, without any infedtion at all; others frighted into idio- 
 .tinn and fooliih diffractions, fome into defpair and lunacy ; others into me- 
 lancholy madnefs." 
 
 The diitemper was found to rage fo violently among the poorer fort, that 
 we are told by Dr. Hodges, fome gave it the name of the poor's plague. 
 This is confirmed by the jounulilt, who informs us that * the mifery of that 
 time lay chiefly upon the poor, who, being infected, had neither food nor 
 < phyiic ; neither piiyikian nor apothecary to affift their., nor nurfe to attend . 
 
 * them s 
 
55*. APPENDIX. 
 
 them : many of thofe died calling for help, and even for fuftenance, out of 
 * their windows, in a moft miferable and deplorable manner ; but it muft be 
 * added, that, whenever the cafes of fuch perfons or families were reprelented 
 to the lord mayor, they were always relieved." Indeed the charity of the 
 more opulent, upon this occafion, almoft exceeds belief. Dr. Hodges informs 
 us, that " though the more opulent had left the town, and it was left almoft 
 " uninhabited, the commonalty who remained felt little of want ; for their 
 " neceflities were, relieved with a profufion of good things from the wealthy t 
 and their poverty wasfupported with plenty." The probable reafon of fuch 
 devaluation among the poor, Dr. Hodges promifes, p. 15, to give, and does 
 not ; at leaft I have not been abl to rind it in his book ; I muft therefore 
 contrnt myfelf with what the journalift (though no phyfician) has delivered 
 on this fubjecl. He fays, that when people began to uie proper cautions, the 
 danger of infection was the lei's. But (fays he) it was impoffible to beat any 
 ** thing into the heads of the poor; they went on with the ufual impetuofity 
 " of their tempers; full of outcries and lamentations when taken, but madly 
 " carelels of themfelves, fool-hardy and obftinate when well : where they 
 " could get employment, they puihed into any kind of bufinefs, the moftdan- 
 ** geious, and the moft liable to infection ; and, if they were fpoken to, their 
 * anfwer would be, I mutt truft to GOD for that ; if I am taken, then I am 
 provided fori and there is an end of me, or the like ; or thus : Why, what 
 muft I do ? I cannot ftarve ; I had as good Jiave the plague, as perifh for 
 ** want. I have no work, &c. , This adventurous condudt of the poor was 
 what brought the plague among them in a moft furious manner; and this, 
 *' joined to the diftrefs of their circumflances, when taken (with the diftem- 
 * per) was the reafon why they died fo in heaps : for I cannot fay that I 
 * l could obferve one jot of better husbandry among them, I mean the labour- 
 ' ing poor, while they were well and getting money, than there was before; 
 * but as lavifh, as extravagant, and as thoughtlefs of to morrow, as ever ; lot 
 ' that, when they came to be taken fick, they were immediately in the ut- 
 moft diftrefs, as well for want as for ficknef s, as well for lack of food as 
 * lack of health." 
 
 In the time of fo great a calamity, the magiftrates exerted themfelves as far 
 as their power and Ikill would permiti to leffen the luiferings of the people. 
 It was natural alfo in fitch a dreadful emergency to call upon the phyficians 
 to exert themfelves. Accordingly the king (Charles II) by his royal autho- 
 rity commanded the College of Phyiicians of London jointly to write fome- 
 what in linglhh, that might be a general directory in this calamitous exigence; 
 nor was it latisfadtory to this honoured Ibciely to discharge their regards for 
 the public in that only ; but fome were chofen out of their number, and ap- 
 pointed particularly to attend the infecled on all occafions ; two alfo out of the 
 court of aldermen were required to fee this hazardous tafk executed-* 
 
 Our author then proceeds to mention the names of fome who were em ployed 
 in this laudable undertaking ; particularly Dr. Clifton, regius profeffor at 
 Cambridge, Dr. Nathaniel Paget, Dr. Wharton, Dr. Berwick and Dr. 
 Brookes ; many others he fays were employed ; * but (he acids) eight or mi\e 
 * fell in the work, who were too much loaded with the fpoils of the eneniv ; 
 among whom was Dr. Conyers, Sec. After, then, all endeavours to reftra in 
 the contagion had proved oi no effctt, we applied ourfelves altogetlier to the 
 41 cure of the difeafed." 
 
 We (hall nt r doubt of the good intentions of the phyficians : of their fuccefs 
 we may judge from what Dr. Hodg?s himfelf fays, that many died while pic- 
 icribing cures for others. To tlie fame purpofe the journalift, p. 43 : I 
 * Hull not befuppofed to Uflen the authority or capacity of the phyficians^ 
 when I lay that the violence of the dilternper, when it came to its extremity. 
 < was like the fire the next year (1666). Trie lire which confumed what the 
 ' plague could not touch, defied all the application of remedies ; the fire- en-. 
 ' gines were brokan, the buckets thrown away- and the power of man was 
 * baffled and brought to an end; fo the plague d<-h.u all ; .e >icine ; thu 
 f very phyficians were feized with it, with their prelcrvutives in their mouthi , 
 
APPENDIX. 553 
 
 ** and men went about prefcribing to others, and telling them what to do, 
 till the tokens were upon iiiem, and they dropped down dead, deftroyed by 
 " that very enemy they direled others to oppofe. This was the cale of ieveral 
 * phyfjcians, even fome of the moft eminent, and of ieveral of the molt fkilful 
 
 * iurgeons ; abundance of quacks too diedi who had the folly to trufl to their 
 
 * own medicines," &c. 
 
 Thus, in defiance of every effort of human (kill, the calamity continued. 
 The contagion (fays Dr. Hodges) fpread its cruelties into the neighbouring 
 'countries; for the citizens, who crowded in multitudes into the adjacent 
 
 * towns, carried the infection along with them, where it raged with equal 
 'fury ; fo that the plague, which at firft crept from one ftreet to another, now 
 
 * reigned over whole counties, leaving hardly any place free from its infult 
 and the towns upon the Thames were more feverely handled ; not, perhaps, 
 from a greater moifture in the air from thence, but from the tainted goods 
 1 rather, that were carried upon it : moreover fome cities and town?, of tfes 
 < moft advantageous fituation for a wholefome air, did, notwithflanding, feel 
 the common uiin. Such was the rife> and fuch the progreis, of this cruel 
 
 * deftroyef, which firft began at London."* 
 
 But it is now time to turn from thofefcenes of horror. The power of the 
 
 peftilential contagion was not abfolutely immeafurable. It had its rife, its 
 
 progrefs, its ftare and declenfion. Dr. Hodges tells us that, when the <worft 
 
 part of the year t9af over, and the height of the dlfeafe* the plague by leifurely 
 
 degrees declined, and before the number infected decreafed, its malignity 
 
 ' began to relax, infomuch that few died, and thole chiefly fuch as were ill 
 
 ' managed j hereupon that dread which had been upon the minds of the 
 
 people wore off; and the Tick cheerfully vfed all the tneans directed for their 
 
 recovery ; and even the nurfes grew either more cautious, or more faithful ; 
 
 * infbrnuch that after fome time a dawn of health appeared* as fudden, and as 
 unexpected, as the ceffation af the following conflagration ; wherein, after 
 blowing up of houfes-, and ufing all means for its extinction to little purpofe* 
 theflames flopped as it were of themfelves for want of fuel, or, out cfjhame* 
 
 * for having done fo much uiifchief. The peftilence, however, did not ftop far: 
 want of fubjedls to adl upon, (as fhen commonly rumouied) but from the 
 nature of the diftemper. Its decreafe was, like its beginnings, moderate, &c. 
 About the clofe of the year, that is, on 1 the beginning of November, people 
 grew more healthful," &c. 
 
 The numbers who periihed in this violent plague are fo variously reported 
 
 that nothing certain can be faid concerning it. Dr. Morton fays that upwards 
 
 cf forty thoufand died ; but from the foregoing accounts it is evident that 
 
 this calculation muft be prodigioufiy underrated. The journalift indeed gives 
 
 ftrong reafons for believing that all the accounts of the numbers who perifhed 
 
 were much below the truth. H thinks that an hundred thoufand at leaft 
 
 muft have fallen victims to it ; and if his own aflertion be true, that thirty 
 
 thoufand died In the lalt three weeks, vv cannot fuppofe but that three times 
 
 that number died in the courfe of the twelvemonth that the difeafe lafted ; 
 
 \vhich would fix the calculation at 120,000. This great mortality however 
 
 was foon forgot ; as foon as the danger was over, the ravages it had committed 
 
 vfere no longer an objeft of terror. The difeafe had its ufual effect, viz. in- 
 
 creafing the defire of the fexes for each other. They had the courage (fays 
 
 Dr. Hodges) now to marry again, and betake to the means of repairing the 
 
 paft mortality ; and even women before deemed barren were faid to prove 
 
 prolific ; fo that, although the contagion had carried off, as fome computed, 
 
 about one hundred thoufand, after a few months their lofs was hardly dii- 
 
 Hodges, p, 25 
 
 IV. 
 
55 4 A P P E N D I X. 
 
 N IV. 
 
 Account of the Plague at Marfeilles in 1720 : From the 
 Periodical Publications of the time. 
 
