Leone, and rapidly extended to the crews of vessels in the harbour, in the river, or in the adjacent rivers and creeks, and to the different settlements along the coast. About the end of March, H.M.S. "Bann," became first affected. The subsequent history of the disease on board this ship has, it is well known, been minutely described in the admirable report of Sir William Burnett.* It will be useful to give the leading points of the narrative.

"The first case appeared on the 25th of March, after she had been at anchor off Free Town from the 11th January until that date, the crew during that time having been employed refitting the ship, and also in refitting a small prize vessel which had been converted into a tender. By the surgeon's report it also appears 'that they were much exposed to the heat of the sun's rays, and had, perhaps, indulged in irregularities,' circumstances that have never yet been known to fail in producing fever at Sierra Leone, particularly when persisted in for several weeks in succession.

"On the 26th of March the master and two seamen were next attacked, but recovered.

"On the 27th the vessel sailed from Sierra Leone, and between that date and the 31st three more cases were added to the list, and other four on the 3rd of April.

According to Captain Phillips' account, the sick list then rapidly increased, the disease beginning forward in the ship, came gradually to the after part, till nearly all the officers and men were attacked. Indeed, when it ceased at Ascension, about the 11th of May, only sixteen of the officers and ship's company had escaped. The total number was ninety-nine, of whom thirty-four died, fifteen of them before the Bann reached Ascension. The disease had also attacked that part of the crew which was detached in the tender, San Raphael, to reconnoitre the Gallinas; and after her return to Sierra Leone it raged with such fury that at one time it was determined to destroy her.'

"The Bann, on her leaving Sierra Leone, was ordered to St. Thomas', but, from the unhealthy state of the crew and the bad weather, it was deemed advisable to proceed directly to the island of Ascension. On her arrival at that place, tents were erected on shore, at the distance of nearly five hundred yards from the garrison, all intercourse with which was interdicted, and the whole of the sick, amounting in number to forty-five, were landed and placed in the tents provided

for them.'

66 6

Eighteen days after her arrival, viz., on the 11th of May, a boy (son of one of the serjeants of the garrison) was violently attacked and died, but it is neither known nor believed that he had any nearer communication with the sick of the Bann than passing daily at no great distance from the tents to feed his father's poultry.'

"About this time the fever in the Bann had nearly ceased, but it went on daily attacking some of the garrison; and it appears by the official report that twenty-eight were taken ill, of which number fifteen died and thirteen recovered. The disease finally became extinct upon the island about the 16th June." P. 37.

Sir William acknowledged his inablility to account with certainty for the origin of the fever, either in the Colony or in the Bann; but, at the same time, expressed his opinion that it was in the first instance merely

Official Report on the Fever which appeared on board H.M. Ship Bann on the Coast of Africa, and amongst the detachment of Royal Marines, forming the Garrison on the Island of Ascension in the year 1823. By William Burnett, M.D. &c. 8vo. pp. 78. London, 1824.

1847] Yellow Fever on board the " Bann," &c. in 1823. 435

the common endemic of the country, brought on by hard labour and exposure to the sun, not possessing, under these circumstances, any contagious properties, and continued to be so until after the middle of February ; that it subsequently, by the state of the weather preventing ventilation, and from a great number of the sick being confined in a small place, became contagious; and that, though it was impossible to trace the fever in question directly from the Bann to any individual of the garrison of Ascension, yet there is just reason to believe that the disease was introduced into the island by that ship."

The "Cyrene" also was at Sierra Leone in March, 1823. Several of her crew, it is stated, contracted fever from intemperance and exposure on shore. Of eleven men, who were affected, one only died; so that it is evident that the disease was not of a malignant type. During April and May, the ship was employed off the Gold Coast. Only one case of fever occurred there, in a man who slept five nights ashore in the town of Cape Coast. The Cyrene sailed for England in December. "During the year, upwards of 80 cases of fever occurred on board, principally between March and September, seven of which proved fatal."

64

The Owen Glendower" arrived on the station in the early part of 1823. On the 26th of March, when at Sierra Leone, there was not a man on the sick list. Although the men were a good deal exposed, only a few cases of fever occurred. After leaving this anchorage, the duties of the crew, while employed in the boats in the Bight of Biafra, were most severe and harassing. Upwards of 70 cases of fever of a remittent charac. ter occured. The disease," it is added, "was not contagious, and was in every instance contracted by exposure and irregularity, chiefly amongst those on detached service."

Towards the close of the year, she proceeded to Sierra Leone, where several cases of fever occurred; only one however proved fatal. In Feb. 1824, she arrived at Cape Coast, where the marines and a party of seamen were landed to garrison the castle; but, on account of the great abundance and cheapness of spirits, it was found impossible to keep the men sober. They were therefore, more particularly as their health began to suffer, re-embarked. A large proportion of them suffered subsequently from hepatitis and colonitis ;-diseases which "are now of comparatively rare occurrence on this part of the coast." There occurred also a number of cases of fever, amongst the men who had been exposed at the castle.

