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I. THE health of the Inhabitants of eve∣ry large Town, depends very much on the police of the place, and on the due per∣formance of every duty connected there∣with.
II. As the establishment, as well as the execution of every regulation, made either for the convenience or health of a City,
are more immediately connected with the functions of magistracy, the Magistrates are in some measure answerable to the In∣habitants, in so far at least, as to enforce a proper obedience to, and of course a per∣fect performance of every law, that for these purposes may have been adopted.
III. The first material consideration for preserving the health of the Inhabitants in a large Town, is a rigid attention, to every step that can tend to produce cleanliness; and in the laying out of every additional building, to secure a free communication of pure air, and a facility of preserving clean∣liness, ought always to be kept in view by those that have the management of the police.
IV. Nor should a house be built in a place likely to prove unhealthy, since not only its own inhabitants would suffer, but it would readily become a source of infec∣tion to the most extensive City.
V. In building a Town, the streets ought to be so wide as to insure a free circulation of air, and the wider the streets are in any
Town, the more healthy will the inhabit∣ants be found; whereas narrow streets, by admitting a less proportion of pure air, have every chance of creating infectious diseases.
VI. When it can be done, houses ought to be built on the north side of any marsh, swampy ground, or large rivers, that are apt often to ebb and flow, rather than on the south side of such places: Because from these, the sun powerfully exhales such vapours, as by being breathed or otherwise applied to the body, are capable of producing many contagious diseases. Whereas the inhabitants on the north side of such places, are in no risque of being exposed to these ascending vapours. Houses built on the north-west of a large Town, will always prove the most healthy.
VII. All slaughter-houses, and butcheries, ought to be in the south of every Town; and the Magistrates ought to enforce the greatest cleanliness in these places, that the nature of such business can admit of; and the filth produced in such places ought not to pass through any channel, that goes
through the City. The most certain way of preventing diseases from arising in con∣sequence of the filth of such places, is by obliging the butchers, &c. to bury all offal, blood, &c. before they have time to become offensive, or to remove them to some dis∣tant place from the City.
VIII. That of slaughtering animals in the streets, and permitting the blood, &c, to remain there, ought to be made highly criminal, and punished accordingly.
IX. All dead horses, dogs, cats, &c. ought to be buried, or carried to some dis∣tant place; nothing gives a stranger a mean∣er idea of the taste of the inhabitants of a Town, or produces more certain sources of contagious diseases, than to see such dead animals laying about the streets* 1.1.
X. Tan-yards, and such factories as pro∣duce offensive smells, ought never to be permitted in the middle of any large Town. They ought only to be in such parts as have least communication with the inha∣bitants at large.
XI. All filth should be removed from every street and lane, early every morning, and carried to a common reservoir at a con∣siderable distance from the Town; and peo∣ple should be appointed, so many to each district, whose business it ought to be dur∣ing the day, to carry entirely out of the Town, whatever filth or dirt may be pro∣duced on the streets. That of collecting dunghills on the streets, and allowing them to remain there, during the pleasure of a Scavenger, is very hurtful to the health of the inhabitants,
XII. Common sewers, or shores, ought to extend through every street, and should empty themselves entirely out of, or at some distance from the Town; and great care should be taken to keep them perfect∣ly free, and fit for their duty; it likewise ought to be a punishable crime, to throw
any thing into a shore that might tend to choke it up.
XIII. The establishing of publick Privies, or Necessary-houses, in convenient parts of a Town, is essential to its cleanliness; as the want of such places of convenience, is a material cause of the filth so frequently found in lanes, &c.
XIV. Such publick Necessary-houses, ought to be carefully attended to, by the police officers, and so constructed as to be easily cleaned, which ought to be done ve∣ry early every morning* 1.2.
XV. A plentiful supply of good water is inseparably connected with the health of a Town; the houses of opulent individu∣als being provided with good water by
means of pipes, is of small benefit to those of inferior circumstances, that in all nati∣ons constitute the great body of the people.
XVI. The easy attainment of an ample supply of this necessary article in life to the people at large, merits the greatest at∣tention of the police. In many Towns where good water can only be obtained at a distance, publick pipes that conduct the water from the grand reservoir are estab∣lished in convenient quarters of the Town, by which means the poor are enabled to partake of this common bounty of provi∣dence, in as great perfection as the rich.
