(see Medicine Index, Encycl.), is a disease which has been lately affected by Dr Moseley to be not contagious. In support of this opinion, he quotes many passages from medical writers, ancient and modern; but he seems to place the greatest confidence (as is indeed natural) in his own observations on pestilential fevers in the West Indies, and on what is said of the plague in Berthier's account of Buonaparte's expedition into Syria.
"At the time of our entry into Syria (says this Frenchman), all the towns were infected by the plague; a malady which ignorance and barbarity render so fatal in the East. Those who are affected by it give themselves up for dead; they are immediately abandoned by every body (A), and are left to die, when they might have been saved by medicine and attention.
"Citizen Degenettes, principal physician to the army, displayed a courage and character which entitle him to the national gratitude. When our soldiers were attacked by the least fever, it was supposed that they had caught the plague, and these maladies were confounded. The fever hospitals were abandoned by the officers of health and their attendants. Citizen Degenettes repaired in person to the hospitals, visited all the patients, felt the glandular swellings, dressed them, declared and maintained that the distemper was not the plague, but a malignant fever with glandular swellings, which might easily be cured by attention, and keeping the patient's mind easy."
Degenette's views in making this distinction were highly commendable; but certainly, says Dr Moseley, this fever was the plague. The physician, however, carried his courage so far, as to make two incisions, and to inoculate the suppurred matter from one of these buboes above his breast and under his arm-pits, but was not affected with the malady. He thus eased the minds of the soldiers, the first step to a cure; and, by his assiduity and constant attendance in the hospitals, a number of men attacked with the plague were cured. His example was followed by other officers of health.
The lives of a number of men Citizen Degenettes was
(A) This can hardly be true. Every one knows that Mahometans are fatalists in the strictest sense of the word; and Mr Browne, whose knowledge of Syria and its inhabitants must be at least equal to that of Berthier, assures us, that, far from abandoning his friend in the plague, "the Moslem, awe-struck, and resigned to the unalterable decrees of fate, hangs over the couch of his expiring relative." was thus instrumental of saving. He dismissed those who had been ill with the fever and buboes, without the least contagion being communicated to the army.
"There are (says Dr Mofeley) annual or seasonal disorders, more or less severe, in all countries; but the plague, and other great depopulating epidemics, do not always obey the seasons of the year. Like comets, their course is eccentric. They have their revolutions; but from whence they come, or whether they go after they have made their revolutions, no mortal can tell.
"To look for the cause of an epidemic in the present state of the air, or weather, when it makes its appearance, is a very narrow contracted method of scrutiny. The cause of pestilential epidemics cannot be contained, and local. It must lie in the atmosphere, which surrounds, and is in contact with every part of us; and in which we are immersed, as bodies in fluids.
"These diseases not appearing in villages and thinly inhabited places, and generally attacking only great towns and cities, may be, that the atmosphere, which I conceive to be the universal propagator of pestilence, wants a composition, or union, with some compound and peculiar air, such as is generated in populous communities, to release its imprisoned virulence, and give it force. Like the divided seminal principles of many plants, concealed in winds and rains until they find suitable materials and soil to unite their separated atoms, they then assume visible forms in their own proper vegetation.
"Diseases originating in the atmosphere seize some, and pass by others; and act exclusively on bodies graduated to receive their impressions; otherwise whole nations would be destroyed. In some constitutions of the body the access is easy, in some difficult, and in others impossible.
"The air of confined places may be so vitiated as to be unfit for the purposes of the healthy existence of any person. Hence gaol, hospital, and ship fevers. But as these dispensers are the offspring of a local cause, that local cause, and not the disordered people, communicate the disease.
"Pestilences and plagues, the produce of the great atmosphere, are conveyed in the same manner, by the body being in contact with the cause; and not by its being in contact with the effect. If pestilences were propagated by contagion, from infected persons, the infection must issue from their breath or excretions, or from the exhalations of the bodies of the diseased. The infection, if it were not in the atmosphere, would be confined within very narrow limits; have a determinate sphere of action; and none but physicians and attendants on the sick would suffer; and these must suffer; and the cause and the effects would be palpable to our senses. Upon this ground the precaution of quarantine would be rational. But who then would visit and attend the sick, or could live in hospitals, prisons, and lazarettos?"
From these reasonings and facts, the author is convinced, that the bubo and carbuncle, of which we hear so much in Turkey, and read so much in our own history of plagues, arise from heating food and improper treatment; that they contain no infection; and consequently that they are not the natural deposit of the morbid virus separated from the contagion.
