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Short Discourse Concerning Pestilential Contagion, and the Methods to Be Used to Prevent It

<h2>PART II.</h2> <h2>OF THE METHODS TO PREVENT CONTAGION.</h2> As it is a satisfaction to know, that the Plague is not a Native of our Country, so this is likewise an Encouragement to the utmost Diligence in finding out Means to keep our selves clear from It. This Caution consists of two Parts: The preventing its being brought into our Island; And, if such a Calamity should happen, The putting a stop to its spreading among us. The first of these is provided for by the established Method of obliging Ships, that come from Infected Places, to perform Quarentine: As to which I think it necessary, that the following Rules be observed. Near to our several Ports, there should be Lazarettos built in convenient Places, on little Islands if it can so be, for the Reception both of Men and Goods, which arrive from Places suspected of Infection: The keeping Men in Quarentine on board the Ship being not sufficient; the only Use of which is to observe whether any dye among them. For Infection may be preserved so long in Cloaths, in which it is once lodged, that as much, nay more of it, if Sickness continues in the Ship, maybe brought on Shoar at the End than at the beginning of the 40 Days: Unless a new Quarentine be begun every time any Person dies; which might not end, but with the Destruction of the whole Ship's Crew. If there has been any Contagious Distemper in the Ship; The Sound Men should leave their Cloaths; which should be burnt; the Men washed and shaved; and having fresh Cloaths, should stay in the Lazaretto 30 or 40 Days. The reason of this is, because Persons may be recovered from a Disease themselves, and yet retain Matter of Infection about them a considerable Time; as we frequently see the Small-Pox taken from those, who have several Days before passed through the Distemper. The Sick, if there be any, should be kept in Houses remote from the Sound; and some time after they are well, should also be washed and shaved, and have fresh Cloaths; whatever they wore while Sick being burnt: And then being removed to the Houses of the Sound, should continue there 30 or 40 days. I am particularly careful to destroy the Cloaths of the Sick, because they Harbour the very Quintessence of Contagion. A very ingenious Author[10] in his admirable Description of the Plague at Florence in the Year 1348, relates what himself saw: That two Hogs finding in the Streets the Rags, which had been thrown out from off a poor Man dead of the Disease, after snuffling upon them, and tearing them with their Teeth, fell into Convulsions, and dyed in less than an Hour. If there has been no Sickness in the Ship, I see no reason why the Men should perform Quarentine. Instead of this, they may be washed, and their Cloaths aired in the Lazaretto, as Goods, for one Week. But the greatest Danger is from such Goods, as are apt to retain Infection, such as Cotton, Hemp and Flax, Paper or Books, Silk of all sorts, Linen, Wool, Feathers, Hair, and all kinds of Skins. The Lazaretto for these should be at a Distance from that for the Men, and they must in convenient Warehouses be unpackt, and exposed, as much as may be, to the fresh Air for 40 Days. This may perhaps seem too long; but as we don't know how much Time precisely is necessary to purge the Interstices of Spongy Substances from infectious Matter by fresh Air, the Caution cannot be too great in this Point: Unless there could be a Way found out, without hazarding Men's Lives, of trying when Bodies have done emitting the Noxious Fumes; which possibly might be done by putting tender Animals near to them, particularly by setting little Birds upon the exposed Goods; because it has been observed in Times of the Plague, that the Country has been forsaken by the Birds; and those kept in Houses have many of them dyed[11]. But the Use of this Fancy Experience only must shew; for I am well aware, that all Plagues do not indifferently affect all Kinds of living Creatures; on the contrary, most are confined to a particular Species of them; like the Disease of the Black Cattle a few Years since, which neither proved Infectious to other Brutes, nor to Men. I take it for granted, that the Goods should be opened, when they are put into the Lazaretto, otherwise their being there will avail nothing. The Misfortune, which happened in the Island of Bermudas about 25 Years since, gives a Proof of this; where, as the Account has been given me by the learned Dr. Halley, a Sack of Cotton, put on Shoar by Stealth, lay above a Month without any Prejudice