Sir,--Being well aware of the handsome manner in which you have always
opened the columns of your liberal journal to correspondents upon every
subject of public interest, I make no further apology for addressing
through the WINDSOR EXPRESS, some observations to the inhabitants of
Windsor and its neighbourhood upon the all-engrossing subject of Cholera
Morbus.
That pestilence, despite of quarantine laws, boards of health, and
sanatory regulations, has now avowedly reached our shores, and we may be
permitted at last to acknowledge the presence of the enemy--to describe
to the affrighted people the true nature of the terrors with which he is
clothed--and to point out how these can be best combatted or avoided.
That the seeds of his fury have long been sown amongst us may be proved,
and will be proved, ere long, by reference to fatal cases of unwonted
Cholera Morbus appearing, occasionally during the last six months, in
London, Port Glasgow, Abingdon, Hull, and many other places, which, as
it did not spread, have been passed unheeded by our health conservators;
but, had the poison then been sufficiently matured to give it epidemic
current, would have been blazed forth as imported pestilence. Some one
or other of the ships constantly arriving from the north of Europe could
easily have been fixed upon as acting the part of Pandora's box, and
smugglers from her dispatched instanter to carry the disease into the
inland quarters of the kingdom. I write in this manner, not from
petulance, but from the analogy of the yellow fever, where this very
game I am now describing, has so often been played with success in the
south of Europe; and will be played off again, for so long as lucrative
boards of health and gainful quarantine establishments, with extensive
influence and patronage, shall continue to be resorted to for protection
against a non-existent--an impossible contagion.
But to the disease in question.--It must have had a spontaneous origin
somewhere, and that origin has been clearly traced to a populous
unhealthy town in the East Indies--no infection was ever pretended to
have been carried there, yet, it devastated with uncontroulable fury,
extending from district to district, but in the most irregular and
unaccountable manner, sparing the unwholesome localities in its
immediate neighbourhood, yet attacking the more salubrious at a
distance--passing by the most populous towns in its direct course at
one time, but returning to them in fury at another, staying in none,
however crowded, yet attacking all some time or other, until almost
every part of the Indian peninsula had experienced its visitation.
There is an old term, as old as the good old English physician,
Sydenham--_constitution of the atmosphere_--and to what else than to
some inscrutable condition of the element in which we live, and breathe,
and have our being--in fact to an atmospheric poison beyond our ken,
can we ascribe the terrific gambols of such a destroyer. 'Tis on record,
that when our armies were serving in the pestilential districts of
India, hundreds, without any noticeable warning, would be taken ill in
the course of a single night, and thousands in the course of a few days,
in one wing of the army, while the other wing, upon different ground,
and consequently under a different current of atmosphere, although in
the course of the regular necessary communication between troops in the
field, would remain perfectly free from the disease. It would then cease
as suddenly and unaccountably as it began,--attacking, weeks after, the
previously unscathed division of the army, or not attacking it at all
at the time, yet returning at a distant interval, when all traces of the
former epidemic had ceased, and committing the same devastation. Now,
will any man, not utterly blinded by prejudice, candidly reviewing
these facts, pretend to say, that this could be a personal contagion,
cognizable by, and amenable to, any of the known or even supposable laws
of infection--that the hundreds of the night infected one another, or
that the thousands of the few days owed their disease to personal
communication,--as well affect to believe that the African Simoon, which
prostrates the caravan, and leaves the bones of the traveller to whiten
in the sandy desert, could be a visitation of imported pestilence.
It may then be asked, have we no protection against this fearful plague?
No means of warding it off? Certainly none against its visitation! It
will come--it will go; we can neither keep it out, or retain it, if we
wished, amongst us. The region of its influence is above us and beyond
our controul; and we might as well pretend to arrest the influx of the
swallows in summer, and the woodcocks in the winter season, by cordons
of troops and quarantine regulations, as by such means to stay the
influence, of an atmospheric poison; but in our moral courage, in our
improved civilization, in the perfecting of our medical and health
police, in the generous charitable spirit of the higher orders,
assisting the poorer classes of the community, in the better condition
of those classes themselves, compared with the poor of other countries,
and in the devoted courage and assistance of the medical profession
every where, we shall have the best resources. Trusting to these, it has
been found that, in countries far less favoured than ours, wherever the
impending pestilence has only threatened a visitation, there the panic
has been terrible, and people have even died of fear; but when it
actually arrived, and they were obliged to look it in the face, they
found, that by putting their trust in what I have just laid down, they
were in comparative safety; that, the destitute, the uncleanly, above
all, the intemperate and the debauched, were almost its only victims;
that the epidemic poison, whatever it might be, had strength to prevail
only against those who had been previously unnerved by fear, or weakened
by debauchery; and that moral courage, generous but temperate living,
and regularity of habits in every respect, proved nearly a certain
safe-guard. They found further, that quarantine regulations were worse
than useless--that the gigantic military organization of Russia--the
rigorous military despotism of Prussia--and the all-searching police of
Austria, with their walled towns, and guards and gates, and cordons of
troops, were powerless against this unseen pestilence, and that as soon
as the quarantine laws were relaxed, and free communication allowed, the
disease assumed a milder character, and speedily disappeared.
