Epidemics Examined and Explained Part 2

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SECTION II.

HISTORICAL NOTICE OF EPIDEMIC DISEASES.

The earliest notices we have of Pestilences are contained in Holy Writ. The plagues which smote the Egyptians in the time of Moses are not unworthy some comment here. Of those ten plagues, four out of the number were due to the miraculous appearance of myriads of the lower animal tribes, in three instances of insects,[13] viz. lice, flies, and locusts; in the fourth, when Aaron stretched forth his hand with his rod over the streams, over the rivers, and the ponds, frogs came up and covered the land of Egypt. In these instances living beings are made the instruments in G.o.d's hand for the punishment of the wicked. These plagues include the second, third, fourth, and eighth. The first plague is mentioned as a conversion of the waters into blood. Now if we may take this expression as being literal, there is no reason to suppose that this blood differed in any respect from ordinary sanguineous liquid; we therefore may a.s.sume, as the blood is every where in Scripture spoken of as the _life_, that this fluid was endowed with vital properties.

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The fifth plague is described as a murrain among beasts; and the sixth, as exhibiting itself as "a boil breaking forth with blains, upon man and upon beast."[14] Now these affections bear a resemblance to the diseases known to us at the present day through authentic records. The Black Death of the 14th century affords in its history but too awful a picture of the horrors of such pestilences. In the tenth plague, the smiting of the first-born, we are not told by what means it was brought about; but we have something even here to lead us to conjecture. In the second visitation of the Black Death, there were destroyed a great many children whom it had formerly spared, and but few women. The seventh plague of hail is within our conception; as is also that of darkness, the ninth plague.

It is not a little remarkable that of the ten plagues, seven of them depended upon agents intelligible to our comprehension; we can conceive of {36} the invasion of a country by myriads of loathsome insects and reptiles, and can imagine the wrath of an offended Deity directing the force of a supernatural storm of hail upon a disobedient people; and we can conjecture, though faintly, the consternation of human nature on being subjected to a total darkness of three days' duration, when we consider _that_ darkness has been described, as "a darkness that might be felt."

From this abstract we discover that the three plagues whose causes we cannot understand, or rather upon which no light has been thrown by Scripture, bear a.n.a.logies to those which we recognise, in the writings of modern authors, as fearful pestilences.

It is now our province to reflect on the causes supposed to be in operation in the three instances, which become naturally separated from the rest.

We are told that a murrain appeared among the cattle, without any preliminary step. When the blains broke out upon man and beast, Moses had been previously directed by the Almighty to take handfuls of the ashes of the furnace, and sprinkle them towards the heaven in the sight of Pharaoh.

"_And it shall become small dust in all the land of Egypt_, and shall be a boil breaking forth with blains upon man and upon beast, throughout all the land of Egypt."

Another coincidence, in connexion with subsequent pestilences, arrests the attention, on the subject of the mysterious appearance on these occasions of {37} matter resembling dust being prevalent about the houses, and on the clothes of the people. Clouds also, and showers of dust-like particles, were not of infrequent occurrence. Indeed, in the summer of 1849, during the progress of the Cholera, several phenomena of a similar nature were observed and authenticated; I myself can bear testimony to one instance of the kind. It was observed by many persons in my neighbourhood after the pa.s.sage of an ominous and lurid cloud, that as they walked their clothes became covered with a singular dust-like matter of very peculiar appearance. That this phenomenon was not dest.i.tute of significance may be gathered from the fact, that on the night of that day several severe cases of Cholera occurred, though our village had been comparatively free for ten days.

Hecker, in writing on the Black Death says, the German accounts expressly speak of a "thick stinking mist which advanced from the east,[15] and {38} spread itself over Italy; there could be no deception in so palpable a phenomenon." It is not unworthy of mention, that in the East successive invasions of locusts "which had never perhaps darkened the sun in thicker swarms," preceded the great outbreak of this disease, for they left famine in their train.

From 1500 to 1503 in Germany and France, during the prevalence of the sweating sickness, spots of different colours made their appearance, "princ.i.p.ally red, but also white, yellow, grey, and black, often in a very short time, on the roofs of houses, on clothes, on the veils and neckerchiefs of women, &c." Blood rain is also mentioned as having occurred at this time, which consisted of the aggregation of minute particles of red matter.

