Page images
PDF
EPUB
[ocr errors]
[ocr errors]
[ocr errors]

difference - he would be able to communicate precisely the same disease to another, while the subject of the first affection would probably be without such power ; --because, say the anticontagionists, he would not be capable of forining the atmosphere indispensable to the maintenance and diffusion of the complaint.

So far, then, all would seem to be in favour of that doctrine which supposes an actual and essential difference in the laws of communication between fevers, for plague is but a virulent fever,) and those distempers which are universally allowed to be communicable in the way of contagion ; and the decided language of Dr. Rush would appear to be well founded, when he remarks, " It is from nastiness degenerating into infection, that the bodies, clothes, beds and apart

ments of the poor in Great Britain, derive their poisonous, their pestilential charge. By a common putrefactive process, this septic venom is formed, and derives pone of its qualities from pulsating arteries or glands. Away, then, with this preposterous phrase, from the poison engendered by septic processes, and let “human contagion” for the future mean nothing but small-pox, vaccinia, and the kindred forms of morbid secretions. It is high time that the products of putrefaction, should be distinguished from those of secretion.'

And when we take into consideration the remarkable localities of those more violent fevers by which different regions are visited at different times, and recollect the diminution of them in some parts of America, especially since investigations have been made into their alleged sources, and these sources removed, we are compelled, to a certain extent at least, to subscribe to the opinion of the anticontagionist, and we seem to arrive at a very satisfactory inference respecting the transportation of these dreadful visitations from one to another part of the world

There are, however, several impediments to this straight forward progress, and strong grounds for qualifying our sentiments on the subject of contagion, wbich claim now to be mentioned.

It has been very forcibly stated by the contagionists, that were nastiness and filth, according to Dr. Rush's account, the cause of disease, the induced complaint would not then be necessarily of the same nature as that of the subject from which it was received. Thus, if two wards of an hospital be devoted, one to the reception of individuals under typhus fever, the other to those under dysenteries, and if the want of cleanliness in each case stand exactly at the same point, the fever patients would never form the atmosphere wbich would occasion dysentery, nor would the dysenteric individuals ever impart fever. And moreover, both the one and the other disease, are it must

[ocr errors]

be allowed, occasionally derived from their peculiar and respective sources, even when every attention shall have been given to ventilation and cleanliness, and when perhaps only one or two sick persons may have furnished the atmosphere of infection.

Some few years since, at Edinburgh, when the disputes and divisions between the contagionists and the anticontagionists ran very high, there were several instances of intentional exposure to the alleged sources of contagion, for the sake of shiewing its existence to be merely imaginary. Many of the students in that university, who, with Dr. Rush, derided the doctrine of contagion as a bugbear, exposed themselves fearlessly and

' with design, to the effluvia from the bodies and lungs of the fever patients in the infirmary, and several in consequence fell with fever, which, in some instances, proved fatal. Now, when Dr. Adams is called upon to reconcile this acknowledged fact, with his notions of the incommunicable nature of fever in the manner supposed by some, he tells us, that there was no instance of the individuals in question infecting others, inasmuch as they went through the disorder in their own apartments, and did not bring with them the hospital air. But we would suggest whether the immunity might not be attributable to more care having been exercised in these cases, and greater precautions taken by their attendants and friends, as the joke of experimental speculation, to use the language of Dr. Gregory, had already been carried sufficiently far. The mention of Dr. Gregory reminds us of a tale which we have heard him relate in his Lectures, for the purpose of establishing the very opposite assumption to that of Dr. Adams and others, and to prove that fever

may be communicated in the same way as the more positive contagions, that is, from something secreted by the communicating individual, or formed by pulsating arteries or glands, and imparted immediately and directly, without the intervention either of filth or infectious atmosphere. The Professor informs us that a young woman, of extraordinary beauty, was adınitted into the fever wards of the infirnary with typhus, and that several of the students, captivated by her person and manners, were in the practice of sitting on her bed and approaching 'nearer to her than was prudent; in consequence, several became affected with typhus, who might have ranged the fever wards during a whole season, or, in other words, exposed themselves to the atmosphere of fever, with perfect impunity,

Another fact favourable to the doctrine of contagion, is, that when any reigning disorder of a given district visits a family, each individual of such family becomes more obnoxious to the infection, than his neighbours and friends, whose houses

the epidemic has not yet entered :-a presumption, say the contagionists, that the poison creative of the malady, is imparted from one to another, in the same way as small-pox or measles. And still further, we are told of instances in which the actual importation of the virus has been traced from one region of the globe to another, as was the case, it is urged, with the yellow fever which some years since raged at Gibraltar, and which was, with an evidence too palpable to be disputed, conveyed thither from Malaga.

The reader will by this time perceive the nature and the state of the controversy. The question, it will be seen, is, whether fever engenders fever, as small-pox engenders smallpox; that is, by a specific secreted virus, created or engendered by the morbid actions of another invalid affected by the same malady. In other words, are fevers generally, engendered, sustained, and propagated, by precisely the same laws as those which regulate the propagation of measles, small-pox, scarlet-fever, hooping-cough, and other maladies, that are admitted by all parties to be actually contagious ?

Our own sentiments on this contested point, are, if we may so say, intermediate. The facts of the case appear to us to favour the inference, and indeed almost to establish the assumption in an unqualified manner, that the distempers in question are at once contagious, and not contagious; that in some instances they have an independent origin, and in others, are received by individuals nearly, if not precisely, in the same manner as are other morbid secretions.

