Title: A Short Discourse Concerning Pestilential Contagion, and the Methods to Be Used to Prevent It
Author: Mead, Richard
Language: English
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                                A SHORT
                               DISCOURSE
                               CONCERNING
                       _Pestilential Contagion_,
                                AND THE
                                METHODS
                       To be used to Prevent it.


                        By _RICHARD MEAD_, M.D.
                  Fellow of the College of Physicians
                       and of the Royal Society.

[Illustration]

                               _LONDON_:
            Printed for _Sam. Buckley_ in _Amen-Corner_, and
              _Ralph Smith_ at the _Royal-Exchange_, 1720.



[Illustration]



                                 TO THE

                            Right Honourable

                          _James Craggs_, Esq;

                                 ONE OF

                        His Majesties principal
                         Secretaries of State.

_SIR_,

I _Most humbly offer to You my Thoughts concerning the_ Prevention of
the Plague, _which I have put together_ _by your Command. As soon as you
was pleased to signify to me, in his_ Majestie's _Absence; that their
Excellencies the_ Lords Justices _thought it necessary for the Publick
Safety, upon the Account of the_ Sickness _now in_ France, _that proper
Directions should be drawn up to defend our selves from such a Calamity;
I most readily undertook the Task, though upon short Warning, and with
little Leisure: I have therefore rather put down the_ principal Heads of
Caution, _than a_ Set of Directions in Form.

The first, _which relate to_ the performing Quarentines, _&c. You, who
are perfectly versed in the History of_ Europe, _will see are agreable
to what is practised in other Countries, with some new Regulations_. The
next, _concerning the_ suppressing Infection here, _are very different
from the Methods taken in former Times among_ Us, _and from what they
commonly Do_ Abroad: _But, I persuade my self, will be found agreable to
Reason_.

_I most heartily wish, that the wise Measures, the_ Government _has
already taken, and will continue to take, with Regard to the_ former
_of_ these, _may make the_ Rules _about the_ latter _unnecessary:
However it is fit, we should be always provided with proper_ Means of
Defence _against so terrible an_ Enemy.

_May this short_ Essay _be received as one Instance, among many others,
of the Care, you always shew for Your Country; and as a_ _Testimony of
the great Esteem and Respect, with which I have the Honour to be,_

                                  SIR,

                          Your most obedient,
                          Most humble Servant,

Novemb. 25. 1720.

                                                                R. MEAD.

[Illustration]

                                PART I.

                                 OF THE

                                 NATURE

                                   OF

                              _CONTAGION_.

That the Reasonableness of any Method, which shall be proposed to
prevent the spreading of _Contagious_ Diseases, may the better appear,
it is necessary to premise somewhat in general concerning _Contagion_,
and the Manner, by which it acts.

Contagion is propagated by three Causes, the _Air_; _Diseased Persons_;
and _Goods transported from infected Places_.

We shall therefore first enquire what alteration of the _Air_ it is,
that makes it _infectious_; and then, by what Means it communicates its
noxious Quality to other Bodies.

The ancientest and best Authors of Physick, who lived in a Country more
exposed to these Calamities than ours, observed the Constitution of the
_Air_, which preceded _Pestilential Fevers_, to be great _Heats_
attended with much _Rain_ and _Southerly Winds_[1]: And one of Them
takes particular Notice, that no other than a _moist_ and _hot_
Temperament of the _Air_ brings the _Plague_; and that the Duration of
this Constitution is the Measure of the Violence of the Distemper[2].

The Natural History of several Countries confirms this Observation; in
_Africa_ particularly, if Showers fall during the sultry Heats of _July_
and _August_, the _Plague_ ensues thereupon, with which whosoever is
infected hardly escapes[3].

It has besides been remarked in all Times, that the Stinks of
_stagnating Waters_ in hot Weather, _putrid Exhalations_ from the Earth;
and above all, the Corruption of dead _Carcasses_ lying unburied, have
occasioned _infectious Diseases_.

From hence it appears to be a _Concurrence_ of Causes, that produces
Diseases of this Kind; which must not only meet, but exert their Force
together for a considerable time. And when this happens, their first
effect is a Degree of _Stagnation_ in the Air, which is afterwards
followed by _Corruption_ and _Putrefaction_.

And upon this account it is, that those Countries are chiefly liable to
these Calamities, where not only the _Heats_ are very great, and the
_Weather_ continues long in the same State; but the _Winds_ (the Use of
which is by Motion to purify the Air) do not shift and change so often
as they do in Northern Climates.

Indeed _Plagues_ seem to be of the Growth of the _Eastern_ and
_Southern_ Parts of the World, and to be transmitted from them into
colder Climates by the Way of _Commerce_. Nor do I think, that in this
_Island_ particularly there is any one Instance of a _Pestilential_
Disease among us of great Consequence; which we did not receive from
other _infected_ Places.

