this presumed chain, the seizure with fever of the two guards at the
Fort. Two European soldiers lately arrived in the colony, and therefore
peculiarly predisposed to an attack of endemic fever, go from Boa Vista,
which at that time was healthy, to a confined, unventilated,
overcrowded, and filthy spot on another island, where fever was raging
to such a degree that within the space of three weeks there had occurred
no less than 60 attacks and 33 deaths, in a crew consisting on the
arrival of the ship of 117 officers and men. There is in this no
evidence of the propagation of disease by a specific contagion; on the
contrary, it is the ordinary production of disease by its ordinary
cause, namely, exposure to a polluted atmosphere, the pollution being,
in this instance, excessive from overcrowding; from accumulation of
filth; from foul and offensive privies; from the impossibility of the
admission of fresh air, owing to the construction of the building, and
from the intense and oppressive heat, the thermometer ranging from 81°
to 86° of Fahrenheit. The seizure of two men with fever under such
circumstances is precisely analogous to the attack of persons,
previously healthy, with typhus, who take up their abode in the crowded
and filthy courts and alleys of English towns.
Take the next link in the chain, the attack of the negro soldier. The
circumstances respecting this man, being precisely the same as those
relating to the two other guards, the same answer would have sufficed
for both, but according to the testimony of the man himself, his illness
was very slight, and his companion who was sent to lodge with him at the
hut in Porto Sal Rey, had no illness at all during the whole time of
their seclusion.
The third link in the chain is the presumed fact, that a woman (Anna
Gallinha), who lived next door to the hut in which these two men had
been confined, was seized with fever soon after they had left it, and
that she was the first person attacked, at least whose illness attracted
public attention, in the town of Porto Sal Rey. Dr King states, that on
a personal examination of the soldier who had experienced the slight
attack of fever, he said that during the seventeen days that he and his
companion were confined to the hut, “they had no communication with any
one.” Dr M‘William, on the other hand, affirms that Gallinha was a
frequent visitor at the hut, and, indeed, cooked for the men. Supposing
Dr M‘William’s account to be the correct one, it is surely more
reasonable to attribute the attack of Gallinha to the local causes to
which she was exposed, and which Dr M‘William admits were sufficient to
account for her illness, than to contagion derived from a man whose
illness was so slight that it had not confined him to his bed for a
single day, and which was incapable of infecting his companion who was
constantly with him night and day.
“By the time Anna Gallinha was taken ill,” says Dr M‘William, “much rain
had fallen; the weather had become more hot, and, in short, there now
(but not before this) existed the recognized elements for malarious
evolution.”
“In that part of the town called Beira, or Pao de Varella,” reports Dr
King, “where Anna Gallinha and the soldiers resided, the houses are of
the lowest description, and the people who occupy them are generally
very poor and destitute; there is a large pool of stagnant salt and
fresh water immediately behind; but to windward of this part of the
town, and still nearer to the houses, there is a locality which is
resorted to by many of the people when obeying the calls of nature; and
the exhalations from the one, and the effluvia from the other, are blown
by the north winds in the direction of Beira.”
A similar description of this locality is given by Dr M‘William,—
“In the upper portion of the town,” he says, “which is called Pao de
Varella, the houses are in general mere hovels, rudely built, and much
crowded together, and with few exceptions dirty. They are occupied by
the lowest classes. From the total absence of any police laws the
streets here are also very filthy.”
Here then were present in full force, as is admitted, the ordinary
localizing causes of fever; to which it is more consistent to refer this
case, than to an extraordinary and foreign cause.
But at this point the presumed chain of evidence stops; the chain is
suddenly snapped; there is no further link traceable; there is nothing
really connecting the illness of Gallinha with the next cases, or with
the general spread of the disease which rapidly followed, and we need
hardly state, that in order to prove the spread of a pestilence by
contagion, communication, either direct or indirect, must be proved to
have existed between all the persons attacked.[34]
Footnote 34:
The widow of the next victim (Affonso) denied his having had
communication with Gallinha; and Dr Almeida “found about 20 people
sick” in Porto Sal Rey only three or four days after Gallinha’s death.