to the People of the House, where it was hid; but when it came to be distributed among the Inhabitants, it carried such a Contagion along with it, that the living scarce sufficed to bury the Dead. Indeed as it has been frequently experienced, that of all the Goods, which harbour Infection, Cotton in particular is the most dangerous, and Turkey is almost a perpetual Seminary of the Plague; I cannot but think it highly reasonable, that whatever Cotton is imported from that Part of the World, should at all Times be kept in Quarentine; because it may have imbibed Infection at the Time of its packing up, notwithstanding no Mischief has been felt from it by the Ship's Company. As all reasonable Provisions should be made both for the Sound and Sick, who perform Quarentine; so the strict keeping of it ought to be inforced by the severest Penalties. And if a Ship come from any Place, where the Plague raged, at the Time of the Ship's Departure from it, with more than usual Violence, it will be the securest Method to Burn all the Goods, and even the Ship. Nor ought this further Caution to be omitted, That when the Contagion has ceased in any Place by the approach of Winter, it will not be safe to open a free Trade with It too soon: Because there are Instances of the Distemper's being stopt by the Winter Cold, and yet the Seeds of it not destroyed, but only kept unactive, till the Warmth of the following Spring has given them new Life and Force. Thus in the great Plague at Genoa near 60 Years ago, which continued part of two Years; the first Summer about 10,000 dyed; the Winter following hardly any; but the Summer after no less than 60,000. So likewise the last Plague at London began the Autumn before the Year 1665, and was stopt during the Winter by a hard Frost of near three Month's Continuance; so that there remained no further Appearance of it till the ensuing Spring[12]. Now if Goods brought from such a Place should retain any of the latent Contagion, there will be Danger of their producing the same Mischief in the Place, to which they are brought, as they XXXVIIIwould have caused in that, from whence they came. But above all it is necessary, that the Clandestine Importing of Goods be punished with the utmost Rigour; from which wicked Practice I should at this Time apprehend more Danger of bringing the Disease from France, than by any other Way whatsoever. These are, I think, the most material Points, to which Regard is to be had in defending ourselves against Contagion from other Countries. The particular Manner of putting these Directions in Execution, as the Visiting of Ships, Regulation of Lazarettos, &c. I leave to proper Officers, who ought sometimes to be assisted herein by able Physicians. The next Consideration is, What to do in Case, through a Miscarriage in the publick Care, by the Neglect of Officers, or otherwise, such a Calamity should be suffered to befall us. There is no Evil in the World, in which the great Rule of Resisting the Beginning, more properly takes Place, than in the present Case; and yet it has unfortunately happened, that the common Steps formerly taken have had a direct Tendency to hinder the putting this Maxim in Practice. As the Plague always breaks out in some particular Place, it is certain, that the Directions of the Civil Magistrate ought to be such, as to make it as much for the Interest of Families to discover their Misfortune, as it is, when a House is on Fire, to call in the Assistance of the Neighbourhood: Whereas on the contrary, the Methods taken by the Publick, on such Occasions, have always had the Appearance of a severe Discipline and even Punishment, rather than of a Compassionate Care: Which must naturally make the Infected conceal the Disease as long as was possible. The main Import of the Orders issued out at these Times was, As soon as it was found, that any House was infected, to keep it shut up, with a large red Cross, and Lord have Mercy upon us on the Door; and Watchmen attending Day and Night to prevent any one's going in or out, except Physicians, Surgeons, Apothecaries, Nurses, Searchers, &c. allowed by Authority: And this to continue at least a Month after all the Family was dead or recovered[13]. It is not easy to conceive a more dismal Scene of Misery, than this; Families seized with a Distemper, which the most of any in the World requires Help and Comfort, lockt up from all their Acquaintance; left it may be to the Treatment of an inhumane Nurse (for such are often found at these Times about the Sick;) and Strangers to every thing but the Melancholy sight of the Progress, Death makes among themselves; with small Hopes of