In the seven plagues, miraculous operations of the Deity consisted in the unusual manifestation of phenomena, but which in their effects are recognizable as of clear and definite import. The miracles here are,--in the _mode_ of producing the swarms of frogs, locusts, &c. but they are manifest and unmistakeable _causes_ of plague and famine; in the other three, on the contrary, we witness only the effects, the causes are hidden from us; we may, therefore, as in current events, legitimately investigate the subject, and what better course can be adopted than that which cla.s.sifies the traditionary past with all subsequent history. Presuming such a method of research to be admitted, I have a.s.sumed that as {39} the _causes_ of the seven plagues have been distinctly given, the others, though only mentioned in their effects, were due to causes of a nature in some way to be compared with their concomitants, that is to say, if a special intervention of the Deity brought about a miraculous appearance of frogs, lice, &c. there is but little reason to doubt that some other agent was miraculously multiplied and concentrated to induce the murrain, engender the blain, and smite the first-born: as if to lead us into this enquiry, on the visitation of the blain in man and beast, the Bible History tells us that Moses threw ashes of the furnace, which became a dust throughout all the land of Egypt; we cannot imagine that this simply as ashes could have caused the blain, we may conclude that by some special miracle, either the ashes were converted into a specific form of matter capable of inducing the effects recorded, or that an independent septic matter was generated for the purpose. If the latter, the act of throwing the ashes of the furnace into the air may have been intended to signify that the extremely minute division of the particles when thus cast into s.p.a.ce, typified the inscrutable and hidden nature of the matter endowed with such marvellous properties.[16]

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Further on in the book of Leviticus are pa.s.sages which I cannot forbear transcribing, for they point out to us most indubitably a line of enquiry in reference to diseases of a contagious nature.

"The garment also that the plague of leprosy is in, whether it be a woollen garment, or a linen garment, whether it be in the warp or woof, of linen or of woollen, whether in a skin, or in any thing made of skin, and if the plague be greenish or reddish in the garment ... it is a plague of leprosy, and shall be shewed unto the Priest, and the Priest shall look upon the plague and shut up it that hath the plague seven days; and he shall look on the plague on the seventh day; if the plague be spread in the garment, either in the warp, &c. ... the plague is a fretting leprosy, it is unclean. He shall therefore burn that garment ... wherein the plague is, for it is a fretting leprosy; it shall be burnt in the fire. And if the Priest shall look, and behold, the plague be not spread in the garment ...

then the Priest shall command that they wash the thing wherein the plague is, and he shall shut it up seven days more: and the Priest shall look on the plague, after that it is washed: and behold if the plague have _not_ changed his colour, and the plague be not spread, it is unclean; thou {41} shalt burn it in the fire; it is fret inward; whether it be bare within or without. And if the Priest look and behold the plague be somewhat dark after the was.h.i.+ng of it, then he shall rend it out of the garment ... and if it appear still in the garment either in the warp or the woof ... it is a spreading plague: thou shalt burn that wherein the plague is with fire.

And the garment ... which thou shalt wash, if the plague be departed from them, then it shall be washed the second time and shall be clean."--Chap.

xiii. 47-58.

Again in Deuteronomy. The curse for disobedience: "The Lord shall make the pestilence cleave to thee until he have consumed thee from off the land.--The Lord shall smite thee with a consumption, and with a fever, and with an inflammation, and with an extreme burning, and with the drought, and with blasting, and with _mildew_, and they shall pursue thee until thou perish.--The Lord shall make the rain of thy land _powder_ and _dust_: from heaven shall it come down upon thee until thou be destroyed."

It may be said, and I doubt not will be said, all this is unnecessarily dragging the sacred volume into an enquiry totally foreign to its general tenor; on the contrary, however, I maintain by that Book we are to learn the ways of G.o.d to man, and further, that no study can impress mankind with so awful, so terrific an idea of his responsible position, as that which leads him into the investigation of the causes {42} by which the Almighty, doubtless in His wisdom, has thought fit at various epochs of this world's history, to place man face to face with pestilence, famine and sudden death.

There is no man would less willingly than myself introduce profanely the revelations of Scripture. The observations here made are not, therefore, intended for light or heedless controversy; if they have a significance of any import, let them be alluded to in the same spirit with which they have been quoted; if they convey nothing for approval to the reader, let silence rest upon them. To those who would fain disregard my request, let me recall to their minds the veneration which from childhood I trust we have always felt on hearing or seeing those two words--Holy Bible.

