Digitized by the Internet Archive in 2015
https://archive.org/details/b21960860_0004
THE
PHILOSOPHY OF MEDICINE
OR,
MEDICAL EXTRACTS
ON THE
NATURE OF HEALTH AND DISEASE,
INCLUDING THE
\
LAWS OF THE ANIMAL (ECONOMY,
AND THE
DOCTRINES OF PNEUMATIC MEDICINE.
BY
A FRIEND TO IMPROVEMENTS.
There are three things which almost every person gives himself credit for under- standing, whether he has taken any pains to make himself master of them or not.— Tlieseare: \. The art of mendhig a dull Jire i 2. Politics s and, 3. PHYSIC.
DR. BEDDOES.
M VOL. IV.
i-H • , FOURTH EDITION.
o
LONDON
- THIVTED BY C. WnnTlNGllAM, DEAN-STREET, FETTER-LASE,
TOR T. COX, ST. THOMAS'S-STREF.T, BOROUGH, AND H. D. SYMONDS, PATERNOSTER-ROW; SOLD ALSO BY J. JOHNSON, ST. VAUfS CHURCH- YARD ; MURRAY AND HIGHLEY, KLEET- STREET; EVANS, PAL[.-MALL; RICHARDSON, ROYAL EXCHANGE; CUTHELL, MIDCLE- ROW, HOLBOKN ; AND BELL AND BRADFUTE, ED1NBUR6H.
1799.
THE CONTENTS
VOLUME IV.
LAW THIRD.
ii TOO GREAT EXCITEMENT OF THE NERVES, OR MOV- ING FIBRES, EXHAUSTS THE POlfERS OF THE MIND, AND ENFEEBLES THE BODY.
SECTION i —OF EXHAUSTION.
Page
THIS is either temporary 1
Or irrfepcirable ;,. ib-;
SECT. II.— OF TEMPORARY EXHAUSTION.
Experiments which prove temporary exhaiiftion 5
Milton's defcription of the elfed: of exceffive light ib'.
Other experiments given to prove the fame 6
SECT.Iil.-OF ASPHYXIA FROM MENTAL AGI- TATION.
The effefts of fright ......;...,.,;...>..•. 7
TJie nervous fluid fimiidr to the e'lcdtrit 7, 8
a . This
iv
This is fhewn, in a note, to be tlie fuppofition of Sir Ifaac
Newton, and Burke 7, »
A curious remark of Mr. Hunter on fear rendering tiie ve- nal blood of the arterial charader 9
The rationale of this fafl 0
The manner in which fwooning patients ought to be
treated 9, !•
SECT. III.— OF TEMPORARY EXHAUSTION FROM FATIGUE OF MIND.
Lord Chatham's famous fpeech on the continuance of the
American war 11 — 16.
His animated anfwer to Lord Suffolk .• 17 — 20
The exhauftionjie felt upon this occalion 20
SECT. IV.— OF PERMANENT EXHAUSTION FROM iMENTAL AGITATION.
Exemplified, by the death of Lord Chatham 21 — 25
SECT, v.— Frequent end of great literary talents 24, 25
SECT. VL— Story of Louifa, Maid of the Hay-Hack ... 26—30
SECT. VII.— Hiftory of Mademoifelle de M 31—42
SECT. VIIL—Edwin and Emma'...; 43—46
SECT. IX.— Story of a clergyman „ 47—50
SECT. X.— Story of Monimia 51—57
SECT. XI.— Caufe of tlie death of Savage 58, 5*
SECT. XII. Hogarth 60, 61
SECT. XIII.— Stoiy of a widow-lady 62
SECT. XIV.— Matilda 63-65
SECT.
SECT. XV.— METHOD OF CONSOLING GRIEF 66
We ought, inftead of upbraiding, participate in the for
rows of others '
An eloquent letter of Pliny to confirm this idea 66—69
The admirable addrefs of the chorus iri the Eledra of So- phocles 1 69—79
■i
SECT. XVI.— CONSOLATIONS FROM CHRISTIANITY.
The reafonings of a Chriftian 80—83
Immediate upon death the fo\il liveth — In a note 82
SECT. XVII.— ADVICE TO PARENTS AND MEN
OF FORTUNE.
Story of Harriet 84—88
Gonclulion from this ftory 83 — 90
SECT. XVIII.— OF TEMPORARY EXHAUSTION OF THE MUSCULAR FIBRE.
This explains feveral phasnOmena 91 — 93
SECT. XIX.— It is proved by the effeds of wine 94, 95
A note, to Ihew that Brown might have caught the idea of
his fyftem from Armftrong 95
SECT. XX.— On drinking 96
An exhortation againft this vice 97 — 99
SECT.XXr.— Of opium and hemlock 100—102
SECT. XXII. The danger of employing opium fliewn, 103, 104
SECT.
VI
SECT. XXIir— OF IRREPARABLE EXHAUSTION IN THE MUSCULAR FIBRE.
SECT. XXIV.— Shewn by the abufe of tonic medicines ... 106
Ap account of the Portland powder i 106, 107
The event which followed its long ufe 107, 108
SECT. XXV. — ^The ordinary ftimuli 109
The progrefsfrom infancy to old age exemplified 103— 111
SECT. XXVI. — ^Theartof prolonging life 112, 113
A note, to reprobate the unbluHiing effrontery of fome
medical men ib, ib.
SECT. XXVII.— The effeds of drunkennefs i n
ANIMAL JND VEGETABLE POISONS,
SECT. XXVIII.— OF VEGETABLE AND ANMAL
POISON 117
SECT. XXIX.— RATIONALE OF THE OPERA- TION OF OPIUM lis— 127
The manner of obviating it by oxygen 127 — 130
SECT. XXX.— POISONS OF THE VIPER, ASPIC, AND POLYPUS.
Their effeds fliewn , 131—135
SECT. XXXT.— OF THE BITE OF THE VIPER, AND METHOD OF CURE BY LUNAR .CAUSTIC AND TARTAR EMETIC 136—140
SECT. XXXII.— POISON OF THE TJCUNAS, AND ITS ANTIDOTE THE MINERAL ACIDS 141, 14-2
Their effeds /hewn to be different from that of fluid vo-
' latile alkali L-.,... 142
The reafon of this fliewu ib.
SECT.
Vll
SECT. XXXIII.— OF THE BITE OF VENOMOUS SERPENTS, AND THE METHOD OF CURE BY MERCURY AND ARSENIC ... 143
SECT. XXXIV.— CANINE MADNESS.
Defcription of the fymptoms 145
Thefe are fliewn not to arife from the nerves, nor to be
removed by what are called nervous medicines 146 — 146
Mercury and vinegar fhewn to be the cure 148 — 151
Some new remedies for this difeafe fuggelled 151, 152
SECT. XXXV.— THE HOOPING COUGH. The effeft of arfenic in this difeafe 153
SECT. XXXVI.— THE SMALL-POX.
The peculiar nature of this difeafe 154
Of the introdudlion of the cow-pox 154, 155
SECT. XXXVII.— THE ANTIQUITY OF INOCULATION.
Of the cuftom of buying the fmall-pox in Wales 157-r-159
' in the Highlands of
Scotland 159
in many other
countries , 159 — 170
SECT. XXXVIII.— OF THE INTRODUCTION OF
INOCULATION IN ENGLAND 171
Origin of inoculation in Turkey ib.
Defcription of the Turkifh mode of inoculating, as re-
prefented by Lady Mary Worthley Montague 171' — 173
The fon of this lady inoculated by Mr. Maitland 174
Her daughter is afterwards inoculated 175
Thefe examples produce very little effect in promoting
the introduction of this art ; 177, 178
Six culprits are taken from Newgate to have the expe- riment tried upon them 178, 179
It is next tried upon five charity children 179
Two of the royal family are ilioculated , ] 80
An
viii
An account of the rapid progrefs of inoculation from this
time 181
Thefuccefsfiatecl 181, 182
( -
SECT. XXX-DL— THE OPPOSITION INOCULATION
MET WITH.
An account of a pamphlet printed againft inoculation 18-1
>j Mr. Maffey's fermon 185
Dr. Wagftaff's letter J 8G
The replies and rejoinder 186, 187
An example of the manner in which this controverfy was
carried on 187, 188
SECT. XL.—THE SUCCESSFUL ESTABLISHMENT
OFINOCULATION IN ENGLAND 189
Of tke number inoculated, and the refult 190
It is again adopted in the royal family 191
The declaration of the College of Phyficians in its fa- vour 191, 193
SECT. XLI.-OF THE DISTINCT AND COxN'-
FLUENT SMALL-FOX 193, 194
!^^:CT. XLIL— THE TREATMENT OF THE NATU- RAL SMALL-POX.
The old error refpecting the treatment of this difeafe T95
Firft corrected by Sydenham 196
The danger of the hot regimen fet forth 198—202
The advantage of a free current of air demonflrated ... 202 — 210
Of the employment of the crottis metallorum 211
The great efQtracy of vitriolic acid fliewn 211 — 217
SECT.
ix
SECT. XLIIL— OF THE TREATMENT OF THE INOCULATED SMALL-POX.
Boerhaave's conjefture refpefting the prophylaftic
power of antimony and mercury 218,219
The fuccefs of this pradice in Penfylvania 219—221
Dr. Andrew, of Exeter, recommends this pradice 221
The fuccefs of the mercurial preparations fully afcertained 222 The cooling pradice of Sydenham had ceafed to be follow- ed in England when the Suttons appeared ib.
Of the fuccefs of Mr. Robert Sutton 223
Some account of his two fons ib.
The prejudice of the old man 224>
The rapid fuccefs of Mr. Daniel Sutton 224, 225
Of the number inoculated by him, and his fuccefs 225
Sir George Baker's attempt to unfold his method of practice 228 He attributes his fuccefs chiefly to his freely recommend- ing of cold air 229
Dr. Glafs next attempts the fame, and lays his fuccefs to
the employment of an acid liquor 230
The invidious perfecution of Mr. D. Sutton 231, 232
Mr. Chandler's account of Mr. Sutton's pradtice 232 — 23S
Baron Dimfdale's account 236
Sutton reveals his plan ib.
His alterative powder 237
The mode of exhibition 237, 238
SECT. XLV.— THE MEASLES.
Its fymptoms 239
The reafoning of Dr. Brown refpedling the treatment of
this and all other contagious diforders 240
Mead ftrongly recommends bleeding in this difeafe 241
The Angular efficacy of antimonial wine 242
The fequel of meafles ib.
SECT. XLVL— OF THE AGUE, OR INTERMITTENT
FEVER.
Of the corruption of the air in marflies 243
The effect of flagnant air on Dr. Franklin 244
Dr.
Dr. Lind's obfervations relative to an eafterly wind 544
An account of the prevalence of the ague in 1765 248, 249
The ancient methods of curing agues 2j0
The prejudice entertained refpefting the Peruvian bark 250 — 253
The rationale of its operation 253
Why lleeJ fo greatly improves its virtues 251-
Cafes in which oxygen air was inhaled 255, 256
A cafe in which the mineral and vegetable acids were em- ployed 256
Of calomel ib.
— change of air 257
— the oxyd of arfenic ib.
The fequel of an ague 25S ■
Jts treatment 258, 259
SECT. XLVII.— FIRST CAUSE, OR SELF-GENERA- TION OF PUTRID FEVER.
Burke's account of Howard 268
liis opinion relative to the caufe of Jail-fever -. 261 — 263
yiiftory of tlie Boulam-fever 263—273
.SECT. XLVni.— SECOND CAUSE, OR PUTRID FEVER, ARISING FROM ANIMAL AND VE- GETABLE MIASMITA OF PUTREFACTION,
Of the vapour arifing from putrid bodies 277—284
Putrid fevers produced by this vapour 284— 2S6
Of vegetable putrefaction 286.
Putrid fevers from this caufe 287
The plague at Delph ib.
Different degrees obferved by Sir John Pringle, and related
to fituation 283
The fever at Copenhagen in 1652 289
. Leyden in 1669 289, 29Q
Rome 291,292
. Grand Cairo i-'93
on the c()allof Guinea 294
Reafon of the unwholefomeuefi of Batavia 299
Cruel
Cruel barbarity of the Arabs in producing a putrid fe-
ver 301
Defcription of the Yellowy fever 303 '
Confirmation of the origin of Putrid fever 303—305
Defcription of the Philadelphiau fever 305
Its origin ib.
The perfons firft attacked 306, 307
Dr. Eulh founds the alarm ^ 307
The covrefpondence of Dr. Hutchinfon, and Dr. Rufli,
on the fubjea of this fever 308— 311.
Defcription of the diflrefs of the Philadelphians 314 — 327
A table of deaths 327
.Of the fufpenfion of the fever , 328—330
$ECT. XLIX.— THIRD CAUSE-^PUTRID FEVER FROM CONTAGION.
Defcription of the plague, in the time of Juftinian, as
defcribed by Gibbon 331 — 335
Its progrefs 334, 333
Its duration and mortality ; .335
The plague at Marfeilles traced from its fource ib.
Its uiortality : 337
Origin and account of the plague of London ib.
An account of the wickednefs of nurfes in thofe>times 341
A defcription of modern nurfes 341, 342
Forty thoufand fervants are difmiffed 343
Sir John Lawrence's noble condudl ib.
The greataefs of the calamity 345
Story of the frantic mother 346
The difappearance of this plague 348
table of the funerals from the bills of mortality 349
Of the plague at Mofcovy ^ ib.
Danger to us of a fimilar calamity from the prefent ftate
,of Europe 350
Origin of the plague at iVIofcow , 351
The fymptoms of this difeafe 351, 352
The reafon of its more rapid progrefs 352 — 354,
Ceffation of this calamity 355
^ts extent 355—357
SECT.
XII
L.— OF PEHSONS MOST LIABLE TO TAKE INFECTION.
The caiifes which predifpofe the body to take infe(5tions are :
J. Fatigue of body 358
2. Heat 35!>
3. Intemperance in eating or drinking ib.
4. Fear 360
5. Grief 361
7. Cold 362
8. Sleep 364.
Of prophylactics, or prefervatives 365 — 368
The beft prophyladic is temperance 368
And fortitude , , 369
SECT. LI.— OF THE LIMITED SPHERE, OR ACTION, OF PUTRID MIASMS.
. Some ci^ious experiments made on this fubjed, by Dr.
Ryan 370—372
The obfervatibns on this fubject by Dr. Carrie 372
Dr. Haygarth 374
Utility of thefe obfervations 375, 37 6
SECT. LII.— THE METHOD OF DESTROYING CONTAGION.
On the nature of quarantine 377, 378
Of the dilfereiit vapours recommended by Dr. Lind ... 37S — 381
The Italian cbmpofitiort ' -"8 1
The advantages refulting from fumigation 382, 383
Dr. Mead's prejudice againft fumigation fliewn to be er- roneous •
The refult of fome curious experiments made with a
new fumigating poAvder at Mofcow 385
Compolilion of this powder 385, 386
Tlie trial of the muriatic aci<l, by De Morveau 387
5 Of
XIU
Of the trial of the nitrous acid, by Dr. Carmichael
Smith ...,M....-— ; 387—396
His memorial 396", 397
He is appointed Phyfician extraordinary to the King 397
SECT. LIII.-THE SAME SUBJECT CONTINUED.
Of the utility of the ventilator 398
The power of prejudice in oppofing all new improvements .ib.
Of infedion arifing from prifoners , ; 400
A remarkable inftance of this happened in the year 1750.. .401, 402 The Rev. Dr. Hales, with Sir John Pringle, occalions the
introduction of ventilators into Newgate 403
The effea that this had on the air 403—405
Putting up the tubes produced a fever in the carpenters,
to the number of fev.en 405 — 413
Itfpread into their families 413, il4>
Ventilators are eftabliflied at the county-hofpital at Win-
chefter 415
Ventilators are eflabliflied at St. George's Hofpital 417
Airing rooms by ventilators preferable to the opening^f
windows 418
The introdu<5lion of ventilators into the fmall-pox hofpitals 419
It confiderably lefl'ened the mortality there 420
Ventilators are introduced into the Savoy 421
How much it decreafed the mortality 422
The benefits derived, and likely to be derived', by venti- lators 423
SECT.. LI v.— THE SAME SUBJECT CONTINUED.
Nature apparently defeftive 426
Her llupendous produdions , „ 427
The world is contrived for the abode of reafon 42^
The connexion of foil with the intermittent fever, firjft
fliewn by LinnjEus „ 430
A curious facl of this kind recorded by Donaldfon 43 1
The properties of lime 43 1 ^ 4,32
The beneficial etTeds frpni agriculture 432
SECT.
s
SECT. LV,— OF THE STAGES OF PUTRID FEVER.
An apology for delaying- fo long on the fiibjcft of fever .... 423
Charaders of the dilferent llages of fev^r 43't
The neceffity of a due confideration of thefe ftages 4.35
The danger of medical enipiricifni — In a note
SECT. LVI— OF THE ADVANTAGE OF GOOD AIR IN FEVER.
The manner in which Captain Ellis afcertained the goodnefs, or badnefs, of the air in the hold of his ihip 436, 437
Experiments made by Dr. Hales, on the different
ftates of the air under diiferent circuniitances 438 — 143
The advantage of good air in putrid fever, fliew-n by
Sir John Pringle 443— 44'6
The fame is particularly ilkillraled by Dr. Wind 446 — 447
Obfervations on this head by Dr. Liud 448 — 451
«
SECT. LVII.— THE METHOD OF CURE IN THE FIRST STAGE.
Sir John Pringle's pradice of bleeding, vomiting, and
purging, in the early ftage 452, 453
The good cftecls of vomits obferved during the Ameri- can war •'• 453
Mr. Townfend's obfervation 454
The fupcrior advantage of calomel noticed by Dr; Wade ... 455 Its greater efficacy wiien combined with an antimonial ... 457 Dr. Rulh's leftimony in favour of bleeding and purging 458—462
The dofe adminiftered •••• 468
This pradice is fuccefsfully followed by others 463—465
An account of the controverfy of Dr. Rufh and Dr.
Kuhn 467-474;
Dr. Rufc's cafe, as drawn up by himfelf 474 — 183
The benclits refulting from this pradice 488—492
The reafou why the people ftiould be infiructed in the
•cure of infediour. fever • * 4i.'2 — 494
Dr.
XV
Dr. Jackfon's teftimony in favour of bleeding 495
An account of Sydenham's pradlice, and his reafoning, 495 — 504
A curious critique on Sydenham, by his tranflator ,501, 502
Of fweating 505—508
Of the employment of a mild purgative 508
The fuccefs of this practice ib.
Of the cold bath in putrid fever 508—513
Further reafon for recommending the abftradion of fti-
muli in the early ftage of fever 513, 5H'
SECT. LVIII.— THE SECOND STAGE OF PUTRID
FEVER.
Reafon for the employment of bark 5 IS
How it fliould be adminiflered 516
Of other flimuli, as opium, ether, and wine ib.
When we ftiould encreafe the quantity of wine 517
Of the conduct of the patient upon the ceffation of the fever , 517,,51»
LAW III.
A too great Excitement of the Nerves, or moving Fibres, exhaufts the Powers of the Mind, and enfeebles the Body,
Vol. IV.
B
3
INTRODUCTION,
SECTION I.
OE" EXHAUSTION.
The ftate of exhatijlion in the nerves, as in tli« irritable fibre, may be either,
- 1. TEMPORARY, or 2. IRREPARABLE.
In the ftate of temporary exkanjiion, the mind is tired, and, like the body, recovers its due tone only by reft :
But in the ftate of jiermanent exhanjlion this re- covery is flow, and, generally, irreparable.
I. TEMPORARY EXHAUSTION
OF
THE NEBVES.
5
SECT. IL
OF TEMPORARY EXHAUSTION.
Jufl as the morning fteals upon tlie night, Melting the darknefs, lb tiieir rifing fenfes Begin to chafe away the fumes that mantle. Their clearer reafon. Their underftanding Begins to fwcll, and the approaching tide Will y^ori/y fill the reafonable lliore That now lies foul and muddy.
SHAKESPEARE.
To fliew the diminution of jenjibility from in- creafed a£lion, if one hand be put into very warm water, and then immerfed with the other into fubtepid water, to the former this water will ap- pear extremely cold, while to the other hand it will impart an agreeable warmth. For the fame reafon we feel a chillnefs on coming into an at- mofphere of a temperate warmth, after having been for fome time in a very clofe apartment. Hence we are unable clearly to diftinguifh objefts, immediately after we have feen a bright flafh of lightning pervade the gloom of night. Thus Milton, in defcribing the light and glory which flows from the divine prefence and the majefty of God, fays.
Dark with excejjive light thy fkirts appear.
Here is an idea not only practical in an high de- gree, but flriftly and philofophically juft. Extreme
light.
6
Hght^ by overcoming the organs of fight, obliterate all ohje6ts, fo as in its effeSls exactly to refemble darknefs. Thus, after having looked at the fetting fun for a Ihort time, if we turn our eyes to a lefs fplendid part of the heaven, a dark fpot will be perceived exa6lly refembling the fliape of that bright luminary.
That thefe pheenomena depend upon the ex~ haiijiion of fenjibility, rnay be proved alfo by looking ftedfaftly on an area of fcarlet filk of about an inch diameter fpread on white paper, the fcarlet colour will gradually become fainter, until it entirely vaniflies, if the eye be kept uniformly upon it. Or if yqu look at a furface of light blue, and then place upon it a fmaller furface painted of the ul- tramarine blue, the appearance of the light blue will be nearly obliterated. It is on this account that painters put in their firft fhades darker than a bye-ftander ignorant of this law would imagine right; and produce the greatefl: efTecl by the con? traft pf fliades.
SECT.
7
SECT. III.
OF ASPHYXIA FROM MENTAL AGITATION,
Ubi vehementi magis eft percufla metu mens,
Concentire animam totam per membra videmus ; Sudores itaque, et pallorem exiftere toto Corpore, et infringi linguam, vocemque aboriri, Caligare oculos, fonere aures, fuccidere artus.
LUCRETIUS.
In exceffive fright the eyes for a moment flafh fire; the hair becomes ele6lric and ilands ereft; the heart palpitates; the body is thrown into the attitude for efcaping; but the danger being in- - evitable, cold fweats fucceed ; the hair of the body droops; the eyes become dim, and as it were femipellucid; the farface flaccid, cold, and pale; and the perfon finks down inanimate. .
Admitting the analogy, if not perfeft identity betwixt the nervous jiidd and that of ele5lricity^,
we
* Sir Isaac Newton, at the end of his Principla^ has the following Query : " Is not all fenfation performed, and the " limbs of animals moved, in a voluntary manner by the power " of a certain fubtle fluids refembling electricity, which " we will call cether^ i. e. by the vibratory motion of this fjiirit " — propagated along the nerves from the external organs of " the fenfts to the brain; and vrom the brain into the *' mufcles." " If a man in the dark," continues Sir Isaac Newton, " prefles againft the corner of his eye, or receives *' a blow, as he turns away his eye haftily from the injury, he " will perceive a circle of colours, or a Jlajli of light, and this
appearance will continue about a fecond of time." Vide his Optics, Qu. i6. It was before obferved, that -if a plate
of
I
8
we can account for one part of the appearances. Upon what other principle can we explain the power that can make
The knotty and combined locks ftand an end. Like quills upon the fretful porcupine ?
Whence otherwife fliall we account for thofe fiery fcintillations of the eye firft excited upon a fudden alarm? And whence that fucceeding dim- nefs, when the hairs of the body fubfide, and the limbs fink down powerlefs?
The phienomena of blood-letting will ferve us to explain the other fymptoms. I bled, fays Mr. Hunter, a lady whofe blood at firft was of a dark colour but fhe fainted, and while flie conti- nued in the fit, the colour of .the blood that came from the vein was of a bright fcarlet. Mr. Hew- soN obfefves alfo the power of the mind, as he terms it, of altering the chara6ler of the blood, and of three fmall cups, the firft fliall fometimes
zinc be placed between the gums qncl upper lip, and a plate of gold bp brought into contaft with the zinc, a fmilar Jlajli of fire will be pefceived ; and if this experiment be tried on the tongue, an acid tafte will be experienced fimilar to that of the eledric aura. Vide Vol. ]. ; alfo Vol. ill. the Section on the Brain.
When we are in the dark, fays the eloquent Burke, in his Eifay on the Sublime and Beautiful, there is a continual endea- vour of the pupil to receive light. Hence arifc thofe jlajlie^ and luminous a/i/iearances, which often feem in thefe tircumftances to play before it, and which can- be nothing but the effe<5l pro- duced by the nervous fibres in their efforts to obtain its proper objeft of yifion.
contaii)
9
contain florid blood, the fecond venal, and the thh-d florid again; but in animals that are bled to death, I always, fays this accurate experimen- talift, found that the venal blood became brighter in proportion as the animals became faint and it coagulated the more *. Might not the violent pal- pitation of the heart; the hurry of the circulation; the retrogade motion of the abforbents ; the cold- nefs and palenefs of the fkin; the inability for mufcular a6lion, &c, depend upon the minute arteries not giving out their oxygen, as is manifeft from thefe experiments? If fo, it v^^ill further con- firm the dodrines contained in Vol. I. of this workf.
Hence it will be proper to allow the fwooning patient to remain in the ftate of quiefcence: for during this torpor the irritable principle will accumulate in the fibres, and by degrees the juft balance will be reftored betwixt the excitability and the natural flimidi. ■ To accelerate recovery, the perfon ought however to be expofed to
That VITAL BREEZE, which Nature pours to fave
The breathlefs vI6lim froii] the untimely grave;
* From pofleffing more oxygen, /. e. the principle of life, I — Dr. Beddoes.
t The Jinlfation of the heart and arteries ; the powers of the ftomach; the colour and warmth of the furface; the ability for mufcular aSlion; was (hewn before to depend on oxygen. Vide Vol. I.
?nd
and the forehead fliould be rubbed with vinegar^^ which ought alfo to be fprinkled all around the fwooning patient; or the real oxygen air might be placed againft the mouth and noftrils, while water is poured into the bottle ; and the hands and face fliould be rubbed with cold water.
* Fermented liquors, when expofed to heat and a/V, abforb VITAL AiK, and become in confequence vinegar. Being fprinkled in fine fprays, it is rendered aeriform^ and parts with its OXYGEN when it comes into contaft with the animal fibre.
SECT.
SECT, III.
TEMPORARY EXHAUSTION FROM FATIGUE OF MINP.
That violent exertions of the mind fatigue the frame as much, jf not more, than bodily labour, every day furnifhes abundant proof.
During the late war with America, when it was propofed to continue . on hoftilities. Lord Chatham, at the clofe of a very long and animating fpeech, faid— My Lords, you cannot conquer America. No man thinks more highly of my country than I do. I love and honour the Englifh troops. I know their virtues and their valour, I know they can achieve aqy thing, ex- cept hnpoffibjlities, As to the conqueft of Ame- rica, I repeat, my lords, it is impoffible. You may fwell every expence and every effort ftill more extravagantly j pile and accumulate every mercenary affiftance you can beg or borrow j traffic and barter with every little pitiful German prince that fells his fubje£ls to the Ihambles of a foreign power: your efforts are for ever vain and impotent ; doubly fo from this mercenary aid on which you rely: for it irritates to an incurable refentment the minds of your enemies, To over- run them with the mercenary fons of rapine and plunder, devoting them and their pofTeiTions to the j-apacity of hireling cruelty! If I were an American
a?
12
as I am 'an Engli^iman, while a foreign troop was landed in my country, I would never lay down my arms? NEVER— NEVER— NEVER.
Your army is infected with the contagion of thefe illiberal allies : the fpirit'of plunder and of rapine is gone forth among them. I know it, I am intormed from the moft experienced officers that our difcipline is deeply wounded. Whilft this is Qotoriouily our finking fituation, America grows and flourirties; whilft our ftrength is low- ered, their s rifes and improves.
But, my lords, ia addition to thefe difgraces and mifchiefs of our army, the minifters have dared to authorize and alfociate to our arms the tomahawk and fcalping knife of the favage I have called into civilized alliance the. wild and inhu- man favage of the wood ! have delegated to the inercilefs Indian the defence of difputed rights, and to wage the horrors of his barbarous war againft even brethren !
My lords, this enormity cries aloud for redrefs, and unlefs thoroughly done away, it will be a (lain on the national character ; it is a violation of the conftitution ; I believe it is againft the law.
It is not amongft the leaft of - our national misr fortunes, that our army is infefted with the mer- cenary fpirit of robbery and rapine, for, familia- rized to the horrid fcenes of cruelty, it can no longer boaft of the noble and generous principles yvhich dignify a foldier, no longer fympathize with
13
« the dignity of the royal banner nor feel " the ■pride, " pomp^ circimftance of glorious war," that make am- bition virtue. — What makes ambition virtue P — A fenfe of honour : — but is a fenfe of honour confident with a fpirit of plunder, and the praftice of mur- der? Can it flow from mercenary motives? Or can it prompt to cruel deeds ?
My -lords, the time demands the language of truth : we muft not now lay the flattering unction of fervile compliment or blind adulation. In a juft or necefl"ary war, to maintain the rights or the honour of my country, I would flrip the fliirt from my back to fupport it : but in fuch a war as this^ unjuft in all its principles, impracticable in its means, and ruinous in its confequences, [ would not contribute a fingle effort, or a Angle fliilh'ng. In this "complicated crifis of danger, weaknefs at home, and calamity abroad, terrified and intuited by the neighbouring powers ; unable to aft in America, or afting only to be de- ftroyed, where is the man with the forehead to fay our affairs are in a hopeful iituation ! who has the forehead to promife or to hope fuccefs from fuch a fituation, or from perfeverance in thofe meafures that have driven us to it ?
But if in an obllinate and infatuated perfeve- rance in folly we meanly echo back the words this day offered to us, we fliail madly rufli into multi- plied miferies, and confufion worfe confounded. Is it pofTible ? Can it be believed, that miniflers are
yet
I
•
yet blind to their impending dcftruaion ? I did hope, that inftead of this falfe and empty vanity ; this overweaning pride engendering high conceits, and " prefumptuous imaginations," that minifters would have humbled themfelves in their errors ; would have confefled and retracted them , and by an a£tive, though late repentance, have endea- voured to redeem them.
But, my lords, fince they had neither fagacity to forefee, nor juftice nor humanity to fliun, thefe oppreffive calamities : fince not even fevere ex- perience can make them feel, nor the imminent ruin of their country awaken them from their ftupefatlion j the guardian care of parliament muji interpofe.
The Americans contending for their rights againft our arbitrary exa£lions, I love and admire. It is the ftruggle of free and virtuous patriots. But contending for a iota/ difconnedion from Eng- land, as an Englifliman I cannot wifli them fuc- cefs, for on this connection depends the mutual happinefs and profperity of both England and America. They derived encouragement, af- fiftance, and proteftion from us, and we reaped from her the moft important advantages. She was indeed the foundation of our wealth, the nerve of our ftrength, the nurfery and bafis of our naval power. It is our duty, my lords, moft anxi- oufly to endeavour the recovery of thefe inefti- mable, thefe moft beneficial advantages : and in
this
15
this perilous crifis, perhaps the prefent moment may be the only one in which we can hope for fuccefs. For the natural difpofition of Ame- rica as yet leans towards England, towards the old habit of connexion and mutual intereft that united both countries. This was the eftab- liflied fentiment of all the continent: and ftill, my lords, in the great and principal part, the found part of America, the middle and fouthern colonies, this wife and affedTtionate difpofition prevails : and there is a very important and con- fiderable part of America yet found. Some parts may be blind to their true interefts ; but if we exprefs a juft, a wife, and a benevolent difpo- fition to participate with them thofe immutable rights of nature and conftitutional liberties, to which they are equally entitled with ourfelves : by a conduft fo juft and humane, we fliall con- firm the moft favourable, and conciliate the moft adverfe. I fay, my lords, the rights and liberties to which they are equally entitled with ourfelves; but no more. I would participate to them every enjoyment and every freedom which the coloniz- ing fubje6ls of a free ftate can poffefs, or wifli to polfefs: and I do not fee why they fliould not enjoy every fundamental right in their property, and every original fubftantial liberty that Devon- fliire or Surry, or the county I live in, or any county in England can claim. I iliall, there- fore,
i6
fore, my lords, propofe to you an amendment to the addrefs to his Majedy ; " to recommend (in- " ftead of profecuting further this calamitous war) " an immediate cejjation of hojlilities ; and the com- " tnencemeni of a treaty to reflore -peace and liberty to " America, flrength and happinefs to England ; ^yfeciirity and permanent prof per ity to both countries
This, my lords, is yet in our power, and let not the.wifdom and juftice of your lordfhips neg- ]e6l the happy and perhaps the only opportunity. By the eftablifliment of irrevocable laws, founded on mutual . rights, and afcertained by a treaty^ thefe glorious enjoyments may be firmly perpe- tuated. The found parts of America of which I have fpoken, muft be fenfible of thefe great truths, and of their real interefls: America is not in that ftate of defperate and contemptible rebellion which this, country has been deluded to believe. It is not a wild and lawlefs banditti, who having nothing to lofe might hope to fnatch fomething from public convulf)ons; many of their leaders and principal men have a great ftake in this conteft ; and let me again repeat to your lordfliips, that the ftrong bias of America, at leaft of the wifer and founder part of it, naturally inclines to this happy and conftitutional re-con- neftion with you.
Lord Chatham was fupported in his propofed amendment by Lord Abingdon, Lord Shel-
BURNE,
BtJRNE, the Duke of Grafton, Lord Camden, the Duke of Richmond, Lord Effingham, and the Bifliop of Peterborough.
Lord Abingdon was fliort and fpirited. Lord Shelburne, as ufual, difcuffed the fubjedt m a very ample and comprehenfive manner. The Duke of Grafton fpoke long, and with much earneflnefs, preferving at the fame time, what generally characterizes this nobleman's fpeaking, a decent and chaftifed ftile of dignity. Lord Camden was argumentative, fluent, fincere, and animated. The Dbke of Richmond was a pow- erful afliftant to the noble mover of the amend- ment. And the Bifliop of Peterborough pro- nounced a fliort and pithy opinion on the quefl:ion; clothed in language uniting qualities rarely found together, being both nervous and elegant.
On the other "fide there were many able fpeak- ers who fupported the continuance and principle of the war. With refpeft to the employment of Indians t Lord Suffolk faid, it was a meafure ne- ceffary in fa6l, and allowable in principle : for it Was perfectly j ufl:ifiable to ufe every means againft our enemies, that GOD and NATURE had put into our hands.
Lord Chatham rofe.
I am aftoniflied— fliocked— to hear fuch princi- ples confefled :— to hear them avowed in this houfe, or in this country : — principles equally un-
VoL. IV. C conftitutional.
i8
conftitutlonal, inhuman, and unchrlftian. — My lords, I did not intend to have encroached aijain on your attention : — but I cannot reprefs my in- dignation : — I feel myfelf impelled by every duty. — My lords, we are called upon as members of this houfe, as Chriftian men, to proteft againft fuch notions ftanding near the throne, polluting the ear of majefty. — That God and Nature put into our hands!! — I know not what ideas that lord may entertain of God and Nature : but I know that fuch abominable principles are equally abhorrent to religion and humanity. — What - — to attribute the facred fan£lion of God and Nature to the maffacres of the Indian fcalping knife ! — to the cannibal favage torturing, murder- ing, roafting, and eating, — literally, my lords, eat- ing the mangled vi£lims of his barbarous battles ! — Such horrible notions fliock every precept of religion, divine or natural, and every generous feeling of humanity : and, my lords, they fliock every fentiment of honour : — they fliock me, as a lover of honourable war, and a detefter of murder- ous barbarity. — Thefe abominable principles, and this more abominable and fliameful avow^al ot them, demand the moft decifive indignation. — I call upon that right reverend bench, thofe holy minifters of the gofpel and pious pafl:ors of our church : — I conjure them to join in the holy work, and vindicate the religion of their God ! — I ap- peal to the wifdom of this learned bench to defend
and
19
and fupport the juftice of their country : — I call upon the bilhops to interpofe the unfullied fanc- tity of then" lawn: — upon the reverend judges to interpofe the purity of their ermine, to fave us from this pollution.^ — I call upon the honour of your lordfliips to reverence the dignity of your anceftors, and to maintain your own : — I call upon the fpirit and humanity of my country to vindicate the national chara£l:er :— I invoke the genius of the conftitution, from the tapeftry that adorns thefe walls, the immortal anceftor * of this noble lord, who frowns with indignation at the difgraces of his country. — In vain he led your vi£lorious fleets againft the boafted Armadas of Spain ; in vain he defended arid eftablifhed the honour, the liberties, the religion, the Proteftant religion of this country againft the arbitrary cruel- ties of Popery and the Inquifition ^ if thefe more than Popifli cruelties and inquilitorial practices are let loofe among us. — To turn forth into our fettlements, among our ancient conne£lions, friends, and relations, the mercilefs cannibal thirfting for the blood of man, woman, and child ! — To fend forth the infidel favasre — ag-ainft whom ? — Againft your Proteftant brethren ! — To lay wafte their country ; to defolate their dwel- lings, and extirpate their race and name, with their hell-hounds of favage war ! — Hell-hounds I ^
* Lord Effingham Howard, Queen Elizabeth's Lord High Admiral.
C 2 fay
20
fay of favage war. Spain armed herfelf with blood-hounds to extirpate the wretched nations of America: — and we improve on the inhuman example even of Spanifh cruelty. We turn loofe thefe favage hell-hounds againft our brethren and countrymen in America, of the fame language, laws, liberties, and religion : — endeared to us by every tie that fliould fanftify humanity.
My lords, this awful fubjeft, fo important to our honour, our conftitution, and our religion, de- mands the moft folemn and effeftual enquiry : and I again call upon your lordfliips, and the united powers of the ftate, to examine it thoroughly and decifively, and to ftamp upon it an indelible fligma of public abhorrence : and I again implore thofe holy prelates of our religion to do away thefe iniquities from among us. Let them purify this houfe, and this country, from fo great a fin.
My lords, I am old, and weak ; and at prejent UNABLE * to jay more •.--—^yxi my feelings and my indignation were too ftrong to have faid lefs. 1 could not have flept this night in my bed, nor repofed my head upon my pillow^, without giving this vent to my eternal abhorrence of fuch pre- pofterous and enormous principles.
* This arofe from Exhaudioii, recoverable.
SECT.
II. PERMANENT EXHAUSTION
OP
THE NERVES,
21
SECT. IV.
OF PERMANENT EXHAUSTION.
THE DEATH OF LORD CHATHAM.
Curse leves loquunter, ingentes Jlupent.
TACITUS.
Notwithstanding a negative had been put upon every propofition and motion made by Lord Chatham concerning America^ yet he refolved to perfevere in the fame line of condu6t. To his •zeal in this caufe he facrificed his life. He had not ftren^th of frame fufficient to bear the exer- tions he made. He was now advanced in the feventieth year of his age, and fuffered the fe- vereft attacks of gout j but although debilitated by infirmity, and enervated by anguifli of body and mind, ftill he refufed to yield to the calls of his diforder, or to mitigate his pains by the indul- gence of a bed — while his country was bleeding, he felt for her and not for himfelf. Her honour and fplendour had been his glory and his pride-^ her debafement and adverfity were now the only fubje£ls of his concern and anxiety.
On the 7th day of April, 1778, the Duke of Richmond having moved to prefent an addrefs to the king on the fubjeft of the ftate of the nation, in which the neceffity of admitting the/«// INDEPENDENCE oi America was hinted. Lord
Chatham,
22
Chatham, for the laft time, rofe to fpeak in the Houfe of Lords.
My lords, he faid, I rejoice that the grave has not clofed upon me; that I am ftill alive to lift up my voice againft the difmemberment of this ancient and moft noble monarchy ! Preffed down as I am by the hand of infirmity, I am little able to affift my country in this moft perilous con- junfture; but, my lords, while I have fenfe and memory, I will never confent to deprive the royal offspring of the Houfe of Brunswick of their faireft inheritance. Where is the man that will dare to advife fuch ameafure? My lords, his Ma- jefty fucceeded to an empire as great in extent as its reputation was unfullicd. Shall we tarnifli the luftre of this nation by an ignominious furrender of its rights and faireft -pojjejfions? Shall this great kingdom truckle to the Houfe of Bourbon? Shall a people, that feventeen years ago was the terror of the world, now ftoop fo low as to tell its ancient inveterate enemy, " Take all we have, " only allow us peace?" Is it poflible! — I wage war with no man, or fet of men. — I wifh for none of their employments; — nor would I co-operate with men (alluding to the Duke of Richmond) who inftead of afting on a firm decifive line of conduft, halt between two opinions, where there is no middle path. In God's name, if it is ab- folutely neceffary to declare either peace or war, ?ind the former cannot be prefervcd with honour,
why
23
why is not the latter adopted without hefitation ? I am not, I confefs, well informed of the refources of this kingdom 3 but, my lords, any ftate is better than defpair, and I truft it has ftill fufficient to maintain lisjiiji rights. Let us at leaft make ano- ther effort J and if we muft fall, let us fall like men.
The Duke of Richmond having fpoken rather harflily to fome parts of Lord Chatham's fpeech, his lordfhip, greatly moved, attempted to rife in reply ; but after two or three efforts to ftand, he fainted and fell down on his feat *. The Duke of Cumberland, Lord Temple, Lord Stam- ford, and other lords, caught him in their arms. The houfe was immediately cleared, and the windows thrown open. This venerable patriot was carried to an adjoining room, and the houfe immediately adjourned. — This unhappy event proved the melancholy prelude to his death. He languiflied at Hayes until the eleventh day of May, 1778, when he died; to the fincere regret of every perfon who has a juft fenfe of human dig^ nity and virtue.
* There is a fine pifture of this Event by Copley,
SECT.
SECT. V.
FREQUENT END OF GREAT LITERARY TALENTS.
Men of letters, fays Baron Van Swieten, who lead a ftudious life, are qn this account much expofed to apoplexy. At firft they become lan- guid] they delight in eafe and indolence; their underftanding grows dull ; their memory decays and fails them; they then grow heavy, fleepy, and ftupid, and often remain long in this wretch- ed fituation before they die. It has given me, he continues, much concern to fee learned men of the firft clafs, who had been very ferviceable to literature, live more than a twelvemonth after the lofs of their faculties, forget every thing ; and at Jaft die on a fudden.
Sure 'tis a curfe which angry fates impofe To mortify man's arrogance, that thofe Who 're fafliion'd of fome better fort of clay. Much fooner than the common herd decay. O, galling circumftance to human pride ! Abafing thought, but not to be denied ! With curious art the brain, too finely wrought, Preys on herfelf, and is deftroy'd by thought. Conjlant attention wears the a5iive mind, Blots out her p.ow'rSy and leaves a blank behind.
CHPRCHILL.
It
25
It was thus with Dean Swift, who was feized in 1736 with violent giddinefs, which in a few years gradually deprived him of his reafon, and he funk at laft into a fpeechlefs idiot; and in the latter end of October 1745, without even giving an alarm to his attendance, he expired. A man in polTeffion of his reafon would have wiflied for fuch a kind diffolution, but the Dean was wholly infenfible; he had not even the power or exprefTion of a child, appearing, for fome years before his death, the reverfe of that fine defcrip- tion of man given us by Milton :
— — A being, who not prone
And brute as other creatures, but endu'd - With fanftity of reafon, might ere6t His ftature, and upright with front ferene Govern the reft, felf-knowing, and from thence Magnanimous to correfpond with heaven. But grateful to acknowledge whence his good Defcends, thither with heart, and voice, and eyes, Direfted in devotion, to adore And worfliip God fupreme, who made him chief Of all his works.
SECT.
1^
26 SECT. VI.
STORY OF LOUISA, MAID OF THE HAY-STACK.
History affords many very ftriking inftances of the effe£l: of mental agitation in difturbing the powers of the underftanding.
A German lady of great beauty and accom- plirtiments having married a Heifian officer, who was ordered to America, and not being able to acquire any tidings of him in her own country, came over to England. Here, (he could only learn the deftiny of her hufband from thofe fliips which had either tranfported troops to the continent, or were bringing back the wounded. Day after day {lie wandered on the beach at Portfmouth^ and hour after hour flie wearied her eyes bedewed with tears in the vain expectation of feeing him. She was obferved, at the fame fpot, ere it was liirht, and watched each motion of the waves until the fetting fun. Then her haunted imagina- tion prefented him mangled with wounds, and the fmaileft guft of wind feemed to threaten her with an eternal feparation. Did a fliip enter into port, her eager fteps led her to the fpot, and many an enquiry was repaid with an infolent rebuff. After eight months fpent in this anxious manner, a (hip arrived, bringing her the melan- choly pleafure, " that fome Heffian officers, who « were wounded, were on their paffage." Her
impatience
27
impatience increafed daily. A veflel at length arrived, reported to have Heffian troops on board. She kept at fome diftance for fear of giving too o-reat a fliock to her hufband's feelings, fliould he be among them. He was landed with others. She fainted, and he was conveyed, fhe knew not where. Having recovered, and going to the dif- ferent inns, fhe found at laft her hufband. The mafter of the inn informed her, "he was very " bad," and flie begged that her being in England might be gradually broken to him. When fhe entered the room, he burft into a flood of tears. A lady was fupporting him in her arms. What words, or painter, could reprefent the tragedy that followed ! He had married in America, and this perfon was alfo his wife. He entreated " pardon," was pafl reproach, for in a few mi-^ nutes after he funk into the arms of death. The \ lady, whofe melancholy hiflory we are recording, ruflied from the room, and leaving her clothes and money at her lodging, flie wandered flie knew not whither, vowing " that fhe would never enter *' houfe more, or truft to man." She flopped at laft near Brijiol, and begged the refrefliment of a little milk. There was fomething fo attraftive in her whole appearance as foon produced her whatever flie requefled. She was young, and extremely beautiful : — her manners graceful and elegant, and her countenance interefling to the lafl degree. — She was alone— a flranger — and in
extreme
28
extreme diftrefs fhe alked only for a little milk — but uttered no complaint, and ufed no art to excite compaflion. Her drefs and accent bore vifible marks that flie was a foreigner of fuperior birth. All the day flie was feen wandering in fearch of a place to lay her wretched head ; fhe fcooped towards night a lodging for herfelf in an old hay-ftack. Multitudes foon flocked around her in this new habitation, attracted by the no- velty of the circumftance, her fmgular beauty, but above all by the fuddennefs of her arrival. French and Italian were fpoken to her, but (lie appeared not to underlland thefe languages ; however when ftie was accofled in German^ flie evidently ap- peared confufed ; — the emotion was too great to be fuppreffed, flie uttered fome faint exclamation in our tongue, and then, as if hurried into an im- prudence, flie attempted to be alfo without know^ ledge of this language. Various conjectures were inftantly formed, but what feemed pafling fl:range was her acceptance of no food, except bread or milk, and that only from the hands of females ! On the men flie looked with anger and difdain, but fweetly fmiled as flie accepted any prefent from the other fex. The neighbouring ladies rcr monfl:rated with her on the danger of fo expofed a fituation, but in vain, for neither prayers nor menaces could induce her to fleep in a houfe.
As flie difcovered evident marks of infanity, flie was at length confined in a mad-houfcj under
the
29
the care of Dr. Renaudet, pliyfician at the Hot PVelh. On the firft opportunity flie efcaped, and repaired to her beloved hay-ftack. Her rapture was inexpreffible on finding herfelf at liberty, and once more fafe beneath this miferable refuge.
Beneath a hay-ftack Louisa's dwelling rofe, Here the fair maniac bore four winters' fnows. Here long flie fliiver'd, ftifFening in the blaft. And lightnings round her head their horrors caft. Difhevell'd, lo ! her beauteous treffes fly. And the wild glance now fills the flaring eye : The balls fierce glaring in their orbits move ; Bright fpheres, where beam'd the fparkling fir.es of love, '111-ftarr'd Louisa!
It was nearly four years that this forlorn crea- ture devoted herfelf to this defolate life, fince fhe knew the comfort of a bed, or the protection of a roof. Hardfhip, ficknefs, intenfe cold, and ex- treme mifery, have gradually impaired her beauty, but fhe ftill is a moft interefting figure ; and there remains uncommon fweetnefs and delicacy in her air and manner j and her anfwers are always per- tinent enough, except when flie fufpe£ts the queftion is meant either to affront or enfnare her, when flie feems fullen or angry. Some Quaker ladies at this time interpofed, and Louisa, as flie was called, was conveyed to Giifs Hofpital,
where
30
where flie at prefent is, and fllll maintains her indignation againft the men *.
The perfon with whom flie lodged, upon her death-bed, divulged the fecret of the flight of this ftranger from Portfmotith, which correfponds near- ly with the time of her arrival near Brifiol, and future enquirers have difcovered, that flie is " the *' natural daughter of Francis Emperor of Ger- " many\**
* When any gentleman enters the room where flie is kept, ilie always turns her head afide, and ftill exprefles a fullcn difdain.
j Vide the Narrative of Fa£ls refpeding the Briftol Stran- ger, or Maid of the Hay-ftack.
SECT.
SECT. VII.
HISTORY OF MADEMOISELLE D£ M .
The page of hiftory furniflies us alfo with ano- ther inftance equally terrible ; when that fyftem of government was eftabliflied in Franc£, during; the continuance of which, to ufe the words of an eloquent member of the Convention, there was under every footftep a fjiring-guny under every roof a fpy, and in every fan[iily an informer^ and on every bench of juftice an ajfajjin.
A fmall tree of liberty which had been planted on a folitary fpot near Bedouin, was, during the night, torn from the ground by a wretch, who knew that this incident would furnifh a pretext for pillage and devaftation. At break of day the very perfon who was the perpetrator of this aft, the /irejident of one of thofe focieties, which was the terror of all good citizens, being the combi- nation only of the violent and worthlefs, founded a general alarm, and accufed the guiltlefs inhabi- tants of Bedouin of the facrilege committed againft the hallowed fymbol of freedom.
Without further inquiry a municipal commif- fion was immediately organized by Maignet, which prefented itfelf for the hope of fpoil. Re- volutionary troops were inftantly fummoned to fpread through the village and territory of Bedouin defolation and death. Five hundred habitations
were
32
were delivered to the flames; the fruits of the harveft were confumed; and the mandate of Maignet, fatal as the fabled wand of an evil magician, ftruck the rich and luxuriant foil with fudden fterility. The fiourifliing filk manufac- tures of Bedouin fliared alfo the fate of its defo- lated fields. The inhabitants being unable to name the guilty perfons, were all involved in one general profcription. Thofe who efcaped the guillotine fought for fhelter in the depths of ca- verns, after the conflagration of their habitations, on the ruins of which bills were afiixed, forbid- ding any perfon to approach the fpot.
Two hundred and eighty young men of Be- douin, who were clothed by the village, and had flown to the frontier even before the requifition in order to defend their country, in vain difpatch fucceflive letters pleading with fond folicitude for their parents. Thofe gallant young foldiers will return to their native village, their brows bound with the laurels of valour. Alas! they will find their native village but one fad heap of ruins! — in vain they will call upon the tender names of father, of mother, of filler: a melan- choly voice will feem to ifTue from the earth that covers them, and figh, they are no more! For thofe victorious warriors no car of triumph is prepared; no mother's tears of tranfport fliall hail the blefi^ed moment of their return; no father fliall clafp them to his bofom with exulting joy,
proud
33
proud of their heroic deeds. Ah, no! their toils, their dangers, and their generous facrifices, fliall find no recorapenfe in the fweetnefs of domeftic affeftian, in the foothing blifs which, after ab- fence, belongs to home! — Alas! their homes are levelled with the ground; they will find no fpot upon which to repofe their wearied limbs but the graves of their murdered parents.
Amidfl: the groans of fo general a calamity, no doubt many a figh of private forrow has never reached the ear of fympathy, and many a vi£lim has fallen unpitied and unknown. Some ot the martyrs of Maignet's tyranny have however found the fad recorder of the penfive tale, and
the fate of Monlieur de M 's family is not
among the leaft affefting of thofe fcenes which were extended over the diftri^t of Bedouin.
Monf. de M , after wandering as far as his
infirmities would permit, for he was old and fick, took refuge in a lonely habitation, a few leagues diftant from Avignon, fituate in one of the wildeft parts of that romantic country; in that celebrated region, for ever dear to the lovers of the elegant arts, where the immortal Petrarch poured forth his impafTioned flrains. Divine poet! no more fliall the unhappy lover feek for confolation in fliedding delicious tears on the brink of that fountain where thou hail wept for Laura! — no more (hall he haunt with penfive enthufiafm that folitary valley, thofe craggy rocks, thofe hanging
Vol. IV. D woods,
34
woods, and torrent ftreams, where thou haft wan- dered with congenial feelings, and to which thy tender complaints have given everlafting renown ! — thofe enchanting dreams, thofe dear illufions, have for ever vaniflied — that delicious country, the pride of France, the garden of Europe, the clalllcal haunt of Petrarch, no longer prefents the delightful images of beauty, of poetry, of paf- lionj the magical fpell is broken, the foothing charm is diftblved; the fairy fcenes have been polluted; the wizard bower profaned; the orange- groves are defpoiled of their aromatic fvveetnefs; the waters are tinged with blood; the hollow cliffs re-echo the moans of the wretched, and the fhriek of defpair ; the guillotine has arifen amidft thofe confecrated thades where love alone had reared its altars ! No longer with the name of Vauclufe is affociated the idea of Petrarch^ that of Maignet prefents itfelf to the ihudder- ing imagination. For here it was that Monf. de M-^ — - ifought for refuge, attempting to fliel- ter himfelf from the rage of his ferocious perfe- cutors.
He had foon after the anguidi of hearing that his brother had periflied on the fcaffold.
Monf. de M fent to inform his fifter-in-law
of the place of his retreat, to which he conjured her to haften with her only daughter, and ftiare the little property which he had refcued from the general wreck of his ;fortune.
His
35
His old and faithful fervant Marianne, who was the bearer of this meffage, returned, accom- panied by his niece: her mother was no more: flie had only furvived a few days the death of her hufband.
The interview between Mademoifelle Adelaide ,
de M and her uncle produced thofe emotions
of overwhelming forrow that arife at the fight of objefts which intereft our afifeftions after we have fuftained any deep calamity; in thpfe moments the paft rulhes on the mind with uncontrollable vehemence j and Mademoifelle de M — ■ — , after having long embraced her uncle with agony, at length pronounced in the accents of defpair the names of father and of mother.
Monf. de M— — endeavoured to fupply to his unfortunate niece the place of the parents fhe had loft, and forgot his own evils in his attempt to footh the affliftion of this interefting moui'ner, who at nineteen years of age, in all the bloom of beauty, was the prey of deep and fettled melan- choly.
She had too much fenfibility not to feel his tender cares, and often reftrained her tears in his prefence becaufe they gave him pain.
When thofe tears could no longer be fup- prefTed, (he wandered out alone, and feating her- felf on fome fragments of rock, foothed by the murmurs of the hollow winds and moaning waters, indulged her grief without controul.
Dz In
36
In one of thofe lonely rambles, facrcd to her forrows, fhe was awakened from melancholy mufing by the fudden appearance of her coufm,
the fon of Monf. de M- , who, after having
repeatedly expofed his life during a long and perilous campaign in the fervice of his country, returned to find his uncle facrificed, his aunt dead, his father an exile, and his home burnt. Such were the rewards which the gallant defen- ders of liberty received from the hands of tyrants.
A fevv^ months before he had beheld his lovely coufm in all the pride of youthful beauty; her cheek fluflied with the gay fuffufion of health, and her eye fparkling with pleafure. That cheek was now covered with fixed palenefs, and that eye was dimmed with tears; but Mademoifelle
de M had never appeared to him fo intereft-
ing as in this moment.
Two young perfons, placed together in fuch peculiar circumftances, muft have had hearts in- fenfible indeed, had they conceived no attachment for each other. The fcene in which they were placed was peculiarly calculated to cherilh the il- lufions of paffion ; not merely from difplaying thofe fimple and romantic beauties the contemplation of which foftens while it elevates the affections — it had alfo that local charm which endears to minds of tafte and fentiment fpots which have been cele- brated by the powers of genius. Petrarch, the tender, the immortal Petrarch, had trod thofe
very
37
very vallies, had climbed thofe very rocks, had wandered in thofe very woods — and the two young perfons, both underftanding Itahan, when they read together the melodious ftrains of that divine poet, found themfelves tranfported into happier times, and forgot for awhile that all be- yond the narrow cleft was mifery and diforder.
From thofe dreams, thofe delightful illufions, they were awakened by a letter, privately con- veyed to him, conjuring him, if he would fhun being claflfed among the profcribed, to repair im- mediately to the army.
Young de M confidered the defence of
his country againft invaders, as a facred duty which he was bound to fulfil. He alfo thought it prudent to depart. He bid adieu to his father and Adelaide with tears wrung from a bleed- ing heart, and tore himfelf away with an effort which it required the exertion of all his fortitude to fuftain.
After having paffed the cleft, which enclofed the valley, he again turned back to gaze once more on the fpot which contained all his treafure.
Adelaide, after his departure, had no confo- lation but in the fad yet dear indulgence of tender recolle£lions; in fhedding tears over the paths they had trod, over the books they had read together.
Alas, this unfortunate young lady had far other pangs to fuffer than the tender repinings of ab- fence from a beloved objeft!
Two
38
Two profcribed vi£lims of the tyranny of
M AiGNET, who were friends to Monf. de M ,
and knew of the place of his retreat, fought for an afylum in his dwelling.
Monf. de M received his fugitive friends
with affeftionate kindnefs. But a few days after their arrival their retreat was difcovefed by the emilTaries of Maignet ; the narrow part of the valley was guarded by foldiers; the houfe was felicompaffed by a military force ; and Monf. de
M^ was fummoned to depart with the con-
fpirators whom he had dared to harbour, in order to appear with them before the popular com- miffion at Orange.
This lafl: ftroke his unhappy niece had no power to fuftain. All the wounds of her foul were fuddenly and rudely torn open ; and alto- gether overwhelmed by this unexpefted, this terrible calamity, which filled up the meafure of her affliftions, her reafon entirely forfook her.
With frantic agony ihe knelt at the feet of him who commahded the troop ; fhe implored, fhe wept, fhe flirieked ; then ftarted up and hung VLpoh her uncle's neck, prefling him wildly in her arms.
Some of the foldiefs brutiflily propofed con- ducing her alfo to the tribunal ; but the leader of the band, whether touched by her diftrefs, or fearful that her defpair would be troublefome on the way, perfuaded them to leave her behind.
She
39
She was dragged from her uncle, and locked in a chamber, from whence her flirieks were heard by the unfortunate old man till he had paffed the narrow cleft of the valley, which he was deftined to behold no more.
His fufferings were keen, but they were not of long duration. The day of his arrival at Orange, he was conduced before the popular comraiflion, together with his friends, and from thence immediately led to execution.
In the meantime Mademoifelle de M , re- leafed by Marianne from the apartment where flie had been confined by the mercilefs guards, wandered from morning till evening amidfl: the wildeft receffes of the valley, and along the moil rugged paths (lie could find.
She was conftantly followed in her ramblings by her faithful fervant, who never loll fight of her a fingle moment, and who retains in her memory many a mournful complaint of her difordered mind, many a wild expreflion of defpair.
She often retired to a fmall nook near the tor- rent, where her uncle had placed a feat, and where he ufaally paffed fome hours of the day.
Sometimes (lie feated herfelf on the bench ; then ftarting up, and throwing herfelf on her knees before the fpot where her uncle ufed to fit, bathed it with floods of tears. " Dear old man," fhe would cry, " your aged head! Poor Charles! " — It is well he's gone. — I fee the guillotine
" behind
40
" behind thofe trees ! — now they drag up the
weak old man ! — they tie him to the plank ! — ^ oh, heavens !"
The acute affli£lion with which young De
M heard of the murder of his father, was
ftill aggravated by the tidings he received from Marianne of the fituation of his beloved Ade- laide. Her image was for ever prefent to his mind J and, unable to fupport the bitternefs of thofe pangs which her idea excited, he again found means to obtain leave of abfence for a few weeks, and haftened to the valley.
He found the habitation deferted — all was dark and filent : he £ew through the apartments calling upon the name of Adelaide, but no voice anfwered his call.
He left the houfe, and walked with eager fteps along the valley. As he paffed a cavern of the rocks, he heard the moans of Adelaide. — He ruihed into the cavern. She was feated upon its flinty floor, and Marianne was fitting near. — Adelaide caft up her eyes as he entered, and looked at him earneftly — he knelt by her fide, and prefled her hand to his bofom — " If you are
Charles," fays fhe, " you are come too late « — it is all over ! — Poor old man !" Then haftily rifing from the ground, and clafping her hands together, fhe cried, " Don't you fee his blood on f my clothes ? — I begged very hard for him — I
told them I had no father or mother, but him —
« If
41
" If you are really Charles, fly, fly !— they are on the way — I fee them on the rock ! — there, " there !"
Such were the ravings of the difordered imagi- nation of this unfortunate young lady, and which were fometimes interrupted by long intervals of filence, and fometimes by an agony of tears. Her lover watched over her with the moft tender and unwearied affiduity ; but his cares were ineffec- tual. The life of Adelaide was near its clofe. The convulfive pangs of her mind had reduced her frame to a ftate of incurable weaknefs and decay.
A fliort time before flie expired, flie recovered her reafon, and employed her laft remains of ftrength in the. attempt to confole her wretched lover. She fpoke to him of " a happier world, " where they fliould meet again, and where *' tyrants would opprefs no more." — She grafped his hand — ffie fixed her eyes on his — and died.
Young De M pafled the night at the
grave of Adelaide. Marianne followed him thither, and humbly entreated him to return to the houfe. He pointed to the new-laid earth, and waved his hand, as if he wifhed her to de- part, and leave his meditations uninterrupted.
The next morning, at break of day, he entered the houfe, and called for Marianne. He thank- ed her for her care of Adelaide, and prefented her with a purfe of money j while he Was fpeak-
ing, his emotion choaked his voice, and for the lirft time his opprefled heart found the relief of tears.
When he had recovered himfelf, he bad Ma- rianne farewell, and haftened out of the houfe, muttering fomething in a low tone. He told Marianne, that he was going to join his regi- ment 5 — but he has never fmce been heard of.
SECT.
43
SECT. VIII.
EDWIN AND EMMA.
Far in the windings of a vale,
Faft by a fheltering wood. The fafe retreat of health and peace,
A humble cottage flood.
There beauteous Emma flourifh'd fair
Beneath a mother's eye, Whofe only wifh on earth was now
To fee her bleft, and die.
The fofteft blufh that nature fpreads.
Gave colour to her cheek j Such orient colour fmiles through heav'n
When May's fweet mornings break.
Nor let the pride of great ones fcorn
The charmer of the plains j That fun which bids their diamond blaze.
To deck our lily deigns.
Long had flie fir'd each youth with love.
Each maiden with defpair ; And though by all a wonder own'd.
Yet knew not flie was fair.
'Till
44
'Till Edwin came, the pride of fwaiiis,
A foul that knew no art, And from whofe eyes ferenely mild.
Shone forth the feeling heart.
A mutual flame was quickly caught.
Was quickly too reveai'dj Nor neither bofom lodg'd a wifh
Which virtue keeps conceal'd.
What happy hours of heart-felt blifs
Did love on both beftow ! But blifs too mighty long to laft.
Where fortune proves a foe.
The father was a fordid man.
Who love nor pity knew. Was all unfeeling as the rock
Frdm whence his riches grew.
Long had he feen their mutual flame.
And feen it long unmov'd ; Then with a father's frown at laft.
He fternly difapprov'd.
In Edwin's gentle heart a war
Of differing paffions drove ; His heart, which durft not difobey.
Yet could not ceafe to love.
D
45
Deny'd her fight, he oft behind The fpreading hawthorn crept.
To fnatch a glance, to mark the fpot Where Emma walk'd and wept.
Oft too in Stanemore's wintry wafte.
Beneath the moonlight fhade. In fighs to pour his foften'd foul.
The midnight mourner ftray'd.
His cheeks, where love with beauty glow'd,
A deadly pale o'ercaft ; So fades the frefli rofe in its prime.
Before the northern blaft.
The parents now, with late remorfe.
Hung o'er his dying bed. And weary'd Heaven with fruitlefs pray'rs.
And fruitlefs forrows fhed.
" 'Tis paft," he cried, " but if your fouls
" Sweet mercy yet can move, " Let thefe dims eyes once more behold
" What they muft ever love."
She came ; his cold hand foftly touch'd. And bath'd with many a tear ;
Firft falling o'er the primrofe pale So morning dews appear.
Now
46
Now homeward as flie hopelefs went.
The church-yard path along, The blaft blew cold, the dark owl fcream'd
Her lover's fun'ral fong.
Amid the falling gloom of night.
Her ftartling fancy found In ev'ry bufti his hovering fhade.
His groan in every found.
Alone, appaird, thus had flie pafs'd
The vifionary vale» When lo ! the death-bell fmote her ear.
Sad founding in the gale.
Juft then fhe reach'd, with trembling fteps.
Her aged mother's door ! " He's gone," fhe cried, " and I muft fee
" That angel face no more !
" I feel, I feel this breaking heart
" Beat high againft my fide :" From her white arm down funk her head.
She fliiver'd, figh'd, and died.
47
SECT. IX.
STORY OF A CLERGYMAN.
A CERTAIN Englifli clergyman, eminent for his accomplifliments, who had fpent many years in travelling with a young nobleman, took up, at length, his refidence in the neighbourhood of a great town, at the feat of his young pupil. He then entertained the firm perfualion, " that true " felicity and virtue confift in uniformly fubject- " ing all the palTions to the dictates of the under- " ftanding." His ardour for knowledge, and the conftant fucceflion of new objefts, which natu- rally refulted from his ambulatory mode of ex- iftence, had hitherto rendered it no very difficult matter to realize this truth. But the moment he was fettled, his mind began to vary with the fcene. Where fo many objefts folicited his at- tention at the fame time, fome were unavoidably preferred. A fine garden, delightful arbours, a beautiful flieet of water, ftreams, cafcades, grottos, wildernelfes, large fields, delicious woods, and ex- tenfive plains, engroffed at firft his whole atten- tion. The united charms of fuch rural and en- chanting fcenes were his evening and morning amufement. Wherever he went on bufinefs or pleafure, he ftlll felt a fecret impulfe recalling his affeftions to the fpot where all his happinefs naturally centered. Even here, however, like
the.
48 ;
1
the firft man in the bofom of paradife, he was ;
foon far from being completely blefTed. Na |
longer abforbed in other purfuits, he fighed in- !
fenfibly for a companion to fliare his enjoyments. :
Now, if a fpotlefs maiden ihould appear; all j
innocence, and all foul ; all love, and of love all i
worthy ; if in her large arched forehead all the ]
capacity of immeafurable intelligence, which wif- i
dom can communicate, be vifible ; if her com- •"
preffed, but not frowning eyebrows, fpeak an ;
unexplored mine of underftanding, or her dimpled |
cheek fympathetic goodnefs of heart, which flows '
through the clear teeth over her pure and effi- j
cient lips ; if flie breathe humility and compla- |
cencyj if dignified wifdom be in each tone of j
her voice ; if her eyes, neither too open nor too :
clofe, often gently turned, fpeak the foul that ^
feeks a fifterly embrace; if flie be fuperior to the , powers of defcription j if all the glories of her
angelic form be imbibed like the mild and golden j rays of an autumnal evening fun ; what do you think would become of our philofopher, and of his fublime theory ? — Near this retirement, there
chanced to refide a lady of moft exquifite beauty; ,
but, alas 1 fhe had not that fanftity of innocence, |
that divinity of maiden purity before defcribed, |
but wiles afFe£ting every look of modefty. She i
pofTeflfed the wretched pride of filence, a mea- ]
fured affeftation of fpeech, eyes arrogantly over- J
looking mifery and poverty, an authoritative nofe, i
and !
49
and lips blue with envy, or half bitten through from artifice or malice. The elegance of her perfon foon, however, attra£led the attention of the philofopher, and fancying the mind mull cor- refpond, through the medium of a friend he ob- tained an interview. This lady, who was fo well able to put on the mafk, lifteiled with attention to his difcourfe, and leemed eager to cultivate his acquaintance. Not infenfible of the conqueft flie had made, flie diverted her female friends with the tender fenfibility of the poor fool, her lover, as flie ufed to ftyle him. This coquetry being managed with addrefs', was; nicely calcu- lated to operate on an eafy and unfufpefting mind. Imagine now the fenfibility of the philo- fopher, who had fingled out the fair by the kindeft partiality, when affured flie had all along regarded him with a fimilar emotion. His happinefs be- came infeparable from her's. He foon, however, experienced all thofe teafing perplexities which the artifice of a cunning woman was able to con- trive. The triumph of conqueft was her only aim. So capricious and evanefcent appeared the attachment of an iticonfiderate and giddy mind. The impreflion on fuch, like thofe made on a ftream by the gentleft breeze, exift but for a moment : far otherwife the attachment of the feeling, the fufceptible, and the penfive. How infinitely more durable the tender fenfibilities he indulged ! He pofTelfed;, however, too much good Vol. IV. E fenf«
50
fcnfe not to fee through her duplicity; and to difcover that flie was trifling with the fcnfibilitic& ot a heart, which thoufands would have foothed and chcrillied with jc^y j yet to- tear from his bofom all at once its deareft objeft on earth, occafioned the moft ferious and inexpreffible concern. The ftruggle was indifpenfable, and competent to all his philofophy. It was reafon alferting her fupre- macy over paffion, and heaven ftriving for the jnaftery over man. At this interval, the lady removed the malk, and marri'ed a wi-ld fortune- hunter, who foon brought her into contempt and •wretchednefs. Happy would it have been for our philofopher, could his wounded mind have been reflored to its former health and tranquillity. But his heart was gone, and with it all relilli for life. It was not henceforward in the power of medicine, variety, or expedient, to afford him the leaft interval of ferenity. His- nights and his days were alike dreary and joylefs. The fcenes, whicb had been the witneffes of his happier hours, now became the conftant and folitary companions of his wretchednefs. At lafi:, averwhelmed with the monotony of the fame thoughts, the brain funk lethargic, and the philofopher was converted into the happier idiot, until death foon, fortunate- ly, clofed the melancholy and degrading fcene.
SECT-
5^
SECT. X
STORY OF MONIMIA.
, She flourilh'd,
Grew fweet to fenfe, and lovely fo' the eye - Till at lafl the efuel fpoiler came, Cropt this fair rofe, and rifled all its fweetnefs. Then threw it, like a loathfome weed, away.
OTWAV.
MoNiMiA was the lovely and aecompliflied daughter of an aged and worthy country fquire. A young officer^ a man of birth and fafhion, who lived in the neighbourhood, took advantage of the unwary difpofition of this innocent girl, and afterwards cruelly def^rted her. — She thus ad- drefles him :
Since language never can exprefs my pain, How can I hope to move when I complain ? Yet fuch is woman's frenzy in diftrefs. We love to plead, tho* hopelefs of redrefs. Perhaps, afFefting ignorance, thou'It fay, * From whence thefe lines ? whofe meffage to * convey ?'
Mock not my grief with that feign'd cold demand. Too well you know the haplefs writer's hand : But if you force me to avow my fhame, Behold them prefac'd with MaNiMiA's name.
E 2 Loft
52
Loft to the world, abandon'd and forlorn, Expos'd to infamy, reproach, and fcorn. To joy and comfort loft, and all for you. And loft, perhaps, to your remembrance too , How hard my lot \ what refuge can I try. Weary of lifcy and yet afraid to die ! Of hope, the wretch's laft refort, bereft. By friends, by kindred, by my lover, left. Oh ! frail dependance of confiding fools, On lovers oaths, or friendfhip's facred rules ! Too late in modern hearts, alas ! I find, MoNiMTA'a fall'n, and thou too art unkind ! To thef6 refledions, each flow-wearing day. And each revolving night, a conftant prey. Think what I fuffer, nor ungentle hear What madnefs dictates in my fond defpair ; Grudge not this fliort relief— too faft it flies I Nor chide that weaknefs I myfelf defpife. For fure one moment is at leaft her due, Who facrific'd her all of life for you. Without a frown this farewell then, receive. For 'tis the laft my fatal love fliall give ; Nor this I would, if reafon could command, But what reftri£tion reins a lover's hand ? Nor prudence, fliame, nor pride, nor int'reft fwaysv The hand implicitly the heart obeys: Too well this maxim has my condu6^ fliown, Too well that conduct to the world is known.
Oft have I writ, as often to the flame Ccndemn'd the after-witnefs of my fliame j
Oft
53
oft in my cooler, recollefted thought. Thy beauties and my fondnefs half forgot ; (Hovv fliort thofe intervals for reafon's aid !) Thus to myfelf in anguifli have I faid :
' Thy vain remonilrance, foolifli maid, give o'er; ' Who a£t the wrong, can ne'er that wrong de- ' plore.'
Then fanguine hopes again_delufive reign, I form thee melting as I tell my pain. If not of rock thy flinty heart is made. Or tigers nur^'d thee in the defert fliade, This would at leaft thy cold compaffion prove, That flender fuften-ance of greedy love : Tho* no return my warmer wiflies find. Be to the wretch, tho' not the miftrefs, kind ; Nor whiljfi: I court my melancholy ftate. Forget 'twas love, and thee, that wrought my fate.
Without reftraint, habituate to range The paths of pleafure, can I bear the change ? Doom'd from the world unv/illing to retire. In bloom of life, and warm with young defire. In lieu of roofs, with proper fplendor gay, Condemn'd in diftant wilds to drag the day ; Where beafts of prey maintain their favage court. Or human brutes (the worft of brutes !) refort. Yes, yes, this change I could unfighing fee. For none I mourn, but what I find in thee : There centre all my woes j thy heart eftrang'd, I weep my lover, not my fortune, chang'd.
• Bleft
54
Biefl: with thy pre fence, I could all forget, Nor gilded palaces in huts regret ; But exil'd thence, fuperfluous is the reft. Each place the fame, my hell is in my breaft ; To pleafure dead, and living but to pain. My only fenfe, to fuffer and complain.
As all my wrongs diftrefsful I repeat, 3ay, can thy pulfe with equal cadence beat? Canft thou know peace ? is confcience mute with-» in?
That upright delegate for fecret fin ; Is nature fo extinguifli'd in thy heart, That not 'one fpark remains to take my part ? Not one repentant throb, one grateful figh ? Thy breaft unruffled, and unwet thine eye? Thou cool betrayer, temperate in ill ! Thou, nor remorfe, nor thought humane, canft feel :
Nature has form'd thee of the rougher kind.
And education more debas'd thy mind.
Born in an age when Guilt and Fraud prevail.
When Juftice fleeps, and Int'reft holds the fcale ;
Thy loofe companions, a licentious crew,
Moft to each other, all to us untrue ;
Whom chance, or habit mix, but rarely choice.
Not leagu'd in friendfliip, but in focial vice i
W^ho, indigent of honour, as of fliame.
Glory in crimes which others blufli to name.
Thefe are the leaders of thy blinded youth, Thefe vile feducers la\jgh'd thee out of truth ;
Whofe
Whofe fcuml jefls all folemn ties profane,
Or Friendfliip's band, or Hymen's facred chain.
With fuch you lofe the day in falfe delight. In lewd debauch you revej out the night. (O fatal commerce to Monimia's peace!) .Their arguments convince becauCe they pleafe; Whilft fophiftry for reafon they admit. And lyander dazzled in the glare of wit. So in the prifm, to the deluded eye. Each pi£lur'd trifle takes a rainbow dye ; With borrow'd charms the gaudy profpe61: glows. But truth revers'd the faithlefs mirror fliows.
Oft I revolve, in this diftrafted mind. Each word, each look, that fpoke my charmer kind ;
But oh j how d^ar their memory I pay ! What pleafures pad can prefent cares allay ? Of all I love for ever difpolfefs'd : Ah ! what avails, to think I once was blefs'd!
Thy fatal letters, O immoral youth, Thofe perjur'd pledges of fi6litious truth. Dear as they were, no fecond joy afford, . My cred'lous heart once leap'd at ev'ry word. My glowing bofom throbb'd with thick-heav'd fighs.
And floods of rapture rufli'd into mine eyes : When now repeated (for the theft was vain, Each treafur'd fyllable my thoughts retain) Far other palTions rule, and diflf'rent care. My joys are ^rief, my tranfports are defpair.
Why
56
Why doft thou mock the ties of conftant love ? jBqt half its joys the faithlefs ever prove ; They only tafte the plcafures they receive, When, fure, the nob) eft is in thofe we give. Acceptance is the heav'n which n^ortals know. But 'tis the blifs of angels to bcftow. Oh ! emulate, my loye, that talk divine. Be thou that angel, and that Jieav'n be mine. Yes, yet relent, yet intercept my fate : Alas ! I rave, and fue for new deceit. Firft vital warmth fliall from the grave return. Ere love, extinguifli'd, with frefli ardour burn. Oh ! that I dar'd to aGt a Roman part. And ftab thy image in this faithful heart; There riveted to life fepure you reign. Ah ! cruel inmate ! fliarp'ning ev'ry pain ; While, coward-like, irrefoliite I wait Time's tardy aid, nor dare to rufli on fate j perhaps may linger on life's lateft ftage. Survive thy cruelties, and fall by age : No — gr/ef Piall fpread my fails^ andfpeed me o'er I Defpah- my pilot ) to that quiet JJiorey IVhere I can trujl, and thou betray no more.
Might I but once again behold thy charms. Might I but breathe rny laft in thofe dear arms, Qn that lov'd face but fix my doling eye. Permitted where I might not live to die, My foften'd fate I wou'd accufe no more ! But fat^ has no fuch happinefs in ftore.
57
'Tis pafl-, 'tis done — what gleam of hope behind. When I can ne'er be falfe, nor thou be kind ? Why, then, this care— 'tis w,eak — 'tis yain — •
farezvel-
At that laft word what agonies I feel !
I faint— — / die remember, I was true- *
''Tis all I afkt — — eternally adieu />- — —
SECT.
58
SECT. XI. I
I 1
CAUSE OF THE DEATH OF SAVAGE. \
\
Savage, that unfortunate genius, born, as he < fays, I
" Of a mother, and yet no mother !" j
who, after he had been allowed j£. 200 per amntm, ' by Lord Tyrconnel, which was taken unjuftly j from him ; after he was penfioned by the Queen, ; on whom he had written verfes, and the penfion j ceafed at her demife ; after having tired his ' friends, who feared to acknowledge him, on ac- i count of his fliabby drefs, fo cxpreflive of his 1 cireumflances, being at length arrefted and thrown ! into Newgate, for the fmali fum of eight guineas, he bore this laft misfortune with uncommon for- titude. Six months elapfcd in prifon, when he received a letter from Mr. Pope, on whofe kind- nefs he had the greateft confidence, and to whom he applied, charging him with ingratitude, drawn up in fuch terms as refentment dictated. Mr. Savage returned an anfwer, proving his inno- cence from the charge. The accufation, how- ever, ftrongly affected his mind: he became im- mediately melancholy, and in a few days afterwards was feized with pains in his back and loins, which not being violent, he was not fufpe6ted to
be i
59
be in danger^; but daily growing more languid and deje^ed, on the 20th of July a fever feized upon his fpirits. The laft time the keeper faw him was on July the 31ft:, when Savage, feeing him at his bed-fide, faid, with uncommon earnefl;- ijefs, " I have fomething to fay to you. Sir but i after a paufe, moved his hand in a melancholy 1 manner, and finding himfelf unable to recolle£i • ■jvhat he was going to compiunicate, added, " It ' " is over." The keeper foon after left him ; ancj ; the next morning he was found dead.
