(From the Spectator.)
The arguments against the continuance of quarantine-regulations have come to flower in the report just issued by the Board of Health, and now, it is to be hoped, they will bear seed. The report is a very masterly and lucid exposition of the knowledge bearing on the subject, illustrated by well-selected facts, and so marshalled that the whole must enforce conviction, even, we should think, on the most prejudiced mind. The argument is exhaustive in its process, and is so broadly based as to make it almost impossible that any essential mistake can have crept in.
Quarantine is founded on the assumption that certain diseases, and most chiefly Oriental " plague," are " contagious " - that is, propagated by the contact of the sick with the healthy. The report refutes the theory of quarantine out of its own practice : the strictest observance of quarantine does not exclude plague or other " contagious " diseases from places liable to such visitations : places, classes, and persons not in themselves liable to such visitations, do not become infected by any breach of the quarantine regulations. The well-known case of cotton imported from Egypt is conclusive, even if it stood alone : the feeblest reasoner, arguing by the method of differences, would have no difficulty in pronouncing that the cause of infection cannot be the contagion, while the disease is propagated where the contagion is prevented, and is not propagated where contagion is not prevented. The same result, however, is to be traced through the whole practice of quarantine : give other circumstances favourable to epidemic or zymotic diseases, and no prevention of contact can arrest the disease ; give circumstances favourable to continued health, and the door of quarantine stands open in vain.
Of late years there has been a considerable impulse to the inquiry into so-called contagious diseases, with a corresponding accession to a true knowledge of them. Hitherto each disease was supposed to possess its own peculiar " virus;" and in some degree that may be true, but only in the same way that every disease known to the pathologist exhibits a tendency to propagate itself by the actual exhibition of diseased matter in healthy flesh. Puncture with the bone of a hare that is " high" will cause mortification and sudden death ; yet we do not say that venatus or the chase is a contagious disease. Introduce diseased matter into a healthy body, and the disease has a tendency to spread by inducing a sympathetic diseased action ; the disease probably being this direct natural method of eliminating that diseased matter. In this sense, perhaps, no disease is non-contagious. But the greatly increased mass of evidence respecting the epidemic diseases called contagious distinctly points to other causes. They are all fevers, all partake of certain leading traits common to fever, all find their abode in certain habitats which are ill-drained and ill-ventilated, are all fatally aggravated by the artificial causes that increase those natural defects by overcrowding, close-shutting, and filth of dwellings. The typhus fever, in its horribly aggravated Egyptian form of " plague, " does not come from Alexandria to London in the twenty-five ships sent out at the height of the plague season ; it is not carried into the bosoms of our families through the cotton packed and shipped by persons actually under the infection of plague ; but it is in London created by the plague - producing local causes of bad drainage, overcrowding, bad ventilation, and filth. Epidemic fever is not imported as a thing, an article of export and import, by ships and travellers ; it is not carried by tramps from workhouse to workhouse ; even the Irish fever was not imported by the invading hordes of Irish starvers. But in one sense fever is imported ; the migrants bring to the low, over-crowded, and ill-constructed districts of our towns, increased numbers and the habits which originally produced the disease ; and hence, where such persons settle the disease appears.
So it is with ships : they are floating " cellars." undrained, ill-ventilated ; the bilgewater of the hold is an infectious pond of decayed animal matter within the dwelling, and by the motion of the ship it is for ever stirred. Its noxious fumes often affect persons of a weakly and irritable temperament at the first encounter. Ships, therefore, are disease manufactories - they make the disease they are supposed to convey. In the mercantile navy, the number of deaths at sea produced by infectious or zymotic diseases is 55.9 per cent on the total of deaths - more than double the ratio (26.5) that the same class of deaths bears on shore. The disease is made in the ships in spite of several circumstances conducive to health, especially the free ventilation of the sea and the invigorating effect of life above deck.
Experience shows. therefore, that the disease is not exported, because no quarantine strictness can confine it to one spot, no quarantine laxity direct its encroachments; it is not carried in ships, because no " contagious" medium has been known to convey it to those in healthy condition and circumstances ; it is made in ships, by causes that make it elsewhere ; it is made amongst us, by domestic causes to which quarantine as little applies as the Coast Preventive Guard checks private stills.
But a diligent scientific inquiry seems to be gradually approaching a knowledge of the specific causes; which are of two classes. The investigation of the bold explorers into the abodes of disease have uniformly detected the presence of putrid or decaying animal or vegetable matter, or both, in the atmosphere immediately surrounding the patient - even lodged on the walls of the room in which he lies, " Dr. Angus Smith has shown, that when the vapour which condenses on the walls and windows of a room in which large numbers of persons are assembled is examined, it is found to be impregnated with animal matter in a high state of putrefaction." In the case of a patient under acute diseases, the noxious fumes may have floated front various sources ; but in proportion as the room is closed the virus is concentrated, especially when the sources of it are incessantly renewed : the morbid exhalations of the patient himself - any accumulated organic matters, diffusing their decayed particles into a limited space - supply an atmosphere charged with mortification, exactly like a the mortification conveyed by the puncture with the decayed hare's bone. But this source of disease is one easy of removal and dissipation - just as the dead hare may be thrown away or buried. Here - you have actually captured and identified that treaded obscurity the virus ; and you find that it is a thing which, instead of being forced into the lungs at every breath, may be carried away by the scavenger and blown away by the winds of heaven.
The other class of causes is meteorological and although it is less distinctly understood, enough is known to point out the azure of the morbific causes and to stimulate further inquiry. Excess of moisture in the air naturally aggravates all the evils attendant on bad drainage and ventilation by checking evaporation, and by throwing increased duties on the functions of the human skin. Electricity is evidently connected in the closest degree with the phænomena of vitality; and a "low" condition of " positive" electricity - terms, as yet used in a very vague and arbitrary sense, to express obvious but ill-understood sets of phænomena - seems to be very unfavourable to the action of vitality. These meteorological causes cannot be prevented ; but their morbific tendencies may be counteracted by whatever promotes evaporation and vital action - by good drainage and good ventilation, by proper diet, clothing, and regimen-by sanatory regulations. Quarantine, however, can have little effect in regulating the importations of the electric fluid, or checking the march of fog-laden winds. In that matter, with our quarantine officers, we intelligent Britons are on a par with savages who carry out drums and cymbals to dissipate the foreboding of an eclipse. Nay, quarantine regulations are positively mischievous - as mischievous as any fantastical medication detected by travellers among savages. Sufferers from the African typhoid in the Éclair steamer must have been doomed to more certain death by the confinement which quarantine enforced.
What the Board of Health proposes to do is to substitute sanatory regulations for quarantine regulations - in other words, to apply the operations of science to the actual and not the traditionary causes of disease; just as the physician now sends in drugs to an atrophied patient, instead of nailing a horse-shoe on his door to keep away the hag that has bewitched him. A change of that kind can scarcely be deferred now that the better knowledge of the day has at last received the stamp of authority. It immediately affects three large and important classes of the community - travellers, a class who represent England in every region of the globe, sailors of the mercantile navy. about 200,000 in number - men who are scourged by the pestilent fevers, still trusting in a horse shoe nailed to the mast; and merchants, with property of which the floating portion is roughly estimated at £2,000,000 annually. The reform is the more likely to be accomplished, since it affects no political interests and must bring credit to any statesmen that do accomplish it. In order that they may make sure of achieving it, we should advise our present Ministers to do it this session-at once
SG & SGTL P 101, 6 Apr 1850
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