Life, and those mixed with Anxiety and Doubt, whether it be not better to Dye, than to survive the Loss of their best Friends, and nearest Relations. If Fear, Despair, and all Dejection of Spirits dispose the Body to receive Contagion, and give it a great Power, where it is received, as all Physicians agree they do, I don't see how a Disease can be more enforced, than by such a Treatment. Nothing can justify such Cruelty, but the Plea, that it is for the Good of the whole Community, and prevents the spreading of Infection. But this upon due Consideration will be found quite otherwise: For while Contagion is kept nursed up in a House, and continually encreased by the daily Conquests it makes, it is impossible but the Air should by Degrees become tainted, which by opening Windows, &c. will carry the Malignity first from House to House; and then from one Street to another. The shutting up Houses in this Manner is only keeping so many Seminaries of Contagion, sooner or later to be dispersed abroad: For the waiting a Month, or longer, from the Death of the last Patient will avail no more, than keeping a Bale of infected Goods unpack'd; the Poyson will fly out, whenever the Pandora's Box is opened. As these Measures were owing to the Ignorance of the true Nature of Contagion, so they did, I firmly believe, contribute very much to the long Continuance of the Plague, every time they have been practised in this City: And no doubt they have had as ill Effects in other Countries. It is therefore no wonder, that great Complaints were sometimes made here against this unreasonable Usage; which, when they prevailed so far, as to procure some Release for the Sick, were remarkably followed with an Abatement of the Disease. The Plague in the Year 1636 began with great Violence, but Leave being given by the King's Authority for People to quit their Houses; it was observed, That not one in twenty of the well Persons removed fell Sick, nor one in ten of the Sick dyed[14]. Which single Instance alone, had there been no other, should have been of Weight ever after to determine the Magistracy against too strict Confinements. But besides this, a preceding Plague, viz. in the Year 1625, affords us another Instance of a very remarkable Decrease upon the discontinuing to shut up Houses. It was indeed so late in the Year, before this was done, that the near Approach of Winter was doubtless one Reason for the Diminution of the Disease, which followed: Yet this was so very great, that it is at least past dispute, that the Liberty then permitted was no Impediment to it: For this opening of the Houses was allowed of in the beginning of September; and whereas the last Week in August, there dyed no less than 4218, the very next Week the Burials were diminuished to 3344, and in no longer time than to the fourth Week after, to 852[15]. Since therefore the Management in former Times neither answers the Purpose of discovering the Beginning of the Infection, nor of putting a stop to it when Discovered, other Measures are certainly to be taken; which I think should be of this Nature. Instead of ignorant old Women, who are generally appointed Searchers in Parishes to enquire what Diseases People dye of, That Office should be committed to Understanding and Diligent Men, whose Business it should be, as soon as they find any have dyed after an uncommon Manner, particularly with livid Spots, Buboes, or Carbuncles, to give Notice thereof to the Magistrates; who should immediately send skilful Physicians to Visit the Houses in the Neighbourhood, especially of the Poorer sort, among whom this Evil generally begins; and if upon their Report it appears, that a Pestilential Distemper is broke out among the Inhabitants, They should without Delay order all the Families, in which the Sickness is, to be Removed; The Sick to different Places from the Sound; but the Houses for both should be three or four Miles out of Town; and the Sound People should be stript of all their Cloaths, and washed and shaved, before they go into their new Lodgings. No Manner of Compassion and Care should be wanting to the Diseased; to whom, being now in clean and airy Habitations, there would, with due Cautions, be no great Danger in giving Attendance. All Expences should be paid by the Publick, and no Charges ought to be thought great, which are counterbalanced with the saving a Nation from the greatest of Calamities. Nor does it seem to me at all unreasonable, that a Reward should be given to the Person, that makes the first Discovery of Infection in any Place; since it is undeniable, that the making known the Evil to those, who are provided with proper Methods