 SO much hath been faid concerning this plague, in the firft part of this 
 treatife, that no particular detail is requifite here. In its fymptoms it 
 differed little if any thing from the plague of London, defcribed in the former 
 number. Many died without any previous ficknefs* and, while the diltemper 
 continued fevere, few outlived the third day ; and fo infectious was its nature, 
 that oae perfon ia a family was feldom attacked without its fucceffively at 
 tacking all the reft. The bodies were faid to putrefy in 24 hours. Very 
 conliderable fums of money were colleded here, as well as in London. The 
 conduct of the bilhop on this melancholy occan'on has been greatly cele* 
 brated by many ; among others by Dr. Darwin, in his Botanic Garden* in 
 the following lines : 
 
 ' So when Contagion* with mephitic breath* 
 
 * And wither'd Famine, urg'd the work of death ; 
 
 * * Marfei lies' good Bifhop, London's gen'rous Mayor* 
 
 With food and faith, with med'cine and witfe prayer 
 
 Rais'd the weak head, and ftay'd the parting iigh, 
 
 Or with new life rehim'd the fwimming eye. 
 
 < ^ The bHhop of Marfeilles, during the time of this rmferable calamity* 
 41 was indefatigable in the execution of his pafloral office, viflting, relieving, 
 " encouraging and abfolving the fick with extreme tendernefs ; and though 
 < perpetually expofed to the infection, like Sir John Lawrence, the lord mayor 
 < of London in 1665, was never feized with the difeafe This lad gentleman* 
 ' with undaunted refolution, continued rn the city during the whale time of the 
 calamity, executing the duties of his office with the utmoft punctuality. 
 < The day after the difeafe was certainly known to be the plague, above 
 * 40)000 fei'vants were difmifled, and turned into the ftreets to perilh, for no 
 * one would receive them into their houfes ; and the villages rear London 
 * drove them away with pitchforks and fire-arms. Sir John Lawrence 
 fuppoited ibem all* as well the needy as thofe \\ho were fick ; at fiift fey 
 ' expending his own fortune, till fubfcriptions could be folicited and 
 received from all parts of the nation." (Dartvitt*s Botanic Garden* 
 of the Plantt t canto ii, p* 6l.} 
 
 V. 
 
 Account of ilie Plague in Syria, Cyprus tsV. From Dr< 
 PATRICK RUSSEL^ Treatife. 
 
 HpHIS plague was preceded by violent cold, famine, an d earthquake*. 
 A In 1759 lt began in Egypt, having been imported in a vefiel from 
 Conftantinople. From Alexandria in Egypt it was brought fey feme Jews 
 to Saftat, a village in Syria, near Aleppo,' which had fuffcreef much by the 
 earthquake ; which laft was for fome time thought to have been the caufe 
 of the diftemper ; but, when its nature was really difcovered, they comforted 
 themfelves with the thoughts that an Egyptian plague was lefs to be dreaded 
 than one which came from the northward. 
 
 The diftemper had been introduced into Cyprus as early as April t75gt 
 by a veflel from Con ftantinople, wrecked on the coaft ; and, having thus 
 footing in Egypt, Syria and Cyprus its progrefs was marked with the 
 
 ufual 
 
APPENDIX. 
 
 iifual mortality. ID Egypt the Europeans in Cairo remained in confinement 
 till the middle of July ; a fpace considerably longer than nfual. Next year 
 they (hut up on the 9th of March, but were releafed on the 4th of June. 
 The diftemper raged in the cify with fuch fury during 1759 and 1760, that 
 in the two years lour hundred and fifty thoufand were computed to hav* 
 periflied j a number, however which Dr. Ruffel thinks muft have been ex- 
 aggerated. Csiro had been free from plague during the whole of this century 
 beforet axcept -in the year 1736, when the diftemper raged with fuch violence 
 that ten thaufand were faid to have perifhed in one day. It was fuppofed to 
 have been brought from Upper Egypt. In Cyprus it broke out at the village 
 of Limfolt where it deftroyed four hundred people. During the hot months 
 of July Auguft and September the infection fhowed itfelf fo little that it was 
 thought to have been extinguished .; but in October it not only reappeared in 
 the places where it had before ftiowed itfelf, but invaded Nicofia, the capital 
 ef the ifland. Endeavours were ufedt by burying the dead bodies in the 
 night, to conceal the exiftence of the diftemper ; but this foon became im- 
 practicable. Towards the end of January, 1760, it raged fo dreadfully in 
 this city that the Mahometans were enjoined to ufe prayers and proceflions . 
 to avert the wrath of Heaven. The crowds brought together on this occafion 
 fpread the diftemper ftill more wide, and in the following month its ravages 
 began at Larnica, a fmall town confiderable for its trade, and which* though 
 alarmed, had hitherto kept free, even though infected perfons had been freely 
 admitted. Here it raged with uncommon malignity, infomuch that few of 
 thofe recovered that were infected during the month of March. It continued 
 to prevail till the month of April, when it fpread to the very eaftern extre- 
 mity of the iftand, into the province of Carpafs $ a thing hitherto unknown. 
 
 Two examples of apparent infufceptibiiity are related ; one was a young 
 Greek, whofe conftant employment was, to nurfe the fick, and affift at the 
 burials ; the other, a Greek woman, who, having with great affection nurfed 
 her hufband and two daughters who died of the plague* continued with admU 
 arable courage to expofe herlelf in affifting the fick in the neighbourhood. 
 
 Towards the end of May the infection was rapidly decreafing ; the Euro- 
 peans came out of their confinement in the month of July, and the plague at 
 laft ceafed, after having deftroyed 70,000 perfons j nearly one half of the 
 whole population. 
 
 In Syria the plague appeared firft in October, 1759, in the village of Saffat. 
 Trom thence it proceeded to Tripoli, where it began about the middle of 
 January, and did not decline till July; neither were the Europeans tho- 
 roughly reieafed from their confinement till towards the end of Aaguft. One 
 Jialf of thofe infected are faid to have recovered j but five thoufand perifhed. 
 The city remained free from any attack during the whole of 1761 ; but early 
 in 1762 the diftemper again made its appearance in the neighbouring villages* 
 and again began its devouring ravages; but, though a free accefs was granted 
 to infected perfons in the city, it does not appear that any general infection 
 took place. 
 
 In Latarkea the diftemper appeared in March, 1760, made confiderable pro- 
 grefs during the month of April, increafed from the I7th of that month to 
 the ijth of May, raged with great violence from that time to the *7th of 
 June, when it fuddenly decreafed, the funerals- falling from 30 to 9. OR 
 the 4th and 5th of July they again rofe to more than 20, but prefently fell 
 below fix. Four thoufand were fuppofed to have died, though it was thought 
 that as many recovered as perijhcd. At Jerufalem the contagion difcovered 
 itfelf in January or February, 1760, and about the middle of March reached 
 Pamafcus, In both places it made great havock, but no accurate account? 
 were kept of thofe who died. 
 
 VI, 
 
556 APPENDIX. 
 
 N VI. 
 
 Remarkable cafe of a Remitting Fever at Bafforak In 1780, 
 
 IN the firft part of this treatife we have given an account of the fever which 
 prevailed at Baflbrah during the year we {'peak of, and likewift of the 
 journey of the gentleman from Baflbrah to Zebire, where he was taken ill on 
 the 4th of June ; but as the firii attack went off for that day, we (hall only 
 begin the narrative from the day following* aS he himfelf does in thefe words : 
 
 5th June. From this day I date the aftual commencsment of my fever. 
 About 2 o'clock after dinner 1 was fuddenly attacked with a violent glowing 
 heat all over my body> uneafinefo, anxiety and oppreffion, but in a very in- 
 confiderable degree to what I afterwards experienced ; alfo a fwelling in my 
 tongue which had been corning on fome daysi and is one of the firft fymp- 
 toms of the fever that prevailed. The fit continued about two hours ; a 
 flight perlpiration fucceeded, which removed the fever, but left a head-ach? 
 thirft, and pains in my back snd limbs. In the evening with affiftance I got 
 upon the terrace, when the moon and flats appeared of a bright yellow, and 
 all objects had that colour through the whole of my difeafc ; alfo th& pain in 
 making water, and acrois my loins, became intolerable, like that felt in com- 
 plaints of the ftone in the bladder. I took fome tartar emetic, which brought 
 up a great deal of bile,_and the next morning a purgative of RocheJle falts 
 manna* tamarinds afid annifeeds. 
 
 6th June. In the forenoon a free, copious perfpiration and a perfect inter- 
 miflion of the fever ; at night became very rcftleis and uneafy, could not 
 fleep, which I partly imputed to a draught of ftrong muftard whey, with, 
 fome aniimonial wine, which, inflead oi caufing perfpi ration, produced the 
 oppofite effect. 
 
 yth. By the advice of a phyfician I took fome weak decoction of bark, i oz, 
 to two pints boiled to one, in the quantity of three tea-cupfuls before dinner. 
 At three in the afternoon I had. another hot fit, but not very fevere. In the 
 evening grew worfe heat and thirft exceffive drank muftard whey on going 
 to bed, but had a very bad night no deep, much oppreffed* fevere head-ach, 
 and pain over my loins. 
 
 8th. Took a gentle purge of cream of tartar and rmwna, which operated* 
 and gave me fome eafe Left off the bark, as it feemed to increafe the febrile 
 fymptoms, and drank fage and apple tea. decoction of prunes, tamarinds, &c. 
 At ID o'clock in the forenoon a very fevere hot fit; heat intenfe, oppreffion 
 in my ftomacrt and breaft almoft infuffesable. Mr. , furgeon of the Ea- 
 gle cruifer, gave me a molt nauleous faline mixture, which vomited and pur- 
 ged me feverely- The quantity of bile which came off my ftomach was incre- 
 dible* yet I felt no relief, and the agony of the hot fit continued, till 4 
 o'clock in the afternoon, when it went off by a mo ft prof nfe perlpiration. 
 During this fit my thirft was conftant and intenfe. In the evening my fkin 
 became dry, the thirft returned, and I had a very bad, fleeplefs night. 
 
