P L .A 
nance is flulhed ; and the utterance hurried. The attack 
is ulhered in by the fame rigors and pains of the back as 
the foregoing. Epiftaxis not unfrequently occurs in this 
clafs of the diforder. The glandular fwellings come out 
very tardily, and, after appearing, recede again without 
any remiffion of the pains of the body or extremities', 
which are rapidly difpofed to gangrenous inflammation. 
The delirium continues extremely high and uninterrupt¬ 
ed, and the patient often peri flies in the courle of two or 
three days. Sometimes he lingers fo far as the feventh, 
yet rarely beyond this period, without fame figns of 
amendment. Of this fecond defcription, the examples 
have been very numerous, and were nearly as fatal as the 
preceding. In the countenances of feme, juIt previous 
to the acceflion of the more violent fymptoms, there is 
an appearance of defpair and horror which baffles all de¬ 
fcription, and can never be well miftaken by thofe who 
have feen it once. 
The third fpecies which I would enumerate, is nearly 
akin to the preceding; only the fymptoms are much 
milder, and the brain comparatively little affeded, The 
buboes and other tumours go on more readily and kindly 
to fuppuration ; and, by a prompt and early employ¬ 
ments of remedies, to affift the falutary operations of na¬ 
ture, the patient has a tolerable chance of furviving. 
Cafes of this kind are often fo mild, that perfons have 
been known to walk about in feeming good health, and 
without any evident inconvenience from the buboes. Of 
this la ft fpecies, the inftances have, thank God, not been 
unfrequent. 
As to the nature and caufes of plague, we know very 
little. Baron Larrey opened a few bodies dead of this 
malady in Egypt, and he found the liver engorged and 
diforganized, the ftomach and inteftines gangrenous; and 
the heart foft and flabby. But this leads to no accurate 
information; and the 1'omewhat exaggerated fear of dif¬ 
fering has prevented poft-mortem refearches from being 
profecuted to any minuter extent. The original caufe 
of plague is miafma; it is propagated by contagion. The 
peculiar nature of the miafma, like that of all other fe¬ 
vers, is unknown; but it feems to have fome relation 
with thofe putrefadive procefles which take place on fo 
large a fcale in warm climates. Great heat or cold is 
however unfavourable to it. That it is propagated by 
contagion none can doubt. Dr. Samoilowitz, who for 
many years officiated as an army-furgeon in places where 
he had numerous opportunities of leeing perfons under 
the plague, and efpecially during that of Mofcow in 1771, 
has filled nearly one hundred pages of his treatife, Sur la 
Pejle, with proofs of its contagious influence; and 
among thefe he mentions, that, having fucceflively volun¬ 
teered his fervices as chief furgeon in three of the princi¬ 
pal hofpitals of Mofcow, all the affiftant-furgeons who 
were employed under him, fifteen in number, took the 
difeafe, which terminated fatally in eleven of them. 
The medical officers of the French army, during their 
campaign in Egypt, experienced the effeds of the conta¬ 
gion to a great extent; about eighty of them perilhed 
by the plague within one year, according to Dr. Sotira, 
who was one of the furvivors. He adds, that in the two 
toilowihg years, it was thought expedient to employ 
Turkilh barbers to drefs buboes, carbuncles, and blifters, 
as well as to bleed, and apply fridions of oil, under the 
infpedion of French phyficians and furgeons; and that, 
in confequence of this arrangement, only twelve medical 
officers died in twice the former time. He alfo ftates, 
that more than half of the Turks who were thus em¬ 
ployed to affift the French furgeons, took the plague, 
which, in feveral inftances, proved mortal. Moreover, 
we have feen how the plague followed the Chinefe cara¬ 
vans through their long journey; how it did not affed 
the Ruffians, with whom they did not communicate, 
but to whom they were contiguous; how rapidly, how¬ 
ever, it did communicate to the latter nation when they 
G U E. .. 588 
received its contagion from their commercial connedions, 
namely, the Poles and Swedes. 
