Loimologia: Or, an Historical Account of the Plague in London in 1665 Part 3

THIS a.s.sertion might be supported by a Mult.i.tude of Instances, if it were not for taking up too much of the Reader's Time; for which Reason we shall only take Notice, that amongst all those Distempers which are thus inclined to join their Forces with this most powerful Enemy, some seem to have a more particular Fitness for such a Union, from a common Affinity in the Nature of their Infection, and the Energy of their Poison.

ONE of the First of this Cla.s.s is the venereal Disease, with which the pestilential Venom does in a very familiar Manner unite it self. At the first breaking out indeed of the last Sickness it was given out by common Fame, that those who were previously infected with any foul Distemper, as the Pox in particular, would be secured thereby against the pestilential Taint; but wicked and impious was the Consequence of such a Suggestion; for many were hereby encouraged to seek the most lascivious and filthy Prost.i.tutions, on purpose to be secur'd by one previous Infection against another: But besides the poisonous Quality peculiar to this nasty Disease, besides that Expence of Spirit in the procuring it, and besides a lost Force of the Const.i.tution thereby, the greatest Aggravation to this Misfortune was, that the very Taint which was to defend against another, had it in its Nature to be more forcibly attracted by it; so that the rash Adventurer was soon brought to a bitter Repentance for his Experiment, by sinking immediately under the pestilential Contagion at its first Stroke; and it was common to find, by a very easy Transition, the venereal Buboes changed into pestilential Carbuncles, except in a few Instances where Nature found out an uncommon Artifice against these united Powers, by endeavouring an Ejectment of their joint Malignities by Salivation, whereby sometimes the Patient was brought into some Chance for his Life, both the Poisons being in a great Measure cast off together that way.

BUT here it may not be improper to admonish the young Physicians not to be too forward Imitators of Nature in such a Circ.u.mstance; unless they will run the same Hazard with a certain Empirick, who crouded his Powders upon the Sick that raised an untimely spitting, and brought a great many into a dangerous Condition, which by a regular Practice might have been, tho'

with Difficulty, saved.

Yet to set this whole Affair in a clear Light, there is great Reason to suspect that in many Cases Mercury had for some time remained in the Body, which, like a Snake in the Gra.s.s, being raised by the Pestilential Infection, flew up into a Salivation; for the febrile Heat, a.s.sisted with Medicines also of an hot Nature, throw up the Mercury, which had long lain quiet, like a Sublimation; which should be a Caution, not only to young Physicians, but those of more standing in Practice, not to be so buisy with mercurial Medicines, to Children as well as grown Persons, as they are too much apt to be; least besides the Inconveniencies already mentioned they cause malignant Ulcers, and Rotenness upon the Bones, as it is too commonly observed to be done in irregular Practice, to the irreparable Detriment of the Patients.

I am not however ignorant that sometimes the Pestilential Venom may tumifie the salival Glands without any other a.s.sistance, and occasion Ulcers in the Mouth as with Mercury; for it is a common Case in many malignant Fevers.

BUT it is so clear a Matter that the Pestilential and venereal Poysons may intimately join together by their Affinity with one another, to the great Detriment of Mankind, as to want no further Proofs to confirm it; nor does their Opinion at all obviate ours, who place the venereal Poyson in Humidity, and that of a Pestilence in Dryness, as long as the Symptoms and Affections of both discover one common Principle, that is, somewhat saline; but yet if this should not be granted, they are naturally enough joined together by their known Malignity and Destruction to human Nature.

BUT the Affinity between a Pestilence and a Scurvy is not a slight, and a supposit.i.tious Conjecture, but strengthened and confirmed by a plain Union between them, whereby they attack like confederate Troops; and both confess the same Origin, _viz._ a saline Principle; as is most remarkably obvious in their eager Coalition, whether we consider the forementioned Transplantation of the like Plague from _Turky_ to _Holland_, where their Alliance was first formed; Or whether we reflect upon them both as Distempers equally epidemical, which when joined make such cruel Havock among the human Species; as neighbouring Flames catch together from a like Affinity of Parts, and burn with united Fury.

