PART II. — CHAPTER I. THE NEGATION OF ATMOSPHERIC CONTAGION FROM THE HISTORY AND ACTUAL OBSERVATION OF DISEASE. — THE EVIDENCE DRAWN FROM THE WIDELY SPREAD AND SIMULTANEOUS PREVALENCE OF DISEASE, IN FAVOUR OF ATMOSPHERIC CONTAGION, CONSIDERED. — CHAPTER II. THE EVIDENCE DRAWN FROM DISEASE ATTACKING THE RELATIVES, ATTENDANTS, AND VISITORS OF THE SICK, IN FAVOUR OF ATMOSPHERIC CONTAGION, CONSIDERED—FACTS EXPLAINED. — CHAPTER III. THE ARGUMENT DRAWN IN FAVOUR OF THE PROPAGATION OF DISEASE BY ATMOSPHERIC CONTAGION, FROM DISEASE APPEARING IN PREVIOUSLY HEALTHY HOUSES AND LOCALITIES TO WHICH PERSONS SICK, OR LATELY SO, HAVE BEEN REMOVED. — CHAPTER IV. THERE IS NO EVIDENCE THAT ATMOSPHERIC CONTAGION TRAVELS, OR IS COMMUNICATED FROM ONE PLACE TO ANOTHER. — CHAPTER V. ON VITIATED AIR. — AIR VITIATED WITH EFFLUVIA FROM BODIES IN A STATE OF DISEASE. — AIR VITIATED WITH EFFLUVIA FROM DEAD ANIMAL MATTER. — CHAPTER VI. AIR VITIATED BY ADMIXTURE WITH EFFLUVIA ARISING FROM THE DECOMPOSITION OF VEGETABLE MATTER ON THE SURFACE OF THE EARTH. — CHAPTER VII. MALIGNANT FEVER. — CHAPTER VIII. GENERAL DISEASED CONDITION OF THE BODY, THE PRODUCT OF MALARIA. — CRETINISM. — INTERMITTENT FEVER, OR AGUE. — CHAPTER IX. OTHER CASES OF PESTILENCE—FAMINE—UNWHOLESOME FOOD AND DRINK. — DRINK. — CHAPTER X. CAUSES OF PESTILENCE CONTINUED—COLD, WANT OF CLOTHING, AND SHELTER—DEPRESSION OF MIND—INFLUENCE OF WEATHER, CLIMATE, HABITS, &C. — CLIMATE. — CHAPTER XI. THE AVOIDANCE OF DISEASES MARKED WITH PALPABLE CONTAGIOUS POISONS—THE LIMITED RANGE OF ACTION OF CONTAGION. — CHAPTER XII. THE PREVENTION AND CORRECTION OF VITIATED AIR. — CORRECTION OF VITIATED AIR. — FORMULA FOR THE PREPARATION OF CHLORINE GAS. — FORMULA FOR OBTAINING MURIATIC ACID GAS. — CHAPTER XIII. THE PREVENTION OF VITIATED AIR IN CONNECTION WITH THE DISPOSAL OF THE DEAD—OFFALS—CONSTRUCTION OF TOWNS, HOUSES, SEWERS, &C. — THE CLEANSING OF TOWNS. — SEWERS. — CONSTRUCTION OF HOUSES. — CHAPTER XIV. PREVENTION OF DISEASE BY AN ACTIVE AND CHEERFUL STATE OF MIND, SUFFICIENT CLOTHING, AND WHOLESOME DIET. — CLOTHING. — FOOD.
56
Ce qu’il y’a d’extraordinaire c’est que ceux qui fatiguent leur
raison pour lui faire rapporter de certains événements à des vertus
occultes n’ont pas un moindre effort à faire pour s’empêcher
d’en voir la véritable cause.
It has been attempted, in the preceding part of this
work, to prove, on general principles, and by a reference to
analogous objects, that atmospheric contagion cannot exist;
but, lest that object should appear unaccomplished, and
that the data are insufficient for the conclusion proposed,
it is purposed to test the merits of the question by the consideration
of the history and phenomena of disease.
Those circumstances, connected with the appearance and
propagation of disease, on which the doctrine of atmospheric
contagion rests, will be inquired into, and their weight and
importance duly ascertained. This inquiry will be prosecuted
as if no such investigation as the preceding had been
made, and as if the existence of that agency was not irreconcilable
57with well ascertained laws; and, for the sake
of argument, the possibility of its existence will be conceded.
The facts in the history of disease, which are held as
lending countenance to the doctrine of atmospheric contagion—of
proving its existence, are, chiefly, the general
prevalence of disease at one and the same time among the
members of the same family, of the inhabitants of the same
town, district, and country,—its affecting the visitors and
attendants of the sick,—and its observation in places
hitherto healthy, shortly after communication with those
ravaged with the distemper. These facts cannot be denied;
and all that can be done is to weigh their value,
as proofs of the existence of atmospheric contagion, and the
first mentioned will occupy our attention.
The widely-spread prevalence of disease at the same time
among the inhabitants of a country or district, is almost
invariably held as affording proof of the presence and operation
of atmospheric contagion.
The ravages of pestilence, rapid, wide, and deadly, are
noticed in the histories of all nations, and at intervals they
have been experienced during the long period of the existence
of the world; and the destruction of whole armies,
and the annihilation of entire nations, prove how widely
spread its operation has sometimes been.
Did the circumstance of disease being widely spread
prove its propagation by atmospheric contagion, then the
58matter were at rest; but the propriety of such an inference
is questionable.
Let it be supposed that there is prevailing, in a district
of country, disease to a great amount, that is to say, many
cases of the same distemper.
That single circumstance proves nothing in reference to
atmospheric contagion, more than to any other probable
cause of disease. It shews, merely, that there is in wide
operation some cause or causes of sickness; and it is totally
unwarrantable to conclude that one agency, more than another,
is the efficient cause, without further information
directly bearing on the subject.
It is with the knowledge of the single fact, and in total
ignorance of others, or with total blindness to them, that
atmospheric contagion is pronounced to be the active agent.
Now it is not the peculiar property, the exclusive prerogative
of that principle, to cause disease; at least, that
character has not been openly sought by its advocates,
though the tone of common conversation, and of medical
writings on the subject, would seem to imply that it had
been tacitly granted.
That cannot be conceded. Many other agencies are known
to be productive of sickness, and have, on many occasions,
induced pestilence of a deadly character, that has ravaged
in no despicable limits.
The isolated fact itself of disease being widely extended
in the absence of particulars, after proving that some cause
existed, should legitimately go to create a suspicion, that
the cause or causes which had produced the first cases, and
acted as the ordinary springs of the malady, were continuing
59to operate on other individuals. Such would be
known to be capable of producing the effect observed, for
the satisfactory reason, that it or they had already accomplished
it. How much more wise, under such circumstances,
it would be to suspect the continuance of that influence
with the continuance of effects identically the same as it or
they had already produced, than to call in a principle whose
only evidence of existence was the presence of effects, the
same as had been only a short time before produced by a
different agency, and of whose removal or absence there
was not a particle of proof.
But a little inquiry will, on most occasions, elicit the
fact, that some pestiferous influences exist; and it will, in
general, be soon enough to pronounce on the probable causes
of a distemper after that investigation has been made.
Disease in general, unconnected with alterations in the
texture of the organs, is neither more nor less than a derangement
of the functions performed by the body; and as
it partakes of a general or local character, so the disease is
either local or general; and, as it relates to functions, more
or less important, so it is more or less dangerous.
It must be obvious, that a machine so nicely balanced,
so complicated and so exquisitely wrought as the human
body, must be liable, on many occasions, to have its operations
impeded and deranged; and, although sometimes
said to be a little world of itself, still, it is dependent on
surrounding agencies. It requires a pure atmosphere for
respiration, food to supply the waste it continually suffers,
and drink to appease thirst, and to take the place of the
fluids that are constantly draining from it.
60The human body is necessarily brought in contact with
the external world; and many are the injuries it suffers
therefrom, both directly and remotely.
The derangements of the functions of the body are in
general owing to circumstances of an unwholesome character,
for the most part relating to food, drink, the various
steps in nutrition, the atmosphere, its temperature, dryness,
moistness, purity, &c. &c., and chemical and mechanical
agents, to whose action the body is exposed.
Were it not for the operation of unfavourable circumstances
of the nature specified, a body in health, were no
special interposition of the Almighty hand made, would go
on in the healthy performance of its functions, till the
frailty and decay, incident to old age, would overtake it.
In general those diseases which are observed to prevail
to a great extent, and over a large tract of country at the
same time, are so uniformly coincident with circumstances
of an unwholesome tendency, connected with those agencies
above referred to, that they appear at once to the candid
and unprejudiced inquirer, to stand in the relation of cause
and effect. Surely it should cause no difficulty, nor occasion
any necessity for the calling in a principle, atmospheric
contagion, without any other evidence, that those effects
are occasionally found not confined to one spot merely, but
are seen developed in an extended sphere—for, assuredly, it
can require no extraordinary effort of the mind to conceive
that the agent acting and causing disease in one place, or
individual case, may with equal force, and with a like
result, act in many situations, and in respect to many
persons.
61The presence of certain operations in several situations
by no means proves that they have reproduced themselves.
Day-light is manifest in many countries, within certain
latitudes at the same hour, but it has never been suggested
that this circumstance in one of them has been propagated
by that of another, through any occult principle, or whatever
else such an agency may be called.
Had the case not presented at once, and in so direct and
striking a manner, a sufficient cause for the effects observed,
then we doubt not, that, perhaps, individuals would relieve
themselves of any present difficulty, and attribute what they
could not readily explain, to the operation of a principle
having as little evidence of its entity as atmospheric contagion
itself. But the sun is too glorious, too resplendent
an object to be overlooked, and its effects are too immediate,
to permit the possibility of the most unreflecting, not
marking its relation as cause to the effect observed.
But, unfortunately, the relation between widely spread
diseases or epidemics, as they are called, and circumstances
connected with the agencies before referred to, is not
so striking—though it is as close. There is no object so
bright to draw the same attention to it, and to proclaim it
from east to west, from the dawn of morning till the fall
of evening, like that luminary dispersing light as he appears
to traverse the heavens.
Yet there is room to believe that the presence of epidemics
is always accompanied, or shortly preceded, by circumstances,
which, though by reason of their less striking
character, and less immediate operation, are sometimes
overlooked or neglected, yet do exist, and, were inquiry
62made by those able for the purpose, doubtless would be
found.
In most of the epidemics recorded, some such agencies
or circumstances were in operation. They were known to
be so—and in almost all that have come under our own
observation, and they have neither been few nor carelessly
noted—there have, on nearly every occasion, been found
the influences to which we allude.
We are led to believe an agent to be the cause of an effect
when the one follows upon the operation or presence of the
other, uniformly, and on every occasion, when the latter
bears some relation in its amount to the force and length of
duration of the former—and when the effect ceases with
the removal of the agent. Such a close connection, as
subsists in that case, entitles the former or agent to be
held as the cause of the effect observed.
For those very reasons day-light is said to be the effect
of the sun that comes with it, remains with it, and goes
with it.
Let us see if the same connection holds with disease and
those agencies and circumstances we have cursorily referred
to.
Those agencies and circumstances, relating to food, drink,
air, heat, contagious matter, &c. &c. are known to present
themselves, and with them are presented diseases. They
are known to remain, and with them are known to continue
diseases. They are known to disappear, and with them
all the world knows diseases disappear also.
These being the causes of epidemic or widely spread
disease, as such a connection proves, it is altogether superfluous
63to admit the operation of atmospheric contagion,
whose existence has never been known, but by the very
circumstances which it is said to bring about.
It is surely most unwise, when we see disease arising with
the existence of unwholesome circumstances, such as scarcity
of food, unwholesome quality of it, great vicissitudes
of weather, uncommon conditions of the atmosphere, want
of sufficient clothing or incommensurate with the severities
of the season, the operation of depressing passions, and the
like,—growing with their intensity—extending where they
extend—abating where they decrease—and finally disappearing
when they disappear—to refuse to grant the relation
as cause and effect, and to plunge into the tide of difficulties
such ill-timed incredulity creates, with nothing but
the appearance, nothing but the assurance, of an object to
grasp at.
In general, such a connection can be made out between
the existence of wide-spread disease and such circumstances.
If, in respect to some diseases, so intimate a connection
cannot be observed, the probability is, that it is the obscurity
connected with these subjects, the less direct way in
which they operate and the remote time at which their effects
may be experienced on the body, that are the occasion
of the difficulty. The human body, unlike mere inanimate
matter, has the power of withstanding, at least for a
time, the operation of unwholesome influences, if not very
virulent; and it is only natural to allow, that, in respect
to a machine so complicated, affected by so many agencies,
and standing in so many relations, there will be less complete
64directness of operation, than with simple or inanimate
substances, and more variety in the amount and duration
of the effect.
On these accounts, the indications of the case are less
direct and obvious, and it should cause no great surprise,
that being considered, and the fact of the imperfect state
of our knowledge on the varieties of the agencies referred
to, being kept in mind, that the causes of disease cannot at
all times be completely and satisfactorily ascertained.
Our knowledge of the derangements of health, from the
operation of these agencies, on some of which we are dependent,
and with others of which we are constantly
brought in contact, is fast increasing, and the relation between
the former and the varieties in the latter is becoming
clear and precise. There is, therefore, reason to hope
that difficulties which now baffle us, will soon be explained
away, and that much of that mist that has long overhung
the causes of pestilence, will soon be dissipated.
Certain circumstances produce certain uniform effects,
and in every instance where they are operating, their effects
will be produced, provided no agency is acting adequate
to neutralize them. Not one hill only, in northern
latitudes, has its summit whitened with snow, nor does
sterility mark a few spots only in the immense deserts of
Africa and Asia.
The same features are spread far and wide. They owe
their existence to agencies acting in immense spheres corresponding
with their own.
The sphere of those circumstances connected with the
agents so often referred to, that produce disease, is sometimes
65large, and no astonishment need be felt, if that of
disease is also large, since a relation ever holds between
the extent of a cause and its effects.
It would certainly be ample time to call in the assistance
of atmospheric contagion to account for the propagation
of disease, when its sphere or circle is found to be positively
eccentric of that of those circumstances alluded to.
But we are satisfied that such a contingency is of very
rare occurrence, and even when it is said to exist, we shall
require some undoubted assurance that the non-correspondence
is not the result of ignorance of the extent of these
hurtful circumstances, rather than the actual absence of
relation between them.
It is not our intention at present to enlarge on the causes
of disease, yet we maintain, that such a relation as that
referred to, will in almost every instance be made out, if
candid and efficient inquiry be instituted; so that, even
granting that atmospheric contagion exists, there can be no
room for its operation. And we are of opinion, that if, in
some extraordinary instance, no such relation can be detected,
the progress which every department of science is
making will in time achieve what may not be accomplished
at present.
The history of nations and the records of medicine shew,
that, coincident with epidemic sickness, there have, for the
most part, been noticed certain circumstances operating
which were prejudicial to the welfare of the human body.
For example, famine, bad or unwholesome food, great and
long continued droughts, great rains followed by intense
heat, sudden vicissitudes of weather, dissipation, irregularities,
66depressed state of mind, insufficient clothing and
fuel, and unwholesome water.
These, and many similar circumstances known to prevail
in the haunts of pestilence, must exert a great, a very
powerful, influence on the human body, and, when the
question of the probable causes of its diseases is mooted, it
argues a strange and discreditable blindness to obvious
facts, to overlook the part which they must exert in their
production; and a strong and dangerous partiality to a
questionable principle, to attribute the whole calamity to
atmospheric contagion.
67
Few points have been held so conclusive of the existence
of atmospheric contagion, as the circumstance of the
attendants and visitors of the sick being attacked with the
same distemper, during, or shortly after, their communication.
It is vain to deny, that where a person is ill of a disease,
such as fever, that those about him, the members of
his family, his attendants, and his visitors, are sometimes
attacked with the same distemper.
Such is a common occurrence, but common as it is, it
cannot prove that the efficient cause is atmospheric contagion.
Were it established that atmospheric contagion existed
in that individual disease, and in that individual case, then
it might be admitted that the circumstance did lend some
countenance to the supposition, and should perhaps entitle
the case to examination.
68But it has never been shown that that principle positively
exists. There is, as has already been observed, no
proof, saving that drawn from the very circumstances for
which it is called in to account.
Thus it is entitled to no exclusive respect.
Here is then an agency, of whose existence there is no
evidence of a sufficient nature, and here there is reason to
believe that the same circumstances are operating widely,
and upon the relatives, the attendants, and visitors of the
sick, which have already produced the disease in those
visited.
These circumstances, in general, are ascertained to be
acting upon these individuals, and where they cannot, from
their obscure nature, be recognised, there is reason, from
the very circumstance of the sick having been affected,
to conclude that they are operating, though perhaps in
an insidious way. Now, a question arises, whether it is
wisest to attribute the prevalence of disease among those
holding communication with the sick, to the operation of
atmospheric contagion, or to those circumstances and
agencies which caused the disease originally, and which
there is room to believe are exerting their influence over
them also.
It has been said in the preceding chapter, that, during
the prevalence of widely spread or epidemic disease, there
are generally found circumstances of an unwholesome tendency,
favouring its career, and that the range of their
action corresponds with that of pestilence. That being
the case, as it undoubtedly is, it would be proper, before
admitting the operation of atmospheric contagion, to shew
69that no such circumstances were in operation. An inquiry
would be necessary; and their presence being proven, it
would not be short of imbecility to attribute to that agency,
effects such as are wont to follow their action. It would
be to call in a principle whose existence has never been
proven, and which, therefore, must be held as at least doubtful,
to account for phenomena, the ordinary results of circumstances
present, which would indeed be absurd.
Before the operation of atmospheric contagion could with
propriety be entertained, it behoved to shew that those
circumstances which induced disease in the visited, were
not operating with those holding communication with
them.
But in all those cases in which atmospheric contagion
is held as acting, no attempt is made to prove such absence,
and the belief in its presence is not the less strong
because these circumstances can be proved to be present.
It is a self-evident truth that some agency or agencies,
totally independent of atmospheric contagion must have
been in operation, and acting as the cause of disease in the
first case or cases that occurred. For this ample reason,
that, for atmospheric contagion to exist at all, it is obviously
necessary that disease pre-existed, since it is the
product of disease, and of disease only.
Thus, then, it is proved, that some causes, totally independent
of atmospheric contagion, produce the first cases
of an epidemic, or widely spread disease. Now, there is
no evidence that these same causes are not operating upon
those who visit the sick, and in absence of any facts to the
contrary, and of the operation of an equally active and
70undoubted agent, there is justice in thinking it probable
that they are acting, more especially if the self-same results
are manifested—and this may, with safety, be done,
even when direct testimony cannot be obtained—which is
very seldom entirely the case.
The causes of the disease being widely extended, and
the visited patient being ill from the operation of forces
shared in common with many, it is only fair to conclude
that as relatives, attendants, and visitors are like the
great mass of people thus operated upon—that they, cæteris
paribus, are as likely to be affected with the prevalent disease,
as those who are suffering were previous to its invasion.
They do suffer, but not in general in a greater proportion
than other persons having no communication, and similarly
situated in other respects.
It would be ample time to look for the operation of some
other agency in addition to those commonly experienced,
when the portion of the community, holding communication
with the sick, is affected with disease in a greater proportion
than that portion having none.
Now, with a few exceptions, it is the result of much
patient investigation, not only into the experience of others,
but of many epidemics we have had the most ample
means of noting, that, in general, in respect to diseases
held to be propagated by atmospheric contagion, those
who have communication with the sick, do not suffer in a
greater proportion than those who keep apart, but remain
in the sphere in which the agencies and circumstances are
operating, which produced the first cases.
71These exceptions are—
- 1st,
- The relations and inmates of the same house inhabited by one sick of fever.
- 2d,
- Those receiving disease from actual contact with the palpable contagious matter, or by
contactual contagion.
- 3d,
- Those persons, through the operation of fear, and from depression of mind, affected with
disease, as fever, cholera, &c.
- 4th,
- The attendants in fever institutions, &c.
These exceptions will meet with a little consideration,
in order to shew in what manner, and wherefore, those persons
are seized in greater proportion, and to prove that it
is not in consequence of atmospheric contagion.
This statement is important, and is made cautiously,
and only after the most detailed examination, and unprejudiced
weighing of evidence.
The facts which have led to that conclusion might be
detailed, but, as they would occupy much room, and perhaps
prove uninteresting to the general reader, they will
be withheld, however, to be produced, if any sufficient objections
be made.
That statement is contrary to common belief, which attributes
disease in a much greater proportion to those communicating
with the sick, than to those keeping apart; but
that is not of much consequence, since implicit reliance is
not to be placed upon the opinions on that subject, held
either by the public or the medical profession.
On the whole, disease does affect, in a greater ratio,
those who communicate with the sick, than those who do
72not, the instances which we excepted being included. But
the difference, on the whole, is very trifling, at least much
less than is usually supposed.
One of the reasons that the difference is thought to be
much more than is actually the case, is, that every case of
a visitor or attendant being affected with disease, after or during
communication, is bruited about, and becomes the subject
of much gossip; while that of hundreds, equally exposed,
who escape, is treated very judiciously with silence. There
is no impartial hearing of evidence. All that is heard is
taken in favour of one side, and instead of an opinion being
formed from the whole bearings of the case, one is got up
on partial statements, which, however, as it agrees with
preconceived notions, answers very well.
But that is not the way in which a case so important
should be treated. Be it hoped that medical men, at least,
will take more enlarged views, when their own reputation
and the public weal are at stake.
The partial statements remind us strongly of the self-deception
of which many persons are the dupes, in respect
to fortune-telling and the solving of dreams. Every instance
of the divination of the fortune-teller, or the solution
of a dream, having any, the most far-fetched, correspondence
with the future history of the individual, is stored
up in the memory, and adduced as undeniable evidence
of the truth of those dark arts, however much a thousand
facts may cry out against them as vile impositions.
The prognostications must, of necessity, be right
sometimes, in much the same manner as Louis the 14th
73declared those astrologers must at some time be correct,
who were constantly foretelling his death.
We now proceed to inquire into the circumstances which
cause disease to attack those having communication with
the sick, in a greater proportion than is observed to hold
with those apart from them, yet living in the sphere of the
epidemic causes, that is, generally speaking, in the same
locality.
Exception 1st, The greater proportion in which relatives
and others inhabiting the same house with one sick of disease,
are attacked, we would explain in this manner:—
1st, The relatives, if inhabiting the same locality, are,
like others, liable to the disease.
They are suffering in general under depression from apprehension
of losing a dear friend.
They are, perhaps, under an apprehension that they
themselves may be affected with the same distemper.
They may have a dread of atmospheric contagion, or, as is
often the case, may have a presentiment of fatal sickness.
They are irregular in the time of taking diet—have often
no appetite—are deprived of their night’s rest—maintain
long and anxious watchings—and are in general in that
feverish state of mind that precludes the possibility of taking
due rest.
They are deprived of their wonted exercise in the open
air, and of that elasticity of mind and body which it imparts.
They respire an atmosphere, though not contagious,
often, and especially in the houses of the poor, deprived of
74its oxygen or more important principle, and tainted with
the admixture of adventitious vapours or gases arising
from the excretions, and perhaps the fermenting of impurities
often found collected on the skin.
It would be wonderful, where there is a widely-spread
disposition to disease, say to fever, if members of the same
family, inhabiting the same house, in which one of them
lay ill of that distemper, did not take ill, seeing how much
they are exposed to it.
Nor is it to be thought extraordinary that relatives
living in the same locality, but in different houses, or even
in different villages, should take the disease also after visiting
the house of a sick friend. What has been stated
will sufficiently explain that occurrence.
Here it will perhaps be permitted to make a slight digression
to mention a fact which has given much credit to
the doctrine of atmospheric contagion,—the simultaneous
invasion of fever among relatives, living together, in different
houses, in different villages, and in very different parts
of the country. We are aware of several extraordinary
instances, where from ten to twenty of the same family
were ill, at the same time, of fever, several of whom were
living far apart.
