Chapter 10 of 20 · 1806 words · ~9 min read

CHAPTER IV.

THERE IS NO EVIDENCE THAT ATMOSPHERIC CONTAGION TRAVELS, OR IS COMMUNICATED FROM ONE PLACE TO ANOTHER.

The question of the communication of atmospheric contagion from one place to another has almost universally, on occasions of pestilence, been much agitated, in respect to individual diseases, but seldom in a comprehensive way, embracing all diseases. We propose to inquire generally into the facts which are held to prove the principle of dissemination from one place to another—whether contagious atmosphere is transmitted from one country to another, from one town to another, and from hamlet to hamlet.

In the many works written by medical men on occasions of great epidemic disease, descriptive of the character of the prevalent distemper, there almost universally appear the most minute accounts of the route pursued by contagion, both fomitic and atmospheric, down to the noting of the very road, the very street or alley by which it reached a town—and of the manner in which it arrived, whether on the rags of a tattered beggar, or seated in a stage-coach.

The line of its progression is taken from the observation of disease, and from that alone. Wherever disease appears, there it is said that contagion has been carried or conveyed; and as a proof of that position, it is gravely maintained, that disease invariably breaks out where there are houses, and where communication is likely to be going on in some way or other. This most extraordinary fact proves what must certainly be thought not less extraordinary, that it appears in the abodes and habitations of men. But where else is disease, we would ask, to manifest itself, if among men at all, if not where alone they are to be found?—surely not among deserts uninhabitable, or on the frosty summit of an iceberg?

It is true that in the course of an epidemic, such as the cholera, one country suffers before another; but there is no alternative to such a course if they are not to be simultaneously affected. And it signifies nothing that communication subsists between them. One part of a country, too, is ravaged first, then another, and so on—one town then another—one part of a town, and after it another part.

But it is evident, that if disease is to begin at all, it must begin somewhere, and if all parts are not to be seized on the same instant, that one will have precedence of another, and so on. Springing and propagating, from whatever causes, that character must hold, and surely it is wrong to hold a feature common to the effects of many causes as decisive evidence of the operation of one, and of one only.

The harvests of Europe begin in one country, sooner than in another. In many, harvest is earlier than in England, but it is never surmised that when that process begins in the latter country, that it is through the mediation of some such influence as contagion. It begins in England, too, it might be shewn, in places having communication with foreign countries. Nay, it might also be proven that the parts in which it in general commences are at the coast, where it is well known ships are wont to appear.

Were such an insane supposition made, the most obvious facts would necessarily be laid aside; but such gross blindness would not, we are satisfied, be much greater, than when the process of diseased action, marked out in an epidemic, is attributed to contagious atmosphere alone.

In the case of the harvest, it would argue a forgetfulness of the object held in view when the seed was sown,—in that of disease, an ignorance of the effects to be expected from the sowing of the seeds of pestilence (the exposure to the common epidemic influences alluded to above), in the first, an insensibility to the influence of climate, intensity of sun’s rays, the quality of the soil, &c.:—And in the other, a blindness to the operation of circumstances not less potent, such as the time of application of the causes, the condition of the body, and the presence or absence of moral adjuvants.

It has universally held with all epidemic sickness, that parts of a country have been attacked in succession—that one town is visited after another, and one part of a town before another, whether the prevailing distemper have or have not been said to depend on contagion.

There is nothing extraordinary in the fact that all persons who are to suffer, do not become affected on one and the same day. Far from proving that any thing of the nature of contagion has been in operation, it only proves what may so readily be admitted, or at once readily understood, that all and sundry the inhabitants of a vast tract of country, inhabiting parts having different climates more or less mild, having different situations, some on the banks of rivers, some along the coast, some inland, some on boggy and some on dry soil; having different occupations, different houses, wearing different dresses, having different habits, different pursuits, different diet, different recreations, and perhaps having constitutions differing in aptitude to be acted upon, may not be all ready for the manifestation of disease on one and the same day, but may attain to that point at times corresponding with the operation of so many different circumstances.

In vegetation, which on the whole is much more simple than living animal organization, there is a gradation in the time at which its various individuals become ripe. The same grain is ripe in some districts weeks before it is ready in others, and even in the same farm, though the seed had been sown on the same day. Thus, by observing that the gradual development of disease over a country is the result of the varying activity and time of action of the epidemic influences, and perhaps of some condition of the body, varying in forwardness—it becomes unnecessary to have recourse to atmospheric contagion. It is unnecessary to repeat here what has been said relative to the operation of unwholesome agencies to account for the wide range of disease—over a country.

It is often said, as decisive proof of disease spreading by contagion, that a beggar, or some poor person left a town affected with disease, and entered another hitherto healthy—and that afterwards disease manifested itself there also.

In the first place, would not sickness have occurred notwithstanding? Its supporters say, not likely, when the effect followed, or immediately on the communication; but we reply, that communication took place before without any such immediate result, and that in all probability it had been going on freely all along, whatever regulation and hinderances might have been adopted.

It seems madness to think of stopping all communication with towns, in a free country such as this, where human intercourse is going on without interruption throughout the entire empire, or, indeed, anywhere at all, tolerably inhabited, or where commerce subsists.

It is in vain to endeavour to shew that opportunities for the transmission of contagious atmosphere have not occurred. The case involves an impossibility, for do not a thousand means of communication suggest themselves to the mind of the reader? The atmosphere itself, currents, winds, water, streams, &c.,—animals,—such as rats, mice, winged insects, &c. &c., which cannot be prevented from operating. We, therefore, leave this case, perhaps to the efforts of the advocates of quarantine regulations, who possibly may arrive at a happier result, and we proceed to the opposite case, where disease fails to spread, where communication does take place.

The advocates of contagion prove, where a disease appears in a town, that communication has taken place. That statement, as the reverse, can never be proven, is easily affirmed; and its insignificance corresponds with the facility with which it can be proven. Of course, it is obvious, that such a fact proves very little, either in reference to contagion or anything else.

We are prepared to prove, that communication has subsisted on many different occasions, without any unusual amount of sickness taking place. We know of many instances where disease has been prevailing in a town or village, which has failed to manifest itself in another at a short distance, although daily unrestrained communication was held.

At the end of the year 1835, and the beginning of the year 1836 the scarlet fever prevailed in Edinburgh to a great extent; and although great traffic was constantly going on between that town and Tranent, by means of foot-passengers, numerous carts and coaches, passing to and fro, daily, still that distemper failed to make its appearance in the latter town till the 20th of January, the day on which the first case was noticed.

That case did not occur at the point where the greatest thoroughfare subsists, but at one, the most remote from it.

Typhus fever has been prevailing, to a great extent, in Edinburgh, for many weeks past, but that disease has failed to make its appearance in Tranent (ten miles distant), although the road is constantly crowded with carriages, with vast numbers of carts conveying coals from that village to the capital, and with passengers both on horse and foot. It has not made its appearance, although several of the inhabitants of Tranent have lately lost relatives who have died of that disease, both in Edinburgh and Leith; and although a woman just recovered from that distemper, and come from the Royal Infirmary, has taken up her abode in this village.

Small-pox appeared about six weeks ago, simultaneously in two very filthy localities in Tranent, and it has been confined to them, although the most free communication has subsisted with other parts of the village, and it has failed to spread to the hamlets and farm-steadings around, notwithstanding the relatives of some of those labouring under that disease have travelled through the country, seeking charity.

We propose to close this part of the work. Much has been said in order to prove the position, that the doctrine of atmospheric contagion gains no support from the actual character of disease, no countenance from the ungarbled history of its career.

Arguments in favour of our views might have been drawn from the fact, that diseases said to be propagated by contagion, do not manifest themselves in all parts of the globe to which the poison would be likely to be taken, as they undoubtedly would do, were they dependent on the operation of one single object, such as contagious matter; and also from the consideration that those diseases, with whose causes we are intimately acquainted, by reason of their immediate operation, or of their being otherwise obvious, such as inflammation and wounds, are never said to be dependent on such an agency; but it is feared in the endeavour to be explicit, we have already been tiresome.