It is evidently more rational to ascribe these numerous attacks to
epidemic influence, which it is admitted was now present, than to
contact with this woman, for the fact of which there is in truth not a
shadow of evidence.
For the only other case of fever that is stated to have occurred shortly
after the sailing of the “Eclair,” namely, that of the labourer (Pathi)
who had been employed on board the ship, will scarcely be considered as
affording an additional link; since admitting that this man contracted
his fever while employed on board the “Eclair,” his case would be merely
one of infection from going on board a foul ship, a generally recognized
cause of fever:—
“Whenever,” says Dr Stewart, “fever has prevailed much in ships on the
West India and African stations, strangers going on board of those ships
have been particularly liable to its attack; but on sending fever cases
from those ships to the hospitals and private houses on shore, it has
not been found that the disease extended from them.”
But as in the locality of the dwelling of Gallinha, so in the district
in which this man lived, there were local causes abundantly sufficient
to account for the endemic origin of his disease. He resided in Rabil,
one of the hamlets in the neighbourhood of Moradinha, at some distance
from Porto Sal Rey. Of this locality Dr King says:—
“If there is one spot more than another in the whole island where, from
its physical peculiarities, endemic fever might be expected to begin
first, and end last, that locality is Moradinha, and the villages in its
vicinity, in one of which Pathi resided.”
It may be observed further, that whatever may have been the cause of
this man’s fever, it is admitted, that for three weeks at least it was
communicated to no one else in the house at Moradinha, where he was
attacked, and remained for eight days, and not to any one else in that
neighbourhood for 11 weeks; that his illness was extremely slight, and
that on his return to his own house no disease broke out for some time
in his family. According to Dr M‘William, the first member of his family
that was attacked was one of his children, who was taken ill “on the
tenth or eleventh day” after his return, the illness of this child being
gradually followed by that of two other children. But Dr King affirms
that these children were not taken ill until “about a month” after their
father’s return, and that it was not until the succeeding month (the
middle of November) that his wife was seized, “when the disease was
general throughout the island.” It is also particularly to be observed,
that a child in another family at Rabil, having no communication with
the family of Pathi, died about the same time as Pathi’s first child,
and that the disease broke out at least as early at Rabil as at Porto
Sal Rey.
Lastly, it may be urged in opposition to the opinion that the contagion
was communicated by the crew of the “Eclair,” that the small island on
which the sick were landed and to which they were confined was a mile
distant from the town of Porto Sal Rey, and that on reference to the map
attached to Dr M‘William’s report, it is obvious that the North-east
trade wind must (according to the theory of Sir William Pym, as applied
to the Neutral Ground at Gibraltar in 1828) have dispersed the contagion
if in existence, or carried it in a contrary direction from Porto Sal
Rey.
* * * * *
For a more minute examination of the cases of the guards at the Fort,
and of Pathi and others, as presented by Dr M‘William, we refer to the
Note of Dr Browne, Appendix No. III. (p. 306),[35] who has there shown
the real value of these cases, considered as links forming a chain of
circumstantial evidence.
Footnote 35:
_Vide_ the Report itself.
The authentic facts attending the intercourse of the ship’s company with
the inhabitants of the island, afford further evidence that no infection
could have been communicated by the former to the latter. Thus, it is
admitted that Captain Estcourt, the commander of the ship, went directly
from the infected vessel to reside with Mr Macaulay, the judge: no
infection was communicated to Mr Macaulay, or any part of his family.
The officers of the gun-room—midshipmen, warrant, and engineer—on
disembarking from the ship, took a house for themselves and their
servants in the town, and mixed unreservedly with the inhabitants: no
infection was communicated to any individual with whom they had
intercourse.
The crew obtained or took leave to pay frequent visits from the small
island to the town of Porto Sal Rey, where, according to Dr M‘William,
they resorted chiefly to the house of one Georgio, who kept a spirit
store; the only consequence of which visit, considered by Dr M‘William a
remarkable one, appears to have been that this man (and “shortly
afterwards” two females who associated with them) was attacked with
headache and general fever on the evening of the day he was visited by
the “Eclair’s” people; a result which admits of a more obvious solution
than the communication of febrile contagion on the part of persons who
were themselves in perfect health.
