Sir,--In my last letter, I treated of the practicability of guarding
our country against the now European and Continental disease, malignant
Cholera Morbus, by quarantine regulations. In the present one, it is
my intention still in a popular manner to scrutinise more deeply,
the doctrine of imported contagions; to point out, if I can, those
true contagions which can be warded off by our own exertions, in
contradistinction to others which are altogether beyond our controul;
and here it may be as well to premise, that when I use the term
epidemic, I mean atmospheric influence, endemic-terrestrial influence,
or emanation from the soil; and by pestilential, I mean the spread of
malignant disease without any reference to its source. The terms
contagion and infection have already been explained.
It must be evident, that legislative precaution can only be made
applicable to the first of these. The last being unchangeable by human
authority, are not to be assailed by any decrees we can fulminate
against them; and if it can be shown, which it has been by our best and
latest reports, that Cholera Morbus eminently and indisputably belongs
to that class--that the strictest cordons of armed men could not avail
to save the towns of the continent, nor the strictest quarantine our
own shores, from its invasion--it surely must be time to cease those
vain attempts, to lay down the arms that have proved so useless, and
turn our undivided attention, now that it has fairly got amongst us,
to conservative police, and the treatment of the disease; but as the
contagionists still insist that it was imported from Hamburgh to
Sunderland, it behoves us to clear away this preliminary difficulty
before proceeding to other points of the enquiry.
I take it for granted, that ships proceeding from Sunderland to Hamburgh
could only be colliers, and that according to the custom of such
vessels, they returned, as they do from the port of London, light; and I
admit, that on or about the time of their return, Cholera Morbus, under
the severe form which characterises the Asiatic disease, made its
appearance in that port, presenting a fair _prima facie_ case of
imported contagion; but as at the period of its thus breaking out in
Sunderland, a case equally as fatal and severe shewed itself, according
to the public accounts, in the upper part of Newcastle, 10 miles off;
another equally well-marked, in a healthy quarter in Edinburgh; a third,
not long before in Rugby, in the very centre of the kingdom; and a
fourth in Sunderland itself, as far back as the month of August, as
well as many others in different parts of the country;[23] it became
incumbent on the quarantine authorities, indeed upon all men interested
in the question, whether contagionists or otherwise, to shew the true
state of these vessels, as well as of the cases above alluded to, and
whether the Cholera Morbus had ever been on board of them, either at
Hamburgh or during the homeward voyage, so as by any possibility they
could have introduced the disease into an English port. Now will any
person pretend to say that this has been done, or that it could not have
been done, or deny that it was a measure, which, if properly executed,
would have thrown light upon the true character of the disease, not only
for the information of our own government but of every government in
Europe; that deputations from the Board of Health, backed and supported
by all the power and machinery of government, with the suspected ships
locked up in quarantine, and the persons of the crews actually in their
power, could not have verified to the very letter, the history of every
hour and day of their health, from the moment of their arrival at
Hamburgh till their return into port? This measure was so obviously and
imperiously called for, as constituting the only rational ground on
which the importing contagionists could stand, or their opponents meet
them in argument, that after having waited in vain for the report, I
raised my own feeble voice in the only department to which I had access,
urging an immediate, though then late, investigation. No good cause,
having truth for its basis, could have been so overlooked, and without
unfairness or illiberality, we are irresistibly forced to the
conclusion, that had the enquiry (the only one, by the bye, worth
pursuing, as bearing directly on the question at issue) been pushed to
the proof, it would have shown the utter nullity of quarantine guards
against atmospherical pestilence, the thorough baselessness of the
doctrine of importation.
[Footnote 23: Two of a type most unusual for this country, and the
Winter Season, have occurred in the vale of the Thames, not far from
here, which, as they both recovered, and the disease did not spread in
any way, were very properly allowed to pass without sounding any alarm,
but the gentleman who attended one of the cases, and had been familiar
with the disease in India, at once recognized it again, in its principal
distinguishing features.]
