Chapter 7

31.Results of Sanitary Improvement by Dr Southwood Smith, 1854.

The case of the “Eclair,” and the history of the Epidemic Fever which occurred at Boa Vista in 1845, have been declared by high medical authority to afford “conclusive evidence that Yellow Fever is sometimes imported.” It will therefore be necessary to make a careful examination of the circumstances relative to this Epidemic.

It has been affirmed, and generally credited, that unusual effort has been made to ascertain the facts of this case under circumstances more than commonly favourable to the discovery of the truth. Two official Reports respecting it, drawn up after personal inspection on the spot, have indeed been presented to Parliament—one by Dr McWilliam, and the other by Dr King; and several official notices of these reports have been published; but the evidence on which these two Reports were founded was not collected until some time after the cessation of the epidemic. The statements of witnesses, for the most part poor and ignorant, many of whom had a direct interest in establishing the importation of the disease by a British ship, have been admitted implicitly, even with respect to dates and circumstances not of recent occurrence, and without due examination of the credibility of their testimony; and on all material points the reporters have arrived at directly opposite conclusions.

On a review and comparison of the whole of the statements which have been made with respect to this case, it appears that the steam-ship “Eclair,” with a crew of 140officers and men, proceeded in 1844 to the coast of Africa, and was stationed for upwards of four months (130 days) at the island of Sherboro, with a view to blockade the eastern outlet of the passage at Shebar. This place is considered one of the most unhealthy on the African coast; vessels remaining near the island very rarely escaping an outbreak of Yellow Fever on board. The land is represented as low lying, some parts being marshy, and the rest thickly wooded, and abounding in rank vegetation.

According to the account of the surgeon of the “Eclair,” Mr Maconchy, the ship on this occasion was anchored at the mouth of the river, in position where she “was surrounded with filthy-looking river water, urged backwards and forwards by the tides through extensive tracts of mangrove bushes.” The fresh water used on board was also bad, holding in solution a quantity of offensive vegetable matter, which produced in some of the crew attacks like mild cholera. The men, in parties of from 30 to 40, were often sent up the river on boating expeditions, where they remained for seven or eight days at a time exposed, “whether they slept on board or ashore, perhaps after a hard day’s labour, to all the exciting causes of fever, and a tainted nocturnal atmosphere, in the rainy season, heavy weather having set in, and the men constantly getting as wet as possible.”

The danger of this boating service is thus stated by Dr King:—

“The duty in boats up African rivers involves considerable risk at any time of the year, but it can never be practised in the rainy season without endangering the health and lives of all who are employed, and such were evidently the sad consequences of the boat expeditions of the ‘Eclair.’”

The crew, according to Mr Maconchy, in addition to this dangerous service, and the dreariness and monotonyof the situation, were exposed to another depressing agency, “from seeing the prizes of other ships passing frequently to Sierra Leone, whilst they considered themselves out of the reach of such good fortune.”

Another cause was probably in operation even at this time, namely, the foul condition of the ship, as will hereafter appear.

Under these circumstances, fever broke out on board the ship, and proved fatal to ten of the crew; eight of the ten deaths being considered by the medical officers as directly consequent on the boating expeditions. Though there were other and severe cases of sickness on board, these deaths appear to include the whole of the ship’s mortality during her stay at Sherboro, a period, as has been stated, of above four months.

In the month of July the “Eclair” left this station, returned to Sierra Leone, and anchored in the harbour, where she appears to have remained 13 days. This happened to be the rainy season. The crew went on shore, where several of them remained at night unable to reach the ship from being in a state of helpless intoxication.

The consequences were soon apparent. While the ship remained in the harbour, fever again broke out on board with great violence, and continued without intermission during this and the following month. In this sickly state she again left Sierra Leone, proceeded northward in company with another ship, the “Albert,” and anchored in the Gambia on the 10th of August “(one of the most unhealthy months at that place),” where she remained until the 15th. All this time, the fever steadily increasing, she arrived on the 21st of August at Boa Vista. She had now lost, since leaving Sherboro, 13 more of her crew, making in all, from the first outbreak of the disease at Sherboro, 37 attacks and 23 deaths; that is, 1 in 6 of the crew had died.

On anchoring in the harbour of Boa Vista, pratique was at once offered to her commander, Captain Estcourt, but he replied that he could not think of accepting it until he had communicated the state of his vessel to the authorities on shore. After some deliberation the Governor-General consented to the landing of the ship’s company, in the hope that the formidable disease, by which so many had already perished, and so many others were still placed in imminent danger, might be checked. Accordingly the crew, both the healthy and the sick, were sent to a Fort on an islet a mile distant from the town (Porto Sal Rey), and the officers were lodged in the town itself. This took place on the 31st of August.