 I now began to experience fome of the dreadful fymptoms which are, I be- 
 lieve, peculiar to fevers in Turky arid Arabia j a fenfation/>f dread and horror, 
 totally unconnected with the fear of death ; for, while the patient is nroft af- 
 flicted with thii iymfifom, it is for the moft part accompanied with a ftrong 
 defire to put an end to hi; exiftence The agony from the heat of the body 
 is beyond conception. I have heard fome qt my fellow fujierers roar hide- 
 ouflv un-.k-r the violence of the pain. 
 
 gth Till noon tolerably well About i o'clock the hot fit attacked me, 
 and was full as levere as vefterday ; heat and thirft rather greater, and but 
 little relief ior more than an hour after the perforation commenced. 'This 
 attack left me very weak, much exhaufted, with cold, weakening fweats, 
 quick unequal pulfe. fevere head-ach, eonfufion, anxiety and inceflant thirft ; 
 a fl'-e -Icfs night, ftauingj>j anxieties, and a eonftant wi(h to terminate my 
 luftenngs by death. 
 
 joth. Forenoons 
 
APPENDIX. 557 
 
 loth. Forenoon* pretty free from fever. Attacked at the fame hour a* 
 yefterdav. The fit more violent delirium The agony of the heat not to 
 be expreffed ; the whole body as if on fire ; unremitting thirft, profqfe per- 
 fpiration, yet no relief till late in the evening ; no fleep, a dreadful night, &c. 
 Pulfe about izo, unequal and fluttering. 
 
 A mere relation of fadls can give but a faint idea of the v/retched fituation to 
 which the factory was now reduced: by this time eleven twelfths of the inhabi- 
 tants of Bullbrah were taken ill. numbers were daily dying* and the reports from 
 Bagdad and Diarbekir, of the increasing ravages of the plague, left the furvivor* 
 not a ray of hope that they could cfcape the calamity. On every counte- 
 nance pain, ficknefs and hon- r .vcre ftrongly painted ; nor were we even left 
 the comforts of fympathy, as every m>nd was too much /engroffed with its own 
 fufierings to think of adminiftering coniolation to others. Four of us lay un- 
 der the portico of one of the fquares of the faclory, calling out for water in a 
 frenzy of thirft. VVe ufe<t t;> fnatch it from each other, and to fupplicate for 
 a mouthful with as much fervour as a dying criminal for an hour of further 
 lire. 
 
 About this period of the fever my eyes became very weak, and every ob- 
 jeci I faw was quire yellow. This efFedl was moft perceptible at night, in 
 looking at the moon and ftars. In the evenings we were fometimes carried 
 in our cots upon the terrace of the failory for air ; but the wind was fo heated 
 by the burning fands of the drferf, that we felt i- more intolerable than even the 
 lower apartments We all remarked that the fiemaa/, or north winds, which 
 blew without intermiflTion at that time, greatly increafed our heat and thirft. 
 
 The daily very evident incveafe of my fever, and its etiTstls upen others be- 
 coming more fatal and alarming, determined me, while any ftrength remain- 
 ed, to embrace theconful's pffer ol 'flying from the feat of infe&ion to Bufhire, 
 in the Ranger cruifer. 
 
 iith. After an exceeding bad night I was carried early in the morning on 
 board the Ranger, and was not very ill until about 9 o'clock* when t felt the 
 fever coming on, with new and more alarming fymptoms violent head-ach, 
 giddinefs, dimnefs of fight, approaching delirium, horror, and a moft painful 
 oppreflion and burning heat in my ftomach. 
 
 In defpair, and to try to quench the unfufferafele heat in my ftomach and 
 bowels, I took a pretty large dofe of nitre. The opprefllon and pain in- 
 creafed ; in my co*fufion I took a paper of tartar emetic, which immediately be- 
 gan to operate. From that time, about ten o'clock, till half paft two in the 
 afternoon, I know but little of what paiTed : [ was almoft all that time either 
 diftradted with pain, or in a fwoon ; and had it not been for the extraordinary 
 care and attention of the commander of the cruifer, who fupported me in his 
 arms, and adminiftered fuch cordials as I, in the ihort moments of recollec- 
 tion, could call for, I have not a doubt but I muft have funk under this attack. 
 He counted eight times that I fainted, and fometimes an interval often mi- 
 nutes before he could perceive any fymptoms of returning life. I was chiefly 
 Supported by wine, hartihorn, and fpirits of lavender. About three o'clock I 
 had recovered my recoliedion : molt copious and continued fweats had car- 
 ried offthe violence of the fever ; but faintings and total privation of ftrength 
 and fpirits remained upon me till late in the evening, when I became to all ap- 
 pearance, for a Ihort time, perfectly well. A little ftrength returned, every 
 fymptom of fever vanilhed, and my feelings were almoft the fame as if in per- 
 fect health. Some circumftances having prevented the Ranger's carrying me 
 to Bufhire, I was taken afhore in the evening. When I was brought to the lac- 
 tory I had an appetite, and ate fome chicken broth for fupper. Mr. Rofs, 
 ^vho had hitherto efcaped the fever, adminiftered a potion of laudanum, and, 
 I believe, antimonial \vjne, on going to reft. I flept pretty well, and awoke re- 
 frefliedin the morning J, however, foon became ill, andatnoon 1 had afevere 
 attack, which continued three or four hours, and left me greatly weakened, my 
 {kin extremely dry, pulfe quick, fluttering and irregular, beating from 100 to 
 :zo, with an unquenchable thirft, which no liquids could allay. We had no 
 acids of any kind, wnich we had fcreat realbn to regret. 
 
 I did net know till late in the evening that Mr. Abrahasn, the vice-conful* 
 Vjio for fome days pall had been ill of the fame fever, had determined lo em- 
 barb 
 
55 8 APPENDIX. 
 
 |rk in the Eagle cruifer next morning for Buftiire, as the only hanee of fa*? 
 ing liis life ; and a converfation which I overheard to this effecl, that as I was 
 fa very ill, and no hopes of my recovery, it would be better to leave me to die 
 at Bufforah, made me (till more anxious to fly from the place, although I re- 
 member well 1 had not the moft diftant hope that I could live. I had fuf- 
 feredrrmch at the factory, and in the peeviihnefs of illnefs I thought (perhaps 
 enjuftly) that my living or dying feemed to be a matter of too little confe 
 quence to thofe whom in health I had treated with much kindnefs and af- 
 fedion. 
 
 About ten o'clock, as I was lying in my cot, on a terrace adjoining the 
 Hairs from whence the boat was to put off, I wasfeized with fuch a fluttering, 
 palpitation, ftarting, difficulty of utterance from the fwelling of my tongue, 
 that I lay in momentary expectation of breathing my laft. This was, however, 
 probably the caufe of my hearing the preparations for the departure of the 
 "boat. About midnight they were leaving the fhore. I could not make my- 
 feif heard", and I was too weak to get up without help. I made feveral ef- 
 forts, and at laft overfet the cot I was lying upon, and brought myfelf to the 
 floor, from whence I crawled on my hands and knees to the fide of the river. 
 Humanity pleaded for me, and I was taken into the boat, rn a fiuation of 
 wretchednefs J never can forget. We were, after being- feveral hours on the 
 Euphrates, carried o-n board the Eagle, oppofi re to Margil, a country houfe 
 fcelongrng to the factory, a few miles diltant from Hufforah. 
 
 rtth. The day was uncommonly hot| and my fever came upon me about 
 
 *en o'clock. The heat was intenfe. Mr , a young unexperienced 
 
 Frenchman, gave me tamarind water and cream of tartar, which had not a 
 good effect. I now difcerned the firft fymptom of a cold fit; but it was 
 Bight and of fhort duration. This day, however, I fupported the fever ra- 
 ther better than ufual, and in the evening had a (hort intermiflion, and flept 
 alittfe during the night. The air on the river was this day cooler and more 
 sefreihing than on ihore. 
 
 rjth. About eleven o'clock had a regular cold miyering fit, fuccecded by 
 stvery fevere hot fever, which continued till five in the eveningi when I was 
 fbmewhat relieved by perfpiration. This day the agony of the hot fir was 
 Hiexpreffible, with great pain in my loins, and aconft-mt inclination to make 
 water, which came from- me in drops like blood- I had a very bad, fleepleft 
 aiglit. 
 
 i4th. By Mr. 's advice I took a dofeof tartar emetic, which not 
 
 workisg. he gave me forAe ipecacuanha. I brought up a great deal of bile* 
 'out the fever increafing, my fufferings under it were greatly increafed by the 
 operation of the emetic, which worked powerfully both upwards and down- 
 wards. This was a trying day indeed. I can give no idea of what 1 fuf- 
 fered, which muft have been intolerable, attended with intervals of delirium 
 and frequently fwooning. About five the fever began to abate a little, and 
 
 and at iix Nfr. gave me a fmall dofe of decoclion of bark, which feem- 
 
 edinflrantly to caufe a return of the fever, heat, thirfi, anxiety and pain. 
 