This I the rather mention, because it is a common Opinion, and
propagated by Authors of great Name, that we are usually _visited_ with
the _Plague_ once in 30 or 40 Years; which is a mere Fancy without any
Foundation either in Reason or Experience: and therefore People ought to
be delivered from the Subjection to such vain Fears.

On the contrary, though we have had several Strokes of this kind, yet
there are Instances of bad _Contagions_ from abroad being brought over
to us, which have proved less malignant here by our Air not being
disposed to receive such Impressions.

The _Sweating Sickness_, called the _Sudor Anglicus_ and _Febris
Ephemera Britannica_, because it was commonly thought to have taken its
Rise here, was most probably of a foreign Original, and no other than a
_Plague_ abated in its Violence by the mild Temperament of our Climate.

For, we learn from Histories, that the first time this was felt here,
which was in the Year 1485, it began in the Army, with which King
_Henry_ VII. came from _France_, and landed in _Wales_[4]; and it was
then thought to have been brought into _France_ from the famous Siege of
_Rhodes_ by the _Turks_ 3 or 4 Years before. And of the four Returns,
which this has made since that Time; two, viz. _those_ in the Years
1527, and 1528, may very justly be suspected to have been owing to the
_Pestilence_, which at those Times raged in _Italy_, particularly at
_Florence_ and _Naples_[5]. And the others were very probably from a
_Turkish_ Infection.

I call this Distemper a _Plague_ with lessened Force, because the
Symptoms of it were of that kind, though in a less Degree; as great
_Faintness_ and _Inquietudes_, inward _Burning_, _Pain_ in the _Head_, a
_Delirium_ &c. All which were accompanied with profuse _Sweats_, and the
Disease lasted but 24 hours. And though for want of Care and due
Management many died of it; yet, as a learned and wise _Historian_[6]
observes, _It appeared rather to be a surprize of Nature than obstinate
to Remedies, for if the Patient was kept warm with temperate Cordials,
he commonly recovered_.

And I cannot but take Notice, as a Confirmation of what I have been
advancing, that we had here the same kind of Fever in the Year 1713,
about the Month of _September_, which was called the _Dunkirk Fever_, as
being brought by our Soldiers from that Place; where it was indeed a
Malignant Disease attended with a _Diarrhœa_, _Vomiting_, &c. and
probably had its Original from the Pestilential Distemper, which some
time before broke out at _Dantzick_ and _Hamburgh_: But with us was much
more mild, beginning only with a Pain in the Head, and by very easy
Means went off in large _Sweats_, after a Day's Confinement.

There being in every Air a greater Disposition to _Contagion_ at one
Time than another, we have indeed sometimes felt this Calamity with
greater Fury; as particularly the last time in the Year 1665; when it
continued in this _City_ about ten Months, and swept away by computation
97306 Persons: But it was generally allowed, that the _Contagion_ came
by _Cotton_ imported from _Turkey_[7]; and the long Duration of it, I
believe, may justly be charged up the unhappy Management of infected
Houses, which was then directed by Publick Authority; as I shall shew
anon.

And the History of the most terrible of all the Plagues, that ever were
in these Parts of the World, which was that in the Year 1349, gives a
manifest Proof from whence all _Europe_ may trace the Origine of these
Evils, viz. from _Asia_: for [8]This taking its Rise in _China_ in the
Year 1346, advanced through the East _Indies_ to _Syria_, _Turkey_,
_Ægypt_, _Greece_, _Africa_, &c. In 1347 some Ships from the _Levant_
carried it to _Sicily_, _Pisa_, _Genoa_, &c. In 1348 it got into
_Savoy_, _Provence_, _Dauphiny_, _Catalonia_, _Castile_, &c. In 1349 it
seized _England_, _Scotland_, _Ireland_, and _Flanders_; and in the next
place _Germany_, _Hungary_, and _Denmark_; and in all these Countries
made most incredible Havock.

But to return to the Consideration of the Air, which we left in a putrid
State: It is to be observed, that Putrefaction is a kind of
Fermentation, and that all Bodies in a Ferment emit a volatile active
Spirit, of Power to agitate, and put into intestine Motions, that is, to
change the Nature of other Fluids into which it insinuates it self.

It were easy to shew from the best _Theory_ of Fevers[9], how the
Alterations made in the _Blood_ this Way will favour _Pestilential_
Diseases, by rendring the Body obnoxious to them: But the Digression
would be too great.

THIS is one step towards _Contagion_. The next, as it seems to me,
proceeds after this Manner. The Blood in all _Malignant Fevers_,
especially _Pestilential_ ones, at the latter End of the Disease, does
like Fermenting Liquors throw off a great Quantity of active Particles
upon the several _Glands_ of the Body, particularly upon those of the
Mouth and Skin, from which the Secretions are naturally the most
constant and large. These, in _Pestilential_ Cases, although the Air be
in a right State, will generally infect those, who are very near to the
sick Person; otherwise are soon dispersed and lost: But when in an evil
Disposition of _This_ they meet with the subtle Parts, its Corruption
has generated, by uniting with them they become much more active and
powerful, and likewise more durable and lasting, so as to form an
_Infectious Matter_ capable of conveying the Mischief to a great
Distance from the diseased Body, out of which it was produced.

