Part 28

During a considerable time the benevolent man and his wife had escaped the malady, but at last his excellent wife was smitten, and died in his arms at the age of 27--far from her children, who had been sent away at the commencement of the invasion.

In 1813, Malta was visited with this fatal malady; when the scenes of the plague that desolated the island in the sixteenth century were renewed, notwithstanding all the sanitary precautions adopted by various governments since that period.

Count Ciantar in his "Malta illustrata," gives an interesting account of the introduction of the plague at four different periods in that island. The first was in 1592; when, in the month of May, four galleys belonging to the Grand Duke of Tuscany, entered the port to procure pilots for the service. By permission of the Grand Master, Cardinal Verclula, a pilot was obtained, and the vessels steered towards the Egyptian coast. In the vicinity of Alexandria, they captured a galley bound to Constantinople, having on board 150 Turks. On hearing that the plague was raging at Alexandria, they returned to Malta with their prize, which was discovered to be infected, and for the first time the plague was brought into the country.

The second plague broke out in 1623, and originated in the house of Paulus Emilius Ramadus, guardian of the port. But the whole of the infected persons having been immediately sent to the Lazaretto, the progress of the disease was checked, and it only carried off forty-five persons.

The third plague took place in 1633, and broke out at the Marina gate, where vessels from the Levant usually anchored. The proprietor of a house in that quarter, having had some communication with one of these ships, contracted the disease, and infected his sister, who resided in the country at Casal Zeitun, and shortly after the whole family was attacked, their speedy removal to the Lazaretto, however arrested the disease.

The fourth appearance of this malady in Malta, was far more destructive than it had been in the preceding years, even in 1675, and it continued its ravages for seven months. This circumstance has been attributed to a difference of opinion that prevailed among the members of the commissioners appointed to take the necessary steps for checking the progress of the disease. It appears that doubts were entertained as to the nature of the malady, hence the requisite precautions were not enforced; and instead of separating the diseased from the healthy part of the community, with the utmost rigour, prayers were put up, vows and offerings were made, and processions paraded the streets, nor it was not until the Grand Master had sent to France for medical aid, that the scourge was mitigated. On their arrival the first steps adopted by these physicians was to confine the inhabitants to their homes, and to remove the sick to the Lazaret. The ravages of the disease must have been very great, since out of a population of about 60,000, there died in Valetta 4000, in Burgo 1800, Senglen 2000, Burmola 1200, and in the villages upwards of 200.

The last plague was supposed to have been brought in by a vessel from Alexandria, that entered the port on the 28th of March, 1813. It appeared that two of the crew had been seized during the voyage with symptoms of plague, then prevailing in Alexandria, which place the vessel had left with a foul bill of health. On the same day another vessel, the Nancy arrived from the same port, having also on board two men labouring under the disease, and she was followed by a Spanish polacca, the Bella Maria, from the same quarter. It was on the 16th of April that the disease first appeared in the island, in the case of a shoemaker in the Strada St. Paolo. The increase of the disorder was gradual, and from Valetta it spread to Citta Vecchia Bircharcara.

My late friend, staff-surgeon Tully, thus describes the situation of the Island at this period: "The warm season was now rapidly advancing, the thermometer having risen several degrees at the latter end of May, and unfortunately, through the superstitious prejudices of the natives, considerable dependence was placed upon the anxiously-looked-for alteration in the state of the atmosphere, and every day was consequently expected to diminish the danger. This belief was too generally inculcated not to be productive of much mischief, as most persons felt assured that, if they could avoid danger until the summer heat set in, the evil would cease, and that the greatly-dreaded disease would then die a natural death. The consequence of this unfortunate belief was fatal--the freedom of intercourse produced by this blind confidence, led to a very general contamination, and men every where exposed to the baneful influence of the plague, became the active agents of the dissemination throughout the whole island."

While the plague was thus raging at Malta, it made its appearance amongst the inhabitants of the Morea, having, it is supposed, been introduced from Romelia, by a man of the name of Kalangi, who was taken ill on his arrival, and died in two days. The following day his wife and daughter were attacked by the malady, which rapidly extended to Tornovo, and all the neighbouring towns. During the years 1813 and 1814, the banks of the Lepanto and the shores of Albania were nearly depopulated.

In 1815 the fatal scourge broke out in the island of Corfu, in the village of Marathia. None of the medical men who attended the sick during this period, attributed the invasion of the disease to contagion.

The doubt that had arisen in the minds of several experienced practitioners in regard to the non-contagious nature of the plague, is a matter of vital interest, since it not only concerns the health of nations, but in a commercial point of view it becomes a question of political economy of the utmost importance, as the severity of the quarantine laws, which must materially effect the prosperity of trade, would become useless if it could be proved that no contagion is to be apprehended from a free intercourse. It is somewhat curious that Dr. Mead long ago expressed his decided opinion that whenever the doctrine of non-contagion should be revived in England, (and it will be so, he adds, even a hundred years hence,) it will always excite alarm amongst those nations who are more prudent than ourselves, and less eager to entertain every kind of wild and visionary speculation.

The contagionists affirm that the destructive ravages of the plague of Marseilles in 1720, when 60,000 inhabitants were carried off, arose from neglect in enforcing a rigid separation of the diseased from the healthy part of the community. The mortality in the plague of Messina, in 1743, during which 43,000 people fell victims to the disorder, is also referred to similar causes. They also maintain that the London plague of 1593, which destroyed 11,503 persons, was ascertained to have been introduced from Alkmaer; that the pestilence of London in 1603, which carried off 36,269 inhabitants, was brought from Ostend, and further that in 1636, the scourge which destroyed 13,480 victims in our metropolis, had been imported from Leyden. In 1665, when its still more fatal ravages swept away 68,596 citizens, it had also been traced to our foreign intercourse. Dr. Merlens who has accurately described the plague that raged at Moscow in 1771, asserts that it was introduced by a communication with the Turkish army. Notwithstanding which, by keeping the patients strictly guarded, the city was maintained free from infection, while the disease raged around in every quarter.

