Chapter 24

“I have known a great cold,” he says, “in a day or two invade multitudes in the same city with violent, and as to many persons, fatal symptoms; when I could not judge (as others also did not), that the bare coldness of the air could so suddenly produce a disease so epidemical and hurtful; and it appeared the more probable that the cause came from under ground, by reason that it began with a very troublesome fog[753].”

“I have known a great cold,” he says, “in a day or two invade multitudes in the same city with violent, and as to many persons, fatal symptoms; when I could not judge (as others also did not), that the bare coldness of the air could so suddenly produce a disease so epidemical and hurtful; and it appeared the more probable that the cause came from under ground, by reason that it began with a very troublesome fog[753].”

I am unable to say whether Boyle was the first to apply the doctrine of telluric or subterranean emanations to influenza; he was certainly not the first to apply it to pestilences in general, for it is found in Seneca among the ancients[754], and it is clearly stated in Ambroise Paré’s essay “Sur les Venins,” having been probably a familiar notion of the sixteenth century, although a mystical and undefined one. Sydenham also, who must have discussed these questions with Boyle, referred all the more obscure or “stationary” epidemic constitutions to effluvia discharged into the air from “the bowels of the earth”: those hypothetical miasmata were for him the τὸ θεῖον of Hippocrates, the mysterious something which had to be assumed so as to explain plague, pestilential fever, intermittent and remittent fevers, the “new fever” of 1685-6, and all other epidemic constitutions which were not caused by obvious changes of season and weather. But it does not appear, and it is not probable, that he ascribed to that mysterious cause the two transient waves of influenza which fell within his own experience, those of November, 1675, and of November, 1679. On the other hand, Boyle certainly did so; he included influenza in his hypothesis explicitly; and if one examines its general terms, it will appear as if it had been made specially for influenza.

Boyle’s general expression, for both endemial and epidemic maladies, is that they are due to subterranean effluvia sent up into the air. As a chemist, and as dealing with the new knowledge then most in vogue, he assumed the sources of these miasmata to be for the most part mineral deposits in the crust of the globe, especially “orpimental and other mischievous fossiles”; but later in his writing he says:

“To speak candidly I do not think that these minerals are the causes of even all those pestilences whose efficients may come from under ground”; there were many mischievous fossils of which physicians and even chymists had no knowledge, and “the various associations of these, which nature may, by fire and menstruums, make under ground and perhaps in the air itself, may very much increase the number and variety of hurtful matters.”

“To speak candidly I do not think that these minerals are the causes of even all those pestilences whose efficients may come from under ground”; there were many mischievous fossils of which physicians and even chymists had no knowledge, and “the various associations of these, which nature may, by fire and menstruums, make under ground and perhaps in the air itself, may very much increase the number and variety of hurtful matters.”

He makes provision, also, for the hurtful matters multiplying in their underground seats, according to a principle which we know now to be true for organic, instead of mineral matters, and to be true for them above ground, or in the air, as well as under ground:

“I think it possible that divers subterraneal bodies that emit effluvia may have in them a kind of propagative or self-multiplying power. I will not here examine whether this proceeds from some seminal principle, which many chymists and others ascribe to metals and even to stones; or (which is perhaps more likely) to something analogous to a ferment, such as, in vegetables, enables a little sour dough to extend itself through the whole mass, or such as, when an apple or pear is bruised in one part, makes the putrefied part by degrees to transmute the sound into its own likeness; or else some maturative power ... as ananas in the Indies, and medlars ... after they are gathered, acquire (as it were spontaneously) in process of time a consistence and sweetness and sometimes colour and odour, and, in short, such a state as by one word we call maturity or ripeness.”

“I think it possible that divers subterraneal bodies that emit effluvia may have in them a kind of propagative or self-multiplying power. I will not here examine whether this proceeds from some seminal principle, which many chymists and others ascribe to metals and even to stones; or (which is perhaps more likely) to something analogous to a ferment, such as, in vegetables, enables a little sour dough to extend itself through the whole mass, or such as, when an apple or pear is bruised in one part, makes the putrefied part by degrees to transmute the sound into its own likeness; or else some maturative power ... as ananas in the Indies, and medlars ... after they are gathered, acquire (as it were spontaneously) in process of time a consistence and sweetness and sometimes colour and odour, and, in short, such a state as by one word we call maturity or ripeness.”

Other of Boyle’s fruitful principles (I am separating them out from amidst much other matter not specially related to influenza) are these:

“It is possible that these effluvia may be, in their own nature, either innocent enough, or at least not considerably hurtful, and yet may become very noxious if they chance to find the air already imbued with certain corpuscles fit to associate with them.”Again, the effluvia sent up into the air may pass by certain places without causing an epidemic, because these “are not inhabited enough to make their ill qualities taken notice of; but, more frequently, because by being diffused through a greater tract of air, they are more and more dispersed in their passage, and thereby so diluted (if I may so speak) and weakened as not to be able to do any notorious mischief.”Again, the effluvia may not produce epidemic disease at the part of the globe where they had emerged from under ground; an illustration of which may be intended in the case of the Black Death, which, as he says, came from China, yet plague is little heard of in that country, a Jesuit, Alexander de Rhodes, who spent thirty years in those parts, testifying that the plague is not so much as spoken of there. Again, why are some epidemics of so short duration at a given place? Either, he answers, because the morbific expiration from under ground had ascended almost at once, and been easily spent; or the subterraneal commotion which sends up the miasmata “may pass from one place to another and so cease to afford the air incumbent on the first place the supplies necessary to keep it impregnated with noxious exhalation; and it agrees well with this conjecture that sometimes we may observe certain epidemical diseases to have, as it were, a progressive motion, and leaving one town free, pass on to another”—as notably in the case of sweating sickness and influenza.Lastly there are ever new forms of epidemic disease appearing, not to count every variation of an autumnal ague “which the vulgar call a New Disease.” Of the really new types Boyle offers the following explanation: “Some among the emergent variety of exotick and hurtful steams may be found capable to disaffect human bodies after a very uncommon way, and thereby to produce new diseases, whose duration may be greater or smaller according to the lastingness of those subterraneal causes that produce them. On which account it need be no wonder that some new diseases have but a short duration, and vanish not long after their appearing, the sources or fumes being soon destroyed or spent; whereas some others may continue longer upon the stage, as having under ground more settled and durable causes to maintain them.”