They who know what strange Attractions and Combinations are made by
volatile Spirits will understand this Reasoning; especially if they
consider, how easily all kinds of _Effluvia_ are diffused in a warm Air,
such as we have described an Infectious one to be; and further, of how
penetrating a Force the finest Parts of Animal Juices are; of which the
strange Stench of a mortified Limb, upon a Body yet living, will
convince any one.

A corrupted State of Air is without doubt necessary to give these
_Contagious Atoms_ their full Force; for otherwise it were not easy to
conceive how the _Plague_, when once it had seized any Place, should
ever cease, but with the Destruction of all the Inhabitants: Which is
readily accounted for by supposing an Emendation of the Qualities of the
Air, and the restoring of it to a healthy State capable of dissipating
and suppressing the Malignity.

On the other hand it is evident, that _Infection_ is not received from
the Air it self, however predisposed, without the Concurrence of
something emitted from _Infected_ Persons; because, by strictly
preventing all Intercourse of Infected Places with the Neighbourhood, it
may be effectually kept from spreading: Whereas the least Wind must
necessarily convey whatever noxious Quality resides in the Air alone,
even to a great Distance. Of this we have had a fresh Proof in the
present unhappy _Plague_ in _France_, which, by keeping careful Guard,
was confined for a considerable Time within the Walls of _Marseilles_;
so that none of the adjacent Villages suffered any thing by it; till at
length some Persons finding Means to escape carried the Infection along
with them. And we find, they have been able, by the like Care, still to
restrain it within moderate Bounds.

This is the Manner by which Infectious _Effluvia_ are generated; The
Way, by which a sound Person receives the Injury, I suppose most
commonly to be this. These _Contagious_ Particles being drawn in with
the Air we breath, they taint in their Passage the _Salival_ Juices,
which being swallowed down into the Stomach presently fix their
Malignity there; as appears from the _Nausea_ and _Vomiting_, with which
the Distemper often begins its first Attacks. Though I make no Question
but the _Blood_ is also more immediately affected by hurtful Particles
being mixed through Inspiration with it in the Lungs.

The third Way, by which we mentioned _Contagion_ to be spread, is by
_Goods transported from infected Places_. It has been thought so
difficult to explain the Manner of _this_, that some Authors have
imagined _Infection_ to be performed by the Means of _Insects_, the
_Eggs_ of which may be conveyed from Place to Place, and make the
Disease when they come to be _hatched_. As this is a supposition
grounded upon no manner of Observation, so I think there is no need to
have Recourse to it. If, as we have conjectured, the _Matter of
Contagion_ be an active Substance, perhaps in the Nature of a _Salt_,
generated chiefly from the Corruption of a _Humane Body_, it is not hard
to conceive how this may be lodged and preserved in soft, porous Bodies,
which are kept pressed close together.

We all know how long a time _Perfumes_ hold their _Scent_, if wrapt up
in proper Coverings: And it is very remarkable, that the strongest of
these, like the _Matter_ we are treating of, are mostly _Animal_ Juices,
as _Mosch_, _Civet_, &c. and that the Substances found most fit to keep
them in, are the very same with those which are most apt to receive and
communicate _Infection_, as, _Furrs_, _Feathers_, _Silk_, _Hair_,
_Wool_, _Cotton_, _Flax_, &c. the greatest Part of which are likewise of
the Animal Kind; which Remark alone may serve to lead Us a little into
the true Nature of _Contagion_.

From all that has been said, it appears, I think, very plainly, that the
_Plague_ is a real Poison, which being bred in the Eastern or Southern
Parts of the World, maintains it self there by circulating from
_Infected_ Persons to Goods; which is chiefly owing to the Negligence of
the People in those Countries, who are stupidly Careless in this Affair:
That when the Constitution of the Air happens to favour Infection, it
rages there with great Violence; That at that Time more especially
diseased Persons give it to one another, and _Contagious Matter_ is
lodged in Goods of a loose and soft Texture, which being packt up, and
carried into other Countries, let out, when opened, the imprisoned Seeds
of Contagion: And lastly, That the Air cannot diffuse and spread these
to any great Distance, if Intercourse and Commerce with the Place
infected be strictly prevented.

[Illustration]



[Illustration]



                                PART II.

                                 OF THE

                                METHODS

                               TO PREVENT

                              _CONTAGION_.

As it is a satisfaction to know, that the _Plague_ is not a Native of
our Country, so this is likewise an Encouragement to the utmost
Diligence in finding out Means to keep our selves clear from It.

This Caution consists of two Parts: _The preventing its being brought
into our Island_; And, if such a Calamity should happen, _The putting a
stop to its spreading among us_.

