[20] Vide Medical Gazette.
Even should that worst of true contagions, the plague of the Levant,
which every nation is bound to guard against, despite of all our
precautions, be introduced amongst us, measures better calculated for
the destruction of a community, could scarcely be devised, than the
ancient quarantine regulations; for they certainly would convert every
house proscribed by their mark, into a den and focus of the most
concentrated pestilential contagion, ensuring fearful retribution upon
those who had thus so blindly shut them up. The mark alone, besides
being equivalent to a sentence of death upon all the inmates, would
effect all this—the sick would be left to die unassisted, unpurified,
uncleansed amidst their accumulated contagion, and the dead, as has
happened before, lie unburied or scarcely covered in, till they
putrified in pestiferous heaps. Most certainly it would be proper and
beneficial, even a duty, for all who could afford the means, and were
not detained by public duties, to fly the place, and equally proper for
the other residents who continued in health, to segregate themselves as
they best could.—Plenty of free labour amongst those who must ever work
for their daily bread, would still remain for all municipal purposes,
and these our rulers, so far from consenting thus to proscribe the sick,
should employ openly in giving them every succour and aid, under the
direction and with instructions of safety from a well arranged medical
police. It would not be difficult to show, that the mortality, during
the last great plague in London, was increased a hundred fold, by
following the very measures now recommended in these regulations; and,
that the barbarous predestinarian Turk, in the very head quarters of the
plague itself, who despises all regulation, but
Pt_2
[Pg 14]
attends his sick friend
to the last, never yet brought down upon his country such calamitous
visitations of pestilence, as enlightened Christian nations have
inflicted upon themselves, by ill-judged laws. The Turk, to be sure, by
rejecting all precaution, and admitting, without scruple, infection into
his ports, sees Constantinople invaded by the plague every year; but,
when not preposterously interfered with, it passes away, even amongst
that wretched population, like a common epidemic, without leaving any
remarkable traces of devastation behind it: and surely to establish and
make a pest-house of the dwelling of every patient who might be
discovered or even suspected to be ill, would be most preposterous. The
writing on the wall would not be more apalling to the people, and
scarcely less fatal to the object, than the cry of mad dog in the
streets, with this difference, that when the dog was killed, the scene
would be closed, but the proscribed patient would remain, even in his
death and after it, to avenge the wrong.
But sufficient to the day is the evil thereof, the question is now of
Cholera Morbus; I am willing to meet any objection, and the most obvious
one that can be offered to me, (if it be not an imported disease) is its
first appearance in our commercial sea-ports. To this I might answer,
that it has been hovering over us, making occasional stoops, for the
last six months, even in the most inland parts of the country; but I
will waive that advantage, and meet it on plainer grounds of argument
and truth.—An atmospherical poison must evidently possess the greatest
influence, where it finds the human race under the most unfavourable
circumstances of living, habits, locality, and condition. Now, where can
these be met with so obviously as in our large sea-port towns on the
lowest levels of the country, and in their crowded alleys, always near
to the harbour for the shipping? There the disease, if its seeds existed
in the atmosphere, would be most likely to break out in preference to
all other situations; and if at the time of its so appearing, ships
should arrive, as they are constantly doing from all parts of the world,
whose crews, according
Pt_2
[Pg 15]
to the custom of sailors, plunge instantly into
drunkenness and debauchery, and present as it were, ready prepared, the
very subjects the pestilence was waiting for; how easy then, for an
alarmed or prejudiced board of health to point out the supposed
importing vessel, and freight her with a cargo of the new pestilence
from any part of the world they may choose to fix upon. This is no
imaginary case; it was for long of annual occurrence with respect to the
yellow fever, both in the West Indies and North America. "There our
thoughtless intemperate sailors were not only the first to suffer from
the epidemic, in its course or about to begin, but they were denounced
as the importers, by the prejudiced vulgar, and the accusation was
loudly re-echoed even amongst the better informed, by all who wished to
make themselves believe that pestilence could not be a native product of
their own atmosphere and habitations."