FOR although there is a great Difference in Salts of different Kinds, yet there is a common Property amongst them all, that when joined together they cannot hardly by any Means possibly be afterwards separated, for which Reason when these two Enemies of Mankind were joined, the complicated Evil was at first customarily distinguished by the _outlandish Scurvy_, which by a confederate Power had increased its Malignity to so great a Degree. But to give some apparent Facts, which irrefragably prove the natural Union between these two Origins of Mischief, it may be proper to recite some Symptoms common to them both, and first of all those Spots which were their certain Characteristicks.

THE Spots of those in the Plague were sometimes so numerous, as to cover all the Body, of which we shall say more hereafter; and if we consider the Appearances and Conditions of the Spots in both, we shall find a very great Agreement; the pestilential Spots sometimes break out broad, at other Times more contracted, just in the same Manner as it happens in a Scurvy; and as to their Duration, sometimes they are longer out than at others in both; now also suddenly appear, and then again as suddenly turn in, and sometimes remain out for two or three Days together; and their Likeness in all Respects is frequently so great, that amongst the ignorant Nurses and Empiricks, sometimes the fatal Tokens of a Pestilence have been mistaken only for Scurvy Spots: As to their Colour in a Plague, as well as in a Scurvy, they are sometimes florid, resembling fresh Flea-Bites, and at others dusky and livid; and I met with them in a certain Youth resembling Violet Flowers painted all over the Body; and in some I have seen them almost quite black, which are with great Difficulty to be distinguished from the true pestilential Tokens.

THERE are other Symptoms also that denote the Agreement herein, such as large Stools, of a saline and fetid Nature, and which are with great Difficulty restrained by the most powerful Medicines; but if such a Flux continues, it threatens irretrievable Injuries, as Corrosion, Inflammation, and sometimes even Sphacelation of the Bowels, with intolerable Gripings, and sometimes Loss of Blood: Furthermore, the Agreement that there is between the Ulcers and Tumours of both evidently demonstrate the Affinity of both their Origins, as will hereafter more fully appear in that Part about the Cure.

THE Pestilence likewise shews its Affinity with the Scurvy, by leaving behind it a s...o...b..tick Habit, even where a Person was not given to it in the least before; and it is not indeed at all strange, that after such Disorders, and Corruption of the animal Juices, and such an Exhalation or Suffocation of subtile and spirituous Particles, an Habit should be confirmed, that can be removed but by the most generous Remedies, and the most powerful Antis...o...b..ticks.

IT remains now briefly to enquire, whether a Pestilence coming upon another Disease, in any Instances proves of Service; and this I shall dispatch in two Histories of Cases, one in a Consumption, and the other in the _King's-Evil_.

A Girl of fifteen Years of Age was so emaciated, that she had left little besides Skin and Bones, and taking no Nourishment for 14 Days together, she was given over as gone, but being called to the same House, to see her Mother, and two others who had the Infection, and recovered, the same Distemper seized that Creature almost half-dead before, whom also I then attended; but she who just before lay as expiring, seemed animated by the feverish Heat, began to move her Limbs, and with the Help of Alexipharmick Medicines, although before speechless, began to complain of painful Swellings about her; but those Buboes, which I suppose would otherwise have broke out, for Want of Matter to raise them, were dissipated by Transpiration; so that she recovered, and in about two Weeks also manifestly lost her former Distemper, and gathered Flesh and Strength.

ANOTHER Maid of about 16 Years of Age had been so scrophulous from her Childhood, as to have many indurated Glands remain after all possible Means had been used to dissipate them. She at last was seized with the Contagion, and pestilential Buboes rose upon the strumous Glands, which suppurated, and let out a great Quant.i.ty of Filth; and upon her Recovery from thence, her former Distemper was quite lost.

SOME gouty Persons likewise, and others accustomed to very obstinate Complaints, were, by a lucky Conjunction with this Infection, quite restored: and indeed most who were rightly managed in the Plague, and perfectly recovered of it, were afterwards, in many Respects, better in their Health than before; so that this terrible Enemy, as it was commonly fatal, so it also sometimes proved a Remedy. And thus much for the Complication of the Pestilence with other Distempers. We shall now proceed to its Symptoms.