“It is possible that these effluvia may be, in their own nature, either innocent enough, or at least not considerably hurtful, and yet may become very noxious if they chance to find the air already imbued with certain corpuscles fit to associate with them.”

Again, the effluvia sent up into the air may pass by certain places without causing an epidemic, because these “are not inhabited enough to make their ill qualities taken notice of; but, more frequently, because by being diffused through a greater tract of air, they are more and more dispersed in their passage, and thereby so diluted (if I may so speak) and weakened as not to be able to do any notorious mischief.”

Again, the effluvia may not produce epidemic disease at the part of the globe where they had emerged from under ground; an illustration of which may be intended in the case of the Black Death, which, as he says, came from China, yet plague is little heard of in that country, a Jesuit, Alexander de Rhodes, who spent thirty years in those parts, testifying that the plague is not so much as spoken of there. Again, why are some epidemics of so short duration at a given place? Either, he answers, because the morbific expiration from under ground had ascended almost at once, and been easily spent; or the subterraneal commotion which sends up the miasmata “may pass from one place to another and so cease to afford the air incumbent on the first place the supplies necessary to keep it impregnated with noxious exhalation; and it agrees well with this conjecture that sometimes we may observe certain epidemical diseases to have, as it were, a progressive motion, and leaving one town free, pass on to another”—as notably in the case of sweating sickness and influenza.

Lastly there are ever new forms of epidemic disease appearing, not to count every variation of an autumnal ague “which the vulgar call a New Disease.” Of the really new types Boyle offers the following explanation: “Some among the emergent variety of exotick and hurtful steams may be found capable to disaffect human bodies after a very uncommon way, and thereby to produce new diseases, whose duration may be greater or smaller according to the lastingness of those subterraneal causes that produce them. On which account it need be no wonder that some new diseases have but a short duration, and vanish not long after their appearing, the sources or fumes being soon destroyed or spent; whereas some others may continue longer upon the stage, as having under ground more settled and durable causes to maintain them.”

As a chemist, Boyle sought for the source of the pestilential emanations in underground minerals, in the new combinations of these under the action of “fire and menstruums,” in their self-multiplying power as if by subterraneous fermentation (“which many chymists and others ascribe to metals and even to stones”), and in their meeting with suitable “corpuscles” in the air of an inhabited spot wherewith to combine for their morbific effects. He assumed, also, their discharge into the air at particular spots of the globe (where they might not be directly morbific in their effects), or in a series of localities from the wave-like progress of the underground commotion; in which assumption he seems to be applying the very old idea of classical times that earthquakes and volcanic eruptions were a cause or antecedent of epidemics. Sometimes his mineral fossils were deep in the crust of the globe, touched only by the greater cataclysms; and then we might expect novelties in the forms of epidemic disease. But he does not exclude emanations from the earth’s surface proceeding more gently or insensibly.

It would be a mistake to set aside Boyle’s hypothesis of epidemical miasmata as made altogether void by his choosing strange minerals to be the source of them, and by his assuming a kind of fermentation in these inorganic matters so as to explain the continuance and spreading of the infections. Substitute organic matters in the soil for minerals in the crust of the earth, and read a modern meaning into the doctrine of underground or aërial fermentation or leavening, and we shall find Boyle’s hypothesis, especially as applied to influenza, far from obsolete. Some such adaptation of the doctrine of miasmata was made two generations later by Dr John Arbuthnot in his ‘Essay concerning the Effects of Air upon Human Bodies,’ the immediate occasion of which was the London influenza of 1733. There is nothing to note between Boyle and Arbuthnot; forWillis and Sydenham, using the Hippocratic language of “constitutions,” explained, as we have seen, the epidemic catarrhs of the spring or winter as the reigning febrile constitution modified to suit the season and weather.

Arbuthnot’s essay makes more modern reading than Boyle’s. He assumes emanations from the ground, but they are no longer from the bowels of the earth, or from deposits of strange minerals requiring earthquakes to set them free, or “fire and menstruums” to give potency to them. Of all the things that pass into the atmosphere, he makes most of the various steams and other volatile decomposing matters of men and animals; and when he brings in the earth, it is as the storehouse or receptacle of such matters, in a surface stratum no deeper than the effects of drought and rainfall could reach. While he accepts the Hippocratic doctrine of epidemic constitutions, and recognizes the air with its various organic contents as the τὸ θεῖον, thequid divinumor mysterious something of epidemical causation, he does not forget that the earth is inhabited by creatures, human and other, who befoul the atmosphere by “their own steams”; again, he lays stress upon alternations of drought and moisture in the soil and subsoil as a cause of morbific emanations, not, indeed, stating the matters of fact in the very terms of Pettenkofer’s law, but assuming the presence of special organic matters in the soil as much as that does. Although Arbuthnot was hardly a serious epidemiologist, any more than Boyle, yet in the growth of opinion on the subject of morbific matters in the air, he may be said to have shifted the interest from inorganic or mineral substances and gases, to organic matters chiefly of human or animal origin, and from the deeper regions of the globe, such as only earthquakes reach, to the surface stratum of soil and subsoil which is affected by every rise and fall of the ground-water. I shall now give a few extracts, to bear out the above summary, from Arbuthnot’s essay.

