Chapter XIII: Section III

WHAT RESULTS DO WE OBTAIN FROM THE EFFECTS OF REMEDIAL AGENTS, IN PROOF OF THE HYPOTHESIS?

I have here used the word hypothesis, because, having so far advanced in the enquiry, I trust sufficient has been said to render the term applicable.

Under the term remedial agents, I shall include all those causes, whether natural or artificial, which tend to neutralize or destroy the germs of infection, or miasmatic poison, whether this be effected out of or within the body.

First, then, let us consider the results of drainage and cultivation in removing the causes of endemic disease. One well authenticated case is as good as a thousand. I will take one, which, from its source, will be received as unexceptionable; and from its association with a very learned and amusing book, will be accepted as an agreeable reminder of the many pleasant hours spent in the perusal of the poet Southey's "Doctor."

"Doncaster is built upon a peninsula, or ridge of land, about a mile across, having a gentle slope from east to west, and bounded on the west by the river; this ridge is composed of three strata; to wit, of the alluvial soil deposited by the river in former {177} ages, and of limestone on the north and west; and of sandstone to the south and east. To the south of this neck of land, lies a tract called Potteric Carr, which is much below the level of the river, and was a morass, or range of fens when our Doctor first took up his abode in Doncaster. This tract extends about four miles in length, and nearly three in breadth, and the security which it afforded against an attack on that side, while the river protected the peninsula by its semicircular bend on the other, was evidently one reason why the Romans fixed upon the site of Doncaster for a station. In Brockett's Glossary of North Country words, Carr is interpreted to mean 'flat marshy land,' 'a pool or lake;' but the etymology of the word is yet to be discovered.

"These fens were drained and enclosed pursuant to an Act of Parliament, which was obtained for that purpose in the year 1766. Three principal drains were then cut, fourteen feet wide, and about four miles long, into which the water was conducted from every part of the Carr southward, to the little river Torne, at Rossington Bridge, whence it flows into the Trent. Before these drainings, the ground was liable to frequent inundations; and about the centre there was a decoy for wild ducks; there is still a deep water there of considerable extent, in which very large pike and eels are found. The soil, which was so boggy at first that horses were lost in attempting to drink at the drains, has been brought {178} into good cultivation, (as all such ground may be) to the great improvement of the district; for till this improvement was effected, _intermittent fevers and sore throats were prevalent there, and they have ceased from the time the land was drained_. The most unhealthy season now, is the spring, when cold winds, from the north and north-east, usually prevail during some six weeks; at other times Doncaster is considered to be a healthy place. It has been observed that when endemic(?) diseases arrive there, they uniformly come from the south; and that the state of the weather may be foretold from a knowledge of what it has been at a given time in London, making an allowance of about three days, for the chance of winds. Here, as in all places which lie upon a great and frequented road, the transmission of disease has been greatly facilitated by the increase of travelling."

I feel certain of being excused for transcribing this long passage from Southey. It would have been impossible to convey its whole meaning without giving it entire. The continuation of the chapter is no less instructive and applicable to our subject, though more particularly so to an extension of the enquiry. The sore throats and intermittents, from which Doncaster has been freed, by the drainage of Potteric Carr, informs us at once that decomposing matter is the material by which the poison of fever is vivified and sustained, the wet and boggy state of the soil is just the condition, when no drainage exists, to bring into activity the germs of {179} disease, which otherwise would lie latent. So satisfied and acquainted are we with the elements necessary for the production of fever, that we might as certainly bring about an endemic intermittent by forming an artificial bog, as we could be sure of growing mushrooms by making a bed in the manner laid down by gardeners for this purpose. Dr. Lindley also says, "the _Polyporus fomentarius_ has been artificially produced in Germany, but merely by placing wood in a favourable situation, and keeping it well moistened. Five or six crops were obtained in the year."

Let warmth, moisture, darkness, and decaying matter be given, and inanimate disintegrated particles will soon be converted into definite forms and combinations instinct with life. It is by the unseen forms of living beings, that the atmosphere is preserved from becoming charged with deadly gases; they take the first rank in the great scheme of animated beings, the plant first, and then the animal. "Let the earth bring forth grass." "Let there be lights in the firmament." "Let the waters bring forth the moving creature, and fowl that may fly," and "Let the earth bring forth the cattle, the creeping thing, and the beast." This is the order of creation, of living things, and the earth was prepared by vegetation for the animal world. The work of conversion is accomplished by vegetation; and this is consumed for the construction of higher organizations.

