ON POISONS, MIASMS AND CONTAGIONS.
§ 1. Although the amount of disease and mortality traceable to
accidents, to the ordinary atmospheric changes of which the thermometer
gives us due information, to the habits of life and the effects of
hereditary influence, be sufficiently great, it yet seems nothing when
compared with the terrible inflictions occasionally and at uncertain
periods visiting man, whether shut up, as it were, within the confined
haunts of cities, or living apart in the open country, in situations
where it might be reasonably imagined no such influences could reach
him. The poison of typhus, for example, if it be a poison, spares
none: in certain epidemics the citizen and the peasant suffer alike:
the strong robust man in the prime of life is its special victim;
cholera attacked the inhabitants of the remote and isolated cottage as
certainly as the careful wealthy citizen, and with the same results.
No mode of life, nor sex, nor age was security against it; no race,
no locality.[45] An inquiry into the origin of such influences is
the most important to which man’s attention can be directed. These
terrible epidemics appear under various forms; sometimes it is by
typhus or influenza, cholera or plague; even those diseases which
seem to be endemic, or confined to a locality, assume the form of
epidemical raging pestilences, and then disappear for a time. Thus
the remittents and yellow fevers of tropical climates do not always
put out their whole strength; there is a lull, a season of repose,
when man, deluded by the security of a few years, hopes that at last
the evil influence has disappeared for ever. Vain hope! It moves
in cycles, like the typhus of temperate climates, falsifying all
predictions. Thus, in Jamaica, the grave of so many noble English
regiments, the fever, sometimes called remittent, sometimes yellow
fever, exhibited its fitful attacks during eighteen years, in the
following capricious manner, at a station called Port Antonio, about
eighty miles from Kingston. At Stoney Hill Barracks, the disease was
still more capricious.[46] As the poison producing intermittents
and remittents must be presumed to be always present, it is
incomprehensible how it should at times cease its attacks on man,
showing that another influence or element requires to be present to
render its attack successful. Again, we find that within a limited
range, a long residence in a land unhealthy to the stranger seems by
acclimation to diminish if not entirely to eradicate the susceptibility
to disease on the part of the latter; but this opinion must be received
cautiously and with reserve, for the phenomenon may be partly due to
the difference in race, respecting which we as yet know but little. The
banks of the Scheldt, the Polders of Holland, and the mouths of the
Rhine, the Danube, and the Indus, are healthy to the natives of these
districts; graves to foreigners. In all inquiries of this kind, these
well-established facts must not be overlooked.
[45] Cholera has not, as yet, passed into the southern hemisphere
beyond the tropical line.
[46] “The town of Port Antonio is situated at the north-eastern
extremity of the island, eighty miles from Kingston, and lies in
a hollow surrounded by an amphitheatre of thickly-wooded hills.
Fort George, in which are the barracks for the troops, is built at
the extremity of a peninsula, nearly surrounded by the sea; and
though possessing no great elevation, it has, from its position, a
tolerably free exposure to the breeze. On each side of the peninsula
are two harbours for the shipping; that on the east side enjoys a
comparatively healthy locality, but that on the west is sheltered
by a thickly-wooded hill, which impedes ventilation; and there is a
considerable space of level ground, generally inundated by the tide,
which at low water is left in a marshy state, and when acted on by
the sun emits exhalations said to be both offensive and unhealthy.
“The barracks stand about twenty yards from the sea, on a piece of
ground of coralline formation, and consist of a building of two
stories, elevated on brick pillars. The hospital is built on a higher
situation, and raised on arches about seven feet. It contains three
wards for the patients, and has a shaded walk attached to it for
convalescents. Water is supplied to the troops, by contract, from a
river a quarter of a mile distant.