He is equally confident that no pestilential or pandemic fever was ever imported or exported; and hence he considers the fumigating of ship-letters, and shutting up the crews and passengers of vessels, on their arrival from foreign places, several weeks, for fear they should give diseases to others which they have not themselves, as an ignorant barbarous custom. Whence was the importation of the plague at Naples in 1656; by which 20,000 people died in one day? Can any person, for a moment reflecting, believe, that the great plague of London in 1665, which imagination traced from the Levant to Holland, and from Holland to England, was caused by opening a bag of cotton in the city, or in Long Acre; or a package of hemp in St Giles's parish? Quarantine, always expensive to commerce, and often ruinous to individuals, is a reflection on the good sense of countries.
That Dr Mofeley is a man of learning, and a lively writer, is known to every one who has looked into his works, and is not himself a stranger to letters. On this account, and still more on account of the opportunities which he has possessed of making accurate observations on various kinds of pestilential diseases, we have detailed at some length his notions of the plague; but as it does not appear that he ever saw the disease which is known by the name of the plague, justice requires that we give some account of it from a man who had the best possible opportunities of obtaining correct information on the subject.
"The facts that appear to be chiefly ascertained relative to the plague (says Mr Browne), are, 1. That the infection is not received but by actual contact. In this particular, it would seem less formidable than several other disorders. 2. That it is communicated by certain substances, by others not; as by a woollen cloth, or rope of hemp, but not by a piece of ivory, wood, or a rope made of the date tree; nor by anything that has been completely immersed in water. It would appear from the report of the Kairinos, that no animal but man is affected with this disorder; though, it is said, a cat passing from an infected house has carried the contagion. 3. That persons have often remained together in the same house, and entirely under the same family circumstances, of whom one has been attacked and died, and the others never felt the smallest inconvenience. 4. That a person may be affected any number of times. 5. That it is more fatal to the young than the old. 6. That no climate appears to be exempt from it; yet, 7. That the extremes of heat and cold both appear to be adverse to it. In Constantinople it is often, but far from being always, terminated by the cold of winter, and in Cairo by the heat of summer; both circumstances being, as may be conjectured, the effect of indisposition for absorption in the skin, unless it be supposed that in the latter case it may be attributed to the change the air undergoes from the incrust of the Nile.
"The first symptoms are said to be thirst; 2. cephalalgia; 3. a stiff and uneasy sensation, with redness and tumor about the eyes; 4. watering of the eyes; 5. White pustules on the tongue. The more advanced symptoms of buboes, fetor of the breath, &c., &c., are well known; and I have nothing authentic to add to them. Not uncommonly, all these have successively flown themselves, yet the patient has recovered; in which case, where suppuration has had place, the skin always remains discoloured, commonly of a purple hue. Many who have been bled in an early stage of the disorder, disorder, have recovered without any fatal symptoms; but whether from that or any other cause, does not appear certain (a). The same operation is reported to have been commonly fatal in a late stage. It is said that embrocating the buboes continually with oil has sometimes wrought a cure; but this remedy is so difficult and dangerous for the operator, that it would appear experiments must yet be very defective."
They are not, perhaps, so defective as Mr Browne supposes. In the hospital of St Anthony at Smyrna, it has been the practice for many years past to rub over with warm olive oil the bodies of persons infected by the plague; and that practice has been attended with wonderful success. It was first suggested by Mr Baldwin the English consul; and from him adopted by P. Luigi di Pavia, who for upwards of 27 years has exposed himself to infection by his unremitting attendance on those who are labouring under this dreadful distemper. This excellent man, whose philanthropy equals that even of "Marcellus' good bishop," declares, that during the long period mentioned, he has found no remedy comparable to that of rubbing olive oil, with the strongest friction, into the whole body of the infected person. When the body is thus rubbed, the pores being opened, imbibe the oil, and a profuse perspiration takes place, by which the poisonous infection is again thrown out. This operation must be performed the first day of the infection; and if only a weak perspiration ensues, it must be repeated till it is observed that every particle of infection is removed, and that the whole body of the patient is covered with a profuse sweat. Neither the patient's shirt nor bed-clothes must be changed till the perspiration has entirely ceased. The operation must be performed in a very close apartment; and at every season of the year there must be kept in a fire-pan, over which sugar and juniper must be thrown from time to time, that the vapour which thence arises may promote the perspiration. The whole body of the patient, the eyes alone excepted, must in this manner be anointed, or rather rubbed over with the greatest care.