Without entering into the miserable disputes on this subject,
which, amidst a tissue of fable and prejudice, self-interest and
misrepresentation, have so often disgraced the medical profession at
Gibraltar; I shall now proceed to shew, by reference to general causes,
how baseless and mischievous have been the same doctrines and authority
when exercised in that part of the British dominions:--
Within the last thirty years, yellow fever has, at least four times,
invaded the fortress of Gibraltar; during which time also, the
population of its over-crowded town has more than quadrupled, presenting
as fair a field, for the generation within, or reception from without,
of imported pestilence as can well be imagined,--yet plague, the truest
of all contagions, typhus fever, and other infectious diseases, have
never prevailed, as far as I know, amongst them. The plague of the
Levant has not been there, I believe, for 150 years; yet Gibraltar, the
free port of the Mediterranean, open to every flag, stands directly in
the course of the only maritime outlet, from its abode and birth-place
in the east, being in fact, to use the language of the road, the
house of call for the commerce of all nations coming from the upper
Mediterranean. Now, can there be a more obvious inference from all this,
than that the plague, being a true contagion, may be kept off without
difficulty, by ordinary quarantine precautions; but the other being an
endemic malarious disease, generated during particular seasons, within
the garrison itself, and the offspring of its own soil, is altogether
beyond their controul. The malarious or marsh poison, which in our
colder latitudes produces common ague, in the warmer, remittent fever,
and in unfavourable southern localities of Europe, (such as those of
crowded towns, where the heat has been steadily for some time of an
intertropical degree)--true yellow fever, which is no more than the
highest grade of malarious disease; but this has never occurred in
European towns, unless during the driest seasons--seasons actually
blighted by drought, when hot withering land winds have destroyed
surface vegetation, and as in the locality of Gibraltar, have left the
low-lying becalmed, and leeward town to corrupt without perflation or
ventilation amidst its own accumulated exhalations. I know not how I
can better illustrate the situation of Gibraltar in these pestiferous
seasons, than by a quotation from a report of my own on the Island of
Guadaloupe, in the year 1816, which, though written without any possible
reference to the question at issue, has become more apposite than
anything else I could advance; "all regular currents of wind have the
effect of dispersing malaria; when this purifying influence is
with-held, either through the circumstances of season, or when it
cannot be made to sweep the land on account of the intervention of
high hills, the consequences are most fatal. The leeward shores of
Guadaloupe, for a course of nearly 30 miles, under the shelter of a very
steep ridge of volcanic mountains, never felt the sea breeze, nor any
breeze but the night land-wind from the mountains; _and though the soil,
which I have often examined, is a remarkably open, dry and pure one,
being mostly sand and gravel, altogether, and positively without marsh,
in the most dangerous places, it is inconceivably pestiferous throughout
the whole tract, and in no place more so than the bare sandy beach near
the high-water mark_. The coloured people alone ever venture to inhabit
it; and when they see strangers tarrying on the shore after nightfall,
they never fail to warn them of their danger. The same remark holds good
in regard to the greater part of the leeward coasts of Martinique, _and
the leeward alluvial bases and recesses[24] of hills, in whatever port
of the torrid zone they may be placed_, with the exception, probably of
the immediate sites of towns, where the pavements prevent the rain-water
being absorbed into the soil, and hold it up to speedy evaporation."
Now, conceive a populous crowded town placed in this situation, and you
have exactly what Gibraltar and the other towns of Spain and North
America, liable to yellow fever, must become in such seasons as I have
above described, only, that as they grow more populous and crowded, the
danger must be greater, and its visitations more frequent, unless the
internal health police be made to keep pace in improvement, with the
increasing population.
[Footnote 24: The leeward niches and recesses of hills, however dry and
rocky, become in these seasons of drought, absolute dens of malaria,
this will be found proven in my reports made especially of the islands
of Dominique and Trinidad, which may be seen at the Army Medical Board
Office.]
Now in the name of injured commerce--of the deluded people of
England--of medical science--of truth and humanity--what occasion can
their be to institute an expensive quarantine against such a state of
things as this, which can only be mitigated by domestic health police;
or why conjure up the unreal phantom of an imported plague, to delude
the unhappy sufferers, as much in regard to the true nature of the
disease, as to the measures best calculated for their own preservation;
when it must be evident that the pestilence has sprung from amidst
themselves, and that had it been an external contagion in any degree,
the ordinary quarantine, as in case of the plague, would certainly have
kept it off; but the question of the contagion of yellow fever, so
important to commerce and humanity; and which, like the Cholera, has
more than once been used to alarm the coasts of England, demands yet
further investigation.
