Part 20

Footnote 33:

For these cases see the Second Report on Quarantine, pp. 64, 299.

Further evidence will be found in the Medical Department of the Navy to show “that the hold of the ‘Eclair’ was in a pestiferous state;” and Dr King states, that long after the people left the ship in England, and when the engines were removed, mud, some inches deep, was found under the flooring.

“I should scarcely have noticed the above circumstance,” he says, “but for some remarkable occurrences which took place in the same vessel at a subsequent period, which confirmed me in the opinion I had previously formed that the origin and continuance of the fever on board depended solely on local causes.

“The ‘Rosamond,’ formerly the ‘Eclair,’ was commissioned at Woolwich on the 5th of November, 1846, for the Cape of Good Hope station, but none of the former crew rejoined the ship. During the time of fitting out, four cases of typhus fever occurred, and were sent to the hospital, where two of them died, but it is necessary to mention that typhus was prevalent at Woolwich at the time. The steamer left England for the Cape on the 23rd of February, 1847. Three days after sailing, one of the men was affected with slight febrile symptoms, and he continued more or less indisposed for a number of days, but occasionally felt so well that he returned to his work. After the ship entered the tropics, however, the disease began to assume a new and alarming character; and when off the Island of St Nicholas, and almost in sight of Boa Vista, the man died, having had for two days previous black vomit and other characteristic symptoms of Yellow Fever. Within a few days afterwards the ‘Rosamond’ arrived at Ascension, where I was then stationed; and Commander Foot having communicated to Captain Hutton, the superintendent of the island, every particular respecting the illness and death of the seaman, I was ordered, with Dr Sloane, the surgeon of the hospital, to make a report on the case, and at the same time to suggest measures for the benefit of the ship without endangering the health of the people on the island. Having obtained from Dr Slight, surgeon of the ‘Rosamond,’ every information relative to his late patient, we stated our opinion that the disease the man died from was sporadic Yellow Fever. * * * On the following morning I went on board with the view of learning something to enable me to form an opinion as to the sanitary condition of the ship, and for the purpose also of inspecting the sick, as the surgeon informed me he had then a suspicious case, with symptoms of a low kind of fever. I had barely time to take a cursory view of the after parts of the ship, when my attention was called to the patients, who were all mustered in the steerage, and I found the man the doctor had alluded to in such a precarious state that I recommended him to be sent on shore immediately. The only other severe case was that of a supernumary lad, who was taken ill the same morning, but the indications of a low malignant fever were so apparent even at that early stage, as to induce me to express my opinion to the surgeon that he would not probably survive 24 hours. As it was most desirable to prevent a panic among the ship’s company, I went on shore to consult with Captain Hutton, and make arrangements for their reception. * * * The patients themselves attributed their illness to foul air in the forepart of the ship; one of them said he suffered so much from an abominable stench in the boatswain’s storeroom, that he represented the circumstance and obtained permission to cut a hole in the floor, which exposed to view a considerable quantity of soft mud, and five or six buckets full of it mixed with decayed shavings, and emitting an offensive odour, were removed at the time.

“It appears then, that besides an unusual number sleeping in the fore-cockpit, some of them at least had been exposed to a morbific miasma, exhaled from a festering mass of filth in the bottom of that part of the ship. The quantity of mud, no doubt, was small in comparison with what had accumulated when the vessel arrived at Spithead from the coast of Africa, yet the malaria eliminated from that small and circumscribed focus was equally virulent in its operation, and produced the same disease in a few who were placed within the sphere of its influence.”

Such is a brief narrative of the circumstances connected with this ship and her crew.

But it has been alleged that while the landing of the crew of the “Eclair,” at Boa Vista, afforded no benefit to the ship’s company, it inflicted a grievous evil on the inhabitants of the island; that several individuals in contact, or close proximity with the sick, became affected with the same kind of fever; that from these individuals the malady spread to others with whom they came in contact, and from these again to others, as from so many centres of contagion, until the disease became general over the island, thus affording a positive instance of the importation of epidemic disease. The alleged facts on which these representations rest are the following:—

