Chapter XIII: Letter III: To the Medical Society of Windsor

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 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]

[Footnote 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 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 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]

[Footnote 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."]

[Footnote 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.]

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 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.

[Footnote 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 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.

[Footnote 32: After sending these letters to the press, I saw in the public prints that the Bishop of the Diocese had forbidden the funerals of the dead from Cholera to be received in the churches of London. Instead of thus forbidding a part, better have the whole of the service performed there (where crowds do not come) under cover from the weather, than in the open churchyard, where the mourners uncovered, are exposed in every way to damp and cold, and the jostling of the mob; better still have all the service deemed necessary, performed at the residence of the deceased.]

Were I called upon to criticise what I have now written, and to review all that I have seen, read, and heard on the subject, I would conscientiously declare that the importation of Cholera Morbus into England or anywhere else, had been clearly negatived, and its non-contagious character almost as clearly established, always however with the proviso and exception of the possibility of its being made a temporary contingent contagion, amidst filth and poverty, and impurity of atmosphere, from overcrowding and accumulation of sick, but neither transmissible nor transportable out of its own locality, through human intercourse. As the disease, like all the other great plagues, which at various periods have desolated the earth, evidently came from the east, it would be most desirable in pursuing our investigation, to have a clear knowledge of the mode of its introduction into Russia on the eastern boundary of Europe. Unfortunately we can place no dependence upon the reports that have been published to prove importation there, which are lame and contradictory, although coming from the avowed partizans of contagion; but even had they been better gotten up, we could not, unless they had been confirmed by the experience of other nations, have received them with implicit reliance.

The Russian Employé of the provinces, _mendacior Parthis_, not from greater innate moral depravity than others, but from the corruptions of a despotic government which compel him to live under the rod of a master, amidst a superstitious barbarous population, whose dangerous prejudices he dare not offend, can only give utterance to what his tyrants command. Even at the more civilized capital of Petersburgh, the mob rose in arms to murder the foreign physicians when they did not act according to their liking. Could the truth then be heard on such a field, or what native officer would venture to impugn the authority of his rulers, proclaiming contagion? If he did, he must cease to live in the official sense of the word. Throughout Europe, from east to west, the disease has followed its own route according to its own incomprehensible laws, despite of every obstacle and precaution. We have the authority of our own Central Board for believing that the disease cannot be conveyed by merchandize of any kind, and that of our mission to Russia for greatly doubting whether it can adhere to personal clothing or bedding; and will it be pretended that human beings, labouring under such a distemper in any form, could have been the vehicles of spreading it in a straight line for thousands of miles throughout civilized nations, armed and prepared to defend themselves against its inroads,--they tried, but in vain. We, too, may strive to discover the demon of the pestilence amidst the clouds of the climate, or the winds of Heaven. He remains hidden to our view; and until better revealed, it only remains for us to exercise towards our fellow men those duties which humanity prompts, civilization teaches, and religion enjoins.

POSTSCRIPT.

My friend, Doctor Stanford, of the Medical Staff, now settled here, has given me the following valuable information, which my own observation confirms, regarding the agency of panic, in promoting the diffusion of epidemic disease. He happened to be serving with part of the British army, at Cadiz, when an eruption of yellow fever took place there, in the autumn of 1813, and as usually happens amongst medical men, the first time they have seen that fever, some of them were staunch contagionists, and impressed that belief upon the corps to which they belonged. In all these the disease was most fatal to great numbers. The men being half dead with fear, before they were taken ill, speedily became its victims, to the great terror and danger of their surviving comrades; but in the other regiments, where no alarm had been sounded, the soldiers took the chances of the epidemic with the same steady courage they would have faced the bullets of the enemy, in the lottery of battle; escaping an attack for the most part altogether, or if seized, recovering from it in a large proportion. From this picture let us take a lesson, in case the impending epidemic should ever come to spread in the populous towns of England, and the cry of contagion be proclaimed in their streets. The very word will spread terror and dismay throughout the people, causing multitudes to be infected, who would otherwise, in all probability, have escaped an attack, and afterwards consign them to death in despair, when they find themselves the marked and fated victims of a new plague. Whatever they see around them, must confirm and aggravate their despair, for desertion and excommunication in all dangerous diseases, too certainly seal the fate of the patient. It will be vain to tell them that hireling attendance has been provided,--the life of the Choleraic depends upon the instant aid--the able bodied willing aid of affectionate friends, who will devote themselves to the task, and persevere indefatigably to the last. If these be driven from his bed, his last stay is gone, for without their active co-operation the best prescription of the physician is only so much waste paper. What, let me ask, must have been the fate of the patient, and what the consequent panic, if the case of Cholera that occurred in London, a month ago at the Barracks of the Foot Guards, had been proclaimed, and treated as a contagion? The poor fellow was promptly surrounded by his fearless comrades, who with their kind hands recalled and preserved the vital heat on the surface, by persevering in the affectionate duty of rubbing him for many hours; but had the Medical Staff of the regiment been true contagionists, they must, as in duty bound, have commanded, and compelled every one of them to fly the infection. It depended upon them, to have spread around a far wilder and more dangerous contagion than that of Cholera Morbus, or any other disease,--the contagion of fear--and from what occurred at Cadiz, as above related, it is to be hoped our medical men will now see how much they will have it in their power, when Cholera comes, to pronounce, or to withhold sentence of desolation upon a community. The word Contagion will be the word of doom, for then the healthy will fly their homes, and the sick be deserted; but a countenance and bearing, devoid of that groundless fear, will at once command the aid, and inspire the hopes that are powerful to save in the most desperate diseases.

