1. Bills of Mortality might be consulted, in order to discover the Difference of Soils, Situations, Businesses, and Use of the Non-naturals, as to Health and Sickness in each Of them. They might find which were lyablest and oftenest visited with Epidemics or Endemics, and by Enquiry find which they were, in what State of the Air the People were most in danger to be invaded by them, and what Constitutions of the Seasons contributed to the Rise, Spread, and Mortality
2. Of all other Diseases, Epidemics come often most unexpectedly, spread soonest, and are sometimes of the shortest Duration, though attended with the greatest Danger and Mortality, return seldom, and at uncertain Times; and though they are often not only of the same Genus but Species, and their Symptoms often very much alike, yet may their successfulp.ii Method of Cure at one Time, be directly opposite to what it was another: So that they may be unwarily taken for Diseases of a quite different Nature. Hence often some Epidemics have spent their Virulence, and carried off their Victims before their right Method of Cure was known ; and some Epidemics return so seldom, that 'tis not in any one Man's Power to lay in a Stock of Observations of his own, to direct and determine him with any successful Certainty, which Method is generally the best and safest in the various Kinds that may occur.
3. Because many Diseases perhaps arose from unheeded and unsuspected Causes, and different Constitutions, and therefore yielded only to different Methods of Cure; thence might arise the voluminous and endless Contentions about the Use of Evacuants, Alexipharmics, Sudorifics, &c. Whether the Epidemic was from an occult Malignity, Malevolence of the Stars, Anger of the Gods, &c. if contagious or not, &c. I say, such a Collection and Comparison might be of some Service to reconcile these Differences, determine the Practice, and set many obscure, yet necessary Things in their true Light.
4. Though we have not Histories enough of Weather and Epidemics, to enable us even to make a tolerable Guess when the latter do return, or in what Order, which Kind will make the next Visit, or of what Duration, Spread, Severity, or Mildness the next will be.p.iiiOr whether It will open a Door to other Sorts of Disease, and what these will be; or of what Places, Soils, Imployments, &c. they will prove most fatal or favourable: Yet we have so many of sundry Ages, that when carefully collected, classed, and judiciously considered, might not be unserviceable to Mankind in general, and to the Practises of Physic in particular.
5. Indeed the Fragments of Histories transmitted to us, are generally not only mostly imperfect, but lie scattered in a Multitude of Authors, moral, theological, historical, natural, and medicinal, that at present they are of no great Service in Physic; and yet the Profession would suffer a Loss by the Want of them: Wherefore it seems neither amiss nor useless, to glean at least a few of them, maimed as they are, and see whether they won't afford some Inferences or Conclusions, that may serve as Rules in Practice, when a Country or Place is visited with such general Calamities. The Lameness of most of our Histories, is just Matter of Regret. Some want the State of the Air and Weather; others the Methods of Cure; Others not only want the Symptoms, but the very Names of the Diseases, which for a great many Ages are huddled up under the general Appellation of Plague, even so low as the 15th Century (a few excepted.) Hence the Necessity of consulting a great Number of Authors upon one and the same Article, to gain any Light into it. The Remissness of the Writers of several Centuries, is no lessp.iv surprizing, as may be seen by Comparing the Writers from the Norman Conquest, to the End of the 13th Century, with those that succeed them to near the Middle of the 16th. 'Tis pleasing to see how careful the first are in their general and short Accounts of Weather, Meteors, and State of Health; and surprizing to see how mute the most Part of the last are upon these Heads.
6. The same Diseases being supposed to arise from unheeded different Temperatures of the Air, or other more inexplicable Causes, were thought to require as various Methods of Cure. Hence arose endless warm Disputes and Contentions about Evacuations, the Use of Alexipharmics, Sudorifics, Pectorals, the cool, temperate, or warm Regimen, &c. and whether the Distemper was from a manifest or occult Malignity; if from the Malevolence of the Stars, Anger of the Gods, &c: if contagious or not, &c. with many endless, subtile, useless Theories, which swelled into many unprofitable Volumes.
7. An epidemic Disease is what infects great Numbers of human Bodies, in one or more Countries, at or near the same Time, from some common Cause, (with or without Contagion) whether that be in the Food, Air, in sensible Vapours, &c.