XVII. Jails, Poor-houses, and Hospitals, ought always to be in the most remote quarters of a Town; but at the same time
in such places as are little likely by situa∣tion to become unhealthy, least they should turn out nurseries for propagating diseases.
XVIII. An officer of the police ought daily to visit every part of the jail, poor∣house, and other publick charity, to enforce a due obedience, to such orders as the po∣lice may think proper to make, for the re∣gulation of such places; and the visiting officer should be authorised, to inflict such punishment as may seem necessary (and as may have been fixed by the police) for any neglect of duty, or disobedience of orders, that the respective officers of such places may be found guilty of.
XIX. In all jails, poor-houses, &c. the utmost attention should be paid, to the shirts and shifts of the prisoners in jail, and the inhabitants of a poor house. Their linen ought to be changed at least twice a week, and the officer of police should not only enforce this order, but should take care that the linen has been properly wash∣ed, and well aired before it is given to wear.
XX. All jails, poor-houses, &c. ought to be provided with a sufficient quantity of linen, to supply such as may be sent there without a sufficiency of this necessary arti∣cle; and those who have the care of such places, ought to be answerable, that such linen is kept in good order, and always forth coming. And every jail should be supplied with a quantity of good blanket∣ting.
XXI. Every room in jail, poor-house, &c. ought to be swept carefully every morning, the sides and ceiling as well as the floor ought to undergo this operation; and the straw and other bedding, when the weather is dry, ought to be carried out, and laid in a yard (that ought always to belong to a jail) for the benefit of the air, five or six hours every day.
XXII. As soon as the straw, bedding, &c. has been carried out of the different rooms, the floors ought to be strewed over with sand or saw-dust, which next morning is to be swept out, and the same process to be repeated every day.
XXIII. When wet weather renders the carrying into the air of the straw and other bedding inadmissible, they should be re∣moved into a corner of the room, to per∣mit it to undergo the directions ordered as above.
XXIV. The straw for a jail, poor-house, &c. ought to be changed at least once eve∣ry month, and care should be taken that the old straw is either burnt, or carried to some distance from the Town.
XXV. If feather-beds, or hair-mattres∣ses, are ever used in a jail, poor-house, &c. besides being regularly exposed to the free air, on every dry day, they ought to be su∣migated once a week, by being held at a proper distance over the smoke of burning brimstone, or gun-powder.
XXVI. All sheeting should be changed once a fortnight, and the sheets and blan∣kets when the weather will permit, ought to be put on ropes fixed in the yard for the purpose of exposing them to the action of the air.
XXVII. Every boarded floor should be washed with soap and water once every week, and it ought to be done in the morn∣ing of a dry day, that the inhabitants of the room may be enabled to remain in the yard, till the floor is perfectly dry and co∣vered over with sand. The sides of the room and ceiling should undergo the same operation.
XXVIII. All dungeons of a jail should have boarded bottoms, and their sides plais∣tered to make cleanliness the more practica∣ble; but when these places happen to have clay floors, and rough walls for their sides, the floors and walls ought daily to be swept with a hard broom, and the walls once a week, ought to be washed by throwing soap and water upon them with a mop, after which they may be dried by careful∣ly sweeping with a broom, and by burning some fuel in a chaffing dish; a practice that ought frequently to be used in all subtera∣neous apartments, and which ought like∣wise to be had recourse to in all rooms in jails, poor-houses, &c.
XXIX. Every room should have its win∣dows so situated, as to admit of a free cur∣rent
of fresh air at pleasure; and all win∣dow sashes, when there is no rain, should be opened some hours every day.
XXX. Every jail, and poor-house or other charity, ought to have a commodious yard annexed to it, and a privy should be situated in some part of it, that will prove least offensive. Into these privies all cham∣ber-pots, &c. should be emptied, and the regular cleaning of such privies, should be carefully attended to.
XXXI. Every prisoner in jail, ought to be (unless prevented by sickness) made to remain in the yard for some hours every day in fair weather, and as a military guard attends on every jail, a proper number of centinels being posted in the yard, would render the walking about of those con∣demned to die, perfectly admissible. Eve∣ry prisoner ought to twig and brush his cloaths in the yard, every day in dry wea∣ther.
XXXII. A separate building with con∣venient rooms ought to belong to every jail, and publick building, for the purpose of an
hospital for the sick, and when this cannot be had, a sufficient number of rooms be∣longing to the building itself, should be ap∣propriated to that purpose.
XXXIII. As the regulation of the apart∣ments for the sick will necessarily belong to the Faculty that attend them, I reckon any directions on that head unnecessary.