It is yet to be determined, whether the greenish or reddish appearance of the garment spoken of, as being contaminated with the plague of the leprosy had any specific relation to the disease itself. The priest orders that the garment shall be shut up seven days, and on the seventh day, if the plague be increased, by which, of course, is meant if the greenish or reddish colour have increased, and from which we may gather that a power of spontaneous increase was possessed by the matter, such a result indicated a fretting leprosy, and the garment was to be burnt. Again, though there may have been no increase, but a persistence of the coloured matter after shutting up and was.h.i.+ng the garment, it is to {43} be burnt, for it is fret inward, signifying, that the germs of the affection are still there, and may soon increase. Other rules follow in reference to the plague of leprosy, and the mode of deciding whether an article be unclean or clean is definitely laid down, but our purpose is served in mentioning the above, to shew that in the time of Moses the spontaneous increase of certain minute multiplying germs was supposed to have a close connexion with disease. It is equally clear, that the priests were aware by the order given them, that if the ordinary modes of purifying articles of clothing failed in their effect, the safest and surest method of destroying infectious matter was to resort to the practice of consuming by fire all materials capable of propagating an infectious malady.

The facts above noticed, accurately correspond to what we now know as applicable to the matter of infectious and contagious maladies. It is a rule, I believe universally adopted throughout the Poor-houses of this country, to put the clothes of all persons about to become residents in these establishments, into ovens, where they are submitted to a temperature incompatible with the existence of either animal or vegetable life. By this means all living matters are destroyed, but the fabrics and inorganic matters retain their properties intact. This simple proceeding, I am credibly informed, is an effectual preventive of contamination by articles of clothing, a desideratum of no small importance, when it is {44} remembered that the diseases among the poor owe much of their inveteracy to the acc.u.mulation of effete organic matters about their persons and clothes.

A few more observations are called for on the quotation from Deuteronomy, in which allusion is made to living matter being an agent in the production of disease. In the curse upon the children of Israel for disobedience, we read that they are to be smitten with mildew. No further information, however, is vouchsafed to us, nevertheless, we can conceive the wretched condition of those on whom the curse might fall. Again, we find in a continuation of this curse that the Almighty uses means such as He adopted in the sixth plague of the Egyptians. The ashes of the furnace became a small dust in all the land of Egypt, breaking forth with blains upon man and beast. In the curse of the Israelites the words are: "The Lord shall make the rain of thy land _powder and dust_: from Heaven shall it come down upon thee until thou be destroyed."

It might be conjectured that the absence of rain would be sufficient to account for the extinction of the people on whom the curse was p.r.o.nounced, by the famine and drought necessarily attendant upon the loss of moisture.

But this does not appear to be the meaning of the pa.s.sage, for the powder and dust are mentioned as the agents of destruction; besides, in the continuation of the curse, the locust is to destroy the grain, the worm the grapes, and {45} the olive is to shed his fruit; we may thus take for granted that drought and famine are not to be caused by the showering of powder and dust, it must consequently be supposed that the effects of the dust in the instance of the Egyptians are to be compared and cla.s.sified with those of the dust which smote the Israelites.

As far then as Sacred History conducts us in the enquiry, concerning the causes of pestilences, we gain encouragement in the belief that living germs are the active agents, for in the case of the leprosy, we have evidence of reproduction in connexion with infection, which, if our line of argument be tenable, amounts to demonstration; then, in the other instances of the plagues, by boils and blains, they distinctly bear comparison with the accounts given by profane writers, of the visitations of pestilences on the earth, subsequently to those mentioned in Scripture history.

This leads now to the consideration of recorded facts observed and noted during the various Epidemics in the early and subsequent periods of Man's History, as given by those on whom reliance may be fairly placed.

Setting aside the uncertain information contained in the writings of the Chinese,[17] a people whose {46} progress in the science and practice of Medicine has nothing to commend it (even as it is at the present day) to the notice either of the physician or the historian, unless it be to the latter as a mark of peculiarity both in a social and political point of view,--pa.s.sing also over the Egyptians, the Arabians, and the Greeks,--and even Hippocrates himself, we are driven to the Romans for any authentic or precise notice of Epidemic Affections. It has been attributed to Hippocrates that he predicted the appearance of the Plague at Athens, {47} and that when it was introduced into Greece he dispelled it, "by purifying the air with fires into which were thrown sweet-scented herbs and flowers along with other perfumes."[18] But little advantage can be derived from enquiries concerning the first appearance of any disease, for the probability of discovering the primary cause is certainly a {48} hopeless case, if attempted by means of the writings of ancient authors, when it is recollected that with all the science and learning of the ancient Egyptians, the use of optical instruments was not comprised among the paraphernalia of their arts. The knowledge that was limited to the powers of natural vision, where the foundation of knowledge is based upon facts obtained through the aid of that penetrator of nature's secrets, the microscope, offers no advantages to the student of the present day.