8. An Epidemic without Contagion is, when People of the fame ConstitutionA body of fundamental principles and established precedents by which a state governs itself; or the composition of something., Age, Sex,p.v Way, and Businesses of Life, &c. are seized near the same Time; but others attending, conversing, and living with them, are not infected. But if contagious, the very Touch, Converse, Look, or near Approaches to the Sick, their wearing Apparel, Bed, Seat, or other Necessaries used by them, communicate it to the Healthy.
9. Different Epidemics at different Times, are often fatal to different Temperaments, Ages, Sexes, &c. in various Soils, Situations, Foods, and Businesses.
10. Epidemics may, and often do reach further than their common Cause extends, either from the Communication of the Air, bad Food, CommerceThe activity of buying and selling of goods and services., a disbanded Army, &c. Hence an Enquiry into the State of the Air with us, is not all that's needful, but also how it was in the Places it first broke out in, together with any additional Causes, Symptoms, or Changes that may have happened to it in its new Colonies or Conquests. From a Nonattendance to these, Diseases are often fathered on inconceivable and inexplicable Qualities of the Air, insensible and unintelligible Miasmata or Effluvia from the Earth, &c. when really it bred not with, but was imported to us by some of the above Means. And as to our own Air, we want a true History of the Winds, Rains, Earthquakes, Comets, Meteors, &c. which may prevent drawing sure and useful Conclusions.
p.vi11. A general Epidemic extending to several Countries, often puts on different Appearances and Symptoms, according to the Difference of its common Cause in sundry Countries, as in one Place it shall be a Hemitritean; in another a continued Spotted Fever ; in a third a pestilential Catarrh; the Plague in a fourth, &c. Hence the Judgment is to know, when near the same, or a very different Method of Cure, will be necessary and successful.
12. The like Genus or Species of Epidemic, reigning in several Countries at the same Time, but in different Constitutions of the Air, or other procuring Cause, may require different Methods of Cure, as in one Country the Anphlogistic in another the Reverse.
13. In Histories of Diseases, their Division into vernal and autumnal should be remembered; the first beginning with January, and ending with August; when the last begins and ends with January, Therefore continued Histories of weather and Diseases, should always begin the Year with January; for cutting the Spring or Autumn in April or October, makes confused and mangled Work in the History, putting the Autumnals of one Year to the Vernals of the next; or the Vernal to the Autumnals; or dividing the Diseases of one Year into two. Thence also a strange Confusion between English, and Foreign Histories of the same Disease, put in two different Years.
p.vii14. Though an Epidemic may roam about, not only for some Seasons, but even Years, in pretty much the same Shape, and requiring near the same Method of Cure; yet upon Enquiry, in fact we find, that the same Epidemic never continues long severe in the same Place, in its first Appearance, Form or Shape, but soon either shifts to a new Place, varies its Symptoms and Cure, or gives Place to some other Diseases, or Health.
15. None possibly can with any Certainty, or ought in Reason to judge of the Propriety, or Impropriety of a Method attempted for Cure of Epidemics, from his Success in two or three, or a few Recoveries, (when the Number of Sick is great) of Persons perhaps of different or stronger Temperaments, or where the Disease and Symptoms are not only apparently, but really milder, the Season more favourable, or the common Cause wearing out, or not arrived at its Height and Severity. But when different Methods are attempted by sundry Persons, he only is Master of the healing Art, who, 1st, Foresaw an Epidemic before it came. 2dly Knows how to prevent many of the worst Symptoms, keep the rest under, and the Fever milder. 3dly, He that out of any given large Number of Sick, shall recover far more by his Method, than others have out of the like Number by any, or several different Ways of Practice at the same Time. 4thly, He that can tell the Event of any Course before 'tis used.p.viii 5thly, He that can tell in all the Sick, what Symptoms or Changes are the Effects of the Disease, or Use of Non-naturals, and which of the Medicines taken. Which Things are not impossible for a Man even of common Capacity to tell, that has dwelt with Nature, made his Profession his sole favourite Study, and has not turned the Exploration of ancient Physicians his Ancestors to ridicule, and solaced himself, and spent his Time in other Studies foreign to his Business, as Dramatics, Poetry, Classics, Architecture, Politics, Gallantry, &c. Hence such during the Reign of fatal Epidemics, are obliged to the pitiful Shifts of calling it a new Disease, or save their Credit by laying hold of some trifling flight Intercurrents, and giving them the same Name with the prevalent Distemper .