The first of these is provided for by the established Method of obliging
Ships, that come from _Infected_ Places, to _perform Quarentine_: As to
which I think it necessary, that the following Rules be observed.

Near to our several Ports, there should be _Lazarettos_ built in
convenient Places, on little Islands if it can so be, for the Reception
both of Men and Goods, which arrive from Places suspected of
_Infection_: The keeping Men in _Quarentine_ on board the Ship being not
sufficient; the only Use of which is to observe whether any dye among
them. For _Infection_ may be preserved so long in Cloaths, in which it
is once lodged, that as much, nay more of it, if Sickness continues in
the Ship, maybe brought on Shoar at the End than at the beginning of the
40 Days: Unless a new _Quarentine_ be begun every time any Person dies;
which might not end, but with the Destruction of the whole Ship's Crew.

If there has been any _Contagious_ Distemper in the Ship; The _Sound_
Men should leave their Cloaths; which should be burnt; the Men washed
and shaved; and having fresh Cloaths, should stay in the _Lazaretto_ 30
or 40 Days. The reason of this is, because Persons may be recovered from
a Disease themselves, and yet retain _Matter_ of _Infection_ about them
a considerable Time; as we frequently see the _Small-Pox_ taken from
those, who have several Days before passed through the Distemper.

The _Sick_, if there be any, should be kept in Houses remote from the
_Sound_; and some time after they are well, should also be washed and
shaved, and have fresh Cloaths; whatever they wore while Sick being
burnt: And then being removed to the Houses of the _Sound_, should
continue there 30 or 40 days.

I am particularly careful to destroy the _Cloaths_ of the Sick, because
they Harbour the very _Quintessence_ of _Contagion_. A very ingenious
Author[10] in his admirable Description of the _Plague_ at _Florence_ in
the Year 1348, relates what himself saw: That two _Hogs_ finding in the
Streets the _Rags_, which had been thrown out from off a poor Man dead
of the Disease, after snuffling upon them, and tearing them with their
Teeth, fell into Convulsions, and dyed in less than an Hour.

If there has been no Sickness in the Ship, I see no reason why the Men
should perform _Quarentine_. Instead of this, they may be washed, and
their Cloaths aired in the _Lazaretto_, as Goods, for one Week.

But the greatest Danger is from such _Goods_, as are apt to retain
Infection, such as _Cotton_, _Hemp_ and _Flax_, _Paper_ or _Books_,
_Silk_ of all sorts, _Linen_, _Wool_, _Feathers_, _Hair_, and all kinds
of _Skins_. The _Lazaretto_ for these should be at a Distance from that
for the Men, and they must in convenient Warehouses be unpackt, and
exposed, as much as may be, to the fresh Air for 40 Days.

This may perhaps seem too long; but as we don't know how much Time
precisely is necessary to purge the Interstices of Spongy Substances
from _infectious Matter_ by fresh Air, the Caution cannot be too great
in this Point: Unless there could be a Way found out, without hazarding
Men's Lives, of trying when Bodies have done emitting the Noxious Fumes;
which possibly might be done by putting tender _Animals_ near to them,
particularly by setting little _Birds_ upon the exposed Goods; because
it has been observed in Times of the _Plague_, that the Country has been
forsaken by the _Birds_; and those kept in Houses have many of them
dyed[11]. But the Use of this Fancy Experience only must shew; for I am
well aware, that all _Plagues_ do not indifferently affect all Kinds of
living Creatures; on the contrary, most are confined to a particular
_Species_ of them; like the Disease of the _Black Cattle_ a few Years
since, which neither proved Infectious to other Brutes, nor to Men.

I take it for granted, that the _Goods_ should be _opened_, when they
are put into the _Lazaretto_, otherwise their being there will avail
nothing. The Misfortune, which happened in the Island of _Bermudas_
about 25 Years since, gives a Proof of this; where, as the Account has
been given me by the learned Dr. _Halley_, a Sack of _Cotton_, put on
Shoar by Stealth, lay above a Month without any Prejudice to the People
of the House, where it was hid; but when it came to be distributed among
the Inhabitants, it carried such a _Contagion_ along with it, that the
living scarce sufficed to bury the Dead.

Indeed as it has been frequently experienced, that of all the Goods,
which harbour _Infection_, _Cotton_ in particular is the most dangerous,
and _Turkey_ is almost a perpetual _Seminary_ of the _Plague_; I cannot
but think it highly reasonable, that whatever _Cotton_ is imported from
that Part of the World, should at all Times be kept in _Quarentine_;
because it may have imbibed _Infection_ at the Time of its packing up,
notwithstanding no Mischief has been felt from it by the Ship's Company.

As all reasonable Provisions should be made both for the _Sound_ and
_Sick_, who perform _Quarentine_; so the strict keeping of it ought to
be inforced by the severest _Penalties_. And if a Ship come from any
Place, where the _Plague_ raged, at the Time of the Ship's Departure
from it, with more than usual Violence, it will be the securest Method
to _Burn_ all the _Goods_, and even the _Ship_.