“Air,” he says, “is the τὸ θεῖον in diseases, which Hippocrates takes notice of. Air is what he means by the powers of the universe, which, he says, human nature cannot overcome; and he lays it down as a maxim ‘that whoever intends to be master of the art of physick must observe the constitution of the year; that the powers and influence of the seasons (what are seldom uniform) produce great changes in human bodies.’” He then pays a compliment to Sydenham as “endowed with the genius of Hippocrates,” and passes on to his own analytic method. “Many great effects must follow, and many sudden changes may happen in human bodies by absorbing outward air with all its qualities and contents.Nothing accounts more clearly for epidemical diseases seizing human creatures inhabiting the same tract of earth, who have nothing in common that affects them except air: such as that epidemical catarrhous fever of 1728 and of this present year [1733].... It seems to be occasioned by effluvia, uncommon either in quantity or quality, infecting the air.... It is likewise evident that these effluvia were not of any particular or mineral nature, because they were of a substance that was common to every part of the surface of the earth: and therefore one may conclude that they were watery exhalations, or, at least, such mixed with other exhalable substances that are common to every spot of ground.”In his account of the qualities and contents of the air, he enumerates them, not so much as detected in the air on analysis, but as having of necessity passed into it, and in some instances been deposited again from it, as in strange dews. One class of substances that pass into the air are the oils, salts, seeds and insensible abrasions of vegetables. Also all excrements and all the carcases of animals vanish into air. Another ingredient of the air is the perspirable matters of animals, the amount of which for human beings he works out by a curious calculation of a column of their own steams raised so many feet high in so many days. Perhaps there are insects in the air invisible to human eyes: one may observe, in that part of a room which is illuminated with the rays of the sun, flies sometimes darting like hawks as if it were upon a prey. Some have imagined the plague to proceed from invisible insects: this system agrees with many of the appearances in the progress or manner of propagation of that disease, but is altogether inconsistent with others. Air replete with the steams of animals, especially such as are rotting, has often produced pestilential fevers in that place: of which there are many instances.But why should certain years or seasons have a pestilential atmosphere, for example the season of the catarrhous fever of 1733? There had been, he says, an unusual drought for these two years past, the best estimate of the dryness of the surface of the earth being taken from the falling of the springs, “the consequence of which has been unusual diseases amongst several animals, and a great mortality amongst mankind. It is true, this did not happen during the dry weather.... The previous great drought must have been particularly hurtful to mankind. Great droughts exert their effects after the surface of the earth is again opened by moisture, and the perspiration of the ground, which was long suppressed, is suddenly restored. It is probable that the earth then emits several new effluvia hurtful to human bodies: this appeared to be the case by the thick and stinking fogs which succeeded the rain that had fallen before.”

“Air,” he says, “is the τὸ θεῖον in diseases, which Hippocrates takes notice of. Air is what he means by the powers of the universe, which, he says, human nature cannot overcome; and he lays it down as a maxim ‘that whoever intends to be master of the art of physick must observe the constitution of the year; that the powers and influence of the seasons (what are seldom uniform) produce great changes in human bodies.’” He then pays a compliment to Sydenham as “endowed with the genius of Hippocrates,” and passes on to his own analytic method. “Many great effects must follow, and many sudden changes may happen in human bodies by absorbing outward air with all its qualities and contents.Nothing accounts more clearly for epidemical diseases seizing human creatures inhabiting the same tract of earth, who have nothing in common that affects them except air: such as that epidemical catarrhous fever of 1728 and of this present year [1733].... It seems to be occasioned by effluvia, uncommon either in quantity or quality, infecting the air.... It is likewise evident that these effluvia were not of any particular or mineral nature, because they were of a substance that was common to every part of the surface of the earth: and therefore one may conclude that they were watery exhalations, or, at least, such mixed with other exhalable substances that are common to every spot of ground.”

In his account of the qualities and contents of the air, he enumerates them, not so much as detected in the air on analysis, but as having of necessity passed into it, and in some instances been deposited again from it, as in strange dews. One class of substances that pass into the air are the oils, salts, seeds and insensible abrasions of vegetables. Also all excrements and all the carcases of animals vanish into air. Another ingredient of the air is the perspirable matters of animals, the amount of which for human beings he works out by a curious calculation of a column of their own steams raised so many feet high in so many days. Perhaps there are insects in the air invisible to human eyes: one may observe, in that part of a room which is illuminated with the rays of the sun, flies sometimes darting like hawks as if it were upon a prey. Some have imagined the plague to proceed from invisible insects: this system agrees with many of the appearances in the progress or manner of propagation of that disease, but is altogether inconsistent with others. Air replete with the steams of animals, especially such as are rotting, has often produced pestilential fevers in that place: of which there are many instances.

But why should certain years or seasons have a pestilential atmosphere, for example the season of the catarrhous fever of 1733? There had been, he says, an unusual drought for these two years past, the best estimate of the dryness of the surface of the earth being taken from the falling of the springs, “the consequence of which has been unusual diseases amongst several animals, and a great mortality amongst mankind. It is true, this did not happen during the dry weather.... The previous great drought must have been particularly hurtful to mankind. Great droughts exert their effects after the surface of the earth is again opened by moisture, and the perspiration of the ground, which was long suppressed, is suddenly restored. It is probable that the earth then emits several new effluvia hurtful to human bodies: this appeared to be the case by the thick and stinking fogs which succeeded the rain that had fallen before.”

Arbuthnot knew the progress of the influenza of 1732-33. Its worst week in London was from the 23rd to the 30th January, 1733; but he tells us that it had been at a height in Saxony from the 15th to the 29th November, 1732, had been earlier in Holland than in England, earlier in Edinburgh than in London, in New England before Great Britain. Again, it appeared in Paris in February, somewhat later than in London, and in Naples in March. This progress, he says, was often against the wind. Nor does he assume a progressive infection of regions of atmosphere. The effluvia, he says, were of a substance that was common to every part of the surface of the earth; they were exhalable substances that were common to every spot ofground; the excessive drought of two years, followed by heavy rains in the end of 1732, is also assumed to have been common, for, in Germany and France, especially in November, 1732, the air was filled with frequent fogs. It is clear that Arbuthnot traced the universality of influenza, the uniform symptoms of which he recognized, to certain conditions of soil and atmosphere common to all the countries visited by the epidemic.

Throughout the rest of the 18th century there were numerous and varied experiences of influenza, in summer and winter, spring and autumn, coming up from the south as if from Africa, or from the east as if from Central Asia, or appearing in America sooner than in Europe—experiences which made a theory of the disease difficult. Some inclined to Arbuthnot’s view of unusual seasons and weather producing the same effects everywhere; others favoured the hypothesis of contagion from a remote source, which might be China or might be some other territory. Geach, a surgeon at Plymouth who was a Fellow of the Royal Society, actually went back to the astrological cause, pointing out that Jupiter and Saturn were in a certain conjunction during the influenza of 1775. The only elaborate theory of the strange disease that calls for notice, besides those of Boyle and Arbuthnot, is that of Noah Webster, the famous lexicographer of Hartford, Connecticut.