It is in vain to think of atmospheric contagion being the
cause. Possibly that notion might be entertained in reference
to those living together, and having communication,—but
cannot possibly apply to those in remote and
different parts of the country. We know of instances
where a family has been seized with fever in our village,
and members of the same, living at great distances, forty
75and sixty miles, have suffered the same distemper at or
nearly at the same time, without any communication having
subsisted, either by person, by packets, or by letter.
These extraordinary circumstances speak of something
more than atmospheric contagion. That could not possibly
have extended to those relatives who had no communication;
and it is remarkable that, in those instances,
disease did not go as with the other members of the community,
attacking at leisure, now this, now that one, but
almost on the same day, many different members of the
same family.
We have sometimes thought, from the consideration of
such circumstances, that there is something like a community
of disposition causing members of the same family to
be similarly affected by like agents, more than subsists between
men who are unconnected:—something like an idiosyncrasy,
which goes to make them suffer after the same
fashion.
There are such things as family characters, family idiosyncracies,
family dispositions, family peculiarities of bodily
conformation, and family temperaments; and may
there not exist some family disposition, to be similarly
affected by like circumstances?
The case appears well worthy of philosophical inquiry,
something beyond the untenable puerilities of Mesmerians.
2d Exception.—Visitors and attendants are liable to
increase their ordinary chance of taking the prevalent distemper,
by touching the body or clothes of the sick, when
he labours under a disease marked by a palpable contagious
poison. Though the poison cannot be diffused through
76the air, it may, and sometimes does, act by contact, which
we call contactual or immediate contagion. That, of course,
can operate in those diseases only in which a palpable poison
is eliminated. Those diseases are in this country
chiefly small-pox, chicken-pox; the plague, if it can now
be said to be a disease of this country; the itch; and, as
is commonly believed, measles, scarlet fever, &c. &c.
Though the propagation of these diseases may take
place from contact with their peculiar contagious matters,
we are disposed to think, that, at least with most of them,
especially the latter, the cases which occur in that way
are very few.
It is sometimes difficult to produce disease, even when
the skin is cut, and the matter is then introduced. That
step sometimes fails in respect to cow-pox matter, even
when fresh; and small-pox matter we have known to be
in contact with the tips of the finger for a minute or so,
in innumerable cases, as in feeling the pulse, and no disease
has followed. Women affected with small-pox bear
healthy children.
Almost the only diseases which we are disposed to think
are propagated by contact with the person or clothes of the
sick, are small-pox, chicken-pox, scabies, plague, &c. They
all possess palpable matters in abundance.
Many instances are known to us, where children have
got small-pox, and of grown-up people who have got itch,
from sleeping with those sick of these distempers, and thus
coming in contact with them closely, and for some time;
and where they have not been seized with them, when
only breathing the same atmosphere used by those sick.
77Thus visitors and attendants may get disease by contact
with palpable contagious matter, that is, by contactual
contagion, and by touching clothes impregnated with the
same, that is, by fomitic contagion, which they would not
have taken, had they merely been respiring the air used
by the patients.
3d Exception.—The visitors, and those in general holding
communication with the sick, are also liable to be affected
more with disease than others who remain free of
it, on account of the sorrow usually felt on all occasions of
public calamities, and particularly of very mortal pestilence,
and more especially experienced in all its acuteness,
in the silent sick-room of a friend.
Among the scenes our professional duties call us to
witness, there is, perhaps, none so touching as the sorrow-striken
countenances of friends, directed to the sick, nay,
perhaps the deathbed of one they love; and we have noted
the unspeakable sorrow then felt, the deep anguish
then experienced, and the silence more touching than eloquence
that reigns throughout the sick-room, as an awful
contemplation, truly indicative of a depression that is calculated
to throw its sufferers into the same situation which
they so much deplore in others.
That sorrow attendant on such calamities, and that was
so well marked, when cholera lately assailed the nations of
the earth, throws into the shade almost every other form,
sinks deep into the soul, and enervates every principle of
life. It gives a pall to every taste, a disregard to all enjoyment,
deprives the unhappy victim of that serenity
78and composure so favourable to health, and, on the contrary,
imparts a restlessness to body and mind, until at
length his system becomes a very nidus of disease.
None who have attentively watched the course of widely-spread
disease, can doubt that that sorrow, so generally
experienced on those occasions, is an active instrument,
and a strong abettor of the original epidemic influences.
It must be obvious to them, that those strong and deeply-felt
emotions, with which man contemplates his relatives,
his neighbours, aye, his very race, falling around him,—feeling,
too, that he is in the midst of danger, and can do
nothing for his security,—must produce a withering influence
on the most vital functions of the body, and prove the
immediate cause of disease.
Under such circumstances, when disease manifests itself,
it certainly cannot be wise to disregard the part they
must enact in the production of the effect observed, and to
attribute the whole, or nearly the whole, to the operation
of atmospheric contagion, which has already been shewn
to be without sufficient evidence of its existence, in any
one case, or in any one disease.
The visitors, also, are exposed to the action of an atmosphere,
which, as it is sometimes impure, is liable to be
hurtful.
4th Exception.—That of the attendants in Fever Institutions.
It has often been remarked, that in some fever
institutions the nurses and medical clerks resident in the
house, are attacked with fever in a much greater ratio than
holds with the population around. The difference has
79been seen on some occasions to be very great, and from information
collected on the subject, we are disposed to think,
on some occasions, and in reference to some institutions
at least, that the statement is correct. That fact has been
attributed to atmospheric contagion; and we shall proceed
to inquire if it is not more likely that it is dependent on
other circumstances which are operating, and that are
known to be adequate for the effect observed.
The history of the Royal Infirmary of Edinburgh, and
of Queensberry House, an institution for the reception of
fever patients, shews that on some occasions almost all
the clerks and nurses waiting upon those affected with fever,
have been seized with it also.
And it would appear to be owing to some agency peculiar
to fever patients or their wards; for in regard to the
first-mentioned institution, it is ascertained that it is with
those attendants only, who wait upon those patients, that
the greater amount of sickness is experienced. Those attendants
exclusively occupied in the surgical wards being
attacked in no greater proportion than those unconnected
with the institution.
This is certainly an important fact, and one on which
the advocates of atmospheric contagion are wont to place
no small weight. Did that principle exist, there is perhaps
no fact in the whole history of medicine, on which
we would place more reliance in proving its operation, for
it is self-evident that nothing relating to the general unwholesomeness
of the institution can be entitled to much
activity in this case, for any insalubrious tendency of its
situation, of the soil on which it stands, or emanations
80therefrom, and of the general economy and discipline, cannot
be confined in their operation to one apartment or ward,
cannot possibly be experienced in the fever wards only.
But an occurrence of this kind is apt to be too readily
received and made the ground of many inferences. In itself
it certainly is a strong, a cogent fact, and such as naturally
leads the mind to believe, that, as some very potent
agency is at work, it may be that of atmospheric contagion,
which in alleged activity is surpassed by none.
Before proceeding to explain the occurrence, on principles
very different from atmospheric contagion, it is right to say
that it is such as does not occur in connection with all such
institutions; and that, if the case which has been stated,
proves it is likely such a principle as contagion is present
in these institutions, that others of a directly opposite
nature, and as much to the purpose, can be produced to
shew, granting the possibility, that it is not present in
other institutions, much larger.
By physicians of the first eminence, such occurrences as
that referred to in connection with the Royal Infirmary of
Edinburgh, are held as decisive proof of the operation of
contagious atmosphere.
Dr Alexander Tweedie, a physician of London, and one
justly eminent, after mentioning the self-same cause, goes
on to say, in a sufficiently assured tone,—“No statement
more conclusive, as to the contagious nature of fever, need
be adduced: and if such facts will not lead to conviction,
the mind of such a sceptic must be strangely constructed
indeed.”
The case had been made much stronger, and would have
81stood inquiry much better, had Dr Tweedie shewn, that
the occurrence he treats of was not solitary or uncommon,
but was such as is wont to be observed in all like institutions.
He should have known, that it is not from extraordinary,
nor even from unique cases alone, that knowledge is to
be obtained, nor laws deduced, of the ordinary characters,
and action of disease. It is dangerous to deduce inferences,
and construct laws, from the knowledge of one circumstance,
and where, too, many can be obtained bearing on
the case.
Let us see if this occurrence holds with other establishments.
We will find that it by no means always holds.
Dr Bateman, who saw much of fever, and gave it much
of his active consideration, in his excellent Treatise on
Contagious Fever, says,—“During the fourteen years, in
the course of which I have almost daily been in contact
with persons labouring under contagious fever, not only
myself, but all the nurses have been preserved from infection,
with one exception, down to the period of the present
epidemic” (in the London House of Recovery).[3]
Similar cases of exemption might be given, but it seems
unnecessary to say more here.
But though Dr Bateman’s evidence in a manner meets
the case recorded, connected with the Royal Infirmary of
Edinburgh, yet it does not disprove its correctness; and
we proceed to explain what has been held as only to be
explained by the presence of atmospheric contagion.
But though the case could not at present be explained,
82we deny that one such circumstantial piece of evidence
should outweigh the many facts, and the results of reasoning,
that have been laid before the reader, and that are
yet to follow.
When evidence is contradictory, it is well to ascertain
on which side it preponderates; and even when it is nicely
balanced, which is not the case here, it should be tested
by a reference to general principles. That was done in
the first part of this work, and the reader cannot have forgotten
the result.
We are disposed to think, that the great prevalence of
fever among the nurses and resident medical attendants of
fever institutions, and fever wards in general hospitals,
which does occasionally occur, is, in no small degree, owing
to the particularly great contamination of the atmosphere,
which is liable to take place from the peculiarly
strong tendency there is in the body of those labouring under
fever, especially of the low or typhoid character, to
run to putrescence.
The body, it is ascertained, so afflicted, is particularly
prone to putrefaction, as is sufficiently attested by the presence
of black spots upon the surface, sordes upon the teeth
and gums, and the general appearance of corruption, often
sufficiently manifest.
The secretions and excretions are marked at first by a
putrid character, and in a short time they are in an active
state of putrefaction. In that state, chemical changes take
place, gases are evolved, such as nitrogen, hydrogen, carbureted
hydrogen, phosphureted hydrogen, singly and
combined, forming for instance ammonia, which is a combination
83of hydrogen and nitrogen: they become mingled
with the atmosphere, and impart to it pestiferous qualities.
In fever, the body is much more prone to run into the
state of putrefaction, than when in health, or even when
affected with merely local disease. The whole system is
then affected, the whole functions are deranged, the decayed
parts of the blood and solids are not removed, nor are
they corrected by admixture with new and purer elements
obtained from the products of digestion. The correcting
influence of exercise is lost, and likewise the assistance it
gives to the due performance of the various secretions;
and it need not cause surprise that a body so situated,
for days and weeks, becomes at length prone to putrefaction.
It will perhaps be argued, that the same corruption or
contamination of the air is as likely to take place in the surgical
wards, where patients are kept having sores, &c. But
in those wards, in general, there is not the same amount of
tendency to putrefaction. Their health is often excellent,
their functions are often not at all deranged, and their bodies,
in general, are not more prone to putrefaction than
those in health.
There are, to be sure, a multitude of sores and the like,
but, as long as they are healthy, and the matter is good,
there is no risk of their injuring the air, provided they are
kept tolerably clean.
Healthy matter is a bland and innocent fluid, not more
prone to putrefaction than healthy blood. When healthy,
matter may be present in an apartment or ward in abundance,
without the least injury being felt by those respiring
84the atmosphere in the room in which it is contained,
as the history of surgical hospitals amply proves.
But as soon as matter, by any means, becomes of a bad
character, acrid, fretting, unkind, and prone to putrefaction,
then it sends forth gases, and perhaps, compound
agents, produced by their combination, which mingle with
the atmosphere, impart to it most virulent properties, and
thus produce havoc among the various patients, as great, as
well marked, and as dreadful as those sometimes observed
among the attendants of fever patients, from the supposed
operation of what has been considered atmospheric contagion.
Wounds are much connected with the state of the general
health. Where that, by any means, is affected in a
serious manner, the wound takes on an unhealthy aspect,
and the matter, which before was bland, becomes acrid and
irritating. If the body is affected with a putrid taint, then
the matter takes on the same, and from the emanations
spoken of, disease spreads around the ward.
That dreadful disease, called hospital gangrene, was
some years ago a common affection in military hospitals,
from effluvia, and inattention to ventilation; and it was
common to observe healthy wounds taking on a sphacelating
character, from such causes. Sir John Pringle says,
“I have seen instances of it (hospital fever), beginning
in a ward, where there was no other cause, but one of the
men having a mortified leg.”[4]
There are other circumstances of a hurtful character,
operating in general upon the young gentlemen who fill
85the offices of clerks, and upon the nurses, in these establishments,
which we doubt not co-operate with the other
circumstances mentioned, in producing the extraordinary
amount of disease sometimes observed among them. But
of these which will readily suggest themselves to all, it is
unnecessary to say much in this place.
It is in the fever wards principally that contagious atmosphere
is apprehended.
The young gentlemen officiating as clerks are generally
arrived at the most important part of their course of
study. They are in preparation for their examination before
the colleges, and are often in consequence in a very
feeble state of health—which, if not always marked with
actual sickness, is often sufficiently indicated by worn out
and emaciated systems, and by complexions of a very sallow
or sickly colour. They are thus predisposed to fever.
The nurses waiting upon fever patients are subject to more
fatigue and more interruptions to their rest, on account of
the great attention which those under their care require,
than the same class of persons are exposed to, who belong
to the surgical wards.
86
A case of an apparently strong nature is made out in
favour of the propagation of disease by atmospheric contagion,
when a person labouring under sickness or lately
recovered from it, is removed into a house or locality in
which the same malady shortly manifests itself. It is often
held conclusive; we hold it otherwise.
Such a case is known to take place, and we have observed
it in our own practice—but that is not entitled to be considered
conclusive. It should be shewn, if that inference is at
all to be arrived at, that the occurrence is so frequent that
the probability is precluded of attributing the phenomena
observed to the ordinary causes of disease, that the number
who thus suffer is greatly more in proportion than holds
among the population generally, and that, in short, those
thus visited by the sick are affected in a greater ratio than
holds with the general community, as ascertained by an
observation of the whole course of the disease or epidemic.
87We know that the appearance of disease among those
visited by the sick, or those lately recovered, does not always
happen. We ourselves, scarcely recovered of typhus
fever, have visited and lived with a family at a distance,
and no such thing as propagation has occurred—and hundreds
of other cases are within our knowledge. We have,
after making calculations on the subject, considering both
those cases, where disease did occur and where it did
not, that, generally speaking, those visited by convalescents,
or even patients, suffer in a proportion very little
greater, if at all greater, than those having no such intercourse—compared
of course with the very many cases that
are wont to occur in a widely spread epidemic.
Yet, though the general proportion may not be much affected,
still we are ready to admit that a case does now
and then occur, where disease is shortly observed after the
admittance of a sick person in a house or locality, and
where the effect is so marked, so immediate and so general
among those exposed, that we are compelled to admit that
there is room for thinking, that the patient is somehow or
other, in some degree at least, the occasion of the catastrophe.
It is sometimes observed that servant girls, affected with
typhus fever, are in that state sent to their homes, and
that disease shortly affects their brothers and sisters, but
before such cases can be held as proving the existence of
atmospheric contagion, there should be a strong assurance
that the agencies of a most unwholesome character,
known to exist in such cases, are inert, and that they
which have on other occasions, without assistance, produced
88of themselves the distemper observed, have been altogether
impotent and inactive.
Their case produces the usual effect, demands the exertion
of night watching, spoken of already, as favourable to
the accession of disease, and their house or apartment, close
and confined as it usually is in that rank of life, becomes
the abode of many unwholesome influences, and among
others, of an atmosphere, deprived in a great degree of its
more essential part, and loaded, too, with foreign gases,
and even perhaps with chemical compounds of a virulent
character, the products of putrefaction. If disease spreads
much among those thus exposed, it seems fair to attribute
the occurrence to these agencies known to be present, and
known to be favourable to the production of sickness, and
not to atmospheric contagion, as is almost universally done.
The case of disease appearing in a house previously
healthy, after receiving one just recovered of disease, which
it is by the way consonant with our experience to say, is
much more rare than the other, or that of persons actually
ill,—is occasionally noticed, and the explanation, perhaps,
is, that the clothes may retain impurities acquired during
the course of disease, and may on this occasion shew their
activity.
89
The question of the communication of atmospheric contagion
from one place to another has almost universally, on
occasions of pestilence, been much agitated, in respect to
individual diseases, but seldom in a comprehensive way,
embracing all diseases. We propose to inquire generally
into the facts which are held to prove the principle of dissemination
from one place to another—whether contagious
atmosphere is transmitted from one country to another,
from one town to another, and from hamlet to hamlet.
In the many works written by medical men on occasions
of great epidemic disease, descriptive of the character of the
prevalent distemper, there almost universally appear the
most minute accounts of the route pursued by contagion,
both fomitic and atmospheric, down to the noting of the
very road, the very street or alley by which it reached a
town—and of the manner in which it arrived, whether on
the rags of a tattered beggar, or seated in a stage-coach.
90The line of its progression is taken from the observation
of disease, and from that alone. Wherever disease appears,
there it is said that contagion has been carried or conveyed;
and as a proof of that position, it is gravely maintained,
that disease invariably breaks out where there are houses,
and where communication is likely to be going on in some
way or other. This most extraordinary fact proves what
must certainly be thought not less extraordinary, that it
appears in the abodes and habitations of men. But where
else is disease, we would ask, to manifest itself, if among
men at all, if not where alone they are to be found?—surely
not among deserts uninhabitable, or on the frosty summit
of an iceberg?
It is true that in the course of an epidemic, such as the
cholera, one country suffers before another; but there is
no alternative to such a course if they are not to be simultaneously
affected. And it signifies nothing that communication
subsists between them. One part of a country,
too, is ravaged first, then another, and so on—one town
then another—one part of a town, and after it another
part.
But it is evident, that if disease is to begin at all, it
must begin somewhere, and if all parts are not to be seized
on the same instant, that one will have precedence of another,
and so on. Springing and propagating, from whatever
causes, that character must hold, and surely it is
wrong to hold a feature common to the effects of many
causes as decisive evidence of the operation of one, and of
one only.
The harvests of Europe begin in one country, sooner
91than in another. In many, harvest is earlier than in
England, but it is never surmised that when that process
begins in the latter country, that it is through the mediation
of some such influence as contagion. It begins in
England, too, it might be shewn, in places having communication
with foreign countries. Nay, it might also be
proven that the parts in which it in general commences are
at the coast, where it is well known ships are wont to appear.
Were such an insane supposition made, the most obvious
facts would necessarily be laid aside; but such gross blindness
would not, we are satisfied, be much greater, than
when the process of diseased action, marked out in an epidemic,
is attributed to contagious atmosphere alone.
In the case of the harvest, it would argue a forgetfulness
of the object held in view when the seed was sown,—in
that of disease, an ignorance of the effects to be expected
from the sowing of the seeds of pestilence (the exposure to
the common epidemic influences alluded to above), in the
first, an insensibility to the influence of climate, intensity of
sun’s rays, the quality of the soil, &c.:—And in the other,
a blindness to the operation of circumstances not less potent,
such as the time of application of the causes, the condition
of the body, and the presence or absence of moral adjuvants.
It has universally held with all epidemic sickness, that
parts of a country have been attacked in succession—that
one town is visited after another, and one part of a town
before another, whether the prevailing distemper have or
have not been said to depend on contagion.
There is nothing extraordinary in the fact that all persons
92who are to suffer, do not become affected on one and
the same day. Far from proving that any thing of the
nature of contagion has been in operation, it only proves
what may so readily be admitted, or at once readily understood,
that all and sundry the inhabitants of a vast tract
of country, inhabiting parts having different climates more
or less mild, having different situations, some on the banks
of rivers, some along the coast, some inland, some on boggy
and some on dry soil; having different occupations, different
houses, wearing different dresses, having different
habits, different pursuits, different diet, different recreations,
and perhaps having constitutions differing in aptitude
to be acted upon, may not be all ready for the manifestation
of disease on one and the same day, but may attain
to that point at times corresponding with the operation of
so many different circumstances.
In vegetation, which on the whole is much more simple
than living animal organization, there is a gradation in the
time at which its various individuals become ripe. The
same grain is ripe in some districts weeks before it is ready
in others, and even in the same farm, though the seed had
been sown on the same day. Thus, by observing that the
gradual development of disease over a country is the result
of the varying activity and time of action of the epidemic
influences, and perhaps of some condition of the body,
varying in forwardness—it becomes unnecessary to have
recourse to atmospheric contagion. It is unnecessary to
repeat here what has been said relative to the operation of
unwholesome agencies to account for the wide range of
disease—over a country.
93It is often said, as decisive proof of disease spreading by
contagion, that a beggar, or some poor person left a town
affected with disease, and entered another hitherto healthy—and
that afterwards disease manifested itself there also.
In the first place, would not sickness have occurred notwithstanding?
Its supporters say, not likely, when the effect
followed, or immediately on the communication; but
we reply, that communication took place before without
any such immediate result, and that in all probability it
had been going on freely all along, whatever regulation and
hinderances might have been adopted.
It seems madness to think of stopping all communication
with towns, in a free country such as this, where human
intercourse is going on without interruption throughout the
entire empire, or, indeed, anywhere at all, tolerably inhabited,
or where commerce subsists.
It is in vain to endeavour to shew that opportunities for
the transmission of contagious atmosphere have not occurred.
The case involves an impossibility, for do not a
thousand means of communication suggest themselves to
the mind of the reader? The atmosphere itself, currents,
winds, water, streams, &c.,—animals,—such as rats, mice,
winged insects, &c. &c., which cannot be prevented from
operating. We, therefore, leave this case, perhaps to the
efforts of the advocates of quarantine regulations, who possibly
may arrive at a happier result, and we proceed to
the opposite case, where disease fails to spread, where communication
does take place.
The advocates of contagion prove, where a disease appears
in a town, that communication has taken place.
94That statement, as the reverse, can never be proven, is
easily affirmed; and its insignificance corresponds with the
facility with which it can be proven. Of course, it is obvious,
that such a fact proves very little, either in reference
to contagion or anything else.
We are prepared to prove, that communication has subsisted
on many different occasions, without any unusual
amount of sickness taking place. We know of many instances
where disease has been prevailing in a town or
village, which has failed to manifest itself in another at a
short distance, although daily unrestrained communication
was held.
At the end of the year 1835, and the beginning of the
year 1836 the scarlet fever prevailed in Edinburgh to a
great extent; and although great traffic was constantly
going on between that town and Tranent, by means of
foot-passengers, numerous carts and coaches, passing to and
fro, daily, still that distemper failed to make its appearance
in the latter town till the 20th of January, the day
on which the first case was noticed.
That case did not occur at the point where the greatest
thoroughfare subsists, but at one, the most remote from it.
Typhus fever has been prevailing, to a great extent, in
Edinburgh, for many weeks past, but that disease has
failed to make its appearance in Tranent (ten miles distant),
although the road is constantly crowded with carriages,
with vast numbers of carts conveying coals from
that village to the capital, and with passengers both on
horse and foot. It has not made its appearance, although
several of the inhabitants of Tranent have lately lost relatives
95who have died of that disease, both in Edinburgh and
Leith; and although a woman just recovered from that
distemper, and come from the Royal Infirmary, has taken
up her abode in this village.
Small-pox appeared about six weeks ago, simultaneously
in two very filthy localities in Tranent, and it has been
confined to them, although the most free communication
has subsisted with other parts of the village, and it has
failed to spread to the hamlets and farm-steadings around,
notwithstanding the relatives of some of those labouring
under that disease have travelled through the country,
seeking charity.
We propose to close this part of the work. Much has
been said in order to prove the position, that the doctrine
of atmospheric contagion gains no support from the actual
character of disease, no countenance from the ungarbled
history of its career.
Arguments in favour of our views might have been
drawn from the fact, that diseases said to be propagated
by contagion, do not manifest themselves in all parts of
the globe to which the poison would be likely to be taken,
as they undoubtedly would do, were they dependent on
the operation of one single object, such as contagious matter;
and also from the consideration that those diseases,
with whose causes we are intimately acquainted, by reason
of their immediate operation, or of their being otherwise
obvious, such as inflammation and wounds, are never said
to be dependent on such an agency; but it is feared in the
endeavour to be explicit, we have already been tiresome.