“There seems to have been no troops at this station in 1825 and 1826,
but the mortality during the other years embraced in the Report has
been as under:
+--------+-----------+---------+-----------------+
| | | | Ratio of deaths |
| Years. | Strength. | Deaths. | per 1000 of |
| | | | mean strength. |
+--------+-----------+---------+-----------------+
| 1817 | 177 | 34 | 192 |
| 1818 | 135 | 12 | 89 |
| 1819 | 130 | 45 | 346 |
| 1820 | 143 | 12 | 84 |
| 1821 | 82 | 18 | 219 |
| 1822 | 194 | 10 | 52 |
| 1823 | 79 | 4 | 51 |
| 1824 | 108 | 21 | 194 |
| 1827 | 32* | 3 | 94 |
| 1828 | 129 | 19 | 147 |
| 1829 | 133 | 31 | 233 |
| 1830 | 155 | 21 | 135 |
| 1831 | 161 | 20 | 124 |
| 1832 | 157 | 29 | 185 |
| 1833 | 164 | 37 | 226 |
| 1834 | 185 | 32 | 173 |
| 1835 | 154 | 18 | 117 |
| 1836 | 160 | 4 | 25 |
+--------+-----------+---------+-----------------+
| Total | 2478 | 370 | ... |
+--------+-----------+---------+-----------------+
|Average | 137 | 20 | 149·3 |
+--------+-----------+---------+-----------------+
* 127 men were here for one quarter of a year only,
which is equivalent to 32 for a whole year.
“Thus the local circumstances remaining the same, the mortality from
fever yet varies exceedingly. It is the same with the typhus of
temperate countries, showing that in addition to malaria, presumed to
be ever present, a something more is required, that we must look for in
the constitution of the atmosphere.”
§ 2. When a chemical substance is applied externally or internally to
the living tissues of an animal sufficiently strong to dissolve the
affinity between them and the vital force, and to substitute for it
other stronger affinities, the explanation of the phenomena is easy,
and the coarsest chemistry offers a solution. The action of caustic
potass, of concentrated sulphuric acid, present the examples of this
kind of dissolution. Other substances alone poisonous when given in
concentrated doses, are known to pass, when sufficiently diluted,
through the blood, and be eliminated by secretion and excretion from
the body: after causing disturbances more or less grave, more or less
important, the combinations they form, if any, with the living organic
molecules are overcome by the vital force, which then resumes its usual
influence. Of such substances some pass off unaltered, others are
decomposed, and the bases only appear in the secretions or excretions.
Whilst passing through the lungs, certain of these vegetable salts
combine with the oxygen of the air, and the respiration in consequence
becomes slower, or in other terms, they diminish the production of
arterial blood.[47]
[47] I am free to admit, with Liebig, that the lungs are the seat
of the most rapid and powerful chemical action (p. 151), yet some
distinguished physiologists think that the external integuments may
become the seat of disease, and give origin to dangerous affections
by mere stoppage of their secretions and excretions. Certain of
these are held to be poisonous and highly irritating, and cholera
itself has been ascribed to the sudden transfer of the tegumentary
secretions into the general torrent of the blood. This seems to have
been the opinion of the celebrated anatomist and physiologist, De
Blainville.
Now, these salts[48] when placed in contact with animal and vegetable
substances, perform the same function as in the lungs: they take a part
in the combustion going on, and, as in the living body, are converted
into carbonates. Left to themselves for a time, from their aqueous
solution, the acids composing them finally completely disappear.
[48] Citrates, tartrates, acetates.
Mineral acids and nonvolatile vegetable acids, as well as mineral
salts with an alkaline base, have the property, when sufficiently
concentrated, to arrest the whole process of this slow combustion;[49]
common salt, as is well-known, arrests putrefaction: so does alcohol.
[49] Eremacaasie: Liebig.
The chemical action of certain other mineral salts is different, such
as the salts of the peroxide of iron, of lead, bismuth, copper, and
mercury. These are inorganic poisons. They combine with the tissues of
the organs, and so destroy life. The mode of action of the poisons of
prussic acid, strychnine, morphine, &c., is as yet unknown.