 My fe 1 1 o-vv-f offerer, Mr. Abraham, was in violent agony this day ; he cried 
 out repeatedly that a fire was con fuming his bowels, and that he was in ex- 
 <juifite torture. The captain of the crurfer had been complaining ; he, Mr. 
 Abraham and myfelf lay in the fame cabin. About 4 o'clock in the after- 
 woon, when my pain was exceffive, I crawled from my cot, with an inten- 
 tion to drop myfelf from a port-hole which was under the captain's 
 ked, into the river. I had nearly accomplished my purpofe, when the cap- 
 tain perceived me, and had me carried into my bed. I was not delirious; 
 and, in fpite of all my reloiutiou, the agony I fuifered this day made me 
 repeatedly fcream cut. One of our feamen died fudc-jnly, and the blood, 1 
 was told, inflanily flowed from all parts of his body. 
 
 This everihig we arrived at Buihire. On our coming to an anchor Mr. 
 Abraham was immediately carried aihore ; but I was too ill to be moved, 
 and accordingly followed in the morning with Capt. Sheriffi after a very 
 i'cvere, lleeplefs night. 
 
 The heat was IbexcefRve this day that even the natives we had on board funk 
 under n, and many of tl>em were ftiuck down with the fun, By noon nobody 
 
 couUL 
 
APPENDIX. 559 
 
 ouH Tceep the deck ; and about this time the veiTel ran aground on the bar at 
 the mouth of the Euphrates, but fortunately beat over, and got into the gulf* 
 Two more of our people died in the evening ; and I ihould have mentioned that* 
 in faiiiup down the river, we law them throwing many dead bodies from the 
 vefiel.- which were at anchor below Builbrah, and many boats crowded with 
 |e<">pir iYoin the Arabian ihore ( pafling over to Periia. 
 
 The Perjjans at firft oppofed the landing of our lick, and threatened to bura 
 the ihip ; but they were prevailed upon by the company's agent at Bulhire* 
 a moft worthy man, to permit us to come afhore. 
 
 i $th. i was fo weak that it was with difficulty they could carry me afhore 
 in my cot ; my ftrength was quite gone, and I was helplefs as an infant. 
 Some grapes, water-melon and ice had been got for Mr. Abraham : of the 
 latter he had eaten freely ; I was much p re fled to do the fame, but was afraid 
 of its increafing my pain, and could hardly be prevailed upon to tafte it ; I* 
 however, fwallowed a little, but by this time my tongue and throat were fo 
 iwelled that I had difficulty in getting any thing down. About 10 o'clock 
 I was attacked as ufual; but I was become fo weak) and the fever running 
 higher than ufual, that 1 appeared in the courfe of this day, more than once, 
 to be in the agonies of death ; perfpiration gave no relief to the violent pain 
 and opprefllon I laboured under. 
 
 The fadtory at Bufhire is a miserable, wretched mud building, bearing 
 snore refemblance to a ftable than a human abode : the few rooms, or rather 
 cells, are infufFerably hot, even to thofe in health, and the reft of the 
 building has no cover from the fun. In one of the beft of thefe receiTes in: 
 ffee wall Mr. Abraham and I were placed, and on the lame bed, as there was 
 riot room enough for two : our agonies were great, and our cries dreadful* 
 About 7 o'clock in the evening I perceived my companion in the agonies oi 
 4eath. The company's agent, Mr. Beaumont, moft humanely afforded -bin* 
 every afliftance in his power ; and when every other perfon was afraid t 
 come near us, he himlelf attended, aad administered fwch cordials as he 
 thought might give us relief. Mr. Abraham died in great pain ; and, for 
 fear of alarming the inhabitants, or rather commandant or fheik of the town* 
 Mr. Beaumont thought it neceilary to conceal his death. It was fome time 
 before the dead body could be removed, which had become very putrid, and 
 covered with purpJe fpots. 1 have been lince told that immediately after 
 death a great quantity of blood or bile flowed from him as black as ink, and 
 fo higlily offeniive as to be fmelt at fome diftance from the fadory. Paft 
 midnight we were both removed to the terrace, but, unfortunately for me* 
 there was only one fpot where we could lie, and the fmell of the dead body 
 became intolerable; I was, however, cleaned and put into another bed by 
 the humane afliftance of Mr. BeaumoHt, who fat by me, and treated me with 
 uncommon tendernefs. 1 recovered a UttJe> but paffed a dreadful night ia- 
 <leed. I fliuddered at the agony which I was to feei on the return of the 
 fun, and moft anxioufly wifhed for death, as the only relief from pain that I, 
 could expecl. 1 was unable at thk time to raove hand or foot, and at limes 
 could not fpeak. I told Mr. Beaumont that I thought a gentie dofe of phy- 
 fic, if it could be got down, might alleviate the racking pain in my breaft* 
 ftomach, bowels and loins ; he accordingly prepared fome fails, manna a ni 
 tamarinds, and gave it to me in the morning. 
 
 i6th. At eleven o'clock the violence of the fever came on; I grew delirious* 
 fwooned, and the fymptoms of approaching death, I was afterwards told 
 grew evident to thofe around me. My eyes were fixed, my tongue hung from 
 my mouth, and my face grew qaite black. I recovered from this fit about 
 twelve o'-clock, and felt excruciating pain, and a burning, fuffbcating heat. 
 My ftomach and bowels feemed all on fire, my lungs played with the utmoft 
 Difficulty, and I felt a pain and fenfation about my heart which I cannot de- 
 furibe. I was unable to move; my fervant lifted me; I fell into a fwoon for 
 a few minutes, and, when I came t myfelf, a great quantity of black putrid 
 bile flowed from me. Relief was inftantaneous, and I flept or fwooned till 
 about 5 o'clock, when I found myfelf free from fever, and able to fpeak, my 
 recolledion clear, and ray mind perfectly compofed, but my body fo weak 
 that I had no power of moving, except one of my hand*. They gave me 
 
 fome 
 
560 P P E N D I X. 
 
 fome fuftenanc*; I had a little flesp ; but about midnight I fell into a fitua 
 lion which I had ail the reafon to think indicated the immediate approach of 
 death. My tongue cieft to my mouth, my extremities were as cold as ice, and 
 the coldnefs alfo appeared to extend up my thigh ; my arm was deftitute of 
 jmife, nor was the fmalieft pulfation of the heart perceptible; I never had my 
 tecojleflion clearer, or perhaps fo clear, in my life. My fervant was lying by 
 iny bedfide; I was convulled for fome minutes ; and, on recovering, I got 
 cut the word t>y. Fortunately for me he was not afleep, and heard me ; t 
 then got out the word iv.ne\ on wnich he brought me a glafs of claret, 
 which, with much difficulty, I got down; I felt myfelf much revived ; I re- 
 flected on my litttation ; and, although I had nut the moft remote idea of fur- 
 viving that night, I recollected tliar I ha i fome fine powdered bark in my 
 trunk, and it occurred to me that, if any thing could be done to preferve my 
 life, it would be that medicine taken in red wine ; but, my fpeech immedi- 
 ately failing me, I could not direct the fervant to give it to me. Death feem- 
 ed approaching; coldnefs had leized all my limbs; my tight became ccn- 
 fufed, as 1 perceived from looking at the ftars, which danced before me ; and 
 the rattle or noifein my throat was very perceptible to the fervant, as he af- 
 terwards told me. I fainted and continued in a ftate of inlenfibility, I be- 
 Jieve, for about an hour. The loud lamentations of the fervant, bewailing 
 his own misfortune in lofing his mafler in a country fo remote from his own 9 
 feemed to recal me to life'; I felt as if refrefhed with a little ileep, and got 
 out the words bark and ivine ; it was inftantly brought, and the man 
 gave me two large tea-fpoonluls in a large glafs of claret. The effedl was 
 inftantaneous, and operated like a charm ; the coldnefs left me, I could fpeak 
 intelligibly, and could move my hands. I told the fervant to give me a 
 tea-fpoonful of the bark every hour, in glafs of claret. By 8 in the morning 
 1 had taken fix dofes, and more than half a bottle of claret. I was confi- 
 derably ftrengthened, and could converge with Mr. Beaumont who encou- 
 raged me t perfevere in the bark, and treated me with uncommon attention. 
 I had been fadly neglccled at Buflbrah, bnt this was arriply made up to me 
 by the humane and tender attentions of Mr Beaumont, who was a great pre- 
 defttnarian, and who never thunned danger when he felt it a duty to aflift a 
 fellow erea'ure. He waited upon me like a nude* confoled me under pain 
 and ficknefs, and, when my fever was at its greateft height, he has often held 
 me in his arms, when I wanted to be removed, or my bed flnfted. About 
 this time my legs and thighs became covered with blotches of a dufky brown 
 hue, fome of them as broad as ihe palm of the hand, quire dry, and they 
 itched intolerably. At the fitfne time feverai little boils bioke out in different 
 parts of my body, but there was only one, over my eye that came to fuppii" 
 ration ; the others, and the eruption on my legs and thighs, all difappeared. 
 
