240 PHILOSOPHICAL TRANSACTIONS. [anNO 1751. 



danger. Some are delirious, and raving ; others to a great degree stupid and 

 dull; both these are fatal appearances. Some die in 5 or 6 days; some outlive 

 20 days, and then die: some walk the streets for many days, and afterwards die. 

 Bleeding at the nose is reckoned a salutary sign. A swelling in the throat is a 

 common symptom: for which if you bleed, it proves almost always fatal: for it 

 is so far from abating this symptom, that after it a greater difficulty of breathing 

 ensues, and the patient seldom survives it above 3 or 4 hours. 



The medical writers are divided as to the expediency of bleeding in the plague, 

 some contending for it warmly, others as warmly condemning it. The Doctor 

 distinguishes between the different stages of the distemper, and says, that as in 

 the beginning, during the ebullition, bleeding may be of some service, so when 

 the disease is advanced, and especially after the eruptions, it will prove fatal, as 

 well as purging, or any other violent evacuation. A moderate diaphoresis ought 

 always to be kept up. To the buboes, parotides, &c. they commonly apply a 

 roasted fig with some white sugar powdered : and this they reckon the best sup- 

 purative. They do not open the tumours, but leave them to break of them- 

 selves. They give the sick cold water to drink, and order the cool regimen quite 

 through the distemper. 



Abstract of Dr. Mackenzie's first Letter concerning the late Plague at Constan- 

 tinople. Dated Constantinople, July 13, 1751. 

 " We have at present the most violent plague, that has been at Constantinople 

 in my time, by all reports. They are all taken the same way, with a shivering 

 and vomiting, a violent head-ach, thirst and fever, of which they die the 3d or 

 4th day, rather in a stupor than a delirium ; and such as have the misfortune to 

 te near the infected person, are taken in 7 or 8 days, though there are already 

 many instances to the contrary. The Greeks and Armenians suffer most, next 

 to them the Jews. The Turks suffer less in proportion than other nations." 



Dr. Mackenzie to Dr. Clephane, F. R. S. Dated Constantinople, Nov. 23, 1751. 

 " During the 20 long years I have lived in this country, here and at Smyrna, 

 there has scarcely been a year, excepting 3, in which the plague did not threaten, 

 more or less; and in all that interval I observed no other difference in the seasons, 

 than that the winters might begin more early, and continue somewhat longer, and 

 with greater rigour ; though, by my thermometers, this difference never exceeded 

 5 or 6 degrees; which is no great difference here, where the south and north 

 winds make a difference of from 15 to 20 degrees in 24 hours : so that I cannot 

 see any other apparent cause of the virulency of the disease this year, besides the 

 occasion of greater communication. In the months of February. March, April, 

 and May last, the distemper was so strong at Cairo, as appears by letters from 

 the English consul there, that no doors were opened for 3 months. In the 



