Cooley's Cyclopaedia of Practical Receipts Volume Ii Part 152

Such is the definition of plague given in the 'Nomenclature of Diseases'

(published in 1869), drawn up by a joint committee appointed by the College of Physicians.

More detailed accounts of the disease, described by other pathologists, state that it attacks the patient with great suddeness, or only after a few premonitory symptoms. These are:--s.h.i.+vering, extreme prostration, intense headache and giddiness, excessive restlessness, and an overwhelming sense of anxiety. The patient's gait becomes uncertain, and he staggers like a drunken man. These symptoms are more or less accompanied by nausea, bilious vomiting, and frequently by bilious diarrha. As the disease advances, delirium very frequently sets in; the nausea, vomiting, and diarrha increase in intensity, the tongue becomes swollen and covered with a dark fur, whilst the lips, teeth, and nostrils are coated with a dry fetid incrustation. Provided the attack does not terminate fatally, in a very rapid manner, these symptoms are accompanied by sharp pains (increasing in intensity during the progress of the malady) in the groin, armpits, and neck. These pains in the above parts precede the appearance of the buboes, and in many cases, of the carbuncles, which, a.s.sociated with the fever, are so characteristic of plague. These glandular swellings vary, in different cases, as to the time when they make their appearance. Sometimes they do so during the first day of the attack, at others, after two or three days--and in others, again, not until near the close of the disease. With the buboes and carbuncles, small red purplish spots (_petechiae_), frequently appear on the body. The carbuncle is by no means an invariable accompaniment of the disease. Dr Russell, out of 2700 cases, found only 490 in which it showed itself. He states that when carbuncle develops itself, it is distributed over the whole surface of the body with the exception of the scalp, the palms of the hands, and the soles of the feet.

"The plague may be said to a.s.sume four degrees of severity:--1. Slight fever, without delirium or buboes. 2. Fever, delirium, and buboes. 3.

Fever, delirium, or coma, buboes, carbuncles, and _petechiae/e_. 4.

Congestive fever, fatal on the first, second, or third day, before the appearance of buboes. The fever, though usually continued, may a.s.sume the intermittent or remittent type."[110]

[Footnote 110: Hooper's 'Vade Mec.u.m,' edited by Messrs Guy and Harley.]

There is considerable diversity of opinion as to the origin of plague. By some pathologists it is maintained that it spreads solely by contagion; by others the contagion theory is altogether repudiated, and certain local and epidemic agencies are referred to as its source; whilst others, again, adopt a medium view and, whilst not denying its contagious origin, hold that it may also be developed by endemic and epidemic causes. It bears a great resemblance to typhus.

With the exception of the outbreak of plague at Veltianka, in Astrakan, in the beginning of the current year (1879), the pestilence has not visited Western Europe during the present century an exemption which, being so obviously due to the improved sanitary and hygienic conditions of the modern European cities and towns, is a forcible ill.u.s.tration of how largely the power of curtailing the propagation and progress of the scourge is within the means of human control. There can be little, if any, doubt that the same total absence of drainage, and the very possible consequent contamination of drinking water, added to the narrowness of the streets, the overcrowded and badly ventilated state of the houses themselves, and the dirty habits of the inmates, which are also characteristic of those quarters of eastern cities and towns in which plague is always more or less occasionally prevalent, obtained in the fourteenth, fifteenth, sixteenth, and seventeenth centuries, amongst European communities.

We learn, on the authority of Mr Marshall (who gets his figures from the weekly bills of mortality of the period), that during the sixteenth and seventeenth centuries London was seldom free from the pestilence, and that in several years, not usually regarded by historians as plague epochs, it annually slew from less than 1000 to 4000 of the inhabitants.

Between the years 1593 and 1665, five severe outbreaks of the disease occurred in London, and the number of deaths for the respective years were as follows:--1593, 11,503; 1603, 36,269; 1625, 35,417; 1636, 10,400; 1665, 68,596. According to Sir William Petty, the average mortality during these several attacks amounted to about a fifth of the population.

That insanitary surroundings and the spread of plague, whilst sanitary ones and its decline, follow each other like cause and effect, may be emphasised by the statement of two facts:--1. The medical commissioner lately sent by the Russian government to the seat of the late outbreak of the malady in Astrakan, discovered the people dirty in their habits, living in noisome, overcrowded houses, and the atmosphere polluted with the smell of decaying fish, added to which the village was most miserably drained. 2. Ranken records that in Rajpootana plague propagated by the filthy habits of the inhabitants was for some years almost entirely obliterated by the adoption of sanitary precautions.

It may here be noticed that the Astrakan plague was a.s.sociated with inflammation of the lungs, a feature which led an eminent Russian physician to adopt the opinion, that the Astrakan malady is the same as the Indian plague, which is believed to be the same disease which, under the name of 'The Black Death,' committed such appalling devastation in Europe, Asia, and Africa, in the fourteenth century.

In his 'Epidemics of the Middle Ages,'[111] Hecker has told of the ravages of this ruthless pestilence, which made its appearance in Europe in 1348.

