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charge of her, after her arrival, does not allude to the question of contagion ; the other who succeeded him on the 16th of February states that, from the information he had received, he was led to regard the disease as decidedly contagious. The sick were admitted to pratique on the 1st of March.” P. 122.
With respect to the “ Forester,” all that we learn is that, " in the early part of the year, and again in May, fever of a most virulent character assailed the ship's company at Sierra Leone, and nineteen fell victims, being upwards of a third part of the whole : amongst them was the assistant surgeon. There is therefore not any history of the disease until the 20th of June, when two-thirds of the crew only were in existence, and in a state of convalescence.”
Besides these vessels, the “ Curlew," the “ Fair Rosamond," and the “ Waterwitch” suffered severely in the first-half of this year, 1838. The history of the last-named ship deserves particular notice.
“ The Waterwitch' was employed cruising on the north part of the station, the crew being healthy until she arrived at Ascension in April, when numerous cases of diarrhea occurred, supposed to have been occasioned by the water of that island having been drunk while in a turbid state. Its progress was immediately checked by abstaining from the cause. About this time a malignant fever prevailed among the inhabitants on shore, but there was not any sickness on board the Waterwitch up to the 3rd of May, when she left for the coast of Africa. On that day one case of malignant fever occurred; and again on the 13th, ten days after being at sea, there were four more added to the list, all resembling the first, but presenting more decidedly the characteristics of true yellow fever. From this time the malady continued its ravages until the 4th of June; within that period no less than sixty had been attacked, and fifteen died. The crew consisted of fifty-two Europeans and eighteen native Africans; only three of the white men escaped. Many of the Africans also suffered, but their attacks were comparatively mild, and not attended with danger.
“ There was not any possibility of separating the sick from the healthy : but ventilation and cleansing were had recourse to as far as circumstances would admit, although unfortunately this was next to an impossibility, so great was the quantity of provisions and other stores taken on board at Ascension for the use of the squadron. The state of the weather, together with the locality (the Bight of Biafra), where the rains had just commenced, also tended to aggravate the disease. As the vessel approached the coast, the number of cases increased with such rapidity, that there were at one time twenty-three fresh attacks within the
space of three days, leaving only five white men to do duty on deck, although from the 4th to the 6th of June there had been only three !
“ The fever was characterised by remissions, yellowness of skin, black vomit, black urine, hæmorrhage from the nostrils, throat and mouth, and vomiting of blood. There were several recoveries after hæmorrhage from the mouth, throat, and nostrils had taken place, but there were not any after black vomit bad occurred.” P. 128.
The "malignant fever among the inhabitants on shore," here alluded to, appears to have broken out in the latter part of March, after heavy rains on the 16th and 17th of that month, preceded by some years (?) of dry weather. ** Among the people of the island, there prevailed an opinion that the disease was imported by the vessels from the coast” —viz. the Ætna, the Forester, and the Bonetta. The surgeon, however, of the hospital at Ascension seems to have been of a different opinion, and to have regarded the disease as of local origin. The town was, at the period of
1847) Epidemic Diarrhæa a precursor of Yellow Fever.
the invasion, in a most offensive state, in consequence of the collection of stagnant putrid water in many parts of it; but whether we can admit the sufficiency of this as the real and primary cause of the epidemic, and quite independently of the arrival of sickly vessels from the African coast, which had been more than usually unhealthy during the season, we shall leave to our readers to judge for themselves, more especially as Dr. Bryson does not think fit to express his own sentiments upon the question.
There is nothing in the medical history of the following 5 years (1839– 43) that calls for particular notice. At no time, does malignant fever appear to have prevailed epidemically on board any of the squadron, or at any of the settlements.* We shall therefore pass to the year 1844, during which there was certainly more than the average amount of sickness in several of the ships on the station. In the early part of the year, the “Hydra" (which had been cruising off the coast to the South of the Line, and had also been up the Congo rirer) suffered not only from remittent fever, but also severely from diarrhæa; no fewer than seventy-two cases of this disease having occurred. Upon this point, Dr. Bryson makes the important remark that “this has been a frequent precursor of severe epidemic attacks of fever upon the station ; it was so in the “ Eclair,” and in many other instances heretofore noticed in these remarks; there is reason therefore to suppose that it is but a different effect of the same general morbific cause. It does not appear, however, that the diarrheal affection has any effect in warding off an attack of fever ; it is in fact more of the nature of a predisponent than of a prophylactic ; while by lowering the general tone of health, it renders the constitution less capable of withstanding the shock of the disease afterwards." Towards the end of the year, fever again made its appearance on board the Hydra, and then seemed to assume two forms; "one being mild, and the other malignant;' the former was the more general, and occurred among men who had not been out of the ship, particularly amongst the stokers; the latter, few in number, occurred in the gig's crew, who were exposed to concentrated malaria for a period of forty-eight hours in the river Sherbro.”