16. In all Epidemics, our first Enquiry should be into their Causes; whereof various have been assigned in different Ages. We should wave all curious (but useless) Speculations or Theories, which have occasioned so much Warmth and Debate to the Detriment of Physick, and so long prevented Benefit from the Profession; and should directly appeal to Facts, as recorded in History, and fatally experienced by Multitudes. From these it plainly appears, that all Epidemics arise either from supernatural or natural Causes. The first may be divided into two Sorts. 1stly, As when a general or fatal Mortality appears as it were instantaneously without any visible orp.ix sensible previous natural Causes, or even a Suspicion of them, as in several of the Israelitish Plagues in the Wilderness; in the Destruction of Sennacherib's Army before Jerusalem; in some of the general Plagues; and in several particular ones, as the Death of the First-born in Egypt; in that from David's numbering the People, &c. 2dly, When natural Causes seem hurried on, and combined to a sudden violent Excess, either of Severities or Duration, out of all their common and ordinary Course, as in the Deluge of the World; the Bituminous Exhalations that occasioned the Destruction of Sodom and Gomorrah; the general Plague that ravaged the whole Globe from 1340 to 1360; and many others. But it must be acknowledged at the same Time, that general fatal Epidemics have rarely surprized a wicked People before that it has had sufficient Premonitions given, in order either to awaken Mankind to Repentance, and thereby either avert the CalamityDisaster, or to prepare for it. Histories abound with many and various Instances of this kind; though the Causes assigned by the Historians are not always to be depended on, as the breaking up an enchanted Coffin, robbing a Heathen Temple, handling a dead Priest's Bones roughly, &c. So that though I would not be so credulous as to admit of every Thing for Truth I read in many Histories; so neither would I be such an Infidel as to discredit and deny the whole, because some Things appear monstrously incredible (which I have mostly omitted in this Collection) asp.xraining of red and green Crosses, Ghosts knocking at Peoples Doors that were to be next infected, &c. But would rather examine when and where the Event answered the tremendous Threatning; or whether the like or greater Plagues have or have not been inflicted without such Menaces. 2dly, When the Consequences answer not the pretended dreadful Notices said to be given, I would advise Mankind to suspend their Belief till better Credentials are produced. 3dly, Though some at first Sight seem surprizing, nay, highly incredible; yet we should make a fair Enquiry whether they may not at least be accounted for by natural Causes, without calling in to our Assistance supernatural ones. 4thly Some Things either cannot, or may be falsly accounted for, nevertheless be true. The God of Nature most certainly has the Universe in his own Hands, and can dispose of his Creatures as he sees proper, either for the Destruction or Relief of Mankind. He can turn Seas, Rivers, and Springs into Blood, can break open the Fountains of the great Deep, and open the Flood-Gates of Heaven to deluge the World again; can send Barrenness upon the fertilest and richest Lands; can tear and swallow up Kingdoms by Earthquakes. He can withhold his Snow from the Ethiopian Mountains, till even a fruitful Ægypt suffer a seven Years Famine; and his Rain from the Earth, till it become dry and barren, and its Inhabitants pine away, or be consumed with Drought or Heat; or make Chasms of the Earth fend outp.xi pestiferous Exhalations; or freezing or furious Blasts, to sweep over a Country to the Destruction of Multitudes; or cause the Winds to blow in a Sea, and drown a Country; or send out his Blasting; or Mildews, to make useless the fairest Prospect of a plentiful Harvest; Nay, he can make the Luminaries of Heaven so many Monitors of his Displeasure. We find he gives Notice of his astonishing Events by the most contemptible Things, such as Insects, Birds, Reptiles, Rains, Meteors, Vapours, Exhalations: Nay, as we are credibly informed, he makes the Sports and Games of little Children the preaching of his Judgments. On the other hand, such is his Power, he can call out his Springs in a dry Land. He can send Manna and Quails to Itinerants in the Desart; or relieve the straitly Besieged, with strange and unexpected Supplies; or cause the Earth to produce a rich spontaneous Crop to the surviving starved Inhabitants; or cause his Clouds pour down ready Grain, or fend his refreshing extroardinary Showers to the Scorched and Joining in the parched and barren Desarts, &c.
17. In attempting the Cure of Epidemic, the late and present Winds, Air, Weather, Meteors, Food, and Rise of the Disease, should not be forgotten. The Urine, Tongue, Pulse, Breathing, Taste of the Mouth, Quiet, or Restlessness, Sleep, or Watching, Costiveness, or Laxness of the Belly of the Sick, should always be observed, on the first and third Days especially; and what Effect this or that Food,p.xii Medicine, Drink, Posture or the Body, &c had. And to recollect if the present Epidemic treads on the Heels of another, and of what Kind that was, and how the two agree or differ in Symptoms, Cause, Cure, &c. in various Constitutions, Ages, Sexes, Businesses, &c. and of all Things used internally or externally, whether by Chance or Design, with their Effects, good or bad.