The laws which govern and control the universe, {180} are as definite and as wonderful among invisible atoms, as those which regulate the enormous masses floating in space; and the time will come when the advancing intellect of man will measure and weigh the morbid poisons, as he measures and weighs the stars. Why should the laws of Epidemics be less understood, than the laws which govern the course of comets? The aspirations of man have led him to penetrate the heavens, which charm and inspire him; he studies rather the more violent disturbing elements of nature, the thunder-cloud and the fire of heaven, than the silent pestilence which steals over the earth. I cannot conceive it possible that the Intellects, which are occupied in procuring means for the Majesty of this empire to issue her mandates with the velocity of a spirit to the nethermost parts of the earth, should be incapable of solving so deeply interesting a mystery as the causes and nature of pestilential diseases. It would seem that man prefers to issue a mandate of destruction many thousand miles distant, than to disarm the pestilence at his door. It is barely a century since Galvani observed the twitchings in the muscles of a frog's leg, and the battery, still named after him, has already become an agent of instantaneous communication between places many miles distant. But how many centuries have passed away, each one succeeding the other, with its millions of victims to epidemics? And where are the remedies for the evils? Drainage and cleanliness, with all their advantages, were better understood and more fully carried out by the ancient {181} Romans than by ourselves; there are monuments, though crumbling to decay, to tell us of the vast enterprise of these people and of the value they set upon a healthy and vigorous constitution, and how well they understood the means of warding of disease.

Cultivation and drainage are now fully understood to be the basis by which a healthy condition of air is to be obtained, next to that, cleanliness and ventilation; if either be neglected a sickly, mouldy, and unwholesome contamination of atmosphere ensues; the odour of a bog is proverbially mouldy, and so is that of an ill-ventilated house or cellar; dryness, or the fresh pleasant scent of clean water, are the antagonists of these; the aromatic odours of vegetation are opponents of putrefaction, and consequently of the development of the lower forms of life. All empyreumatic matters prevent mouldiness and decomposition; and odours arrest and prevent the growth of mouldiness. The oil of birch, with which the Russia leather is impregnated, and which gives it so pleasant an odour, effectually prevents mouldiness, and consequently decay.

Lindley says, "It is a most remarkable circumstance, and one which _deserves particular enquiry_, that the growth of the _minute fungi_, which constitute what is called mouldiness, is _effectually prevented_ by any kind of perfume."[71] Cedar has {182} been used, from time immemorial, for a like purpose; and I doubt not the recommendation of Virgil, before quoted, in reference to the burning of cedar, was founded on some practical utility of this kind, though its _modus operandi_ was unknown to him. Allied to these is a curious circumstance, and worthy attention. I copy the following from an old work on Pestilences. "It is remarkable that when the Plague raged in London, Bucklersbury, which stood in the very heart of the city, was free from that distemper; the reason given for it is, that it was chiefly inhabited by druggists and apothecaries, the scent of whose drugs kept away the infection, which were so unnatural to the pestilential insects, that they were killed or driven away by the strong smell of some sorts of them." "The smell of _rue_, and the smoke of tobacco, were prescribed as remedies against the infection; but especially tar and pitch barrels, which it was imagined preserved Limehouse, and some of the dock-yards from infection."[72]

Pitch and tar dealers are everywhere spoken of as being remarkably exempt from infectious diseases.

Cold infusion of tar was used in our colonies as a prophylactic against the Small Pox. Bishop {183} Berkeley was induced to try it when this disease raged in his neighbourhood. The trial fully answered expectation--for all those who took tar-water, either escaped the disease, or had it very slightly.

Tan yards and places in the immediate vicinity, are said to be free from pestilences. The tanners of Bermondsey are said to have escaped the Plague of London, and one person only died in Gutter Lane, where was a tan yard. The tanners of Rome are also stated to have been free from Plague. Dr. McLean refers to the exemption of tanners at Cairo. _Tannin is prejudicial to most vegetables_,--but Dr. Lindley says it is not always so to fungi. "A species of Rhizomorpha is often developed in tan pits." I should imagine that neither plants nor insects would be found very abundantly, where tannin prevails; yet we find that the gall-nut is formed for the protection of an insect from injury by weather, and as a temporary means of sustenance.

The custom of fumigating with odoriferous substances, does not therefore appear upon this view of the matter to be destitute of importance; indeed, the universal practice stamps it at once, as an efficacious remedy for the purposes of disinfection. The introduction of chlorine fumigation, seems to have superseded, in a great measure, the use of fragrant herbs and woods; and it is questionable whether the substitution be altogether desirable or {184} advantageous. Many scents may be agreeably and usefully employed, with much less chance of annoyance to the patient, and considerably less injury to articles of furniture, &c.

The fumigations of sulphurous acid and chlorine are, perhaps, more adapted as disinfectants in uninhabited apartments;--their power to destroy vegetation, is well known. They have been used, chiefly, with the idea of neutralizing gaseous exhalations, particularly chlorine, as it tends to combine with hydrogen, to form hydrochloric acid, and then to unite with ammoniacal matters, forming hydrochlorate of ammonia. This, supposing noxious or pestilential effluvia consisted of the ammoniacal exudations variously combined, was an exceedingly efficacious method of rendering them inert; but as we feel convinced that no ammoniacal compound could possibly be the cause of infection, we must look to the influence these gases possess over other forms of matter, and as they are so destructive, even in minute quantities, to vegetable existence, it is possible that their beneficial effects may be due to this property. The immediate neighbourhood of gas works is prejudicial to vegetation, I imagine, from the amount of sulphurous vapours, and to this has been attributed the exemption of persons employed in these works. Many other instances might be cited of a similar nature.