Before I have done, I feel called upon to say a few words upon the
efficacy of fumigation as a preservative against Cholera Morbus and
other infectious diseases. In regard to the first the question is
settled. In Russia, throughout Germany, and I believe everywhere else in
Europe, they were productive of no good, they did mischief, and were
therefore discontinued. This has been verified by reports from the seats
of the disease everywhere. In regard to other contagions I can speak,
not without knowledge, at least not without experience, for it was the
business and the duty of my military life, during a long course of
years, to see them practised in ships, barracks, hospitals, and
cantonements, and I can truly declare I never saw contagion in the
smallest degree arrested by them, and that disease never failed to
spread, and follow its course unobstructed, and unimpeded by their use.
In the well-conditioned houses of the affluent where ventilation and
cleanliness are matters of habit and domestic discipline, they may be a
harmless plaything during the prevalence of scarlet fever and such like
infections, or even do a little good by inspiring the attendants with
confidence, however false, as a preservative against contagion; but in
the confined dwellings
Pt_2
[Pg 16]
of the poor they are positively mischievous,
because they cannot be used without shutting out the wholesome
atmospheric air, and substituting for it a factitious gas, which for
aught we know, or can know of the nature of the contagious vapour,
whether acid, alkaline, or anything else, may actually be adding to its
deleterious principle instead of neutralising it: but in thus striking
away a prop from the confidence of the poor, I thank God I can furnish
them with other preservatives and disinfectants, which I take it upon me
to say, they will find as simple and practicable as they are infallible.
For the first, the liberal use of cold water and observance of free
ventilation, with slaked lime to wash the walls, and quick lime when
they can get it, to purify their dung heaps and necessaries, are among
the best; but when actually infected, then heat is the only purificator
yet known of an infected dwelling. Let boiling water be plentifully used
to every part of the house and article of furniture to which it can be
made applicable. Let portable iron stoves, filled with ignited charcoal
only, be placed in the apartment closely shut, and the heat kept up for
a few hours to any safe degree of not less than 120° Farenheit, and let
foul infected beds and mattresses be placed in a baker's oven heated to
the same,[21] and
my life for it no infection can after that possibly
adhere to houses, clothes, or furniture. The living fountain of
infection from the patient himself, constantly giving out the fresh
material, cannot of course be so closed, but whether he lives or dies,
if the above be observed, he will leave no infection behind
him.[22]
[21] The oven on that account need not lose character with bread-eaters, for according to the old adage, Omne vitium per ignem excoquitur.
[22] Light too, more especially when assisted by a current of atmospheric air, is a true and sure disinfectant, but it is not so applicable as heat in the common contagions, from requiring an exposure of the infected substances for days together, or even a longer period, before it can be made effective.
It is now time to bring this tedious letter to a close; I shall be
happy, through the same channel, to give any information, or answer any
inquiries that may be authenticated by the signature of the writer; but
anonymous writing of any kind, I shall not consider
Pt_2
[Pg 17]
myself bound to
notice. Should the dreaded disease spread its ravages throughout our
population, I may then, at some future early opportunity, trusting to
your indulgence, trespass again upon your columns with further
communications on this most interesting subject.
P.S.—Throughout the foregoing letter, I have used the words contagion and infection as precisely synonymous terms, meaning communicability of disease from one person to another.
Sir,—In my last letter, I treated of the practicability of guarding our country against the now European and Continental disease, malignant Cholera Morbus, by quarantine regulations. In the present one, it is my intention still in a popular manner to scrutinise more deeply, the doctrine of imported contagions; to point out, if I can, those true contagions which can be warded off by our own exertions, in contradistinction to others which are altogether beyond our controul; and here it may be as well to premise, that when I use the term epidemic, I mean atmospheric influence, endemic-terrestrial influence, or emanation from the soil; and by pestilential, I mean the spread of malignant disease without any reference to its source. The terms contagion and infection have already been explained.
It must be evident, that legislative precaution can only be made
applicable to the first of these. The last being unchangeable by human
authority, are not to be assailed by any decrees we can fulminate
against them; and if it can be shown, which it has been
Pt_2
[Pg 18]
by our best and
latest reports, that Cholera Morbus eminently and indisputably belongs
to that class—that the strictest cordons of armed men could not avail
to save the towns of the continent, nor the strictest quarantine our own
shores, from its invasion—it surely must be time to cease those vain
attempts, to lay down the arms that have proved so useless, and turn our
undivided attention, now that it has fairly got amongst us, to
conservative police, and the treatment of the disease; but as the
contagionists still insist that it was imported from Hamburgh to
Sunderland, it behoves us to clear away this preliminary difficulty
before proceeding to other points of the enquiry.
