At the commencement of this month affairs wore a very unfavourable aspect. The plague, which first appeared in Rosetta, and had hitherto, with little exception, been confined to that place, at the present period had travelled as far as Aboukir on the one side, and as far as Rahamania on the other side, of Alexandria; and we had information that most of the intermediate stages, betwixt us and these two places, were infected. Withso much severity did the disease rage at Rosetta, that, at the end of last month, it was found necessary to withdraw the commandant and every person from it, and the inhabitants shut themselves up. From information received by the Board of Health, they likewise found it necessary to place all those coming from Cairo and Ghiza under quarantine.
It was well known, that, in Upper Egypt, the plague was making dreadful ravages among the Mamalouks. The few cases which occurred in Alexandria made every one alert there, and a very strict police was kept up in the town by the commandant and by the Scorbatchie.
The weather in the beginning of the month was variable. The thermometer rose a little. It was rarely so low as 60°, and only once as high as 71° 50″. We had much high wind on twelve days. It rained on fifteen days, but the quantity which fell was not so great as in the lastmonth. The sky was cloudy throughout the month.
On the 20th there was much loud thunder.
On the 1st, sixty-four invalids, from the Indian army, were embarked for England. The greater part were cases of blindness.
Both Mr Price and Mr Rice, who dissected the body of Signior Positti in the lazaretto, had been ill ever since; and this day they were so ill that Dr Buchan was sent in to relieve Mr Price, and Mr Moss to relieve Mr Rice.
On the 3d, a case of the plague appeared at Ghiza on a private follower, and another case was detected in the hospital of the 26th Dragoons at Alexandria.
On the evening of the 14th, Mr O’Farrel, who had charge of the pest-house at Aboukir, was attacked with the disease. This day all the hospitals were moved out of town, and encamped under the walls of Alexandria.
On the 6th, a Jewess dropped down dead in the streets of the city, and it was discovered that she had been ill for four days of the plague. Her husband, who concealed it from the Board of Health, was bastinadoed; and afterwards was sent, with his whole family, into quarantine. On the same evening an Arab’s family reported that one of them was ill of the plague. The person affected was sent to the pest-side, and the rest of the family to the observation-ground, of the lazaretto.
On the 7th, Mr Dyson, who on the 4th went to Aboukir to relieve Mr O’Farrel, discovered bubo and symptoms of the plague in himself.
On the 10th, a serjeant of the 61st, who had had the disease last month, and who, after recovering, officiated as in-steward of the pest-house in Alexandria, was again attacked with the plague.
On the 11th Mr Angle died, being the fourteenth day of his disease. He, threeweeks before, went to assist Dr Buchan in the lazaretto.
On the 14th, symptoms of the disease were first discovered on Mr Moss in the lazaretto. Of the Jew family sent to the observation-ground on the 6th, which amounted to seven persons, two were sent to-day to the pest-side.
On the 15th the husband of the jewess died in an observation-tent, having glandular swellings, which were not discovered till after his death. He did not appear to be ill. Mr Cloran was accustomed, once a day or oftener, to examine those under observation, but nothing was discovered to ail this man.
On the 16th, he discovered some symptoms of the disease in another of the same family, and sent him in to Dr Buchan.
On the 17th, a deserter from the 61st regiment, sent to the regimental guard-house, where he was discovered to have the plague, was sent to the lazaretto, and the guard, amounting to nineteen persons,into the observation-ground of the lazaretto. This man confessed that he had slept one night near the pest-house at Aboukir. On the 19th Mr Moss died. On the 24th the plague was discovered in another Jew family. The plague of the Indian army, during the month, was as follows, viz.
On the whole, it was a pleasing circumstance to see so little of the disease among the native corps, as, when it did occur, it proved so much more fatal to them. From my correspondence with different gentlemen in the pest-houses it appears, that, during the month, bubo was not so constant a symptom, and that carbuncles were now frequent.
At first this symptom was seen in no case. Excepting the 61st regiment, thearmy was in a very healthy state. Fever was equally mild as in last month. Opthalmia began again to appear. In the last return there were sixty cases, fifty of which were Europeans. Of seventy-one men with ulcers, sixty were Europeans. The total sick of the army, at the end of the month, did not exceed three hundred; and in this are included every ulcer, accident, or less serious complaint, which prevents a soldier from appearing on parade.
At the commencement of this month the principal part of the army was still encamped at Alexandria. On the last day of April orders arrived from England to General Baird, to return with his army to India, and to detach the 10th, 61st, and 88th, regiments, which were placed on the British establishment.
On the 3d the Indian army began the march to Ghiza, where it remained encampedby the pyramids for some days, until water and the passage over the desert were reported to be ready. At length the march commenced with the sick.
We crossed the river, encamped at Boulac, set off from Cairo, and, passing the ruins of Heliopolis, made Birket El Hadje our first stage. Our marches over the desert of Suez, as in crossing the great desert, were all performed during the night, and we always encamped by sunrise in the morning. Luckily there had much rain fallen before we marched; and at one place in the middle of the desert, and again at Suez, we found large collections of rain-water, from which all were well supplied.
By the end of the month the whole corps, except the 7th Bombay regiment, had crossed the desert and arrived at Suez. Part of the army was encamped near the town of Suez, and part at Moses Wells, nine miles on the eastern side of the RedSea. The march over the desert of Suez was performed with much greater ease than that over the desert of Thebes. The weather was cool and favourable, the hot winds were less felt, and we found abundance of good water provided at the different stations. At the time of our arrival we found Suez very healthy. Though the plague had travelled as far as Cairo and all the neighbouring villages, it had not reached Suez till the arrival of the army.
The women and children of the army, as well as some invalids, were here; and they, with the Lascars of the fleet, were under the medical charge of Dr Colquhoun and Mr Waring, whose reports had all along shewn a very great degree of health. The only disease was the tropical dysentery, and this was confined to the women and children, who were inactive. The Lascars, who were actively employed, were all very healthy. During the month, several cases of the plague were reported, but theywere all very mild. On the 4th, a Sepoy of the 1st Bombay regiment, on duty with the pioneers in the desert, was attacked with the disease, and was the only man who died of it during the month. On inquiry afterwards, it was found that the Sepoy had got the infection from one of the interpreters, named Peter, and that Peter brought the disease from the Turks in Cairo. The case of the interpreter was so mild, that it was treated by Mr Dick as a venereal complaint. He took mercury to produce salivation, the bubo came to suppuration, and Peter recovered. As soon as the Sepoy died in the desert, every article belonging to him was burnt with the body. A perfect separation was effected, and every precaution taken in consequence. No other case appeared in this detachment.
