The Common Nature of Epidemics, and their relation to climate and civilization

Part 11

Chapter 112,773 wordsPublic domain

“I have observed that Caffiero added to his original testimony so much as to give to it a new character altogether; I now observe that six days after Caffiero’s amended testimony, and sixteen days after her own original examination, the woman Villalunga comes back with a new story, of which, singularly enough, the principal point is made to coincide with the alterations and emendations in the evidence of Caffiero.”

On an examination of the surviving member of the Fenic family, the widow of Fenic himself, it appears that she gave a positive denial to this alleged visit of her husband and children to the ship.

“She was at my desire,” says Mr Howell, “particularly reminded that the duty which she owed to society required her to disclose everything that she knew; and from the ingenuous manner in which her evidence was given, I am led to believe that she spoke the truth.

“She declared that she did not know the cause of her children’s illness:—‘They were attended by Dr Lopez, who is dead, and who said they had a tabardillo and indigestion, _caused by eating green figs_. He did not say what was the cause of the tabardillo. My husband was a cigar-maker; but he did not go on board ship either to buy tobacco or to sell cigars. Neither my husband nor my children went into the bay at any time during last summer or autumn. I know this: because if they had gone, they would have told me, and they did not tell me.’ Nor, indeed, is it to be supposed that the children would not have told their mother, and that the husband would not have told his wife, that which all of them are declared to have communicated so freely to other people.”

On being cited before a Public Notary at Gibraltar (November 14th, 1829), this witness still more particularly deposed—

“That it was utterly untrue that her husband went on board any ship in the bay at any time last summer; that on account of his age and infirmity, he had not been in a boat for ten years past; that she is equally certain that her two children never went on board any boat or ship; that, with respect to the boy Caffiero, neither she nor any of her family knew anything about him; and that his story of having gone on board the ship with her husband and her two children, ‘is a made-up falsehood.’”

Mr Howell sums up the result of his examination of the evidence adduced before the Board respecting the Fenic family in the following words:—

“Having thus examined in detail the evidence adduced to connect the illness of Salvador Fenic (the alleged first case of the epidemic) with the ‘Dygden,’—and no other vessel has been pointed at,—I find not only that it completely fails to make out even a _primâ facie_ case, but also, from the whole complexion of the evidence, I am convinced that the story of Fenic’s visit to that vessel on the 10th of August is, from beginning to end, a fabrication.”

Apparently in anticipation of a failure to connect the illness in Fenic’s family with a foreign source, much testimony was given before the Board derived, as is stated by Mr Howell, “through channels most impure,” about instances in which foul clothes are supposed to have been brought ashore by sailors arriving from the Havannah, in the early part of the epidemic, and which foul clothes infected the washerwomen.

After showing at some length the discrepancies and contradictions which proved the whole testimony adduced on this point to be utterly worthless, Mr Howell says:—

“Here I leave the journals of washerwomen, and the tattle of their gossips, remarking this fatal objection to each washing-tub anecdote, however circumstantial, that _not one of them goes back so far as to precede_, and therefore to account for, _the alleged first case of the epidemic_, namely, that of Salvador Fenic, who, as we are told, fell ill _on the 11th of August_, and upon whose single case, therefore, the proof of importation rests. And if the attempt to connect the illness of Salvador Fenic with a foreign source be, as I hold it to be, a complete failure, how is the illness of the boy Caffiero to be accounted for? And to what is to be ascribed the illness of Mr Martin’s child on August 16th, a case quite as early as that of Caffiero, and which has not been attempted to be traced to importation? not one of the washing-tub cases being anterior either to that of Mr Martin’s child or to that of Caffiero, both of which are unquestioned cases of the epidemic.”

It was essential to the proof of the connection of the “Dygden” with the outbreak of the epidemic, to establish the fact of the existence of Yellow Fever on board the ship. No proof of this appears to have been adduced. On the contrary, the captain of the ship declares that no such disease existed on board; the head of the Quarantine Department, after an official examination into the fact, affirms that there is no evidence whatever to disprove the truth of the captain’s statement, and the Quarantine Medical Officer, after “a minute inspection of the captain and crew,” states that he “found them all in perfect health.”