The hope of benefiting the crew by the change of their quarters from the ship to the land was not realized. On the contrary, the sickness continued to increase with so much virulence that, at the end of the third week after the arrival of the ship at Boa Vista, no fewer than 60 fresh cases were added to the sick list, and some deaths took place nearly every day.

In this state of things a consultation of the medical officers was held on the condition of the crew, the result of which was a recommendation that the ship should immediately proceed to Madeira, and if the fever received no check, that she should go on to England. In conformity with this advice, the whole of the crew, the sick as well as the healthy, were forthwith re-embarked, and the ship sailed from Boa Vista on the following day, namely, the 13th of September.

The sequel to this sad narrative shows that no improvement took place during the passage of the “Eclair” to Madeira, where she was refused pratique. She therefore proceeded next day on her voyage to England, and anchored off the Isle of Wight, at the Motherbank, on the 28th of September, having lost, since sailing from BoaVista, 12 more of her crew. Thus in the short space of 37 days, that is, from the time when she anchored at Boa Vista on the 21st of August, till her arrival at the Motherbank on the 28th of September, there occurred no less than 90 attacks and 45 deaths, including the death of her excellent and devoted captain.

On her arrival in England the ship was put in quarantine, and remained under the direction of the Privy Council until the 31st of October.

On the day following her arrival, Dr Richardson proposed that the sick should be immediately removed to a wing of Haslar Hospital, to be appropriated exclusively for them; stating, that in his opinion, if the sick were placed in well-ventilated wards, with fresh bedding, and the other means of cleanliness afforded by an hospital, there would be no further risk to the attendants than would occur in wards set apart for cases of typhus fever.

To this advice, Sir William Pym objected, and instead of allowing the removal of the sick, he ordered the vessel, with the whole of her crew, to proceed from the Motherbank to the Foul Bill Quarantine Station at Standgate Creek, which place she did not reach until the afternoon of the 2nd of October, that is, four days after her arrival at the Motherbank, where they remained six days more before their removal into another vessel. Thus were all on board detained close prisoners in a pestilential atmosphere on the shores of their native land; their anticipations that at length they should quit the scene of such terrible sufferings, and of so many horrors, their hopes of life and health, totally destroyed. The consequence was, that within these ten days, five more deaths took place, nor was it until the Lords of the Admiralty declared their conviction that the only means of preserving the lives of the survivors of the crew would be the entire removal of every individual fromthis ill-fated ship, that they were permitted to quit it. Their removal took place on the 8th of October, after which event two more deaths occurred, one of them being that of the pilot who took the vessel from the Motherbank to Standgate Creek.[32]

32.A striking contrast to this treatment of the crew of the “Eclair” is exhibited in the case of Her Majesty’s frigate, the “Arethusa,” which recently (Feb. 14, 1852) arrived at Plymouth from Lisbon, having on board cases of small-pox. Instead of putting the ship in quarantine, and confining the healthy in the same poisonous atmosphere with the sick, wiser counsels on this occasion prevailed, and more humane measures were adopted. On the advice of Dr Rae, Inspector of the Royal Naval Hospital, the sick, twelve in number, were immediately removed to that establishment, and of these two died, without any communication of the disease.

As already stated, official inquiries were directed to be made into the causes of this extraordinary mortality, from which it appears:—

That there was nothing peculiar in the disease itself. The medical and other officers of the ship, as well as the medical and other officers at Boa Vista, that is, all competent witnesses who actually saw the disease, concur in stating that it was nothing more than an aggravated form of the common endemic fever of the African coast; a view which is decisively confirmed by the original description of the disease in the medical journal of the ship, and by post-mortem examination.

In opposition to this generally-received opinion, however, Sir William Pym promulgated a statement that, in addition to the common African fever, the celebratednova pestisof Dr Chisholm had been introduced into the vessel by a passenger taken on board at Sierra Leone; this disease being, as he represents, a feversui generis, known by the name of the African, Bulam, Yellow, or Black Vomit Fever, attacking the human frame but once, and differing from the common remittent fever in being highly contagious.

That the doctrine on which Sir William Pym’s assertion rests met with little countenance from medical authorities is apparent from the statement of Sir William Burnett, who says:—

“The whole of this, as regards the peculiar properties of the disease, called by Sir William Pym, Bulam, &c., is a gratuitous assumption on his part, and, in my opinion, has no foundation in fact; and in my view of this part of the subject I am supported by nineteen-twentieths of the medical officers of both services, who are of opinion with myself that the more ardent form of Yellow Fever is a mere modification of the bilious remittent so extensively known all over the tropical regions.”