Its devastations at Florence have been very powerfully described by Boccaccio in the introduction to his 'Decameron.' Boccaccio was in Naples at the time it was devastating Italy, therefore, it is conjectured, his graphic description must have been derived from hearsay and the reports of eyewitnesses.

[Footnote 111: Published by the Sydenham Society, 1844.]

In August of the same year it broke out at Dorset, from which county it soon reached Devon and Somerset, and thence rapidly spread throughout England, slaying its thousands in its progress. In London alone it has been estimated that the mortality caused by it amounted to a hundred thousand.

Hecker a.s.sumes that in Europe its victims were twenty-five millions. These however, as well as the following figures, must only be received as approximations to the correct numbers, which, owing to the absence of any contemporary bills of mortality, cannot but be very imperfect:--

In Florence there died of the black plague 60,000 In Venice 100,000 In Ma.r.s.eilles, in one month 16,000 In Sienna 70,000 In Paris 50,000 In St Denis 14,000 In Avignon 60,000 In Strasbourg 16,000 In Lubeck 9,000 In Basle 14,000 In Erfurt at least 16,000 In Weimar 5,000 In Lemburg 2,500 In London at least 100,000 In Norwich 51,000

To which may be added:--

Franciscan Friars in Germany 124,434 Minorites in Italy 30,000

From the circ.u.mstance--ill.u.s.trative of the religious and blind bigotry of this period--that the Jews were brutally tortured, ma.s.sacred, and burnt, on suspicion of having poisoned the wells from which drinking water was drawn, it may be inferred that the wells, owing to the entire absence of drainage, which led to their contamination by sewage matters, contributed largely to the spread of the pestilence.

Of the potency of the contagion disseminated by the 'Black Death' Hecker records:--

"Every spot which the sick had touched, their breath, their clothes, spread the contagion; and in all other places the attendants and friends, who were either blind to their danger, or heroically despised it, fell a sacrifice to their sympathy.

"Even the eyes of the patient were considered as sources of contagion, which had the power of acting at a distance, either on account of their unwonted l.u.s.tre, or the distortion which they always suffer in plague, or in conformity with an ancient notion, according to which the sight was considered as the bearer of a demoniacal excitement.

"The pestilential death of the sick, who expectorated blood, caused a terrible contagion far and near, for even the vicinity of those who had fallen ill of plague was certain death, so that parents abandoned their infected children, and all the ties of kindred were dissolved."

There is a striking similarity between the above description, referring to the plague of 1348, and the following, which is extracted from Dr Doppner's official medical report to the Russian government on the plague which manifested itself at Veltianka in Astrakan as lately as January, 1879. Dr Doppner, writes:--

"The necessary remedies were employed to combat the disease. I prescribed especially salicylic acid, muriatic acid, quinine, &c., but everything proved useless. Not a single patient recovered, viz. Dr Koch and six of his a.s.sistants died, the priest of the Stanitza, the Cossacks employed in burying the dead; in a word, all those who approached the persons attacked with the disease, although furnished with the means of preservation used in like circ.u.mstances, very few escaped the plague.[112]"

[Footnote 112: 'Lancet.']

No case of plague has occurred in England for more than two centuries, although in 1721 it half depopulated Ma.r.s.eilles, and committed fearful ravages at Moscow, in 1771.

Within the present century it has appeared in Europe at the following places:--At Malta, in 1813; at Calabria, in 1816; at Corfu, in 1818; in Silesia, in 1819; and amongst the Russian troops in Bulgaria, in 1824. In Malta between 4000 and 5000 people fell victims to it.

It made its last appearance in England in 1665, and was especially fatal in London, where it carried off, as we have already seen, 65,596 people.

Because of the frightful mortality it occasioned, this particular outbreak of the disease has been named by historians "The Great Plague of London."

Rapidly spreading from Westminster, where it first manifested itself, to the more closely built city, its progress increased with the warm weather, until during the sultry months of August and September it reached its height. "Thus," writes Pepys in his diary, August 31st, 1665 "this month ends with great sadness upon the public through the greatness of the plague everywhere through the kingdom almost. Every day sadder and sadder news of its increase. In the city died this week 7496, and of them 6102 of the plague. But it is feared the true number of the dead this week is near 10,000; partly from the poor that cannot be taken notice of through the greatness of the number, and partly through the Quakers and others that will not have the bell ring for them." The general aspect of the pestilence stricken city is thus described by Pepys, "To the Exchange, where I have not been a great while. But, Lord! how sad a sight it is to see the streets empty of people and very few upon the 'Change. Jealous of every door that one sees shut up, lest it should be plague; and about us two shops in three, if not generally more, shut up."

The doors of a house infected with the plague were marked with a red cross, and on them was written the words, "The Lord have mercy upon us."

Pepys tells of the fright he experienced when he came upon two houses of this description, in Drury-lane, for the first time; and as he adds that he was compelled to buy some roll tobacco to smell and to chew, it may be concluded that this substance was at that time regarded as somewhat of a safeguard against the disease.

