« ΠροηγούμενηΣυνέχεια »
Have they any power over Infectious Miasms ?
on the cases of disease under treatment, during the time before specified, I leave to you and others to draw your and their own conclusions from the facts which I am now about to state.
“ In the month ending June 15th, 83 persons of both sexes were treated in hospital; of those, 10 died. Whereas, from June 15th to this day, July 15th, there were admitted 162, of those four died (three males and one female), 94 were discharged cured, and 64 remain under treatment.
“ Of those who died in this latter month, one was a very old man, a long confirmed drunkard ; one a boy of cachectic constitution from infancy, and one a woman with pneumonic complication.
“ You have seen how many (almost all) of those cases were of a severe typhoid character.” P. 12.
Dr. Lindsay, Deputy-Inspector of Hospitals, in transmitting Dr. Cronin's letter, remarks :
“ The patients admitted into the Cove Hospital are mostly all labouring under fever of a typhoid form, many of them with the characteristic eruption at the beginning, and petechiæ appearing during the progress of the disease, accompanied by great debility, feeble pulse, and all the other symptoms of bad typhus.
“ The rate of mortality, however, has been exceedingly low since the use of the chloride of zinc was commenced, and if any conclusion can be drawn from a three wecks' trial of it as a disinfecting agent, it must be highly in its favour.
“ I herewith enclose a report from Dr. John J. Cronin, the present attendant physician of the hospital, and as I have myself been in almost daily observation of its use amongst his patients, I can add my testimony to his.” P. 13.
We have already seen what the reporters on M. Ledoyen's fluid have stated on this point. Their report, it deserves to be noticed, is dated 29th March of the present year. On the 27th of April, they addressed the following letter to Col. Calvert.
“ There is nothing in Mr. Ledoyen's disinfecting fluid that can arrest the progress of fever, or influence the connexion which the history of the human family shows is universal and indissoluble between pestilence and famine. But though this preparation can produce no effect on the primary, it may have some influence on the secondary causes of fever, that is on those causes which increase its intensity, and favour its spread when once generated.
Among the most powerful of the secondary causes are the excretions of the patients, whether those from the bowels, the lungs, or the skin. The disinfecting fuid will instantly remove all putrescent smell from uterine (alvine ?) discharges, leaving only the odour of recent fæces, and that in a less offensive degree, and at the same time it will render those discharges very much less capable of giving off their volatile and diffusible exhalations. It is also probable that it may be so used as to keep the air of the hospital ward and of the private sick chamber in a state of purity, by destroying the offensive odours arising from the exhalations of the breath and skin.
“ It is therefore our opinion, that it would be useful to make this preparation known to the physicians and surgeons of Ireland, and also to private families; for if it be properly and assiduously used, it may have a beneficial effect upon the sick themselves, by keeping the air around them pure, and thereby materially facilitating their recovery, and it will unquestionably be a great protection to the attendants on the sick. But we must beg leave to give a distinct caution against this preparation being spoken of as a remedy in fever, for if it be so considered, it must lead to disappointment, and it will probably bring doubt on the properties which it really possesses, and which are capable of being applied in various ways to the public advantage.” P. 35.
Dr. Leeson also, at the same time, having been requested by Col. Calvert to give his opinion as to what might be expected from the use of the fluid “ in arresting the progress of infection and fever,” expresses himself to the following effect :
“ Until much more is known with regard to the true exciting cause of fever, or, rather, the immediate vapour exhalation or gas by which such infection is conveyed, it would be presumptuous in any one to say whether such cause would or would not be affected by your liquid.
“ This, then, is an important object of experiment.
“ It is well known, that wherever a fever-exciting atmosphere does exist, there also abound the very gases which your liquid is capable of destroying ; but whether such gases are merely concomitant, or whether they are themselves wholly or partly the exciting cause, is at present a mystery : this, at least, is evident, that such concomitants are not harmless, although (as shown in the paper already referred to) the general opinion seems to incline to the belief that there are other exhalations which are the true miasmata on which fever is dependent." P. 36.
On the 26th of May, we find Dr. Smith writing to Col. Calvert respecting the use of the fluid in the Fever Hospital here, in these terms:* It is nearly full, and we find the use of the fluid in the present crowded state of the wards extremely beneficial.” He had previously remarked in the same letter ;_" that there should be no death in a ward in which six deaths occurred daily before the disinfecting fluid was used, is an amount of success, if it should continue, which was not to be expected, and the continuance of which is not to be looked for.” This certainly leaves a very favourable impression as to the " disinfecting” properties of the fluid on the mind of an unprofessional reader at least; we cannot, therefore, be surprised that Colonel Calvert pounces upon the Doctor's letter with peculiar avidity :-“ it must excite,” says he, with his usual fanfaronade," every feeling of humanity to get this fluid into immediate general use, as it will save the lives of thousands who are at this time afflicted with fever and dysentery."
