Part 2

This hospital stands out of the town, near the suburb inhabited by the Germans, from which it is separated by a small stream, called the Yausa. We advised that it should be immediately shut up, and that guards should be placed round it, in order to cut off all communication; that all the attendants upon the hospital-invalids should be removed, together with their wives and children, to a detached situation, care being taken to separate the infected from the healthy; and, lastly, that all the clothes and furniture, not only of those who were dead, but likewise of those who still survived, should be burnt.

The cold had set in later this year than usual; the weather was very damp and rainy until the end of December, when a hard frost came on, and continued through the remainder of the winter.

In addition to our joint report, Field-Marshal Count Soltikoff, governour-general of the place, consulted me in private, and desired to know what steps I thought adviseable under the present circumstances. On a subject pregnant with so much danger to the public at large, I did not hesitate to communicate my sentiments in the most unreserved manner. Accordingly I put into the governor's hands a paper, wherein I laid great stress upon the necessity of employing every possible precaution with regard to the hospital, where I affirmed, that the plague had appeared among the attendants, as before mentioned; I added, that it would be necessary to make strict enquiries to ascertain, whether the contagion was concealed in any part of the town, and that, wherever it should be discovered, the same precautions, as in the case of the hospital, should be adopted: that, for the same purpose, it would be further necessary to desire the physicians and surgeons, whenever they should perceive any unusual or doubtful symptoms in their patients, to give immediate notice thereof to the Board of Health; and to order the police-officers to appoint a consultation of physicians, whenever several persons should fall ill in the same house. I remarked, however, that there would be great difficulties in the business, if the contagion existed in other parts of the town besides the hospital; but, I added, that, even in this case, we might hope to eradicate the evil when the frost should set in, provided speedy and proper measures were resorted to.

We wished that what had passed on this subject should not transpire; but the rumour of the plague having broke out at Kiow, some months before, had produced such an effect upon the minds of the public, that the precautions which were adopted, with regard to the military-hospital, threw the whole city into the greatest alarm. All attempts to dissipate the fears of the inhabitants were fruitless.

After some days, however, when it was known that only seven persons in the hospital itself were ill of the disorder, and that the rest remained free from infection, the public fell into the opposite extreme, and thinking themselves in perfect security, the grandees, nobles, merchants, common people, in a word, all the inhabitants, except the governour and a few others, ceased to give themselves any further trouble about the means of prevention.

This idea of security, which was countenanced by the before-mentioned state-physician, Dr. Rinder, continued until the month of March. The medical consultations ceased. In spite of all our efforts to the contrary, every kind of precaution was neglected in the city; it was only at the military-hospital that, by order of the Empress, the means of prevention were still observed; in consequence whereof the plague was entirely suppressed there, after twenty-four persons had been seized with it, only two of whom recovered. Six weeks after the death of the last of them, all their clothes, beds, &c. together with the house, to which they had been removed, and which was built of wood, were burnt. The hospital was opened again at the end of February.

The generality of mankind judge of things by events only; and will never believe that the plague is among them, until they have certain proof thereof in the number of funerals. It is owing to this and other mistaken notions, that the plague is not put a stop to in the beginning; at which period it may be compared to a spark which might easily be extinguished, but which, if left to itself, bursts out into a conflagration which nothing can resist.

The opinion which went to assure the inhabitants that they were safe from the plague, was very generally believed, as in such cases almost always happens. It only remained for us to console ourselves with the consciousness of having discharged our duty faithfully, and to the best of our abilities. Would to God that the business had stopped here, and that what afterwards took place had not confirmed the truth of our assertions. We should not then have beheld the dreadful destruction of so many of our fellow-creatures, nor have witnessed the most horrid of all public calamities.