It is stated, that during the occupancy of the Fort by the crew, there was a small Portuguese guard stationed there; that this guard was several times relieved; that at the time when the “Eclair” left the island, the guard consisted of one negro and two European soldiers; that within three days after the sailing of the “Eclair” both Europeans were attacked with fever similar to that from which the crew of the “Eclair” had suffered; that the negro soldier, who, with his comrade—the man sent from Boa Vista to nurse the two Europeans—on returning from the small island to Porto Sal Rey, had been—“as a matter of precaution”—“restricted for [‘about 8’ or] 17 days to the occupation of a small hut at the northern end” of the town, was afterwards attacked,—though not confined to bed until the day following his return to barracks; and that a woman (Anna Gallinha), who lived next door to this hut, was the first person who was attacked with fever in the town. It is further stated that a man (Pathi), who had been a labourer on board the “Eclair,” was also attacked with fever, according to one account, on the day after the “Eclair” sailed; but according to another account, on the third day after that event.

Such are the alleged facts, and the only ones bearing directly on the communication of a specific contagion by the crew of the “Eclair,” collected by Dr M‘William by personal inquiries on the spot; and these, in his opinion, present a chain of evidence sufficient to establish a positive instance of the importation of epidemic disease.

With reference, however, to these inquiries, it has been already stated that they were not instituted until several months after the departure of the “Eclair” from Boa Vista;—the only regular practitioner on the island (Dr Kenny) who could have given authentic and trustworthy information respecting the nature and progress of the disease, had died;—the witnesses examined by Dr M‘William, poor and ignorant, gave their evidence, hearsay and otherwise, in the loosest possible manner;—their statements as to dates and occurrences, alleged to have happened several months before the inquiry took place, were received implicitly, without examination into the correctness of their answers and the credibility of their testimony;—all the witnesses of this class appear to have spoken under the influence of the strongest feeling of self-interest, with a view to establish a claim to pecuniary compensation should they be able to make out a case against the “Eclair,” in which expectation they were not disappointed, since the sum of £1000 was eventually granted by Great Britain for the benefit of the inhabitants;—and to this motive may probably be ascribed the highly coloured and exaggerated statements put forth by these people on the re-appearance of fever in the following year.

Taking the facts, however, precisely as they are represented in the Report of Dr M‘William, they do not, as the proof of the allegation in question requires, present a clear and palpable chain of evidence, connecting as cause and effect the fever of the ship with the epidemic on shore; but, on the contrary, there is not a single link undoubtedly connecting the one with the other.

Take the first case forming what is represented as the first link in this presumed chain, the seizure with fever of the two guards at the Fort. Two European soldiers lately arrived in the colony, and therefore peculiarly predisposed to an attack of endemic fever, go from Boa Vista, which at that time was healthy, to a confined, unventilated, overcrowded, and filthy spot on another island, where fever was raging to such a degree that within the space of three weeks there had occurred no less than 60 attacks and 33 deaths, in a crew consisting on the arrival of the ship of 117 officers and men. There is in this no evidence of the propagation of disease by a specific contagion; on the contrary, it is the ordinary production of disease by its ordinary cause, namely, exposure to a polluted atmosphere, the pollution being, in this instance, excessive from overcrowding; from accumulation of filth; from foul and offensive privies; from the impossibility of the admission of fresh air, owing to the construction of the building, and from the intense and oppressive heat, the thermometer ranging from 81° to 86° of Fahrenheit. The seizure of two men with fever under such circumstances is precisely analogous to the attack of persons, previously healthy, with typhus, who take up their abode in the crowded and filthy courts and alleys of English towns.

Take the next link in the chain, the attack of the negro soldier. The circumstances respecting this man, being precisely the same as those relating to the two other guards, the same answer would have sufficed for both, but according to the testimony of the man himself, his illness was very slight, and his companion who was sent to lodge with him at the hut in Porto Sal Rey, had no illness at all during the whole time of their seclusion.

The third link in the chain is the presumed fact, that a woman (Anna Gallinha), who lived next door to the hut in which these two men had been confined, was seized with fever soon after they had left it, and that she was the first person attacked, at least whose illness attracted public attention, in the town of Porto Sal Rey. Dr King states, that on a personal examination of the soldier who had experienced the slight attack of fever, he said that during the seventeen days that he and his companion were confined to the hut, “they had no communication with any one.” Dr M‘William, on the other hand, affirms that Gallinha was a frequent visitor at the hut, and, indeed, cooked for the men. Supposing Dr M‘William’s account to be the correct one, it is surely more reasonable to attribute the attack of Gallinha to the local causes to which she was exposed, and which Dr M‘William admits were sufficient to account for her illness, than to contagion derived from a man whose illness was so slight that it had not confined him to his bed for a single day, and which was incapable of infecting his companion who was constantly with him night and day.