He adds: “The fever which prevailed in the ‘Eclair’ was unquestionably a remittent fever, originating in marsh miasmata, and the exposure of the men in boats during rainy weather.”

Dr King and Dr Stewart, in official Reports upon this case, state their concurrence with Sir William Burnett. Dr McWilliam, on the other hand, is of opinion that the disease, though primarily an endemic remittent of the African coast, became, from a series of causes, exalted into a concentrated remittent or Yellow Fever, and in that manner acquired new and peculiar properties, not primarily and essentially belonging to it.

With reference to this latter opinion, it may be observed that the Governor-General of the Cape de Verd Islands affirms, that not one of those who with a view to escape the pestilence emigrated to the different islands of the Archipelago, had the disease, or communicated it to others. According to the view of Dr McWilliam, therefore, this disease must have been of a very singular character, for in its origin at Shebar, it was not contagious, at Boa Vista it became contagious, while in the other islands of the Archipelago, wherever the sick or the uninfected fled, itagain laid aside its contagious character, and did not spread to a single individual.

All the inquirers and reporters agree in stating that among the causes which concurred in communicating to this disease so extraordinary a degree of prevalence and mortality, the more important were the following:—

The employment of the crew uninterruptedly for an unusual length of time, including the sickly season, in a peculiarly unhealthy situation, and dangerous local duty.

The exposure of men, whose systems were impregnated with the seeds of disease imbibed in this unhealthy locality, to the risks of unrestricted liberty on shore, in the atmosphere of Sierra Leone, during the rainy season; one consequence of which freedom being their “inordinate indulgence in ardent spirits of the worst description.”

And subsequently, at Boa Vista, the confinement of the crew, the sick as well as the uninfected, in a place still more crowded, filthy, and unventilated than their quarters on board, instead of their dispersion in a pure atmosphere.

Some conception may be formed of the unfavourable circumstances under which the crew were placed at the Fort, from the account which, on personal inspection, Dr King gives of its sanitary condition, who states that from the absence of all means of cleansing, from the actual accumulation of filth, and from the impossibility under any circumstances of obtaining a free circulation of pure air, owing to the plan of the building, the atmosphere which the sick, the convalescent, and the healthy were compelled to breathe, day and night, must have been polluted and deleterious in the extreme; and that into a space incapable of affording sufficient accommodation for 50 men, upwards of 100, including the sick, were huddled together under a most oppressive heat, the thermometer ranging from 81° to 86°. This description is confirmed by the testimonyof Dr Almeida, who states that having been requested by the Governor-General to go to the Fort and see the sick, “he found them so extremely crowded that he could hardly pass between them.”

The influence of such conditions in conducing to the virulence and spread of the disease has been already exemplified in what has been stated under the head “Localizing Causes;” but it must be added, that the crew had here also access to ardent spirits, in which both the sick and the uninfected indulged to still greater excess even than at Sierra Leone.

“It is with great regret,” says Sir William Burnett, “I have now to state on the best information, that while in this situation means were found to supply the sick as well as others with enormous quantities of ardent spirits, which were drunk with avidity and produced the most deleterious effects; indeed, I have reason to believe that some were absolutely killed by it as if by poison. Had there not been a fever already in existence, the intense heat (86° of Fahrenheit), the nature of the soil, and this dreadful intoxication together, would have been fully sufficient to have produced it, and one of the worst kind too, in which irritability of the stomach and dark-coloured vomiting would have been conspicuous symptoms.”

The actual result, as stated by Dr McWilliam, was that the accession to the sick-list and the mortality became much greater at this time than they had been at any previous period, and that from an endemic remittent of the African coast, the disease became exalted into a concentrated remittent or Yellow Fever.

Indubitable evidence further shows that, in addition to all these causes of disease, the crew when on board were constantly inhaling a poison generated in the ship itself. On a superficial examination the ship may have appeared clean, and Sir William Pym positively asserts that she wasso; but there is conclusive evidence that this appearance was fallacious.

From the records of the Medical Department of the Navy have been extracted the following decisive statement with reference to this point, by Captain Simpson, late of the “Rolla:”—

“In June, 1845, being then in command of the ‘Rolla,’ I went on board the ‘Eclair’ off Shebar River. Commander Estcourt reported to me that he had sent a boat up the Sherborough River, and that the crew, during night, were exposed to heavy rain and much lightning, and were sick: some deaths had occurred on board. In the early part of July I went to Sierra Leone for supplies; the ‘Eclair’ was there; the vessel was anchored close to the shore; and I advised her Commander to move her further out, which he did. There seemed much excitement amongst the crew; some liberty had been given them, and drunkenness and sickness were the consequence. Wood was received on board for fuel in lieu of coals. This wood was green, as I understood at Sierra Leone, and very unhealthy to burn.”