For nearly 40 years have the medical departments of our army and navy
been furnished with evidence, from beyond the Atlantic, that this
disease possessed no contagious property whatever. These proofs now lie
recorded by hundreds in their respective offices, and I take it upon me
to say, they will not be found contradicted by more than one out of a
hundred, amongst all the reports from the West Indies, which is as much
the birth-place of the yellow fever, as Egypt is of the plague: yet, in
the face of such a mass of evidence, as great or greater probably than
ever was accumulated upon any medical question, has our Government been
deluded, to vex commerce with unnecessary restraints, to inflict
needless cruelties upon commercial communities, (for what cruelty can be
greater than after destroying their means of subsistence by quarantine
laws, to pen them up in a den of pestilence, there to perish without
escape, amidst their own malarious poison?) and to burden the country
with the costs of expensive quarantine establishments. Surely if these
departments had done their duty, or will now do it, in so far as to
furnish our rulers with an abstract of that evidence, with or without
their own opinions, for opinions are as dust in the balance when put in
competition with recorded facts, it must be impossible that the delusion
could be suffered to endure for another year; or should they unluckily
fail thereby to produce conviction on Government, they can refer to the
records of commerce, and of our transport departments, which will shew,
if enquiry be made, that no ship, however deeply infected before she
left the port, (and all ships were uniformly so infected wherever the
pestilence raged) ever yet produced, or was able to carry a case of
yellow fever beyond the boundaries of the tropics, on the homeward
voyage, and that therefore the stories of conveying it beyond seas to
Gibraltar, must have been absolutely chimerical. It would indeed, have
been a work of supererrogation, little called for, for I think I have
fully shown that Gibraltar must be abundantly qualified to manufacture
yellow fever for herself.
No less chimerical will be the attempt to shut out Cholera Morbus from
our shores by quarantine laws, because throughout Europe, ready
prepared, alarmed, and in arms against it, they have succeeded nowhere;
whereas, had it been a true contagion and nothing else, they must, with
ordinary care, have succeeded everywhere; the disease, as if in mockery,
broke through the cordons of armed men, sweeping over the walls of
fortified towns, and following its course, even across seas, to the
shores of Britain; and yet we are still pretending to oppose it with
these foiled weapons.
We are indeed told, by authority, that its appearance in towns has
always been coincident with the arrival of barges from inland, or by
ships from the sea, but if it be not shown at the same time that the
crews of these barges had been infected with the disease, or if, as at
Sunderland, no person on board the ships can be identified as having
introduced it, while we know that the disease actually was there two
months before, we may well ask at what time of the year barges and ships
do not arrive in a commercial seaport, or where an epidemic disease,
during pestiferous seasons could be more likely to break out than where
the most likely subjects are thrown into the most likely places for its
explosion, such as newly arrived sailors in an unwholesome seaport,
where the license of the shore, or the despondency of quarantine
imprisonment must equally dispose them to become its victims.--Besides,
what kind of quarantine can we possibly establish with the smallest
chance of being successful against men who have not got, and never had
the disease. Merchandise has been declared incapable of conveying the
infection,[25] and are we to interdict the hulls and rigging of Vessels
bearing healthy crews, or are we to shut our ports at once against all
commerce with the North of Europe, and would this prove successful if we
did? a reference to a familiar epidemic will I think at once answer this
question.
[Footnote 25: Vide Russian Ukase.]
It is only three months ago that the epidemic Catarrh or Influenza
spread throughout the land, travelling like the Cholera in India, when
it went up the monsoon, without regard to the East wind; and what could
be more likely than the blighting drying process of such a wind, in
either the one or the other case, to prepare the body for falling under
the influence of whatever disease might be afloat in the atmosphere.