“But there exists a class of substances no less fatal than the
preceding, originating in certain decompositions. In a preceding
Chapter (III.) we have inquired into the origin of these poisons, and
shown them to originate in fermentation and putrefaction. Let us apply
the chemical principles regulating these processes to organic matters,
to the products of the animal economy; all the elements of these
matters are derived from the blood, the most complex of all existing
substances. In decomposing, a poison is occasionally produced speedily
mortal when it comes in contact with the blood of the living animal.
The venomous principle produced by decomposing animal bodies is not
always the same: that originating in certain German sausages is quite
peculiar; the person who partakes of this fatal dish dies mummified;
he does not rot or fall to pieces like those who perish from wounds
received in dissecting-rooms; on the contrary, he dries up and withers,
but does not putrify.[50] Liebig, the discoverer of this poison and its
effects on man, states that the venom is destroyed by boiling-water and
alcohol, but that these do not absorb it.
[50] All constitutions are not equally liable to be affected by
morbid poisons. This has been proved as regards dissecting-room
wounds; and as regards typhus, cholera, plague, ague, &c., the matter
admits of no doubt.
Similar in the mode of action on the economy are the poisons of
small-pox, plague, &c. The substances which arrest fermentation and
putrefaction, also neutralize the power of these poisons; but the
essence of these poisons has not yet been obtained in an isolated
form, and thus nothing positive is known of its real nature. One thing
seems certain; contagions, poisons and miasms are not living beings
nor animalcules, any more than yeast. They may be, and probably are,
produced by fermentation, but this is neither caused by nor terminates
in the formation of living animalcules, to which all or any of these
phenomena might be attributed.
A nice distinction has been drawn by a distinguished chemist between a
contagion properly so-called and a miasm. When the disease-producing
matter is the product of a disease, it is a contagion; if it be the
product of putrefaction or of eremacausis of any substance, animal or
vegetable,--does it act by virtue of its chemical character, and not
of its condition (_etat_), in forming a combination, or in causing a
decomposition, it is then a miasm.
The history of diseases so originating scarcely supports this view.
Typhus, which at times seems to originate in a miasm, at times seems to
assume a contagious character. The same may be said of yellow fever.
But however this may be, the distinction applies to such diseases
as intermittent and remittent fevers, which originating in a miasm,
itself springing from the putrescence of animal or vegetable bodies,
gives rise to disease which does not reproduce the miasm. Now, between
diseases so produced and those arising from contagion properly so
called, there is this remarkable distinction: the blood once altered
is no longer susceptible of the same contagion, whereas against miasms
there is no such security.[51]
[51] Blood has a _mordant_ given to it which dyes it red; when
this is in excess, the blood becomes black, or very dark. This was
the colour of the blood in cholera. Its crasis seemed to be broken
down, and I have it on sure anatomical testimony, that in dissecting
those who had died of cholera, the larger veins, when once opened,
continued to pour out blood for many days.
In every contagious disease, and perhaps even in those simply arising
from miasms, there is an odour which fills the chambers of the sick,
and is recognisable at once. Ammonia is very generally present, as it
is wherever animal decompositions are going on, that is, putrefaction.
The foul airs emanating from stagnant and neglected ditches is
composed, as has been long known to chemists, of carbonic acid and
sulphuretted hydrogen gases, and these are viewed by some as amongst
the most dangerous of miasms. These gases may be destroyed by acid
vapours now in common use.[52] From chemistry we also derive another
valuable lesson in respect of substances directly destroying human
life. The materials ready to undergo putrefaction, and thus to generate
miasms, may all be present, and yet no miasms are given out, and man
escapes; this security depends upon the absence of that third principle
requisite to bring the others into activity.
[52] The various plans for the deodorization of cesspools,
water-closets, dead-wells, sewers, &c., were first introduced into
England from France and Belgium. Under French management Paris
is sweet, and proverbially clean and pleasant; London, under the
management of parties without individual responsibility, notoriously
filthy and full of bad odours. Under certain circumstances, and
especially when limited to small quantities of the matter to be
deodorized, they are successful enough in destroying the unpleasant
odour, but in the experiments made a few years ago on the comparative
merits of various kinds of deodorants, it was obvious that no real
dependence could be placed on them, unless the cesspool was at the
same time flushed or cleansed out with a very strong flow of pure
water poured in along with the deodorant. In how far the various
deodorants recommended are at the same time disinfectants, has never
yet been shown.