 I continued the bark till 12 o' clock, and then left it offtill 4, when 1 took 
 another dole. The dreadful fVverofthe preceding days did not Return on 
 this, but I was ftill extremely ill, had very great difficulty in fpeaking and 
 breathing; a fwelli'.ig alfo in my throat, parched tongue, and unquenchable 
 thirft. I had not the molt ciiftant hope of living. 1 tried to take fome broth, 
 but the fwelling in iny throat prevented my (wallowing. I pafled a very bad 
 night, with ftartings, anxiety, an<i ^reat pain over the kidnies ; and what lit- 
 ite fleep I got feemed to make me wojie; I was fatigued with it, and under 
 the conftant dread of lutTocation : towards morning my throat grew worie, ard 
 my thiilt was exceftive. 
 
 i3:h. Left off the bark, uncertain what I ought to do no fever, but th* 
 ft me fvmptoms as the day before drank a little chicken broth, which was 
 the only iuftenance 1 had taken for four days before great oppreflion .and 
 heat in my itornach and bowels. Mr. Beaumont found out an Armenian wh 
 profeffcd phylk. This man gave me a clyftcr, which gave nie great lelief, 
 and a water to drink, famous as a febrifuge ai \ ifiar.s ; I drank of it 
 
 freely, and found much benefit from it. Bu: ihc m:t extraordinaiy^ of all 
 the fyinptoms I experienced was this, that, the :hird duy after the firft in- 
 ter million of my fever, one of my teeth, a-d one of the nails of my hand* 
 came out without the fmalleft pain, only a little iwelHrig t n she gum ; and, on 
 the rail falling off fome matter flowed from the end o< m. linger. I never 
 had the tooth-ach. At this'time the bull on my eye iuppi:i 
 
APPENDIX. 561 
 
 - from" the ifcth of June to the $th of July, being feventeen days, iny fever 
 did not return. I recovered ftrength flowly, and could walk a little, fup- 
 ported by two men. My food was chiefly chicken and veal broth, and about 
 a glafs and a half of Madeira wine a day. Yet I had many fymptoms of dif- 
 cafe hanging about me reftlefs, fatiguing nights great thirft bad tafte in 
 my mouth : every thing I took feemed bitter and fait pains in my back* 
 fides and loins, and great difficulty in making water. In this time I palled 
 much bile, naturally and by clyfter ; and I had a purgative from the Arme- 
 nian, whicn weakened me greatly. 
 
 The fprings lifted, as feamen term it, three days before the change. The 
 opinion is univerfa! in thofe countries, and alfo in India, particularly Bombay, 
 where intermittents are prevalent, that the change and full of the moon has 
 an effect upon all intermitting difeafes, of which afterwards I had many proofs 
 in my own cafe. To prevent a relapfe, I took fome decoction of bark but 
 in too fmall quantities to anfwer the purpofe. 
 
 4th July. My water, from being thick and muddy, became quite clear. 
 
 The 5th of July, after dinner, I was taken with a flight hot fit, which con- 
 tinued about two hours, and then went off by copious perfpiration ; the re- 
 maining part of the evening I was entirely free from fever. 
 
 6th. I took decoclion of bark no fever. 
 
 7th. At ti d' clock a regular cold and hot fit; the former continued three 
 Quarters of an hour, the latter two hours. Although much lefs fevere than 
 my former fever, yet I fuffered a good deal from the hot fit. Lett off the 
 bark by the advice of the Armenian, who told me that it heated me and made 
 me woffe. Much weakened by this day's illaefs; nor did the perfpiration 
 entirely free me from the fever. 
 
 8th. Had a clyfter thrown up, and early in the morning took a draught 
 from the Armenian, compofed of fine vinegar, fugar, and a country feed in- 
 fufed over night in water. A llight hot fit, but of fhort continuance. 
 
 gth. The draught of yefterday repeated at 10 a regular cold and hot fit> 
 rather lefs violent than the laft. 
 
 loth. No fe^er tolerably well. 
 
 nth. Between 8 and 9 in the morning a cold and hot fit, much more fe- 
 vere than the laft great heat, thirft and opprefTion -much weakened. I now 
 perceived 1 had got a regular tertian, and determined on the bark, but was 
 prevailed on by the Armenian not to ufe it, he prosniling to cure me in a 
 day or two. He gave me water-melon and his infuTion of vinegar and feeds. 
 
 1 2h. No fever find the water-melon to difagree greatly with my ftomach. 
 
 ijth. Had not as yet indulged much hopes of recovery. I felt (till, even 
 IE thole days previous to this laft" relapfe. many alarming fymptoms of dif- 
 eafe, which made me apprehend I could not recover ; and this laft attack 
 hid again reduced me fo low, that it was evident that, unlefs I could get re- 
 moved from thofe feorching climates, a very fliort time would put an end to 
 my life. Except in the humanity and good ne is of Mr. Beaumont, I was 
 without a fingle comfort or convenieucy of life at Buihire. The heat of the 
 weather feeraed daily to increafe, and the houfe we were in hardly covered us 
 from the direct rays of the fun. My fervant was taken ill, and appeared to 
 be dying : it was with the greateft pleafure, therefore, I received the accounts 
 tRis day of the Eagle cruffer having arrived laft night from Buiibrah, on her 
 way to Bombay. 
 
 At half paft feven o'clock I had a very fevere fit; the hot fit was uncom- 
 monly violent, and continued about three hours. I was much reduced, and 
 rcTolved at all events to take the bark in powder, and in large dofes, and to 
 d if mi is the Armenian. In this I was confirmed by Mr. Puget, who informed 
 me that the few furvivors at Bufforah owed- their livea entirely to the bark 
 which had at laft been given in very large dofes. 
 
 i4th. I took four dofes, or eifcht tea-fpoonfuls, of powdered bark. It pur- 
 ged me, and carried off a great quantity of black pxxtrid bile. This evening I 
 was carried in my cot on board the Eagle, refolved at all events, even it I 
 had been certain of dying in the boat, to leave Buihire, where I had hardly 
 Jhdter from the fun, and where the heat was fo exceflive that Capt, Alderfon 
 
 of 
 4 C 
 
562 
 
 APPENDIX. 
 
 of the Eagle and two paffengers were taken ill from it laft night. I got oft 
 board very late, yet found myfelf refreihed from the fea air. 
 
 1 5th. The tever did npt return. I continued to take the bark as yefterday* 
 and found myfelf furprifingly (lengthened. I p'crfevered under this courfe 
 till the 3d of Auguft, when the vellel arrived at Mufcat, and I was aftonifh- 
 ingly recovered for the fhortnefs of the time. 
 
 From the i4th of July to the 3d of Auguft I had taken feven ounces ef 
 bark; and as the fever had returned upon me the laft day of the fprings at 
 the preceding change of the moon, two days before this change I increafed my 
 daily dofe, and continued in this manner- till the 4th, when the fprings be- 
 ing over, and perceiving no fymptoms of fever remaining. 1 left off the bark 
 entirely. I had generally taken fix tea-fpoonfuls every clay. 
 
 From the 1510 of July till my arrival at Mufcat, a leaport on the coaft of 
 Arabia, my recovery was exceedingly rapid. I had a keen appetite, a pretty 
 good digeftion, found, refrefhing ileep, and rny daily increafe of ftrength was 
 very perceptible. My diet, till this time, had been generally chicken broth, 
 rice and boiled fowl, light pudding, &c. On leaving off the bark I obfei ved 
 no particular regimen, only abftaining from fahed and high-feafoned meats* 
 and confining myfelf to three or four glades of Madeira. I found that an in- 
 fufion of prunes, with a fmall quantity of cream of tartar, was of much fervice 
 to me during the courfe of the bark, as it kept me cool, and my body open. 
 I was fenfible, at times, during my recovery, of a flight but troublefome pain 
 under my fifth rib on the right fide, efpecially when I lay on that fide ; but 
 from feeling and preffing my hand over the region of the liver, and from other 
 circumftarces, I had no reafon to fufpedl that my liver -va-s affected ; andi as 
 itfoon left me, thecaufe was probably trifling or accidental. 
 
 On rny leaving Mufcat a large boil came upon the hip-bone, the fize of a 
 fmall melon, extending fome way up the fide, and down the thigh, with a 
 hard balls- After arriving at Bombay, which we did in fourteen day?, it 
 broke, and in a few days healed up. I (hall only add, that at Bombay I was 
 detained four months before I had an opportunity of proceeding to Europe. 
 In that time I had three returns of my ague, but on taking a few dofes of 
 bark' it left me. Thofe attacks happened at the change of the moon.- From 
 Bombay to Europe I had three or four flight fits of the ague; the worft on 
 our making thecoaft of South Guinea, at the fettlement of Benguela", where 
 we found the wretched remains of a Portugucfe gairiion, the furvivors of a 
 fatal putrid fever, which, as they told us, raged in thofe parts for eighteen 
 months before. The laft attack 1 had was the- day we made the Rock of 
 Lifbon, fince which time I have had no returns of the ague, although, whea 
 the wind continues long at eaft, I am fenfible of a tendency to thai: complaint. 
 
 I fhal! now give a brief account of the fate of my fellow fuH'eiars at Buf- 
 forah This unfortunate party confifted of capt. Sheriff, of the Eagle cruifer; 
 Mr. Brown, a Bengal merchant, carrying goods from India to Aleppo; Mr. 
 Palmer, a gentleman returning with his fortune from Bengal to Europe ; 
 Mr Robfon, iurgeon to the fadory ; Mr. Abraham, the vice-conful ; Dr. 
 Kofs, \vhohad pracYiled many years at Constantinople, forne time in Bengal, 
 and was then taking the opportunity of accompanying me acrofs the defer t ; 
 Mr. Smith, a merchant from India ; and an Italian Carmelite, the vicar of 
 Buflbrah, who came from Bombay. It is unnecellary to fay that the/era dak 
 is a common 1'ymptom in the Turkilh fever, or, in other words, a ftrong dc- 
 iireof feif-dcftrudtion. We had a fatal inftance of it in our party. Mr. 
 Brown, the fecond day of his fever, being left alone, got to his piftols, and. 
 throwing in four or five balls, difchargcd them into his bread, and was found 
 dead a few minutes afterwards. I believe every one of s at times would 
 have done the fame, had we been poffeffed of the means of accomplishing it. 
 Mr Robfon died the rhird day of his fever, in g^eat agonies, but perfedly 
 fenfible. His was a continued high fever, without any remiilion. Mr. Pal- 
 mer died the 4th day, under the fame fymptoms as the preceding. The Car- 
 melite, the fecond morning after he was taken ill, had opened a vein in his 
 arm, and bled to death, moft probably intentionally. Captain Sheriff was 
 feized with the fever on his return from Bullbrah to Bufhire. He died the 
 third day, in a manner which is even painful to relate. H was a man of 
 
 lingxilar 
 
APPENDIX. 363 
 
 Angular ftrength of conftitution, and fuffered unufual agonies before he died. 
 His cries were heard all over the factory ; he foamed at the month* gnaflhed 
 with his teeth, and tore his arms with his teeth. Thofe who heard him com- 
 pared his cries to the bellowing of a mad bull.* He was no fooner dead but 
 his body was covered with purple fpots, and fo oftenfive that th-e people 
 could hardly carry it out to be buried. Mr. Sheriff' swas what they call the 
 worft kind of plague. 
 