SECT.
SECT. XIL
HOGARTH.
Churchill is faid to have killed Hogarth by the ftroke of his pen. The painter made a caricature of Churchill, and he in return wrote a fatire on Hogarth. He thus defcribcs him :
Pale quiv'ring lips, lank checks, and fault'ring tongue.
The fpirits out of tune, the nerves unftrung. Thy body flirivell'd up, thy dim eyes funk Within their fockets deep, thy weak hams flirunkj The body's w^eight unable to fuftain. The ftream of life fcarce trembling through the vein.
More than half-kiird by honeft truths, which fell. Through thy own fault, from men who wifli'd thee well ;
Canft thou, e'en thus, thy thoughts to vengeance give.
And, dead to all things elfe, to malice live ? Hence, dotard, to thy clofet, fliut thee in. By deep repentance wafli away thy fm ; From haunts of men to fhame and forrow fly. And, in the verge of death, learn how to die.
Vain
6i
Vain exhortation I Wafti the Ethiop white, Difcharge the leopard's fpots, turn day to nighty Controul the courfe of nature, &c. — Thou wretched being, whom, on Reafoii^s plan. So chang'd, fo loft, I cannot" call a man. What could perfuade thee, at this time of life. To launch afrefli into the fea of ftrife ? Better for thee, fcarce crawling on the earth, Almoft as much a child as at thy birth, To have refign'd in peace thy parting breath. And funk unnoticed in the arms of death, • Now, by my foul, it makes me blufh to know My fpirits could defcend to fuch a foe, &c. &c.
Hogarth did not lon^ furvive tbls fatirev
SECT.
62
SECT. XIIL
STORY OF A WIDOW LABY.
A WIDOW lady, who loft an afFeQionate huf- band, an officer, was left in narrow circumftances, with a boy and girl, two beautiful and lively children, the one five and the other feven years of age ; as her circumftances allowed her to keep but one maid fervant, the two children were the fole attention, employment, and confolation of her life ; flie fed them, drefted them, flept with them, and taught them herfelf. They were both fnatched trom her by a putrid fore throat in one week -y fo that the poor woman loft, at once, all that employed her, as well as all that was dear to her. For the firft three or four days after their death, when any friend vifited her, fhe fat up- right, with her eyes wide open, without (bedding tears, and without utterance. Afterwards flie began to weep much, and foon inceflantly talked of nothing but of her dear children. Bereaved of all that made exiftence pleafant, a heavy gloom fettled upon her mind, and her body became in confequence daily more emaciated and weak. Thefe, indeed, are evils too terrible for the vvcak- iiefs of humanity to bear, and which admit of no remedy but the grave '
SECT.
^3
SECT. XIV.
MATILDA.
Outrageous did the loud winds blow
Acrofs the founding main : The velfel, toffing to and fro,
Could fcarce the ftorm fuftain.
Matilda to her fearful breafl:
Held clofe her infant dear : His prefence all her fears increas'd.
And wak'd the tender tear.
Now nearer to the grateful fliore
The moving veffel drew : The daring waves now ceas'd to roar>.
Now Iliout th' exulting crew.
Matilda, with a mother's joy. Gave thanks to Heaven's pow'r :
How fervent flie erabrac'd her boy ! How blefl: the faving hour !
Oh ! much deceiv'd and haplefs fair. Though ceas'd the waves to roar.
Thou, from that fatal moment, ne'er Can'fl talle of pleafure more.
64
Tdr, ftepping forth from off the deck. To reach the welcome ground,
The babe, unclafping from her neck,. Plung'd in the gulph profound.
Amazement chain'd [ her haggard eye
Gave not a tear to flow. Her bofom heav'd no confcious figh.
She ftood a fculptur'd woe *,
To fnatch the child from inftant death. Some brav'd the threatening main.
And to recal his fleeting breath Try'd ev'ry art in vain.
But when the corfe firft met her vie\^, Stretch'd on the pebbly ftrand,
Rous'd from her ecftafy fhe flew. And pierc'd th' oppofing band.
With
* This, though exprelfed in pottry, is a true picture of na- ture. Cambyses, when he conquered Egypt, made Psam- n^ETicus, the king, prifoner; and, to try his conftancy, ordered his daughter to be dreffed in the habit of a flave, and to be em- ployed in the meaneft drudgery ; his fon was alfo led to exe- cution with a halter about his neck. The friends of the king Vented their forrow in tears and lamentations : Psammeticus only, with a downcaft eye, remained filent. Som'e time after <his meeting one of his countrymen, a man advanced in years, who, being plundered of all, was begging alms, he wept bitterly, calling him by his name. Cambyses was ftruck with wonder,
and
6g
With trefles difcompos'd and rude.
Fell proftrate on the ground ; To th' infant's lips her lips flie glew'd.
And forrovv burft its bound.
Now throwing round a troubled glance.
With madnefs' ray inflam'd, And, breaking from her filent trance.
She wildly thus exclaim'd :
« Oh ! Oh ! his little life is fled,
" His heavelefs breaft is cold j " What tears will not the mother flied,
" When thy fad tale is told !
" Ah me ! that cheek of livid hue — .
" That brow— that auburn hair— " Thofe lips where late the rofes blew, .
" All, all my fon declare."
She added not — but funk opprefs'd —
Death on her eye-lids ftole. While from her grief-diftrafted breaft
She figh'd her tortur'd foul.
JERNINGHAM.
nd enquired the reafon of this difference. " O, fdn of Cv- Rus," returned Psammeticus, "the calamities of my family are too great to leave me the power of weeping; but the misfortunes of a fubjeft, reduced in his old age to want of bread, is a fit fubjedl for lamentation."
Vol. IV. F PRACTICAL
66
PRACTICAL OBSERVATIONS,
SECT. XV.
. METHOD OF CONSOLING GRIEF.
O ! caa'ft thou minifier to a mind difeas'd. Pluck from the memory a rooted forrow, Raze out the written troubles of the brain ; And, with fome fweet oblivious antidote, Cleanfe the fluff'd bofom of that perilous fluff Which weiglis upon the heart ?
SHAKESPEARE.
There is nothing fo difficult as the cure of paflions of the mind, becaufe application muft be made to the .mind itfelf, which is a difeafed part, and which in return muft apply its own remedy. This Yubjeft, however, merits fome attention from every one, and requires great addrefs. Perfons unacquainted with human na- ture, are very apt to reafon with people under their heavieft affli£lions, inftead of participating in their forrow. We have a precept againft this manner of confoling from the eloquent pen of Pliny, who addreffing Marcellinus, fays :
" I write to you, imprelTcd with the deepeft forrow : the youngeft daughter of my intimate friend Fundanus is dead ! Never furely was there a, more agreeable and more amiable young per-
fon.
6/
fbn, or one who better deferved to have enjoyed a long, I had almoft faid, an immortal life ! She was fcarcely fixteen, and yet united the wifdom of age and difcretion of a matron, with the fprightlinefs of youth, and fweetnefs of virgin modefty. With what an endearing fondnefs did flie hang on her father's neck ! How kindly and refpe6tfully behave to us his friends ! How affec- tionately treat all thofe who, in their refpeBive offices, had the care of her education! She em- ployed much of her time in ftudy and reading ; indulged herfelf , in few diverfions, and entered even into thofe with lingular caution and referve. With what forbearance, with what patience, with what fortitude, did flie endure her laft illnefs ! She complied with all the dire6tions of her phyficians ; encouraged the hopes of her fifter and her father ; and when her ftrength was totally exhaufted, fup- ported her fpirits by the fole force of her own mind. The vigour of her mind indeed continued, even to her laft moments, unbroken by the pain of a long illnefs, or the terrors of approaching death : a refle£lion which renders the lofs of her fo much the more fenfibly to be lamented by us. It is a lofs infinitely indeed fevere ! and aggra- vated by the particular conjuncture in which it happened ! She was contracted to a moft worthy youth J the wedding-day was fixed, and we were all invited. How fad a change from the higheft joy to the deepcft forrow ! How (hall I exprefs
F 2 the
68
the wound that pierces my heart, when I heard Fundanus himfelf (as grief is ever fond of dwelling Upon every circumftancc to incrcafe the affli6tion) ordering the money he had dcfigned to lay out upon clothes and jewels for her marriage, to be employed in myrrh and fpices for her funeral ! He is a man of great good fenfc and accompliflv ments, having applied himfelf, from his earlieft youth, to the noblefl: arts and feiences > but all the maxims of fortitude and philofophy v/hich he has derived from books, or delivered by his own precepts, he now abfolutely reje61:s > and every firmer virtue of his heart gives place to paternal tendernefs. You will excufe, you will even ap- prove his grief, when you confider what a lofs he has fuftaincd ! He has lofl" a daughter who refembled him in his manners, as well as his per- fon, and exadly copied out all her father. If you fhould think proper to write to him upon the fubjed of a calamity fo juftly to be deplored, let me remind you not to urge feverer arguments of confolation, which feem to carry a fort of reproof with them, but to ufe thofe only of a gentle and fympathizing humanity. Time will render him more open to the dictates of reafon: for, as a recent wound fln-ink.s from the hand of the fur- geon, but gradually fubmits to, and even requires the means of cure ; fo a mind under the firft imprefiion of a misfortune ihuns and reje£ls all the perfuafions of reafon, but at length, if ap-
^9
plied with tendernefs, calmly and willingly rcfigns itfelf to confolation. Farewel."
In the play of Eleftra, by Sophocles, we have an example of the different methods of confoling, with their effefts, extremely well pointed out. The fcene lies juft before the gates of the palace of yEgifthus J on the back part of it is reprefented a view of the two cities of Argos and Mycenae, the temple of Juno, and the grove of lo, which muft, altogether, have made a noble and magni- ficent appearance, as the Greeks fpared no ex- pence in the decorations of their theatre.
Electra appears before the palace of tEgist- Hus, thus complaining;
O ! facred light, and O ! thou ambient air ! Oft have ye heard Electra's loud laments, Her fighs, and groans, and witneffed to her woes. Which ever as each hateful morn appeared I poured before you ; what at eve retired . , I felt of anguifli my fad couch alone Can tell, which watered nightly with my tears Received me forrowing ; that beft can tell "What pangs I fuffered for a haplefs father. Whom not the god of war with ruthlefs hand Struck nobly fighting in a diftant foil. But my fell mother and the curfed yEcisxHUs, The partner of her bed, remorfelefs flew. Untimely didfl: thou fall, lamented fliade. And none but poor Electra mourns thy fate;
Nor
70
Nor fliall (lie ceafe to mourn thee, while thcfe eyes View the fair heavens, or behold the fun ^ Never, O ! never ! like the nightingale W'hofe plaintive fong bewails her ravillied brood j Here will I ftill lament my father's wrongs, And teach the echo to repeat my moan, Ol ye infernal deities, and thou, 'Terrcftrial Hermes, and thou, Nemefis, Replete with curfes, and ye vengeful furies. Offspring of gods, the minifters of wrath To vile adulterers, who with pity view The flaughtered innocent, behold this deed! O ! come, alllft, revenge my father's murder ; Quickly, O! quickly brin^ me my Orestes*;
For
* Okestes was faved in his cradle from his mother, and concealed by Electra, He is reported to be dead, and his urn is brought to the palace of ^Egisthus, king of Mycenae, by Phocians, but inftead of bearing tlie aflies of Orestes, he himfelf comes to revenge his father's murder — and being admitted into the palace, CLyXiEMNEsxR a is murdered. By this time jiEgisthus returns to the palace.
JEgi. Which of you knows aught of thefe Phocian guefls Who come to tell us of Orestes' death ? You firft I afli, Electra, once fo proud And fierce of foul; it doth concern you moft; And therefore you, I think, can beft inform me ?
Ele. Yes, I can tell thee ; is it poffible I fliould not know it? that were not to know A cirjcumftance of deareft import to me.
JE.G1. Where are they, then?
Ele. Within.
4^01, And fpake they truth?
■ 71
For lo I fink beneath oppreffive woe. And can no longer bear the weight alone.
THE
Ele. They did; a truth not proved by words alone, But fadls undoubted.
JEgj. Shall we fee him then?
EtE. Aye, and a dreadful fight it is to fee.
^Gi. Thou art not wont to give me fo uiiuch joy; 'Now I am glad indeed.
Ele. Glad may 'ft thou be, If aught there is in that which can give thee joy.
^Gi. Silence within, and let my palace gates Be opened all ; that Argos and Mycenae May fend her millions forth to view the fight ; And if there are who nourifli idle hopes That ftill Orestes lives, behold him here. And learn fubmiffion, nor inflame the crowd Againft their lawful fovereign, left they feel An angry monarch's heavieft vengeance on them.
Ele. Already I have learned the talk, and yield To power fuperior.
Scene opens, and difcovers the body of CtYXiEMNESTR a extended on a biei*, and covered with a veil.
Orestes, Pylades, Governor of Orestes, ^gisthus, Electra, Chorus, an^l a crowd of Spectators from the city.
^Gi. What a fight is here! O ! Deity fupreme ! this could not be But by thy will; and whether Nemesis Shall ftill o'ertake me for my crimes, I know not. Take off the veil, that I may view him well ; He was by blood allied, and therefore claims Our decent forrows.
Ore. Take it off thyfelf; 'Tis not my office ; thee it beft befits To fee and tp lament.
JEgi.
72
THE CHORUS ENTERS.
Cho. O ! wretched daughter of an impious mother!
Wilt thou for ever ipourn, for ever thus With unavailing tears, and endlefs forrow, Lament the royal Agamemnon's fate. By a viJp woman's wi.cked arts betrayed ?
Ele.
^Gi. And fo it does ; And I will dp it; fend CLYXiEMNEsTR a hither.
[Taking off the veil.
Ore. She is before thee. ^Gi. Ha! What do I fee?
Ore. Why, what's the matter ? what affrights thee fo J Po you not fee him ?
^Gi. In what dreadful fnare Am I then fallen >
Ore. Doft thou not now behold That thou art talking with the dead?
^Gi. Alas! Too well I fee it, and thou art— Orestes.
Of all the cataftrophes, ancient or modern, which I remem? bcr to have met with, this of Electra appears to me infir nitely the moft interefting, natural, and truly dramalic. — There cannot poffibly be a fpe<ftacle more affefting than the fcene before us ; a tyrant, murderer, and adulterer, is reprefented as cxuhing on the death of the only perfon in the world whom he had to fear, and whofe dead body he expefts to fee before him; inftead of this, on liftipg up the veil, he is fliocked, not with the corpfe of Orestes, but that of his own wife; he perceives at once that Clyt/Emnestr a is murdei-ed, that Orestes is aliv? ^nd clofe to him, and that he has nothing to expeft himfelf but immediate death : the fudden change pf fortune to all the perfons, concerned, the furprife and delpair of ^gisthus, the joy and triumph in the countenances of Prestes and Electra, muft altogether have exhibited a
pifturc
73:
Ele. Ye come to comfort me, I know ye do, I know my tears are fruitlefs all and vain ; 3ut 01 permit me to indulge my griefs. For I muji zveep.
Cho. Thy tears can ne'er recal him From the dark manfions of the common grave, No, nor thy prayers; tliey can but make thee,
wretched, And fink thee deeper in calamity ; Why art thou then fo fond of mifery ?
Ele. Devoid of fenfe and feeling is the heart That can forget an injured parent's wrongs. I love the airy meffenger of Jove, The mournful bird that weeps her Ity's fate. And every night; repeats the tender tale: Thee too I reverence as a goddefs, thee. Unhappy Niobe ! for ftill thou weep'ft. And from the marble, tears eternal flow.
Cho. But O ! reflect that not to thee alone Misfortune comes, that comes to all * : behold
Iphianafla,
pidure worthy the pencil of a Raphael to execute: how it was acled on the Greek ftage, we cannot pretend to determine; moft probably with tafte and judgment. Let the Englifii reader conceive thofe inimitable aftors, Palmer, Kemble, and Mrs. Siddons, in the parts of TEgisthus, Orestes, and Electra, and from thence form to himfelf fome idea of the efFeft which fuch a cataftrophe would have on a Britilli audience.
The Chorus here employ reafoning. — ^' I will reftore your daughter again to life," faid the Eaftern fage, to a prince who grieved immoderately for the lofs of a beloved child, *' provided you are able to engrave on her tomb the names
" of-
74
Iphlanafifaj and Chryfothemis *,
And him who hides his grief, illuftrious youth.
The loved Orestes, thefe have fuft'ered too.
Ele. Orestes! yes, Mycense fliall receive In happy hour the great avenger; Jove With fmiles aufpicious fliall conduft him to me ; For him alone 1 wait, for him, a wretch Defpifed, of children and of nuptial rites Hopelefs I wander ; he remembers not What I have done for him, what fuffered, ftill With airy promifes he mocks my hopes. And yet he comes not ta me.
Cho. But he will. Defpair not, daughter; Jove is yet in Heaven, The god who fees, and knows, and governs, all : Patient to him fubmit f , nor let thy rage Too far tranfport thee, nor oblivion drown The juft remembrance of thy matchlefs woes ; Time is a kind, indulgent deity. And he fliall give thee fuccour, he flnall fend
" of three perfons who have never mourned." The prince made inquiry after fuch perfons ; but found the inquiry vain, and was filent.
* Ijihianaffa and Chryfotkcinls. Homer II. (Book IX.) men- tions three daughters of Agamemnon, Chryfothemis, Laodice, and Iphianafla. Euripides takes no notice of any but Iphigenia, (who was facrificed) and Electra. Poffibly the Laodice of Homer is the Electra of Sophocles. The poets took the Hberty of changing circumftances of this nature, not eflential to the fubjeft, as they thought proper.
f The Chorus next employ religion.
The
75
The god of Acheron, from Chryfa's fhorcs To bring Oreftes, and avenge thy wrongs.
Ele. Ol but the while how much of life is gone 1
And I a hopelefs, wretched orphan ftlll. Without a friend to guard, or to prote£l: me; Difgraced, diflionoured, like a ftranger clad In bafe attire, and fed with homelieft fare.
Cho. Sad news* indeed the haplefs meffenger To Argos brought, that fpoke the wiflied return Of thy loved father to his native foil ; Fatal the night when Agamemnon fell Or by a mortal or immortal hand ; The work of fraud and luft f , a horrid deed ! Whoe'er performed it f .
Ele. O! detefted feaft! O ! day, the bittereft fure that ever rofe ! With him I periflied then ; but may the gods Repay the murderers ; never may they hear The voice of joy, or tafte of comfort more 1
* Finding thefe not avail, the Chorus now particijiate in the forrows of Electra.
f The work of fraud and hijl.\ ^Egifthvis and Clytaemneflra are faid to have watched Agamemnon as he came out of the bath, when they threw over his head a fliirt without any open- ing at the neck ; entangled in this they murdered him ; thus was the fcheme laid by fraud and treachery, and executed by luft.
% IVhoe^er performed it. The Chorus feem fearful of attribut- ing fo great a crime to ClytJEmneftra and j^lgifthus, which they knew them however guilty of.
Cho.
76
Cho. Ceafc thy complaints, already hafl thou fuffered
For thy loud difcontents,and threatened vengeance. 'Tis folly to contend with power fuperior*.
Ele. Folly indeed, and madnefs ! but my grief s Will force their way, and whil/i -^.-lt-ctra breathes She mvfi lament ; for who will bring me comfort, Or footh my forrows ? let me, let me go. And weep for ever.
Cho. 'Tis our love intreats; Truft me, we feel a mother's fondnefs for thee. And fain would fave thee from redoubled w^ocs.
Ele. And would ve have me then neq-lect the dead?
Forget my father ? Can there be fuch guilt ? When I do fo, may infamy purfue me ! And if I wed, may all the joys of love Be far removed ! if vengeance doth not fall On crimes like thefe, for ever farewell juftice. Shame, honour, truth and piety, farewell !
Cho. Pardon me, daughter; if my warmth offend.
Glad I fubmit \ vi'c'll follow, and obey thee f .
Ele. I am myfelf to blame, and blufli to think Hovv- much unfit I feem to bear the weight Impofcd upon me ; but indeed 'tis great : Forgive me, friends, a woman born as I am, Mull flic not grieve to fee each added minute
* They recur again to renfon'mg.
•(• They change their mode and fee the efFe£l.
Fraught
77
Fraught with new miferies ? thus to be a Have •
E'en in my father's houfe, and from thofe hands
Which flied his blood, to a{k the means of Hfe !
Think what my foul muft fuffer to behold
The curfed yEcisxHus feated on the throne
Of Agamemnon, in the very robes
Which once were his ! to fee the tyrant pour
Libations forth e'en on the fatal fpot
Where the fad deed was done ! but, worft of all,
To fee the murderer ufurp his bed.
Embrace ray mother (by that honoured name
If .1 may call a guilty wretch like her,)
Who, pleafed, returns his love, and, of her crimes
Unconfcious, fmiles, nor fears th' avenging furies ;
But ever as the bloody day returns
WHiich gave the royal viftim to her wiles.
Annual the dance and choral fong proclaim
A folemn feaft *, nor impious facrifice
Forgets flie then to her prote6ling gods,
Sho,cked at the cruel banquet, I retire.
And in fome corner hide my griefs, denied
E'en the fad comfort to indulge my forrows ;
For Clyt^mnestra in opprobrious terms
Reviles me oft, " To thee alone, flie cries,
" Is Agamemnon loft, detefted maid !
" Think'ft thou Electra only weeps his fate?
* Proclai?n a folernn fenjl. Nothing could add more to the horror of the crime than luch a circumftance. Ci.yt^emnes- TRA, not content with murdering Jier hufband, inftitutes a folemn feaft in commemoration of the happy event, and calls it, with ci:uel raillery, the fupper of Agamemnon.
" Perdition
78
" Perdition on thee ! may th' infernal gods " Refufe thee fuccour, and protract thy pains !" Thus rails llie bitter, and if chance flie hear Orestes is approaching, ftung with rage. Wild flie exclaims, " Thou art th' accurfed caufe, *' This is thy deed, who ftole Orestes from me, " And hid him from my rage ; but be affured, " E'er long my vengeance fliall o'ertake thee for it !" Thefe threats her noble lord ftill urges on ; That vile adulterer, that abandoned coward, Whofe fearful foul called in a woman's aid To execute his bloody porpofes. Meantime, Electra fighs for her Orestes, Her wiQied avenger; his unkind delay Deftroys my hopes ; alas ! my gentle friends. Who can bear this, and keep an equal mind? To fufFer ills like mine, and not to err From zvild diJlraEiion^ would he Jlrange indeed.
Ci-io. But fay, Electra, is the tyrant near ? Or may we fpeak our thoughts unblamed ?
Ele- Thou mayft ; I had not elfe beyond the palace dared To wander hither.
Cho. I w^ould fain have afked thee '
Ele. Afkwhat thou wilt, ^Egisthus is far off.
Cho. Touching thy brother then, inform me quick
If aught thou knovv'll: that merits firm belief*.
* The Chorus finding Electra fornewhat appeafed by giving vent to grief, m-w turn the fuljed of dljcourfe.
Ele.
79
Ele. He promifes, but comes not.
Cho. Things of moment Require deliberation and delay.
Ele. O ! but did I delay to fave Orestes ?
Cho. He boafts a noble nature, and will ne'er • Forget his friends : be confident.
Ele. I am ; Were I not fo, I had not lived till now.
fThe buftle of the Play now commences.]
SECT.
,8o
SECT. XV.
CONSOLATIONS FROM CHRISTIANITY.
As Chrijlians^ we are able to employ moi^e powerful perfuafives againft excefs of forrow.
Many are the fayings of the wife In ancient and in modern books inroll'd. Extolling pAriENCE as the frueft fortitude r And to the bearing well of all calamities. All chances incident to man's frail life. — Many are the confolatory writs, form'd Vv^ith ftudied argument, and much perfuafion. But with th' afflicted in his pangs fuch founds Little prevail, or rather feem a tune Harfli, and of diflbnant mood from his complaint, Unlefs he feel within
Some fource of consolation from above. Secret refrefliings, that repair his ftrength. And fainting fpirits uphold.
MI LTON.
Wlien a feeling heart is oppreffed with fome painful difeafe in his body, or wrung with fome fore diftrefs of mind, every former comfort, at that moment, ufually goes for nothing. Life is beheld in all its gloom. A dark cloud feems to hang over X; and it is too often reviled, as no other than a fcene of wretchcdnefs and forrow. But this is to be unjuft to human lite^ as well as ungrateful to
8i
its Author. — Let me only defire you to think how many days, how many months, how many years, you have paffed in health, and eafe, and comfort ; how many pleafurable feelings you have had; how many friends you have enjoyed ; how many blef- lings, in fliort, of different kinds you have tafted ; and you will be forced to acknowledge, that more materials of thankfgiving prefent themfelves than of lamentation and complaint. — Thefe bleffings, you will fay, are paft. But though paft, ought they to be gone from your remembrance ? Do they merit no place in the comparative eftimate of the goods and evils of your ftate ? Did you, could you, expeQ:, that in this mutable world, any temporal joy was to laft for ever ? Has gratitude no influence to form your minds to a calm acqui- efcence in your BENEFACTOR'S appointments? What can be more reafonable than to fay, " Hav- " ing in former times received fo many good " things from the hand of GOD, fliall I not now, " without defpondence, receive the few evils " which it hath pleafed him to fend ?" — If we are deprived of friends whom we tenderly loved, are there not ftill fome remaining from whom we may expedl much comfort ? If our bodies are affli£led with fore difeafe, have we not reafon to be thankful that our mind continues vigorous and entire; that we are in a fituation to look around us for whatever can afford us eafe; and that after the decay of this frail and mouldering Vol. IV. G tabernacle.
82
tabernacle, we can look forward to a houfe not made zvilh hands, eternal in the heavens ? — \w the midft of all diftrefles there remains to every fin- cere Chriftian, that mixture of pure and genuine confolation which fprings from the promifes and hopes of a future life. Confider, I befeech you, what a fingular diftinclion this makes in your fituation, beyond the ftatC of thofe who, under the various troubles of life, are left without hope; without any thing to look up to, but a train of unknown caufes and accidents, in which they fee no light nor comfort. — Thank the FATHER OF MERCIES, that into all the evils he fends, he infufes joyful hope, that the fufferings of the pyefent time are not worthy to he compared with the glory that fJiall be revealed in the end to the virtuom and good.
. Have we fuftained the greateft of all lofles, that of a child, refle6t, that if it is our lofs, it is his gain that he yet liveth *, that this life is but the threlli- old, the portal, the entrance to a palace, the pre- lude to a better play, and that his happinefs is as complete, as our mifery is great. Let us turn
* Tlie Chriftian reHgion teaches us, that the moment of the reparation of the foul from the body, that the foul is inftantly embodied and received up into Paradife. Hence the appearanct of Mofes and Elias in an embodied form. Hence the expref- fion of our Saviour, " this day flialt thou be with me in Para- " dife." Hence the vifion of St. Paul, " I was caught up into " the third heaven, whether in tiie body, or out of the body, I " cannot tell, God knoweth."
our
83
our eyes from earth to heaven, from the perifli- able body to that which endureth for ever; and even whilft we are heavy with affliftion, let us fmile, with our eyes turned upwards, and fay, " It is thy will, I fubmit. — He is happy. — I would " not wifli him back to a troublefome world. — " I foon fhall follow after him. — The mortal " hath put on immortality. — We fhall then meet, " never, never, to be feparated more."
vSECT.
84
SECT. XVII.
ADVICE TO PARENTS AND MEN OF FORTUNE.
Marriage is fure a matter of more wortii Than to be.fubjeft for attorneyfliip. ' For what is wedlock forced but a hell,
An age of difcord and continual ftrife ? Whereas the contrary bringeth forth blifs. And is a pattern of celeftial peace.
. SHAKESPEARE.
In W , a fmall village of Saxony, there
lived a poor but honeft and upright Curate, who for many years had enjoyed, without alloy, the tranquil pleafures of domeftic happinefs. He had a wife and an only daughter. Content with- in the fphere in which they were placed, and unacquainted with the turbulent paflions of the fafliionable world, their days flowed quietly on in an uniform courfe of undifturbed felicity. The mother and daughter took a joint care of all the domeftic concerns, and ftrove, by every confi- derate aft of attention and love, to diminifh the burthen which the duties of the good old man impofed on him. Harriot (this was the name of his daughter) was, in the ftrifteft fenfe of the words, the child after his own heart. He was unhappy if flie was abfent even for a few hours, and flie was therefore his conftant attendant, y She
85
She was about eighteen years old, but had not yet experienced the inquietudes of that paffion which often exhibits itfelf in very early life in the great world, and her principles and mode of thinking were too noble and good to infpire her parents with even the flighteft apprehenfions as to the wanderings of her heart — But hear her hiftory.
It is the cuftom, in that country, for the cavalry to be quartered, during the time of peace, in different villages, where it is maintained at the expence of the peafantry. Many of thefe fol- diers are riotous young men, who, by virtue of their profeflion and uniform, have an entrance into the houfes of all the peafantry, arid even of the curates. One of them, a handfome but giddy
young man, was quartered at W , where he
foon made the acquaintance of the good old parfon.
The young foldier had more culture of mind than is commonly met with in fuch a clafs of men. He pleafed the curate; they met fre- quently, and often fat up till paft midnight, enter- taining themfelves with the hiftories of battles and warlike atchievements, of which each qf them knew an abundance of anecdotes.
Harriot found great entertainment in the company of the warrior, and like Othello's miftrefs, the ftory of his life, the battles, fiegcs, fortunes that he had paft, the hair-breadth 'fcapes,
thQ
86
the moving accidents by flood and field, o'ercame her heart. Love had taken poflelTion of her bofom before flie was aware of its approach. The progrefs of this paflion, when once admitted into the human breaft, is certain as fate. She bluftied when he look her by the hand, and was unhappy when he left her. The foldier qould not refifl the beautiful girl, his heart was formed for love ; they therefore foon came to an explanation, but carefully concealed their mutual attachment from her parents ; for they were juftly afraid that prudential motives would caufe them to oppofe it. They bound themfelves to each other, however, by an oath, which at the fame time that it (hewed the ftrength of their affe£tion, exhibited the moft romantic turn of mind. They promifed to marry each other as foon as he fhould attain the rank of Serjeant-major, and agreed that the one Jlioidd dejiroy the other who firjl failed in the engagement.
Thus matters flood when, contrary to the hopes of the lovers, a lawyer from a neighbour- ing town applied to the father of Harriot for the hand of his daughter. He was well received, and his views promoted by the old people ; but when his intention was declared to the unfortu- nate girl, flie fell into the arms of her father as if ftruck with lightning, and upon her recovery llie wept bitterly, and intreated him not to en- courage the addrelJes of this new lover.
Her
87
Her parents^ being ignorant of the true caufe of her averfion, thought that time alone would overcome it, and they therefore gave their folemn promife to the lawyer, and refolved to employ every means in their power to fecond his wiflies. Harriot, however, refifted every argument, and remained true to her promife ; but her parents at laft, growing tired ofher oppohtion, determined to employ their authority. The arguments that were made ufe of are needlefs to mention, and they were attended with fuccefs. I'he young foldier foon received the intelligence, and from that moment defifted from vifiting the parfonage. His refolution was taken — for without the girl he could not live.
A fliort time before the marriage-day, a dance was given in W— in honour of the pair. To this he reforted, unable any longer to refift the defire of feeing his once beloved. He concealed himfelf among the fpeftators until he faw her dance ; this roufed him to a (late of fury • he ran home, took a pair of piftols which were loaded, and waited until the party broke up. It was a dark night, but he difcerned the unhappy bride and her bride- groom, walking hand in hand. He ftept up to her, and in a low voice requefted that flie would indulge him with a moment's converfation. She difengaged her arm from that of the lawyer, in- treated him to walk on, aflTuring him flie would immediately return ; but alas ) it was the laft
minute
88
minute of her cxiftence: a piflol fliot was heard, find when her friends reached the place, fhe was feen lying weltering in blood at the feet of her murderer. " Now art thou mine again !" cried the foldier, " our oaths are fulfilled and with thefe words he disappeared, favoured by the obfcurity of the night : but he did not fly to efcape. He delivered himfelf to the officers of juftice who were neareft the place, and defired to be inflantly executed ; which event indeed foon followed.
Learn, parents, from this ftory, the danger of ' marrying your children to thofe they cannot love ; for (hould an event lefs tragical enfue than the above, yet what fhould be their paradife would be hell, and your grand-children the worthy offspring of fuch purchafed connubial rites.
If children inherit the eyes and forehead of their parents, it is certain that they as often are heirs to the internal formation of their vifcera. Nothing is more certain than that there are here- ditary difeafes, or what comes to the fame thing, predifpofition to fuch. Men of fortune and opu- lence have it in their power to obey the laws of nature and of love ; and yet how common are the examples of fuch men a£ling an interefted part in their matrimonial engagements. Inftead of following the diftate? of nature, they difregard the high privilege they enjoy, facrifice their tafte, their paffion, and often their happinefs during ]ife, at the flirine of gold. To accomplifli this
fordid
89
fordid end, they often embrace deformity, difeafe', ignorance, peeviflinefs, and every thing that is difgufting to the generous mind. The confe- quences do not affe£t them only, but the public. Men of rank, in all nations and governments, are the natural guardians of the ftate. For thefe important purpofes, their minds fliould be noble, generous, and bold ; and their bodies fliould be ftrong, mafculine, fit to encounter the fatigues of war, and to repel every hoftile affault that may be made upon their country. But when men of this defcription, whatever be their motives, intermarry with weak, deformed, puny, or dif- eafed females, their progeny muft of neceflity degenerate. The ftrength, beauty, and fymmetry of their anceftors, are, perhaps, for ever loft. What is ftill more to be regretted, debility of body is almoft invariably accompanied with weak- nefs of mind. Thus, by the avarice of one indi- vidual, a noble and generous race is completely deftroyed. By reverfing this conduft, it is true, the breed may again be mended j but to repair a fmgle breach, many generations, endowed with prudence and circumfpe61;ion, will be requifite. A fucceflive degeneration, however, is an infalli- ble confequence of imprudent or interefted mar- riages of this kind. One puny race may for fome- time be fucceeded by another, till at laft their conllitution become fo feeble, that the animals lofc even the facility of multiplying their fpecies.
This
90
This gradual degeneration is a great caufe of the total extinftion of fome of our noble families. That it fliould be fo, is a wife and beneficent inftitution of nature; for if fuch debilitated races were continued, an univerfal degeneration might foon take place, and mankind would be unable to perform the duties, or to undergo the labour of life. Nature thus firft chaftifes, and at laft extirpates, all thofe who a£l contrary to her eftab- lifhed laws.
Certainly more than one half of the miferies of life arife from marriages contraBed where there previoufly exifted no love ; arifmg from the fordid oppofition of friends andrelations to fuitable matches^ who are always looking out for a lord for their relation, or a rich heirefs for their fon, thwarting honeft inclinations, and rendering their children the melancholy viftims of the mod corroding of all pafTions, difappointed love ; or, as they ought to be, marrying without love^ from obedience or defire, mijerable for ever.
vSFXT.
]I. TEMPORARY EXHAUSTION
OF
THE FIBRES.
I*
'J
SECT. XVIII.
OF TEMPORARY EXHAUSTION.
The fibres as well as the nerves are under the fame laws, being fubjeft alike to exhaujimty which is either temporary, or irreparable.
In the ftate of temporary exhaujiion, the fibre fails for want of irritability. The application of the ordinary flimulus, while it is in this Jiate, will not make it contra£t. It is only by little and little that the fibre recovers its irritability. This truth, I dare venture to fay, is as new as it is Jlrikingy and it unfolds a vaft number of phaenomena hi- therto unexplained.
Let us obferve, for example, the motion of the heart ; — the heart contrails from the flimulus of the blood, and impels the blood through the arteries ; it then again dilates, and the blood en- ters. But the heart does not contraft itfelf im- mediately upon the firft impreflion of the blood. Its irritability having been lefTened by the preceding contraction, it requires half, or three quarters of a fecond, before the irritability of the heart fliall have been recruited to fuch a degree that the flimulus can aft upon it.
Thus alfo during the operation of an emetic or cathartic, the ftomach and bowels are alternctely
in
92 '
in a ftate of excitement and repofe. And thus the ; mod violent pains and labour of a parturient \ woman, if not effeflual for the expulfion of the I offspring, ceafe for a time, and are then renewed, t Thus likewife all the appetites are liable to fits, j returning after ce{ration at ftated periods ; if it be ^ hunger, at the diftance of fome hours j if it be | fever, it may be explained on the fame principle; | •that is to fay, any ftimulus which is always pre- fent, and continually acting upon the fibres, pro- ^ duces no fenfible effeft till the exhmifled irritability \ of the fibre fliall have accimiulaied afrefli. \
You can fcarcely touch the leaf of the mimofdy \^ or fenjitive plant, fo flightly as not to make it clofe. ,j The large rib which runs along the middle of the \ leaf, ferves as an hinge on which the two halves of the leaf turn on being touched, till they fland • e^ft, and by that means meet one another. The Jligktejl touch gives this motion to one leaf; if a lit- I ile harder, it gives the fame motion to the leaf ' oppofite. If the touch be Jiill rougher, the whole j arrangement of leaves on the fame rib clofe in the ! fame manner. If it be Jlronger Jlill, the rib itfelf i moves upwards towards the branch on which it grows. And if the touch be yet more rough, the very branches flirink up towards the main ftem.
In Auguft, one of thefe plants growing in a pot was put into a carriage. The motion of the car- riage caufed it to fliut up all its leaves, and the effccl: of this great Jiimulus was, that it did not again
expand
93
expand Its leaves for more than four and twenty- hours. A TORPOR then enfued : for having opened their leaves, they clojed no more for three days and as many nights. — Being then brought again into the open air, the leaves recovered their natural motions, Jlmtting each night, and opening in the morning, as regu/ar/y as ever.
All the periodical motions of animals, may be ex- plained upon the fame principle; that is to fay, any Jiimulus which is always prefent, and continu- ally afting upon the fibre, produces no fenfible effe£t till the exhaujied irritability of the fibre fliall have been accumulated afrefli. The periodical mo- tions in organized bodies depend on the alternate exhaujlion and accumulation of the irritability of the fibre. A temporary exhaujlion of the irritability of Xht hedyfaritm gyrans , is produced by the heat of the fun and by eleftricity. The ele6trical fluid exhaiijls in like manner the irritability of the mimofa.
SECT.
94
SECT. XIX.
EFFECTS OF WINE.
Let us confider the flimulating or exciting power of wine. When a depreffed man is infuf- ficiently excited with the natural Jlimidi, and rifes not, fuppofe, above 30 degrees in his excitement, a glafs carries him up to 32 degrees, another to 34 degrees, and fo forth, till after five glaffes he is carried up to 40 degrees, he then finds himfelf well and vigorous in all his fun61:ions. But ftill we are not fo flimfily made, as not to bear a little of what is either too much or too little. Suppofe he then takes five glaffes more, and confequently is raifed to 50 degrees. As his ipirits, his intellec- tual, and all his other fun£tions, were low, while his excitement remained at 40 degrees, fo are they all proportionally exalted by the time that his excitement is elevated to 50 degrees. Let him ftill go on, and his intellectual functions will rife ftill higher ; he will now difplay the full ex- tent of his genius ; and his paffions and emotions of whatever kind they be. — If he goes on, how will the appearance be reverfed ! The hero foon ftirinks
into
95
into a mere brute. He falls off in both his intel- leftual and corporeal funftions his tongue, his feet, his eyes, his memory, fail him ; and at laft, deprived of all power of motion and fenfe, he fmks into an inanimate sleep *. >
* How will the ajipearance he i-everfed! The hero hecomes fhe mere brute, and finally finks into an bianhndte sleep. Thefe ex- preffions of John Brown are nearly verbatim the fame as i\i*m- ftrong, which fee over-leaf. Many fuch refemblances r^ake me fiifpe£t that Brown caught up his firft idea from the poet, which he worked up into his beautiful fyftem. Vide Vol. itv p. -i6o, where the fame thing was before hinted at.
PRACTICAL
9^
PRACTICAL OBSERVATIONS.
SECT. XX.-
ON DRINKING. ♦
" Struck by the powerful charm, the gloom
" diffolves " In empty air ; Elyjtum opens round. " A pleajing phrenzy buoys the lighten'd foul, " And Jangtdns hopes difpel your fleeting carej " And what are difficult, and what was dire, *' Yields to your prowefs and fuperior Jlars : " The happieft you, of all that e'er were mad, " Or are, or fliall be, could this folly lafl:. " But foonyour heaven is gone ; a heavier gloom " Shuts o'er your head : and, as the thundering " ftream,
" Swoln o'er its banks with fudden mountain rain, " Sinks from its tumult to a silent brook; ** So, when the frantic raptures in your breaft " Subjide, you languiJJi into mortal man ; " You SLEEP, — and waking find yourfelf undone. " For prodigal of life in one rash night
" You
9?
^ You LAVISri-D' MORE THAN MIGHT SUP- " PORT THREE DAYS.
" A heavy morning cornet; your f^yr^'j- return " With tenfold rage>" &c.
ARMSTRONG.
Let thofe who have been enticed frequently to tafte fpirituous liquors, or rich cordials, till at length they begin to have a fondnefs for them, refleft a moment on the danger of their fituation, and refolve to make a fpeedy and honourable retreat. Remember, that cuftom foon changes into habit: that habit is a fecond nature more ftubborn than the frrfl:, and of all things mo ft: dif- ficult to be fubduedk Remember, thai it is bv little unfufpefting beginnings, that this unfortu- nate'vice is generally contraded, and when once confirmed, rarely terminates but with life ! Learn then, in time, to refift this bewitching fpirit, whenever it tempts you. Then will you find yourfelf fo perfeftly eafy without it, as at length never to regret its abfence ; nay, peculiarly happy in having efcaped the allurements of fuch a dan- gerous and infidious enemy.
The manner however of overcoming this fatal propenfity, when once formed, requires fome ad- drefs in the phyfician. It is in v^in to defire an immediate dcfcrtion of this habit. Human na- ture is too frail, It cheriflies knowingly the ufurper in its bofom. Art muft be ufed. The
Vol. IV. U drunkard
$8
drunkard muft be advifed to change his liquofy taking rum inftead of brandy, and then Geneva > afterwards it muft be diluted, and in time it may without much difficulty be changed for ale, or porter, and a habit broken, or elfe fixed upon fome lefs hurtful liquor than fpirits*.
To thofe who pride themfelves in living faft. and are bent upon " a fhort and merry life i" though, in truth, it is a fliort and miferable one ; they will doubtlefs fpurn at thefe admonitions, and run headlong to their own deftructiou. Strange infatuation ! Can you fubmit to fuch def- picable bondage, and tamely give up your free- dom without one generous ftruggle. The prefent conflid, remember, is not for the fading laurel, or tinfel'led wreath, for which others fo earneftly contend, but for thofe more blooming, more fub- ftantial honours, which Health, the daughter of Temperance, only can beftow. For it is thine, O Health, and thine alone, to diffufe through the human breaft that genial warmth, that ferene funfliine whi^ch glows in the cheek, Ihines in the eye, and animates the whole frame ! But if ftill you have no regard for this bleffmg, let me then remind you of an hereafter. To
*I once cured a patient of this propenfity by ordering a fniall portion of emetic tartar to be put into the brandy bottle. This, when taken to excefs, produced naufea, or vomiting; and' the idea getting aflbciated, even the ffght of it became after- wards difguftful.
" die
9^
" die — to fleep — nay, perchance, to dream" — yes, there s the rub ! — How great will be your furprife and terror fliould you be fuddenly roufed by that dream ! — When the thick mift is difpelled — when the day begins to dawn, and difcovers you on the confines of that unknown country ! — When the
Sun of Righteousness But here let me
flop, for exhorting, and not preaching, is my pro- vince. To the divine it belongs to refurae the fubjeft where I am obliged to drop it, and to ex- patiate on thofe higher arguments, which, with a trembling pen, I have fcarcely ventured to fug- gcft.-
SECT.
lOO
SECT. XXI.
OF OPIUM AND HEMLOCK.
. If a grain of opium be fwallovvcd by a perfon unufed to fuch a ftrong ftimulus, all the vafcular fyftera in the body a£ts with greater energy, all the fecretions, and the abforption from thofe fecreted fluids, are increafed in quantity, and much pleafure is introduced into the fyftem, independent of our ordinary train of thinking, which adds an additional ftimulus to that already too great.
After fome time the excitability becomes diminijlied in quantity, being expended by the great activity of the fyftem ; and hence, when the ftimulus of the opium ceafes, the fibres will not abey their natural Jiimuliy and a confequent torpor enfues, as is expe- rienced by drunkards, who, on the day after a great excefs of fpirituous liquor, feel tremor, pal- pitation of the heart, head-ach, and general de- bility. During this torpor an accumulation of excita- bility in the exhaufted fibres takes place, which is fo great, as to occafion a fecond over-exertion on the application even of the ordinary Jlimuli, and thus an unequal balance of the excitability and of the natural Jlimuli continues for two or three days, where the ftimulus employed has been violent in decree ; and for weeks in fome fevers, from the ftimullis of contagious matters.
But
101
But if Tifeconddofe of opium be exhibited before the fibres have regained their natural quantity of due excitabihty, its effetts will be much lefs than the former, becaufe the excitability is in part ex^^ hauled by the previous excefs of exertion. Hence- all medicines repeated frequently gradually ]ofe> tlieir effe£l. Thus aloetic purges lofe their ef-. ficacy by repetition ; and opium and tobacco, if not taken beyond their ufual dofes, ceafe to ftupify and intoxicate thofe who are habituated to their life.
But when a ftimulus is repeated at [iich dijlant intervals of time, that the natural quantity of ex- citability becomes completely reftored in the a6ting» fibres, it will then aft with the fame energy as when firft applied. Hence thofe who have lately accuftomed themfelves to large dofes of opium or aloes, by beginning with fmall ones, arid gradually increafing them and repeating them frequently j if they intermit the ufe of it for a few days only, muft begin again with as fmall a dofe as they took at firft, otherwife they will experience the incon- venience of an over-dofe.
A lady labouring under a cancer of her breaft, was advifed to the ufe of cicuta (hemlock) ; and flie accordingly got a quantity of it in powder, and weighed out the dofes of it for herfelf. She began with a fmall dofe j and feeling no fenfible effe£ts from that, (he went on increafing the quan- tity. By the time fhe had come to 60 grains, flie
had
102
had taken the whole parcel fhc had got from the apothecary, and therefore fent to him for a frefli parcel of the powder. In the interim fhe had been advifed, that when {he was to pafs from one parcel to another, flie fliould begin with a fmall dofe only ; therefore, as fhe had taken 60 grains of the former, fhe fliould take 20 of the new parcel. But fuch was the efFeft of intermijjion, fays Dr. Cull EN, who relates this ftory in his Materia Medica^ that thefe 20 grains had very nigh killed her. In iq or 15 minutes flie was affefted with ficknefs, tremor, giddinefs, delirium, and convul' fions. Happily for her the ficknefs proceeded to a vomiting, which threw up part or the whole of the powder, but notwithftanding this the delirium, ^nd ^ven the convulfions, continued m^ny hours,
PRACTICAL
103
PRACTICAL OBSERVATIONS.
SECT. XXII.
•OF THE CUSTOM OF TAKING LAUDANUM.
Opium is certainly the moft fovereign remedy 5n the materia medica, for eafing pain and pro- .<:uring fleep, and alfo the moft certain antifpafH modic yet known:; but, like other powerful medicines, becomes highly noxious to the human conftitution, and even mortal, when improperly adminiftered.
The firft efFefts of opium are like thofe of a ftrong, ftimulating cordial, but are foon fucceeded hj univerfal languor or irrefiftible propenfity to fleep, attended with dreams of the moft rapturous and enthufiaftic kind. After thofe .contrary ,effe£ls are over, which are generally terminated by a profufe fweat, the body becomes cold and torpid ; the mind penfive and defponding ; the head is affecled with ftupor, and the ftomach with ficknefs and naufea. Its liberal and lone continued ufe has been obferved greatly to injure the brain and nerves, and to diminifli their in- fluence on the vital organs of the body. By its firft effefts, which are exhilarating, it excites a kind of temporary delirium, which diflipates and exhaufts thx? fpirits ; aiid, by its fubfequent nar- cotic
104
-cotic power, occafions confufion of ideas and lofs of memory-, attended with naufea, giddinefs, head- ach, and conflipation of the bowels ; in a word, it feems to fufpend or diminifli all the natural fecretions and excretions of the body, that of perfpiration only excepted.
Thofe who take opium to excefs become ener- vated, and foon look old ; when deprived of it, they are faint, and experience the languor and deje£lion of fpirits common to fuch as drink fpirituous liquors in excefs ; to the bad effe£ts of which it is fimilar, fince, like thofe, they are not eafily removed without a repetition of the dofe.
By the indifcriminate ufe of that preparation of opium called Godfrey's Cordial, many children are yearly put off ; for it is frequently given, dofe after dofe, without moderation, by ignorant women and mercenary nurfes, to filence the cries of infants, and lull them to fleep, \n order to pre- vent nurfing, by which they are at laft rendered ftupid, inaftive, and rickety, Nor do grown up people receive lefs injury often from the fame enticing medicine. They foon become fo be- wedded to their night-draught, that they muft have of the apothecary one every night, or a box of pills, and thefe become at length abfolutely ne- ceffary articles. Unfortunate infatuation ! What was fent as a folace in the moment of affliction muft now be had daily recourfe to,
SECT.
11. PERMANENT EXHAUSTION
OF
THE FIBRES,
■i.
i05
SECT. XXIIl.
OF IRREPARABLE EXHAUSTION.
The fibre is faid to be in a ftate of irreparable exkaiijiion^ when it does not recover its due degree pf IRRITABILITY, and fails upon the application of the proper Jlimuli. All then is languor and debility. The aftions within the body are infuf- licient, or nearly fo, for the. maintenance of hfe,
Mille modis lethi fors una fatiget.
The fame lot of death harafles in a thoufand ways, yet terminates, however, in the fame point, the extinftion, fooner or later, of the irritable pririr fiple within the body.
SECT.
io6
SECT. XXIV.
THE ABUSE OF TONIC MEDICINES.
Of the evil effects from the abufe of tonic
■«-]••
MEDICINES we may relate the hiftory of the Port- land Powder i called fo from its having cured, of an hereditary and inveterate gout, 'one of the dukes of that name. It confifts of equal parts of the following herbs, viz. Take the roots of round birthwort,
. and GENTIAN,
The tops & leaves of fraall-oERMANDER,
: ' — leffer centaury,
, and ground PINE. Equal parts.
Powder them.
A dram of this powder was ordered to be taken, in fome convenient liquid, jn a morning, fafting, the patient tafting nothing for an hour and an half after it ; it muft be ufed in this dofe for three months without the leaft interruption. Forty-five grains are to be taken daily in the fame manner for the fucceeding three months: half a dram every day for the next fix months : and half a 4ram ever^ other day during the fecund
From very anclept times down to the prefent, aromatic hitters have been recommended and em- ployed for the gout ; and as this remedy, on its
fivll
107
firft coming into ufe in England, feems to have been of fervice, and to have cured feveral, it might have been expetled, had not its confe- quences been often found hurtful, that the ufe of it would have continued, and this difeafe would have ceafed to be one of the opprobria medicorum. We find, however, that while at one period a courfe of bitters, prolonged above a year, has been in fafiiion in this difeafe, at ano- ther it feems to have been entirely negle£ted ; 3nd this I can impute only to its being attended often with confequences more ferious than the gout itfelf. That the latter was the cafe, may prefume from the accounts of the ancients, who, though they recommend the remedy in cer- tain conjlitiuions as highly beneficial, allow that in other cafes it has been as highly pernicious.
In nine inftances, fays Dr, CuIvLen, I had occafion to know, or to be exaQly informed, of the fate of perfons who had taken the Portland Powder for the time and in the quantities pre- fcribed. Thefe perfons had beep liable for fome years before to have fits of a regular or very painr ful inflammatory gout ; but after they had taken the medicine for fome time, they were quite free from any fit of inflammatory gout ; and particu- larly when they had completed the courfe pre^ fcribed, had never a regular fit, or any inflammar tion of the extremities, for the reft of their life, Jn no inftance, however, w?s the health of thefe
perfon^
io8
perfons tolerably entire. Soon after finifliing the courfe of their medicine, they became valetudi- nary in different fliapes ; and particularly were much affefted with dyfpeptic, and what are called nervous complaints. In thofe whom 1 knew, fome hydroptic fymptoms appeared, which gradually in^ creafing in the form of an afcites or hydrothoraXy efpecially the latter joined with anajarca^ in lefs than two, or at moft three years, proved fatal,. Thefe accidents happening to perfons of fome rank, became very generally known in this coun- try, and has prevented all fuch experiments fince. .
SECT.
i09 SECT. XXV.
THE ORDINARY STIMULI.
' At firft,. the infant.
Mewling and puking in the nuife's arms : And then, the whmmgfihool-boy with his fatchel, And [liining morning face, creeping like I'nail Unwillingly to fchool. And then, the lover; Sighing like furnace, with a woeful ballad Made to his miftrefs' eye-brow. Then, the foldier\ Full of flrange oaths, and bearded like the pard, Jealous in honour, fudden and quick in quarrel, Seeking the bubble reputation
Even in the cannon's mouth. And then, ihejujlice,
In fair round belly, with good capon lin''d.
With eyes fevere, and beard of formal cut,
Full of wife faws and modern inftances,
And fo he plays his part. The Jixth age iliifts
Into the lean and flipper'd pantaloon,
With fpeclacles on nofe and pouch on fide;
His youthful hofe, well-fav'd, a world too wide
For his flirunk flianks; and his big manly voice.
Turning again towards childifh treble, pipes
And whiftles in its found. Lafl fcene of all,^
That ends this flrange eventful hifiory.
Is fecond childilhnefs, and mere oblivion;
Sa}is teeth, fans eyesyfans tafie,Jans every thing.
SHAKESPEARR.
The babe is a compound of matter fo orga- nized as to be capable of being afted upon by various ftimuli, neceffary to the continuance of life J and immediately upon its birth the firft ftimulus it receives is a quantity of atmofpheric air in the lungs; this, with the addition of fome milk, or mild food, taken into the ftomach, is all the ftimulus it feems capable of bearing, at this
period.
116
period, confident with life and healthy the extcf- nal fenfes cannot endure any ftrong a£tion on them; hence the tympanum, or drum of the car, is kindly covered for fome time after birth with a thick mucus, occafioning deafncfs ; and the eyes are fliut againft, or turn from, the imprcflion of ftrong light. In this (late, as was before fliewn, there is the keeneji irritability^ the fmalleft ftimu- ]us, even that of the air of a chamber, more efpe- cially the purer and colder air abroad, and the mildeft food, fo aft upon it, and exhauft it, as to produce almoft conftant deep.
From day to day the irritabiliiy of the fibre gets diminijiiedy as is known to us by the circumftance of the fame ftimulantshavingaleffer effeft on the fibre, in proportion as we advance from infancy to puber- ty, and from puberty to manhood. At this pe- riod of life, viz. about thirty-five years of age, it appears that there exifts, as it were, a jufl: equi- librium between the powers of the ordinary Jiimu- lants and the irritability in the mufcular fibre j yet, at the fame time, as the continued application of the ordinary ftimuli is abfolutely neceffary to life and health, fo the daily eflfefts of thefe is a fmall degree of exhaujlion of irritability, reftored nearly by periodical fleep. But again, according to the organization of our bodies, though fleep reftores the healthy ilate of irritability in a certain degree, yet it feems never to reftore aftually the former Jlate; a fmall degree of exhanjiion of irritability takes place every year^ This gradual change,
cpnfequently,
Ill
I confequently, not only indicates the power of ' bearing, but alfo the neceffity of the application of Jironger Jlimuli, as we advance in life, until at ilaft, that ftate takes place w;hich we call old age^ iwhich is little afFefted by the ordinary, and fcarce ifenfible of the llronger, ftirhuli j and as thefe gra- idually ceafe.to make the impreflions neceffary to tthe continuance of life, the death of old age muft cenfue*.
* Vide Vol. I. Se£i. III. on Stimuli, which muft be varied :iccording to the age of the individual; which verifies the old iidage, that milk is the food of infantt^ and wine o{ old age.
Vol. IV. I PRACTICAL
PRACTICAL OBSERVATIONS.
SECT. XXVI.
tHE EFFECTS OF DRUNKENNESS. j
The ftate of the frame, in confequence of fye-' | qiient inebriety, confifts in the end, if it does not ^ cccafion immediate death, in the Jiaralyjts which j ufually fucceeds long and violent excitement. Sometimes the ftomach is more materially afFe£l- ed, and paralyjis of the ladleal fyftem is induced ; whence a total abhorrence from fiefh food and | general emaciation. In others, the lymphatic fyftem is affefted with ^-paraly/is, and dropfy is the confequence. More frequently the fecretory vef- fels of the liver become firft paralytic, and a torpor ^ with confequent gall-ftones, or fchirrus, of this vifcus, is induced vi^ith concomitant jaundice ; or it becomes inflamed in confequence of previous tor- poYy and this inflammation is frequently tranf- ferred to a more fenfible part, which is affociated with it, and produces the rofy eruption of the face, or fome other eruption on the head, or arms, or legs. In fome inebriates the torpor of the liver produces pain without fchirrus, gall- ftones, or eruption, and in thefe epilepfy, or infa- liity, are often the confequence*.
* Darwin.
PRACTICAL
113
PRACTICAL OBSERVATIONS,
SECT. XXVU.
THE ART OF PROLONGING LIFE. Various have been the panaceas for the pro- longmg of human life. Sage was fuppofed by the ancients to have this virtue*: but the
* Hence the following vprfe. Cur moriatur homo, cui falvia crefcit in horto ? How c?n man die, in whofe garden there grows fage? in allufion to its many virtues. — rWhat % lhameful abufe of this pretended property was lately made by the late Sir John Hill, in his patent Tinfture of Sage for the prolonging of human life, and warding off old age, is known to every one. This conduft could not fail to draw upon him- felf the pen of the wits of the age, and Garrick, with ThpmpT fon, conjointly, published the following Epigram:
Thou effence of dock, valerian, and fage, At once the difgrace and the pert of this age, The worfl; that we wilh thee, for all thy bad crimes, Is to take thy oim phyjic^ and read thy own rhymes, Pr. Hill made the fpUowing reply;
Ye defperate junto, ye great, or ye fmall,
Who combat dukes, doilors, the deuce, and 'eni all ;
"Whether gentlemen, fcribblers, or poets in jail.
Your impertinent curfes fliall never prevail :
I'll take neither fage, dock, or balfam of honey ;
J)oyou take the Jihyjic, and PU take the money.
The reader will pleafe to call to mind what has been fald on quackery. Vol. I, p, 2or. Such fhamelefs impoficions on comn mon fenfe deferve more than ridicule ; for deceivipg the fi&k; and helplefs, they merit the execrations of every man yi'ho hasi one fpark of humanity,
114
fecret lies in a very narrow compafs, a tem- perate ufe of all the means of excitement. Old age happens fo mankind at different periods of life, earlier, if they have given themfelves up to pleafure and a variety of exceffes, and later with thofe who have followed a moderate way of living, and been generally temperate in their en- joyments.
O! Temperance! thou fupport and atten- dant of other virtues! Thou preferver and re- ftorer of health, and protraElor of life ! Thou maintainer of the dignity and liberty of rational beings, from the wretched inhuman flavery of Senfuality, Tafte, Cuftom, and Example ! Thou brightener of the underftanding and memory 1 Thou fweetener of life and all its comforts! ' Thou companion of reafon, and guard of the paf- lions! Thoa bountiful re warder of thy admirers and followers ! how do thine excellencies extort the unwilling commendations of thine enemies ! and with what rapturous delight can thy friends raife up a panegyric in thy praife !
CLASS
CLASS III.
VEGETABLE AND ANIMAL POISONS.
Vol. IV.
f
115
PRACTICAL OBSERVATIONS.
SECT, xxviir.
TREATMENT OF THE DISEASES OF DRUNlCARDS.
Where there is a total exhauftion from ex- cefs of drinking, as might chance to happen at the time of convivial meetings, or the folly of drinking for a v/ager, the perfon ought to be kept very ftill, and the head to be raifed above the level of the body by means of a pillow, and the utmoft care fhould be taken that the mouth fliould not get ftopt by the want of power in the mufcles of the neck, or the exertion of the will, to avoid the danger, left fuffocation fhould enfue. As there is a great determination to the brain, leaches fhould be applied to the temples: but an emetic would be of the greateft fervice, provided it could be got down, or plenty of lemon-juice *. However m.edical exertion is feldom required,
* I have known medical men, when called from a convivial party, where they had rather indulged in the bottle, drink vine- gar in order to clear their heads, which renders them imme- diately fober. In the Weft Indies the quantity of rum being poured in, the negro is in the habit of a/king his mafter, as he is putting in the lemon juice, whether he drinky for drunky, or drinky for dry, proportioning the lemon according as he re- ceives his anfvver.
12 * but
ii6
but to relieve the diforder occafioned by drink- ing.— The moft eflcclual means which I have found, are, after the exhibition of an emetic* and purge f, to throw in a mixture of decociion of
bark,
* R. Ipecac — for. r.
Andm. tart. — gr. z, Syr. (imp. — dr. 2.
Aq. Rofae — unc. 2\.
F. Hauft. emetic. Cap' dimid liori vii. vefpcie, et poft quadrant, part. hor. cap' coch. min. i et repet, Gmni quinque minuta ufque ad voniitionem.
Take of Ipecacuanha — a fcruple.
Tartarized Antimony — twa grains.
Simple Syrup — two drachms.
Rofe water — an ounce and a half.
For an emetic draught. Take the half at feven in the evening, and after a quarter of an hour, repeat a tea-fpoonful every five minutes until it vomits.
f R. Rhel pulv. — fcr. i.
Kali vitriolat. — fcr. i|. Syr. zingib. — dr. 2. Aq. Cinnam. — Aq. Menth. pip. — aa dr. 7.
F. Hauft. cathartic — Cap' primo mane, vcl dimid. hora fomni et reliq. primo mane fequent.
Take of Rhubarb in powder — one fcmple.
Vitriolated Kali — a fcruple and a half. Syrup of Ginger — two drachms. Cinnamon, and
Peppermint waters, of each, feven drachms.
Make into an aperient draught. Take this early the next morning, after the vomit, or the half at bed- time, and remainder when rifing the next morn- ing.
* R.
117
PRACTICAL OBSERVATIONS,
SECT, xxviir.
OF VEGETABLE AND ANIMAL POISON.
We are arrived now at a very interefting pait of our work, the confideration of vegetable and' animal poifons. By confiderirtg them together, and thepra£tice recommended frorii the beft au- thorities, in obviating their influence, we fliall fee whether any analogy exifts between them^ and may, perhaps, be able to form fome philo- fophic indu6tion, and improve this part of the- branch of medicine. In thus feparating infeftious difeafes from the reft of thofe maladies whicH' humanity is heir to, we have deviated from all former fyftems, and this divifion is prefented, with-- tlie utmoft diffidence, before a candid and dif-- cerning Public.
SECT.
ii8
SECT. XXIX.
RATIONALE OF THE OPERATION OF OPIUM, AND THE MANNER OF OBVIATING IT.
The attention of phyficians has defervedly been turned towards opium, in order to afcer- tain its falutary operation on the animal oecono- my, and its powers as a poifon. After having been fo long employed, it may feem furprifmg that any contrariety of opinion ftiould exift among liberal minds ; but fome ftill deem il altogether fe- dative in its operation ; others Jiimulant; and others again both Jiimulant and fedative. This controverfy appears to have its rife from the difference in effe£i which takes place according as it is admi- niftered. — As a Jiimulant it (lands before wine, and has nearly the fame operation. Wine quickens the pulfe, raifes the fpirits, increafes vigour, and gives more than coriimon animation for the time j but no fooner are the fumes of the intoxicating drink exhaufted, than the drunkard becomes weak, enervated, and deprelfed in fpirits. Here we diftinclly fee both the Jiimulant and fedative power of wine ; and the fame exactly holds with regard to opium. Thus if any one is under the preffure of fleep, he will, by opium, be rendered furprifmgly fprightly, lively, and vigilant ; it ba- nifhes melancholy j begets confidence j converts
fear
119
fear into boldnefs, makes the filent eloquent j and daftards brave. Has it not the fame eflfe£t upon the Turks that wine has upon us? Or are we to fuppofe, that the troops of that people, on their march to the onfet of battle, chew opiimi with the intention of checking their natural alacrity and propenfity to aStion, and of blunting and depref- fing their high fpirits and cou;-age? But after awhile, the excitability becomes diminiJJied in quan- tity, being expended by the great activity of the fvftemi and hence, when the ftimulus of the opium ceafes, the fibres will not obey their natural Jlimuli, and a confequent torpor enfues, as is experienced by drunkards, who on the day after a great excefs of fpirituous liquor, feel tremor^ head-ack, and general debility. During this torpor an accumidation of excitability in the exhaufted fibres takes place, which is frequently fo great as to occafion a fecond over-exertion from even the ordinary Jiimiili, and thus an mieqtial balance of tlie excitability and natural Jlimuli may continue for tzvo or more days.
But where the dofe firft adminiftered is great, its fedative effe^s are almoft immediately per- ceived. By a folution of opium, injected into the ftomach of a frog, while the tranfparent membrane of its toes was under a good microfcope, the dofe hemg /mail, there was at firft an inrrea/e, and after- wards a diminution of the blood's velocity. By a fecond and larger dofe, given an hour after the
firll,
120
flrll:, the blood was feen to move immediately Jlower.^ and its WQ\oQ.\iy gradually decreafing^ it ftag- nated at length, and the animal expired.
A folution of opium injected into the inteflines of a dog, brought on paljy of his pofterior extre- mities, attended with convulfions and ftupor.
Some days after, when the dog was recovered, the like folution was injected, by a perforation through the integuments, into the abdomen of the fame dog: he h<tz2im^-paralyiic inftantaneoufly, and died in a few minutes.
We are now to enquire, hy what channel does opium a5l f — Seeing the many erroneous opinions that have prevailed, we fhould be careful how we fuffer ourfelves to be led away by great authorities, and fliould bow our affent only to fa5is, and fuck concluftons as naturally refult from them.
We are to enquire, '* zvhether opium aSls by " means of the blood on the irritable fibre, as will be proved with the other poifon, or " has its opera- " tion folely on the nerves ?"
Notwithftanding it appears certain, that opium, even when fimply diffolved in water, whether it is introduced into the ftomach, or into the inteftines; whether it is inje£led beneath the fkin, or into the abdomen ; whether it be applied to the heart or mufcles ; equally a6ts on the animal body : yet a doubt ftill remains whether its aftion and energy are wrought on the nerves, or whether it needs the vehicle of the blood, and the circulation, to give it a6tivity.
It
121
It is certain that all polfons, as well as ophm, kill when fwallowed; but this does not prove •that their action is wrought immediately on the nerves, and that they do not employ the medium of the />/ood. There are we know in nature prin- ciples attractive and deftruftive of each other, and may not the fubtle and a£tive particles of a poifon, penetrate from this law of affinity, and introduce themfelves into the blood? We are under the ne- ceflity of admitting unknown powers, of whofe principles and mechanifm we are ignorant. We allow that iron is attra£ted by the magnet, though we are wholly ignorant of magnetifm. Thus the difficulty which arifes from the mortal effefts of opium, when taken internally, does not prove that it acts immediately on the nerves ; and befides, it can be demonftrated, that the venom of the viper and ticunas have no immediate a61:ion on the nerves themfelves *.
To be enabled to make forae very probable affertion on this difficult matter, an experiment
* ift. FoNTANA divided the nerves goirjg to the leg of a rab- bit, it was rendered ififenfihk and jiaralytic. He then applied the venom to the leg, and though the nervous injluence was in- tercepted, it communicated all the fymptoms of the poifon of the viper.
2d. On the contrary, when the veins and arteries going to, and returning from, the leg were intercejited^ and the poifon inferted, it did not communicate the difeafe of the venom of the viper.
And 3d. When the nerves were feparated from the body, and furrounded with venom, it produced no fymptoms of this jdiieafe.
muft
122 I
mufl: be imagined in which oj)ium may acl freely i againrt: the nerves, without the fmalleft introduc- ; tion of it into the /;/ood, or rather, without its ] touching the blood-vejjels. Such an experiment, | confjdering the dexterity and precilion it requires, j is not one of the eafieft to make, and can be only ij well tried on very fmall animals, and on a very V few of the nerves. To obtain certain confe- li quences, and fuch as do not proceed from deceit- i ful and variable experiments, it was neceffary to |ij make a great many trials, to exclude all the re- i fults that accidental circumftances might have i rendered imperfeft, to compare the different con- | fequences with each other, and to weigh them in I each cafe with thofe of the experiments intended to ferve as comparative ones.
I deftined, fays Fontana, 300 frogs for thefe experiments, and by means of pincers and fciflars, I laid bare the crural nerves in fuch a manner as they w^ere entirely free of every other part, and obtained about eight or ten lines of nerve totally clear, and in fomc very large frogs even more. I then let fall the nerves of each thigh into a fmall hollow glafs, which receives them in fuch a way, that I can fill each giafs with a fluid of any kind without its touching the adjacent mufcles. I lafually have been able to put into thefe glaffes fuch a proportion of whatever I wifli to try on the nerves, as to cover the greater part of them with it, without its being pollible for any of the
liquor
123
liquor to find its way to the thighs, and mix with the blood. In this way I can make a comparifoii betwixt the nerves that are envenomed, and thofe that tire not, compute the time that they continue to contract the mufcles, and judge of the vivacity of the motions.
At the end of the firft ten minutes, I flimulated the medicated nerves; I fliall diftinguifli in this way thofe to which I applied the opium, and thofe which w^ere not medicated, and found that the two extremities, the right as well as left, con- traSed with the fame force and vivacity.
At the end of twenty minutes, I tried the ftimula- tion, and could perceive no fenjible difference betwixt the motions of the two feet, which were almoft as lively as thofe in the firft experiment.
At the end of thirty minutes, the motions of the two feet were feebler, but alike in both.
At the end of forty minutes, the feet fcarcely contracted ; but their diftinft mufcles were clearly feen to contract, when the crural nerves were ftimulated ; and the motions of thefe mufcles were equally lively in each foot.
At the end o'i fifty mw^/^j, the' motions were very fmall, but alike in both fides.
At the end of eighty minutes , there was no longer any motion to be obferved in feveral of the frogs, in whatever way i ftimulated either their crural nerves that were medicated, or thofe that were pot,
I can
124
I can conceive, adds Font an a, nothing more <3ecirive and more certain, than from this feries of experiments, that the aftion of opium is not di- re6ily on the iierves; and when I related thefe ex- periments to Sir John Pringle, he very frankly told me, that for his part " he had never too great a *' belief in the explanation given of NERVOUS " DISEASES, a}id that for the future he Jliould have " lefs faith in tJie doctrine than ever."
In order to make this point flill clearer, I wifhed to fee whether opium, when injected into the veffels, caufes death, and whether it produces the fame derangements in the animal ceconomy, when introduced into the circulation of the blood, as it does when fwallowed, or inje6led into the different organs and vifcera.
I injefted about eighteen drops of the aqueous folution of opium into the jugular vein of a large rabbit. It was fcarcely injefted when the animal felt drowfy, could no longer fupport itfelf, and fell down. It, however, recovered in a few hours, and became perfectly well.
I next injefted a tea-fpoonful of the fame aqueous folution into the vein of another rabbit, and it died infant ly.
I repeated this experiment on a third rabbit, with the fame quantity of folution, and it died alfo at the moment of injeftion.
Thus then ofmm, inje£led into the veins, pro- duces heavinefs, and even death itfelf.
IVine
125
IVine or alcohol produces, as I found, pretty near-' ]y the fame effefts.
I conceive it to be altogether fuperfluous to relate a greater number of experiments on opium injetled into the jugular vein, and introduced into the circulation, without its touching any of the wounded folids. When once it is received into the velTels, I do not fee how it can commu- nicate itfelf in an immediate way to any of the fierves, fince all-prying anatomy affures us, that the coats of the blood-veffels are not furnithed with any nerves, and we have a further confirma- tion of this point from an experiment made by the celebrated profeffor of anatomy at Edin- bursrh.
I difcovered, fays Dr. Monro, when I poured a folution of opium under the ikin of the thigh and leg of a living frog, not only the leg itfelf was very foon affe<Stcd, but the affeftion was communicated to the mojl di^ant part of the body : but if, previous to the application of opium, I cut out the heart, or cut acrofs the femoral blood-velTels, the effefits of the opium were not communicated from that limb to dijlant parts, — which feems to prove how much the circulation of the blood, and the fluid of the machine, is the vehicle for o'pium, and that without this fluid it would have no a61ion on the living body.
Having cut out the heart of a young kitten, fays Dr. James Johnson, it notwithftanding
continued
126'
continued its natural movements in a very lively and regular manner. In that ftate I put it into i a tea-cup containing fome laudanum : in a mo- i ment the pulfations of the heart ceafcd, and could i] not be removed by any kind of ftimulus. j| Having divided the heart of another kitten, i fays this ingenious experimentalift, into ivio pieces, ( out of the body, one of them was thrown into b laudanum, a little diluted with water, and it foon i; loft its pulfatory motions, and llimuli had no b power or efFeft in reftoring them : but the other i] half Q)^ the heart, lying at the fame time upon the >i table, contra£\ed very brifkly whenever it was i touched with the point of a needle or a knife, and -\ that long after the part fteeped in diluted jauda- num remained immoveable. j The fame events happened to a piece of intejiine, i cut out, when dipped in laudanum : the periftal- tic motions, which were brifk before, ceafed in- ftantly, and could not be removed by ftimulij yet another -piece of the fmall gut, cut out, lying on the table, continued to move and twift itfelf with great vivacity when it was ftimulated.
Does not OPIUM then aft upon the mujcular fibres through the medium of the blood f Does not the motion and power of thefe fibres depend upon their union with OYGEN, chiefly taken into the body by refpiration, and dilfufed by the circulation of the blood ? And does not its aElion confift in dijmiting the OXYGEN from theje fibres
fo
12/
fo rapidly, by changing the law of elective ATTRACTION, HS to extinguiOi their vitality^ before they can have a fre(h and adequate fupply of VITAL AIR? — The fudden extui6tion of life, and the ftate of the body after death, entitled the ingenious Dr. Beddoes to make thefe fugg^^f- tions ; and ftart an opinion, which an enlightened and reformed fyftem of phyfic will foon, perhaps, fatisfaftorily elucidate.
Mr. Y , of the age of fifty years, took by
miftake, at bed-time, about ten drachms of lau- danum : he had a fit of the gout at the time. No alarm was given till about four o'clock next morning, when exceffive drowfinefs and languor came on : after that he took repeated dofes of the oxYD of ANTIMONY, (antimony combined with oxygen) by which fome of the laudanum was rejected' by vomiting.
I faw him, fays Dr. Johnson, about nine the fame morning : his palenefs, languor, and lethar- gic difpofition, were very great j his pulfe beat languidly, about thirty-eight ftrokes in a minute. By ftimulating his throat with a volatile embro- cation, he was empowered to fwallow a cathar- tic : blifters were applied to the back and arms and finapifms to his feet. He took, by my direc- tion, coffee frequently, and after each dofe of it, a dcfert fpoonful of vinegar *. He was alio carried out, and well fliaken in a poft chaife on a
^ Jlnegar owes its acidity to the abforption of vital air.
roujjh
128
rough road. About four o'clock in the after- noon, he was fo much roufed, that his pulfe beat i at Icaft feventy ftrokes in a minute. The dan- | gerous fedative power of this enormous dofe of j opium was thus obviated, and his brain put into j fuch a ftate of vigilance, that the enfuing even- ( ing he pafled a reftlefs night. He then returned < to his ufual ftate of health. I We have a cafe ftill more to our point in a i letter from Colonel Braithwaite Boughton, b to Dr. Beddoes, in Part III. of his Obfervations \\ on the Medicinal Ufe of FaSlitious Airs, and their ^ ProduSIioH. j
To Dr. beddoes.
Po^on Hall, July 24, 1793.
SIR,
Having for a confiderable time been troubled with Rheumatic pains, it was recom- men^ied to me to take a mild opiate estrv night on going to bed, and in the event of that dofe not proving fufficiently foporific, I was to add to it a few drops of laudanum, for which purpofe I had procured a three-ounce phial of laudanum. Neverthelefs, being unwilling to accuftom myfelf to the ufe of opium, I generally poftponed taking the opiate till extreme p^iin and want of fleep rendered it abfolutcly necelTary. In one of thefe moments, about four o'clock in the morning,
I reached
129
i reached out my hand to the table, on which, by miftake, my fervant had placed the phial containing the laudanum, and believing this to be my ufual night- draught, I poured out the con- tents into a tumbler glafs, and drank it off. I foon perceived my miftake by the tafte of the laudanum, but from my immediate relief from pain, accompanied by a certain pleafing languor, it was fome time before I could roufe myfelf fo as to call affiftance. Being, however, perfectly- convinced that I muft foon beat a quick march to the other world, unlefs my ftomach was eafed of the poifon it contained, I rang the bell, and ordered fome warm water. It was fometime before this could be got ready. As foon as it was brought, I drank large quantities, bijt without any effeCl. The apothecary was then fent for, who gave me three feveral dofes of vitri- OLATED ZINC *, whcn at laft they fuccee^ed fo well, that I brought up a confiderable quantity of the laudanum. In the morning early I fent for Dr. Thornton, who adminiftered the vital AIR f, and ordered me Lemonade f, which,
* This metal, like the rellj has no power until it be com- bined with oxygen.
t Dr. Thornton, in his obfervations on this cafe, remarks that the vital air was very rapidly confumed, which miift recal to the reader's mind the celebrated experiment of Spalu^ iNG, recorded in Vol. I. p. 89.
X A mixture of lemon-, fugar, and water.
Vol. IV. IC from
130
from the weak ftate of my ftomach, was almoft as fpeedily returned, bat perfectly f%veet to the tafte, and fo deprived of all acidity *, as to be like fugar and water, and did not effervefce with alkali. This was frequently repeated, when in the even- ing I ate my dinner, without any fenfible diffe- rence, and felt the next day much as ufual. This is the fimple fa£t, to the beft of my remem- brance ; if it can be of any ufe in a fcience which has for its objeft the eafe and happinefs of man- kind, I fliall always look back with pleafure to an accident which has afforded me an opportu- nity of giving you this detail, I have the honour to be,
SIR,
Your moft obedient Servant,
G, G. Brathwaite Boughtok.
P. S. Among the Indians, who take great quantities of folid opium, when they wifh to re- move the etfefts of ftupefaftion, they drink plenty, of lime juice, which they know, from experience, produces that effect.
* The acid principle has been before proved tq be derivecj from the OXYGEN, or VITAL AIR,
SECT.
