Full Title: An Account of the Principal Lazarettos of Europe; With Various Papers Relative to the Plague: Together with Further observations on some Foreign Prisons & Hospitals; and additional remarks on the present state of those in Great Britain and Ireland, By John Howard London: T. Cadell, 1789.
A NEW PLAN FOR A LAZARETTO.
Having now given the plans of the principal lazarettos in Europe, I shall in what follows take the same liberty that I took with respect to prisons, and draw the outlines of a proper lazaretto. – Many lazarettos are close, and have too much the aspect of prisons; and I have often heard captains in the Levant trade say, that the spirits of their passengers sink at the prospect of being confined in them. In those of them which I have visited, I have observed several pale and dejected persons, and many fresh graves. To prevent as much as possible these disagreeable circumstances, a lazaretto should have the most cheerful aspect. A spacious and pleasant garden in particular, would be convenient as well as salutary.
But waving this observation, I will offer a few remarks respecting quarantines and lazarettos in general; after which I will take notice of some advantages in respect of commerce as well as health, which may accrue from such an establishment in England. I will farther, in the sequel, give the answers of some physicians abroad to a set of questions which I was led to propose to them, by considering that should a lazaretto be erected among us, and this country be ever visited with a scourge so dreadful as the plague, the opinions of eminent physicians experienced in this calamity might be of particular service.
OBSERVATIONS UPON QUARANTINES AND LAZARETTOS.
1. All vessels subject to a quarantine, arriving on our coast, should be obliged to hoist a red flag, or some other signal, at the main top-gallant mast head; in order to warn all persons coming on board notwithstanding such warning, should be detained to perform the quarantine.
2. All boats belonging to any ship in quarantine, as well as all craft employed in unloading the same, should be obliged to carry a red pendant at the mast head, whenever sent from the ship.
3. The ship’s hatch-ways ought not to be opened till the captain and mate have given in their depositions; and all the passengers, the secretary, and such of the sailors who may be permitted to leave the ship, should be landed at the lazaretto, under a very severe penalty.
4. The place appointed for receiving deposition should be so contrived, that the person who takes them may at all times place himself to windward of those who make them. This should also be observed as much as possible, at the barrier of the lazaretto, where people are permitted to speak with those in quarantine. But if not, they should be placed on this account at a greater distance from one another.
5. A fort of quarantine having been performed during the long voyage to England and there being, in my opinion, a great probability that the infection cannot remain in any person without shewing itself, beyond forty-eight hours; the persons under quarantine ought to be allowed to quit the lazaretto sooner than is now customary in other countries. Perhaps a residence of twenty-two days may be fully sufficient.
6. Fumigating of passengers as practiced at Marseilles is an advantage; for a person may carry the infection in his clothes, and communicate it to others, without taking it himself, as in the gaol-fever. But this implies, that it ought to be done at the end of the quarantine, to those only who go out with the clothes which they wore when they came in.
7. Great care should be taken, to keep at a proper distance from persons performing quarantine, all sailors and passengers as well as others. My reason for giving this caution is, that I have seen persons just arrived in ships with foul bills, permitted at the bar of a lazaretto, to come very near to persons whose quarantine was almost over; and thus danger was produced of communicating the plague. – And here I shall take occasion to observe, that in my opinion, this distemper is not generally to be taken by the touch, any more than the gaol-fever, or small-pox; but either by inoculation, or by taking in with the breath in respiration the putrid effluvia which hover round the infected object, and which when admitted set the whole mass of blood into a fermentation, and sometimes so suddenly and violently as to destroy its whole texture, and to produce putrefaction and death in less than forty-eight hours. These effluvia are capable of being carried from one place to another upon any substance where what is called scent can lodge, as upon wool, cotton, &c. and in the same manner that the smell of tobacco is carried from one place to another.
It is by these ideas of the communication of the plague that the foregoing rules have been suggested; and were the regulations for performing quarantine directed by them, some of the restrictions in lazarettos would be abolished, and more care would be taken to improve and enforce others.*
It may be asked, how it is possible, if the plague be communicated by infected air, that a whole body of men in a town where it rages should be capable of being preserved from it, as is the case with Englishmen in Turkey: and also, why every individual in such a town is not taken with it? In answer to the first of these questions, it may be observed, that the infection in the air does not extend far from the infected object, but lurks chiefly, (like that near carrion) to the leeward of it. I am so assured of this, that I have not scrupled going, in the open air, to windward of a person ill of the plague and feeling his pulse. The next question may be answered, by asking why, of a number of persons equally exposed to the infection of the small-pox, or of the gaol-fever, some will not take it? Perhaps physicians themselves are not capable of explaining this sufficiently. It is, however, evident in general, that it must be owing to something in the state of the blood and the constitutions of such persons which renders them not easily susceptible of infection. – The rich are less liable to the plague than the poor, both because they are more careful to avoid infection, and have larger and more airy apartments, and because they are more cleanly and live on better food, with plenty of vegetables; and this, I suppose, is the reason why Protestants are less liable to this distemper than Catholics during their times of fasting; and likewise, why the generality of Europeans are less liable to it than Greeks, and particularly Jews. And would not the former be still more secure in this respect, were they more attentive to the qualities of their food, and lived more on plain and simple diet?**
*It is remarkable, that when the corpse is cold of a person dead of the plague, it does not infect the air by any noxious exhalations. This is so much believed in Turkey, that the people there are not afraid to handle such corpses. The governor at the French hospital in Smyrna told me, that in the last dreadful plague there, his house was rendered almost intolerable by an offensive scent (especially if he opened any of those windows which looked toward the great burying-ground, where numbers every day were left unburied); but that it had no effect on the health either of himself or his family. An opulent merchant in this city likewise told me, that he and his family had felt the same inconvenience, without any bad consequences.
**The poorer sort of Greeks and Jews use much oil with their food; and this I reckon a disadvantage to them. I have heard of instances of servants in European families, who through imprudence and carelessness, have been attacked with the plague, while the rest of the family escaped it.