96
The question of air holding in solution, an animal contagious
matter, eliminated in the body of a sick person,
and capable of producing the same disease, when inhaled
by another, has hitherto occupied our attention.
It is now our design to treat of vitiated air, that is, an
atmosphere deprived of part of its more essential principle,
viz. oxygen gas, or tainted with the admixture of effluvia
or gaseous products, from putrefying animal bodies, both
living and dead, and from corrupting vegetable matter.
It is one of the most common, and most widely spread
causes, of the most virulent and widely prevalent diseases,
to which humanity is subject.
The importance of the atmosphere to the animal economy,
is so very great, and its derangements so very hurtful
to health, that it appears that a few observations respecting
it may be useful to some non-professional readers.
It may enable them to understand better the observations
that are to follow on its vitiation.
The atmosphere is a fluid of an elastic nature, encompassing
the globe, occupying the space comprehended from
97its surface, to the distance of twenty or thirty miles therefrom.
It possesses weight, and it is by this property that
water rises in pumps, and that mercury is sustained in the
barometer. It is in constant motion, going, as it does, with
the globe itself, revolving on its axis, and rushing, in counter
streams, from the tropics to the poles, and from the poles
to the tropics.
That portion nearest the sun becomes rarefied and lightened
with the heat which it acquires:—it then rushes, by
virtue of its comparative lightness, to the poles, and that
in temperate regions presses forward to occupy its place.
By means of this motion, the temperature of the earth
is kept pretty uniform, and it is corrected of any impure
taint it may acquire.
The atmosphere is composed of two gases, oxygen and
nitrogen, a small quantity of watery vapour, and a fraction
of carbonic acid gas, or fixed air.
Oxygen is the agent on which its more active properties
depend. The other component, viz. nitrogen, serving to
dilute it.
They are united in the proportion of about seventy-seven
of nitrogen by volume, and twenty-one of oxygen,
the rest being made up of watery vapour, and carbonic
acid gas.
The atmosphere supports combustion,—oxygen gas being
the essential agent. During combustion, it is consumed,
and at the end of the process, it will be found wanting,—the
other gas being undiminished.
This may be seen, at least the diminution in the volume
of air, by burning a candle in a large wide mouthed bottle,
98inverted over coloured water. As it continues to burn,
the water ascends in the bottle, and occupies the place of
the oxygen consumed.
Atmospheric air supports respiration, a process essential
to the continuance of life. Oxygen gas here, too, is the
agent on which it depends. Air, which has been once respired,
is found to be deprived of part of its oxygen, from
ten to twelve per cent.
Air, deprived of oxygen, or even deprived of a small portion
of it, is unfit for respiration. A mouse, put into a
vessel containing air, which has been robbed of that fluid,
dies immediately. Put into one containing pure air, it
breathes well at first, but, as the oxygen gets less, its breathing
becomes laboured, it is convulsed, and shortly dies.
The air is concerned, besides, in a thousand operations,
constantly going on at the surface of the earth. It gives
up a portion of its component parts in an immense number,
and in a considerable proportion receives bodies foreign
to its constitution.
By one set of operations, it is deprived of its oxygen,
and becomes vitiated by the admixture of deleterious principles.
By others, again, its oxygen is restored, and the
impurities removed; so that between two opposite forces,
it is in general kept in a wholesome condition.
An immense number of bodies on the surface of the
earth, are constantly attracting to themselves the oxygen
of the air; some become what is called oxydized, as the
metals, the dull incrustation which is found upon them
after long exposure to the air, being an oxide, or a combination
of the metal, and the oxygen of the air. Some
99bodies become acids, as the various vegetable juices which
form their respective acids, by combination with the oxygen
of the atmosphere.
During fermentation, the oxygen is absorbed, and carbonic
acid is evolved. During putrefaction, oxygen is taken
up also. There are many operations, too, connected with
the arts, in which that fluid is abstracted from the air.
The very soil is constantly acting on the atmosphere, and
is, indeed, one vast and extended laboratory, where chemical
processes, on a large scale, are going on without interruption.
The putrefaction of the animal and vegetable
materials, used as manure, is much promoted by free exposure
to the air; hence one of the advantages of ploughing
the land so universally adopted. The very nature of the soil
is greatly altered by that process, and much of that change
depends not only on the chemical processes just spoken of, but
upon the action of the air itself, on the essential particles
of the clod. From the surface of newly turned up soil, it
is understood by intelligent agriculturists, that much gaseous
or elastic vapour is evolved; and we have heard it observed
by intelligent ploughmen, that one of the most delightful
things is the air which arises from newly ploughed
fields in the morning. It is said that it imparts an invigorating,
and wholesome sensation throughout the body,
and from thence to the mind.
All those processes we referred to, abstract from the atmosphere
its most essential part, the oxygen gas. Did
that process of abstraction go on without its being counterbalanced
by others, imparting that principle to supply the
place of that abstracted, then the atmosphere in the course
100of time would become unfit to support combustion or flame,—unfit
to support animal respiration; and the consequence
would be, that the surface of the earth would soon be uninhabitable,
would soon be a lifeless desert. Such would
be the inevitable consequence.
But a wise and a good Creator has prevented the
occurrence of that catastrophe. He has so ordered it,
that one department of nature shall correct the bad tendencies
of the other;—he has placed a weight at the opposite
end of the balance, to counterpoise and balance the
glorious work of his hand. Animal life is met by vegetable
life: their results are made to neutralize those of
each other, and with a wisdom truly the Father’s, found
in his works alone, he has made the apparently hurtful
consequence of animal life, the very means for the maintenance
of the life of vegetation. The results of the function
of respiration so necessary to animals, are highly
useful to vegetables. Those products that are hurtful are
absorbed by the leaves of plants, which are analogous to
our lungs or breathing apparatus, and the oxygen consumed
by animals is replaced by the evolution of a large quantity
of that principle.
During sunshine, plants, especially in water, give out a
large quantity of that principle, as may be seen by putting
grass leaves into a jar filled with water, and exposing them
to sunshine. Bubbles of air soon appear, and collect at
the top of the jar; they are oxygen gas.
The evolution of oxygen gas in sunshine, is the chief
means with which we are acquainted, by which the chemical
101equipoise of the atmosphere is maintained, against
the operations constantly going on, to which we alluded.
These observations relate to the chemical composition of
the air, considered as one great whole.
There are many situations in which it becomes not only
deprived of its oxygen in part, but becomes vitiated by admixture
with foreign bodies or vapours, most detrimental
to health, in short, most pestiferous. But, before pointing
out the manner in which it becomes so tainted, and
its unwholesome consequences, we would here point out
the use of the atmosphere. By the act of respiration, air
is carried into the lungs; it acts upon the blood brought
there in large quantities, and spread out in innumerable
vessels, forming a sort of network. The blood, upon its
arrival at the lungs, is dark, grumous, and unfit for the
maintenance of life, and the nutrition of the body; but,
under the action of the air, it becomes florid or crimson, has
changes wrought upon it, by which it is fitted to perform
its various and important functions.
This chemical process gives a crimson and florid hue to
the old blood of the system, and imparts a colour and other
qualities to the fluid brought from the bowels, the result of
digestion, which give it the character of blood. It gives
to that fluid the last preparation before being converted
into blood.
The heat of the body, which is above that of the
surrounding atmosphere, is maintained by the chemical
changes which occur between the mass of blood in the
lungs, and the air to which it is there exposed. There is
a constant generation of heat, which is diffused along with
102the blood throughout the whole system,—to supply the
place of that which is ever being abstracted by surrounding
bodies, among which exists a constant tendency to preserve
an equilibrium of temperature.
When the atmosphere is vitiated, it is reasonable to suppose,
that the changes in the blood passing through the
lungs will not take place in their wonted integrity, and
that, among other results, a diminution of the vital heat
of the body may be experienced.
Vitiated air admits of division into different kinds:—
1st, Into air simply deprived more or less of its oxygen.
2d, Into air holding in solution, or having mingled with
it, effluvia from animal bodies, living and dead.
3d, Into air holding in solution, or having mingled with
it, noxious gases or effluvia arising from decomposing vegetable
matter.
Vitiated air, of every kind, is unwholesome and favourable
to the invasion of disease.
Vitiated air has been coexistent with many of the most
appalling visitations of disease, which have befallen man
since the creation of the world. It delights in the production
of the most formidable distempers, such as are marked
with extreme debility and proneness to the putrefactive
character.
The plague, in its various visitations, from the time of
its prevalence in Athens, as described by Thucydides and
Lucretius, down to the period when it last raged in England,
viz. in the year 1665, has been observed to be coincident,
for the most part, with circumstances proving the
existence of vitiated air: and at this day the most mortal
103diseases prevail, where foul air exists, whether that arises
from this or that source.
The atmosphere becomes vitiated, when great numbers
of men in health are crowded together in apartments too
close and confined to admit of a sufficient supply of pure
air for the perfect maintenance of respiration. In this
case, the vitiation is effected by the abstraction of the oxygen
of the atmosphere, the exhalation of carbonic acid gas,
and the dissemination of effluvia which arise from the bodies
of those who are confined.
The immediate effects of confinement to an atmosphere
thus vitiated are, oppressed breathing, sense of great anxiety
and suffering, fixedness of the eyes, and torpor, which
gradually increases to insensibility; and the miserable sufferer
dies bereft of sense and motion, from suffocation.
When the atmosphere is not so impure as to cause immediate
death, disease of a putrid character, for the most
part takes place. Typhus fever attacked those persons
who survived the memorable struggle in the black hole of
Calcutta.
A low form of fever used to commit great havoc in jails
and other places of confinement, where prisoners were wont
to be crowded together in great numbers, from the atmosphere
being deprived of its more vital part, and being
loaded with unwholesome emanations arising from the
filthy persons, and clothes of those confined.
This disease is called “Jail Fever,” and manifests a peculiarly
malignant character.
In hospitals crowded with wounded soldiers, but otherwise
in health, where sufficient ventilation cannot be maintained,
104the same distemper makes its appearance, and is
there denominated “Hospital Fever.”
In besieged towns and in camps, where the inmates are
exposed to the offensive and unwholesome effluvia, commonly
experienced in such situations, the same putrid disease
prevails, and goes under the name of “Camp Fever.”
Air vitiated with effluvia from bodies in a state of disease,
and their excretions, has been variously denominated.
By some it has been styled “Contagious Air;” by some
“Infectious Air;” and, when it is in connection with fever,
“Febrile Miasm or Contagion.”
Vitiated air of this kind differs from that referred to
above, in this particular, that it arises from bodies in a
state of disease.
Both forms of vitiated air produce, or assist to produce,
disease of the same character; but as the latter form not
only goes to produce disease, but arises from disease also,
it has been considered to be analogous to the contagious
poisons, such as those of small-pox, cow-pox, and the like.
From the circumstance of this vitiated air arising from
persons in disease, and assisting in the propagation of the
same malady, it has all along been regarded as a specific
contagious animal poison in an atmospheric menstruum;
and thus has been created the perplexing and entangled
web of confusion and vagueness that has been wove around
the principles, viz. contagious poisons, and vitiated air
105arising from effluvia from persons in disease, and from their
excretions.
From this circumstance, these principles, viz. specific
contagious poisons, and vitiated air arising from persons in
disease, have been erroneously classed together, and a
supposed analogy has been created.
But these principles are widely different in their nature,
and in the laws by which they are regulated.
The specific contagious poisons produce the same diseases
as those with which the bodies, whence they arose,
were affected, and them only; and their operation is
marked by uniform effects, observing stated and unvarying
periods. Vitiated air, of the kind under examination,
though it arises from persons in a state of disease, and is
sometimes known to operate in the production or propagation
of the same distemper, does not always induce disease,
does not induce that disease only, whence it sprung,
but various others; and, in short, its effects are not uniform,
and do not observe stated and unvarying periods.
The specific contagious poisons produce their peculiar
diseases, as their proper and only effects, without the cooperation
of other influences; but vitiated air, when the
same disease extends, whence it arose, cannot be said to
be causing its proper, only, and peculiar effects, as the
same disease does not invariably follow its action. In
general, the effluvia which proceed from a sick person,
where they prove hurtful, cause the same distemper as
that with which he is affected; for instance, the effluvia
arising from a person affected with typhus fever, produce
that disease again:—but that is not always the case, and
106an instance will be presently detailed, where the effluvia
which proceeded from a body dead of one disease, produced
another of a very different nature.
The reason that the presence of vitiated air is generally
attended with the same disease as that with which the
body is affected, whence it sprung, is, that there is existing
at the time, a disposition to that particular malady: and
the vitiated air only gives it form by acting as an ordinary
exciting cause upon individuals prepared for its invasion.
It appears probable that vitiated air, unlike the palpable
contagious poisons, assists in the production of that
disease only which is prevailing, or to which there exists
a disposition from the operation of other agencies; and it
appears probable that vitiated air, whether it arises from
persons affected with this or that disease, will, within certain
limits, produce one disease as readily as another, the
required particular disposition being present; for instance,
that the effluvia from a small-pox patient will induce
small-pox or typhus fever, according as there exists a disposition
to the one disease or the other, and vice versa.
The effluvia arising from newly opened graves have been
often productive of putrid fever.
The following case will shew that effluvia arising from
the remains of a person who died of consumption of the
lungs, and not of small-pox, produced that disease, viz.
small-pox. When that case occurred, small-pox was prevailing,
and doubtless, had there been existing at the time
a disposition to putrid fever, that disease, and not small-pox,
would have been induced by the effluvia which arose
from the grave.
107In September 1834, Peter Macawley, about twenty-eight
years of age, gardener and grave-digger, was employed
in the churchyard of Tranent. While busily digging
a grave, he unexpectedly struck a coffin with his
spade, and broke it open. The coffin contained the remains
of an old woman, who had died of consumption
of the lungs, and who had been interred about fourteen
months.
There immediately issued from the coffin the most offensive
effluvia, which threatened suffocation, and made
him feel very unwell.
He proceeded home, and continued throughout the night
very poorly, giddy, and uncomfortable. He rose next
morning, and although no better, proceeded to the churchyard,
gave some directions, and returned home, feeling
giddy and unsteady. He was put to bed, and passed a
very uncomfortable night.
Called in next morning to prescribe for him, I found
him to be affected with severe pain of head, great heat and
sweating of skin, and great quickness of pulse. He complained
of thirst, could take no food, and was occasionally
delirious. On the third day of his illness, pimples appeared
over the whole surface of the body, which gradually becoming
larger, assumed the form of small-pox. The pocks
or pustules did not mature or fill with matter in the usual
way, but continued throughout to be flat, and assumed a
dark blue or inky colour.
His strength fast declined,—he became very low,—muttered
incoherently to himself, and symptoms of a putrid
character supervening, and the energies of the system
108fast failing, he died insensible about the twelfth day of
his illness, of the worst form of immature, putrid, confluent
small-pox I had ever witnessed.
He was a powerful, well-formed, and laborious man, was
in good general health up to the moment of his being affected
in the grave,—and it was not ascertained that he had been
in a situation to receive infection from any other source.
Vitiated air arising from persons in a state of disease, is
found in those situations only where the apartment is close
and confined, where the person and clothes are allowed to
remain in a state of impurity, where the secretions and excretions
are left to ferment; and, in short, where no attention
is paid to cleanliness, the removal of respired air, and
the introduction of a fresh atmosphere. The production
of vitiated air is thus only occasional, while, in the contagious
diseases, the specific poisons are produced in every
case of their respective diseases, and were they capable of
being diffused in the atmosphere, there would be present
as constantly an atmospheric contagion.
When vitiated air is produced, its removal can readily
be accomplished, as daily experience, and the testimony of
Dr Haygarth, given at the beginning of this work, amply
prove.
There is still another source whence effluvia of a pestiferous
nature arise. Dead animal matter, during putrefaction,
exhales gases which taint the atmosphere, and
render it unwholesome.
109When these materials are exposed to heat and moisture,
the decomposition is rapid, and the air becomes more obviously
tainted than when that process is retarded by cold,
breezy weather, and some other circumstances. When
the decomposition takes place in the open air, and when
that is kept in motion, the quantity of decomposing materials
not being very great, the bad effects are not so serious.
When, however, buried along with a sufficient quantity
of atmospheric air, to allow of the play of the chemical affinities,
and kept there a considerable time, if they be exhumed
previous to their total digestion or complete assimilation
with surrounding objects, effluvia are exhaled,
having the most intolerable stench, causing instant sickness,
faintness, and giddiness, and eventually producing
disease.
“Thus, we are told by Fourcroy, that in some of the
burial-grounds of France, whose graves are dug up sooner
than they ought to be, the effluvium from an abdomen,
(belly), suddenly opened by the stroke of the mattock,
strikes so forcibly upon the grave-digger, as to throw him
into a state of asphyxy, if close at hand; and if at a little
distance, to oppress him with vertigo, fainting, nausea,
loss of appetite, and tremors for many hours: whilst numbers
of those who live in the neighbourhood of such cemeteries
labour under dejected spirits, sallow countenances,
and febrile emaciation.”[5]
Instances are likewise known where graves containing
human bodies, long dead of plague, upon being opened,
110have emitted effluvia, which have produced typhus fever
among the workmen.
It is probable that, in general, the effluvia arising from
dead animal materials, undergoing decomposition in the
ordinary way, are the common results of the putrefactive
fermentation,—carbonic acid gas, hydrogen, nitrogen, &c.
These gases form various combinations; carbonic acid
gas and hydrogen gas forming carburetted hydrogen, an
inflammable gas, the same as is used for the purpose of
illumination, and which cannot support respiration. Hydrogen
unites with nitrogen, and forms ammonia, or spirit
of hartshorn, which is volatile, and imparts a strong odour
to the atmosphere, such as is experienced in stables and
byres, producing sneezing and watering of the eyes.
Hydrogen, at its extrication, sometimes carries with it
a portion of phosphorus, already contained in the decomposing
body, and becomes phosphuretted hydrogen, a gas
which ignites spontaneously in the atmosphere, the same
that is sometimes observed in churchyards under the title
of corpse-lights.
Hydrogen sometimes also unites with sulphur, and the
combination is called sulphuretted hydrogen, a gas readily
discovered by its offensive odour,—which it imparts to
many very useful mineral waters.
These gases are discovered, not only in an atmosphere
exposed to decomposing dead animal materials, but are also
found in that atmosphere containing numbers of men in
health, closely crowded together, and persons suffering putrid
diseases, where no attention is paid to cleanliness and
the removal of impurities.
111A body affected with putrid disease is more liable to
decomposition than one in health; and the secretions and
excretions are more prone to putrefaction, and the emission
of effluvia or gases.
Some facts are known, which shew that bodies, in some
forms of low or malignant disease, both before and after
death, possess a virulence, never found in bodies in health,
or affected with disease of a non-malignant character.
The worst consequences have followed wounds in the dissection
of bodies recently dead of typhus fever; the introduction,
under the skin, of the fluid contained in the petechiæ
or black spots common in that disease, and even the
washing of bandages and clothes employed in cases of
mortification and the like.
In such diseases, the body becomes a very centre of
contamination and virulence; its fluids become acrid and
poisonous; and on the surface of the body, fluids are elaborated,
which are productive of the most malignant and
pestiferous effects. Whether these fluids, those virulent
secretions, are ever diffused in the air, and impart to it
their deadly properties, is a point of much interest, but one
which cannot be entertained here.
112
It is not only from such sources as those already treated
of, that effluvia or gases arise, to contaminate the atmosphere,
and to spread disease among men and beasts.
Effluvia likewise spring from the putrefaction of vegetables;
and, in many instances, from circumstances favourable
to their development and action, they so vitiate the
atmosphere, that its respiration induces some of the most
virulent diseases, and, where the effects are not so serious,
a state of slow sickness and great suffering is often the lot
of the sufferer, during the whole course of his miserable
existence. The situations of these effluvia will shortly be
pointed out, along with the respective diseases incident to
them.
But let us for a moment consider the changes on which
these effluvia depend. Putrefaction of vegetable matter
is one of the many wise provisions which the Almighty
has instituted for the accomplishment of his comprehensive
plan of the creation.
The surface of the earth is covered with vegetation, to
113supply man with food, and likewise to support the various
animals placed below him in the scale of creation, so necessary
to his comfort and existence. They are consumed,
and, by means of digestion, become component parts of
animals; and when these, in their turn, die, they go down
to the earth, whence they originally sprung.
Mixed there, with other matters composing the soil,
the carcasses of animals afford nourishment to vegetation
again, and once more they are found as the component
principles of vegetable forms. Thus the animal is constantly
supplying food to the vegetable world, which, in
its turn, supplies food to the other again.
In life, we found them performing functions useful to each
other, and mutually correcting their unwholesome effects;
in death, they are no less useful: the one is converted into
the other.
All animated creation is the scene of endless changes, and
is the object of successive transformations. ’Tis one mighty
circle, of a thousand parts, constantly revolving,—one part
occupying now this, now that place,—and each taking the
place of that next it, till at length it completes the entire
circle; and even then the race is not yet run, the revolution
must be performed again and again, to the very end
of time.
The immediate agency by which these wonderful changes
are effected, is putrefaction. We have alluded to it shortly,
in connection with man in health, in disease, and in
death.
We have now to speak of putrefaction in connection
114with dead vegetable matter, in marshy situations, &c.,
where it is the occasion of much disease.
There is no reason to believe that it was the design of
the Almighty, that the process of putrefaction, which is so
essential to the great plan of successive races of animals
and vegetables, should be the active engine of pestilence,
which it is in many situations.
That is not the necessary consequence of putrefaction;
and when it does occur, it is rather the effect of accidental
circumstances. Under ordinary circumstances, where putrefaction
goes on, as among vegetables moderately moist,
exposed to currents of air, and mixed up with the soil, as
in the various processes of agriculture, no bad results are
experienced.
But when vegetation is allowed to go on year after year,
without being cropped, where, as it ripens, it withers and
dies; and when it dies, is allowed to accumulate and putrefy,
where there is much moisture, much solar heat,
and little motion of the air, where, perhaps, other circumstances
are operating, favourable to rapid decomposition,
effluvia are wont to ascend and vitiate the atmosphere.
Such a vitiated atmosphere has acquired various appellations,
according to the place in which it has been observed,
and according to the effects or diseases it produces.
But, under whatever name it passes, its origin is the
same, namely, decomposing vegetable matter on the surface
of the earth, perhaps, in some situations, mixed more
or less with dead animal matter.
It is decomposing vegetable matter which produces the
yellow fever of the West Indies, the jungle fever of India,
115the deadly pestilential fever of the coast of Africa, the
ague in this country and in many others, the cretinism
of Switzerland, the pellagra of Milan, the unwholesome
condition of humanity in many parts of Italy, and especially
in the country surrounding Rome, or the Campagna
of Rome, as it is called. The decomposition, however,
takes place under circumstances somewhat different, and
hence the difference in the results of its action.
These effects are attributed to the decomposition of vegetable
matter; but there is room to think that, along
with that, there is combined no very insignificant proportion
of matter of an animal nature.
It may safely be inferred, that wherever there is vegetation,
there animals are found also; and it is well known
that vast numbers of many kinds of animals live wherever
decomposition is taking place, especially if the situation is
warm and sheltered. The carcasses of these animals will
be added to the vegetable matter, and add to the common
mass of corruption.
That matter in swamps, and in unwholesome situations,
said to be purely vegetable, is then a compound of
animal and vegetable origin; and these effluvia arise, not
from vegetable decomposition only, but from both dead animal
and vegetable substances in a state of putrefaction.
There is little known of the composition of these effluvia.
We are most conversant with their situations, and
their effects upon health. In different situations, they
produce different diseases. But no known facts entitle us
positively to say that their composition is different. It is
a remarkable fact, but one well ascertained, that the atmosphere,
116in all parts of the world, in all climates, and in
all situations, is much the same in its chemical composition.
It manifests the same general physical characters
in all situations, whether healthy or pestilential, and the
nicest investigations have detected nothing in an atmosphere
known to be pestilential, that is not found in the
most wholesome.
However, there is much reason to think, that this circumstance
is owing, not to the absence of hurtful gases,
but to the comparative insignificance of their volume beside
that of the atmosphere itself, so vast in its dimensions.