During the last three months of the year, the “ Growler” steamer had 63 cases of fever, 21 of febrile catarrh, and 11 of dysentery-"an amount of disease that clearly enough indicates the pestilential nature of the locality,” Sierra Leone and the adjoining coast. Twenty fresh cases of fever occurred in the course of Jan. and Feb. 1845 : three of these terminated fatally. In March, she went to the Cape de Verde islands to recruit the health of her crew, returned again to her old station, where she remained till the following August, and then returned to England.
The “Lily" and the “Penelope” do not seem to have suffered more than usual during this year, 1845 ; but we find that on board the “Styx," six days after leaving Fernando Po where the crew had worked hard in coaling and watering the ship, fever of a malignant type made its appear
From the 23rd of November to the 3rd of December, thirteen cases in all occurred ; and of these, five proved fatal—one on the third day, three
* It may be of importance to know that, during the interval mentioned, the men were much less engaged in the harassing and dangerous duties of boatservice than they had ever been before.
NEW SERIES, NO. XII.-VI.
on the seventh, and one on the ninth. “ During the early period of the disease, the exacerbations and remissions were remarkably distinct, there being a good day and a bad one alternately; on the good day there was nearly a total remission of febrile symptoms ; but, as the fever advanced, and the vital energies declined, the remissions became more irregular, the skin being sometimes dry and harsh, at other times covered with a cold clammy perspiration; the thirst was then great, the tongue became cleaner and sometimes red and shining. One of the fatal cases occurred in a Krooman; in him the disease presented a very aggravated form, with early and restless delirium."
The medical history of the “ Eclair,” from the time of her leaving England in Nov. 1844 to her disastrous return in September of the following year, is traced with considerable minuteness by Dr. Bryson. As a matter of course, we have no occasion to follow him in this narrative. We shall, therefore, merely mark one or two topics that will serve to complete the lengthened details which we have already given, first in the number of this Journal for July 1846, and subsequently in that for July of the present year, when we brought the instructive report of Dr. McWilliam under the attention of the reader.
Between the 8th of March and the 3rd of April, a number of cases of Diarrhea occurred on board. As already stated, this is a frequent precursor of the invasion of malignant fever on the coast of Africa.
The first cases of fever were observed in the men who had been em. ployed in the boat expeditions in the Sherbro river. Up to the 15th of June, fourteen cases in all had occurred; and, of these, no fewer than nine had proved fatal; seven among those (26 or 28 in number) who had been in the boat expeditions, and two among those who had not been out of the ship. From this circumstance Dr. Bryson infers " that the disease was contracted from local causes exterior to the ship; for although two cases occurred in persons who had not been out of her, still, from her close proximity to the land, the whole crew must have been more or less exposed to the same malarious emanations as the men employed in the boats, although perhaps in a less concentrated form, while, not having suffered from privation and fatigue, they were not so susceptible of the disease."
Notwithstanding the amount of sickness already experienced, it appears that the expeditions in the boats were not discontinued until the 2nd of July, when the steamer sailed for Sierra Leone, where she arrived on the 4th, " the crew, comparatively speaking, healthy, and the last remaining cases of fever advancing favourably towards convalescence." The subsequent stay there for three weeks in one of the most unhealthy months of the year ; the cleaning out of the hold of the “ Albert,” with the irregularities and excesses then committed ; the unfortunate permission granted to the men to go on shore, few returning at sunset, as ordered; the subsequent exposure of part of the men in painting and refitting the other steamer—these are circumstances that are well known, and will not fail to be taken into account in examining the history of the Eclair epidemy. Not a word is said by Dr. Bryson as to the time when the first case of “ black. vomit” occurred among the fever patients ; although it will be remem. bered) Sir William Pym took it upon himself to fix the date with precision ! We need scarcely say that he disapproves, in the strongest terms, of the delay on the part of Sir William to have the crew immediately removed 1847)
Yellow Fever on board the “Ecluir."
from the vessel on her arrival at the Motherbank. On this point there can be but one opinion, and that opinion is against the measures that were taken.
