"

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tory evidence has been brought before the public. Even with respect to the cause of the occasional appearance of the pestilence at Sierra Leone and other parts of the west coast of Africa, no little contrariety of opinion has been expressed by different medical writers. While Chisholm and Pym maintain that Bulam is the true birth-place and nursery of the disease, the late Mr. Fergusson wrote an article* to prove that it is unquestionably indigenous in Sierra Leone, 130 miles distant, and that it is generally transported from that pestiferous place to other points on the African coast. On the other hand, of the two epidemics which prevailed there in 1823 and 1829, Dr. Copland expresses his opinion that they (at least the latter) did not originate in the colony, but had been imported :—from what place, he does not say. He rests his opinion on the report of the then governor, Major Ricketts, who," our author says, "has thrown light upon a subject which they (the colonial surgeons) have confused and mystified." Allusion must here be made to Mr. Boyle, who wrote a work upon the subject. In that work, after adducing a variety of details, this gentleman says:"The foregoing information appears to be so conclusive as to the origin and original nature of the disease, that further discussion upon these points must be unnecessary. That there are differences in the accounts given by the natives is true; but they do not amount to discrepancies of such a magnitude as at all to invalidate or shake the one leading supposition and conviction, viz. that the epidemic fever, which raged so fatally in Freetown in 1829, was immediately caused by peculiarities in the seasons, originated in the interior, was borne to Freetown by the North-east winds, and, in its primary and true character, was not contagious."

With respect to the former epidemic, we learn from Dr. Gillkrest that Mr. Showers (who was resident Colonial Surgeon from 1816 to 1826) has stated that, when the fever broke out in 1823, it was supposed by some to have been imported thither from the Mediterranean, by a vessel called the Caroline! Mr. Showers, however, was of opinion that the disease proceeded from the atmosphere. Well may Dr. Gillkrest say, when alluding to this matter, that "to those, who had been led to believe that the true black-vomit fever had been not unfrequently exported from the coast of West Africa, its reputed birth-place, this visitation as a perfect stranger, and its alleged importation from Europe, must appear somewhat strange.' It is remarkable how unwilling the residents of a place often are to allow that a pestilential disease has originated among themselves: they will generally assert that it has been brought ab extra to them.

39

Dr. Copland's views, as to the origin of these two epidemics at Sierra Leone, may be gathered from the following passage:—

"Although persons belonging to the colony had visited places adjoining where the pestilence was raging at the time, had returned to the colony, and were immediately afterwards attacked and died, other cases of the disease following upon these admitted to have been the first; and although ships, more especially slaveships with sickly cargoes of human beings, arrived at the colony just before and at the time of the outbreak of these epidemics, some of the writers on the subject contended that the distemper had arisen from malaria brought from a distance

* Medical Gazette for August 31, + Account of the West Coast of Africa, &c.

1839.
London, 1831.

NEW SERIES, NO. XI. VI.

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by the winds, and others concluded that it had travelled from the interior of Africa to the coast-a sufficient admission of infection; whilst the more observant of the residents believed in its introduction through one or other of the channels just indicated, or through both." Vol. III., p. 172.

The reader will naturally enquire whence came the pestilence to the adjoining places, from which the colony is supposed to have received it? The mention of "the slave-ships with sickly cargoes of human beings," has reference doubtless to the hypothesis of the origin of the disease, which has been noticed in a preceding page. From the coast of Africa, we now pass to the shores of Europe.

Without entering upon the angrily-disputed field of enquiry as to the probable origin of the several epidemics of yellow fever, which have made their appearance in different parts of Spain during the course of the present century-and what good could result from such an investigation, when we have not a single datum or position that has not been flatly contradicted?—one or two remarks may not be without some interest and even profit to the reader.

The evidence, adduced by Dr. Gillkrest to shew that many parts of the Peninsula had repeatedly suffered from visitations of this fever in the course of the last and the preceding centuries, and probably also at a still earlier date, cannot, we should think, be resisted by any unprejudiced person. Sir Gilbert Blane himself expressed his belief that it was known at Cadiz in 1764; and Dr. Copland not only alludes to this case, but also mentions that the pestilence appeared at Lisbon in 1723, black vomitings being the most prevailing and fatal symptom." With such an admission, it seems rather strange that he should afterwards talk of " the first appearance of the pestilence" at Gibraltar in 1804; and, notwithstanding this too, the particulars mentioned by Dr. Gillkrest of the visitation in 1798 (not to allude to any earlier ones), when " Dr. Harness, then physician to Lord St. Vincent's fleet, and afterwards one of the Commissioners to the Sick and Hurt Board, declared the fever to be precisely the same he had seen in the West Indies;"—a statement that is confirmed by Dr. Monro in his Work on Diseases of Armies.* It may be mentioned also that Dr. Copland himself acknowledges that the pestilence was at Cadiz and Xeres in 1800, and at Malaga in 1803, places not above forty or fifty miles east and west from Gibraltar. He says that the escape of the "Rock" in these years was owing to the quarantine regulations that were adopted. Yet he is obliged to confess that, in spite of these regulations enforced too, be it remembered, under the vigilant eye of Sir W. Pym then superintendent of quarantine at Gibraltar, it found its entrance in the following year, 1804. Such was the case also in 1810 and 1813; and again at the last visitation, that of 1828; "the quarantine," says our author, in reference to the vessel called the Dygden, that was believed to have imported the disease from the Havannah, appears not to have been rigidly enforced." Alas!