I take it for granted, that ships proceeding from Sunderland to Hamburgh
could only be colliers, and that according to the custom of such
vessels, they returned, as they do from the port of London, light; and I
admit, that on or about the time of their return, Cholera Morbus, under
the severe form which characterises the Asiatic disease, made its
appearance in that port, presenting a fair prima facie case of
imported contagion; but as at the period of its thus breaking out in
Sunderland, a case equally as fatal and severe shewed itself, according
to the public accounts, in the upper part of Newcastle, 10 miles off;
another equally well-marked, in a healthy quarter in Edinburgh; a third,
not long before in Rugby, in the very centre of the kingdom; and a
fourth in Sunderland itself, as far back as the month of August, as well
as many others in different parts of the
country;[23] it
became incumbent on the quarantine authorities, indeed upon all men
interested in the question, whether contagionists or otherwise, to shew
the true state of these vessels, as well as of the cases above alluded to,
and whether the Cholera Morbus had ever been on board of them, either at
Hamburgh or during the homeward
Pt_2
[Pg 19]
voyage, so as by any possibility they
could have introduced the disease into an English port. Now will any
person pretend to say that this has been done, or that it could not have
been done, or deny that it was a measure, which, if properly executed,
would have thrown light upon the true character of the disease, not only
for the information of our own government but of every government in
Europe; that deputations from the Board of Health, backed and supported
by all the power and machinery of government, with the suspected ships
locked up in quarantine, and the persons of the crews actually in their
power, could not have verified to the very letter, the history of every
hour and day of their health, from the moment of their arrival at
Hamburgh till their return into port? This measure was so obviously and
imperiously called for, as constituting the only rational ground on
which the importing contagionists could stand, or their opponents meet
them in argument, that after having waited in vain for the report, I
raised my own feeble voice in the only department to which I had access,
urging an immediate, though then late, investigation. No good cause,
having truth for its basis, could have been so overlooked, and without
unfairness or illiberality, we are irresistibly forced to the
conclusion, that had the enquiry (the only one, by the bye, worth
pursuing, as bearing directly on the question at issue) been pushed to
the proof, it would have shown the utter nullity of quarantine guards
against atmospherical pestilence, the thorough baselessness of the
doctrine of importation.
[23] Two of a type most unusual for this country, and the Winter Season, have occurred in the vale of the Thames, not far from here, which, as they both recovered, and the disease did not spread in any way, were very properly allowed to pass without sounding any alarm, but the gentleman who attended one of the cases, and had been familiar with the disease in India, at once recognized it again, in its principal distinguishing features.
Without entering into the miserable disputes on this subject, which, amidst a tissue of fable and prejudice, self-interest and misrepresentation, have so often disgraced the medical profession at Gibraltar; I shall now proceed to shew, by reference to general causes, how baseless and mischievous have been the same doctrines and authority when exercised in that part of the British dominions:—
Within the last thirty years, yellow fever has, at least four times,
invaded the fortress of Gibraltar; during which time also, the
Pt_2
[Pg 20]
population of its over-crowded town has more than quadrupled, presenting
as fair a field, for the generation within, or reception from without,
of imported pestilence as can well be imagined,—yet plague, the truest
of all contagions, typhus fever, and other infectious diseases, have
never prevailed, as far as I know, amongst them. The plague of the
Levant has not been there, I believe, for 150 years; yet Gibraltar, the
free port of the Mediterranean, open to every flag, stands directly in
the course of the only maritime outlet, from its abode and birth-place
in the east, being in fact, to use the language of the road, the house
of call for the commerce of all nations coming from the upper
Mediterranean. Now, can there be a more obvious inference from all this,
than that the plague, being a true contagion, may be kept off without
difficulty, by ordinary quarantine precautions; but the other being an
endemic malarious disease, generated during particular seasons, within
the garrison itself, and the offspring of its own soil, is altogether
beyond their controul. The malarious or marsh poison, which in our
colder latitudes produces common ague, in the warmer, remittent fever,
and in unfavourable southern localities of Europe, (such as those of
crowded towns, where the heat has been steadily for some time of an
intertropical degree)—true yellow fever, which is no more than the
highest grade of malarious disease; but this has never occurred in
European towns, unless during the driest seasons—seasons actually
blighted by drought, when hot withering land winds have destroyed
surface vegetation, and as in the locality of Gibraltar, have left the
low-lying becalmed, and leeward town to corrupt without perflation or