The late plague at Malta was certainly brought to that 
ifland by an infeded veflel : the progrefs of infedion was 
foretold by fir A. B. Faulkner; was watched and noted 
by him; and it prevailed in every fituation, and during 
every variety of 1 weather. It appeared firft in the houfe 
of a man who had received art article from the veflel: this 
man took the difeafe, and died ; and from him its pro¬ 
grefs was traced through feveral ftages, till it was loft in 
the multitude of the affeded. During the plague of 
Marfeilles, the galley-flaves, being feparated from the 
infeded populace, though dirty, crowded, and ill-fed. 
differed comparatively little. But ftill more concluflve 
evidence that the plague is contagious, may be adduced 
from the effed of police regulations. Thefe, which are 
the only true prophyladics for peftilences, confift in 
feparating, by limitations ftridly guarded, the infeded 
from the found portions of thecommunity; and, wherever 
this has been effeded, the ravages of the plague have been 
invariably ftopped. In Malta, in Cephalonia, at Noya,and 
in Naples, this plan of infulating has been tried on a very 
large fcale, with the greateft fuccefs; but it is ufelefs to 
do any thing of this kind by halves. The indifpenfible 
feverity with which thefe regulations Ihould he enforced, 
may be judged of by the following anecdote: An inha¬ 
bitant of Noya threw a pack of cards over the trench to a 
ferjeant of the Prince’s regiment; a foldier took them 
up : not only the ferjeant and foldier, but the piquet of 
eleven men, wefe fent to the obfervation-hofpital. The 
conlequences were moft fatal to the latter (the foldiers), 
for three of them died of the difeafe (hortly after, and 
two more lingered within the lazaretto for fome time. 
The inhabitant who threw the cards, and the foldier who 
picked them up, were condemned to death by a court- 
martial and executed ; a meafure not too fevere, fince the 
example prevented fuch dangers from being again in¬ 
curred. 
The beft preventive regulations which can be put in 
force, appear to us to be the following. They are ga¬ 
thered from fuch as were adopted by fir T. Maitland at 
Malta, by the Auftrian government at Noya, and by 
■others. 1. When one or two perfons only have manifefted 
fymptoms of plague, they Ihould be removed to a laza¬ 
retto or other convenient fever-houfe, where they muft 
be placed in a freely-ventilated fituation, and fuch com¬ 
munion only allowed with them as may be abfolutely ne- 
ceffary ; their attendants being armed againft infedion in 
a manner we fnall prefently deferibe. 2. The houfes they 
have left Ihould be perfedly purified; that is, all the fur¬ 
niture, clothes, &c. waftied 5 fuch things as cannot be 
thus lerved Ihould be burnt; and the infide of the houfe 
waftied in every part with unflaked lime. 3. The attend¬ 
ants, and the perfons employed in purifying the houfes 
of the infeded, Ihould have on complete (uits of oiled 
Jilh, which of courfe, when well made, will prevent the 
contad of any infeded particles of air whatever. For 
the purpofe of breathing, a large fponge may be fixed in 
the mafic before the mouth, and may be occafionally 
fteeped in vinegar and water. Thusarmed, the infpedor, 
the nurfe, the medical attendant, and all others, may 
fafely enter the chamber of the flek without any rifle of 
catching the difeafe. 
When a village or city is infeded, it becomes neceffary 
toinfulate it from the furrounding parts. We detail, as 
the beft, the manner in which this was done at Noya. , 
The complete infulation of the place was the firft meafure 
adopted ; and this was effeded by means of a cordon of 
troops ftationed at the diftance of ninety fathoms from 
the town. Within this line two broad trenches were 
dug, the one at fixty, the other at thirty, fathoms diftance 
from the walls, completely encompaffing the town. The 
only paffage over thefe was by a drawbridge, in a dired 
line with the great gate of the city. Whoever attempted 
to 
7 