* We might allude also to the well-authenticated case of the yellow fever prevailing on board of the Bedford man-of-war, 74, in the bay of Gibraltar in 1794. + Dr. Copland tells us that Sir W. Pym met with one case of the distemper in this fortress (Gibraltar) in 1803.

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the watchmen seem always to be asleep, at the very moment when the enemy is ready to enter!* Dr. Copland gives a minute and most circumstantial account of the exact mode in which the pestilence was introduced by that unfortunate vessel, and he even traces each successive step in its stealthy progress "from the smuggler and washerwoman to whom the foul clothes had been sent," the first affected, until its full-blown development, when it prevailed to a fearful extent in almost every part of the garrison. It is surely very strange, to use the gentlest expression, that he does not even so much as allude to what Dr. Gillkrest has written on the subject, although this gentleman was on the spot at the time of its outbreak, and had an opportunity of watching its rise, progress and termination. Courtesy alone might have prompted Dr. C. to have referred to the statements of an honourable opponent, writing in what may be fairly deemed a rival work. Any one, who reads Dr. Gillkrest's apparently most fair narrative of this epidemic, will hesitate before he receives our author's circumstantial details, if he does not at once wholly discredit them. If we are to give credit to Dr. Gillkrest's statement that "the failure of proof as to the importation of the disease has been admitted by the Army Medical Board in England, to whom a copy of all the proceedings of the Gibraltar Commission was sent for examination," can we require any further reason to make us pause in our decision upon the matter, and not hastily to adopt an opinion, one way or the other, merely because it may happen to coincide with our previous and favourite notions? These remarks must suffice upon this part of our subject. The fair and legitimate conclusion may surely be asserted to be that the Yellow fever was not a nova pestis introduced, for the first time in 1793, into the western hemisphere from the African coast, and re-exported from the former, in some subsequent year, into the south of Europe. Yet this opinion is still most tenaciously held by one, if not by more, of the veteran writers upon the disease! We are glad to find, as already stated, that Dr. Copland does not give the weight of his authority to a doctrine not only not proved, but altogether so improbable.

There still remain one or two topics connected with the history of Yellow fever that we had wished to notice; but we must pass them over altogether, and proceed, without further delay, to examine, and that very briefly, the Report of the Commissioners of the New York House of Assembly on the quarantine laws of that state. We had hoped to have been able to give a con

As a matter of course, whenever the pestilence does not appear for a number of successive years, the immunity is at once attributed by our author to the salutary effects of the quarantine which has kept the disease out. But to shew how fallacious such a mode of reasoning may be, it is worthy of notice that we have the high authority of Humboldt, in stating (we quote from Dr. Gillkrest) that, although the disease usually exists among the newly arrived every year at Vera Cruz (one of the most pestilential spots in the world), it never prevailed epidemically there between 1776 and 1794, although the intercourse with the Havannah and other places, where the disease continued to prevail, was quite free. He even says that there was not a single example of the vomito during the eight years preceding 1794, although the concourse of Europeans and Mexicans from the interior had been very great."

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densed analysis of the medical testimony in this Report; our want of space, however, prevents us doing so at present. As usual, there is no little dis crepancy of opinion among the medical witnesses upon many of the questions that were proposed to them. The weight, however, of influential evidence is unquestionably in favour of the infectiousness and consequent importability of the disease; but not to the extent that Dr. Copland might lead his readers to suppose. Take the following as an instance. Dr. C.

says;

"From 1751 until 1791, this pestilence made its appearance in New York on several occasions; but after the latter period it appeared more frequently and more destructively, as might have been expected from the increased size and population of the city, and the more frequent intercourse with places where it prevailed. It even occurred during two or three successive years, and was seldom absent for a longer period than this, until 1822, when it prevailed most fatally. Since that year quarantine regulations have been strictly enforced, and the distemper has not appeared again in that city-now a period of nearly a quarter of a century—although it has scarcely been a year absent from vessels detained in quarantine, and in the quarantine hospital.