ventilation amidst its own accumulated exhalations. I know not how I can
better illustrate the situation of Gibraltar in these pestiferous
seasons, than by a quotation from a report of my own on the Island of
Guadaloupe, in the year 1816, which, though written without any possible
reference to the question at issue, has become more apposite than
anything else I could advance; "all regular currents of wind have the
effect of dispersing malaria; when this purifying influence is
with-held, either through
Pt_2
[Pg 21]
the circumstances of season, or when it
cannot be made to sweep the land on account of the intervention of high
hills, the consequences are most fatal. The leeward shores of
Guadaloupe, for a course of nearly 30 miles, under the shelter of a very
steep ridge of volcanic mountains, never felt the sea breeze, nor any
breeze but the night land-wind from the mountains; and though the soil,
which I have often examined, is a remarkably open, dry and pure one,
being mostly sand and gravel, altogether, and positively without marsh,
in the most dangerous places, it is inconceivably pestiferous throughout
the whole tract, and in no place more so than the bare sandy beach near
the high-water mark. The coloured people alone ever venture to inhabit
it; and when they see strangers tarrying on the shore after nightfall,
they never fail to warn them of their danger. The same remark holds good
in regard to the greater part of the leeward coasts of Martinique, and
the leeward alluvial bases and
recesses[24] of
hills, in whatever port
of the torrid zone they may be placed, with the exception, probably of
the immediate sites of towns, where the pavements prevent the rain-water
being absorbed into the soil, and hold it up to speedy evaporation."
Now, conceive a populous crowded town placed in this situation, and you
have exactly what Gibraltar and the other towns of Spain and North
America, liable to yellow fever, must become in such seasons as I have
above described, only, that as they grow more populous and crowded, the
danger must be greater, and its visitations more frequent, unless the
internal health police be made to keep pace in improvement, with the
increasing population.
[24] The leeward niches and recesses of hills, however dry and rocky, become in these seasons of drought, absolute dens of malaria, this will be found proven in my reports made especially of the islands of Dominique and Trinidad, which may be seen at the Army Medical Board Office.
Now in the name of injured commerce—of the deluded people of
England—of medical science—of truth and humanity—what occasion can
their be to institute an expensive quarantine against such a state of
things as this, which can only be mitigated by domestic
Pt_2
[Pg 22]
health police;
or why conjure up the unreal phantom of an imported plague, to delude
the unhappy sufferers, as much in regard to the true nature of the
disease, as to the measures best calculated for their own preservation;
when it must be evident that the pestilence has sprung from amidst
themselves, and that had it been an external contagion in any degree,
the ordinary quarantine, as in case of the plague, would certainly have
kept it off; but the question of the contagion of yellow fever, so
important to commerce and humanity; and which, like the Cholera, has
more than once been used to alarm the coasts of England, demands yet
further investigation.
For nearly 40 years have the medical departments of our army and navy
been furnished with evidence, from beyond the Atlantic, that this
disease possessed no contagious property whatever. These proofs now lie
recorded by hundreds in their respective offices, and I take it upon me
to say, they will not be found contradicted by more than one out of a
hundred, amongst all the reports from the West Indies, which is as much
the birth-place of the yellow fever, as Egypt is of the plague: yet, in
the face of such a mass of evidence, as great or greater probably than
ever was accumulated upon any medical question, has our Government been
deluded, to vex commerce with unnecessary restraints, to inflict
needless cruelties upon commercial communities, (for what cruelty can be
greater than after destroying their means of subsistence by quarantine
laws, to pen them up in a den of pestilence, there to perish without
escape, amidst their own malarious poison?) and to burden the country
with the costs of expensive quarantine establishments. Surely if these
departments had done their duty, or will now do it, in so far as to
furnish our rulers with an abstract of that evidence, with or without
their own opinions, for opinions are as dust in the balance when put in
competition with recorded facts, it must be impossible that the delusion
could be suffered to endure for another year; or should they unluckily
fail thereby to produce conviction on Government, they can refer to the
records of commerce, and of our transport departments,
Pt_2
[Pg 23]
which will shew,
if enquiry be made, that no ship, however deeply infected before she
left the port, (and all ships were uniformly so infected wherever the
pestilence raged) ever yet produced, or was able to carry a case of
yellow fever beyond the boundaries of the tropics, on the homeward
voyage, and that therefore the stories of conveying it beyond seas to
Gibraltar, must have been absolutely chimerical. It would indeed, have
been a work of supererrogation, little called for, for I think I have
fully shown that Gibraltar must be abundantly qualified to manufacture
yellow fever for herself.