While Webster was a journalist in New York about the years 1794-6, the subject of yellow fever, which was then of great practical moment, set him reading and speculating about pestilences in general. Writing to Priestley, he said that in the course of his inquiries he found the American libraries ill supplied with books[755]; but he certainly made diligent and skilful use of his literary materials, and produced in his ‘Brief History of Epidemic and Pestilential Diseases,’ a work which was better than any before it in the chronological part, and remains to the present time unique in its philosophical part for the boldness of its generalities[756]. He saw that influenza was the crux of epidemiology, and paid special attention to it.

In looking for the antecedents of influenza, he kept in view the greater telluric changes and convulsions, such as earthquakes and volcanic eruptions. He did not regard these as the cause ofinfluenza, but as the index of some hidden cause to which both they and the universal catarrh were due.

“It is probable to me,” he says, “that neither seasons, earthquakes, nor volcanic eruptions are the causes of the principal derangements we behold in animal and vegetable life, but are themselves theeffectsof those motions and invisible operations which affect mankind. Hence catarrh and other epidemics often appearbeforethe visible phenomena of eruptions and earthquakes[757].” As to influenza, he found “reason to conclude the disease to be the effect of some access of stimulant powers to the atmosphere by means of the electrical principle. No other principle in creation, which has yet come under the cognizance of the human mind, seems adequate to the same effects.”And again: “It is more probable that it is to be ascribed to an insensible action of atmospheric fire, which is more general and violent about the time of eruptions, and which fire is probably agitated in all parts of the globe, although it produces visible effects in explosions in some particular places only.” It is due to Webster to give his reason for preferring a physical force to an organic poison: “If a deleterious vapour were the cause, I should suppose its effects would be speedy, and its force soon expended, the atmosphere being speedily purified by the winds. But if stimulus is the cause, it may exist for a long time in the atmosphere, and the human body not yield to its force in many weeks or months. This would better accord with facts. For, although diseases appear soon after an earthquake, yet the worst effects are often many months or years after[758].”

“It is probable to me,” he says, “that neither seasons, earthquakes, nor volcanic eruptions are the causes of the principal derangements we behold in animal and vegetable life, but are themselves theeffectsof those motions and invisible operations which affect mankind. Hence catarrh and other epidemics often appearbeforethe visible phenomena of eruptions and earthquakes[757].” As to influenza, he found “reason to conclude the disease to be the effect of some access of stimulant powers to the atmosphere by means of the electrical principle. No other principle in creation, which has yet come under the cognizance of the human mind, seems adequate to the same effects.”

And again: “It is more probable that it is to be ascribed to an insensible action of atmospheric fire, which is more general and violent about the time of eruptions, and which fire is probably agitated in all parts of the globe, although it produces visible effects in explosions in some particular places only.” It is due to Webster to give his reason for preferring a physical force to an organic poison: “If a deleterious vapour were the cause, I should suppose its effects would be speedy, and its force soon expended, the atmosphere being speedily purified by the winds. But if stimulus is the cause, it may exist for a long time in the atmosphere, and the human body not yield to its force in many weeks or months. This would better accord with facts. For, although diseases appear soon after an earthquake, yet the worst effects are often many months or years after[758].”

Dr Blagden also saw a difficulty in “the prodigious quantity of matter required in the air to infect the space not only of the Chinese land, but to a hundred leagues of the coast, or, as in this instance [1782] all Europe and the circumjacent sea,” and was accordingly driven to Arbuthnot’s view of an origin in the unusual weather of each locality.

Webster drew up a chronological table of influenzas in either Hemisphere, with the volcanic eruptions, earthquakes, comets, etc., to suit[759]. A few instances from near the beginning may serve as samples:

1647. First catarrh mentioned in American annals, in the same year with violent earthquakes in South America, and a comet.1655. Influenza in America, in the same year with violent earthquakes in South America and an eruption of Vesuvius. It began about the end of June.1658. Influenza in Europe after a severe winter: the summer cool.1675. Influenza in Europe while Etna was still in a state of explosion: the winter mild.1679-80. Influenza in Europe during or just after the eruption of Etna: the season wet: a comet.1688. Influenza in Europe in the same year with an eruption of Vesuvius, after a severe winter, and earthquakes: it began in a hot summer.1693. Influenza in Europe in the same year with an eruption in Iceland and great earthquakes: the season cool.1697-98. Influenza in America after a great earthquake in Peru: a comet the same year: the winter severe.

1647. First catarrh mentioned in American annals, in the same year with violent earthquakes in South America, and a comet.

1655. Influenza in America, in the same year with violent earthquakes in South America and an eruption of Vesuvius. It began about the end of June.

1658. Influenza in Europe after a severe winter: the summer cool.

1675. Influenza in Europe while Etna was still in a state of explosion: the winter mild.

1679-80. Influenza in Europe during or just after the eruption of Etna: the season wet: a comet.

1688. Influenza in Europe in the same year with an eruption of Vesuvius, after a severe winter, and earthquakes: it began in a hot summer.

1693. Influenza in Europe in the same year with an eruption in Iceland and great earthquakes: the season cool.

1697-98. Influenza in America after a great earthquake in Peru: a comet the same year: the winter severe.

In most instances the region of the earthquake is not specified in the table; but it is sometimes named in the text of the annals under the respective years. Volcanoes are on the whole made more of than earthquakes, Webster’s object being to find evidence of “electrical stimulus,” and not of material miasmata discharged into the air. Etna and Hecla are much in request. Any earthquake suits, as if “earthquake” and “volcano” were like algebraic symbols, alwaysaandb, and never anything butaandb, “influenza” being alwaysx. One begins to realize the difficulties of the volcano or earthquake theory of influenza on turning to Mallet’s Catalogue of Earthquakes[760]. Here, indeed, is an embarrassing choice between China and Peru, Asia Minor and North Africa, Portugal and Sicily or Calabria, Iceland and Jamaica, the Azores and the Philippines, Caracas or Acapulco and Valparaiso, Hungary and Savoy, Kamtschatka and Amboina; between earthquakes great and small; between earthquakes and volcanoes. Any influenza year might be suited with one or more earthquakes, perhaps in either Hemisphere; but there are some long clear intervals between the greater influenzas in Europe, for example the interval from 1803 to 1831, which seem to occupy as many pages of the catalogue of earthquakes as the years wherein influenzas came thickest, for example from 1729 to 1743, or from 1831 to 1847.