On the 12th, another case appeared in the 7th regiment, now encamped at a village opposite Boulac. No plague could be discovered to have been in the village.The occurrence of this case, therefore, could be accounted for in no other way than that the seeds of the disease still lurked in this very unfortunate corps, and that they brought it from Aboukir with them. A pest-house was established under the charge of Dr Henderson at Boulac, and two other mild cases were admitted into it towards the end of the month.
On the 23d, the disease was discovered on a Madras tent-Lascar at Moses Wells. On the 26th it was discovered on a serjeant of the 86th regiment in crossing the desert. This was the last case which appeared previous to the embarkation of the army.
The weather, during the month, was uncommonly fine. The thermometer was greatly on the rise. During the month it was from 60° to 68°: at Alexandria from 60° to 78°: in the tents on the desert, and at Moses Wells, from 60° to 98°. The wind was generally from north to north-west. In the desert, and at Moses Wells, we had the dry suffocating wind that wefound in the desert of Thebes, at Kossier, at the same time in the former year; and the atmosphere was generally cloudy. The army was very healthy.
Ophthalmia now, however, became a more frequent disease, particularly among the Europeans, and it might be said to be the only disease which prevailed.
On the 2d, the embarkation commenced, and by the 15th the whole army was embarked, and had sailed for the different presidencies, except the 7th regiment, which, on account of the plague still prevailing in it after the rest of the army had embarked, was ordered to remain two months. Most of the corps in the army embarked in the most healthy state. There was hardly a sick man, except a few cases of the venereal disease which had resisted mercury.
To conclude, never, perhaps, was there an army embarked for any service morehealthy than the Indian army was when it re-embarked on its return from Egypt.
Previously to the arrival of the army from Egypt, in order to provide against the introduction of the plague into India, quarantines were established at the presidencies of Bombay, Bengal, and Madras, as well as at the island of Ceylon. The principal of these was at Butcher’s island, near Bombay, where there were pest and quarantine establishments, of which, on my arrival in June, I took the charge. At this period, letters from Dr Short, at Bagdad, and from Mr Milne, at Bassorah, described the plague as raging in Persia, and particularly at Ispahan and Bagdad: in consequence of this information every vessel, both from the Red Sea and Persian Gulf, was ordered to Butcher’s island.
As the ships arrived, the troops from the Red Sea were landed; but the artillery, 86th regiment, 1st Bombay regiment, and the commissariat department, were so uncommonlyhealthy, that I detained them but a very few days on the island.
The 7th Bombay regiment landed at Butcher’s island in August. As this was the corps in which the plague had principally prevailed, though they were not unhealthy, I judged it prudent to detain them a month. On my last inspection of them before they left the island, of a total of seven hundred, including Sepoys, their wives, and the public and private followers of the corps, I found only four sick, and these I believe were all catarrhs.
Dr Henderson, with the pest-establishment, and all those whom we had left at Suez, arrived at Butcher’s island on the 1st September. The convalescents from the plague, as well as the guard, and the pest-house servants, were, on their arrival, all of them very healthy; but I thought it safe to keep them in quarantine on the island till October, when, like all the others who had been in quarantine, theywere provided with new clothing and sent over to Bombay.
The company’s packets from Bassorah, and the vessels which arrived from the Persian Gulf, had none of them the least suspicious appearance, and I found that their crews were all very healthy.
I had likewise the satisfaction to receive accounts from the medical gentlemen employed in the expedition, after their arrival at Calcutta, Madras, and Ceylon: their accounts were so late as November. In none of the corps did any death occur from the time of embarkation at Suez. The deaths which appear in the annexed table, in the 80th regiment, were men lost in the wreck of one of the transports.
END OF PART I.
From my own observation, from accurate reports made to me, as well as from an extensive correspondence with the medical gentlemen of the Indian army in Egypt, I have presented a faithful, and I believe an accurate, narrative of the medical occurrences of the late campaign.
Perhaps it may be thought that I have descended to a great degree of minuteness: however, I conceive, that, from the facts stated, important and useful deductions may be made. I think it a matter of regret that such journals are not more frequently kept; with a little industry on the part of the profession they might always be so. Had such records been always faithfully kept, many practical points would not, asthey now are, be involved in doubt and uncertainty. We should not now be so ignorant of some diseases, of the countries where we have so often made campaigns, or of which we have so long been in the possession.
Humble as the labours may seem, and confined as the abilities of an individual may be, were he only faithfully to relate observations made with care, to compare them with those of his contemporaries, and by these to correct the opinions of his predecessors, he would perform no mean service to his art.
I shall, in this part, advert to what appeared to be the principal causes of the diseases which prevailed. Previously to this it will be necessary to take notice of the state of the different corps, composing the army, as they landed at Kossier.
With the exception of the Sepoys from Bombay, every corps disembarked at Kossier in the most healthy state. Rarely, indeed, have troops on any expedition beenlanded in the degree of health in which the Indian army landed in Egypt.
There is little doubt that their situation on ship-board was the cause of the sickness which prevailed among the troops from Bombay. The Sepoys were but a short time encamped at Kossier when they began to recover; yet the situation there was by no means what we would recommend, or make choice of, for the recovery of health.
The army under General Baird was composed, as already observed, very nearly of one half Europeans, and of one half natives of India. We shall begin with the Europeans.
A detachment of the Royal Artillery came with Sir Home Popham from the Cape of Good Hope, where they had been stationed for nearly four years. The Honourable Company’s artillery, collected from the different presidencies in India, had all of them been a considerable time in that country. Of the artillery, the Bombay suffered the most; next to themthe Royal; next the Madras; then the Bengal; and, least of all, the horse-artillery. The prevailing diseases were dysentery and hepatitis. At one period, indeed, fever prevailed among the Bombay artillery.
The troop of the 8th Light-Dragoons was landed in a very healthy state, and continued healthy throughout. The dragoons came from the Cape of Good Hope, where the regiment had been for five years. The only man they lost in Egypt was from hepatitis.
The 10th foot had been a short time at Madras and had been two years stationed in Calcutta, whence they were embarked for Egypt. At Calcutta this regiment was at first very unhealthy, and lost a number of men; but they landed in a most healthy state at Kossier. The 10th regiment, but for having lost their way, and making some prodigious marches across the greater desert, would have suffered less, perhaps, than any other corps. In consequence of this march,soon after they reached Ghenné, a number of cases of fever appeared, all of which terminated either in hepatitis or in dysentery. Half the sick of the army, on leaving Ghenné, was from the 10th regiment; and the diseases contracted by their march across the desert continued, at Rosetta, to croud their sick-reports for four months after.