“I have minutely inspected the captain and crew,” he says, “whom I found in perfect health. The reason for putting this ship in quarantine for 40 days was, that two men died on the passage. It is now 66 clear days since the first man died, and 61 since the death of the last, and nothing like disease has since appeared, nor have I the most distant reason to apprehend danger to the public health from any circumstances connected with the ‘Dygden.’”

Mr Howell calls special attention to this report of the medical officer:—

“This report,” he says, “was written, as it strikes me, under circumstances which entitle it to much consideration. This ship had been officially pointed out to him (as the Medical Officer of Quarantine) as being strongly suspected. The responsibility of his office was thus brought fully before his eyes, and he had _then_ no motive for making a false report of his inspection of the ‘Dygden’s’ master and crew, because the epidemic had not at that period commenced. If he had observed any reasonable grounds for suspicion, he had only to fall in with the rumour, and recommend that none of the persons or susceptible articles on board should be permitted to land. The conduct and declarations, therefore, of Dr Hennen, as a responsible public officer, under such circumstances, when, if he erred at all, it would probably be on the side of _over caution_, I hold to be most material.”

Such is a fair specimen of the evidence adduced on this occasion to establish a positive case of importation. It breaks down at every point. There is complete failure in the proof that Yellow Fever existed on board the ship; there is complete failure in the proof that there was the slightest connection between the ship and any persons on shore; and there is even failure in the proof that the individuals who are alleged to have introduced the disease were really affected with a malady of the same nature as the epidemic that subsequently prevailed.

The Judge Advocate thus states the conclusion at which he arrived after a careful examination of the proceedings of the Commission:—

“I am of opinion that the evidence brought forward has totally failed to prove that the late epidemic disease was introduced from any foreign source, either by the Swedish ship ‘Dygden’ or by any other means; and I am further of opinion that the late epidemic had its origin in Gibraltar.”

Medical observers on the spot, not members of the Board, but who carefully watched its proceedings, it is believed, without any exception, arrived at the same conclusion. Thus Dr T. Smith sums up the result of his examination of the subject in the following words:—

“That it was not imported I think every candid man will admit who has deliberately weighed the evidence given on the subject before the Board of Commissioners, and the facts I have stated. Every endeavour to establish the importation doctrine has failed, and both the Colonial Secretary, Sir George Murray, and Sir James McGrigor, Director-General of the Army Medical Department, I have heard, are convinced there is not the slightest ground for such a belief; but, on the contrary, that there is every reason to suppose the disease owed its origin to causes within the walls of the garrison.”

Several comments were made by those who paid attention to the subject at the time, on the manner in which this investigation was conducted, which appear to deserve notice.

Complaints were made that the result of the inquiry was prejudged. In proof of this it was found that the President of the Board, a few days before it held its first meeting, addressed to the military secretary of the garrison an official letter in which, among other observations directly tending to a prejudgment of the case, he affirms, that “the fever in question has often been traced to importation, and against this source _only_ must we look for its prevention.”

It appears further that before the meeting of the Board an official intimation of the views and wishes of the local authorities was promulgated in the Government Gazette, into which nothing is admitted but by authority, in the following words:—

“The scourge from which we have been by Divine Providence just delivered must be an exotic of some kind. It is in its origin independent of everything inherent in the soil which we inhabit, incapable of existing among us during the winter months, and totally distinct from and unconnected with the Remitting and Intermitting Fever, which may be said to be unknown in this garrison.”

“Two causes,” observes Mr Howell, “concurred to operate injuriously upon the proceedings of the Board: _First_, the conviction universally prevalent among the _civil_ population of Gibraltar, that the prosperity of that community would be undermined if it should be proved that the epidemic had been generated on the spot, because of the prohibitions and restrictions which it was anticipated would in that case be inflicted upon its commercial intercourse with other places. Hence the notion that not only the last epidemic, but that all its predecessors had been imported from some foreign country was not only anxiously supported by the unanimous voice of the civil community, but it was with equal unanimity believed that a different doctrine would be fatal to the commercial prosperity of the place. From this feeling of self-interest it is to be admitted that the _military_ were exempt, a distinction between the two classes which ought to be taken into account in estimating the value of the evidence taken by the Board, and more especially the evidence of the medical practitioners.

