The Common Nature of Epidemics, and Their Relation to Climate and Civilization

Part 1

THE COMMON NATURE

EPIDEMICS

AND THEIR RELATION TO CLIMATE AND CIVILIZATION.

ALSO REMARKS ON

CONTAGION AND QUARANTINE.

FROM WRITINGS AND OFFICIAL REPORTS

SOUTHWOOD SMITH, M.D.,

PHYSICIAN TO THE LONDON FEVER HOSPITAL, CONSULTING PHYSICIAN TO THE HOSPITAL FOR DISEASES OF THE SKIN, “THE FATHER OF SANITARY REFORM,” MEMBER OF THE GENERAL BOARD OF HEALTH, 1848–1854, AUTHOR OF “THE PHILOSOPHY OF HEALTH;” “THE DIVINE GOVERNMENT,” &C., &C.

EDITED BY

T. BAKER, ESQ.,

OF THE INNER TEMPLE, BARRISTER AT LAW, AUTHOR OF “THE LAWS RELATING TO PUBLIC HEALTH, SANITARY, MEDICAL, PROTECTIVE;” “THE LAWS RELATING TO BURIALS,” &C., &C.

PHILADELPHIA: J. B. LIPPINCOTT & CO. 1866.

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INTRODUCTION.

The recent very serious outbreak of Epidemic disease among the cattle in England may not unreasonably induce the fear that a human Epidemic is approaching. Cholera has prevailed in Paris and several other places on the Continent during the late autumn, and it is well known that the former visitations of that terrible disease in this country have appeared the year following similar attacks abroad. Moreover, human epidemics in numerous instances have been preceded or accompanied by extensive murrain among cattle.

Footnote 1:

See pp. 7, 65, 110.

Never was a country guided through the perils of an Epidemic with greater wisdom and energy than Great Britain during the Cholera of 1848–9. The master spirit on that occasion was Dr Southwood Smith. Long previous to that time this great man had had a more extended experience of the nature, causes, and treatment of Zymotic diseases than perhaps any physician before or since. He had made them his special study, and applied the great powers of his clear, reasoning, and philosophic mind, to the discovery of their causes, and the best means of arresting their progress.

Whilst occupying the post of responsibility as the chief medical adviser of the nation in his capacity of Medical Member of the General Board of Health, Dr Southwood Smith left behind him a set of official reports on the subjects of Epidemics, Contagion, and Quarantine, which will never die.

“The reports drawn up by Dr Southwood Smith,” writes Dean Peacock, “on the proper precautions to be taken to meet the recent outbreaks of cholera, have been of the most essential service wherever their recommendations have been followed. If Dr S. Smith, however, had no other claims on the lasting gratitude of the nation, I would refer to his reports on quarantine, as quite sufficient to establish them. They have contributed, more than any other publications on this subject, to dissipate the gross and mischievous delusions upon which these regulations are founded, and which are known to be so injurious to the free commercial intercourse and prosperity of nations.”

After Dr Southwood Smith left office he gave us a concise summary of his experience in two masterly lectures, now published, together with extracts from his official Reports.

In times of distress it is only natural to look for the most efficient help. Our herds only have extensively suffered of late, but we ourselves may follow, and it is well to be prepared. Even with reference to the causes and treatment of the Epizootic, the reasonings, facts, and conclusions again brought forward in the following pages will apply. But should the worst fears become realized, and an extensive human epidemic follow, these writings will tell with greater force, and the nation will be better prepared to meet the danger, for having calmly considered beforehand the probability of its approach.

* * * * *

One ground of hope that we may escape a visitation of Cholera during the coming summer, may be afforded by the remarkably tempestuous weather which prevailed in December and January last. The loss of the steam-ship “London,” which foundered in the Bay of Biscay, with 226 souls, on the 11th January, and the still more remarkable fact, that during the night of the 10th, out of 62 vessels riding at anchor in Torbay, 41 either foundered or were dashed to pieces on the rocks;—these were terrible calamities, and they were only the most striking examples of the numerous wrecks and disasters which occurred in the course of the late most tempestuous season;—but they afford a hope of escape from a worse peril, viz. nations prostrated by disease and premature death.

T. B.

KINGSCOTE, WOKINGHAM,

May, 1866.

Footnote 2:

Part 2

See p. 18.

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CONTENTS.