SECTION V.

_Of the manifest Signs of the late Pestilence._

IT is altogether foreign to my Design here, to enumerate all the Appearances that belong to a pestilential Const.i.tution, because a great deal may be ascribed to Phantasie and Conjecture, as the Influence of Comets, and the Conjunctions of Planets, with others of like Nature: For what strange Notions have been broached concerning this Contagion, which was imported to us from Abroad? Are the Tails of Comets always armed with pestilential Arrows? Or is the Air the more impure and unhealthful? Had we any Famine before the last Sickness? Or had we portentious Swarms of Insects like Clouds over us? No, just the contrary, as we before observed; all Things from Nature were promising and serene, and this Destroyer invaded us on a sudden from strange Countries; it is therefore of more Advantage to our Design here, to take all its concomitant Signs from its manifest Effects.

AND indeed there are not many peculiar to a pestilential Fever, as that is chiefly a Collection, or an Epitome of all other Fevers together, which in such a Confederacy are not therefore without a tedious Work to be enumerated in all their Affections; I shall therefore satisfie my self with describing such only which are most obvious to common Observation, and are met with in most infected Persons: And these for Method Sake I shall distribute into two Cla.s.ses.

_FIRST_, The manifest Signs of Infection.

_SECONDLY_, The Appearances after Infection.

BUT hereunto I think it necessary to premise, that a Pestilence puts on sometimes one, and at others another Appearance, and sometimes even contrary ones, according to the Const.i.tution or Age of the Patient, the Season of the Year, present or preceding Distempers, a faulty Way of Living, and the different Means of Communication, both with Respect to Virulence and Degree.

THE Symptoms of the first Cla.s.s are Horror, Vomiting, Delirium, Dizziness, Head-ach, and Stupefaction.

OF the second, a Fever, Watching, Palpitation of the Heart, Bleeding at Nose, and a great Heat about the _Precordia_.

THE Signs more peculiar to a Pestilence, are those Pustules which the common People call _Blains_, Buboes, Carbuncles, Spots, and those Marks called _Tokens_; of all which distinctly.

I do not know indeed throughout the whole Compa.s.s of Nature, (as before it hath been frequently hinted) any Thing so subtile as the pestilential Poison, and what will penetrate the Body with so much Swiftness and Secrecy, insomuch that it is not perceived sometimes till long after its Entrance; what therefore is commonly said of its sensible Attack, and that the infected feel its first Insult as from a sudden Blow, is more the Effect of a deluded Imagination and Conjecture, than any solid Judgment; as the Populace are apt enough to frame strange Conceits out of their own Heads, and what hath long obtained amongst them is very difficult to erace.

WHEN therefore such a kind of People hath received the Notion, as was common in the late Sickness, concerning the forementioned Manner of Infection, it is no great Wonder that others likewise in general go into the Error, and take it for granted that this unmerciful Destroyer makes its Seizure in this violent Way, and therefrom wait for it as for a hidden Stroke.

ALTHOUGH I am not insensible, that some may have thus perceived its first Impression, upon taking in ungrateful and filthy Smells; for the pestilential _Seminium_, (as before observed) when it incorporates with other Bodies that are gross, fat, and viscid, may strike the Organs of Sensation very manifestly at its first Entrance.

AFTER the pestilential _Miasmata_ have thus seized a Person, and the Spirits are overcome, the whole Ma.s.s of Blood, and other animal Juices, partake of the Disorder; from whence proceed Struggles not to be born, and a Train of Symptoms, of which quaking or shuddering is the chief, all of a sudden, without any manifest Cause.

THIS Symptome owes its Origin to the Conflict of Nature with the infused Malignity, whose Efforts of Resistance excite a Sense of Cold from the pestilential _Seminium_; after the same Manner as Nitre put upon the Tongue excites the same Sensation; it is also to be suspected that this Rigor may be owing to a Quality in the poysonous _Effluvia_ of extinguis.h.i.+ng the native Heat: And the Spasmod.i.c.k Affections of the Nerves proceed from salt, sharp, malignant, and heterogeneous Particles rus.h.i.+ng into the sensible Fibres, and vellicating them into involuntary Motions and Twitchings.