It has already been stated, and indeed it is a fact generally known, that even those epidemic diseases which are attributed to some unknown states of the atmosphere, as their immediately exciting cause, are, nevertheless, apt to run in families :—that is, if a fever prevail for a given time in a certain district, and one individual of a family fall ill, there is greater reason to fear for the remaining members, than previous to this occurrence : such is likewise most decidedly the case in respect of measles or small-pox. But here, in our minds, consists the cardinal point of distinction between the one and the other infection ;-the acknowledged and absolute contagion never affects the frame, how mildly and slightly soever, without producing that state of the secretions by which a precisely similar distemper is capable of being given to another; (similar we mean in kind, whatever be the difference in degree;) while an epidemic fever may have the power of engendering a certain quantum of indisposition in the system of another, without positively reproducing itself, unless the external circumstances and internal condition of the new recipient, act conjunctively in aid of the disease-creating virus, or unless, as the anticontagionists say, the infectious atmosphere be present. But this is by no means necessary for the continuance and spread of the real contagions, although, even these must be allowed to appear and disappear in a way that is not very susceptible of explication upon any other principle than that of something extraneous or atmospherical being essential to their support and propagation.

We have dwelt rather at large, and perhaps with some appearance of repetition, upon these two points; the one, of similarity, the other, of difference, between the virus of fever and the specific contagions; because, while we do not perceive that it is distinctly pointed out by writers on the subject, it appears to us the only clew for unravelling the seeming inconsistency of the facts conneeted with the diffusion, on the one hand, and the limits, on the other, of infectious disorders.

Against the opinion of those, (for some there are who argue the absolute necessity of contagion in all instances for the production of genuine fever,) we may relate the following narrative from Dr. Rollo; and we shall afterwards endeavour to shew of what importance such facts are to the moderate and intermediate inference that we have just announced, as, in our minds, the only legitimate one that can be made from a collation and comparison of seemingly opposite facts. One man (Dr. Rollo

• says) of the Horse Artillery, was admitted into the hospital with suspicious fever; next day, another. This excited enquiry. It was found they came from two different barrack rooms. These were followed by other men, in all amounting

to eight; three of whom came from a separate room; the 6 rest from the same room. The rooms were visited by the 'commanding officer. All the rooms whence the infected came,

were found to have different bedding from the rest of the barracks. The horse artillery being a corps in constant readiness for service, and whose appointments were always complete, had, for convenience of carriage, hammock bedding. The hammocks were rolled up tight every morning

the moment the men rose, and they were unloosed when they ' went into them again at night. At this time we had so much

and so constant rain, that this bedding had not been aired or opened, for a single day, for at least two months. The ham

mocks with their bedding, were examined, and the moment ' they were opened, a very peculiar nauseating smell was

perceptible. Immediate steps were taken, and no further mischief ensued. Thus, an infectious fever evidently arose

(Dr. R. says) from the confinement of the eflluvia of a 'man's own person, in a term of about two months.'

Here a difficulty presents itself to the contagionist, which we conceive to be insurmountably in opposition to his tenets, inas

[ocr errors]
[ocr errors]
[ocr errors]

much as the maladies in question had, we have every thing but absolute demonstration to prove, an independent origin. Nothing of this kind can ever have become the source of smallpox, or measles, or any other really contagious affection. But, on the other hand, these soldiers, thus infected, would be capable of delivering over, as it were, such infection to another, by direct contact or communication, but the secondary disease would, we conceive, assume a type corresponding to the interior state and external circumstances of the new recipient. And it is not perhaps an unwarrantable postulate, to assume that the disorder thus imparted, would in one part of the world, prove to be typhus, in another, yellow fever, and in a third, plague; and that these respective maladies would, from such source, be made to spread, should every thing around them be favourable to their propagation, while they would immediately decline and die away, should they meet with no pabulum of growth and nourishment.

In a practical point of view, then, we have arrived, although by a somewhat different route, at pretty nearly the same conclusions with the anticontagionists; and we verily believe that quarantine laws are both unnecessary and inefficient, unless the ship's crew upon which they are enforced, are bound to a place of the same latitude, the same temperature, and the same general circumstances, internal and external, as those from which the vessel had embarked. In other words, we do not believe that the yellow fever could ever by importation be planted in the north of Europe, or that the plague is capable of being brought from the shores of the Levant, into the metropolis of Britain.

It will be seen that we have all along granted to the anticontagionist, the existence and necessity of an atmosphere of fever, in order to insure its continuance. Now, it is a remarkable, and would seem to be a providential circumstance, that although this atmosphere is necessary for the propagation of the particular distemper, those persons who are gradually inured to it, are less likely to be injured, than they who are exposed to it suddenly : thus, a child in a family living in the district of an epidemic, would, if affected at all with the complaint, be likely to have it in a much milder form than one who should visit such family, and in this manner take the disorder. Upon this ground Dr. Adams argues,

· That if a ship's crew immediately on its arrival, should be the first to shew the plague or any other fever, the probability is, that the cause is to be looked for in their greater susceptibility, and not in their bringing a contagion with them. If the disease should spread, not only over such a town, but wherever else the diseased may fly, the question may be involved in some obscurity. But should it be

[ocr errors]
« PreviousContinue »