No less chimerical will be the attempt to shut out Cholera Morbus from our shores by quarantine laws, because throughout Europe, ready prepared, alarmed, and in arms against it, they have succeeded nowhere; whereas, had it been a true contagion and nothing else, they must, with ordinary care, have succeeded everywhere; the disease, as if in mockery, broke through the cordons of armed men, sweeping over the walls of fortified towns, and following its course, even across seas, to the shores of Britain; and yet we are still pretending to oppose it with these foiled weapons.
We are indeed told, by authority, that its appearance in towns has
always been coincident with the arrival of barges from inland, or by
ships from the sea, but if it be not shown at the same time that the
crews of these barges had been infected with the disease, or if, as at
Sunderland, no person on board the ships can be identified as having
introduced it, while we know that the disease actually was there two
months before, we may well ask at what time of the year barges and ships
do not arrive in a commercial seaport, or where an epidemic disease,
during pestiferous seasons could be more likely to break out than where
the most likely subjects are thrown into the most likely places for its
explosion, such as newly arrived sailors in an unwholesome seaport,
where the license of the shore, or the despondency of quarantine
imprisonment must equally dispose them to become its victims.—Besides,
what kind of quarantine can we possibly establish with the
Pt_2
[Pg 24]
smallest chance of being successful against men who have not got, and never had
the disease. Merchandise has been declared incapable of conveying the
infection,[25] and
are we to interdict the hulls and rigging of Vessels
bearing healthy crews, or are we to shut our ports at once against all
commerce with the North of Europe, and would this prove successful if we
did? a reference to a familiar epidemic will I think at once answer this
question.
[25] Vide Russian Ukase.
It is only three months ago that the epidemic Catarrh or Influenza spread throughout the land, travelling like the Cholera in India, when it went up the monsoon, without regard to the East wind; and what could be more likely than the blighting drying process of such a wind, in either the one or the other case, to prepare the body for falling under the influence of whatever disease might be afloat in the atmosphere. In general this passing disease can be distinctly traced, as having affected our continental neighbours on the other side of the channel before ourselves: now can it be supposed that any quarantine could have prevented its first invasion, or arrested its farther progress amongst us. How ridiculous would have been the attempt, and yet with the experience of all Europe before us, have we been enacting that very part with the Cholera Morbus: but further, the same authority which calls for the establishment of quarantine in our ports, tells us that neither proximity nor contact with the sick,[26] is requisite for the production of the disease: now can anything further be wanting beyond this admission, to prove that it must be an epidemic atmospherical poison, and not a personal contagion, and that, under such circumstances, the establishment of quarantine against persons and goods, would manifestly be absurd and uncalled for. So fully satisfied has the Austrian Government been made by experience, of the futility and cruelty of such quarantines, that the Emperor apologises to his subjects for having inflicted them. The King of Prussia makes a similar amende, and the Emperor of Russia convinced by the same experience, abolished or greatly relaxed his quarantines several mouths ago.
[26] Vide Reports from Russia.
Pt_2
[Pg 25]
I am by no means prepared to assert, because I cannot possibly know to
the contrary, although from the analogy of other disease I do not
believe it, that the Cholera Morbus may not become contagious under
certain conditions of the atmosphere, but these cannot be made subject
to quarantine laws, and I am fully prepared to acknowledge, that as in
the case of other epidemics, it may be made contagious through defective
police; but independent of these, it possesses other powers and
qualities of self-diffusion, which we can neither understand nor
controul. Such, however, is not the case with that other phantom of our
quarantine laws—the yellow fever—which can never, under any
circumstances of atmosphere, without the aid of the last be made a
contagious disease. I speak thus decisively from my experience of its
character, as one of the survivors of the St. Domingo war, where, in a
period of little more than four years, nearly 700 British commissioned
officers, and 30,000 men were swept away by its virulence; as also from
subsequent experience, after an interval of 20 years, when in the course
of time and service, I became principal medical officer of the windward
and leeward colonies, and in that capacity, surveyed and reported upon
the whole of these transatlantic possessions.