None the less, Webster, like Boyle, obeyed a true impulse when he looked for the cause of influenzas in something telluric, occasional, phenomenal. A wave of influenza comes up unexpectedly from a particular point of the compass, passes quickly over many degrees of latitude and longitude, lasting a few weeks at any given place, disappears in the distance, and does not return again perhaps for a whole generation. Influenza has the qualities of suddenness, swiftness, transitoriness; it has a certainsameness in its symptoms; it can be identified as certainly in the brief phrases of medieval chronicles as in elaborate modern descriptions; it has had no season for its own, as plague and cholera have had the summer and autumn, but has reached a height in Europe sometimes in midsummer, sometimes in midwinter. No other epidemic malady can compare with it in these respects; all the rest seem to have been provoked more or less by the turns and changes in human affairs, some being of a medieval colour, others of a modern, each in its own way admitting of explanation from unwholesome living, or from famine, or from over-population, or from something more recondite but still within the sphere of things insanitary in an intelligible sense. Other plagues besides influenza were, it is true, once reckoned mysterious, or associated in the popular mind with earthquakes and comets. But several such plagues have disappeared from among us, while their alleged causes, the earthquakes or comets, continue as before. Influenza alone returns at intervals as of old, untouched by civilization, by sanitation, by the immense differences between medieval and modern, making the same impression upon England in the year 1890 as it did in 1173, or 1427, or 1580, or, if changed at all, then changed for the worse inasmuch as the epidemic came back more severely in 1891, and still more severely in 1892. It is not surprising that for such a disease something telluric or even cosmic should have been assigned as the cause, something as occasional as itself, phenomenal, if not cataclysmic. It may be proper, therefore, that we should try over again the philosophic generalities of Boyle, Arbuthnot and Webster, peradventure a combination of them may yield a true theory. From Boyle we may take the great principle of a progressive infection through regions of air (or leagues of ground), which was expressed once for all by Lucretius in the sixth book of the ‘De Rerum Natura’:

... atque aer inimicus serpere coepit;Ut nebula ac nubes paulatim repit, et omneQua graditur, conturbat et immutare coactat;Fit quoque ut in nostrum quum venit denique coelumCorrumpat reddatque sui simile atque alienum.

From Arbuthnot we may take the organic source and nature of the influenzal miasmata, and the association with changes in the level of the water in the soil. From Webster we may take the idea that the historic influenzas, having been sudden,occasional or phenomenal, must have had phenomenal causes somewhere in either Hemisphere. Instead of sketching a theory in the abstract, and safeguarding it by following all its ramifications, I shall proceed by the way of instances, choosing them so as to bring out particular points in order.

The only generality which may be indicated at starting is one that has presented itself time after time in the foregoing history, namely that there is something more than accident in the association between epidemics of influenza and epidemics of ague. So close was this association in former times that both the influenza and the widely prevalent ague were included together under such names as “the new ague,” “the new fever,” “the new distemper.” As late as 1679, Morley did not distinguish the epidemic of influenza from the epidemic agues in the midst of which it was set, although the distinction was real, and was actually made by Sydenham on that occasion, as it had been made by Willis and in a manner by Whitmore on the occasion immediately preceding, and as it was made by everyone on the last great occasion when an influenza made an interlude among epidemic agues in the year 1782. It has often been suspected that influenza was related to some other infection: at one time it was taken for a volatile emanation of plague, in our own time it has been regarded as a volatile emanation of Asiatic cholera. In a wider historical view the question may arise, whether the real relation is not rather to those remarkable agues which have been epidemic in company with influenza when there was no plague and no cholera.

I come now to certain influenzas, as illustrating particular points of theory, in order.

I.

It is probable that Webster’s theory of influenza as related to earthquakes and volcanoes, first published in 1799, was suggested to him by a communication to the Royal Society on the volcanic waves seen at Barbados on the 31st of March, 1761, and on the epidemic of influenza thereafter ensuing all over the island. At Bridgetown, in the afternoon of the 31st of March, 1761, the water in the bay and harbour ebbed and flowed to the extent of eighteen inches or two feet at intervals of eight minutes, and continued to do so for the space of three hours, the oscillation regularly decreasing till night when it was no moreobservable. These tidal waves were due to volcanic upheavals somewhere; and it was found that the centre of disturbance had been in the Atlantic near the coast of Portugal, and the time some hours earlier than the waves were felt at Bridgetown. The Barbados chronicler proceeds:

“It is very remarkable that since that time the island has been in a very deplorable condition, having suffered under the severest colds that have been ever known. The distress has been so general that I may venture to assert (with confidence) that nineteen twentieths of the inhabitants of the island have felt the effects of the contagion; and to some it has been repeated several times. It has puzzled all the adepts in pharmacy to find out the cause and cure of it. One favourable circumstance has attended it, viz. few have died with it. The Leeward Islands have not escaped, it having raged there more violently and more fatal. His Majesty’s ships have severely felt the effects of it, some of them not being capable of keeping the seas for want of men fit for service. This happening at a season of the year remarkably the healthiest, makes it the more surprising[761].”

“It is very remarkable that since that time the island has been in a very deplorable condition, having suffered under the severest colds that have been ever known. The distress has been so general that I may venture to assert (with confidence) that nineteen twentieths of the inhabitants of the island have felt the effects of the contagion; and to some it has been repeated several times. It has puzzled all the adepts in pharmacy to find out the cause and cure of it. One favourable circumstance has attended it, viz. few have died with it. The Leeward Islands have not escaped, it having raged there more violently and more fatal. His Majesty’s ships have severely felt the effects of it, some of them not being capable of keeping the seas for want of men fit for service. This happening at a season of the year remarkably the healthiest, makes it the more surprising[761].”

This is as good an instance as we shall find, of explaining something sudden, swift, and phenomenal, by something else sudden, swift, and phenomenal, in a purely empirical way and without pausing to ask whether the latter could have been avera causaof the former. That the influenza came to Barbados in the wake, as it were, of the volcanic waves, had been a common subject of talk among the residents; and that common opinion of the colony had found expression in the paper sent to the Royal Society. The influenza was not only in Barbados, in the Leeward Islands, and in the ships on the West Indian Station, but also in New England and “over the whole country” of the North American Colonies. Dr Tufts, of Weymouth, New England, wrote to Webster that “it began in April, and in May ran into a malignant fever which proved fatal to aged persons. It spread over the whole country and the West India Islands[762].” It was not until some nine months after that influenza appeared in Europe, at first in the east of that continent,—Hungary, Vienna, Breslau, Copenhagen—in February and March, 1762, in central Germany and Scotland in April, in London about the first of May and all over England and Ireland thereafter, but not in France until June and July.

Precisely the same order was followed by the influenza twenty years after: it began in North America in March, 1781, and, says Webster, spread over that continent; it appeared inthe East Indies in October and November, 1781, and on the eastern confines of Europe in January, 1782, having been traced from Tobolsk, made a slow progress westwards, and was at its height in London about the end of May or beginning of June. Assuming, says Webster, that the American influenza of 1781 had been continuous with the European of 1782, it must have “passed the Pacific in high northern latitudes,” traversed Siberia and Tartary, and so reached Russia in Europe. In like manner, if the European influenza of 1762 were continuous with the American of 1761, it must have made the circuit of the globe in the same order, as if it were following the first impulse of the volcanic waves across the Atlantic from the coast of Portugal westwards, and so round the earth until it came back to Europe on its eastern frontier. So much may be fairly advanced on the ground of a particular set of facts. But then there were many other facts, both in 1761-62, and in 1781-82. Meanwhile let us take another instance of volcanic waves felt at Barbados six years before, on the same afternoon as the great earthquake of Lisbon.

II.

At Bridgetown, on the 1st November, 1755, Dr Hillary saw the peculiar flux and reflux of the water in the harbour from 2.20 p.m. to 9 p.m. and pronounced that there must have been an earthquake somewhere. The waves came at first at intervals of five minutes, and at last at intervals of twenty minutes. The day was calm, and the ships in the bay were not touched; but small craft lying in the channel over the bar were driven to and fro with great violence. There was no motion of the earth, and no noise. The distance from Lisbon was 3400 miles, the vibrations having taken seven and a half hours to reach Barbados. The one notable effect in the harbour of Bridgetown was that the water flowed in and out with such a force that it tore up the black mud in the bottom of the channel, so that a great stench was sent forth and the fishes caused to float on the surface, many of them being driven a considerable distance on to the dry land where they were taken up by the negroes[763].

It so happened that there was an epidemic catarrh prevalent at that very time all over the island of Barbados, chiefly amongchildren, few or none of whom, white or black, escaped it. It had begun in October, says Hillary[764](who chronicled the epidemiology very exactly), and continued into November, so that it both preceded and followed the great convulsion in the bed of the Atlantic, which destroyed Lisbon and tore up the mud in the harbour of Bridgetown, disengaging a great stench therefrom and poisoning the fish. Webster’s theory of a relation between earthquakes and influenzas provides for such discrepancies in the dates of each: it is probable, he says, that seasons, earthquakes and volcanic eruptions are themselves the effects of those motions and invisible operations which affect mankind, so that catarrh and other epidemics often appearbeforethe visible phenomena of eruptions and earthquakes. In like manner, the chronicler of the earthquake of Lisbon in thePhilosophical Transactionsdrew attention to the fact that there had been a remarkable drought for several years before, and that some of the springs near Lisbon were actually dried up at the time. That droughts precede earthquakes is perhaps the most instructive generality that has yet been reached as to the cause of the latter.

Let us see, then, whether any such remote antecedents, in a possible relation to the influenza epidemics, hold good for the island of Barbados. Hillary’s chronicle is sufficiently full to let us answer the question.

Following the seasons and prevalent maladies backwards from the influenza of children in October-November, 1755, we find a catarrhal fever all over Barbados in February of the same year, which “few escaped having more or less of.” The immediate precursor of that influenza had been a very definite constitution, eighteen months long, of a “slow nervous fever,” from February, 1753 to September, 1754, which corresponds in every respect to the “remittent” fever of nearly the same period in England and Ireland, described by Fothergill, Rutty, Huxham and Johnstone, and to the famous Rouen fever described by Le Cat. Hillary is clear that the “slow nervous fever” was not seen again so long as he remained in the colony (1758). Just before it began, there had been an influenza so general in December, 1752, and January, 1753, “that few people, either white or black, escaped having it,” and that, in turn, was preceded by a season of agues, which, says Hillary, “are never seen in Barbados now [1758], unless brought hither from some place of the Leeward Islands.”

Following the seasons and prevalent maladies backwards from the influenza of children in October-November, 1755, we find a catarrhal fever all over Barbados in February of the same year, which “few escaped having more or less of.” The immediate precursor of that influenza had been a very definite constitution, eighteen months long, of a “slow nervous fever,” from February, 1753 to September, 1754, which corresponds in every respect to the “remittent” fever of nearly the same period in England and Ireland, described by Fothergill, Rutty, Huxham and Johnstone, and to the famous Rouen fever described by Le Cat. Hillary is clear that the “slow nervous fever” was not seen again so long as he remained in the colony (1758). Just before it began, there had been an influenza so general in December, 1752, and January, 1753, “that few people, either white or black, escaped having it,” and that, in turn, was preceded by a season of agues, which, says Hillary, “are never seen in Barbados now [1758], unless brought hither from some place of the Leeward Islands.”

So many influenzas in Barbados, and so many things possibly relevant to them among their antecedents. So also in New England, the influenza which seemed to follow the earthquakealong the coast of Portugal on the 31st of March, 1761, had the same remittent and intermittent fevers among its antecedents.

In the winter and spring of 1760-61 there had been much fever in New England, which was believed to be malarious. Webster, however, says: “There is no necessity of resorting to marsh exhalations for the source of this malady. The same species of fever [as at Bethlem] prevailed in that winter and the spring following in many other parts of Connecticut where no marsh existed. In Hartford it carried off a number of robust men, in two or three days from the attack.... In North Haven it attacked few persons, but everyone of them died. In East Haven died about forty-five men in the prime of life, mostly heads of families. The same disease prevailed in New Haven among the inhabitants and students in college.” In Bethlem the sickness began in November, 1760, and carried off about forty of the inhabitants in the winter following. This was the fever, generally reckoned malarious, which preceded the influenza of April and May, 1761[765].