Nor ought this further Caution to be omitted, That when the _Contagion_
has ceased in any Place by the approach of Winter, it will not be safe
to open a free Trade with It too soon: Because there are Instances of
the _Distemper's_ being stopt by the Winter Cold, and yet the Seeds of
it not destroyed, but only kept unactive, till the Warmth of the
following Spring has given them new Life and Force. Thus in the great
Plague at _Genoa_ near 60 Years ago, which continued part of two Years;
the first Summer about 10,000 dyed; the Winter following hardly any; but
the Summer after no less than 60,000. So likewise the last _Plague_ at
_London_ began the Autumn before the Year 1665, and was stopt during the
Winter by a hard Frost of near three Month's Continuance; so that there
remained no further Appearance of it till the ensuing Spring[12]. Now if
Goods brought from such a Place should retain any of the latent
Contagion, there will be Danger of their producing the same Mischief in
the Place, to which they are brought, as they would have caused in that,
from whence they came.

But above all it is necessary, that the _Clandestine Importing_ of Goods
be punished with the utmost Rigour; from which wicked Practice I should
at this Time apprehend more Danger of bringing the _Disease_ from
_France_, than by any other Way whatsoever.

These are, I think, the most material Points, to which Regard is to be
had in defending ourselves against _Contagion_ from other Countries. The
particular Manner of putting these Directions in Execution, as the
_Visiting_ of _Ships_, _Regulation_ of _Lazarettos_, &c. I leave to
proper Officers, who ought sometimes to be assisted herein by able
Physicians.

The next Consideration is, What to do in Case, through a Miscarriage in
the publick Care, by the Neglect of Officers, or otherwise, such a
Calamity should be suffered to befall us.

There is no _Evil_ in the World, in which the great Rule of _Resisting
the Beginning_, more properly takes Place, than in the present Case; and
yet it has unfortunately happened, that the common Steps formerly taken
have had a direct Tendency to hinder the putting _this Maxim_ in
Practice.

As the _Plague_ always breaks out in some particular Place, it is
certain, that the Directions of the _Civil Magistrate_ ought to be such,
as to make it as much for the Interest of Families to discover their
Misfortune, as it is, when a House is on _Fire_, to call in the
Assistance of the Neighbourhood: Whereas on the contrary, the Methods
taken by the Publick, on such Occasions, have always had the Appearance
of a severe _Discipline_ and even _Punishment_, rather than of a
_Compassionate Care_: Which must naturally make the _Infected_ conceal
the Disease as long as was possible.

The main Import of the _Orders_ issued out at these Times was, As soon
as it was found, that any House was infected, to keep it shut up, with a
_large red Cross_, and _Lord have Mercy upon us_ on the Door; and
Watchmen attending Day and Night to prevent any one's going in or out,
except _Physicians_, _Surgeons_, _Apothecaries_, _Nurses_, _Searchers_,
&c. allowed by Authority: And this to continue at least a Month after
all the Family was _dead_ or _recovered_[13].

It is not easy to conceive a more dismal Scene of Misery, than this;
Families seized with a Distemper, which the most of any in the World
requires Help and Comfort, lockt up from all their Acquaintance; left it
may be to the Treatment of an inhumane Nurse (for such are often found
at these Times about the Sick;) and Strangers to every thing but the
Melancholy sight of the Progress, Death makes among themselves; with
small Hopes of Life, and those mixed with Anxiety and Doubt, whether it
be not better to Dye, than to survive the Loss of their best Friends,
and nearest Relations.

If _Fear_, _Despair_, and all _Dejection of Spirits_ dispose the Body to
receive _Contagion_, and give it a great Power, where it is received, as
all Physicians agree they do, I don't see how a Disease can be more
enforced, than by such a Treatment.

Nothing can justify such _Cruelty_, but the Plea, that it is for the
Good of the whole _Community_, and prevents the spreading of
_Infection_. But this upon due Consideration will be found quite
otherwise: For while _Contagion_ is kept nursed up in a House, and
continually encreased by the daily Conquests it makes, it is impossible
but the _Air_ should by Degrees become _tainted_, which by opening
Windows, &c. will carry the Malignity first from House to House; and
then from one Street to another. The shutting up Houses in this Manner
is only keeping so many _Seminaries_ of _Contagion_, sooner or later to
be dispersed abroad: For the waiting a Month, or longer, from the Death
of the last Patient will avail no more, than keeping a _Bale_ of
infected _Goods_ unpack'd; the Poyson will fly out, whenever the
_Pandora's Box_ is opened.

As these Measures were owing to the Ignorance of the true Nature of
_Contagion_, so they did, I firmly believe, contribute very much to the
long Continuance of the _Plague_, every time they have been practised in
this City: And no doubt they have had as ill Effects in other Countries.