The 61st regiment was, in several respects, the finest corps in the army. The men were all young and very healthy, and the regiment joined the army in a state of high order and discipline. They came from the Cape of Good Hope, where the body of the regiment had been for nearly three years. This regiment continued healthy till they were encamped at El Hammed, and they lost very few till they came to Alexandria. They were quartered in the Pharos, and the surgeon attributed much of the sickly state of the regiment to the situation of this quarter. The situation is indeed a very damp one, surroundedevery where by the sea, except on the side of the mound which connects it with Alexandria. However, this corps had not yet lost those men which every corps loses on its arrival in a warm climate, and which, in some shape, seems necessary to their naturalisation to it. The diseases by which the 61st regiment suffered were dysentery and hepatitis; and, after their arrival in Alexandria, they were wont to lose, on an average, four men a week, for some time.
The 80th regiment came from Trincomalée, in Ceylon, a very unhealthy station, and where, during a five-years stay, they lost a very great number of men. This regiment was very healthy on landing. It was composed of what are usually termed old Indians; draughts from the 36th, 52d, 71st, and 72d, regiments, which had been sent home after a stay of fifteen or twenty years in India. The 80th suffered most of their loss after crossing the desert. At Ghiza, at El Hammed, and at Alexandria, they were the most healthy corps. However,there were many old men in this regiment who never recovered the fatigue of the march, nor the illness at Rhoda island, and who felt most severely the cold weather at Alexandria. A fact regarding this corps deserves mention. Mr Brown, who was in charge of it, informed me, that many men, who, at Trincomalée, were never free from liver-complaint, and were almost always in the hospital with this disease, never complained at Alexandria. This fact, on inquiry, I found held good in most other corps, and I had observed many instances of it in the 88th regiment.
The 86th regiment landed in a healthy state. This regiment had been six years in a warm climate. They came from Bombay, where they had been in garrison for the two last years. They continued very healthy till they were encamped at Rhoda island; there, and at El Hammed, they suffered much: subsequently, no corps in the army suffered less or lost fewer. The frequent movements of this corps contributedto their being in a more healthy state than some other corps were.
The 88th regiment had been about three years in a warm climate. They likewise came from Bombay. This regiment crossed the great desert with the loss of only one man. They were very healthy at Ghenné, and continued so till their arrival at Rhoda. The 88th was the first regiment from the Indian army that arrived at Ghiza, where they found the 89th regiment, and the ophthalmic hospital of the English army. In the course of the first week after their arrival at Ghiza, the 88th regiment sent one fourth of their strength into the hospital; all of them cases of fever or ophthalmia. At El Hammed, in proportion to the strength of this corps, ophthalmia prevailed more in it, and the regiment suffered more from it, than any other corps, except the 10th regiment. It will be remembered, too, that it was in the 88th regiment that the plague first broke out; and this regiment had more cases and more deathsfrom it than any other European corps. Mr Tonrey and myself, who attended these first cases, were among the few medical men who were exposed to the contagion and came in contact with the patients, and yet escaped the disease. The 88th regiment became at last one of the most healthy corps in the army. From the 1st December, 1801, to the 1st May, 1802, they only lost two men; of these, one was from the plague, and the other from sudden death, cause unknown.
With the exception of the two Bombay corps, all the native Indians lost fewer men than the European corps. After they marched from Kossier, and till the plague appeared in the two Bombay battalions, where it committed the greatest ravages, they were the two most healthy corps in the army.
The Bengal volunteer-battalion, composed of volunteers for the expedition to Egypt, from different regiments of Sepoys in Bengal, was a fine body of men, andthey were mostly what are called old or made soldiers. They were in general very healthy, and during the campaign their loss was very inconsiderable. Though the plague at one time appeared in this corps, yet, by the system established throughout the army by this time, and by the active vigilance of the officers of the corps, the contagion was extinguished; and, though the plague prevailed in every other corps, it never subsequently visited this battalion.
The Artillery-Lascars were, on the whole, very healthy throughout the campaign. The few deaths which they had were from dysentery.
The 1st Bombay regiment, after recovering from the fever contracted on ship-board, continued healthy, and suffered few deaths but from the plague. It was remarked, that this corps effected the march across the desert of Thebes, as well as that over the isthmus of Suez, with less difficulty than any corps in the army. In general, we observed that the native troops enduredthis better than the European. It ought not to be forgotten, that, under Captain Mahoney, detachments from the native corps were employed, some time before the march of the army, in clearing the roads, digging wells, and on other duties of fatigue more harassing than any that fell to the lot of any other part of the army. Nevertheless, these men continued in a high state of health.
At the period when the plague attacked the 7th Bombay regiment, they were far from unhealthy. The prodigious loss of this corps, which appears in the annexed table, was at first from the fever which raged at sea, and subsequently from the plague, which continued to persecute this corps from December, when it broke out among them, till the whole army was embarked at Suez.
The pioneer-corps was uncommonly healthy till they came to El Hammed. Here they had much severe duty. They were employed in building the hospitals,and very often in cutting the reeds by the river-side, or in conveying them through marshes. A very considerable share of the intermittents that prevailed in the army was from this corps.
The departments (under which title are included about five hundred men employed by the commissaries of cattle, of provisions, and of stores, and by the quarter-master general) were, from beginning to end, more healthy and had fewer deaths than any one corps in the army. They lost none but from the plague; and, when this was discovered, such precautions were taken that the contagion was very speedily eradicated. The extraordinary health of this body of men, as well as their escape from the plague, though particularly exposed to the contagion, I could only attribute to the commissary of cattle, who had the greater part of them in his charge. Captain Burr was constantly among these men, and wasmost singularly attentive to every thing that regarded their internal economy.
I am decidedly of opinion, that in the peculiar soil and climate of Egypt we are to look for the principal causes of the diseases which prevailed the most in that country.
On grounds that appear not slight, we suspected that several of these diseases were propagated by contagion. But I have no intention of entering on the discussion of the theories of contagion; an obscure subject, and on which I do not presume to think that I could throw any new light. If ever the veil which covers it be removed, the late discoveries in chemistry bid fair to do it. The accurate knowledge which we have acquired of the composition of bodies, and in particular of the constituent parts of the atmosphere, have opened new fields of inquiry to the philosopher and to the physician. The successful application of these discoveries to the practice of physic by the Doctors Beddoesand Thornton, by Dr Rollo, Mr Cruickshank, Dr Wittman, and other eminent surgeons of the artillery, and more particularly by the philanthropic Mr Scott, of India, deserve the gratitude of the profession and of mankind at large. Hereafter, most probably, and when introduced into general practice, they will be looked upon as the greatest improvements that the healing art has received in modern days.