It is scarcely necessary to detail any particulars respecting the "Swinger," or the "Maidstone." Of the former vessel we read that, when at Bunce Island, twelve miles higher up the river than Sierra Leone, "she was secured alongside the wharf, and her holds cleared out, the crew in the meantime having opportunitics of indulging immoderately in trade rum. In consequence of their imprudence, fever of a malignant character broke out and carried off eight men." It does not appear to have spread.

On board the "Victor," there occurred, between June 1824 and March 1825, between twenty and thirty cases of fever, of which five terminated fatally. In one of these fatal cases, a liquid, like coffee-grounds, was found on dissection in the stomach."

After mentioning the cases of the "Atholl" and the " Redwing," Dr.

Bryson makes the following general remarks on the state of health during the years 1823, 1824, and 1825.

"It appears that there existed a great amount of sickness, both throughout the squadron, and throughout the different European settlements along the coast, than usually happens; but whether this resulted from accidental circumstances, or from some epidemic condition of the atmosphere, there is no means of determining. The probability however is, that both in some degree assisted in causing the more general prevalence of disease, and the increase in the mortality.

"In the first place there was a greater number of soldiers, the refuse of other regiments, sent out to Sierra Leone to fill up the ranks of the African corps, many of whom were men of incorrigibly bad habits, who in a manner drank themselves to death in a short time after they had landed in the colony.

"There was also a greater influx of Europeans upon the Gold Coast, in consequence of the Ashantee war, in which several of the vessels of the squadron also took a part, particularly in the defence of Cape Coast Castle; and it would appear that the squadron congregated more in harbour than it has ever done since. All these causes, therefore, if they did not add to the virulence of the epidemics in 1823 and in 1825, at least tended to multiply their victims.

"The prominent features of the disease, whether in the endemic or epidemic form, appear to have been identically the same with those presented to the medical officers upon the coast in the present day, notwithstanding the great diminution of bush in some parts, and particularly around Sierra Leone. Lassitude, dull erratic pains and rigors marked the stage of invasion; heat and headache, with general pains, thirst, intolerance of noise and light, irregular pyrexial exacerbations and remissions, the stage of maturation; yellowness of skin, stupor, and somnolency, dark dry tongue, irritability of stomach, black vomit, and black dejections, the stage of decline in cases terminating in death.

"In almost every instance where the disease assumed a formidable character, its origin could be traced to one or more of the common well-known predisposing and exciting causes, namely, to undue exposure to the vicissitudes of the weather, either on shore or in boats near the shore, combined with fatigue, cold, wet, insolation, or with intemperance, and other imprudences included under the head of irregularities.

"The Bann contracted the fearful scourge, which swept off nearly one-third of her crew in little more than two months, at Sierra Leone, from a protracted exposure to the influence of that pestilential locality. The Cyrene contracted a similar disease, although less virulent, from similar causes, and in the same locality. The Owen Glendower, in the Bight of Biafra, and at Sierra Leone; the Swinger, in the rivers Pongos and Bunce; the Redwing, in the rivers of Benin; and the Atholl, at Bunce Island and at Sierra Leone. It however does not appear to have assumed a contagious form in any vessel but the Bann." P. 45.

1826-1830.-It would seem that, from the year 1825 to 1829, fever did not prevail as an epidemic, or with an unusual malignancy, in any of the settlements on the coast, or on board any of the vessels of our squadron. The latter year, however, was marked by the outbreak of a most fatal pestilence, primarily (it was believed) at Sierra Leone, and subsequently at Fernando Po, and in three, if not more, of the ships of war on the station. The following details will be found to possess much interest.

The Eden" arrived at Sierra Leone in Sept. 1827, and sailed for Fernando Po, in the beginning of October, with the necessary stores for the projected establishment at Clarence Cove on that island. In the course of the nexth month, "ulcer made its appearance on board in a

1847]

Fever on board the "Eden" in 1829.

437

somewhat malignant form." Its occurrence was attributed, no doubt very properly, "to the crowded state of the ship, there being more than double the number of people on board than there was fitting accommodation for." Notwithstanding that the vessel was several times whitewashed and otherwise purified, the disease continued (in the Spring of 1828) to prevail. It was remarked that those persons, whose ulcers became foul, were generally attacked in groups of three or four in one night, and mostly after much thunder and lightning, preceded by several days of hot, sultry, and oppressive weather. The sloughing process only attacked the lower extremities, particularly the feet and ankles, and never ascended higher than midleg.