The soiled linen of the officers and crew having been brought on shore
on the first arrival of the vessel, was immediately given out to be
washed to the washerwomen of Porto Sal Rey, and the careful search made
after these women, brought to light no fewer than seventeen persons who
were so employed.
“The soiled clothes,” says Dr King, “linen, cotton, and flannel, which
had accumulated in the officers’ cabin from the time of their departure
from Sierra Leone, were contained in at least 12 bags, which were taken
on shore at Porto Sal Rey the same evening the ship arrived, and
distributed next morning (22nd August) to the washerwomen of the town.
Now, if the disease possesses the power of reproduction, its poison must
[according to general opinion] have been as certainly communicated
through the medium of _fomites_ as by direct contact with the sick on
board or at the fort; yet none of the washerwomen nor any in their
families were attacked with fever until November, showing an interval of
70 days after exposure to the infection.”
That it was not from any want of susceptibility to the influence of
febrile poison that these women escaped the danger of this exposure to
_fomites_ was proved by subsequent events; for during the progress of
the epidemic, all of these women, according to Dr McWilliam, with only
one exception, were attacked with the prevailing fever; two between six
and seven weeks after the sailing of the “Eclair;” five, two months;
two, three months; three, four months; and one, five months afterwards.
“None of the deaths,” says Dr M‘William, “took place until fever was
general in Porto Sal Rey, so that in none of these cases can the
occurrence of the fever be fairly attributed to infectious matter
conveyed by the linen.”
The Guards at the Fort were many times relieved, and the soldiers were
sent direct from the small island to their barracks in Porto Sal Rey,
without conveying any disease to their comrades. On one occasion two
soldiers who are stated to have lived in a room next to that in which
the sick of the “Eclair” were lodged, on being taken ill, were conveyed
at once to the barracks, yet they infected no one in their quarters.
From a list drawn up by Dr King, of the names of the islanders who were
engaged as labourers on board the “Eclair,” it appears that there were
in all 63 persons employed in coaling, watering, and cleansing the ship.
These men appear to have had unrestricted communication with the ship’s
crew. According to Dr M‘William, the whole of these labourers went to
their respective homes every night, except those from Estacia and the
Eastern villages, who generally slept at Porto Sal Rey. None of these
men were themselves attacked with fever, excepting one (Pathi) whose
case has been already considered; none of them communicated fever either
to their own families or to the persons with whom they lodged in the
town, yet subsequent events proved that they as well as the washerwomen
were sufficiently susceptible subjects, since, during the progress of
the epidemic, the greater part of them were attacked by the disease;
none, however, within a month after the departure of the “Eclair;” a few
within two months, but the majority not until four or five months
afterwards.
That the geographical position of the Cape de Verd Islands places them
within the legitimate domain of Yellow Fever, and that this disease is
no stranger to these islands, is admitted on all hands. According to Dr
M‘William,
“The north-western part of the island, where Porto Sal Rey is situated,
is low and flat, and almost wholly occupied by sand, which, blown up
from the north-western shore through the water-courses, and other
hollows, accumulates in mounds twenty and thirty feet high, which are
drawn about and shifted by any little variation of the direction of the
wind.”
On the flat between Porto Sal Rey and the village of Rabil, which is
about four miles to the southward of Porto Sal Rey, Dr M‘William states
that there is a point where the sea, when the waves are high—
“Breaks over the elevated beach, and penetrates through the shingle, so
as to accumulate, and run inland in the form of a narrow creek, from 200
to 300 yards from the sea-shore. During the rainy season, this, in
common with the other flats on the island, is inundated to a
considerable extent, as is evident from the appearance of the soil in
those places not covered with sand, as well as by the presence of a rude
raised causeway, which the people have constructed over part of the
hollow flat, to render it passable during the rains. * * * Near the town
is a hollow flat, spread over an area of about a mile, with the same
soil and subsoil as that in the town. The central part of this area is
occupied by a salt pan, which contains not less than 300 troughs, each a
foot deep, and about thirty feet square, into which the salt water is
poured, there to evaporate and form salt. During and for some weeks
after the rainy season, the whole of this space is more or less
inundated. * * * The water is left to stagnate on the Rabil side, and as
it dries up during the hot weather, little alluvial islets are from time
to time exposed, which the people avail themselves of to raise a small
crop of corn. Indeed the greater part of the ravine, from Rabil
downwards, is in a state of rude cultivation, and contains large green
fœtid pools, with all kinds of decomposing matter, the effluvia from
which was most offensive when I was there in May, 1846.”