"Can any stronger proof of the propriety of enforcing these regulations be adduced than that to which I have now referred?" Vol. III., p. 237.

To estimate, however, fairly the value of the statements here made and the conclusion thence deduced, the reader should be informed of one or two circumstances that cannot fail to qualify in some measure the opinion which he might otherwise at once adopt. The following extracts from the Report will explain what these circumstances are.

"The State of New-York, as early as 1784, enacted quarantine laws, and the examination of them will show that they are scarcely behind those now existing, in their practical operation; and yet in 1798, when the city contained only about fifty-eight thousand inhabitants, between two thousand four hundred and two thousand five hundred persons died with the disease the law was passed to prevent. At subsequent periods laws have been enacted, and precautionary measures taken, still, in the years 1805 and 1822, the city found itself in the midst of pestilence, and, in some other years, cases have occurred, but the number has been so small, that the disease could hardly be regarded as epidemic, and they have not been as numerous, if we except the years 1805 and 1822, as at the quarantine grounds.” P. 41.

Moreover, we learn that there was no Yellow Fever in New York from 1805 to 1822, a period of fourteen years; therefore before " the quaran tine regulations have been strictly enforced."*

* To give an idea of the excessive stringency of these regulations, we quote the first:

"All vessels direct from any place where yellow, bilious-malignant, or other pestilential or infectious fever existed at the time of their departure, or which shall have arrived at any place, and proceeded thence to New-York, or on board of which, during the voyage, any case of such fever shall have occurred, arriving between the thirty-first day of May and the first day of October, shall remain at quarantine, for at least thirty days after their arrival, and at least twenty days after their cargo shall have been discharged, and shall perform such further quarantine as the health officer shall prescribe.' P. 51.

Thirty days quarantine imposed upon a vessel, although not a single case of fever has ever been on board!-and this too after it has been declared that "the yellow fever will develop itself in from two to twelve days after infection,

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The exemption of the city from any invasion of the pestilence since 1822,* is attributed by our author, as well as by one or two of the medical gentlemen of New York, whose communications appear in the report, entirely to the more stringent operation of quarantine regulations; but then they omit to mention, not only that the general sanitary condition of that city has undergone a most material improvement since the period mentioned, by the removal of the crowded grave-yards, the purification of the quays, the cleansing of the streets, &c., but also that-and this is a very important circumstance-while a most rigorous system of defence and exclusion has been adopted, during the last twenty-five years, at New York against suspected as well as against infected vessels, an infinitely less severe code of regulations has been in force all the while at Brooklyn, which is only a few hundred yards distant, and between which and New York there is an incessant and unrestricted communication. We gather this from the following statements :

"Vessels arriving at the quarantine from interdicted ports with a healthy crew, not allowed to come to New York, have usually been permitted to come to the wharves at Brooklyn, after two days quarantine, and immediately discharge their cargoes, and the vessel remain at the wharves, or reload for any outward port." P. 17.

We are told by Mr. Brower, a most intelligent witness, that "after a vessel has discharged a healthy cargo at Brooklyn, during the quarantine season, and has been cleansed and ventilated, she is not permitted to come to New York to re-load until after the first of October, and these vessels are frequently thrown out of employ for months, while nothing can be more evident than if they were unhealthy at Brooklyn, it would be known as soon, and the effects as prejudicial to the health of New York as if they were at the wharves of the city. The contiguity and almost instantaneous communication between the two cities forbid any other conclusion."

It thus appears that there is good reason to believe that the health of New York during the last twenty-five years would, in all probability, not have suffered in the least, although its quarantine regulations had been much less rigorous than they have been all the while. We have alluded to the good effects of the improved sanitary condition of the city of New York, in rendering it less liable to the diffusion, if not to the invasion ab extra, of yellow fever. How strikingly is the truth of this exemplified in the following statement of Dr. Hort with respect to New Orleans, where he has resided for upwards of twenty years.

and even sooner, if the exposure is to the morbid effluvium of the disease in a concentrated form." It will be observed that no distinction is made between the (alleged) true or genuine pestilence and malignant bilious fever. Are we to infer from this, that they are regarded as one (or all but one) and the same disease? At all events, this circumstance alone shews how hard a thing it is to distinguish between what Dr. Copland and some other writers assert to be "essentially distinct diseases."

* "Since the year 1822 the city has been free from any epidemical yellow fever; yet some of our eminent physicians have expressed the opinion that deaths occur every year in the city, of a disease, if not the yellow fever, one which has all its characteristics except its epidemic, contagious, or malignant form.” P. 14.