This fact is substantiated by the log of the “Eclair,” which shows that from July 16th to the 19th inclusive, the crew were employed at Sierra Leone in wooding.

The influence of a quantity of greenwood recently taken on board a ship navigating the tropical seas, in producing destructive fever, is shown in the most striking manner by the history of the “Regalia,” and by that of the “Vestal.”[33]

33.For these cases see the Second Report on Quarantine, pp. 64, 299.

Further evidence will be found in the Medical Department of the Navy to show “that the hold of the ‘Eclair’ was in a pestiferous state;” and Dr King states, that long after the people left the ship in England, and when the engines were removed, mud, some inches deep, was found under the flooring.

“I should scarcely have noticed the above circumstance,” he says, “but for some remarkable occurrences which took place in the same vessel at a subsequent period, which confirmed me in the opinion I had previously formed that the origin and continuance of the fever on board depended solely on local causes.

“The ‘Rosamond,’ formerly the ‘Eclair,’ was commissioned at Woolwich on the 5th of November, 1846, for the Cape of Good Hope station, but none of the former crew rejoined the ship. During the time of fitting out, four cases of typhus fever occurred, and were sent to the hospital, where two of them died, but it is necessary to mention that typhus was prevalent at Woolwich at the time. The steamer left England for the Cape on the 23rd of February, 1847. Three days after sailing, one of the men was affected with slight febrile symptoms, and he continued more or less indisposed for a number of days, but occasionally felt so well that he returned to his work. After the ship entered the tropics, however, the disease began to assume a new and alarming character; and when off the Island of St Nicholas, and almost in sight of Boa Vista, the man died, having had for two days previous black vomit and other characteristic symptoms of Yellow Fever. Within a few days afterwards the ‘Rosamond’ arrived at Ascension, where I was then stationed; and Commander Foot having communicated to Captain Hutton, the superintendent of the island, every particular respecting the illness and death of the seaman, I was ordered, with Dr Sloane, the surgeon of the hospital, to make a report on the case, and at the same time to suggest measures for the benefit of the ship without endangering the health of the people on the island. Having obtained from Dr Slight, surgeon of the ‘Rosamond,’ every information relative to his late patient, we stated our opinion that the disease the man died from was sporadic Yellow Fever. * * * On thefollowing morning I went on board with the view of learning something to enable me to form an opinion as to the sanitary condition of the ship, and for the purpose also of inspecting the sick, as the surgeon informed me he had then a suspicious case, with symptoms of a low kind of fever. I had barely time to take a cursory view of the after parts of the ship, when my attention was called to the patients, who were all mustered in the steerage, and I found the man the doctor had alluded to in such a precarious state that I recommended him to be sent on shore immediately. The only other severe case was that of a supernumary lad, who was taken ill the same morning, but the indications of a low malignant fever were so apparent even at that early stage, as to induce me to express my opinion to the surgeon that he would not probably survive 24 hours. As it was most desirable to prevent a panic among the ship’s company, I went on shore to consult with Captain Hutton, and make arrangements for their reception. * * * The patients themselves attributed their illness to foul air in the forepart of the ship; one of them said he suffered so much from an abominable stench in the boatswain’s storeroom, that he represented the circumstance and obtained permission to cut a hole in the floor, which exposed to view a considerable quantity of soft mud, and five or six buckets full of it mixed with decayed shavings, and emitting an offensive odour, were removed at the time.

“It appears then, that besides an unusual number sleeping in the fore-cockpit, some of them at least had been exposed to a morbific miasma, exhaled from a festering mass of filth in the bottom of that part of the ship. The quantity of mud, no doubt, was small in comparison with what had accumulated when the vessel arrived at Spithead from the coast of Africa, yet the malaria eliminated from that small and circumscribed focus was equally virulent in its operation, and produced the same diseasein a few who were placed within the sphere of its influence.”

Such is a brief narrative of the circumstances connected with this ship and her crew.