To say that a disease commenced in the East and travelled westward, and at length found a habitation and a name in every part of the globe, is no more than to say that disease is coeval with the fall of man. The cause is as much hidden in the region of its birth, as in that where it sojourns for a time. The cause of the sweating sickness was as much a mystery in England as in all the other nations of Europe, which were visited by its devastating power. And these observations apply with as much force to one disease as another; for even our indigenous ague, originating in some places so limited that the shadow of a pa.s.sing cloud may mark the boundary of its dwelling place, as inscrutably evades our vigilance, with all the appliances that art can bring to our a.s.sistance, in endeavouring to evoke its extraordinary properties under the cognizance of our senses.

If we weigh the air which carries the poison, or a.n.a.lyze it by the most delicate chemical tests, or {49} take the weight of the atmosphere which is charged with it, or if we take the blood which carries the germs of the disease to the tissues of the body, and submit them after the work of destruction is accomplished, to the most rigid inspection, we can but exclaim,

"These are Thy marvellous works!"

and confess our total inability to fathom the unbounded.

If then no practical advantage can accrue from investigating the writings of the ancients on these subjects, beyond comparing their historical statements with those of more recent date, our purpose will be served by occasionally embodying any remarkable observations of the former with those of the latter.

In proceeding with this course it were better to confine our minds chiefly to two diseases which appear from history to have been known from the earliest periods, these are the Plague and the Small Pox, mentioning other diseases only _en route_.

Pa.s.sing then, to the sixth century of the Christian era for the first distinct and connected account of the Plague, it appears from a host of testimony, that the history of this disease, as given by Procopius, well merits our attention. Drs. Friend and Hamilton, in their Histories of Medicine, and Gibbon, in his History of Rome, are equally warm in their praise of Procopius: the latter says, he "emulated the skill and diligence of Thucydides in the {50} description of the Plague at Athens." The account given by Procopius of this disease, does not differ materially from that given by subsequent eye-witnesses of similar pestilences. Its point of origin is clearly marked, and its mode of dispersion in all directions distinctly traced from "the neighbourhood of Pelusium, between the Serbonian bog and the eastern channel of the Nile." It commenced in the year 542. It raged in Constantinople in the following year, and it was in this city that our historian gathered the materials which are handed down to us. When, however, we anxiously look for any explanation as to the cause of the malady, we are told that it must have been a direct visitation from Heaven, in consequence of the eccentric characters exhibited in its wide-spreading influence, in not yielding to the scrutiny nor bending to the laws known to prevail, and to regulate the course of other diseases: neither country nor clime, age nor s.e.x, the strong and healthy, nor the weakly and previously diseased, could be said to be free from its indiscriminate destruction.

But some phenomena preceding the outbreak of the pestilence are observed as coincidences by all authors. Gibbon thus writes: "I shall conclude this chapter with the comets, the earthquakes, and the plague which astonished or afflicted the age of Justinian." From the accounts given by this author, earthquakes for some years had been threatening and destroying many portions of the globe, {51} that in the ruins of cities and in the chasms of the earth, great was the sacrifice of human life. Constantinople, which suffered so severely from the plague is said to have been shaken for forty days. These great disturbances of the globe have been always looked upon as indicating other and important influences of a secret or hidden nature; these impressions on the minds of the people are traceable throughout the histories of all epidemics, and have been sufficiently distinct among the people of our own time, preceding and during the period of infliction.

From this short notice of the Plague of 543, I pa.s.s to the ninth century, when Rhazes, the Arabian physician, endeavoured to enlighten the world on the subject of Small Pox.[19] In quoting his opinions, I am not to be understood as subscribing to them, but merely endeavouring to point out some peculiar and interesting observations.

