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The Common Nature of Epidemics, and Their Relation to Climate and Civilization · Southwood Smith — chapter 22 of 25 · ~1,766 words · public domain

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Footnote 36:

See note, p. 16.

These prognostications were so manifest as to excite the attention and alarm of the intelligent classes of residents. The Governor-General states:—

“Great falls of rain took place at a very advanced period of the season, which remained stagnant.”

The British Consul says:—

“Up to the month of October, extraordinary heat and the fall of a large quantity of rain had been experienced, events which were surprising to the oldest inhabitants.”

The British Judge says:—

“Stagnant water had settled in great quantity at the back of the town, to which was joined great heat in the weather.”

Dr King says:—

“The information received on the island in 1846, fully corroborated what is stated in the above extracts, the periodical rains, contrary to what usually happens, did not set in till late in September. In October, November, and December the winds were light and variable, with frequent calms, and the weather became in consequence extremely sultry and oppressive. The grass and green crops were nearly destroyed by the long previous drought, and what little appeared after the rains was devoured by the locusts, which visited the island in greater numbers this year than was ever known to be the case before.”

Though Dr M‘William, on his inspection of the island with a view to ascertain the true cause of the pestilence, took no notice of any of these premonitory signs of its approach, Sir William Burnett was fully aware of their signification, and calls special attention to one of the most important of them in his Report to the Lords of the Admiralty.

“I beg to lay before their Lordships,” he says, “an extract of a letter from the Governor-General of the Cape de Verd Islands, and likewise extracts of letters from Mr Macaulay and the British Consul, residents on the island of Boa Vista, distinctly showing the very remarkable state of the weather preceding the attack of the inhabitants of the island, which very important circumstance in a case of this kind I regret to observe Dr M‘William has omitted to take any particular notice of.”

The event foreshadowed by these occurrences rapidly followed. As early as the middle of September a few cases of unusually malignant fever broke out, but, as has been already stated, the first case that attracted public attention occurred on the 12th of October; a few others followed during the remainder of this month; a still greater number broke out in the beginning of November, and the epidemic came to its height in the latter half of November, continuing to prevail throughout December, and recurring for several months in the following year.

As in epidemic outbreaks in general, so in this instance, individual or sporadic cases occurred some time before the appearance of the epidemic in its true and proper form. On minute inquiry, it was discovered that one if not two cases occurred as early as the 14th of September (Pathi), another on the 20th of September (Roque), and a third on the 21st of September (Agostinho): no other cases, at least none that attracted attention, appeared to have occurred until the one already mentioned (Gallinha), on the 12th of October. These sporadic cases all occurred in the ordinary localities of epidemic disease, and among individuals belonging to the classes that usually furnish its first and chief victims.

At Boa Vista, in addition to other proofs of the presence of a stagnant and pestilential atmosphere, there was the evidence derived from the prevalence of unusual sickness and mortality among domestic animals.

“That the common air,” says Dr King, “which was inhaled by every living thing on the island was in an epidemic condition in the months of October, November, and December of both years, is sufficiently demonstrated by the simultaneous occurrence of universal sickness and great mortality among the cattle (including horses, cows, mules, donkeys, and goats) at the very time that fever was raging among the inhabitants. And, further, there was this remarkable coincidence, that after an interval of some months and the disappearance of the disease both in man and beast, the same fever broke out again in the towns and villages about the rainy season of the following year, and was again accompanied by the same murrain among the cattle, which in the two seasons proved fatal to two-thirds of the whole stock of the island.”

These considerations afford all the evidence which the nature of the case admits of, that the sickness which affected the island on this occasion arose, not from the landing of the sick of the “Eclair,” but from climatic and endemic causes.

To sum up the whole of this case, then, it appears that the evidence in favour of the allegation that fever was imported into Boa Vista by the “Eclair,” amounts to this: that four men, not of the ship’s crew, were attacked with fever while performing military service in a locality in which no fewer than 60 of the crew themselves were seized; that one man not of the ship’s crew who worked as a labourer on board the ship “about eight” or “two” days, had a slight attack of fever, while 62 men also not of the ship’s crew, and who also in like manner worked as labourers on board the ship a longer time, were wholly unaffected; and that a month after the sailing of the vessel, a woman was attacked with fever who happened to be a next-door neighbour to two of the soldiers who had served on duty at the Fort—one of whom was unaffected, and the other not even confined to bed—simultaneously with the children of the labourer (Pathi) who resided in one of the dirtiest localities of the island.