We do not remember having seen the following account of the fever on board, as it existed when Mr. Bernard joined the vessel at Madeira : Mr. B., in his first report, says :
“ The cases which presented during the above period were characterized by intense frontal head-ache, and a sensation of weight over the eyes, severe pain across the loins, and in some cases there were general pains; the tongue loaded with a white mucus in the centre, leaving the edges and apex of a bright red, its substance firm; thirst urgent, the skin hot and dry, bowels constipated, the pulse small and without any hardness. In the course of about six hours, vomiting of a greenish yellow fluid took place, accompanied with pain in the epigastrium, or across the chest. The vomiting then became continuous. The dejections procured by purgatives or enemata were dark and fetid. On the evening of the second day brownish flocculi might be detected in the fluid vomited, which increased on the third day, by which time a sinking of the pulse was observable, with coldness of the extremities, and sometimes low delirium, whilst at others there was a wildness of manner, and a disinclination or absolute refusal to take either food, drink, or medicine. The tongue then became of a bright red colour; in some it was quite moist, but generally dry. From this state none rallied. Such were the prominent symptoms, although the latter sometimes did not occur until the fourth or fifth day. The Kroomen, who are still on board, and have been employed in attendance on the sick, have not suffered.” P. 191.
There is no mention here of any remissions, or tendency to their occurrence; and Dr. Bryson subsequently says that the fever was "of a typhoid character."* 'In conclusion, Dr. B. points to the close similarity between the cases of the Eclair and of the Bann, as we had previously done in our article of last year. His words are—“Both vessels contracted the disease at Sierra Leone, and apparently from the same cause or causes, and under similar circumstances. In both vessels, in the course of a few weeks it assumed an epidemic character, if it did not acquire contagious properties; the one vessel proceeded to the barren rocky island of Ascension, a few degrees to the south of the equator, where a disease of the same character made its appearance amongst the inhabitants, and committed great ravages; the other proceeded to the nearly equally barren island of Bona Vista, a few degrees to the north of the equator, where in like manner a disease a short time afterwards broke out, and raged with equal severity.”
From the tabular account given by Dr. Bryson of the total loss sustained by each vessel of the squadron on the African Coast, during the year 1845, it appears that, while the Eclair lost no fewer than 74 men from fever, the greatest mortality from this cause on board any other ship did not exceed 3! The following table,-exhibiting the annual mean strength, and the number of deaths from disease, from accident, and from all causes,
* The following statement, which, as far as we know, has not been made known before, deserves to be noticed :
“ The holds of the Eclair it was supposed had been made perfectly clean, while her crew were disembarked at Bona Vista ; but there was afterwards found, when she was re-commissioned, a large collection of mud, fully three inches in depth, upon that portion of her bottom occupied by the boilers and machinery, which apparently had not been disturbed for a long time.” P. 223.
between the years 1825 and 1845, both years inclusive-serves well to point out how pre-eminently sickly some seasons were above others.
1825 1826 1827 1828 1829 1830 1831 1832 1833 1834 1835 1836 1837 1838 1839 1840 1841 1842 1843 1844 1845
663 1043 955 958 792 667 785 512 562 620 815 965 815 885 790 855 1070 1330 1267 1715 2540
48 63 44 84 204 76 25 21 22 26 22
3 2 4 3 3 10 8 3 4 4 3 5 3 17 29
12 18 19
109 118 60 35 85 72 27 99 128
“ Total mean force for twenty-one years 20,604; ratio of mortality per 1000 of mean force, 58:4; ditto from all causes, 64.9.” P. 177.
“ It would thus appear,” adds our author, “ that the annual ratio of mortality from disease alone on the African station for a period of twenty-one years, was 54:4 per 1000 of the mean force employed. The fatal nature of the climate, however, becomes more apparent when placed in juxta-position with the mortality on other stations, to wit :South America.
9.8 East Indies
15.1 West Indies
18.1 Coast of Africa
. 54.4 “ It is proper, nevertheless, to observe that nearly one-half of this proportional amount resulted from epidemic fever alone, which was confined to a few vessels of the squadron during the years 1828-9 and 30; again in 1837-8, and 39, and in the Eclair in 1845. Deducting the loss from epidemic fevers, therefore, the ratio of mortality from all other classes of disease on the station will be about 20'0 per 1000 of the mean force annually; this, however, can give no adequate idea of the permanent loss of health, which is assumed to be great. Still, from these and other data, it seems fair to deduce that if boat-service were in some degree restricted ; if prize crews were not permitted to land at Sierra