Medical men have been disposed to think that effluvia
which cause one disease, say the yellow fever, are not the
same as that which cause another, say the fever of the
coast of Africa. The only reason offered is the difference
of the diseases; but that is not enough to prove that the
effluvia are different in their nature. Different effects, or
effects so modified as to appear very different, are the results
of the same cause on many occasions. The smoke of
tobacco will make one person feel comfortable, another
merry, another sick, another faint, and so on; but it would
be unfair, from these differences in the effects, to pronounce
that tobacco-smoke was in all these cases different in its
own nature.
We are satisfied that the effluvia or gases arising from
marshy or unwholesome soil, are the same, generally
speaking, in all situations, whatever disease is produced;
and that the difference in the results is to be attributed to
the varying circumstances under which they act,—for instance,
the constancy or inconstancy of their operation,
117their greater or less intensity, the greater or less degree of
concomitant moisture and heat, the greater or less amount
of motion of the air,—the sheltered situation of human
habitations,—the condition of the body, its predispositions
from native country and the like, and the individual being
accustomed or unaccustomed to the action of effluvia.
Gases are known to arise from the marshy grounds
mentioned, where animal and vegetable matter is putrefying,
from the fact, that the neighbourhood of swamps is
most unwholesome, the inhabitants and visitors almost
uniformly suffering, because unwholesome effluvia are
invariably known to emanate where animal and vegetable
matter is thus corrupting, and because the gases themselves
may be seen rising in bubbles out of putrid water,
containing dead animal and vegetable matter in a state of
corruption.
These bubbles contain gases the very same as are disengaged
when animal and vegetable matter are putrefying
among water. They are nearly the same as proceed from
merely animal matter dead and putrefying, not incorporated
with the soil, viz. carburetted hydrogen, or inflammable
gas, carbonic acid gas, or fixed air, and sometimes a
little phosphuretted and likewise sulphuretted hydrogen.
These gases are sometimes appreciable to the organ of
smell. Carburetted hydrogen is very strong, and is perceptible
in many situations where there is much corruption
going on; for instance, at the meadow-ground between the
Dairy, on the Portobello road, and Comely Green, near
Edinburgh, where the stench is so strong as to prove most
offensive to passengers on the road. The source is the corrupting
118animal and vegetable materials, in the foul water
conducted from Edinburgh, and made to overflow the
ground, for the purposes of irrigation.
In such situations, it is not uncommon to observe lights
floating along during the night, and superstition has not
failed to make them represent evil spirits. They are known
by the name of “Will o’ Wisp” and “Jack o’ Lantern;”
and have, on many occasions, proved objects of no slight
dread to many ignorant persons. The lights are merely
ignited carburetted hydrogen gas,—the same kind of gas
as that used for lighting our shops and houses.
The gas is ignited, perhaps, by the rising to the surface
of the putrid water, of a bubble of phosphuretted hydrogen,
which, as was before observed, burns the moment it comes
in contact with the atmosphere.
Other products of an aeriform kind may be evolved also,
but we have no direct evidence of their existence,—but an
atmosphere, loaded with vapours of the kind mentioned, is
enough to account for the production of the observed disease,
in all its varied forms, when there is conjoined with
it other unwholesome agencies. In some countries, the
pestilential air is present throughout the year, for instance,
in the country around Rome, in the fens of Lincolnshire,
where ague is seldom absent; in others it is periodical,
chiefly confined to the hot and rainy seasons, as in India
and in the West Indies, where fevers prevail to a great
extent; and in others, again, it is observed only when the
wind blows from a particular direction.
These effluvia are conveyed to a distance by currents,
and produce their peculiar effects, more or less, upon almost
119all they encounter. The malaria at Rome is carried
by the wind into the city, by the channels most open to
its entrance; and those parts, it is said by medical men
who reside there, that are most exposed to the wind blowing
off the adjacent marshy grounds, are most unhealthy.
It is for that reason that the suburbs are more unwholesome
than the interior of that city, where the wind does not find
ready access, on account of the obstacles offered to its course
by the high buildings. The high houses and streets thus
act as a barrier against the entrance of the pestilence, and
it is even said that the narrowest streets there, are the
most healthy, as they shut out the pestilential vapour.
An obstacle of the same kind is offered by hills which
interrupt the course of winds carrying with them vapours
from marshy grounds. In the West Indies, where the
yellow fever commits such frightful ravages, many instances
are known where a town or district retains its health,
from the shelter which a hill affords against the visitation
of a wind that has loaded itself with deadly miasms, while
sweeping over a marsh or swamp. It is the practice of
those residing in those countries, not only to remove from
the swamps, but also from those points to which the wind
blows after passing over them.
Inattention to that consideration has led to the loss of
much human life, and to the fruitless expenditure of much
money in the erection of houses, barracks, and the like,
which, after completion, have been found to be totally uninhabitable,
from the pestilential vapours carried to them
by the winds. In illustration of the influence of winds, we
submit the following interesting extract from Dr Good’s
120Study of Medicine. He has been speaking of effluvia from
animal matter. “But the foul and stinking Harmattan,” (a
pestilential wind) “when it rushes from the south-east upon
the Guinea coast, loaded with vegetable exhalations alone,
with which it impregnates itself while sweeping over the immense
uninhabitable swamps and oozy mangrove thickets of
the sultry regions of Benin, triumphs in a still more rapid
and wasteful destruction; so much that Dr Lind informs us,
that the mortality produced by this pestilential vapour in
the year 1754 or 1755 was so general, that in several negro
towns, the living were not sufficient to bury the dead;
and that the gates of Cape Coast Castle were shut up for
want of sentinels to perform duty. Blacks and whites falling
promiscuously before this fatal scourge.”
So loaded is the air on some occasions with these pestilential
vapours, that they attach themselves to whatever
objects they meet, houses, the sides of hills, and woods,
through which they pass along with the wind, and so completely
has a wood stripped the currents of their baneful
accompaniments, that they have been respired after with
no injury whatever.
Trees are found to give great shelter and salubrity to
towns in this way, acting as they do as so many sieves retaining
impurities.
It is understood that the effluvia arising from putrefying
vegetable matters ascend high in the atmosphere under
the influence of the solar rays, and spread far and wide,
and that at night during the cold they fall with the dew
to the ground again, and impart to it and to those exposed
to its action, much virulence. The ground is there known
121to be extremely unwholesome, and those who have been
compelled by want, by sickness, while travelling, overtaking
them, or by being benighted, to lie down with nothing
but the soil for a couch, and with no shelter from the vapours
and dew that falls at night, save the sky itself, have
felt this pestilential influence: on the morrow they awake
distressed, parched, and affected with headach, and the
usual symptoms of malignant fever.
With the close of day or the setting of the sun, the pestilential
vapour falls and envelopes the country and the
habitations of men with a deadly mantle—and it is then
unsafe to venture into the open air in many of the finest
countries of the world.
The pestilential effects of exposure to these night dews
and vapours have, on many occasions, been experienced by
soldiers encamping in the open grounds, and our gallant
countrymen on foreign service are wont to yield in fearful
numbers to a foe, merciless and unsparing.
But it is not in swampy grounds only that these vapours
arise, for there is reason to think that in those places where
sickness is constant, and where no such dampness of
ground is observed, that decomposition of animal and vegetable
matter is going on some depth below the surface,
and that the extricated gases issue through the soil. This
is rendered almost certain, by the fact which has sometimes
been observed, that the most dangerous and sickly
season is, when the ground is parched and rent with heat,
permitting the exhalations generated below to ascend into
the atmosphere. Instances of this occurred among our
soldiers in the Peninsular war—the season, marked with
122the greatest prevalence of disease, the common result of
vitiated air, being that when the soil was most rent with
heat.
In some parts of Italy, it is remarked by that eminent
physician and philosopher, Dr James Johnstone, in his admirable
volume, entitled the Diary of a Philosopher, which,
by the way, is a work of rare virtue, in so much as it is
replete, not only with accurate medical knowledge, but with
reflections in literature and the fine arts such as prove an
intimacy with polite learning not always found, that fever
and that general unwholesome state of body, observed in
districts infested with vitiated air, prevail where inquiry
has discovered no appearance of unusual dampness and corruption
of the soil. He thinks that streams of putrid water,
containing animal and vegetable materials, that have
sunk down from the surface, in some part of their course
are making their way at a little depth, and that when the
soil, parched with excessive heat and drought, becomes
rent, as it commonly does, the emanations previously confined
rush out by the channels now presented by these fissures,
and deal their deadly effects around.
Such an explanation seems to me highly probable, and
deserving of more inquiry. Connected with this subject,
the following facts may be interesting, and assist in forming
an estimate of the probability of the truth of that explanation.
In mines, as well as on the surface of the earth, changes
are constantly going on; and as in the latter situation the
animal, vegetable, and mineral components of the soil are
decomposing, so the minerals in the former are giving out
123some of their component parts and abstracting oxygen, &c.
in turn from the atmosphere.
In mines some of the fossils attract oxygen from the air,
but the chief process by which the atmosphere becomes vitiated
there, is by the evolution of gases from the minerals. In
coal pits the principal gases emitted are carbonic acid gas,
commonly known as fixed air, which will support neither
animal life nor combustion, as proved by the disastrous results
on men having been confined in it, and by the extinction
of light when immersed therein, and carburetted
hydrogen gas, known as fire-damp, which cannot support
respiration, and which takes fire when brought in contact
with a light. These gases are the results of chemical
changes going on in the minerals, in the same way as the
gases before alluded to attend the decomposition of animal
and vegetable substances.
These gases arise not only from the minerals exposed to
view at the various surfaces, as the roof, sides, and pavement
of coal pits, but issue also from the unworked minerals
in the interior, by fissures or cracks in the various
strata, produced by the violence used in detaching the
minerals.
These fissures extend in the course of the beds, or strata,
and are often scarcely visible, but are sometimes so wide
as to admit the finger. It is probable that they sometimes
extend a considerable way into the solid minerals.
In general, from these fissures there is constantly issuing
streams of gas, of a nature varying with the character of
the minerals, but for the most part they are such as have
been mentioned. In the mines of Great Britain, when the
124atmosphere above is much agitated, as by the prevalence
of southerly winds, and more especially if the violence
amounts to what is termed a storm, the gases pour out in
prodigious quantities, making a rushing noise, and filling
the pit and excavated parts. The pit then becomes so full
as to interfere with the operations of the men, who are
frequently, for their safety, obliged to retire. In this case
the atmosphere is lightened, and the pressure it is constantly
exerting on all bodies with which it comes in contact
is diminished, and the consequence is, that the gases
rush out, under the circumstances already mentioned. It
is known, that, during the prevalence of stormy weather,
the mercury in a barometer falls; it is for a like reason,
the weight upon it being less. Not only the gases issue
from their caverns when the air is thus lightened, but water
contained in fissures in the floor or pavement of mines rises
also, sometimes to the amount of an inch or two, and it is
no uncommon thing to see the extrication of vapour from
a little collection of water on the floor, such as takes place
when water is boiling, a movement which it very much
resembles.
These facts shew that it is not improbable that pestilential
vapours, ordinarily passing under the soil, may be
extricated when fissures are present. It may happen that
effluvia may be prevented from issuing even when fissures
exist in the soil, from an increase in the weight of the atmosphere,
and in this way may be explained the occasional
disappearance of pestilence with a change of weather, not
unfrequently remarked in some tropical countries.
During the prevalence of strong north, north-east, and
125north-west winds, blowing with considerable violence the
currents in mines are reversed—for, instead of gases issuing
from the fissures and crannies, currents of atmospheric air
pour into them. These currents may be felt with the
hand, and the ear can detect the rushing sound; a flame
applied to a fissure is immediately drawn in, shewing the
direction of the current. These facts illustrate the influence
which the state of the atmosphere has upon terrestrial
vapours.
As has been already observed, the exhalations from the
soil obtain different names from the effects they are wont
to produce. When they produce intermittent fever or
ague, they are termed marsh miasms. When they produce
the various forms of malignant fever, such as the yellow,
the bilious fever of India, and the coast of Africa,
simply pestilential effluvia—and when they induce general
bad health and degeneracy of the inhabitants of a country,
they are styled malaria, an Italian expression signifying
bad air.
As the subject appears one which may interest the general
reader, it is proposed to add a few observations on the
diseases which are caused by air vitiated with effluvia
from the soil.
126
A vast proportion of the most virulent diseases to which
the human race is subject in almost all parts of the world,
but more especially in tropical regions, is produced by the
action of effluvia arising from decomposing dead animal
and vegetable matter on the surface of the earth, and incorporated
with the soil. These effluvia are the immediate
instrument by which thousands of our fellow men are annually
deprived of existence, the career of the young and
the robust is abruptly stopped, never again to be renewed.
Malignant fever is the disease, by which death is occasioned
from these effluvia; and this fever assumes forms, characters,
and titles, various and manifold. It ravages in
almost every country within the tropics, and in many
situations it annually commits the most dreadful havoc—cutting
down so rapidly that the ordinary forms of burial
cannot be observed. Whole communities suffer, the inhabitants
of a particular tract of country are sometimes almost
extirpated, and to visit some countries is almost to incur
death from pestilence, so near to certain is attack, and its
destructive character is so uniform.
The average duration of life in many countries is extremely
127low, chiefly on account of the wasteful career of
that scourge, under its various characters and designations;
and it is not saying too much that there the number
of deaths is four times as great as occurs in our own
happy country.
In those regions in which malignant fever prevails so
much, almost every inhabitant at one period of his life,
sooner or later, is afflicted with it. If he survive he is more
fortunate than thousands of those who lived beside him;
but his health is often deteriorated, he is often deprived
of that vigour and elasticity both of mind and body, which
spring from a sound constitution, and he not unfrequently
lingers under the sufferings of chronic disease till his life
is gradually though slowly exhausted; unless, indeed, as
often happens, it is suddenly terminated by a fresh attack
of the active pestilence.
“Almost every territory in which it (malignant fever)
has committed its ravages has given it a new name. It is
as gorgeously arrayed with titles as the mightiest monarch
of the East. From the depredations it has committed in
the West Indies, and on the American coast, it has been
called the St Domingo, Barbadoes, Jamaica, and American
fever; and from its fatal visitations on the Guinea Coast,
and its adjoining islands, the Bulam fever. In British India
it is distinguished by the name of Jungle fever, and
still farther to the east by that of Mal de Siam. Nearer
home, in the lowlands of Hungary, and along the south of
Spain, it is called the Hungarian or the Andalusian pestilence.
From its rapid attack on ships’ crews, that are fresh
to its influence, the French denominate it Fievre Matelotte,
128(fever of sailors) as the Spanish and Portuguese call it
vomito Prieto or black vomit, from the slaty or purplish
and granular suburra (grounds) thrown up from the stomach
in the last stage of the disease; while, as its ordinary
source is moist lands, it has frequently been named
Paludal Fever.”[6]
This fever is severe with new settlers in these countries.
Persons visiting places in which it is endemic, during its
severity almost necessarily suffer, but sometimes they
escape with a slight attack, in which case they are said to
have had a “seasoning fever.” The pestilential vapours
may be carried to a great distance, by winds and currents.
Instances have already been given where districts are immediately
rendered unhealthy upon the visitation of a wind
which has passed over an unhealthy swamp at a distance.
Many instances are also well known where ships, riding at
the distance of a league from an unhealthy coast, have had
their crews affected with the distemper, on the vapours
being sent among them by the wind coming off that direction.
The British navy is, alas, too familiar with instances
of ships being visited by that pestilence when lying off the
coast of Africa, where, too, no direct communication had
been maintained. The most appalling mortality occurs in
these cases; it is not unusual during the short period a ship
remains on that station for the whole officers and crew to be
swept away in one general tide of death, and it not unfrequently
happens that, after the short space of three years,
the ordinary time of service, that when a ship returns to
England, she has not a hand on board she carried out—but
129is manned with a crew that has succeeded one which
had, in its turn, taken the place of that which danced in
joy, and looked all gallantry, only a few short months before,
when with hearty huzzas they left their native land,
and committed themselves to their bark and to the buoyant
billows. At the time of the expedition to Walcheren a
disastrous state of health prevailed among the soldiery in
Holland, in consequence of vitiated air and other forcible
adjuvants;—the pestilential vapours which arose from the
soil were borne by the winds to the ships riding at a distance,
and there fever failed not to manifest itself with its
usual severity.
The actual amount of mortality produced by pestilential
effluvia from the soil has never been accurately calculated
in those countries where they are most severe. No bills of
mortality or registers of deaths are kept, as in this country,
in connection at least with the natives. But enough
is known to shew that the amount is prodigious.
Tables are kept of the deaths occurring among the soldiers
belonging to this country, serving on foreign stations,
and they amply shew that the mortality is frightfully
greater in those countries infested with these effluvia, and
with the diseases which these effluvia are wont to excite,
than at home—and as they are the chief agency of an unwholesome
character, known to prevail in these regions, it
is not unfair to attribute to them, in a general manner at
least, a very great proportion of the excessive mortality.
The following extract, from an official return, will shew
the greater mortality among the military when serving in
the British Colonies than when stationed at home—
130Official return of the mortality among officers and soldiers
in the several British Colonies, chiefly for the
seven years from 1820 to 1826, shewing the annual
deaths out of ten thousand men.
| Great Britain (1824 and 1826), out of 10,000 there died per annum, |
144 |
| Mauritius, |
240 |
| Madras Civil Service in 1820, |
600 |
| Ceylon, soldiers on the island, |
1328 |
| West Indies, |
701 |
Such is the fearful mortality which occurs among our
soldiers stationed in some of our colonies, where effluvia of
a pestilential character exhale from the ground. In Ceylon,
where terrestrial effluvia are known to prevail, the
number of deaths of our soldiers is more than nine times
that which occurs among those who are stationed in Great
Britain.
The immediate cause of that frightful mortality is the
malignant fever, the chief agent in whose production, again,
is the pestilential atmosphere, rendered such by terrestrial
effluvia, and not by the presence of specific contagious poisons,
as defined at page 105, assisted, perhaps, by other
hurtful influences, such as, the intemperate habits which
new comers in those colonies frequently adopt, the great
heat of the climates, operating with particular force upon
those accustomed to the more temperate climate of England.
This pestilential fever, the product of effluvia from the
soil, commits such mortality among our gallant soldiery,
131as throws into insignificance the carnage attendant on active
warfare, as renders that, even in the field of battle,
comparatively of little moment.
Men in action may fall fast around; whole lines, nay
columns of living humanity, its boldest samples, in one
brief moment may be hewn down; still, as such carnage
can last but a few hours of the day only, or, if protracted,
a few days at most, the work of death is inconsiderable,
compared with that effected by pestilential effluvia in
many situations, operating both night and day, from day
to day, and from year to year, unceasingly.
132
The inhabitants of countries infested with malaria, or
vitiated air, when they have been spared the more acute
forms of disease, or have recovered from them, are generally
the victims of a miserable state of health, compared
with which many conceive that death itself would be preferable.
The body loses its vigour and aptitude for exertion, becomes
weak, disabled, sluggish, and impotent; the appetite
fails: the limbs refuse to carry their burden aptly so called,
and they become swollen and dropsical. The mind
becomes lethargic and unfit for exertion, and the unhappy
sufferer, who is insensible to whatever gratifies his more
highly favoured fellow-men, becomes often weary of existence,
a burden to himself, and an object of pity to others,
who are accustomed to regard the activity, the cheerfulness,
and graceful lineaments of health.
Thousands are so afflicted; and the number of those who
thus have their existence embittered,—who are deprived
of the manifold enjoyments which our condition can afford,
and whose lives are prematurely terminated,—is even
133greater than that of those who die of the more violent and
more speedily mortal distempers which are induced by vitiated
air.
“A glance at the inhabitants of malarious countries or
districts, must convince even the most superficial observer,
that the range of disorders produced by the poison of malaria
is very extensive. The jaundiced complexion, the
tumid belly, the stunted growth, the stupid countenance,
the shortened life, attest that habitual exposure to malaria,
saps the energy of every bodily and mental function,
and drags its victim to an early grave. A moment’s reflection
must shew us, that ague and fever, two of the
most prominent features of the malarious influence, are as
a drop of water in the ocean, when compared with the
other less obtrusive, but more dangerous, maladies that
silently but effectually disorganize the vital structures of
the human fabric, under the operation of this deleterious
and invisible poison.”[7]
Such is the general state of health of the inhabitants of
many parts of the world; but it is chiefly in some parts
of “fair Italy,” whose celebrated blue skies invite, whose
luxuriant vegetation delights, whose gay and extensive
prospects ravish, and whose classic associations charm the
ecstatic spectator,—where humanity acquires that degenerate
character, and that hideous aspect, which it assumes
as if on purpose to mark the contrast between the gay revelry
of vegetation, and the revolting degeneracy of mortality.
The resident in Italy can scarcely escape entirely the
134action of malaria; if he survive or escape the more immediate
and more violent effects, those just described are, in
the course of time, almost sure to manifest themselves.
Many of our countrymen make their residence in Italy,
invited by its sky, its sun, its fertility, its ancient monuments,
and stirring associations, and they not unfrequently
prolong their stay so much as to imbibe the seeds of
general bad health, which, though it may not develope itself
at the time, will manifest itself at some future day.
The malaria of Italy, like that of some other countries,
sometimes acts slowly, and does not produce its effects,
until the sufferer is again resident in his native country.
Assailed with general decay, he is at a loss to know its
cause, happening, too, at a time, when he had expected that
his general health would have been more than ever established
by his residence in a warmer climate, and under a
clearer sky. It is a remarkable feature in the general bad
health thus produced, that it is marked with periodical
alternations of activity and repose, or with aggravations
and remissions.
Cretinism, by which is meant a degenerate state of
body, and an imbecile state of mind, which occurs for the
most part in the valleys of Switzerland, and among the
hollows of the Alps and the Pyrenees, and that is in a
great measure the product of vitiated air, emanating from
the swampy valleys and basins, which contain animal and
vegetable materials, powerfully acted upon by the direct
and reflected rays of a burning sun.
135From the mountains there pour many streams into the
valleys or troughs beneath, and, as the water is seldom
completely carried off, it there forms an excellent or very
favourable nidus for the putrefaction of animal and vegetable
remains.
It is said, by those who have attentively observed the
miserable population in these regions, that they form the
most humiliating picture of humanity. The body presents
the most loathsome condition, and the mind is removed
only a step from idiocy itself.
The unwholesome tendency of these terrestrial vapours
is materially increased by the almost incredible filth in
which the inhabitants keep their persons, clothes, houses,
and streets, the effluvia of which alone are almost intolerable
and most offensive.
The general degeneracy of the body is frequently accompanied
with a large swelling at the front of the neck,
which gets the name of “Goitre,” and which is known in
England under the appellation of “Derbyshire Neck.”
Cretinism has prevailed in Switzerland for many centuries,
and has been likewise noticed among the mountains
of China.
Cretinism is thus ably described by Dr James Johnson:
“The stature is seldom more than from four to five feet,
often much less;—the head is deformed in shape, and too
large in proportion to the body;—the skin is yellow, cadaverous,
or of a mahogany colour, wrinkled, sometimes
of an unearthly pallor, with unsightly eruptions;—the
flesh is soft and flabby;—the tongue is large, and often
hanging out of the mouth;—the eyes red, prominent,
136watery, and frequently squinting;—the countenance void
of all expression, except that of idiotism or lasciviousness;—the
nose flat;—the mouth large, gaping, slavering;—the
lower jaw elongated;—the belly pendulous;—the
limbs crooked, short, and so distorted as to present anything
but a waddling progression;—the external senses
often imperfect, and the Cretin deaf and dumb;—the tout
en semble of this hideous abortion of nature presenting the
traits of premature old age. The Cretins are voracious,
and addicted to low propensities. To eat and sleep form
their chief pleasures. Hence we see them, between meals,
basking in nonchalance on the sunny sides of the houses,
insensible to every stimulus that agitates their more intelligent
fellow-creatures.”
Before closing this sketch of the effects of malaria in
Italy, a table of the annual decrement of life is submitted,
which will shew the fearful mortality of that country over
that of England, the disproportion against the former
country being owing, in a very great degree, to the contamination
of the atmosphere, caused by the effluvia which
arise from the soil.