SECT. XXX.
POISONS OF THE VIPEll, ASPIC, AND POLYPUS.
I PROCURED, fays FoNTANA, fifty of the ftrongeft and Idrgeft frogs I could meet w^ith. I preferred thefe animals becaufe they are livelier th&n others; becaufe they die with greater diffi- culty: and, laftly, becaufe their mufcles contraft evert feveral days after they are dead. I had each of them bit by a viper ^ fome in the thigh, dthers in the legs, back, head. Sec. Some of them died ift lefs than half an hour, others inl airf hour, and others again in two arid thrfee hours. There w'ere likewife others among them that fell irtto a laiiguifliirig ftate, fheif hind legs that had been bitteri continuing very weak and paralytic. In fome of them' I contented myfelf with intro- ducing cautioufly into a wound, made with a lan- cet at the very inftant> a drop of venom. Thefe' laft" lived longer than thofe I had caufed to be bit; rieither af them however efcaped. A fliort time- after thefe animals had either been bit, or wounded and venOmed, the l&fs of their mufailar force was very evident. When they were fet at libertffj they no longer leaped, but dragged their legs arid bodies along with great difficulty, and could fcarcely withdraw their, thighs when violently ir-
K 9 ritated :
132
ritatcd: by degrees they became motionlefs, and paralytic in every part of the body, and, after con- tinqmg a very fliort time in this ftate, died.
I now opened the abdomen, and ftimulated the nerves that pafs through it in their way from the vertebrae to the thighs. I employed the ftrongeft corrofives, but could excite no motion or tremulus in the lower extremities. I pricked the mufcles with as little effect, and thrufl: a long pin into the fpinal marrow, without producing any motion or trembling either of the mufcles or ]imbs. In none of thefe parts was there a veftige of fenfibility or irritability. The nerves were no longer the inftrumerit of motion. The mufcles no longer contratled, or were fenfible to ftimuli. ' The heart alone, in a few of them, continued to. move languidly, and its auricles were filled and. blackened by the blood which it feemed incapable of difpellirjg. This motion, and thefp pfcillations, were however but of fliort duratipn. . Perfons have been met with, who having been bit by a viper, have remained paralytic in fome particular part of the body during life. A fliort time ago a woman in Tuscany, who had been bit in the little finger by a viper, became, after various other corqplaints, paralytic throughout the whole right fide of her body, and could never be cured. In a word, it is certain that all thofe who haye met with this accident complain foon after of an piiverfgl weaknefs. Their mufcles re-
.' fufe
133
fufe their office. They become dull and heavy, have no longer the free exercifc either of body or mind, and fall infenfibly into a kind oi' lethargy: fo true it is^ that this venom induces a ^aljy of the mufcles, and robs them of their a6live property, called by the moderns animal irritability.
The afpic alfo kills by occafioning a fudden drowjinefs and tmiverfal weaknefs, followed by death, in the animal llruck by it. Hence it feems that all the perfons fupplied by the animal kingdom, occafion death by exhaujiing the irritability of the moving fibres.
But of all the poifonous animals hitherto known, the polypus feems to poflefs the moft powerful and afctive venom. However irritable thefe creatures may be in other cafes, and difficult to kill, the polypus fucceeds inftantly in extinguifliing the principles of motion and life in water-worms. What is very fingular, its mouth or lips have no fooner touched this worm, than it expires ; fo great are the force and energy of the poifon it conveys into it. No wound is however found in the dead animal. The polypus is neither provided with teeth, nor any other inftrument calculated to pierce the fkin, as I have affijred myfelf, fays Font AN A, by obferving it with excellent rai- crofcopes.
If we refleft on the effi^fts of opium, its mode of a£tion will alfo clearly illuftrate this fubjeft. That vegetable juice, if taken in a large dofe, be- gins
134
gins by rendering an animal weak and torpid, and foon kills it by exhaujling the irrkability of the mufcular fibres, as 1 have feveral tinies obferved in animals with cold blood, and as the famous Baron de Haller demonftratcd a long time ago, even in thofe that have the blood warm.
The fymptoms and accidents that follow the bite of the viper, do tiot differ effentially from thofe I have juft fpokcn of, and may at leaft in- duce one to fufpecl that the venom of that ani- mal likewife kills by totally deftroying tlie irrita- bility of the fibres.
Both of them aft by exciting violent, convul- fions and vomiting. Each conveys gn miiverfal. debility into t]ie organs. They render the ipufqlesi paralytic, m^ke the animal heavy, ^nd, fin^Jly bring on lethargy and death.
It avails nothing to animals with, cojd blood, that thpy 4re endued with an obftinate life^ and are capable of preferving that, as well as- rnotion, after they are cut to pieces. If either of thefe poifons attacks the principle of their- motion, that is, deftroys oxygen upon which the IRRITABLE PRINCIPLE dcpcuds, thcv di«? fpeediiV; all motion is annihilated in them, and their parts will no longer give any figns of life. Their body, it is true, will preferve its organi- zation; but' an organized body that has loft its motion, is truly a body without life, and the body th^n differs in nothing from a foffil, or any
other
i35
other dead matter, for all this aflemblage of vef- fels, fo many different organs, and this aftonifli- ing ftrufture of parts, are no longer of any ufe to the animal, and fhould be regarded as not exifting, for without irritability there is nei- ther fenfation nor life.
PRACTICAL
136
PRACTICAL OBSERVATIONS.
SECT. XXXL
THE BITE OF THE VIPER, AND THE METHOD Of
CURE.
FoNTANA made more than fix thoufand ex- periments upon the poifon of the viper; he cm- ployed more than four thoufand animals, and the conclufion he draws from this enormous number of experiments, is, that this poifon does not aft on the NERVES, but on the irritable principle in the moving fibres, throudi the medium of blood. Hence, in thofe animals that recover, the parts bitten are ufually paralytic, but not injenfible. He obferves, that the venom of the viper produces a perfect gangrene^ and the mufcular parts are either difcoloured or pale; and that the jlorid colour of the blood alfo is wholly dejiroyed.
His experiments are very numerous refpefting the antidotes againft this poifon. After reading two thick volumes of experiments, ingeniouHy devifed, we are at laft amply repaid by the ac- count he gives us of the LUNAR CAUSTIC; that is, filver combined with oxygen. He had no theory that conduced him to the trial, and therefore cannot be fufpefted of having any bias on his mind.
He
137
He mixed equal quantities of lunar caustio with the venom of the viper, adding thereto a few drops of water. I wounded with this mix- ture, fays He, the legs of five.fmall birds, but none of them died, or feemed affeEled tvith the difeafe of the venom, and there ivas 7iq gangrene or paralyfis -pro- duced!
I tried this mixture on ten other birds, which added to my great aftonifliment. Still I could not determine as to the unexpe6ied novelty of thefe favourable confequences; and fearing that accidental circumftances might have prevented, the action of the venom, I refolved to make orther, experiments on the fame animals. I wounded the legs of fix others, multiplying the incifions, to introduce a good deal of the venom. In thefe experiments two of the birds aftually died, one in the fpace of fix hours, the other in twenty- eight.
On the morrow I repeated this experiment, with the fame circumftances, on ten other birds; two only of them died, and that at the end of twelve hours.
Fearing that the wounds alone might have brought on death, particularly as they were irri- tated by the cauftic, I tried ten birds, on the legs of which I made wounds as ufual, and applied the cauftic by itfelf. One of them died at the end of eight hours. So it feems at leaft very, probable, if not very certain, that the two birds
before-
138
before-mentioned, died likewife of their wounds, i anci not of the effecls of the venom. j
Tlie pigeon, next to fmall birds, particularly if | very young, is the animal killed with the fmalleft ' quantity of venom. I chofe four of thefe for a ] trial, and operated on all of them in the fame ! way. I made feveral tranfvcrfe wounds with fciffars, in .the mufcles of their legs, and intro- j duced this venomous liquor, mixed with lunar ; CAUSTIC, abundantly into the wounds. Neither \ of thefe pigeons either died, or feemed to have the difeafe catifed by the venom of the viper. The next dciy I repeated the experiment on tvrelve pigeons, the legs of which 1 wounded in feveral places, ilnd neither of them died. I varied the application of the venomous mixture, which I fometimes forced into the wounds with fmall bits of wood, 1 fometimes with pieces of ftout thread fmeared t with it. Neither of them died in thefe trials. . I proceeded to the mufcles of the breaft, whfch I wounded in different ways, and diverfified the application of the mixture: but' it was ih vaiit that I multiplied my experiments, neithei- of the )i pigeons died !
It cannot now be doubted, but that the LU- NAR CAUSTIC, vtrhen mixe'd with the venom oftke'vipe'r, renders it i nnoce n t ; and thtrS' every thing concurs to mfake regard it as the triie ^
only fpecific againft this poifon. I catt no^ flatter mVfelf, fays Font an a, with having at
length
1^
139
length difcovered a certain remedy againfl: the bite of the viper; a remedy that fo many people have fought f(j>r in vain.
I next proceeded with confidence to try the LUNAR CAUSTIC, after the bite or infertion of the venom had taken place. I wounded! the jaufcles of the legs of four fmall birds, as. birds are the eafiefi killed by the venom of the viper, and after having made flight fcarifications,, I ap-- plied the lunar cmtfticy wall] ing the wounds foon after. Neither of them died, nor had the dipafe of the venom.
I wounded next four other birds like the pre- ceding ones, in the legs, with venomous teeth; ?ipd afterwards wafhed and fcarified the wounds, but did not apply the lunar caiiftic. They aljd DIED. I then w^ounded eighteen birds, fcarified the. wounds, applied the remedy, and wafhed them, and they all recovered! . I proceeded then to. try this new remedy on fix; fmall Guinea-pigs. To three of them I ap- plied the venom to. the mufcles of the legs/to the other three to thofe of the breaft, each of which I had previoufly wounded. I then ap- plied the LUNAR c AU S T I c . Neither of the Guinea- pgs died.
I began to vary my experiments. I had fix fowls bit in the thigh by as. many vipers. Five of them fwallowed three, tea-fpoonfuls each of the folution of the lunar caufiic, the other did not
fwallow
1
146
fwallow any. I applied the /rmar caujlic in the ; fame way to each of their wounds; the laft died, ' and the other five who took the folution all re- ' covered.
Among the multitude of other experiments, 1 we find but one other remedy befides the lunar \ caujiic, which was of any material advantage for | the bite of the viper, and this ferves alfo to con- I firm the theory maintained in this part of the ] work, refpe£ting the power of oxygen in overcom* | ing poifons.
I obferved, fays Font an A, that dogs and cats recovered in proportion to the violence of their vomiting. I wiflied to follow the indications of nature. The refult of fome of thefe experiments contradifted that of others, but feveral of them were very favourable and uniform. Amongft a great number of trials, I had, fays he, a dozen dogs bit in the leg, each by three vipers, and by each repeatedly. To fix I gave emetic tar- tar ^««//wo;(y combined with oxygen), and to the other half nothing. All who had the ertietic tar- tar recovered: and the others, except two, foon died^ fo that I am inclined to think that emetics* \ are of fervice, as feven or eight fucceilive trials I had not unfrequently the fame fuccefsful termi- i nation. i
* The query is, Whether any other emetic than a ttietallic \
oxyd would have had this efFeft ? j
j
SECT. \
141
SECT. XXXIL
' POISON OF THE TICUNAS, AND ITS ANTIDOTE.
I HAD intended to have made no mention of poifons which are uncommon, but there is one particular mentioned refpe61ing the vegetable poifon, called ticunas, with which the American Indians fatalize their arrows, that I cannot help here relating it.
I diffolved, fays Font an a, this deleterious poifon in the three MINERAL ACIDS, as alfo m diftilled VINEGAR.
I made flight incifions into the fliin of a fmall Guinea-pig, and wet it feveral times with the folution of the poifon in nitrous acid. What the animal fuffered feemed to refult from the wounds and acid alone, for in an hour it became as lively as ufual.
Two hours after, I repeated this experiment on another part of the Ikin prepared in the fame way, employing a folution of the poifon in rum-j, in lefs than four minutes the animal died.
I then wounded the Ikin of a fmall rabbit flightly, and applied to it feveral drops of a folu- tion of thp poifon in oil of vitriol. The rabbit felt no ill effefts from it.
I next prepared as ufual the Ikin of a fmall rabbit, and wet it with a folution of the poifon in the dephlogijlicated marine acid: and the animal 4id not fuffer from it.
lalfq
142
I alfo made an experiment with the folution ot this poifon in vinegar.
Of fix animals treated with the folution in vinegar, two died, two had all the fymptoms of the difeafe caufed by the poifon, and the other two were not affefted by it.
In thefe inftances, we cannot fuppofe, fays FoNTANA, that the mineral acids prevented the effefls of the poifon of the ticunas; or the lunar caujiic that of the viper; by crifping and harden- ing the blood-veffels, and thus preventing the poifon from infinuating itfelf this way into the blood, for the Jiiiid volatile alkali has no fuch pro- perty, and this muft appear to us Jlrange^ he adds, when we confider the great agreement there is be- twixt the FLUii> ALKALI and lunar caustic.
Now the dawn of a probable theory has broke in upon U'S, we are abfe to diftinguifli the ope- ration of thefe two bodies, which deftroy conti- guity of -parts in the living body from very diffe- rent caufes. The lunar caustic, as was faid before, is ftlver combined with the nitrous acid, and that to the oxygen of that mineral- acid- if owed its powers. Now the fluid volatile ALKALI is azot and hydrogen, which has the ftrongeft affinity for fixed air (carbon combined with oxygen,} and by difpolfeffing from animal- matter its carbon and oxygen it afts; for when pfevioufly faturated with fixed air^ it has then no- fuch property, but becomes mild alkali^
SECT,
i43
SECT. XXXIII.
OF THE BITE OF VENOMOUS SERPENTS, AND THE METHOD OF CURE.
I HOPE the reader will forgive me, if I adduce one more inftance of a poifon to which we are ftrangers, from the confideration of a fpecific being difcovered, which tends to confirm the ge- neral conclufion jrefpe^ting the power of oxygen. Dr. RulTel, in his account of ferpents, affures us, that what is known in the Eaft, by the name of the fnake-pillj never fails in curing the bites of the moft venemous ferpents. The Tanjore, or Snake- pll, confifts principally of the OX YD OF MER. CURY, and of ARSENIC.
S warts, a Moravian prieft, inftigated by the celebrity thefe had obtained for the bite of the Cobre de Capello, and other Indian ferpents, through the nobleft motives of philanthropy, purchafed the fecret from the Brachmlns, and communicated it to the Company's furgeons. One of thefe gave the information to Dr. RufTel, with an account of feveral cafes, proving their (iiccefs ill fuch cafes,
1
SECT,
144
SECT. XXXI V.
OF CANINE MADNESS.
In the whole catalogue of difeafes, hydropho- bia feems the moft dreadful. It often attacks in a healthy period of life, and when death appear? far off, and leaves the patient until the approach of the difcafe in a horrid fufpenfe*. In viewing ii hydrophobic patient, when labouring under the action of this dreadful poifon, the attention is naturally ftruck with the horrid convulfions which torture the unhappy patient, the difficulty of deg- lutition, and the wonderful diftrefs which he ex- preffes at the fight of water, though at the fame time his thirft be exceffive. Thefe, with his ghaftly countenance, extrerne reftleffnefs, and con- ftant wakefulnefs, has upiverfally led the pra£li- tioner to confider the complaint as purely nervous. He flics, therefore, to whatever he prefumes may ftill the a£lion of the nerves. Hence blifters. Opiates, affafoetida, camphor, valerian, tonics, and every medicine of which he has either read or heard mentioned for that purpofe, are imme- diately called to his aid. With what fuccefs
* John Hunter, though a man of courage, was difle£ling a clog, which died of canine madnefs, and cut himfelf. He was fo alarmed that he dates the origin of his difeafe of the heart to this caufe. — Plde Homers Life of Hunter,
145
may be feen from the wretched detail of cafes, as fatal as they are numerous, which the experience of many centuries have recorded; The time in- deed for a£tIon is fliort; its longeft. period little more than a day or two; the difeafe moft rapidly running its courfe, the fymptoms hourly doubling their violence. The late period when the phyfi- cian is called in, is another reafon for fo little having been done, for what can be effeftually done towards the clofe of the fatal period? Thus placed, what can he often do, than merely to caft, with the bye-ftander, a look of com- miferation on the hopelefs fufferer, prepare the friends for the approaching cataftrophe, or order fome medicine, which for the prefent fitua- tion of things, though powerful in itfelf, he is confcious cannot for a moment arrefl: the fatal blow.
We have a very accurate defcription of the fymptoins of hydrophobia, or as it is more properly called, rabies contagiofa, by Dr. Wolf, in five cafes of perfons who died of this dreadful difeafe. The eye, as in typhus fever, is impatient of the leaft light ; any bright colour creates uneafi- nefs ; the mind is very irritable ; the beft friends are difliked. It is remarkable that the lint, or other dreffings, when taken off, difcover a black furface, even though the wound may difcharge good pus J the fauces have «o appearmtce of red- nefs ; the face, which at firft is J)a/e, becomes
Vol. IV. L i>rown.
14^
brown, and during each fpafmodic attack turns aJmoft quite black; the lips are extremely //W; as the difeafe advances each paroxyfm is lefs violent ; the patient has intervals of reafon ; the dread of ftrangulation from water goes off; the pulfe becomes weak, quick, and fluttering ; and the body feels remarkably cold; he then com- pofes himfelf as it were to fleep, and expires. Upon difTcftion there is not to be found the leqfi trace of inflammation.
From this appearance of things, have we not reafon to expetl fome advantage from fubftances containing OXYGEN? Opium, camphor, mufk, and fubmerfion, have from repeated trials juftly loft their reputation in this difeafe *. The ab-
ftraftion
* Thefe remedies have been employed from confidering this difeafe as purely ■nervous. Opium in every different prepa- ration yet invented, has been employed. It has been given in moderate, and alfo in large and powerful dofes. Dr. Vaughan, gave to one of his patients no lefs than 57 grains in fourteen hours. John Hunter exhibited it in a cafe that came under his eare with a tolerable free hand, and Dr. Meufe has carried it from 5 to 15 grains; but it failed in eveiy inftancc, and fufpi- €ion may arife whether this difeafe has not been aggravated by it, and the other antifpafmodics. The nature of fpafmodic difeafes, and the operation of opium, was formerly unknown. Its aftion on the blood has been before explained in Seflion XXVIII.
Convulfions appear to arife, fays Font an a, from the def?ruc- tion at different times, and in an irregular manner, of the irri- tability of the mufcular fibres. It has been unjuftly attributed to a fuperabundance of animal fpirits. Weak languifliing ani- mals, that die from hunger, perifli in dreadful convulfions, It
is
147
ftra61iGn of oxygen from the fyftem by immoderate
exercife,
is befides certain, that men and women of a delicate and wea^ frame, are always the mofl fubjeft to convulfionsj and it is not poffible to fuppbfe in thefe perfons a fuperabundance of animal fpirits.
We know that all the muicles, even in a relaxed ftate, pre- ferve notwithftanding a certain t 'enjion of their fibres, which, when they are cut, never fail to contraft themfelves and enlarge the wound. When a mufcle becomes paralytic it lengthens, and its antagonift then contrails the more; which fliews that repofe of the mufcles depends on the equilibrium of ftrength betwixt the different mufcles, and betwixt their different fibres. The powers thus balanced deftroy and renew themfelves at every inftant, without producing any motion or fenfible change. This natural tenjion of the mufcular fibres arifes either from the nervous eleflricity, or from the exa£l diftribution of -well oxygenated blood through the whole fubftancc of the mufcles. If thefe mufcles do not receive the fame proportion of well oxygenated blood, or if the arterial blood be diftributed with an unequal quicknefs and energy amongft them, the equili- brium of the mutual efforts of the mufcles is immediately de- ftroyed ; the ftrongefl of them contrafl ; and hence arife con- vuljions and agitations of the whole frame. It iy for this reafon, that thofe who die of an haemorrhage, as well as thofe who perifh by poifon, or by breathing mephitic airs, are feized with convuljions : for it certainly is not probable that the lofs of blood, and of ftrength, Ihould bear an equal proportion in every part, in every mufcle, and in every fibre, whilft the circulation itfelf is unequal, and the Jirinci/ile of irritability is dependent, on, or de- rived from, the blood.
Some frefli light, I think, may be thrown on this interefting fubjeft, by comparing the fymptoms which arofe in the cafe of that mofl: eminent anatomift John Hunter, which appeared upon diffeftion (Vide Vol. I. Seft. The Vitality of the Blood, where his death is related) in whom was found an offi- fication of the valves of the great vefTels of the heart. Who in this cafe would not have affirmed, that the rotatory motion of the room, the falfe perception of being as it were fufpended in
148
cxercife *, is alfo found to be no remedy, and in dogs it is the fymptom of the difordcr.
M. Matheu, after bleeding and purging, ex- cites as foon as poflible falivation. He fays, " the
hydrophobia yields, as it were, by enchantment, " when the falivation appears; and it muft be " kept up according to the degree of the difeafe " and the flrength of the patient." The illuf-
air, was referable to the nerves, and to thefe alone ? But the accurate hiftory of this (trange complaint, compared with the difTeftion, clearly fhows, that the primary caufe was in or- ganic changes in the heart and arteries, preventing the due circulation of the blood. The afFe£lions of the nerves was doubtlefs fecondary. I throw out this hint merely as expref- five of my doubts, whether thofe men are correal who refer all to the nerves primarily. Purfuing the opinion of the im- jTiortal Hunter before referred to, I would fay, that all feda- tive poifons attack the oxygen of the blood, the moving fibres are thence afFefted, the heart is convulfed, the brain is affefied, and fymptoms called nervous enfue. For the nerves are a part of the fyftem framed from the blood ; they grow from this pa- rent fource, and whatever be, what is termed the nervous fluiJ^ it cannot but be confiefted with the blood, being conftantly expended and renewed, and therefore to be confidered only as a branch from the parent flock. Deny, therefore, parts of their due proportion of blood, or encreafe the quantity, or let this blood be deficient in its oxygen^ and the nerves will imme- diately indicate the change. This doftrine relates then to all other poifons as well as hydrophobia, and it will refer us to the jiuids as a primary, and to folids (including nerves) only as a fecondary caufe in tracing this complaint to its origin^ and cftablifliing a pathology.
* This is recommended by John Hunter, becaufe a man in hydrophobia ran three times round Smithfield, and, exhaufled by t^e fatigue, feemed for awhile relieved! Allquando bonus dormitat Homerus. Vide John Hunter's Diflertation on Hydro- phobia.
trious.
j
149
trious Sauvage, fpeaking of Mercury, declares, ** apres bien de recherches. L'ignor.e que ce " remede ait encore manque, etant, meme ap- " plique quand le rage'etoit declaree." " After " many enquiries, I know not," fays Sauvagev " whether mercury has ever failed, even when the " hydrophobia had commenced."
It may be faid by fome, that the oxyd of mercury has been adminiftered in this difeafe, and without advantage ; , but as far as I have read, it has been conftantly in fuch cafes, accompanied with mufk, bleeding, opium, or camphor. But whether in this alarming diforder it be better to oxygenate the blood or not when the difeafe has taken place, as -prevention is always better than cure^it Ihould occupy moft of our attention.
When the contagion of a putrid fever is taken by the faliva into the ftomach and bowels, which is its conftant road, if the patient, the moment he finds himfelf attacked with a fenfe of chillii^efs, lofs of appetite, and an mipleafant tafte in -his mouth, has recourfe to two emetics at proper intervals, and after the operation of the firft eme- tic, takes a cathartic, he has certainly got rid of the infedlion : in the fame way, even after three days, or perhaps a week, if the part bitten by the dog be cut out with the knife, even after a few days, the danger is efcaped.
Vinegar has of late been recommended as a fpecific. Dr. Moreta, phyfician to the King of
Poland,
Poland,- is among the number who extols its vir- tue, aflerts his having prevented the difeafa in mor^ than fuxty cafes, when ufed immediately after the bite, and for nine fucceeding days as an external application to the wound. Whilft this procefs is carried on, an ounce and a half at a dofe is frequently to be adminiftered internally-j and this is to be continued until the ijth day, not thinking it necelTary, however, to keep the wounds open longer than the 9th day. The hy^ drophohia itfelf, he aflures us, has been ftopt at its commencement by the fame means. Did exr perience in the hands of other men furnifli fimilar events, the difcovery woi^ld be as valuable as the method is fimple.
A mad fow is faid to have been cured by this remedy. The creature wa,s feized, we are told, ^yith, the difeafe on the 6th day after the bite. Being fliut up immediately on being bitten, an opportumty was afforded for obfervation. The iirft fymptom was refufal to eat. She ftood for three days with hej- h^a4' leaning on her food, :ivjthput eatiipg it.. M. B^udon directed four pots of ftrong warm vinegaji; to be let dov^n through si l?ole in the liable where the creature ftood j then flopped, up th(e b(j>le to, preve-nt communication >yi-itl?; the ex;temj^l air. About a,n hour after flie was obferved to difiijJ^ the vinegar with the greateft avidity. This induced him to put a quantij^ Q^br^, B)§^^-ea?|ed,wit^, vinegar, in,to her
trough;
^5^
iTOUgh; it was all confumed by the following day. The plan was purfued, and the animal, it is faid, recovered. Two dogs bitten with the fow were cured by the fame means *.
Should the principle of acidity be confidered as the ufeful part, and alone containing the vir- tues of the medicine, the cohefion of combination between it and the fubftance in union with it, is to be taken into confideration. The more loofe the combination, the more eafy will the fepara- tion become, to afford it an opportunity of a ne\f combination with the frame.
If an acid compofition be thought ufefuf, t fhould be inclined to prefer the oxalic to the acetous.
Sugar is compofed of carbon and hydrogen in conjunftion with oxygen f. By the addition of nitrous acid to fugar, we can feparate its and in form of pure cryjiah, and are enabled by this procefs to fuperfaturate fugar with oxygen^ and in this way obtain a larger quantity of it in a given bulk, and in a loofer bond of union j a confidera* tion of confequence in a difeafe where deglutition is fo difficult.
Arjenic is another remedy which deferves par- ticularly to be tried. We are aflured by the fame furgeon who gave the communication of the
* Vide I^erriar's excellent Hiftories and Reflexions, f See Cruikfhank's excellent account of the formation of fugar, in Dr. Rollo's work on Diabetes,
fnake-
152
fnake-pill to Dr. Ruffe], that he tried thefe pills, whofe efficacy we before proved to depend prin- cipally in arfenic, in no fewer than fourteen difr ferent perfons bitten by mad dogs, with perfect fuccefs ; and with no other unpleafant fymptoms than purging in moft, and a flight vomiting in a few.
Lunar canjlic, the fpecific againft the bite of the viper, both as an external application, and an internal remedy, in fuch a difeafe deferves to be tried.
Added to thefe, I would recommend the iu' halation of fuperoxygenated air. In a difeafe fo ftiort in its fatal termination, every moment is of confequence. If this air can more immediately reach the blood, and reftore to the fyftem the oxygen which is dpftrpyed by the a(Stion of the poifon, it will be one of the moft valuable ac- quifitions to the Materia Medica.
Thus have I affembled a few faQ:s towards a conje6lure on the probable good effe£ls of oxygen as the antidote of this poifon. I grant that yet more fa£ls are wanting to afcertain this point, which is founded upon the fuppofition that the hydrophor bic virus enters the fyftem, and by a certain modus operandi on the blood, creates a certain fet of actions, inducing changes, of which the ab^: Jlra5iion of oxygen may form the principle,
^ECT,
153
SECT. XXXV.
THE HOOPING COUGH.
This difeafe, fo well known by the peculiar Cbund of the cough, incidental to the human race but once, is a poifon whofe nature is but very- little known. The clear air of the country, is the remedy ufually reforted to. The inhalation. I of oxygen air was tried with fuccefs in fome iinftances by Dr. Thornton, after the exhibi- 1 tion of a vomit. Accident has, however, brought Itp light the power of arjenic over this difeafe. '.The white drop, fo famous for the cure of the ague ((which fever is probably derived from the opera- ttiou of the poifon of marflies, or marfh miafmata) I being taken by children who laboured under both tthefediforders, were very foon recovered from both, aand reftored to health *. The trial, however, of tthis mineral muft be made with extreme cau- ttion, for in injudicious hands the remedy would the generally found to be more fatal than the dif- eeafe in queftion.
.- * This circumftance was related- to the author by Mr. Xorp, an emjnent furgeon of Barnet.
.1* -
j
SECT.
154
SECT. XXXVI,
THE SMALL-POX,
A • < 1 . .
' ■^His is another poifon, which is peculiar to tiife human rac6, and exerts its influence but once in the body *. Nor does our wonder at the or- dinance of God ceafe here, (for he equally ap- pears in the thunder and the tempeft, as in the ferenity of fpring, which refembles our ftates of difeafe and health); for as the blood is converted into callous for bones, when wanted, into mufcu- lar /fibre, into nerve, which is by the procefs of iiffimulation, fo the minuted partielea£ls throughout
! * Great advantage has been lately taken of this itriftinw phaeiiomeiiQn. . Th^e is a diforder poj _ unfrequent among cows, called the;C o w- p o x, fKom Its producing puftules. When the niatter of tfie Tores about tHe teat of the cows Tabouring iirider this difeafe gets applied to any- part of the human body an ephemeral f?ver, ^fter a. certain pgriod, enfues, and.the pa- tient is ever after rendered infufcefitibley like animals, or thofo who have had the fmall-pox, of tliat dreadful fcourge of hu- manity. The Cow-pox, however, may be cangbt feveral times. This diforder had exifted unnoticed by praditioners for time immemorial, until the attention of the faculty was called to it by Dr. Jenne>r, and the truth of this circura- flance put beyond a queftion; and it is probable that the ' ravages of the fmall-pox will be in future prevented by the general inoculation of the Cow-pox, as foon as truth fliall have conquered oppofition.'
the
^55
^he frame, after which matter of a fimilar nature is engendered in the whole body. In the natural way the quantity of this poifon is greater than from inoculation, hence the advantage of raifing^ this difeafe artificially. The fecondary fever is alfo common to the natural fmall-pox, and atr tended with great danger, from the abforption of the new-fgrmed variolous matter and the throat is frequently affefted, and goes into gangrene. This affection of the throat, in, the natural frpall- ,p.ox, is fupppfed, by Dr. Darwin, to arife from ji^ariolous matter imbibed and adhering to tbefe .parts. On the contrary, the celebrated Sutton thinks, that the whole difference between the natural and inoculated fmall-pox, arifes from the different Hates of the body for the reception of this difeafe : But fafts daily contradift this fuppo^=- ■tion, where, without preparation, the inoculated go through this difeafe generally well, few^ if any, dying from it *.
Vide the following Sef^ions.
SECT
156
I
I
i
j
SECT. XXXVII. '
. THE ANTIQUITY OF IN OC ULATION. \
' ■ 'By what means the inoculation of the Small- pox was firft difcovered, or at what time and : place' it was 'firft ufed, we are totally ignorant. \ "It may be inferred^ therefore, that the art of mocu- ^ /(^/'wz, which is 'capable of faving more lives than the whole Materia Medica, was originally a for- tuitous difcovery i and I may add, that to the diflionour of the medical profeffion, it was for a -long time under the management of old women, and ignorant perfods, in //as and many other countries^ before it was patronized and adopted by the legi- tmiate pra6titioners of medicine.
Inoculation was certainly firft introduced into Conjlantinople from Georgia * ; but as this event did not take place till towards the end of the laft century, we may conclude, that had the art been pra6tifed for many ages at fo fhort a diftance from that metropolis, it would have been known i there much fooner. Befides, in various countries, \ very remote from the Cafpian fea, it is proved to > have been fin inimemorial ufage,
* It is generally thought that the Circaffians firft inoculated 0
their children in order to rear them as flaves for the Turkilh li
Seraglio. Vide page 171 in this volume. j
InocuIatioK i
157
hioculation was introduced mto Loudon as an invention wholly foreign, and from • its fuccefs upon the younger branches of the royal family, in 1722, became the fubje6l of public converfation, when, to the great furprife of the learned, feveral com- munications to the Royal Society proved that, it was already a praftice known in South Waks^ where it had exifted under the denomination of buying the fmall-pox, as far back as tradition could be traced. — That this Cambrian mode of buying the fmall-pox was in effeft the fame as the Byzan- tine inoculation^ then juft adopted in England, the letters of Dr. Williams, Mr. Owen, and Mr, Wright *, bear ample teftimony. The laft-men- tioned gentleman writes to Mr. Bevan as follows:
" I received yours the 9th inft. and, in anfwer " to it, will readily give you all the fatisfaftion " I can in relation to a very ancient cuftom in " this country, commonly called buying the Jmall- " pox; w^hich, upon ftrift inquiry fince I had " your letter, I find to be a common praEiice, and of " a very long Jlanding, being affured by perfons " of unqueftionable veracity, and of advanced " age, that they have had the fmall-pox com- " municated to themfelves in this way, when " about fixteen or feventeen years of age : they " then being very capable of diftinguiiliing that
^ * Thefe letters may be feen in the Philofophical Tranfac- tions for the year 1 722 ; and in Dr. Jurin's account of the fuccefs of Inoculation in 1723.
" diflempep
158
" diftemper from any other, and that they have
parted with the matter contained in the puf- " tales to others, producing the fame effe£ls.
" There are' two large villages in this county, " near the harbour of Milford, more famous for " this cuftom than any other, namely. Sr. " Ishmael's and Marloes. The old inhabi- " tants of thefe villages fay, that it has been a " common fraBice with them time out of mind ; and " what was more remarkable, one W. Allen, of " St. Iflimael's, ninety years of age, who died " about fix months ago, declared to fome perfons " of good fenfe and integrity, that this praftice
was ufed all his time, and that he got the " fmall-pox that ve^ay. Thefe, together with " many other informations I have met with, " from all parts of the country, confirm me in
the belief of its being a very ancient praSiice " among the common people ; and to prove that " this method is flill continued among us, I will " give you the relation of an elderly woman, a " midwife (who accidently came into company " when your letter was reading,) whofe name is " Joan Jones, aged feventy years, of good credit, " and perfeft memory. She folemnly declares, " that about fifty-four years ago, having the " fmall-pox, one Margaret Brown, then about " twelve or thirteen years of age, bought the « fmall-pox of her; and flie further fays, that " flie has known this way of procuring the fmall-
" pox
159
" pox praftifed from time to time above jifiy *' yean-., that it had been lately ufed in her neigh- " bourhood; and (lie knows but of dying of " the faid diftemper when communicated aft^r " the method aforefaid, which accident hap- " pened within thefe two lad years."
The manner of inoculating ^ or buying the Jmall- pox, here alluded to, was not always the fame, but was varied by different perfons. Dr. Wil- liams fays, " They either rub the matter, taken " from the puftules when ripe, on feveral parts " of the Ikin of the arms, &c. or prick thofe parts ** with pins, or the like, being firfl: infefted with
the inoculating matter." Mr. Owen, and five of his fchool-fellows, " fcraped the Ikin w^ith a knife " until the blood began to flow, before they " applied the variolous pus." Others produced the diftemper, " by holding a certain number " of dried puftules for a confiderable time in the " palm of the hand."
We are alfo informed, that the inhabitants of the Highlands of Scotland"^, for many ages, have had recourfe to a fpecies of inoculation, performed by tying worfted threads, moiftened with variolous matter, round the wrifts of their children.
This vulgar or domeftic cuftom of inoculating the fmall-pox, likewife prevailed in many other parts of Europe, and in various countries of Afa and Africa ; and, what is highly curious, In feveral of thefe diftant nations, the pra61ice was, as in
* See Monro on Inoculation in Scotland.
Wales,
i6o ,
Wales, termed buying the small-pox. For it was fuperftitioufly imagined, that inoculation would not produce the proper effect unlefs the perfon, from whom the variolous matter was taken, received a piece of money, or fome other article in exchange for it, from thofe whom it was intended to infect.
At Naples, Monf. de la Condamine, in 1769, learned that inoculation had been fecretly ufed by the people there from time immemorial: and the celebrated P. Bofcowich affured him it was pra£tifed in the farne manner at Pavia, where the nurfes often inoculated, without the parents knowledge, the infants entrufted to their care. For this purpofe they commonly rubbed the palm of the hand of the child with fluid variolous mat- ter, recently taken from a puftule.
The praftice of buying or inoculating the fmall- pox prevailed alfo in fome of the provinces of France, efpecially in Auvergne and in Perigord ; and ftill more generally among the ignorant peafantry in many parts of Germany *, Denmark, and Sweden f .
In
* See Condamine, /, c. He alfo fays, Ce n'eft pas feule- ment dans le Duche de Cleves & dans le comte de Moeurs, ou le Dofteur Schwenke trouva cet iifage ctabli en 1713: il y a pres d'un fiecle qu'on le connoiflbit en Dannemarck, puifque Bartolin en fait mention dans une lettre fur la ti'anfplantatioii des maladies, imprimee a Copenhague en 1637.
Le Dofteur Carburi, premiere profeffeur de medicine en I'univerfite de Turin, natif de Ceplialonie, m'a dit en 1756, que I'inoculation ctoit en ufagedans cette Ifle avant I'an 1537.
f See Profeflbr Murray's Hijioria infitionis variolarum in
i6i
In tlie northern parts of Europe this practice feems to have been lefs complete * than that adopted on the fouthern and eaftern coafts of the Mediterranean Sea. For in Barbary and in the Levant, though they placed implicit confidence in the efficacy of buying or purchafing the vario- lous puftules \ yet their method of performing the operation v^^as fuch as could not fail of producing the inoculated fmall-pox. The infeElious matter was injerted at a Jmall opening made in the fieJJiy part of the hand, between the thumb and fore-jinger ; and, according to Dr. Shaw, " the perfon who is to " undergo the operation, receives the infeftion " from fome friend or neighbour, who has a " favourable kind, and who is entreated to fe// *' two or three of his pudules, for the fame num- " ber of nuts, comfits, or fuch like trifles."
This account of inoculation differs not mate- rially from that praftifed in the kingdoms of Tripoli, Tunis, and Algier, as related by his excel- lency Caflim Aga, in 1728 when ambafi^ador to our court. He fays, " If any one has a mind to " have his children inoculated, he carries them
Suecia^ p. 96. Sckultz's Account of Inoculation^ 65. Ejihem. Germ. An. 2. A. D. 1671. Obf. 165. Alfo An. 8. Anm iSyy. 0^15. Werlhof Di/q. de variolis et anthyaciius, /i:
* Vide Roeder. Dijf. utrum natiiralibus puejlent variola artifi- ciales^ Jt. 34.
t See Scheuchzer's Account of the Succefs of inoculating the Small-pox in Great Britain, for tlje years t-jzy and 1728, p. 61. '
Vol. IV. M « to
16. ^
" to one that lies ill of the fmall-pox, at the time ' " when the puftules are come to full maturity. I " Then the father makes an incifion on the ' " back of the hand, between the thumb and i " fore-finger, and puts a little of the matter, " fqucezed out of the largeft and fulleft puftules, j " into the wound. This done, the child's hand " is wrapped up in a handkerchief, to keep it j " from the air, and he is left to his liberty, till " the fever arifmg confines him to his bed, which ] " commonly happens at the end of a few days. " This pra6tice is fo innocent, and fo fure, that " out of ICO perfons inoculated not tzvo die j ; " whereas, on the contrary, out of loo perfons " that are infe£led with the natural fmall-pox, " there die commonly about t/iirfj. Inoculation " is fo ancient in the kingdoms of Tripoli, Tunisy " and A/gier,thsLt nobody remembers its firftrife ; " and it is not only praftifed by the inhabitants " of the towns,.-but alfo by the wi/d Arabs."
That this praftice is very common with the Arabs, and is by them alfo called buying the Jmall- | pOA', fully ajjpears from Dr. Rufiell's communica- i tion to the Royal Society*. About the year i 1758, while this ingenious phyfician- was on a ;i vifit at a Turkifh Harem, a lady happened to :^ cxprefs much anxiety fof an only child who had \ nc^t had the fmall-pox j the diftemper at that ,lj
* An Account of Inoculation in Arabia, in a ktter from ;f| Br. Patrick Rufiell. Phil. Tranf. vol. 56. p. 140. . ij
time I
i63
time being frequent in the city. None of the ladies in the company had ever heard of inocula- tion, fo that the Do6lor having once mentioned it, \\'as obliged to enter into a detail df the ope- ration, and the peculiar advantages attending it. Among the female fervants in the chamber, was an old Bedouin Arab, who having heard the Do£lor with great attention, afTured the ladies, " that the account given by the Do£tor was " upon the whole a juft one j only that he did " not feem well to underftand the way of per- " forming the operation, which flie aflerted " fliould not be done with a lancet but with a " needle * :" fhe added, " that fhe herfelf had " received the difeafe in that manner when a " child, and had inoculated many ; that the whole " art was well known to the Arabs, and that " they termed it buying the fmall-pox.'" In con- fequence of this hint. Dr. RufTell made further inquiries, by which he difcovered, that inocu- " lation had been of long {landing among them. " They, indeed, did not pretend to affign any " period to its origin ; but perfons feventy years " old and upwards, remembered to have heard it fpoken of as a common cujiom of their ancef- " tors, and they believed it to be of as ancient a ** date as the difeafe itfelf."
* Niebuhr has fince told us^ that the Bedou'm women inocu-' late their children, " avec ime epine, faute de meilleur rnftru-
M 9 Df,
164
Dr. Ruffell was likewife affured, " that inocii- " latlon was equally common among the eajlern " Arabs, being pra£lifed not only at Bagdad and " Moful, but alio at Bajfora ; and that at Moful particularly, when the fmall-pox firft appeared " in any diftrict of the city, it was a cuftom fome- " times to give notice by a public cryer, in order " that thofe who were fo inclined might take the " opportunity to have their children inoculated."
" In Armenia:' Dr. Ruffell fays, " the Turko- " man tribes, as well as the Armenian Chriftians, " have prattifed inoculation Jince the memory of " man ; but, like the Arabs, are able to give no " account of its firjl introdudion among them. " At Damafciis, and all along the coaft of Syria " and Palejiine, inoculation has been long known. " In the Cajiravan mountains it is adopted by the " Druli as well as the Chriftians. Whether the " Arabs of the defert to tlie fouth of Damafcus, " are acquainted with this manner of commu- " nicating the fmall-pox, I have not," fays thii? phyfician, " hitherto been able to learn ; but a " native of Mecca, whom I had occalion to con- verfe with, alTured me that he himfelf had been " inoculated in that city."
From, the various accounts ot inoculation here related, it is highly curious that in fo many dijiant nations, differing widely in manners, cuftoms, laws, habits, and religion, this art fhould be generally known by the name of " buyinh the
" SMALL-
165
** SMALL-POX.'^ It is alfo to be confidercd as a remarkable proof of its great antiquity, that the Icfs civilized part of mankind, or people of the moft fimple and uniform habits, have retained this euftom the longeft.
Having before related Caffim Aga's account of inoculatiofl 'in Tripoli, Tunis, and Algiers, I tliink it proper to add, that there are likewife proofs of its long ufage in Senegal ; and that the negr'oes in the interior parts of Africa, whenever the fmall-pox threatens to invade them, have re- courfe to inoculation, performing the operation in the arm, and obliging the patients to abftain from animal food, and fufferlng them to drink nothing but water, acidulated W'ith the juice of
LIMES *.
In Hindojlan this pra61ice fliould feem to be a more ancient cufiom than in China ; for D'Entre- colles, by obtaining accefs to feveral medical books at Pekin, difcovered that one of them gave fome account of the introduftion of inoculation into China, and ftated that in this empire it had lirft to encounter ftrong oppofition. The author of the book here alluded to, lived in the latter part of the dynafty of Ming ; hence it may be concluded, that inoculation in China has not yet
* See the Letter of C. Golden, Efq. to Dr. J. Fothergill in Med. Obf. and Inq. vol. i. p. 227. Alfo the " Narrative of '* the Method of Succefs of Inoculation in New England," by D. Neal, p. 34.
been
^66
been praftifed two hundred years * ; whereas, in Hindojtan, from tradition, it feems to have been an immemorial cuftom j and the methods of prac- tifmg this art by the Chinefe and Hindoos are fo widely different as clearly to fhew that they could not be derived from the fame origin. J The ChimJSi in order to inoculate, take from two to four dried variolous puftules or fcales (according to their fize), between which they place a fmall portion of mulk j the whole is then wrapped up in cotton, and inferted within the noftril of the patient. If the child undergoing the operation be a male, this infjeftipus tent is introduced into the left, but if a girl, into the right noftril. The fcales, thus ufed, are to be kept in a clofe jar for feveral years. When the Chinefe are obliged to ufe recent puftules, they think it neceffary to correft the acrimony of the matter, by expofmg it to the fteam of an infufion of the roots of fcorzonera and liquorice. They fome- times reduce the dried fcales into powder, and forn> jthem into a pafte, for the purpofe of inoculation.
On the contrary, inoculation, as pra£tifed in Hindojlan by the Bramins, very rarely fails of pro- ducing the diftemper in the moft favourable way : I lhall therefore circumftantially relate the whole procefs in the words of Mr, Holwell f- " Inocur
* D'Entrecolles, 1. c. p. 10.
f Sec An Account of the Manner of imculi^tw^ the Small'Jtox in the Eaji Indies.
" lation
16/
" lation is performed in Hindoftan by a particU'- lar tribe of Bramins, who are delegated annu- ally for this fervice from the different colleges " of Bindoobund, Eleabas, Banaras, &c. over " all the diftant provinces i dividing themfelves " into fmall parties of three or four each ; they " plan their travelling circuits in fuch w^ife as to " arrive at the places of their refpeftive deflina- " tion fome weeks before the ufual return of the " difeafe ; they arrive commonly in the Bengal " provinces early in February ; although, in fome " years, they do not begin to inoculate before " March, deferring it until they confider the ftate ** of the feafon, and acquire information of the " ftate of the diftemper. The inhabitants of " Bengal, knowing the ufual time when the " inoculating Bramins annually return, obferve " ftritily the regimen enjoined ; this preparation confifts only in abftaining for a month from " fifh, milk, and gee (a kind of butter made " generally of buffalo's milk :) the prohibition " of fifli refpe£ts only the native Portuguefe and " Mahomedans, who abound in every province " of the empire. When the Bramins begin to " inoculate, they pafs from houfe to houfe, and " operate at the door, refufmg to inoculate any " who have not, on a ftrift fcrutiny, duly ob- " ferved the preparatory courfe enjoified them. " They inoculate indiflferently on any part j but " if left to tfieir choice, they prefer the outfide
" of
i68
of the arm, midway between the wrift and the " elbow, and the flioulders for the females. " Previous to the operation, the operator takes a " piece of cloth in his hand, and with it gives a ** /'Vi^^^f^ 'tipon the part intended for inocula- " tion, for the fpace of eight or ten minutes* ; " then, with a fmall inftrument he wounds, by " many flight touches, about the compafs of a " filver groat, juft making the fmall appearance " of blood ; then opening a linen double rag " (which he always keeps in a cloth round his " waifl:,) takes from thence a fmall pledget of " cotton, charged with the variolous matter, " which he moiftens with two or three drops of " the Ganges water, and applies it to the wound, " fixing it on with a flight bandage, and order- " ing it to remain on for fix hours without being " moved ; then the bandage to be taken off, and *■ the pledget to remain until it falls off itfelf.
The cotton, which he preferves in a double " callico rag, is faturated with matter from the " inoculated puftules of the preceding yearj " for they never inoculate with frefli matter, nor " with matter from the difcafe caught in the *' natural Way f, however diftin£t and mild the *' fpecies. Early in the morning fucceeding the " operation, four collons (an earthen pot con-
* This promotes abforption.
I Is this a popular prejudice, or is there any truth in the dif- ference of matter ? It is generally fuppofed here that frefli mat- ter produces the mildeft difeafe.
" tainingf
169
taining about two gallons) of cold watery are " ordered to be thrown over the patient from
the head downwards, and to be repeated every " niorning and evening until the fever comes on, " which ufually is about the clofe of the fixth
day from the inoculation ; then to defift until " the appearance of the eruption (about . three " days,) and then to purfue the cold bathing*^ " as before, through the courfe of the difeafe, " and until the fcabs of the puftules drop off. " They are ordered to open all the puftules with " a fine fliarp pointed thorn as foon as they " begin to change their colour, and whilft the
matter continues in a fluid Hate f. Confine-
ment to the houfe is ahjolutely forbid^ and the " inoculated are ordered to be expofed to every air that
blows J, and when the fever comes on, to be laid
upon a mat at the door j but in faft the eruptive " fever is generally fo inconfiderable and trifling " as very feldom to require this laft order. Their " regimen is ordered to confift of all the refri-
gerating things the climate and feafon pro- " duces, as plaintains, fugar-canes, water-melons,
rice, gruel made of white poppy feeds, and
* This praftice has been lately introduced in the putrid fever by Dr. Currie of Liverpool, and the rationale of its opera- tion will be therefore exarqined in another place.
f This is an excellent praftice, and greatly affifts nature.
X This is the late well-known improvement introduced by the Sutton's in this country. Its rationale will be afterwards explained when confidering his praftice.
" cold
I/O
" cold water, or thin rice gruel, for their ordinary *' drink. Thefe inflruclions being given, and " an injunftion laid on the patients to make a " thankfgiving poojahy or offering, to the goddefs : " on their recovery, the operator takes his fee, " which from the poor is a pund of cowries, equal " to about one penny fterling, and goes on to " another door, down one fide of the ftreet, and " up on the other, and is thus employed from " morning till night, inoculating fometimes eight or ten in a houfe."
This, and indeed all the preceding accounts of imcidationy as anciently praSiifed in different countries , were not known in London till after this art had been regularly adopted in England*.
* The above account is extrafted from The Hiftory of Inoculation, by Dr. Woodville, phyfician to the Small Pox Hofpital, a work which reflefts the higheft honour on the author for his great candour and able refearches.
•r •
SECT.
SECT. XXXVIII.
ON THE INTRODUCTION OF INOCULATION IN
ENGLAND.
It is a well known fa£l, although it muft flag- cer the belief of moft fathers and mothers, that there exifts a clafs of people in Georgia, who re- gularly train up their daughters for fale and prof- titution. Forming the /peculation, if their child has a fine form, and fair complexion, they edur cate her for the market j but frequently, when they had expended much money, they were dif- appointed in their fordid views by the attack of the fmall-pox, when all the education received was then thrown away. Such were the confiderations which firft induced the natives of Georgia to inoculate, and the firft intimation of this praftice was derived to the Turks by the fair Circaffians, as thefe flaveswere called.
But it was immediately from Conjlantinople that the Englifli firft derived a competent knowledge of the advantages of inoculation; and to fhew in what fliape, and what grounds, the pra6tice of it came originally recommended to this country, I fliall tranfcribe a letter written by Lady Mary WoRTLEY Montague:
" The Small-pox," fays this lady in her natural eafy ftylc, " which is fo fatal and fo general
" amongft
172
" aniongft us, it here entirely liarmlefs, by the " invention of ingrafting, which is the term they " give it. There' is a fet of old women who make " it their bufmefs to perform the operation every " autumn here, in the month of September. *' When the great heat is abated, people fend to *^ one another to know if any of their family has a " mind to have the Small-pox ; they make parties " for this purpofe, and when they are met (com- " monly fifteen or fixteen together,) the old woman " comes with a nut-fhell-full of the matter of the
beft fort of Small-pox, and aiks where they pleafe " to be inoculated. She immediately pierces that ** you offer to her with a large needle (which " gives you no more pain than a common fcratch) *' and puts into the part as much matter as can " lie upon the head of her needle, and after that
binds up the little wound with a hollow bit of " fliell ; and in this manner makes four or five in- " cifions. The Grecians have commonly the fu-
perftition of making a fcratch in the middle of " the forehead, one in each arm, and one in the " breaft, to make the fign of the crofs; but this
has no very ill effecl, all thofe wounds feldom " leaving fears, and is not done by thofe who *' are not fuperftitious, who choofe to have them
in the leg or that part of the arm that is
concealed. The children, or young patients, " play together all the reft of the day, and are in <' perfect health to the eighth. Then the fever
" begins
173
begins to feize fbem, and they keep their beds " two days, very feldom three. They have very « rarely above twenty or thirty in their faces, « which never mark, and in eight days, time they « are as well as before their illnefs. Every year " thoiifands undergo this operation ; and the French " ambaffador fays, pleafantly, that they take the •* Small-pox here by way of diverfion. There is no " example of any one that has died in it ; and yon " may believe 1 am well fatisjied of the fafety of this " experiment, fince I intend to try it on my dear little " fon. I am patriot enough to take pains to bring this " lifeful invention into faJJiion in England; and I " Jliould not fail to write to fome of our doctors very " particularly about it, if I knew any of them that I " thought had virtue enough in them to deftroy fuch a *' confider able branch of their revenue, for the good of
mankind. — Perhaps, if I live to return, I may, " however, have courage to war with them^
This communication, dating the advantages of inoculation upon indubitable authority, as well as fimilar accounts of the fuccefs of this new practice, orally given by merchants and others, who, from bufinefs or pleafure had vifited the Ottoman me- tropolis, could not fail greatly to intereft many i^ this couritry. Indeed, any fcheme njuch lefs plaufible than the prefent, which promifed to dif- arm of its terrors fo univerfal and dellruftive a diftcmper as the Small-pox, muft have had a ftrong claim to the attention and patronage of
any
174
any nation. Among the Englifli, therefore, whofe fondnefs for novelties is proverbial, it is fomewhat
furprijing that inoculation was not attempted before the
year 1721.
Mr. Mait LAND, Surgeon to the Honourable Wortl-ey Montague in his diplomatic character at the Ottoman court, informs us, that the ambafla- dor's lady, being convinced of the advantages of inoculation, was determined that her only fon, then fix years of age, fliould undergo the opera- tion. For this purpofe flie delired Mr. Maitland to procure the variolous matter from a proper fubje6t, which being done, an old Greek woman, manv years in the conftant habit of inoculating, was employed to infert it. " But," fays Mr. M. " the good woman went to work fo aukv/ardly, and by the fliaking of her hand put the child " to fo much torture with her blunt and rufty " needle, that I pitied his cries, and therefore ** inoculated the other arm with my own inftru- " ment, and with fo little pain to him, that he " did not in the leaft complain of it*/' The con- fequent difeafe was very mild, there being only about fifty puftules; and it may be remarked, that this inoculation, which was performed at Pera, near Gonftantinople, in the month of March, 1717 (if the mode of buying the Small-pox be
* Mr. Maitland's Account of Inoculating the Small-pox, page 7-
excepted)
175
excepted) was the firft ever pra£lifed upon any EngliJJi fubjea.
Having now ftated all the principal fa£ls which immediately led to the eftablifliment of the By- zantine method of praftice in this country, I pro- ceed to relate the progrefs of Inoculation under the conduft of men educated in the medical pro- feflion.
Inoculation of the Small-pox was firft regularly adopted in England in the month of April, 1721; and it was owing to the enlightened and philofo- phic mind of Lady Mary Wortley Montague, that Great Britain had the honour of adopting this praflice the firft among the nations of Europe. For after this celebrated lady had witneffed the good efFetls of inoculation upon her fon at Pera, die determined alfo to try it upon her daughter*, then an infant of three months old. The parti- culars of the cafe are ftated by Mr. Maitland in the following manner; — This noble lady fent for " me laft April, and when I came, (he told me llie " was now refolved to have her daughter inocu- " lated, and defired me to find otit matter for " that purpofe. I pleaded for the delay of a week " or two, the weather being then cold and "wef ; " for indeed I was unwilling to venture mt aii '* experiment altogether new a«4 uncoriin>oh iil
* She was afterwards married to the'Earfo^ feute in^ig-^, and died in her 77th year, November 5th, iV94-
1
ij6
" England, in a cold feafon: though I am now " convinced it may with due care be pra£lifed at
all times and feafons, but (till with more fafety " in the temperate and favourable. I alfo pray'd, " that any two phyficians, whom they thought " fit, might be called in, not only to confuit the " health and fafety of the child, but likewife to " be eye-witnefles of the practice, and contribute " to the credit and reputation of it. In the " meantime, having found proper matter, I en- " grafted it in both arms; the child was neither " blooded nor purged before, nor indeed was it " neceflary, confidering the very cool regular " diet (he had ever been kept to from her infan- *' cy. She continued eafy and well, without any " fenfible alteration, bating the ufual little fpots " and flufliings, till the tenth night, when flie was " obferved to be a little hot and feverifli. An " old apothecary in the neighbourhood being " then called, prudently advifed not to give the ** child any medicine, affuring them there was " no danger, and that the heat would quickly ** abate, which accordingly it did ; and the Small- " pox began to appear the next morning. Three
learned phyficians of the College were admit- " ted, one after another, to vifit the young lady; " they are all gentlemen of honour, and will, on " all occafions declare, as they have hitherto ** done, iha! they faw Mifs Worthy playing about " the roomy cheerful and well^ with the Small-pox
" raifed
177
" raijecl upon her; and that in a fezv days after JJie " -perfeElly recovered of them. Several ladies and " other perfons of diftindiion, vilited alfo this " voung patient, and can atteft the truth of this " faa.''
The very favourable event of this firft trial of the Byzantine mode of inoculation in Britain, and alfo that of a fecond made on the fon of Dr. Keith*, which immediately followed, was foon generally known in London, and confequently communicated to the different parts of the king- dom. For an art Jd new and interejling to the pub- lic, could not fail to excite the attention of people of all ranks, and more ef/iecially thoje of the medical profef- fion, on zvhofe concurrent opinions the efiablijiment of this foreign pra^lice here was ultimately to depend.
However, though thefe profperous inftances of inoculation had hitherto confirmed the reports of its fuccefs at Confiantinople; and though the praftice had been introduced among the Englifh by a woman who, from her brilliant accomplifh- ments, mafculine underftanding, and great in- fluence in the fafhionable circles, was, above all
* See Sir Hans Sloane's MSS. preferved in the Brltifli Mufeum. — Alfo Dr. Douglafs's Eflay on the Small-pox, p. 67.
Mr. Maitland does not mention the name; but fays, on the nth May he inoculated the fon of one of the learned phyfi- cians who vifited Mifs Wortley. Condamine Rirkpatrick, and fucceeding writers, have fallen into the miftake of dating Sir John Shad well's fon as the fecond perfon inoculated by Mr. M.
Vol. IV. N others.
others, moft likely to be followed as an example i in the metropolis; yet this valuable art was Hill regarded with a fufpicious cautioDj and feveral months elapfed before a third trial of it was made ' in London.
Even foiir nionths after the inoculation of Mifs ' Wortley, this praftice vvas ftill viewed in fuch a j dubious light, that it was determined that feveral | culprits, then in Newgate, who had forfeited j their lives to the laws of their country, fhould, on j fubmitting to be inoculated, receive full pardon by th€ royal prerogative: a propofition which is faid by fome to have been fuggefted by the Col- lege of Phyficians to their Royal Highnefles the Prince and Princefs of Wales; but Sir Hans Sloane Hates 'it to have wholly originated with the Princefs of Wales. Mr. Maitland was accor- dingly requefted to perform the operation, which he declined; but left the opportunity fliould be loft, Sir Hans wrote to Dr. Terry, at Enfield, wha had praftifed phyfic in Turkey, to know his opinion concerning inoculation. The Do£tor re- plied, that he had feen the pradtice there among the Greeks encouraged by the patriarchs, and that not one \w eight hundred had died in confe- quence of the operation. Upon which inocula- , tion was performed upon the following fix crimi- i nals at Newgate, on- the ninth day o-f Auguft„ i 1721, in the prefence of feveral eminent phyfi- j cians and furgeons. • j
Mary [j
'i
■
Mary North ...... 36 years oU
Anti ToMPioN ..... 25
Elizabeth Harris oN . . 19 Joh'n'GAWTflERV . . 1 i 25 John Alcock 20 Richard Evans 19
All thefe'^jc, who w^re inoculated by rtiakirt^ incifions in both arms, and on the right leg, ob- tained a remiflion of the fentence of the law on very eafy terms j for in Alc^ock, oti whom' the:' operation produced the greateft crop of puftules^' the number did not exceed /".v/)'} and Evans^ having had the Small-poji the preceding year, of* courfe did not receive the difeafe a fecond time.
Thefe experiments, no doubt, tended much' tO' the encouragement of inoculation, whi^h in ft)' many infrances had now fully anfwered the- ut- mofti expectations of its patrons. The trials of it, however, -werC' yet confidered by the faculty as ftill )f^?~o//ie> to afcertain the general fafety and advantage' of the praftice* , • .
' Early in the fpring of the year 1722, inocufa^ 6on began to be adopted m various parts of England ; and by order of her Royal Highnefs the Princdfs of Wales, it was praftifed lirft upon j£v, and afterwards upon five, chanty children, be- longing to the parilh of Saint James's. The fuccefs with which thefe trials were attended, in- duced her Royal Highnefs to eaufe Princefs
N 2 Amelia
0
i8o
AMEtiA and Princefs Carolina to be inocu- lated on the 19th of April, 1722*; the former being then eleven and the latter nine years of age. They were inoculated by Serjeant Surgeon Amyand, under the dire£tion of Sir Hans Sloane: but before her Royal Highnefs determined upon the inoculation of the Prmcejfes^ flie confulted Sir Hans refpedting the propriety and fafety of the meafure. He " told her Royal Highnefs, that " by what appeared in the feveral eflays, it feem- " ed to be a method to fecure people from the " great dangers attending the Small-pox in the *' tmtttral way. That the preparations by diet, *' and necelTary precautions taken, made that " practice very defirable; but that not being cer- tain of the confeqiiences which might happen, *V he would not perfuade nor advife the making " trials upon patients of fuch importance to the " public." The Princefs then afked him if he would dijjiiade her from it: to which he anfwered, he would not in a matter Jo likely to be of fuck ad- vantage. Her reply was, that flie was then refolv- ed itflmUd be done; and ordered Sir Hans to go to the King (George the Firft) who had commanded the Doftor to wait on him upon the occafion, and it being agreed upon between his Majefty and Sir Hans, the two Princelfes were inoculated f ,
* See Hiftorical Regifter for the year 1722. t Phil. Traiif. vol. 49. p. 518.
Both
i8i
* . •
Both thefe younger branches of the Royal Family pafled through the Small-pox in a very favourable manner: and inoculation, in confe- quence of this illuftrious example, was now mak- ing a rapid progrefs, when the number of perfons inoculated in England amounted to 182, viz.
By Dr. Nettleton 61
Mr. Maitland, Surgeon 57
Claud. Amyand, Efq. Serjeant Surgeon . 17
Dr. Dover 4
Mr. Weymilh, Surgeon 3
The Rev. Mr. Johnfon 3
In or near London ... 145
Mr. Smith, Surgeon, and Mr. Dymer,
Apothecary, at Chichefter 13
Dr. Brady, at Portfmouth 4
Mr. Waller, Apothecary, at Gofport . . 3
A Woman, at Leicefter 8
Dr. Williams, at Haverfdrdweft 6
Two other perfons near the fame place . 2
Dr. French, at Briftol 1
In all ... 182
Out of this number (fays Dr. Jurin) the oppo- fers of inoculation affirm, that two perfons died of the inoculated Small-pox; the favourers of this
pra£lice
pra£tice maintain, that their death was occafion- ed by other caufes. If, to avoid difpute, thefe two be allowed to have djed of inoculation, we muft eftimate the haxar4 of dying of the inoculated ^mall-po;?:, a? f^r as can be colle£led from our own experience at prefent, to be that of two out of 182, or one out of 91, fmce which time by a proper preparation by medicine the favourable chances hfive been yet more increafed. In the natural vyay the chances are as otie to 6, which is a yi'onderfjjl.pdds in favour of inoculation.
* Vide Sea. XLIIL
SECT.
i83
SECT. XXXIX-
THE OPPOSITION INOCULATION MET WITH.
Previous to my farther inveftigation of the na- ture of this difeafe, it may be proper to take fome notice of the oppofttion which inoculation excited, and which was continued with much clamour throughout the year 1722. The objeQ:ioiis then urged againft inoculation, were both of a phyfical and moral nature, and gave rife to a controverfy, in which men of various profeflions engaged. But as many of the objc6liohSj alledged by medi- cal practitioners againft the practice of inocula^ tibn, were founded upon cafual and temporary circumftances, a recital of them now would be confidered as wholly ufelefs and uninterefting. Mr. Maitland, however, had to encounter fome accufations which it was not eafy to repel. Pie had afferted, and his enemies did not fail to remind him of it, that inoculation, as pra£tifed at Conftantinople, was a procefs which almoft uni- verfally produced the Small-pox in its mildeft form ; infomuch that not one per/on in many thou- fands died under it: and he had entertained no doubt of experiencing the like fuccefs in Eng- land. But after a few trials of inoculation made here, the refult proved different from his flatter- ing
i84
ing proniifes. Two pcrfons actually died in con- fequence of the operation, when not even 200 liad been inoculated. Mr. Maitland was there- fore reprefented by fome as felfijli and defigning, and by others as the ignorant and credulous dupe of the old women in Turkey. That inoculation did not conflantly fuccced in producing the diftincl or favourable kind of Small-pox, was at that time, and ftill continues to be, a melancholy truth. But the inoculators were at firfl: unwilling to- acknowledge it, and by attempting to attri- bute the death of perfons inoculated to other accidental cauJeSy expofed themfelves to a juft cenfure.
On the other hand, the writers againft inocula- tion purfued a condu6t ftill more reprehenfible. Inftead of waiting to afcertain fuch fa6ts as might have enabled them to form juft conclufions on the advantages and difadvantages of this new art, they immediately proceeded to employ falfe- hood and inve5iive-y reproaching the inoculators with the epithets poifoners and murderers.
I fliall firft notice a pamphlet publifhed about the middle of the year 1722, entitled. The new practice of inoculation conjidered, with an humble application to the approaching parliament for the pre- venting of that dangerous experiment. In this work, however, the anonymous author confines his hu- mility wholly to the title page. He reprefents the death of Lord Sunderland's fon, and an un- fortunate
i85
fortunate cafe of inoculation at Bofton, in the moft aggravated point of view ; and declares this new praflice to be founded in atheifm, quackery, and avarice, which, to ufe the author's words, " pujh men to all the helliJJi praSiices imaginable y " making men murder fathers, mothers, relations, and " innocent children, and any that Jland in the way " of their wicked defires'' — He adds, " While this hellifi principle has Jo much hold upon mankind, it is " highly necejfary that there flioidd be no covering of " fuch horrid things from the reach of the law, by " inoculating death in/lead of a difeafe, and making " ufe of an art never before praSiifed, in a manner not " forefeen, and by the laws not yet fufficiently guarded " againjir
The Rev. Mr. Massey, in a fermon, preach- ed at St. Andrew's, Holborn*, " Againfi the danger rous and ftnful practice of inoculation,^' treated the inoculators with the mod unqualified abufe, call- ing them helliJJi poifoners, enemies of mankind, and hoped they would be diftinguiflied from thofc of the faculty who deferve honour, and not be per- mitted to mingle with them as the devil among the fons of God.
But the intemperate zeal of the preacher does not ftop here J it not only hurries him into nume- rous and palpable inconfiftencies, but alfo to
* On Sunday, July 8th, 1722. His text was: — " So went • Satan forth from the prefence of the Lord, and fmote Job ' " with fore boils, from the fole of his foot unto his crown."
' C/iaji. xi. veiife 18.
grofs
i86
grofs mifreprefentations of faEts: for he roundly aflerts, that " the mijcar yiciges in this new method " (of inoculation) are more than have happened in the ordinary way.^'
But the moft redoubted champion who at this time appealed to the public againft inoculation, was Dr. Wagstaffe, a man of cxtenfive pro- feflional practice; and as a fellow of the College, and Phyfician to St. Bartholomew's Hofpital, he could not fail to influence the minds of many to a conliderable degree; more efpecially as his - Letter, Jhewin^ the danger and uncertainty of inoctt-
lating the Small-pox y' was addrelTed to the learn- ed Dr. Freind.
Of the other writings, which now appeared againft inoculation,. I truft it will be unnecelTary to take notice, as they contain little more than unfounded conje6iures on the practice, with fanciful conceits concerning its effeiis, and fupply the place of arguments with the utmojl obloqiiy and ahnfe of Mr. Maitland.
The numerous attacks upon this gentleman and the other inoculators, produced various replies, efpecially to Dr. Wagftaffe and the Rev. Mr. Maffey. The chief of them were by Dr. Crawford*, Dr. Brady f, Dr. Williams, Dr.
* The cafe of inoculating the Small-Jiox confJered, and its adr vantages averted, in a review of Dr. Wagmffe's Letter^ by J. Crawford, M. D.
f Some remarks ujion Dr. Wagstajfe's Letter and Mr. Maffefi Sermon againfl inoculation^ by Samuel Brady, M. D.
Slare,
.1.87
Slare*, and Mr. Maitland, or rather Dr. Arbuth- notf, who is faid to have written Maitland's Vindication; and the fubjeft was puflied forward fo warmly, that even rejoinders to thefe were publifhed before the terminatioft k)f the year 1722.
I fliall be readily excufed from following the iabove difputants, through the extraneous, and multiplied points of controverfy with which they indulged themfelves, and have no doubt but that, both as to the manner and matter of their argu- ments, a fmgle example will be deemed fufficient- Dr. Wagftaffe having afferted, " It never came ■ " into men's heads to take the work out of na- ' ^' ture's hands, and raife diftempers by art in the human body." Received the following reply : in Maitland's Vindication, " That the pra£tice of ' " phyfic is founded upon the principle of curing natural by railing artificial difeafes. What is bleeding, but an artificial hamorrhagyf Purging, but raifing an artificial diarrhaaf Are not blij- '^^ ters, ijfuesy and Jeatons, artificial impofihumations f^* <On this Mr. Ifaac Maffey, apothecary, calls out, '^^ Very good, fir; but go on: — What is corre£liou " " at the cart's tail, but the noble art of muscular phle-
* Some remarks on Dr. Wagstaffe's Letter, by Perrott Wil- liams, M. D. With an ajijiendix in favour of inocitlc^tion, by F. S51are, M. D.
f Mr. Maitland's account of inoculating the Small-Jiox vinJi- 'Xatedfrom Dr. Wagstaffe's mifrejtrefentations of that pa^ice, with (ifome remarks on Mr. Maffey' s fermon.
y . boiomyB
i88
'■^ botomyf — What is burning in the hand, but the " art of applying a caujlic? — What is hanging, but an " artificial quinjyy which makes the patient feel for the *' ground y and chokes him P — What is breaking on the " wheely but the art of making difiocations and frac- " tureSy and differs from the wounds and amputations ^ offurgeons only by the manner and intentions* f'"
X A Jhort and Jilain account of inoculation, ivith fome remarks^ ^c.—Ji. 19.
SECT.
i89
SECT. XL.
THE SUCCESSFUL ESTABLISHMENT OF INOCU- LATION IN ENGLAND.
Although the advantages of inoculation were great, in the firft place, as it gave every profpeft of recovery in this otherwife often fatal difeafe, and fecondly, fecurity in future, which removed the terror of apprehenfion, which, like a fword hung over the head, was fure often to pre- fcnt itfclf to the feared imagination, yet was its firft introduction from the oppofition it expe- rienced extremely flow.
During the year 1723, the practice, however, of Inoculation made a confiderable progrefs in England. It was adopted not only among the nobility of the firft rank, but (which ftill more tended to its promotion) it received encourage- ment from the heads of the church, having been introduced into the family of the Bifliop of Win-^ cheftcr, and alfo into that of that learned divine Dr. Calamy. Whence the. number of the inocu- lated that year^ far exceeded the numbers in the two preceding years taken together. It amount- ed to 292, which being added to 182, makes the; whole number of the inoculations in the years 1721, 1722, and 1723, to be 474, viz,
Jhr
igo
The Refults of tJiefe Cafes are reprefented in the an- nexed Table, taken from Dr. Jurin.
AGES. |
PcrTons itioculat- td. |
Had the bmaU- pox b)- inucula' tion. |
Had an imverfcci fort. |
Had no effect. |
Supixjfed to tlAVC (lied of inucula- tioa. |
u 1 rA ^ ■ 1 A/ 1* unaci vjne icai - - |
1 1 |
1 i |
V |
0 |
0 |
• V/IH-- LKJ X V\ w ~ |
1 J |
1 |
■6 |
||
T*wn tci Thrpp — . JL «V 1^ 4.V X ••''^•1 — • • |
O I |
V |
o \J |
1 * |
|
Three to Four |
41 |
38 |
0 |
3 |
1 |
Four to Five |
33 |
31 |
0 |
2 |
1 |
Five to Ten - - - - |
140 |
13T |
1 |
2 |
3 |
Ten to Fifteen |
82 |
76 |
0 |
6 |
0 |
Fifteen to Twenty - |
56 |
50 |
1 |
5 |
2 |
, Twenty to Fifty-two |
62 |
50 |
3 |
- 9 |
0 |
Age unknown |
3 |
2 |
0 |
1 |
0 |
Total |
474 |
440 |
5 |
29 |
9 |
Hence we find, that of the 474 perfons fii-ft inoculated in England, Kw^died, and their deaths were juftly fufpetted to have happened in confe- quence of inoculation.
Thus inoculation triumphed, under the aufpices iof roya/ patronage; and Dr. WagftaflFe, after his invidious remark, " that pojierify ivill fcarcely be " brought to believe, that an experiment, praEiifed only *' by a few ignorant zvomen, JJiould fo far obtain in one
" of
of the politejl mtions in the world, as to he received " buo the Royal palace^' had the raortlfication to find it introduced a fecond^ time, into the Royal family. For their Royal . Highiieffes Prince Frederick and Prince William were both inoculated this year. The former^, who refided at Hanover, and was then eighteen yeai's of age, fubmitted to be inoculated by Mr. Maitland on the firft of May, 1724, and the event was ex- tremely favourable ; his Royal Highnefs not hav- ing more than from eleven to eighteen piiftules. The latter, was about the fame time inoculated here by Serjeant Surgeon Amy and, under the dire£tion of Sir Hans Sloane, who likewife paffed through the Small-pox without any alarming or even troublefome fymptom.
But what tended ftill more efFe£lually to eftab- lifh general inoculation, was the fubfequent de- claration of the College of Phyficians, viz. " The
" COLLEGE HAVING BEEN INFORMED, THAT FALSE REPORTS CONCERNING THE SUCCESS " OF INOCULATION IN ENGLAND, HAVE BEEN " PUBLISHED IN FOREIGN COUNTRIES, THINK " PROPER TO DECLARE THEIR SENTIMENTS IN " THE FOLLOWING MANNER; viz. THAT THE " ARGUMENTS WHICH AT THE COMMENCE- " MENT OF THIS PRACTICE WERE URGED " AGAINST IT, HAD BEEN REFUTED BY EX~ " PERIENCE; that IT IS NOW HELD BY THE
Ir
ENGLISH IN GREATER ESTEEM, AND PRAG--
" TISED
192
i
" TISED AMONG THEM MORE EXTENSIVELY
*' THAN EVER IT WAS BEFORE ; AND THAT THE
" COLLEGE THINKS IT TO BE HIGHLY 5ALU-
" TARY TO THE HUMAN RACE*.'*
• The words are as follow; — " Qiioniam coUegio nuntiatiim fuit, falfos de variolarum infititiarum in Anglia fiiccefTii et exif- timatione apud exteras gentcs nuper exiiHe nirnores, eidem col- legio fententiam fuam de rebus hifte ad hunc modum declarare placuit: videlicet, argiimenta, quai contra banc variolas infe- rendi confuetiidinem in principio afFerebantur, experientiam refellifTe; eamque hoc tempore majori in honore apud Anglos haberi, magifque quam unquam antea inter eos nunc invalef- cere; atque humano gencri valde falutareni eJe fc cxiftimare. fide Taylor Orat. Harv. Jiage 29
SECT.
193
SECT. XLL
OF THE DISTINCT AND CONFLUENT SMALL-POX.
The moft cafual obfervers have noticed the diJlhiEi and confluent fmall-pox, and this is fome- times exhibited under the titles of the -purple, and the black.
With thofe who labour under the Small-pox, at firft reddifli puftules, as fmall as a pin's head, appear fcattered over the face and body. Thefe form into puftules, often of the diftinEl kind, which are painful, and heighten by degrees, rendering the fpaces between the eruptions of a light red colour, refembling that of damalk rofes ; and the milder the fmall-pox, the nearer do the intermediate fpaces approach this colour.
In the confluent or malignant Small-pox, there is a greater degree of fever, and the puftules are fmaller, and run into one another. Inftead of filling up on the feventh day from their firft appearance, maturating and looking yellow, and then fcaling, they have frequently, even at firft, a purplifli appearance, and finally become Ihidy and laftly black. Frequently purple fpots appear in the fpaces furrounding the erup- tion, and often fmall black fpots, fcarce fo large
Vol. IV. O as
194
as fmall pins heads, and deprcffed in the middle, are difcovered on the top of the puftules in dif- ferent places. The face foon refembles one en- tire encruftation, brown at firft, afterwards of a frightful black. Sometimes bladders arife, filled with a limpid ferum, which burft when the flefli underneath appears black, and as if gangrened*. The change from red to purple, and black, in this difeafe, is extremely obvious ; and, before the fatal cataftrophe, the tortured being appears more like a negro than a white j all which feems to de- note a deftru£lion, or lofs, of the oxygenous PRINCIPLE in the blood.
* I was fent for, in the beginning of January, 1670, by Mr. Collins, a brewer, in St. Giles's parifh, to his fon, an in- fant, who had bladders on his thighs as large as a walnut, and full of tranfparent ferum, which afterwards burfting, the flefli •underneath appeared as it were quite mortified, and he died foon after; as did all thofe I had feen attacked with tlik dreadful fymptom. — Sydenham..
PRACTICAL
195
PRACTICAL OBSERVATIONS'.
SECT. XLII.
THE TREATMENT OF THE NATURAL SMALL-POX,-
The prevailing theory, refpe6ling this difeafc;! was, that the blood, by the matter of the fmall-pox, .Was put into a ferment, and therefore to promote conco6lion the external heat muft be augmented, in order that the fkum, or filth, might be thrown off upon the furface. How many thoufands be-* fore, and fmce the days of Sydenham, have pe- riflied through this erroneous conception ! This immortal phyfician firft laid the foundation for abolifliing this grand error i for his, as well as modern experience, fhews, that the eruption greatly depends upon the quantity of combuftible ; matter in the blood, or in other words, feven It is during the eruptive fever that the quantity of the fmall-pox matter is determined, as well as its kind ; for this is invariably found to bear an exaft proportion to the preceding fever ; and
O 2. hence
hence it is that the diminution of this fever will di- | minifli the quantity, and obviate the danger, of the variolous eruption. Hear the illuftrious Sydenham on the prefcnt occafion. " What reafon feemed, fays he, to intimate formerly, appeared mani- feft to me this year, (1681), namely, that it was improper to confine the patient conjlantly in bed before the eruption of the puftules; for the fpring and fummer having been the drieft feafons that any perfon living could remember to have happened, fo that the grafs was burnt up in moft places, the blood was by this means de- prived of the greater part of the humidity, which the air otherwife ufually communicated thereta ; whence the then reigning fmall-pox was accom,- panied with a more confiderable inflammation than ordinary, and the other fymptoms thence ] arifing were more violent *. And this, I conceive, , was the caufe thofe purple fpois frequently pre- i ceded the total eruption of the puftules, and that i the violent inflammation which expelled them, , by^diflblving the texture of the blood, fuddenly ' defl:royed the patient, even on an early day of I the difeafe. And the difeafe proved fo much, the more dcftrucfive, becaufe the eruptions fo
* As the fpring and fummer were remarkably dry feafons, it is probable they were likewife very hot ; and then the im- ufual violence of the fniall-pox-, and its fymptoms, may be eafily acCQUnted for.
readily
^97
r-cadlly ran together, for the reafon above inti- mated ; the intempcrature of the air, now, doing the fame mifchief fpontaneoufly, which ignorant practitioners ordinarily occafion, by ufing a hot re- gimen and cardiacs, at the beginning of the diftemper. For it is a remark well worth noting, and the refult of the moft careful obfervation, that the fmall-pox is the leaft dangerous w^hen the eruptions are few, and mod fo, when they are numerous ; and accordingly as they do, or do not abound, the patient lives, or dies.