In respect to the soil and climate of Egypt, as giving rise to disease, they are of considerable variety. In a country of such extent, stretching from the tropic, on the one side, to the shores of the Mediterranean, on the other, this might be expected. If, in Lower Egypt, and on the bleak shores of the Mediterranean, we saw the diseases of Europe, and met with the inflammatory diathesis; in Upper Egypt, and as we approached the tropic, we met with the same diseases, and succeeded withthe same treatment, as in the peninsula of India.
Perhaps no country is better known, or has been oftener described, than Egypt. I therefore presume that every thing regarding the climate and soil is generally known.
Upper Egypt, that is, the cultivated part of it, is a narrow stripe, laid out sometimes on one and sometimes on both sides of the Nile, which, in its course from Abyssinia till it passes Cairo, is on both sides enchained with a ridge of mountains.
Lower Egypt is, in general, a fine, rich, flat, country, interspersed in different places by branches of the Nile, and overflown by this river at a particular season; at which time the country is in the situation of Holland, or of the fenny counties of England.
The soil in most places is argillaceous or sandy, and in some calcareous; but every where there is a strong mixture of a salt: in most places there are incrustationsof it to some depth. The quality of the atmosphere, and the proportions of its different constituent parts, I regret that I never had an opportunity of ascertaining.
The cultivated part of Egypt, particularly the Delta, is a very rich country; in fertility and luxuriance of soil yielding to none under the face of heaven. The art of husbandry is there but imperfectly known; and at their harvests there is a very great destruction of vegetable matter, from which hydrogene gas, or hydro-carbonate, is extricated in great quantities. Under similar circumstances, in America as well as in India, I have seen a bad fever of the intermittent or remittent type appear. But in Egypt, after the subsiding of the Nile, which in many places had covered a great extent of country, there is a great exhalation from the mud, and from the putrid animal and vegetable matters left behind. The effluvia of these substances, acting on the human body, will readily account for much disease. If weadd to these the extreme filth of the inhabitants of Egypt, their poor diet, their narrow, close, and ill-ventilated, apartments, generally much crouded, with the extreme narrowness of their streets, and the bad police of their towns, we will not be astonished if a fever, at first intermittent or remittent, should have symptoms denominated malignant, superadded to the more ordinary symptoms of the disease. If an imported contagion should make its appearance at the same time, and under the above circumstances, we expect a most terrible disease.
The dry parching wind, which comes over the desert, and which at certain seasons blows in Egypt and in Arabia, is well known, and was often severely felt by the army on their march, both across the desert and the isthmus of Suez. The whirlwinds of sand roll with great impetuosity, are very troublesome, and insinuate fine sand and dust every where. It is hardlypossible to keep the minute particles out of the eyes.
The dews, which fall in Egypt, I always heard were very heavy, and were a cause of the diseases of the country. I had occasion too, more than once, to hear the natives attribute much to them as the cause of their diseases; with what justice I will not pretend to decide. From some experiments which I made in India, on the Red Sea, and lastly in Egypt, I am inclined to think that they are equally heavy in the two former as in the latter quarter. After weighing it carefully, I took a piece of lint, twelve inches square, exposed it for a night to the dew, and, by weighing it in the morning again, ascertained the quantity which it had gained. I am aware that this is by no means a nice experiment, and that in the performance of it several particulars demand attention; but it is sufficient to our purpose, and I learned by it, that, in the island of Bombay, on the Red Sea, andin Lower Egypt, the quantity of dew which falls is nearly equal.
It ought to be mentioned, that, during the year we were in Egypt, the season was not the usual one. There was a greater overflow of the Nile. It rose higher on the Nilometer than it had done for several former years, and it was remarked to be much later in subsiding at Rosetta.
The fall of rain at Alexandria was greater than on former years; and, at Rosetta, the rains were in setting in later than usual. The season of the plague set in much earlier than usual.[2]
In general, the Thebaid, or Upper Egypt, is healthier than the Lower. Never were troops more healthy than the army when encamped near Ghenné.
Ghiza, the ancient Memphis, at the time the army disembarked there fromUpper Egypt, we found to be a very unhealthy quarter. For a considerable time, and immediately before the arrival of the Indian army, it had been the station of large armies: alternately of Turks, Mamelukes, French, and English. From all these armies a number died at Ghiza, and there was much filth and noxious effluvia. We saw there enough of putrid animal matter to generate contagion. Whether this was or was not the cause of the fever which prevailed, I will not attempt to decide. One circumstance may be mentioned. We were here joined by a detachment of the 86th regiment under Colonel Lloyd, which, for some months before, had been doing duty with the Vizier’s army, which never was healthy. That the circumstances which existed at the time of our occupying Ghiza were the cause of the fever is manifest from this, that, subsequently to the army going to the coast, the garrison left in it found Ghiza a most healthy quarter. The sameobjections are to be made to Rhoda that are applicable to any marshy situation.
The 86th regiment found Damietta healthy, till the Turkish troops came down in great numbers from Cairo; but, at this period, the British troops were removed from it.
Rosetta is not a healthy quarter. It is one of the largest and worst-built towns in Egypt. There is hardly one street in it. There are only narrow dirty lanes, with high houses overhanging each other, and the passage frequently interrupted by houses in ruins. It is, on two sides, surrounded with swamps. The river is in the front, and behind, it is nearly encompassed with burying grounds.
The place of the encampment at El Hammed was an unhealthy spot. About half a mile in the rear of it there was a great extent of swampy ground; but there was no choice: it was necessary to encamp where there was water.
As a station for the army, Alexandria had every recommendation. It is built on a peninsula which formed the antient harbour, on a fine dry and open situation. Some squares, and several of its streets, are open and spacious; very unlike an African or Asiatic city. Its numerous mosques afforded us large and airy hospitals and barracks. In point of health, the inundation of the water from the lake Maadie was favourable. It insulated Alexandria; but the water was in motion, and at such a distance, that nothing was to be apprehended from exhalation. All the hospitals at first were within the walls of the modern city. The situation of the Pharos is well known to every one. I have said, that it was complained of as a quarter for troops, and with justice. The state of the 61st regiment shewed this. Subsequently to their being removed from it, they were encamped on the outside of the walls. From this period both the sickness and mortality in this corps disappeared. The10th regiment found Fort Triangulaire a dry, spacious, and airy, barrack. In the fort they had the means of keeping the men constantly in their quarters; they were at some distance from Alexandria, and thus it was in their power to preserve a regular internal economy and prevent drunkenness. When the regiment came to take possession of this quarter they had a numerous sick-list: it decreased daily after they came here; and, finally, the 10th was as healthy as most other regiments. The barracks of the 80th regiment, and of the Bengal volunteer-battalion, were situated close to Fort Triangulaire; and they possessed all the same advantages, but that it was not so easy to confine the men to the barracks.