In Rome, 1 out of every 25 persons dies annually, or a
25th part of the whole population.
In Naples, 1 out of every 28 persons dies annually, or a
28th part of the whole population.
In England, 1 out of every 60 persons dies annually, or a
60th part of the whole population.
Thus, in England, the mean term of life is more than
double what it is in Rome or Naples; and thus, while it
137takes 60 years to extinguish a generation in England, the
brief period of 25 years completes the same work at Rome.
Intermittent fever, more familiarly known as ague, is
also a common product of air which is vitiated with effluvia
arising from the soil.
That disease was much more prevalent some years ago
in England than it is at present, where it is almost confined
to Lincolnshire, and some of the low grounds and
meadows of Kent and Essex, through which the Thames
flows.
It is unnecessary to mention the symptoms of ague, as
they are familiarly known. Convalescents are very liable
to relapses, and many of those who have recovered from the
more violent symptoms, are frequently affected, throughout
the whole term of life, with very troublesome complaints,
which arise from what is vulgarly known as ague cake,
which is an enlargement of the spleen, an organ which lies
near the stomach.
Ague is very prevalent in the West Indies, America,
Holland, and other countries which are much covered with
wood, are ill drained, and liable to be periodically inundated.
This disease displays none of the virulence of the
malignant remittent fever already noticed, yet affects vast
numbers in its peculiar localities, and not unfrequently
leads to mortal results.
The whole population of those fens and swamps in
138which ague is endemic, is generally affected at some period
of existence, scarcely one person escaping.
The effluvia which produce that disease are sometimes
carried to a considerable distance, and there induce their
peculiar distemper; and instances are well known, where
effluvia have been conveyed to high grounds, where they
have attacked the inhabitants, while those in the immediate
neighbourhood of the source of these vapours, have
escaped for the time.
Ague is a much milder disease than the remittent fever,
which springs from the same general source, viz. terrestrial
effluvia, and which prevails in the East and West Indies,
and on the coast of Africa.
When and where intermittent fever only is produced, it
would appear that the effluvia from the soil are less virulent
and concentrated, and perhaps their activity is modified
or tempered by a proportionately great quantity of watery
vapour combined with them in the atmosphere, by the climate
of the country, and by the constitution of the people.
In this country, even so lately as half a century ago,
ague or intermittent fever prevailed to a considerable extent,
but is now almost unknown.
In East Lothian many of the old inhabitants remember
ague as being a common disease in that county. At present
it is there unknown.
In respect to this disease particularly, the health of the
population of England has greatly improved, and it is well
ascertained that the gratifying fact is chiefly owing to the
country having been cleared of its superabundant wood,
which prevented the land being readily dried, and which
139interfered with the due action of the winds, and to the
speedy removal of water from the surface of the earth by
draining, which is now so universally adopted. By draining,
the water which formerly formed a receptacle for the
decomposition of animal and vegetable remains, is now carried
off, and with it the opportunity it afforded for the extrication
of unwholesome vapours.
140
The operation of vitiated air in the production of disease
is often very much assisted by the presence of other prejudicial
influences.
It has been frequently remarked that one stroke of misfortune
seldom comes alone, and that observation holds
with striking force in reference to the causes of disease.
One cause of disease produces another, which in its turn
generates another, and so on, till the tendencies to, and the
excitants of, pestilence, are so strong and so numerous, that
whole communities are affected, one after another.
It not unfrequently happens that the predisposing source
of some of the most severe visitations of the most virulent
distempers, is the want of food, which generally depends
on the exorbitant prices of provisions, raised either by the
arbitrary regulations of rulers, or by comparative scarcity.
The total or almost total want of food is calculated to
bring about, very shortly, a mortal result, from exhaustion
or from sinking of the powers of the system.
When food is not withheld altogether, but is only given
in sparing quantity, in an amount insufficient for the
141maintenance of the body in vigour, a condition of the system
is induced, in which the functions are imperfectly performed,
in which the blood and the various humours become
universally prone to morbid change, and in which
there arises a great tendency to disease of a low or asthenic
character.
If, under such privation, vitiated air be present, whether
arising from men in health, but uncleanly or crowded
in close apartments; from the clothes, or excretions of
the sick; or from terrestrial effluvia; it will give form to
disease, will act as a spark amid fuel, and will shortly
convert any predisposition to sickness that may exist into
reality itself.
In those suffering under scarcity of food, there is generally
experienced great depression of mind, which is hurtful
in itself and injurious by preventing sufficient exertions
for the maintenance of cleanliness: there is an inability to
procure requisites for the purpose, and when, perchance,
they are obtained, there is too often too much apathy or
supineness to admit of their being used.
That miserable individual who is famishing, who is so
unfortunate as to hear his helpless children call for bread,
which he, alas, cannot give, who himself is exhausted and
sinking with want, is seldom found to be very solicitous
about cleanliness.
A mother so situated will, in her misery, amid her actual
sufferings, and with the dark yet immediate prospect
of further hardships, forget the necessity or disregard its
call; of removing impurities from her hut, of retaining the
persons and clothes of her family clean—and of washing
142the furniture, the walls and floor of her pestilence-haunted
cabin.
In such a situation, cleanliness is neglected and impurities
of all kinds accumulate which emit effluvia, to add
to the number of the causes of gradual death impending
over a family thus situated.
Let a case be supposed in which disease makes its appearance
in obedience to the summons of so many forces,
and let the malady be of a low or putrid character, and
the patient dangerously ill. This family is unable from
depression of mind, and from that exhaustion attendant
upon actual want, to give him the requisite attention and
assistance, and neither the means of cure are administered,
nor is a suitable diet afforded. Effluvia arise, and no means
being adopted to remove them, they become highly concentrated,
and prove the immediate exciting cause of disease
among all around who may be prepared by the operation
of other favouring influences for that consummation. The
occurrence of typhus fever among the labouring classes of
this country, which is observed every winter, but more
especially on those occasions when provisions, the necessaries
of life, are high in price, when employment is with
difficulty obtained, and when the wages are low, sufficiently
attests the fact that scanty food is a powerful cause
of disease, and one of a widely extended range of action.
It is invariably in those years when there is least correspondence
between the severity or inclemency of the season,
the price of provisions and the means of the labourer that
typhus fever commits most havoc. I have had occasion
to note the prevalence of an unusual amount of disease,
143and amongst other forms, that of fever, in winters following
partial failures of the crops, and the most satisfactory
evidence has been afforded that a large proportion of the
sickness was the consequence of high prices, and consequent
scanty and insufficient food.
Such great prevalence of disease can be readily accounted
for, when it is known that the ordinary amount of the wage
of the day labourer does not exceed nine or ten shillings
per week. I have heard labourers of the most sober and
frugal habits affirm, that if their whole wage were spent
in the purchase of oat meal for porridge, and of bread, that
there would not be more of those provisions than would
barely satisfy their children and themselves.
A scanty and unwholesome diet induces a bad and acrimonious
state of the fluids, and leads to many diseases, and
among others, to scurvy, which was long a frightful pestilence
among our sailors.
Where there exists that tendency to scrophula, which
is common in this climate, the relaxing influence of a poor
and scanty diet is particularly hurtful, and proves the exciting
cause of that hideous disease in all its frightful
forms. Scrophula is much connected with a sluggish state
of certain organs called glands. These organs are found in
all parts of the body, and in health vary in size from that
of a pin’s head to that of a bean, but in scrophulous subjects
they are found much larger, the smaller being often
more than the size of a pea, and the larger being equal to
a hen’s egg.
Glands are congeries of vessels in which fluids of various
kinds are elaborated, and it is partly from these fluids or
144those from which they are formed, stagnating in their vessels,
owing to want of vital action, that the swelling arises,
which is always found in scrofulous subjects.
That sluggish disposition of these parts is generally connected
with a languid and lax state of the general system,
which is liable to be greatly increased by whatever diminishes
the vigour of the body. Few circumstances are better
calculated to produce that effect than insufficient food,
and hence it is that those diseases whose foundation is a
scrophulous taint, are so much promoted in times of scarcity,
and among individuals accustomed to a liberal diet
when accidentally placed on scanty fare.
Instances are known where persons have become affected
with weak eyes, with tenderness, watering and disposition
to ulceration in these organs, immediately upon being put
on spare and poor diet, and where a liberal supply of nutritious
food has proved an almost immediate cure. That
affection of the eyes was a form of scrophula, and fortunate
it was for them that the form in which that disease manifested
itself was not more dangerous. They had much reason
to be thankful that the injury was capable of cure, and
was not irremediable, as it has been in many instances,
where the first intimation of the bad consequences of a
scanty and insufficient diet has been decided and incurable
consumption of the lungs.
When the glands which assume the scrofulous action
are those of the lungs, and when they become the seat of
the formation of matter, pulmonary consumption is said
to be produced, a disease which annually carries off a great
proportion of the adult population of this country.
145Consumption of the lungs, or pulmonary consumption, is
a common affection among those who subsist on scanty and
insufficient food, and is frequently observed with dogs and
other animals whose sustenance is small and precarious.
Scrophula manifests itself in other forms, not less severe
and extremely loathsome—in running sores on the neck
and other parts, in swellings of the joints, and in various
wasting diseases of the bones and their coverings.
In the various forms which this disease assumes, the
blood and the different humours of the body become unhealthy
and often acrimonious. The milk of nurses who
are tainted with that habit is unwholesome, and when
they are made to subsist on scanty and insufficient diet, it
becomes poor, less nutritious, and positively injurious—and
instead of being bland and white, it often appears watery
and yellowish, and is irritating and acrimonious.
Food of an unwholesome or vitiated quality is also injurious,
and has on many occasions proved to be the cause of
much disease. Plants as well as animals are subject to
disease, and food when obtained from such sources is highly
unwholesome and detrimental to health.
The flesh of animals which have laboured under disease,
has, on many occasions, done much harm, and is liable to
be much more injurious than flesh which is merely putrid
from being too long kept. Flesh merely putrid much more
seldom proves hurtful, as, long before it can be very pernicious,
it becomes so offensive that it cannot be consumed.
Moreover, food which has acquired a slight taint, is more
easily digested, its fibres become less tense, less hard, and
more easily divided and dissolved in the stomach.
146But the most important injuries of the kind have arisen
from the use of diseased grain. On the Continent the rye
sometimes becomes diseased, and the grain throws out a
fungus somewhat like the spur of a cock. Rye thus deteriorated,
when used for food, has produced disease of a
very serious character. Persons who partake of it suffer
great pain of stomach, fiery heat in the extremities, and
very violent convulsions. This spurred rye produces mortification
of the extremities, of a very remarkable nature.
The late celebrated surgeon, Mr Pott, thus describes
these affections. “At the extremity of one or more of the
small toes, in more or less time, it passes on to the foot or
ankle, and sometimes to a part of the leg, and in spite of
all the aid of physic and surgery, most commonly destroys
the patient. It is very unlike to the mortification from
inflammation, or to that from external cold. In its severer
attacks, however, the constitution seems to be generally
contaminated, the mind and body become equally debilitated,
there is great irritability and a tendency to convulsive
action.”
Rye thus diseased produces another distemper, which
partakes of the nature of typhus fever and that of plague:
it is called by the French “Mal des ardens,” and is generally
considered one of the worst forms of the pest. That
disease is marked by the most virulent character, and has,
on many occasions, committed the most fearful ravages.
It commences with a sensation of burning, prostration of
strength, delirium, and vehement headach; a bad form
of erysipelas attacks the skin, ending in suppuration, matter
forms in the armpits and groins, and these symptoms
almost invariably terminate in death.
147There is good reason to believe that the fungus or cock-spur
is the product of disease in the plant. It is about the
size of a cock-spur, is coffee-coloured, and may be readily
detected when the farmer is disposed to use his eyes.
In this country, wheat which has been blighted or infected
with the parasitic plant called mildew; has sometimes
produced very bad effects, not unlike the severe burning
at stomach, and the mortification which supervene on
the use of spurred rye on the Continent. Not long ago,
several families living in England were nearly destroyed
by their using some diseased grain, which a farmer, knowing
it to be bad, had sold at a reduced price. Other plants
are sometimes known to be attacked with disease, and in
that state are ascertained to inflict much mischief. The
potato is more particularly injurious when its quality is
bad.
Plants, like animals, may be affected with disease, and
may be most unwholesome, without exhibiting any very
marked signs of their morbid condition.
Drink is as essential as food itself, to the maintenance
of the health of man. Thirst is no less urgent than hunger
itself, and it often happens that it must be satisfied
when the calls of the appetite for food are unheard. Drink
of a wholesome quality is highly salubrious, and conduces
much to maintain the blood, and the various humours in
a healthy condition. Water is the only beverage with
which Providence has directly supplied his creatures, and
148is, under ordinary circumstances, the liquid of all others
the best adapted to their use.
Pure water is refreshing, cooling, and dilutes the blood,
which, without some diluent, would become too thick to
move readily along its containing vessels, to perform aright
its manifold duties, and to accomplish its numerous purposes
in the animal economy. Water taken into the stomach
goes to supply that very considerable part of the
mass of blood which is constantly earned off in the shape
of sensible and insensible perspiration, and of other secretions,
and to correct the tendency in that vital fluid, to
become irritating and acrimonious from the formation and
accumulation of various salts.
In order that the deleterious action of some liquids may
be the more readily understood, we will inquire how drink,
which is taken into the stomach, is there disposed of.
One of the chief objects which is obtained from the use
of drink, is the dilution and mollifying of the blood; and
in order that this important purpose may be effected, it is
necessary that they be brought in contact and mixed with
each other.
Water, or any watery beverage, being received into the
stomach, many thousand vessels open their mouths upon
the walls of that organ, and imbibe the contained liquid,
in virtue of a vital action which they possess. The liquid
is soon sucked up, and is carried by the veins and the absorbent
vessels into the general circulation, there to be
mixed and incorporated with the mass of blood. It has
been popularly thought, that there exists a direct communication
between the stomach and the kidneys, by which
149the contents of the former are conveyed to the latter organs;
and that supposition probably arose from the fact,
that the kidneys have an immediate increase of duty after
copious drinking; and that fluids having a peculiar and
strong odour have been detected, discharged, very soon
after their reception into the stomach.
However, there is no direct communication between
these organs, and all liquids which are taken into the stomach
must be passed through the general circulation before
they can reach the kidneys; and thus it is worthy to
be observed, that liquids which are possessed of deleterious
properties, have an ample field for their operation.
It is rare that any bad effects follow the use of moderately
cold water in a state of purity, and any instances
in which injury has followed, may, with perfect propriety,
be regarded as depending on accidental circumstances.
It sometimes happens, that water free of impurities, cannot
be obtained, and that, what is highly impure is taken
into the stomach. Many nations are occasionally subject
to the privation of pure water, and are compelled to have
recourse to the tainted waters of sluggish rivers, of almost
stagnant rivulets, and putrefying lakes; and the consequence
is, that their health suffers, and that the invasion
of disease is much promoted.
The inhabitants of Switzerland, and of several other
countries, are supplied on some occasions, with no other
water than that which is obtained from snow, and the
prevalence of goitre among the Swiss, has been attributed
by some physicians to that circumstance.
But man is not satisfied with this excellent beverage—water—which
150is ever at hand, and to be obtained without
a price.
While yet little advanced in the knowledge of the arts,
man discovered that the various juices with which the various
fruits of the earth abound, afforded, during fermentation,
a liquor which possessed properties such as strongly
recommended it to his use. These juices, after fermentation,
prove exhilarating and intoxicating, and all the nations
of the world have their respective wines or intoxicating
beverages. This liquor, which is the product of fermentation,
gives to these juices their peculiar character. It is
called spirits of wine, is colourless, and is lighter than water.
The liquors in which that active agent resides, when
taken in small quantities, quicken the circulation of the
blood, render more acute the perceptions, and augment the
heat of the body. When these liquors are taken more
copiously, the circulation becomes violently affected, the
face flushes, and the blood is sent to the head, with too
great velocity, and in too great abundance.
At first the mind is stimulated, but there gradually ensue
sleep, stupor, and privation of sense and motion, which
may continue even unto death. Several cases, in which
death took place in this way from drinking to excess, are
detailed in Mr Watson’s excellent work on homicide. But
when the quantity which is taken is insufficient to produce
the last-mentioned effects, but is often repeated, it frequently
happens that disease, more or less acute, attacks
some of the more important organs of the body, as the stomach,
liver, kidneys, brain, heart, and the general nervous
system.
151The diseases which follow the long continued excessive
use of liquors, containing spirits of wine, vary in their nature,
but, on the whole, they prove highly dangerous, interfere
with the performance of some of the most important
functions, and often lead directly to a mortal result.
Where death is not the immediate consequence of the
diseased condition of these organs, symptoms arise which
make the course of life run bitterly along, the general system
breaks up, the miserable victim presents in vivid colours,
the signs of premature decay, the accession of acute
and mortal sickness is greatly favoured, and the intellectual
faculties are impaired.
Many melancholy instances are known of soldiers at the
sacking of conquered towns, who, indulging in wine and
other spirituous liquors to great excess, have died in vast
numbers, both immediately, and more slowly, through
the operation of disease, which had been induced by too
deep potations, by too long protracted carousing, and by
that exposure to those influences favourable to the developement
of disease, to which excess never fails to lead.
“Some thousands of soldiers covered the great square
and the adjoining streets (of Moscow), but they lay extended
and stiff in front of the magazines of brandy which
they had broken open, and from which they had drawn
death, expecting to derive from them life.”[8]
The habit of indulging to excess in spirituous liquors,
when it does not directly induce pestilence, assuredly lays
those who are its victims, particularly open to its invasion,
and is, therefore, entitled to be regarded as a very important
agent in the great tragedy of life which is enacting.
152
Few of the primary causes of pestilence among large
bodies of men are so powerful or so extended in the range
of their action, as extreme and long continued cold, want
of sufficient clothing and shelter, and depression of the
mind.
Coincident with many of the epidemics which are wont
to prevail in this country, these circumstances are almost,
without exception, found to be present; and if they are not
admitted to be considered as the sole and exclusive causes
of the prevalent disease, it is proved that they are co-agents
or adjuvants of the very first importance.
Much of the continued fever which infests the poorer
classes of our countrymen, and almost all the pleurisies,
colds, and consequent consumptions, which prevail more or
less among the various ranks every winter, are in a very
great degree dependent on the extreme cold of the season
which suddenly sets in, and against which the dress of
the inhabitants of these islands is insufficient to provide.
The labouring classes suffer much, more particularly from
the action of cold and the inclemency of the weather. They
153are generally very scantily clothed, nay, they are sometimes
scarcely covered, and the consequence is, that the
cold makes a strong and lasting impression, the circulation
on the surface is suddenly impeded, the perspiration is
checked, and the whole fabric involuntarily shivers. Now
these are the very first symptoms of fever, and unless the
constitution is possessed of stamina to remove those symptoms
without loss of time, and to establish the circulation
in its vigour again upon the surface of the body, that disease,
or some other, will undoubtedly be established.
When a body thus affected with cold is placed in a warm
situation, there supervenes an excitement or reaction, which
is marked by increased force of the circulation, and with
redness and heat of the skin, a condition which is often
experienced by persons who go immediately to the fire
when newly arrived from a journey in the cold. When
that reaction ceases, and is followed by a sense of coldness
and by shivering, which again is succeeded by reaction,
fever, in its proper sense, is established, and will assume a
character of violence, lowness, or malignity, according to
circumstances.
The clothes, the house, and the diet of the working man,
are insufficient to protect him against the action of the cold,
and to resist its operation when once it has fastened upon
him; and thus it is, that to comparative want and to many
privations, there is so often conjoined so much disease.
But it is in vain to expect any other result as long as
our most deserving labouring population is worked in an
inordinate degree,—so long as they labour beyond what
their limited energies will, with impunity, permit—so long
154as they are often unable to obtain a diet sufficient for the
maintenance, even of an idle person, and so long as their
very breasts, from very want of clothing, are literally open
and exposed to the fiercest blast that blows, and to the
most searching and chilling rain that falls from Heaven.
Observe the industrious labourer at his work; behold his
powers are taxed to the utmost, his energies, his capabilities,
are put upon the stretch, and the entire fabric, God’s
most complicated and most delicate creation, is actually
labouring and heaving with protracted exertion. His blood
distils the dew of labour, and his clothes, such as they
are, are moistened with perspiration bursting from a thousand
pores.
It frequently happens, that the labour of the poor man
being over, sorely fatigued, too exhausted even to enjoy
the consciousness that his hour of rest has arrived, with a
heavy and unwieldy gait and hanging head, he seeks his
comfortless abode, his scanty board, his dreary, dark, scarcely
furnished apartment, with its faint and glimmering embers.
He swallows his spare repast and falls asleep at his fireside,
but having no change of clothes, and those which he
has on being wet with perspiration or with rain, are allowed
to dry upon him. In the mean time the heat of the fire
proves sufficient to create a steam on the side next it, and
the house of course being open to the wind, currents of air,
chillingly cold, pervade the apartment, and strike upon that
side of the poor inmate which is most remote from the fire,
and thus he of a thousand misfortunes and privations is
actually steamed on one side, and perished with cold on
155the other. Persons placed in such a situation can scarcely,
for any length of time, escape disease, and it is consonant
with my knowledge to say, that the condition of a great
proportion of the labouring classes is not one tittle better.
Fever and many other diseases will continue to assail our
labouring population as long as their food is insufficient, as
long as they are barely covered during the inclement season,
and as long as their habitations scarcely own a roof or
a door, as long as the wind and rain enter at a thousand
crevices; and while the cheerful and salubrious light of
heaven is denied admittance by the old hats, bunches of
straw, and rubbish which so frequently, in the absence of
glass, fill up the space originally intended for a window.
Yes, so long as every energy is exerted, and every moment
that can be cheated from rest, to obtain that wherewith a
supply of the necessaries of life may be procured, and when
every other consideration sinks and gives way to the more
pressing wants of nature, will disease prevail.
Such is the destitution among many of the labouring
class, and the vast amount of disease which prevails among
them, is the necessary consequence.
The following facts illustrate well the influence which
scanty food, insufficient clothing, and the privations attendant
upon poverty, exert in the production of disease.
During the last three months (10th February 1839),
the fishermen and potters living in Prestonpans, have been
in a very destitute condition, the former, partly from the
very boisterous weather which has prevented their going
regularly to sea, and the latter from the closure of the
potteries at which they were employed. During that time,
156these two classes of people have been suffering much from
fever, about ten of their number having died in that short
period; while the people, amounting to 750, including
children, connected with Prestongrange colliery, who are
well employed, well paid, and well fed, though inhabiting
the same locality, and the houses stretching from Prestonpans
to Musselburgh Links, have been almost entirely free
of that disease, fever having affected two of those families
only, in the course of the same time; and while fever is
still prevailing extensively among the potters and fishermen,
the people connected with the colliery have been entirely
free of that disease since about the 7th of last December.
On these facts I am well informed, being the
medical attendant of the colliery.
Let us mark the operation of the same or similar circumstances
upon soldiers; the consequences of exposure to
cold, to the inclemency of the weather, of the want of sufficient
clothing, and of habitations, among young and robust
men, employed in the most active and spirit stirring
occupations, connected with the most kindling and heart-rousing
anticipations, and flushed with the glory and honour
of victory.
Let the case be that of Napoleon’s Grand Army in Russia,
perhaps the most remarkable recorded in human history,
and that, perhaps, will equal any that will yet mark the
future career of man, in the total discomfiture, in the unspeakable
sufferings, in the awful destruction of human
life, and, in short, in the triumph of nature over humanity,
which, from beginning to end, attended the disastrous retreat
of that mighty congregation of France’s bravest sons.
157Let the case be that of the retreat of the Grand Army
from Moscow, which, alas, was one horrid series of unprecedented
disasters, of wreck upon wreck, whose course was one
prolonged deathbed—one white, one snow-white shroud—one
extended grave, which barely spared enough to convey
the fatal tidings, and which received heroes by thousands,
valour and all that is ennobling in the mass, which monuments
can never note,—and broken hearts and broken ties,
those of husband, of father, and of comrade, for which tears
have flowed, but which tears can never bind again.
“At every step he (the Emperor) saw his soldiers,
stricken by cold, extenuated by hunger and fatigue, falling
half dead into the hands of the Russian cavalry.