" I conceive it eafy to account for the patient's being more or lefs endangered, in proportion to the paucity or number of the eruptions ; for as every puftule is at firft a phlegmon, or boil, though of a very fmall fize, and foon impoflumates, fo the fecondary fever, which depends on the matter hereafter to be produced, muft needs be more or lefs violent at the height of the difeafe, ac-r cording to the quantity of matter to be fappu- rated, which is ufually completed in the rnildeft fpecies of the confluent fmall-pox on the eleventh day, in the middle fort on the fourteenth, and the worft on the feventeenth day,
" Hence, therefore, if the patient be not otherr- wife endangered than from the abundance of eruptions, I confider well whence this proceeds, and if it can be done with fafety, ufe all my en- deavours to reprefs them, which in reality is the principal thing to be effefted, and the way to
relieve
198
relieve the patient ; every thing being doubtful and dangerous v^hen this fpecies of the difeafe is confirmed. Now fuch an extraordinary eruption of puftules, in ray opinion, proceeds from the too pov^^erful an affimilatiori of the variolous jnatter ; which feems chiefly to arife either from the over- hot and fpiritiious conjlitution of the patient, or from his having raifed the fermentation too high, by a too early confinement in bed, the ufe of hot cardiacs, or any fpirituous liquor ; by which means the blood is difpofed to receive the imr prefllons of the difeafe more intimately, and na- ture, being greatly difturbed by the vaft quan- tity of the variolous matter, changes almoft all the folids and fluids into puftules *.
" The immoderate aflTnnilation of the variolous matter, however, cannot be more effeftually pror moted, than by the patient's confining himfelf
* Mr. Sutton, in the vicinity of Plymouth, inoculating a lady, who on the third day after the commencement of the fever, had five or fix red pimples, which formed gradually into puftules. During the progrefs of the difeafe, as flie fat at table, flie exprefied uneafinefs, and wifhed to have ftronger evidence, than yet appeared, that ftie had the Small-pox. Mr. Sutton told her, that ftie had only to eat a portion of hare, which was on the table, and drink one gtafs of "loincy and flie would have fufficient evidence to fatisfy her mind. She accepted the propofal ; the fever increafed ; and the Small-pox, from being difcrete, became confluent. Sutton then took fright, and delivered her to the care of Drs. Mudge and Huxham, by whofe watchful attention fhe was carried fafely through the fecpndary fever.
in
199
in bed unfeafonably, namely, before the fixth day from the begmning of the illnefs, or the fourth inclufive from the eruption j when all the puftules are come out, and no more are expedled. And though the moderate warmth of the bed, even after this time, does in fome meafure contribute to the rife of the delirium, watching the other fymptoms, yet thefe are of fuch a nature, that they readily yield to proper remedies j whilft the imminent danger of death that happened on the eleventh day, from the great abundance of the puftules, cannot be prevented, or removed by medicine.
" The patient therefore is here to be diligently admoniihed, by no means to keep his bed in the day-time, at the onfet of the difeafe, whereby the eruptions will be fewer, and he will be; greatly refrefhed. But after this time, if the puftules be very numerous, he will fcarce be able to leave his bed at all, on account of the pain thence arifing, and a greater difpofition to fainting upon fitting up j fo that having frequently remarked this, it came into my niind that na- ture, in the common courfe of the difeafe, firft pointed out the time when a confinement in bed becomes neceifary.
" But in order to confirm this practical rule, which is fo highly ferviceable in leffening the impending danger from the Small-pox, and in
treating
200
treating of it, at the fame time, to deliver our hiflory thereof from the beginning to the end, it will be proper to draw up a kind of plan of the whole difeafe, and make a ftrict fearch into the nature and progrefs thereof ; fo that we may at length be enabled to afcertain the matter clearly, from the unerring reafon of thofe who make ufe of the jujlejl obfervations, and not from opinion founded on the Jlippery bafis of fancy.
" It the firlt place, therefore, its elfence, fo far as we can trace the efTences of things, feems to confift in a peculiar inflammation of, or a£tion on the blood ; in the courfe of which nature is employed for fome days, in the beginning, in preparing and moulding the inflamed particles, for their readier expulfion to the external parts ; at which time the blood being difturbed, a fever mufl: needs be occafioned ; for, the agitated par- ticles, hurrying in a tumultuary manner through the veflTels, neceifarily caufe a ficknefs at fto- mach, fliarp pains in the head, and all the other fymptoms preceding the expulfion, according as they are carried to this or that particular part. But when the eruption is over, the fleJJiy parts become the feat of the difeafe ; and, as nature has no other method of expelling the peccant matter from the blood, but by raifing a fever, fo, likewife, it does not free the fiefliy parts from ?iny extraneous body, but by impoftumation.
Thus
201
Thus if by accident a thorn, or the like fljarp- : pointed body be lodged in the flefli, unlefs it be
immediately extrafted, the parts around foon 1 impoftumate. Hence it is, that when thefe par- i tides are lodged in the flefli, they at firft occa- ; (ion very fmall phlegmons, wherein they lie con- icealed; which encreafing every hour, and be- I coming more inflamed, at length come to fuppu- r ration ; when a part of the matter muft needs be .licked up by the blood which returns by the > veins, and if too large a quantity thereof be re- iceived into the mafs, it is not only productive of I a fever, which the debihtated patient is unable tto bear, but alfo taints the whole mafs.
" But if only a fmall quantity of the pum- llent matter be received into the blood, the vio- llence of the fecondary fever is eafily checked by tthe encreafing ftrength of nature, and the puf- ttules drying avi^ay gradually, the patient foon re- tcovers.
" Now allowing this to be the genuine and jjuft hiftory of this difeafe, it is manifefl:, that tthe failure or fuccefs, on either hand, depends lupon laying a good or bad foundation for the (cure in the beginning : for if thefe hot and fpi- rrituous particles be quickend by hot medicines, jand efpecially by a confl:ant confinement in bed, t the affimilating virtue, which they already pof- ifefs in too great a degree, will neceflTarily be I heightened
202
heightened and encreafed. And, befides, the blood and other juices being hereby heated, yield more readily to the ftronger impreflion of the particles, whence more eruptions appear than fliould, and life is, in confequence, unne- ceffarily endangered. Whereas the contrary, viz. the moderate cooling regimen and the FREE USE OF THE AIR, abate the force of the hot tumultuary particles, whence they are better enabled to refift the morbific particles, and fup- port their violence ; and hence no greater quan- tity of variolous matter is prepared, than is pro- per to mark this difeafe.
" But the only inconvenience arifmg from a too early- confinement in bed, is not from the affimi- lation of too large a quantity of the morbific matter, and the immoderate exaltation of the ferment of the difeafe ; for the fame caufe fre- quently PRODUCES kloody urine and purple fpots, with hamorrhage^ efpecially in fummer, and in perfons in the vigour of Hfe. I conceive that both thefe fymptonis proceed from the heat and commotion raifed in the blood, by hot and fpi- rituous particles ; by which it is agitated and confiderably attenuated, fo that it burfts the vef- fels, caufing bloody urine when it forces its way through the kidnies, and purple fpots, when it is ftrained through the extremities of the arte- ries, terminating in the mufcles and fkin, which
refemble
203
refemble fo many mortifications In thofe parts' wherein the extravafed blood is coagulated. ' And though all thefe fymptoms might eafily have been prevented in the beginning, hy ^ cool- ing regimen and diet ; yet when they a6iually ap- pear, whoever attempts to cure them, by cori-" fining the patient in bed, and exhibiting car- diacs, will find himfelf as much in the wrong ;as an old woman would be, who, to niake her- pot boil more gently, fliould make a larger fire jmderneath.
" But to acknowledge the truth upon this .occafion, how little foever it may be liked by the dogmatical, and fuch as are unacquainted with this matter, and therefore incompetent judges, it is not only unfafe to keep the patient' always in bed the firft days of the illnefs, bu^ fometimes neceflary to expofe him to the OPEN AIR ; viz. if it be the fummer feafon, and he not pall the prime of life, or that he has been accuftomed to fpirituous liquors, and efpecially if the difeafe be owing to hard drinking. Now in thefe cafes I conceive, that the too hafty eruption of the puftules cannot be fufficiently' checked by refraining from bed, and taking no cardiacs ; for the blood, unaffifted by thefe, is fo overftocked with hot fpirits, of a like kind with the difeafe, that a kind of violent explofion thereof muft necelTarily happen ; and moreover, fuch a plenitude of humours will refolve into
puftules,
204
puftules, that the patient being quite op- preffed by the copious matter returning into the blood, muft inevitably perifli at the clofe of the difeafe.
" Nor have I hitherto found that bleeding, though it be ufed early, does fo effectually check the over-hafty affim'ilation of the variolous matter, as cooling the blood*, by the air received in by breathing, efpecially if the patient be put to bed immediately after the operation, and injured by hot cardiacs ; the blood being by this means more difpofed to receive the impreflions of the adventitious heat, than it was before bleeding. And I pofitively affirm, that one of the worft cafes I ever met with in the confluent Small- pox, in which the patient died on the eleventh day, happened in a young woman foon after her recovery from a rheumatifm, by the ufual method of copious and repeated bleeding. And from this inftance I firft learned, that bleeding did not contribute fo much to keep the Small-pox within its due limits, as I heretofore imagined ; though I have frequently obferved that repeated purging^ whilft the blood remains uninfeded, generally renders the fubfequent Small-pox of a mild and diftinft kind.
" I am well aware that feveral obje£tions may
* This was the error of Harvey and of the times. The office of the air is now better known, as imparting oxygen to the blood.
be
205
be made to this opinion of ours, of permitting the patient to fit up in the day time ; which may have great weight with the common people, and fuch as are Httle ikilled in this difeafe, to whom the lower rank of phylicians generally appeal as proper judges in the cafe, that they may fupport their ill-grounded reafonings by their authority : fuch reafonings being in reality better adapted to their capacities, than thofe that are the refult of deli- berate confideration in men of deeper penetra- tion. Hence it follow that as the bulk of mankind can only arrive at a fuperficial knowledge of things^ and hit few have ability to go to the bottom, fo thefe pretenders to learning eafily acquire a fitperiority over the more intelligent, who are often expofed to calumny , but without being dijcouraged thereby, becaufe they have truth, and the men of found judgment on their fide.
" However I am not fo attached to my own opinion, as to think, that what I have here deli- vered fliould be credited upon the authority of my flender judgment. And in reality, I have ever fo flightly efteemed the fentiments of the generality of mankind, that I may always rea- fonably fufpett my own, when they clafli with thofe of others ; and I fliould alfo be upon my guard in this cafe, if my reafonings were not unanimoufly fupported by praEiical obfervatiom. For fetting afide thefe, what appears reafonable merly prevailed, no one would have fought after
fuch
206
to me or any other perfon, may, perhaps, be' tiothmg more than the fhadow of reafon, that is barely opinion. And the more I converfe with
. men, the more I am convinced how dangerous it \
is for perfons of the acuteft underftanding, to i
make a ftri6t fearch into any art or fcience, un- ]
leh matter of faSi be conftituted the judge and !
teft. of truth and faUity. For, to ufe Cicero's ]
. phrafe, thofe who are fo ftrongly prepoffeffed of '
their abilities, deviate widely from truth, in mere j
Jpeciilative matters ; whereas thofe who apply their \
minds only to fuch things as may be certainly j
•determined by pr^2;3/V^, though they fhould hap- '
. pen to miftake, would foon be fet right, by j
bringing their ideas to this touchftone. For in- i fiance in the prefent cafe, cannot I certify my-
felf by obfervatioHy what method is moft produc- j
tive of a favourable or fevere kind of Small-pox $ |
and form a judgment thereof, fui table to the \
clearnefs of i\\Q fa6i P And if others would follow ' this way of reafoning, I fhould be fatisfied with
. their, conduft } but it is moft unjuft to accufe j
me of advancing falfities, without having once |
experienced, whether the method, fo often men- "i
tioned above, of keeping the patient up in the !
day time, at the beginning of the illnefs, be ad- J
vantageous or detrimental. Sure if this humour ,
. of defaming thofe who difcovered truths, though !
contrary to generally received opinions, had for- \
merly
207
fuch things, as when found, might be ufeful to mankind. But why {hould I give myfelf fo much trouble, if a long courfe of experience did not manifefl: this method to be much /7/"^r than thfe common one : for I am not fo fenfelefs as to en- deavour to acquire reputation, by exploding the
||; opinions of thofe whom I ought to flatter, if I fought after applaufe. Neither is it to be fup- pofed that I am fo abandoned, as to ufe my au-
li thority to compafs the deftruftion of late pofte- rity after my deceafe, that though I might mur- der my fellow creatures when I am dead, as well as during my life j which I tremble even to mention.
However it be, I have followed this method
I in my own children, my neareft relations, and •all thofe I have attended ; and am confcious of no error, unlefs in yielding fometimes to perfons ,of a contrary opinion, to avoid the imputation of morofenefs and obftinacy ; and for the truth of this, I appeal to my intimate acquaintance. " When the cafe is thus circumftanced, the phy- fician, confulting his duty rather than a precari- ous reputation, ought with authority to order the patient to be refrejlied with the open air ; and to ob- tain the endhere, it has frequently feemed fufficient to me, for the patient to rife, and fit up awhile, even in a delirium, the window being opened, by which expedient I have faved feveral from death.
And
208
And befidcs thofe I have feen, there are number lefs inftances of Jjerfons who by this means have been fnatched from imminent danger. For fome delirious perfons deceiving their nurfcs, and getting out of bed, have remained expofed to the cold air, even in the night-time, with advan- tage ; and others again, either fecretly, unawares, or by entreaty, have procured cold water to drink, and thus, by a happy miftake, faved their lives, when defpaired of.
" I fliall here fet down the hiftory of a cafe, which I had from the perfon concerned. He told me, that when he was a young man, he went to Briftol, and was there feized with the Small- pox about Midfummer, followed foon after by a delirium. His nurfe, going into the city, left him in the mean while to the care of fome other perfons, intending to be back foon ; but making a pretty long flay, the patient in the interim died, as the attendants thought ; who confidering the heat of the feafon, and his corpulency, that the body might not fmell, took it out of bed, and laid it naked on a table, throwing a fheet over it. The nurfe at length returned, and hearing the ill news, entered the room to behold the fad fpe£lacle, and immediately throwing by \h^. flieet, and looking on his face, flie imagined flie faw fome fmall iigns of life, and therefore put him to bed again direQly, and ufmg fome means
or
209
or other, flie brought him to Ijirafelf, and he re- covered ,in, a few days *.
. " I own, indeed, that the Small-pox, in what manner foever it be treated, will Ibmetimes prove highly confluent j whence this difeafe is never void of danger, though the befl: method gnd medicines ]be ufed to prevent it.
" And therefore I fcruple not to afiert, that the reputation of the phyfician, who is frequently employed in it, is much expofed to cenfure ; for not only the vulgar are apt to attribute the caufe of the patient's death to the over-officioufnefs of the phyfician, but even the profeflbrs of the fame art fometimes take occafion from thence to de- fame their brother, and haranguing before partial judges, eafily obtain the fevere fentence againft him, with this view, that they may pro- cure greater efteem for themfelves, and build their rife upan the ruin of others j which is a praftice utterly unbecoming men of letters, and even the meaneft artizans, provided they have a regard for probity.
" But this I affirm, which is fufficient for my purpofe, that it is manifell, from frequent expe-
* I have good ihformation, fays the learned Dr. Monro, Profeflbr at Edinburgh, of i la being Inoculated in the middJe of winter, in fome of our moft northern ifles, where there was fcarce fuel enough to prepare viftuals, and many of the inoculated went abroad bare-footed in fnow and ice ; yet not one of the whole number died. , :T' 'c v '.' :
Vol. IV. P rience.
210
l icnce, that he that refrains from bed in the day time, at the beginning of the difeafe, abflains entirely from fiejli, and drinks only fmall liquors, is abundantly fafer than he that confines himjelf immediately in bed, and takes hot cardiacs. For this method, as above- mentioned, generally occafions only few eruptionSy and confequently checks the exceflive effer- vefcencc of the fecoiidary fever. Moreover, this method is preventive of the purple fpots, and bloody urine both which fymptoms feize at the begin- ing of the difeafe, and often before any fign of the eruption appears, which ordinarily happens alfo in the meajles, fcarlet fever, and other acute difeafes proceeding from a violent inflammation. Not to mention the fingular refrefliment the pa- tient finds from the admiffion of frejh air, every time he is taken out of his warm bed ; which, all thofe that I was fuffered to treat in this man- ner openly declared, and were very thankful for J having, as it were, received nezv life and" fpirits from breathing a freer air.
*' I muft proceed next to obferve, that though the patient may fometimes refrain from bed in the day time, yet in cafe of extreme ficknefs, a high fever, enormous vomiting, a vertigo, rheu- matic pains of the limbs, and the like diforders ; he cannot be indulged this refrefliment, thefc fymptoms indicating the contrary ; which, if they be violent, efpecially in the young and fan- §;uine, foreOiew that a large quantity of the va- riolous
211
riolous matter is generated in the body, and threaten great danger from the tumultuary eruption of the puftules, which will prove very confluent. In this cafe, therefore, as all endea- vours muft be ufcd to check the immoderate fer- ment, which notwithllanding, on the one hand, will rage more by the continual warmth of the bed, and yet, on the other hand, the patient cannot keep up, by reafon of extreme ficknefs, unlefs we relieve him ; it is indifpenfably necef- fary to give a vomit of the infufion of i:rocus me- tallorum *, which not only expels the matter oc- cafioning this unufual ficknefs, but refreflies the patient fo confiderably, that being now in a man- ner wellj he is able to refrain from bed. Neither are we to endeavour to weaken the force of the ferment by this method only, but in order to put the patient further out of danger, befides the evacuations juft mentioned, it is proper to give him a large dofe of Jpirit of vitriol (vitriolic acid,) in every draught of fmall beer, till the eruption be over. And notwithllanding thefe evacuations, and the ufe of the cooling drink, the patient jnuft refrain from bed in the day time, if he can bear to fit up ; becaufe thefe general remedies do not check the aflimilation of the variolous matter, near fo much as once cooling the blood by drawing in the freJJi air, and breathing it out by the lungs ; M'hich alone immediately abates
* Semi-v.itrious fiilphurated oxyd of antimony,
P 2 the
212
the fymptomatic ficknefs above-mentioned, as I have fometimes experienced. But this unufual method is not neceffary, unlefs in fuch as are in the prime of life, vvhofe blood has been over- heated by food, or wine, and in others (alv^'ays excepting young children,) who, together with the Small-pox, flruggle with the above-mentioned violent fymptoms. For where the blood is lefs inflamed, and the fymptoms milder, as there is much lefs danger of aflimilating the variolous mat- ter too haftily, fo of courfe, neither the above- mentioned evacuations, nor the fpirit of vitriol^ need be ufed.
" This fpirii, as if it were truly a jpecific in this difeafe, furprizingly abated all the fymptoms ; the face fwells earlier, and in a greater degree, the fpaces between the eruptions approaches more to a bright red colour, like that of a da- mafk rofe ; the fmalleft puftules alfo became as large as this fpecies would allow, arid thofe, which had otherwife been blacky difcharged . a yellow matter, refembling a honey-conib ; the face, inftead of being blacky appeared everywhere of a deep yellow ; laftly, the eruptions came fooner to fuppuration, and ran through all their ftages a day or two fooner than ufual. In this manner did the difeafe proceed, provided the pa» tient drank freely of the liquor above com- mended ; fo that, when I found there was not enough of it drank to take oif the fymptoms, I
exhibited
213
exhibited fome drops of the fpirit of vitriol be- tween whiles, in ,a fpoonful of fome fyrup, or a mixture of -fcime diftilled water and fyrup, in order to make amen'ds for the fparing ufe of the above-mentioned liquor, where this acid was more largely diluted.
" I have enumerated the many advantages of this' medicine,' and indeed I have not hitherto found the lead inconvenience attending the ufe thereof : for though it moftly flopped the faliva- tipn on the tenth or eleventh day, yet fome ftools ufually fuoceeded at this time inftead of if, which were lefs dangerous than that ftoppage 5 for, as we have often mentioned, fuch as have the con- fluent Small-pox are principally endangered on thefe days, becaufe the faliva, being rendered more vifcid, does then threaten fuffqcation. Now, in the prefent cafe, this fyraptom is relieved by the loofenefs, which yet' either goes off fpontane- oufly, or is eafily cured by the milk and water, and an opiate, when the danger from the Small- pox is over.
" On the 26th of July, i675, Mr. Elliot, one of the grooms of the bed-chamber to the king, committed to my care one of his fervants, who had this dreadful fpecies, the black Small-pox. He was about eighteen years of age, of a very fanguine conftitution, and was attacked with this diftemper foon after hard drinking. The puftules were of the confluent kind, and xm, to-
<?ether
214
gether more than any I had hitherto feen, fo that fcarce any intermediate fpace was left be^ tween them. Relying upon the virtue of this i efficacious medicine, I omitted bleedings though I j was called in foon enough to have done it, and ! ought indeed to have performed it, as the difeafe ^ was occafioned by drinking wine too plentifully. , When the eruption was over, viz. on the fifth or fix th day, I ordered spirit of vitriol to \ be dropped into fome bottles that were filled j with fmall beer, and allowed this liquor to be • flrank at pleafure for common drink. On the ' eighth day he bled fo much at the nofe, that j the nurfe, terrified by this fymptom, fent in great i hafte for me. Accordingly I went, and perceiv- ; ing that the hasmorrage arofe from the immode- i rate heat, and extraordinary commotion of the blood, I ordered him to drink more freely of the \ acidulated fmall beer, whereby the flux of blood was foon flopped. The falivation being plen^ ! tiful enough, and the fwelling of the face and j hands, and the filling of the puftules, proceeding in -a proper manner, the difeafe went on very i well, except that in the decline it was attended j with fome blood, and mucous ftools, which ' might poffibly have been prevented by bleeding | in the beginning. Neverthelefs, I ufed no other ! medicine in this dyfentery, fince this fymptom required nothing further than the opiate, which I jQiould h^ve ordered to be taken every evening, '
if '
215
if this diforder had not happened; and by thus means it was checked, till the eruptions went off; and the patient foon recovered.
" About the fame time Mr. Clinch, a neigh- bouring gentleman, committed two of his chil- dren to my. care ; the one was four years of age, and the other fucked, and was not fix months old ; the eruptions were very fmall and confluent in both, and of the black kind, and came out like an eryfipelas. I directed fpirit of vitriol to be dropped into all their drink, which, notwith- ftanding their age, they drank without averfion ; and not being affecled with any more violent fymptom, they foon recovered. My intimate friend. Dr. Mapletoft, accompanying me to vifit them, found the eldeft recovering, and the youngeft then lying ill in the..cradle.
" I will fubjoin a late cafe, as a fpeeimei:i of this whole procedure. I was fent for this winter by lady Dacres, to attend her nephew, Mr. Thomas Chute, a perfon of a very fanguine conftitution, and in the prime of life. The day before I came he was feized with a high fever, vomited aconfiderable quantity of bilious matter, and had a violent pain in his back. In order to miti- gate thefe fymptoms, he went to bed, and by heaping on clothes, and taking hot liquors, fpent a day to no purpofe, in endeavouring to fcce fweat, the great tendency to vomiting, and the purging, though moderate, rendering the fudo-
rijics
2l6
rifics inefFetlual, and in the mean time incrcaf- ing the fever. I fufpe£led the Small-pox would fliortly appear, and likvvife prove very confluent, both on account of his youth, and the great inflammation raifed in his blood by the fruitlefs at- tempt to procure fweat, which, if the difeafe had happened in the fummer, would certainly have Gccafioned bloody urine and purp/e /pots ; but chiefly, becaufe I have always obferved, that in young perfons, attacked with exceifive vomiting, ficknefs, and extraordinary pain, the fucceeding Small-pox proved highly confluent. For this reafon, judging it requifite to ufe all endeavours tp prevent the too-hafl^y aflimilation of the vario- lous matter, I kept him up till his ufual time of going to bed ; and the next day in the morn- ing, which was the third, the Small-pox not appearing, I directed eight ounces of blood to be taken away from the right arm. The blood was good and florid, and having as yet only re- ceived the fpiritupus miafm, and not that pu- trefaftion oecafioned by a longer continuance of the difeafe, and generally obfervable in the blood of perfons lately recovered from this difeafe. The fame dav, at five in the afternoon, I ex- hibited an ounce of the infufion of crocus me- iallorum; which operated well, carrying off" his ficknefs, fo that he feemed niuch better and willingly refrained from bed, which he did not care to quit before by reafon of hi^ great ficknefs
and
and giddinefs. On the fourth day in the morn- ing, I found the eruptions coming out fo co- pioufly, notwithflanding the endeavours I had ufed to prevent it, that they threatened the ut- moft danger, I was, therefore, very cautious' to keep him up in the day time, and advifed the drinking of fmall-beer acidulated with fpirk of vitriol. He continued the ufe of thefe things to the fixth day, when, though he was not fick, but much refreflied by the f re/It air, yet his belly was foluble between whiles j towards night he was obliged to go to bed, which is common in this cafe, and therefore, he continued therein, by my confent, during the whole courfe of the difeafe ; the eruption being now over. Though the puftules were fewer than I have obferved hi fome that have died of this difeafe, yet. they were more numerous thai:^ they generally are in moft that recover.
" And now I have given the reader," fays Syden- ham, " my f///^obfervations relating to the Small- pox ; and though they may perhaps in this cen- forious 'age, hp efteemed of little moment, yet I have with great pains and care fpent many years in. examining them j nor had I now publiflied them, if a defign of benefiting mankind had not in- duced me to it, even at the expence of my reputa- tion, which I am fenfible will fuffer on account of the novelty of the method."
SECT.
2l8
SECT. XLIII,
OF THE TREATMENT OF THE INOCULATED SMALL-POX,
This is divided into two parts, the preparation before, and the plan to be followed after, the ap- pearance of the eruption. The immortal Boer- have conje£lures that the higheft advantage will "hereafter be derived by finding out an antidote to the variolous as to other poifons. " Let us en- " quire," fays he, with a fagacity almoft pro- phetic, " whether in ANTIMONY and MER- " CURY, reduced to a Hate of CALX (an oxyd) " this prophylaftic power does not exift*?'*
His commentator. Van Swieten, relates, that feveral phyficians have profited of this hint, and the refult w^as, that not only few,, but fometimes even no puftules whatever have appeared. A phyfician gave to his own child, who had all the fymptoms of the eruptive fever, a fufficient dofe of dulcified mercury (calomel) by which flie purged and vomited, after which flie flept quiet- ly, nor did any eruption whatever appear, al- though her brother at the fame time, who was not fo treated, was a fight from the quantity of eruption. After which he gave the fame to eight
* Vide Aphorifm 1391 and, 1392.
Others,
219
others, and with this effeft, that they had very few puftules*. Modern experience has fince fliewn, that if you mix the virus of SraalKpox with muriate of Mercury, it is difarmed of its power of producing the nifeafe.
Jn 1750, Dr. Adam Thomfon, upon the fug- geftion of the 1392 aphorifm of Boerhaave,. was led to prepare his patients by a compofition of antimony and mercury; which he employed with uninterrupted fuccefs for the fpace of twelve years. He relates that only one out of 700 died with this manner of preparation*. We find his plan more particularly noticed in the Pennfylvania Gazette, June 26, 1760.
A CERTAIN WAY OF AVOIDING THE DAN- GER OF THE SMALL-POX.
" The night before you inoculate, give a few grains of calomel, (oxyd of mercury) well levi- " gated, with a like quantity of diaphoretic anti- mony, (oxyd of antimony) unwaflied, propor- " tioning the quantity of calomel to the conftitu- " tion of your patient ; from four grains to ten f* for a grown perfon, and from one to three for
* Van Swieten refers us to Mifcellaa cunor. dec. i. an. 3. 'page 13. for this hiftory.
f Vide A Difcourfe on the preparation of the body for the Small-pox, and the manner of receiving the infection, as it was -lelivered in the public hall of the Academy.
" a child.
220
a child, to be made up into a bolus or fmall " pill, with a little conferve of rofes, or any com- " mon fyrup. The next nnorning give a purge " of the pulvis cornachini, made with equal " parts of diaphoretic antimony^ fcammony, and " cream of tartar. Repeat the bolus or pill " three times, that is, once every other night *' after inoculation 5 and on the fifth day give a *^ dofe of Boerhaave's Golden. Sulphur of Antimony: " about four grains of it for a grown perfon, with *' two or three grains of calomel, made into a " fmall pill, will operate both as a vomit and a " purge at the fame time/'
" In the intermediate days, , give two or three " papers of the following powders, viz. diapho- " retic antimony'*, ten grains; fal prunel\y fix " grains; and calomel, one grain, mixed together, " for a grov^m perfon; and about one fourth part " of a paper for a child.
Thefe powders are to be continued until the " variolous or Small-pox fever is over; and while
the fever is high, let your patient drink a cup " of uohey two or three times a day; the whey to " be made of cream of tartar \ inftead of runnet, " and thofe that are of a full habit, fliould be " blooded once or twice within the firft eight
* White oxyd of antimony by nitre, according to the new nomenclature of chemiftry. f Purified nitre. % Acidulous tartrite of potafli.
" days.
221
" days, and muft abftani from all fpirituous " liquor, and from meat of all kinds, broth, fait, « and butter."
The next publication which I fliali : notice, is that of Dr. Andrew, of Exeter, in 1 7 6'5, en- titled, " The praBice of Inoculation impartially con- *' fidered; its Jignal advantages fully proved; and
the popular objedions agaiyijl it confuted.'''' In the praftical part of this pamphlet the author ftre- nuoufly contends for the ufe of mercurial purgatives and antimonials, as a neceffary preparation for inoculation.
On this fubjeft he cites the following letter from Dr. Huxham, dated Plymouth, January 1765: — So long ago as 1724, I fuggefted that " mercurials, as well-prepared cnlomel, or the *' like, might be of ufe in the Small-pox. I fel- " dom fail of giving a mercurial purge or two^ " previoufly to inoculation of a perfon for the " Small-pox. Sometimes alfo I give my nntimo-
7iiated athiops. He adds, the ufe of mercurials " and antimonials will more fully appear, as prc-
paratory to inoculation, by what the ingenious " Dr. Benjamin Gale, of Conne£licut, in New " England, has communicated to me in his ' Dif- " fertation on the Inoculation of the Small-pox in Ame- " rica;\ in which he fays, * Before the ufe of mer- " cury and antimony , in preparing perfons for inocula-
tion, one of 100 of the inoculated died, but fince " mly one of 800."
According
222
According to Dr. Gale, the ufe of mercury in, the Small-pox was firft reforted to in the Emiijk American Colonies in 1745, when it was employ- ed with fuccefs by Dr. Thomas, of Virginia, " and Dr. Murison, of Long Ifland, in the Province of New York.
In the year 1752, there was an exact account taken by order of the magiftrates of the town of Bofton, and rendered upon oath, of all who had the Small-pox, either in the natural way, or by inoculation, and the precife number of thofe who had died of it in either; by which it appears, the number of the inhabitants amounted to 15,734. Thofe who had the diftemper in the natural way amounted to 5,544, of which 514 died. — The whole number inoculated amounted to i^,II3, of which 30 died. Hitherto mercury had not been made ufe of in inoculation at Bofton; but in 1764 the Small-pox vifited Bofton again, when Dr. Gale fays, by the laft accounts 3,000 had reco- vered from inoculation in the nezv method by the ufe of mercury, and five only had died.
The pra6lice of the venerable Sydenham was nearly exploded, when a new sra in the hiftory of inoculation took place, by the introduc- tion of the Suttonian prafiice, which in the year 1765 had extended fo rapidly in the counties of EfTex and Kent, as to much intereft the public, who were not lefs furprifed by the novel manner in which it was conducted, than by the uninter- rupted
223
mpied Juccefs with which it was attended upon a. prodigious number of perfons.
Mr. Robert Sutton, the firft of this name who acquired celebrity as an inoculator, refided at Debenham, in Suffolk, where he praftifed fur- " gery and pharmacy. He began to inoculate in February, 1757, in which year the number q£ perfons inoculated by him was .... 41 In the year 1758 he inoculated 27
1759 . . » 132
1760 135
1761 113
1762 452
1763 575
4764 243
1765 835
1766 224
1767 239
2,514
Two of his fons, Robert and Daniel, de- signing to follow the profeffion of their father, were employed in the difpenfing of medicinesi and in affifting him during the three firft years of his praftice of inoculation; after which Robert, the elder brother, removed to Bury St. Edmund's, where he became an eftabliihed inoculator; while Daniel afted as affiftant to Mr. Bumftead, a fur- geou and apothecary at Oxford, — The latter, on
his
his return to Debenham, in the year 17C3, fug- gefted to his father (as I was informed by him) a NEW PLAN of inoculation, in which he propofed to JJiorten the time of preparation to a few days^ and not to confine the inoculated patients to the houfe, but to oblige them to be in the open air as much as pojjible during the whole progrefs of the diflemper.
To reduce , the procefs preparatory to inocula- tion, from a month, which was then the ufual time, to eight, or ten days, was to obviate the objeftions that many, pcrfons had made to inocu- lation, from the great length of time it required. This, therefore, might be thought a meafure of expediency, to. bring a greater number of pa- tients; but obliging thofe under inoculation to walk out in. the cold air, during the eruptive fever, feems to have been a pra£tice derived from Sydenham, and confirmed by experience. How- ever, Mr. Sutton, the father, could not be per- fuaded to adopt any innovation in his pra£lice of inoculation, and would not hear of his fon's new fcheme, which he condemned as not only rajh and abfurd, but as extremely dangerous. Daniel foon afterwards, however, availed himfelf ot repeated opportunities of carrying it into efFe6l, and found it to anfwer his utmoft expeclations. The ad- vantages of this nezv plan were foon perceived by the patients, who now began to manifeft a defire of being folely under the direction of Mr. D. Sutton. This preference gave occafion to a dif-
pute
2^5
pute between the father and the fon, about the end of the year 1763, when the latter determined to praftife inoculation uncontrolled by parental authority j and for this purpofe he opened a houfe in the neighbourhood of Ingateftone, in ElTex. Here the young adventurous inoculator, by public advertifements, and hand-bills, propofed to inoculate upon an improved method, peculiar to himfelf; and alfo hinted, that by the nfe of certain medicines, he could always render the Small-pox an innocent and traSiable difeafe. Three months elapfed before he profited by his new fituation : but he afterwards fucceeded fo well, that at the clofe of the firli year his profeffion produced him 2000 guineas: and in the fecond year, which he fays was the moft profitable of any that he expe- rienced, his fees amounted to more than treble this Jimu His fame was now fpread to the moft diftant parts of the kingdom ^ and the numbers that reforted to him for inoculation, conftantly filled the village of Ingateftone, fo that it was with grea:t difficulty lodgings could be procured for the purpofe; His practice in Kent being alfo very extenfive, he was under the neeeffity of employing feveral medical affiftants*.
* In 1767, Mr. D. Sutton, removed to London,' where he hoped to profit by his profeffion ftill more than he had done in the countr}'; but his pradice here fell far fliort of his expefta- tions} and the two houfes, one at Ki^nfington Gore, and ano- ther at Brentford, which were procured for his inoculated pa- tients, were foon abandoned.
Vol. IV, Q Great,
226
Great, however, as might be the number which he inoculated, and the fticcefs of his practice, yet they were both, perhaps, exaggerated, not only by public report, but by the pen of the Reverend Robert Houlton*. This gcntle- m<in, who ftiles himfclf " Chaplain to the Earl of " Ilchejlcr,''' afferted, " that not one perfon out of a
thuufand inoculated by Mr. Sutton, had more vario- ** loUs fujlules than he could wiJJi, and that if any
patitnt had twenty or thirty pujiules, he was faid to " have the Small-pox very heavily." He fays, " If Mr. Sutton perceives a Jymptom in patients of " great fever, or a probability of their having more " pujiiiks than they would choofe, he quickly prevents
both by virtue of his medicines-,^'' for, according to this writier, " the Sutton family is in pojjejjion of an *^ iNESTiMAfeLE MEDICINE, by the ufe of which " a too great burthen of puflides can infallibly be pre-
vented.'^
According to Mr. Houlton's rtatement, the iiumber of p6rfons inoculated by Mr. Daniel Sutton, in the year, 1764 was 1629
1765 . . •. 4347
1766 . . . 7816
13,792
* Vide " A Sermon preached at Ingateftone, EfTex, 0£lober " 12, 1766^ in Defence of Inoculation. To which is added, « au Appendix on the prefent State of Inoculation."
" To
, 22/
*^ ■ Te the above number (fays he) Jlwuld be added " 6,000 that have been inoculated by Mr. Sutton's
aJJiJiantSf Jo that4ie may be /aid to have inoculated " within thefe three years 20,000 perfons,
" Of the above multitude he denies that a Jitin " gle patient has died really from inoculation " (by him or his ajjijiants) or from its effeEls. The " death of tzvo or three who died, was owing, " one to his own imprudence in being drunk " feveral times during the eruption j the other " two to complicated diforders, which would *' have killed them had they not been inoculated : " for as to Small-pox, they had but very few " puftules, and had taken their leave of Mr. « Sutton/'
Though this and other accounts of Mr. Sutton's praftice, magnified it probably beyond its real merit, yet not a doubt could be entertained but that the Suttonian plan of inoculation was incom- parably more fuccefsful than that of any other praftitioner.
It cannot therefore appear furprifing, that the attention of medical men lliould be dire6led to inveftigate the caufes which gave this new method of inoculation fuch a decided advantage. Thus we find Sir George Baker, Prefident of the Lon- don College, and Phyfician to the King, was the firfl: to embark in the purfuit, and to detail the n^w procefs of inoculation by Mr. D, Sutton, which he has done as follows : —
Q 2 « All
228
All perfons," fays this phyfician, " are " obliged to go through a ftrift preparatory fegi- " men for a fortnight before the operation is per- " formed. During this courfe, every kind oY *' animal food, milk only excepted, and all fer-
merited liquors and fpices, are forbidden. Fruit " of all forts is allowed, except only on thofe " days when a purging medicine is taken. In this *' fortnight of preparation, a dofe of a powder is *' ordered to be taken at bed-time, three fevera:! " times; and on the following mornings, a dofe " of purging fait. To children, only three dofes
of the powder are given, without any purgitig *' fait. The compofition of this powder is in- " duftrioufly kept a fecret. But that it confifts " partly of a mercurial preparation, is demon- *' f rated by its having made the gums of fever al peo-
" P^^ Z^''^' ^'^'^^^ falivated others.
" As foon as the eruption has made its firft " appearance, he obliges every body to get up, " to walk about the houfe, or into- the garden. " From this time to the turn of the difeafe, he " gives milk-gruel ad libitum.
" What is above-written is to be confidered as " relating only to the praftice of one gentleman " (Mr. D. Sutton.) There are in different parts " of the country feveral other inoculators, fome " of whom are faid to have furpalfed this perfon
in the boldncfs of their pra£tice. We have " heard of patients who have been carried into
« the
229
" the fields while fliivering in a rigor; or of their ^' having been allowed no liquor, except what
they have been able to procure for themfelves " at the pump, while the fever has been upon " them; and of their having been indlfcriminate-
ly expofed to the air, in all forts of weather, " and in all feafons, during every period of the " eruption. Tk's and more has hen related upon
good authority : and indeed it is certain that many " thoiifands, of all conjlitutions and ages, even to that " of feventy years, have within thefe few years been " inoculated, according to the general method above
defcribed; and in general have gone through the
difeafe almoji without an unfavourable fymptom, .** ylccording to the bejl information which I can pro^ " cure, about seventeen thousand have been *' thus inoculated; of which number nq more thai} *■ FIVE cr SIX have died'''
After ftating this as the Suttonian praftice, Sir George proceeds to examine, to what caufes its fuperior fuccefs is to be afcribed ; and upon comr paring it circumftantially with the other methods, he concludes that the principal advantage of it is derived from the free ufe of COLD AIR, in which the Suttons indulged their patients through the whole procefs pf the difeafe, to a much greater degree than what had generally been allowed. In confirmation of this opinion, he inquires into Sydenham's method of treating his variolous pa- tients, and fliows, that this accurate practitioner
gradually
230
gradually became a greater patron of the cool regimen, in proportion to the progrefs which he made in his knowledge of the difeafe. Many other fa£ls are alfo adduced, proving the great efficacy of the cool treatment in the Small-pox.
A few months after the publication of this " Inquiry," appeared " A letter from Dr. Glass *' (of Exeter) to Sir George Baker,'' in which the former differs from the latter, in not attributing the chief advantage of the Suttonian procefs of inoculation to the more free employment of the cool regimen. Dr. Glafs, however, admits that pra£lical obfervations furnifh undeniable evidence of the good, effefts of cold air, as well in common ns in (bme very defperate cafes of Small-pox; but he contends, that the extraordinary fuccefs of inoculation, under the direction of Mr, Sutton, depends upon other means. He fays, the pa- tients, on having a confiderable degree of fever^ are permitted to lie in bed, and that an apothe- cary of his acquaintance, who vifited the inocula- tor's hofpital laft year, found three of them in bed, and favv the matron of the houfe give to each of them a fmall tumbler of liquor, and was in- formed by her they w^ere to continue in bed until the eruption appeared. The liquor fhe gave them, they called ; it had the appearance of pure water, and tafted fomewhat like flierbet. This ACID LIQUOR was given three or four times a day, to all the patients in whom the
eruptive
231
eruptive fytriptoms were attended with much fever, and its ordinary efFeft was that of a fudo- rific; but if it did not produce perfpiration, a pill or powder, ftill more powerful, was adminiftered. Thus, Dr. Glafs obfervcs, it is a conftant rule with the Suttons to keep their patients in a fweat .for fome time before the appearance of the eruption, and to proportion the degree of the fweat to the height of the fever. Hence he thinks it " highly " probable, that their great fuccefs is chiefly " owing to their lingular method of difpofmg " their patients to fweat, and then fweating them " by the medicines given after inoculation, and " during the eruptive fever."
The Reverend Mr. Houlton now came for- ward to declare, that the publications of Drs. Baker and Glafs contained " little, very little in- " deed, of the true Suttonian practice of inocula- " tion. The time, fay he, will come perhaps ^' when the Sutton family will generoufly difclofe " to the world their juftly fingular, noble, and " ineftimable practice of inoculation*."
This Reverend Author here complains of the perfecution of D. Sutton, even to the following ex- tent : — About the beginning of laft fummer, the " Small-pox broke out in a mofh violent manner " at Chelmsford, in ElTex, fweeping off every " week many of the inhabitants. This was a
fine opportunity for Mr. Sutton's enemies to
f This has been done. Vide p. 237.
furmife.
232
furmife, invent, and propagate what calumnies " theypleafedj efpecially as he fometimcs came " on market-days to treat with people who were inclined to be inoculated. If any perfon " chanced to accompany him in his carriage, it was always induftrioufly reported, that fuch perfon was a patient, brought to inoculate from or fpread the difeafe. In confequence of thefe groundlefs infmuations and mifreprefentations, " an indi£iment was aftually preferred laft fummer " affize, againft Mr. D. Sutton, furgeon-, for a " nuifance ; but the grand jury would not find ^* the bill againft him."
To the above fucceeded " An EJfay towards an " mvejiigation of the prefent fuccefsful and mojl general method of inoculation^ by B. Chandler, Sur- *' geon, at Canterbury." This gentleman informs us, that a number of perfons of all ranks had been inoculated at Canterbury, according to the Sut- tonian plan, by Mr. Peale, a furgeon of eminence at Maidftone, and one of the partners of Mr. Sut- ton ; and that in Mr. Peale's abfence, he had been by many defired to attend, fo that by thefe opportunities, and by frequent converfations with Mr. Peale, he was enabled to carry the inveftiga- tion of the new praftice farther than it had been done by Drs. Baker and Glafs. Nay, he made trials of it upon great numbers at Chilham, and fays his patients, in every ftage of the Small-pox, %vere " exaft copies of Mr. Peale's patients."
Hie,
233
His method of conducing the procefs of inocu'Ui- tion, and which he confiders as being efrcntiall)'" the fame with that of Mr. Sutton, is thus de-- fcribed : — " My patients have taken, if adults, a *' dofe of calomel, adapted to their age and ftrength, « at bed-time, and purged it off with Glauber's " fait next morning ; this has been repeated to the third time j at the intermediate diftance of two days from each. Children have fometimes " taken a purging powder, with calomel, three " times, of a morning only. — In regard to diet, \ have ftriclly forbade all animal and fpiced food, " and all fermented liquors, not only through the " preparatory courfe, but in general through the " whole of the difeafe, conftantly advifing them to return to their ufual way of living gradually " and cautioufly. On the day following the laft " dofe of phylic, I have performed the operation ; " which I do by wetting my lancet in the moifture " of the puftule, which rifes on the arm of an inoculated perfon, before the little feverifhnefs and general eruption cjppear 5 and then making two very fmall oblique punftures with it in the " arm of the perfon to be inoculated, dire£ting the inftrument not perpendicularly, but hori- " zontally, fp as to divide the cuticle from the " cutis underneath ; as foon as the leaft tinge of " blood appears, I wipe my lancet on the wound, " and make another puncture in the fame man- Hgr^ immediately pulling down the fleeve, and
" applying
234
apph ing neither plafter nor bandage. From " this time I take care to keep ray patients cool " and open, advifmg moderate exercife in the
free air, and giving to moft, except very young " children, two or three pills every other day, or " thereabout, from the fifth after inoculation,
compofed of aloes, kermes mineral*, and " camphire. If the preparatory medicines have " been inaftive, thefe fupply their place ; if the " patient has been irregular, thefe are as likely as
any thing to corretl the inconveniences which *' may arife from it. ' And as fomething wrong " in the habit may often juftly be fufpe£led, when " the punftures do not inflame fo much as ufual, " I give the pills, in fuch cafes, fomewhat more " freely. This is no new obfervation ; it has *^ often been experienced in the old inoculation, " that thofe patients had the difeafe moft favour- *' ably, whofe inoculated arms difcovered an
earlier inflammation, a more confiderable fwel- " ling, and a broader difk of furrounding rednefs. " I do not pretend that thefe have any fpecific " powers ; indeed, I think they have not : but " they are more commodioufly carried about, and " as eafily taken as any other form of medicine. *^ I have Boerhaave's fanSlion for their ufe, and a " ftrong probability of their being the fame as " Mr. Sutton's : I have always feen them operate
* The Red fiilphurated Oxyd of Antimony.
" in
235
<^ in the fame manner, and anfvver every inten- " tion equally well. From the feventh to the " ninth day, I expeft my patients to begin to " complain a Uttle; but fome few entirely ef- " c^pe : then I give nitre, diffolved in a decoo- " tion of oats, acidulated with lemon juice, or " weak SPIRIT of y it vhol^, ad libiiim. This " cooling liquor is agreeable to the palate, af- " fuages their thirft, if they have any, and for the " moft part proves a little fudorific, if taken at " bed-time. In a day or two from their iirft be- " ginning to complain, the puftules feldom fail to " appear immediately, upon vi^hich all ficknefs " vanifhes, and I have never heard one complaint " afterwards." —
Mr. Chandler, after a very minute examination of Mr. Sutton's praftice, concludes, that the fuc- -cefs of this celebrated inoculator does not prin- cipally depend upon his mercurial preparation, nor yet upon the free expofure of his patients to cold air^ as alledged by Sir George Baker. Szveat- ing the inoculated, he afferts, Mr. Sutton never attempts, and therefore afcribes but little efficacy to what has been called the ptmc^ ; the pills he thinks ufeful merely as evacuants, not as poffeffing any fpecific power ; whence he cannot impute the chief advantage of the Suttonian fyftem of inocu- lation to any of the above caufes. In fliort, the
* Vijriolic Acid.
grand
236
grand fecret in the new mode of inoculation, Mr.
C. fays, is " the taking of the infeEling humour in a crude Jiute, before it has been, if I may allow the . exprefjion, ultimately variolated by the fucceeding fever."
Thus it appears, that the three firft perfons who inveftigated the Suttonian pra6lice of inocu- lation, all differed in opinion refpefting the moft effential point of it ; fucceffively afcribing its fuperior fuccefs to the more free ufe of cold air, to fzveatingy and to inoculating with crude uncon- coEled variolous matter. — And here I may add, that Baron Dimfdale, who immediately after- wards gave his fentiments on this fubjeft, fays, " Should it be afked then, To what particular
circumftances the fuccefs of Sutton is owing, *' I can only anfwer, that although the whole " procefs may have fome fliare in it, in my opi- " nion it confifts chiefly in the method of inocu- " lating with recent fluid matter
The grand fecret has at laft tranfpired in a work called the. Inoculator, publiflied by D. Sut- ton hirafelf, in which he has unveiled the whole myftery. Here it will be found that lefs depends upon the variolous matter *, than upon an alte- rative powder abounding in oxygen.
* He, however, recommends the recent fluid matter, as being more certain, and as producing an earlier eruption of the puftules, generally of a kinder fort,
Sutton's
237
Sutton's alterative powder he openly declares to be
Antim. calcin. lot * — dr. id. Calomel. f— dr. 8. Antim. tart. J — dr. 2. M.
That is.
Take of Calx of antimony— ten drachms. Calomel — eight drachms. Emetic tartar — two drachms.
This powder he dire6ls to be kept in a wide- mouthed vial, with a gaiize covering only j 'kn'd it will be found to anfwer better after it has flood a month, or fix weeks, before ufing, in order that it may imbibe more oxygen. Of this twelve grains is a dofe for a grown-up perfon. This is his grand alterative powder, on which, he fays, he places his higheft dependence. It is given, in currant jelly, every night. The patient having taken the medicine, is ordered immediately to get into bed, in order that it may reft upon the ftomach. It is not unufual, however, fays Sutton, for the firft, and fometimes the fecond alterative powder, to caufe a flight ficknefs and vomiting. Afterwards it feldom has this effeft 5 nor do I wifh it, fays he, to produce any other effe61:, than to caufe a laxative motion towards morning. After the third morning, I gently purge with Glauber's
* Tartrite of antimony- f Oxyd of mercury.
X Oxyd of antimony.
falts.
238
falts *, or rhubarb and jalap. The patients are kept upon a vegetable diet^ and the quantity of food reftrifiled. The purging powder, fo as to give three or four evacuations, fliould be repeated every other morning. Nor is there, adds Sutton, any, the leaft danger to be apprehended, that the patient can be reduced fo low as not to have ftrength enough to throw out tlie Small-pox. The fa6t is, the fewer are produced, the lefs the conftitution will have to ftruggle with ; and this depends upon following the plan here laid out,, from an infinite experience of above forty, years.
* Sulfate of pot-afli.
PRACTICAL
239
PRACTICAL OBSERVATIONS.
SECT. XLV.
THE MEASLES.
The polfon of the Meafles differs greatly from that of the fmall-pox and hooping-cough, ex- erting its influence for a much fhorter period on the human body, the whole difeafe being goncj through in a few days : and whereas the hoop- ing-cough feems chiefly to effe£t the ftomach, fo this, like the fmall-pox, affefts the furface of body, as alfo the lungs, and its chara8:eriftic fymptom is the fuffujion of water in the eyes *. Sydenham obferves, that by an improper treat- ment, the eruption, which fhould referable flea- iDites, bring fmall red fpots, turn purple or livid, and fometimes black. The wifh of forcing out the eruption, or what was thought the expulfion of the morbific matter, has deftroyed its thoufands in this difeafe, as well as in the fmall-pox. As its dura-; tion is fhorter than either of thefe diforders, and its violence greater, the moft decifive remedies fliould
* Inoculation has been performed with this water, drawn from the eye, and with great advantage. It is a pity fo falu- tary a praftice fliould be fo foon and eafily abandoned.
be
24(3
be fpeedily employed. Dr. Brown conceived " that all difeafes were the action of ftlmuli on the " excitability or living principle of the body, for " none of the ftimuli aft on the dead body *i and
that the province of the phyfician was to ma- " nage, in return, the quantum of a£lion in the ** fyflem. Thus, when added to the natural ftimuli, " a foreign, or poifonous one, was exerting its in- " fluence, the funi of the two powers was a ftate *^ of too ftrong excitement ; and as the foreign
power could not be removed, the art of phyfic " was therefore to remove the natural ftimuli, fo " as to make the fum of ftimuli not dcftru£tive to " the living powers." Here this great improver of the praftice of medicine was right, provided we had no means of attacking the nature of the poi- fon itlelf ; and hence the important advantages derived to medicine from the B-runonian practice^ as It is called.
Mead, fpcaking of the advantages of bleeding, fays, in commendation of it : "I am afraid, left I fliould feem vainly to court applaufe by the following narration ; yet it is fo much to th6 purpofe_, and fo happily confirms what 1 have faid, that I muft beg leave to relate it. About forty years ago, the Meafles raged with fo gi-eat violence in this city, that it proved more fatal than even the fmall-pox. At. that time a phy-
* Thus a blifter will not rife on the dead body.
fician
241
fician of great eminence came to me, defiring that I would inform him what method I followed in this difeafe. I aflced himj whether or not he ufed to take away blood ? He anfwering no^ becaufe Sydenhani very feldom did it ; I advifed hirri to open a vein in the beginning of the dif- temper j or, if he was called in latef, as foon however as he poflibly could : for, faid I, this difeafe always brings with it jl peripneumony^ which he \6ty well knew ever required bleeding. Not long after he met me again, returning me hearty thanks for my counfel, afluring me, that he had not loft one patient whom he had treated in this manner."
Mead adds : " The fuppofition that the emp- tying of the veffels would hinder the coming out of the eruption, is a popular error, as daily ex- perience evinces 5 but it is this prejudice that will give room for many to find fault with my prac- tice, and hinder my reputation in life : yet I am happy if I fliall have proved myfelf, in any way, beneficial to my fellow creaitures. This is: all I defire ; for the confcioufnefs of having done right is beyond all praife, efpecially of the vulgar ^ and car- ries with it its own reward^ zvhich he abundantly enjoys who confidts the good of his fellow creatures^ andy by his aElions^ Jliews that he thinks he is
Non fibi, fed toti genitum fe credere mundo
LUC AN.
'* That he is not born for himfelf, but for the whole M'orld.
Vol. IV. R I have
242
I have frequently ufed fmall dofes of antimo- fi'ml 'Wine, as twenty or forty drops, repeated it every two or three hoilrs, and until it produced either vomiting, purging, fweating, or all three, which evacuate plentifully, and the diforder is readily fubdued j or has the ox yd any particular fpecific power in this difeafe ?
The Meafles, if badly cured, when violent, often ends in difeafes of indireft debility, as pulmonary confumption, or water in the cheft : both which difeafes afterwards will be conCi- dered.
THEORETICAL
THEORETICAL AND PRACT/CAT, OBSERVATJONS.
SECT. XL VI.
OF THE AGUE, OR INTERMITTENT FEVER.
The queftion, whether putrid marJJies are, or are hot, unwholefome, is of confiderable moment. Dr. Prleftky, therefore, by a clear and cpnclufive experjnientj firft proved, that the vapour whiclj arjfes from putrid water is exceedingly noxious, ^ and thus guards us againft the mifchief whichi might ptherwife proceed from a carelefs belief of* theoppofite opinion. " Happening," fays he, "tp ufe at Calne a much larger trough of water, for the purpofe pf my experiments, than I had done at Leeds, and not having frefli watqr fo ne^r at hand as I had there, I neglefted to change it, ' till it became pffenfive, but by no means to fuch a -degree as to determine me from not making ufe of it. In this .ftate of the water, I obferved bubbles pf air to rife froni it, and efpecially in one place, to which fome flielves, that I had in, it, direclcd them j and having fet an inverted ^la(s
R 2 veffel
244
tefifel to catch them, in a few days I collefted a confiderable quantity of this air, which iffued fpontaneoufly from the putrid water ; and put- ing nitrous air to it, I found that no change of colour or diminution epfued, fo that it mufl: have been in the higheft degree noxious."
The celebrated Dr. Franklin has likewife pointed out the pernicious effe6ts of air from fiagnant waters. Speaking of the flame which may be lighted up on the furface of fome waters in Arnerica : " I have frequently," fays this excellent phllofopher, " tried the experiment in England. One day being employed in ftirring up the ftag- nant water at the bottom of a deep ditch, I was feizcd foon after with an intermitting fever, which I can afcrlbe to no other caufe than to my breathing too much of that foul air which I ftirred up from the bottom, and which I could not avoid while I ftooped in endeavouring to kindle it."
An eaft wind in England is often accompanied with a fog, which it is faid to bring with it from the fea : but the truth of the matter is, that this wind then raifes a copious vapour from water, mud, and all marfliy or damp places.
I do not remember to have met with any obfer- vations on this exhaling quality of the eafterly wind, fays Dr. Lind, though I have been an eye- witnefs to it. When the wind changes to the eaft, the mud fometimes fends up a vapour as thick as
fmoke.
245
fmoke. Two fifh ponds in my neighbourhoodj one of frefli, the other of falt-water, upon the ap- proach of an eafterly wind, fometimes alfo emit a denfe vapour, as from a pot of boiling water.
In order to view this phasnomenon diftindly, the perfon fhould ftand at about 100 yards dif- tant from the ponds. If the fun fhines, when the wind changes to the eaft, he will obferve a conftant ftream of vapours rifmg out of the ponds, from about five to ten yards height, while the air about him remains ferene. As the vapour or fog arifing from other places glides along the fur- face of the earth, and is brought by the eafterly wind to the ponds, he will ftill be able, for fome time, to diftinguifli the vapours afcending per- pendicularly out of the ponds, from thofe which are carried in an horizontal direction by the wind ; efpecially if the fun continues to fhine, though faintly.
This evaporating quality of an eaftwind, feeras to manifeft itfelf alfo by its effefts, both on the thermometer, and the human body. A thermo- meter, hung over a damp piece of ground, during the fogs or exhalations arifing from it, will often indicate a degree of cold below the freezing point. There is alfo a chlllnefs of the body, fenfibly perceived in this fituation, nearly the fame as that arifing from the wet floor of a chamber.
But
246
But winds are fiot conftaAt iti their eftefts *. as have forriefimes warm weather with a north "v^ifiid, and fometimes very little heit With a wind from the fouth j fo thd fogs attending an eaft wind are tidf conftant ; Neither is the evaporation which we haive mentioned at all times to be
I ini perfeftly fenfible, thit there may be a deeeptioh in thefe matters, and that, inftead of fiippofirig the quantity of vapours exhaled to be jnfcr6afed by an eafterly wind, the coldnefs of that Wind rnay be fuppofed only to condenfe and render vifible the vapours in the air at that time. But eVen this fuppofition is liable to great objec- tibrife, as bur coldeft north winds feldom or never produce fuch an ef!e£l, but are commonly at- tended by ferene dry weather.
Let that be as it will, an eaft wind is ufually accompanied by a cold, damp, and unwholefome Vapbiirj Avhith is bbfefved to affe£t both animal md vegetable health, and iii many places to give rife ahd obftinacy to jnterrtiitting fevers, as alfo to produce frequent relapfes.
In particular fpots of the lov^ damp ifland of Portfea, the ague frequeritly prevails, and fome- tillifes the fliix, during the autumnal feafon ; in fome years they are much more frequent and vio- lent than in others. It is obfervable, that their jittack proves always moft fevere to ftrangers, or
thpfe
247
thofe who have formerly lived on a drier foil, an4 on a more elevated fituatipn, from not being haf bituated to this poifon.
The year 1765 was remarkable, not only for the long continuance of eafterly winds, but alfo for t^n exceffivc degree of heat, which produced a more violent and general rage of thpfe difeafes, than had been known for many years. During the rnonths. of May, June, and July, we had fel- dom fevsfer ^t Haflar-hofpital, continues Dr, Lind, than thirty or forty patients, labouring under re- gular tc'rtian agues, with perfeft intermillions. Of thefe, fome were feized on board the guard- fhips that lay in the harbour near the mud, but the grea.teft number were marines, who did duty at Portfmouth.
In the nionth of 4-Uguft the quickfilver, in Farenheit's thermoineter, often rofe to eighty-two degrees in the middle of the day. This heat, to- gether with the want of refrefliing rains, fpread the fever, increafed its violence, and in many places changed its form. At Portfmouth, and throughout almoft the whole ifland of Portfea, an alarming continual, or remitting fever, raged, which extended itfelf even as far as phichefter. At the fame' time the town of Gofport, on the oppofite fide of the harbour, though diftant qnly one mile from Portfmouth, enjoyed an almof): total exemption from ficknefs of every kin4 > and in the neighbouring villages and farm-hpuf^s
on
1
248
on that fide, only a mild regular tertian ague prevailed, which however diftreffed whole fami- lies. The violence of the fever, with its appear- ances in a continued remitting or intermitting form, marked, in fome meafure, the nature of the foil. In Portfmouth its fymptoms were had, worfe at Kingfton, and Jiill more dangerous and violent, at a place called Halfway-houfes, half a mile from Portfmouth, where fcarcely one in a family ef- caped this fever, which there generally made its firft attack with a delirium. In the large fuburb of Portfmouth, called the Common, it feemed to rage with more violence than in the town, fome few parts excepted; but even whole ftreets of this fuburb, together with the houfes in the Dock-yard, efcaped it.
The marines, who were three times a week exercifed early in the morning on South-Sea Beach, from the effeft of the ftagnant water of an adjoining morafs, fuffered much. Half a dozen of them at a time were frequently taken ill in their ranks, when under arms ; fome were feized with fuch a giddinefs in the head, that they could fcarcely ftand ; others fell down fpeechlefs, and upon recovering their fenfes, complained of a violent head-ach.
When fuch patients were received into the hof- pital, fome few had a regular ague, but far the greater number laboured under a remitting fever, in which fometimes, indeed, there was no per- ceptible
H9
ceptible remiffion for feveral days. A conftant pain and giddinefs of the head were the moft mfeparable and diftrefling fymptoms of this dif- eafe. Some were delirious^ and a few vomited a quantity of bile; in all, the countenance was yellow.
A long continuance of the fever produced either a dropfy, or a jaundice^ or both; even a flig-ht attack reduced the moft rbbuft conftitution to a ftate of extreme debility ; which, together with the giddinefs, continued long after the fever.
The univerfality of this fever, together with its uncommon fymptoms, were at firft alarming; but when the lancet was withheld, and the bark freely given in large dozes, few died*. It de- creafed with the heat of the weather, and in the winter appeared chiefly under the form of a quar- tan ague.
This may fuffice for a brief defcription of the autumnal fever of Great Britain, which in its ut- moft violence prevailed in 1765, not only in Hampfliire, but in many other parts of this ifland, and which feemed to have been increafed that
* When the head-ach or giddinefs were very violent, and the pulfe neither full nor ftrong, I ordered, fays Dr. Lind, (to whom the world owes fo much for improvement in medi- cal knowledge) a blifter to the back, and endeavoured to re- duce the fever into an, intermitting form, by giving half ^ grain of tarfar- emetic (antimonial tartrite of pot-afli) with a few grains of niitr, every fix hours, which ufually fucceeded.
year,
250
year, by the unufuul and excellive heat of the fummer,, together with an undiluted putrid moif- ture in the foil, and the long duration of eafterly winds,.
In looking over ancient authors, I find the cur^ of intermittents was by regularly abftaining from food for five days, and afterwards eating and drinking to excefs. Celfus, who improved upon this barbarous pra£lice, advifes only tliree days abftinence, and a cautious return to a full diet.
Before the difcovery of the bark, the cure of agues was generally attempted by bitters, fuch ^■Qhamcemehm, centaurmm winits, gen/iam, cortex aitraniioytm, zedoaria. Thefe bitters^ together with fixed alkaline falts, are ftill in great efteem with fome phyficians, who entertain prejudices againll th^b^rkj all which, it is to be hoped, will foon be.?^ji5kp,ved.
Opinionum commenta delet dies.
It is curious to obferve with what diffidence bark was formerly employed in the cure of agues. The great Dr. Willis, fpeaking of this medicine, fays, concerning the Peruvian bark, " becaufe of late it hath begun to be in ufe, there arc Ibme things to be faid, which offer themfelves to common obfervation. The common manner of exhibiting this is, that two drachms of it, beaten to powder, be infufed in fack or white \vine, in an open glafs, for two hours, and then, upon the coming of the fit, the patient being
put
251
put to bed, that the liquor and powder be drunk up. This potion often takes away the approach- ing fit^ yet oftentimes, though taken after the wonted manner, it prevents the next ; however, either in the firft, fecond, or third period, the fit is inhibited, and the difeafe Jeems to be cured, it is often wont to return, within twenty or thirty days ; then this powder, being again exhibited, the difeafe is for a time deferred about the fame fpace, and by this means I have known many^ fick of a quartan, to have fufFered fome {t\v fits only, a whole autumn and winter, and fo to have detained the enemy in his precinfts, till the fpring coming on, the difpofition of the blood is altered for the better, by the help of the time of the year, dnd of other phyfic, and fo this diftemper vanifhes by degrees. Thofe, who by this means, have procured the frequent truces of the quartan, have lived cheerful, lively, and ready for any bufinefs, when otherwife, being weak and pale, they were brought into languifliment, and a vi- tious habit of body : fcarce one of an hundred hath tried this medicine in vain, yea, if but half, or a lelTer quantity, viz. the weight of but one drachm, taken, it very often takes away the fits, and fufpends the fame, a fliorter fpace only j nei- ther is it any matter, whether it be taken in ftrong or fmall wine, unlefs with the refpe£t to the difpofition of the fick : becaufe in a more hot temper, it may be profitably taken in diftilled
water.
252
Water, oi' whey ; alfo a clear infafidn of it, the more thick fabftance being caft away, produces the hke effe£l, but of fliorter durance : I have taken care to reduce this powder into pills, with the mucilage of tragacanth, with a little cofl: to the fick, to be given to fome ; after what manner foever it is taken, unlcfs to thofe loathing and abhorring every medicine, it caufes no manifeft evacuation, and takes away the fit, almofl: from all ; neither is it only in a quartan fever, but in the other kinds of intermitting fevers, to wit, in every one where there is any remiffion coming between, given with good fuccefs. It is commonly ordered, that a gentle purge fhpuld be taken be- fore this, but in fome who are very weak, and keep their beds, this powder being taken care- fully, without any previous medicine, hath pro- duced laudable efFefts. In the mean time, I will mgenuoujly confefs, that I have not, feen an inter- mitting fever quite cured by this bark, once taken : nay, rather the fits not only of a quartan, but of a tertian and quotidian fever, wholly overcome eafily by other remedies, feeming to be driven away by this powder, have conjianily relumed after a (hort time. For this reafon, they who Jupprejs in- tsrmitting fevers, otherways eafily curable, no necef- Jity urging them, by this medicine, for a little while, only fiem to injiitute a deceitful medicine, and do no more than thofe who fain over a rotten ulcer, which willfiortly break out again ; in truth, in fome cafes,
the
^53
the ufe of this will be requifite, viz. \vhe\i hf the too great affiduity of the fits, the fpirits of the fick are caft down, truces are by this mean<} procured, by which nature may recollecl: herfelf^ and afterwards may be more able to fight againft this potent enemy: alfo, that a quartan fever^ during the autumn and winter, may pafs over with little trouble, this bark is profitably admi- niftered : but thofe, who expeft a longer refling time, from the alTaults of this fever, are bid to take this powder in greater quantity, and more often, to wit, that they fliould take two drachms, three fev^eral times one after another, whether the fits return or no ; by this means they remain longer free, yet they retain within the enemy Jlill^ though ajleep.''^
The early exhibition of bark we fee then was thought only to put this difeafe ajleep, and inju^ rioj[s,hY preventing the expulfion of the morbific matter. Sydenham firft rooted out this error.
Modern phyficians perceive, that though like other aftringents, it braces the fibres, and as it often produces vomiting, or naufea, that it muft a6t as a flimulus, yet the efFeft of this is chiefly by giving an encreafed power in the blood to im- bibe OXYGEN, whereby this fever is cured.
Thofe who have had much pra£lice in marfhy countries, have feen that when Jieei which ren- ders
* Monf. de Hallef conjeftures, that the u'on which is found in the earthy parts of the blood, is particularly conneiled with
the
254
^ers the blood M more attraaive of OXYGEN has been conjoined with hark, the efFecls are in proportion great, often conjointly overcoming the difeafe when the bark alone has failed *.
the reJ particles, and this conjefture of his appears to be founded in truth, ,if we may believe the experiments of Pro- feflbr Buckwald at Copenhagen. Buckwald took a quantity of the white part of the crafTamentum from which the reJ particles had been entirely waflied off, and calciived it, along with a certain portion of fixed alkaline fait; than he diffolved this mafs in water; and laftly, added a folution of alum; but the colour was not changed by this addition of the alum. He then calcined a quantity of red craflamentum along with fixed alkaline fait, and having dilTolved the mafs, added a fo- lution of alum. This immediately turned lilue, and yielded a portion of the blue pigment, called PrulTian Blue, which is a fure teftof the prefence of -iron ', hence Dr. Buckwald con- cludes, that the.red colour of blood is chiefly owing to a mix- ture of ferruginous matter. The deterioration of the air with perfons labouring under ague, is much fmaller than when cured, efpecially after 'taking fteel. The florid red of the cheeks is another proof this pofition.
* This is the famous elei^tuary of Penrofe, fo much prized in Lincolnfhire and Cambridgefliire, and may be made as follows ; R. Cinchon. pulv. unc. i.
Rubig. Ferri. dr. z.
Bulv. aromat. xlr. i .
Conf. cort. aur. unc. |.
Syr. zingib. q. f. • F.eleft.
Cap. magnltud. snuc mofcbat. omnlb. hor.
That is, take of
Powdered bark, one ounce.
Rufl of iron (carbonat of iron) two drachms.
Aromatic powder, one drachm.
Conferve of orange peel,- half an otmce.
Syrup of ginger, as much as is fufficient. Make this into an eleftuary, and take the, fize jof,a nutrneg of.it every two houi:s.
In
^55
In 'tlip cure of Mary Rhodes, the power cjf OXYGEN air, in conjunftion with i>^rk Sind Jl&el^ was very ftriking. This patient had been to Xeie fome friends in Effex,and returned with an agiie. •Living with her father, who Was a bookbinderj, and being by trade a folder of the printed llieets, flie was conftantly engaged with danip paper, and her diforder, probably from this caufe, ire- fifted for two years, what has been long deemed the fpecific bark. Being at length advifed to come under the care of Dr. Thornton, he ordered her to inhale twenty quarts of vital air, mixed with twice that quantity of atmofpheric, and previous to the time of the acceffion of tertian to take thirty drops of tincture of opium, with twenty of ether, in fome cold porter. A ftrong deco£libn of liquorice was alfo drank warm, and the cold fit was nearly prevented, and a powerful perfpiration enfued. The bark with Jieel was im- mediately after adminiftered, and the GXYG-EN air continued, and the patient had no more pa- roxyfms, and was fo'on reftored to health.
Mr. Bufh, a watch-maker, in Wood-ftreet, had an ague that for fix weeks refilled bark under Mr. Chamberlirt. He applied to Dr. Thornton, who ordered him to come to him half tan hour before the expe£led paroxyfm. He was bound tight in flips of flannel of eonfiderable extent, for half an hour, when he had a yawning, and all the .fymptoms of '.the approachir][g:fit. After
this
2S6
this he was liberated, took thirty drops of* lauda- num, and fifty of ether, in fome port wine, and then inhaled twenty quarts of vita/ air, mixed with thirty of atmofpheric ; and now feeling extremely warm, he walked home, and had no fit then, or afterwards. The bark however was continued.
Dr. Thornton has cured feveral agues fimply with the different acids. From many inilances we can adduce the following: —
Charles Davis, living at No. i, Great Titch- field-ftreet, plafteref, went into the Hundreds of EfTex, where he was felzcd with a remittent fever immediately after harveft, (common to that part of the country at that feafon of the year) and the ague which followed continued even after his return to London, which was a tertian. Previous to the coming on of the paroxyfm, he took the juice of a lemon every two hours, with fifteen drops of the diluted vitriolic acid, and his ague ceafed immediately. Bark was had recourfe to at the end of a week, to prevent a return.
Hoffman mentions, that in obfllnate quartans, he has repeatedly cured by calomel, carried even fo far as to produce falivation.
The numberlefs charms employed for ague, feem to aft upon the fame principle, hope power-^ fully difpofing the blood to imbibe OXYGEN, as will be feen when we come to treat on fcurvy.
Hence it is, that a change of air is frequently the mofl efFeftual means^ of obtaining a cure :
the-
257
the moft obflniate intermittept I ever had occa-i fion to fee. was removed by a change from the land to the fea air; the patient never had one fit after being fent on board a fliip.
But the remedy lately found to be fuperior to every other, is the OXYD OF ARSENIC. It comes fanftioned to us by the recommendation of Drs. Fowler, Arnold, Withering, Willan, Marfli, and Fearfon,
Mr. Jenner, of Painfvvick, in Gloucefterfliire, relates, that he had cured more than 200 inter- mittents with it.
The form recommended by Dr. Fowler is, R. Arfenic alb.
Sal. alk. veget. fix. aa. gr. 64. Aq. diilil. lb. |. Immittantur in ampullam, qua in balneo are- nae pofita, aqua lente ebulliat, donee arfenicum perfe^te folutum fuerit , dein folutioni frigid^ adde,
Sp. lavend. comp. unc. f * Aq. diftil lb. |. Dofis gtt. lo bis die ad. gtt. 20 ter die. That is, take of
White arfenic, and
Fixed vegetable alkali, equal parts,
fixty-four grains. Diflilled water half a pound. Let thefe be put into a jug, placed upon a Vol. IV. S fand
258
fond bath; and gently boil, until the arfenic bo pcife61:ly diffolvcd, and when cold, add to it,
Compound fpirit of lavender, half an ounice.
Diftilled water, half a pound. Tlie dofe is ten or twenty drops, twice or thrice a day.-
An ague, if not cured, leaves the patient in- the ftate of the greateft indiretl debility, and often obftrutlions of the vifcera enfue, and dropfy or jaundice, from general debility.
Such dropfies are to be cured by exciting a gentle a8:ion of mercury with fquills, thus : R. Pil. e fcilla, gr. lo. Pil. ex hydr. gr. 4. F. pil. 3. alternis noftibus fumcnd. . That is, take of
The fquill pill, ten grains. The mercury pill, four grains. And make them into three pills, to be taken every other night. And, in the intermediate days, the following mixture is to be taken :
R. Aq. pulegii fimp. une. 5. Aq. Raphanr comp. unc. i. Kali acetat. dr. i . Oxymel fcill, unc. |. M. cap.- unc. | 4tis horis.
That
259
That is, take of
Pennyroval water, jfive ounces.
Compound horfe-radifli water, one ouncd.
Acetated kali^ one drachm *
Oxymel of fquills, half an ounce. Mix, and take half an ounce every four hours.-
When the water has been removed, the fyftemi muft be afterwards fortified with bark and fteel.
ORIGIN
s6o
ORIGIN OF PUTRID FEVER.
SECT. XLII.
FIRST CAUSE, OR SELF-GENERATION OF PUTRID
FEVER.
Howard, who vifited all Europe and tVre Eaft, not, as Mr. Burke beautifully exprefles it, , to furvey the fumptuoufnefs of palaces, or the ftatelinefs of temples; not to make accurate meafurements of the remains of ancient grandeur, nor to form a fcale of the curiofity of modem arts ; not to collect medals, or to collate manu- fcripts; but to dive into the depth of dungeonsj to plunge into the infection of hofpitals ; to furvey the manfions of forrow and of pain ; to take the gauge and dimenfions of mifery, depreffion, and contempt ; to remember the forgotten ; to attend to the negle6led ; to vifit the forfaken ; and to compare and collate the diftreffes of all men, in all countries. His plan is original ; and it is as full of genius as it is of humanity. It is a voyage of difcovery, a circumnavigation of cha- rity; and already the benefit of his labour is felt more or lefs in every country.
' ' This
26l
This benevolent man, who went about vifiting prifons, and relieving the affliaed, fpeaking of the putrid, or jail-fever, fays, " If it were alked me, what is the caufe of this difeafe? I fliould not anfwer, a want of cleanlinefs ; for I have found in. forae prifons, cells, and dungeons, as of- fenfive and dirty a& any I have obferved in this country, where, however, this diftemper was, un- known ; I am obliged to look out therefore for fome other caufe of its production. This, in my- opinion, arifes from want of proper ventilation, and the corruption of the fluids. Our convicts are ironed, and thru-ft into clofe ofFenfive dungeons,, and there chaiped down, fome of them,, without ftraw, or other bedding ; in which they con- tinue, in winter, fixteen or feventeen hours out of the twenty-four, in utter ina£tivity, and ini- merfed in the noxious effluvia, exhaling, and not carried o6f from their own bodies j on this, ac- count, the jail-fever is always, obferved to reiga more in our prifons during winter than in fum- mer; contrary, I prefume, to the nature of other putrid difeafes. Their diet, at the fame tinie,, i,s low and fcanty, and they feel this change the more feverely, being before accuflomed, ge- nerally, to free diet, tolerable lodgings, and vi- gorous exercife, and the fluids cannot fail fooii to degenerate under fo many caufes of ficknefs, and defpair.
Let
262
Let me draw the fkctch only of a fingle cap- tive. It is taken from the life. I had to look through the twilight of his grated door tp take his true features,
I beheld his body half wafied away with long expeftation and confinement, and felt what kind of ficknefs of the heart it was which arifes from hope deferred. — Upon looking nearer, I faw him -pale and wan : — in thirty years the weftern breeze had not once warmed his blood — he had feen no fun, no moon in all that time — nor had the voice of friend or kinfman breathed through his lattice : — his children — but here my heart be- gan to bleed — and I am forced to go on with another part of the portrait. He was fitting upon tiie ground upon a little ftraw, in the furtheft corner of his dungeon, which was alternately his chair and bed 5 a little calendar of fmall fticks were laid at the head, notched all over with the difmal days and nights he had pafTed there — he had one of thefe little fticks in his hand, and with a rufty nail he was etching another day of mifery to add to the heap. As I darkened the little light he had, he lifted up a hopelefs eye towards the door, then caft it down — fhook his head, and went on with his work of afflitlion. I heard the chains upon his legs, as he turned his body to lay his little ftick upon the bundle — He gave a deep figh — I faw the iron enter into his foul — I burft into tears—
This
263
This is too faithful a pitture of every prifoner, fume few excepted, who appear totally devoid of feeling. Hence it is, fays Howard, and I fpeak from my own obfervations, during many fuccejGTive years, that more die of the Jail-fever than by the arm of the executioner.
