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.