But it has been alleged that while the landing of the crew of the “Eclair,” at Boa Vista, afforded no benefit to the ship’s company, it inflicted a grievous evil on the inhabitants of the island; that several individuals in contact, or close proximity with the sick, became affected with the same kind of fever; that from these individuals the malady spread to others with whom they came in contact, and from these again to others, as from so many centres of contagion, until the disease became general over the island, thus affording a positive instance of the importation of epidemic disease. The alleged facts on which these representations rest are the following:—

It is stated, that during the occupancy of the Fort by the crew, there was a small Portuguese guard stationed there; that this guard was several times relieved; that at the time when the “Eclair” left the island, the guard consisted of one negro and two European soldiers; that within three days after the sailing of the “Eclair” both Europeans were attacked with fever similar to that from which the crew of the “Eclair” had suffered; that the negro soldier, who, with his comrade—the man sent from Boa Vista to nurse the two Europeans—on returning from the small island to Porto Sal Rey, had been—“as a matter of precaution”—“restricted for [‘about 8’ or] 17 days to the occupation of a small hut at the northern end” of the town, was afterwards attacked,—though not confined to bed until the day following his return to barracks; and that a woman (Anna Gallinha), who lived next door to this hut, was the first person who was attacked with fever in the town. It is further stated that a man (Pathi), who had been a labourer on board the “Eclair,”was also attacked with fever, according to one account, on the day after the “Eclair” sailed; but according to another account, on the third day after that event.

Such are the alleged facts, and the only ones bearing directly on the communication of a specific contagion by the crew of the “Eclair,” collected by Dr M‘William by personal inquiries on the spot; and these, in his opinion, present a chain of evidence sufficient to establish a positive instance of the importation of epidemic disease.

With reference, however, to these inquiries, it has been already stated that they were not instituted until several months after the departure of the “Eclair” from Boa Vista;—the only regular practitioner on the island (Dr Kenny) who could have given authentic and trustworthy information respecting the nature and progress of the disease, had died;—the witnesses examined by Dr M‘William, poor and ignorant, gave their evidence, hearsay and otherwise, in the loosest possible manner;—their statements as to dates and occurrences, alleged to have happened several months before the inquiry took place, were received implicitly, without examination into the correctness of their answers and the credibility of their testimony;—all the witnesses of this class appear to have spoken under the influence of the strongest feeling of self-interest, with a view to establish a claim to pecuniary compensation should they be able to make out a case against the “Eclair,” in which expectation they were not disappointed, since the sum of £1000 was eventually granted by Great Britain for the benefit of the inhabitants;—and to this motive may probably be ascribed the highly coloured and exaggerated statements put forth by these people on the re-appearance of fever in the following year.

Taking the facts, however, precisely as they are represented in the Report of Dr M‘William, they do not, as theproof of the allegation in question requires, present a clear and palpable chain of evidence, connecting as cause and effect the fever of the ship with the epidemic on shore; but, on the contrary, there is not a single link undoubtedly connecting the one with the other.

Take the first case forming what is represented as the first link in this presumed chain, the seizure with fever of the two guards at the Fort. Two European soldiers lately arrived in the colony, and therefore peculiarly predisposed to an attack of endemic fever, go from Boa Vista, which at that time was healthy, to a confined, unventilated, overcrowded, and filthy spot on another island, where fever was raging to such a degree that within the space of three weeks there had occurred no less than 60 attacks and 33 deaths, in a crew consisting on the arrival of the ship of 117 officers and men. There is in this no evidence of the propagation of disease by a specific contagion; on the contrary, it is the ordinary production of disease by its ordinary cause, namely, exposure to a polluted atmosphere, the pollution being, in this instance, excessive from overcrowding; from accumulation of filth; from foul and offensive privies; from the impossibility of the admission of fresh air, owing to the construction of the building, and from the intense and oppressive heat, the thermometer ranging from 81° to 86° of Fahrenheit. The seizure of two men with fever under such circumstances is precisely analogous to the attack of persons, previously healthy, with typhus, who take up their abode in the crowded and filthy courts and alleys of English towns.

Take the next link in the chain, the attack of the negro soldier. The circumstances respecting this man, being precisely the same as those relating to the two other guards, the same answer would have sufficed for both, but according to the testimony of the man himself, his illness was very slight, and his companion who was sent to lodge with himat the hut in Porto Sal Rey, had no illness at all during the whole time of their seclusion.

The third link in the chain is the presumed fact, that a woman (Anna Gallinha), who lived next door to the hut in which these two men had been confined, was seized with fever soon after they had left it, and that she was the first person attacked, at least whose illness attracted public attention, in the town of Porto Sal Rey. Dr King states, that on a personal examination of the soldier who had experienced the slight attack of fever, he said that during the seventeen days that he and his companion were confined to the hut, “they had no communication with any one.” Dr M‘William, on the other hand, affirms that Gallinha was a frequent visitor at the hut, and, indeed, cooked for the men. Supposing Dr M‘William’s account to be the correct one, it is surely more reasonable to attribute the attack of Gallinha to the local causes to which she was exposed, and which Dr M‘William admits were sufficient to account for her illness, than to contagion derived from a man whose illness was so slight that it had not confined him to his bed for a single day, and which was incapable of infecting his companion who was constantly with him night and day.