against it, is the first and main Step towards the overcoming it. When the Sick Families are gone, all the Goods of the Houses, in which they were, should be burnt; nay the Houses themselves, if that can conveniently be done. And after this all possible Care ought still to be taken to remove whatever Causes are found to breed and promote Contagion. In order to this, the Overseers of the Poor (who might be assisted herein by other Officers) should visit the Dwellings of all the meaner sort of the Inhabitants, and where they find them stifled up too close and nasty, should lessen their Number by sending some into better Lodgings, and should take Care, by all Manner of Provision and Encouragement, to make them more cleanly and sweet. No good Work carries its own Reward with it so much as this kind of Charity; and therefore be the Expence what it will, it must never be thought unreasonable. For nothing approaches so near to the first Original of Contagion, as Air pent up, loaded with Damps, and corrupted with the Filthiness, that proceeds from Animal Bodies. Our common Prisons afford us an Instance of this, in which very few escape, what they call the Gaol Fever, which is always attended with a Degree of Malignity in proportion to the Closeness and Stench of the Place: And it would certainly very well become the Wisdom of the Government, as well with Regard to the Health of the Town, as in Compassion to the Prisoners, to take Care, that all Houses of Confinement should be kept as Airy and Clean, as is consistent with the Use, to which they are designed. The Black Assize at Oxford, held in the Castle there in the Year 1577, will never be forgot[16]; at which the Judges, Gentry, and almost all that were present, to the Number of 300, were killed by a poysonous Steam, thought by some to have broke forth from the Earth; but by a noble and great Philosopher[17] more justly supposed to have been brought by the Prisoners out of the Goal into Court; it being observed, that they alone were not injured by it. At the same time, that this Care is taken of Houses, the proper Officers should be strictly charged to see that the Streets be washed and kept clean from Filth, Carrion, and all Manner of Nusances; which should be carried away in the Night Time; nor should the Laystalls be suffered to be too near the City. Beggars and Idle Persons should be taken up, and such miserable Objects, as are neither fit for the common Hospitals, nor Work-houses, should be provided for in an Hospital of Incurables. Orders indeed of this kind are necessary to be observed at all times, especially in populous Cities; and therefore I am sorry to take Notice, that in these of London and Westminster there is no good Police established in these Respects; for want of which the Citizens and Gentry are every Day annoyed more ways than one. If these early Precautions, we have mentioned, take Effect, there will be no need of any Methods for Correcting the Air, Purifying Houses, or of Rules for preserving particular Persons from Infection: To all which, if the Plague get head, so that the Sick are too many to be removed, Regard must be had. As to the first; Fire has been almost universally recommended for this Purpose, both by the Ancients and Moderns; who have advised to make frequent and numerous Fires in the Towns infected: By which Means, it is said, Hippocrates preserved Greece from a Plague, which was entring into it from Æthiopia[18]. And it is certain, that some evil Dispositions of the Air, particularly such as proceed from Damps, Exhalations, &c. may be corrected by Fire, and the Predisposition of it to receive Infection from these Causes sometimes removed. But when the Distemper is actually begun, and rages, since it is known to be spread and increased by the Heat of the Summer, and on the contrary checked by the cold in Winter; undoubtedly, whatever increases that Heat will so far add Force to the Disease. Whether the Service Fires may do by correcting any other ill Qualities of the Air will counterbalance the Inconvenience upon this Account, Experience only can determine; and the Fatal success of the Tryals made here in the last Plague, is more than sufficient to discourage any further Attempts of this Nature; for Fires being ordered in all the Streets for three Days together, there dyed in one Night following no less than 4000; whereas in any single Week before or after, not much above three times that Number were carryed off[19]. What has been said of Fires, is likewise to be understood of firing of Guns, which some have too rashly advised. The proper Correction of the Air would be to make it fresh and cool. Accordingly