“Around these (their bivouacs) hunger and cold rivetted
those wretched sufferers. It was impossible to tear
them away.
“Above sixty thousand men well clothed, well fed, and
completely armed, attacked eighteen thousand half naked,
ill armed, famished men, encumbered by more than fifty
thousand stragglers, sick and wounded. For two days the
cold and misery were so intense that the old guard lost a
third, and the young guard one-half of their effective men.
“It was indeed but the shade of an army, but it was
the shade of a grand army. It felt itself conquered by
nature alone.
“Under these circumstances, the elements appeared
more hostile to us than the Russians themselves. Their
climate did its part—if they had done theirs.”
In that disastrous retreat there was a most extraordinary
accumulation of influences powerfully destructive of health.
158There was extreme cold, that of an intensely cold climate,
there was an insufficiency of food and of clothing, and there
was a want of proper habitations,—the wretched sufferers lying
almost naked around their fires in the open air, perhaps
enjoying the partial protection of a shed, a ruin, or a stable,
and sometimes seeking shelter in the carcasses of horses.
But there was also present another influence, highly prejudicial
to health, and equal of itself to a considerable proportion
of the fearful amount of disease which prevailed,
and that was depression of mind.
Depression of mind conveyed a withering influence to
the hearts of the bold victors of a thousand actions, and
paralyzed the whole energies of the system. Here it acted
on a gigantic scale, and its work of death, yes, of death
itself, was not less prodigious.
The humiliation, the mortifications, and the heart-rending
misfortunes of which these once victorious but now unhappy
men were the prey, could not but induce a state of
mind, which, of all other circumstances, must have been
the most favourable to the invasion of disease. Daily experience
demonstrates that disease is much favoured by
the presence of circumstances, such as are referred to in
the following passages.
“That grand army, which, in the course of the preceding
twenty years, had marched in triumph through all
the capitals of Europe, now, for the first time, reappeared,
mutilated, disarmed, and fugitive in one of those (Konigsberg)
which its glory had reduced to the greatest abasement.
Its inhabitants hastened into the streets, as we
passed along, to observe and reckon our wounds, and to
159estimate by the number and the extent of our misfortunes,
the foundation on which they might build their hopes: we
were forced to regale their eager and delightful eyes with
our miseries; to submit to pass under the yoke of their
delight, and, dragging our squalid and miserable forms in
full review before their detested scrutiny, to march under
the almost insupportable weight of calamity which the
hatred of the spectators beheld even with transport.”[9]
The very knowledge and observation of mental distress
and bodily suffering creates a depression of mind, and sickness
arising therefrom spreads among the spectators, although,
in other respects, they are comfortably situated,
and have abundance of clothing and wholesome food.
Segur further relates:—“Consternation took possession
of the soldiers of Marshal Victor, though unbroken in numbers
and in spirits, after having given way to their customary
acclamations on beholding their Imperial commander,
when, instead of the grand column which was to achieve
the conquest of Moscow, they perceived behind Napoleon,
only a band of spectres, covered with rags, women’s pelisses,
bits of carpet, or with dirty cloaks scorched and burnt by
the fire of the bivouacs, and with feet wrapped in the most
wretched tatters.”
Depression of mind favours the accession of many diseases.
This was noticed when the prevalence of fever
was under observation.
It has been remarked by Citois, that the colic of Devonshire
and Poutou attacks more particularly those families
who are suffering under that calamity.
160Disease frequently makes its first appearance when
friends and relatives assemble to pay the last marks of
respect at the funeral of the departed. I am acquainted
with several instances in which, shivering, tremors, and
sense of great debility, have suddenly supervened in men
in perfect health upon the “lifting” of the corpse, and
upon the “lowering” into the grave, moments in which
the hearts of many would seem to threaten to melt away,
and in which they have proved to be the primary symptoms
of fever; the other more violent and more dangerous
characteristics being duly developed. A man, named Stevenson,
died at Tranent last winter; the friends were assembled
in the house to attend the funeral; his brother arrived
from a distance, just as the body was about to be lifted,
went into the apartment, apprehended he smelt infection,
and instantly felt very ill. After having gone to the churchyard,
and returned home, he was immediately attacked
with sickness, which assumed the form of fever, and he
died in the course of a few days.
The following statement, made by Dr Paris, illustrates
well, how depression of mind, by affecting the system, promotes
the action of poison:—
“A patient had been taking mercurial medicine, and
using frictions for a considerable period, without any apparent
effect; under these circumstances, he was abruptly
told that he would fall a victim to his disease; the unhappy
man experienced an unusual shock at this opinion,
and in a few hours became violently salivated (that is,
became affected with the peculiar action of mercury on the
mouth).”
161
Besides the various causes of pestilence to which reference
has been made, there are many others connected with
peculiarities of climate, irrigation, soil, and habitudes of
nations, of which the limits of this work will not permit an
extended account. Of the peculiarities of climate, the most
important are the greater or less intensity of the sun’s rays.
It is found that much solar heat disposes to excessive action
of the liver, and hence it is that fever in tropical regions
is biliary; characterized by derangement of the biliary
organs, of which the liver is the principal; that fever in
the West Indies is yellow, a colour which proceeds from
the dissemination of the bile throughout the body. Few
persons who have remained long within the tropics are free
of disease of the liver, and this is well known to be a common,
nay, almost a universal complaint among soldiers
who have returned to this country after many years’ service
in those regions.
Another active agent in the production of disease in
these climates is the great fall of dew which takes place
between the setting and rising of the sun, and the extreme
degree of cold which attends it. The dew begins to fall as
soon as the sun gets below the horizon, and increases till
about an hour or two before dawn; the cold at that time
is extreme, more particularly felt on account of the great
heat which is experienced during the day. The cold is the
immediate cause of the falling of the dew, which is only
the water that was dissipated in vapour by the action of
the sun’s rays. The dew favours the action of the cold;
162and persons who are exposed to it, are in consequence frequently
attacked with disease.
Persons unaccustomed to the heat, and ignorant or regardless
of the consequences of exposure to the night air,
often suffer much, and become affected with the peculiar
distempers of the climate, in this manner: they lie down
on the ground scantily covered, while the sun is still above
the horizon, and make no provision for the cold and damp
of night which is sure to overtake them.
Persons go to bed also with too few clothes, being then
warm and oppressed with heat; in the night the dew falls,
the cold arrives, and they are often awakened with severe
rigors or shiverings; and thus fever, dysentery, and the
like disorders are induced.
The winds in all latitudes are often instrumental in the
production of disease. Some have been already referred to
in connexion with the conveyance of vitiated air. Some
are hurtful from their excessive heat, as, for instance, those
blowing directly off the burning deserts of Arabia and
of Africa. The Sirocco is not only extremely hot, but
is copiously loaded with aqueous vapour. It visits Italy,
blowing there several days at a time, and acts almost as a
vapour bath upon the inhabitants. The Sirocco blows off
the deserts of Africa, passing over the Mediterranean sea,
there imbibing a large quantity of water, converted into
vapour, and rushes upon the fair shores and degenerate
population of Italy. Its immediate effect is to relax the
system, and to open up all the pores on the surface of the
body. These effects are very hurtful to health, and become
particularly so, when they are long continued, as sometimes
163happens. But more dreadful are the results of exposure
of persons so situated, to the sudden action of an
intensely cold blast, such as the Tramontane, which, driving
from the northern side of the Alps and Pyrenees, passing
over their snow-capt summits, and sharing their bitterness
and frost, rushes, without warning, upon the inhabitants.
The tramontane is very cold, and acting upon persons
in a manner “forcing” in a hot house, soon produces pleurisies,
colds, consumptions, &c. &c.
These vicissitudes in Italy, and those which are wont
to occur in regions within the tropics, are much greater
than the variations of weather which are experienced in
the British Isles, and which are comparatively harmless;
or are hurtful, at least, in a much less degree.
In many countries the rivers periodically overflow their
banks and cover the surrounding territory. The Nile overflows
annually, and when the water has almost disappeared
by infiltration into the soil, and by evaporation,
and when that which is left is muddy, slimy, and mixed
with organized remains, exhalations arise, and a vitiated
atmosphere is produced, which is said by medical men,
who have lived upon the banks of that river, to be productive
of plague.
The territory again on the banks of the Canton river in
China, is almost constantly under water, and its fertility
is thereby much increased. The ground there is used for
the growth of rice which delights in a soil covered with
water. When the heat is intense, when the water contains
organized putrefying materials, and when the weather
is close, and the atmosphere is a little agitated, then
164vapours ascend which, mixing with the air, cause it to
be vitiated, and to be productive of malignant remittent
fever.
The habits of nations are also influential in the production
of disease. The privations and penances which devotees
endure are followed by a very hurtful influence on the
health, whether they be what are enjoined, or whether
they be voluntarily suffered, as they suppose, to conciliate
the favour of the Deity.
The diet, clothing, occupations, pleasures, government,
laws, social usages, genius, and ambition of nations, materially
influence their health, and give tendencies to particular
maladies; but interesting as the subject is, the investigation
cannot be pursued here.
165
It was shewn in the first part of this work, that the contagious
poisons of disease, such as the matter of small-pox,
are known to act in two modes only, first, by application
of the palpable matter itself to a person, or by contactual
contagion; secondly, by application of clothes or other such
substances, impregnated with that matter, forming what
has been styled fomitic or mediate contagion. It was also
shewn, that their action through the medium of the atmosphere,
has never been ascertained. Experiments were
detailed, which were performed on those poisons, to ascertain
their capability to become dissolved in the air, and
their evidence was as strong as it possibly could be, against
their possessing that attribute.
It was, in short, fully ascertained, that contagious diseases
do not propagate by atmospheric contagion.
Contagious diseases propagate among those who expose
their persons to contact with the matters or clothes impregnated
with them. There are many facts of an incontrovertible
166character, which prove the occasional operation
of the former mode at least, and to render probable, that of
the latter; and hence, whatever attention is paid to cleanliness
of the sick person, his apartment, and to the prevention
and removal of vitiated air, persons touching a
body, when there is present on its surface specific contagious
poison, such as the matter of small-pox, or even handling
clothes, which have become impregnated with it, incur
a risk of being affected with the same disease, by means
of that matter or fomitic contagion.
In all the contagious diseases (those in which there is
eliminated a palpable poison, or matter capable of causing
the same disease in others), their respective matters are
invariably formed, and are apt to propagate in the modes
specified, so that visitors and other attendants should ever
be upon their guard, the first not to touch the sick person
at all, and the latter not to touch more than is necessary,
and to take precaution to render the risk as slight as possible.
Subjoined is a list of diseases which are known to be
contagious, or to be possessed of a matter of the nature referred
to, and that are therefore wont to be propagated by
contact with the sick, or with his clothes.
Small-Pox.
Scarlet Fever.
Measles.
Chicken-Pox.
Cow-Pox.
Itch.
Plague.
Porrigo.
&c.
167These are almost the only diseases known in this country,
which are positively ascertained to be characterized by
the elimination of contagious matter, and which, therefore,
there is any risk of getting by contagion. The continued
fever of this country has been supposed, by some physicians,
to be a contagious disease, from there being sometimes
observed pimples on persons affected with it; but
that is by no means an ascertained point.
Those above enumerated seem to include all the most important
diseases in this country, which are capable of being
propagated by contagion, acting in either of the two ways
already described. Some of them are capable of affecting
the same individual only once, and some affect persons
as often as they are exposed to their specific contagious
matters.
How comparatively small, then, is the range of contagion,—an
agent which has been thought to accomplish
worlds of mischief, and to destroy almost whole communities.
Visitors may approach within a very short distance of
persons afflicted with these distempers, without danger
of suffering, provided they do not touch the bodies or the
clothes.
They have nothing to apprehend from the atmosphere,
if attention is paid to the maintenance of its purity,—such
as is necessary in other situations, as well as in the sick-room.
Never brought into that immediate contact with the
poisons which is necessary for their propagation, they stand
in need of no directions for their removal or counteraction.
168Those persons, on the other hand, who are called upon
to touch the patient and his clothes, are exposed to danger;
and they should lessen its amount, by instantly putting
their hands into warm water, and by freely washing
them, with the assistance of soap,—and that ablution
should be performed after each instance of contact.
I have often had occasion to feel the pulse of persons
ill of the worst forms of confluent and black small-pox,
and any risk that has thereby been incurred, has been
removed or remedied by immediately washing the hand as
directed.
In addition to washing, after that process is done, a
small quantity of a strong smelling liquid, such as Lavender
water or Eau de Cologne, should be poured into the
hands. Their grateful odour may hide or cover that of the
apartment, which the attendant may mistake for contagious
air, as is often done, and thereby remove groundless
apprehension. These seem to be the chief precautions that
are necessary for meeting the dangers of contagion, if there
is included what is sometimes used, viz. a covering for the
hand,—a glove and the like,—which, as being harmless,
and such as may possibly be useful, should be employed;
and likewise the avoiding of eating and drinking with the
same instruments and vessels used by the sick persons.
The propagation of disease by contagion, in the modes
already stated, though it can take place, and though it
sometimes does take place, still there are the strongest
grounds for supposing it a comparatively rare occurrence.
I have already shewn, at the beginning of this work,
that in one form, the atmospheric, contagion never operates,
169and I am now prepared to assert, that in the two forms
in which alone it can act, that the instances of its undoubted
agency are by no means nearly so common as they are
commonly believed to be, especially in connexion with
those acute diseases, accompanied with fever.
It is my belief, founded on much observation, study,
and reflection, that almost all cases of those contagious diseases,
arise from causes or circumstances connected with
those great agencies already detailed at full length, as inductive
of pestilence in general, and of a nature epidemic,
endemial, meteorological, and the like.
I am led to the opinion, that this course of origin, even
in contagious diseases, is the rule, and that the origin of
disease, by contagion, whether contactual or mediate, is
the exception. The grounds of this opinion are,—
1st, A fact well ascertained, and of which I had lately
two instances, in houses contiguous. Infants neither inoculated,
nor vaccinated, lie with their mothers and others
ill of small-pox, and do not take that distemper.
2d, Women, while labouring under small-pox, occasionally
bear children in perfect health.
The above are common occurrences, and I am in possession
of the particulars of several which came under my
own observation in the beginning of 1838.
These cases prove the occasional, nay, the frequent inactivity
of contagious poison, even when applied in a palpable
form, and in a recent condition, to the bodies even
of those who are not protected against its operation by inoculation
for cow or small-pox, or by a previous attack of
disease; and this inactivity is observed too, when the
170most ample opportunity is afforded for the action of the
poison, viz. while children are asleep together in the same
bed, and when infants are upon the breast of mothers affected
with small-pox.
Those very children who thus escape taking disease by
contagion, are frequently known to be seized with that
identical disease, at some future time, varying from months
to years, when no other case is known to exist in the
neighbourhood, and where there is no room to suspect the
operation of contagion.
It is, I believe, as common as the contrary course, for
small-pox, and other reputed contagious diseases, after appearing
in one house in a town or hamlet, to break out in
others at a distance and in different directions, and not
to progress from that which was first attacked to those
lying adjacent, or to spread around as from a centre.
For example, the first case of Typhus Fever which occurred
in my practice, in January 1839, was at Meadow
Mill, a village half a mile north of Tranent; the second
case was at a hamlet called Redcoll, about four miles east;
the fourth and fifth cases occurred in Tranent; while the
sixth and last for that month appeared at Elphinstone, a
village situated about two miles to the south-west of Tranent.
I am led also to the opinion, that the ordinary cases,
even of those diseases which are known to be occasionally
propagated by contagious poison, do not arise from contagion,
but from other circumstances and agencies; by the
history of the plague, for while that scourge is ravaging in
the East, and destroying hundreds daily, it frequently
171ceases, immediately upon the overflowing of the Nile,
which buries and covers the pestiferous soil, and the putrefying
materials which had been exhaling noxious emanations.
This sudden departure or cessation of plague, upon the
overflowing of the Nile, proves that contagion, though it
may be the cause of some cases of that disease, is not the
occasion of the vast majority,—the great mass of cases, in
short, which constitute the Epidemic; and goes far to
prove that distemper to be dependent upon an unwholesome
condition of the soil, or vitiated atmosphere, and other
widely extended and unwholesome agencies, of a nature
totally different from specific contagious poison.
That fact goes to prove, in reference to one disease, viz.
Plague, what I believe holds with all other contagious
distempers, that contagion, at most, is only an occasional,
while such influences as those to which reference has been
made, are the constant and general causes of sickness.
172
The important part which vitiated air enacts in the
production of many forms of disease, has been already fully
shewn; and it must be admitted, that whatever has for
its objects the prevention and correction of that principle,
is deserving of attention.
By preventing the production, and by removing vitiated
air when already formed, a vast amount of disease may be
arrested, and much of that benefit will actually be accomplished,
which it was boldly but fallaciously pronounced
would revert from many absurd measures which were
adopted, and which are still recommended for the avoidance
of contagion, and would realize almost all the advantages
which Quarantine Regulations, and the most efficient
systems of Contagion Police can or propose to afford; and
that, too, at no inconvenience to individuals, no restraint
upon communication, after certain processes of purification
have been undergone, and no ruinous hindrance of commercial
transactions.
The various sources of vitiated air have been already
noted. Some of them are beyond any present remedy, as
the unwholesome condition of the surface of the earth in
173many regions, within the tropics, for whose correction or
improvement, time, capital, enterprise, labour, and perhaps
new climates, are essential. To that source of vitiated
air, draining, cutting down superabundant wood,
embanking rivers, reclaiming partially inundated land, and
cultivation, must be applied before the emanations which
infest these situations can be prevented from arising.
Another source of vitiated air is, men being crowded together
in close and confined apartments, where no attention
is paid to the preservation of cleanliness and the removal
of impurities, as in some jails and other places for the confinement
of criminals.
That source of vitiated air is particularly worthy of notice
here, because a very common form of disease which it
induces is what is well known as Jail or Contagious Fever.
The means for the prevention of this form of vitiated
air are obvious. Large, airy, well ventilated and lofty
apartments are essential, if many persons must be put together;
and, where that is not necessary, it is advisable
to have them separated in several different chambers,
where due ventilation is strictly maintained, by retaining
the windows more or less open through the day, or by
other equally effective means.
By the sleeping of many persons in one apartment, the
atmosphere is deprived to a great extent of its more vital
fluid, and becomes unfit to support respiration in its integrity;
and the health of the inmates is not unfrequently
injured in consequence. The sleeping of many persons in
one bed-room, therefore, should be avoided, where it is
possible; but, where that is not practicable, it becomes
174necessary to lessen the evil consequences, and this may be
done by keeping a door or window partially open during
the night, when the weather is not too inclement to forbid
that procedure.
At all times, exhalations to a great extent are proceeding
from the bodies of men; and, where individuals are
much confined to one apartment, and where that is small,
close, and ill ventilated, they fasten or adhere to the furniture,
curtains, carpets, and the very walls. During sleep, the
amount of these exhalations, it would appear, is increased.
It is then that the pores of the entire system, as well upon
the internal as the external surfaces, are most freely laid
open, and that they pour forth their respective fluids most
abundantly. The quantity of watery vapour which issues
during sleep from the lungs is prodigious; and the large
quantity of water which is sometimes seen collected on the
panes of windows in the morning, and which is condensed
vapour, affords some idea of the vast quantity of fluid
which is exhaled during sleep. With this watery vapour,
other ingredients of a hurtful nature are conjoined, and,
like it, adhere to the furniture and clothes. When these
exhalations are permitted to remain, they impart to the
room a disagreeable odour, cause the bed-clothes to be damp
and unwholesome, which, with the progress of fermentation,
at length emit offensive effluvia. In order to avoid these
hurtful consequences, the following measures should be
adopted. When the bed-room is left in the morning, the
window or windows should be opened, and the bed-clothes
freely exposed to the air for some time: the constant passing
of fresh air over the clothes and through the apartment,
175will shortly carry off the greater part of the exhalations
which may have adhered.
The window should be left open during a part of the
day, if the atmosphere without is not particularly damp,
as the removal of impurities, when they have adhered to
solid bodies, is not effected at once, or so immediately as
is generally believed.
Exhalations of a very hurtful nature proceed also from
excretions, which should be removed immediately, certainly
before fermentation can have proceeded to any considerable
length.
The furniture of bed-rooms requires special care. The
various processes of rubbing, washing, and scouring, should
be frequently repeated; and articles, such as bed and
window curtains, should be oftener in the washing-tub
than is dreamt of by many very careful housekeepers, and
when they are composed of fabrics of a nature to forbid
contact with soap and water, the necessary purification
may be effected, at least in a partial manner, by occasional
exposure to the wind in the open air.
In those apartments in which the sick are contained,
the atmosphere is particularly liable to become vitiated
from the exhalations of the body, and from the excretions
being in general more disposed to be virulent than those of
persons in health.
The necessity for a constant supply of pure air is, if
possible, increased, and the utmost care and attention is
demanded, in order that this may be duly provided. In
large hospitals for the reception of sick, ventilation becomes
a point of the most important nature; and, when
176efficiently established, is entitled to be considered one of
the most powerful remedies which can be obtained to
check the progress of disease, and to promote recovery,
when that is once established.
Various methods have been devised to promote ventilation
in hospitals, which it is unnecessary to describe here;
for this reason, as well as others, that the importance of
ventilation is too well understood by medical men, for
them not to enforce it in establishments of which they
have the management.
During sickness in private houses, ventilation cannot be
too much enforced. When the weather will permit, one window
at least should be partially opened, pulled down, if possible,
during the summer. In winter, the door of the apartment
should be left open for a short time occasionally; and,
if the chamber is not very small, a fire may be used, which
will not only remove the cutting dullness of the air, but
will also ensure a constant change of the atmosphere, from
the ventilation which it causes.
In some forms of disease, as in the “Sweating Sickness
of England,”—the typhus fever, the skin is wont to become
covered with perspiration, which is particularly prone
to undergo putrefaction. To obviate that putrefaction, and
to prevent the formation of effluvia, it is proper to wash
the skin of the patient, in almost every form of disease,
with soap and warm water, which will purify that important
organ, and assist in rectifying its functions. Where
the character of the disease is putrid, sponging the skin
with vinegar and water, either warm or cold, should be
adopted, and is often of the greatest use.
177All impurities should be removed from the sick-room,
as they are liable to vitiate the atmosphere; and all
clothes and utensils which have been used by the patient
should be immediately put among warm water, and left
there till a convenient season occur for their being thoroughly
cleansed.
When the patient is in a state to bear the fatigue of
being removed for part of the day to another chamber, advantage
should be taken of his absence from his bed-room,
to ventilate the apartment, by throwing open the doors
and windows, to expose his bed and body clothes to the
free action of the air, and to cover the sickly smell frequently
present in sick chambers, by the burning or dissemination
of some fragrant substance in the atmosphere.
The effluvia which are wont to arise in sick-rooms, are
sometimes so very strong, especially where little attention
is paid to cleanliness and ventilation, as to fasten most tenaciously
to the contents of the apartments, and to impart
to them a most disagreeable and sickly odour, not immediately
removeable upon the establishment of currents of
air obtained by opening the doors and windows.
These effluvia, for the most part, are cognizable to the
organ of smell, and they have long been, and are still,
vaguely designated “Contagion,” “Infection,” and the
like.
Where effluvia are not recognised by the organ of smell,
there are many good reasons for believing, notwithstanding
178that circumstance, that they may be present in rooms which
contain, and which have lately contained, sick persons.
Well authenticated cases are on record, where persons
in health have inhabited apartments which, at a former
period, contained sick persons, and have been attacked
with disease in such a manner as to leave little doubt of
the presence of unwholesome effluvia, and of their having
been the efficient agency in the production of the evil.
These instances have occurred, where it is impossible to
suppose that the effluvia could have been commingled with
the atmosphere during the whole interval, often amounting
to years, from the period of the removal of the sick,
to that of the taking up of their abode there by those who
have suffered.
The period during which the apartment has been uninhabited
has, on many occasions, been too long to admit of
the opinion that the atmosphere has not been again and
again changed. It would therefore appear, that not only
the atmosphere becomes infested, on those occasions, with
effluvia, but that the walls, the furniture, and the floors
may likewise become impregnated with them.