In general this passing disease can be distinctly traced, as having
affected our continental neighbours on the other side of the channel
before ourselves: now can it be supposed that any quarantine could have
prevented its first invasion, or arrested its farther progress amongst
us. How ridiculous would have been the attempt, and yet with the
experience of all Europe before us, have we been enacting that very part
with the Cholera Morbus: but further, the same authority which calls for
the establishment of quarantine in our ports, tells us that neither
proximity nor contact with the sick,[26] is requisite for the production
of the disease: now can anything further be wanting beyond this
admission, to prove that it must be an epidemic atmospherical poison,
and not a personal contagion, and that, under such circumstances, the
establishment of quarantine against persons and goods, would manifestly
be absurd and uncalled for. So fully satisfied has the Austrian
Government been made by experience, of the futility and cruelty of such
quarantines, that the Emperor apologises to his subjects for having
inflicted them. The King of Prussia makes a similar _amende_, and the
Emperor of Russia convinced by the same experience, abolished or greatly
relaxed his quarantines several mouths ago.
[Footnote 26: Vide Reports from Russia.]
I am by no means prepared to assert, because I cannot possibly know to
the contrary, although from the analogy of other disease I do not
believe it, that the Cholera Morbus may not become contagious under
certain conditions of the atmosphere, but these cannot be made subject
to quarantine laws, and I am fully prepared to acknowledge, that as in
the case of other epidemics, it may be made contagious through defective
police; but independent of these, it possesses other powers and
qualities of self-diffusion, which we can neither understand nor
controul. Such, however, is not the case with that other phantom of
our quarantine laws--the yellow fever--which can never, under any
circumstances of atmosphere, without the aid of the last be made a
contagious disease. I speak thus decisively from my experience of its
character, as one of the survivors of the St. Domingo war, where, in a
period of little more than four years, nearly 700 British commissioned
officers, and 30,000 men were swept away by its virulence; as also from
subsequent experience, after an interval of 20 years, when in the course
of time and service, I became principal medical officer of the windward
and leeward colonies, and in that capacity, surveyed and reported upon
the whole of these transatlantic possessions.
It was my intention, in these times of panic, to designate to my
countrymen, in as far as I could, the true essential intrinsic
contagions of the British Isles, (for such there are, and terrible ones
too,) which prevail under all circumstances of season, atmosphere, and
locality, as contradistinguished from the factitious ones, of our own
creating, and the imaginary or false which often spread epidemically,
(for there may be an epidemic as well as contagious current of
disease)[27] although they possess no contagious property whatever; as
well as the foreign contagions, which if we relax in due precaution,
may, at any time, be introduced amongst us--but the unreasonable length
of this letter, for a newspaper communication, warns me to stop.
[Footnote 27: For as long as men congregate together, and every
supposable degree of communication must of necessity be constantly
taking place amongst them, to distinguish a spreading epidemic from a
contagious disease when it first breaks out, must obviously be a matter
of impossibility; and upon this point the contagionists and their
antagonists may rail for ever,--the one will see nothing but contagion,
whether in the dead or the living body, and the other will refer every
fresh case to atmospheric or terrestrial influence, and both with as
much apparent reason as they possibly could desire: but the candid
impartial investigator, who waits to observe the course of the disease
before coming to a conclusion, and refers to the facts furnished in the
Cholera Hospitals of Warsaw and the sick quarters of Sunderland, will
never be deceived in regard to its real nature, nor propagate the
appalling belief that Cholera Morbus can be made a transportable and
transmissible contagion.]
I have written thus earnestly, because I deeply feel what I have here
put down. It is possible I may have made mistakes, but if I have, they
are not intentional, and I shall be happy to be corrected, for I do
not live at the head quarters of communication, and my broken health
prevents my frequenting in person, the field of investigation. In
candour I ought to declare, that the establishment of quarantine against
this new and hideous pestilence in the first instance, was the most
sacred duty of Government, but now that its true character has been made
known, and the futility of quarantine restrictions demonstrated, I feel
equally bound, as one of the lieges, to enter my humble protest against
their continuance.
Should I write again, I shall still adopt the same popular style,
for no other can be adapted to a newspaper communication, and the
subject-matter is as interesting to the public, and every head of a
family, as it can be to the professional reader; and, in thus making
use of your columns, as I can have no motive but that of ardent
research after truth, I know that I may always rely upon your
assistance and co-operation.
WILLIAM FERGUSSON,
Inspector-General of Hospitals.
_Windsor, Nov. 26, 1831._