 Mr. , formerly mentioned as having efcaped the plague at Buflbrah 
 
 by (hutting himfelf up in a mud houfe, was leized on his voyage to Bufforah 
 with a kind of infanity, imagining that people were conipiriag againft his 
 life, and that he was capable of overhearing, at.a great diftance, even a whif- 
 per fpoken to his difadvantage. He, however, efcaped the infection, and re- 
 turned to England in health. 
 
 N* VII. 
 
 Set of Queries furni/hed by Doffors AIKIN and JEBB ; 
 and by Mr. HOWARD put to fever al foreign Phyfician^ 
 during his tour -, with their Opinions concerning the 
 Plague. 
 
 j. TS the infection of the plague frequently received by the French? 
 
 A Anfwer, by Raytnsndt phyfician at Marfeilles : Sometimes it is. 
 Ditnollinst furgeon do : In the lazaretto feme have touched infected bodies and 
 things with impunity. Attributed to the temperament of the body. Giova- 
 neIH t phyfician to the Leghorn lazaretto : The plague cannot be communicated 
 but by very near approach, or touch : air cannot be the vehicle. They t phyfi- 
 eian to the Malta lazaretto : It may happen that one perfon may inhabit the 
 fame chamber, or even touch an infected perfon, with impunity 5 of which I 
 have known inftances ; but all who approach the atmofphere of an infe&ed bo- 
 dy may receive the infection by refpiration. Contagion is almoft always received 
 before touching or approaching the infected peribn.- Mnrandi, phyfician at 
 Venice : Contact is one of the moft powerful and dangerous means of com- 
 municating the infection ; but for the developement of its effects a predifpofi- 
 
 tion in the receiving body isneceffary. Ferttoni^ phyfician at Triefte : It is 
 
 moft frequently communicated by the touch. It has been given by a flower 
 held and fmelt at, firft by two perfons who remained tree; and then by a 
 third, who fickened and died in 24 hours. -Jew phyfician at Smyrna: The 
 infection is in reality communicated by the touch alone ; for all who keep 
 from contact of infected perfons or things remain free. To the effect of 
 contact, however, a certain difpofition of the air is neceflkry ; for we often fee 
 infected perfons arrive from other countries, yet the difcafe does not fpread. 
 But what this difpofition is can fcarcely be conceived. Commonly in this 
 climate, the difeafe appears at the end of fpring, and continues to the middle 
 of fummer; with this particularity, that, in cloudy weather, and during the 
 Jiracco winds, the attacks are more frequent. Alfo in the fame diathefis of 
 the air lome receive the infection, while others expofed to the fame dangers 
 efcape it. From obfervation it appears, that cachectic perfons, and thofe of 
 conftitutions abounding in acid, do not readily take it. The contagious mi- 
 afmata may be dormant in the body for fome tin;e without doing the leaft 
 
 harm, till let in motion by fudden fear, or the exceffive heat of a bath. 
 
 fra, Luigl di Pavia t prior of thehofpital of San Antonio at Smyrna : The 
 plague is communicated by contact, according to all the obfervations I have 
 been able to make for eighteen years. 
 
 2. Does the plague ever rife fpontaneoufly ? 
 
 Raymond : Inconteilible experience fhows that it only proceeds from 
 fontad. DtKuliitt* ; Irrom all ages tfes plague has been brought to Mar- 
 feilles 
 
5 6 4 
 
 APPENDIX. 
 
 feilles by merehandife or perfons beyond fea GiwatteHi : As the difeafe 
 
 always appears with the lame fymptoms, it is not probably fpontaneous, 
 
 but the confequence of a particular contagion. Ihty : Some contagious 
 
 fevers come of themfelves ; others proceed from the communication of con- 
 tagion. The plague is though* to have originated in Egypt, and fpread itfelf 
 
 from thence. Morandi; Contagious fevers do not arife of themfelves, but 
 
 are always the produd of a peculiar poifon Verdonl : I know na fever that 
 
 can properly be called contagious, and doubt if even the plague can be con- 
 lidered as fuch. My reafons are drawn from the very different manner in 
 which the plague appears in different years, and the different degree in which 
 itfpreads^ I therefore conclude that contagious fevers come of themfelves. 
 Jetv phyfician : According to the mod ancient authorities, the plague has 
 always been brought to Smyrna by contagion, and was never produced here. - 
 Fra. Lulgi : Ancient and common obfervation in this city prove that the 
 plague is derived folcly from contagion. 
 
 5. To What diltance is the air infeded > How far does adual contadt, 
 wearing infected clothes, or touching other things, produce the dileafe ? 
 
 Raymond: The infeded are fafely converged with acrofs a barrier, which 
 
 feparatts them only a few paces. Demollins . The air round the patient is 
 
 infeded more or lets according to the degree of poifon Which exhales. Her* 
 in the lazaretto they are fpoken with acrofs two barriers, a few paces from 
 each other, without fear of contagion. Hence it would appear that the plague 
 is communicated only by the touch, or ftill more by weaving infeded clothes. 
 -Gilvanelii : If one fpeaks of an infeded perfon fhut up in an unventilated 
 chamber, it may be laid that the whole chamber is dangerous ; but if one 
 fpeaks of a patient expofed to the open air, it has been proved that the in- 
 fedion does not extend beyond five geometrical paces from the body. Be- 
 yond this diftance o'ne is in fafety. The adual touch of an infeded perfon 
 or thing is proved to be very dangerous by fatal experience ; but to what de- 
 gree, is not ascertained. They: The infection extends only Tome paces ; and 
 the miafms, at the diftance of about ten paces, are fo corrected by the air as 
 to lofe all their activity. It may be communicated by touching infeded 
 
 things, efpecially of a porous nature, as cloth, wool, fkins, &c Verdoni : 
 
 From the moment of infedion to the time when nature has entirely diflipated 
 the contagious principle, which ufually happens in forty days, there is always 
 a capacity of communicating the infedion. The degree of infedion is in 
 proportion to the volume of air furrouhding the patient ; the air being what 
 abforbs, dilfipates and communicates the contagious principle Infeded 
 fubftances communicate the difeale for many years, in proportion to the 
 ventilation they have undergone, or of which they are lufceptible. jfe-w phy- 
 fician : The degree of infedion in the air about the fick depends upon the 
 greater or lefs malignity of the difeafe, and other cifcumftances. The air 
 about poor patients is more infectious than about the rich Thefe things be- 
 ing eftabliihed, I am of opinion that, in the greateft contagion, we may fe- 
 curely fee a patient at the diftance of two ells, if the chamber windows, be 
 
 not all mut. Fra. Lulgl .- The infedion is greater or lefs in proportion to 
 
 the virulence of the contagion ; but I have made no obfervation as to the dif- 
 tance. The difeafe is communicated by contact of all infeded things, an4 
 by clofe infpiratiori of the breath of the lick. 
 
 4. What are the feafons in which the plague chiefly appears; and what is 
 the interval between the infedion and the difeafe : 
 
 Raymond: The plague mows itfelf at all feafons, but lefs at thetwofol- 
 flices.- D'.mclllns : Great ravages may be made in 'all feafons > but principally 
 in the greateft heats of fummer. From the infedio'n to the difeafe is two or 
 three days. GiwantlH : The plague appears at all times, in the fame man- 
 ner as poifons at all times prodace their effeds. But observations fhow that 
 its ravages are greater in hot feafons than in cold ; and it feerris that fummer 
 and the firft months of autumn are moft to be dreaded. There is no certain- 
 ty as to the interval between \\\z infedion and the difeafe, as it depends on 
 the paiticulat conltitution of the patient. They : Warm, moift feafons con- 
 tribute to the produdion of all infectious difcafes. The interval from the 
 infection to the leisure is various, according to the virulence of the poifonj 
 
 and 
 
APPENDIX. 565 
 
 and the conftifutien of the patient. Sometimes it a&s flowly, fdmetimes lik 
 a ftroke of lightning. Verdoni 3 The fpring is the principal feafon. Gene- 
 rally the difeafe fhows itfelf at the iaftant of touch* like an electrical fhock. 
 Sometimes a perfon retains the contagious principle without any fenfible ef- 
 fect, and then unknowingly communicates it to a third* in whom, if predif- 
 pofed to the difeafe, it becomes active; or, otherwife, it may be commuHica- 
 ted to others fucceflively in the fame way, till it becomes diffipated and an- 
 nihilated, as happened at Smyrna in 1783. In bodies predifpofed it very 
 rarely conceals itfelf till the third day. Jew phyfician : Arffwered in the firft. 
 