“By the time Anna Gallinha was taken ill,” says Dr M‘William, “much rain had fallen; the weather had become more hot, and, in short, there now (but not before this) existed the recognized elements for malarious evolution.”

“In that part of the town called Beira, or Pao de Varella,” reports Dr King, “where Anna Gallinha and the soldiers resided, the houses are of the lowest description, and the people who occupy them are generally very poor and destitute; there is a large pool of stagnant salt and fresh water immediately behind; but to windward of this part of the town, and still nearer to the houses, there is alocality which is resorted to by many of the people when obeying the calls of nature; and the exhalations from the one, and the effluvia from the other, are blown by the north winds in the direction of Beira.”

A similar description of this locality is given by Dr M‘William,—

“In the upper portion of the town,” he says, “which is called Pao de Varella, the houses are in general mere hovels, rudely built, and much crowded together, and with few exceptions dirty. They are occupied by the lowest classes. From the total absence of any police laws the streets here are also very filthy.”

Here then were present in full force, as is admitted, the ordinary localizing causes of fever; to which it is more consistent to refer this case, than to an extraordinary and foreign cause.

But at this point the presumed chain of evidence stops; the chain is suddenly snapped; there is no further link traceable; there is nothing really connecting the illness of Gallinha with the next cases, or with the general spread of the disease which rapidly followed, and we need hardly state, that in order to prove the spread of a pestilence by contagion, communication, either direct or indirect, must be proved to have existed between all the persons attacked.[34]

34.The widow of the next victim (Affonso) denied his having had communication with Gallinha; and Dr Almeida “found about 20 people sick” in Porto Sal Rey only three or four days after Gallinha’s death. It is evidently more rational to ascribe these numerous attacks to epidemic influence, which it is admitted was now present, than to contact with this woman, for the fact of which there is in truth not a shadow of evidence.

For the only other case of fever that is stated to have occurred shortly after the sailing of the “Eclair,” namely, that of the labourer (Pathi) who had been employed on board the ship, will scarcely be considered as affording an additional link; since admitting that this man contractedhis fever while employed on board the “Eclair,” his case would be merely one of infection from going on board a foul ship, a generally recognized cause of fever:—

“Whenever,” says Dr Stewart, “fever has prevailed much in ships on the West India and African stations, strangers going on board of those ships have been particularly liable to its attack; but on sending fever cases from those ships to the hospitals and private houses on shore, it has not been found that the disease extended from them.”

But as in the locality of the dwelling of Gallinha, so in the district in which this man lived, there were local causes abundantly sufficient to account for the endemic origin of his disease. He resided in Rabil, one of the hamlets in the neighbourhood of Moradinha, at some distance from Porto Sal Rey. Of this locality Dr King says:—

“If there is one spot more than another in the whole island where, from its physical peculiarities, endemic fever might be expected to begin first, and end last, that locality is Moradinha, and the villages in its vicinity, in one of which Pathi resided.”

It may be observed further, that whatever may have been the cause of this man’s fever, it is admitted, that for three weeks at least it was communicated to no one else in the house at Moradinha, where he was attacked, and remained for eight days, and not to any one else in that neighbourhood for 11 weeks; that his illness was extremely slight, and that on his return to his own house no disease broke out for some time in his family. According to Dr M‘William, the first member of his family that was attacked was one of his children, who was taken ill “on the tenth or eleventh day” after his return, the illness of this child being gradually followed by that of two other children. But Dr King affirms that these children were not taken ill until “about a month” after their father’s return, andthat it was not until the succeeding month (the middle of November) that his wife was seized, “when the disease was general throughout the island.” It is also particularly to be observed, that a child in another family at Rabil, having no communication with the family of Pathi, died about the same time as Pathi’s first child, and that the disease broke out at least as early at Rabil as at Porto Sal Rey.

Lastly, it may be urged in opposition to the opinion that the contagion was communicated by the crew of the “Eclair,” that the small island on which the sick were landed and to which they were confined was a mile distant from the town of Porto Sal Rey, and that on reference to the map attached to Dr M‘William’s report, it is obvious that the North-east trade wind must (according to the theory of Sir William Pym, as applied to the Neutral Ground at Gibraltar in 1828) have dispersed the contagion if in existence, or carried it in a contrary direction from Porto Sal Rey.

For a more minute examination of the cases of the guards at the Fort, and of Pathi and others, as presented by Dr M‘William, we refer to the Note of Dr Browne, Appendix No. III. (p. 306),[35]who has there shown the real value of these cases, considered as links forming a chain of circumstantial evidence.

35.Videthe Report itself.