It is stated, in a Scotch newspaper, that two poor travellers, passing from Kirkintulloch to Falkirk, ran the risque of being stoned to death by the populace of the latter place, and were saved from the immolation only by escaping into a house; and in an Irish one, that some shipwrecked sailors incurred a similar danger. Such barbarities must, in the nature of things, be practised every where under a reign of terror, however humane or christianized the people may be--even the fatalism of the Turk would not be proof against it. In Spain they have been enacted in all their horrors (thanks to the quarantine laws) upon the unfortunate victims of yellow fever;[33] and we shall soon see them repeated amongst ourselves, unless the plain truth be promulgated by authority to the people. Let them be told if such be the pleasure of our rulers, (for it is not worth while disputing the point), that Cholera Morbus is a contagion, but of so safe a nature in regard to communicability, that not one in a hundred, or even a thousand, take the disease,--that in this country, besides being a transient passing disease, which according to certain laws and peculiarities of its own, will assuredly take its departure in no long time; it is limited almost always to particular spots and localities--that it is in their own power, while it remains, to correct the infectious atmosphere of these spots, by attention to health police--that they may fearlessly approach their sick friends with impunity, for that the danger resides in the above atmosphere, and not in the person of the patient; and that in all situations they may defy it, for as long as they observe sobriety of life and regularity of habits. Thus will public confidence be restored, and thus be verified the homely adage of, "honesty, in all human affairs, being ever the best policy"; for the concealment, or perversion of the truth, however much it may be made to serve the purposes of the passing day, can never ultimately promote the ends of good government and true humanity, but must lead, sooner or later, to the exposure of the delusion, or what would be far worse, to the perpetuation of error and prejudice, and grossest abuse of the people, in regard to those interests committed to our charge.

[Footnote 33: Vide O'Halloran, upon the Yellow Fever in Spain.]

* * * * *

Doctor Henry, of Manchester, has, in a late paper, published some most interesting experiments, upon the disinfecting power of heat. He found that the vaccine virus was deprived of its infecting quality, at 140° of Farenheit, and that the contagions of Scarlatina, and Typhus fever, from fomites, were certainly dissipated and destroyed, at the dry heat of boiling water. In regard to these last, he might surely have ventured to fix the standard of safety at a greatly lower temperature; for if the grosser vaccine matter could be rendered inert at 140°, there can be little doubt of the subtile gaseous emanations, which constitute the aerial contagions, being dissipated by the same agent, at an inferior degree. In the absence of direct experiment, we may venture to infer, that 120° would suffice, to nullify these last. Such, at least, has been the belief of those, who have been employed to purify ships, barracks, and hospitals, from contagion, and I should think it must have been founded on experience.[34]

[Footnote 34: As far back as the years 1796-7-8, this fact was familiar to us in the St. Domingo war, only we were satisfied with a minimum heat of 120°, from a belief that a temperature of that height, as it coagulated the ova of insects (the cock roach for instance), and was otherwise incompatible with insect life, would avail to dissipate contagion.]

He does not treat of the disinfecting property of light, although such an agent was well worthy of his notice; for the power, which in closely stopped bottles can deprive Cayenne Pepper of its sting--render our Prussic Acid as harmless as cream, and convert the strongest medicinal powders into so much powder of _post_, can also avail to destroy the matter and principle of Contagion. In fact, no other is used for purifying goods, at our Lazzarettoes, where suspected articles of merchandise, after some nugatory fumigations, are simply exposed to light and air with such certain effect, that there is not, I believe, in this country, any record of infection being propagated from them afterwards. The experiments of Doctor Henry are as simple and beautiful in themselves, as they promise to be useful and important, for now even the horrible contagion of hospital gangrene would appear to be under the controul of the pure agent he has been describing; and the principle now established of light and heat, the grand vivifying powers of the creation, being the sure and true preservers of the creature, man, from the poisons generated even by himself, and otherwise around him, calls for our admiration and gratitude, as shewing that these agents and emanations of Almighty power can be made, in the hands of the practical philosopher, to serve the purposes of domestic science, and in as far as we can see, to fulfil, at least in that respect, the best intentions of the Creator.

WINDSOR: PRINTED RY R. OXLEY, AT THE EXPRESS OFFICE.

Transcriber's Note

Spelling variations have been retained in this ebook to match the original text, e.g., quarrantines & quarantines, shew & show, Farrell & Farrel, control & controul, employe & employé, coridors, land wind & land-wind, reccommended & recommended, versts & wersts, clothing & cloathing, apalling & appalling, prima facie & primâ facie, alledged, and par metier & par métier.

Placement of footnote markers has been regularized to be located outside of neighboring punctuation.

The following typographical corrections have been made to this text: