CHAPTER I.

PREVALENCE OF DOCTRINE OF ATMOSPHERIC CONTAGION, INJURY TO PATIENT, ATTENDANTS AND VISITORS.

Atmospheric contagion, to which public attention is directed, has been regarded for many ages as the cause of a great proportion of the pestilence incident to the human race; and, at the present day, most of the diseases which are wont to be widely spread, and to be very mortal, are usually considered as depending on that agent, both by the unprofessional and the medical world: indeed, so extended has been thought its sphere of action, that it is suspected to be operating in almost every case that occurs, of those diseases which usually attack many at the same time; and, in nearly every instance, its existence is positively inferred, where previous cases can be shewn to have been prevailing, though at the distance of several miles.

It is a fact familiar to many, that, on the occasion of the late prevalence of Cholera Morbus in the years 1831 and 1832, that infection, through the medium of the air, was considered the most common cause of the propagation of that scourge; and every mother is taught to regard every case of scarlet fever, common fever, hooping-cough, and many such disorders, as a very centre of infectious air that possesses qualities subversive of the health of her children.

Ordinary conversation, too, marks well the common belief in the positive injury that agent inflicts. In general, it seems a matter quite out of the question to suppose, that the patient may have got his sickness from the operation of other and distinct causes, as is sufficiently evident from such common questions as these, “Had he visited any person ill of the same complaint?”—“Where, and from whom, did he get the infection?” and likewise from the ordinary replies, “He got it from a friend, at whose house he called to inquire after his health,”—“He caught it when passing through a street in which a person lay ill of the same distemper.” Such inquiries and replies are made not only by the public, but by the medical profession also, who are, in general, sufficiently satisfied if such answers and solutions as those above be given. Were it necessary to say more to prove the important position infection holds as a cause of disease, and as the chief instrument of its propagation, references might be made to thousands of instances, narrated, too, on medical authority, where whole visitations of pestilence have been attributed to its operation, and volumes might be filled with the most skilful artifices, devised, and actually carried into execution, to deprive the air of its invisible poison; but these steps are deemed unnecessary here.

The belief in the doctrine of atmospheric contagion is hurtful to the patient by its direct influence on his mind, and the gratification of his wishes.

The patient laid on the bed of sickness, having many wants and occasions for a thousand little offices, but being unable to assist himself, generally desires, and, where apprehension does not cause desertion, obtains the aid of good and gentle friends, whose very presence affords a gratification to the sufferer which none can sufficiently value, who have not, like him, felt its blessings. Their assistance and constant presence is absolutely necessary to supply his several wants, and to render a situation, often painful, and ever irksome, less acutely so.

But not more necessary is such assistance to the mitigation of the sufferings of the body, and the soothing, the calming of a fevered mind, than is it urgently wished for, and longed for by the patient, to whom even the momentary absence of the ministering being from his bedside is frequently the cause of much mental agitation and of pain.

But where, as we have often seen, the patient has still his senses left, and dearly loves the objects around him, what must be the amount of that bitterness of mental struggle going on in his breast, alternately heaving with desire for their presence as his greatest comfort, and with the alarm every amiable being must feel, lest those most dear to him should fall the victims of their tenderness, and be cut down themselves, in their holy endeavours to relieve his sufferings?

The apprehensions of the patient lest those kind and beloved friends ministering to his wants, and nobly incurring on his account all the risk of a dangerous situation, should unhappily derive from him, through the medium of Atmospheric Contagion, the same disease,—are calculated to produce a state of excitement highly injurious and directly opposed to that calm and cheerful state of mind so favourable to his recovery. But these apprehensions are often changed for the dreadful reality, and no little mental suffering has been produced, and no trifling obstacle to the convalescence of a patient has been raised up, by the intimation that a dear friend has caught the pestilence from him, and has in consequence been deprived of life.

The belief in the doctrine of Atmospheric Contagion is hurtful also to the friends and attendants of the patient—by its naturally conveying the impression that he is a centre of a poisonous agent, whose immediate tendency is to propagate the distemper and diffuse itself through the atmosphere, extending to it, its deleterious attributes, to be felt by all who respire it.

The poison is said to diffuse itself in the air of the apartment; hence it is believed, that entering into the apartment is tantamount to destruction, or at least, is nothing less than exposure to an influence of the most virulent and deadly quality.