It is therefore no wonder, that great Complaints were sometimes made
here against this unreasonable Usage; which, when they prevailed so far,
as to procure some Release for the _Sick_, were remarkably followed with
an Abatement of the Disease. The _Plague_ in the Year 1636 began with
great Violence, but Leave being given by the King's Authority for People
to quit their Houses; it was observed, That _not one in twenty of the
well Persons removed fell Sick, nor one in ten of the Sick dyed_[14].
Which single Instance alone, had there been no other, should have been
of Weight ever after to determine the Magistracy against too strict
Confinements. But besides this, a preceding _Plague_, viz. in the Year
1625, affords us another Instance of a very remarkable Decrease upon the
discontinuing to _shut up_ Houses. It was indeed so late in the Year,
before this was done, that the near Approach of Winter was doubtless one
Reason for the Diminution of the Disease, which followed: Yet this was
so very great, that it is at least past dispute, that the Liberty then
permitted was no Impediment to it: For this _opening_ of the Houses was
allowed of in the beginning of _September_; and whereas the last Week in
_August_, there dyed no less than 4218, the very next Week the _Burials_
were diminuished to 3344, and in no longer time than to the fourth Week
after, to 852[15].

Since therefore the Management in former Times neither answers the
Purpose of _discovering the Beginning_ of the _Infection_, nor of
putting a stop to it when _Discovered_, other Measures are certainly to
be taken; which I think should be of this Nature.

Instead of _ignorant old Women_, who are generally appointed _Searchers_
in Parishes to enquire what Diseases People dye of, That _Office_ should
be committed to _Understanding and Diligent Men_, whose Business it
should be, as soon as they find any have dyed after an uncommon Manner,
particularly with _livid Spots_, _Buboes_, or _Carbuncles_, to give
Notice thereof to the Magistrates; who should immediately send skilful
Physicians to Visit the Houses in the Neighbourhood, especially of the
_Poorer_ sort, among whom this Evil generally begins; and if upon their
Report it appears, that a _Pestilential Distemper_ is broke out among
the Inhabitants, They should without Delay order all the Families, in
which the Sickness is, to be _Removed_; The Sick to different Places
from the _Sound_; but the Houses for both should be three or four Miles
out of Town; and the _Sound_ People should be _stript of all their
Cloaths_, and _washed_ and _shaved_, before they go into their new
Lodgings.

No Manner of _Compassion_ and _Care_ should be wanting to the
_Diseased_; to whom, being now in _clean_ and _airy_ Habitations, there
would, with due Cautions, be no great Danger in giving Attendance. All
Expences should be paid by the Publick, and no Charges ought to be
thought great, which are counterbalanced with the saving a Nation from
the greatest of Calamities. Nor does it seem to me at all unreasonable,
that a _Reward_ should be given to the Person, that makes the first
Discovery of _Infection_ in any Place; since it is undeniable, that the
making known the _Evil_ to those, who are provided with proper Methods
against it, is the first and main Step towards the overcoming it.

When the _Sick Families_ are gone, all the Goods of the Houses, in which
they were, should be _burnt_; nay the Houses themselves, if that can
conveniently be done. And after this all possible Care ought still to be
taken to remove whatever Causes are found to breed and promote
_Contagion_. In order to this, the _Overseers_ of the Poor (who might be
assisted herein by other Officers) should visit the Dwellings of all the
meaner sort of the Inhabitants, and where they find them _stifled up too
close_ and _nasty_, should lessen their Number by sending some into
better Lodgings, and should take Care, by all Manner of Provision and
Encouragement, to make them more _cleanly_ and _sweet_.

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

Our common _Prisons_ afford us an Instance of this, in which very few
escape, what they call the _Gaol Fever_, which is always attended with a
Degree of _Malignity_ in proportion to the _Closeness_ and _Stench_ of
the Place: And it would certainly very well become the Wisdom of the
Government, as well with Regard to the Health of the _Town_, as in
Compassion to the _Prisoners_, to take Care, that all _Houses of
Confinement_ should be kept as Airy and Clean, as is consistent with the
Use, to which they are designed.

The _Black Assize_ at _Oxford_, held in the Castle there in the Year
1577, will never be forgot[16]; at which the _Judges_, _Gentry_, and
almost all that were present, to the Number of 300, were killed by a
_poysonous Steam_, thought by some to have broke forth from the _Earth_;
but by a _noble_ and _great_ Philosopher[17] more justly supposed to
have been brought by the _Prisoners_ out of the _Goal_ into _Court_; it
being observed, that they alone were not injured by it.

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

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

If these early _Precautions_, we have mentioned, take Effect, there will
be no need of any Methods for _Correcting the Air_, _Purifying Houses_,
or of _Rules for preserving particular Persons from Infection_: To all
which, if the _Plague_ get head, so that the _Sick_ are too many to be
removed, Regard must be had.