First, then, Rhazes attributes the disease to a condition of the blood, which he thus describes, to shew how it happens that in infancy and childhood the disease is most prevalent, and that old age is {52} least liable to the affection.[20] "The blood of infants and children may be compared to _must_, in which the coction leading to perfect ripeness has not yet begun, nor the movement towards fermentation taken place; the blood of young men may be compared to must which has already fermented and made a hissing noise, and has thrown out abundant vapours and its superfluous parts, like wine which is now still and quiet, and arrived at its full strength, and as to the blood of old men, it may be compared to wine which has now lost its strength, and is beginning to grow vapid and sour."

"Now the Small Pox arises when the blood putrifies and ferments, so that the superfluous vapours are thrown out of it, and it is changed from the blood of infants which is like must, into the blood of young men which is like wine perfectly ripened: and the Small Pox itself may be compared to the fermentation and the hissing noise which take place at that time."

But the cause of the disease is simply alluded to by this author, as depending upon "occult dispositions in the air," and as he speaks here of Measles with the Small Pox he goes on to say--"which necessarily cause these diseases and predispose bodies to them." This notion of Rhazes that there is some peculiar condition of the blood which favours a process resembling fermentation is not without interest. The circ.u.mstance that individuals are not {53} usually liable to a second attack of the disease, no doubt directed the attention of this physician to compare the process of fermentation with disease of such a nature, seeing that when the whole of the saccharine matter was converted into spirit, the hissing noise, as he calls it, or the disengagement of carbonic acid gas would cease, and the capacity for fermentation be entirely gone. So that the occult conditions of the air, their power of inducing a disease, and multiplying the matter capable of engendering a similar affection, stood in the mind of Rhazes as a.n.a.logous if not identical phenomena.

We pa.s.s now without further comment to the epidemics of the Middle Ages; and here the work of the philosophical Hecker leaves us little else to desire in the way of information, as far as it is obtainable from published records. From the manner in which he has grouped the facts which presented themselves to his mind in the course of a most laborious research, he has saved the student of this subject much toil in acquiring matter for reflection; he has here but to read and digest.

I know not how to select from this invaluable work the most striking pa.s.sages, to strengthen and support my hypothesis, for not a page is dest.i.tute of facts corroborative of the doctrine that vital germs are the material agents of pestilential disorders. The opening paragraph to the Black Death is a most cogent ill.u.s.tration of the a.s.sertion; it is, as it were, the theme of the work. "That {54} Omnipotence, which has called the world with all _its living creatures into one animated being_, especially reveals himself in the desolation of great pestilences. The powers of creation come into violent collision; the sultry dryness of the atmosphere; the subterranean thunders; the mist of overflowing waters are the harbingers of destruction. Nature is not satisfied with the ordinary alternations of life and death, and the destroying angel waves over man and beast his flaming sword."

I must here apologise for large transcripts from Hecker's work, for neither could I command the amount of knowledge there displayed, nor use such appropriate language as the learned translator has employed.

It is not doubted that the Black Death was an Oriental plague, only of more than usual severity, and wider spread influence of the infectious nature of this disease, and the active properties of the matter producing it. Hecker says, "articles of this kind--bedding and clothes--removed from the access of air, not only retain the matter of contagion for an indefinite period, _but also increase its activity, and engender it like a living being_, frightful ill consequences followed for many years after the first fury of the pestilence was past."[21]

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As extraordinary atmospheric and telluric phenomena preceded the Plague in the time of Justinian, so do we find similar instances recorded as the precursor of a similar visitation 700 years later. I am concerned more with those circ.u.mstances which refer more especially to my subject, _viz._ the development of organic matter, and the peculiar odours of the atmosphere, the latter being evidence of some foreign and unusual production in our respiratory media. "On the island of Cyprus, before the earthquake, a pestiferous wind spread so poisonous an odour, that many being overpowered by it, fell down suddenly and expired in dreadful agonies. A thick stinking mist advanced from the east, and spread itself over Italy."

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It is probable that the atmosphere contained foreign and sensibly perceptible admixtures to a great extent, which, at least in the lower regions, could not be decomposed or rendered ineffective by separation. In 1348 an unexampled earthquake shook Greece, Italy, and the neighbouring countries. During this earthquake the wine in the casks became turbid, a proof that changes causing a decomposition of the atmosphere had taken place. "The insect tribe was wonderfully called into life, as if animated beings were destined to complete the destruction which astral and telluric powers had began."