 Fra. Luigl : The plague is moft fatal in Smyrna from April to July ; and 
 
 it is conftantly obferved that great colds and hears much diminilh it. and copi- 
 ous dews extinguiih it. The infection (hows itfelf in 24 hours, more or lefs, 
 according to the difference of temperament. 
 
 5 . What are the firft fymptoros of plague ? Are they not frequently a fwel- 
 ling in the glands of the groin and armpit ? 
 
 Raymond : The plague often conceals itfelf under the form of an inflam- 
 matory . ardent or malignant fever. Tumours of the glands are often its firft 
 fynij>'om --Demollins: The firft fymptoms of the plague vary ; but the moft 
 common are, buboes in the armpit and groin ; parotids and carbuncles in va- 
 rious parts of the body. Gio-vanelH . The firft fymptoms are, debility, fe- 
 ver, exceffive thirft, followed by great heat ; after which carbuncles or buboes 
 appear in the armpits, groin and parotids. The groin is fooner attacked than 
 
 the armpit. T6(y t Swellings in the armpits and groin are indeed the cha- 
 
 raderiftics of the plague; yet they are not the fole nor the firft fymptoms, 
 and often are not feen at all ; as when the plague difguifes itfelf under the 
 
 form of other difeafes. Morandi .- Glandular fwellings are properly the 
 
 ifymptom of the fecond ftage, and are preceded by thofe febrile fymptonss 
 which are immediately the confequence of receiving the infection ; fuch as 
 pain in the head t drowfinefs, great proftration of ftrength, dry nefs of the tongue, 
 vomiting, hiccough, tremor, diarrkcea. ferdoni : Its firft fymptoms are rela- 
 tive to the conftitution of the year, and of the body feized, and the place where 
 it was produced, or whence it came. In 1783 all the parts of Natolia were 
 znfecied ; and the difeafe tranfported to Smyrna, which is the centre, was ex- 
 tinguilhed without the lofs of a fingle perfon. Generally the plague of Con- 
 ft^ntinople, tranfported to Smyrna, does little harm. That of Egypt caufes 
 havock, as in every country. That of the Thebais is always cruel, and, car- 
 ried to Lower Egypt, is fatal. The inguinal glands are moft generally af- 
 feded. Jetu phyfician : The fwelling of the glands is feldom the firft fymp- 
 tom. Patients are every day feen who, being fuppofed ill of another difor- 
 <Jer, in two/three or more days fhow glandular fwellings, or carbuncles, by 
 which the plague is manifefted. On the contrary, many, who from the ufuil 
 iigas are fuppofed to have the plague, become well in a day or two, without 
 any external fwelling. The firft fymptoms are, horripilation, or actual fhi- 
 \ering, naufea or vomiting, lofs of ftrength, and fever. Thefe are common to 
 many difeafes ; but the pathognomic figns are, a difference in the pulfations of 
 the two fides, with this circurnftance, that from the diverfity a prognoftic ari- 
 ies ; it having been obferved that if the pulfe on the fide of the tumour or 
 carbuncle be greater or more frequent, it bodes well ; whereas, if it be fmallert 
 it fhows greater malignity, and more is to be feared Further, there is ob- 
 ferved among the firft fymptoms a vifible pulfation in the carotids, greateft on 
 the affected fide; and alfo a cryftalline vivacity in the eyes, with a kind ot 
 
 contraction or diminution of the eye on the aifeded (ide. Fra. Luigl : The 
 
 moft remarkable fymptoms of the plague are, turbidnefs and fparkling of the 
 eyes, the tongue furred with a white mucus, and very red at its tip, frequent 
 -biting of the lips, violent pain in the head, and inability to hold it up ; afenfe 
 of great cold in the loins, vomiting, debility. Swellings of the glands are not 
 among the firft fymptoms. 
 
 6. Is it true that there are two diftind fevers with nearly the fame fymp- 
 toms, one of which is properly termed the plague, and is communicated from 
 a dittance by the air, and without contad ; while the other, which is properly 
 termed contagion, is only communicated by the touch, or at leail by near 
 approach to infected peribn* or things : 
 
 frforanji .- 
 
APPENDIX. 
 
 Morandl t It is certain, from multiplied obfervations, that there are tw 
 forts of neftilential fevers, fimUar in appearance ; one of which proceeds from 
 the contamination of the air alone, and is communicable to any diftance ; the 
 other is produced alone by contad, or near approach. The former of thefe is 
 
 properly termed a peftiletuial fever, the latter a contagious one. Ferdoni t 
 
 The diftin&ion of thefe fevers is ufelefs ; fince the fame which is communi- 
 cated by the touch, is that alfo conveyed by the air to a certain diftance, efpe- 
 ially in aclofo^place. -Jciv phyficiau : That there are two kinds of plague 
 is abfolutely to be denied ; yet fometimes it happens that perfons are attacked 
 with the plague without knowing from whe.ice it came. Fra. Luigi : I hold 
 it for certain that there is only one fpecics of plague, though differing in ma- 
 lignity. 
 
 7. What is the method of treatment in the firft ftage; what in th mot* 
 advanced periods ? What is known concerning bark, fnalceroot, opium, wine, 
 pure air, the application of cold water ? 
 
 Raymond: The difeafe is treated as inflammatory. No fpecific has been 
 
 difcovered for it. DemoUln-s : At the beginning, bkeding,vomiting, purgar 
 
 tives, diluents, refrigerants and antifeptics are ufed ; afterwards antiicptics 
 and cordials, relatively to the temperament and fymptorns Giovanelii .- The 
 plague caufmg always adiipofition to inflammation and putrefadtion, it is al- 
 ways proper to bleed proportionally to the ftrength, and to ufe a cooling re- 
 gimen, with the vegetable, acids. The repeated ufe of emetics is alfo proper* 
 both to clean the firft paiTages, and to difpofe the virus to pals off'by thefkin. 
 In the progrefs it is neceiiary to favour the evacuafion of the virus by that 
 illue winch nature feems to point at. Thus either amiphlogiftic purgative* 
 are given, if nature points that way, or fuppurative plafters are to be applied 
 to any tumours which may appear. Epifpaftics to the extremities are proper 
 where nature wants routing. The vitriolic acid* in large dofes has been found 
 very femceable in the plague at Mofcow, attended with carbuncles. When* 
 the inflammation is over, awd marCks of fuppuratioa appear, the baik, with 
 wine and other cordials, is proper. The lurgeou's affiftaEce is propei in the 
 treatment of boils and anthraces, which laft are feldowi cured without the ac- 
 tual cautery. They ~ In the beginning of peftilential fevers bleeding is fome- 
 times proper, and vomits almoft always. In their progrefs fret^ient fubacid 
 and cold drinks, the bark given liberally, and vitriolic acid, have been found 
 powerful remedies when there was a diffolution of the blood. Morandi : In 
 the firft period, evacuations, according to the particular circumftances of the 
 cafe, are proper : in the fecond, bark mixed with wine, and opium as a tem- 
 porary fedative. Pure air is very neceflary ; and fire as a corrective, with the 
 burning of antifeptic and aromatic fubftances. Verdonl : As foon as a Chrif- 
 tian 3nds he has got the plague, he eats caviare, garlic and pork ; drinks 
 brandy, vinegar and the like, to raifc the buboes. Upon fheis he applies 
 greafy wool, caviare, honey of r0fes, dried figs, &c. to bring them to fuppura- 
 tioa. The Turks and Arabs drink bezoar in powder with milk, and other 
 i'udorifks, in order to expel the virus. They vomit, and poiTibly a fecond 
 time. At Cairc- they take opium, and cover themfelves with mattrefies in 
 order to excite fweat ; and, though parched with Tieat and thirft> they drink 
 nothing. They open the immature buboes with a red hot iron. At Con- 
 ftantinople and Smyrna they eat nothing, and drhik much water and lemonade. 
 The Jews drinka dscodion of citron feeds, lemon or Seville orange peel, and 
 1 heir own urine. They abftain fcrupuloufty from animal food. In 1700 a 
 phyfieian in Smyrna found bleeding very ufefal. 'Another, in another year a 
 cured the plague by bleeding, and an antiphlogiftk jegicien. My brother in 
 Cairo treated it like a biliary fever, with vomits, taponaceou attenuants^ 
 and antiphlogiftics ; an-d fuccdi'sfully. * Some failorsat Confiantinople in the* 
 frenzy of the plague have thrown themfelves into the fea ; and it is faid 
 that on being taken out of it they have recovered. My opinion upon the 
 whole is, that tiro treatment ought to be relative totheconftitution of the"year 
 and of the patient, by which the nature of the difeafe itfelf is greaty altered. 
 Jrw phyiieian : Bleeding in many cafes may be ferviceable, as I haveknowa 
 patients, who were bled by miftake, recover ; and others recovered from a 
 moft defpcuiej, condition by afpomaneoas hemorrhage. On the other hand> 
 
APPENDIX. 567 
 
 {terfons have been apparently "injured by both thefe circumftancss. The 
 difference of effect feems to depend on the (late of the blood* whether it ha 
 difpoled to coagulation or diffolution. In the former, bleeding is ufeful, in 
 the latter, hurtful. Vomits, according to my experience, have not fucceeded; 
 yet I fhould not hefitate to try ipecacuanha in fubftance, exhibiting half a 
 fcruple at two or three times, in the expectation that in this manner it would 
 not run down. Bark may beufeful in diflblutions of the bloed ; and a lfo> 
 ftnall dofes of ofium, and other medicines prudently adrniniftered. In ex- 
 ceffive watchfulnefs I have known relief procured by anointing the temples 
 with ung. populeon. In a cafe of hiccough the liquor anod. miner. HoW- 
 manni fucceeded with one. The Turks, in the violence of the fever, take 
 handfuls of fnow, and apply it all over their bodies, and "alfo eat it; and 
 Sometimes threw cold water on their feet. But whether this is of fervice or 
 not cannot be determined ; as thefe people in other refpedls pay no regard to 
 rules of diet. Fra. Luigi : They who pradtife empirically in the plague ufe 
 none ot the recited methods, but only ftrong fudorifics, and ventilation of the 
 air ; and complete the cure by proper treatment of the fores by fuppuration. 
 