The _excreta_ deodorized have hitherto proved of but small commercial
value, farmers very generally declining their use. It is singular
that the same _guano_ (human) which is said to be so valuable in
China, should prove a failure in Europe, and especially in England,
showing how much still remains to be discovered in practical
agriculture. If human guano really be of such value in China as has
been reported, might it not be worth while to import into Britain
a few Chinese agricultural labourers and gardeners thoroughly
acquainted with the agriculture of their country, and from whom might
be learned the art of preparing the manure? Capitalists have engaged
in many less promising speculations than this.
From whatever source the Chinese derived their knowledge of the
domestic and fine arts they now possess (for it is impossible to
imagine that they invented them), one thing is certain--that they
were recording eclipses, printing books, building temples, raising
crops equal to the support of a vast population, whilst the great
nations of Western Europe were wandering about in their native woods,
clothed in the skins of animals, ignorant even of agriculture, and
barbarous to the last degree. Nor was the knowledge and taste of the
Chinese confined, in the matter of agriculture and horticulture, to
the merely useful, as is obvious by a passage in Humboldt’s “Kosmos,”
wherein the illustrious savant proves that the ancient Chinese, in
respect of taste in horticulture, and in the composition of park
scenery, excelled all the world.
Thus it happens that in his extensive and elaborate inquiries, Major
Tulloch was continually met by difficulties which overthrew at once all
existing medical theories, rendering it even probable that the supposed
relation of cause and effect between marshes and miasms, and miasm and
fever, was merely accidental. In what that third element consists,
that immediately exciting power which urges on the decomposition to
an extent it had not before attained, rendering that miasm mortal, or
at least most dangerous, which heretofore the vital force was able to
resist, has not yet been discovered.
Is it electricity? is it ozone?[53] or does it depend on some unknown
principle in the elements of the atmosphere, for the detection of
which we have no instrument? Does security in such cases depend on the
presence in the atmosphere of some such principle as ozone? Whatever
be the cause, the fact is certain; epidemics follow cycles of increase
and decrease; like comets, they come and disappear at long intervals.
Our business in the mean time lies with what is constantly present, in
a more or less aggravated form--the malaria continually reproduced,
always efficient in certain regions of the earth; in the overcoming of
which, as I have endeavoured to show, well-directed human industry is
far from unavailing.[54]
[53] Ozone is said to oxidize the poison. It destroys sulphuretted
hydrogen and all oxydable miasms, and is the most powerful
disinfecting agent, but is itself unfit for respiration: it causes
suffocation. Air in its normal state contains one ten-thousandth part
of ozone; when raised to one two-thousandth part it is sufficient to
kill small animals.
[54] Hydrogen, or inflammable air, is the lightest known substance;
its specific gravity is to that of air as 732 to 1000. The gases,
into the composition of which it enters, rising from these ditches
and banks of mud carry with them dried humus, and even animal matter
in a state of putrefaction, which, being dry or moist, may act as
strongly as variola itself, in respect of its injurious effects on
man, who breathes it either as it rises from ditches, or is driven by
currents of air circulating round watery places covered with humus.
It is even (_onctueux_) so strong that it will sustain seeds and dust
upon water, as I have witnessed at Amsterdam, Rotterdam, Verona,
Bologna, Venice, and even in the canals of Lambeth and Deptford.
By means of hydrogen we raise a balloon; can we not imagine it to
be equal to the raising up of humus? It is generally supposed that
sulphuretted hydrogen is amongst the dangerous miasms, but it cannot
be so hurtful, for no boat can go into canals without disturbing it,
and yet we see no evil results from this; but if the water-level
lowers, and leaves vegetable or animal matter upon mud in a state of
slow combustion, then it is that fevers commence--a fact, I think, I
have proved by an appeal to the history of pestilences in ancient and
modern times.