The hiftory of the Boullam fever, as it has been called, is a ftriking inftance of a felf-gene- rated fever.
The Hankey failed from England, in company with another fliip, both chartered by the Sierra Leone company, loaded with ftores and adven- turers, for the proje£ted colony at Boullam, about the beginning of the month of April, 1792. When thefe fliips failed, and during the voyage out, the crews and fettlers were all healthy ; and as the latter were in general of the middling clafs of people, and appeared to be induced to fettle in this new country, more from the delufive profr peel of wealth held out to them, than by apy de- privation of the means of fubfiftance in their own country, no fufpicion whatever can be en- tertained of the exiftence of latent infeftioii. among them ; nor can marfli effluvia be fuppofed as the origin of the djfeafe which afterwards fvvept off fo many of thofe unhappy people, Boullam, being furrounded by the fea, enjoys all the advantages of the fea-breeze 3 and being dry, and not incommoded by any marfliy tra6ls, it is confidered as the healthicft fpot on the windward
coalt,
264
CQ^ft\ It is not inhabited, but occafionally vifited by the natives of the adjoining continent, ■who have fniall fcattered patches of millet on it. It is, however, deftitute of frefli water ; and that, procured by digging temporary wells on the beech, is brackifh, and confequently unwhole- fome. The negroes of this part of Africa ai-e fe- TDcious in an extraordinary degree ; and are even faid to "be cannibals. This circumftance prevents ing the erection of any fort of accommodation on iliore, during the nine months the Hankey lay
* This part of Africa is allowed, by all who have vlfited if, to be uncommonly healthy and pleafant, I have converfed with feveral intelligent captains of flave-ftiips, who have uni'^ formly agreed in this point: and indeed the appearance of the flaves brought from the windward coaft, part of which this is, conftitutes a convincing proof of the falubrity of the climate. Many travellers have given their teflimony to this efFeft : the Chevalier de Marchais, in particular, is very full of its praife ;
Le lit dp cette riviere (Sierra Leona) renferme quantite d'ifle§ d'un terrein parfaitement bon, gras et profond qui prodiiit de lui-m^me et prefque fans culture tout ce-qui eft necefTaire a 1» vie— Mais ce qu'on ne fgauroit eftimer affez, c'eft que Pair y efl tres pur, et qu'on n'y ell: point fujet a ces maladies violente? et dangereufes qui regnent a la Cote de Guinte et qui ont fait perir tant d'Europcens." See Voyage du Chev. Des Marchais en Guin6e et ifles voifines, par le R. Pere Labat. torn. I. p. 58--~ Dr. Lind alfo fpeaks favourably of thofe iflands, and the ad- joining continent. Difeafes of Hot Climates, p. 56. Capt. Nor- ris, in his African Pilot, lately publifhed, the moft corre£V thing of the kind I ever faw, lays down 3oullarn in lat. N. 11 ; and long. W. from Farro, 3 ; almoft in the mouth of Rio Grande, having Hen Ifland between it and the ocean. It appears to be pearly circular, about 15 miles long, and 15 broad ; and con- fequently about 45 round.
there
there, the fettlers were obliged to ]ivc on board i aiid the rainy feafon . coming on ahuofl; imme- diately after their arrival, and the heat being at the fame time exceffively great, they endeavoured to fheher themfelves from both, by raifmg the fides of the fhip feveral. feet, and covering her with a wooden roof.
Among upwards of., two hundred people, of whom women and childreii conftituted a part, thus confined in a fultry moil^ atniofphere, clean- linefs could not be well attended to, however well-inclined the people themfelves might be. Thefe circumftances, joined to the depreffion of mind confequent upon their difappointment, muft certainly be confidered as the caufes of the ma- lignant fever which broke out among thofe un- fortunate people, fometime after their arrival at Boullam*. And no doubt can be entertained, that neglefting to fw^eten the flu'p, to ventilate her afterwards, and to deftroy the clothes, bed- ding, &c. of thofe who died on board, was the fole caufe of her retaining the feeds of infection when fhe arrived at this port, Th? following fa£ls will ferve to illuftrate this : Capt. Coxe, finding the water at Boullam unwholefome, proceeded with his fliip to Bijjao, where there is a Portu- guefe fettlement, for a fupply. The fliip was na- vigated by about twelve feamen, moft of whom
* Such is the origin of the jail-fever, according to Howard. Vide p. 265. It iti here we deliver the opinion of Dr. Chifliolm.
had
•266
had not experienced fickncfs, and had been pro- bably procured trom Sierra Leone : at any rate they were then taken on board for the firft time. Of thefe^ before tlie return of tlie Hankey to Boullam, nine died ; and the remainder were re- duced to a deplorable ftate.
The time for which the Hankey was char- tered being expired, Mr. Paiba, with his fa- mily, intended to return to England in her ;
as no feamen could be procured, they ■were obliged' to proceed to fea, having on board the captain fick, and only the mate, Mr. Paiba, and two feamen to navigate the fhip. With much difficulty they arrived at St. Jngo, where they fortunately found the Charon and Scorpion fhips of war. Capt. Dodd, of the for- mer, humanely rendered them every fervice in his power ,; and, on leaving them, put two men of each fliip on board the Hankey. With this aid they proceeded 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 tVom the fliips of war were feized with the fever, which had carried off three-fourths of tliofe on board the Hankey at Boullam ; and having no affiftance, two of the four died : the remaining two were put on fliore here in the moft wretched ftate poffible. Capt. Dodd, on his arrival at Barbadoes from the coaft of Africa, was ordered by Admiral Gardener to
convoy
267
convoy the homeward-bound fleet of merchant- men. In the execution of his orders, he came to Grenada on the 27th 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, to repair her rigging, &c. that from this circumftance, and the communi- cation which his barge's crew had with that fliip, the peftilence was brought on board both Jliijis i and that of the Charon's crew thirty died ; and of the Scorpion's about fifteen. The Hankey ar- rived at the Port of St. George on the 19th of February, in the moft diftrelTed fit nation ; and for a few days lay in the Bay, but was afterwards brought into the Carenage *,
From
* Our Lieut. Governor, Ninian Home, Efq. fometime after the diieafe became epidemic, informed me, that in confequence of the information he had received of the clothes, &:c. of the viftims of the fever ^t Boullam being ftill on board the Han- key, he ordered Capt. Coxe to be brought before him and fome gentlemen of the council, &c. He then acknowledged that all the efFefts of thofe who had died were then on board his ftiip; and faid, that he would not deftroy them, unlefs he was indem- nified for the lofs he might fuftain, ftiould the heirs of the de- Qeafed call on him for thofe effefts. Every argument was ufed to induce him to deftroy the articles, but the only one which influences a man of this defcription, Indemnification ; and he of courfe carried the feminium of the difeafe to England when the Hankey failed with a convoy in July. Mr. Hume was fo jmprelT'ed with the idea of the danger Capt. Cox's condu£l might be productive of on the arrival of the fhip in England, that he
wrote
^68
_^ From this period we are to date, fays Dr. Chiiholm, the cornmencpment of a difeafe before, I believe, unknown in this country, and certainly unequalled in its deftructive nature.
— IMQva peftis adeft : euj ncQ vjrtute r^Wii Nec telis, arinilVe potell • ■ . ovid.
. The manner in which this difeafe wg$, firfl communicated, and its fubf^quent progr^fl, too plearly evinced its jusilign^nt and peftii^^ti^ll pitture,
. A Capt. Rmingtm, an intimate acquaintance of Capt, Coxe'g, was the firft perfon who vifjted the Hankey, after h^r arrival in St.. George's Bay, This perfon went on board of her in th^ evening 4tfter flie anchored, and remained three day* i at the end of which time he left St. George's, and proceeded in a Drogher * to Grenville Bay, where his fliip, the Adventure, lay. He was feized with the malignant peftilential fever on the palfage 5 and the violence of the fymptoms increafed fo rapidly, as, on the third day, to put an end to his exiftence.
The crew of the Defiance, of Blythe Port, near Newcaftle, were the next who fuffered by vifiting
wrote to the Secretary of State, ftating the danger. Proper riottice of this reprefentation waa taken by Government ; for the Hapkey was obliged to perform quarantine ; or perhaps we might have had the fame fever in F.ngland, and a fecond plague.
* A coafting velTel.
this
269
this (hip : the Mate, boatfzvain, and four faikrs^ went on board the day after her arrival : the mate remamed either on deck or in the cabin, but the reft went below, and fliaid all night there. AH of them were immediately feized with the fever, and died in three days. The mate was alfo taken ill, but, probably from his having been lefs ex- pofed to the virulence of the infeQion, he reco- vered.
The crew of the ihip Bailies, from the fame im- prudent civility or curiofity, were the next who fuffered. Thefe communicated the infection to the ihips neareft them j and it gradually fpread from thofe neareft the mouth of the Carenage, where the Hankey for fome time lay, to thofe at the bottom of it ; not one efcaping, in fucceffion, whatever means the captains took to prevent it 5 even the fmell and fmoke of coal-tar, which is unc<5mmonly pungent and penetrating', had no effeft as a preventive ; for the Hope of London, then careening, and having her bottom paid with this bitumen, received the infedUon as extenfively as the others.
In the fliort fpace of time from the beginning of March to the end of May, 2CX) of about 500 jailors, who manned the ftiips in the regular trade^, died of this fever. If to thefe we add, thofe who fuffered on board Guinea-fhips, and other tran- lient veffels, the number cannot fall Ihort of 250 ;
which
270
which is neatly one in three, or a third of all thf^ failors during about ten weeks in harbour.
From the beginning of June till the middle of Augufl, when the difeafe had nearly difappearedy the number of failors was confiderably diminifhcdj by two fleets having failed for Europe, but the mortality was proportionably great. Although fo great a mortality naturally leads us to form a dreadful idea of the virulence of the contagion which gave rife to it, it muft not remain uncon- fidered,- that the predifpolition of the clafs of men among -ivhom it happened, was very great. The failors were men from the age of fifteen to fifty j and the circumftances whieh appeared to predif-^ pofe them more ftrong:ly than other m€h to the a£lit)Ti of the contagion,- were violent exereife in the fun ; the immoderate u-fe of midiluted new rum J bathing in a {late of intoxicaition, and often when violently heated ; fleeping on deck during the night. All the caufcs of direft, or indireft debility, predifpofe to catch the infection of contagious fever.' Fear has a remarkable effect this way. Other circumftances which did not depend fo much on their own prudence, no doubt,, contributed very much to give the difeafe fo very fatal a tendency j the damp heat between decks ; the exceffive filth of moft of the fhips j and the uncleanly ftate of the perfons and clothc3 of the men themfelves.
About
About the middle of April the difeafe began tG appear on fhore. The firft houfe it fliewed itfelf in, was that of Meflrs. Stowewood and Co. fituated elofe to the wharf ; and the infeiStion was evi- dently introduced by a negro-wench, who took in failors clothes to wafli. The whole of the fa- mily were fucceflively affli6lcd with it ; and by them communicated to all thofe with whom they had any intercourfe- The difference of living, and the being more apart, difpofing them to be lefs a6led on by the contagion, with the fupe- rior care and attention to cleanlinefs, rendered the fever infinitely milder when it appeared among the inhabitants. The manner, however, in which it fpread in town, clearly evinced its contagious nature ; for all who, from friendfhip, bufmefs, or duty, communicated with the difeafed, were themfelves infefted j and no inftance occurred wherein the contagion could not be traced to its particular fource.'
That part of the garrifon quartered nearefl: to wliere the Hankey lay, were the firft of this clafs of men wIk) received the infeftion. A barrack, con- taining nearly one-half of the 45th regiment, was fituated exactly to leeward of the Hankey, aud:dir- tant from her about two hundred yards. It is not to be fuppofed, that this circumftance alone could be produftive of a difeafe arifing from contagion; but it was fo in a fecondary manner, by exciting the curiofity of fome of the officers. One of thefe vifited the Hankey, and, with two or three fol-
diers
2j2
diers who rowed his boat, remained on board fome time. The confequence of this imprudence was fatal to himfelf almofl: immediately after j and, in a little time, too many of the men : all the officers and men were fucceflively feized with the difeafe ; but it proved fatal only to recruits who had lately joined. The ftrength of the regiment at this time was 280, and of thefe 24 died; fo that the proportion was one to fomething lefs than twelve. The fmallnefs of this proportion arofe from the mode of treatment by mercury 5 as will be fliewn hereafter.
About the beginning of May, the difeafe made its appearance in the detachment of Royal At til- lery : a circumftance rather extraordinary, as that corps were quartered in a fituation far removed from the focus of infeftion. It was evidently produced, however, by the communication which the gunners, doing duty in Fort George, had with the 45th regiment ; and the predifpofition of the men to receive infection, as far as that could be induced by excefles in drinking, and other irregularities, was by no means lefs than that of the failors and foldiers of the 45th regi* ment. Of 84 people belonging to the ordnance department at that time, about 56 were feized with the difeafe before the 1ft of July, and of thefe five died : a trifling mortality, confidering the nature of the complaint. All thefe men, however, had been about three years in the country,, and confequently fuffered lefs from the
difeafe.
273
fliTeafe, than about 27 recruits who joined the artillery in July. Of 26 of thefe unfortunate men who were infected, 21 died before the middle of Auguft : a dreadful inftance of its peculiar ten- dency to prove fatal to ftrangers to the climate.
About the middle of June, the difeafe broke out in the 57th regiment -y and among the artificers and labourers on Richmond-hill. The infeftion was communicated by fome of the latter, whp had vifited their friends in town labouring under it. All were fucceflively feized with it i but it fell heavier on the officers than the men, feveral of the former being young men lately arrived from Europe. The proportion of deaths was about on^ to fifteen.
The difeafe, in the courfe of the months of May, June, and July, appeared in feveral diilinft and diftant parts of the country, whither the in- fection was carried by perfons who imprudently vifited infe6led houfes in town.
But the infeftion was not confined to Grenada alone ; from this, as a focus, it fpread to Jamaica^ St. DomingOy and to the other iflands, by means of veffels on board of which the infeftion was retained by the clothes, more efpecially the woollen jackets of the deceafed failors ; and the multitude which petiflied from this caufe fcarcely credible.
Vol. IV.
SECT.
274
SECT. XLVIII.
SECOND CAUSE, OR PUTRID FEVER ARISING FROM ANIMAL AND VEGETABLE MIASMATA.
Another, and I believe a more frequent caufe of putrid fever, is the miafms from the cor- ruption of animal and vegetable fubftances.
PutrefadHon is the great procefs appointed by the Creator, for the refolution of animal and vegetable fubftances into the elements from which they were firft formed. By this procefs, the oak and the bramble, the cedar and the hyffop, fruits, whether delicious or nutritive, or acrid or poifon- ous, the moft beautiful of the human fpecies, and the moft frightful of the other tribes of ani- mals, are all reduced to one common lot : they finally return back to their original and primeval elements. Hence the adage — Omnia metit tempus.
This refolution of bodies, when philofophically confidered, is equally wonderful with their for- mation j and is alike governed by regular and in- variable laws. Every plant brings forth its own kind, and every animal its own fpecies. Thefe live, they are nouriflied, and filently hafteri to decay; they pafs back to their elementary Jlate, and are again employed as the conjiituent -j^arts of other vegetables and other animals. Such, with re-
fpea
275
{pe£t to the material part of the creation, is the amazins: circle of life and death ! a circle in which nature keeps her fteady rounds, and moves agreeably to laws eftablifhed by the Al- mighty.
Vegetable fubftances which confift of hy- drogen, OXYGEN, and carbon, maintain for a long while their organized firudtiire, and putrefy with difficulty. Having palTed through firft the 'vinous* and then the acetous fermentations '\, they at length become fubjeft to the pitrefaEtive fer-
* The firft efFe£l we fee produced on vegetable fubftances which have loft their vital tRiNciPLE, is the deftruftion of the equilibrium, or juft union of their three Gonftituent prin- ciples {hydrogen^ oxygen^ and carbon)^ by the aftion, or opera- tion, of heat and rnoifture. The oxygen unites with the CARBON, and the fermenting juice is covered on its furface vi'ith. carbonic acid gas. The fpecific gravity of the liquor is now confiderably diminiflied, and if expofed to diftillation, it affords a light inflammable fubjiance, called alkohol, or spi- rit OF wine: which, as we might reafonably expeft from the volatilization in great part of the carbo7i and oxygetiy is almoft entirely made up of the other vegetable principle, hydrogen : for if eight ounces of spirit ok wine or alkohol be burnt in a confined apparatus containing only oxygen gas, the produft will be nine ounces of water. The alkohol, having in this cafe increafed its weight an ounce, muft have at- trafted fame thing, arid this fame thing can be nothing elfe but OXYGEN, the bafe of oxygen air, and the caloric of the oxygen air being difengaged, is feen in its active form during the combuftion.
f This fecond Jlage of fpontaneous decompofition, as it is called, is nothing more than the abforption or imbibing of OXYGEN from the air.
T2
276
meni'*, and the hydrogen of the vegetable efcapes in the form of hydrogen gas, while the OXYGEN and carbon evaporate in the form of carbonic acid gas, leaving nothing behind but a fmall refiduum of carbon and vegetable earth.
It is different with fubftances containing a por- tion of AZOT. The equilibrium of parts is foon deftroyed. Hence it is that animal excrements, which contain, like other animal matter, a quan- tity of AZOT-j-, are added to the elements ca- pable of putrefaction, to form compofts or dung- hills.
The addition of azot not only accelerates the putrefaftive procefs, but the azof combining with the hydrogen, affords a new produft, which is
AMMONIAC or VOLATILC ALKALI J. Mouf.
Bertholet has proved, by a variety of experi- ments, that AMMONIAC is produced by the union of azot and hydrogen, for if the azot in the animal fubftances be difengaged by the a£tion of diluted nitrous acid, no ammoniac will be produced,
* When the fpontaneous decompofition is fuffered to pro- ceed beyond the acetous frocefs, then the thirel jiate, or pu- trefactive F E R M E'N T, ta kes place.
f The putrefactive procefs is moft eminently perceived \%. animal bodies. Thefe either putrefy immediately; or, if the putrefaction be Jireceded by either of the other ftages, their duration is too fhort to be perceived.
% This com/iomid did not naturally exift in the animal fub- ftance, but is formed by the combination, in a certain pro- portion, of two of its Gonftitueut elements,
and
277
and in all cafes putrifying fubftances furnilli AMMONIAC only in proportion to the azoi they contain.
The following experiment alfo fully proves the compofition of ammoniac.
If AMMONIAC be combined, fays Monf. Four- CROY, with a METALLIC oxYD, the hydrogen of the ammoniac will unite with the oxygen of the METALLIC OXYD, and form water^ whilft the metal is revived, and the azot, being left free, will unite with the caloric and affume the form of a gas or air.
Ammoniac has a peculiar penetrating odour. In the putrefa£lion of animal fubftances fome- times ammoniac predominates, which is eafily perceived by its . fharpnefs upon the eyes, and fometimes, as in putrid herrings, the phospho- rated HYDROGEN GAS is moft abundant.
Phosphorus is found in almoft all animal fubftances, and in fome plants which give indeed a kind of animal analyfis.
It is chiefly to ammoniac (hydrogen and azot). and PHOSPHORUS dilTolved in hydrogen gas, that the foetor ilTuing from the putrefaftion of animal fubftances depends.
This vapour is highly hurtful to animal life. When accumulated, if the pick-axe of the grave- digger unfortunately ruptures the coffin, it burfts forth, and oftentimes proves fatal to the fexton, and is feen to affe6l every perfon at a dijiance with vertigo, naufea, and uneafinefs. After having ob-
ferved
278
ferved the conftant dread that grave-diggers have for this poifonous vapour, after having feen the cadaverous palenefs of countenance, and other marks of the gradual atlion of a flow poifon, fo evident in the appearance of all men employed much in church yards ^ it is impolTible not to believe that the air in their immediate neighbourhood mud, in fome meafure, injure the health of the in- habitants.
I have foanetimes obferved, fays Dr. St. John, a pheenomenon to take place during the putrefac- tion of human bodies, and which I cannot but think of very great importance to be enquired into and known. This is the exhalation of a particular gas, which is the moft active and dread- ful of all corrofive poifons, and produces moft fudden and terrible effe6ls upon a living crea- ture. This I more than once have had an oppor- tunity of remarking in the dilTefting room of Mr. Andravi at Paris*. The aeriform fluid which is exhaled at certain times frgfn animal bodies in putrefa6tion, is infinitely more noxious than any
* Mr. Andravi has had more aftual praftice in anatomy than any other man in Europe. He has difcovered a method of amputating the humerus at the articulation, by which he faves the deltoid mufcle, and the parts are healed in a few days : an improvement very little known, but which in Eng- land would render him immortal. He is looked upon at Paris as a very Angular man, becaufe he always fpeaks his mind, and is as much an admirer of fimplicity in chirurgical opera- tions as our late celebrated Meflrs. Pott and Hunter.
elafl:ic
279
elaftic fluid as yet difcovered. So that it is ut- terly dangerous to approach a body in a ftate of putrefa£tion. I have known a gentleman who, by nightly touching the inteftines of a human body beginning to liberate this corrofive gas, was afFefted with a violent inflammation, which in a very fliort fpace of time extended up almoft the entire of his arm, producing an extenfive ulcer of the moft foul and frightful black appearance, which continued for feveral months, and reduced him to a miferable fl:ate of emaciation. This is only one example of many which I have feen. I have known a celebrated profeflbr who was at- tacked with a violent inflammation of the nares and fauces, from which he with difficulty reco- vered, by Hooping for an infl:ant over a body which was beginning to give forth this deleterious fluid. It is happy for mankind that this particular ftage of putrefafiiion continues but for a few hours j and what may appear very, remarkable, this de- ftruftive gas is not very difagreeable in . fmell, and has nothing of that abominable and loath- fome fetor produced by dead bodies in a lefs dan- gerous fl:ate of corruption ; but has a certain fmell totally peculiar to itfelf, by which it may be infl:antly difcovered by any one that ever fmelled it before.
This is an objeft very worthy the attention of phyficiansi it is both extremely interefting, and very little known j but at the fame time it is a
ftudy
28o
fludy In the higheft degree unpleaiant, from the deteftable fmell and naftlnefs which attend the putrefa£lion of animal bodies j and a man muft be armed with uncommon philanthropy and re- folution to attempt it. I think it probable that there is a rapid fixation of the bafis of vital air in dead bodies at a certain ftate of putrefaction, on account of the luminous appearance which they fometimes make, as if all over painted with liquid fire. This phofphoric flate, if I may fo call it, exifts but for a few hours at the moft; and fometimes affords a more beautiful and brilliant appearance than can be imagined. But whether it takes place in every body, or w-hether it precedes or follows the exhalation of the corrofive gas above-mentioned, I have not been able to difcover. As I know of nothing more a£live or corrofive in nature than the gas above- mentioned, which difcngages from animal bodies in putrefaction, I think it probable, that the fame gas modified, or mixed, or united with others, niay be the occafion of putrid fever, &c. If fo, it furely deferves our attention; and by acquiring a knowledge of its caufe, nature, and affinities, we may know how either to prevent its production, or proteCt ourfelves from its in- fluence after it is produced. We have had an Englilhman generous enough to make a voyage to the Levant, to cure the Turks of the plague ; fuch an adventure, undertaken by men of genius
and
28l
and fcience, may be productive of more benefit to mankind J and if my ideas arejufl, we have here a feeming poffibility of being able to tear up the evil by the very roots.
Becher had the courage to make obfervations, during the courfe of a year, upon the decom- pofition of a carcafe in the open air ; and to obferve all the phaenomena. The firft vapour which rifes, fays he, is fubtile and naufeous : fome days after it has a certain four and pene- trating fmell. After the firft weeks, the ikin be- comes covered with a down, and appears yel- lowifli ; greenifli fpots are formed in various places, which afterwards become livid and black; a thick moffy or mouldy fubftance then covers the greateft part of the body j the fpots open, and emit a fanies.
Carcafes buried in the earth prefent very dif- ferent phcenomena ; the decompofition in a bury- in2:-srround is at leaft four times as flow. It is not perfectly ended, according to Mr. Petit, tilt three years after the body has been interred, at the depth of four feet ; and it is flower in pro- portion as the body is buried at a greater depth. Thefe fafts agree with the principles which we have already eftabliflied for bodies buried in the earth, and fubjeCted to laws of decompofition very different from thofe which take place in bodies expofed to the open air. In this cafe the de- compofition U favoured by the waters which fil- ter
282
ter through the earth, and diflblve and carry with them the animal juices. It is alfo favoured by the earth, which abforbs the juices with more or lefs facility. MefTrs. Lemcry, Geoffroy, and Hunaud, have* proved that argillaceous earths exert a very flow a£lion upon bodies; but when the earths are porous and light, the bodies then dry very fpeedily. The feveral principles of bodies abforbed by the earth, or carried by the va- pours, are difperfed through a great fpace, im- bibed by the roots of vegetables, and gradually decompofed. This is what pafTes in burying^ grounds in the open air ; but it is very far from being applicable to the fepulchres which are made in churches and covered places. Here is neither water nor vegetation; and confequently no caufe which can carry away, diflblve, or change the nature of the animal fluids: and it is an inftance of wifdom in the French government, that has prohibited the burying in churches; a praftice now confidered by them as a fubje£t of horror and infection.
The accidents which have happened at the opening of graves and vaults, are but too nu- merous to render any apology neceflary for our fpeaking a few words refpefting the method of preventing them.
The decompofition of a body in the bowels of the earth can never be dangerous, provided it be buried at a fufiicient depth, and that the grave be
not
283
not opened before its entire and complete de- compofition. The depth of the grave ought to be fuch that the external air cannot penetrate it j that the juices with which the earth is impreg- nated may not be conveyed to its furface j and that the exhalations, vapours, or gafes, which are developed or formed by decompofition, fliould not be capable of forcing the earthy co- vering which detains them. The nature of the earth in which the grave is dug, influences all its effe61:s. If the ftratum which covers the body be argillaceous, the depth of the grave may be lefs, as this earth difficultly aflfords a pafTage to gas and vapour ; but in general it is. admitted to be neceflary that bodies fliould 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. This decompofition, according to Mr, Petit, is not perfect until the expiration of three years, in graves of four feet depth j or four years, when they are fix feet deep. This term affords many varieties, according to the nature of the earth, and the confl:itution of the fubjefts buried in it ? but we may confider it as a medium. The per- nicious cufl:om which allows a fingle grave to fa- milies more or lefs numerous, ought, therefore, to be fuppreffedj for in this cafe the fame grave may t?e opened before the time prefcribed. Thefe are
abufes
284
abufes which ought to occupy the attention of government ; and it is time that the vanity of individuals fliould be facrificed to the public fafety. It is likewife neceffary to prohibit bury- ing in vaults, and even in coffins. In the firft cafe, the principles of the bodies are fpread into the air, and infeft it ; in the fecond their decom- pofition is flower and lefs perfect.
If thefe precautions be negle£led ; if the dead bodies be heaped together in too confined a fpace; if the earth be not proper to abforb the juices, and decompofe them; if the grave be opened before the entire decompofition of the body — unhappy accidents will, no doubt, be produced; and thefe accidents are but too com- mon in great towns, where every wife precaution is neglefted. An inftance of this happened when the ground of the church of St. Benoit, at Paris, was dug up a few years ago ; a naufeous vapour was emitted, and feveral of the neighbours were affected by it. The earth which was taken out of this grave was un£tuous, vifcid, and emitted an infectious fmell. MefTrs, Maret and Navier have left us fimilar obfervations.
Moft authors have obferved putrid fevers to have arifen from the corruption of the dead bo- dies after battle. This Ga/en notes as one of the caufes of peftilential fevers *, and is fupported
* Epit, Galen de Feb. Differ, lib. I. cap. iv.
by
2 85
by the teftimony of other authors j in particular by ForeJiiiSy who was eye-witnefs to a dlftemper of this kind, (which indeed he calls a plague) owing to the fame caufe, attended with buboes, and a high degree of contagion *. The fame author alfo gives an account of a malignant fever break- ing out at Egmont, in North-Holland, occafioned by the rotting of a whale that had been left upon the Ihoref. We have a like obfervation of a fever affefting a fliip's crew, upon the putre- fa£lion of fome cattle they had killed in the ifland of Nevis, in the Weft-Indies \. Thefe men were feized with a pain in the head and loins, great weaknefs and diforder of the ftomach, ac- companied with a fever. Some had carbuncles, and it was remarked that purple fpots appeared ' even after death.
Foreftus informs us of a plague (rather a pefti- lential fever), that raged at Fenice in his time, owing to the corruption of a fmall kind of fifh in that part of the Adriatic §. And the fame author quotes Montanus, for a defcription of the pefti- lential endemic fever at Famagujla, in Cyprus, arifmg in furamer from the corruption of a lake in the neigbourhood.
* Obfervat. lib. VI. obf. xxvi.
f Obf. ix. fchol. Paraeus fays, tliat m his time the like happened on the coaft of Tufcany. Fid. de Pefte^ cafi. III. + Traite de la Pefte. § Obfervat. lib. VI. obf. ix. fchol.
Hiftory
28G
Hiftory abounds with many examples of pcill- lential fevers, added to the other miferies of a fiege : nay, there is fcarce any inftance of a town •being long inverted, without fomc fatal malady of this kind. Sometimes it may be owing alfo to the filth of a place, crowded with people and cattle brought in for Ihclter 5 as it formerly happened both at Athens * and at Rome f.
From this view of the caufes of malignan! fevers and fluxes, it is eafy to conceive how in- cident they rauft be to all populous cities, low and ill-aired > unprovided with common fliores ; or where the ftreets are narrow and foul ; or the houfes dirty ; where water is fcarce ; where jails or hofpitals are cfowded^ and not ventilated and •kept clean ; when in fickly times the burials are within the towns |, and the bodies not laid deep ; when flaughter-houfes are alfo within the walls ; or when dead animals and offals are left to rot in the kennels, or on dunghills.
Though the putrefa£l:ion of a vegetable fub- ftance is not to be reckoned nearly fo fatal as that of animals, it is not, however, without dan- ger J for vegetables, rotting in a clofe place, yield a cadaverous fmell ; and we have in- ftances of malignant fevers occafioned by the
* DioDOR. 5'/V«/. Blbliothec. Hiff. lib. XII. cap. xiv. f Tit. Liv. anno U. C. 291. % ScRKTA de Feb. Caftrens.
effluvia
28/
effluvia of putrid cabbages as well as of plants in marflies.
Forejiiis imputes the plague at Delft, in the year 1557, to the eating of mouldy grain, that had been long kept up by the merchants in the time of a dearth f. And I have heard it re- marked, that in this ifland the dyfentery is ob- ferved to be moft frequent among the common people, in thofe parts where they live wholly on grain, when the preceding crop has been da- maged in a rainy feafon, or kept in damp gra- naries.
We cannot but obferve, that though all moift countries are fubje£l to intermittents, yet if the moifture is pure, and the fummers are not clofe and hot, thefe fevers will moftly appear in a re- gular tertian fhape, and be eafily cured. But if the moifture arifes from long ftagnating water, in which plants, fifties, and infe6ts, die and rot, then the damps being of a putrid nature, not only oc- cafion more frequent, but more dangerous fevers, which oftner appear in the form of quotidians, or double tertians, than that of fingle ones. Thefe are not only apt to begin in a continued ftiape, but after intermitting for fome days, to change again into continuah of a putrid and malignant nature. It is remarkable how much thefe fevers
* Dr. Rogers's Eflay on Epidemic Difeafes, p. 41. t Obfervat. lib, vi. obf. ix.
vary
288
vaiy with the feafon ; for, however frequent, vio- lent, or dangerous, they have been in the decline of fummer, or beginning of autumn, when the putrefaftion is at the height, yet before winter they are reduced to a fmali number, become mild, and generally affume a regular tertian form .
The worft kind of fevers are mentioned by Sir John Pringlc, in his obfervations on the di- feafes of the army in the campaign in the Low Countries, to prevail in the country bordering upon the inundations in Dutch Braba-nt , the next were thofe of Zealand ; of the third degree were fuch as appeared in the lines of Berg en-op- Zoom j and the mildeft fort, comparatively, were thofe that were moft frequent in the cantonments round Eyndhven, in villages rendered moifl: by plantations and under-ground-water, but that not putrid- I {hall defcribe the firft and worft kind, from which it will be eafy to judge of the nature of the reft.
In the end of July 1748, when the troops had been about a fortnight or three weeks in the can- tonments, whilft the days were fultry, but the nights cool and foggy, feveral of the men (of thofe regiments that lay neareft the inundations) were feized at once with a burning heat and vio- lent head-ach i fome feeling a fliort and flight chillinefs before ; others mentioning no preceding diforder. They complained, befides, of intenfe
thirft.
289
thirft, aching of the bones, a pain of the back, great laflitiide and inquietude, frequently of a naiifea, ficknefs, or a pain about the pit of the ftomach, fometimes attended with a vomiting of green or yellow bile of an ofifenfive fmell. The pulfe was, upon the firft attack, generally de- preffed ; but rofe upon bleeding. .
At Copenhagen, in the year 1652, a fever beggn in autumn, after an unufually hot and dry fum- mer *. The city is fituated in a low and marfhy country. The fever was accompanied either with quotidian or tertian paroxyfms, with bilious vo- mitings, a burning heat, violent head-achs, fre- quently a delirium ; and with petechial fpots, that came out in the fits, and difappeared in the re- mifllons. Thefe, with an extraordinary debility, indicated the malignant nature of the fever, far* ther afcertained by its ending in profufe fweats, abfceffes, a diarrhoea, or dyfentery. The author of this account, Thomas Bartholine, upon differing the bodies, and finding the ftomach and duodenum always inflamed or mortified, afligns thefe parts as the feat of all malignant fevers.
In the year 1669 a like fever raged at Leyden, defcribed by the famous Sylvius (De le BoeJ f , who lived at the time, and pra6tifed there. The fituation of this place is alfo very low and damp.
* Bartholin. Hiftor. Anatomic. Rar. cent. II. hlft. Ivi. •f- pRAx. Med. append, traft. x.
Vol. IV. U The
290
The fpring and beginning of fummer were cold, but the remainder of fummer and autumn were exceeding hot^ with little or no rain, and with a conftant calm or ftagnation of the air. The water of the canals and ditches was highly corrupted ; and the more fo, as the author obferves, by an inlet of falt-water mixing with the frefh. The air being thereby rendered impure, brought on an epidemic fever, of a remitting or intermitting form, and very fatal. Befides a diforder of tlie ftomach, great anxiety, bilious vomitings, quo- tidian or tertian paroxyfms, and other fymptoms, the! conftant attendants of this illnefs, he men- tions fpots, oozing of blood from the nofe and hasmorrhoidal veins, dyfenteric ftools, putrid urine^ great debility, aphtha, and other appearances, that argued an extraordinary refolution and pu- trefaftion. of the blood. " And yet, what is " ftrange," fays Sir John Pringle, " Sylvius afcribed *' the caufe to a prevailing acid*, and treated the " diftemper accordingly ; fo that we cannot help " remarking, that the great mortality among the " principal inhabitants of that city (of which, " he fays, two-thirds died) may have been owing, ** m fome meafure, to the method of cure by " abforbents and other fuch medicines, agreeable to the notion that author, and his followers, " entertained of its caufe."
* Svtv. Prax. loc. cit. dcxxvii.
Thefe,
Thcfcj and other inftances of the fame kind, • may confirm what was obferved before, of the danger arifing from hot and dry fummers to moift and low countrieSi
.'. But the bilious difeafes are ftill more frequent and fatal in the marfliy countries of the fouth, where the heats are longer and more intenfe. In fome parts of . Italy, and other tra6ts of the fame latitude, thefe fevers have appeared with fuch dangerous and putrid fymptoms, as not only, to have been called peflilential, but confounded with the plague itfelf In this fenfe we are to underftand Celfus *, in the terms ■pejlikntia and febris pejientialis, \^-\{\ch. he defcribes as peculiar to the grave ami tempiis and the graves regmies. His meaning is, that the bilious and malignant fever is the difeafe of the latter part of fummer, and of autumn, when the air is thickeft and moft foggy ; and that it is moft incident to low and wet countries.
Rome was always liable to thefe fevers* Galen calls the hemitritaa the epidemic of that city, and fpeaks of its moift air ^. Nay, in the beginning of the Republic^ before the Romans feem to have been aware of the noxious effefts of ftaraating: water, or at leaft knew how to let it off, that place appears to have been fo very fickly, that
* Vid. Cels. de Medicin. lib. I. cap. x. lib. III. cap. vii. ■\ De Temperam. lib. II.
U 2 from
292
from the beginning of the (late, to the year U. C, 459, I find no lefs than fifteen plagues mentioned by Livy * : which yet, from other circumftances, appear to have been only fo many malignant and defl:ru61ive epidemics, occafioncd by the putrid effluvia from the neighbouring marflies. But when drains and common fliores were made, Rome became much more healthful ; and then only the low and wet places of Latium remained fickly. Afterwards, when the city fell into the hands of the Goths, the drains being flopt, and the aquedu6ls cut, the Roman territory became one continued mardi ; which for a fcries of years oc- calioned an incredible defolation j*. And though thefe evils have been fince greatly remedied, yet ftill, by neglecting to draw off the flagnating and corrupted water, after inundations of the Tybe)' fucceeded by great heats, the malignant remit- ting and intermitting fevers become both general and fatal. The diffedions made by Lancifms, added to his excellent account of thofe epide- mics, are a full proof of their putrid nature J.
Although it does not appear that the countries in which Hippocrates praftifed were either marfhy, or fubjeft to inundations, yet we find him fre- quently mentioning thefe fevers as common in
* Lancisius reckons up feveral more from the fame au- thor, Fid. Dijfert. dc Advent. Roman. Cceli Clualit. cap. III. f Id. loc. cit.
X De Nox. Plaud. Effluv. lib. II. epid. I. cap. vi.
fummer
293
fummer and autumn ; and as prevailing moft when wet fprings, with foutherly winds, were fucceeded by hot and clofe fummers. A re- markable conftitution of this kind is defcribed in the epidemics at which time the difeafes were ardent, remitting and intermitting fevers of the worft kind, attended with fluxes, parotids, and eruptions of a pcftilential nature.
Pro/per Alpinus obferves, that the ftagnated ca- nals at Grand Cairo breed every year putrid and peftilential fevers, that prevail in March, Aprily and May, which the conftant foutherly winds make the hotteft months in that country f . He alfo remarks, that the peftilential fevers are both epidemic and fatal at Alexandria in autumn, after the recefs of the Nile. Thefe begin with a nanjea, great ficknefs at the llomach, extraordinary in- quietude, and a vomiting of an acrid bile | : and many have bilious and putrid ftools. Now, as thefe diftempers rage in both cities every year, it is not furprizing, if in feafons uncommonly hot and moift, they fliould be raifed to a true plague. For although the learned author afTerts, that the true plague is not properly indigenous to Egypt, but is brought thither from Greece, Syria, or the ■more fouthern parts of Africa, yet he owns that jt fometinies begins there after extraordinary
* Lib. IIL § ili.
■\ De Medicin. iEgyptior. lib. 1. cap. xiv, \ The author's phrafe is, bilis virulaita.
inundations
294
Inundations of the Nile-, when the water, ex- tending itfelf beyond the ufual drains, remains on the land, and forms into putrid marfhes*.
There is a pretty exaft uniformity in the ap- pearances and nature of the fevers and fluxes which attack flrangers in Guinea; only their ma- lignity or violence, and the mortality proceeding from them, in the rainy feafon, are in propor- tion to the fituation of the place, and its venti- lation.
The natives themfelves are not exempted from thofe djfeafes. They are in general fliort-lived, and perceive as various degrees of purity and infalubrity of the air, in different fpots of their country, as are felt in Europe, or in any other part of the world. On account of the badnefs of the climate, black priefts, natives of the country, are hired by the Portuguefe to undcr^ take the converfion of thofe of their own colour, who refide in unhealthy places : hence the milTions of Rio Nunes and at Gagafliore have been rendered both honourable and lucra- tive, to fuch black miffionaries as chofe to un- dertake them.
We fliall conclude our account of Guinea, with fome extrafts frqm the journal of the fur- ■geon of a fliip, which failed up the rivers of that country : " Upon the 20th of February, we failed from Liibon, and on the 16th of March arrived at
^ Pe Medicin. ^gvptior. lib. I.. cap. xv.
' ■ the
'2 95
the ifland of St. Jago. Here we found fliips of different nations, whofe crews, as alfo the white people on the ifland, were perfectly healthy. Tlie latter, however, feemed to have been fickly, and many of thein were afflifted with ague- cakes, or hard fwellings on the feat of the fpleen.
« Upon the 5 th of April, we failed up the river Gambia, and found all the Englifli in the fort in perfe£t health. The furgeon of the fa£lory in- formed me, that a relaxation of the ftomach, and confequently a weakened digeftion, feemed to bring: on moft of the dieafes fo fatal to Euro- peans in the fickly feafon. They were gene- rally of a bilious nature, attended with a low fever, fometimes of a malignant, at other times of a remittent kind. Fluxes were alfo then pre- valent, and often proved mortal. The flux fome- times appeared alone, at other times attended the fever, moft frequently followed it.
" In the month of June, almoft two-thirds of the white people were taken ill. Their fickr nefs could not well be charafterifed by any de- nomination commonly applied to one clafs of fevers : it however approached neareft to what is called a nervous fever, as the pulfe was always low, and the brain and nerves feemed principally affefted. It had alfo a tendency to frequent tct miffions. It began fometimes with a vomiting, ]?ut oftener with a delirium. Its attack was comr monly
296
monly in the night, and the patients being then delirious, were apt to run into the open air. / obferved them frequently recover their fenfes for a fliort time, by means of the heavy rain, zvhich at that time fell upon their naked bodies. But the delirium foon returned : they afterwards became comatofe ; their pulfe funk, and a train of nervous fymp- toms followed ^ their Ikin often became yellow j bilious vomitings and ftools were frequent.
" The fever reduced the patient's ftrength fo much, that it was generally fix weeks or two months before he was able to walk abroad, A confuming flux, a jaundice, a dropfy, or obftruc- tions in the bowels, were generally the confe- quences of it. Of fifty-one white men, being the companies of four fliips which were at Cat- chou, one-third died of the fever, and one-third more of the flux, and other difeafes confeqiieni upon it ; of thefe not one was taken ill till after the rains began.
" I believe, on the whole face of the earth, there is fcarce to be found a more unhealthy country than this, during the rainy feafon : the idea I then conceived of the fituation of our white people, was by making a comparifon of their breathing fuch a noxious air, with a num- ber of river-fifli put into ftagnating water, where,
the water corrupts, the filli grow lefs lively, they droop, they pine away, and many die. Thus., feme perfons became dull, ina6tiye, or flightly
delirious
297
delirious at intervals, and without being fo mucb as confined to their beds, they expired in that delirious (late, in lefs than forty-eight hours, al- though fuch event feemed not to be apprehended. The white people in general became yellow ; their ftomach could not receive much food, with- out loathing and reachings. Indeed it is no wour der that this ficknefs proved fo fat^l, that reco- veries from it were fo tedious, and that they were attended with fluxes, dropfies, the jaundice, ague-cakes, and other dangerous chronical dif-r tempers.
" It feemed to me more wonderful that any white people fhould ever recover, while they con- tinued to breathe fo peftiferous an air, as that at Catchou, during the rainy feafon.
" We were, as I have already obferved, thirty miles diftant from the fea, in a country altogether uncultivated, overflowed with water, furrounded with thick impenetrable woods, and over-run with flime. The air was vitiated, noifome, andthichy infomuch that lighted torches or candles burnt dim, and feemed ready to be extingui/Jied. The fmell of the ground and of the houfes was raw and ofFenfive ; the vapour arifmg from the putrid water, in the ditches which furround the town, was much worfe. All this, however, feemed tolerable when compared with the infinite numbers of infefts fwarming every where, both on the ground and in the air 3 which, as they feemed to be produced and
cheriflied
298
clieriflied by the putrefaclion of the atmofphere, fo they contributed greatly to incrcafe its impu- rity. The wild bees from the woods, together with millions of ants, over-ran and deftroved the furniture of the houfes ; at the fame time, fwarms of cock-roaches often darkened the air, and ex- tinguiflied even candles in their flight ; but the greatefi: plague was the the mufquitoes and fand- flics, whofe inceffant buzz, and painful flings, were more infupportable than any fymptom of the fever. Befides all thefe, an incredible num- ber of frogSj on the banks of the river, made fuch a conftant and difagreeable croaking, that no- thing, but being accuftomed to fuch an hideous Hoife, could permit the enjoyment of natural fleep.
" In the beginning of Oclober, as the rains abated, the weather became very hot ; the woods .were covered with abundance of dead frogs, and other vermin, left by the recefs of the river j ail the mangroves and fhrubs were likewife over- jfpread with a {linking flime."
How different is this from the air of the Canary, iflands. The Canaries arc bleffed with a tempe- rate, pure, and wholefome air. No fooner were the Englifh ofHcers landed there, when brought fick from Senegal, than they found an immediate and fatisfaftory alteration in their health. There they no longer were fcorched with the fierce heat of a meridian fun, but found its warmth tem- pered
1
299 i
pered with refreflilng breezes, and a cool air ; j
from which impenetrable furrounding woods had ;
before debarred them. They were no longer fen- , j
fible of the fudden and piercing chillnefs of the ]
evenings, not tortured with fwarms of blood- ,
fucking gnats and flies. It was furprifing in how |
fliort a time they recovered their health, llrength, i
and colour, in thofe delightful iflands. j
The Dutch, with a folly almoft incredible, by ' endeavouring to make their capital in India re-
femble their own cities, have adorned it with ca- j
nals or ditches, interfecling each other, and run- ' |
ning through every part of it. Thofe canals, j
filled with water, may ferve for fome ufe, or per- '
haps ornament ; but notwithftanding the utmoft '■ care to keep them clean, in the hot and unwhole-
fome climate of Java, during and after the rainy j
feafon, they become extremely noxious to the in- ■
habitants, and more particularly to ftrangers. ,
The unwholefome air of that place alone has cut I
off" mere Europeans thab have fallen by the fw^ord, i
in all the bloody wars carried on by the. Dutch j
in that part of the world. In Jmie the rains be- j
gin ; in July, and the fucceeding months, ficknefe i
rages moft. It is remarked, that in the war which i
terminated in 1763, the Englifh Ihips of wai" 'i
which touched at Batavia, fufFered more by the , |
malignant difeafes of that climate, than they did I
in any other part of India, if we except a fatal \
fcurvy which once raged in that fleet at fea. i
Sqou
300
Soon after the capture of Manilla, the Fal- mouth, a fliip of 50 guns, went to Batavia, where flie remained from the latter end of July to the Jatter end of January j during which time flic bu- ried 75 of her crew, and 100 foldiers of the 79th regiment, who were embarked on board her ; not one perfon having efcaped a fit of ficknefs, except her commander. Captain Brcreton.
The Panther, a fliip of 60 guns, was there iq the years 1762 and 1764 ; both times unhappily during the rainy feafon. In the year 1762 flie bu- ried 70 of her men, and had 92 of them very ill when flie left the place. In the year 1764, during a Ihort ftay, flie buried 25 of her men : the Med- way, which was then in company with her, loft alfo a great number of men.
Nor was the ficknefs at that time confined to the fliips ; the whole city afforded a fcene of difeafe and death : ftreets crowded with funerals, bells tolling from morning to night, and horfcs jaded with dragging the dead in hearfes to their graves. At that time a flight cut of the fkin, the leail: fcratch of a nail, or the moft inconfiderable wound, turned quickly into a putrid fpreadhig ulcer, which in twenty-four hours confumed the flefli, even to the bone. This fa6t is fo extraordinary, that, upon a fingle tcftimony, credit would hardly be given to it ; yet, both on board the Medway and Panther, they had the moft fatal experience of it, and feveral died from that caufe.
Mr.
301
Mr. Ives gives us another mofi: remarkable de- count of the deftru6tion occafioned by the pefti- ferous air of marflies.
" After failing up the river Tigris from Baflbra, we arrived at Bagdat. In this city, fuppofed to contain 500,000 fouls, a purple' fever then raged j but though it was computed that an eighth-part of the inhabitants were ill, yet the diftemper was not generally mortal. Here we were informed, that the Arabs had broken down the banks of the river near BalTora, with a deftgn to cover witk mater the deferts in its neighbourhood. This, it feemSy is the ujual method of revenge taken by the Arabs, for any injury done them hy the Turks in Baffora ; and was reprefented to us as an a£i of th^ mofi shocking H. BARBARITY, ftnce a general confuming f chiefs would undoubtedly be tJie confeque-nce. This was the cafe fifteen years before, when the Arabs, by demo- lifliing the banks of this river, laid the environs of Baffora under water. The ftagnatlng and putrifying water in the adjacent country, and the great quan- tity of dead and corrupted fi/Ii, at that time lying upon the fliore, polluted the whole atmofphere, and produced a putrid and mortal fever. Of this fever between 12 and 14,000 of the inhabitants died ; at the fame time not above tv^^o or three of the Europeans who were fettled there efcaped with life : fo dreadful are the effects of corrupt flag- nating zvaters in ftich fultry climates /"
.1 have.
302
I have perufed many Englilli accounts, botli in nianufcript and print, of the yellow fever, in moft of which the authors have agreed only in the common epithet of yellow, from the (kin's being frequently tinged with that colour. But the fame appearance is alfo ufual in moft intermitting fe- vers, in fome contagious fevers, and in many other fevers, fo cannot properly be a difiinguifli- ing mark of this.
The yellow fever has been fuppofed by fome to have been imported to the Weft Indies by a fliip from Siam : an opinion truly chimerical ; as fimilar difeafes have made their appearance, not only in the Eaft and Weft Indies, but in fome of the fouthern parts of Europe, during a feafon when the air was intenfely hot and unwholefome. This happened at Cadiz in Spain, in the months of September and 06lober 1764, when exceffive lieat, and want of rain for fome months, gave rife to violent, epidemic, bilious diforders, refembling thofe of the Weft Indies, of which an hundred perfo7is 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.
This difeafe began commonly with alternate flight chills and heats, naufea, pains of the head, of the back, of the loins, and at the pit of the ftomach. Thefe fymptoms were often followed, in lefs than 24 hours, with violent reachings, and a vomiting of a green or yellow bile, the fmell
of
303
of which was very offenfive. Some threw up ail humour black as ink, and died foon after, in vio-^ lent convulfions, and in a cold fweat. The pulfe was fometimes funk, fometimes quick, often va- rying. After the firft day the furface of the body was generally either cold, or dry and parched. The head-ach and ftupor often ended in a furious delirium, which proved quickly fatal. The dead bodies having been examined, by order of the court of Madrid, the Jlomachy myfentery, and intef- tines, were found covered with gangrenous fpots. The orifice of the fiomach appeared to have been ^x:^?iCiN affeEled, the jpots \y^ox\ it h^m^ ulcerated. The liver and lungs were both of a pitrid colour snd texture. The ftomach contained a quan- tity of an atrabilious liquor^ which, when poured on the ground, produced a Jenfible effervefcence y and, when mixed with fpirit of vitriol, a violent ebullition. The dead bodies turned fo quickly putrid, that at the end of fix hours their flench was intolerable ; and, in fome of them, worms were found already lodged in the ftomacb.
I am informed by Mr. Martin, furgeon of the Cataneuch, a Guinea trader, that when he w^as in Gambia river, in company with four other fliips, the men, in one of thofe fhips, were daily taken ill of fevers and fluxes, and feveral of them died delirious ; while all the Englifli in the other fliips, and in the faftories, were in perfect health : but upon removing that Ihip about half a league
from
304
from her firfl: ancliorage, which was too near fome fwamps, her men became as heahhy as thofe in the other (hips.
In the year 1766, fixteen French proteftant fa- mihes, confifting of fixty pcrfons, were fent, at the expence of the Enghfli government, to JVeJl Florida. The ground allotted for their refidence was on the fide of a hill, furrounded with marflies, at the mouth of the river Scambia. Thefe new planters arrived in winter, and continued per- fectly healthy until the fickly months, which in that country are thofe of July and Auguft. About that time, eight gentlemen (from one of whom 1 received this account) went to this new fettle- ment, to folicit votes for the ele6lion of a repre- Tentative in the general affembly of the province ; by remaining but one night, every one of them was feized with a violent intermitting fever, of which the candidate for becoming the reprefenta- tive, and another of their number, died. The next day feven other gentlemen came, upon the fame bufmefs, to this unhealthy fpot ; b.ut, by leaving it before night, they efcaped the ficknefs, and all continued in perfe£t health. Among the French fettlers, during thefe two months, the an- nual fever of the climate proved fo fatal on this unwholefome fpot, that of fixty perfons, four- teen only furvived ; and even thofe who remained alive, in the September and Odober following, were all in a very ill ftate of health j not one of
them
305
tlicm had efcaped the attack of the fever, and moil of them died within a few months after- wards, from the injury it had done to their con- iVitutions.
In the year 1793, the manufa£lures, trade, and commerce of Philadelphia, were flourilhing in the greateft degree. The number of coaches, chairs, &c. lately fet up in that city, by men in the middle rank of life, is hardly to be believed. And although there had been a very great in- creafe of hackney chairs, yet was it next to im- poffibleto procure one on a Sunday, unlefs it was engaged two or three days beforehand. Luxury, the ufual, and perhaps inevitable concomitant of profperity, had eradicated the plain and whole- fome manners of an infant town. Every one looked forward to the full harveft of profperity. But how fleeting are all human views ! how un- certain all plans founded on earthly appearances I All thefe flattering profpefts, as Mr. Carey beautifully exprelTes it, vaniflied like the bafelefs fabric of a vifion. At this feemingly propitious moment, the dejlroying Jcourge crept in among us^ and nipped in the bud the fairefl: blofforas of hope. And, oh! what a dreadful contrail fud- denly took place !
■ This fever is fuppofed to have originated from, the miafm of damaged coffee. On the nineteenth of Augufl: I was requefted, fays Dr. Rufh, to vifit the wife of Mr. Peter Le Maigre, in Water-
VoL IV, X ' ftreet.
30^
ftreet, between Arch and Race-ftreets, in conful- tation with D. Foulke and Dr. Hodge. I found her in the lafi: ftagc of a highly bilious fever. She vomited conftantly, and complained of great heat and burning at her ftomach. The moft powerful cordials and tonics were prefcribed, but to no purpofe. She died on the evening of the next day.
Upon coming out of Mrs. Le Maigre's room, I remarked to Dr. Foulke and Dr. Hodge, that I had feen an unufual appearance of bilious fever, accompanied with fymptoms of uncommon ma- lignity, and that I fufpe£led all was not right in our city. Dr. Hodge immediately replied, that a fever of a moft malig^iant kind had carried off four or five perfons within fight of Mr. Le Maigre's door, and that one of them had died in twelve hours after the attack of the diforder. This infor- mation fatisfied me that my appreheniions were well founded. The origin of this fever was dif- covered to me at the fame time, from the ac- count which Dr. Foulke gave me of a quantity of damaged coffee which had been thrown upon Mr. Ball's wharf, and in the adjoining dock, on the 24th of July, nearly in a line with Mr. Le Maigre's houfe, and which had putrefied there, to the great annoyance of the whole neighbourhood.
After this confultation, I was foon able to trace all the cafes of fever which I have mentioned to thh fource. Dr. Hodge lived a few doors above
Mr.
3^7
Mr. Le Maigre's, where his child had been ex- pofed to the exhalation from the coffee for feveral days. Mrs. Bradford had fpent an afternoon in a houfe direftly oppofite to the wharf and dock on which the putrid coffee had emitted its noxious effluvia, a few days before her ficknefs, and had been much incommoded by it. Her filter, Mrs. Learning, had vifited her during her illnefs, and probably caught the fever from her, for fhe per- feftly recollefted perceiving a peculiar fmell, un-^ like to any thing fhe had been accuftomed to in a fick room, as foon as fhe entered the chamber where her lifter lay. Young Mr. M'Nair, and Mrs. Palmer's two fons, had fpent whole days in a compting-houfe, near where the coffee was ex- pofed, and each of them had complained of hav- ing been made fick by its offenfive fmell ; and Mr. Afton had frequently been in Water-ftreet, near the fource of the exhalation.
Upon my leaving Mrs. Le Maigre's, I expreffed my diftrefs at what I had difcovered, to feveral of my fellow-citizens. The report of a malignant and contagious fever being in town fpread in-, every direftion, but it did not gain univerfal cre- dit. Some of thofe phyficians, who had not feen patients in it, denied that any fuch fever exifted ; and affcrted (though its mortality was not denied) that it was nothing but the common remittent of the city. Many of the citizens joined the phy- ficians in endeavouring to difcredit the account
X 2 I had
308
I had given of this fever; and, for awhile, it waa treated with ridicule or contempt. Indignation in fome inftances was excited againft me.
My lot, fays Dr. Rufli, in having thus difturbed the repofe of the public mind, upon the fubject of general health, was not a fmgular one. There are many inftances, upon record, of phyficians who have rendered themfelves unpopular, and even odious to their fellow citizens, by giving the firfl notice of the exiftence of malignant and mortal difeafes. A phyfician who aflerted that the plague was in Meflina, in the year 1743, ex- cited fo much rage in the minds of his fellow ci- tizens ajjainft him, as to render it necelTarv for him to fave his life, by retreating to one ot the churches of that city.
In fpite, however, of all oppofition, the report of the exiftence of a malignant and contagious, fe- ver in the city, gained fo much ground, that the governor of the ftate directed Dr. Hutchinfon, the infpedfor of fickly veffels, to inquire into the truth of it, and into the nature of the difeafe. In con- fequence of this order, I received the following letter from Dr. Hutchinfon,
DEAR SIR,
A confidcrablc alarm has taken place, in confequence of the appearance of an infe6tious diforder in this city ; from which the governor has been induced to dire6\ me to make enquiries rela- tive
309
live to the exigence and nature of fuch dlforder. In executing this duty, I muft rely on the afiift- ance of fuch of ray medical brethren as may have been called to attend any of the perfons fuppofed to have been infe<Sled : as I underftand you have had feveral of them under your care, I would be much obliged to you to communicate to me {as fpeedily as can be done with convenience to your- felf ) fuch fa£ts as you have been able to afcertain relative to the exigence of fuch diforder y in what part of the city it prevails ; when it was intro- duced J and what was the probable caufe of it.
I am, Sir,
With the greateft refpe£l,
J:,gu^ 24///, Your obedient fervant,
1793.
J. HUTCHINSON.
Dr. Benjamin Rujh.
To this letter I wrote the following anfwer a few hours after it came to hand :
DEAR SIR,
A malignant fever has lately appeared in our city, originating, I believe, from fome da- maged coffee, which putrefied on a wharf near Arch-ftreet. The fever was confined for awhile to Water-ftreet, between Race and Arch-ftreets ; but 1 have lately met with it in Second-ftreet, and in Kenfington ; but whether propagated by con-
tagion.
310
iagion, or by the original exhalation, I cannot tell. The difeafe puts on all the intermediate forms of a mild remittent, and a typhus gravior. I have not feen a fever of fo much malignity, fo general, fmce the year 1762.
From, Dear Sir,
Augtcjl ^^th, Yq^^5 fincerely,
. 1793. ^'
BENJ. RUSH.
A few days afterwards the following publica- tion, by Dr. Hutchinfon, appeared in the Ame- rican Daily Advertifer of Auguft 28th.
The Governor having direfted an inquiry to afcertain the fafts, refpefting the exiftence of a contagious fever in the city, and the probable means of removing it, Dr. Hutchinfon, the phyfician of the port, has made the following ftatement upon the fubjeft, in a letter to Nathaniel Falconer, Efq, health-officer of the port of Philadelphia.
DEAR SIR,
Immediately on the receipt of your letter, with the enclofure from the governor, ftating that a confiderable alarm had taken place, in confequence of the appearance of an infectious diforder in this city, I endeavoured to take mea- fures to afcertain the fafts, relative to the exift- ence of fuch difeafe : for this purpofe, I wrote to fuch of my medical brethren who had been called on to attend perfons fuppofed to have been infedledj and from their anfwers, as well as
from
311
from my own obfervations, I am convinced that a malignant fever has lately made its appearance in Water-ftreet, and in Kenfington ^ principally in Water-ftreet, between Arch and Race-ftreets. This part of the city I examined perfonally on Thurfday and Friday laft ; and found, that eart of Front-ftreet, and between Arch and Race-flreets, ftxty-feven perfons were difeafed, many with the malignant fever. Thirteen of them are fince dead, and numbers remain ill. For awhile this fever was confined to the above-mentioned part of the city, but the diforder is fpeading, and now ap- pears in other plac-es, fo that feveral are affe£led in other parts of Water-ftreet, fome in Second- ftreet, fome in Vine-ftreet, fome in Carter's-alley, fome in other ftreets; but, in moll: cafes, the con- tagion can be traced to Water-Jireet. As far as I have been able to afcertain, the number of per- fons who have died altogether, of. this fever, amounts to 40, or thereabouts*.
The general opinion, both of the medical gen- tlemen, and of the inhabitants of Water-ftreet, is, that the contagion originated from fome damaged £off'ee, or other putrefied vegetable and animal matters ; and, on enquiry, it appears, that on a few wharfs above Arch-ftreet, there was not only a quantity of damaged coffee^ which was extremely offenftve,
* The regifter of the deaths fliows that it amounted, at that tiifle, to upwards of 1 50.
expofed
312
expofed for fome time, but alfo fome puirid hides, and other putrid animal and vegetable fub- Jlances.
It does not appear to be an imported difeafe ; for I have heard of no foreigners or Tailors that have hitherto been infected ; nor has it been found in any lodging-houfes ; but it is, on the contrary, principally confined to the inhabitants of Water- Hreet, and fuch as have done bufinefs, or had confiderable intercourfe with that part of the city. The Difpenfary phyficians tell me, that out of the large number of fick, now under the care of that charitable inilitution, they have had but one perfon afflifled with this fever. In the Penn- fylvania Hofpital the diforder does not exifr.
I am, with the grcateft refpeft. Your moft obedient fervant,
PhiladeJhhia.
Auguji o^vi 1793. J. HUTCHINSON.
From a convI£lion that the difeafe originated in the putrid exhalations from the damaged cof- fee, I publifhed, in the American Daily Adver- iifer of Auguft 29th, the following fliort addrefs to the citizens of Philadelphia, with a view of directing the public attention to the fpot where the coffee lay, and thereby of checking the pro- grefs of the fever, as far as it was continued by the
original caufe.
Mr. 1
3^3
" Mr. Dun LAP,
" A doubt has been exprefled, whe- ther the malignant fever, which now prevails in our city, originated in an exhalation from Ibme putrid coffee, on a wharf between Arch and Race-ftreets.
" It is no new thing for the efBuvia of putrid vegetables to produce malignant fevers. Cabbage^ onions, black pepper, and even the mild potatoe, when in a ftate of putrefa^ion, have all been the remote caufes of malignant fevers. The noxious quality of the effluvia from mill-ponds is derived wholly from a mixture of the putrefied leaves and bark of trees with water,
" It is much lefs common for the effluvia of putrid animal matters to produce fevers. How feldom do we hear of them in the neigbourhood of flaughter-houfes, or of the workfhops of fkin- oers or curriers }
" Thefe obfervations are intended to ferve two purpofes : ]fl. To fupport the opinion of Dr. Hutchinfon, that the malignant fever, which has excited fo general and fo juft an alarm in our city, is not an imported d'lksiie ; and, 2dly, To direft the attention of our citizens to the fpot from whence this fevere malady has been derived. It will be impofTible to check it during the continuance of warm and dry weather, while any of the impure matter which produced it remains upon the pef- tilential wharf. R."
This
314
This publication had no other effe£l: than to produce frefli clamours againft the author for the citizens, as well as moft of the phyficians of Philadelphia, had adopted a traditional opinion, that the yellow fever could exift among us only by importation from the Weft Indies.
In confequence, however, of a letter from Dr. Foulke to the Mayor of the city, in which he had decided, in a pofitive manner, in favour of the generation of the fever from the putrid coffee ; the mayor gave orders for the removal of the cof- fee, and the cleanfmg of the wharf and dock. It was faid that meafures were taken for this purpofe ; but Dr. Foulke, who vifited the place where the coffee lay, has repeatedly affured me, that they were fo far from being effeclual, that an offenfive Jmell was exhaled from it many days afterwards. The fever, however, extended.
Difmay and affright are foon vifible in every one's countenance. Moft people, who can by any means make it convenient, are flying from the city. Of thofe who remain, many have fliut them- felves up in their houfes, and are afraid to walk the ftreets. Thofe who venture abroad, have handkerchiefs or fpunges impregnated with vine- gar or camphor perpetually at their nofes, or elfe are fmelling at bottles with the thieves's vinegar. Others carry pieces of tar in their hands or poc- kets, or camphor bags tied round their necks. Many never walk on the foot path, but go into
tbf
1
3^5
the middle of the ftreets, to avoid being infected in palling houfes wherein people have died. Ac- quaintances and friends avoid each other in the ftreets, and only fignify their regard by a cold nod. Every one appears to fliift his courfe at the fight of a hearfe coming towards him. A perfon with a crape, or any appearance of mourning, is Hiunned as a viper. Indeed it is probable Lon- don did not exift ftronger marks of terror than were feen in Philadelphia from about the middle of Auguft till pretty late in September. Many of our firft commercial houfes are totally diffolvcd by the death or flight of the parties, and their affairs neceffarily left in fo deranged a ftate, that the lolTes, and protefts of notes, v/hich have enfued, are beyond eftimation.
While affairs were in this deplorable ftate, and people at the loweft ebb of defpair, we cannot be aftonifhed at 'the frightful fcenes that were a£led, which feemed to indicate a total diffolution of the bonds of fociety in the neareft and deareft connexions. Who, without horror, can read of a hufband deferting his wife, united to him perhaps for twenty years, in the laft agony ; — a wife un- feelingly abandoning her hufband on his death- bed j — parents forfaking their children : — children ungratefully flying from their parents, and re- figning them to chance j — mafters hurrying off their faithful fervants to the hofpital, eftabliflied o]it of the town, even on fufpicion of the fever ;
and
3i6
and that at a time when, Hke Tartarus, it was open to every vifitant, but never returned any ; — fervants abandoning tender and humane mafters, who only wanted a Httle care to reftore them to health and ufefulnefs : — who, I fay, can even now reflect on thefe things without horror ? Yet fuch were the daily fpe^Stacles exhibited throughout our city. Many men of affluent fortunes, who have given employment and fuftenance to multitudes, have been abandoned to the care of a hired negro, after their wives, children, friends, clerks, and fervants, have fled away, and left them to their fate. With the poor the cafe was, as might be expe£led, infinitely worfe. Many of thefe have perifhed without a human being to hand them a little water, to adminifter medicines, or perform any charitable oflice for them. Various inftances occur of dead bodies found lying in the ftreets, of perfons who had no houfe of their own, and, looking ill, could procure no flielter.
The number of the infe6led daily increafing, and every one afflicted with this difeafe being re- fufed admittance into the alms-houfes, as fome temporary place was requifite, three of the guar- dians of the poor took polTeflion of tJie Circus y in which Mr. Ricketts had lately exhibited his equeftrian feats, being the only place that could be procured for the purpofe. Thither they fent Teven perfons afflifted with the malignant fever, where they lay in the open air for fome time,
without
317
without affiftance, for nurfes could not be pro- cured them, though high wages were offered. Of thefe, one crawled out on the common, where he died at a diftance from any houfe. Two died in the Circus, one of whom was feafonably re- moved, the other lay in a ftate of putrefaftion for above forty-eight hours, owing to the difficulty of procuring any perfon to remove him.
Tlie inhabitants of the neighbourhood of the Circus took the alarm, and threatened to burn or deftroy it, unlefs the fick were removed ; and it is believed they would have aftually carried their threats into execution, had a compliance been delayed a day longer,
A fervant girl, belonging to a family in this city, in which the fever had prevailed, was apprehen- fiye of danger, and refolved to remove to a rela- tion's in the country. She was, however, taken fick on the road, and returned to town, w^here flie could find no perfon to receive her. One of the guardians of the poor provided a cart, and took her to the alms-houfe, into which fhe was refufed admittance. She was brought back, and the guardians offered five dollars to procure her a fingle night's lodging, but in vain. And, in fine, after every effort to provide her flielter, flie abfolutely expired in the cart.
To add to the dreadful affliction of the inhabi- tants of Philadelphia, the alarm was fpread throughout the different ilates of America. The
inhabitants
Si8
inhabitants of New York firft came to a refo- lution to flop all intercourfe with the infc£te(i city j and for this purpofe guards were ftationed at the different landings, with orders to fend back every perfoii coming from Philadelphia. All perfons taking in lodgers were called upon to give information of all people of every defcrip- tlon, under pain of being profecuted according to law. All good citizens were required to give information to the mayor of any breach of thefe premifes.
All thefe ftrift precautions being eluded by the anxious fugitives from Philadelphia, there was a fecond meeting held, of the delegates from the feveral wards of the city, in order to adopt more effectual methods. At this meeting it was refolved to eftablifli a night watch, of not lefs than ten citizens in each ward, to guard againft fuch as might efcape them by day. Not yet eafed of their fears, they next day publiflied an addrefs, in which they mentioned; that, notwith- ftanding their utmoft vigilance, many perfons had' been clandejlinely landed upon the fliores of New- York Island. They therefore again called upon their fellow citizens to be cautious how they re- ceived ftrangers into their houfes ; not to fail to report all fuch to the mayor immediately uporr their arrival ; to remember the importance of the oc- cafion \ and to confider zvhat reply they JJiould make to the JUST refentme'tit of their fellow citizens ^ ivhofe lives
they
319
thy might expofe by a criminal negkEl and infidelity. They likewife refolved, that they would confider and publifh to the world, as enemies to the welfare of the city, and the lives of its inhabitants, all thofe who fhould be fo felfifli and hardy as to at- tempt to introduce any goods, wares, merchan- dize, l>edding, baggage, &c. imported from, or packed up in Philadelphia, contrary to the rules prefcribed by that body, who were, they faid, deputed to exprefs the will of their fellow citizens.
While our citizens were thus, complains Mr. Carey, profcribed in feveral cities and towns, — hunted up like felons in fome, — and debarred ad- mittance, and turned back in others, whether found or infe61:ed, — it is with extreme fatisfaftion I am able to record a few inftances of a contrary procedure.
A refpe£table number of the inhabitants of Springfield, in New Jersey, after a full confide- ration of the diftreffes of our citizens, pafled a refolve, offering their town as an afylum to the people flying from Philadelphia, and dire£t- ing their committee to provide a fuitable place, as an hofpital, for fuch of them as might be feized with the prevailing malignant fever. An afylum. was likewife offered to the Philadelphians by fe- ■ veral of the inhabitants of Elkion, in Mary- land i and the offer was couched in terms of
the
320
the utraoft fympathy for the diftreffes of the Philadelphians.
At this time the diforder was raguig with in- creafing vehemence. By order of the mayor the bells were flopped from tolling. This was a very expedient meafure ; as they had before been kept pretty conftantly going- the whole day, fo as to terrify thofe in health, and drive the lick, as far as the influence of imagination could produce that efFeft, to their graves. An idea had gone abroad, that the burning of fires in the ftreets would have a tendency to purify the air, and ar- reft the progrefs of the diforder. The people had, therefore, almoft every night, large fires at the corners of each flreet. The mayor publiftied alfo a proclamation, forbidding this dangerous prac- tice. As a fubftitute, many had recourfe to the firing of giins^ which was imagined a fure pre- ventative of the diforder. This was carried fo far, and attended with fo great noife, that it was alfo forbidden by an order from the mayor.
The lituation of the pihiic hojpital was moft dreadful. A profligate and unfeeling fet of nurfes (none of good cbarafter could be procured at this moment) rioted on the provifions and comforts prepared for the fick, who (unlefs at the hours the doftors attended) were left almoft entirely deftitute of every afliftance. The dying and dead were indifcrirainately mingled together. The or- dure
321
dure and other evacuations of the fick were often allowed from ' inattentioii to remahi. Not the fmatleft order or regularity exifted. It was, ifi h&f a great hUtnan Jlaiighter-houfe, where nume- rous ti£lims were immolated at the altar of riot a!nd intemperance. No wonder, then, that a ge- neral dread of the place prevailed throughout the city, and that a removal to it was confidered as the feal of death. In confequence, there wer0 various iriftances of fick perfons locking their rooms, and refrftfng every attempt to carry them away. At length the poor were fo much afraid of being fent to Bush-hill, that they would not acknowledge their illnefs, until it was no longer poflible to conceal it. For it is to be ob- ferved, that the fear of the contagion was fo pre- valent, that as foon as any one was taken fick, an alarm was fpread among the neighbours, and every effort was ufed to have the fick perfon hur-' ri'ed off to Bush-hill, to avoid fpreading the diforder. The cafes of poor people forced in this way to that hofpital, though labouring uridet only common colds, and common fevers of irri- tation, are numerous and affli£ling. There were not wanting, inftances of perfons, only flightly ill, being fent to Bush-htll by their panic-ftrucfc neighbours, and embracing the firft opportunity of running back to Philadelphia.
At this time a circumftance however occurred, which alone would be fufficient to refcue the
Vol. IV. Y charaaer
322
chara£ler of man from obloquy and reproach. As a human being, I rejoice, fays the benevolent Mr* Carey, that it has fallen to my lot to be a witnefs and recorder of the fa£l. Stephen Gerard^ a wealthy merchant, and native of France^ touched with the wretched fituation of the fufferers at Bush-hill, voluntarily and un- expeftcdly offered to fuperintend that hofpital. The furprize and fatisfaftion excited by this ex- traordinary effort of humanity can be better con- ceived than expreffed. Peter Helm, a native of Pennfylvania, a6luated by the like benevolent motives, offered his fervices alfo in the fame de- partment.
To form a juft eftim^te of the value of the offer of thefe good men, it is neceffary to take into con- fideration the general confternation which at that period pervaded every quarter of the city, and which made attendance on the fick be regarded little lefs than certain facrifice. Uninfluenced by any refleftions of this kind, without any polTible inducement but the pureft motives of humanity, they came forward, and undertook what would by others be deemed a forlorn hope. They under- went a laborious round of duty. They inceffantly encouraged and comforted the fick ; they gave them neceffaries and medicines ; they even per- formed many difgulling offices of kindnefs, which nothing could render tolerable, but the exalted motives that impelled them to this heroic conduct.
On
323
On the contrary, the jail of Philadephia is under fuch excellent regulations, that the difor- der made its appearance there only in two or three inftances, although fuch abodes of mifery are the places where contagious diforders are mofily generated. When this putrid fever raged moft violently in the city^ there vi^ere in the jaii one hundred and fix French foldiers and failors^ confined by the order of the French conful, be- fides eighty convi6ls, vagrants, and perfons for trial ; all of v^^hom, except two or three, remained perfeftly free from the complaint. Several cir- Gumftances confpired to produce this falutary effea.
The people confined are frequently cleanfed and purified by the ufe of the hot and cold bath ; — they are kept conftantly employed ; — vegetables form a confiderable portion of their diet in the yard vegetation flourilhes^ — and many of them being employed in ftone-cutting, the water, con^ ftantly runnings keeps the atmofphere in a tnoijl and pure ftatCi Whereas the inhabitants of dirty and confined ftreets have feverely expiated their neg- lect of cleanlinefs and decency, by the number of them that have fallen facrifices. Whole families in fuch houfes have funk into one filent and un- dift:inguiflied grave.
As I have been obliged to note a variety of horrid circumftances, which have a tendency to throw a fliade over the human chara6ter, it is
Y 2 proper
f)foper to reflea a little light on the fubjeft, wherever juftice and truth will permit it. Here it ought fo be recorded, that fome of the convi£ts in the jail voluntarily offered themfelves as nurfes to attend the fick at Bush^hill, and have in that capacity conducted themfelves with fo much fide- lity and tendernefs, that they have had the re- peated thanks of the managers.
In the progrefs of this diforder, from the nume- rous deaths of heads of families, a great number of children were left in a raoft abandoned and forlorn ftate. The bettering houfes, in which fuch helplefs fubje£ls have been ufually placed, was barred againft them. Many of thefe little in- nocents were aftually fuffering for want of even common neceffaries. The deaths of their parents and protestors, which Hiould have been the ftrongefl: recommendation to public charity, was the very reafon of their diftrefs, and of their being fliunned as a peflUence. The children of a family, once in affluent circumftances, were found, their parents being dead, in a blackfmith's Ihop, fqua- lid, dirty, and half ftarved, having been for a confiderable time without even a tafte of bread. This early caught the attention of the humane, and 160 children were foon refcued from this forlorn condition, and lodged in a building called the Loganian Library.
Rarely has it happened that fo large a proportion of the gentlemen of the faculty have funk beueath
the
325
the labours of their very dangerous profejjion, as on this occafion. In little more than a month, ex- clufive of medical ftudents, no lefs than ten phy- fuians have been fwept off. Hardly any of the apothecaries^ who remained in the city, efcaped from indifpofition. The venerable Samuel Ro- bes an has been, like a good angel, indefatigably performing, in families where there was not one perfon able to help another, even the menial of- fices of the kitchen, in every part of his neigh- bourhood. John Connelly has fpent hours befide the fick, -when their own wives and chil- dren had abandoned them. Twice did he catch the diforder, — twice was hp on the brink of the grave, which was yawning to receive him, — yet, unappalled by the imminent danger he had ef- paped, he again returned to the charge.
To habits defectively oxygenated, as with tiplers and drunkards, and men of a corpulent habit, and women with child, this djforder proved very fataL Of thefe many were feized, and thp recoveries were very rare,
If you examine the regifler of the weather, you will find there was no rain from the 25th of Auguft until the 14th of 0£l:ober, except a few drops, hardly enough to lay the duft ip the flreets, which fell on the 9th of September, and the 12th of Ofilober. In confequence of which, the fprings 3i?d wells failed in many p&rts of the country,
The
326
Tlie dud in fome places extended two feet below the furface of the ground. The paftures were deficient, or burnt up, and there was a fcarcity of autumnal fruits in the neighbourhood of the city. The regiller of the weather fliews alfo how little the air was agitated by winds during the above time*". In vain were the changes of the moon ex- pelled to alter the ftate of the atmofphere. The light of the morning as conftantly mocked the hopes which were raifed by a cloudy Iky in the evening. Hundreds fickened each day beneath the influence of the fun ; and even when his beams did not excite difeafe, they produced a languor in the body, and, to ufe the country phrafe, the labourer in the field gave in, and that too when the mercury in the thermometer was under 80 degrees. On the 12th of September a
* Howeyer inoffenfive uniform heat, when agitated by gen- tle breezes, may be, there is, I believe, no record, where a dry and ftagnating air has exifted for any length of time, with- out producing difeafe. HippocRATKs, in defcribing a pefti- lential fever, fays, the year in which it prevailed was without a breeze of wind: The fame ftate of the atmofphere, for fix weeks, is mentioned in many of the hiftories of the plague which prevailed in London in 1665. Even the fea-air itfelf becomes unwhplefome byftagnating; hence Dr. Clark in- forms us, that failors become fickly after long calms in their voyages to the Eaft Indies. Sir John Pringle deUvers the following aphorifm, from a number of fimilar obfervations upon this fubje£t : " When the heat comes on foon^ and continues " throughout autumn, not woderated by winds or rains, the feafon
proves fick^y-i dijlcivpcrs appear early, and arc dangerous
tneteor
327
meteor affrighted the inhabitants. Mufchetoes were uncommonly numerous. Here and there a dead cat added to the impurity of the air of the flreets ; for many of thofe animals periflied with hunger in the city, in confcquence of fo many houfes being deferted by the inhabitants who had fled into the country.