It is consonant with experience to admit, that solid bodies
occasionally combine with, or imbibe, or attract gasiform
products, or that aeriform or vaporic agents adhere to
solid substances.
The opinion may be entertained, that the effluvia of sick
rooms may fasten to the furniture, &c., and in that situation,
even where ventilation is maintained, form centres
from whence they may be disengaged, either constantly,
for a long period, or only on occasions which are particularly
179favourable for their redissemination in the atmosphere.
It is common to designate these effluvia primarily disseminated
in the atmosphere, and the vitiated air which
is formed in old fever and plague wards, and to which reference
has just been made, Contagion, without any other
term to mark the distinction between these principles and
those which are legitimately so called. In a previous part
of this work, the distinction has been carefully made, and
it was shewn that the effluvia under discussion do not
form, strictly speaking, a contagious, but only a vitiated
atmosphere.
As it appears that effluvia which arise from the bodies,
and the excretions of the sick, do not only mingle with the
atmosphere, but also adhere to furniture, walls, &c., when
concentrated and long exhaled, it becomes necessary not
only to remove that atmosphere in which they are disseminated,
but also to adopt means for the purification of all
those bodies to which they may adhere, in order that the
atmosphere may not become again and again loaded with
them, arising, as they may, from the places to which they
are adhering.
The means best calculated to obtain that end, are those
processes to which reference was made above, viz. rubbing,
scouring, washing, and exposing to the free action of the
air.
But besides these means of purification, there are others,
as fumigations, which are calculated to be highly useful,
and which should be used on all occasions of severe general
disease.
180Fumigations are vapours of an elastic nature, permanent
and non-permanent. They are diffused through the atmosphere,
and impart to it their peculiar odours.
They are highly useful. In the first place, there is
reason to believe that they, especially the more active,
may decompose the effluvia which are mingled with the
atmosphere, and which are adhering to solid bodies, all of
which they can be made to reach and act upon, and even
to penetrate where the scrubbing-brush and hot water
cannot be applied; in the second place, they insure a
change of atmosphere; and, in the third place, they effectually
cover or hide the smell of the sick-room, which is
at all times highly disagreeable, and which is often regarded
with great terror and apprehension, being ever associated
with ideas of contagion and disease;—and in this way,
fumigations are found of very great value, giving, at the
same time confidence to the timid, and affording something
different from what contagion is commonly thought to be,
on which the organ of smell may be safely exercised.
Some fumigations are produced by the volatilization of
solid bodies, as camphor and carbonate of ammonia, or sal
volatile;—some by the volatilization of liquids, such as
vinegar, pyroligneous acid, and the various essential oils,
as cinnamon, rose, thyme, mint, pennyroyal, carraway,
and turpentine, while others are permanently elastic fluids
or gases, as muriatic acid gas, chlorine, and ammonia.
The first-mentioned substances, viz. camphor and ammonia,
are not very strong, and may be disseminated through
the apartment of the patient, even when he is present,
without giving him any uneasiness. Carried about with
181those who visit the sick, and who are apprehensive of contagion,
they are useful by affording a grateful odour, which
hides disagreeable taints, and perhaps it is in that way
chiefly that they are useful.
The liquids which have been named above, have been
long used for the purposes of fumigation, and in general,
they may be employed even in the presence of the patient.
A few of them may possibly decompose effluvia, but there
is much reason to think that they are useful, for the most
part, by hiding ungrateful odours, and imparting to the
atmosphere, which is liable to be suspected as unwholesome,
a delightful fragrance.
Vinegar is much used for the purpose, and with very
considerable benefit, and is therefore to be employed.
The essential oils are capable of being diffused throughout
the air, and with the assistance of heat, are often made
available for the purpose of covering odours. When they
are to be used, the oils should be poured upon a piece of
live coal, held in the middle of the apartment; they are
then immediately converted into vapour. In like manner,
vinegar and the other volatile liquids may be disseminated
through the atmosphere.
The oils, the vegetable substances in which they are contained,
tar and the like, are occasionally burnt with the
same intention, and sometimes with advantage.
The incense so much used by the ancients, was procured
for the most part by the burning of the vegetable
substances in which these essential and fragrant oils resided,
by which part of them is diffused in vapour.
The ostensible and pretended object of the priests, in
182offering up incense, while that and other religious rites were
performing over the bodies of deceased persons, was the
conciliation and propitiation of the Deity. But while this
was the sole ostensible object of the priests, and that which
was held by the people, as the only and exclusive purpose
proposed, there is good reason to believe that the offering
up of incense, like many other observances of religion, had
its temporal, and worldly, as well as spiritual ends; and
that the sweet smelling odours, which were thought would
be so grateful to Heaven, were, on those occasions, used in
no small degree, as so many fumigations, to defend the
pious and resigned priests from the effluvia of the dead
body, and the consequent corruption of the atmosphere.
The use of fumigations, in a disguised form, was perhaps
rendered necessary, as the purpose of purifying the
atmosphere, might have seemed to cast reflections or imputations
on the dead, which the vile, barbarous, and superstitious
people, especially relatives, might have resented
with acts of violence, or which might have thrown priest-craft
into contempt and abhorrence.
Perhaps it was in reference to this matter, as it was in
many others of graver import, that the ignorant and superstitious
condition of the people on the one hand, and
the cunning, subtlety, despotism, and superior knowledge
of the ministers of religion on the other, in early times,
made it convenient that certain ends, thought to be desirable,
should be accomplished without reasons, explanations,
or intentions being given.
There is, then, reason to believe, that the burning of oils
183and other fragrant substances, was used in very early
times to purify the atmosphere from the effluvia of dead
bodies.
The products of the combustion of essential oils, tar,
pitch, and the like, are carbonic acid gas and watery vapour,
which, there is reason to think, cannot be useful in
purifying the air, or in neutralizing hurtful effluvia.
The permanently elastic gases which are used as fumigations,
are the most potent agents of the kind, and they
are generally used, and with much propriety and advantage,
in all cases where disease is of a putrid character,
and where, in short, the atmosphere is likely to be vitiated
to a great extent. They form also the most useful
fumigations for the purpose of purifying the atmosphere,
and the walls and furniture of apartments lately inhabited
by the sick, and their employment, in such cases, should
never be neglected, even when there is no great reason to
apprehend vitiation of the atmosphere, for when advantage
is doubtful, there can exist no possibility of detriment.
The agent now most commonly employed, is chlorine gas,
and it is perhaps the most efficient in the list of fumigations.
Chlorine gas has a greenish colour, and a most disagreeable
and suffocating odour. Water impregnated with it,
has the property of destroying colours, and chlorine is, on
that account, much employed in bleaching, in the forms of
“Bleaching Powder” and “Tennant’s Powder.”
When chlorine gas is disseminated through an apartment,
any stench, however strong and intolerable, which
may have been present there, is no longer perceptible, the
184odour of the chlorine taking its place, or so completely
covering it, as to render it no longer cognisable to the
senses.
Chlorine gas is employed both alone, and in combination
with other bodies, as lime and soda.
In combination with these alkalis, chlorine forms the
chlorides of lime and soda. The former is well known in
this country, and the latter, when dissolved in water,
forms the “Liqueur disinfectante” of Monsieur Labarraque,
which is much celebrated on the Continent.
The solutions of these salts in water, are sprinkled occasionally
through the apartments which are to be purified.
When these solutions are sprinkled about, and exposed
to the action of the air, the chlorine escapes in its gaseous
form and mingles with the atmosphere, while the lime and
soda, which are now uncombined, attract and unite with
any carbonic acid which may have arisen from the patient,
his clothes, or excretions.
The solution of chloride or chloruret of lime, answers
sufficiently well, but as it is to be obtained in all drug
shops, it is unnecessary to add here a formula for its preparation.
Take three parts of common salt, one of black oxide of
manganese, and three of strong oil of vitriol. Mix the salt
and the oxide together in a stoppered retort, pour in the
oil of vitriol and apply a gentle heat. The gas is immediately
evolved, and rapidly diffuses itself throughout the
185atmosphere. Muriatic acid gas, a combination of chlorine
and hydrogen gases, though considered as inferior to chlorine
as a fumigation, is frequently employed for the purpose
of decomposing effluvia, as the materials for its preparation
are almost ever at hand.
Put a handful of common salt previously made very hot
into a saucer, and pour over it an ounce of strong oil of
vitriol. The gas is immediately extricated.
It has been already said that the fumigations just noticed
are on many occasions highly useful, and their employment
is much recommended in all situations where the
atmosphere is liable to be contaminated by effluvia from
sick persons or from dead bodies; but it is not therefore
to be understood that, because the use of these agents has
been advocated, it is for the purpose of destroying atmospheric
contagion, of decomposing the specific animal poisons
which have been supposed to be present, and dissolved
in the atmosphere, which is the object, or one of the objects,
held in view by the generality of those who advise the use
of fumigations. These fumigations have been recommended
with the view of correcting what has been treated of as
vitiated air, which is distinct from, but which has long
been erroneously regarded as, Atmospheric Contagion. On
some occasions, great fires of wood, coal, pitch, gunpowder,
and the like, have been recommended for the purpose of
destroying contagion and purifying the atmosphere. During
the prevalence of the plague in London, great fires
186were kindled in the streets, and, according to some historians,
with considerable benefit.
Such great fires produce great agitation of the atmosphere,
and it is possible that in this way they may prove
useful in improving the condition of that fluid, particularly
when, as happened occasionally during the visitations of
plague in London, the weather is sultry and close, and
when the atmosphere is confined and little agitated, and
allowed almost to stagnate.
There is much reason to think that the agitation of the
ocean, by its waves and tides, is not more favourable to
the preservation of the purity of its waters, than the movement
of the atmosphere, by winds and currents, is to
the maintenance of its wholesome condition, and when
this is lost, to restore it; and in the absence of winds,
and when pestilence is raging, the use of combustion on a
large scale may with advantage be adopted; but in this
climate, where the weather is seldom long calm, the occasions
for the employment of that agency can be very rare
indeed.
Heat is much used for the purpose of dissipating effluvia,
and purifying goods, clothes, letters, &c., which are supposed
to be impregnated with contagious matter, or other
unwholesome impurities; and there is good evidence to
shew that this agent is perhaps the most powerful instrument
which is ever employed for the purpose in question.
Heat when applied to an atmosphere containing effluvia
will rarefy it, cause it to become lighter, and dissipate it,
amid the atmosphere above, where any opportunity is
afforded for its egress; and when the heat is employed
187in the sick chamber, much good is effected by the dissipation
of the damp and condensed vapour which cannot fail
to be frequently present in that situation.
In the sick chamber, the presence of a fire for even an
hour daily is highly useful where there is little opportunity
for ventilation, and when the external atmosphere is
damp and motionless, for the heat issuing from it, will dislodge
and dissipate any effluvia which may have become
condensed, and have fastened on the furniture of the apartment.
The condensation of effluvia, &c., is thus depicted in
the “Mussulman.” The apartment is that of a prison.
—— The pestiferous breath of the surviving was
mingled with the effluvia from the dead, and the empoisoned
exhalation was condensed on the damp walls, and
was seen trickling down in drops of poison to the ground.[10]
Heat, when applied to clothes which are impregnated
with specific contagious matter, or merely impurities or
condensed effluvia, is calculated to be highly useful, and
where washing cannot be adopted, should never be neglected.
Clothes which are thus tainted will be deprived in a
great measure of their power of doing mischief, by placing
them before a fire for a considerable time, for there is good
reason to think that specific contagious poisons will be decomposed,
and it is ascertained that condensed effluvia may
be dissipated by the application of a smart heat.
The following experiment will at once illustrate the property
which some bodies possess of absorbing effluvia from
the atmosphere, and prove the influence of heat in again
188expelling and dissipating them. Pure sand, exposed to a
red heat to drive off impurities, was put amidst tainted
air. Put into a glass tube and exposed to a spirit lamp,
it yielded ammonia or hartshorn,—a product of putrefaction
which the sand had undoubtedly absorbed from the
tainted atmosphere. Ammonia is a compound of nitrogen
and hydrogen, gases which are evolved during the putrefaction
of animal materials.
The investigation of the means by which persons, merchandize,
clothes, letters, &c., may be most speedily and
most effectually freed from effluvia, contagion, and other
unwholesome impurities, is a most important point, for it
relates to the most vital interests of society, commerce,
freedom of intercourse, personal liberty, and the safety and
health of the community. But from the very important considerations
with which the investigation is connected, the
merits of the respective means employed for the purpose
will not be treated of here, as they deserve a more extended
consideration than can be given. In the mean time it
would be highly dangerous and impolitic, to adopt any
great and rash change in a system so important as quarantine,
until the most full and sound inquiry has been made
upon the subject. Public safety demands the utmost caution.
There may exist great diversity of opinion respecting
the nature of the impurities with which merchandize and
clothes are sometimes impregnated, on the period during
which they retain their activity, and on the means of purification;
but it has been often clearly demonstrated, that
specific contagious matter, or virus, and effluvia, may be
189conveyed by these bodies, may be retained for a considerable
time, and, on a favourable opportunity, produce very
hurtful effects.
The impurities may be variously designated, yet their
unwholesome tendency is much the same, and it is necessary
to adopt provisions to counteract it.
190
In the Chapters which have been dedicated to the subject
of Vitiated Air, its sources were pointed out in a general
manner, and it is intended to consider those usages in
society, certain conditions of towns and houses, and some
other circumstances, which favour the production of an impure
and unwholesome atmosphere, and this will be done
with the hope that a knowledge of their hurtful tendency
may lead to their correction.
The disposal of the dead will be first considered.
As soon as the life of man is extinct, his body becomes
the seat of chemical decomposition or putrefaction, and
effluvia are exhaled from the putrid corpse, varying in
some degree, in amount, rapidity, and activity, according
as the circumstances in which it is placed are more or less
favourable to putrefaction.
The effluvia which are exhaled are deleterious, and an
atmosphere in which they are evolved, if close, small, and
191confined, often becomes so contaminated and vitiated as to
be calculated to produce death by suffocation and disease.
The body of man after death is thus a centre of putrefaction,
and the source of agencies prejudicial to the living,
and on that account alone, it is wise so to dispose of the
dead that they may not prove hurtful to the surviving,
which has been done with more or less efficiency from the
very earliest epochs of time, by various forms of burial.
But solicitude for the safety of the living has not been
the only motive for the burial of the dead, for the destiny
of man after death is clearly pointed out, and his doom to
the earth is amply shewn by various expressions contained
in the Holy Writings, and his burial or interment has
been performed in obedience to the original or divine plan.
The interment or burial of the dead has likewise been
considered as a rite due to the memory of the deceased,
and a mark of respect which the friends and relatives were
bound by every sacred obligation, to perform with all becoming
solemnity.
To neglect the sacred office of interment, or any of the
solemnities usually in practice, was, even among the earliest
Greeks and Romans, to treat the memory of the departed
with the grossest disrespect and indignity.
The denial of burial, with all its formalities, was esteemed
by the Greeks as a mark of infamy due only to villains,
traitors to their country, and those who died in debt, and
the bodies of such characters were accordingly decreed unfit
for ordinary interment.
The Jews interred the bodies of the dead for the most
part contiguous to the high ways, in gardens, and on hills.
192The Greeks and Romans interred their dead in the ground
which surrounded their sacred buildings, and at the gates
and porticoes of their temples.
The Saxons, Danes, and other Scandinavian nations, enclosed
the bodies of the deceased in stone coffins, which
were placed or built at the distance of two or three feet
from the surface of the earth.
At this day, these stone coffins are occasionally discovered
at a little depth from the surface. Some such
coffins were lately discovered in the parish of Gladsmuir,
in East Lothian, by the coulter of the plough coming in
contact with them. On examination, the coffins were
found to be only a foot and a half below the earth’s surface:—they
were about five feet long, and were composed
of several stones fitted together, or built up. Within were
found human bones of the adult size, quite entire in figure,
but so friable, as to fall to powder along with the clay in
which they were imbedded, on being handled. The vertebræ
or bones of the spine, which are at present in my
possession, present the same accuracy of outline to be found
in the recent skeleton.
The situation at which these coffins were found, is the
very summit of Seton Hill, a point which commands a
view of the surrounding country to a very great extent,
and of the Forth, from its mouth to its meanderings in
Stirlingshire, and which there is much reason to think,
may have been at a very early time, a Danish or Saxon
encampment.
The Hindoos dispose of their dead or dying by throwing
them into the Ganges, where they rot and decompose.
193In this country the dead are interred at a much greater
distance from the surface than was practised by the Scandinavian
nations, generally at the depth of five, six, or
eight feet, and sometimes even more.
After death, corpses are usually kept several days before
interment, and as the temperature of this climate is
seldom very great, bad effects are very seldom experienced,
and in that respect, Britain is very unlike some tropical
regions, where, almost as soon as death has taken place, it
becomes necessary to bury the bodies of the deceased in
order to avoid the noxious vapours, which are immediately
emitted.
During the time the corpse is kept before interment,
attention should be paid to secure a full and frequent
change of air, which is best obtained by keeping the windows
partly open, by volatilizing vinegar, or by sprinkling
the apartment occasionally with the solution of chloride of
lime.
The mode of burial of the present time, which is practised
in this country, is, partly from accidental circumstances,
a great improvement upon that which was in use
by our ancestors; for there is much reason to think that
effluvia, proceeding from dead bodies, may percolate or be
strained through a covering of soil of only two or three
feet, which may be completely confined by one of earth and
stones of five or six feet in depth. The great depth to
which graves are now dug, originated not so much with
the view of preventing the percolation of effluvia, as with
the intention of embarrassing the operations of the bodysnatcher,
whose violation of tombs is now happily at an
194end. But though there now remains no occasion for adopting
measures for that purpose, the good practice of deep
burial to which that evil gave rise should not be allowed
to go into desuetude from the absence of those circumstances
which called it into existence.
It is agreeable to information which has been gathered
from various sources, to state, that effluvia may and do
penetrate through the loose soil and other materials of
churchyards, when the body is placed within three feet of
the surface of the earth.
With that covering, effluvia do not escape in large quantities
at a time, so as to produce very serious and instantaneous
effects; yet a small amount may percolate from time
to time, which, by acting constantly, without intermission,
may be the mean of deteriorating or undermining the
health of those persons who live in their immediate neighbourhood,
and more especially if the situation be one
which is not readily accessible to winds and currents.
It is stated by grave-diggers, that when a body is interred
in a grave five or six feet deep, the effluvia do not
reach the surface; so that it is evident that deep graves
are much less dangerous to the living, and should be
adopted in preference to those which are shallow. It is
much to be desired, that no more burying-grounds should
be opened or formed in the heart of towns, and that those
which are at present in use, in such situations, be entirely
closed against the admission of more bodies, and that cemeteries
be opened at some distance from the habitations
of men.
Every good purpose which is at present obtained from
195the burial-grounds situated in towns, might be also procured
from cemeteries placed at a little distance in the
country; and many disadvantages might be avoided in the
latter situation, which attend burial-grounds in densely
populated situations.
One great advantage to be obtained from exurban cemeteries,
is the freedom which the population would enjoy
from those exhalations which must ever arise, in a
greater or less degree, from overcrowded burial-grounds
which have, for any considerable time, received the remains
of the dead, and a consequent improved state of health.
Deep graves may for a time prove a security against
effluvia, but a day must come when these graves will be
opened, and when their contents, perhaps not yet totally
assimilated with the surrounding clay,—not yet completely
deanimalized,—will be thrown to the surface, and mingled
with the soil, there to finish the process of decomposition,
and there to vitiate the atmosphere.
The burial-grounds of our densely populated towns are
actually supersaturated, if such an expression can be used,
with the partially decomposed remains of mortality, which
have not yet had time to be assimilated with the earth, or
to be “ripe,” as the grave-digger would say.
In general, also, those burial-grounds are so small and
ill-proportioned to the wants of the population, that it is
necessary to open graves, and heap body upon body, until
they reach to within a very short distance of the surface,
or to clear the ground of its contents while they are yet
green, in order to procure a place of rest for other bodies.
Such is occasionally the scarcity of ground, small though
196that space be which will suffice for any one individual,
that ere a few short years have rolled away, the intrusive
spade of the indifferent sexton disturbs the grave, perhaps
of a friend,—that place where peace was promised and
through life expected;—his ashes are rudely handled, and
his bones, not yet denuded of their flesh, are cast without
remorse amidst the rubbish;—and thus the best feelings
of humanity are outraged, and the human heart, already
wrung with anguish, is crushed or cruelly lacerated.
It will perhaps be urged in reply, that the vicinity of
burial-grounds in the large towns of Great Britain are not
more unhealthy than other quarters.
But the answer to this is, that no extended and minute
inquiry has been instituted on the subject; that though
the absolute amount of disease may not be increased
(which, however, has not been shewn), still, a part of the
disease which does occur, may arise from the operation of
the emanation from the burial-grounds; and, lastly, it
must be obvious to all who are sensible of the advantage
of a pure atmosphere, that the effluvia which necessarily
prevail in those situations, must be prejudicial to
health, whether it be in an amount, or intensity, or mode,
to admit of the detection of the relation between them,
as cause and effect.
If, perchance, in some instances, no prejudicial influence
is exerted upon the health of persons inhabiting the neighbourhood
of burial-grounds, that fortunate immunity from
the ordinary effects of effluvia arising from decomposing
animal remains, accumulated in large quantities, is to be
attributed, not to the innocence or innocuous nature of the
197emanations, but to the wholesome influence of winds and
currents, in securing a constant supply of pure air, and
which prevent the accumulation of these gaseous poisons
in quantities sufficient to produce the bad effects which are
commonly experienced in situations where they are much
concentrated. It is almost impossible to adopt measures
which will completely prevent the admission of effluvia
from burial-grounds into the atmosphere, and it were therefore
wise that the evil, a necessary one as it would appear
to be, should be made to exist where it is least likely to
do harm,—and that situation is certainly in the country,
in the open fields, where there are few or no houses.
It is to be hoped that the subject of exurban cemeteries
will shortly obtain the consideration of the government
of this country, and of the magistrates of the various
towns,—as it involves interests of the most important nature.
Several large towns have already cemeteries at a little
distance in the fields; and among others, Glasgow has its
City of the Dead, or Necropolis, as it is styled, which is
situated on a height adjoining the town.
Paris, the capital of that country which has produced
many of the most eminent chemists, has not been tardy
to avail itself of the light which their philosophers have
thrown upon the composition of animal bodies, and the
chemical constitution of the atmosphere. That capital
boasts a magnificent cemetery, called Pere la Chaise, which
is situated at a little distance in the open country.
Pere la Chaise is becoming, as the Place of Rest of the
198dead, worthy to hold the ashes of departed mortality.
There the bodies of men can in no way be hurtful to
the health of those who survive; there, now incapable of
being useful, they are at least harmless to that community of
which they lately formed a part. There the silence—the
proper silence—of the tomb is maintained; there a serenity
of aspect exists, which comports well with the solemn,
the quiescent state of its inhabitants; and there is a
cheerfulness, and a beauty, aye a brightness, of a softened,
and a mellowed kind, which seem to refer to the pure enjoyments
of the promised land. There, as in the burial-grounds
situated in our thickly populated towns, there is
no obvious and striking unwholesomeness, no offensive and
humiliating appearance of mortal remains, to deter from a
casual glance, or from entrance on the part of the friends
and relatives of the departed. On the contrary, in Pere
la Chaise, they are invited and allured by the softened
and chastened beauty of the place, and there, without endangering
their health from close and vitiated air, they
linger by the ashes of the dead, and revolve those solemn
thoughts, so wholesome and so heavenward bending to the
soul;—there the bereft parent is seen giving the reins to
his feelings, fondly recalling cherished associations, and
there he is learning to hear unappalled that he must share
a like fate with that of the object whose grave he now regards;—there
may be seen the orphan, come to shed the
tear of filial love over the manes of his departed parents,
reviving ties and affections which are too liable to be entirely
worn away by youthful enjoyment, and the various
unsubstantial fascinations of the world;—and there he
199learns that most useful and wholesome lesson, to look with
complacence, if not with prospective joy, on death and its
silent abode,—to divest himself of that dread and horror
often excited by these ideas, and which, alas, too frequently
drive the young from such considerations altogether.