On the 11th of March we are again convened at the Board of Health. In the centre of the town there was a large building used for manufacturing clothing for the army; three thousand persons were employed in it, nearly a third part of whom, of the most necessitous class, occupied the ground-floors; the rest, after working there the whole day, returned in the evening to their respective homes, in different parts of the town. Dr. Yagelsky, at that time second physician to the Military Hospital, whom the Governor-General had sent to the manufactory in the morning, brings word that he had found several patients, (eight to the best of my recollection) labouring under the same disorder, (accompanied with petechiæ, vibices, carbuncles, and buboes) which he had seen three months before at the military hospital; and that on seven dead bodies which he had examined, he had perceived similar appearances. On enquiring of the workmen in the manufactory, in what manner, and how long this disorder had made its appearance among them, he was told that a woman who had a swelling in her cheek, had betaken herself to one of her relations who lived in the manufactory, and had died there; and that, from that time, one or other of them was every day taken ill of the disorder. They further stated, that from the period above-mentioned to the present day, they had lost one hundred and seventeen persons, including the seven dead bodies not yet interred. This account given by Dr. Yagelsky, was corroborated by two other physicians, who had been sent the same day to examine the patients and dead bodies.

In a Memoir addressed to the Governor-General and the Senate (by whom we had been called together) we renew our declarations, that this disorder is the plague; and we advise them to remove out of the town all the persons dwelling in the manufactory, taking care to separate the sick from the healthy; that they should order the clothes and furniture of the dead and infected to be burnt; and that the strictest search should be made to find out whether the contagion existed in any other part of the city. The inhabitants are again seized with a panic; and they now too well perceive the consequences of their neglect of the precautions recommended. We were thirteen physicians at this meeting, two of whom, who three months before had agreed with us that the disease which broke out at the military hospital was the plague, now said that the present disorder was not the plague, but a putrid fever; an opinion which they enforced in a separate conference with the Senate. These two physicians (Drs. Kuhlmann and Schiadan) who still differed from us in opinion, had been led into their error, by observing that the number of deaths in the town was not greater than usual, but rather less than in the preceding years, and that there were very few people ill.

Some days after, being summoned to meet the other physicians and surgeons at the senate, where each of us was required to deliver our sentiments explicitly, I affirmed, in the most solemn manner, that I was thoroughly convinced that the disease under consideration was the plague; ten of my colleagues were of the same opinion, and the two others before mentioned still maintained the contrary; nevertheless, they admitted the propriety of adopting precautions against a disorder, which, though not the plague, was of a contagious nature.

The first day (the 11th of March) is spent in deliberations. The infected building is shut up, and guards are placed there, to prevent any person from going in or coming out. Several make their escape through the windows, and the rest are removed out of the town during the night, the uninfected to the convent of St. Simon, and the infected to the convent of St. Nicholas, one of which is distant six, and the other eight versts; from Moscow. These convents are surrounded with high walls, and have only one entrance. As it was discovered that some had died among the workmen who lived in their own houses, these were taken to a third convent, situated in like manner out of the town. Orders were given to the surgeons who had the care of all these people, to transmit daily to the Board of Health a list of the sick and dead. A committee of physicians was appointed to regulate every thing concerning the treatment of the sick, and the keeping of those who were performing quarantine free from infection; and great attention was paid to the interment of the dead. Drs. Erasmus and Yagelsky (now no more!) were entitled to great praise for the manner in which they acquitted themselves in this business. When any one of those who were under quarantine was taken ill, he was put in a separate room, and kept there until the symptoms of the plague shewed themselves, when he was conveyed in a carriage, by persons hired for that purpose, to the pest-house, viz. the convent of St. Nicholas.

The public baths, where the people are accustomed to go, at least once a week, were shut up. The town was divided into seven districts, to each of which one physician and two surgeons were appointed, for the purpose of examining all the sick as well as the dead bodies; in which business police-officers were joined with them. It was forbidden to bury the dead within the city; proper places for burying-grounds were fixed upon at some distance from the town. It was ordered, that whenever any one of the common people should be seized with the plague, he should be sent to the hospital of St. Nicholas, and that, after burning his clothes and furniture, those who had been living in the same apartment should be detained for the space of forty days in some buildings appropriated to that purpose out of the town; that if the like occurrence should happen in the house of a principal inhabitant or person of rank, all the servants who had been in the same room with the patient should perform quarantine, and that the master, together with all his family, should remain shut up in his own house for the space of eleven days. All this was sanctioned and passed into the form of a law by a resolution of the Senate. General Peter Demitrewich de Yeropkin, not more distinguished by his birth and valour than by his polished manners and humane disposition, was appointed by the Empress, Director-General of Health.