The barracks of the 88th regiment, at Fort Cretan, were dry and airy. Though in a different quarter they possessed nearly the same advantage as Fort Triangulaire, with the disadvantages of the quarters of the 80th regiment.
The horse-artillery and 8th dragoons were, along with the 26th dragoons, stationed at Damenhoure, which had every advantage of a country quarter. It was situated in a fine, open, cultivated, country. The station was thought so good, that at last we sent the sick of the army to this quarter; and old cases of dysentery and hepatitis, as well as some of fever, recovered here with astonishing rapidity. By the time of their arrival there was in many a great amendment. They were conveyed in waggons constructed for them, and made three days easy journey to Damenhoure.
In the difference of Upper Egypt in June, and El Hammed and Rosetta in December, is included perhaps more than change of season; there was change of climate and of heat from 108° to 49° of the thermometer. We have said that, in many instances, the causes of disease at El Hammed could be traced to the march across the desert and the encampmentat Rhoda. Very much, however, was likewise to be attributed to the change of weather experienced in November and December.
In every part of the world, with change of season, some diseases pretty constantly make their appearance; but in no part is this so observable as in the countries under the tropics. In the West-Indian islands, as well as on the shores of India, I have repeatedly and uniformly observed the sick-list of European corps more than doubled by the third week after the setting in of the monsoon.[3]In these countries a very considerable increase of sick is likewise found to take place on the change from the rainy to the dry season. The change of season in Egypt had nearly an equal influence on the health of the army while there.
In a memoir, which, four years ago, I had occasion to present to the Military andMedical Boards at Bombay, on the state of health of the 88th regiment, and of detachments of the 75th, 77th, 84th, and 86th, regiments, under my care, one passage is so very closely applicable to the subject I am now on, that I will extract it. After pointing out the smaller proportion of sickness in different corps, and in proportion as they had been in India from one, two, three, to twenty, years, and the very great proportion of disease and mortality which the European bore to the native Indian corps, the memoir goes on:
“Though, perhaps, a residence for a certain length of time, or a naturalisation to the climate, be necessary, yet one reason may, with probability, be brought forward to account for the very great difference, in point of health, between European and Indian corps, viz. the great intemperance of the European in eating and drinking. A native of India is astonished, at first, to see the meals of animal food devoured, and the quantity of spirits drank, by Europeans.There can be little doubt, that the nearer we approach to the mode of living of the natives, the more nearly we shall attain their state of health.
“On looking over the returns, and observing the proportional sickness of different periods, a periodical increase was very striking. The eight or ten days that followed the payment of the men, on the twenty-fourth of every month, regularly produced much sickness. The soldier’s pay in India, as in England, and perhaps every where else, allow him at times to indulge in excess. He is most amply supplied with meat and bread, and generally he has a portion of vegetables; but the allowance of spirits issued to him is too great. In the dry season it is a quarter of a pint daily, and in the rainy months it is double this quantity. As the price of arrack is low, the soldier very often procures as much as he can use; besides which, he has often access to farrey, or toddey, the fermented juice of the cocoa-nut tree.Some degree of intoxication and intemperance, in a corps in India, is perhaps unavoidable. Intemperance has hitherto always appeared as a principal cause of the diseases which have prevailed.
“The difference, in point of health, between the hot and the cold, the dry and the rainy, months is striking. For the last eighteen months, in the hot season, the men had much duty. They were daily marched two miles to the fort of Bombay; while there, they were much exposed to the sun on the garrison-duty; and, in the heat of the next day, were marched back to their barracks on the island of Colabah. Yet it appears, by the accompanying tables, that the hot months were the most healthy by far. If heat be very noxious, something in this instance obviated its effects. Was this exercise?
“The first year after the arrival of the 88th regiment, in India, they suffered considerably. During the month afterthat on which the monsoon set in, one hundred and forty, or more than one fourth of the corps, were ill of hepatitis or dysentery. In the second year of the regiment being in India, only seventy were admitted into the hospital in the course of the same month, and this number was not quite one tenth of the then strength of the corps. Here, then, we appear to have gained considerably by being one year inured to the climate.”
In Egypt I found that all the above-quoted remarks held good; in particular that relating to heat. Though the degree of it be very considerably increased, I believe that, unless combined with intemperance, or some other cause, it very rarely is the exciting cause of disease. At Kossier, and in crossing the desert, the degree of heat was very great, and both the officers and men, from Madras, as well as Bengal, complained that it was more insupportable than they had ever felt it in the hottest seasons. Yet, at theabove period, the army enjoyed an uncommon degree of health, though they necessarily were much exposed to the sun: but their minds as well as their bodies were at this time exercised. Not only on crossing the desert, but for some time after we reached the Nile at Ghenné, we all thought that we were in the neighbourhood of a division of the French army, and the Indian army was for some time kept in the constant hopes of being engaged.
That simple moisture is noxious, the situation of the 61st regiment, in the Pharos, shewed; and that moist exhalations from marshes were active as causes of the diseases which prevailed, from the arrival of the army at Rhoda till their departure from El Hammed, the journal gives abundant proof.
We received still farther confirmation of the very great influence which intemperance has as a cause of disease. We had demonstration how very little spiritsare required, in a hot climate, to enable the soldier to bear fatigue, and how necessary a regular diet is.
At Ghenné, and on the voyage down the Nile, (on account of the difficulty of at first conveying it across the desert,) the men had no spirits delivered out to them; and I am convinced that, from this, not only did they not suffer, but that it even contributed to the uncommon degree of health which they at this time enjoyed. From two germs, or boats, the soldiers one day strayed into a village, where the Arabs gave them as much of the spirit which they distil from the juice of the date-tree, as induced a kind of furious intoxication. It was remarked, that, for three months after, a considerable number of these men were in the hospitals.
On the causes of the plague I do not mean to dwell. I may just mention, that, after seeing the first cases which occurred in the Indian army, and attentively studying the histories of some of the caseswhich subsequently appeared, it struck me that there were many points of resemblance between this disease and the destructive fever of the West Indies, which, some years ago, I saw a good deal of in several of the islands there. I would by no means, however, have it implied that I consider the diseases as the same.