It was my intention, in these times of panic, to designate to my
countrymen, in as far as I could, the true essential intrinsic
contagions of the British Isles, (for such there are, and terrible ones
too,) which prevail under all circumstances of season, atmosphere, and
locality, as contradistinguished from the factitious ones, of our own
creating, and the imaginary or false which often spread epidemically,
(for there may be an epidemic as well as contagious current of
disease)[27] although
they possess no contagious
Pt_2
[Pg 26]
property whatever; as
well as the foreign contagions, which if we relax in due precaution,
may, at any time, be introduced amongst us—but the unreasonable length
of this letter, for a newspaper communication, warns me to stop.
[27] For as long as men congregate together, and every supposable degree of communication must of necessity be constantly taking place amongst them, to distinguish a spreading epidemic from a contagious disease when it first breaks out, must obviously be a matter of impossibility; and upon this point the contagionists and their antagonists may rail for ever,—the one will see nothing but contagion, whether in the dead or the living body, and the other will refer every fresh case to atmospheric or terrestrial influence, and both with as much apparent reason as they possibly could desire: but the candid impartial investigator, who waits to observe the course of the disease before coming to a conclusion, and refers to the facts furnished in the Cholera Hospitals of Warsaw and the sick quarters of Sunderland, will never be deceived in regard to its real nature, nor propagate the appalling belief that Cholera Morbus can be made a transportable and transmissible contagion.
I have written thus earnestly, because I deeply feel what I have here put down. It is possible I may have made mistakes, but if I have, they are not intentional, and I shall be happy to be corrected, for I do not live at the head quarters of communication, and my broken health prevents my frequenting in person, the field of investigation. In candour I ought to declare, that the establishment of quarantine against this new and hideous pestilence in the first instance, was the most sacred duty of Government, but now that its true character has been made known, and the futility of quarantine restrictions demonstrated, I feel equally bound, as one of the lieges, to enter my humble protest against their continuance.
Should I write again, I shall still adopt the same popular style, for no other can be adapted to a newspaper communication, and the subject-matter is as interesting to the public, and every head of a family, as it can be to the professional reader; and, in thus making use of your columns, as I can have no motive but that of ardent research after truth, I know that I may always rely upon your assistance and co-operation.
In this paper it is my intention to treat of the contagious diseases of the British Isles, as well as to offer to the Society some observations on malignant Cholera Morbus, and the mode of its propagation from the tropical regions, where it first arose, to the colder latitudes of Europe.
Having already published two letters on this last part of my subject, I need not here take up your time in recapitulating their contents, but proceed to the consideration of some remaining points of the enquiry; which I find I have either overlooked, or not been so explicit in illustration, as I otherwise might, had I been addressing a body of professional men, instead of the community where I live, with the view of disabusing their minds from the effects of irrational panic, and opening their eyes to what I deemed true measures of preservation against the impending disease; and here I may as well add that when I wrote in a newspaper and adopted the style suited to such a channel of communication, I knew none so likely to attract the attention of those influential men, who might possess the power and the will, when disabused of prejudice, to enforce proper laws, instead of running the course that had already been imposed upon them, by men interested in the upholding of our quarantine establishments, or by prejudiced, however well meaning, Boards of Health.
In looking over those letters, I find that the points most open to
dispute are the course of the disease throughout the Indian peninsula,
and its progress to the frontiers of Russia; as well as its supposed
infectious nature, and mode of propagation by human intercourse. In
regard to the first, there is no contagionist however avowed and
uncompromising, who does not admit that this erratic disease did not
often wander from its straight line when the most promising fields lay
directly before it; or stop short most
Pt_2
[Pg 28]
unaccountably in its progress,
when the richest harvest of victims seemed actually within its
jaws—that its course was circuitous when, according to the laws of
contagion, it ought to have been straight,—that it refused its prey at
one time, and returned to it at another, in a manner that showed its
progress was governed by laws which we could neither understand nor
controul; and if we search the reports of contagionist writers, we shall
find fully as much, and as strong evidence of its progress being
independent of human intercourse, as of its being propagated and
governed by the laws of
contagion.[28]
[28] Vide Orton, Kennedy, &c.