As to the _first_; _Fire_ has been almost universally recommended for
this Purpose, both by the Ancients and Moderns; who have advised to make
frequent and numerous _Fires_ in the Towns infected: By which Means, it
is said, _Hippocrates_ preserved _Greece_ from a _Plague_, which was
entring into it from _Æthiopia_[18]. And it is certain, that some evil
Dispositions of the Air, particularly such as proceed from _Damps_,
_Exhalations_, &c. may be corrected by _Fire_, and the Predisposition of
it to receive _Infection_ from these Causes sometimes removed. But when
the Distemper is actually _begun_, and rages, since it is known to be
_spread_ and _increased_ by the _Heat_ of the _Summer_, and on the
contrary checked by the _cold_ in _Winter_; undoubtedly, whatever
increases that _Heat_ will so far add Force to the Disease. Whether the
Service _Fires_ may do by correcting any other ill Qualities of the Air
will counterbalance the Inconvenience upon this Account, Experience only
can determine; and the Fatal success of the Tryals made here in the last
_Plague_, is more than sufficient to discourage any further Attempts of
this Nature; for _Fires_ being ordered in all the _Streets_ for three
Days together, there dyed in one Night following no less than 4000;
whereas in any single Week before or after, not much above three times
that Number were carryed off[19].

What has been said of _Fires_, is likewise to be understood of _firing
of Guns_, which some have too rashly advised. The proper Correction of
the Air would be to make it _fresh_ and _cool_. Accordingly the
_Arabians_[20], who were best acquainted with the Nature of
_Pestilences_, advise People to keep themselves as _airy_ as possible,
and to chuse Dwellings exposed to the Wind.

For keeping _Houses_ cool, they took to be the best Method of
_purifying_ them; and therefore to answer this End more fully, they
directed to strew them with _cooling_ Herbs, as _Roses_, _Violets_,
_Water-Lillies_, &c. and to be washed with _Water_ and _Vinegar_; than
all which, especially the last, nothing more proper can be proposed:
Though it be directly contrary to what Modern Authors mostly advise,
which is to make Fumes with hot Things, as _Benzoin_, _Frankincense_,
_Asa Fœtida_, _Storax_, &c. from which I see no reason to expect any
Virtue to destroy the Matter of _Infection_, or to keep particular
Places from a Disposition to receive it; which are the only things here
to be aimed at. It is of more Consequence to be observed, that as
_Nastiness_ is a great Source of _Infection_, so _Cleanliness_ is the
greatest Preservative: Which is the true Reason, why the Poor are most
obnoxious to Disasters of this Kind.

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

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

The Advice to keep at a Distance from the _Sick_, is also to be
understood of the _Dead Bodies_: which should be _buried_ at as great a
Distance from Dwelling Houses, as may be; put _deep_ in the Earth; and
_covered_ with the exactest Care. They should likewise be _carried out_
in the _Night_, while they are yet fresh and free from Putrefaction:
Because a Carcass not yet beginning to Corrupt, if kept from the Heat of
the Day, hardly emits any kind of Steam or Vapour.

As for those, who must of necessity attend the _Sick_; some further
Directions should be added for their Use. These may be comprehended in
two short Precepts. _One_ is, not to _swallow their Spittle_ while they
are about the _Sick_, but rather to _spit_ it out: _The other_, not so
much as to _draw in their Breath_, when they are very near them. The
reason for both these appears from what has been said above concerning
the Manner, in which a sound Person receives the Infection.

This is the Sum of what I think most likely to stop the Progress of the
_Disease_ in any Place, where it shall have got Admittance. If some few
of these _Rules_ refer more particularly to the City of _London_, with
small Alteration they may be applied to any other _Place_. It now
remains therefore only to lay down some Directions to hinder the
_Distemper's_ spreading from _Town_ to _Town_. The best Method for
which, where it can be done, is to cast up a _Line_ about the _Town
infected_, at a convenient Distance; and by placing a _Guard_, to hinder
People's passing from it without due Regulation, to other Towns: But not
absolutely to forbid any to withdraw themselves, as they have now done
in _France_, according to the usual Practice abroad; which is an
unnecessary Severity, not to call it a Cruelty. I think it will be
enough, if all, who desire to pass the _Line_, be permitted to do it,
upon Condition they first perform _Quarantine_ for about 20 Days in
_Tents_, or other more convenient _Habitations_. But the greatest Care
must be taken, that none pass without conforming themselves to this
Order, both by keeping diligent _Watch_, and by _punishing_ with the
utmost Severity, any that shall either have done so, or attempt it. And
the better to discover _such_, it will be requisite to oblige all, who
travel in any Part of the Country, under the same Penalties, to carry
with them _Certificates_ either of their coming from Places not
_Infected_, or of their passing the _Line_ by permission.