the Arabians[20], who were best acquainted with the Nature of Pestilences, advise People to keep themselves as airy as possible, and to chuse Dwellings exposed to the Wind. For keeping Houses cool, they took to be the best Method of purifying them; and therefore to answer this End more fully, they directed to strew them with cooling Herbs, as Roses, Violets, Water-Lillies, &c. and to be washed with Water and Vinegar; than all which, especially the last, nothing more proper can be proposed: Though it be directly contrary to what Modern Authors mostly advise, which is to make Fumes with hot Things, as Benzoin, Frankincense, Asa Fœtida, Storax, &c. from which I see no reason to expect any Virtue to destroy the Matter of Infection, or to keep particular Places from a Disposition to receive it; which are the only things here to be aimed at. It is of more Consequence to be observed, that as Nastiness is a great Source of Infection, so Cleanliness is the greatest Preservative: Which is the true Reason, why the Poor are most obnoxious to Disasters of this Kind. The next thing after the purifying of Houses, is to consider by what Means particular Persons may best defend themselves against Contagion; for the effectual doing of which it would be necessary to put the Humours of the Body into such a State, as not to be alterable by the Matter of Infection. But since this is no more to be hoped for, than a Specific Preservative from the Small-Pox; the most that can be done, will be to keep the Body in such Order, that it may suffer as little as possible. The first Step towards which, is to maintain a good State of Health, in which we are always least liable to suffer by any external Injuries; and not to weaken the Body by Evacuations. The next is, to guard against all Dejection of Spirits, and immoderate Passions; for these we daily observe do expose Persons to the more common Contagion of the Small-Pox. These Ends will be best answered by living with Temperance upon a good generous Diet, and avoiding Fastings, Watchings, extreme Weariness, &c. Another Defence is, to use whatever Means are proper to keep the Blood from Inflaming. This, if it does not secure from contracting Infection, will at least make the Effects of it less violent. The most proper Means for this, according to the Advice of the Arabian Physicians, is the repeated Use of acid Fruits, as Pomegranates, Sevil Oranges, Lemons, tart Apples, &c. But above all of Wine-Vinegar in small Quantities, rendered grateful to the Stomach by the Infusion of some such Ingredients as Gentian Root, Galangal, Zedoary, Juniper Berries, &c. Which Medicines by correcting the Vinegar, and taking off some ill Effects it might otherwise have upon the Stomach, will be of good Use: But these, and all other hot Aromatic Drugs, though much recommended by Authors, if used alone, are most likely to do hurt by over heating the Blood. But since none of these Methods promise any certain Protection; as leaving the Place infected is the surest Preservative, so the next to it, is to avoid, as much as may be, the near Approach to the Sick, or to such as have but lately Recovered. For the greater Security herein, it will be advisable to avoid all Crouds of People. Nay it should be the Care of the Magistrate to prohibit all unnecessary Assemblies; and likewise to oblige all, who get over the Disease, to Confine themselves for some time, before they appear abroad. The Advice to keep at a Distance from the Sick, is also to be understood of the Dead Bodies: which should be buried at as great a Distance from Dwelling Houses, as may be; put deep in the Earth; and covered with the exactest Care. They should likewise be carried out in the Night, while they are yet fresh and free from Putrefaction: Because a Carcass not yet beginning to Corrupt, if kept from the Heat of the Day, hardly emits any kind of Steam or Vapour. As for those, who must of necessity attend the Sick; some further Directions should be added for their Use. These may be comprehended in two short Precepts. One is, not to swallow their Spittle while they are about the Sick, but rather to spit it out: The other, not so much as to draw in their Breath, when they are very near them. The reason for both these appears from what has been said above concerning the Manner, in which a sound Person receives the Infection. This is the Sum of what I think most likely to stop the Progress of the Disease in any Place, where it shall have got Admittance. If some few of these Rules refer more particularly to the City of London, with small Alteration they may be applied to any other Place. It now remains therefore only