A TABLE OF DExiTHS,
Died. |
Died. |
Died. |
|||||
August 1 |
9 |
5 |
■ |
20 |
1 A i u |
— 93 |
|
2 |
- |
8 |
g |
24 |
1 i |
— 119 |
|
3 |
C) |
7 |
J 0 |
1 o |
— Ill |
||
4 |
10 |
c O |
4.9 |
J o |
]04 |
||
5 |
10 |
9 |
32 |
T? 3 1 n 1 .]. |
— 81 |
||
6 |
3 |
10 |
-'9 |
1 ^ |
— 80 |
||
7 |
12 |
11 |
1 a I o |
— 70 |
|||
8 |
- |
■ i; |
17 |
||||
0 |
|
1 1 |
13 |
37 |
|||
10 |
Q |
14 |
48 |
1 Q |
— 65 |
||
11 |
7 |
15 |
9(1 |
— 55 |
|||
12 |
5 |
16 |
67 |
21 |
59 |
||
13 |
— |
11 |
17 |
— |
81 |
22 |
— - 82 |
14 |
4 |
18 |
68 |
23 |
— 54 |
||
15 |
9 |
19 |
61 |
24 |
— 38 |
||
16 |
7 |
20 |
67 |
Cloudy, 25 |
— 35 |
||
17 |
6 |
21 |
57 |
Cloudy, 26 |
— 23 |
||
18 |
5 |
22 |
76 |
Rain, - 27 |
— 13 |
||
19 |
9 |
23 |
68 |
Rain, - 28 |
— 24 |
||
20 |
7 |
24 |
96 |
fair, - 29 Raiii, - 30 |
— 17 |
||
21 |
8 |
25 |
87 |
— 16 |
|||
22 |
13 |
26 |
52 |
Rain, - 31 |
— 21 |
||
23 |
10 |
27 |
60 |
Nov. Rain, 1 |
— 13 |
||
24 |
17 |
28 |
51 |
Fair, - 2 |
— 21 |
||
25 |
12 |
29 |
57 |
Cloudy, 3 |
— 15 |
||
26 |
17 |
30 |
63 |
Rain, '- 4 |
— 15 |
||
27 |
12 |
OCTOB. 1 |
74 |
Rain, - 5 |
— 14 |
||
28 |
22 |
2 |
66 |
Cloudy, 6 |
— 11 |
||
39 |
24 |
3 |
78 |
Fair, but cold, 7 |
— 15 |
||
30 |
20 |
4 |
58 |
Fair, - 8 |
— 8 |
||
31 |
17 |
5 |
7! |
Fair, - 9 |
~ 6 |
||
^EPTEM. I |
17 |
6 |
76 |
Fair, - lo |
2 |
||
2 |
18 |
7 |
82. |
, Fair, - li |
-— 0 |
||
3 |
11 |
8 |
90 |
||||
4 |
23 |
0 |
102,' |
TOTAX. - |
4,000 |
From
328
From this table it appears that the principal mortality was in the fecond week of October. A general expe6tation had obtained, that cold weather was as deftru£live of the contagion of this fever as heavy rains. The ufual time for its arrival had come, but the weather was ftill not only moderate but warm. In this awful fitua- tion, the ftouteft hearts began to fail. Hope fick- ened, and defpair fucceeded diftrefs in almoft every countenance. On the 14th of O£iober it pleafed God to alter the ftate of the air. The clouds at laft dropped health in Jfiowers of rain, which continued during the whole day, and which \vere fucceeded for feveral nights afterwards by cold and froji. The effects of this change in the weather appeared firft in the fudden diminution of the fick, for the deaths continued for a week afterwards to be nearly as numerous, but they were pf perfons who had been confined before, or on the day in which the change had taken place in the weather.
The appearance of this rain was like a dove with an olive branch in its mouth, to the whole city. Public notice was given of its beneficial effects in a letter fubfcribed by the mayor of Phi- ladelphia, who a£led as prefident of the com- tnittee, to the mayor of New York.
329
TO RICHARD VANCHE, ESQ.
*' SIR,
" I am favoured with your letter of the 12th inftant, which I have communicated to ** the Committee.
" The part. Sir, which you perfonally take in *' our affliflions, and which you have fo patheti- " cally expreffed in your letter, excites in the *' breads of the Committee the warmeft fenfations " of affeftion. The fubfcription made in New *' York is a balm to the fores of our diftreffed " city.
" I am overjoyed as I inform you, that the re- " frefhing rain which fell on the 14th, though *' light, 3indi\\Q cool weather which hath fucceeded, " appear to have given a check to the prevalence " of the fever. Few fince appear to have taken " the infection ; the applications for the hofpital " are few, and the funerals are decreafed.
" With fentiments of the greateft efteem and
regard," &c.
On the 30th and 3lft of 0£tober there was a confiderable fall of rain. The fever was in cour fequence wholly fubdued. A vifible alteration foon took place in the city. Every hour long ab- fent and welcome faces appear, — and, in many inftances, thofe of perfons whom public fame has buried for weeks paft. The (lores, fo long clofed, are opening faft. Some of the country merchants,
bolder
330
bolder than the reft, are daily venturing into their old place of fupply. Market-ftreet is almoft as full of waggons as ufual. The Cuftom-houfe, for weeks nearly deferted by our mercantile people, is thronged by citizens entering their veffels and goods : — the ftreets too, long the abode of gloom and defpair, have afTumed the buftle fuitable to the feafon. The arrival in the city of our beloved Prefident, continues Mr. Carey, gives us a flat- tering profpe£l of the next feffion of congrefs being here. And, in fine, as every thing in the early fi:a2;e of the diforder, feemed calculated to add to the confternation ; fo nov^'', on the contrary, every circumftance has a tendency to revive the )ippes and happinefs of our afflicted city.
SECT.
331
SECT. XLIX.
THIRD CAUSE, PUTRID FEVER FROM CONTAGION,.
yExHiopiA and Egypt have been ftigmatized, in every age, as the original fource and feminary of the plague. In a damp, hot, ftagnating air, this African fever is generated from the putrefaction of animal fubftances, and efpecially from the fwarms of locufts, not lefs deftru£live to mankind in their. death, than in their lives. This fatal difeafe, which depopulated the earth in the time of Juftinian, and his fucceflbrs, firlt appeared in the neighbourhood of Pelufium*. From thence, tracing as it were a double' path, it fpread to the Eaft, over Syria, Perfia, and the Indies, and pene- trated to the Weft, along the coaft of Africa, and over the continent of Europe. In the fpring of the fecond year, Conftantinople, during three or four months, was vifited by the plague : and Procopius, who obferved its progrefs and fymptoms with the eyes of a phyfician, has emu- lated the Ikill and diligence of a Thucydides. This fever was charaflerized by fwelling of the glands, particularly thofe of the groin, of the arm-pits, and under the ear ; and when thefe buboes or tumors were opened, they were found to contain
" A town fituated on the mouth of the Nile.
a coal.
332
a coal, or black Juhjlance*, of the fize of a lentil. If they came to a juft fwelling and fuppuration, the patient was faved by this kind and natural difcharge of the morbid humour. But if they continued hard and dry, a mortification quickly enfued, and the fifth day was commonly the term of his life. The fever was often accompanied with lethargy or delirium ; the bodies of the fick were often covered with black puflules or car- buncles J and in the conftitutions too feeble to produce an eruption, the vomiting of blood was followed by a mortification of the bowels. To pregnant women the plague was generally mortal. Youth was the moft perilous feafon j and the female fex was lefs fufceptible than the male : but every rank and profelTion was attacked with
* Thefe arc the words of Gibbon : The carbuncle^ fays Hodges, is at firft a fmall eruption, whofe contents are foon idifcharged, then it crufts, loolcs blacky and turns hard. It is furrounded with a circle of inflammation, at firft of a bright red, which grows dufl<y, often livid, and finally black. This change to black is obferved in all the other dire marks of the Plague. Speaking of tokens^ which he elfewhere calls Jiigmata vigra, which are fmall fpots, often the fize of a filver-penny ; in fome, fays he, the colour was reddifli, of a faint blue, and often pf a black-bronany refembling a mole in the body. So of fett- chicey they are faid to be ruddy at firft, but in a few hours be- pome dufky, and finajly of a leaden-purple. The fame is faid of the macula^ or large broad patches on the ikin. Welks, or vibices, are narrow ftreaks, and they look like bruifes by fome narrow inftrument ; or as Foreftus fays, Ut fi quis fufti- bus caefiis eflet, aut ab alto cecidifTet; as if one had been beaten, or had fallen from an eminence.
indifcriminate
333
indiicriminate rage, and many of thofe who ef- caped were in a wretched condition, without being fecure from a return of the diforder*. The phyficians of Conftantinople were zealous and (kilful ; but their art wa^ baffled by the various fymptoms and pertinacious vehemence of the difeafe ; and doubts are entertained, whether me- dicine did not fometimes aid the fatality of the di- feafe. The order of funerals and the right of fepul- chres were confounded ; thofe who were left with- out friends or fervants lay unburied in the ftreets, or in their defolate houfes j and a magiftrate was authorized to colle6t the promifcuous heaps of dead bodies, to tranfport them by land or water, and to inter them in deep pits beyond the pre- cin£ls of the city.
Contagion is the infeparable companion of the plague, which, by refpiration and perfpiration, is wafted from the infefted perfons to the lungs and ftomachs of thofe who approach them.- While philofophers, fays Gibbon, believe and tremble, it is fmgular that the exiftence of a real danger fliould have been denied by a peo-
* Thucydides (c. 51.) affirms that the infection could only be once taken ; but Evagrius, who had family experience of the plague, obferves, that fome perfons, who had efcaped the firft, fiink. under the fecond attack ; and this repetition is confirmed by Fabius PauUinus (p. 588). RuiTei, whofe authority at the prefent day is greateft, mentions, in his Hiflory of the Plague, that occurrences of this- kind happen, although very rarely.
pie
334
pie mod prone to vain and imaginary terrofs*. Yet tlie fellow-citizens of Procopius were fatif- fied, by fome lliort and partial experience, that the infection could not be gained by the clofeft converfation ; and this ^erfuafion might fupport the affiduity of friends or phyficians in the care of the fick, whom inhuman prudence would other- wife have condemned to folitude and defpair. But the fatal fecurity, like the predeftination of the Turks, muft have aided the progrefs of the contagion ; and thofe falutary precautions, to which Europe is indebted for her fafety, were unknown to the government of Juftinian. No reftraints were impofed on the free and frequent intercourfe of the Roman provinces : from Perfia to France, the nations were mingled and infefted by wars and emigrations ; 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. The mode of its propaga- tion is explained by the remark of Procopius himfelf, that it always fpread from the fea-coaft to the inland country: the moft fequeftered iflands and mountains were fucceffively vifited ; the places which had efcaped the fury of its firft paf- fage, were alone expofed to the contagion of the enfuing year. The winds might diffufe that fub- tle venom ; but unlefs the atmofphere previoufly
i<- Vide an account of the Plague at Marfeilles, page 335.
difpofed
335
difpofed the body for its reception, the plague would foon expire in the cold or temperate cli- mates of the earth. Such, however, was the tem- perament of the air, that the peftilencc which burft forth in the fifteenth year of Juilinian was not checked or alleviated by any difference of the feafons. In time, its firft malignity was abated and difperfed ; the difeafe alternately languiflied and revived j but it was not till the end of a ca- lamitous period of fifty-two years, before this plague ceafed its devaftations. No fafts have been preferved'to fuftain an account, or even a conjefture, of the numbers that periflied in this extraordinary mortality. I only find, that, during three months, five, and at length ten thoufand per- fons died each day at Conftantinople ; that many cities of the Eaft were left vacant, and that, in feveral diftricts of Italy, the harveft and the vin- tage withered on the ground. Gibbon, however, conje£tures, that this plague, which began in the year A. D. 542, ending 594, carried off not lefs than one hundred millions.
Mead proves that the plague is contagious, from Thucydides, Lucretius, Ariftotle, Galen, and common experience ; and he refutes the contrary opinion of the French phyficians, who vifited Marfeilles in the year 1720. He inconteftably proves, from the account of Ruffel, that the Plague raged in the Levant in 1719 ; that in 1720 a fliip arrived with goods from this quarter, commanded
by
by Chataud, who had certain Turks paflTengers on board, with their luggage ; that foon after one of thefe died ; that two failors, who were em- ployed in throwing the corpfe overboard, alfo fickened and died. A third failor was feized with the fame fever, and died j as apfo the furgcon, who died. After this three other failors fell fick of this fame fever, and died. Two days from the arrival of this fliip in Marfeilles, an officer of qua- rantine, who came on board, died. Six porters, employed to open the goods en board, and air them, were feized with this difeafe alfo, and died. A prieft who adminiftered to the fick, and a fur- geon of the Lazaretto, with part of his family, were infefted alfo, and died. The apothecaries, their affiftants, the houfe fteward, with his fons, a cook, the fcuUions, the other porters, and the waflier-women of the Lazaretto, in fhort, not one but fell vi6lims to the devouring monfter.
This fever afterwards appeared in the city. A woman from the rue de I'Efcale being received into the principal hofpital with the fame fever, two of the nurfes who afhfted at her reception, and the matron who changed her linen, were taken ill next day, and died after a few hours illnefs. From them, the contagion fpreading with dreadful rapidity, deftroyed phyficians, furgeons, apothecaries, confeiTors, and all the other officers and fervants of the houfe, with the whole oi the poor in the hofpital, including in all upwards of
i37
four hundred. Laftly, of two hundred and thirty galley-flaves, employed in going into the infc6ted houfes, and in burying the dead, two hundred and twenty periflied in the fpace of ten or twelve days. If this is not contagious, I am at a lofs to know what is. Befides this, they beheld the fame fever, which in a few months fwept away 50,000 inhabitants of a city that^ at the prefent hour of profperity and trade, contains no more than 90,000 fouls. All that the French phyficians oppofe to this is, that neither they who were fent by the Regent to Marfeilles, and who cou- rageoufly expofed themfelves, caught the difeafe> or their alTiftants. This, however, on/y proves, that all do not equally take the Plague, the reafon of which will be the obje6l of confideration in the enfuing feftion. They might as well affert, that the people who fall in battle are not killed, becaufe fome efeape the danger*
What is ftyled by pre-eminence the plague of London, may be traced to the fame fowce. A violent plague had raged in Holland in the year 1663,- on which account the importation of merchandize from that country was prohibited by the Britifli Legiflature in 1664. Notwith- .ftanding this, however, it appears that the Plague lhad been aftually imported ; for in the clofe of the ;year 1664, two or three perfons died in London 'With fymptoms of the Plague 5 that is a fenfe of kCold, fuccecded by flufhes of heat, often rigors, • Vol. IV. Z proftration
338
profti-ation of ftrength, carbuncles,, buboes, pe- techia;, &c. Hereupon, fays Hodges, fome of tlieir timorous neighbours, under apprehenfions of a contagion, removed into the city of London, Avho unfortunately carried along with them the peitilential taint; whereby that difeafe, which was before in its infancy, in a family or two, fuddenly got ftrength, and fpread abroad its fatal venom ; and merely for want of confinmg the perfons firft fei^ed with it, the whole city was in a little time fffecoverably infe6ted. Not unlike what hap- pened the year following, when a fmall fparkj, from an unknown caufe, for want of timely care, increafed to fuch a flame, that neither the tears of the people, nor the profufion of their Thames, Gouid extinguifli, and which laid wafte the greateft- part of the city in three days time, where the altars themfelves became fo raanyiTictims,^ and the fineft churched in the wliole world carried up to heaven fupplications in flamesi, while their marble pillars, wet with tears, melted like wax nor' were monuments fecure from the .inexorable flames, ?wrhere^many- of their venerable . remains palfed a fecond martyrdom ; the moft auguil pa*: laces were fodn laid wafte, and the flaiiiies feemed to be in a fatal engagement to deftroy tlie great ornament of commerce ; and the burning of .all the commodities of the world together feemed a proper. .epitome' of this conflagration: neither cOftfedeiate Jcrowns, nor the drawn fwords ot
kings.
339
khiffs, could refl.rain its fanatic and rebellious rage ; large halls, ftately houfes, and the fheds of the poor, were together reduced to aflies ; the fun bluflied to fee himfelf fet, and envied thofe flames the goverment of the night, which had rivalled him fo many days: — as the city, I fay^ was next year burnt without any diftinftion, in like manner did this Plague fpare no order, age, or fex; the divirie was taken, in the very exercife of his prieftly office, to be inrolled amongft the faints above i phyficians could not find affiftance in their own antidotes, btit died in the admini- ftration of them to others ; and although the fol- diery retreated from the field of death, and en- camped out of the city, the contagion followed, and vanquiflied them ; many in their old age, others in their prime, funk under its cruelties of the female fex moft died, and hardly any chil- dren efcaped; and it was not uncommon to fee an inheritance pafs fucceflively to three or four heirs in as many days ; the number of fextons were not fufficient to bury the dead ; the bells feemed hoarfe with continual tolling, until at laft they quite ceafed ; the burying places would not hold tht dead, but they were thrown into large pits dug in wafte grounds, in heaps, thirty or forty together ; and it often happened, that thofe who; attended the funerals of their friends one evening, were carried the next to their own long home :
Z 2 Quis
340
•— Quis tali a fando
Temperet a lachrymis r-
As fnion as the magiflracy, to wliom belonged the public care, faw how tlie contagion daily in- creafcd, and had now extended itfelf to feveral pariflies, tin otder was immediately ifiued out to ihiit up all the inte£l:ed houfes, that neither rela- tions nor acquaintance might unwarily receive it from them, and to keep the infefted from car- rying it about with them.
Fbr this purpofe, it is to be obfcrved, that a law was made for marking the houfes of infefted perfons with a red crofs, having with it this fub- fcription. Lord have mercy upon us : and that a guard fliould there continually attend, both to hand to the fick the neceffaries of food and medicine, ^ind to reftrain them from coming abroad until forty days after their recovery.
But althoudi the Lx)rd Mavor and all inferior officers readily and effectually put thefe orders inf execution," yet it was to no purpofe, for the Flague more and more increafed ; and the con- fternation of thofe who were thus feparated from all fociety, unlefs with the infected, was inexpref- fible ; and the difmal apprehenfions it U\d them under, made them but an eafier prey to the de- vouring enemy. And this feclufion was on this account much the more intolerable, that if a frefli perfon was feized in the fame houfe but a day before another had finiflied the quarantine, it
was
341
was to be performed over again; which occa- fioned fuch tedious confinements of fick and well together, as fometimes to caufe the lofs of the whole.
But what greatly conjjiibuted to the lofs of people thus flmt up was the wicked pra6tices of nurfes (for they are not to be mentioned but in the moft bitter terms) : tJiefe wretches, out of greedi- nefs to p/under the dead, woidd Jlr angle their -patients ^ and charge it to the dijlemper in their throats ; others would fecretly convey the pejiilential taint from fores of the infected to thofe who were well ; and nothing indeed deterred thefe abandoned mijcreants from profe - cuting their avaricious purpofes by all th^ 'methods their wickednefs could invent, who, although they were without witnelTes to accufe them, yet it is not doubted but divine vengeance -will overtake fuch wicked barbarities with due punifhment : nay, fome were remarkably ftruck from heavpn in the perpetration of their crimes ; and one par- ticularly amongft many, as fiie was leaving the houfe of a family, all dead, loaded with her rob- beries, fell down dead under her burden in the ftreets : and the cafe of a worthy citizen was very remarkable, who being fufpe£ted dying by his nurfe, was before-hand flripped by her ; but. recovering again, he came a fecond tiitic into the world naked *.
Moreover,
* This IS related upon the authority of Hodges, an eye - witnefs ; and it is much to be lamented that this athcrwife tjfe-
fiil
34^
Moreover, this flmtting up infecled houfes made the neighbours fly from thejrs, who other- wife might have"t)een a help to them on many accounts ; and I verily believe that many who were loft might have n^w been alive, had not the tragical mark upon their door drove away proper afliftances from them.
But to return : the infection had long doubt- fully reigned, and continued through May and June with more or lefs feverity, fometimes rag- ing in one part, and then in another ; as often as the number of funerals dccreafed great hopes were conceived of its difappearance \ then, on a fudden again, their increafe threw air into de- jeftion, as if the whole city was foon to be un^ peopled ; which uncertainty gave advantage to
ful order of people ftiould not be chofen from a better defcription of perfons. In the prefent times I have known the ear-rings torn from the ears of the dying, the cap removed in the aft of dying, and a better one put on, the bell clean linen put on the bed un-aired, as the perquifite after death, and the dying lifted out of bed, to prevent thefc from being ftained by the laft aftions of death. Some have been aftually jumpt upon, to force the blood to the liead, to make a better corpfe; and thefe over-anxious nuifes for charafter, wafli out the chambers of the fick at night, and only, they fay, open a piece of the win- dow. " Good God I" fays one of this defcription, " would " you put on a blifter on the fair fkin of her royal highnefs ? "
*' Dam it !" fays Dr. E , " her highnefs fliall have the fame
" chance as her waflier-woman." It is a pity to torment with medicine," fays another, " or to flarve the poor crea- *' ture. One glafs of wine can furely do nobody any harm," fays a fourth. Thus it is, people are cheated out of their lives by the low ignorhnt tribe of nyrfes,
the
343
the dlftemper, becaufe perfons were more remifs in their provifions againft it during fuch fluc- tuation.
. As foon as the nature of the difeafe was tho- roughly known, 40,000 fervants were difmifled, and turned into the ftreets to perifli, for no one would receive them into their houfes ; and the villagers near London drove them away with pitch-forks and fire-arms.
Sir John Lawrence, " London's generous mayor," fupported them all, as well as the needy who were fick, at firft by expending his own for- tune, till fubfcriptions could be folicited and re- ceived from all parts of the nation.
HE
Rais'd the weak head, and ftay'd the parting figh.
Or with new life relum'd the fwimming eye.
DR. DARW.IN.
Yet after the chief of the people were fled, and thereby the nouriftiment of this cruel enemy had been in a great meafure taken away, yet it raged ftill ; and it foon returned with redoubled fury, and killed not by flow paces, but almofl: immediately upon feizure ; not unlike what is often feen in battle, when, after fome fkirmiflies of wings, and feparate parties, the main bodies come to engage ; fo did this contagion at firft only fcatter about its arrows, but at laft cover the whole city with death.
The
344
The government, however, to the duty of pub- lic prayers, negleded not to add what afiTiftances might be had from medicine ; to which purpofe his majefty, with the divine helps, called in alfo all that was human ; and, by his royal authority, commanded the college of phyficians, of London, jointly, to write fome what inEnglifh that might be a general directory in this calamitous exigence. Nor was it fatisfaftory to that honoured fociety to di(- charge their regards for the public with that only, but fome were chofen out of their number, and appointed particularly to attend the infe£led on all occafions : two alfo out of the court of alder- men were required to fee this hazardous tafk executed ; fo that encouraged with all proper means, this province was cheerfully undertaken, and all poflible caution was ufed fully to anfwer the intention. But this talk ^yas too much for four perfons, and wanted rather the concurrence of the whole faculty: thcfe were |ioweyer afliamed to give it up, and ufed our utmpft application therein ; but all their care and pains were eluded, for the difeafe, like the Hydra's heads, was no fponer extinguKhed in one family, but it broke Qut in many mprp with aggrjivations ; fo that in a little time they found their talk too great, and finally defpaired of putting an entire flop to the, infe^liqn.
In the months of Augufl: and September the contagion changed its former flow and languid
pace,
345
pace, and having as it were got mafler of all, made a mofl: terrible {laughter, fo that tliree, fow\ or five tJiouJand^ died in a week, and once eight ihoufand, Wh.Q ,cau exprefs the calamities of fuch times ? In fomc houfes carcafes lay waiting foj: burial, and, in others, perfons in their laft ago- nies j in one rpom might be heard dying groans, in another the ravings of a delirium, and nof far off relations and friends bewailing both their lofs, gnd the difmal prpfpeft of their own fudderji de- parture : death was the fure midwife to all chil- dren, and infants paffed immediately from the womb to the grave ; who would not burft with grief, to fee the ftock for a future genera- 'tion hang upon the breafi: of a dead mother ? or the marriage-bed changed the firft night into a fepulchre, and the unhappy pair meet with death in their firft embraces ? Some of the im fefted run about ftaggering like drunken men, and fall and expire in the ftreets ; while other^ lie half-dead and comatous, but never to be waked but by the Jaft trumpet ; fpme lie vqmit- ing, as if they had drunk poifon j and others felj dead in the market, while they are buying rjeccf- faries for the fupport of life.
A pit, 40 feet long, |6 feet wide, and ^bout 20 feet deep, was dug in the Charter-house ; and in two weeks it received 1,114 bodies.
During this dreadful calamity there were in- fiances of mothers carrying their own children to
thof?
34^
thofe pul)lic graves, and of people delirious, or in defpair for the lofs of their friends, who threw ikemf elves alive into thefe pits.
One fmiling boy, her lafl: fweet hope, (he warm'd,
Hufli'd oii her bofom, circled in her arms. Daughter of woe ! — ere morn, in vain carefs'd. Clung the cold babe upon thy milklefs breafi-. With feeble cries thy laji fad aid required, Stretch'd its ftifF limbs, and on thy lap ex- pired I
Long with wide eye-lids on her child flie gazed.
And long to heaven their tearlefs orbs flie raifed ;
Then with quick foot and throbbing heart flie found
Where Chartreuse open'd deep his holy ground ;
Bore her laft treafure through the midnight gloom,
"And kneeling dropp'd it in the mighty tomb ; / follow next ! the frantic mourner faid. And living plung'd amid the feftering dead.
DR. DARWIN.
About the beginning of September the difeafe was at the height, in the courfe of which month
more
/'ii/j/i.r/i/i/ Ay Cox ,/aii. i./yt^() .
347
more than twelve thoufand died in a week : but at length, that nothing might go untried to divert the contagion, it was ordered by the governors, who were left to fuperintend thofe calamitous affairs, (for the Court was then removed to Ox- ford) to burn fires in the Hreets for three days together j yet while ' this was in debate, the phylicians concerned were diffident of the fuc- cefs, as the air in itfelf was un-infe61:ed, and therefore rendered fuch a Ihowy and expenfive a project fuperliuous, and of no effect and thefe conjectures were fupported by the authority of antiquity, and Hippocrates himfelf ; notwithftand- ing which, the fires were kindled in all the ftreets. But, alas 1 the controverfy was foon de- cided ; the moft fatal night enfued, wherein more than four thoufand expired. May poflerity by. this miftake be warned, and not, like empy- ricks, apply a coflly remedy where they are igno- rant of the effeft.
In this account we fhould not negleft to men- tion, that the contagion fpread its cruelties into the neighbouring counties ; for the citizens, which crowded in multitudes into the adjacent towns, carried the infeElmi along with them, where it raged with equal fury; fo that the plague, which at firft crept from one flreet to another, now reigned over whole counties, leaving hardly any place free from its ravage; and the towns upon the
Thames
348
Thames were more fcvcrely handled, i#)t, per- haps, from a great moiftiirc in the air from thence, but from the tainted goods rather that were carried upon it : moreover, fome cities and towns, of the moft advantageous fituation for a wholefome air, did notwithftanding feel the com- mon ruin. Such was the rife, and fuch the pro- grefs of this cruel deflroyer, which firft began at London. But the worft part of the year being over, and the height of the difeafe, the Plague by flow degrees decHned, as it had gradually made its firft advances.
About the clofe of the year, that is, in the beginning of November, people grew more healthful, and fuch a different face was put upon the public, that although the funerals were yet frequent, yet many who had made moft hafte in retiring, made the moft to return, and came into the city without fear ; infomuch, that in Decem- ber they crowded back nearly as thick as they Red : the houfes, which before were full, of the dead, were now again inhabited by the living ; and the fliops, which had been moft part of the year fhut up, were again opened, and the people again cheerfully went about their wonted affair^ of trade and employ.
A TABLE
pi
O <
§
o
ti
o
s
It. o
-J
.-I
g
CTj O ^ p »0 CO CO oi ^ —
-3 c:
= 3 <5
^ 3
-i- ^ cij ty I
^ f- QJ >
3 o S o u o
Pi -5:00
- tn m
G.-^ J. .-5
5 ^1^5
P —
o « 05:
^2
c o
1 a; J- - i,
■ oj
!-. ^ j:; (u Qj <y a.
r~ O CO
S) C-( t- " CO _3 CI — — '
1^
^ -r; —
pa «
~X rt rt ^ o c
2 « n to 13 ' " . . ^ ^ ^ b.
X X io 55 X 55 ^ K 73 Cn C/: X' V2 03 '73 »3 cn CO !/3 Cfi t/3
i — O — OJ c-i
CI :T — C't t- to 10 n _ CO ■ ■ "
in Cl 00 I- )- O —
J- ^ - . -, , . . CO O 'O CO C't 10
_H _CO-H —CO — '*
— 01 ■-' o i~ i~ o t- o o ^r- o »o cr,
-) ^ J.O ^ ^ O CO O t- O CO
v:^-j,.-^,nOTiOoo — — -^'■oc^^o^cococo^~^-lO— cocooooooiioOi-o-T'^oi "= o — ™ — ' r» c OD 'O 'O ■^f' »n — 00 '.n CO <^ C) o —
'S o — ' 'io c-j v>f <o CO '-o
n , a; -^'.^
.2 J
c c o
X 5
C ^ ft
2 ^ <ca-
5 y
3
o
■/^ ^ ^ ^ —
o
X 55 M X X M M ;
S C ^
to CO -T I- CM 1-1 ^ t- CO — ' —
CO tM
iO CT) *0 00 CO O 1— "0 lO
CM in 'T' — '-'
ly; </> o ^ 5
0-3 a
Dp--.—
X X H ,c :5 X X X H ■<
^ o ' --) o Qo - n o o to o 20 O 'H ^ 0( 00 l~ ^ t» ^ Cn)
CO TT GO CO C?>
oj <o in — ' to Oi to o t~
^ C") QO ^
-*-' >^
<«
00a
popaQ
(3
S WIS
3 0,3
o a. o X -n X
000
X X X X X X
n -* c7) I- cn 'fj O CO I- — C-! •* —
CO
CO CO O — O I-
m c;^ CI — I CO CT)
O, ^ -. Si
•0-1
n flj 5j
'O 13 +J
5 > &
>^-2 _ 2 o c 11 _ a, ^ 5 £ 4"" o c ca cj JO
mxxxWcfi
c^ ^
IT) to O CO
cn 10
»0 CO -o
CO CO -T CO
C7) CO o 01 10 r~ CO »o
c
o
M
c ■
« « S I
X X 93 X
J- CO ^ CO ^ CO o '-0 <^ CO o
CO CJ^ CO CM O CO t;!' l- l.- CO ai C^^
O) — -.
CJ C3
o
1^ b td .
(LI O
« *J - MXXX
CO CN ^- — ' — CO I- o
5>} r-. CO CO
t_ (>( CO CO
10 c^ CO o ■.3. c» (3)
bo
to 5
5P 'S^
C3 ft. CM
(U OJ
— U. — ^ ft)
01 CO
o o
go
— to
OS z o
K 61
CS
!3
ft?
O >
349
Hiftories of the Plague, exhibiting the modifi- cations it undergoes in different climates, mufl at all times and in all places be acceptable, if not to the public at large, at leaft to that clafs of per- fons who make the art of medicine their particu- lar iludy and employ : and, to a country lituated like our own, hiflories of this terrible diforder occurring but lately in the northern parts of Europe , are more particularly interefting, by holding up to our view a picture of what it probably would be, whenever it ihould vifit us again, even at the prefent time. Such a pifture is prefented to us in the hiflory of the Plague which depopulated Mofcow, and other parts of the Ruflian empire, in the year 1771, which will form the fubjett of the following pages. What, at the prefent time, mufl give a greater degree of interefl to fach a fubjeft, is the danger to which we are ex- pofed of importing the peftilential contagion from America * on the one hand, and from Tur- key and the Levant on the other : for, although the cold has, happily, fuppreffed for the prefent the peftilence which has been committing fuch
" Whatever doubts might have been entertained, as to the real nature of the yellow fever, on Its firfl appearance in North America, I believe almoft all phyficians are now agreed that it is the plague^ with fuch modifications as are eafily referable to difference of climate and different mode of living. But whe- ther it is, as the French wifhed to fay of the plague of Marfeilles, z fievre /lutriJe only, or the true plague, is immaterial, if it is proved to be fat;U and infeftious.
<3readful
350
tlreadful ravages at Philadelphia * and New York 5 yet -it is to be feared that it may be retained in many boufes, and lie dormant in various goods, ready to break out again, whenever it lliall be favoured by the weather : and no one who is ac- qoaainted with the nature of that contagion can deny tJ^e pGfffibillty of its importation from Ame- 'lfiba irtt6 this country, either now or hereafter* by infe£led perfons, or infected merchandize. On the other hand, are we not threatened with a fimilar danger from the Eaft ? In executing the hoflile operations which are going forwards in the Medi- terranean and in Egypt, it fecms fcarcely poffible for our fleets and armies to keep quite clear of contagion. No nation was ever long engaged in a war w^th the Turks, without taking the P /ague. Ill this refpeft they- are as much to be dreaded by their friends as their foes. If, in the prefent conteft, Italy, and France, and England, lliall efcape this fcourge, it will form an exception to pall events, which all Europe muft devoutly pray for.
In the year 1769 war was declared by the Ruf- fians againft the Turks. Added to the miferies of war, the plague followed the devaftations of fire and the fword ; and more periflied by it in
* The hiftory of one attack has been given ; and iinlefs it had fwelled out the work too much, the raging of the fame Plague this laft fummer would have again arrefted our attention, za,d excited our commiferations.
a few
35i
a few months, than by the arm of the murderer- Soon after the inroads of the Turks into Wallachia and Moldavia, the Plague fliowed itfelf, where it made dreadful ravages. The following fummer it extended itfelf into Poland, and a multitude died; It then paffed to Kiovv, where it deftroyed 4,000 fouiilis. All communication betwixt this, place and the city of Molcow was cut off, and guards were ftationed on fall the great roads ; but vigilance was 'of no avail,': ■''■■i.if . .:.
Soldiers, who ha)d;~tl5ebn'c0rit-efiii3j'"ng with the Turks, were obliged to be receiTed into the rniiitary hofpital at Mofcow ; and here the Plague broke out with all its dreadful reti- nue: Thofe who were feized with this direful diftemper at firft complain of a general fenfe of illnefs. Sometimes they exhibit marks of iti*-' toxication or drowfmefs. They have a particular tafte in their mouths, which foon turns to a bittef j To thefe fucceed chilly and hot -its^ and, laftjy^ . all the fymptoms which charafterize the plagu^< The difeafe fometimes terminates favourably by perfpiration, before the appearance of purple, fpotsy ^buboeis, oV carbuncles. < Thie contagion ji^i- fometimes •' more rapid -and wore violent in its afliori ;' irl -that cafe ■the infeftfed- -atfe fuddenly- feized after making a hearty meal,- after a fit of anger, or too much bodily motion, with head- ach, naufea, and vdmit'ing ; 'tHe'e)''es* 'become in- flamed and watery (lachrymans) ^ and pains are
felt
352
felt in thofe parts of the body where buboes and carbuncles arc about to appear. There is no great degree of heat; The pulfe is fomctimes full and hard ; fomctimes fmall, foft, and fcarcely perceptible ; it often intermits j and, what fliould be particularly noticed, it is often feeble; Thefc fymptoms are accompanied with laffitude, a white tongucj dry ikin, urine of a pale yellow colour, or turbid, but without fediment ; frequently at- tended with a diarrhoea, which it is difficult to flop 5 and laftly, with delirium, buboes, carbun- cles, and petechiie*;
The military furgeon firft fell a vidlimj and each iiurfe in turn, until all of them, to the number of eleven, periflied ; nor did it ceafe until twenty- four pcrfons had been feized with it, only two of whom recovered.
• The houfe, with all its furniture, was ordered to be burnt, which was accompliflicd j the dead were burled at a diftance from the city : but this proved of flight avail, it broke out afrefli ; and what added to the contagion was a riot of the populace, which began on the 15th of September, late in the evening, when a frantic mob, chiefly compofed of women, broke open the pefl-houfes and quarantinC'hofpitals, renewing all the reli- gious ceremonies which it is cuftomary with them
* This defcription is from Baron Arch, firft phyficii^n to the Ruffian army. //
to
353
to perform at the bed-fide of the fick*;, and dig* ging up the dead bodies, and burying them afrefli in the city. Agreeably to their ancient cuftom, the people began again to embrace the dead, defpifing all manner of precaution, which they declared to be of no avail, " as the public calamity " (I repeat their own words) " was fent by God, to punifli " them for having neglefted their ancient forms " of worfliip." They further infifted, that as it was pre-ordained who fliould and who fliould not die, they muft await their deftiny ; therefore, that all endeavours to avoid the contagion were only a trouble to themfelves, and an infult to the Di- vinity, whofe wrath was only to be appeafed by their refufmg all human afliftance. In their pa- roxyfm of phrenfy, the populace attempted to wreak their vengeance upon thofe who had la- boured for their prefervation. After they had facrificed one vi£iim to their blind rage, they fought for the other phylicians and furgeons ; all of whom happily efcaped. General Yerop- kin, with a fmall party of foldiers, drawn toge- ther as fpeedily as poffible, difperfed the mob, and reftored tranquillity in a few days, after which every thing was placed on its former footing.
* Befides praying by them hi the ordinary manner, it is (cuftomary, in Ruflia, to carry in great pomp to the fick the images of their faints, which every perfon prefent kifTes in ro^ tation.
Vol. IV. A a This
354 'I
This vaft concourfe and intermixture of the j
healthy and infected, caufed the contagion to t
fpread to fuch a degree, that from this time the \
daily number of deaths amounted to one thoufand '
two hundred, and upwards, per diem ! The J
number of deaths kept at this rate for fome \
days, and then diminiOied to one thoufand. As i
the populace, during the riots, had re-efta- j
bliflied all the religious ceremonies cuftomary i
on burying the dead, almoft all their priefls, j deacons, and other ecclefiaftics, fell victims to the
contagion. j
The people, brought to a fenfe of their duty, j
partly by the rigorous meafures employed againft j
them, and partly by feeing that the public cala- i
mity had been aggravated by their diforderly |
proceedings, now began to implore our medical j
afliftance. The monafteries and other peft-houfes j
were full ; the fick were no longer carried thither; I
the contagion had fpread every where ; infomuch i
that the city itfelf might be confidered as one \ entire hofpital.
At this time Prince Orlow arrived at Mofcow, ■ inverted with full powers by the emprefs. Hav- ing taken the neceHary fteps to prevent all fur- j ther popular commotions, the Count felected, j from all our papers, what appeared of moft mo- \ ment, and drew up a fet of regulations, as well j for the treatment of the fick, as for the keeping ;
of I
355
of thofe who were yet well free from infc£tionv He alfo ordered new hofpitals to be immediately built for the reception of the poor feized with the Plague *.
The weather was intenfely cold during the whole of the winter. In order to deftroy all re- mains of the contagion, the doors and windows of the rooms, in which there had been ajiy per- fons ill of the Plague, were broken, and the rooms were fumigated with the antipeftilential powder f ; the old wooden houfes were entirely demoliflied.
At the clofe of the year 1771, this dreadful fcourge ceafed, by the bleffing of God, at Mof- cow, and in every other part of the Ruffian em- pire. Befides the three towns before-mentioned, upwards of four hundred villages had been in- fe6ted.
The effefts of the Plague were traced in every part of the city, Even as late as the month of February, 1772, upwards of four hundred dead bodies were difcovered, which had been fecretly buried the year before in private houfes, So
* In Ruffia it is no uncommon thing to have a large edi- fice built of wood in a few days, See Coxe's Travels. To perfons unacquainted with this faft, the ere£ling of new hof- pitals might feem a very tardy meafyre for checking the pro* grefs of the plague.
f Vide the next fe£tion, On Prevention.
A a 2 powerful
356
powerful is cold in deftroying the contagion^ that not one of thofe who were employed in digging up thefe bodies, and carrying them to the public burying-grounds, became infedted *.
The total number of perfons carried off by the Plague amourited, according to the reports tranf- mitted to the Senate and Council of Health, to upwards of 70,000; more than 23,000 of this number of deaths happened in the month of Sep- tember alone. If we add to thefe the private and clandeftine interments f , the whole number
;,* For carrying away and burying the dead, criminals capi- tally convifted or condemned to hard labour, were at firft em- ployed ; but afterwards, when thefe were not fufficient for the purpofe, the poor were hired to perform this fervice. Each was provided with a cloak, gloves, and a ma(k, made of oiled cloth ; and they were cautioned never to touch a dead body with their bare hands. But they' would not attend to thefe precau- tions, believing it to be impoffible to be hurt by merely touch- ing the bodies or clothes of the dead, and attributing the ef- fe£ls of the contagion to an inevitable deftiny. We loft before this time thoufands of thefe people, fays Dr. De Mertens, who feldonri remained well beyond a week. I was informed by the Infpeftors of Health, that moft of them fell ill about th« fourth or fifth day.
f The number of thefe was by no means inconfiderable ; for during the height of the Plague, there was fcarcely a fufficient number of men, horfcs, and carts, to carry off thfe dead ; many remained uninterred for two or three daySj and were at length taken awav by their relations, friends, or poor people hired for that purpofe. Many of thefe could not be regiftered, befides numbers of other* who were buried in fecret, and wliofe iUiiefs was never reported to the fenate.
of
357
of deaths in Mofcow will amount to 80,000 : and reckoning thofe who died in upwards of four hundred villages, and in the three towns of Tula, Yaroflaw, and Kalomna (or Kaluga), it will fol- low that this Plague fwept off altogether as many as 100,000 perfons !
SECT.
358
i>ECT. L.
OF PERSONS MOST LIABLE TO TAKE INFECTION.
Many in the times of contagion have recom- mended high^ others low living i but both as pro- ducing debility — the former of the direEl, the other of the /W/>r(5Z kind, have been blind leaders of the blind : for the conftitutions moft liable to be afted upon, are thofe where debility prevails. Hence, according to the accurate obfervations of of Dr. Rufh, the yellow fever invaded chiefly thofe where there had been —
1. Fatigue of body, induced by labour, by walking, riding, watching, or the like exercifcv. It was labour which excited the difeafe fo uni- verfally among the lower clafs of people. A long walk often induced it. Few efcapcd it after a day, or even a few hours fpent in gunning. A hard trotting horfe brought it on two of my patients. Perhaps, riding on horfeback, and in the fun, was the exciting caufe of the difeafe in moft of the citizens and ftf-angers who were af- fe£ted by it in their flight from the city. A fall excited it in a girl ; and a ftroke upon the head excited it in a young man who came under my care. Many people were feized with the diforder in confequence of their exertions on the night of
the
359
the 7th of September, in extinguifliing the fire which confumed Mr. Dobfon's printing-office; and even the lefs violent exercife of working the fire engines, for the purpofe of laying the duft in the ftreets, added frequently to the number of the fick.
2. Heat, from every caufe, but more efpecially the heat of the fun, Vi'as a very common exciting caufe of the diforder. It aided the ftimulus of the contagion in bringing on indireft debility. The regifter of the weather, during the latter end of Auguft, the whole of September, and the firft two wrecks in 0£lober, vi^ill fhew how much the heat of the fun muft have contributed to ex- cite the difeafe, more efpecially among labouring people. The heat of common fires likewife be- came a frequent caufe of the activity of the con- tagion, where it had been received into the body ; hence the greater mortality of the difeafe among bakers, blackfmiths, and hatters, than among any other clafs of people.
3. Intemperance in eating or drinking. A plen- tiful meal, and a few extra-glalTes of wine, fel- dom failed of exciting the fever. But where the body was ftrongly impregnated with the conta- gion, even the fmalleft deviation from the cuf- tomary ftimulus of diet, in refpeft to quahty or quantity, roufed the contagion into aftion. A meat fupper in one, and eating oyfters for fupper in another of my patients, produced the
difeafe^^
36 o
difcare. Half an ounce of meat rendered tlic contagion a6Hve in a lady who had lived, by my advice, for two weeks upon milk and vegetables. A fupper of falad, dreffed after the French fefliion, excited it in one of Dr. Mcafe's patients. It is beeaufe men are more predifpofed by their conftitution and employments to indirect debility than women, and that young and middle aged perfon& are more predifpofed to this fpecies of debility than old people, that more men than tvomen, and more young than old people, were affected by the diforder.
There were feveral exciting eaufes of the di- feafe, which a6l£d by inducing ciired debility upon the fyftem. It may appear difficult, at firlt figlit, to explain how caufes fo oppofite in their nature, as indireSl and direSl debility, fliould pro- duce exaftly the fame cfFe61. The difficulty va- nifhes when we reflect that the abfrraciion of one flimulus, by accumulating the excitability of the fyftem, increafes the force of thofe which remain. The contagion. When received, into the body, was frequently innocent, until it was aided by the addition of a new, or by the abftra(SliGn of a cuf- kiraary ftimulus. The caufes which afted in this wav were —
1. Fear. This- paffion debilitates, only beeaufe k abftra£ts its antagonift paffion, of courage. In^ many people the difeafc was excited by a fudden paroxyfm of . fear i but I faw fome remarkable
inftances
S6i
inrtanccs where timid people efcaped the difealc, although they were conftantly expofed to it. Perhaps a moderate degree of fear* ferved to ba- lance the tendency of the fyftcm to Indireft de- bility from the exceffive ftimulus of the conta- gion, and thereby, to preferve it in a Hate of healthy equilibrimn. I am certain that moderate fear did no harm, after the difeafe was formed, in thofe cafes where a morbid excefs of a6lion, or proftration of the moving powers from excefs of ftimulus, bad taken place. It. was an early dif- covery of this faft which led me not to conceal from my patients the true name of this fever, when I was called to them on the day of their being attacked by it. The fear greatly co-operated with fome of my remedies in reducing the morbid excitement of the arterial fyftem. A total abfence of. fear, however, in many cafes that came under my notice, did not prevent an attack of the fever.
2. Grief. It was remarkable, that the greateft concentration of the contagion did not produce the difeafe in many inftances in the attendants upon the iick, while there was a hope of their recovery. The grief which followed the ex- tinftion of hope, by death, frequently produced the difeafe within a day or two afterwards 5 and that not in one perfon only, but often in moft of the near relations of the deceafed. But the di- feafe was alfo produced by a change in the ftate
of
362
of the mind directly oppolite to that which has been mentioned. Many perfons, that attended patients who recovered, were feized with the diforder a day or two after they were relieved from the toils and anxiety of nurfing. The col- lapfe of the mind from the abftraftion of the flimulus of hope and defire, by their ample grati- fication, probably produced that debility and lofs of the equilibrium in the fyftem, which favoured the'a£livity of the contagion.
The effefls of both the dates of mind which have been defcribed have been happily illuftrated by two fa61s which are recorded by Dr. Jackfon*. He tells us that the garrifons of Savannah and York Town were both healthy during the fiege of thofe towns; but that the former became fickly as foon as the French and American armies retreated from before it, and the latter immedi- ately after its capitulation.
3. Cold. It will not be neceffary to paufe here, to prove that cold is a negative quality, and produced only by the abfence of heat. Its aftion in exciting the difeafe depended upon the dimi- nution of the nece{fary and natural heat of the body, and thereby fo far deftroying the equili- brium of the fyftem, as to enable the contagion to produce excellive or convulfive motions in the blood velTels. The night air, even in the warm
* Treatife on the Fevers of Jamaica, page 298.
month
3^3
month of September, was often fo cool, as to ex- cite the difeafe where the drefs and bed-cloaths were not accommodated to it *. It was excited in one cafe by a perfon's only wetting his feet in the month of Oftober, and neglefting afterwards to change his flioes and (lockings. Every change in the weather, that was fliort of producing froft, evidently increafed the number of fick people. This was obvious after the 18 th and 19th of Sep- tember, when the mercury fell to 44° and 45''. The hopes of the city received k fevere difap- pointment upon this occafion, for I well rccolleft there was a general expectation that this change in the weather would have checked the diforder. The fame increafe of the number of fick was ob- ferved to follow the cool weather which fucceeded the 6th and 7th of Oftober, on which days the mercury fell to 43° and 46°.
It was obferved, that thofe perfons who were habitually expofed to the cool air were lefs liable to the difeafe than others. I afcribe it to the ha- bitual impreffion of the cool night air upon the bodies of the city watchmen, that only four or
. five of them, out of twenty-five, were affected by
•diforder.
* Lind frequently remarks in his work on the Difeafes of Warm Climates, that perfons who had quitted their fhips and ftopt on ftiorc, were foon after attacked with fever : whereas thofe who were on the very fame infalubrious fpot, only during the day-time, returned back uninjured.
After
3^4
After the body had been heated by violent cx - ercife, a breeze of cool air fornetimes excited the difeafc in thofc cafes where there had been no change in the temperature of the weather.
4. Sleep. A great proportion of all who were afFe£led by this fever were attacked in the night. Sleep induced dire£l debility, and thereby dif-
r ■ ■
pofed the contagion, which floated in the blood, t£>^ a£^,with fuch force ypon the fyftem as to de- ftroyj.its equilibrium, and thus to excite a fever. The, influence of fleep, as a predifpofing and ex- citing canfe, was often aJjTifted by the. want of bed-cloaths, fu i ted, :tg.^^^, midnight or morning i;;oolnf;fs of the *ir* ; .
,5, , Immoderate. Evacuations. The eflicacy of moderate purging and bleeding, in preventing the difeafe, led fome people to ufe thofe reme- dies in an excefs, vi'hich both predifpofed to the difeafe and excited it. The morbid effefts of thefe evacuations were much aided by fear ; for it was this pallion which perverted the judgment in fuch a manner, as to lead to the exceflive ufe of remedies, which, to be efFe£lual, fliould only be ufed in moderate quantities.
Hence is the necefllty, in times of contagion, of a knowledge, and careful obfervance of, the laws of -the animal oeconomy*.
■* Thefe have been before amply difcuffed in Vol. I. II. and III.
Befides
3^5
Befides fumigation, various remedies have heeix recommended as prefervatives, external and in- ternal. Of the firft kind, fome are to be carried in the hand, or worn about the body, or other- wife applied externally. Little need be faid of the ingredients of which the fmall bags, balls, ointments, or amulets, are compofed, as they have no juft claims to the title of antidotes, and are for the moft part either the offspring of em- pirical craft, or are mere innocent devices, to give confidence to thofe under the neceflity of approaching the fick. In this laft view, fuch as can do no harru may be admitted, in compliance with popular notions ; but amulets of poifonous or doubtful quality fliould be admitted with more caution, or rejefted *. Some of the perfumes or- dered by the College, are perhaps as proper as finy ; but their forms fhould be rendered more fmiple, excluding coftly ingredients, or fuch as are procured with difficulty. No difference, per- haps, fhould be made between compofitions of this kind intended for the rich or the poor; the latter, by their fituations in life, {land moft ex- pofed, and fhould not have their confidence in the defenfative lelTened, by the refletlion that their poverty mufl deprive them of the mofl effi- cacious. The pomander prefcribed for the richer
* Muratori, lib. ii. c. p, 129. See alfo a Treatife of the plague by Thomas Lodge, M. D. Lohd. 1603. .
366
fort, by the College, contains lignum aloes *, which can be of no poflible ufe when inclofed in an ivory box, bccaufe it emits its fcent only when much heated or burning.
Many of the people of Aleppo carry a little ball of labdanum in their hands, or fmell to vi- negar in which rue has been fteeped.
As to • internal prefervatives, the number of fimple, recommended under the title of antidotes, is much greater, and the compound forms are in general moft unjuftifiably complex. Medical books are filled with them, and fome with eulogies on their approved efficacy. The reader may find a copious colle£tion in Muratori f , upon which it is needlefs to comment.
The College at London, in J 665, made fome alterations on the head of Inward Medicines, leaving out a very few articles of the old forms, and fubftituting others in their place, fome of which do not appear to have any juft claim to fuperior efficacy. Among the principal new compofitions introduced, are fome medicated ales, diftilled waters, and two or three eleftuaries ; of all which the ingredients are fuperfluoufly multi- plied. Among the old compofitions retained, is one calculated for the rich, and which ftands dif- graced by the following ingredientss — oriental
\
* Advice of the Phyficians, xii. f Muratori, lib. ii. c. iii.
bezoafj
3^7
bezoar, pearl, hyacinth ftone, unicorn's horn, and lignum aloes ; the proportion of the laft article being about three grains to four hundred and fifty of the other ingredients.
In the Epiftle, dedicatory, prefixed to the ad- vice of the College in 1665, it is faid, " We " have been tender in omitting many forms and prefcripts, which by reafon of the plainnefs and " homelinefs of them we looked upon as very " obnoxious, to be cenfured and vilified, efpccially " by perfons pretending to rare preparations and " fecrets ; we confidered that our predecefTors " (amongft whom were then the mofl; eminent " phyficians in England, and fuch as had expe- " rience of plagues in their times, raging to a far " greater height than through God's mercy any hath done fince) might fee juft caufe, upon their experience and fuccefs to bring them in." But it is to be hoped, whenever the College come to revife their public advice, that the fame fcrupulous delicacy will no longer reftrain their corre£lions. Indeed the fame reafon for delicacy no longer exifts ; for the reigning prejudices in favour of names and authorities, which at that time rendered a cautious refpeft in fome degree neceffary, have, in the long interval which Bri- tain has providentially enjoyed free from the plague, either been configned to oblivion, or re- tain little of their former influence over the minds of men.
The
368
The reformation that in the prefent century has taken place in moft of the European difpen- fatories, more efpecially in Britain, has difencum- bered the Materia Mediga of many ufelefs arti- cles s and the later improvements in pharmacy, joined with the modern more fimple mode of prefcription, have prepared the way for high im- provement in medical direftions for the pre- vention and cm-e of the plague, without danger ot offending popular opinions.
It feem.s highly expedient, that fome compo- litions, under the denomination of prefervatives, ihould be prepared, with the fanclion of the Col- lege, and fold at eafy rates. Many perfons will never think themfelves fecure without fomethin? of that kind, and where they cannot find an- tidotes regularly recommended, will be the more eafily tempted to have recourfe to every boafting impoftor who offers his noftrum : of which num- bers, at fuch times, are always ready to take ad^ vantage of the public credulity *,
At the fame time it muft be confeffed, that prefervative internal remedies do not appear to be neceffary for perfons in good health ; and, except where there is a ftrong prepoffeffion in their favour, may fafely be omitted. A tempe- rate eourfe of life, and temperate indulgence in cuftomary liquors, promife every advantage that
* Hodges's Loirpologia, p, 21. Journal of the Plague Year,
can
3^9
can be expe£led from cordials and ftomachics. To valetudinarians, hypochondriacal perfons, and others of weak nerves, or difturbed digeftion, fomething medicinal, befides wine, may perhaps become requifite for the bowels, and for pre- ferving a conftant and lalutary moifture on the furface of the Ikin ; but inanition, and fudden changes in diet, ought to be avoided ; and all evacuations ought in general to be profcribed, in refpe£l to thofe who are obliged to go into the way of infeftion.
Terror, defpondence, and other debililating affeftions of the mind, have been univerfally held of mod dangerous tendency in times of peftilence. On the contrary, a regular flow of fpirits, a tem- per not given to anticipate evils, or, when they happen, to brood over them, and a lively hope of efcaping the infe£l:ion, are confidered as the beft fafeguards againft contagion*. But thefe are not in the power of medicine to beftow ; they are the bleffings of natural conftitution j and, where wanting, muft be fought in a cheer- ful aflbciation with others who poflefs them, and by engagements that divert the mind from the contemplation of melancholy objefts.
* Muratori, lib. iii. cap. ii.
Vol. IV.
SECT.
37^
SECT LI. j
OF THE LIMITED SPHERE OF ACTION OF PUTRID !
MIASMS. j
Having eftabliflied a houfe in the neighbour- ] hood of this city (Lyons), fays Dr. Ryan, for the j reception of inoculated patients, many people, -j falfely perfuaded that a perfon infected by a ^ good kind of fmall-pox would have the dif- s temper in the like favourable manner, brought their children to vifit my patients, with an V intention that they fliould be infected by a /' communication with thofe who were inoculated, f ■ After many unfuccefsful attempts to convince thefe people of their error, feeing that they re- jefted my offers to inoculate thefe children, and not doubting, in fpite of my arguments and ex- prefs prohibition, that fooner or later they would feize another, and perhaps a lefs favourable op- portunity, I expofed them to the following ex- periments, after they had undergone a due courfe of preparation.
I placed a large dolTil of cotton, foaked in va- riolous matter, on the middle of an oval table, whofe leaft diameter was three feet : I feated fix children around it, three on each fide of the table, in fuch a manner, that all were fituated within half a yard of the infe6tious cotton. This expe- riment
371
rlment was fometlmes made in the open dir, fometimes in the houfe : 1 took care to renew, every fecond day^ both the variolous matter, and the fubftance which contained it : I alternately ufed the poifon taken froni the inoculated, and from the cafual fm all-pox ; and I copioufly im- pregnated with it balls of cotton, lint, wool, and filk. This operation, repeated during a whole week, morning, noon, and night, for an hour at; each fitting, produced no effeQ-.
I then fent away the children, defirihg the pa- rents to acquaint me, in cafe any indifpofition appeared, and to bring them to me a fortnight afterwards, although no alteration fliould have taken place in their health: I declare that, not only for that term, but for many fuccedding months^ during vphich I took care frequently to vifit them, they all enjoyed perfe6t health. It was not till nine months after this time that four of thefe children had a mild kind of fmall-pox;
Having concluded from thefe experiments, that the children could not have efcaped infeflionj, but becaufe the variolous matter might have loft that fpring, and that degree of energy, which, perhaps, it may poffefs on arifing immediately from the human body, I placed a perfon, in the eruptive fever of the fmall-pox by inoculationj at the diftance of about half a yard from four children properly prepared ; each expofure con* tinued one hour, and was repeated daily for a
B b 2 fortnight.
372
fortnight, reckoning from the commencement of the fever till the puftules were become perfectly dry : not one of the four received the infeftion. Two months afterwards I inoculated three of thefe children : they had the diftemper in a very mild manner, and recovered without difficulty.
Like experiments made with the blood, and with the flimy matter which runs from the eyes and the nofe of perfons attacked by the meafles, have uniformly had the fame refult.
I can, fays Dr. Currie, bring many fafts, to prove that the contagion has fpread a very little way into the atmofphere in fituations where many patients have been confined together, and confe- quently the quantity of effluvia greatly multiplied. Thefe are chiefly from the accounts of our Guinea voyages, in which the fmall-pox ufed formerly to make, at times, dreadful havoc among the flaves. The practice, however, of late years has been, immediately on the appearance of the ca- fual difeafe on Ihip-board, to inoculate the whole cargo 5 and nothing can fpeak more forcibly the fafety of inoculation, than the complete fuccefs with which it has generally been attended on perfons of all ages, entirely unprepared, and under circumftances every way unfavourable. As however a general inoculation, under fueh cir- cumftances, is always followed by unpleafant, and fometimes, though rarely, by deftruftive con- fequences, it is not now uncommon to feparate
373
the difeafed perfons, and to trufl: to means of prevention for the fafety of the reft. Thefe fre- quently, perhaps I might fay generally, fucceed, provided the voyage is performed with light and favourable winds, which is neee0ary to enable them to make the feparation complete. An iur fiance of this has juft occurred in a Guineaman, called the Golden Age j foon after flie Jeft the coaft of Africa the; fmall-pox appeared, arid, be- fore the difeafe was known, eight perfons were afFe6led j the whok were immediately brought on deck, their apartments wafhed and- ventilated with the greateft care, and the eight perfons ill were placed in the main-top about twenty feet from the deck, where they regularly patfed through the difeafe. Before coming down, they were waflied, the contagion was extinguifhed, and the whole cargo, as well as crew, arrived in perfe£l health in the Weft Indies. Puring all 'this time, the flaves, as is ufual, paffed the day near them ; but though all were fuppofed liable to the difeafe, not one of two hundred and upwards thus fexpofed received the infeftion. My friend Mr. Beg, formerly furgeon, afterwards mafter of a Guineaman, and now a confiderable merchant here, informs me, that, in one of his voyages, he practifed the fame method of flopping the contagion of this difeafe, and with the fame fuceefe. He acquaints me alfo, that twice, when the fmall-pox appeared among the flavcs, while
they
374
they were at anchor on the coaft, he put the in- fe61ed perfons in a boat a-ftern of the fliip, and pfFeftiially fccured the people on board from the contagion. Many fimilar fa£ls might be collc£led ; and, as I fee they may iUuftrate and inforce your do£lrines, i will attend to the fubjecr. The fame holds good of other difcafes.
In .April, 1779, Mafter Plumbe, the fon of a gentleman of fortune near Liverpool, was at- tacked, in a dangerous degree, with a fcarlet fever and fore throat, in the houfe of his fchool- mafter, the Rev. ]\lr.Vanbrugh, at Chefter, Tjiere were at the time thirty^feven young gentlemen, boarders in the family, moft of whom, it is highly probable, were difpofed to receiye this dangerous contagion. . My patient's chamber, fays Dr. Hay- garth, was fituated in the middle of the houfe, at the landingofthefirftpj^ir of flairs : all the fcholars :went.clofe pafl: his door feyeral times a day. At this feafon,- Winchefter, and feveral other large fchpols •in.Englan4, fent home 7\nd difperfed their fcholars^ on - account of this dillemper, which had alarm- ingly fpread among them. Whether this mea- sure,, w-ith all its incpnyenicncies, \vas not advife- able;, became a very, ferious queftipn. The. nume- rous fa£t3 whiph I had then cplle6ted, to prove that the variolous infe£liQn, though probably the moft virulent- we are acquainted witli in this cli- mate,, exerted its baneful influence at but a fmall fliftancc only from the poifon, cncQuraged me to
hope
375
hope that the contagion of a fcarlet fever was in- capable of producing more cxtenfjve mifchicf. The rules of prevention were placed on the door of the patient's chamber, and rigid attention to their faithful obfervance was required. The event fully rjuftified my hopes. Though all the thirty-feyen (eholars remained in the fame houfe and family, during the whole difeafe, yet not one of them was infefted.
I do not recolleft any obfervations recorded by authors to determine what proportion of man- kind are liable to the attack of the fcarlet fever. In Oftober 1778, out of forty young ladies at a boarding-fchool in Chefter, all but four had the diftemper, twelve very feverely, and two moft dangeroufly. This comparative ftatement of fafts, which happened in two fchools, fliews, beyond all reafonable doubt, to what a little diftance from the poifon the .infectious miafms extend, and that the rules of prevention are, in this re- fpetl, fully adequate to their purpofe.
Thisknowledge is extremelyufeful in makingus acquainted with the real ftate of our danger ; for like a city befieged, even before the befiegers ap- proach near enough to do any damage, every thing is in the utmoft confufion : fo I have known a whole houfe deferted on the appearance of a putrid fever, and as much precipitation in flight as if the houfe had been on fire. This know- ledge fhould alfo reconcile thofe who happen to
37^
be in a houfe where the Plague rages, and the ftate places centinels at the door of the infc£led houfes, forbidding any one to leave them. The danger is not fo great as they imagine. It may be avoided by a few fimple rules. Thefe confift in avoiding the fphere of infedion, and con- tact of any clothes that has been within this fphere *.
\^ Vide Dr. Haygarth on the Small-pox, who has been inde- fatigable in removing the prejxidices of mankind, and clearing this ipterefting fubjed.
PRACTICAL
377
PRACTICAL OBSERVATIONS,
SECT. LIL
THE METHOD OF DESTROYING CONTAGION.
The prefent fyftem of quarantine proceeds on ] a fuppofition, that infefted goods are capable of being purified, in a certain time, by ventila- tion. If this be not fuppofed, quarantine is no more than a very undecifive trial whether the goods be really contagious ; I fay undecifive, be- caufe though the goods be really contagious, thofe employed in unloading or opening them may poffibly efcape unhurt, in like manner as it fome- times happens, that of feveral perfons frequent- ing the chamber of a patient in the plague, no one is infe£ted. It is certain, however, 2, llrong prefumption either of the goods being not tainted, or pf the ftate of the air being not favourable to contagion, when thofe employed in handling them receive no harm. But, be- jfides this, it is the common opinion, that the peftiferous effluvia, conveyed in fubftances clofe packed up, when opened, either evaporate during a long expofure to the air, or are other- wife deftroyed by its agency. In confequence of
which.
378
which, thofe who affift at the firft opening of the goods are confidered as being in much more danger of infeftion, than thofe' who re^packthem after an airing of forty or fifty days.
Quarantine, however, is not merely an experi- ment to determine whether the merchandize re- tain infefilion; but the ventilation, during the quarantine, is reported to be the means of puri- fying them,' if they happen to be infe£lious. The lerrns eftabliOied for ventilation may appear to be unnecelFarily long. It is much to be wifhed, tj^at means could be devifed for the expurgation of merchandize more expeditioufly than by Cm- ple expofure to the air ; and perhaps fumigation
Wherever irife£lion lurks, and in what€ver matQrials it . is. harboured^ the admiffion. of th^ ^j,,]^j^reft air,:,or th^ moft perfeSt ventilation, wii] " J often not a.Yatl,,,e;ither in ren;oving,,or ,abatin^ *' rts a9;ivity,..fay,s Dr. Lind.^-^ Jt ^-jipw ;gives me the bigheft fat.i&fa£tipn to affirm,, that I feldom *'^^pr never knew a proper application of fumes of l^^ ijRIMSTONE to be unfuccefsful, in producing " ifhc happy cpAfeguenqe of effeftually purifying " all tainte.d places^, materials, and fubltances*. ^-^^y^It is jQot to \)p doubted but that, ejicepting "^^t^ie, true plague, there has. beeii an infe6tion
.riLind's DiffertatiDn' on FevQi!s'afi)d;'Iqfe<aibiii ^ aa^. alfo a times added the OXYD OF . ARSENIC." . ^ • •
379
".f\i\ly as peftilential, and as mortal, in fome " fhips, as in any other place whatever ; yet I
never heard of any Ihip, which after having
been carefully and properly fumigated, did not " immediately become healthy. And if after- " wards they turned fickly, it was eafy to trace " that ficknefs from other infefted fliips, jails, " and the like places."
After defcribing the mode of fumigating fliips, he adds, "From the known and experienced " efficacy of thefe procelTes, it appears that fire " and fmoke are the moft powerful agents for "annihilating infection J and it maybe prefumed *5 even the plague itfelf. I have known in feveral " /hips, where there are the faireft opportunities f'rof trying things of this nature, that the con- " tagion of the fmall-pox has been entirely ftop-
ped by means of wood fires, fprinkled with ",brimftone, kept burning and clofely confined
in the infefted placed.
I fliall laftly deliver my fentiments with re-f f gard to the purification of goods, moveables, " clothes, &c. which are fufpefted to harbour
contagion 3 and I cannot but take notice, that " the ufual cuftom of only unpacking and ex- " pofing fuch materials to the open air, is, in
nriany inftances, infufficient to deftroy the latent " feeds of the dife^fef,"
t Ibid. p. 235.
Muratori
38o
Muratori has given us an ample defcription of the purification of goods by fumigation.
The infefted apparel, linen, flieets, coverlets, Bcc. are to be fpread out upon lines, ftretchcd acrofs the chamber. The doors, windows, and chimneys are then to be fliut up, fo as to prevent the fmoke from making its efeape too foon. When this is done, four or five po-uiids of dry hay are placed at bottom, and upon that are ftrewed four handfuls of the ingredients in powder, which being covered with a little more hay, the whole is fprinkled with VINEGAR, in order that the materials may not be confumed too faft. The fire is applied in feveral places at the bottom, the hay being raifed and fupported by a poker; and after the whole is well kindled, the perfon employed, immediately retiring, takes care to fhut the door. The houfe, or chamber, remains tlofe fhut up three days ; after which the houfe and goods are carefully aired. ■ ' 'T>^ combuftible materials, I fuppofe, are laid upon a brafifer, whieb may anfwer very well in Italy*,'' where the fioors- are generally brick or plafter; but for boarded floors, the fire muft be ■gutirded by a better apparatus, toprevent accidents. ' The method of fmoking fl^ips, defcribed by Dr. Lind, feem« preferable t» this. After care- fully (lopping up all the openings and crevices, ^ jnumber of iron pots, properly fecured, are placed in the hold, &c. Each of thefe contain a layer pf charcoal at the bottom, then a
layer of brimftone, and fo alternately three of four layers of each. On the top, fome oakum, dipped in tar, is laid to ferve as a match*.
A great variety of fubftances have been re- commended for the purpofe of fumigation, and a number of compofitions have been emploj^ed, confining of a farrago of ingredients which^ though they enhance the coft, add nothing per- haps to the efficacy of the compofition. The Italian compofition for fumigation might there- fore be reformed, leaving feveral of the more coftly ingredients out, v^athout impairing its vir- tue* The forms mentioned by Muratori might be thus reduced f .
SULPHUR, 5 pounds.
ORPIMENT, 2 pounds.
Common Frankincenfe, and
Juniper Berries, of each 3 pounds. To thefe, after being reduced to a powder, are added :
Shavings of the Pine Tree, 5 pounds.
Bran, 20 pounds. In like manner a ftill ftronger fumigation is prepared, by increafing the proportion of SUL- PHUR, and adding one pound of OXYD OF ARSENICK.
Thefirftof thefe two fumigations is ufed for the purification of infe£ted houfes j the fecond,
* Lind's Diflertation on Fevers, 2d edit. p. 22^. t Muratori, lib. i. cap, ix. p; 72.
for
382
for Lazarettos, fepulchres, and fluff more flrongly tainted than common furniture. A third fumi- gation, intended for pcrfons and their apparel^ who are obliged to approach the fick, is compofed of SULPHUR, aromatic gums, and fpiceries^ without arfenick *.
Muratorij after remarking that fumigation was ufed anciently in the peflilence, fays, the prac- tice was brought into more general ufe by P. Maurizio da Tolono, a Capuchin, who had great fuccefs with it in the plague of Genoa, in 1657. He obferves further, that Francefco Ran- chino, and others, were of opinion, that fetid and poifonous fumes were the moft cffeftual. Declining however a decifion on this point, he refers to the experience of the Capuchin, who delivers himfelf to the following purpofe: "That " his milder fumigation, intended for perfons " obliged to go among the infe£ted, or other- " wife to expofe themfelves to danger, was an " admirable prefervative, and was ufed with re- " markable fuccefs in Genoa, in 1657; thefumi- " gation being applied to the perfon, and his " clothes, before coming out from his houfe." — He adds further, " that the application of his " other fumigations rendered the former prac- " tice, of burning infefted or fufpe6led goods, " unneceffary ; as alfo the fhutting up infected
* Muratori, lib. i. cap. ix. p. 73.
" houfes.
383
houfes, which bemg abandoned by theib inha- " bitants, were left expofed to the depredation " of robberSi He acknowledges that infefted " goods may be purified by proper expofure to " the air, but then a fpace of forty days is re- " quifite for their purgation, during which time " they are fubje£l to many inconveniencies, " befides being fpoilt by the rain, or flolen by " thieves : whereas, by his metJiod, twenty-four " hours are fiifficient for the pmfying; not only houfeSy " with their furniture^ hut even Lazarettos, and the " infeded beds of the fick." Muratori fubjoins two inftances of the goodefFe£t of fumigation, at Venice, in 1576; and at Malta, in 1675 ; and gives feveral inftances of the bad confequences of the negleft of fuch precautions, at Rome, in 1656; at Marfeilles, in 1649 ; and at Modena, in 1630, alfo at Palermo, Florence, Sec *.
Notwithftanding thefe authorities in favour of fumigation, Dr. Mead appears to think the prac- tice injudicious, if not prejudicial, the fumes of VINEGAR, and perhaps BRIMSTONE ex- cepted, founding this opinion chiefly on the pra£lice of the Arabians, who, he fays, recom- mend the keeping the houfes cool and airy, and ftrewing them with cooling herbs, as rofes, violets, water lilies, &c. fprinkling them at the fame time with VINEGAR. But I apprehend there
* Muratori, lib. i. c. i;^.
is
384
is a little inaccuracy in this reprefentation of the Arabian pra6tice j for though the Arab writers certainly recommend the keeping the houfes cool, Scc. they are far from condemning fumiga- tion with aromatic herbs and gums. The faft is, the Arabians made a very material diftinftion, which the Doftor feems not to have attended to, namely, between the regimen for perfons lying fick in peftilential diforders, and perfons, yet in good health, ufmg precantionsior their prefervation.
I have collefted the above authorities, with a view to refcue the praftice of fumigation, as a means of purifying infefted goods, from the de- rogation implied in Do£tor Mead's manner of expreffing himfelf on the fubjeft ; and I am alfo obliged to differ from him in what follows : " when the fick families are removed, aJl the " goods of the houfes, in which they were, fhould ** be burnt, or rather buried deep under ground " - - - and moreover, the houfes themfelves
may likewife be deftroyed by fire, if that can " conveniently be done, that is, if they are re- " mote enough from others ; otherwife it may " fuffice to have them thoroughly cleanfed, and ** then plaftered up*." The burning of houfes in a town muft,, for the raoft part, be attended with danger ; and the burning of furniture, &c. lias been found by experience to occafion dange- rous concealment, and theft, befides many other inconveniences.
* Mead, p. io8.
Since
385
Since there is no diforder to which human nature is fubjc6t, more deftru6rive or alarming than contagious fever, the humane reader will not require an apology for delaying his attention upon fo important a point, more efpecially as it confers the higheft honour on the prefent en- lightened age, and holds out a profpect that one of the greateft fcourges to mankind may be at iaft baniflied from the earth, never again to rear its truly formidable head.
The commifiion at Mofcow having, in the year 1770, invented a fumtgntmi-pozvdery which, from feveral lefler experiments, had proved effi- cacious in preventing the infeftion of the plague 5 in order more fully to afcertain its virtue in that refpe£t, it was determined, towards the end of the year, that ten malefaftors under fentence of death fliould, without undergoing any other pre- cautions than the fumigations, be confined three weeks in a Lazaretto, be laid upon the beds, and drefled in the clothes, which had been ufed by perfons fick, dying, and even dead^ of the plague in the hofpitah The experiment was accordingly tried, and none of the ten malefactors zvere then infeCied, or have been fince ill. The fumi-^ gation-powder is prepared as follows.
'Powder of the firfl flrength.'] — Take leaves of juniper, juniper-berries pounded^ ears of wheat, guaiacum-wood pounded, of each fix pounds j common faltpetre pounded, eight pounds ; SUL-
VoL.lV. Co PHUR
386
PHUR pounded, fix pounds; Smyrna tar, or myrrh, two pounds ; mix all the above ingredients together, which will produce a pood of the pow- der of fumigation of the firfl: ftrength. [A^. B. A pood is 40 pounds Ruffian, which are equal to 35 pounds and a half or 36 pounds Englifli avoir- dupoife.]
Powder of the fecond jirength?\ — Take fou- thern-wood cut into fmall pieces, four pounds ; juniper-berries pounded, three pounds ; common SALTPETRE pouuded, four pounds; sulphur pounded, two pounds and a half ; Smyrna tar, or myrrh^ one pound and a half ; mix the above together, which will produce half a pood of the powder of fumigation of the fecond ftrength.
Odoriferous pozvder.l — Take the root called kal- mis, cut into fmall pieces, three pounds ; leaves of juniper cut into fmall pieces, four pounds ; frank- incenfe pounded grofsly, one pound ; ftorax pounded, and rofe-flowers, half a pound ; yellow amber pounded, one pound ; common salt- petre pounded, one pound and a half; sul- phur, a quarter of a pound: mix all the above together, which will produce nine pounds and three quarters of the odoriferous powder.
In all thefe, the ACID FUMES from the nitre and fulphur form the principal part. The reft appear only ufeful in holding thefe in a ftate of longer fufpenfion.
In
387
In 1773, the cathedral of Dijon was fo ia- fe£led by opening a vault containing dead bodies, :that it was obliged to be fliut up. De Morveau, one of the moft able chemifts in France, to ^difmfeft this church, employed the following I means: He put into a chaffing-difli, covered 'with fine charcoal, a tubulated retort of green Iglafs, filled with nine ounces of marine acid^, iflightly moiftened with half an ounce, or a little more, of water. The fire being lighted, four 'Ounces of the vitriolic acid-f was poured on the diluted marine acid. The MURIATIC ACID GAS was immediately difengaged, and this, fays he, uniting with the ammo-diacal gas of putre- faction, neutralizes it, prevents its injurious quar lity, removing at the fame time all its loathfome foe tor. In the prefent inftance it was ftrongly exemplified. It was afterwards tried with equal -fuccefs in the hofpital at Dijon, and fince which a decree of the National AfTembly has been palTed, ordering it to be employed in the different military hofpitals where infe£lion prevailed.
In the year 1782 an infectious fever broke out among the prifoners in Winchejier. This excited the attention of Parliament, and many eminent phyficians in London were applied to, to take charge of the prifoners there ; but they refufed venturing upon fo hazardous an oflice. The late Dr. Fothergill then waited on Dr. Smith,
* Munat of Soda. f Sulplnirie acid.
an4
388
and requeftcd him, in the mofl: urgent manner, to accompany the commiffioner to Winchefter. He accepted the offer. One hundred and eighty- eight perfons had already perifhed by this dread- ful malady, whofe violence feemed daily increaf- ing. Moft of the officers and fervants belonging to the hofpital had fallen viftims to this fatal diftemper. He had previous to this turned his attention to the power of the mineral acids in deftroying contagion. He had before noticed, that the vitriolic and marine acids^ in a ftate of vapour, had proved effeftual in deftroying con- tagion ; although, owing to its deleterious quality, it could not be employed, except in fituations from which people had been removed. But is the NITROUS ACID*, he reafons, in a ftate of vapour, equally dangerous, and may it not be equally effeftual in deftroying contagion? To prove that it was not very injurious to life, w© put, fays he, a moufe, confined in a wire trap, under a glafs cylindrical jar, capable of holding about 25 pints, beer meafure, or 881 cubic inches; the jar was inverted upon wet fand, contained in a flat earthen trough or pan ; it was then filled with the fumes of the finoking nitrous acid, until the animal could not be very diftinftly per- ceived. The moufe was kept in this fituation for a quarter of an hour, when the jar was re-
* Dr. vSmith ufes the term nitrous acid, but probably meant tfie nitric,
» ' moved^
389
moved, and the animal expofcd to the open air ; it immediately ran about the wire trap, as ufual, and had not the appearance of having fuffered the flighteft inconvenience from its confinement. After a few minutes, the nioufe was again put under the glafs jar, which was now filled with the vapour of pure nitmis actdy detached from nitre by the vitriolic acid. It remained much about the fame time as before, and when the jar was removed, feemed perfeftly well.
We repeated the fame experiments with a greenfinch, only with fome little variation iri the manner. We placed, on a table covered with green baize, a brown earthen veffel or pan, containing heated fand \ in this was put a glafs faucer, with about half an ounce of ftrong vitrio- lic acid J above which we placed the bird-cage, fupported with fome fmall pieces of wood laid acrofs the pan; then, adding a drachm or two of nitre, in powder, to the vitriolic acid, we covered the whole with the glafs jar. The ni- trous acid rofe in fuch quantity, that, in a very little time, the bird feemed as if in a cloud or fog. We kept it in this fituation fifteen minutes, by which time the cloud had difappeared, and the acid was in part condenfed on th€ fide of the glafs jar 3 during the whole time the bird neither panted, nor appeared to fuffer any uneafinefs, from the atmofphere in which it was confined.
We
S90
We made trial alfo of the marine acid, bv add- ing common fait inftcad of nitre, to heated vi- triolic acid: during this experiment, the bird appeared to be now and then fomewhat uneafy, and opened its bill ; but, at the end of fifteen minutes, upon removing the jar, it hopped about as lively as before. We then expofed the bird to the fumes of fulphur, burnt with an eighth part of nitre j it immediately gave figns of uneafinefs, opened its bill, and feemed to pant for breath in fuch a manner, that we were afraid to cover it with the glafs jar. We like- wife made trial, in the open air, of the oxyge- nated marine acid^ \ for, as this is fo extremely deleterious, we did not think it fafe to expofe ourfelves to the vapour of it in a room, nor did we venture to expofe the bird to it in any other way but in the open air, and even there it ap- peared to fuffer very much.
Having made trial of the effeft of the dif- ferent mineral acids, in a ftate of vapour, upon animals, we determined to render the experiment ftill more conclufive, by trying what effect they \vould have on ourfelves. With this intention,
* The oxygenated marine acid is a difcovery of the famous Scheele, and hds been recommended by BerthoUet and Chaptal, two French chemifts, for the purpofe of bleaching. This was the vapour employed by Dr. Morveau to purify the infeded cathedral of Dijon.
we
39^
we filled the room* in which we were with the fumes of nitrous acid, (obtained by mixing nitre with heated vitriolic acid, in the manner already defcribed) until the different obje6ls became fome- what obfcure, by a kind of fog or mift produced. The fire irons and fteel fender loft their poHfli, and the vapour arifing from a bottle of aqua am- monite purae, placed at fome diftance from the table, was evidently neutralized, as it iflfued from the bottle by the vapour of the nitrous acid.
Mr. Hume and I remained in the room the whole time, without perceiving the flighteft in- convenience ; the fumes did not excite coughing, nor affeft the eyes, in the way the fmoke of wood commonly does, even when I held my head over the glafs faijcer, and breathed them immediately arifing from it. We made trial likewife of the eflfeO: of the marine acid, which we found more pungent and ftimulating than the nitrous ; but, though it excited poughing, it did not caufe that conftriclion of the windpipe, and tightnefs at the cheft, with the fenfe of fuffocation, which is immediately induced by the volatile vitriolic or Julphiireous acid. Indeed we were imprudent enough to try how far we could breathe this laft, hut I was inftantly obliged to run to the window for air, from the fenfe of conftriftion and of
* The room in which we made the experiments was a fmall parlour 13 feet by 10, and 8 feet high ; or about 1040 cubic (eet.
fuffocation
392
fuffocation which it occafioned. We likewifc tried the effeftof the mixed fumes of tlie marine and nitrous aeid, a kind of volatile aqua regia, which we found more pungent than the marine acid by itfelf. As for the oxygenated marine acid, perceiving the effeft of it on the bird, and knowing how extremely daiigerous it is^ we did not venture tq go very near it.
From the preceding experiments, the diftcrent acid vapours, in refpefit to the {afet}' with winch they may be breathed, may be arranged in tlie following order :
ift. The vapour of nitrous acid, arifing from nitre decompofed by vitriolic acid.
2. Ditto — of nitrous acid in its fuming ftate,
or when the nitric acid is mixed with nitrous gas.
3. Ditto^ — of marine acid, arifing from com-
mon fait, decompofed by vitriolic acid.
4. Ditto — of nitrous and marine acids, ob-
tained from the decompofition of nitre and common fait by vitriolic acid.
5. Ditto — of fulphur, burnt with an eighth
part of nitre.
6. Ditto — of oxygenated marine acid*, obtain-
ed by putting manganefe to marine acid.
* The oxygenated marine acid is obtained by diftilling marine acid from manganefe, but may alfo be procured in fmall quantity, by putting manganefe to heated marine acid, or by gradually adding a mixture of manganefe and sea-falt to heated vitriolic acid.
As
393
As the firft vapour is perfe£tly harmlefs, In any quantity in which it may be required, it is evi- dently the moft proper to be employed in all fituations where people are necelTarily prefent j and if it fliould prove efficacious in dellroying contagion, of which I have not the fmalleft doubt, it is the deftdcratum fo much fought after by Dr. Lind.
The fecond, though more pungent than the firfl, may, I believe, be employed with the greateft fafety ; at leaft, I have never obferve4 any inconvenience from ufing it. But as it can- not fo eafily be procured in confiderable quantity, and is attended with greater inconvenience and expence, I would advife only the firft.
Our experiments likewife warrant us to affirm, that the third, or marine acid, though more ilimulating, and more apt to excite coughing than the nitrous, may be fafely ufed, at leaft in a moderate quantity, where people are prefent ; and when nitre cannot be had, I fliould have no hefitation in employing it,
Of the fourth lean fay but little, only that in breathing it I perceived it more pungent than the pure marine acid ; and therefore, unlefs it fliould be found to poffefs fuperior efficacy in deflroying contagion, I would not employ it where there are people prefent.
As the fifth never can be ufed with fafety where there are people prefent, its ufe muft be
~ folely
394
tolely confined to fumigating empty apartments, clothes, furniture, &c.
Of the fixth I have no particular knowledge, only that it is extremely deleterious, and I believe extremely powerful ; but whether it has more efie£l on contagion than the other mineral acids, experience only can determine.
Having now fully proved that the nitrous, and poffibly alfo the marine acid, obtained in the manner already defcribed, may be employed with perfeft fafety, I fliall, in the next place, relate how far my experience went to afcertarn the efficacy oinitroits acid in deftroying contagion.
When I arrived at Winchefter I found the hofpital in this ftate :
TABLE OF DEATHS.
Number of Spanifli Prifoners.
Weekly Accounts. |
In Cuftody. |
Sick. |
Dead. |
March 26, 1780 |
1247 |
60 |
1 |
April - 2, |
1243 |
106 |
4 |
9, |
1475 |
150 |
10 |
16, |
1457 |
172 |
18 |
23, |
1433 |
142 |
21 |
30, |
1412 |
171 |
21 |
May - 7,. • |
1388 |
191 |
25 |
-— 14, |
135 1 |
197 |
27 |
21, |
1523 |
205 |
30 |
28, |
1494 |
, . 226 |
31 |
Total |
188 |
Immediately
395
Immediately upon the admlffion of the nitrous acid vapour, the deaths funk down June 17th to 9, oil the 27th to 5, July ift to 5, and July 8th to 1, when the contagion ceafed. None after its ad- milTion caught it, and the difeafe immediately fliewed a milder afpeft.
The efficacy, however, of the nitrous vapour, as appears from almoft the whole of the reports fince publiflied, is not confined to the deilroying or preventing the communication of contagion ; its falutary influence is no lefs remarkable on the lick and on thofe recovering from ficknefs ; but on this very important fubjeft I could wifh the reader to confult Mr. Paterfon's Table of the Weekly Returns at Forton Hofpital, from which it appears, that during the fliort fpace of fix weeks, in an hofpital containing from 300 to 400 men, there was a difference, from employing the nitrous fumigation, of about 50 lives faved, and about 110 rnen fpeedily reftored to a ftate of health fit for aftive duty ; but if the reader is defirous of forming an accurate judgment of the immediate effe£t of the nitrous vapour on thofe ill of typhus fever, I would advife him to read with attention what Mr. M'Grigor and Mr. Hill have written on the fubjeft. — By Mr. M'Grigjor *
we
* The EfFed of the Nitrous Vapour in preventing and deftroying Contagion ; afcertained from a variety of trials made chiefly by furgeons of his Majefly's navy, in prifons, hofpitals,
and
39^
we are told, that fome years back, during the prevalence of a fever fimilar to the one he de- fcribcs, in the fame place, the illand of Jerfey, the 88th regiment to which he belongs, in the fpace of ten weeks, fuffered a lofs of 40 or 5Q men ; whereas during the prcfent illnefs, when he employed the nitrous fumigation, of 64 men Seized with the fever, he did not lofe a fingle -patient. Jie further remarks, that by ufmg conftantly the nitrous vapour, the malignant fymptoms of the dif- eafc difappeared,and that from a typhus it became a fimple fever without much danger. Dr. Car- MiicHAEL Smith himfelf, on the firft day of his aijival at Winchefter, was feized with this diforder, and confined to his bed, yet, like a true hero, he would not yield to his difeafe, but continued to give directions. In a memorial which he after- wards fent to the minifter of ftate, in mentioning thefe circumftances, he fays, " But thefe, ray " lord, are only the fufferings of an individual, I readily complied with your lordfliip's wiflies, and, as to the conditions of my attendance I ^* rr)ade none : convinced that no pecuniary re- tl compence could be an adequate compenfation tt.to.me, circumftanced as I then was, for the
and on board of fiiips : with an Introduftion refpefting the Nftture of the Contagion which gives rife to the Jail or Hofpital Fever.; and the various methods formerly employed to prevent or deftroy this. By James Carmichael Smyth, M. D. F. R S. Fellow of the Royal College of Phyficians, and Phyficiaa Extra ordinai-y to liis Majefty.
rilk
397
" rifk I ran ; and that if I was fortunate enough " to furvive, and fucceed, I was certain of the *' firfl: of all rewards, the confa'oufnefs of having " difcharged a duty to which I was called by the " voice of my country, and in the event of which " the national as well as my own honour was " involved. My endeavours have been attended " with a fuccefs which even my friends could " hardly expe6l, and which I believe ftands zvithout example in the annals of phyfic. I have already received from the public the fullefl: ap- " probation of my conduft, and make no doubt " that, in confequence of your lordfliip's favour- *' able reprefentation of it to the King, I fhali " receive from his Majejly, ever attentive to re- " ward merit in the lowefi: of his fubjefts, fome " mark of his Majefty's royal favour." In confe- quence of which difcovery, he was appointed phyfician extraordinary to the king.
SECT.
398
PRACTICAL OBSERVATIONS.
SECT. LIIL
THE SAME SUBJECT CONTINUED.
OF THE VENTILATOR. The good Dr. Hales, in his trealife
on this fubjeft, remarks, that when ventilators are proved, as tliey undoubtedly will one day be found, to be greatly and extenfively beneficial to mankind, fo as thereby to have a con- fiderable influence on tlie atlairs of the world, it will hereafter be matter of wonder, that fo plainly felf-evident a benefit fhould be fo many years propofed befoi-e the world could be prevailed on to receive them ; which proceeds from a general backwardnefs to all new propofals, not caring to give them- felves the trouble thoroughly to confider and examine them. But it is reafonable to believe that ventilators will, from time to time, come into more general ufe, not only for the feveral important purpofes hereafter to be mentioned, but alfo for many other at prefent unthought-of ufes to the great benefit of mankind. New difcoverios are apt, he adds, to be de*- fpifed, efpeciully by tliofe who are incompetent judges of them ; and that no wonder ; for we are flavcs to old habits and cuftoms, even to the degree of fuffering inconveniencies which we might eafily remedy. And this very difpofition is fometimes beneficial to us, as it enables us the better to bear inconveniencies which we cannot remedy. But in all other cafes, where a remedy can be had, it is renouncing our reafon blindly to follow the old track we are in, only becaufe it is a beaten one, or becaufe we will not give ourfeives the trouble to enquire wliether we cannot find a Jhorter and more commo- dious luay. One would think it altogether needlefs to ufe many arguments to prevail with men to make ufe of fo eafy and certain a way to preferve their own lives and that of their comrades. But I am fenfible that narrow minds, who do not care to go out of an old beaten, though very bad track, are apt to view new propofals, though ever fo rational,
only
399
only on their worft fide, without duly weighing the advan- tages. This was lately the case of a very ufeful contrivance for fleering the rudder with great eafe and fafety, by means of a wheel above deck. And 1 make no doubt, but that whatever difcouragement it may meet at firft, yet its great benefit in preferving the health and lives of men, will hereafter recommend it to the general eflecm and ufe of man- kind : for I cannot tliink that men will cliufe to licken and die in and by flench in an old exl>erienced luay, when tiiey have it in their power to prevent it by new, rational, and efle6tual mean.
HALES ON THE VENTILATOR.
The noxioufnefs of the putrid air in unven- tilated jails, may be feen in the following ac- count, which was drawn up by the late Sir John Pringle, viz.
Having lately had an opportunity of feeing feveral cafes of the jail fever, arifing from the jail itfelf, I thought it would not be improper to lay before the public a fliort account of the manner in which thofe perfons were feized ; the chief fymptoms and progrefs of the difeafe, with fome remarks upon it, in order further to illuflrate what I have advanced * elfewhere, concerning the danger arifing from foul air, and the agree- ment of this diftemper with what has been called the Fever of the Hofpital, or more generally, a malignant or peftilential Fever.
In the month of Oftober, 1750, a committee of the Court of Aldermen was appointed to en- quire into the beft means for procuring in New- gate fuch a purity of air as might prevent the
* Obfervations on the difeafes of the army.
rife
400
rife of thofe infc£tions diflcmpers which not only had been deftructive to the prifoners thcmfelves, but dangerous to others who had any communi- cation with them, and particularly to the courts of juftice upon the trial of malcfaftors, whereof a fatal inftance had occurred that year at the fef- fions held in the Old Bailey.
Jails have often been the caufe of malignant fevers, and perhaps no where oftener than in this country. Lord Bacon makes the following obfervation: The mojl pernicious infeSlion next the plague is the Jmell of the jail, when the prifoners have been long, and clofe, and naflily kept ; whereof we have had, in our time, experience twice or thrice, when both the Judges that fat upon the jail, and num- bers of thofe who attended the buftnejs, or were pre^ fent, fickened upon it and died. Therefore it were good wifdom, that in fuch cafes the jail were aired before they be brought forth. It is probable, that one of the times pointed at by this noble author. Was at the fatal affizes held at Oxford, -in the year 1577 j of which we have a more particular account in Stowe's Chronicle j in thefe words : On the 4th, 5th, and 6th days of July, were the ajfizes held at Oxon ; where was arraigned and condemned Rowland Jenkins, for a {editions tongue ; at which time there arofe amidfl the people fuch a damp, that almofi all were [mothered. Very few efcaped that T/uere not taken. — Here died in Oxon three hundred
perfons ;
401
perfons ; and ftckened there, but died in other places, two hundred and odd"^.
Of thfe fame kind of infe£i:ion we have an un- Bappy inftance fo frefli ' in our memory, that I need not have meiitioned it here, had it not been to iniform fuch as live at a diftance, or thofe that are to come after us. In the year 1750, on the 1 1 th day of May the feffions began at the Old-Bailey, and continued for fome days ; in which time a ffreat number of criminals Were tried, atid there was prefent in the court a greater multitude than ufually attend. The hall in the Old-Bailey is a room of no more than about 30 foot fquare. Now, whether the air was at firft tainted from the bar by fome of the prifoners, then ill of the jail-difiemper, or by the general uncleanlinefs of fuch perfons, is uncertain ; fmce, from the latter caufe, it will be eafy to account for its corruption; efpecially as it was fo much 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 : and, it appeared afterwards, that thefe places had not been cleaned for fome years. The poifonous quality of the air was ftill aggravated by the heat and clofenefs of the court, and by the perfplrable matter of a great number of all forts of people penned up for moft
* This account is confirmed by Cambden, vid. Annal. Eli%.
Vol, IV. Dd part
402
part of the day without breathing the free air, or receiving any refrefhment. The bench confided of fix perfons*, whereof four died, together with two or three of the counfe], one of the under-flieriffs, feveral of the Middlefex jury, and others prefent, to the amount of above forty in the whole, without making allowance for thofe of a lower rank, whofe death may not have been
* Fiz. The Lord Mayor, one of the Lords Chief Jiiftices, two of the Judges, one of the Aldermen, and the Recorder. Of thefe died Sir Samuel Pennant, Lord Mayor; Sir Thomas Abncy and Baron Clark?, Judges; and Sir Daniel Lambert, Alderman. It is remarkable^ that the Lord Chief Juftice and the Recorder, who fat on the Lord Mayor's right hand, efcaped, whilft he himfelf, with the reft of the bench on his l^t, vvece fei7.,ed vrith the. infedlion : and thftt the Middlefex jury, on, the fame lide of the court, l.oft fq many, whilft the London jury, oppofite to them, received no harm; and that of the whole n^ultitudc, but one or two, or at moft a fmall num- ber of thofe that were on thfi fide of the court tjq the Mayor's righX' haoid, Wiere taken ill. Some, unacquainted with the dangerous nature of putrid effiuvia^ have afcribed both this circumftance, and the ficknefji in general, to a cold taken by apeniug a w'mdaw, by which a, ftream of air was directed to the ftde of the court on the Lord Mayor's left hand : but it is to be obferved, that the window was at the fartheft end of the room from the bench, though the judges fuffered moft. Nei- ther could the kind of the fever, or the mortality attending it> be imputed to any fuch caufe. It is therefore probable, that the frefli au- dire£led the putrid fleams to that part of the court above-mentioned. This, indeed, muft be granted, that all feptic particles pafEng into the blood, become more aftive and fatal if the infected perfon catches cold, or by any accident fuffers a ftoppage of perfpiration ; for a free perfpiration is the chief means by which the blood is freed from any morbific matter of that kind.
heard
403
heard of, or including ally that did not fitkeli within a fortnight after the feflions.
The Rev. Dr. Hales arid I being confulted by the committee upon the point referred to them, tmd halving vifited the jail in company with thofe gentlemen, it was then agreed that, confidering the fmallnefs of the place, in propor- tion fo the number of the prifoners, it would be proper to make a farther trial of the ventilator, and to have it worked by a machine in the man- ner of a windmill, to be eretled for that purpofe Upon the leads of Newgate.
The fcheme was laid before the Court of Al- dermen and approved of, but not put in execu- tion till fiear two years after. For on the 11th of July, 1752, Dr. Hales acquainted Dr. Knight and me, that feveral of the tubes were finiflied, and that the machine had been going about fix weeks i wherefore being defirous to fee the eifefts, he had appointed Mr. Stibbs, the car- penter employed in that work, to meet him at Newgate, and defired us to go along with him. — ■ We went accordingly, and having vifited feveral of the wards, we were all of us very fenfible that fuch as were provided with ventilating tubes were much lefs offenfive than the reft that wantecL them ; and Dr. Hales and I could perceive a con- fiderable improvement made upon the air of the whole jail fince the time we had been firft there with the Committee. Some of the: wards were
D d 2; fo.
404
lb free from any fmell peculiar to fuch places, that I am perfuaded, were Dr. Hales's defign completed, and a perfon appointed to regulate the Aiders of the tubes, and to keep the machine in order, the ufual bad confequences from foul and crowded jails, might in a great mcafure, if not wholly, be prevented in that place.
One of the wards allotted for the women had a fmall room adjoining to it, in which they ufually flept. Both places feemed at that time well aired, though the latter was elofe, and, if I miftakenot, without either window or chimney. The prifoners informed us that before this ward received the tubes, this fleeping place had been very offenfive, but that foon after it became iweet y and though upon the firft working of the ventilator they had been more fickly than before, they foon recovered their health, and had pre- ferved it ever iince. Now from this account we muft not infer that any danger will arife from a fudden change of bad air for good, fince this accident may be better accounted for from ano- ther circumftance we were then likev^-ife told of, viz. that this ward of the women had been fup- plied by a ventilating tube before thofe in the lower ftory, where the air being in a more cor- rupted ftate, it had pafTed from thence through the feams of the floor and other palTages, to re- place that which was drawn off by the tube in the ward above: but that after the bad air was
exhaufted.
405
exhaufted, the benefit of the frcfli air foon ap- peared by the better health of the prifoners. '-i
But as it was not my defign in this paper to fet forth all the advantages that may be expected from the ventilator, I fliall leave that fubjeft to be treated of by the inventor of it, and fliall only take notice, that the tubes from the feveral wards, uniting in one great trunk, convey all the putrid fteams by that channel into the atmofphere, through a vent made in the leads of Newgate.— Though the wind was moderate during the time we ftaid, yet we obferved that the ventilator threw out a confiderable ftream of air of a riioft ofFenfive fmelL
Before we parted, Mr. Stibbs informed us, that Clayton Hand, one of his journeymen, whilft he was employed in fetting up the tubes, was feized with a fever, and carried to St. Tho- mas's Hofpital, after lying fome days ill at his own houfe ; whereupon apprehending that this man's ficknefs might be owing to the air of the jail, and Dr. Knight and I having the curiofity a few days after to go to St. Thomas's to make the enquiry, we found the patient fitting in one of the courts, recovered of his fever, though ftill weak, and had the following account from himfelf.
He faid, that upon firft finding himfelf indif- pofed, he had left off work for fome days, but upon growing better he had returned to Newgate. That foon after happening to open que of the
tubes
4o6
tubes of the old ventilator, which had ftood there for three or four years, fuch offenfive fraell iffued from it, that being immediately feized witli a naujea and ficknefs at his .ftomach, he was obliged to go home, and that the night after he fell into a fever, in which he lay about eight days .before his friends carried him to the hofpital. That becoming foon delirious, h^ recollected no other fymptom fucceeding thofe mentioned, be- fides frequent Teachings to vomit, a trembling of kis handsj, and a conflant pain in his head. This man had taken no medicine before he came into St. Thomas's, and fince that time was attended by Dr. Reeves j but as that gentleman was not then piefent, we were informed by the apothe- cary, that Clayton Hand had be^n- admitted in the advanced fl?ate of a continued fever, attended with a great Jlupr and a funk pulfe, and' that the.fever had not left him till feveral days after his admiffion.— ^The nurfes account was, that: he had all along lain like one ftupified, and that after the fever went off, he had continued for fome time very dull of hearing. We could learn nothing certain about the duration of the fever ; but- from what the patient and his attendants told us, we recolleQed that he muft have been ill about three weeks. So that from all thefe marks we made little doubt but this perfon had been ill of the jail diftemper, and were confirmed in our opinion by the following circumftance.
In
407
In company with the convalefcent was one Thomas Wilmot, another of Mr. Stibbs's jour- neymen, who had Itttcwife worked in Newgate, and whom we remembered a few days before to have feen in that place, very a£live and m perfe£l health. This man told us he had come to fee his companion, but as he apprehended himfelf in dan- ger of falling into the fame fever, he fliould there- fore be glad of our advice. Upon examination we found his tongue white, his pulfe quick, and that he complained of a pain and confufion of hishcad,with a fhaking of his hands, and a weaknefs of his limbs. He faid his diforder had come on gradually fihce the time we faw him in Newgate, but that he was then fo very ill he could work no longer. From which account it appeared to us, that this man had alfo catched the infection, but aS ithe fever feemed not to be quite formed, we had hopes of (topping its progrefs : and with this view we advifed hitn to take a v6mit, and on the follbw- ing night a fudorific, He followed the prefcrip- tion, and the effefits fhall afterwards be men- tioned.
After Wilmot had told us his own cafe, he in- formed us of the indifpofition of three more of his companions, who had all been employed by Mr. Stibbs in Newgate : whereupon we took their direftions, vifited them, and found them all jll of the jail diftemper.
The
4o8
The firfl: was Michael Sewel, who lodged in the Swan-Yard, near Newgate. This man had been ten days confined to his bed without taking any medicine. He was then delirious, and ha^i the petechial eruption. But obferying that he lay in a clofe, ill-aired, and dirty room, without any attendants but his wife, then fuckling a child, we believed he had no chance to recover where he was, and therefore recommended his cafe to Mr. Stibbs, who procured his admiffion that day into St. Thomas's Hofpital, where he alfo re- covered.
The fecond was Adam Chaddocks, who lay at a green ihop in the Little Qld Bailey. He was taken ill on the fanle day with the former, andhadufed no medicine. He had hkewife the petechial fpots upon his breafl: and back, and though he was not altogether infenfible, v^^as af- fefted with a Jiupor, attended with a funk pulfe, and other fymptoms of the diftemper. Hi§ landlady, who took care of him, inform^ii us he had been troubled with retchings to vomit, and a head-ach from the beginning, and that for fome days paft he had been feized with a loofe- nefs, and that his ftools were very offenfive. As the room this perfon lay in was large and well aired, we did not think it neceffary to remove him, but recommended him to the care of Dr. Pate, phyfician of St. Bartholomew's HofpitaJ, who attended him till he recovered.
The
409
The third was John Dobie, apprentice to Mr, Stibbs, and about 15 years old, who lived with his parents in a court by the White Bear, in Cannon-ftreet. We faw him on the fame day with the other two, which was the 14th of his ficknefs, and the 12th fince he took to his bed. His mother told us that fome of the journeymen working in Newgate, had forced him to go down into, the great trunk of the ventilator, in order to bring up a wig one of them had thrown into it ; and that as the machine was then working, -hehafd almoft .died of the ftink before they could get him up. That upon coming home he com- plained of a violent head-ach, a great diforder at his ftomach, with teachings to vomit, whicl^ had never entirely left him. We found him ex^ treraely low, with a funk pulfe, a delirium, and an unufual anxiety or oppreffion about his breaft. This laft fymptom we afcribe to the opiates he was then taking for a loofenefs that had come on two or three days before we faw him. This lad being in no condition to be moved, and being befidps well attended by his mother, and in 'a well aired chamber, we prefcribed to him there, and repeated our vifits till he was quite free of the fever. It was obfervable, that before he was taken ill he had been twice let down into the great trunk of the ventilator, when the machine was (landing ftill, without complaining of any ill fmell, or receiving any hurt thereby, but that
410
i
the lafl time, when the machine was work- ing, he immediately cried out he was ready to be j fuifocated, and the two men who helped him ' out, by receiving the foul ftcam from the trunk, | were both fet a vomiting fo violently as to bring | up blood.
On the 23d of Auguft, Thomas Wilmot above- ; mentioned, called upon Dr. Knight, and told j him, that after taking the vomit and fvveats, he ; had immediately recovered, but begged him to \ fee his wife, who then lay ill of a fever at his « houfe in Snow's Fields, Southwark. The Doftor i fufpe^ling that this woman's indifpofition might be owing, to the contagion received from her huf- ' band, acquainted me with itj, and carried me to j fee her. There we were informed that Wilmot's : daughter, a girl of eight years old, who lay with \ her parents, had been feized with a fever foon j after her father's recovery ; that flie had been ill j about a fortnight, and they believed had fpots ! upon her breaft, but that the had recovered with- ! put any medicine. That her mother had not only *\ liurfcd her, but continued to lie with her, and J that fome time after the girl's recovery, the mo- ther began to complain, and foon after fell into i a fever, and that it was the 12th dayfmce fhe was confined to her bed. This woman having the I feiechia, a ftupor with deafnefs, and a funk pulfe, \ there was no doubt of her being likewife infefted with the diftemper, and probably by her daughter.
As
4U
As fhe had been without an}'' afli fiance, we ad- vifed her hufhand to fend for Mr. Breach, apo- thecary in the Borough, who having ferved in the hofpital of the army during the war, was well acquainted with the nature of fuch fevers; and having left directions with him, we did not return till after the crifis, which happened upon the J 6th or 17th day from the time fte was confined to her bed.
Some time after thisMr. Breach, the apothecary, informed us, that he was again employed in Tho- mas Wilmot's family ; for that Elizabeth IVTar- lhall, his fifter-in-lavv', after nurfing his wife, was taken ill of the fame kind of fever, and defired our affiftance. This perfon we found in the fame bed, and in the' fame condition in which we had feen her fiftei- fome time before ; and in the room with her, in another bed, a fon of Wilmot's, a boy of nirie years old, ill of the fame diftemper. The former had been attacked on the 15th of September, and the latter the day before. The woman's fever ran out the ordinary length of fix- teen or feventeen days, but the boy's came fome days fooner to a crifis, and was all along of a milder nature. She recovered very llowly, com- plaining of great weaknefs, deafhefs, and a con- fufion in her head, the ordinary confequences of thefe malignant fevers.
In my return I called at St. Thomas's Hofpital, 'to enquire for one William Thompfon, a lad of
about
413
about fifteen years of, age, who, as Wilmot then told me, was another of Mr. Stibbs's journeymen, and had been taken ill by working in Newgate, Ijnce the three he had mentioned to me before. irhjs;lad .was recovered, but not yet difmilfed. He faid, that upon; finding himfelf growing ill he had left , his work, and kept at home for about a week, complaining of a pain in the hinder part of his head, and in his back, of a trembling of .his hands, and of reftlefs nights ; that his feVerifli indifpofition increafmg, he had been obliged to take to his bed, where he lay about eight' days before he was fent to the hofpital. The i apothecary added, that he had continued al^OiJt .ithe fame number of days" before the turn of his fever ; that, his pulfe had been extreniely Jow all that time, and that they beheved him to Jje in the utmoft danger. He added, that, the wife of Michael Sewel (the fecond patient they had received of thofe that had been employed in Newgate), fome days after her hufband's admif- fioh, came to feek advice for herfelf, and that her complaints had been the fame with Wilmot's, at the time we faw him; \\q added, that he had giv^n her fome medicines, but had heard nothing of her fince.
On the laft day of December, Mr. Breach in- formed me, that about a month ago, he had been called to attend Thomas Wilmot, but as he died Ijcfore he fuw him, he could give no other ac- count
413
count of his ficknefs, than as they told him he had long been in a bad ftate of health, and that at laft he became feverifli, and went off with a loofcnefs.
In the beginning of this month, the widow applied to Dr. Hales and me, in order to have the fufferings of her family attefted and laid before the Lord Mayor, in hopes of having fome provi- fion made for them. Upon which occafion we learned, that Thomas Wilmot, her hufband, after taking the fudorific, fo far recovered as to work at his bufinefs, but that though he did not return to Newgate, yet his ftrength would not permit him to continue at work above a day or two at a time, ftill complaining of a head-ach and pains acrofs his breaft, or, as he expreffed it, about his heart ; of a feeblenefs of his limbs, a fliaking of his hands, and a conftant drought.. , (That not- withftanding thefe ailments, he went out daily till a week before he died, when he grew very . weak and more feverifli, had fometimes profufe fweats, and at other times a loofenefs, and that both thefe excretions, and alfo his breath, were re- markably offenlive. That at laft he was feized with convulfions, and died in one of them. His wife added, that her youngeft fon James, a boy of four years of age, was after the father's de- ceafe feized with a fpotted fever, of the fame kind with what had prevailed ia the family, but that he recovered ; and that her own mother, Eleanor
Meggit,
414
Meggit, who did not live in the houfe, but came often to fee them, was alfo taken ill of a fever without fpots, and died about ten days after her hufband. She concluded with telling us, that the diftrefs of her family had been increafed by their being deprived of all affiftanco from theif neighbours, who having thus feen the whole family, one after another, feized with this fever, were as much afraid to come near them, as if they had been infe£led with the plague.
It will be proper to add, that befides thefe fix perfons that w^ere taken ill by working in New- gate, and whom I faw, there was another, as Mr. Stibbs has lately informed me, but whom I never vifited. So that, befides Wilmot's whole family, and Sewel's Wife, who received the con- tagion at fecond-hand, there were feven perfons originally feized with the fever out of eleven only that were employed in the jail by Mr. Stibbs. Now as moft of thefe feven were taken ill within a few days of one another, and of the fame kind of diftemper, it is not to be doubted but that it was owing to the foul air of Newgate.
From all which it appears how requifite it is that the public fliould take fuch meafures as may prevent the like accidents arifing from foul and crowded jails, or indeed from any place, wherein a multitude of people are long, clofely, and naftily kept i and which can never be obtained- without a conflant change of air.
Nor
415
*Nor are diftempers of this fort to be accounted among fuch rare occurrences as require no par- ticular provifion to be made againft them, fmce from this very inftance it is manifeft how often, difafters of this kind may happen without any notice beinsT taken of them. Had it not been for the accident of Sir John Pringle's going at that timg tc>, Newgate, hearing of the firft man's ill- n^fsi, and feeing his companion with him, all tbefe men might have been ill, and not only the public, but raoft of themfelves ignorant of the caufe. And as for Wilmot's family, they might have received the infection, and even have pe- rifhed by it, without any perfon being convinced of the danger arifing from jails, or the contagious and malignant nature of the fever, excepting a few in the neighbourhood, which is a remote and obfcure quarter of the city.
The firft trial of ventilators in an hofpital, was made in the county hofpital at Winchefter ; where they are fixed under the floor, at the far- ther end of the ward from the entrance, yet fo ais to. be worked with great eafe by thofe in the ward, by means of a lever F, G, vide Fi^. 2. fixed acrofs the ward between the beds. The midriffs of the ventilators are each feven feet long, and three feet wide. The ventilators arc not feparate, as in Fig. 2. but have only one com- mon partition of thick plank. ^ The air is drawn out of the ward through a large trunk, which
reaches
4i6
reaches near up to the ceiling, that it may no^.. incommode the patients with the velocity with which itruflics into the trunk ; which velocity is fo great as to twirl fad round a little wind-mill placed at the mouth of the trunk. And in cafes where fuch a wind-mill cannot be feen by the workers of the ventilators, then the wind-mill may be made to' make a very fraall tinkling bell to found, as was done at Newgate, when the firft ventilators were worked by hand, and as is done in Durham county jail, with a very fmall bell. The like twirling wind-mill is found to be of con- liderable ufe in diverting, and thereby encouraging thofe who work the ventilators to perfift in work- ing ; without which fenfible amufement they are apt to be difcouraged from working the ventila- tors ; becaufe, as it has been found by experience, they are apt to look upon it as working to no purpofe, lince they can fee no viiible effeft that it has on the invifiblc air.
This ward being filled with the fumes of burn- ing pitch, they were drawn off, and difpelled by the ventilators, through trunks which conveyed them out into the open air, in nine minutes, not- withftanding the length of the ward is fifty-eight feet, audits whole capacity equal to 278 tuns. When the farther door was flmt of another long ward, which communicated with this by a long paiTage, on working the ventilators, the fmoke was drawn down the chimney of that ward j and
with
417
with ten minutes ventilation the ward was fenfibly fweeter.
There are ventilators alfo in St. George's Hof- pltal, near Hyde-Park-Corner, whofe midriffs are each nine feet long, and four, and a half teet wide. They are fixed on the top of the hbufe, and are worked by a windmill. From the ven- tilators there goes a trunk, a foot fquare ill the clear, to the three large wards on the weflern lide of the hofpital, which are over each other, and extend north and fouth. From the above- mentioned perpendicular trUnk, there is near the ceiling of each ward a like trunk, which reaches from near the door of the ward to the farther end of it, viz. about feventy-five feet \ where the foul air being drawn into the trunk, the fucceed- ing frefli air enters at the ward-door, and thereby drives out the foul air before it j and the like trunks are fixed in the wards On the eaftern fide of the hofpital. But the frefh air muft by no means enter at the windows in cold weather, be* caufe fuch cool air will fall precipitately down through the warmer air of the ward, and thereby greatly incommode the patients 5 whereas, by entering principally at the lower part of the open door-cafe, that inconvenience will be avoid- ed: or holes might be made through the wall for the air to enter the wards from the ftair-cafe; by which means the foul air at that end of the ward will be drawn to the other end of the ward.
Vol. IV. E e and
and thence be drawn off by the ventilators. The doors fliould be always open while the ventilators are working. There are alfo air-trunks to fevcrai lefler wards.
As feveral of thefe wards may thus be venti- lated at the fame time, and as the change of air will therefore be fo very gentle as to be in a man- ner infenfible ; therefore the ventilation maybe continued much the longer with great fafety to the patients.
Some are apt to think ventilators ufelefs in hofpitals, becaufe they can in good warm wea- ther air the wards by opening the windows, and that doubtlefs much better than by ventilation ; and were there fuch good kindly weather all the year round, then ventilators would be ufelefs. But fince, for the greateft part of the year, the external air is too cold to be admitted in at win- dows, becaufe it is a well-known truth, viz. that cold air admitted into the upper part of a warm room, being fpecifically heavier, falls precipi- tately down through the warmer air. And this it muft doubtlefs do in the warm wards of an hofpital, fo as to incommode and endanger the welfare .of the patients ; befides that, the indraft of air at open windows will be much greater than what comes in by the more gentle method of ventilation ; befides this further great advan- tage, that the frefli air drawn in by ventilators, principally enters the wards at the lower half of
open
419
open door-cafes, as is plain to be feen by holding a lighted candle at the lower and upper parts of an open door-cafe ; or elfe the freQi air may be conveyed into fome wards, by trunks placed near the floor, as is done with good effeft in 32 cham- bers in the Small-Pox Hofpital at Sir John Oid- caftle's. It has been faid, that fome hofpitals fland in fo open and airy a fituation, that they have no occafion for ventilators ; yet it is well known, that notwithftanding Ihips at fea are in fo airy a fituation, that millions of people have loft their lives there by the foulnefs and putrid- nefs of the air in fliips which inconvenience is effeftually prevented by ventilators, as is now fully proved by repeated experience in many fhips, which the people on board are fo fenfibie of, that they work the ventilators with eagernefs.
In the year 1752, a pair of double ventilators were put into an hofpital for the fmall-pox at Sir John Oldcaftle's, near London. Their midriffs were feven. feet long, and three feet wide. The houfe was four ftories high, with galleries on every floor, on each fide of which were four chambers, with vacant fpaces in the middle, in which there was a chimney. In the middle of one of thefe galleries the ventilators were fixed up to the ceil- ing, where the lever was comn^od.ioufly worked up and down by means of long iron rods fixed to it at F and G, Fig. 2*, the lower ends of which
* Vide Hales on the Ventilator.
E e 2 rods
42 o
rods were fixed to fliort levers, one end of whiclr worked on iron pins fixed in the fides of the vacant fpace where the chimney was. By means of trunks branching from the larger perpendicular ones, all the thirty-two chambers were ventilated in their turns, viz. the eight rooms of a gallery at a time, by having the foul air drawn with a cautious hand through a hole four inches fquare, near the ceiling of each room, in which were two patients, the frefli air entering through a long trunk under the bed oii the other fide of the room -y which trunk is full of fmall holes, efpe- eially at its farther end, thereby not only to pre- vent the inconvenience of a large Aream of air in one place, but alfo to convey fome of the frefh air to the farther fide of the room, and by that means impel all the foul air fo as to have it drawn out. The foul air is conveyed by a trunk through the roof of the houfe, where the upper part of the trunk is turned horizontally, to prevent the entrance of rain. In cafe it may not be proper to ventilate any particular wardsj there is a valve to prevent the drawing out of any air. The midrifFs' were feven feet long, and three wide. This kind of ventilator is no annoyance to the neighbourhood.
Such ventilation caufes the hofpital to be in a- manner as fweet as a private houfe. And it was obferved, ///<?/ fewer by more than one third diCy fmce the drawing the foul putrid air out of the
chambers'
421
■chambers by ventilation 5 and it is reafonable to think, that the danger of fo putrid a diftemper as the fmall-pox is, will be much greater in a foul putrid than in a purer air. The good efFe6l of this method moft probably led to the not keeping the chambers of the fick very clofe in private houfes.
By order of the Right Honourable Henry Fox, Efq. fecretary at war, ventilators were fixed under a guard-bed in the Savoy, whofe midriffs were eight feet long, and five feet broad ; with thefe five rooms are ventilated 5 three always, and fometimes four at a time. The air-pipes draw air from under the guard-beds ; grate-work- paflages being made through the fore-front of the beds, at an oblique diftant pofition from the mouth of the pipes, thereby to prevent the in-^ draft of any thing the foldiers may out of divert fion put there. And, for the fame reafon, one of the air-pipes which goes down through the boards of the floor to a room below, does not go direftly through the ceiling, which is opened ajt about two yards diftance from the air-pipe,
Mr. Hayward, Mafter of the Savoy Prifon, has always been very careful to have the wards fcraped and fwept every morning j for he ob- ierves that the dirt of the fhoes much increafes the ftench and foulnefs of the air. Yet, not- withflanding this his care to keep the rooms
clean^
42 2
clean, when there were many prifoners, they were apt, fays Hales, to be fickly, and to get the jail dif- tcmper, for want of changing the foul, ftagnant, putrid air. The doing of which, by means of ven- tilators, has made thofe wards fo healthy, that in the year 1749, of 200 men but one died, and he of the fmall-pox. And in the year 1750, of 240 which were there three months, but two died. In the year 1751 none died : and in the year 1752 only one old perfon died. Whereas before the ventilators were put up, there often died 50 or 100 of the infeftious jail diftcmper. And this, iiotwithftanding they have a paved open court to walk in, which was waflied thrice a week in the evening, and the wards as often in the morn- ing in warm weather, and every 14 or 20 days in cold damp weather. But before ventilation, the foul air of the wards, which became putrid by long continuance, being not frequently chang- ed for frefli air, was infeftious and deadly. This probably occafioned the jail diftemper there in the year 1757 ; one of the large wards having no ventilation, whence the infedlion might arifc. And what contributes the more to the prefent healthinefs of the place, is, that
Mr. Hayward, the mafter of the prifbn, conti- nues with the fame care and zeal to keep it clean. And, the more efFeftually to cure the wards ot §ny infection, he burns, as I delircci him, every
fix.
423
Cx. weeks, two pounds of brimjlone in the larger wards, and a pound in the fmaller wards.
And Mr, Akerman, the keeper, informed me, that the wards in Newgate are cleaned every week ; a laudable example that ought to be prac- tifed in jails ; but one of the wards having no ventilators, and the place being crowded with men, the jail diftemper was bred in the very hot fummer of the year 1757, which was prevented from fpreading, by removing the lick, and puri- fying the wards with the fumes of burning brim- Jlone and vinegar''^.
Ventilators were fixed in Newgate by order of Sir Richard Hoare, when Lord-Mayor, which ventilated five principal wards where the women were. It was obfervable that in confequence the prifoners were more healthy, and confiderably fewer of them died, for a year after thofe wards were ventilated, although thofe apartments con- tained often a great number of prifoners. And the greateft part of thofe who died arofe from fickly prifoners brought from other jails to New- gate to attend the feffions.
As ventilators were firft fixed in Winchefter Hofpital, fo were they firft ufed in that jail, which were found to be of great benefit to the prifoners, in freeing them from the intolerable ftench of a foul, clofe, putrid air, by often drawing it off, and introducing frefti air. They are fixed upon the
* This account from Hales was publiflied in 1758,
ceiling
424
ceiling of the debtors room, as well that they may be out of the reach of the prifoners to da- mage them, as alfo that they may take up none of their room ; where they are worked by the lever F, G, which is placed near a wall, thereby ventilci,ting both the debtors roont and the Crimi- nals dungeon, or night-room — the prifoners en- joyed good health for more than two years after they were fixed there, viz. till two fellows from Reading jail, who had the jail diftemper, firfl: gave it to a man who fliaved them ; and fome time after eight more were feized with it, who were all in the fame day-room, in which the felons had been till they were executed ; and no more than thofe eight were ill of that diftemper for a long time after ; an evident proof that the felons brought the diftemper there, and that ventilation arrefted its progrefs. The jail diftem- per is of fo infeftious and peftilentious a nature, that it is well known, by many inftances, to have been carried into towns refrethed with the open air ; and may well, therefore, infe£t eafier in clofe prifons, notwithftanding the wards are ventilated to fuch a degree as very fenfibly to refrefti them. And it is very probable that the like degree of ventilation would effectually prevent, if not ar- reft, the breeding of jail diftempers, which are chiefly occafior.cd by a high degree of putrefac- tion of foul, long confined, and ftagnant air. Thus filk-worms aredeftroyed by their own ftench.
425
It were therefore to be wiflied, that the pri- Toners which are removed from unventilated jails, to thofe ■v^hich have ventilators, were carefully kept in feparate wards, till ventilators are put into all jails. For though ventilation may effec- tually prevent the iirft breeding of the jail diftem- per, yet it will not abfolutely cure it, nor prevent its fpreading infe£lion. Which fliews how rea- fonable it is to have all jails thus ventilated, there- by to prevent the breeding of that peftilential iu- feftious difeafe, called the Jail Diftemper.
Many are apt to think that there is no occafion for ventilators in thofe prifons which have an open area or court for the prifoners to air themfelves in. But this is a great miftake ; for there are many jnflances of the Jail Diftemper's being bred, and deftroying many in jails with open courts. This was frequently the cafe in the Savoy, before ven- tilators were fixed there to change the foul putrid air of the wards. And in the Fleet prifon an hundred (died of that diftemper in the winter, between the years 1753 and 1754, notwithftand- ing there is a large area. And it is notorious, that millions of mankind have been deftroyed by the noxious putrid air in fliips, and this notwith- jftandjng they have the . advantage of plenty of very pure air to breathe in whenever they come upon the open deck. Thefe daily inftances fully •prove the great importance of refrefliing the foul air in prifons, lliips, &?;c.
PRACTICAL
426
PRACTICAL OBSERVATIONS.
SECT. LIV.
THE SAME SUBJECT CONTINUED.
God in his infinite goodnefs was pleafed to exert fuperior power in creating man a fuperior being ; a being endued with a choice of good and evil ; and capable, in fome meafure, of co- operating with his own intentions. Man, there- fore, may be confidered as a limited creature, endued with powers imitative of thofe refiding in the Deity. He is thrown into a world that ftands in need of his help ; and has been granted a power of producing good out of evil. If, therefore, we confider the earth as allotted for our habitation, we fhall find that much has been given us to enjoy, and much to amend ; that we have ample reafons for our gratitude, and ftill more for our indnjlry. In thofe great outlines of nature to which art cannot reach, and where our greateft efforts muft have been ineflTedual, God himfelf has finifhed thefe with amazing grandeur and beauty. Our beneficent Father has confidered thefe parts of nature as peculiarly his own J as parts which no creature could havelkill,
or
42/
or ftrength, or power, to amend : and therefore made them incapable of alteration, or of more perfe£t regularity. The heavens, and the firma- ment, {hew the wifdom and the glory of the Divine Artificer. Aftronomers, who are beft fkilled in the fymmetry of fyftems, can find nothing there that they can alter for the better. God made thefe perfeft, becaufe no fubordinate being could correft their defeats.
When, therefore, we furvey nature on this fide, nothing can be more fplendid, more correct, or amazing. We there behold a Deity refiding in the midft of an univerfe, infinitely extended every way, animating all, and cheering the vacuity with his prefence 1 We behold an immenfe and fhapelefs mafs of matter, formed into worlds by his power, and difperfed at intervals, to which even the imagination cannot travel ! In this great theatre of his glory, a thoufand funs, 'like our ov^n, animate their refpeftive fyftems, appearing and vanifliing at divine command. We behold our own bright luminary, fixed in the centre of a fyftem, wheeling its planets in times propor- tioned to their difiances, and at once difpenfing light, heat, and action. The earth alfo is feen with its tw^ofold motion 3 producing, by the one, the change of feafons ; and, by the other, the grateful viciffitudes of day and night. With what filent magnificence is all this performed ! with what fceming eafe ! The works of art are
exerted
428
ocerted with interrupted force ; and their noify progrcfs difcovers the obftruftions they receive : but the earth, with a filent fteady rotation, fuc- ceflively prefents every part of its bofom to the fun ; at once imbibing nouriOimeht and light from that parent of vegetation and fertility.
But not only provifions of heat and light are thus fuppHed, but its whole furface is covered with a tranfparent atmofphere, that turns with its motion, and guards it from external injury. The rays of the fun are thus broken into a genial warmth ; and, while the furface is affiftcd, a gen- tle heat is produced in the bowels of the earth, which contributes to cover it with verdure. Wa- ters alfo are fupplicd in healthful abundance, to fupport life, and alTift vegetation. Mountains arife to diverfify the profpe6i:, and give a current to the ftream. Seas extend from one continent to the other, repleniflied with animals that may be turned to human fupport ; and alfo ferving to enrich the earth with a fufficiency of vapour. Breezes fly along the furface of the fields to pro- mote health and vegetation. The coolnefs of the evening invites to reft ; and the frefhnefs of the morning renews for labour.
Such are the delights of the habitation that has been afllgned to man ; without any one of thefe, he muft have been wretched ; and none of thefe could his own induftry have fupplied. But while many of his wants are thus kindly furniflied, on
the
429
ttie one hand, there are numberlefs difficulties f o excite his induftry on the other hand. This ha- bitation, though provided with all the convenien- cies of air, pafturage, and water, is but a defert place without human cultivation. The lovveft animal finds more conveniencies in the wilds of nature than he who boafts himfelf their lord. The whirlwind, the inundation, and all the afpe- lities of the air, are peculiarly terrible to man, who knows their confequences, and, at a dif- tance, dreads their approach. The earth itfelf, where human art has not pervaded, puts on a frightful gloomy appearance. The forefts are dark and tangled 5 the meadows over-grown with rank weeds ; and the brooks ftray without a de- termined channel. Nature, that has been kind to every lower order of beings, has been quite negle6lful with regard to him ; to the favage un- contriving man the earth is an abode of defola- tion, where his fhelter is infufficient, and his foo^ precarious.
A world thus furniflied with advantages on one fide, and inconveniencies on the other, is the pro- per abode of reajon^ is the fitteft to exercife the induftry of a free and thinking creature. Thefe evils, which art can remedy, and prefcience guard againft, are a proper call for the exertion of his faculties ; and they tend ftill more to afli- milate him to his Creator, God beholds, with
pleafure.
43'^
pteafure, that being which he has made, convert^ ing the wretchednefs of his natural fituation intd a theatre of triumph ; bringing all the headlong tribes of nature into fubje6lion to his will ; and pfoducing that order and uniformity upon earth, of which his own heavenly fabric is fo bright an example.
In Linnaeus you read an hypothefis (l Amsnitat. Academic.) on the caufe of mtermittent fevers, and you will find a colleftion of fa£ts to prove their conne£lioil with argillaceous earth, or clavcy foil. Of this he was fo well fatisfied, that he concluded that attenuated particles of clay, taken into the body with food and drink, entered the blood, ftuck in the extreme branches of the arte- ries, and brought on, as a true proximate caufe, the fymptoms of the difeafe. (Hypothcfis nova, § y.) The fenfible inquirer will find, in his fourth fe£tion, an enumeration of all the parts of Swe- den famous for intermittents and ftrata of argilla- ceous foil ; and the authority of Mr. Sandel, quoted as an eye-witnefs of the fame coincidence of clayey bottoms and intermittent fevers in Pen- fylvania. The fa£ls I take to be indubitable. But the hypothefis I would difpute. I conceive that the true caufe is the putrid miafms of half-cor- rupted vegetable fubje£ts, as we before attempted to prove, and by this may be fatisfa£torUy ex- plained the following fa£t:
The
43^
The foil, fays Donaldfon (in his General View, &c. p. 12.) of the Carfe of Gowrie, in the county of Perth, in Scotland, confifts chiefly of rich clay, loam, and (liarp gravel ; and the inhabitants, until the year 1735, ufed to be fubje6l to the ague. Then one or two of the principal pro- prietors undertook, by draining, fummer-fallow- ing, and fowing grafs-feeds, to improve their eftates. Accident led them to a difcovery of the efficacy of lime on that foil, from obferv- ing the powerful effe6'ts of fome old lime rubbifli of decayed buildings, when fpread on the corner of a field. The liming their lands then gradually came into ufe, and has fince been generally adopted ; the confequence of which is, the Ague has long ago difappeared. Here feems to have been a beautiful experiment made upon about ninety-fix fquare miles of country, where the putrid fleams that formerly gave the people agues, are now attracted by the lime and turned to cal- careous nitre, while increafed produ6tivenefs of the land, and greater wholefomenefs of the air, continue to be the happy confequences. Some judgment may hence be formed concerning the power of art in changing the face of nature I What a grand refledlion !
Lime, we know, is the grand agent of deftruc- tion, and being ftrewed on the earth, produces a hafty decompofition of vegetable matter. It is not in itfelf a manure, for nothing grows iij
pure
4^2
pilrc calcareous earth j but it becomes the digeftef and preparer of the vegetable food, and henee it is elleemed the beft manure.
God, with confumitiate wifdom, has made re-, ciprocal wants. He has formed the barren hill and the fenny marfli, and by the exertion of man^ the manure of the valley is tranfported to the hill, the waters affume their bed, and the chalk of the mountain is carried down to the valley. It is the earth, fays Pliny, that like a kind mo- therj receives u& at our birth, and fuftains us when born. It is this alone, of all the elements around tis, that is rarely found an enemy to man. The body of waters deluge him with rains, opprefs him with hail, and drown him with inundations. The air rufhes in ftorms, prepares the tempeft, or lights up the volcano ; but the earth, gentle and indulgent, ever fubfervient to the wants of man, fpreads his walks with flowers, and bistable with plenty ; returns with intereft every good com- mitted to her care ; and, though flie produces the f)oifon, fhe ftill fupplies the antidote ; though con- ftantly teized more to furnifli the luxuries of man than his neceffities, yet, even to the laft, (he con- tinues her kind indulgence, and, when life is over, fhe pioufly covers his remains in her bofom.
PRACTICAL
433
PBACTICAL OBSERVATIONS:
SECT. LV.
OF THE STAGES. OF PUTRID FEVER.
As putrid fever is faid by Sydenham, and other equally good authorities, to be a difeafe that cuts off a tenth-part of mankind, the reader will there- fore pardon me, if I fix his attention in a particu- lar manner upon fo interefting a fub]e£t, more efpe- cially as at this time we are engaged in a war, not lefs deftruftive by the wicked contrivances of mankind to infli£t the moft horrible fufferingSji fuch as tongue cannot exprefs, nor the imagina- tion raife any pifture of, on beings of the fame fiefli and blood as ourfelves, and profeffing the Chriftian religion, which teaches that all are brothers ; I fay, not lefs deftruftive by the con- trivances for murder, than for the generation and fpreading of pcftilential diforders. The deftruc- tion of our troops in the Weft Indies has been fo great by the contagion of fever, that moft thought themfelves felf-devoted, when they accepted any command in thofe quarters ; nor has the lofs been trifling on the continent from the fame caufe. . Vol. IV. F f When
434
When any one is feized with putrid feva', the firft thing that fliould occupy our attention is, whether its courfe can be arrefted ? Sir John- Pringle divides this fever into three ftages, or periods; when it firll attacks; the intermediate time ; and the laft ftage.
In the firft ftage, he fays, the craffamentum of the blood iooks more florid than ufual ; in the fe- cond, it is broken and incoherent, and of a more purple hue ; and, after that period, ia ftill lefs te- na£ious> more like ichor, and often extremely dark and offenfive, even when frelh drawn. Wc fliall, however, txnly divide this fever into two ftages. It is the confounding thefe that has pro- duced fuch contradiftory evidence, and with a poifon fo' a£live, it is not to be wondered if the right praftice has been often wrong timed. The mifchiefs occalioned by this have been fo great, that we are confcious to have a very powerful and general prcjiKlicc tO' overcome : for tUL of late the laws of the animal osconomy were little
attended to, and fpecific re?nedies * were the
order
«• How often do we hear, even at the prei'ent day, practi- tioners apologize to their patients, " We have tried evay thing.'' am furey madam, you gave each drug a fair trialJ" «♦ Yes, fin,," is the anfwer, " my frame has been an apothecary's " fliop indeed, and it is luonderful l am no better." The true wonder is, that the patient fliould be arfje to make any com- plaint. Every one has heard of the doftor, who obferving a Welchman, juft recovered from a fever, as the call of nature, long for a red herring and ale, ordered it him, and he re-
Govered y
435
order of the day. Hence bleeding and tonics, with opium, in putrid fever, have faved a few only, and killed thoufands.
covered ; he gave it to another who was really in a fever, and he died. He noted it in his book— a red herring and ale is good for a Welchman in fever, but kills an Englifhman ! The fame kind of empiricifm has been too long praflifcd in putrid fever with refpeft to bleeding, evacuants, &c.; and the pradti- tioner was aftoniftied to find his want of fuccefs, not fecin* that the circumftances differed. This deftruftive empiricifm is very well defcribed by Monf. Peron, in the following Epigram :
Dans un bon corps, Nature et Maladie Etoient aux mains. Une aveugle vient li, 6 'eft Medecine, une aveugle etourdie, Qui croit par force y mettre le hola, A droite, a gauche, ainfi done la voili, Sans favoir ou, qui frappc a I'aventure Sur celle-ci, comme cellc-1^, Tant qu'une enfin ceda — ce fut Nature.
Ff2 PRACTICAL
43^
PRACTICAL OBSERVATIONS.
SECT. LVI.
OF THE ADVANTAGE OF GOOD AIR IN FEVER.
The firft objeft of our confideration fliould be, that the patient, immediately upon an attack of fever, be in as pure an air as polTible.
Captain Ellis, author of a voyage to Hudfon's Bay, and now governor of Georgia, gives the following account, from on board the Halifax flave-fliip, at Cape Monte, Africa ; viz. he took a wax-candle, of eight to the pound, and drew it through a mould, to make it of one thicknefs, from end to end ; and found it wafted 67 grains in burning thirty minutes in the hold, which had not been ventilated in twenty-four hours : but after fix hours' ventilation, it wafted 944 | grain* in the fame time, viz. jd more*.
When ventilation had been omitted twelve hours, he hung the fliip's bell under the lower
* This is the firft EUDIOMETER fpoken of, and probably gave the idea to Prieftley and LavoiCer. Vide Vol. J. page 337.
decl^.
437
deck, took out the clapper, and fufpended it by a line, which with its own length, made 44 inches : the angle which the rim of the bell made, with a line let fallen perpendicular from the pin on which the clapper hung, was equal to 34 degrees. He then held the clapper at the fame angle, on the other fide of the line, in order that the ftrokes at different times might be with the fame force :• when letting it go, it ftruck the bell ; in its re- turn he catched it, and counting the vibrations, he heard them dillin6lly but three times; whereas, when the hold was well ventilated, it vibrated five times, but its vibrations were not fo quick in the latter as in the former cafe. He took all pof- fible precautions that thefe experiments might be fairly tried, to prevent deception, but always found them to produce the fame effe6t*.
We fee in thefe curious and accurate experi- ments, the great difference in the purity and im- purity of the air, of a ventilated and unventilated ihip, and, confequently, the plain reafon why, when fuch a foul ajr prevails, it not only impair^ the health, but caufes the death of multitudes.
The people on board . were all healthy for a confiderable time viz. till the ventilators were fo fpoiled by the rats eating not only the leathern, but the wooden p^rts of them, in fuch a mannerj
* This account is taken from Hales on the Ventilator,
that
438
that they were obliged to give over the ufe of them long before they had any ficknefs, when, as Captain Ellis obfervcs, many of their flaves died of extremely infeftious diftempers ; as fmall^pox, meafles, fluxes, and fevers, which came upon them almoft all at once.
In order the more efFeftually to roufe the at^ tention of mankind, in a matter of the greateft importance to the health and lives qf thoufands, and thereby the more fully and clearly to con- vince them, I made, fays the good Dr. Hales, the fame kind of experiment, by placing lighted candles in foul, clofe, and confined airs ; it being well known, that the vital lamp of animals is either enlivened and invigorated, or incommoded and quenched, in proportion to the different de- grees of purity oy impurity of the air which they breathe in.
I have found, fays he, after variety of trials with candles of different fizes, that the larger candles, of about fix to the pound, are beft for the purpofe ; and in order to prepare them for thefe experiments, it is proper to cut off, or wafte by burning, one-fourth or one-third of the candles, where they are ufually fmaller and taper, viz. till they are nearly of an equal cylindrical fiz€: Then firft weighing the candle, when it is well lighted, I begjn to eftimate the time, for its burning half an hoqF in good air: then I put it put with an extinguiflier, that a fair fnuff, with
439
its black part about half an inch long, may be preferved ; if it be too long, I fnuff it to a due length, in order to fit it for further trials in foul airs, it being of great importance to begin each trial with a good fnuff: the candle rauft be weighed again after each trial, by burning both in good and foul air : and in order to prefcrve a fair fnuff in carrying a candle into a mine, &c. it may be well to make a cafe for it of cards, nailed in a femi-circular form to the fides of a flat piece of wood, about an inch and a half wide ; or to wrap it in ftifF paper with a flick.
If feveral candles are prepared at the fame time, by burning them firft in a good air, they may be marked, number 1,2, 3, by holes made near the bottom with a pin's point, and filled with ink with the nib of a pen ; for every can- dle which is ufed in thefe experiments muft firfl be tried in a good air.
I defired a furgeon of the fecond regiment of foot-guards, to burn a wax candle, of about half an inch diameter, for half an hour, among the fick foldiers at the Savoy, where it wafted but 11 grains ; whereas the fame candle, in a good air, had wafted in the fame time 27 grains, which is more than double of what it wafted in that bad foul air : and it was often obferved, that the ftench there is fometimes intolerable, and that candles give but a very weak light.
Dr.
44Q
Dr. Langrifli made the like experiments, at my defire, with a wax candle, of fix to the pound, juft before the Lent Afli zes, in the dungeon of Winchcfter Goal, in the morning, before the doors or window-fliuttershad been opened ; the candle, which had wafted 88 grains in half an hour, in a good air, wafted but 66 | grains in the dungeon, in the fame time, which is near one-fourth lefs; and Mr. Thomas, a furgeon of Chelfea Hofpital, obT ferved the like difproportion in burning a tallow candle, of fix to the pound, where the fmall-pox was. After the dungeon had been well ventilated for half an hpur with the ventilators, the prifoners remaining there all the while, the fame candle wafted in another half hour, 87 + 1 grains, that is, very nearly as much as in the good air at firftj which fhews the great life of ventilators both in goals, hofpitals, and fliips. The do6tor obferved, that at the firft going down into the dungeon, the foul air afFefted the mouth and throat with a re- markable faltnefs, but not at all at their going down after it had been well ventilated.
In St. George's Hofpital, near Hyde Park Cor- ner, a like tallow candle, which in a good air had wafted in half an hour 77 + ^ grains, wafted in the King's Ward, early in the morning, before fire? were kindled, 7Q grains, viz. ^-Vth part |efs : and even this lefs degree of foulnefs in the 3ir, by putrifyin^, is obferved to caufe putrid difr
eafes,
44i
.eafes,. and to be very hurtful, not only to dcr bilitated perfons, but alfo to thofe with brokei? Jlmbs, who have their health impaired thereby^ infomuch that they find it requifjte of late to leave the wards fometimes vacant, in their turns, for a time, to be aired, cleanfed, and fumed vyith the acid fumes of burning brimftone.
I was obliged to the Reverend Mr. Emmerfon, of Middle ton, near Barnard Caftle, Durham, for making the like experiments with lighted candles, in Lord Darhngton's l,ead-m)nes, in his parifli; -where he found they wafted, in burning 15 mi- ?iutes, in fome places 7 grains, in others H, 13, and 15 grains lefs than in a frefli air, mpre or lefsj according to the different ftatcs of the air, not only in the mine, but alfo above ground, as to its weight or lightnefs, wjnd or calm, which piade fome alteration. ,
In the drifts, while digging to the air-fliafts, the air is very noxious ; fo that a candle will burn only when held inclining lide-ways. But Mr. Emmerfon having placed a fmall ventilator at the entrance qf an adit, that was digging 50 fathom to a new air-fhaft, where the miners com- plained much of the badnefs of the air when they were got about 2Q fathom, infomuch that they could work but few hours at a time ; yet when ^:he air was renewed through a long trunk, which reached from the ventilators to the miners, they could then work all the day with pleafure. This
cheap
442
cheap and eafy method of relief is, therefore, not only of great benefit to the health and lives of the miners, but will alfo be very profitable to the proprietors and owners of mines. On commu- nicating the fuccefs of this method of ventilating drifts while digging, to Mr. Percival at Briftol, he put it in pra6i:ice in his mines in Cornwall, and that with fo good effeft, that it is like to become a general practice in that country.
Thefe and the like experiments with candles*, will be of great ufe to fliew the degrees of un- healthinefs of the foul flagnant air in goals, hof- pitals, fliips, and mines ; but with this diftinttion, viz. that a lefler degree of foulnefs of air long con- fined, being thereby become the more putrid, will, on that account, be more noxious than a greater dejrree of foulnefs of air which has not been long enough confined to become putrid. Thus the long ftagnant air of a common goal, in which there are comparatively much fewer perfons than in a fliip, will breed the infectious goal diftemper ; whereas the much fouler air of a fhip, crowded full of perfons, if it has not been long enough confined to putrify, may not produce that dirtemper ; though, when long confined, it frequently produces that diftemper, the fcurvy, flux, and other difeafes, which are the bad confe- quences of a putrid air, which is the principal
* The Eudiometer of Dr. Prieftley and Lavoifier, will better anfwerthis purpofe. Vide vol. I. page 337.
caufe
443
caufe of fcurvy. Perhaps frequently repeated experiments with candles in the rooms of thofe who are fick of different diftempers, may lead to eftimate the different degrees of putridnefs of fome diflempers, as alfo fhew the different effefts that putrid and unputrid diflempers have on burning candles : at leaft it feems very probable, that repeated trials with candles, in the rooms of thofe who are fick of the mofl putrid and ofFenfive diflempers, will fhew when it is requifite, in fome meafure, to abate the great degree of foulnefs of fuch air, by cautioufly admitting frefh air, and keeping the bed-curtains clofe for a fliort time, till that frefh air is grown warm, as has been fometimes praftifed with fuccefs. And whereas a cool frefh air^ though admitted in but fmall quantities into a hot air, will immediately de- fcend, fo as to be fenfibly felt j might it not, therefore, be advifeable to admit the frefli cool air near the floor of the room.
Having, in the account I have given of the feveral campaigns*, mentioned the dire- ful effefts of the hofpital-fever, I need not urge the necefTity of ufing all precautions againfl it. I fliall at prefent propofe the means whereby this difeafe may be either kept from appearing at all, or at leaft with fo much contagion and danger. Thefe means fhall be confidered under two heads j one relating
* This is takpn from Sir John Pringle.
to
444
to the choice of hojpitak, and the other to the right management of the air therein.
In treating of the bloody-flux, the mofl: airy and fpacious houfes that could be procured in the neighbourhood of the camp, were recommended, for the better recovery of the fick, and for pre- venting infeftion. Now the fame means will alfo tend to prevent the hofpital-fever ; as the dy- fentry is fo apt to breed it*. On thefe occafions, it is common to look out for clofe and warm houfes, and therefore to prefer a peafant's houfe to his barn ; but experience has convinced us, that it is air that is mofl: requifite : for this rea- fon not only barns, flables, granaries, and other out-houfes,'but, above all, churches make the beft hofpitals, from the beginning of June to October. Of this there was an jnftance in the campaign qf 1747, when a large church at Maeftricht was applied to that ufe 5 and where, notwith- flanding above a hundred lay in it, with foul fores, fluxes, and other putrid difeafes, for three months together, (during the greateft part of which time the weather was very hot) there was no appearance of contagion. Wherefore we may lay it down as a rule, that the more frefh air we let into hofpitals, the lefs danger there is of breeding and propagating this diftemper.
* The putrid effluvia of the dyfenteric feces, are not only apt to propagate the common bloody flux, but likewife tQ breed the malignant hofpital-fever, with or without bloody ftools.
It
445
It may be neceffary to add the following rc- fnark : in the firft part of a campaign, when in- flammatory diftempers prevail, fuch as are taken ill are then to be left behind, as their cafes admit- ieaft of motion, and at the fame time are not in- feftioLis. But for thofe that fall ill from the end of fummer till the decline of autumn, as having difeafes of a putrid kind, but which bear motion, and generally mend upon a change of air, they- are therefore rather to be carried with their re- giments and difperfed, than colle6ted into one- general hofpital to propagate the infeftion.
As to the difpofition of hofpitals, with regard to preferving the purity of air, the beft rule is, to admit fo few patients into each ward, that a per- fon' unacquainted with the danger of bad air, might imagine there was room to take in double or triple the number. It will alfo be found a good expedient, when. the ceilings are low, to remove fome part of them, and to open the garret itory to the tiles. It is incredible, in how few^ days the air will be corrupted in thronged and clofe wards: and what makes it harder to remedy the evil, is the impoffibility of convincing either the nurfes, or the fick themfelves, of the neceffity of opening the doors or windows, at any time, for air. I have always found thofe wards the moft healthful, when, by broken windows and other wants of repair, the air could not be excluded.
In
446
In the firfi: ftage, as well as in all the other, thd flrft objeft, continues Sir John Pringle, is to have the patient in a fpacious apartment ; when that cannot be done, the room or ward is to be pu- rified, by making a fucceillon of air by means of fires, or letting it in by doors and windows, dif- fufing the fteams of vinegar, or the like: for, whatever medicines are given, whilft the air con- tinues in this corrupted ftate, or indeed increafes in it by the effluvia of the difeafed, there can be little hope of a cure. Wherefore, in every ftage, though the patient can breathe no other infectious air, but that of his own atmofphere, it will be neceffary to keep the curtains undrawn, and ufe all other meatus to procure a free ventilation. On the ftriB obfervation of i/its ru/e, the cure will in a great meafure depend.
The following obfervations made by Dr. Wind, will ferve to illuftrate what Sir John Pringle has here advanced.
The Middlebwgh, a Dutch fliip of war, failed from the Texel in Holland, on the 25 th of De- cember 1750„ and on the 12 th of March 1751, entered the harbour of Cura90a, with a healthy lliip's company ; one only having died during their paffage from Europe. The air at Cura9oa was foggy and moift, and the weather exceflively hot ; fo that in the beginning of April two very bad difeafes diftrelTed the crew j a putrid dyfen-
tery,
447
tery, attended with great pain, ftenclj, and hic- cup 5 and alfo a violent fever, accompanied with a black vomit.
They failed on a cruize the 17th of April. The weather at fea was then moift and rainy : the difeafes ftill continued, but not in fo violent a de- gree as in the harbour. Thofe who laboured un- der the dyfentery, were not at fea attacked with the hiccup, and its other bad fymptoms ; neither did the black vomit feize thofe who had the fever, as when in the harbour.
None of thofe taken ill at fea died of either of thefe diftempers : but when the fhip returned into the harbour, in the latter end of April, the former dangerous fymptoms returned ; the hiccup attended the dyfentery, and the black vomit ac- companied the fever, the number of the fick was greatly increafed, and feveral of them died.
When a violent and fatal ficknefs raged at Cadiz, it did not extend its influence to any fhip which lay at a diftance from the city ; as I am informed by Dr. Maguire, an eminent phyfieiau of that place. His majefty's fhip the Tweed wa» then at anchor in Cadiz Bay : an officer and fe-c veral of her men^ who had been on fhore, were feized with this fever ; but all th-ofe who were fent on board the fhips recovered, no bad fymp- toms appearing in. their fever ; whilft a difeafe, fimilar to the black vomit and the yellow fever^ and equally mortal, depopulated tliat large city.
I acknowledge It to be new, fays Dr. Line!, to propofe the immediate removal of a pcrfon la' bouring under a violent fever, to fomc diftanl J>lace, let the fymptOms be what they will. It liiay be objeftcd, that the gentleft motion will, in' many fueh cafes, affect the head and bring on a delirium, or increafe the fynnptoms of the difeafe ^ that as uninterrupted reft and quiet appear necef- ■fary to the; welfare of fuch patients, the hurry of motion, and even the difturbance produced by taking them out of bed, but efpecially the expo- fing of them to the open air, muft be highly in- jurious.
The experience of many years in thrfe matters lias convinced me, that fiich apprehenfions of danger' are entirely groundlefs. I have had the nioft ample means of afcertaining, that perfons labouring under fevers, fluxes, and other difeafes, may with great fafety be moved from one place to another ; nay more,- that by a removal of them,- with proper care, from a bad into a pure air, fuch patients receive immediate benefit. Of many thoufand patients labouring under fevers, whom I have vifited in Haflar Hofpital, for twenty-five years, nine-tenths of them were moved during the continuance of their fever, either from Spithead, from the fliips in the harbour, or from the Marine Infirmary at Portfmouth : they were" brought in boats, or otherwife, to the hofpital ; and I do not remember that any patient was ever
injured
44d
injured by fucli removal J on the contrary, lam perfuaded that many hundreds, under the moft dangerous and malignant fymptoms of the difeafe, have received great benefit by the removal from the foul air of their {hips into the pure air of th^ hofpital.
In the year 1764, the kingdom of Naples fur^ hiflied a very remarkable example of the healthi- fief$ of the fea air, and of the benefit of remov- ing the fick thither, during the rage of an epide- mic fever* In July, it became highly infeftious, was attended with petechia, fwellings of the pa- rotid glands, obftinate delirium, violent vomiting, and fluxes of blood.
This difeafe raged, with unremitting violence, for a conliderable time, till it was happily ob' ferved, that the fick who were moved into the hofpitals near . the fea, recovered much quicker than in other places, and few of them died* Upon this being reprefented to the king, mon^y was ordered out of the treafury for the fitting up of other hofpitals near the fea* In thefe hofpi- tals, well ventilated, and open to the fea air, the progrefs of the contagion was entirely ftopped none of the nurfes or attendants on the fick were infe6led : and even when they became crowded with fick, the number that died in them was in- confiderable in proportion to the number who died in other places.
Vol. IV. Gg When
45 o
When the Lion, Spence,and feveral otlier flilps of war, were employed at Port Antonio, in the ifland of Jamaica, in clearing Navy Ifland of Wood, in order to build wharfs and ftore-houfes there, many of the men, when cutting down the wood, were feized at once with a fever and delirium. This attacked fo fuddenly and with fo much fury, that often the perfon feized would with his hatchet, if not prevented, have cut to pieces the others who flood near him. Orders were ifTued, that as foon as the men were thus feized, they fliould be bled, and immediately fent on board their refpe£tive fliips. The confe- quence was, that all who were carried on board quickly recovered ; whereas thofe who remained on fliore, either died, or fuffered a dangerous fit of ficknefs.
It was formerly not uncommon for fix or eight of the centinels who were ported at Greenwich hofpital in Jamaica, which was fituated in a marfh, and is now evacuated, to be taken ill. in one night, with copious vomitings or purgings, a delirium, and all the alarming fymptoms of a vio- lent fever ; of which they recovered in fome hours after they were removed to Kingflon.
But fliould a change inta a purer air fail to produce fuch immediate efFe£ts, it will at leaft mitigate the fymptoms of the fever ; the ufe of medicines will afterwards be attended with more
fuccefs y
451
Tuccefs J and the patient wiJI recover fooner, and will more fpeedily regain a vigorous ftate of health.
I fliall here infert an obfervation, communi- cated to me by a very fenfible man, v^ho refided long in Jamaica.
I have often obferved the poor feamen in the merchant fervice to recOVer from the yellow fever, folely by having the benefit of a free and conftant admiffion of the cool fea air, into a fhip anchored at a diftance from the fliore, where they lay utterly delHtute of every affiftjmce in ficknefs, and even of common necelTaries, having nothing but cold water to drink, and not fo much as a bed to lie upon ; while gentlemen, newly arrived from Eng- land, by being fliut up in fmall, clofe, fufiFocating chambers at Kingfton^, or Port-royal, -expired with their whole mafs of blood dilTolved, flowing frojn every pore ; the flifling heat of their room having produced a ftate.of univerfal putrefa6tion in the body, even before death.
This fupply of oxygen to the bloodj is appli- cable to every ftage of fever, and will be the ob- .je£l of future confideration, when we come to the enquiry whether we have any fpecific remedy for the cure of putrid fever. It muft be no^y confidered only in the light of an affiftant tp other means.
G g 2 PRACTICAL
452
PRACTICAL OBSERVATIONS.
SECT. LVIl.
THE METHOD OF CURE IN THE FIRST STAGE.
The cure of the Camp Fever, depends, fays Sir John Pringle, in the early ufe of evacuants. Bleeding being indifpenfable, it is the firft thing to be done in every cafe, and is to be repeated once or oftener, according to the urgency of the fyrhptoms. The vernal and latter autumnal fe- vers are accompanied vv^ith pleuritic and rheu- matic pains, and other figns of high inflamma- tion ; and on that account require more bleed- ing than are neceflary in the intermediate feafon. A perfon unacquainted with the nature of the diftemper, and attending chiefly to the paroxyfms and remiflions, may be apt to omit this evacua- tion, and to gi'Ve the bark too foon, v^^hich would bring on a very dangerous inflammatory fever. A vein may be fafely opened either during the remif- ^On, or in the height of a paroxyfm. For, be- fides that I have obferved the remilTion to come fooner and fuller after an haemorrhage, I have re* peated experience of the fafety of bleeding in the
hot
453
hot fits ; and not only in this, but in the marjk fever, even after coming to almoft regular inter- miffions. Soon after bleeding, it is neceflary to give an emetic. There is fome difficulty in deter- mining the kind of vomit ; and fometimes it may be doubtful whether any is proper or not. Vo- mits do harm when the ftomach is inflamed, or whenever the fever has been of fome Handing, and affumed a continued form. But withal, it muft be obferved, that an inflammation of the ftomach is a rarer occurrence than one would ima- gine, amidft fo many complaints of vomiting, pain, ficknefs, and oppreffion about the epigaf- tric region ; all which being commonly relieved by an emetic, we may, in general, very fafely venture upon it. The ipecacuanha is the fafeft and eafieft, but the ANTIMONIALS are the moft efficacious. I commonly added two grains of emetic tartar to a fcruple of ipecacuanha. The vomits that are alfo productive of ftools, are the moft ufeful ; but efpecially if they are power- ful enough to procure a plentiful difcharge, up- wards or downwards, of the corrupted bile. By this means they fometimes effe^ a cure without farther medicines.
It was a general obfervation during the Ame- rican war, that if an emetic was given in the firft ftage of fever, the fever was either ftifled in its birth, or fhortened in its duration, or at leaft rendered more benign. The fame alfo is the
obfervation
454
obfervation of Sir John Pringle, in his Hiftory of the Difeafes of the Army.
Stationed, fays the Rev. Mr. Townfend, in a country parifli, my pra£lice has been confined chiefly to the rigid fibre of laborious peafants ; and, among thofe of them who made an early application for affiftance, I never fufFered fever to continue.