Experience has shown, that such a condition of sandy soil is as fruitful
a source of endemic and malignant fever as a marsh or swamp. Dr Lind,
who wrote nearly a century ago, expressly notices the unhealthiness of
Boa Vista, particularly during the rainy season, stating that,
“strangers who arrive here at this season are liable to be visited by a
general sickness,” and instances its white sand as a mark of an
unhealthy locality. Dr Fergusson confirms the correctness of this
indication of insalubrity.
“That sandy soils,” he says, “should, in malarious climates, prove as
productive of aggravated remittent fever as the swamp, has never been
sufficiently explained. Certain it is, however, that they do so, in a
marked and prominent degree. The Alemtejo and Algarve of
Portugal—regions, I may say, altogether of sand—are the most prolific of
fever of any in the Peninsula.”
Another instance is found in the unhealthiness of Vera Cruz, which is
spoken of by McCulloch in the following words:—
“It is said to be the original seat of the Yellow Fever.” [Bulama?] “The
city is well built and the streets clean, but it is surrounded by
sand-hills and ponds of stagnant water, which, within the tropics, are
quite enough to generate disease. The inhabitants and those accustomed
to the climate are not subject to this formidable disease; but all
strangers, even those from the Havannah and the West India Islands are
liable to the infection. No precautions can prevent its attack, and many
have died at Xalapa, on the road to Mexico, who merely passed through
this pestilential spot.”
Dr King states, that if ever endemic fever derives its origin from a
vitiated and malarious state of the atmosphere, Boa Vista abounds with
the elements for its production. Among these he enumerates swamps and
pools of stagnant water, in the immediate vicinity of Porto Sal Rey, and
over the whole district of Rabil; patches of rich alluvial soil near the
other villages, the recognized sources of noxious exhalations; the
wretched food of the lower classes, and still more, the polluted
atmosphere which they breathe in their crowded and ill-ventilated
abodes, and the general disregard of cleanliness in their houses and
streets, “a combination of morbid causes,” he says, “which would produce
malignant fevers in any part of the world.”
The relative position of Boa Vista to the African coast would further
naturally lead to the expectation that it must be subject to diseases of
the same character, and no one disputes that this is the case. The
residents of the island, military, medical, and civil, concur in stating
that endemic, bilious remittent fever, prevails there more or less every
year; that there is no season in which it does not carry off several of
the inhabitants, and that it often prevails epidemically.
“The testimony of the most intelligent men in the island,” says Dr King,
“including Dr Almeida, Senor Baptista (the Consul’s agent), the Mayor of
Rabil, the Judge of Fundas Figieras, and the Judge at Old Town, removes
every doubt as to the fact that fever prevails to a certain extent, and
carries off several of the inhabitants in the months of November and
December every year; and this endemic fever, which recurs annually, and
which Dr Almeida calls the bilious remittent, does not always present
the same mild aspect and character; on the contrary, it is well known
that in certain years the disease was epidemical, and in comparison with
other seasons, very fatal.”
Dr M‘William records the fact, that such epidemic seasons occurred and
proved unusually mortal in the years 1821–2, in 1827, and in 1833.
It is most material to a right understanding of this whole subject to
observe, that a Yellow Fever Epidemic had broken out at this very time
in an adjoining island, St Jago. It is stated by Dr Stewart, in his
Report in the Admiralty Correspondence, that “in the adjoining island at
Porto Praya, there was Yellow Fever whilst the ship was at Boa Vista.”
Captain Simpson states that it recurred in the following year at Porto
Praya; “is common there at times and quite endemic.”