It does not at the time signify to the attendants, the evidence on which the doctrine rests. It is believed, and that is enough to cause the most baneful effects upon the spirits, to inspire the worst apprehensions, and has also, as is well known, produced those very effects they had feared from its operation, has caused the increase of disease, nay, death itself, and that not on one occasion only, but on many.

The most common causes of Pestilence, Plague, Putrid and low Fevers, and Cholera, are mostly of a depressing nature, and, usually, the more they partake of that character, they are the more effectual in their operation. Famine is chiefly favourable to the sickness which is usually coincident with it, from the depressed and feeble state of body it produces; and an impure atmosphere is deleterious, chiefly from its allowing the body to become less energetic, by withholding that vigour and elasticity which the respiration of pure air imparts to the system at large, and thence to the mind.

These are powerful depressing causes, but not more so than fear, especially that kind that is deep and lasts long. Moral philosophers rank Fear as one of the most depressing passions, and its characteristics with the artist are paleness, contraction of the features, the best and surest indication of a weakened circulation (of blood) and diminution of vital power. The first are well aware of the hurtful influence it imparts to the whole body, and narrate instances, on excellent authority, where death, even immediate death, has been the consequence, where the brain has had its functions impaired, and thus imbecility induced; so that in short, they are accustomed to regard it as one of the most powerful agents, applied both to the mind and body.

The Medical Philosopher, too, has frequent occasion to mark the great depression of the powers of the body, the imperfect discharge of its functions, and the general exhaustion consequent upon the long continued operation of apprehension.

Be the apprehension of whatever nature, it is always detrimental—in a ratio too, proportionate to its intensity, and its other contingent circumstances. In the lesser degrees, it causes indigestion, flatus, loss of appetite, headach, and often general restlessness, with feelings of great discomfort.

It is found operating with great force, whether it arise from apprehension of damnation in respect to a future state, of ruin in a pecuniary point of view, or perhaps from what is most immediate and striking in its effects, of catching the infection of pestilential disease, which is the point with which we have most to do.

We have known many persons much affected with the fear of taking infection, and allowing this to prey upon their spirits, who were among the first attacked with pestilence; and if any weight is to be given to our knowledge of the probable causes of disease, there is great reason for concluding that those persons were the victims of their very fears, more than of any other causes of a prejudicial character. It is often impossible, with complete justice, to say decidedly that any one influence has been the exclusive cause of disease, when there is room to think there are, or may be many ready to operate; but, in many instances, the relation has been so immediate, and so striking between the known presence of depressing apprehension, and the supervention of sickness, that there is no room left to doubt the propriety of placing them in the relation of cause and effect. It must be familiar to many, quite a common occurrence, and one of which we heard constantly during the ravages of Cholera a few years ago, that persons took that disease from mere fright, and of the attack having been very much encouraged by its operation among the attendants, and more especially of those believing in the existence of the infectious nature of the disease.

These facts, it is thought, will prove that the doctrine of Atmospheric Contagion is calculated to excite much apprehension among the attendants and visitors of one sick of pestilence, and to shew in what manner that very apprehension is disposed to produce disease.

The attendant or visitor persuaded of the atmospherically contagious character of the disease, must possess considerable fortitude to venture at all into the presence of the patient, and even when once there, he must possess more than common hardihood, who does not feel more or less depressed with apprehension for that potent, and not the less imposing agent, because invisible, which, like a drawn sword, hangs over him, and threatens his existence.

By the belief in the doctrine of Atmospheric Contagion, the attendant not only becomes, in general, exposed to one of the most common and efficient causes of disease, viz. fear, but his offices are performed more as a duty than as a gratification, which it is to a well disposed mind, where no extraordinary danger is encountered, and he is thus forced to make a sacrifice of his feelings, and the valued assurance of security to a rigid sense of duty; but however much such conduct may agree with morals, it is detrimental to health.

It is hurtful also to the patient, from its influencing so far those, who, by relationship, by previous terms of friendship, and by duty, are bound, by every moral obligation, to assist him, now helpless, sick, and perhaps expiring,—as to forget their most sacred duties as to make them disregard his forlorn situation, and indeed to induce them to fly from and desert him; thus sacrificing every good principle and wholesome consideration, (as they erroneously think) to make their own lives the more secure.

Such contingencies are of frequent occurrence; and the result is, that many unhappy persons are left to perish, their thirst unslaked, their latest requests unheard, and their last moments unwitnessed. Parents have been known to forsake their children, and the offspring their parents, whom, at all hazards, they were bound to serve,—by every holy affection, to assist the more diligently, the more they were pressed with adversity.