XXXIV. Whenever any person belong∣ing to a jail, or other publick building is taken sick, he ought immediately to be re∣ported to the Surgeon, or Physician, and the person taken ill, should be removed to the hospital.
XXXV. Men of the first abilities only, in physic and surgery, should be entrusted with the care of the sick, the consequence of delegating this important office, to the charge of an apothecary is highly danger∣ous to the inhabitants at large. Since in all such places, infectious diseases are more likely to break out than any where else, it follows, that the practitioners should be such, as by their abilities are best able, speedily to put a stop to them.
XXXVI. In every large Town there ought to be commodious hospitals for the reception of medical, as well as surgical pa∣tients, and in such hospitals there should be a suite of rooms for the accommodation of such servants of the inhabitants of the Town, as may be taken ill of infectious diseases* 1.3.
XXXVII. There should likewise be a publick Dispensary, where such of the dis∣eased poor whose cases do not require con∣finement, may receive medicine and advice, and the medical attendants of the Dispen∣sary should visit such as are confined at home, whenever the hospitals happen to be full.
XXXVIII. Whenever any infectious dis∣ease appears in a Town, it ought immedi∣ately to be reported to the chief magistrate, who ought to summon a meeting of the police, to consult with some of the most eminent of the Faculty, on such steps as by being carried into execution, may be most likely to put a stop to its progress.
XXXIX. Every person that dies of any infectious disease, ought to be buried in twenty-four hours after death; and when infectious diseases prevail and great morta∣lity, the ringing of bells at deaths and fu∣nerals should be strictly prohibited. And the idle, dissipated custom of a number of people assembling at wakes, ought on all such occasions to be forbidden, as such a practice is extremely dangerous.
XL. Those who attend funeral cere∣monies, should not perform these duties with an empty stomach, for in this situati∣on they will be more apt to catch infection, both from the corpse, and the hurtful va∣pours that arise from a newly opened grave, than after a meal.
XLI. When infectious diseases are pre∣valent in a Town, it will be of great ser∣vice to burn gun-powder in the streets, and to make fires in different parts of the Town, of any wood that abounds with re∣sin, such as the different species of fir.
XLII. In every house where there is any infectious fever, vinegar ought several
times in the day to be boiled, and sprinkled while hot in every room; and a sauce-pan filled with hot vinegar, should always be kept in the patients chamber. The burn∣ing of frankincense* 1.4 is very pleasant to the smell, and very powerful in purifying pu∣trid air.
XLIII. When infectious diseases pre∣vail, every attention to cleanliness of per∣son should be doubled, particularly in re∣gard to linen; for during such times the perspiration sooner becomes hurtful, and more powerful in producing a contageous matter capable of bringing on a fever, than when such diseases are not general.
XLIV. All attendants on the sick in such fevers, should be careful in holding the head as little over the patient as possible, or in speaking very near to the patient: this caution is to prevent the hurtful essluvia (that are more powerful in proportion as they are near to the patient) from entering the lungs.
XLV. When the Faculty, Clergy, or others that may for any time be obliged to stay by the patients bed-side, are there, a vessel containing warm vinegar ought to be placed near them; and it is better to smell to any grateful substance, than to chew any thing as a preventative, because in doing the latter there is danger of the infectious matter being entangled with the spittle, and thereby of producing what it was intended to prevent.
XLVI. Whenever a person dies of any contagious disease, the corpse ought quick∣ly after death to be put into a close coffin, and the room in which the person died should be well aired, by having the win∣dows opened, until a charcoal fire be kin∣dled with some rolls of sulphur upon it;
after which both doors and windows ought to be kept shut, for a considerable time, not less than eight or ten hours, until the room be thoroughly smoked; after which the windows ought to be again opened for se∣veral hours, and the room should not only be well scoured with soap and water, but likewise with warm vinegar, before any one inhabits it. The same steps ought to be taken with every room in which an in∣fectious disease has been, though the pati∣ent may have recovered: and for this pur∣pose it is proper that whenever a person is so far recovered from any contagious dis∣ease, as to admit of being moved with safe∣ty, the patient should be conveyed to ano∣ther chamber, to permit the one occupied during the disease to undergo the necessary purification.
XLVII. It may perhaps be proper to ob∣serve, that the blankets, linen, &c. of such as die of infectious diseases, ought to be steeped for some time in cold water, before they undergo the usual process of being washed: for if without this precaution they were to be washed in hot water in the usual manner, the hurtful steams that
would thereby be produced, might prove very dangerous to the person employed in washing them.