“By the time Anna Gallinha was taken ill,” says Dr M‘William, “much rain had fallen; the weather had become more hot, and, in short, there now (but not before this) existed the recognized elements for malarious evolution.”

“In that part of the town called Beira, or Pao de Varella,” reports Dr King, “where Anna Gallinha and the soldiers resided, the houses are of the lowest description, and the people who occupy them are generally very poor and destitute; there is a large pool of stagnant salt and fresh water immediately behind; but to windward of this part of the town, and still nearer to the houses, there is a locality which is resorted to by many of the people when obeying the calls of nature; and the exhalations from the one, and the effluvia from the other, are blown by the north winds in the direction of Beira.”

A similar description of this locality is given by Dr M‘William,—

“In the upper portion of the town,” he says, “which is called Pao de Varella, the houses are in general mere hovels, rudely built, and much crowded together, and with few exceptions dirty. They are occupied by the lowest classes. From the total absence of any police laws the streets here are also very filthy.”

Here then were present in full force, as is admitted, the ordinary localizing causes of fever; to which it is more consistent to refer this case, than to an extraordinary and foreign cause.

But at this point the presumed chain of evidence stops; the chain is suddenly snapped; there is no further link traceable; there is nothing really connecting the illness of Gallinha with the next cases, or with the general spread of the disease which rapidly followed, and we need hardly state, that in order to prove the spread of a pestilence by contagion, communication, either direct or indirect, must be proved to have existed between all the persons attacked.

Footnote 34:

The widow of the next victim (Affonso) denied his having had communication with Gallinha; and Dr Almeida “found about 20 people sick” in Porto Sal Rey only three or four days after Gallinha’s death. It is evidently more rational to ascribe these numerous attacks to epidemic influence, which it is admitted was now present, than to contact with this woman, for the fact of which there is in truth not a shadow of evidence.

For the only other case of fever that is stated to have occurred shortly after the sailing of the “Eclair,” namely, that of the labourer (Pathi) who had been employed on board the ship, will scarcely be considered as affording an additional link; since admitting that this man contracted his fever while employed on board the “Eclair,” his case would be merely one of infection from going on board a foul ship, a generally recognized cause of fever:—

“Whenever,” says Dr Stewart, “fever has prevailed much in ships on the West India and African stations, strangers going on board of those ships have been particularly liable to its attack; but on sending fever cases from those ships to the hospitals and private houses on shore, it has not been found that the disease extended from them.”

But as in the locality of the dwelling of Gallinha, so in the district in which this man lived, there were local causes abundantly sufficient to account for the endemic origin of his disease. He resided in Rabil, one of the hamlets in the neighbourhood of Moradinha, at some distance from Porto Sal Rey. Of this locality Dr King says:—

“If there is one spot more than another in the whole island where, from its physical peculiarities, endemic fever might be expected to begin first, and end last, that locality is Moradinha, and the villages in its vicinity, in one of which Pathi resided.”

It may be observed further, that whatever may have been the cause of this man’s fever, it is admitted, that for three weeks at least it was communicated to no one else in the house at Moradinha, where he was attacked, and remained for eight days, and not to any one else in that neighbourhood for 11 weeks; that his illness was extremely slight, and that on his return to his own house no disease broke out for some time in his family. According to Dr M‘William, the first member of his family that was attacked was one of his children, who was taken ill “on the tenth or eleventh day” after his return, the illness of this child being gradually followed by that of two other children. But Dr King affirms that these children were not taken ill until “about a month” after their father’s return, and that it was not until the succeeding month (the middle of November) that his wife was seized, “when the disease was general throughout the island.” It is also particularly to be observed, that a child in another family at Rabil, having no communication with the family of Pathi, died about the same time as Pathi’s first child, and that the disease broke out at least as early at Rabil as at Porto Sal Rey.