Large carts called nightly at the infected habitations and collecting the bodies of any dead conveyed them to pits, into which they were flung, covered with quicklime. This rude kind of burial became a necessity as the disease gained ground, because the ordinary grave-yards were full to overflowing. "This is the first time," writes Pepys, "since I have been in the church since I left London for the plague, and it frightened me indeed to go through the church more than I thought it could have done, to see so many graves lie so high upon the churchyards where people have been buried of the plague."

Such was the fury of the pestilence, and frequently so sudden were its attacks, that wayfarers were often a.s.sailed with it in the streets, and staggering like drunken men fell down into the road or pathways insensible or dead. Merchants in their counting-houses, clergymen in the act of reading the burial service, buyers and sellers in the market-place, were similarly a.s.sailed by the malignant malady, and it was no uncommon occurrence for the mourner at the grave of a relative or friend one day, to be himself borne to his own tomb the next. It is not improbable the infection may have been conveyed by the rapidly decaying and putrid corpse to large numbers of people, owing to the custom that prevailed of crowds of mourners attending the obsequies.

Pepys records how he saw in broad daylight two or three burials, one at the very heels of another, each followed by forty or fifty people.

Furthermore, he states that one day on his way to Greenwich, during the month of August in 1665, he pa.s.sed a coffin, "with a dead body therein, dead of the plague, lying in an open close belonging to Coombe Farm."

If this exposure of plague-stricken corpses were at all general, it will readily be perceived how greatly it must have aided the propagation of the pestilence.

Another important agent in the diffusion of the plague must have been the infected clothing, whether of the dead or of those who had been in near or close contiguity to them. On this part of our subject Dr Guy, remarks:--"Nor will this surprise us if we imagine the frantic and successful efforts that must have been made by the non-infected to escape, and the temptation to servants and nurses to appropriate and remove the property of the dying and the dead. Indeed, Dr Hodges accuses the nurses of strangling their patients, and secretly conveying the pestilential taint from sores of the infected to those who were well; and he justifies his accusations 'of these abandoned miscreants'--the Gamps and Prigs of the seventeenth century--by two instances; the one, of a nurse who, 'as she was leaving the house of a family, all dead, loaded with her robberies, fell down dead under her burden in the streets,' the other, of a worthy citizen who, being considered dying by his nurse, was beforehand stripped by her, but recovering again, he came a second time into the world naked."

Lastly, in endeavouring to account for the great prevalence and excessively fatal character of this pestilence, we must not leave out of consideration one important factor--viz. fear.

We can easily conceive how powerfully the appalling incidents by which the plague was accompanied must have affected the imaginations of those who were in its midst, and thus have stimulated the fear, which, acting by its depressing mental effect, would predispose and prepare men and women for the reception of the contagion.

In 'Pepys' Diary' we find a circ.u.mstance recorded corroborative of this. A certain alderman, stumbling at night over a dead body in the street, when he reaches home tells his wife of his adventure, and she is forthwith seized with the plague and dies of it. Furthermore, the belief derived from knowledge of the deadly character of the disease, operating upon the minds of those who were attacked by it, would greatly diminish the chances of their recovery, since they would most likely regard seizure and death as synonymous.

There is an old Eastern fable which tells of a traveller journeying from an infected city, and overtaking the plague, who had not long left it. The traveller accosts the plague and reproaches him for having slain thirty thousand people in the city. "You are in error there," replied the plague, "I slew only ten thousand, fear slew the rest."

Tropical climates are never visited by plague. In those countries which suffer from its ravages it prevails most during the hot months of the year, and its virulence and spread appear to be commensurate with increase of temperature. In northern climates it diminishes with the approach of cold weather. In Europe it has always been most fatal during the summer and autumn, and in the great plague of London the greatest mortality prevailed during the months of August and September.

=PLAICE.= The _Platessa vulgaris_, a well-known flat fish, common to both the English and Dutch coasts. Its flesh is good, and easy of digestion, but more watery than that of the flounder.

=PLANTAIN.= The plantain, which belongs to the nat. ord. Musaceae, and is a native of the East Indies, is cultivated in all tropical and subtropical regions of the world, in many of which it const.i.tutes the princ.i.p.al food of the inhabitants. There are a great many varieties of the plantain, in some of which the stem is 15 or 20 feet high, whilst in others it does not exceed 6 feet. It is one of the largest of the herbaceous plants.

The fruit is sometimes eaten raw, but is more generally boiled or roasted.

It contains both starch and sugar. Boiled and beaten in a mortar, it forms the common food of the negroes in the West Indies. It also const.i.tutes the chief food of the Indians of North and South America.

Humboldt has calculated that the food produce of the plantain is 44 times greater than that of the potato and 133 times that of wheat.

The banana is a species of plantain. See BANANA.

=PLASMA.= The liquor sanguinis. A tenacious plastic liquid, forming the coagulating portion of the blood, and that in which the corpuscles float.

=PLAS'TER.= (In boiling, &c.) See MORTAR.