XLVIII. Those whose duty it may be to go amongst the sick, ought never to per∣form that duty fasting; even a small quan∣tity of aliment taken into the stomach, gives great vigour to the whole body; and the body is more or less likely to be affect∣ed with contagion, in proportion to the state of strength or weakness of the stomach: It is therefore proper for those that are oblig∣ed to have much intercourse with the sick in contagious diseases, to take a dose of some comfortable stomachic medicine every morn∣ing an hour before breakfast; and I have from much experience found, that an ounce of Huxham's Tincture of Bark, is as useful a preventative as can be taken* 1.5.
XLIX. Whatever effects the strength of the stomach, has a powerful effect in pro∣ducing or preventing contagious diseases; therefore every step ought to be taken, to keep that organ in the utmost vigour dur∣ing the prevalence of infectious diseases: and for this purpose, the utmost circum∣spection in the way of living ought to be attended to, and all such food as has been generally found to disagree with the sto∣mach, ought on such occasions to be care∣fully avoided.
L. A due quantity of generous wine, should be used by every one whose circum∣stances will admit of it; at the same time, I think it necessary to say that excess in drinking, by leaving the stomach, and of course the whole body in a weakened state, would prove hurtful. Excess in eating on all such occasions should be carefully avoid∣ed, as being capable of throwing the sto∣mach into that state, that may readily in∣vite any infectious disorder; nay some of the ancient physicians reckoned any excess in eating, more dangerous than that of drinking, for Celsus says,
"Si qua, intem∣perantia subest, tutior est in potione, quam
in esca."that is, it is safer to exceed in drinking than in eating. But every kind of intemperance is hurtful.
LI. During the continuance of contagi∣ous diseases, it is improper to go abroad in∣to the streets before breakfast, and it would be proper for those that are obliged to go abroad before this meal, to take a draught of new milk to which a little good brandy has been added.
LII. Such as have weak stomachs and are not able to make a hearty breakfast, ought to take a glass or two of good wine, some time before dinner; the addition of a little bark to the wine would be of service* 1.6.
LIII. A moderate use of ripe fruit, is of great service in preventing putrid diseases; and vegetable acids such as lemon juice, &c. when they agree with the bowels are very proper ingredients in drink. The best time for eating fruit is two or three hours before dinner.* 1.7
LIV. Sitting up late, and laying long in bed, are hurtful at all times, but by weak∣ening the body become particularly dange∣rous during the prevalence of infectious
diseases. A moderate degree of exercise in the open air which is at all times proper for health, is particularly necessary when contagion reigns. Cold bathing is an use∣ful assistant in the prevention of diseases.
LV. Nothing so much predisposes a per∣son to receive infection, as to entertain a constant dread of catching any disease. No∣thing weakens the whole body so much as constant anxiety and fear; and as I have already remarked, whatever tends to dimi∣nish the vigour of the body, acts powerful∣ly in laying the foundation of disease. A fearless disposition is best calculated to en∣able the body to resist any contagious dis∣order* 1.8.
LVI. Nothing is more injurious to health than to walk late in the evening: dews be∣gin to fall as soon as the sun is set, and walking abroad after this time, has in all countries been found to be a powerful cause of producing diseases.
We have a well authenticated account of a very violent infectious fever breaking out at Fgmont in North Holland, occasioned by the rotting of a Whale, which had been left on the shore. There is likewise an instance of a contagious fever breaking out in the cr••w of a French ship, owing to the putrefaction of some cattle that they had killed on the island of Nevis, in the West-Indies.