I have one agedfervant, who in the thirty years during which he has lived with me, has frequent- ly been attacked by fever. I have often found him in the chimney-corner, with a dry and parched fkin ; foul tongue ; pulfe frequent, hard, and ftrong ; no appetite; thirfty; coitive : yet the very firft emetic, difcharging a quantity of bile, of phlegm, and of indigefted food, affifted by a mercurial pill at night, and followed by rhubarb with fenna in the morning, has fent him after the fecond day to work, without even the ufe of the Peruvian bark.
From the earlieft: periods, decided opinions in favour of the exhibition of purgatives may be detefted in authors of every clafs, as far as op- portunities of confulting them have offered. Some amongft the moft illuftrious of modern wri- ters, it has been already mentioned, recommend them to a confiderable extent ; but not one, as far as reading ferves on this fubjeft, to the degree and in the form which becomes indifpenfibly ne- ceflfary in moft inftances. "
That
455
That the caufe of the protra6lion of fevers is often conne£led with the ftate of the mucus, as well as of the other fecretionSj. appears from the immediate cefTation or alleviation of all the fymp- toms on a copious difcharge ; and that the mu- cus is often vitiated in a moft extraordinary man- ner, the fenfes of the obferver will afford arpple teftimony. There are pra£litioners to whom thefe cannot prove a fource of information, The extreme delicacy of fome gentlemen will not permit them to carry their refearches fo far ; yet it is from this fource, and this alone, that any precife knowledge refpefting the nature, proba- ble duration, and other circumftances of the dif- order, but particularly the neceffity of further evacuations, can poflibly be acquired.
It may be deemed particularly fortunate, fays an experienced praftitioner, that the purgatives which prove moji fuccefsful in fevers are as mild in their operation as they are certain and powerr ful ; that they are not fubjeft to the inconve- niences attending the other clafTes, for from their want of bulk they are more retainable in the fto-^ mach ; and that from their fulP operation they may be fuppofed to reach more readily the fources of the evil, and to combat thefe with more fuc- cefs. Mercurial purgatives, particularly CALO- MEL, continues Dr. Wade, poflefs thefe advan- tages in the trifling quantity of two or three grains j but fuch fmall dofes are feldom of mucl^
efficacy
45^
efficacy after the firll and fecond, and a repetition would beefteemed rafli by the generality of prac- titioners. They have frequently, however, in the fmalleft proportion, an operation fo extenfive, as to remove the complaint altogether, in flighter Cafes, by copious evacuations. But other occa^ fions * require their exhibition in fuch quantities, and after intervals fo fhort, as would terrify moft of the faculty, even in India, and appear to prac- titioners in Europe neceffarily fatal. The moft trifling detriment, however, has not been obferved by me in any one inftance, though a difcharge from the falivary glands has not unfrequently enfued. It may be, however, proper, as well to obviate thefe inconveniencies, as to render their evacuat- ing powers more certain, to urge their operation by other cathartics, efpecially in a liquid form. It Ihould be received as a general rule, that the calo- mel, either alone or in conjun£lion with cathartic extract, refin, or extract of jalap, fcammony, gamboge, fliould be exhibited at night, and the me-r dicines neceflary to promote its effects given early the enfuing morning, as well as during the courfe of that day, according to circumftances. From two to ten or more grains of calomel, with a greater proportion of any of the other articles, may form adofe with the utmoft fafety j for thefe
* This arifes from the mucus fliielding the living fibre from liie operation of the purge. This muft be firft cleared, before any effeft can enfue.
medicines.
457
medicines, as evacuants, do not aft with a dif- turbance, nor perhaps with an efficacy, in the exaft proportion of their quantities, owing to the mucus coating the inteftines. Thefe dofes may and fliould be repeated every fecond night, or, , according to the prelTure of the fymptoms, every night, as long as any thing offenfive fliall remain to be difcharged from the bowels, in the form of groffer excrement, vitiated bile, mucus, 3£c. Forty or more grains of calomel, with a larger quantity of the laxative mercurial pill, have been exhibited with innocency, and with great benefit, in this manner, during the courfe of five or fix days. Laxatives alone, or with additional efficacy from an union with ANTIMONIALS, fhould be admjniftered, not only in the mornings after the calomel, but in fmaller quantities during the whole of the intervals ; a very dilute folution of tarlar emetic alone generally anfwers this pur- pofe extremely well.
As fymptoms called putrid, nervous, &c. indi- cate the excefs in quantity and vitiation of the offending matters, and confequently the greater obftinacy and danger of the diforder, notwith- ftanding the general prejudices againfl: the ufe of mercurials as weakening in putrid cafes, this courfe of purging by calomel is more effentially neceffary when fuch fymptoms prevail, than on any other occafion whatever.
Purging,
458
Purging, therefore, on the firfl hints from na- ture, will generally obviate the accefs of all fevers in every conftitution. On the firfl: attack of thefe, purging will infallibly prevent the approach of dangerous fymptoms, particularly thofe called putrid^ and, at their height, will always fave, and generally cure, the patient*.
Dr. Rufli t ingenuoufly confefles, that in his firft treatment of the Yellow Fever by bark infu- fion, powder, or tin6lur.e, nearly all his patients died. Baffled in every trial I made to fi:op the ravages of this fever, I anticipated, fays he, all the numerous and complicated diflirefTes in our city, which pefl:ilential difeafes have fo often pro- duced in other countries. The fever had a ma- lignity, and an obfl:inacy, which I had never before obferved in any difeafe, and it fpread with a rapi- dity and mortality, far beyond what it did in the year 1762. Heaven alone bore witnefs to the an- guifli of my foul in this awful fituation. But I did not abandon a hope that the difeafe might yet be cured. I had long believed, that good was commenfurate with evil, and that there does not exifl: a difeafe for which the goodnefs of Pro- vidence has not provided a remedy. Under the impreffion of this belief, I applied myfelf with
* This doflrine waspubliflied in 1793, and beautifully con- firms Dr. Rufli's praftice. The work in which it is contained, is on the prevention and treatment of diforders in India, by Dr. Wade.
-I- Vide his Hiftory of the Yellow Fever.
' frefl;
459
frefli ardour to the inveftigation of the difeafe be- fore me. I ranfacked my library, and pored over every book that treated of the yellov^ fever. The refult of my refearches for awhile was fruitlefs. The accounts of the fymptoms and cure of the difeafe by the authors I confulted, were contra- diftory, and none of tliem appeared altogether applicable to the prevailing epidemic. Before I defifted from the inquiry to which I had devoted myfelf, I recollefted that I had among fome old papers, a manufcript account of the yellow fever, as it prevailed in Virginia in the year 1741, which had been put into my hands by Dr. Franklin^ a fliort time before his death; I had read it for- merly, and made extracts from it into my lectures upon that diforder. I now read it a fecond time. I paufed upon every fentence^ even words in fome places arrefted and fixed rriy attention. In reading the hiftory of the method of cure, I was much ftruck with the following paffages:
It muft be remarked, that this evacuation " (meaning by -purges) is more neceflary in this, " than in moft other fevers. The abdominal vif- " cera are the parts principally afFe6ted in this " difeafe, but by this timely evacuation, their " feculent corruptible contents are difcharged, " before they corrupt and produce any ill effefts, " and their various emunftories, and fecerninsr vefTels are fet open, fo as to allow a free dif-
" charge
460
" charge of their contents, and confequently 2 " fecurity to the parts themfelves, during the " courfe of the difeafe. By this evacuation the " very minera of the difeafe, proceeding frona " the putrid miafma fermenting with the falivar)^, " bilious, and other inquiline humours of the body, " is fometimes eradicated by timely emptying " the abdominal vifcera on which itfirft fixes, after " which a gentle fweat does as it were nip it in " its bud. Where the primze via?, but efpecially " the flomach, is loaded with an offenfive matter, " or contracted and convulfed with the irritation " of its ftimulus, there is no procuring a laudable " fweat till that is removed ; after which a ne- *' cefiary quantity of fweat breaks out of its " own accord, thefe parts promoting it when " by an abfterging medicine they are eafed of *• the burden or ftimulus which opprelfes them.
All thefe acute putrid fevers ever require fame " evacuation to bring them to a perfe£t crifis and " folution. On this account an ill-timed fcrupn- *' loufnejs about the weaknejs of the body, is of bad " confequence in thefe urging circumftances ; for " it is that which feems chiefly to make evacua- ** tions necelTary, which nature ever attempts, " after the humours are fit to be expelled, but is ^' not able to accomplifh for the moft part in this *' difeafe ; and I can afiirm, that I have given a " purge in this cafe, when the pulfe has been fo
" low
4^1
^' low that it could hardly be felt, and the debi- " lity extreme, yet both one and the other have been reftored by it.
" This evacuation muft be procured by ftrong ** cko/ogoqne purges."
Here I paufed. A new train of ideas fuddenly broke in upon my mind. I believed the weak and low pulfe which I had obferved in this fever, to be the efFea of debility of the indire£t kind, but the unfuccefsful ifTue of purging, and even of a fpontaneous diarrhoea, in a patient of Dr. Hut- chinfon's, had led me not only to doubt of, but to dread its effefts. My fears from this evacua- tion were confirmed, by the communications I had received from Dr. Stevens. I had been ac- cuftomed to raife a weak and low pulfe in pneu- mony and apoplexy, by means of blood-letting, but I had attended lefs to the effe6ls of purging in producing this change in the pulfe. Dr. Mit- chell in a moment diffipated my ignorance and fears upon this fubjeft. I adopted his theory and praftice, and refolved to follow them. It re- mained now only to fix upon a Suitable purge to anfwer the purpofe of difcharging the contents of the bowels. I had been in the habit of occa- fionally purging with calomel in bilious and in- flammatory fevers, and had recommended the practice the year before in my lectures, not only from my own experience, but upon the authority of Dr. Clarke. I had, moreover, other precedents
fof
462
for its life in the praaicc of Sir John Pringk, Dr. Cleghorn, and Dr. Balfour, in difcafes of the fame clafs with the yellow fever. But thefe were not all my vouchers for the fafcty and efficacy of CALOMEL. In my attendance upon the military hofpitals during .the Jate war, I had feen it given .combined with jalap in the bilious fever, by Dr. Thomas Young, a fenior furgeon in the hofpitals. His ufual dofe was ten grains of each of them, j^'his was given once or twice a day, until it pro- cured • large evacuations from the bowels. For a while I renionftratcd with the Doclor againil this purge, as jbeing difproportioned to the violence and danger of the fever i but I was foon fatisfied that it was as fafe as cremor tar- tar, or Glauber's falts. It was adopted by feve- ral of the furgeons of the hofpital, and was uni- ■verfally known, and fometimes prefcribed, by the fimple name of ten and ten. This mode of giving calomel occurred to me in preference to any other. iThe jalaji appeared to be a neceffary addition to it, in order to quicken its paffage through the bowels ; for cailomel is flow in its operation, more efpecially when, it is given in large dofes. I re- folved, after mature deliberation, to prefcribe this purge. Finding teij grains of jalap infuffi- cient to carry the calomel through the bowels, in the rapid manner I wiflied, I added fifteen grains of the former to ten of the latter ; but even this dofe was flow, and uncertain in its operation. I then ifl'ued three dofes, each confifting of fifteen grains
of
463
of jalap, and ten of calomel j one to be given every fix hours until they procured four or five large evacuations. The effefts of this powder, not only aufwered^ but far exceeded my expec- tations. It perfeSily cured four out of the firfi five ■patients . to whom I gave it^ notwithfianding fome of them zvere advanced feveral days in the diforder. -Mr. Richard Spain, a block-maker,, in Third- llreet, took eighty grains of calomel, and rather more of rhubarb and jalap mixed with it, on the two lafl- days of Auguft, and on the firft day of September. He had pafTed twelve hours before li began to give him this medicine, without a pulfe, and with a cold fweat on all his limbs. His. relations had given him over, and one of his neighbours complained to me of my neglefting to advife them to make immediate preparations for his interment. But in this fituation I did not defpair of his. recovery. Dr. Mitchell's account of the effefts of purging in raifing the pu/fe, excitr ing a hope that he might be faved, provided his bowels could be opened. I now committed the exhibition of the purging medicine to Mr. /Sta'//', one of my pupils, who mixed it, and gave it. with his own hand three or four times a (day. At length it operated, and produced two,- copious, foetid ftools. His pulfe rofe immediately afterwards, and an univerfal moifture on, his fkin fucceeded the cold fweat on his limbs. In a few days he was out of danger, and he now lives, in good
health.
464
health, as the firft fruits of the efiicacy of ^//ifr* curia/ purges in the yellow fever.
After fuch a pledge of the fafety and fuccefs of my new medicine, I gave it afterwards with con- fidence. I communicated the prefcription to fuch of the pra6titioners as I met in the ftreets. I im- parted the prefcription to the College of Phyfi'- cians, on the third of September, and endea- voured to remove the fears of my fellow citizens, by affuring them that the difeafe was no longer incurable, Mr, Lewis, the lawyer. Dr. M*Ilvain>e, Mrs. Bethel, her two fons, and a' fervant maid, and Mr. Peter Baynton's whole family (nine in number), were fome of the firft trophies of this new remedy. The credit it acquired brought me an immenfe acceffion of bufmefs. It ftill conti- nued to be almoft uniformly effe£tual in ail thofe which I was able to attend, cither in perfon or by my pupils. Dr. Griffits, Dr. Say, Dr. Penning- iOHy and my fbrm-er pupils who had fettled in th-e city, viz. Dr. £«'i&. Dr. Fcrter^ Annan, Df- fVoodhoufe, and Dr. Meafe, w-^re among the firft phyficians who adopted it, I <:an never forget the tranfpor.t with which Dr. Pennington K2d\7icxo{B the ftreet to infdtm me, a few days after he began to give ftrong purges, that the difeafe yielded to them in every cafe. But I did not rely upon purging alone to cure the difeajfe. The theory of its approximate caufe, which I had adopted, led me to life other remedies, to abfirad excejs
of
465
cf fthniili from the fyftem. Thefe were blood- letting, cool air, cold drinks, low diet, and applica- tions of cold water to the body. I had bled Mrs. Bradford, Mrs. Learning, and one of Mrs. Pal- mer's fons, with fuccefs, early in the month of Auguft. Never before did I experience fuch fublime joy as I now felt in contemplating the fuccefs of my remedies. It repaid me for all the toils and ftudies of my life. The conqueft of this formidable difeafe was not the efPeft of accident, nor of the application of a fmgle remedy ; but it was the triumph of a principle in medicine*. The reader will not wonder at this joyful Rate of my mind, when I add a fliort extra6t from my note bookj dated the 10th of September, "THANK GOD! OUT OF ONE HUN- DRED PATIENTS, WHOM I HAVE VISIT- ED, OR PRESCRIBED FOR, THIS DAY, I HAVE LOST NONE."
Being unable to comply with the numerous de- mands which were made upon me for the purging powders, notwithftanding I had requefted my fifter, and two other perfons to alTift my pupils in putting tliem up J and finding myfelf unable to attend all the perfons who fent for me, I furniflied the apo- thecaries with the recipe for the mercurial purges, together with a copy of the following dire6lions.
* How contrary this to what is called the Brunonian Prac' tke, although exadly confo/iant to Dr. Brown's theory.
. Vol, IV. H h for
466
for giving them, and for the treatment of the dif- order.
DireBioH. — " As foon as you are affected (whe- ther by night or day) with a pain in the head or back, ficknefs at ftomach, chills, or fever j more efpecially, if thofe fymptoms be accompanied by a rednefs or faint yellownefs in the eyes, take one of the powders in a little fugar and water^ every fix hours, until they produce four of five lar^c evacuations from the bowels — drink plentifully of water gruel, or barley water, or chicken wa- ter, or any other mild drink that is agreeable, to aflill the operation of the phyfic. It will be pro- per to lie in bed while the medicine is operating^ by which means a plentiful fweat will be more eafily brought on. After the bowels are thoroughly cleanfed, if the pulfe be full or tenj'e, eight or ten ounces of blood fliould be taken from the arm, and more, if the tenlion or fullnefs of the pulfe lliould continue. Balm tea, toaft and water, lemonade, tamarind water, (hoUld be drank dur- mz this ftate of the diforder— and the bowels fliould be kept conftantly open, either by another powder, or by fmall dofes of cremor tartar, or cooling falts, or by common opening glyfters j but if the pulfe Ihould become zveak and /ozy after the bowels are cleanfed, infufions of camo- mile and fnake-root in water, elixir of vitriol, and laudanum i alfo wine and water, or wine,.
punch.
46?
plincli, and pbrtcr fliould be given, and the barkj either in infufion in water, or in fubftance, may- be adminifteredm the intermiflion of the fever. Blill:crs may likewife be apphed to the fides, neck, or head, in this ftate of the diforder, and the lower iitnbs may be wrapped up in flannels wetted in hot vinegar. The food fliould confill: of gruel, fago, panada, tapioca, tea, coffee, weak chocolate, wine whey. The fruits of the feafon may be eaten with advantage at all times. Frefli air Ihould be admitted into the room in all cafes, and cool air when the pulfe is full and tenfe. The floor fhould be fprinkled now and then with vine- gar j and the difcharges from the body be removed as Ipeedlly as polTible.''
Hitherto there had been great harmony among the phyficians of the city, although there was at firft a diverfity of fentlment as to the na- ture knd cure of the prevailing fever. But this diverfity of fentiment and pra£lice was daily leflening, and would probably have ceafed altogether in a few days, had not the follow- ing publication, fubfcribed A. K. and faid to be written by Dr. Adam Khun, made its ap- pearance on the 11th of September, in the Gene- ral Advertlfer, from which it was copied into all the papers of the city.
H h 2
SIR,
468
Philadelfhia, Sept. 7th, t79J«
SIR,
"I RECEIVED your letter to-day, and (hall with pleafure give you every information in my power refpefting the malignant fever, which proves fo fatal among us. As I confider debility and putre- faEiion the alarming circumftances to be attended to, and to be obviated from the earlieft commence- ment of the difeafe, I do not adminifter any emetic, neither do I. give a laxative, unlefs indi- cated by coftivenefs, when I recommend cream of tartar, or caftor oil, but prefer a clyfter to either. In cafe of naufea I order a few bowls of camomile tea to be taken ; if the naufea continues, it Is to be relieved with the jaline draught in. a Jiate of effervefcence, elixir of vitriol, and if necef- fary, laudanum. The ficknefs of the ftomach may alfo be alleviated by applying mint, cloves, or any other fpice, with wine or fpirits, to the pit of the ftomach. The ftomach being compo- fed, 20 drops of elixir of vitriol are to be taken every two hours in a tea cup full of ftrong cold camomile tea, and if bark can be retained, two drachms of the beft pale bark, in fubftance, are to be given every two hours, alternately with the elixir of vitriol. When an ounce of bark has been adminiftered in this manner, the dofe is to be di- miniflied to one drachm every two hours, as the continuance of the large dofes might diforder the
ftomach
4^9
flomach or bowels. Should the bark prove pur gative, it will be neceflary to give 10 or 15 drops of laiidamm after every ftool. But if the bark cannot be retained on the ftomach, 20 drops of elixir of vitriol are to be taken every hour, and recourfe muft be had to bark clyjlers.
Of regimen it is needlefs to fay much to you: ripe fruits, fago with wine, and rich wine-whey are the moft proper. A fpacious chamber, with a free circulation of air, and repeatedly changing of bed and body linen are highly necelTary. If the bark clyfters fliould bring on coftivenefs, the laudanum may occalionally be omitted j if this is not attended with the defired confequences, we have recourfe to a common inje6tion. Sprink- ling the chamber with vinegar, waOiing the face, neck, hands, and feet with it, and then wiping them dry, will have their ufe. The fumes of vinegar and of nitre will contribute much to fweeten the air in the chamber.
I am, &c. A. K.
" N. B. The pra£lice of applying the cold bath in fevers is not new."
To obviate the effefts of this letter upon the minds of the citizens, I publiflied, fays the hu- mane Dr. Rufh, the next day an account of the ill fuccefs which had attended the ufe of the reme- dies
470
(^ics recommended by Pr. Kuhn, in my practice, and of the happy effects of mercurial purges and Heeding, This publication was concluded with the following remarks : *
I have had fo many unequivocal proofs of the fuccefs of the fiiort and fimplc mode which I have adopted of treating this diforder, that I am now fatisfied, that under more favourable circum- llances of attendance upon the fick, the difeafe would yield to the power of medicine with as much certainty as a common intermitting fever. September 13, 1793. BENJ. RUSH.
The ^bove addrefs to the citizens, produced the following letter from Dr. Kuhn to the Mayor of the city.
" SIRj
"If you are of opinion that the enclofed ftate- ment can have the leaft tendency to abate the ap- prehenlions of the citizens, I beg of you to make any ufe of it you may think proper.
J am, Avith refpeft,
Your moft humble fervant,
September XI, 1793. A. KUHN.
Matthew Clarkfon, Efq. Mayor | of the City of Philadelphia. 5
This
471
This letter was followed by one from Dr. Ste- vens to Dr. Redman, the prefident of the CoU kge of Phyficians, which was publiflied in the Federal Gazette of the 16th of September. He argues that this difeafe produces debility, and the vis vitaj muft in confequence be fupported.
Dr. Rufli immediately takes up the club of rear fon to combat the hydra prejudice, and gives the public the theory of his praftice, with its fuc-f cefs, when applied to the touchftone of experience. He thus addreffes the College :
" GENTLEMEN,,
" It is with extreme regret that I have read Dr. Stevens's letter to the prefident of our College in one of the newfpapers. It will, I fear, co-operate with Dr. Kuhn's plan of treating the diforder, and Mr. Hamilton's well-meant let- ter, in adding to the mortality of the diforder. If I fliould furvive my prefent labours, I hope to prove that Dr. Stevens's theory of the difeafe in the Weft Indies, is as erroneous as the practice he has recommended has been fatal in Philadel- phia. It is a moft inflammatory diforder in its firft ftage. The contagion, it is true, in its firft aftion upon the fyftem, frequently produces de- bility ; but the debility here is of the indirect kind, and arifes wholly from an excefs of the ftimulus of contagion upon the fyftem. This indire6t debility, as in many other difeafes, yields
only
472
only to the abftraaion of other ftlmuh', and to none fo fpeedily as to large evacuations from the bowels and the blood-veflels.
" I have fo high an opinion of Dr. Stevens's candour and liberality as a gentleman and a phyfi- cian, that I fhall make no apology for thus pub- licly dilTenting from his opinions and praftice.
" Could patients be vifited by phyficians as of- ten, and attended by nurfes as carefully, as in other acute difeafes, I am fatisfied that the mode of treating it which I have adopted and recom- mended, would foon reduce it in point of danger and mortality, to a level with a common cold.
From, Gentlemen,
Sejtt. i-jth, Your fincere friend and brother, ^793-
B. RUSH."
During this controverfy with the opinions and praclice of Dr. Kuhn and Dr. Stevens, I alfo pub- lifhed in the Federal Gazette, the following letter to the College of Phyficians ; alfo fome additions to the directions I had given with the mercurial purges.
" GENTLEMEN,
*' As the weekly meetings of our Col- lege have become no longer practicable, I have taken the liberty of communicating to you the re- fult of further obfervations upon the prevailing ^ epidemic.
I have
473
I- have found bleeding to be ufeful, not only in cafes where the pulfe was full and quick, but where it w^as JIow and tenfe. I have bled in one cafe, where the pulfe beat only 48 ftrokes in a minute, and recovered my patient by it. The pulfe became more full and more frequent after if.
" I have bled twice in many, and in one acute £afe four times, with the happieft effefts. I con- -fider intrepidity in the ufe of the lancet at prefent to be as neceffary, as is the ufe of calomel and jalaps in this infidious and ferocious difeafe.
From, Gentlemen,
Sejtt. i2th. Your friend and brother,
1793.
BENJ. RUSH." In fupport of the efficacy of thefe remedies. Dr. Porter, Dr. Annan, and Dr. Meafe, gave very de- ' cided teftimonics in the public papers. I fliall infert as an epitome of them all, the following letter from Dr. Porter.
" DEAR SIR,
" As I know it will afford you much pleafure, I fend you the following ftatement of cafes. Within three days paft I have been called to thirty-feven perfons labouring under the pre- vailing epidemic. I have treated them all in the new method, with the greateft fuccefs j nearly half of them are fo far recovered as to require no farther alTiftance from me. . I cannot avoid men- tioning
474
tioning one cafe of a man in whom the advan- tages of bleeding were remarkable. — The pain in his head was fo violent as to lead rne to order bleedintj previous to purging — from fome inac- curacy in the operation, he loft a greater quantity than I dire6^ed, his attendants fuppofe fixteen ounces ; the confequence however was, that at my next vifit I found that my patient had walked out perfectly recovered. This cafe was clearly marked with all the fymptoms attendant on the difeafe in its firft ftages, particularly pain in the head and rednefs in the eves.
With great regard,
I am your obedient fervant,
Se/iteijiber iph, '
JOHN PORTER."
JDr. RnJJi,
The beft confirmation of this doclrine, is the cafe of Dr. Rufli, as drawn up by himfelf.
Sometime before the fever made its appearance, fays he, my wife and children went into the ftate of New Jerfey, where they had long been in the habit of fpending the fummer months. My fa- mily, about the 25th of Augufl, confifted of my mother, a fifter who was on a vifit to me, a black fervant man, and a mulatto boy. I had five pu- pils, viz. Warner Wafliington,and Edward Fiflier, of Virginia, John Alfton of South Carolina, and John Redman Coxe (grandfon to Dr. Redman),
and
475
and John Stall, both of this city. They all crowd- ed around me upon the fudden encreafe of bufi- nefs, and with one heart devoted themfelves to my fervice, and to the caufe of humanity.
The credit which the new mode of treating the difeafe acquired in all parts of the city, pro- duced an immenfe influx of patients to me from all quarters. My pupils were conftantly em- ployed ; at iirft in putting up purging powders, but, after a while, only in bleeding and vifiting the fick.
Between the 8th and the 15th of September, I vilited and prefcribed for between an hundred and an hundred and twenty patients a day. Se- veral of my pupils vifited a fourth or fifth part of that number. For a while we refufed no calls. In the fhort intervals of bufinefs which I fpent at ray meals, my houfe was filled with patients, chiefly the poor, waiting for advice. For many weeks I feldom ate without prefcribing for num- bers as I fat at my table. To aflift me at thefe hours, as well as in the night, Mr. Stall, Mr. Fiflier, and Mr. Coxe, accepted of rooms in my" houfe, and became members of my family. Their labours now had no remiflion.
From my great intercourfe with the fick, my body became highly impregnated with the conta- gion. My eyes were yellow, and fometimes a yellownefs was perceptible in my face. My pulfe was preternaturally quick, and I had profufe
fweats
476
fweats every night. Thefc fvveats were fo offeii- iive as to oblige me to draw the bed-cloaths clofe to my neck to defend myfelf from their fmell. They loft their foetor entirely upon my leaving off the life of broth, and living intirely upon milk and vegetables. But my nights were rendered difagreeable, not only by thcfe fweats, but by the want of my ufual lleep, produced in part by the frequent knocking at my door, and in part by anxiety of mind, and the ftimulus of the conta- gion upon the fyftem. I lay down in conformity to habit only, for my bed ceafed to afford me reft or refrefhment. When it was evening, I wifhed for morning ; and when it was morning, the pro- fpeft of the labours of the day, caufed me to wifli for the return of evening. The degrees of my anxiety may be eafily conceived, when I add, that I had at one time upwards of thirty heads of families under my care : among thefe were Mr. Jofiah Coates, the father of eight, and Mr. Ben- jamm Scull, and Mr. John Morrell, each fathers of ten children. They were all in imminent danger; but it pleafed God to make me the in- ilrument of faving each of their lives. I rofe at 6 o'clock, and generally found a number of per- fons waiting for advice in my fliop or parlour. Hitherto the fuccefs of my practice gave a tone to my mind, which imparted preternatural vigour to my body. It was meat and drink to me to fulfil the duties I owed to my fellow citizens in
this
477
this time of great and univerfal diftrefs. From a hope that I might efcape the difeafe, by avoiding every thing that could excite the contagion in ray body into aftion, I carefully avoided the heat of the fun, and the coldnefs of the evening air. I likewife avoided yielding to every thing that fliould raife or deprefs my paffions. But at fuch a time, the events which influence the flate of the body and mind, are no more under our com- mand than the w^inds or weather. On the even- ing of the 14th of September, after eight o'clock, I vifited the fon of Mrs. Berriman, near the Swedes church, who had fent for me early in the morning. I found him very ill. He had been bled in the forenoon by my advice, but his pulfc indicated a fecond bleeding. It would have been difficult to procure a bleeder at that late hour. ^ I therefore bled him myfelf. From hanging over his breath and blood for ten minutes, and after- wards riding home in the night air, debilitated as I was by the labours of the day, I found myfelf much indifpofed the enfuing night. I rofe .not- withftanding at my ufual hour. At 8 o'clock I loft ten ounces of blood, and immediately after- wards got into my chair, and vifited between forty and fifty patients before dinner. At the houfe of one of them, I was forced to lie down a few mi- nutes. In the courfe of this morning's labour, my mind was fuddenly thrown off its pivots, by the laft look, and the pathetic cries of a friend
for
478
for helji^ who was dying under the care of a French phyfician. I canne home about two o'clock, and was feized immediately afterwards with a chilly fit and a high fever. I took a dofe of the mercu- rial medicine^ and went to bed. In the evening I took a jecond purging Jiowder, and loft ten ounces more of blood. The next mornitig I bathed my face, hands, and feet in cold water for fome time. I drank plentifully during the day and night of weak hyfon tea, and of water in which currant jelly had been diflblved. At 8 o'clock I was fo well as to admit perfons who came for advice into my room, and to receive reports from my pupils of the ftate of as many of my patients as they were able to vifit j for unfortunately they were not able to vifit them all (with their own) in due time : by which means feveral died. The next day I came down flairs, and prefer! bed in my parlour for not lefsthanan hundred people. On the 19th of the fame month, I refumed my labours, but in great w-eaknefs. It was with difficulty that I afcended a pair of flairs, by the help of a banifler. A flow fever, attended with irregular chills, and a troublefome cough, hung confiantly upon me. The fever difcovered itfelf in the heat of my hands, which my patients often told me were warmer than their own. The contagion now began to affeft me in fmall and infefted rooms, in the mofl fenfible manner. On the morning of the 4th of 06lober, I fuddcniy funk down in a fick
room
479
room upon a bed, with a giddinefs in my head. It continued for a few minutes, and was fucceed- €d by a fever which confined me to my houfc the remaining part of the day. Every moment, in the intervals of my vifits to the fick, was employ- ed in prefcribing in my own houfe for the poor, or in fending anfwers to meffages from my pa- tients ; time was now too precious to be fpent in counting the number of perfons who called upon me for advice. From circumftances, I believe it was frequently 150, and feldom lefs than 50 in a day, for five or fix weeks. The evening did not bring with it the leaft relaxation from my labours. I received letters every day from the country, and from diftant parts of the Union, containing inqui- ries into the mode of treating the diforder, and after the health and lives of perfons who had re- mained in the city. The bufinefs of every even- ing was to anfwer thefe letters, alfo to write to my family. Thefe employments, by affording a frelh current to my thoughts, kept me from dwel- ling on the gloomy fcenes of the day. After thefe duties were performed, I copied into my note, book all the obfervations I had collected during the day, and which I had marked with a pencil in my pocket-book in lick rooms, or in my car- riage. To thefe conftant labours of body and mind were added dijirejfes, from a variety of cau- fes. Having found myfelf unable to comply with the numerous applications that were made to me,
I was
48©
I was obliged to refufe many every dsy. My filler counted forty-fcven in one forenoon before
II o'clock. Many of them left my door with tears, but they did not feel more diftrefs than I did from refufing to follow them. Sympathy^ when it vents itfelf in acts of humanity, affords pleafure, and contributes to health, but the reflux of pity, like anger, gives pain, and diforders the body. In riding through the ftreets, I was often torced to refifh the entreaties- of parents imploring, a vifit to their children, or of children to their parents. I recolleiSt, and even yet, I recolleft with pain, that I tore myfelf at one time from five perfons in Moravian-alley, who attempted to ftop me, by ordering the man to drive as fpeedily as poffible beyond the reach of their cries^ The folicitude of the friends of the' fick for help, may further be conceived of, when I add, that the moft extravagant compenfations were fometimes offered for medical fervices, and, in one inftance, for only a fingle vifit. I had no merit in refufing thefe offers, and 1 have introduced an account of them only to inform fuch phyficians as may here- after be thrown into a fimilar fituation, that I was favoured with an exemption from the fear of death, in proportion as I fubdued every felHfli feeling, and laboured exclufively for thfe benefit of others. In every inftance in which I was torced to refufe thefe pathetic and carneft applications, my diftrefs was heightened.. by. the fear^ that the
perfons
484::
perfons whom I was unable to vifit, woiild fall into improper hands, and perifli by the ufe 0^ bark, wine, and laudanum.
But I had other affliaions befides the diftrefs which arofe from the abortive fympathy which I have defcribed. On the 11th of September, my ingenious pupil Mr. WaHiington fell a viaim to his humanity. He had taken lodgings in the country, where he fickened with the diforder. Having been almoft uniformly fuccefsful in curing others, he made light of his fever, and con- cealed the knowledge of his danger from me, until the day before he died. On the 18th of September Mr. Stall fickened in my houfe. A delirium attended his fever from the firft hour it affefted him. He refufed, and even refifted force when ufed to coriipel him to take me- dicine. He died on the 23d of September. Scarcely had I recovered from the fliock of the death of this amiable youth, when I was called to weep for a third pupil, Mr. Alfton, who died in my neighbourhood the next day. He had worn himfelf down before his ficknefs by uncommon exertions in vifiting, bleeding, and even fitting up with fick people. At this time Mr. Fiftier was ill in my houfe. On the 26th of the month, at 12 o'clock, Mr. Coxe, my only affiftant, was feized with the fever, and went to his grandfather's. I followed him with a look which I feared would be the laft in my houfe.
Vol. IV. I i At
482
At two o'clock, my fifter, who had complained for feveral days, yielded to the diforder, and re- tired to her bed. My mother followed her, much ihdifpofed, early in the evening. My black fer- vant-man had been confined with the fever for feveral days, and had on that day for the firft time quitted his bed. My little mulatto boy, of eleven years old, was the only perfon in my fa- mily vvho was able to afford me the leaft affif- tance. At eight o^clock in the evening I finifhed the bufmefs of the day. A folemn ftillnefs at that time pervaded the ftreets. In vain did I ftrivc to forget my melancholy fituation by anfwering letters, and by putting up medicines, to be diftri- buted next day among^ my patients. My faithful black man crept to my door, and at my requeft fat down by the fire j but he added, by his filence and dullnefs, to the gloom which faddenly over- jx)wered every faculty of my mind.
Frdm this time I declined in health and ftrength. All motion became painful to me. My appetite began to fail. My night fweats continued. My fliort and imperfeft lleep was difturbed by diftreffing or frightful dreams. The fcenes of them were derived altogether from fick rooms and grave yards. I concealed my forrows as much as poflible from my patients ; but when alone, the retrofpecl of what was paft, and the profpeft of what was before me, the termination of which was invifible, often filled my foul with
the
483
the moft poignant anguifh. I wept frequently when retired from the public eye ; but I did not weep over the loft members of my family alone. I beheld or heard every day of the deaths of ci- tizens ufeful in public, or amiable in private life.
I have faid before, that I early left off drinking wine J but I ufed it in another way; 1 carried a little wine in a phial in my pocket ; and when I felt myfelf faint, after coming out of a fickroom, or after a long ride, I kept about a fpoonful of it in my mouth for half a minute, or longer, with- out fwallowing it. So weak and excitable was rny fyftem, that this fmall quantity of wine re- freflied and invigorated me as much as half a pint would have done at any other time. The only difference was, that the vigour I derived from the wine in the former was of fliorter duration than when taken in the latter way.
For the firft two weeks after I vifited patients iii the yellow fever, I carried a rag wet with vine- gary and fmelled to it occafionally in fick rooms : but after I faw and felt the figns of the univerfal prefence of the contagion in, my fyftem, I laid afide this, and all other precautions. I refted myfelf on the bedfide of my patients, and I drank milk, or eat fruit in their fick rooms. Beftdes being faturated with the contagion, I had ano- ther fecurity againft being infe£ted by my pa- tients y and that was, I went into fcarcely a houf^
I i 2 "which
484
which was more infcfled than my own. Moft of the people who called upon me for advice left a portion of contagion behind them. Four per- fons died next door to me on the eaft ; three a few doors above me on the weft ; and five in a fmall frame houfe on the oppofite fide of the ftreet, towards the fouth. On the north fide, and about one hundred and fifty feet from my houfe, the fever prevailed with great malignity in the family of Mr. James CrefTon. But this was not all. Many of the poor people who called upon me for advice, were bled by my pupils in my (hop, and in the yard, which was between it and the ftreet. From the want of a fufiicient number of bowls to receive their blood, it was fometimes fuffered to'flow upon the ground. From all thefe fources', ftreams of contagion were conftantly poured into my houfe, and conveyed into my body by the air, and in my aliment. Thus charged with the fuel of death, I was frequently difpofed to fay with Job, and almoft without a figure, to " corruption, thou art my father; and to the worm, thou art my mother and my fifter."
The deaths of my pupils have often been urged as objefilions to my mode of treating the fever. Had the fame degrees of labour and fatigue which preceded the attack of the yellow fever in each of them, preceded an attack of a common pleurify, I think it probable that fome, or per- haps all of them, would have died with it. But
when
485
when the influence of the concentrated contagion which filled my houfe, was added to that of con- ftant fatigue upon their bodies, what remedies could be expe8ed to fave their lives ? Under the above circumilances, I confider the recovery of the other branches of my family from the fever (and none of them efcaped it) with emotions, fuch as I fhould feel, had we all been revived from apparent death by the exertions of an hu- mane fociety.
For upwards of fix weeks I did not tafle ani- mal food, nor fermented liquors of any kind. The quantity of aliment which I took, inclufive of drinks, during this time, was frequently not more than one or two pounds in a day. Yet upon this diet I poiTefTed for awhile uncommon afitivity of body. This influence of abfiinence upon bo- dily exertion, has been happily illuflrated by Dr. Jackfon, in his directions for preferving the health of foldiers in hot climates. He tells us that he walked an hundred mile§ in three days in Jamaica, during which time he breakfafled on tea, fupped on bread and fallad, and drank nothing but le- monade or water. He adds further, that he walked from Edinburgh to London in eleven days and an half, and that he travelled with the moft eafe when he only breakfafted and fupped, and drank nothing but water. The fatigue of riding on horfeback, is prevented or leffened by abfti- nence from folid food. Even the horfe fuffers
leait
486
leaft from a quick and long journey, when hq is fed fparingly with hay. Thefe fa6ls add weight to the arguments formerly adduced in favour of a vegetable diet in mitigating the action of the con- tagion of malignant fevers upon the fyftem. In both cafes the abftraction of ftimuli removes the body further from the reach oiindired debility.
Food fupports life as much by its ftimulus, as by affording nourifhment to the body. Where an artificial ftimulus a£ls upon the fyftem, the natural ftimulus of food ceafes to be necelfary. Under the influence of this principle, I increafed or diminiftied my food with the figns I difcovered of the increafe or diminution of the contagion in my body. Until the 15th of September I drank weak coffee, but after that time I drank nothing but milk, or milk and water, in the intervals of my meals. \ was fo fatisfied of the efficacy of this mode of living, that I believed life might have been preferved, and a fever prevented, for many days with a much greater accumulation of the contagion in my fyftem, by means of a total abftinence from food. Poifon is a relative term, and an excefs in quantity, or a derangement in place, is neceffary to its producing deleterious effects. The contagion of the yellow fever pro- duced iicknefs and death only from the excefs of its quantity, or from its force being increafed by the addition of tkofe other ftimuli which I have elfewhere called exciting caufes.
(
487 1
In addition to low diet, - as a preventive of the difordcr, I obviated coftivenefs by taking occa-
Ibnally a calomel pill, or by chewing rhubarb. ;
On the ninth of October, I vifited a confidcr- | able number of patients, and as the day was ] warm, I leffened the quantity of my clothing. Towards evening I was feized with a pain in the ^ back, which obliged me to go to bed at eight o'clock. About twelve I awoke with a chilly fit. ; A violent fever, with acute pains in different I parts of my body, followed it. At one o'clock ] I called for Mr. Fifher, who flept in the next room. He came inftantly, with my affe£lionate ' black man, to my relief. I faw my danger paint- ed in Mr, Fifher's countenance. He i^/ed me I plentifully, and gave me a dofe of the mcrctirial \ medicine. This was immediately rejefted. He gave me a fecond dofe, which likewife aQ:ed as an emetic, and difcharged a large quantity of bile | from my ftomach. The remaining part of . the ] night was pafled under an apprehenfion that my ' labours were near an end. I could hardly fuf- j pe£l to furvive fo violent an attack of the fever, •: broken down, as I was, by labour, ficknefs, and ; grief. My wife and feven children, whom the i great and diftreffing events that Were paffing in j our city, had Joftled out of my mind for fix or \ feven weeks, now refumed their former place in i my afFe6lions. My wife had ftipulated in con- | fenting to remain in the country, to come to my \
affiftance |
) 1
I
488
afliftance in cafe of my ficknefs ; but I took mea- fures, which, without alarming her, proved efFec- tual in preventing it. My houfe was a Laza- retto, and the probability of my death, made her life doubly neceflary to my family. In the morning the medicine operated kindly, and my fever abated. In the afternoon it returned, at- tended with a great inclination to fleep. Mr. Fifher bled me again, which removed the fleepi- nefs. The next day the fever left me, but in fo weak a ftate, that I awoke two fucceffive nights with a faintnefs which threatened the extinction of my life. It was removed each time by taking a little a.liment. My convalefcence was extremely flow. I returned in a very gradual manner to my former habits of diet. The fmell of animal food, the firft time I faw it at my table, forced me to leave the room. During the month of Novem- ber, and all the winter months, I was haraUed with a cough, and a fever fomewhat of the hec- tic kind. The early warmth of the fpring re- moved thofe complaints, and \ now enjoy, through divine goodnefs, my ufual ftate of health. In fpeaking of the comparative effefts of purg- ing and bleeding, it may not be amifs to mention, fays Dr. Ruth, that not one pregnant woman to whom I prefcribed them died, or fuffered abor- tion. Where the tonic remedies were ufed, abor- tion or death, and in many inftances both, were nearly univerfal.
Many
489
Many whole families, confiding of five, fix, and in three inftances, of nine members, were recovered by plentiful purging and bleeding. I could fvvell this work by publifliing a lift of thofe families ; but I take more pleafure in adding, that I was not fmgular in my fuccefs in the ufe of the above remedies. They were prefcribed with great advantage by many of the phyficians of th;e city, who had for awhile given tonic medicines without efFe£t. I ftiall not mention the names of any of the phyficians who totally renounced thofe medicines, left I fliould give offence by not men- tioning them all. Many large families were cured by fome of them, after they adopted and pre- fcribed copious purging and blood-letting. One of them cured ten in the family of Mr. Robert Haydock, by means of thefe remedies. In one of that family, the difeafe came on with a vomit- ing of black bile.
But the ufe of the new remedies was not di- rected finally by the phyficians alone. The clergy, the apothecaries, many private citizens, feveral intelligent women, and two black men, prefcribed them with great fuccefs. Nay, more, many per- fons prefcribed them to themfelves j and as I fliall fay hereafter, with a fuccefs that was unequalled by any of the regular or irregular pra£titioners in the city.
It was owing to the almoft univerfal ufe of purging and bleeding, that the mortality of the
difeafe
490
difeafe diminiflied, in proportion as the number of perfons who were affe61ed by it encreafed, about the middle of October, It was fcarcely double of what it was in the middle of September, and yet fix times the number of perfons were proba- bly at that time confined by it.
The fuccefs of copious purging and bleeding was not confined to the city of Philadelphia. Se- veral perfons who caught the difeafe in town, and fickened in the country, were cured by them.
Not lefs than 6,000 of the inhabitants of Phi- ladelphia probably owe their lives to purging and bleeding during the late autumn.
I have faid that the clergy, the apothecaries^ and many other perfons who were uninftru6led in the principles of medicine, prefcribed purging and bleeding with great fuccefs in this diforder. Neceffity gave rife to this undifciplined feft of praftitioners, for they came forward to fupply the places of the regular bred phyficians who were fick or dead. I fhall mention the names of a few of thofe perfons who diftinguilhed themfelves as volunteers in this new work of humanity. The late Rev. Mr. Fleming, one of the minifters of the Catholic church, carried the purging powders in his pocket, and gave them to his poor pa- rifhioners with sreat fuccefs. He even became the advocate of the new remedies. In a conver- fation I had with him on the 22d of September, he informed me, that he had advifed four of -our
phyficians.
49^
phyficians, whom he met a day or two before, to renounce the pride of fcience, and to adopt the new mode of praftice, for that he had wit- nelfed its good effefts in many cafes." Mr. John Keihmle, a German apothecary, has affured me, that out of 314 patients w^hom he vifited, and 187 for whom he prefcribed, from the reports of their friends, he loft only 47 (which is nearly but one in eleven), and that he treated them all agree- ably to the method which I had recommended. The Rev. Mr. Schmidt, one of the minifters of the Lutheran church, was cured by him. I have before mentioned aninftance of the judgment of Mr. Connelly, and of his zeal in vifitjng and pre- fcribing for the fiek. His remedies were bleed- ing and purging. He moreover bore a conftant. and ufeful teftimony againft bark, wine, lauda- num, and the warm bath, Mrs. Paxton, in Car- ter's Alley, and Mrs. Evans, the wife of Mr. John Evans, in Second-ftreet, were indefatigable ; the one in diftributing mercurial purges, compofed by herfelf, and the other in urging the neccffity of copious bleeding and purging among her friends and neighbours, as the only fafe remedies for the fever. Thefe women were the means of faving- many lives. Abfalom Jones, and Richard Allen, two black men, fpent all the intervals of time, in which they were not employed in burying the dead, in vifiting the poor who were fick, and in bleeding and purging them, agreeably to the
directions
492
(lireftions which had been printed in all the newf- papers. Their fuccefs was unparalleled by what is called regular prafticc. This encomium upon the practice of the blacks, will not furprife the reader when I add, that they had no fear of pu- trefadion in the fluids, nor of the calumnies of a body of fellow citizens in the republic of medi- cine, to deter them from plentiful purging and bleeding. They had befides no more patients than they were able to vifit two or three times a day. But great as their fuccefs was, it was ex- ceeded by thofe perfons who, in defpair of pro- curing medical aid of any kind, purged and bled themfelves. This palm of fuperior fuccefs will not be withheld from thofe people, when I ex- plain the caufes of it. It was owing to their early ufe of the proper remedies, and to their be- ing guided in the repetition of them, by the con- tinuance of a tenfe pulfe, or of pain and fever. A day, an afternoon, and even an hour, were not loft by thefe people in waiting for the vifit of a phyfician, who was often detained from them by ficknefs, or by new and unexpected engage- ments, by which means the precious moment for ufing the remedies with eifeft, pafled irrevocably away. I have ftated thefe fa£ts from faithful in- quiries, and numerous obfervations.
From a fliort review of this account, reafon, and humanity, awake from their long repofe in medi- t:ihe, and unite in proclaiming, that it is. time to
take
493
t^ke the cure of peftllential fevers out of the handd 'of phyficians, and to place it in ihe hands-of the -people. Let not the reader ftartle at this propo- fjtion. I fliall give the following reafons for it :
1ft. In confequence of thefe peiUlential fevers affefting a great number of perfons at one time, it has always been, and always will be impoffible for them a// to have the benefit of medical aid, more efpecially as the proportion of phyficians to the number of fick is generally diminiflied upon thefe occafions, by defertion, ficknefs, and death.
2d. The fafety of committing to the people the cure of peftilential fevers, particularly the yellow fever and the plague, is eftablilhed by the fimpli- city and uniformity of their proximate caufe, and of their remedies. However diverfified they may be in their fymptoms, the fyftem in both difeafes is always at firft under a ftate of indired debility, and in all cafes requires the abftratStion of ftimuli in a greater or lefs degree, either in a fudden'or gradual manner. There can never beany danger of the people injuring themfelves by miftakingany other difeafe for a yellow fever, or plague, for no other febrile diforder can prevail with them.
3d. The hiftory of the yellow fever in the Weft Indies, proves the advantage of trufting patients to their own judgment. Dr. Lind has remarked, that a greater proportion of failors who had no phyficians, recovered from that fever, than of thofc w^ho had the beft medical afllftance. The
fj-elh
494
frcfli air of the deck of a fliip, a purge of fait water, and the free ufe of cold water, were found, fays he, to triumph here over the cordial juleps of phyficians.
4th. By committing the cure of this and other peftilential difeafes to the people, all thofe circum-' Itances which prevented the univerfal fuccefs of purging, and bleeding in our late epidemic, will have no operation. The remedies will be ufed the moment the difeafe is felt or even feen, and the contagion generated by it will be feeble, and propagated only to a fmall diftance from fuch pa- tients. There will then be no difputes among phyficiam about the nature of the difeafe to dif- tra6t the public mind> for they will feldom be confulted in it. None will fuffer from forbodinji fears of death, or defpair of recovery, to invite an attack of the difeafe, or to enfure its mortality.
The fmall-pox was once as fatal as the yellow fever and the plague. At prefent, it yields as univerfally to a vegetable ^iet, and evacuations, in the hands of apothecaries, the clergy, and even of good old women, as it does in the hands of doftors of phyfic.
They have narrow conceptions, not only of the Divine goodnefs, but of the gradual pro- grefs of human knowledge, who fuppofe that all peftilential difeafes (hall not, like the fmall-pox, fooner or later ceafe to be the fcourge and terror of mankind.
The.
495
The informatwn derived' from- Dr. JaGkfon of the Britilh army, affords ftrong teftimony oh this fubje£l, viz. " that he. had cured 19 out of 20, of all the foidiers whom he attended, by copious bleeding, provided it was performed within fix hours after the attack of the fever. Beyond that, period it mitigated its force, but feldom cured. The quantity of blood drawn in this early ftage of the difeafe was always from 20 to 30 ounces."
It was our Englifli Hippocrates, however, who firft taught this dofctrine. I am of opinion, fays Sydenham, that the plague is a truly inflammatory difeafe. If this opinion of mine fliould appear to any one unfatisfaftory, let him confider the feveral particulars attendant on it ; as for inftance:*
ift. The colour of the; blood taken away, which plainly refembles that taken away in pleu- ritic and rheumatic diforders.
2d. The dark livid colour of the carbuncles, not unlike the mark left by an aftual cautery.
3d. The buboes, which are equally difpofed to inflammation, as other tumours of any kind, and terminate by way of abfcefs, as mofl: inflam- mations ufuallv do.
4th. The feafon of the year in which an epi- demic plague arifes feems likewife to flrengthen my opinion, for at the fame time, namely be- twixt Spring and Summer, pleurifies, quinfies, and other inflammatory difeafes, ufually prevail 5
and
49^
and I never knew thefe more frequent than they were for feme weeks preceding the beginning of the late plague at London*.
But here perhaps it may be afked, allowing the plague to be an inflammatory difeafe, how it hap- pens that heating medicines, as mod alexiphar- raics are, iLouId be fo fuccefsfully ufed, both for prevention and cure. To this I reply, that thefe medicines only relieve by accident, inafmuch as this depends upon their procuringyw^^/^, whereby the inflamed particles of the blood are exhaled and expelled ; but if they fail of raifing a fweat, as it frequently happens, the blood, being more inflamed by this additional heat, foon manifefts the bad effefts of fuch kind of remedies. As to prevention, I am well aware how much the ufe of warm antidotes is generally commended, but with what advantage has not yet appeared. Too free an ufe of wine, and the taking of other ftrong prefervatives every day, at fet hours, have occa-
* Sydenham, however, elfewhere obferves, that the air figni- fies nothing, unlefs there is contagion ftalking abroad ; for the very fame year, fays he, which proved fatal to fo many thou- fands, was otherwife very mild and healthy, and that fuch as efcaped the plague never enjoyed better health; and likewife, that thofe who recovered were not fubjeft to a cachexy, and other indifpofitions ufually arifing from the foul remains left by- preceding diftempers ; and farther^ that impofthumes and car- buncles, though of the largeft fize after the inflamed particles, together with the fanies. was difcharged, were eafily cured by tlie common chirurgical methods.
fioncd
497
fibhed this difeafe in numbers of perfons, who btherwife might probably have efcaped it. ■ As to the cure of thefe fevers, fome perhaps tvil] accufe me of pfefumption and imprudence for undertaking to treat thereof, as having hved af fdme diftance from the town, during the greateft part of the time the late plague prevailed, and confequently being not fuf&ciently furniflied with obfervations relating thereto. But fmce fome phyficians of greater abilities, who coura- geoufly flayed in town at the peril of their lives, whilft the plague raged, have yet had no inclina- tion to publifli what they have learnt, by frequent obfervation, refpefting its nature, it is hoped every good man will excufe me for communi-r eating my Jentiments of it, founded on a few of my own obfervations.
And firft, the indications of cure are to be con^ fidered^ which muft always be direfted either (l) to affift nature in expelling the difeafe, keep- ing clofely to her method of procedure herein ; or (2) diftrufting the method flie ufually takes to. overcome the inteftine enemy, to fubftitute a dif- ferent and fafer method from art.
Since; then it appears quite unfafe to follow nature in her method of curing this difeafe, we are in the next place to confider in what manner the fecond intention is to be anfwered, which Gonfifts in attempting the cure by a different one.- And this I conceive is only to be effe61;ed by
Vol. IV. Kk bleeding
498
Heeding or fweating. As to tlie former, 1 am well aware that it is generally condemned in this difeafe ; but, fetting afide vulgar JirejndiceSy I fliall here briefly and equitably examine the reafons ufually brought againft it.
And, firft, I appeal to the phyficians who con- tinued in town during the late plague for an an- fwer to this quefl:ion. Whether free and repeated bleeding, before a fwelling appeared, was ever obferved to prove fatal to any of the infefted r But it is not at all to be wondered at, that bleeding in a fmall quantity, or after the appearance of a fwelling, fliould always be prejudicial : for in the former cafe the management of the cure is taken out of the hands of nature, who ufed all her en- deavours to raife a tumour, without fubftituting in its ftead any other fufficiently effettual method to expel the morbific matter; and, in the latter, bleeding, by attracting from the circumference to the center, occafions a dire£lly oppofite mo- tion to that of nature, which is made from the center to the circumference. And yet nothing is more frequently urged as a capital argument, by thofe who condemn bleeding in general in this difeafe, thaQ the mifchief of bleeding in this im- proper manner; as may be collefted from Diemer- broeck, and other writers of obfervation. But for my own part I cannot affent to their reafonings, till I know what anfwer they will make to the queftion above propofed; for I am well aware
. . that
499
that feveral writers of great character have judged bleeding proper in the plague > the principal of which are, Ludovicus Mercatus, Joannes Cof- taeus, Nicolaus Mafia, Ludovicus Septalius^Trin- cavellius, Foreftus, Mercurialis, Altomarus, Paf- chalius, Andcrnachus, Pereda, Zacutus Lufitanus, Fonfeca, &c. But Leonardus Botallus, a cele- brated phyfician of the laft century, is the only one I know of who places the whole of the cure in as copious bleeding as we demand, I fliall tranfcribe his words, that I may not be judged fingular in this pradlice.
" Briefly, fays our author, I conceive there is no plague wherein bleeding may not prove more *' beneficial than all other remedies, provided it be " feafonably lifed, in due quantity ; and am of opi- " nion that the reafon of its having fometimes " done no fervice, proceeds either from having " had recourfe to it too late, or the too /paring ufe " thereof, or to fome error in both thefe particu- " lars." And a little farther he fubjoins, " that if our apprehenfion be fo confiderable as to *' prevent our taking away enough blood, how is " it pofiible to judge exaftly what good or mif- " chief bleeding may do in this difeafe ? For if *' a difeafe, in which four pounds of blood are " required to be taken away, in order to its cure, " and yet but one is taken away, deftroys the pa- " tient, it does not therefore prove defl:ru6live " becaufe bleeding was ufed, but becaufe it was
K k 2 " performed.
500
performed in an improper manner : but male- " volent and indolent men always endeavour to " fix the failure on a particular remedy, not be- " caufe it did really do mifchief, but becaufe they " corruptly defire to have this remedy generally " difcredited. Or, fuppofing there be no ma/ice •** in- their attempt, they cannot be excufed from
ignorance, and following a bad cuftom herein ; " both which are doubtlcfs pernicious, but the *' former much more fo." Then proceeding to confirm his reafonings from experience, he has thefe words a little lower : " Thefe particulars be- *' ing attended to, no fenfible perfon can juftly " cenfure bleeding, but muft rather highly efteem
and commend it as a divine remedy, and pra£tife " it with ajj'urance ; which indeed / have done for
thefe fifteen years pajl. And in pefiilential dif- " ea;fes, at the ficge of Rochel, and four years " ago, at. Mons, in the province of. Henault, at " Paris for thefe two years, and the preceding *^ year at Cambray, I found no remedy quicker and " fafcr in its effe6l in all my patients, whofe num-
ber was very confiderable, than plentiful and " feafonahk bleeding." To thefe remarks the au- thor adds fome in (lances of perfons cured by this method, which I here omit for brevity fake ; and I muft beg leave to relate an uncommon hiftory of a fa£l, no way foreign to our prefent fubje6t, which happened a few years fince in England. At the fame time, when, amongft the other
calamities
5or
crilamltles of the civil war that fcverely afIlI(?teGl this nation, the plague alfa raged in feveral places, it was brought by accident from another place to Dunftar-caftle in Soperfetfliire, where fome of the foldiers dying fuddenly with an eruption of fpots, it likewife feized feveral others. It hap- pened at that time, that a furgeon, who had tra- velled much in foreign parts, was in the fervice there, and applied to. the governor for leave to aflifl his fellow foldiers, who were afflided with this dreadful difeafe, in the beft manner he was able, which was accordingly granted. His me- thod was, at the beginning of the difeafe,, and before a fwelling could be perceived, to take away Jh large a quantity of blood, that they were ready to. faint and drop down; for he bled them as they floodj.in the open air, and had no veffels to meafure the blood, which falling on the ground, the quan- tity each perfon loft could not of courfe be known. The operation being over, he fent them to lie in their tents ; and though he gave no kind of remedy ixfter bleedings yet, of the number that were thus treated, not a fingle -per Jon died* , I had this rela- tion,
■ * We have the following curious note on Sydenham, by Dr. Swan, his iranflator, fo bhnd is prejudice, and the appreciation of truth. "The fuccefs that attended this very fingular method, ivill, in all probability, be no encouragement to a firudcnt prac- titioner to attempt the fame upon a like occafion, nor fcreen the nuthor from the cenfurcs he feems juftly liahle to on account of his V lOLE^iT and iMVRovEK MEASURES. To bleed in fo irrer
gular
i.
502
tlon, continues' Sydenham, from Col. Francis Windham, a gentleman of great honour and vera- city, and at that time governor of the caftle.
I fhall now attempt to fet down what I have met with deferying notice, with refpeft to this fubjeft, being about to deliver the few obferva- tions I was enabled to make whilft the late Lon- don plague prevailed.
Whether the fever under confideration deferves to be entitled a plague, I dare not pofitively affirm; but this I know by experience, that all who were feized with the true plague, attended with all its peculiar concomitants, in my time, had the fame train of fymptoms both in the beginning and courfe of the difeafe. But when there was dan^ ger from the near approach of the plague to the houfe wherein I lived, yielding at length to the
gular and extravagant a jnanner, in a difeafe that is generally accompanied with an extreme lownefs of fpirits and lofs of flrength, feems a very irrational and unsafe tractice ; but to treat a number of perfons thus, vifithout any regard to the difference of conftitution, the different manner of their bc^ ingaflPefted, and other circnmftances, argues great rashness, uNSKiLFULNEss, and an obstinate attachment to a vagjit, diforderly^ and ill-ejiallijlied empiricism. Not to men- tion that fome would lofe more blood than others, before they became faint, which, however, appears to have been the cir- cumftances that determined him to I'top the bleeding ; and that the quantity loft muft have differed coufiderably in particulars, as the orifice happened to be fmaller qr larger, and the blood thicker or thinner ; whence again, it is manifeft, he afted ra- ther by CAPRICE and humour, than found and deliberate judgment.
felicitations
!
folicitatlons of my friends, I accomi)anled the |
vaft numbers that quitted the city, and removed
my family fome miles didant from it. But I re-
turned to town in fo fhort a time, and whilft the j
plague yet raged fo violently, that on account of
the fcarcity of abler phyficians, I could not avoid \
being called to affift the infe£led ; and trufting to !
my own experience, as a guide to be preferred to :
all manner of airy notions, I fcrupled not to di- j
reel bleeding:, as I had formerly done in the like ]
cafes. ;
I continued this pradlice of plentiful bleeding, ;
along with the ufe of a ptifan and a cooling diet, ]
in numbers with wonderful fuccefs ; until at length ' it failed me, through the objiinacy of the patients
friends, who were fo unreafonably prejudiced againjl \ it, as not to let enough blood be taken away, to the great detriniient of the difeafed, from whom,
as the cure turned chiefly upon bleeding either a j
fuflicient quantity of blood, or none at all was j
to be taken away. Finding my endeavours fo ;
warmly oppofed, I judged that the difcovering ;
another method of curing this difeafe would be of ' eminent fervice for the future.
I fhall here, however, relate an inftance of the ^ mifchief I once innocently did, not by bleeding, j but becaufe I was hindered from taking away as \ much blood as I judged requifite. I was called to a young man, who had been feized with a vio- lent ^ i
504
lent fevci- two days before, attended with verllg'I- noLis pains in tlie head, cxcenive vomiting, and other fymptoms of a like i<.ind ; when I imme- diately directed a large quantity of blood to be taken away, the top whereof, when cold, refem- bled corrupt pleuritic blood ; and I alfo prefcrib- ed a ptifan, and cooling jalaps and broths. In the afternoon, bleeding was repeated in the fame quantity, and again, in like manner, the next morning. Calling upon him in the evening, \ found him much better, neverthelefs his friends mightily oppofed farther bleeding, which yet I in- iifted on again, sflTuring thern that only a fmgle bleeding more \vas neceffary, and he would then be out of danger, but that if they continued to oppofe it, bleeding had better have been wholly omitted, and the cure undertaken by fweat, add- ing, in fliort, that otherwife he would certainly die. The event confirmed my prognoftic ; for the difpute about the operation to be performed laft- ed fo long that the opporiunity of doing it zvas lojl, and the patient died.
Having frequently met with fuch perplexing obftacles, I folicitoufly bent my thoughts to difr cover, if poffiblp, as efFe61ual, and at the fame time a Jefs pbje6lionable method of curing this difeafe. And after frequent and long confidera- tion of the matter, I pitched upon the following, which has fmce proved always ferviceable, and every way complete.
5^5
FIrft, if a fvvelling has not yet appeared, I hked moderately, according to the ftrength and conftitu- tion of the patient, after which a fweat is readily and expeditioufly raifed, which otherwife would not only be difficultly procured in fome fubjefts, but there would alfo be danger of increafing the inflammation thereby, and thus driving out the purple fpots. And the immediately fuccecding fweat makes abundant a^nends for the confidera- ble mifchief the lofs of blood, though in a fmall quantity, would otherwife occafion. After bleed- ing, which \ direft to be done in bed, fo foon as all things are in readinefs to raife a fweat, I imme- diately order the patient to be covered over with clothes, and a piece of flannel to be applied to his forehead, which laft expedient contributes more towards raifing a fweat, than one would eafily imagine. Then, if the patient does not vomit, I iidminifter thefe and the Ijke fudorifics:
Take of Venice treacle, half a dram ; the elec- tuary of the egg, a fcruple ; Gafcoigns pow- der, twelve grains ; cochineal, eight grains ; faifron, four grains ; and the juice of kermes enough, to make the whole into a bolus ; to be taken every fix hours, drinking after it fix fpoonfuls of the following julap. Take of the diftilled water of cardials benediEiiis^ and compound fcordium water, of each three ounces ; treacle water, two ounces ; fyrup of cloves, an ounce : mix them together for a julap.
I remember.
506
I remember, that when I was defired by an apothecary to vifit his brother, who lay dange- roufly ill of a peftilential fever, and fpoke of giv- ing a fudorificy he faid he had already given feve- ral ftrong ones without effeft, the patient having thrown them up by vomit. To this I made an- fwer, that he might prepare one of the moft naufeous of thofe that had been exhibited, and I would eafily prevent his vomiting it up. The . event verified my promife ; for the patient having firft fweated moderately, by the weight of the bed-cloaths only, fwallowed and kept dov^Ti a large bolus of Venice treacle, which caufing him to fweat plentifully, he recovered.
But to come back to my fubject : I dlre£l the fweat to be continued for twenty-four hours, by giving draughts of fage poffet drink between whiles ; ftrickly cautioning againft wiping off the fweat, and not allowing the patient's linen to be changed, however moift or foul it be, till twenty- four hours after the fweat is gone off : and this I recommend to be obferved with particular care. For if the fweat vanifties in lefs time, the fymp- toms immediately return with their former vio- lence, and the health of the patient is left expofed to a frefh conflift, which by a longer continuance of the fweat would have been out of danger.
And, in reality, I wonder much at Diemer^ broeck, and others, when I confider upon how flight a pretext they are induced to ftop the fweat,
namely.
507
namely, tojireferve the firength of the JiaUent. For (l) that the patient is ftronger whilft the fweat flows than before, muft have been obferved by every one that is but flenderly acquainted with the treatment of this difeafe. (2) I fliall not fcru- pie to publifh and defend what praQice and ex- perience have taught me, with refpe61: to this mat- ter. Several, who by my advice were kept in a fweat for twenty-four hours, have been fo far from complaining greater zveaknefs * from thence, that they have declared, that in the fame propor- tion the fuperfluous humour was thus carried off, they perceived their ftrength increafe. And to- wards the latter part of the time, I have often obferved with furprize, that there appeared a more natural, genuine, and copious fweat than the former occafioned by the fudorific, and which gave greater relief, as if it were truly critical, and terminated the difeafe. (3) Again, I do not fee what inconvenience would attend refrefliing the patient with reftorative broths and liquids, when the fweat is at the height, and then the obje£lion of want of ftrength to bear long fweats, vaniflies. If, therefore, a faintnefs be perceived towards the end, I allow the patient to fup a little chicken- broth, the yolk of an egg, or the like, which, together with the cordials and draughts, ufually directed to keep up the fweat, fufficiently fup-
* The weaknefs is occafioned by the difeafe, as this is re- jfjoving the weaknefs vaniflies.
port
5o8
port the ftrcnglh. But in a matter of fact fo evi- dent, it is necdlcfs to ufe many arguments , for what clearly Ihows the advantages of this method is, that whilft the patient continues to fweat, he judges himfelf in a fair way of recovery, and in the opinion of the attendants, feems in no farther danger ; but as foon as the fweat ceafes, and the body begins to dry, all things change for the worfe, a kind of relapfe being thereby occafioned.
For twenty-four hours after the fweat is gone off, I advife tlie patient to be cautious of catch- ing cold, to let his linen dry on his body, take all his liquids warm, and alfo to continue the ufe of the fage poffet drink. Next morning I give the common purge, made of an infufion of tamarinds, the leaves of fena, rhubarb, with manna and folu^ tive fyrup of rofes diffolvedin the ftrained liquor. And by this method I recovered feveral perfons, who were feized with a peftilential fever ; and did not lofe a Jingle patient after I began to ufe it.
Another remedy, which comes fanftioned by authority, is that of the cold bath. Of the ancient phyficians, the moft copious on the ufe of water, in all its forms, is Galen. He not only ufed cold drink, but immerfion in the cold bath, in burning fevers, with extraordinary fuccefs. His relations appear to me, in general, tedious and obfcure, but not deflitute of truth ; and the wearinefs of perufmg him is occafionally relieved by the plea- sure.
509
fure of refcuing a fa6t that was buried under maffes of falfe theory,
Mafuah, fays Bruce, is very unwholefome, as, hideed, is the whole coaft of the Red Sea from Suez to Babel Mandel, but more efpecially be- tween the tropics. Violent fevers, called there Nedad, 2.rQ vcxy prevalent, and generally termi- nate on the third day in death. If the patient Survives till the fifth day, he very often recovers by drinking water only, and throwing a quantity of cold water over him, even in his bed, where he is permitted to lie without attempting to make him dry, till another deluge adds to the firft.
Fie defcribes the fame fever as prevailing in Abyffinia, efpecially in all low marfhy grounds. " It is really," he fays, " a malignant tertian. It " always begins with a (hivering and head-ach, a " heavy eye, and inclination to vomit. The face *' affumes a remarkable yellow appearance," This is doubtlefs the yellow fever of the Weft Indies and America. The praftice of ufing cold water internally and externally in this fever in the lower Egypt, Nubia, and Abyffinia, has not indeed been interrupted by the influence of a falfe theory : but we may afcribe its continuance in part to another circumftance. The water in the fprings of thofe uniformly fultry climates is never much colder than the air, and hence the fatal ac- cidents from the improper ufe of cold drink or the cold bath, have fcldom if ever occurred.
In
5^^
In page 225, tljc fame author gives the cafe of a captain of a fliip (a man of credit), as related by himfelf, who having taken fome fallors on board affefted by the plague at Conftantinople, caught the infeftion. " I felt," fays the captain, " an excefiive heat, which made my blood boil, " my head was very foon attacked, and I perceiv- " ed I had but a few moments to live. I employ- ^'^ ed the little judgment I had left to make an ex- *• perlment. I ftripped myfeif quite naked and " laid myfeif for the remainder of the night on the deck : the copious dew that fell pierced me to the very bones ; in a few hours it rendered ** my refpiration free, and my head more com- " pofed. The agitation of my blood was calmed, " and after bathing myfeif in fea-water, I re- " covered."
On the ift of Augufl, 1777, fays Dr. Wright, I embarked in a fhip bound to Liverpool, and failed the fame evening from Montego Bay. The mafter told me he had hired feveral fallors on the fame day we took our departure ; one of whom had been at fick quarters on fbore, and was now but in a convalefcent ftate. On the 23d of Au- guft, we were in the latitude of Bermudas, and had a very heavy gale of wind for three days, when the above-mentioned man relapfed, and had a fever, with fymptoms of the greateft malignity, I attended this perfon often, but could not prevail with hira to be removed (Vom a dark and confined
fituation.
fituation, to a more airy and convenient part of the fln'p ; and as he refufed medicines, and even food, he died on the eighth day of his illnefs.
By my attention to the fick man, I caught the. contagion, and began to be indifpofed on the 5th of September, and the following is a narrative of my cafe, extraSled from notes daily marked down: I had been many years in Jamaica, but, except being fomewhat relaxed by the climate, and fa- tigue of bufmefs, I ailed nothing when I embark- ed. This circumftance, however, might perhaps difpofe me more readily to receive the infe6lion.
Sept. 5th, 6th, 7th, fmall rigours now and then, a preternatural heat of the fkin, a dull pain in the forehead, the pulfe fmall and quick, a lofs of ap- petite, but no ficknefs at ftomach, the tongue white and flimy, little or no thirft, the belly regu- lar, the urine pale, and rather fcanty, in the night reftlefs, with ftarting and delirium.
Sept. 8th. Every fymptom aggravated, with pains in the loins and lower limbs, and ftiffnefs in the thighs and hams.
I took a gentle vomit in the fecond day of this illnefs, and next morning a decoflion of tama- rinds ; at ^ed-time, an opiate, joined with anti- monial wine, but this did not procure fleep, or open the pores of the Ikin. No inflammatory fymptoms being prefent, a drachm of Peruvian bark was taken every hour for fix hours fuccef- fively, and now and then a glafs of Port wine,
but
^12
but with no apparent benefit. When upon decU^ tny pains were greatly mitigated, and the colder the air the better. This circumftance, and the failure of every means I had tried, encouraged,me to put in praftice on myfelf what I had ofteii winded to try on others, in fevers fimilar to my own.
Sept, 9th. Having given the neceflfary direc- tions, about three o'clock in the afternoon, I ftripped off all my clothes, and threw a fea-cloak lodfely about me till I got upon the deck, when the cloak alfo \vas laid afide : three buckets full of fait water were then thrown at once on me ; the fliock was great, but I felt immediate relief. The: head-ach and other pains inftantly abated, and a fine glow and diaphorefis fucceeded. Towards evening, however, the febrile fymptoms threaten- ed, a return, and I had again recourfe to the fame method as before, with the fame good effeft. I now took food with an appetite, and for the firft time had a found night's reft:.
Sept. 10. No fever, but a little uneafmefs in the hams and thighs — ufed the cold bath twice.
Sept. 11th. Every fymptom vaniflied ; but to prevent a relapfe, I ufed the cold bath twice.
Mr. Thomas Kirk, a young gentleman, paffen- ger in the fame fliip, fell fick of a fever on the yth of Augufl:. His fymptoms were nearly fimilar to mine, and having taken fome medicines with- out experiencing relief, he was defirous of trying the cold bath, whicli, with my approbation, he
did
5^3
did on the 11th and 12th of September, and, by this method, was happily reftored to heahh. He lives at this time (Jan. 1786) near Liverpool.
This praftice has been followed up by Dr. Wright, and many fince the publication of his cafe have adopted the plan, but more particu- larly by Dr. Currie of Liverpool, a phyfician of the higheft refpe£lability.
To thofe who oppofe the do£trine of ahJlrciElion of fiimiili in the early ftage of fever, let them fe- rioufly confider the voice of nature in this difeafe ; for a perfon is no fooner attacked with fever, than he feels a defire of going to bed, where, by an eafy horizontal pofture, he lefTens the ftimulus on the vafcular fyftem, which arifes from the ac- tion of fuch a number of mufcles as muft be em- ployed in an ere£l pofition of the body : but, in whatever direftion he may lay himfelf, particular mufcles, by being kept in conftant a£lion, foon become tired, and the patient feeks for a new pofture to give relief to his wearied mufcles ; the fame wearinefs recurs in a few minutes, and gives rife to that remarkable reftleffiiefs which takes place in fevers. I have already taken notice of the incapacity of the fick to endure any great noife, bright light, ftrong fmell, animal food, or whatever ftimulates their fyftem, which expe- rience teaches would aggravate this difeafe. All ftimuli of this kind they avoid in the moft folici- tous manner, from a confcioufnefs of their hav-
VoL. IV. L I inff
ing ^tendency increafp their (Jiforder; but an ardent dsfirp pf drink and dilution, which ha§ fo confider^bl<2 a fliare in the cure of fevers, 15 flrqngly pointed out. They haye likewife the flrongefl: defirp for acid fruits and fpbacid liquors. This is one of thofe natural appetites beftowed on us for anfwering fonie valuable purpofe in the. ceconomy, which, in the prefent cafe, is not only the corre^ion of a putrid eolluvies in the primae viae, but an abatement of the putrefcency of the blood that every day inqreafes : for, whatever may be the nature of the fever at firft, it feldom fails, in fix or eight days, to fliew its putrid dif- pofition by a variety of fymptoms. This is the antiphlogiftic method of cure dif^ated in fuch ftrong and pathetic expreflions by nature, in eyery putrid fever, and ought to be followed ftri£tly by us, unlefs in cafes of debility in the more advanced ftage of the difeafe, when cor- dials, ftiraulants, and antifpafmodics, are 'exhi- bited with advantage, as will be fliewn in the ng3{| fe^tipn.
PRACTICAL
PBACTICAL OBSERVATIONS.
SECT. LVIIL
THE SECOND STAGE OF PUTlllb FEVER.
TiiE efFe6ts of the poifon of typhus are con* fonant to thof(^ of other poifons, mucb depend- ing upon the conftitution, and more perhaps oti- the degree of virulent, or the quantity afFefting th^ fraiYie. In fome infliancfe's, as ofi the open- ing a bale of goods, thfe pOifon has KrHed like' a ftfokc of lightning ; and it is obferved, that^ the body becomes immediately purple, and ra- pidly putrid. The appearance of this fliage mufl, therefore, depend upon the above circum- fiances j but, in g'eheral, the a£!ion of this p'oi- fon is feen in a leffer degree, and the putrid fllage^ does riot come on' for feveral days.
Some pra£^itioners\vait for an intermiffion of ihd feve^ before they throw in the bark ; but the fooner after evacuations have been eriiployed, the* ba'rk is ^friiniilered the better. This fortifies' the habit, eliab'les it th'e better to overcome' tlie viru^y and, as- was before obferved of ague, renders- the bloocf more attraftive of oxygen, which tTiis poifon-
feems
5i6
fcems to confume in a greater proportion than it can readily be received into the frame.
The bark fliould be adminiftered at regular, and not far diftant, intervals, as two fcruples every three hours at firft, waflied down with an alkaline draught in the (late of effervefcence ; and if the ftomach, or bowels, are much de- ranged, inftead of the effervefcing draught, porter fhould be taken, or wine, with twenty or thirty drops of vitriolic acid , and as the vis vitai feems to decline, the interval muft be fliorter j viz. every two hours, and a fcruple of ferpentaria, and twenty or thirty of aether, be added each time of tak- ing the bark.
If the fever remit, with perfpiration, a good night procured by thirty or forty drops of lau- danum has been found of the higheft fervice^ but laudanum is a medicine carefully to be^ adminiftered. Its e'fre6t, as a ftimulant, when given in a fmall dofe, has been before explained ; but it was there fhewn, that it is of too powerful a nature to be ufed without the greateft caution, and that porter, wine, and aether, with ferpen- taria and bark, are better fubftitutes where ftimulant powers are required. As an apology for the dofe of thefe fomctimes adminiftered, let it be remembered, that the irritability has been exhaufted; and the frame refembles a jaded horfe, which to keep up, and going, requires not only the fpur but the whip.
Blifters
5^7
BHftcFS are of fervice, as exciting, when the power of life are very ' low, and towards the twentieth day ; fo are muftard cataplafms. . .Madeira, at this time, even to the extent of two bottles a day, may be ufed, under the idea that the a6tion of this poifon is overcome after the twentieth day, and if the patient can be car- ried on to this period, the fever is gone, and that he refembles a fliipwrecked mariner, who, after long buffetting the waves, is within the reach of Ihore, fpent and exhaufted, and has to make but a few efforts more which bring him to the wi(lied-for haven.
On the final ceffation of the fever, the conduft is critical. The conftitiition labours under the utmoft Hate of indireft debility, and many, it is apprehended, lofe their lives at this moment from an uncautious conduct in the pra£litioner. This period is marked by conftant dofing, like a new-born child, and, upon waking, recourfe muft be had to food, as fago, the white of an egg, fome calves foot boiled in milk, tapioca, and medicine mull: be differently adminiflered and chamomile may be fubftituted for bark, and taken at more diftant intervals. No exertion muft be now ufed *, and meat be given fparingly, with wine, after which the patient will find he has
* There are records where getting the patient out of bed after recovery from fever, he has died in the attempt.
again
51 8
a^ain to learn to walkj and fliould new return his thanks to an all powerful Creator, who has prc- ferved his life thus far, and reflefting' on paft dan- ger, he fliould regulate his after condu£i; in life. With a conftant eye towards futurity, in grateful remembrance.
END OF THE FOURTH VOLUME.