I say, then, confidently, that Cholera Morbus never will commit ravages
in this country, beyond the bounds of the worst purlieus of society,
unless it be fostered into infectious, pestilential activity, by the
absurd, however well-meant, measures of the conservative boards of
health, such as have been just recommended in what has always been
esteemed the most influential, best-informed journal of England, I mean
the QUARTERLY REVIEW. If the writer of the article who recommends the
enforcement of the ancient quarantine laws in all their strictness, be
a medical man, he surely ought to know, that wherever human beings are
confined and congregated together in undue numbers, more especially if
they be in a state of disease, there the matter of contagion, the
typhoid principle, the septic (putrefactive) human poison or by what
other name it may be called, is infallibly generated and extends itself,
but in its own impure atmosphere only, as a personal infection to those
who approach it, under the form and features of the prevailing epidemic,
whatever that may be. Hence we have all heard of contagious pleurisies,
catarrhs, dysenteries, ulcers, &c., and if the doctrines of that writer
be received, we shall soon also hear of contagious Cholera Morbus with
a vengeance. His exhortations would go to shut up the sick from human
intercourse, to proclaim the ban of society against them, and under the
most pitiable circumstances of bodily distress, to proscribe them as
objects of terror and danger, instead of being as they actually are,
helpless innocuous fellow creatures, calling loudly for our promptest
succour and commiseration in their utmost need. They would go further to
array man against his fellow man in all the cruel selfishness of panic
terror, sever the dearest domestic ties, paralize commerce, suspend
manufactures, and destroy the subsistance of thousands, and all for the
gratification of a prejudice which has been proved to be utterly
baseless in every country of Europe from Archangel to Hamburgh and
Sunderland. Happily for our country, these measures are now as absurd
and impracticable as they would be tyrannical and unjust. They could not
be borne even under the despotic military sway of Prussia and Russia,
and in this free country it would be impossible to enforce them for a
single week. The very attempt would at once, throughout the whole land,
produce confusion and misery incalculable.
I say, on the contrary, throw open their dwellings to the free air
of heaven, the best cordial and diluent of foul atmosphere in every
disease--let their fellow townsmen hasten to carry them food,
fuel, cordials, cloathing, and bedding, speak to them the words of
consolation, and should they have fear to approach the sick, I take
it upon me to say, they will be accompanied by any and every medical
practitioner of the place, who, in their presence, will minister to the
afflicted, inspire their breath, and perform every other professional
office of humanity, without the smallest fear or risk of infection; for
they read the daily records of their profession, where it has been
proved to them, that in the open but crowded hospitals of Warsaw, under
the most embarrassing circumstances of warfare and disease, out of a
hundred medical men, with their assistants and attendants, frequenting
the sick wards of Cholera, not one took the disease; that, for the sake
of proving its nature, they even went so far as to clothe themselves
with the vestments of the dying, to sleep in the beds of the recently
dead, and to innoculate themselves in every way with the blood and
fluids of the worst cases, without, in a single instance, producing
Cholera Morbus.[20] The accounts may not, indeed, cannot be the same
from every other quarter, for medical men must be as liable to fall
under the influence of an atmospherical epidemic disease as other
classes of the community; but the above fact is alone sufficient to
prove that it cannot be a personal contagion.
[Footnote 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 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 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 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]
[Footnote 21: The oven on that account need not lose character with
bread-eaters, for according to the old adage, Omne vitium per ignem
excoquitur.]
[Footnote 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 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.
WILLIAM FERGUSSON,
Inspector-General of Hospitals.
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.
_November 9, 1831._