THE greatest Part indeed of the Infected perceived this Horror, but some of them more vehemently than others; but of the immediate Impression upon the Spirit there is no Room to doubt, nor of a consequent Degeneration of the whole Ma.s.s of Blood; although I am sensible that the Subtilty of the pestilential Taint took Place sooner or later, according to the different Degrees of Strength and Texture in the Body to resist it.

IT is certain that the fine and exquisite Contexture of the nervous System, and the Agreement and Consent of one Part with another, as well as the extraordinary Perfection of the Animal Spirits, set as Guards over such sensible Parts, could not but be affected with the Apprehensions of Mischief, and shake and tremble, and use their Efforts to throw off the Danger; and indeed I take it further to be probable, that the pestilential Poison might be shook by such Means out of the Nerves into the Muscles, and there cause Tention, Trembling, Vellication, Yawning, Stretching, and all those other Concomitants of putrid and malignant Fevers.

THE Duration also of this Shuddering was as uncertain as its Degree, for it went off sometimes sooner, and at others later; sometimes in half an Hour, and at others, not till four or five Hours; which Difference I conjecture owing to the Quant.i.ty and Intenseness of the Malignity, as to the greater or lesser Struggles of Nature to resist it.

AS soon as this Horror could be said to terminate, for the most commonly a Nauseousness and Reaching succeeded, from whence there was such an excessive Loathing of Food, that even the Mention of it was irksome; a certain and infallible Sign of Seizure.

BESIDES the Nauseousness and Loathing, some were followed by grievous Vomitings, occasioned by the poisonous Quality of the Pestilence irritating and subverting the Stomach; for that, by Means of its nervous Coats, being endowed with an exquisite Sense, endeavours to throw off any Thing offensive and corrosive with the utmost Efforts, and prevent the saline, pestilential Venom, if possible, from taking Place; insomuch that nothing is more certain, than that the Stomach, by this fine Contrivance of Nature, is ready also to throw off any other Thing disagreeable to it, as well as the Poison we are here speaking of.

SOME endure hereby such a vehement and continued Irritation, that cannot be a.s.swaged by any Remedies, how often soever repeated, and sometimes the Reaching continues after the Strength of the Patient is too far spent to throw any Thing up, whereby the Symptoms aggravate, and the pestilential Venom takes deeper Root in the Const.i.tution.

AFTER the princ.i.p.al Load of Humours at the Stomach are thrown up, a very frothy Bile, fermenting like Yest, follows, that in its Colour is greenish, and sometimes so fetid, that a Person cannot endure the Room without holding his Nose, such is the prodigious Putrefaction and Malignity in some of these Cases.

BUT where the Use of Medicines, otherwise effectual to stop the most obstinate Vomiting, proves ineffectual, and there follows a great Thirst and Heat, it gives strong Suspicion of Carbuncles in the Stomach, and immediate Death, so that the infected as it were vomit up their Souls, which (if we believe _Helmont_) have their Residence there; but this will be further spoke of in the Prognosticks.

BUT before I proceed any further, the Health of my Country, and the Concern of Posterity, oblige me to take Notice of the pernicious Practice of Empiricks of all Orders, with whom it was a Custom to give Emeticks; for certainly many were destroyed by this Practice, the convulsive Reachings to vomit being carried beyond a Possibility to bear it. And truly the best Deliberation and Thought I was able to take in such Exigencies, where I happened to be called, was but of little Effect, and after Administration of the best Medicines that the Rules of Physick could invent, Things generally grew worse; which made it appear as impossible to rectifie a rash and fatal Error in the Conduct of a violent Disease, as in the Management of a military Engagement; but of this we shall have Occasion to say more hereafter.