In the winter and spring of 1760-61 there had been much fever in New England, which was believed to be malarious. Webster, however, says: “There is no necessity of resorting to marsh exhalations for the source of this malady. The same species of fever [as at Bethlem] prevailed in that winter and the spring following in many other parts of Connecticut where no marsh existed. In Hartford it carried off a number of robust men, in two or three days from the attack.... In North Haven it attacked few persons, but everyone of them died. In East Haven died about forty-five men in the prime of life, mostly heads of families. The same disease prevailed in New Haven among the inhabitants and students in college.” In Bethlem the sickness began in November, 1760, and carried off about forty of the inhabitants in the winter following. This was the fever, generally reckoned malarious, which preceded the influenza of April and May, 1761[765].

III.

The next great influenza, twenty years after, which was in America in the spring of 1781 and in Europe in the winter and spring following, will repay the same kind of scrutiny. There had been influenza here or there in Europe since the beginning of 1780, but no great epidemic of it; and in England, as elsewhere, there had been epidemic agues and dysenteries since that year, or the autumn before. The epidemic agues became worse in England in 1783, 1784, and 1785, appearing in places which had never been thought malarious. The whole period from 1780 to 1784 was remarkable for hot and dry summers and great earthquakes. Italy and Sicily were troubled by earthquakes to an unusual extent in 1780, 1781, 1782, and 1783; they were so frequent in 1781 that the pope ordered public prayers. The great earthquake of the period was in Calabria at half an hour after noon of the 5th of February, 1783, about six months after the great influenza of the period was over. Sir William Hamilton, the British ambassador at Naples, visited the numerous scenes of the earthquake in Calabria and Sicily in the first fortnight of May, 1783, and sent to the Royal Society an account of what he saw. At several places he found fever epidemic, part of it from the overcrowding and filth of the temporary barracks in which the people were living, part of it malarious from the damming of water by changes in the river beds. At Palmi the spilt oil mixed with the corn of the overthrown granaries, and the corrupted bodies, had a sensible effect on theair, which threatened an epidemic; at the village of Torre del Pezzolo an epidemical disorder had already manifested itself[766].

But the most striking effect of the earthquake was that a dry fog began in Calabria in February, and overspread until autumn the greater part of Europe, extending even to the Azores. This fog, though not consisting apparently of moisture, was so dense that the sky was quite obscured, appearing a light grey colour instead of blue, while the sun became a blood-red disc. In Calabria the darkness was so great that lights were needed in the houses, and ships came into collision at sea. There was a most disagreeable odour[767]. The fog spreading over all Europe from Calabria was not at all mythical, as we are apt to suppose that similar recorded phenomena of the wonder-loving Middle Ages may have been. The phenomenon was independently reproduced in Iceland the same year, from the 1st to the 11th of June, causing the same darkness at sea, the same atmospheric effects at a distance, but not to so great a distance, and some amount of sickness, but seemingly not aguish or febrile, among the population[768].

Those two great convulsions of the year 1783, each of them the cause of a widely spreading dry fog, may have been conceivably the cause of pestiferous miasmata in the air, such as the corresponding hypothesis of influenza requires; but how little comparable or equivalent were the miasmata—in the one case from the ancient and well-peopled soil of Southern Italy, in the other from the inhospitable Danish colony just without the Arctic Circle! In any case, the earthquakes of 1783 were both too late for the great influenza of the period. The antecedent common alike to the influenza and the earthquakes was the extraordinary droughts, which caused famine and famine-fever in Iceland, and, according to old experience, was probably related to the epidemic prevalence of agues in Britain and on the continent of Europe.

IV.

What kind or kinds of epidemic sickness earthquakes may produce as an effect immediate and at the place, will appear from other instances. One of the most remarkable of earthquakes was that which destroyed Port Royal and nearly all the planters’ houses and sugar-works throughout the island of Jamaica on the 7th of June, 1692. Jamaica had been an English colony for little more than thirty years, during which time it had passed from its state of lethargy under the Spaniards into an emporium of commerce with a rapidly growing population of slaves and whites. The business capital was at Port Royal, wholly built since the British occupation. The site of it was a sandy key or shoal which was said to have risen perceptibly within the memory of original settlers; a writer in September, 1667, said of it: “wherever you dig five or six feet, water will appear which ebbs and flows as the tide. It is not salt, but brackish[769].” A quay had been built along this spit of land, at which vessels of 700 tons could lie afloat. It was here that the havoc of the earthquake was most complete.

Sloane, who had visited Jamaica a few years before, said that the inhabitants expect an earthquake every year, and that some of them were of opinion that they follow their great rains[770]. The year 1692 began in Jamaica with very dry and hot weather which continued until May: then came gales and heavy rains until the end of the month, and from that time until the day of the earthquake, the 7th of June, the weather was excessively hot, calm and dry. The shakes began at 11.40 a.m., and at the third shake, the ground of nearly all Port Royal fell in suddenly, so that in the course of a minute or two most of the houses were under water and the whole wharf was covered by the sea to the depth of several fathoms. The loss of life was, of course, greatest where population was densest; but in the interior of the island the effects on the soil were greater than at the shore: in the north a thousand acres of land sank and thirteen people with it; mountains on either side of a narrow gorge came together and blocked the way; wide chasms appeared in theground, and on one mountain side there were some dozen openings from which brackish water spouted forth. The first effect in the streets of Port Royal was that men and women seemed all at once to be floundering up to the neck in the wet shifting sand, and were speedily drowned or floated away by the inrushing water. The shakes ceased for days at a time, and then began again, five or six perhaps in twenty-four hours; so that those who had escaped to ships in the bay remained on board for two months, being afraid to come ashore. The weather was hotter after the earthquake than before, and mosquitoes swarmed in unheard of numbers.

During the upheavals or subsidences in Port Royal, and the rushing of water into or from the gapings in the ground, “ill stenches and offensive smells” arose, so that “by means of the openings and the vapours at that time belcht forth from the earth into the air, the sky, which before was clear and blue, was in a minute’s time become dull and reddish looking (as I have heard it compared often) like a red-hot oven.” A very great mortality followed among those who had escaped the earthquake. Some of them settled at Leguanea, others at the place on the bay which became the Kingston of later history, enduring many hardships in their hastily built shelters, from the heavy rains that followed the earthquake, and from want of clothes, food and comforts.