To the question, which has so often been triumphantly asked, of its
progress to the Russian frontiers being conducted by caravans along the
great highways of human intercourse, and what else than contagion could
cause it to be so carried? An admirable journalist has already replied
by asking in his turn, on what other line than amongst the haunts of men
could we possibly have found, or detected a human disease? And surely
the question is most pertinent, for in those barbarous regions that
interpose between Russia and India, where the wolf and the robber hold
divided alternate sway, and isolated man dares not fix his habitation,
but must congregate for safety; where else than in those great
thoroughfares could the disease have found its food; or if beyond these,
man, almost as ignorant and as savage as the wolf, could have been
found; who under such circumstances would have recognised, described,
and testified to its existence? Even at Sunderland, amongst ourselves,
its existence was long hotly disputed by the learned of the faculty; and
the fatalist barbarian of these regions would have dismissed the enquiry
with a prayer of resignation, while he bowed his head to the grave, or
if his strength permitted, with a stroke of his dagger against the
impious enquirer who had dared to interfere with the immutable decrees
of fate. The stories too of its importation into Russia, are exactly the
same as have come to us from our own Gibraltar, in the case of
Pt_2
[Pg 29]
the yellow fever, and may be expected to come from every other quarter where
a well paid officious quarantine is established to find infection in its
own defence, and to trace its course in proof of their own services and
utility. Under such circumstances, this well gotten up drama of
importation may be rehearsed in every epidemic, adapted in all its parts
to every place and every disease, they wish to make contagious. First
will be presented, as at Gibraltar, the actual importers—their course
traced—the disease identified—its reception denounced, and quarantine
established; and this will go down until sober minded disinterested men
become engaged in the enquiry, when it will turn out in all probability,
that the importers, as at Sunderland, never had the disease—that it was
in the place long before their arrival—that in its supposed course, it
either had no existence, or had long ceased—in fact that the
importation was a fable, the product either of design or an alarmed
imagination. On this point I shall not here farther dwell, but proceed
to the still keenly disputed question of its contagious, or
non-contagious nature.
Amongst all those who have advocated the affirmative side of the
question, an anonymous writer in the
Lancet, of Nov. 19th. seems to me
the ablest special pleader of his party, and the best informed on the
subject, which he has grappled with a degree of acumen and power that
must at once have secured him the victory, in any cause that had truth
for its basis, or that could have stood by itself; but strong and
scornful as he is, he has himself furnished the weapons for his own
defeat, and has only to be correctly quoted in his own words, for answer
to the most imposing and powerful of his arguments. I take it for
granted, that no one will give credit to instantaneous infection, at
first sight, but allow that an interval must elapse between the
reception of the virus, and explosion of the disease. Kennedy and the
best of the contagionist authors, have fixed the intervening time from
two days to a longer uncertain period; yet that writer (in the Lancet)
proceeds to tell us, in proof of the virulence of the contagion, that
when twenty healthy reapers
Pt_2
[Pg 30]
went into the harvest field at Swedia, near
Tripoli, and one of them at mid-day was struck down with the disease, he
then instantly, as if, instead of being prostrate on the ground, he had
run a muck for the propagation of Cholera Morbus, infected all the rest,
so that the whole were down within three hours, and all were dead before
the following
morning.[29]—All
this too in the open air. Another writer
of note relates that when a healthy ship on the outward voyage arrived
in Madras Roads, her people were seized with Cholera Morbus that very
morning; but they go further than this, and command us to believe in its
contagious powers, without sight at all, quoting the report from our
Commissioners in Russia, where it is officially announced "that neither
the presence, nor contact of the patient is necessary to communicate the
disease." Surely in candour we may be allowed to say that when they
limit their views to contagion alone, they have attributed powers to it,
which it never did, and never can possess. That some other principle,
besides their favourite one, must have been in operation, as well in the
field of Swedia, when it struck down the reapers, as when it blighted
our armies in the East, for these sudden bursts and explosions of
pestilence are incompatible with the laws and progress of natural
contagion,—that if, under a tropical temperature, which dissipates all
infection, there be contagion in the disease, their must also be other
powers of diffusion hitherto inscrutable, incomprehensible, and
uncontroulable,—that their doctrine of contagion exclusively, is
superficial narrow, and intolerant, and their arguments in support of
it, no more than a delusion of prejudice, a piece of consummate special
pleading to make the worse appear the better
reason.[30]
[29] The precise words are "20 peasants of Swedia, robust, vigorous, and in the flower of life, were labouring at the harvest work, when on the 9th. of July, at noon, one was suddenly attacked, and the others in a short time showed symptoms of the disorder. In three hours, the entire band was exhausted; before sunset many had ceased to live, and by the morrow there was no survivor."