When large armies have been long encamped on the same ground, putrid diseases frequently arise, in con∣sequence of the filth unavoidably produced by a large body of people, for a length of time occupying the same place; and the only mode of restoring health to the ar∣my, has been found, to be that of removing the camp to new ground; and an army is generally most healthy, where the nature of the service makes it necessary, for the army to move frequently. This mode, so well known to the moderns, was sometimes practiced by the ancient Generals. Vegetius seems to have been well ac∣quainted with the necessity of cleanliness to remove or prevent contagious diseases, for in his system de Re Mili∣tari, he uses these words,
"Si autumnali, aestivoque tem∣pore diutius in iisdem locis militum multitudo consistat, ex contagione aquarum, et odoris ipsius foeditate vitiatis haustibus, et aere corrupto, perriciesissimus nascitur mor∣bus, qui prohiberi non potest aliter, nisi frequenti muta∣tione castrorum." VEGET. de Re Militari, lib. iii. cap. 2.Quintus Curtius likewise tells of Alexander the Great af∣ter the battle of Arbela, being obliged to follow the same method to preserve the health of the soldiery. "Ingruentibus deinde morbis, ques odor cadaverum to∣tis jacentium campis vulgaverat, maturius castra movit." lib. v. 32. And in the most ancient times we find that cleanliness was reckoned essential to the preservation of health; and the proper injunctions for that purpose, were by no means supposed incompatible with the dig∣nity of those highest in power. Thus we find the divine law-giver Moses, enjoining cleanliness in the camp of the Jews, in a most particular manner, when he says.
"Thou shalt have a place also without the camp, whe∣ther thou shalt go forth abroad: and thou shalt have a paddle on thy weapon, and it shall be when thou wilt ease thyself abroad, thou shalt dig therewith, and shalt turn back and cover that which cometh from thee. For the Lord thy God walketh in the midst of thy camp, to deliver thee, and to give up thine enemies before thee: therefore shall thy camp be holy, that he see no unclean thing in thee, and turn away from thee," DEUT. chap. xxiii. ver. 12, 13, 14.—Since then we find how fre∣quently contagious diseases are produced in a camp, by a great body of people collected together, while at the same time, the most judicious regulations for preserving clean∣liness, are by military discipline better enforced, than per∣haps the best regulated civil police can ever accomplish; and since it is evident, that the inhabitants of a Town, cannot avail themselves of changing ground, and thereby leaving behind them whatever might tend to produce dis∣eases, it is easy to see how essentially necessary it must be to take every step, that can tend to prevent the direful consequences arising from putrid substances laying in, and about a Town.
The happy effects of such an institution are amply Selt by the inhabitants of Edinburgh.
I remember to have checked the progress of a ve∣ry contageous fever by this mode, after all others had failed, in a Barrack situated in the midde of the Bog of Allen. The smoke of the Juniper, or of its rocts and berries, has long been esteemed an efficacious remedy against distempers; and Mindererus in his Medicina Mi∣litaris, advises to burn fires of Juniper before the tents, when the Hungarian-disorder, the spotted-fever, or other pestilential disorders are frequent in an army.—During the continuance of infectious diseases, fires ought to be burnt in every house, whenever the temperature of the the weather permits.
Some people labour under diseases that render the use of bark improper, and in such cases, I would as a preventative against infection recommend an ounce of Rue, and half an ounce of Garlick, to be steeped in a quart of Brandy, for two days, and a wine glass-full of this Tincture to be taken every morning before break∣sast.
During the campain in Hungary, in the year 1717. Count Boneval preserved both himself and family from disorders, by taking himself, and making all his domestics take, two or three times a day, a small quantity of Bran∣dy in which Bark had been infused, at a time when all the rest of the army were infected with malignant disor∣ders.—A regiment in Italy continued healthy by the use of the Bark, when the rest of the Austrian army, that did not pursue the same method were greatly annoyed with sickness.
Towards the end of the year 1743, Mr. Tough, then a mate to a regiment, was ordered to go down the Rhine from Germany to Flanders, with a party of sick, that had the seeds of the Hospital or Jail-fever among them, and were to go in Bilanders. Having had a cask or two of Brandy put on board as stores for the sick, he was afraid lest the men should make too free with the spirits, to prevent which he threw a quantity of Bark into each cask, and gave the men regularly merning and evening, a glass of this bitter tincture. At the same time the men were kept extremely clean. By these means most of the sick mended on the passage, and they had no return of the malignant fever amongst them; whereas Sir John Pringle, who takes notice of the other partics that came from the same Hospitals in Germany, tells us, that the malignant fever broke out in a violent degree, and half the number died by the way, and several others soon af∣ter their arrival.
We have a striking instance of the dangerous con∣sequence of fear, in the case of a man at Constantinople, when the plague happened to rage there with unusual vi∣olence. This man from a natural intrepidity of mind, had been extremely useful in carrying out of the city, and burying many hundreds that died, at a time when it was very dissicult to find people hardy enough to perform this necessary duty. It happened however one morning that he found one of those he was carrying to bury to be one of his nearest relations and most intimate friends, by which he immediately became so much shocked, that he was speedily seized with the plague and died.