This I take to be a more effectual Method to keep the _Infection_ from
spreading, than the absolute refusing a Passage to People upon any
Terms. For when Men are in such imminent Danger of their Lives, where
they are; many, no doubt, if not otherwise allowed to escape, will use
Endeavours to do it secretly, let the Hazard be ever so great. And it
can hardly be, but some will succeed in their Attempts; as we see fell
out in _France_ notwithstanding all their Care. But one that gets off
thus clandestinely, will be more like to carry the Distemper with him,
than twenty, nay a hundred, that go away under the preceding
Restrictions: Especially because the _Infection_ of the Place, he flies
from, will by this Management be rendered much more intense. For
confining People, and shutting them up together in great Numbers, will
make the Distemper rage with augmented Force, even to the increasing it
beyond what can be easily imagined; As appears from the _Account_, which
the learned _Gassendus_[21] has given us of a memorable _Plague_, which
happened at _Digne_ in _Provence_, where he lived, in the Year 1619.
This was so terrible, that in one _Summer_ out of _ten thousand_
Inhabitants, it left but _fifteen hundred_, and of them all but _five_
or _six_ had gone through the _Disease_. And he assigns _this_, as the
principal Cause of the great Destruction, That the Citizens were too
closely confined, and not suffered so much as to go to their Country
Houses. Whereas in another _Pestilence_, which broke out in the same
Place a year and half after, more Liberty being allowed, there did not
dye above _one hundred_ Persons.

For these Reasons, I think, to allow People with proper _Cautions_ to
remove from an infected Place, is the best Means to suppress the
_Contagion_, as well as the most humane Treatment of the present
Sufferers: But though Liberty ought to be given to the _People_, yet no
sort of _Goods_ must by any means be suffered to be carried over the
_Line_, which are made of _Materials_ retentive of _Infection_. For in
the present Case, when _Infection_ has seized any Part of a Country,
much greater Care ought to be taken, that no _Seeds_ of the _Contagion_
be conveyed about, than when the Distemper is at a great Distance;
because a _Bale of Goods_, which shall have imbibed the _Contagious
Aura_ when packt up in _Turkey_, or any remote Parts; yet, when unpackt
here, may chance to meet with so healthful a Temperament of our Air,
that it shall not do much hurt. But when the Air of any one of our Towns
shall be so corrupted, as to spread and maintain the _Pestilence_ in it,
there will be little reason to believe, that the Air of the rest of the
Country is in a much better State.

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

I have gone through the chief Branches of _Preservation_ against the
_Plague_. And shall only add, that if the _Burning of Goods_, which has
been proposed, be thought any Way _offensive_ or _inconvenient_, The
_Burying_ of them six Feet, or more, under Ground may answer the Purpose
as well.

What has been said of the _Nature of Contagion_, upon which the
foregoing Directions are grounded, may also be of Use towards
establishing a better Method of _Cure_, than _Authors_ have commonly
taught: But to engage in this is beyond the present Design.

                                _FINIS._

------------------------------------------------------------------------


                               FOOTNOTES:

Footnote 1:

  Vid. Hippocrat. Epidem. lib. 3.

Footnote 2:

  Galen, de Temperament, lib. 1. cap. 4. & Comment. in Epid. l. 3.

Footnote 3:

  Vid. J. Leon. Histor. Afric. lib. 1.

Footnote 4:

  Vid. Caium de Febre Ephemera Britannica.

Footnote 5:

  Vid. Rondinelli Contagio in Firenze, & Summonte Histor. di Napoli.

Footnote 6:

  _Lord_ Verulam's _History of_ Henry VII.

Footnote 7:

  Vide Hodges de Peste.

Footnote 8:

  Vid. Histor. Fiorent. di Matteo Villani.

Footnote 9:

  Vid. Bellini de Febrib.

Footnote 10:

  Boccaccio Decameron. Giornat. prim.

Footnote 11:

  Diemerbroeck de Peste, L. 1. C. 4.

Footnote 12:

  Hodges de Peste.

Footnote 13:

  Vid. _Directions for the Cure of the_ Plague, _by the_ College _of_
  Physicians; _and Orders by the_ Lord Mayor _and_ Aldermen _of_ London,
  _published_ 1665.

Footnote 14:

  Discourse upon the Air, by _Tho. Cook_.

Footnote 15:

  Vid. _The shutting up of Houses soberly debated. Anno, 1665_.

Footnote 16:

  _Camden. Annal. Regin. Elizab._

Footnote 17:

  _Lord Verulam_, Natural History, _Cent. 10. Num. 914_.

Footnote 18:

  Galen. de Theriac. cap. 16.

Footnote 19:

  Hodges _de Peste_, pag. 24.

Footnote 20:

  Rhazes de re Medica, lib. 10. c. 16.

Footnote 21:

  Notitia Ecclesiæ Diniensis.



                          Transcriber's Notes.

This Book is 300 years old and the advice given has been superceded by
more modern methods and is of historical value only.

The use of irregular small caps used at the start of paragraphs has not
been retained for the ease of reading and consistency.

The original spelling and punctuation has been retained.

Italicized words and phrases are presented by surrounding the text with
_underscores_.





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