A month subsequently to the date of this propitious letter, viz. on the 28th of June, appeared another letter from Dr. Smith, which, not only as it contains an account of his further experience, but also as it enunciates opinions of very questionable accuracy, deserves particular notice: It is addressed to Lord Morpeth. “My Lord,
28th June, 1847. One of the constant and distinguishing characters of a severe epidemic is that it attacks the attendants on the sick. The fever which is at present prevailing to such a deplorable extent in almost every part of the United Kingdom exhibits this character in an unusual degree. From the accounts daily received from the larger towns in England, but particularly from those of Ireland and Scotland, it is certain that in great numbers of instances fever is communicated not only to clergymen and relieving officers who visit the sick in their own wretched homes and poisonous localities, but also to the nurses and medical men in attendance even on private families; while it is far more prevalent and mortal among nurses, medical students, and the surgeons and physicians of hospitals and unions. Now this part of the calarnity at least might be spared. Whatever difficulties your Lordship may have encountered in obtaining the necessary powers to make even any commencement of a system of prevention, by the removal of the causes of fever, you have in your own hands, and have had for some months past, the 1847]
Dr. Smith's Testimony impugned.
sure and certain means of preventing the extension of fever to the immediate attendants on the sick. An agent has been discovered (M. Ledoyen's Disinfecting Fluid) capable of entirely destroying the noxious gases arising from decomposing animal and vegetable substances. The properties and powers of this Auid, after having been examined by a series of careful and exact experiments, performed partly under your Lordship's own observation, have been further tested in the crowded and poisonous fever-wards of the hospitals and unions of Manchester, Liverpool, and Dublin. All classes of witnesses, from the nurses and wardsmen to the highest medical authorities, without a single exception, have corroborated (from what they have themselves seen) the correctness of the conclusions deduced from the original experiments, and given in detail in a report presented to your Lordship on the 29th of March, 1847. “ When used in a sick chamber, or in hospital and union wards,
this disinfecting agent decomposes and destroys the poisonous matters given off from the breath and skin, and from all the discharges of the body, and thus maintains the air surrounding the patients in a state of perpetual purity. It therefore effects more than ventilation ; for while ventilation merely dilutes the poisonous matters diffused in the air, by the introduction of fresh currents of pure air, this agent destroys the very sources of impurity.
“ No instructed person will suppose that this fluid can exercise, as a remedial agent, any influence on the state of fever itself, or on the diseased processes so often set up in it; yet the effect produced indirectly by it (merely by maintaining the purity of the surrounding air), in improving the condition of the patient, is sometimes most striking and permanent. It is a further property and advantage of this fluid, that it creates no disagreeable odour of its own (as is the case with other disinfecting agents), but, on the contrary, produces a peculiar sensation of freshness.
“ I have been unable to afford my patients in the Fever Hospital the full benefit of this important discovery, on account of my inability to procure the fluid in sufficient quantities for daily and regular use. I have regretted this the more, because a bad form of erysipelas, proving fatal in several instances, has spread extensively through the wards, and I am satisfied that this might have been checked by the free use of this fluid.
“ I have also been anxious to procure enough of the fluid to immerse in it the body-linen and the bed-clothes of the patients; for we have scarcely ever had in the Fever Hospital a laundress who has not sooner or later been attacked by fever ; but, from what has been stated, it is obvious that all these classes of persons, nurses, laundresses and medical men, who are always in imminent danger, and who so often suffer, might perform their arduous duties with perfect security. I therefore respectfully but earnestly beg of your Lordship no longer to withhold from the public, more especially in the present condition of the country, the knowledge of a preventive and remedial agent, the general employment of which (irrespective of other uses to which it is applicable) will undoubtedly contribute towards saving the lives of many valuable persons.” P. 24.
That any instructed medical man should entertain so high an opinion of this, or of any other, alleged disinfecting agent as unwaveringly to assert that “it decomposes and destroys the poisonous matters given off from the breath and skin," and also that he has in his own hands the sure and certain means of preventing the extension of fever to the immediate attendants on the sick, does certainly surprise us not a little ; and we must withhold our belief in the accuracy of such assertions, until much more satisfactory evidence be adduced than what has yet been brought before the public. Would it not have been well to have given the ipsissima verba of the medical officers of the fever hospitals alluded to, touching the very important point in question ? And is it not rather surprising that Dr. Smith, on the very day that he addressed Lord Morpeth in the terms we have just read, wrote to Colonel Calvert, respecting his own personal experience of the fluid, in language that is much less energetic and unqualified ?
“ By the free use,” says he,“ of the disinfecting fluid in the bed-pans; by the suspension of cloths saturated with it round the beds of the patients, and by the abundant diffusion of its vapour in the atmosphere of the wards, I am satisfied that the poisonous exhalations constantly emanating from the bodies of the patients would have been decomposed and destroyed much more rapidly and completely than could have been effected by any amount of ventilation alone.” P. 26.