Against such evidence, if evidence it can be called, must be weighed the following countervailing considerations:—

It is admitted that the “Eclair” had been exposed on the coast of Africa to the causes which usually develope epidemic fever in that country; that intensity was given to those causes by circumstances which occurred at Sierra Leone, where she took in green wood as fuel, and where her men went on shore during the rainy and sickly season, and indulged in the unlimited use of ardent spirits; that her hold was in a pestiferous condition, and that a quantity of putrid mud had collected between her timbers. It is proved that the fever which broke out under these circumstances was the common endemic African coast fever, which, it is admitted, is not contagious, and which is assumed to have become contagious on this particular occasion, expressly to account for its alleged importation. It is admitted that on the landing of the ship’s crew at Boa Vista, though the men mixed freely with the islanders,—though the officers lodged in the town,—and though, when some of them became sick, they were nursed by the inhabitants,—there was no communication of the disease in a single instance. It is admitted that of seventeen washerwomen who washed the linen of the officers and crew, not one became infected, although all these women, except two, suffered severely from the disease at subsequent periods after the epidemic became general. It is admitted that with the exception of one case, which has been proved on inquiry to have been no real exception, 87 labourers worked on board or in the neighbourhood of the ship daily, and returned to their homes at night, without taking any precautions,—without becoming themselves infected,—and without communicating infection to any individual of their families;—though, like the washerwomen, the greater part of these men suffered severely when the epidemic became general. It is admitted that the Cape de Verde Islands are within the Yellow Fever zone, and are liable to frequent and severe outbreaks of epidemic fever. It is admitted that the physical and social conditions of Boa Vista are eminently those which are found by universal experience to localize epidemic diseases whenever an epidemic influence is present. It is admitted that the “Eclair” arrived at Boa Vista at the season of the year when endemic fevers usually prevail. It is admitted that at the very time of her arrival, Yellow Fever was actually prevailing at Porto Praya, in the island of St Jago, into which it is not alleged that the disease had been introduced by importation. It is admitted that some time before the outbreak of the epidemic, the atmospheric and other conditions which usually precede and accompany the development of epidemic disease, were so manifest as to attract general attention. It is proved that sporadic cases of the disease appeared, as is usual, some time before the presence of the epidemic was declared in its distinct and recognized form. It is admitted that the epidemic influence extended to animals as well as man, a mortal epizootic disease prevailing over the whole of the island at the same time. It is proved that the epidemic did not break out until about a month or six weeks after the “Eclair,” with all her crew, healthy and sick, had left the island. It is admitted that a similar epidemic appeared among men and animals the following year, not imported, but entirely of local origin.

Footnote 37:

The aggregate number of the lists furnished by Dr M‘William.

A consideration of these circumstances has satisfied most of those who have inquired into the case, that the arrival of the “Eclair” at Boa Vista with fever among her crew, and the occurrence of a similar disease on the island, were mere coincident events, and that the appearances which might at first view have given some colour to the notion of importation were fallacious.

Among those who arrived at these conclusions were—The Governor-General, who says:—

“The disease was perfectly endemic. Not one of those who emigrated to the different islands of the Archipelago had the disease or communicated it to others. It did not make its appearance till a month after the departure of the steamer.... The disease had its origin in the great falls of rain which took place at a very advanced period of the season, and which remained stagnant in the neighbourhood of the place.”

Mr Rendall, the Consul, who says:—

“The competent officers of the ‘Eclair’ at all times pleaded that the fever which had appeared and rested on board was nothing more than the ‘common African coast fever;’ the opinion of the medical men on the spot continued to be that the fever was merely the common African fever, and that no danger existed of its spreading among the people.”

Mr Macaulay, the Judge, who says:—

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