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Immanuel Kant: Note to Physicians (1782) Kants Werke. Akademie Textausgabe VIII, pp. 5-8.
[tr. by Robert R. Clewis]
With respect to the symptoms and the effective remedies against them, the noteworthy and bizarre epidemic that just subsided for us is in fact a topic only for physicians; yet its spread and traveling through vast countries still elicits the bewilderment and scrutiny of those who see this peculiar phenomenon merely from the perspective of a physical geographer. In this regard, one will not see it as a meddling into foreign business if I expect physicians of broader ideas to investigate as much as possible the course of this disease, which seems to spread not by the air quality, but by simple contagion. The community with the rest of the world into which Europe, by ship and by caravan, has entered, spreads many diseases around the world, so that it is with great probability that one believes that Russia’s land trade with China brought into their country several kinds of harmful insects from the Far East, which with time may well spread further. According to public announcements, our epidemic began in St. Petersburg, and from there gradually proceeded to the coast of the Baltic Sea, without skipping over the places in between, until it came to us and moved westward, to and beyond West Prussia and Danzig, almost like the pestilence of Aleppo as described by Russell, although this one in no way compares to that terrible plague with regard to destructiveness. Letters from St. Petersburg brought it to our attention under the name of influenza, and it seems that it is the same disease that raged in London in 1775, and that the contemporary letters from that time likewise called influenza. To allow experts to compare the two epidemics, I here append the translation of a note by the famous D. Fothergill (now deceased) as it has been communicated to me by a friend. I. Kant.
The Gentleman’s Magazine of February 1776
A Sketch of the late Epidemic Disease,
as it appeared in London.
About the beginning of the last month, it was mentioned to me in many families, that most of the servants were sick; that they had colds, coughs, sore-throats, and various other complaints.
In the space of a week these complaints became more general ; few servants escaped them, especially the men, who were most abroad : many of the other sex, likewise, and people of higher condition, were attacked ; nor were children wholly exempted.
The disease, which had hitherto been either left entirely to itself, or had been treated with the usual domestic medicines appropriated to colds, now claimed the attention of the faculty, and, for the space of near three weeks, kept them for the most part universally employed.
Most of those whom I saw, were seized (and often so suddenly as to be sensible of the attack) with a swimming or flight pain in the head, a soreness of the throat, and all over the body with a sense of coldness, particularly in the extremities. A cough soon followed, a running of the nose, watery eyes, flight nausea, frequent calls to make water, and some were seized with a diarrhoea.
More or less of feverish heat, inquietude, pain about the breast, praecordis, and in the limbs, soon succeeded, but in various degrees. Many were capable of coninuing in their usual occupations under these symptoms ; others were obliged to submit to confinement ; and not a few to their beds.
The tongue was always moist ; the skin seldom remarkably hot or dry ; the pulse often full quick, and harder than one would have expected from such a temperature of the skin.
Several were seized with a diarrhoea : the stools were always black, or of a deep yellow colour ; and so were those, for the most part, which were procured by purgative medicines.
In a few days every complaint abated, except the cough ; this continued the longest of all the symptoms, and, in the fore part of the night, was exceedingly troublesome and vexatious ; towards morning generally came on a sweat and easy expectoration.
Those who were seized at first with very copious defluctions from the nose and the fauces, or had a plentiful and spontaneous discharge of black bilious stools, or made large quantities of a high-coloured urine, or sweated profusely, of their own accord, a night or two after the seizure, soonest grew well.
In many cases itw as necessary to take away some blood, the condition of the pulse and vehemence of the cough making it necessary. The blood was almost uniformly sizy, representing a flat cake of yellow tallow, floating in a deep yellow serum. Very few instances occurred where the size formed that cup-like appearance which occurs in most of the genuine inflammatory disorders.
By warmth, diluting, cooling liquids, mild diaphoretics, gentle and repeated purgatives, the disease for the most part soon gave way, in subjects otherwise healthy. Sometimes it was necessary to repeat the bleeding ; sometimes blisters became necessary and were serviceable in abating the cough, which was the last of all the symptoms that gave way ; after the necessary evacuations, anodynes for the most part had very salutary effects.
In many instances the disease assumed the type of an intermittent towards its decline ; the bark however did not generally succeed in curing it. The symptoms, as often happens in bilious disorders, were sometimes aggravated by this medicine. A few doses of some mild cathartic most commonly removed it effectually.
Many who neglected themselves and went abroad with the distemper upon them, frequently got additional colds, and brought on a fever of the most dangerous kind ; a few died phrenetic.
Ancient, asthmatic persons, were likewise great sufferers for the most part ; a peripneumonic fever came gradually on, which often terminated fatally ; and of those who did recover, their amendment was slow, and medication difficult.
And indeed it appeared that very few persons wholly escaped the influence of this morbid constitution : for it seemed to aggravate every present malady.
It proved fatal likewise to several very young children, disposing them to violent coughs or diarrhoeas.
Perhaps, however, there is scarcely an instance to be met with, of any epidemic disease in this city, where so many persons were seized, and in so short a time, and with so little comparative mortality.
Though attempts to ascertain the causes of epidemics are for the most part more specious than substantial, it may not be improper to mention a few facts that gained my attention ; to others many more may have occurred, and worthy to be recorded. During the greatest part of the summer, in that part of the country where I then was (Cheshire), the air was of the most equal temperature I ever knew. In the space of two months the quicksilver in the thermometer once rose to 68°, once fell to 56; but for six weeks together, it kept between 60 and 66 continually, day and night.
The barometer did not vary much more. The weather was during this time very changeable, much inclining to wet; and though it rained more or less almost every other day for six weeks, yet upon the whole no unusual quantity of rain fell; it sank into the ground as it fell, and made the earth very soft and miry; but seldom swelled the brooks, or occasioned floods.
During this time, horses and dogs were much affected; those especially that were well kept. The horses had severe coughs, were hot, forbore eating, and were long in recovering. Not many of them died that I heard of; but several dogs.
To the consideration of the faculty in this city, is this sketch of the late epidemic submitted, with all due deference; and with a request, that, if the observations they have made do not correspond with this recital, they will be pleased to communicate their remarks while the remembrance of the facts are recent; in order that as exact an account of this disease as possible may be submitted to our successors.
If those physicians in the country, into whose hands this essay may come, will be so obliging as to mention the time when this epidemic made its appearance in their neighbourhood, and wherein it differed from the preceding sketch, either in the symptoms, or the method of cure, they will likewise contribute to the same good purpose. The united observations of the faculty at large must greatly exceed the utmost efforts of any individual, however warmly he may be disposed to promote the utility of his profession.
London, 6th Dec. 1775.
JOHN FOTHERGILL.