I have now to speak of medicinal agents, and here comes a considerable difficulty. {185}

If we might believe all that has been written on the sure and certain remedies for the "ills that man is heir to," we should be led to acknowledge that both nature and art were prodigal in antidotes and specifics. The all-bountiful hand of nature, I do not doubt, has at the same time scattered the seeds of good and of evil. The fertilizing showers fall to irrigate the soil, and produce food and nourishment to man; here and there is the reeking morass "feeding unnatural vegetation," and if man takes up his abode in its vicinity, the rains which made it unhealthy, have also made it highly fertile; by labour and cultivation he may convert the mephitic bog into a waving corn-field, and the seeds of life and sustenance be made to supplant the seeds of death and corruption.

It is generally believed, that where there are particular and specific diseases, there also may be found appropriate and specific remedies; the discoveries of chemistry, it is not improbable, may in some respects have retarded the progress of natural medicine. In the early ages of the world, the "healing plant" must have formed the staple of medical commerce, for though Tubal Cain[73] has been considered as the first surgical instrument maker, because he was the first artificer in brass and iron, we have not discovered that chemical compounds entered into the composition of physic, till very {186} many years after his time. To the alchemists we owe the science of chemistry, and much of the physic of the present day may be traced to them. The multiplicity of ingredients which at one time entered into the composition of one dose of physic could only be spoken of under the title of "legion." Who shall specify the active and curative ingredient (if there be one), when from five to a hundred may have been exhibited at the same time? It has been the pride of our physicians, that the pharmacopoeia has been simplified; it has not reached its most simple form yet. That many simple plants have specific and wonderful power over disease, is an indubitable fact, but I firmly believe that the laudable, though mistaken efforts of physicians to improve their effect by various combinations, have been the means of throwing many valuable medicines into oblivion; I must also add, that cheap physic and adulterations have had no small share too in the banishment of much valuable physic from ordinary practice. It has been believed, and I think with much reason, that a thorough search into the qualities of plants, would shew that "they are capable of affording not only great relief, but also effectual and specific remedies." "That they are not already found, is rather an argument that we have not been sufficiently inquisitive, than that there are no such plants endued with these virtues."

Of the result obtained by medical treatment, in cases of epidemic or infectious disease, it is most {187} difficult to speak, but as my province here is only to shew that living germs are the morbific agents, I have but to refer to such remedies as have been most extolled in controlling these affections. The disinfectants have already been mentioned in a cursory manner. An enumeration only of simple medicines used during the late Epidemic, shall conclude this work, as the treatment in former times could not by any possibility furnish satisfactory information. Aromatics and fragrant stimulants have in all times taken the foremost rank with acids, such as vinegar, lime and lemon juice. Mr. Guthrie's adoption of lemon juice in preference to bark, which he said made him worse while suffering from an attack of fever, during the Peninsular campaign, and his speedy recovery from the disease, though not from its effects, shews, when many others can bear equal testimony to its value, that such a remedy though simple is not to be despised.

But to the late Epidemic. Dr. Stevens' saline treatment, appears, on the whole, to have been the most successful. Common salt was used both medically and dietetically, and formed the greatest bulk of the medicine employed. Chlorate of potash and carbonate of soda were added to the medicine.

The nitro-hydrochloric acid was used with success at St. Thomas's Hospital.

Dr. Copland used chlorate of potash, bicarb. soda, hydrochloric, ether, and camphor water.

Dr. Ayre's calomel treatment had as many, if {188} not more, opponents than advocates. Phosphorus had several advocates.

Creasote and camphor were lauded by some. The beneficial operation of all these remedies might be explained on the theory here supposed, that living germs are the cause of Epidemic disease, but the specific action of any one remedy has not yet had sufficient attention or trial to enable me to make any deductions of a satisfactory or conclusive nature.

In the uncertainty which generally prevailed as to the best method of treating Cholera patients, I was induced (for reasons stated in a pamphlet published last year) to try the efficacy of sulphur, which had been extolled as a specific. In its effects I was not disappointed; but as the results are already before the public, I need not do more than refer to it among other remedies.

I did not contemplate even alluding to this subject, as it would extend far beyond my intended limits. This portion of the enquiry would be more properly carried out by keeping records of cases, treated in accordance with the view attempted to be established, and I have not the slightest hesitation in saying, that the most ample success would ultimately attend a well directed practice, based upon the principles inculcated in these pages.

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