The authentic facts attending the intercourse of the ship’s company with the inhabitants of the island, afford further evidence that no infection could have been communicated by the former to the latter. Thus, it is admitted that Captain Estcourt, the commander of the ship, went directly from the infected vessel to reside with Mr Macaulay, the judge: no infection was communicated to Mr Macaulay, or any part of his family.

The officers of the gun-room—midshipmen, warrant, and engineer—on disembarking from the ship, took a house for themselves and their servants in the town, and mixed unreservedly with the inhabitants: no infection was communicated to any individual with whom they had intercourse.

The crew obtained or took leave to pay frequent visits from the small island to the town of Porto Sal Rey, where, according to Dr M‘William, they resorted chiefly to the house of one Georgio, who kept a spirit store; the only consequence of which visit, considered by Dr M‘William a remarkable one, appears to have been that this man (and “shortly afterwards” two females who associated with them) was attacked with headache and general fever on the evening of the day he was visited by the “Eclair’s” people; a result which admits of a more obvious solution than the communication of febrile contagion on the part of persons who were themselves in perfect health.

The soiled linen of the officers and crew having been brought on shore on the first arrival of the vessel, was immediately given out to be washed to the washerwomen of Porto Sal Rey, and the careful search made after these women, brought to light no fewer than seventeen persons who were so employed.

“The soiled clothes,” says Dr King, “linen, cotton, and flannel, which had accumulated in the officers’ cabin from the time of their departure from Sierra Leone, were contained in at least 12 bags, which were taken on shore at Porto Sal Rey the same evening the ship arrived, and distributed next morning (22nd August) to the washerwomen of the town. Now, if the disease possesses the power of reproduction, its poison must [according to general opinion] have been as certainly communicated through the medium offomitesas by direct contact with the sick on board or at the fort; yet none of the washerwomen nor any in theirfamilies were attacked with fever until November, showing an interval of 70 days after exposure to the infection.”

That it was not from any want of susceptibility to the influence of febrile poison that these women escaped the danger of this exposure tofomiteswas proved by subsequent events; for during the progress of the epidemic, all of these women, according to Dr McWilliam, with only one exception, were attacked with the prevailing fever; two between six and seven weeks after the sailing of the “Eclair;” five, two months; two, three months; three, four months; and one, five months afterwards.

“None of the deaths,” says Dr M‘William, “took place until fever was general in Porto Sal Rey, so that in none of these cases can the occurrence of the fever be fairly attributed to infectious matter conveyed by the linen.”

The Guards at the Fort were many times relieved, and the soldiers were sent direct from the small island to their barracks in Porto Sal Rey, without conveying any disease to their comrades. On one occasion two soldiers who are stated to have lived in a room next to that in which the sick of the “Eclair” were lodged, on being taken ill, were conveyed at once to the barracks, yet they infected no one in their quarters.

From a list drawn up by Dr King, of the names of the islanders who were engaged as labourers on board the “Eclair,” it appears that there were in all 63 persons employed in coaling, watering, and cleansing the ship. These men appear to have had unrestricted communication with the ship’s crew. According to Dr M‘William, the whole of these labourers went to their respective homes every night, except those from Estacia and the Eastern villages, who generally slept at Porto Sal Rey. None of these men were themselves attacked with fever, excepting one (Pathi) whose case has been already considered; none of them communicated fever either to their own families or to thepersons with whom they lodged in the town, yet subsequent events proved that they as well as the washerwomen were sufficiently susceptible subjects, since, during the progress of the epidemic, the greater part of them were attacked by the disease; none, however, within a month after the departure of the “Eclair;” a few within two months, but the majority not until four or five months afterwards.

That the geographical position of the Cape de Verd Islands places them within the legitimate domain of Yellow Fever, and that this disease is no stranger to these islands, is admitted on all hands. According to Dr M‘William,

“The north-western part of the island, where Porto Sal Rey is situated, is low and flat, and almost wholly occupied by sand, which, blown up from the north-western shore through the water-courses, and other hollows, accumulates in mounds twenty and thirty feet high, which are drawn about and shifted by any little variation of the direction of the wind.”

On the flat between Porto Sal Rey and the village of Rabil, which is about four miles to the southward of Porto Sal Rey, Dr M‘William states that there is a point where the sea, when the waves are high—

“Breaks over the elevated beach, and penetrates through the shingle, so as to accumulate, and run inland in the form of a narrow creek, from 200 to 300 yards from the sea-shore. During the rainy season, this, in common with the other flats on the island, is inundated to a considerable extent, as is evident from the appearance of the soil in those places not covered with sand, as well as by the presence of a rude raised causeway, which the people have constructed over part of the hollow flat, to render it passable during the rains. * * * Near the town is a hollow flat, spread over an area of about a mile, with the same soil and subsoil as that in the town. The central part of this area is occupiedby a salt pan, which contains not less than 300 troughs, each a foot deep, and about thirty feet square, into which the salt water is poured, there to evaporate and form salt. During and for some weeks after the rainy season, the whole of this space is more or less inundated. * * * The water is left to stagnate on the Rabil side, and as it dries up during the hot weather, little alluvial islets are from time to time exposed, which the people avail themselves of to raise a small crop of corn. Indeed the greater part of the ravine, from Rabil downwards, is in a state of rude cultivation, and contains large green fœtid pools, with all kinds of decomposing matter, the effluvia from which was most offensive when I was there in May, 1846.”