On the 29th of October, 1827, the Eden reached her destination. It was not long before the unhealthy nature of the place became felt; several cases of fever having occurred before the end of the year. It became more general in April of the following year.

In consequence of its shewing a disposition to spread in the hospital that had been established on shore, the whole of the sick were removed on board. Besides these, two cases of fever were removed from the Horatio tender, employed in cruising off the Calabar river on the opposite coast, and one came from a prize.

During the Spring quarter, ulcer was entirely subdued; but four cases of dysentery occurred. The ship, being free from disease, sailed in June for Sierra Leone, which she reached on the 6th of July, and again left on the 21st. During this fortnight it rained with very little interruption. In the course of a few days after leaving Sierra Leone, the usual fever made its appearance, and was chiefly confined to men who had recently volunteered from timber ships, and most of whom had been living on shore and committing every kind of excess. The disease was marked by great mental depression, with but little determination to the head. The remis sions were in some cases very indistinct. In the majority, there was more or less of yellow tinge in the eyes and skin; this appearance was usually first observable about the seventh day.

While at sea, between the 17th of September and the 12th of October, cruising off the Bonny and occasionally anchoring near the coast, there were not any severe cases of fever; but, on returning to Fernando Po on the day last-mentioned, five were received from the shore, in a very dangerous state. On the 20th, she sailed for the island of Ascension, having embarked seven cases of fever, all of which were contracted on shore. She returned to Fernando Po on the 26th of December, and remained (it is presumed) in Clarence Cove until the beginning of April of the next year, 1829. On the first of May she arrived at Sierra Leone, all on board being then healthy. At this time, some cases of "malignant fever" occurred on shore and on board the trading vessels in the river, on which account medical men augured an unhealthy season. The Eden at once began to suffer,* and from the first week in May to the 11th of June, when she arrived at Fernando Po, having left Sierra Leone on the 26th of

The first cases seem to have been two midshipmen, who were taken ill on board a prize of the Eden. Both died.

May, between 40 and 50 of the crew were attacked, and of these 25 died. The whole of the officers, with the exception of one lieutenant and the gunner, were either dead, or confined to bed. The men were dying daily, amidst almost incessant rain and frequent tornadoes, accompanied with much thunder and lightning; the main deck was crowded with sick, and constantly wet. The moral effects of these scenes became palpable in every countenance; while, from the want of medical attendance, the surgeon and two assistant-surgeons having died, it was impossible to pay that attention to the ventilation of the ship, or even to the personal comforts of the sick, which their situation required." The sick were landed on the following day upon an isolated spot; and the ship was thoroughly cleansed, whitewashed, and fumigated. But it is unnecessary to follow out the details. Suffice it to say, that "the deaths in May amounted to twenty-seven; in June, to thirty-one; in July, to thirty-two; and in August, to seven; while, out of thirty men left in hospital at Fernando Po, only nineteen were alive on the 1st of December: making the total number of deaths from fever and its sequelæ, between the 1st of May, 1829, and the 1st of December of the same year, one hundred and ten!-of whom fifty died on board the Eden, and fifty on shore at Clarence Cove. Thirteen were natives of Africa, all the others were Europeans."* The deaths must have exceeded two-thirds of the persons attacked. The disease was most indubitably malignant Yellow fever, typhus icterodes. The symptoms of the last stage are thus given :—" The debility increased; the eyes became more yellow, bloodshot, and glassy; the skin also became of a yellow tinge, and covered with a cold perspiration, with sordes on the teeth, chapped lips, and hurried respiration, vomiting of black matter (black vomit), sometimes delirium and convulsions; at others, coma and insensibility to surrounding objects closed the scene. All the deaths occurred between the third and ninth day of the disease, but the majority on the fourth or fifth."

Respecting the supposed origin of the pestilence, and the cause of its propagation, Dr. Bryson, after alluding to "the febrific exhalations eliminated in that pestilential spot," Sierra Leone, where the Eden was when the sickness first appeared on board, says:

"The emanations from the flats between the town and the Bunce River, and from the Bullom shore, although seven miles distant, together with the state of the weather, are therefore supposed, in the first instance, to have originated the disease, which spread with fearful rapidity and virulence over the greater part of the colony, and assumed a more than ordinary degree of malignancy amongst the shipping at anchor in front of the town; some merchant vessels in fact lost nearly all hands. From a variety of circumstances, it was considered not to have been transmissible from person to person, although it appeared to be developed in certain infected spots, and that exposure for a very short time to the exciting cause in a concentrated form, was sufficient to produce the specific effect: thus a soldier contracted fever in the Earl St. Vincent merchantman, although he remained only two hours on board." P. 65.

We must now look at the history of the "Sybille" frigate, which arrived

"This number probably includes several men who were not entered on the ship's books." P. 64.