In Pere la Chaise, a murmur is heard proceeding from
the town, and the impression made upon the mind is,
that the world is receding, that the noise, mirth, and tumult
of man is vanishing away, and that, in short, the reign
of death has commenced,—the reign of death, solemn but
not terrific.
How different is the abode of the dead in the bustling
commercial towns of Britain. Here, solemnity is incongruously
enough and offensively mixed up with the noise
and bustle of every-day concerns of men bent on business
or pleasure. Reflections on eternity are here interrupted,
perhaps by the music, or rather the ungrateful noise, of a
musical instrument being played in an adjoining street, the
rolling of carriages, the trampling of horses, the smacking
of whips, and the indecent oaths of waggoners;—while
in another street, or fashionable promenade, which the
eyes of the mournful visitor of the abode of death cannot
possibly avoid, the ill comporting sight is seen, fine
ladies and still finer gentlemen laughing and tittering,
busied with fantastic displays. ’Tis an ill-assorted scene,
’tis Nature burlesqued beside humanity defunct.
But the improvement in burial-grounds is urged, not on
the plea of feelings and sentiments, but on that of public
utility and general health.
200
Until within a comparatively short period, the large
towns of this country were kept in a very unclean condition,
from the accumulation of impurities; and the consequence
was, that there prevailed a vitiated and most offensive
atmosphere, which often proved hurtful to the
health of the inhabitants.
Habits of cleanliness, and proper notions of domestic
comfort have made rapid progress of late years, and fortunately
all classes of the community enjoy clean and wholesome
apartments and streets, compared with those occupied
by their ancestors of a century back; and families at
the present day, who belong to the middle class of society,
have the advantage of greater cleanliness, both of house
and locality, than was then enjoyed by persons of the
higher classes.
In many large towns an admirable system of cleansing
is maintained, by which the removal of impurities is insured,
which might taint the atmosphere. The laudable
endeavours of the magistrates for this purpose, have uniformly
met that ready cooperation from the more respectable
portion of the inhabitants which they so well merit;
but with the lowest classes, whose ideas are too coarse to
permit their recognising danger in such things as uncleanliness
and impure air, the suggestions of philanthropic individuals,
and the exertions of authority, have failed, in a
great degree, to produce that wholesome condition of
houses and localities which is so desirable.
Much uncleanliness still prevails in some streets in
201those quarters of towns occupied by the labouring population,
which proves the source of many effluvia, which
again, it is probable, assist much in the production of the
great amount of disease which is wont to prevail in those
parts.
There is reason to fear that a considerable proportion of
the lowest classes in all large towns is too much degraded
to give themselves any concern about lessening the tendencies
to disease, or to put themselves to any trouble to remove
impurities, further than is absolutely necessary for
their own convenience; but, in such instances, the authority
of the law should interfere, and compel compliance
with regulations for that purpose, the infringement of
which is calculated to produce consequences prejudicial to
the public health.
Many, nay most, of the villages of Scotland are kept in
a most offensive and unwholesome state of filthiness; large
heaps of corrupting animal and vegetable materials being
allowed to accumulate, in many instances, in the public
thoroughfares, and before the very doors and windows of
the houses, proving the source of the most abominable effluvia,
offensive to the senses of those who are accustomed
to a pure atmosphere, and injurious to the health of all
who inhale them. Trenches or hollows are, in many instances,
to be found before the doors, where water is collected,
and forms a nidus for the putrefaction of the materials
above mentioned, and whence issue effluvia which are
often to be recognised in the houses.
In these hollows or cavities are thrown all sorts of impurities,
and they are allowed to remain till a cart-load or
202two have accumulated, when, if sufficiently decomposed,
they are sold as manure to farmers and others, at the rate
of about a shilling the cart-load.
The collection of impurities is in this case not the result
of apathy and laziness, as in the purlieus in large towns,
but of the desire of gain, or of a trifling advantage, such,
for instance, as getting a small piece of ground, rent free,
for the growth of potatoes, which is a common practice.
Very bad consequences attend the unwholesome condition
of the atmosphere always found in these situations,
and more especially in warm and close weather.
The quarter of Tranent in which typhus fever prevails
most is that called Dow’s Bounds, and a more filthy part
is not to be met with in Scotland; a large area in front of
the houses being completely occupied with the cavities
afore-mentioned, with their putrefying contents, and the
place being ill adapted for ventilation, forming three sides
of a square, and the ground having no declivity, nor efficient
sewers to carry off the rain, the most favourable circumstances
exist for putrefaction, and for the contamination
of the atmosphere.
In the construction of future towns, and in additions to
the old, the utmost attention should be given to promote
the free agitation of the atmosphere, if it is proposed that
they should be salubrious. Where health is to be protected,
the streets should be made wide, open, and occasionally
terminating in squares or other open places.
Where circumstances will permit a choice, towns should
be built in wholesome situations and dry soils; and the
same holds with additions making to old towns.
203The health of a community is much influenced by the
situation in which they live, and by the nature of the
ground on which their houses are built.
In many towns there are some particular districts in
which disease is more particularly prevalent, and the result
of careful inquiry is, that the excessive disease is owing
to unwholesomeness of situation. Persons in all other
respects similarly situated, enjoy a better state of health,
or suffer less disease, who inhabit a more wholesome or
less prejudicial situation or locality.
A point next in importance to a proper construction of
streets, and the selection of good situations, is an efficient
system of drains or sewers for the removal of impurities,
and the formation of water-courses.
Of the importance of sewers it is unnecessary to enlarge,
that being sufficiently understood.
By water-courses is meant channels for the immediate
passage of rainwater from off the streets. They are easily
formed, and where the ground is level, the advantage is
very great. In streets having a slope or declivity, the
water is soon dispersed; but where they are level, it is
apt to collect, and there create dampness, which is communicated
to the houses, and a favourable nidus for putrefaction,
where impurities are permitted to accumulate.
In some parts, principally the suburbs of large towns,
and in many of the villages of Scotland, perhaps more
especially those along the coasts, inhabited by fishermen,
no means being adopted to expedite the removal of rainwater,
204and there being no natural water-run or course, the
rain collects, and animal and vegetable materials mixing
therewith, green putrefying ditches are formed, plentifully
evolving gaseous products, and supporting a luxuriant vegetation
on their surface.
So much attention is now paid to health and comfort
in the construction of the houses of the wealthy, that it is
unnecessary to say a word respecting these points, in connection
with the higher classes.
But the circumstances being so very different in relation
to the houses of the poor or the labouring class, some
notice is required here.
It too often happens that the house of the labouring
man in the country is, in almost every respect, little better
than a shed, and calculated to produce disease. The
walls are frequently the only substantial part of the tenement,
the roof of tiles being often pervious to the rain and
wind, and there being no other covering either of lath or
lime; the door opens directly into the body of the house,
and the floor is generally either below or on a level with
the ground outside.
When floors of houses are below the level of the ground
outside, they must necessarily be damp, and cause the
house to be unwholesome.
The floors even of cottages should be situated about a
foot or more above the level of the adjacent ground, and
the interval between them and the soil should be filled up
with small stones, or such materials, and then the houses
205might possibly be free of damp, and the rain would not
run in off the streets, and form ditches before the very
fire-place, as it does in many houses in this village.
The necessity of the floors of their houses being at a
little distance above the ground is well known to the natives
of Manilla. To avoid the dampness and the unwholesome
emanations of the soil, the poor natives build
their bamboo houses upon a foundation of wooden piles,
by which contrivance a considerable space is left to permit
the winds to enter, and to dissipate the damp and exhalations.
In like manner, the rich inhabitants of Manilla
build on piles of brick. Could our working population, or
rather their landlords, not take a hint from these less refined
people, and form some security against that unwholesomeness
inseparable from damp houses?
It is unnecessary to detail at length instances of the
greater prevalence of disease among the inhabitants of low-lying,
confined, damp, ill ventilated, and filthy towns, over
the populace of cities more favourably situated in these
respects.
It will suffice to say, that typhus fever prevails more in
the Old Town, where there are many local causes of disease,
than in the New Town of Edinburgh, where the
streets are clean, wide, and well drained;—and that the
plague prevails more in the Jews’ quarter, remarkable for
the filth and closeness of the streets, than in any other part
of Constantinople.
206
The bad effects of despondency and apprehension have
been already stated, and they were found to be very important
and highly favourable to the invasion of disease.
Instances have already been given of disease and general
decline of health following depression of mind and long
continued apprehension, and it now remains to point out the
salutary action of an active and cheerful state of mind.
An active and cheerful state of mind imparts an activity
to the various organs of the body, whereby their functions
are more perfectly performed; it spreads a kindly glow
over the entire system, and tends to dispel any sluggishness
of action present in any part which perhaps would,
under other circumstances, increase, and lead to the development
of disease.
On some occasions a cheerful state of mind, induced by
sudden improvement of prospects, or by the unexpected receipt
of good intelligence, has been the efficient instrument
in dispelling the first symptoms of disease which had been
induced by depressing causes.
It has been often observed among soldiers and sailors,
who, losing their health and beginning to suffer from disease,
207under no other apparent unwholesome cause than
the distrust with which they regarded an insufficient and
unskilful commander, that their health has suddenly improved,
and disease has rapidly diminished when they have
been put under an able chief in whom they reposed confidence,
and with whom they were willing and ready to
place the safety of their lives.
Soldiers and sailors suffering many privations, mortified
with defeat, failing in their energies, and beginning to drop
under the influence of disease, have, on the sudden and
unexpected brightening of their prospects, regained their lost
strength, cast out the seeds of disease, thrown off their
despondency, and have achieved worlds of enterprise. The
following interesting case, which illustrates well the powerful
influence of hope, and a cheerful state of mind, is taken
from Paris’s Pharmacologia.
“In the celebrated siege of Breda in 1625 by Spinola,
the garrison suffered extreme distress from the ravages of
scurvy, and the Prince of Orange being unable to relieve
the place, sent in, by a confidential messenger, a preparation
which was directed to be added to a very large quantity
of water, and to be given as a specific for the epidemic;
the remedy was administered, and the garrison recovered
its health; when it was afterwards acknowledged
that the substance in question was no other than a little
colouring matter.”
That impaired state of health, and much of the disease,
especially of the digestive organs, which is so much experienced
by persons who are suddenly deprived of much
occupation of the mind in business, and find themselves
208totally unemployed, and who, from their previous habits,
are unable to derive enjoyment from literary and scientific
pursuits, as some retired tradesmen, have been suddenly
removed, and health has been fully re-established on the
individuals being again immersed in business, either from
choice or by a happy reverse in their circumstances rendering
that step unavoidable.
During epidemics, that confident assurance which some
persons are known to entertain, that they will escape the
prevalent distempers, there is much reason to think, has
on many occasions been a complete prophylactic or preventive.
Instances are not uncommon where an assurance or
settled conviction on the part of the patient has gone far
to promote, if not to produce, recovery from very dangerous
disease, when physicians have despaired of life, and even
when that opinion has been communicated to the unmoved
and still confident sufferer.
The history of amulets or charms and of the cures performed
by the royal touch, affords much amusing and interesting
detail illustrative of confidence and hope, in the
prevention and cure of disease. Instances are also familiar
of naval and military officers who have lost their health
from the long continued suffering of “hope deferred” in
respect to promotion, and of neglect of meritorious services,
where advancement and the grant of their longing and
earnest wishes has at length acted as a charm upon every
bodily ailment, and where a rapid succession of cheerfulness
and health has been the immediate consequence, to
the joy of anxious and apprehensive friends.
209The beneficial effects of activity and cheerfulness of mind
in warding off the attack of disease, and in promoting recovery
therefrom, having been so strikingly illustrated in the
above examples, there remains no occasion to say more
than to recommend them strongly for adoption, both among
those in health and in sickness.
The want of sufficient clothing as productive of disease
has been already noticed.
Clothing in this climate is used for the purpose of retaining
the body warm. Now this is an important purpose,
and the means by which it is attained are highly deserving
of notice, and they exert a very powerful influence upon
health.
The temperature of the human body is generally about
98° Fahrenheit, and that of the surrounding atmosphere
being in this climate always below, sometimes in severe
winters, as for instance the last, being near zero.
Now, all bodies possess a property by which they are
disposed to maintain an equilibrium of temperature, that
is, to be of the same amount of heat, and the temperature
of the human body being above that of the surrounding
atmosphere, in an amount varying at different times, it
parts with a portion of its heat, or caloric, as it is called by
chemists, which is communicated to the atmosphere and
surrounding bodies.
A portion of the heat of the body is constantly, and under
all circumstances, being abstracted by the atmosphere
and other surrounding bodies which are at a lower temperature,
210and were it not that the loss of heat, which the
body is thus constantly sustaining, is supplied by the formation
of heat in the system, which is ever going on, the
body would soon become so very cold as to be incapable of
performing its functions, and death would consequently
ensue.
The amount of heat which the body loses, and the rapidity
with which it is abstracted, is proportionate to the
coldness of the atmosphere and surrounding bodies.
But the rapid and great abstraction of heat from the human
body, which is apt to take place when it is immersed
in a very cold atmosphere, is very hurtful, and often induces
disease, especially fevers, colds, coughs, and inflammations.
It is for the purpose of checking the rapid abstraction of
heat from the body, that the warm clothing used in these
latitudes is adopted. It is a bad conductor of heat, and
the consequence is, that the temperature of the body is not
reduced so rapidly as it would be were it exposed without
any covering to the atmosphere, which, more especially
when damp, is a superior conductor of heat.
Clothing of a sufficient nature is useful in the preservation
of health, by preserving in its integrity the circulation
of the blood on the surface of the body, by maintaining the
constant flow of the secretion from the skin, or perspiration
as it is commonly called, which is so useful to the
system in many different ways, and by preventing any
deviation from that balance in the distribution of the fluids
of the body which that process goes so far to maintain,
much to the comfort and freedom from disease of the individual.
211Many instances of a very striking nature are known,
where such inveterate and mortal disease has supervened
in consequence of the privation, total and partial, of clothing,
and from that being of a texture and nature inadequate
to meet the exigencies of the case. Some have been
referred to in this work where the want of sufficient clothing
has been one of many concurrent potent circumstances,
the attendants and consequences of poverty and destitution
which have given rise to epidemics. On occasions of great
distress and destitution, the disease which is then so very
prevalent is not the product of one circumstance merely,
such as want of food, but is induced by the many concurrent
powerful and unwholesome influences to which poverty
is ever sure to give rise. One of the chief circumstances on
which the wide prevalence of disease depends on those
occasions, there can be little doubt, is insufficiency of clothing
among the poorer classes. But it is the advantages
which are to be derived from sufficient clothing which
should here occupy attention. Of late years, it has been
the practice in some towns in this country, on occasions
of fever and other diseases prevailing during the cold and
inclemency of winter, for funds to be collected for the purchase
and distribution of clothes among the poor and ill-clad
portion of the population.
The motives and feelings with which this form of charity
has been adopted, must of themselves be a sufficient
and highly delightful return for the liberality and exertions
of its benevolent projectors and supporters, but it must
afford them much gratification and much encouragement
in their laudable and christian endeavours, to know that
212the clothing which they have dispensed has had a powerful
influence in preserving many from becoming the victims
of the prevalent distempers, and of preventing the
relapse of the convalescent.
The late Sir John Pringle, a distinguished army surgeon,
states that “the best clothed were generally among the
most healthy regiments.”
The quantity of clothing should of course vary with the
season, more being used in winter than in summer. A
minute account of the outer clothing is unnecessary here,
but a word may not be thrown away; the body should at
all times have that quantity of clothing which will secure it
from unpleasant feelings of cold and chilliness, and it
would be wise to be influenced more by comfort and a
regard to health, and less by fashion and caprice in the
choice of clothing, which is so intimately connected with
the preservation of health and its unspeakable comforts and
enjoyments.
The clothing which is next the skin is more important,
and will here obtain some consideration. It may be laid
down as a general rule that flannel or some such woollen
cloth should be used next the skin throughout the entire
year. It will be well to vary the cloth or flannel in different
seasons, perhaps using a thick flannel during winter,
and a material of lighter and less close texture during summer
and autumn. A fabric of fine flannel, or what is called
“stocking,” answers very well for the summer, when the
flannel which is commonly used is felt to be too warm and
irritating to the skin. In the summer it is common for
many persons who use flannel during winter to discontinue
213its use, but it is safer, merely to exchange the thick flannel
which has been used during winter for one of a finer fabric
or some such equally fine material.
During winter when the weather is always cold, and in
spring when it is generally chilly, flannel or some such
material should form an essential portion of the clothing of
every inhabitant of these islands.
It is safe to say that hundreds in this country are at
present alive and enjoy excellent health who, but for the
use of flannel and such like fabrics next the skin, would
have been, ere this, numbered with the dead; and it is
not too much to say that thousands are at this moment in
perfect health through the kindly action of the same clothing,
whose lives were threatened with constant coughs,
periodical colds, quinseys, rheumatisms, and incipient
disease of lungs, and other organs of the chest, before this
efficient guardian of health was adopted.
Flannel and fabrics of the same or like nature go far to
preserve an equable temperature at the surface of the body,
promote the perspiration of the skin, which they readily
absorb when copiously secreted, and are specially useful in
preserving the balance of the secretions on the surface and
in the interior of the body. Now all these most important
conditions, which the use of flannel goes so far to maintain,
are ever liable to be subverted and disturbed, whenever
the body is thinly or inadequately covered, by changes in
the ever varying temperature of the atmosphere, and by the
prevalence of winds and currents.
Most of the important constitutional diseases which
214occur in this country, begin with a sensation of coldness
with shivering and trembling; now it is the usual property
of flannel, and such fabrics, when worn next the skin, and
indeed of warm and general good clothing, to obviate and
prevent these conditions of the body, and thus disease may
be met at its very onset, and perhaps baffled ere it has
time to establish its dominion.
“In some situations my personal experience enables me
to vouch for the utility of flannel. Of this we had a very
striking proof in the second battalion of the Royals, while
suffering from a most aggravated form of dysentery in India.
General Conran, the late Lieutenant-Governor of Jamaica,
who at that time commanded the Royals, was so fully
persuaded of the benefits likely to accrue from the general
use of flannel, that he went down from Wallajahabbad,
where the regiment was then stationed, to Madras, on
purpose to represent to the government the distress of his
men, and to suggest the expediency of a supply of flannel
shirts. This he did with so much effect, backed by the
late Dr Anderson, the Physician-General, that the flannels
were immediately ordered, and, in my opinion, contributed
much to check the alarming progress of the disease.”[11]
It is usual with many individuals to wear flannel only
over the chest, but it is wise to envelope the whole body
in that most useful article of clothing.
The poor or labouring man should endeavour to procure
thick soled shoes, in good repair, and substantial worsted
stockings.
215The latter are generally esteemed stronger and more
durable when made at home, and will form excellent work
for his wife or daughter in the winter nights.
The working man will find, that though clothing substantially,
as has been above recommended, takes a considerable
proportion of his money immediately out of his
pocket, he will be a certain gainer in the end, aye, probably
in the course of a few years or months, by consequent
immunity from disease, and from continued capacity
for labour.
It has been already shewn in this work, that the want
of sufficient and wholesome food is frequently attended
and followed by disease. It is now proposed to shew how
important food and drink, of good quality, are to the preservation
of health; but the fact is so well known, and so
undoubted, that it is almost unnecessary to say that they
are essential to the preservation of the body in its strength
and dimensions.
That sense of sinking and languor, which is so commonly
experienced upon long fasting, would soon be exchanged
for the actual pains of disease, were it not to be removed
shortly by the taking of food.
When the body is exhausted from the want of food for
some hours, a good and ample repast imparts strength to
the body, and cheerfulness to the mind, and goes far to
prevent the evasion of some forms of disease.
An individual who is well fed, is generally more secure
against the invasion of disease of a low character, than another
216who is only scantily and occasionally supplied with
food.
It is generally believed that individuals who have lately
partaken of food, are less subject to the operation of vitiated
air, or as it is commonly termed, “contagious air;” and
it was commonly reported during the late prevalence of
cholera, that persons who took breakfast before going out,
suffered less from that disease than those who followed a
contrary course.
Many well authenticated instances are recorded of the
health of armies undergoing very great improvement, and of
disease in these bodies being greatly checked by the distribution
of ample wholesome food, and by the privation which
they had suffered for some time previous, being ended, by
some accidental circumstances, as the gaining the enemy’s
magazines, or the reduction of a siege. Sir George Ballingall
relates in his work on Military Surgery, that “during
the prevalence of a malignant fever in this regiment
(33d), then stationed in the garrison of Hull, in the autumn
of 1817, amongst other measures calculated to check
the rapid extension of the disease, I recommended the regular
supply of breakfast to the men. This was immediately
ordered by the commanding officer, and nothing appeared
either to the officers, to the soldiers, or to myself, to have
so much effect in obviating attacks of the fever.”
The institution of soup kitchens in this country, for the
distribution of wholesome and nourishing food to the perishing
poor, there is no doubt, has a most salutary influence
in the prevention of disease, by, in short, so fortifying individuals,
otherwise incapable of resistance, as to render
217them proof against the influence of many causes of pestilence.
There can be little doubt that the liberal distribution of
nutritious food, which of late years has happily taken place
from these charitable institutions, has gone far to check the
ravages of fever, which is so prevalent in this climate, during
winter, when the labouring classes are subject in so
great a degree to cold, and the privation of food and other
necessaries of life.
It is stated on good medical authority, that no measure
which was instituted for the purpose of stopping the progress
of typhus fever in Glasgow, in the winter of 1837–8,
then very prevalent and mortal, was so useful, and so immediately
and obviously efficient, as the establishment of
soup kitchens in that city.
Among the arrangements in Edinburgh in 1832, which
tended apparently to render cholera less extensive than in
other large towns, a soup kitchen formed one.
Fever has been much less prevalent in Tranent during
the present, than for many winters past, and this is to be
attributed partly to a soup kitchen which has been instituted
in that village, and which has been in operation for
about two months (16th March 1839).
The excellent tendency of such establishments must be
obvious to all who are at all conversant with the nature of
disease, and the animal economy, and it can form no valid
objection to that proposition, that fever is still known to
have raged where soup kitchens have been established;
for, though the pestilence may not have been extinguished,
still it may have been abated, and though the malignant
218character and mortality may not have been reduced, still
these excellent institutions may have been the means of
preventing their being increased.
Let not, therefore, those who are willing and able to support
whatever is calculated to reduce the sufferings and
privations of the poor, be driven from extending their support
to soup kitchens, because they have only diminished
the number of the victims of disease, and made the stage
of convalescence more sure and less liable to relapse.
It would indeed be vain to expect, that the distribution
of food would act as an entire preventive of fever and disease,
which is the result not of scanty food only, but of
that and many other circumstances of a very different nature,
whose operation, the supply of soup, in any quantity,
can go a very short way only, to remedy.
Some of the circumstances which exert the most important
influence in the production of pestilential disease,
and the measures which are best calculated to counteract
their pestiferous tendencies, have now been detailed.
It is hoped the enforcement of the hurtful operation of
many circumstances, erroneously thought to be innocent,
may lead to their being remedied in future, and it is expected,
that if the suggestions which have been thrown
out in the latter part of this work, are duly acted upon,
or if others of a like nature, which may, at a future period,
emanate from another better qualified for the task,
should meet with the attention, which this object so well
demands, the amount of disease will be diminished, human
suffering will be abated, and human life extended nearer
to that point of maturity which the Divinity has decreed,
219and which the organization of the human body proclaims
was meant to be attained by one and all of the members
of the human family.
By avoiding the causes of disease which have been detailed
in this work, and by attending to the rules which
have been laid down here and elsewhere for the preservation
of health, disease will be greatly abated, but a mighty
revolution must be accomplished in the habits, the dispositions,
and minds of men, ere mankind will enjoy that
course of health, and all that greater freedom from pain
and disease, of which their lot is capable:—but far from
the consideration of the manifold changes and long course
of time which will be required to make a very great improvement
in the health of the human race, leading to
apathy and inaction, it should serve to stimulate to powerful
attempts, and persevering and reiterated efforts for
amelioration.
PRINTED BY NEILL AND CO. OLD FISHMARKET, EDINBURGH.
- Typos fixed; non-standard spelling and dialect retained.