Experience has shown, that such a condition of sandy soil is as fruitful a source of endemic and malignant fever as a marsh or swamp. Dr Lind, who wrote nearly a century ago, expressly notices the unhealthiness of Boa Vista, particularly during the rainy season, stating that, “strangers who arrive here at this season are liable to be visited by a general sickness,” and instances its white sand as a mark of an unhealthy locality. Dr Fergusson confirms the correctness of this indication of insalubrity.

“That sandy soils,” he says, “should, in malarious climates, prove as productive of aggravated remittent fever as the swamp, has never been sufficiently explained. Certain it is, however, that they do so, in a marked and prominent degree. The Alemtejo and Algarve of Portugal—regions, I may say, altogether of sand—are the most prolific of fever of any in the Peninsula.”

Another instance is found in the unhealthiness of Vera Cruz, which is spoken of by McCulloch in the following words:—

“It is said to be the original seat of the Yellow Fever.” [Bulama?] “The city is well built and the streets clean, but it is surrounded by sand-hills and ponds of stagnantwater, which, within the tropics, are quite enough to generate disease. The inhabitants and those accustomed to the climate are not subject to this formidable disease; but all strangers, even those from the Havannah and the West India Islands are liable to the infection. No precautions can prevent its attack, and many have died at Xalapa, on the road to Mexico, who merely passed through this pestilential spot.”

Dr King states, that if ever endemic fever derives its origin from a vitiated and malarious state of the atmosphere, Boa Vista abounds with the elements for its production. Among these he enumerates swamps and pools of stagnant water, in the immediate vicinity of Porto Sal Rey, and over the whole district of Rabil; patches of rich alluvial soil near the other villages, the recognized sources of noxious exhalations; the wretched food of the lower classes, and still more, the polluted atmosphere which they breathe in their crowded and ill-ventilated abodes, and the general disregard of cleanliness in their houses and streets, “a combination of morbid causes,” he says, “which would produce malignant fevers in any part of the world.”

The relative position of Boa Vista to the African coast would further naturally lead to the expectation that it must be subject to diseases of the same character, and no one disputes that this is the case. The residents of the island, military, medical, and civil, concur in stating that endemic, bilious remittent fever, prevails there more or less every year; that there is no season in which it does not carry off several of the inhabitants, and that it often prevails epidemically.

“The testimony of the most intelligent men in the island,” says Dr King, “including Dr Almeida, Senor Baptista (the Consul’s agent), the Mayor of Rabil, the Judge of Fundas Figieras, and the Judge at Old Town, removes every doubt as to the fact that fever prevails to a certainextent, and carries off several of the inhabitants in the months of November and December every year; and this endemic fever, which recurs annually, and which Dr Almeida calls the bilious remittent, does not always present the same mild aspect and character; on the contrary, it is well known that in certain years the disease was epidemical, and in comparison with other seasons, very fatal.”

Dr M‘William records the fact, that such epidemic seasons occurred and proved unusually mortal in the years 1821–2, in 1827, and in 1833.

It is most material to a right understanding of this whole subject to observe, that a Yellow Fever Epidemic had broken out at this very time in an adjoining island, St Jago. It is stated by Dr Stewart, in his Report in the Admiralty Correspondence, that “in the adjoining island at Porto Praya, there was Yellow Fever whilst the ship was at Boa Vista.” Captain Simpson states that it recurred in the following year at Porto Praya; “is common there at times and quite endemic.”

That co-incident with the presence of the “Eclair” at Boa Vista one of these epidemic seasons was impending, was declared by the usual indications, which in warm climates precede and accompany such visitations. These premonitory signs on this occasion were a great fall of rain at an unaccustomed season; the consequent accumulation of large quantities of stagnant water in and about the towns and villages; the occurrence of extraordinary heat; the prevalence of light winds with frequent calms rendering the weather extremely sultry and oppressive; the appearance of sporadic cases of fever of more than common intensity; the almost simultaneous outbreak of pestilence amongst cattle and other domestic animals; and the visitation in greater numbers than common of destructive insects.[36]

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