This practice of the pious monk is mentioned by Mr Howard in his work on Lazaretos; but a more satisfactory account of it is given by Count Leopold von Berchtold, who adds the following remarks by way of illustration: 1. The operation of rubbing in the oil must be performed by means of a sponge, and so speedily as not to last more than about three minutes. 2. The interval between the first and the second rubbing, if a second be necessary, must be determined by circumstances, as the second must not be performed till the first perspiration is over, and this will depend on the constitution of the patient. If any sweat remains upon the skin, it must be wiped off with a warm cloth before the second rubbing takes place. This strong friction with oil may be continued, for several days successively, until a favourable change is remarked in the disease; after which the rubbing may be performed in a more gentle manner. The quantity of oil requisite each time cannot be determined with accuracy; but, in general, a pound may be sufficient. The purest and freest oil is the best for this operation: it must not be hot, but only lukewarm. The breast and privities must be rubbed softly. In a cold climate such as ours, those parts only into which the oil is rubbed must be exposed naked. The other parts must be covered with warm clothing. In this manner each part of the body must be rubbed with oil in succession, as quickly as possible, and be then instantly covered. If the patient has boils or buboes, they must be rubbed over gently with the oil till they can be brought to suppurate by means of emollient plasters. The persons who attend the patients to rub in the oil must take the precaution to rub themselves over in the like manner, before they engage in the operation. They must, if possible, avoid the breath of the patient, and not be under any apprehensions of catching the infection.
P. Luigi then says: "In order to prevent the patients from losing their strength, I prescribed for them, during four or five days, soup made of vermicelli boiled in vinegar without salt. I gave them six or seven times a day a small spoonful of preserved four cherries; preserved not with honey, but with sugar, as the former might have occasioned a diarrhoea. When convinced that the patients were getting better, I usually gave them the fifth morning a cup of good Mocha coffee, with a piece of toasted biscuit (biscotto) prepared with sugar; and I doubled the latter according to the strength and improvement of my patients."
In the course of five years, during which friction with oil was employed in the hospital at Smyrna, of 250 persons attacked by the plague the greater part were
(a) Dr Moseley, we think, has assigned a very sufficient reason why bleeding should generally prove effectual, if recourse be had to it at the commencement of the disease. "In the common order of pestilential fevers (says he), they commence with coldness and shivering; simply demonstrating, that something unusual has been in contact with the skin, agonizing cutaneous sensibility. Sickness at the stomach, and an immovable pressure about the precordialia, follow. These demonstrate, that the blood cannot pervade the extremities of the body, and that the quantity which ought to dilate through the whole machine is confined to the larger organs, and is crowding and distending the heart and central vessels.
"The restraining power of the remoter blood-vessels being destroyed, the thinner parts of the blood escape their boundaries; hence arises yellowness in the skin in some climates; in others, the extravasated groser parts of the blood stagnate, forming black lodgements, bubo, anthrax, and exanthemata.
"The object in these fevers is, to decide the contest between the solids and the fluids; and this appears to me to be only practicable, when spontaneous sweats do not happily appear, or cannot be raised by a cooling regimen; and by draining the vital parts, by bleeding and purging, before the fluids have burst their confines, and dissolved their bond of union with the solids. The next step is to regain the lost energy of the surface of the body, by exciting perspiration; and then of the whole system, by tonics.
"When these things are not done in the first hours of attack, in pestilential fevers, and the conflict is not extinguished at once, attempting to extort sweats from the body, by heating alexapharmics, will do mischief; and bark, wine, stimulants, and cordials, may be called on, like undertakers, to perform an useless ceremony." were cured; and this would have been the case with the rest had they not neglected the operation, or had it not been employed too late after their nervous system had been weakened by the disease so as to render them incapable. Immense numbers of people have been preserved from the effects of this malady by the above means; and of all those who have mounted themselves with oil, and rubbed it well into their bodies, not one has been attacked by the plague, even though they approached persons already infected, provided they abstained from heavy and indigestible food.
Thus we see, if this account may be depended on, that oil rubbed into the skin acts as a preventative, as well as a cure. When the operation is performed to prevent infection, and it is successfully performed with that view at Smyrna, as often as the plague makes its appearance in the city, as it is not done for the purpose of promoting perspiration, it is not requisite that it should be performed with the same speed as when for curing the disorder; nor is it necessary to abstain from flesh and to use soups; but it will be proper to use only fowls or veal for ten or twelve days, boiled or roasted, without any addition or seasoning (condiments). In the last place, it will be necessary to guard against fat and indigestible food, and such liquors as might put in motion or inflame the maws of the blood.
This important discovery deserves the serious consideration of all medical men; for if olive oil has been found efficacious in curing or preserving against one species of infection, it is not absurd to suppose that the same or other kinds of oil might be productive of much benefit in other malignant infectious diseases. We hope soon to hear of some trial being made with it in this country. Would it be of any service in the yellow fever, so prevalent in the western world? See the Philosophical Magazine, Vol. II.