But alas! the affections, the instincts of Nature, the dictates of gratitude, have been thrown aside, and every thing fair and holy in the human soul has been foully stained, in the almost universal wreck, attendant on the course of pestilence.

The history of the cholera visitation affords many examples of perishing persons deserted and left to the mercy of a cruel scourge; and we are familiar with many instances which have come under our own charge, where it has been found impossible to procure the attendance of relations, or even the mercenary aid of hirelings, although extraordinary remuneration has been offered.

Last winter, the father and mother of a family were seized with fever, and their sole attendants were their infant children. There were several relatives of the family not far off, but none, not even one, could be persuaded to lend assistance. Their neighbours refused to hold any communication; and, notwithstanding repeated and continued attempts by the Author to induce those who make it their business to wait upon the sick, the family had to struggle on, without the least attention being paid, saving by the almost useless children, to their wants, to cleanliness, and to the administration of the remedies.

It was truly a deplorable scene, such as made the Author reprobate that cowardly desertion, and regret the operation of a doctrine so baneful, and moreover so groundless. Yet we know not whether to blame most the people or the doctrine. Did those see the scenes, the distress and cruelty inflicted through the operation of infectious air, who believe in it, and preach its avoidance; surely, did they possess one spark of humanity, it could not fail to manifest itself, by causing them to institute, or at least to listen to, an inquiry touching its evidence.

The medical attendants are not free from the hurtful operation of this doctrine. If believers in infectious air, they are under a feeling of apprehension which, perhaps with some, may not be strongly felt, on account of the frequency of impunity from exposure; but with many it is strongly felt, and influences their attendance on the sick, their communication with them, and their own comfort and feeling of security.

Many instances are known—they are of very frequent occurrence—where the physician, from apprehension, has failed to pay so many visits as were necessary, or to remain with his patient sufficiently long to ascertain his situation, and watch well the progress of the case. Cases are known where patients have been looked at by their advisers, stationed at the door, where it was impossible to ascertain the expression of the countenance, the condition of the tongue, the state of the skin, not to say any thing of that of the pulse.

We are acquainted with instances in which medical men have so acted under the apprehension of taking infection, and where, too, they have not felt they were doing any thing reprehensible, as was sufficiently evident from the fact, that they themselves were the informants.

These facts prove that injury has been done to the patient from insufficient care; and cases are not wanting, where medical men themselves have taken disease, where the circumstances of the case warranted the belief that fear was the chief, if not the only cause. Many very cunningly-devised plans have been recommended for the adoption of the physicians visiting patients labouring under infectious diseases, such as standing in a current of air passing between windows, or doors and windows,—keeping a handkerchief applied to the mouth and nose, washing the mouth with water, &c. These are sometimes adopted, yet there is room to think that, where a man of merely ordinary fortitude supposes that he inspires an atmosphere holding in solution a very virulent, nay deadly poison, that he will be anxious to make his visit as short as possible, even though the preventives above mentioned be religiously adopted.

Several of the cases of death among medical men, which have been unhesitatingly attributed to infectious air, the Author is convinced, from his knowledge of particular circumstances, and from the known tendency of fear, have arisen from depression, in consequence of that passion.

The prejudicial operation of the doctrine of infectious air has been proved in reference to the patient himself, _1st_, From his apprehension for the safety of others ministering to him; _2d_, From the neglect and desertion of friends and others; _3d_, From the insufficient medical treatment which his case frequently obtains.

It has been proved in reference to friends and attendants, who are often in consequence in a state of apprehension, favouring the invasion of disease; and in relation to the first, who are made to regard one of the most delightful offices as a duty of imminent peril.

It is hurtful both to patient and friend, by forbidding that intercourse which, but for the danger in question, would be so delightful and consoling to both.

It tends to the commission of crimes of no trifling character, the desertion of kindred and of friends, the hardening and debasing of the heart, and the general corruption of the finest sentiments that bind and ornament society.

It has led to deeds not the least dark in the page of human history.

It takes much from the efficiency of medicine, and has been the frequent cause of much evil to its professors.

For all those reasons, it is an important subject, and demands patient investigation.

Surely a case has been made out to shew how important are its effects, and how much evil might be avoided were it proven, as is proposed to be done, that Atmospheric Contagion has no existence. That is all, that is desired to be shewn from what precedes, and we would on no account wish the amount of mischief it inflicts to be thought as put forward as an argument against its entity, which would be absurd.