One of our medical gentlemen persevered in an opinion that the plague was not contagious. He made the first, and we sincerely hope the last, experiment of the kind to determine this question. Dr Whyte fell a victim to his own temerity.
Never were the effects of fear, in the treatment of diseases, more felt than at one period in the Indian army in Egypt. At the time the plague first broke out, (as shall be more particularly noticed hereafter,) the dread of the disease, particularly among the native troops, was a bar to every kind of treatment. They exclaimed that they were sent to the pest-houses merelyto die; and some of them refused every kind of medicine or sustenance.
I shall now advert to some of the principal measures of prevention of disease in general: some regulations regarding the plague are mentioned under the head of that disease.
Within the last thirty or forty years the improvements made in the means of preserving the health of seamen have been great. These had their rise from the great Captain Cooke; after him, very much was done by Dr Lind, of Haslar-hospital; since, by Dr Blane; and, more lately, by the present able physician to the fleet, Dr Trotter.
Under the eminent surgeon-general of the artillery, a very great deal has been done in the ordnance-department. Abroad, as well as at home, their hospitals and the medical department are in a state not unworthy of imitation.
Since the time of the Carthagena expedition, a good deal has been done in thearmy likewise. To the present commander-in-chief the army owes very much; and the Army Medical Board have, of late, corrected many abuses, and introduced much improvement into the medical department: but much remains to be done for the soldier, especially when embarked for service.
Often, during the late war, have we seen troops suffer much in transports; and, on one or two occasions, a confinement of two or three months on ship-board has crippled regiments, if not armies, and left them unfit for service.
At no time, I believe, have troops on any expedition been so long confined on ship-board as during that of which we are treating; and in none I believe, not even in the shortest, has there been a smaller loss of men.
This is to be ascribed entirely to the very liberal policy of the great character at the head of affairs in India, and to the gallant general selected to commandon this expedition. It was the governor-general’s order, that every convenience and comfort, that might conduce to the health of the soldier, should be most amply provided. In consequence of this, a sufficiency of tonnage, and that calculated for a warm climate, was procured. Large, lofty, and roomy, ships were fitted up, and the greatest care was taken to embark only such as were in perfect health. The transports were liberally provided with every requisite or comfort for a long voyage: the quality of the water was particularly attended to. Besides a large stock of fresh provisions, vegetables of every kind were shipped. There was a large stock of potatoes, of onions, bread-fruit, pickled vegetables, of tea, rice, and pepper, which were regularly served out to all. Besides these, for the sick there was provided a large stock of wines, of fermented liquors, and of every other comfort.
To the very liberal manner in which the transports were fitted up, and to the regulations established in every transport of the fleet, which were rigorously enforced, is undoubtedly owing the very healthy state in which most corps remained, for half a year, on ship-board; and that, on landing, they were fit to march on any service.
At Bombay there was, at first, a scarcity of shipping. One ship sailed thence much crouded; and, in a three-weeks passage to Ceylon, those on-board suffered much: there occurred much sickness and several deaths. On their arrival at the island of Ceylon, Mr North immediately ordered two more vessels for the troops with which this vessel (the Minerva) was crouded. The good effects of this measure struck all: thereafter, during a three-months passage to Kossier, there died not a man in the Minerva.
The clothing of the Indian army conduced much, in our opinion, to their healthiness. They landed with their whitecotton dresses, which were admirably adapted to the warm season in which we came to Egypt; favourable to cleanliness; and, by consequence, to the exclusion of pestilential contagion.
From the time of the army first landing at Kossier, in every situation where it could be done, bathing was enjoined throughout the army. In every corps it was regularly done under the inspection of a commissioned officer, and any neglect of cleanliness was most severely punished. In any country or climate, attention to cleanliness will be found a principal means of preserving the health of troops; but, in Egypt, where contagion was lurking in every corner, it became indispensably necessary.
In the cold season, and while we were in Lower Egypt, warm comfortable clothing and bedding were provided, not only for every soldier or Sepoy, but likewise for the women, children, and all the numerous followers of the army.
The simple diet of the Hindoo is well suited to a warm climate. It is seldom more than rice with aromatics, or clarified butter with a kind of pea, to which the luxury of a little salt-fish, of preserved tamarinds, or some fresh fruit, is occasionally added. As far as it could be done, the Europeans were made to conform to this diet; and we are convinced that it was with much advantage to them. The light wines of the Greek islands were issued to the Europeans in the warm season; but in the cold they got spirits.
In the cold season it was found necessary to make some change in the diet of the Sepoys. In the month of January they suffered so much from the severity of the weather, and a climate very unlike their own, that a portion of animal food, as well as of wine, was ordered to be issued to them.
The prejudices of country, religion, and of the different casts of Gentoos, were first overcome in the Bombay regiments. Atlength, the most austere yielded; and, finally, even the severe Brahmin, as well as the rigid Mussulman, gave way to the necessity imposed by their situation in a foreign country.
The length of time, which most corps had been in a warm climate, deserves to be mentioned, as a cause of the health of the Indian Army in Egypt, till attacked by the endemic diseases of the country. No corps in the army had been less than two years in a warm climate. During the late war, the value of the Cape of Good Hope, to us, was often felt and acknowledged in India. After being at this healthy settlement and there seasoned to a warm climate, the 80th, 84th, and 86th, regiments and the Scotch brigade, landed in India, in an effective state, never before witnessed with European troops in that country. This fact is not undeserving public consideration.
The fact cannot be too often repeated or too generally known, that nothing conducesmore to the health of a corps, than the preserving a good internal economy in it. A good commanding officer has, in general, a healthy regiment. Every thing can be done in the prevention of disease; but, unfortunately, very often, little in the treatment when it supervenes.
One point remains still, and I know no fitter place to introduce it than here.
It has been mentioned, that liver complaints rarely recovered in Egypt, and, likewise, that cases of hepatitis and flux, which, in India, had long remained obstinate, here yielded of themselves and without medicine. This fact leads me to the suggestion of a measure, which, I conceive, would save many useful lives. It is, whenever a case of fever, dysentery, or liver complaint, in India, is obstinate, or continues for a long time on the reports, to send such cases to sea or to Europe.
It is a truth, well known to every medical man in India, that, after continuing ill of these disorders a certain time, soldiersor sailors never do well there. They linger, and are, at length, carried off, either by a suppuration in the liver or ulceration of the intestines. In India, when patients, whose situation in life permits them to take a voyage to Europe, are in this state, they never fail to take it, and, most commonly, are recovered by it; but there is no hope for the poor soldier or sailor there.