YET to satisfie any inquisitive Person how this primary Affection of the Stomach does arise, and through what Pa.s.sages the pestilential Poison makes its Entrance, it is to be observed, that nothing is more plain than that the pestilential _Miasmata_ not only enter at the larger Pa.s.sages, but also through the Pores of the Skin, even to the whole nervous System, from whence they are communicated to all other Parts; for this is peculiar to the Nerves, that they not only convey the first Impression to the Stomach by its general Consent with all Parts, but also when that is after any Manner whatsoever affected, they communicate it to the whole Frame, as in the taking a Vomit.

SOMETIMES the pestilential _Aura_ is mixed with the Food, and swallowed therewith, which after some Delay in the Stomach being digested and dissolved, lets out the imprisoned Venom to vellicate the Fibres into Reachings and convulsive Motions: And to put this altogether out of Dispute, I have often observed Persons immediately to fall sick from a State of perfect Health after eating, and to throw up their Food, in other Respects good and wholsome, as somewhat corrupted and poisonous.

VOMITING also may be promoted by Scents, as well those which are fetid, as such as are contrary, by some particular Antipathy to the Nature and Const.i.tution of the Patient; and this I conjecture happens from the Harmony and Consent of the Organs of Smelling with the Coats of the Stomach, insomuch that the Stomach immediately perceives any Thing that ungratefully strikes the Nose, and rises up against it. In the mean Time I would however transiently make this one Remark, that as in many Cases the Administration of Emeticks was pernicious, whether or no Evacuation of the first Putrefaction at Stomach, might not be much better encouraged upwards by Scents; as, on the contrary, the Reachings at Stomach are sometimes allayed by like Means, as by the Smell of Vinegar, _&c._ I do confess, that this is a Practice I cannot attest the Success of by Experience, yet it is not unworthy a rational Physician to attempt it.

ALL the Sick likewise quickly after Seizure grew delirious, running wildly about the Streets, if they were not confined by Force; when some tired with Rambling, on Increase of the Distemper, would fall down, ignorant of their Condition, or where they were; and lastly, to repeat what hath been already remarked, that sad Calamity seemed to have complicated in its Production every Thing of a poisonous and a destroying Nature.

MANY were seized with a _Vertigo_, which, without any Motion of external Objects, made them believe their Heads to turn round: Without doubt the Brain grievously suffered from the pestilential Taint, not only because the Spirits used to be clouded, but that all Things were done as if in Sleep, which might arise from the inflammatory, caustick, and narcotick Nature of the Venom, and the Texture and Consent of the Vessels with the various Dispositions of the Fluids. This vertiginous Disposition also in my Opinion might sometimes arise from the inordinate and anomolous Motions of the Spirits.

A great many likewise much complained of the Head-ach, which was so vehement, as if the Parts would have flown asunder; a Complaint the most intolerable of all, because it continued without any Remission or Intervals; the Enemy never retreating of it self, and only to be vanquished by the Efforts of the Const.i.tution, and apposite Medicines.

Indeed nothing was more plain, than that the _Meninges_ were stimulated by the saline _Spicula_ of the Contagion; and from the Inflammation of the Brain, and its Sphacelation in those who died, there is a strong Suspicion that this cruel, shooting Pain continued to the last.

IN this Cla.s.s of Symptoms, Stupefaction is also to be ranked; because from the Moment of Seizure many were taken with a _Coma_, and slept as if they were dozed with an Opiate; many in the middle of their Employ, with their Friends in Conversation, or other Engagements, (as was before taken notice of) would suddenly, without any Reluctance, fall into profound, and often deadly Sleeps.

BUT by what Means this Venom does exert its narcotick Qualities, is not with me so ready to be accounted for; that is to say, whether it be from its original _Seminium_? Or from Its affinity and Complication with the Scurvy? Or from its predominant Malignity, and Antipathy? Or from an Obstruction of Circulation, or Coagulation, or Extravasation of Blood? Or lastly, from some particular Impression made upon the Origin of the Nerves? For this is a Difficulty reserved for another _Hippocrates_. In the mean while it is by all confessed, that by such Stupefaction or Sleeping, the pestilential Venom becomes not only more deeply rooted, but also more cruelly affects the nervous System, and greatly weakens it.