 8. When the plague prevails, do the phyficians prefcribe to thofe who have 
 the diforder a more generous, or a more abftemious diet ? and do they prefcribe 
 any thing to the uninfeded ? 
 
 Jew phyfician : In times of the plague, many are accuftomed to eat no 
 fieih; others, no fifh ; but I know not whether by the advice of phyficians. 
 For myfelf, I have been in many plague years, but have made no alteration in 
 the management of myfelf Pra. Lta'gis In Smyrna the plague is generally 
 treated with a rigorous diet. They only ufe rice and vermicelli boiled in wate*; 
 and fometimes, when the patient is too coftive, juices and herbs boiled without 
 feafoning. From time to time they give fome acid preferves, and raifins, and 
 in great heats, fome (lender lemonade ; and a difh of good coffee with a bilcuit 
 every day. For drink they only ufe toaft and water ; and they follow this ab- 
 ftemious regimen till the fortieth day of the difeafe is completed, after which 
 they take chicken broth, lamb, and other food of eafy digeftion. 
 
 9. Are convalefcents fuhjed to repeated attacks from the fame infeftion? 
 
 Raymond; Not unlefs they touch fomething infected. Demsllint : Con- 
 valefcents are fent to fumigated chambers, and there is no inftance of relapfe. 
 Ginvanelli : No inftance of relapfe, after being well recovered from the 
 iirfl: attack, have come to my knowledge ; bu.t they are liable to fall into other 
 
 diforders, fuch as confumption, haenaoptoe, &c. 'They: Convalefcents are 
 
 without doubt liable to a relapfe, and authors are full of inftances of it. In 
 the plague of Medina M. Cotogno fa^s that a man had fucceflively fourteen 
 
 buboes, and was cured at laft. Morandl : All convalefcents may relapfe. 
 
 Verdoni : They have it not twice in the fame year. Jew phyfician : Con- 
 valefcents are often attacked anew, and die ; but this does not ufually happen 
 from a frefh infection taken el fewere, but from fome remains of their own. 
 contagion, excited by intemperance in food, or the venereal ad. Fra. Luigi .- 
 From irregularities in eating and drinking, bodily fatigues, afTedlions of the 
 mind* efpecially anger, they are liable to repeated ani very dangerous re- 
 lapfes. 
 
 10. What is the proportion of deaths, and the ufual length of the difeafe ? 
 Raymond: The mortality is different in different feafons and years. - 
 
 Demollirt\ : In the plague of Marfeilles in 1720, half the inhabitants perifhed. 
 The ufual length of the difeafe is that of other acute diforders ; but longer 
 when the tumours come to fuppurate. Giovanelii : The proportion of 
 deaths is variable and uncertain. As to duration* when the difeafe is very 
 acute and fatal, the patient generally dies within five days from the firft in- 
 vafion of the fever, or firft marks of the plague- When lie recovers, no cer- 
 tain termination can be affigned. If the time of healing all the fores be 
 
 reckoned, it may be to three, four or five months, or more. They .- The 
 
 mortality is very various. Of ten whom I treated in the lazaretto, three 
 died. I have obferved that the fever generally runs OH to twenty or twenty- 
 one days. Mrrandi : The bills of mortality in places vifited by the plague 
 ufually amount to thirty per cent, fometimes" to fifty. (He- feems to mean of 
 
 the whole number of inhabitants.) V<rd*nl .- The proportion of deaths 
 
 varies 
 
568 
 
 APPENDIX. 
 
 varies infinitely. It ha? been obferved that the Jews in Conflantinople an<f 
 Smyrna Jofe only one third ; which is attributed to the care they take of 
 their fick. At Cairo, on the other hand, they are the firft attacked, and lofe 
 more than three fourths. The Turks Ipfe two thirds ; other nations a little 
 more or lefs. Europeans in Cairo lofe five fixths. Sometimes it kills im- 
 mediately; fometimes in twenty-four hours; commonly in three days. When 
 the patient gets over the ninth day there are great hopes of recovery, as the 
 buboes are then fuppurated. They may, however, die within the fortieth 
 day, efpecially if they commit any irregularity, the principal of wnich is eat- 
 ing flefh, which inftantly caufes a return offerer, and death. It never paffes 
 beyond the fortieth day. Jew phyfician : The mortality is various, as alfo 
 the duration : fome in twoi three or four days ; fome hold out fix, eight, or 
 more. Fra. Luigi : Generally more die than furvive; but in our hofpital of 
 San Antonio of bmyrna, from the '-are taken of the fick, the number reco- 
 vering has, for eighteen years paft, exceeded that of the dead. 
 
 ii. What are the means to prevent the plague, to ftop its contagion, and 
 to purify infected place* I 
 
 Raymond: There is no other method of preserving one's felf from the 
 plague, than avoiding the contaclof infected things Goods are purified by 1 
 expofingthem to the open air for forty days ; and furniture by a ilrong fu- 
 migation with aromatics and fulphur. Demo/ 'tins .- Here, in the lazaretto, in- 
 fected goods and furniture are expofed to a current of air for forty days. The? 
 air of in feel ed places is purified by burning all forts of aromatics. GiovrnmUi : 
 The method of prevention is, to avoid all communication with inleded. 
 perfons or goods. The means of (lopping the contagion form a body of 
 police, tooextendve to be here mentioned- Ihfy : The means of prevention* 
 befides avoiding inte&ed things and perfons, are fobriety in living, the ufe of 
 vinegar internally and externally, and an ifiue. Infected places are purified 
 by fumigation and ventilation, by fcraping the lime from the walls, (which 
 is then thrown into the fea) and whitewalhing them anew with lime and fea- 
 water, by wafhing the floors, windows, doors, &c. firft with fea- water, and 
 then with vinrgar, taking great care to leave nothing that is infected. The 
 bodies ef the dead are buried in a place fet apart for that purpofe ; and their 
 beds and bedding are burned. As to other things not ufed during the ill- 
 nefs, the linen is wafhed with foap and ley ; the woollen clothes are put into 
 lea-water for two days, and then ventilated for twenty days. Thofe which 
 would befpoiled by water are hung on aline in the air for 40 days, and fumi- 
 gated from time to time according to their quality. Morandi . A fire is to 
 be kept conftantly in the fick chamber in all leafons. All faeces, &c. are to 
 be immediately removed. Clean fheets and (hirts daily. The healthy muft 
 avoid commerce with the infected ; muft purge gently now and then, fmoke 
 tobacco, drink pure wine medicated with wormwood, gentian, zedoary, &c. 
 
 and avoid fear and other paflions, and excels of all kinds. Jeiv phyfician : 
 
 No means ef prevention are ufed in the Turkiih dominions. Fra. Luigi ; 
 
 Fire, water and air are ufed for (topping the contagion, and purifying places. 
 Verdoni ; The beft preservatives are fuppofed to be fpririkling the room with 
 vinegar and perfumes, ventilation and fumigation. The Greeks in Smyrna dur- 
 ing lent, when they eat only vegetables, are feldem attacked ; while among 
 thole who eat flefo the contagion makes great havock. Hence the beft means 
 of prevention are to eat moderately, and not at all of animal food ; to drink: 
 xvater and vinegar ; to fprinklethe chamber with the latter; and ufe frequent 
 ventilation ; to change the clothes, efpecially the linen, daily ; hanging in the 
 air luch as has been ufed, for 15 or *o days. For fupprefling the infection 
 every thing is to be waihed that can undergo the operation, and the walls of 
 the chamber to be whitened with lime, but after the 241*1 of June no further 
 care is taken. , 
 
 FINIS. 
 
ERRATA. 
 
 PACE. LINE. 
 
 20. 23. For deftroy!ng three or four thoufand,* Tead 'Ueftroying fix- 
 teen hundred out of three or four thoufand.' 
 39. 13. from bottom, for Zibira,' read Zebire.' 
 86. 10- for obfcuredt' read obfcure.' 
 153. 20. for acid other,' read acid in the other.' 
 
 302. 15. from bottom, after the inhabitants,' add, Farther eaft it does 
 
 not go.' 
 280. 7. from bottom, for ' flattering,' read fluttering.' 
 
 303. 8. from bottom (in a few copies) for 'gout, fever,' read ' gaol- fever.' 
 309. 10. for lately to,' read fafety of.' 
 
 460. 2. from bottom, for fluid,' read fluids.* 
 
 480. 12. from bottom, for ' Black affizes,' read < Black Hole.' 
 
 486. 5 for Hansforth,' read Hansford ;' alfo in pages 489 & 510, 
 
 5<as. i. for parcity,' read paucity.' 
 
 13. i, bottom, for vol- x,' read vol. iii. 1