Notwithstanding what had happened, the number of those who were convinced that the plague had reached Moscow, was as yet inconsiderable. Dr. Orræus, physician to the army, who had visited impested patients at Jassy, was now passing through Moscow in his way to Petersburgh, and was requested to examine the sick and dead bodies before mentioned, which he accordingly did, and declared, that the disorder was exactly like that which, a short time before, had proved so destructive in Moldavia and Wallachia; that it was, in fact, the plague. This was further confirmed by Dr. Lærch, who was just returned from Kiow, where he had remained during the time that the plague raged there.

The weather continued very cold until the middle of April, in consequence of which the contagion became more fixed and inactive, attacking only those who dwelt with the infected. In the pest-house, the daily number of deaths did not exceed three or four; and of the manufacturers who were performing quarantine only about the same number fell ill.

According to the reports of the physicians, surgeons, and police-officers, the town appeared to be healthy. Almost every body believed that the physicians who had called the disorder the plague, had imposed upon the public; others entertained doubts on the subject. Things went on in this way until the middle of June, during which time nearly two hundred persons had died at the hospital of St. Nicholas. The number of sick and dead diminished daily there, in so much that, for a whole week, although the weather was very warm, not one fell ill of the disorder, and there only remained in the hospital a few convalescents. No further vestige of the disorder could be traced in the town.

As among the workmen of the manufactory, who had been removed from their own houses to a third convent at a distance from the other two, in order to perform quarantine, not one had been attacked with the disorder for the space of two months, they were allowed to return to their respective homes.

We now began to flatter ourselves that the plague had been entirely eradicated by the precautions which had been adopted. Scarcely, however, had we indulged in these fond hopes, when, towards the end of June, some people are taken ill of the same disorder at the hospital of St. Simon, where the quarantine was performed. On the 2nd of July, six people die in one night at a house in the suburb of Preobraginsky; a seventh, who lived with them, absconded. Livid spots, buboes, and carbuncles are found upon the dead bodies. On the following days, many of the common people fall sick in different quarters of the town, and the mortality increases to such a pitch, that the number of deaths, which commonly amounted to about ten or fifteen per day, and which, even during the prevalence of putrid fevers (as was the case for the two last years) did not exceed thirty, amounted at the end of July to as many as two hundred in the space of twenty-four hours. The sick, as well as the dead bodies, exhibited large purple spots and vibices; in many there were carbuncles and buboes. Some died suddenly, or in the space of twenty-four hours, before the buboes and carbuncles had time to come out; but the greatest number died on the third or fourth day.

In the middle of August, the number of deaths amounted daily to four hundred; and at the end of the same month to as many as six hundred. At this time buboes and carbuncles were more frequent than they had been in July. At the beginning of September there were seven hundred deaths in the space of twenty-four hours; in a few days, there were eight hundred deaths within the same number of hours; and a short time after, the deaths amounted to one thousand in a day!

The havoc was still greater during the time of the riots, which began on the 15th of September, in the evening; when an outrageous mob broke open the pest-houses and quarantine-hospitals, renewing all the religious ceremonies which it is customary with them to perform at the bed-side of the sick, and digging up the dead bodies and burying them afresh in the city. Agreeably to their ancient custom, the people began again to embrace the dead, despising all manner of precaution, which they declared to be of no avail, as the public calamity (I repeat their own words) was sent by God, to punish them for having neglected their ancient forms of worship. They further insisted, that as it was pre-ordained who should and who should not die, they must await their destiny; therefore, that all endeavours to avoid the contagion were only a trouble to themselves, and an insult to the Divinity, whose wrath was only to be appeased by their refusing all human assistance. General Yeropkin, with a small party of soldiers drawn together as speedily as possible, dispersed the mob, and restored tranquillity in a few days, after which every thing was placed on its former footing. This vast concourse and intermixture of the healthy and infected, caused the contagion to spread to such a degree, that at this time the daily number of deaths amounted to one thousand two hundred and upwards!