One writes: “Our people settled a town at Leguanea side; and there is about five hundred graves already [20th September, 1692], and people every day is dying still. I went about once to see it, and I had like to have tipt off.” Another says: “Almost half the people that escaped upon Port Royal are since dead of a malignant fever”: and another, referring to the hasty settlement on the bay at Kingston, says “they died miserably in heaps.” But the most interesting information is his next sentence: “Indeed there was a general sickness (supposed to proceed from the hurtful vapours belched from the many openings of the earth) all over the island, so general that few escaped being sick: and ’tis thought it swept away in all parts of the island three thousand souls, the greatest part from Kingstown, only yet an unhealthy place[771].”

One writes: “Our people settled a town at Leguanea side; and there is about five hundred graves already [20th September, 1692], and people every day is dying still. I went about once to see it, and I had like to have tipt off.” Another says: “Almost half the people that escaped upon Port Royal are since dead of a malignant fever”: and another, referring to the hasty settlement on the bay at Kingston, says “they died miserably in heaps.” But the most interesting information is his next sentence: “Indeed there was a general sickness (supposed to proceed from the hurtful vapours belched from the many openings of the earth) all over the island, so general that few escaped being sick: and ’tis thought it swept away in all parts of the island three thousand souls, the greatest part from Kingstown, only yet an unhealthy place[771].”

That great mortality from a malignant fever after the earthquake of 7th June, 1692, is usually counted an epidemic of the yellow fever which became established at Kingston and Port Royal from that time for at least a century and a half. I have not found any contemporary medical account of it, but all thelater writers on yellow fever at Kingston and Port Royal have accepted the tradition that it was yellow fever. But there was one peculiarity, which marks it off from all subsequent epidemics of yellow fever—the sickness was all over the island, so general that few escaped being sick, and was supposed to proceed from the hurtful vapours belched from the many openings of the ground in and near Port Royal. In all subsequent experience yellow fever has been almost confined to the shore or to the ships in the bay[772]. Certainly it has never been all over the island as in 1692, “so general that few escaped being sick”: that is rather in the manner of influenza, although there is nothing to show that the sickness of the interior was so different from that of the shore as to be counted an influenza, or that the mortality of the sick was other than that of a “malignant fever.”

The earthquake at Port Royal in 1692 produced “ill stenches and offensive smells.” The tidal waves, or the subterranean vibrations which caused them, in tearing up the mud at the bottom of the channel at Bridgetown, Barbados, in 1755, had in like manner sent forth a great stench which poisoned the fish. Such offensive vapours were supposed in former times to come, as in a figure, from “the bowels of the earth”; and undoubtedly the sulphurous fumes which have overhung the region of Sicilian earthquakes must have had a source as deep as the strange minerals or “fossils” of Boyle’s hypothesis. But, while the commotion of an earthquake is deep, it is also superficial; whatever miasmata issue from the ground in the ordinary alternations of wet and drought, would be discharged into the atmosphere in unusual quantity and with unusual force in such disturbances of soil as sunk Port Royal in 1692 or were felt at Barbados across the whole width of the Atlantic in 1755. Nor is that effect upon miasmata instantaneous or quickly past; in Jamaica the rumblings and shakes lasted for nearly two months, during which time the pressure upon the gases in the subsoil must have been such as to make them pass into the atmosphere in stronger ascending currents than the mere alternations of moisture and drought would have done. And just as the ordinary seasonal changes in the level of the ground-water areof little or no account for miasmatic-infective disease unless the soil in which they occur be full of organic impurities from human occupancy, so one may reason that the great cataclysmic changes of the earth’s crust are, in this hypothesis of influenza, of most account as touching the stratum of soil wherein lie organic impurities, and as touching those areas of the surface,—the sites of cities, the populous plains, the shores of bays, the bottoms of harbours or any other definite spots—in which the products of organic decomposition are present in largest amount and, perhaps, of somewhat special kind. Such impurities of the soil are indeed avera causaof infective disease, known to be capable of the effect which has to be accounted for; and, as discharged into the air in great volume and with great force by some upheaval, they would make a local beginning of that “aer inimicus” which the Roman poet figures as creeping like a mist from one region of the heavens to another so that it corrupts each successive tract of air with its own baleful qualities, “reddatque sui simile atque alienum.”

But, as soon as we begin to apply this formula to particular historic cases, difficulties and ambiguities arise[773]. To come back to the instance of Jamaica in 1692, did the general sickness of the island, manifestly miasmatic as it was, and due to disturbances of soil, become an influenza for other regions of the globe? About fifteen months after there was, indeed, a universal catarrh in Britain and Ireland, of no great fatality, which is said by Molyneux, of Dublin, to have prevailed also in the northern parts of France, Flanders, and Holland, but is not reported in the usual way from Europe generally nor from America. Let us suppose a miasmatic cloud formed over theisland of Jamaica in June, July, August and September, a cloud of infective particles which might produce influenza at a distance from its place of origin, whatever disease the miasmata after the earthquake may have produced in Jamaica itself. Let this invisible cloud, or emanation, get into the warm atmosphere over the great oceanic current that sets out from the Gulf of Mexico. The vehicle lies ready to hand,—to receive the miasmata not far from their place of origin, to carry them far into the Atlantic, and to bring them, perhaps, to the shores of Britain. This may seem a sufficiently plausible source of the influenza of October and November, 1693, which appears to have been felt only in the British Isles and on the opposite shores of the North Sea. But Webster’s own choice is the volcanic eruption in Iceland in the same year as the influenza; and if we prefer, in this hypothesis, an earthquake to an active volcano, there is a rival source for the British influenza of 1693, nearer both in place and time than that of Jamaica in 1692, and not less important in respect of miasmatic disease in its own locality. This was the disastrous series of earthquakes in Calabria and Sicily, culminating on the 9th of January, 1693. The following extracts from the account sent to the Royal Society will show how great was the commotion of soil, of underground water, and of atmosphere, and how close the connexion of these with the sickness ensuing[774]:


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