Mr. Jackson gives a similar account of the plague at Morocco; and he adds, that daily observations convinced him that the epidemic was not caught by approach, unless that approach was accompanied by an inhaling of the breath, or by tending upon the infected person. With such a discrepance of opinion, we cannot be surprised at this anxiety to impugn the doctrine of those practitioners who maintain, that contagion is not to be dreaded, and that severe sanitary precautions are therefore vexatious and oppressive. If the progress of the disease, say the non-contagionists, depends upon personal contact with infected persons or goods, its ravages would never cease in those countries where no precautionary measures are taken to prevent communication between the infected and the healthy; that in Turkey for instance, where these precautions are not resorted to, there would be no cessation of the malady until it had swept away the whole of the population.

To these arguments, plausible as they may appear in theory, it has been replied, that the plague to a certain extent has never ceased to exist in the Ottoman empire, but breaks out occasionally after temporary intermissions. As to the permanence of the diseases it is well known that like all other epidemic or endemic diseases, the plague may also be subject to atmospheric influence and be arrested in its progress without human aid. Sir James M'Grigor illustrates this fact in his "Sketches of the Expedition of the Indian Troops to Egypt." When the disease first broke out in the army, the cases sent from the regiments were from the commencement attended with typhoid symptoms; while those from the Bengal volunteer battalion, and the other corps encamped near the marshes of El Hamed, were of an intermittent and remittent type. The cases that occurred in the cold and rainy months of December and January, were of an inflammatory character, after which, as the weather became warmer, the disease at Cairo, Ghiza, Boula, and the isthmus of Suez assumed the form of a mild continual fever. The plague of London in 1665, was in like manner distinguished by a peculiar constitution of the atmosphere.

It has also been doubted whether the plague be contagious in every instance of its appearance. Various persons have inoculated themselves with its virus with impunity, though several were ultimately victims of the bold experiment. In Egypt Dr. White inoculated himself ten times, but died of the disease after the eleventh trial.

The atmosphere of contagion it appears is limited, and strict attention to keep up a line of separation generally proves effectual in arresting or checking its progress. Contact appears necessary to extend the malady, and a direct absorption through the skin forms the ordinary means of transmission. When the cutaneous pores are closed by oil, or any other substance of the kind, an exemption from the fatal scourge has been frequently observed. Mr. Baldwin states, that among upwards of a million of inhabitants carried off by the plague in Upper and Lower Egypt during the space of four years, not a single oil-man, or dealer in oil, had suffered. Mr. Jackson made the same observation in the plague of Tunis. Dr. Assalini, an intelligent medical officer of the French army in Egypt, does not attribute this exemption to the stoppage of the pores, but as the result of profuse perspiration which the inunction of oil produces. The zeit jagghy or olive oil, is considered a specific by most of the Asiatics; and my late friend Mr. Tully observed that all the attendants upon patients suffering from the plague, who carefully smeared their persons and their clothes with this substance, were exempt from the infection. The same observation was corroborated by Sir Brooke Faulkener, during the plague of Malta.

Various have been the remedial means proposed in this terrific malady, and preservatives against it have been recorded in the following distich:

Haec tria labificum tollunt adverbia pestem; Mox, longe, tarde,--cede, recede, redi.

The celebrated plague-water was composed of master-wort, angelica, peony, and butter-bur, viper-grass, Virginia snake-root, rue, rosemary, balm, carduus, water-germander, marygold, dragon-blood, goats'-rue, and mint, infused in spirits of wine.

It appears manifest from all the evidence adduced by the contending theorists, that we may come to the following corollaries:

1. Plague may generally be considered as arising from contagion.

2. The spread and decline of the disease is influenced by local peculiarities and revolutions in atmospheric constitution.

3. It appears probable, that under peculiar local circumstances, it may have arisen spontaneously, without having been introduced by contagion; but this invasion must be considered of very rare occurrence.

4. Although transmitted by contagion, a certain distance preserves the healthy from the contamination of the diseased.

5. The enforcement of a limit of separation must be considered indispensable in all our sanitary regulations, in the framing of which great attention must be paid to discriminate between contagion and infection--two sources of distemper essentially different from each other.

Although these precautions are pointed out by the result of long and unbiassed experience, they will in all probability be solely applicable to the plague: for we have every reason to believe that these sanitary measures will not prove efficient against the invasion of cholera, the yellow fever, and other diseases, which are by no means proved to be infectious or contagious. Without entering into the discussion, I feel no hesitation in giving it, as my decided opinion, that the cholera and yellow fever are not contagious.

ABSTINENCE.

Hippocrates asserted that most individuals who abstain from food for seven days, die within that period; or, if they survive this time, and are even then prevailed upon to eat or drink they still perish. Various instances of persons who have lived much longer without sustenance have been observed. In the records of the Tower we find the history of Cicely de Ridgeway, who was condemned to death for the murder of her husband in the reign of Edward III., and who remained for forty days without food or drink. This being ascribed to a miracle, she was of course pardoned. From the result of this starvation, the story may be considered fabulous for two reasons: first, from the improbability of the alleged abstinence; and, secondly, from the selection of forty days, a period clearly fixed upon for miracle-making, being the exact number of days our Saviour fasted.