Moscow, one of the largest cities in Europe, consists of four circles, or inclosures, one within another; the smallest, which occupies the centre, is called Kremmel, and the second, which surrounds it, Kitaya, (or Chinese-Town); they are both inclosed by brick-walls, and the houses within them are built of brick; the third, which is called Bielogorod (or White-Town) is without walls, they having been levelled with the ground; and, lastly, the fourth called Zemlanoïgorod (from Zemla, land or earth, and Gorod, town) is defended by a ditch and rampart of earth. In the two last-named parts of Moscow the houses are, for the most part, constructed of wood. These houses do not stand close together, but are detached with spaces between, and, in general, only one family inhabits each; hence they rarely consist of more than one story, and often of a ground-floor only. The nobles keep a great number of servants; and the common people live crouded together in small wooden houses.

In winter time the nobles repair to Moscow, from all parts of the empire, bringing with them a large train of attendants. Great numbers of the common people, who were engaged during the summer in agricultural labour, return to this great city in the winter, to gain subsistence by different employments. This conflux of people makes the town so full, from the month of December to March, that the population, at this season, amounts, according to some computations, to two hundred and fifty thousand; according to others, to three hundred thousand. In the month of March, people begin to go into the country again; hence, during the summer, the number of inhabitants is, at least, one-fourth less than in winter. In 1771 the fear of catching the plague had caused a much greater number to leave the city; so that I do not think that, in the month of August, there were more than one hundred and fifty thousand remaining in the place. An idea may be formed of the destructive nature of this disorder, and the terrible activity of its poison, by reflecting, that of these one hundred and fifty thousand inhabitants, twelve hundred were daily carried off by it, (in the month of September!) The number of deaths kept at this rate for some days, and then diminished to one thousand. As the populace, during the riots, had re-established all the religious ceremonies customary on burying the dead, almost all their priests, deacons, and other ecclesiastics, fell victims to the contagion.

The people, brought to a sense of their duty, partly by the rigorous measures employed against them, and partly by seeing that the public calamity had been aggravated by their disorderly proceedings, now began to implore our assistance. The monasteries and other pest-houses were full; the sick were no longer carried thither; the contagion had spread every where; insomuch that the city itself might be considered as one entire hospital. All, therefore, we could now do, was to exhort every individual to take care of himself; to warn all those who were yet free from the contagion, to avoid, as much as possible, touching with their bare hands any infected person; to direct them to burn the clothes, and every thing else that had been used by those who had been ill of the plague; and, lastly, to keep their rooms clean and well aired.

At this time Count Gregory Orlow arrived at Moscow, invested with full powers by the empress. I received an order, in common with the other physicians, to deliver, in writing, my private sentiments on the subject; we were required to turn our attention principally to the most proper measures for destroying the contagion. Having taken the necessary steps to prevent all further popular commotions, the Count selected, from all our papers, what appeared of most moment, and drew up a set of regulations, as well for the treatment of the sick, as for the keeping of those who were yet well, free from infection. He also ordered new hospitals to be immediately built for the reception of the poor seized with the plague.

Some months had elapsed since the plague had been carried to many of the villages, as well in the vicinity as at a distance from Moscow. Persons who fled from this city had also carried it with them to Kalomna (Kaluga, according to Orræus), Yaroslaw, and Tula. Inspectors of health, attended by physicians and surgeons, were sent to these infected towns and villages.

A Council of Health was formed, composed of General Yeropkin (who was president), of some counsellors of state, and of three physicians, and one surgeon. This council received daily reports from the physicians and police-officers, and took cognizance of every thing which related to the health of the inhabitants. Two physicians, Drs. Pogaretzky and Meltzer, being offered a reward of one thousand roubles, undertook, each of them, the care of a pest-hospital; and went thither accordingly.

On the 10th of October the frost set in; from that day the disorder was less fatal, and the contagion became more fixed. The number of sick and dead gradually diminished; and the disorder, which a short time before had terminated on the second or third day, now kept on to the fifth or sixth. Neither those large purple spots, which we have before described, nor carbuncles, were by any means so frequent as they had been; buboes were now almost the only tumours found upon the infected.

The hard frost which prevailed during the two last months of the year, weakened the pestilential virus to such a degree, that those who attended the sick and buried the dead were in much less danger of being infected; and when they were infected, the symptoms were much milder; so that at this period, several persons who had the plague were but slightly indisposed, and walked about though they had buboes upon them.