And straightway he adds this not unimportant statement respecting the very salutary effects of simple Ventilation on fever patients :
By the construction and arrangement of the windows we have it in our power to introduce into the wards of the fever hospital any quantity of fresh air we desire; and the soothing and healing influence of this air on the patients is most striking ; for when brought into the hospital in a state of violent delirium, with a parched and black tongue, they often become perfectly calm, and the tongue gets moist and begins to clean at the edges in a few hours after they have breathed the comparatively cool and pure air of the spacious and well-ventilated fever ward ; but surely we may hope to effect still more, when, in addition to the inestimable advantage of ventilation, we obtain the means of destroying at their very sources the impurities which it is the object of ventilation to remove." P. 26.
The rest of the letter about the doctor and his family eating the peas and potatoes, which had been raised in his garden that was well manured with Ledoyenised night-soil, without suffering from any symptoms indicative of lead or of any other poison, need not detain us.
In place of the frivolous communications from the resident medical officer of the Fever Hospital at Battle Bridge, how comes it that Dr. South's colleague has not been applied to, to give his opinion of the virtues of the marvellous fuid ? A few lines from Dr. Tweedie would surely have had greater effect, with the profession at least, than the correspondence between Mr. Sankey and Colonel Calvert. By-the-bye, we accidentally learn from Mr. Sankey a strange and certainly very reprehensible state of things that occasionally exists at the fever hospital, viz. that dead bodies have sometimes to be kept eight or ten days in the dead-house, "owing to the clumsy working of the registry of deaths.”
The evidence of the resident medical officers of the Liverpool Fever Hospital merely goes to prove the stencb-destroying properties of the fluid; but these gentlemen say not a word as to its efficacy as a " disinfectant.” The same thing may be said of the testimony of the medical officers of the Infirmary and other hospitals at Liverpool. We now pass over to Dublin, where the Colonel seems, according to his own report, to have achieved his greatest triumphs. His modest statement is as follows:
“ On our arrival (in Dublin), I had the honour to present Mr. Labouchere's letters to Mr. Redington and Sir P. Crampton, one from Sir W. Somerville to Mr. Carmichael, and your Lordship's kind letters to Mr. Macdonnell and Mr. Roe: I was most kindly received, and immediately assisted by all to put to the test of the fluid in the fever and dysentery wards of different hospitals, and a most dreadful dysentery ward was selected by us to show what could be effected : it 1847)
Results of Experiments in Dublin.
was, in fact, the condemned ward of the North Union Workhouse, Dublin, where poor wretches were sent to die, and they usually had five or six deaths a week : effluvia and the stench was dreadful; the men in a wretched and helpless state: the doctors refused going into it: in the presence of at least a dozen physicians and surgeons, we entered; we undertook the care of the ward and patients ; we purified it in a very short time; we recovered the sick, and we did not lose a single patient during three weeks: this will be certified to your Lordship by certificates from the physicians, &c. of the house, and others who witnessed, to their astonishment, this severe test: we have had other severe tests, for all of wbich I hold certificates from the physicians, &c."* P. 36.
We beg, before proceeding, to say that we do not believe the assertion contained in the words we have italicised. And now, how is the above statement born out by the medical certificates ? Sir P. Crampton testifies to the antibromic properties of the fluid, and to them alone. Sir H. Marsh and Dr. Cusack certify to its effects “ in quickly neutralising and finally destroying the noxious effluvia arising from urinary and fæcal deposits.” Dr. Carmichael, while recognising its value in destroying fætid odours, says :—“As to its power of disinfecting contaminated places, I could not positively vouch, without an extended system of experiments fairly conducted; but I think there is a strong presumption that it does possess this power, from the fact that, while it removes the most offensive odours, it leaves none in their place.”
Dr. Kirkpatrick, also, physician to the Workhouse where the wonderful effects were produced, after mentioning certain facts shewing the efficacy of the fluid in “ decomposing, or in some unknown manner of removing, noisome odours, and without producing any peculiar smell of its own,' observes :-" The patients experienced great relief from the improvement in the air ; and it is strange, although several deaths had occurred in this ward during the preceding week, yet, during the time of his visit here, no death happened amongst the patients first seen by Colonel Calvert,” and on the very following day, when writing to the Colonel, Dr. K. adds :-" The extraordinary effect it possesses in the decomposition of foul odours has been proved beyond dispute, and that to it may also belong the greater value of destroying that pernicious condition of the atmosphere upon which disease depends is neither impossible nor improbable."
There is another communication from Dr. Kirkpatrick, which for his sake, we trust, was never intended for publication; as it is anything but creditable either to his judgment or good taste. It contains, we may observe, nothing that is worthy of notice. Not so the letter of Drs. Car. michael and Macdonnel; who, in alluding to the experiments made at the Union Workhouse, fully recognize the value of the fluid in destroying offensive smells, but with proper caution add :-"We wish to be understood as pronouncing no opinion respecting the disinfecting powers of the liquor ;
It subsequently oozes out, by the Marquis of Downshire's note, that the fluid is not entitled to the exclusive merit of the cure in the Colonel's cases. The Marquis, writing to him, says—“ be so kind as to send some by as early a period as you conveniently can, and write your own directions for its use, and your own change of diet, which appears to have so wonderfully brought about the sick under your charge in Dublin and Drogheda.”
NEW SERIES, NO, XII.-VI.