The same benefit might, however, be acquired for the soldier, and with little, or, perhaps, no, expense: it is not always necessary that the voyage be a long one, or, that the change of climate be to Britain. Were the cruisers of the company or the king’s ships, from time to time, to take on-board some of these chronic cases, for one cruise, the men would be frequently recovered by it, and, in many cases, they would soon be capable of doing duty on ship-board, where, in time of war, Europeans are very much wanted, but cannot be found in India. Whenever a voyage in India is not attended with complete success, a voyage to Europestill offers one chance for life. The prospect of this, by removing that despondency which, in chronic diseases is a never-failing attendant, and which we have too often found baffle every mode of treatment, would cheer the patient, and of itself do infinite good. Men of his Majesty’s regiments might be brought home, and attached to the recruiting companies there, whence able healthy men might be sent in exchange for them, while the invalid from India would at the same time recover his health in a country-quarter at home, and be equally useful as another man on the recruiting service.
Humanity, as well as policy, loudly calls for something to be done. From what I have seen, I fear that invalids and ineffective men are sometimes detained by far too long in India.
END OF PART II.
We have now arrived at the last part of these Sketches; where it is intended to offer some account of the diseases which we met with in Egypt.
The catalogue of military diseases is never extensive. If his peculiar way of life exposes the soldier more to some distempers, it entirely exempts him from many others. In an Indian army the diseases are even fewer than in any other; at the same time, that the practice of medicine is more simple. I am of opinion, that in India the practitioner goes on surer ground than in Europe, partly for the above reason, and partly from the causesof disease being less varied in that country. Though the diseases which occurred in the Indian army, when in Egypt, were not numerous, yet some of them were highly important, and on our arrival in Egypt were new to every one of the medical gentlemen, excepting Mr Bellars, of the 86th regiment, who had treated a few cases of the plague, which occurred in a detachment of that regiment acting with the Vizier’s army, and had himself suffered from the ophthalmia of Egypt.
I propose to include every thing that I have to offer on this part under two heads. Under the first, I shall notice two diseases which may be termed the endemics of Egypt, viz. the plague and the ophthalmia of that country.
Under the second, the other diseases which prevailed will be noticed. They are mostly tropical diseases; and with them the reader will not be long detained.
I begin with the plague; a disease of which accounts have been handed down to us from the earliest ages of history or of physic. The consideration of it is important, not only on account of its frequent and fatal occurrence, but, as being, perhaps, the most formidable disease that the art of physic has to encounter. On this subject, however, much will not be expected from me. Of no disease have we a more clear, accurate, and complete, history than of this, in Dr Russel’s work on the plague. In Egypt, we often had recourse to this work, and we readily acknowledge our obligations to the venerable and learned author.
Though since the time that Dr Russel gave his ample history of the plague in Syria, we have had several accounts of this disease as it appeared in other countries; yet much has not been added toour stock of information, and little of improvement has been made in the practice. The proper and well-timed use of mercury, and, perhaps still more, the application of the newly-discovered remedies analogous in their effects to the calces of that mineral, hold out a prospect of success the most encouraging.
In Europe, but more particularly in Britain, much of the dread, and much of the real danger, that attended the most fatal diseases in this country are now done away, by the late improvements in medicine, and in chemistry.
The time was, when fever, when it broke out in different parts of England, proved little less fatal to whole villages and towns than the plague does in the countries where it resides. From the improved practice of the treatment of fever, but more from our knowledge of the means of destroying contagion and preventing its spreading, the mortality from this class of diseases is now comparatively small.
The small-pox, that plague which once carried off so great a proportion of the population of Europe, now bids fair to be expunged from the catalogue of diseases.
May we not indulge a hope, that, as the intercourse of civilized Europe, with the countries of which the plague is now the scourge, becomes more regular and intimate, we may be enabled to extend to them our discoveries and improvements, and so direct them to the means of divesting the plague of its terrors, and reducing the mortality from it to the scale of that of fever and the small-pox in Europe?
Egypt has been called the cradle of the sciences. From this we acknowledge, that the arts were derived to Greece, and subsequently to every part of the world. It would surely be the noblest gratification, if in return, at this period, Europe, by extending her benefits and improvements to Egypt and to Greece, could free them from the most cruel scourge of countries, oncethe most civilized and polished in the world. It would in some measure compensate and console them for the low state of degradation into which they have fallen.
All that I have to say of the plague will tend to diminish the dread which has hitherto been entertained of it.
A formidable disease undoubtedly it is; but, when we hear how much of the population of Persia, Arabia, Turkey, Syria, Egypt, and Barbary, is now and then swept off, all must not be laid to the account of the plague, as if its ravages admitted of no remedy. The experience of the French and English, in Egypt, will now convince Europe, that much of the vast mortality, in the above countries, is to be ascribed to the gross ignorance in which they are immersed.
Were typhus, our jail or hospital fever, to be imported into a town of Egypt, we can hardly conceive how it could ever be eradicated by the natives. Whenever thesmall-pox does appear in that country, it proves a dreadfully-destructive disease. The structure of their houses and plans of their streets are calculated for the production of disease, and the preservation and concentration of contagion.
It is a matter of no little consolation to us, that we know the means, not only of excluding the plague from our own country, but that, when our armies are stationed in the countries where the disease is endemic, we can arrest the progress of the contagion, and with certainty eradicate it.
The plague made its first appearance, in the army from India, in the middle of September, 1801. From its early appearance the natives were very much alarmed, and prophesied a dreadful season of plague. They have observed, that, when it breaks out before December, they have always a generally-prevailing and a very destructive disease.
The number of cases which appeared in the Indian army, from the 15th of September, 1801, to the 15th of June, 1802, is seen in an accompanying table.
After the plague broke out, the disease was for a long time confined to Rosetta; it was otherwise in the former season.
Soon after the British army effected their landing at Aboukir, in March, 1801, they were attacked with the plague, though the season was then on the decline. In the beginning of the year, the disease had prevailed very generally over the whole country, and the loss arising from thence, to the French, was considerable. It continued to spread in the British army till May, during which month few cases appeared; but none I believe in June.
Though the contagion is seldom or never, I believe, out of the country, the natives of Egypt denominate the season of plague from November or December of one year, to June of the year following; they observe,that the disease constantly stops at the period of the summer solstice.
I have said, that, during the season ending in June, 1801, the disease prevailed very generally in Egypt; Rosetta, however, was an exception; if any case did occur there it was concealed.