to lay down some Directions to hinder the Distemper's spreading from Town to Town. The best Method for which, where it can be done, is to cast up a Line about the Town infected, at a convenient Distance; and by placing a Guard, to hinder People's passing from it without due Regulation, to other Towns: But not absolutely to forbid any to withdraw themselves, as they have now done in France, according to the usual Practice abroad; which is an unnecessary Severity, not to call it a Cruelty. I think it will be enough, if all, who desire to pass the Line, be permitted to do it, upon Condition they first perform Quarantine for about 20 Days in Tents, or other more convenient Habitations. But the greatest Care must be taken, that none pass without conforming themselves to this Order, both by keeping diligent Watch, and by punishing with the utmost Severity, any that shall either have done so, or attempt it. And the better to discover such, it will be requisite to oblige all, who travel in any Part of the Country, under the same Penalties, to carry with them Certificates either of their coming from Places not Infected, or of their passing the Line by permission. This I take to be a more effectual Method to keep the Infection from spreading, than the absolute refusing a Passage to People upon any Terms. For when Men are in such imminent Danger of their Lives, where they are; many, no doubt, if not otherwise allowed to escape, will use Endeavours to do it secretly, let the Hazard be ever so great. And it can hardly be, but some will succeed in their Attempts; as we see fell out in France notwithstanding all their Care. But one that gets off thus clandestinely, will be more like to carry the Distemper with him, than twenty, nay a hundred, that go away under the preceding Restrictions: Especially because the Infection of the Place, he flies from, will by this Management be rendered much more intense. For confining People, and shutting them up together in great Numbers, will make the Distemper rage with augmented Force, even to the increasing it beyond what can be easily imagined; As appears from the Account, which the learned Gassendus[21] has given us of a memorable Plague, which happened at Digne in Provence, where he lived, in the Year 1619. This was so terrible, that in one Summer out of ten thousand Inhabitants, it left but fifteen hundred, and of them all but five or six had gone through the Disease. And he assigns this, as the principal Cause of the great Destruction, That the Citizens were too closely confined, and not suffered so much as to go to their Country Houses. Whereas in another Pestilence, which broke out in the same Place a year and half after, more Liberty being allowed, there did not dye above one hundred Persons. For these Reasons, I think, to allow People with proper Cautions to remove from an infected Place, is the best Means to suppress the Contagion, as well as the most humane Treatment of the present Sufferers: But though Liberty ought to be given to the People, yet no sort of Goods must by any means be suffered to be carried over the Line, which are made of Materials retentive of Infection. For in the present Case, when Infection has seized any Part of a Country, much greater Care ought to be taken, that no Seeds of the Contagion be conveyed about, than when the Distemper is at a great Distance; because a Bale of Goods, which shall have imbibed the Contagious Aura when packt up in Turkey, or any remote Parts; yet, when unpackt here, may chance to meet with so healthful a Temperament of our Air, that it shall not do much hurt. But when the Air of any one of our Towns shall be so corrupted, as to spread and maintain the Pestilence in it, there will be little reason to believe, that the Air of the rest of the Country is in a much better State. For the same Reason Quarentines should more strictly be enjoined, when the Plague is in a bordering Kingdom, than when it is more remote. I have gone through the chief Branches of Preservation against the Plague. And shall only add, that if the Burning of Goods, which has been proposed, be thought any Way offensive or inconvenient, The Burying of them six Feet, or more, under Ground may answer the Purpose as well. What has been said of the Nature of Contagion, upon which the foregoing Directions are grounded, may also be of Use towards establishing a better Method of Cure, than Authors have commonly taught: But to engage in this is beyond the present Design. <div class='nf-center-c1'> <div class='nf-center'> <div>FINIS.</div> </div></div> <div style="break-after:column;"></div>

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