[30] The remainder of the paper, as presented to the Society, treated of Typhus fever, and other matter, that had no reference to the disease in question.
Pt_2
[Pg 31]
Before concluding these observations, I would wish to make a few remarks
upon some points of the enquiry which have been either too cursorily
passed over, or not noticed at all; and first of its supposed attraction
for, and adherence to the lines and courses of rivers whether navigable
or otherwise. I do not think this quality of the disease has been
assumed on grounds sufficient to justify anything like an exclusive
preference. Along these lines, no doubt, it has very frequently been
found, because a malarious, a terrestrial, a contagious, or indeed any
other disease, would for many reasons, best prevail on the lowest levels
of the country, or the deepest lines on its surface, like the vallies of
rivers, provided the food on which it fed—population—there abounded.
It would be difficult almost anywhere to point out a populous city
unconnected with the sea, rivers, or canals, the water population of
which, from their habits of life and occupations, everywhere crowded,
dirty, careless, and exposed, must always afford ready materials for any
epidemic to work upon, and this may have given currency to the
prevailing opinion; but I rather believe, when enquiry comes to be made,
it will be found that the worst ravages of Cholera Morbus have been
experienced in the great level open plains of Upper Germany, and the
boundless jungly districts of India, remote from, or at least
unconnected with water communication, denoting thereby atmospheric
influence and agency, rather than any other.
Another consideration of some importance is the burial of the dead,
which according to published reports, has in some places been enforced
in so hurried a manner as deeply to wound the feelings of surviving
relatives, and in others to give rise to the horrid suspicion of
premature interment. Can this have been necessary in any disease, even
allowing it to be contagious, or was it wise and dignified in the
medical profession to make this concession to popular prejudice, at all
times when excited, so unmanageable and troublesome. Although we cannot
analyse the matter of contagion, we surely know enough of it to feel
assured, that it must be a production and exhalation from the living
Pt_2
[Pg 32]
body, arising out of certain processes going on there, in other words
out of the disease itself, which disease must cease along with the life
of the patient, and the exhalation be furnished no longer—that during
life it was sublimed, so as to leave the body and become diffused around
through the agency of the animal heat, created by the functions of
respiration and circulation of the blood, which being foreclosed and the
supplies cut off, all that remained of it floating before death in the
atmosphere, must be condensed upon the cold corpse and lie
harmless.[31] It
must also be evident that when putrefaction begins, no production of
what belonged to the living body can remain unchanged, but must undergo
the transformation in form, substance and quality, ordained for all
things; for putrefaction, although it may possibly produce a disease
after its own character, is not pestilence, nor even compatible with it
in the case of specific diseases.
[31] Even when a living product, we are authorised to believe, from observations made upon the plague, that it cannot be propelled to a greater distance than a few feet from the body of the patient—that it is heavier than common air, settling down in a remarkable manner upon the sick bed, and saturating the lower strata of the atmosphere in the sick apartment.
The puerile stories, therefore, of infection being taken from following
a coffined corpse to the grave, without reference to the state of grief,
fear, and fatigue, not improbably, of drunkenness, in the mourners, must
be unworthy of attention. I am no friend to the absurdly long interval
which in this country is allowed to
elapse,[32] even
in the hottest
weather, between death and burial; but still more do I deprecate the
indecent haste which would give sanction to panic, and incur the risk or
even the suspicion of interment
Pt_2
[Pg 33]
before dissolution. In regard to
separate burying grounds, should the disease come to spread, I am sure
no one will expect, after what has just been said, that I should attempt
to argue the question seriously, nor enter a protest against the further
gratuitous wrong of withholding the rites of sepulture in consecrated
ground from the victims of an epidemic or even a contagious
disease.—Nothing could warrant such a measure but want of room in the
ordinary churchyards, where police should never be allowed to interfere
with the rights and feelings or property, of the living, unless to
ensure the privacy of funerals; nothing being so appalling to an alarmed
people as the spectacle of death in their streets, or so trying to the
health of the mourners, as tedious funeral ceremonies amidst a crowd of
people.