At Cairo, Alexandria, and Damietta; at Suez, in the villages, and in Upper Egypt; it proved very fatal: at Siout, at Girgé, and in general throughout the towns and villages in Upper Egypt, we saw continued marks of its desolation, and heard many dismal accounts of its ravages.
The reason of the plague first appearing in, and afterwards being confined only to, Rosetta, in the last season, was, that it was the only open port to which vessels from Turkey and Greece resorted; and that from some of these, no doubt, the disease was imported.
In the pest-houses of the army, thirteen medical gentlemen did duty, who in theIndian army might be said to have had the post of honour. They were, Mr Thomas, Mr Price, Mr Rice, Dr Whyte, Mr Grysadale, Mr Adrian, Mr O’Farrel, Mr Whyte, Mr Dyson, Mr Angle, Mr Moss, Dr Buchan,[4]and Dr Henderson. Besides these, Mr Cloran was in charge of the cases under observation, and Mr Bell of cases under quarantine. Mr Blackwell, surgeon on the staff of the English army, acted as inspecting surgeon to the Board of Health. He visited every case in the first instance, and, as he judged it necessary, sent them to the quarantine, to the observation-ground, or to the pest-house: to Mr Blackwell’s unceasing attention and discriminating knowledge of the pestilential symptoms, we owed no small share of our safety in Alexandria.
Besides the above gentlemen, we had two Greeks, the barber-doctors usually employedin Egypt, who visited the inhabitants, and before interment narrowly examined every body. These two made a daily report to the Board of Health of the number of deaths and of their inspection of the bodies; they likewise did other duties under Mr Blackwell.
In order to take from our medical gentlemen, in the pest-houses, some of the most dangerous part of the duty, it was my wish to procure some of the Greek doctors of the country to reside in the pest-houses, to feel the pulses there, draw blood, open and dress buboes, &c. The most diligent search was made for those people, and very high pay was promised to them, but we could tempt none of them to live in our pest-houses: a plain proof of the opinion which they entertain of the contagious nature of the disease.
The thirteen gentlemen first mentioned, were those only that were directly in the way of contagion, for, it became their duty to come into contact with the infected,and seven of them caught the infection, and four died.
To the atmosphere of the disease all the medical gentlemen of the army were exposed, as they saw and examined the cases in the first instance; but, except from actual contact, there never appeared to be any danger.
The sketch which I mean to give of the plague, I draw principally from the reports made to me by the surgeons of the army, and from a pretty voluminous correspondence with the gentlemen whose names have been already mentioned. From my own experience I hardly can venture to speak: it was very limited. Though I saw a great many cases, in the first stage of the disease, the number of cases which I treated throughout was very small; they were the cases which first appeared in the army, and my success in them leaves me little to boast of.
The reports and statements of the different gentlemen I have compared together,and endeavoured to reconcile them by what I myself saw of many of the cases.
I have generally given the names of the gentlemen by whom the different facts are related: I have always done this where the reports of two gentlemen disagreed.
From the sources of which I am possessed, I think I can bring forward some new facts regarding the disease, particularly in the treatment. It is much to be regretted, that no traveller, acquainted with the modern practice with mercury and the analogous remedies, ever resided in the countries where this disease is endemic.
In one circumstance, there is a very generally-prevailing opinion in regard to the plague, viz. that extremes of both heat and cold stop the progress of the contagion.
If this be true, in regard to heat, it did not appear to be so in the army in Egypt in regard to cold.
The period at which the plague raged the most was in the coldest months.
It would appear, that, in different countries and in different seasons in the same countries, the plague assumes very different appearances. The plague is seen as varied in its appearance as the different fevers described by Sydenham to prevail in different years, and under different constitutions of the air, in England.
Our knowledge of this fact enables us to reconcile the different or opposite accounts given of the disease, and of its treatment by different writers.
In the Indian army, when the disease first broke out, the cases sent from the crowded hospitals of the 61st and 88th regiments, were from the commencement attended with the typhoid or low symptoms.
The cases sent from the Bengal volunteer battalion, and from the other corps, when the army was encamped near themarshy ground at El Hammed, were all of the intermittent or remittent type.
The cases which occurred, in the cold rainy months of December and January, had much of the inflammatory diathesis. Mr A. Whyte remarked, that every case admitted into the hospital, at Rahamania, had the symptoms of pneumonia.
In the end of the season, at Cairo, Ghiza, Boulac, and on crossing the isthmus of Suez, the disease wore the form of a mild continued fever.
The resemblance which some cases shewn and of others described to me bore to the West-Indian fever struck me very forcibly.
I know not that I can better describe the disease, than by a short statement of the cases of some of the medical gentlemen who had the disease; most of whom wrote me accurately every thing that they felt. Dr Whyte entered the pest-house at El Hammed on the evening of the 2d of January, 1802. In a letter of that datehe writes to me, “I just now inoculated myself, by friction, with bubonic matter on the left thigh;” on the 3d, he says, “I have this morning inoculated myself by incision on the right fore-arm.” Mr Rice, then doing duty in the pest-house at El Hammed, gives the whole of the case. In a letter on the 3d of January, he writes to me, “Dr Whyte came here last night; soon after he came in, he rubbed some matter from the bubo of a woman on the inside of his thighs. The next morning, he inoculated himself in the wrist with a lancet, with matter taken from the running bubo of a Sepoy; he appears now very well.”
In subsequent letters, Mr Rice says, “that Dr Whyte continued in good health on the 5th, and all day on the 6th, till the evening, when he was attacked with rigors and other febrile symptoms. He said himself that it was the attack of an intermittent; and it bore a great resemblance to it. After sweating profusely, he wasbetter in the morning of the 7th, but in the afternoon the shivering returned; and, after it had continued 30 minutes, a severe hot stage came on, then a profuse sweating followed, but with it much affection of the head, tremor of the limbs, particularly of the upper extremities, tongue black and dry, skin hot, pulse full, hard, and irregular, thirst great, prostration of strength, and anxiety. The head was the only place that he complained of, and it seemed to be the principal seat of his disease; he still persisted that the disease was not the plague; he would not allow his groin or arm-pits to be examined, and he refused all medical assistance.” He asked for a purgative, which Mr Rice gave him, and he requested to be bled, this Mr Rice thought the state of the symptoms would not justify him in doing. On the 8th, these symptoms continued, and there was some delirium; he begged to be removed from the pest-house at El Hammed, to the old pest-house at Rosetta,under the charge of Arabs. He was removed on the morning of the 9th, and died in the afternoon of that day very delirious.