That co-incident with the presence of the “Eclair” at Boa Vista one of
these epidemic seasons was impending, was declared by the usual
indications, which in warm climates precede and accompany such
visitations. These premonitory signs on this occasion were a great fall
of rain at an unaccustomed season; the consequent accumulation of large
quantities of stagnant water in and about the towns and villages; the
occurrence of extraordinary heat; the prevalence of light winds with
frequent calms rendering the weather extremely sultry and oppressive;
the appearance of sporadic cases of fever of more than common intensity;
the almost simultaneous outbreak of pestilence amongst cattle and other
domestic animals; and the visitation in greater numbers than common of
destructive insects.[36]
Footnote 36:
See note, p. 16.
These prognostications were so manifest as to excite the attention and
alarm of the intelligent classes of residents. The Governor-General
states:—
“Great falls of rain took place at a very advanced period of the season,
which remained stagnant.”
The British Consul says:—
“Up to the month of October, extraordinary heat and the fall of a large
quantity of rain had been experienced, events which were surprising to
the oldest inhabitants.”
The British Judge says:—
“Stagnant water had settled in great quantity at the back of the town,
to which was joined great heat in the weather.”
Dr King says:—
“The information received on the island in 1846, fully corroborated what
is stated in the above extracts, the periodical rains, contrary to what
usually happens, did not set in till late in September. In October,
November, and December the winds were light and variable, with frequent
calms, and the weather became in consequence extremely sultry and
oppressive. The grass and green crops were nearly destroyed by the long
previous drought, and what little appeared after the rains was devoured
by the locusts, which visited the island in greater numbers this year
than was ever known to be the case before.”
Though Dr M‘William, on his inspection of the island with a view to
ascertain the true cause of the pestilence, took no notice of any of
these premonitory signs of its approach, Sir William Burnett was fully
aware of their signification, and calls special attention to one of the
most important of them in his Report to the Lords of the Admiralty.
“I beg to lay before their Lordships,” he says, “an extract of a letter
from the Governor-General of the Cape de Verd Islands, and likewise
extracts of letters from Mr Macaulay and the British Consul, residents
on the island of Boa Vista, distinctly showing the very remarkable state
of the weather preceding the attack of the inhabitants of the island,
which very important circumstance in a case of this kind I regret to
observe Dr M‘William has omitted to take any particular notice of.”
The event foreshadowed by these occurrences rapidly followed. As early
as the middle of September a few cases of unusually malignant fever
broke out, but, as has been already stated, the first case that
attracted public attention occurred on the 12th of October; a few others
followed during the remainder of this month; a still greater number
broke out in the beginning of November, and the epidemic came to its
height in the latter half of November, continuing to prevail throughout
December, and recurring for several months in the following year.
As in epidemic outbreaks in general, so in this instance, individual or
sporadic cases occurred some time before the appearance of the epidemic
in its true and proper form. On minute inquiry, it was discovered that
one if not two cases occurred as early as the 14th of September (Pathi),
another on the 20th of September (Roque), and a third on the 21st of
September (Agostinho): no other cases, at least none that attracted
attention, appeared to have occurred until the one already mentioned
(Gallinha), on the 12th of October. These sporadic cases all occurred in
the ordinary localities of epidemic disease, and among individuals
belonging to the classes that usually furnish its first and chief
victims.
At Boa Vista, in addition to other proofs of the presence of a stagnant
and pestilential atmosphere, there was the evidence derived from the
prevalence of unusual sickness and mortality among domestic animals.
“That the common air,” says Dr King, “which was inhaled by every living
thing on the island was in an epidemic condition in the months of
October, November, and December of both years, is sufficiently
demonstrated by the simultaneous occurrence of universal sickness and
great mortality among the cattle (including horses, cows, mules,
donkeys, and goats) at the very time that fever was raging among the
inhabitants. And, further, there was this remarkable coincidence, that
after an interval of some months and the disappearance of the disease
both in man and beast, the same fever broke out again in the towns and
villages about the rainy season of the following year, and was again
accompanied by the same murrain among the cattle, which in the two
seasons proved fatal to two-thirds of the whole stock of the island.”