18. One Year rarely produces above one Epidemic (Catarrhs, Diseases, of the Season, and of Children, as Small Pox, Measles, or Rash, excepted) and in several Places, one Epidemic happens not in many Years. If the Epidemic begin in the Spring, sometimes the Autumnals retain much of its Genus; or if in August, it mostly ends with the Year or in February.
19. In our quest of natural Causes, we shall run over the most considerable Meteors and Phenomena in the Table, and see which of them do most ordinarily produce Epidemics and Mortality, and whether they produce them when alone, or attended by other Concomitants; and we think it cannot be denied, that what Meteors, Seasons, or Changes of the Air, may produce Diseases alone, may be allowed to do the same when conjoined to other Circumstances. On the contrary, such Things as do, not ordinarily, or very rarely occasion Epidemics when alone, cannot justly be charged with them, when accompanied with suchp.xiii Circumstances, that often produce Diseases. Now what these Things are that generally give rise to such common Calamities, shall be fairly and faithfully tried from History and Facts only.
20. It should always be enquired, whether the Epidemic belongs to the pituitous or inflammatory Class, especially if it tend to a sudden Suppuration or Gangrene; what kind of Inflammation it is, and its general Characters, e. gr. if the Sick becomes suddenly delirious after great shooting, throbbing, Pains of the Head, and die quickly, &c. Nor should the State of the Bile or Blood ever be neglected; if the first is redundant, obstructed, not separated from the Blood, its Colour, and Discharge; if the last is dissolved, salt, watery, siezy, coriaceous, &c.
21. Histories of Diseases should not only be distinct, but give first the general Characteristics of the Disease common to all the Sick, then these particular to different Constitutions, Ages, Sexes, &c. and of Foods and Medicines used, or applied inwardly or outwardly, designedly or accidentally, with their sensible Effects, good or bad. And they should have an Extract of the Bills of Mortality, Weather, BarometerAn instrument used to measure atmospheric pressure, using either liquids, such as water or mercury, or springs, Thermometer, &c.
22. Such Histories would give us a better Acquaintance with the true Causes, various Symptoms, and exact Methods of Cure, of the fame Diseases from sundry Causes and differentp.xiv Seasons. A too great Nicety Tediousness, Minuteness, or Prolixity about the Weather, or too much Laxness or Remissness, or especially a total Neglect of it, would not be so well, no more than a too general, particular, or needless Description of the Diseases, and their trifling minute Symptoms in each Individual. Nor is it necessary to crowd the History with all Sparodics and Intercurrents, far less to run up a long Catalogue of a very trifling Complaint besides Epidemics and the chief Intercurrents. None seems to have come up to this beautiful and excellent Medium, equal to the learned and ingenious Dr. Huxham in his Epidemics of Plymouth. Some have wholly omitted the curative Part, or only transiently glanced it. Some again have been so verbose, as to stuff even a Quarto Volume with one Epidemic. Some have given the Weather, without either Symptoms or Cure of the Disease; others the Disease without the Weather. Such Histories should only contain real Facts, not Theories.
23. Let it be allowed (as the Generality of Physicians since Hippocrates have done) that the manifest different Constitutions of the Air, is the common Cause of Epidemics; then let us see what will follow according to this Opinion, and their Observations.
24. An even or equal Temperature of the Air, though seemingly of not the best Sort, seldom produces Epidemics, except it is a longp.xv Southerly one, attended with sultry Heats, long and great Rains, Fogs, Calms, Inundations, Millings, or close and cloudy, said to produce putrid or pestilential Fevers; or a very long North, N. E. or Easterly Constitution, productive of epidemic Scurveys in all their most exalted Symptoms of Scorbutic, Sciatic, Arthritic, Erratic, and other Pains, with a Saltness, inequal Mixture, or Dissolution of the Blood; or' continued Cold, dry N. E. or East Winds, causing inflammatory or intermittent Diseases, with a Thickness and Sieziness of the Blood, and Fulness of the small Vessels; or great Droughts, with Heat, generating several bad Fevers, with a thin, salt, stimulating Blood, with a very bilious, acrid Serum, &e.