EPIDEMICS—

PAGE

Their Common Nature 1

Are all Fevers:—e.g. Plague, Sweating 2 Sickness, Cholera, &c.,

Rapidity of their Course 4

Warnings of their Approach 5

Periodicity of their Return 8

Are produced by the same Causes 10

Foul Air—Overcrowding 12

Attack Animals 7, 13, 16, 65, 110

Their Attendant Signs—Meteorology 17

Action of Air on the Blood 19

Theories of Epidemic Causes 23

Influence of Climate 25

Mortality within the Tropics 29

Their Relation to Civilization 33

State of England in the 14th Century 35

Improvements in the 15th Century 41

Prolongation of Life in the 17th and 45 18th Centuries

Disappearance of the Earlier Epidemics, 51 e.g. Jail Fever, Sweating Sickness, Plague, Typhus-Gravior, &c.

Experience of the Model Dwellings 54

Sanitary Legislation and Works 57, 129

Epidemics are within Human Control 58

QUARANTINE—

Originated in the Belief that Epidemics 61 spread exclusively by Contagion

Part 3

Sanitary Measures the only Safeguards 63

Effects Attributed to Contagion 67

Inutility of Quarantine 71

Plague, Yellow Fever, Cholera, &c. 73

Mitigation of Disease by Migration, 75 e.g. Tramps

Sanitary Regulation of Ships 77

CONTAGION—

Cholera averted at Baltimore 79

Cholera averted at Newcastle Barracks 82

Yellow Fever in the Eclair 84

Alleged Communication of Disease to Boa 96 Vista, and Examination of Evidence

Alleged Importation of Disease by the 117 Dygden into Gibraltar, and Examination of Evidence

APPENDIX.

Sanitary Works accomplished under the 129 Public Health Act

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THE COMMON NATURE

EPIDEMICS.

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Some account of the structure and functions of the human frame, of the action of physical agents on this wonderful machinery, and of the principles which relate to Individual, as well as to Public Health, ought to form a part of elemental education. There is a growing conviction that the necessity for such knowledge is not restricted to the physician; that it is essential also to the educator, the mother, the nurse, and indeed to every one who would enjoy, together with the due development of his physical, intellectual, and moral nature, the full term of the boon of life.

The main causes which shorten and embitter human life, as far as that unhappy result depends on the disturbance of health, are within our own control. There is the closest connection between the knowledge we have acquired of the physical conditions on which the life and health of individuals and communities depend, and on our command over those conditions. Every fact we have learnt respecting the great laws of nature, on our conformity to which our very existence depends, has taught us that the circumstances which produce excessive sickness and early death are preventible.

The character of Pestilence which gave it its great power and terror—that it walketh in darkness,—is its character no longer. Its veil has fallen, and with it its strength. A clear and steady light now marks its course from its commencement to its end; and that light places in equally broad and strong relief its antagonist and conqueror—CLEANLINESS.

* * * * *

The term Epidemic has become a popular one. It is derived from two Greek words, which signify “upon the people—prevalent among the people”—diseases which, at one and the same time, prevail extensively among large masses of the people.

Recently these diseases have received another name, which is also becoming familiar—“Zymotic,” from a Greek word, which signifies to “ferment,” as if the efficient cause of these diseases, whatever it may be, acts in the manner of a ferment.

Epidemic diseases, though called by a common name, present great differences in their external characters. Plague, Yellow Fever, Cholera, Small-Pox, Typhus, Scarlet Fever, Influenza, present characters so definite and special, that they have been naturally regarded as distinct diseases, and they really are so different as to render it desirable, for many reasons, that each should be discriminated and denoted by its proper name. Amidst this great diversity in form, however, they present very striking resemblances, of which the following are generally recognized:—

1. Epidemics resemble each other in being all fevers. They all exhibit that particular assemblage of symptoms which from time immemorial it has been agreed to denote by the term Fever.

This is as true of the great Epidemics of former times as of those which prevail in our own.

The so-called Black Death of the 14th century was a fever—an aggravated form of the Oriental or Bubo-Plague; in which there occurred, in addition to the ordinary symptoms of that dreadful disease, effusions of black blood, forming black spots on the arms, face, and chest. From this circumstance it derived its name. These effusions on the external surface of the body were accompanied by profuse and mortal discharges from the internal organs.

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