“The _second_ cause operating injuriously upon this inquiry was the publication, in the official government newspaper (into which nothing is admitted except by official authority), on January 12, 1829, of an article authoritatively announcing that the late epidemic had been imported into Gibraltar, and denouncing as void of common sense any person who should hold a different opinion. This official notification of the feelings of the local Government (preceding as it did by only 12 days the appointment of the Board of Inquiry) could hardly fail to encourage evidence on one side, and discourage evidence on the other.”

Complaints were also made that there was a partial selection of witnesses.

“It always appeared most extraordinary and ‘unjustifiable,’” says Dr Gillkrest, “that on this kind of inquiry, which was intended by the Secretary of State to be so beneficial to the interests of humanity, the Superintendent of Quarantine, as president, should have assumed the right in several instances of selecting the witnesses, which obviously prejudiced the question, and by which much of the truth was intercepted.

“Several medical officers of the garrison who had much experience respecting the progress of the epidemic, were either not examined at all, or only in a very imperfect manner. I was among the latter, being surgeon to the 43rd Regiment, and present during the whole epidemic. After a very limited examination, I officially informed the President, by letter, that I had much to state; but, like others, I was not called afterwards.

“From what I felt due to the service of which I had been a member for so many years, as well as the cause of truth, I was induced to protest against such proceedings, which protest will, I presume, be found with the documents connected with the inquiry forwarded from Gibraltar to the Colonial Office in London.”

Complaints were further made of the mode of collecting the evidence adopted on this occasion, which was such as to excite the suspicion of some of the members of the Commission, and to lead eventually to their condemnation of it, and their repudiation of the Report which was founded upon it.[38]

Footnote 38:

_See_ Letter of Sir George Murray, and reply of Colonel Chapman, the Civil Secretary, p. 274;—also Report of Judge Howell, Second Report on Quarantine of the General Board of Health, Appendix II., pp. 245, 273.

APPENDIX.

A return of the Sanitary Works carried out in those towns to which the Public Health Act has been applied, was laid on the table of the House of Commons, on the 12th of April last, and ordered to be printed (No. 176, Session 1866). In view of the threatened Epidemic, however, the unusual labour cast upon the Local Government Office,—now charged with the superintendence of Local Boards of Health,—must render it improbable that time can be found to examine the proof of this important return before the end of the Session.

At this still early period in the progress of Sanitary Reform, any such return must be manifestly imperfect; yet it will probably be found that ten times the sum mentioned in the text[39] is already known to have been expended on these works; and previous returns show that about a million and a half sterling has, in addition, been laid out in the provision of Extramural Cemeteries.

Footnote 39:

See p. 57.

The effect of these measures, in reducing the mortality of the population, cannot of course be calculated at present with any degree of accuracy; because no statistics of this nature can be reliable, unless based upon an average of many years. It will, nevertheless, be exceedingly interesting to watch the results of these improvements in the civilization of England; improvements which have been, perhaps, mainly effected by the labours of Dr Southwood Smith.

That such Sanitary appliances are not yet all that could be wished in many of our larger towns, is abundantly exhibited by the following extract from the Quarterly Report of the Registrar-General for January, February, and March, 1866.

“If the map of England were shaded to represent the rates of mortality of last quarter in the registration districts, the eye, travelling from the lighter south to the darker north, would be instantly drawn to a spot of portentous darkness on the Mersey; and the question would be asked whether cholera, the black death, or other plague, imported with bales of merchandise, had been lately introduced into its busy and populous seaport. Happily this has not been the case; but fever, probably developed or aided by the mild and damp atmosphere of the season, and by overcrowding in an increasing population, has been busy and fatal in Liverpool, and in other towns of the same county and of Yorkshire. The annual mortality of the borough of Liverpool in the three months was excessive, and demands immediate and earnest consideration; it rose to 4.593 per cent. This implies that if this death-rate were maintained for a year, 46 persons out of 1000 in the population would die in that time, or 15 more than died in Glasgow, its northern rival, 19 more than in London. The mortality in the city of Manchester, though far less than that of Liverpool, was higher than in any other of the 13 selected towns of the United Kingdom; it was 3.742 per cent.; and that of Leeds was hardly less.”

THE END.

JOHN CHILDS AND SONS, PRINTERS.

● Transcriber’s Notes: ○ Missing or obscured punctuation was silently corrected. ○ Typographical errors were silently corrected. ○ Inconsistent spelling and hyphenation were made consistent only when a predominant form was found in this book. ○ Text that was in italics is enclosed by underscores (_italics_).