IX.

A brief View of the Yellow Fever, as it appeared in Andalusia, during the Epidemic of 1820: together with the Mode of Treatment adopted, and an Account of the Appearances on Dissection. To which is prefixed, a short Topographical Sketch of the Country. By THOMAS O'HALLORAN, Esq. Octavo, pp. 171. London, 1821.

THE dreadful epidemic of which this work treats, has, as usual, suspended its ravages till the elements are again disposed to reproduce it-or, until ignorance, prejudice, or crooked policy, shall invent a new tale of its importation. from a distant soil. The best historical records inform us, that the first great sickness that nearly depopulated Cadiz, appeared in 1466. A similar event took place in 1507. The epidemic of 1582 is said to have ceased through the intercession of St. Roque! It was not, however, until the year 1730, that the disorder, since known by the name of "el vomito negro," or black vomit, first made its appearance, and swept off great numbers of the inhabitants. In the year following it was equally dreadful, exhibiting spots of a livid yellow, or dark colour, that covered the body, and were the certain forerunners of the black vomit. Don Josef Cervi, physician to Charles the Third, declared that it was not the plague; and Don F. Navarette affirmed that this disease (el vomito negro) was introduced into Cadiz, by a vessel from Spanish America -a tale that has been repeated by one importer after another, down to the present day, when it has become, not only flat, stale, and unprofitable, but also exceedingly pernicious.

In 1764, a similar disorder appeared in Cadiz, which was witnessed by our immortal countryman, Dr. Lind, who has written an account of the disease. Dr. Salvaresa, a famous Spanish physician, has also written a Latin account of the same epidemic. Both accounts exactly agree in describing the disease, precisely as it has appeared in the late epidemic; but Salvaresa says nothing about its being contagious-on the contrary, he attributes it to atmospheric causes and corrupted corn, while Lind so wavers in his opinion, that nothing decis ve can be gleaned from it,

During a period of sixty years after the last-mentioned fever, Cadiz remained healthy, notwithstanding the progressive increase of population. The last months of 1799, and the beginning of 1800, were characterized by remarkably severe weather, so that, at the end of May, there was scarcely any appearance of Spring. All at once, however, "the heat of Summer (we quote Sir James Fellowes, a deci

ded contagionist and importer) set in from the beginning of June, and by the month of August, the mercury was 90°Fahrenheit, while the Levanter tended to increase the distress, which the intense heat of the weather generally occasioned."*

During the months of June and July, no material alteration took place in the public health; but in the beginning of August the scene began to change. A fever broke out in the district of St. Maria, (the residence of poverty, the theatre of filth, where are situated the posadas, taverns, and lodging houses, for the dregs of society) whence it radiated in all directions, and in whatever house it appeared, all the family was ultimately attacked. About the middle of August, all heads were laid together to discover the cause and origin of the epidemic, and, as in all such cases, the Junto pitched upon a ship, the Dolphin, from Spanish America, on board of which ship, some smugglers from the shore had been, and must, of necessity, have brought the infection into the town.

By the middle of September the diurnal mortality amounted to 200, and Cadiz presented a most melancholy scene of mourning and desolation. At this time, according to the statements of the contagionists and importers themselves, and among others Sir James Fellowes, the disease imported from Spanish America spread to domestic and other animals, and dogs and cats were seen dying with the black vomit. The very horses died. This is a fair specimen of the credulity of the importers-whose creed indeed appears generally to be -"credo quia impossibile." But the worst of it is, that credulity is almost always accompanied by an illiberal and overbearing disposition, which endeavours to stifle fair and rational investigations of truth, by its imperious ipse dixits. We every day see examples of this, both at home and abroad, but we shall here notice a remarkable instance in point. Mr. Doughty, a zealous and intelligent surgeon, who had seen and suffered from yellow fever in the West Indies, and who acted under Sir James Fellowes at Cadiz, in 1810, readily recognised a striking similarity, if not an identity, between it and the fever at Cadiz. This officer having opened some bodies, and found the most decisive marks of inflammation in some of the internal organs, reported the same to Sir James Fellowes, but that cautious physician never acknowledged the receipt of the letter, nor took any notice of it in his publication. Nay, because Mr. Doughty stated in a letter to the Duke of Kent that he was the only officer who had re

*Reports. p. 33

course to dissection, he was brought to a court martial by Sir James, and dismissed the service. Mr. Doughty states, "that he never had the honour of seeing Sir James Fellowes by the side of any one of the many bodies he opened." No, The contagion importers act on a very different principle. Like Falstaff, they are mighty shy in the engagement, but once they get to a distance from the scene of action, we are deafened with the narratives of what they have seen and done.

no.

It would be endless to notice the absurd tales invented by importers of contagion. Thus when, in 1810, the fever raged at Barcelona, Dr. Risneno, Physician to the Spanish Hospital there, positively asserted that the contagion was brought from Gibraltar and Cadiz; while Dr. Pym as positively asserts that it was brought to Gibraltar from Carthagena !

Our readers are aware that the doctrine uniformly advocated in this Journal, and we believe very generally admitted in this country, is that of contingent contagion in fever. We are not so mad, or so blinded by prejudice, as to believe with the ultra or importing contagionists, that the epidemics which have, from time to time, ravaged Spain, America, the coasts of the Mediterranean, and other parts of the world, were never of local origin in those places, but always transmitted by bales of goods or other vehicles from distant sources; nor can we agree with the anti-contagionists that such fevers, when once produced by aerial or terrestrial influence, are totally incapable of communication from individual to individual afterward. But we do most solemnly protest against that barbarous doctrine which would barricade the sick, like so many rabid animals, and leave them to form an increasing focus of that contagion which it ought to be the duty of the physician and legislator to dilute, dissipate, and prevent. We consider plague as a distinct disease, sui generis, and do not object to its circumvallation. But to throw cordons of troops round those places where the causes of the fever are perpetually extricating themselves from the soil, at particular seasons, and thus prevent the wretched inhabitants from leaving the insalutary city or district, is one of the greatest cruelties that purblind man was ever permitted, by Providence, to inflict on his fellow-creatures. It is a measure disgraceful to medical science, because it is contrary to the best established principles upon which we act-it is disgraceful to human nature, because it violates and uproots all feelings of charity and philanthropy towards those who are most entitled to our commiseration, and most in need of our assistance. In every quarter of the globe medical evidence is fifty to one in favour of separating the sick, and removing them

out of the sphere both of the febrific causes that first produced them, and the accumulated effluvia emanating from their own bodies afterward. The records most worthy of credit prove satisfactorily that the above measures may be carried into effect, with perfect security to those residing in the vicinity of places affected with endemic and epidemic fevers. On the western side of the Atlantic this scarcely admits of a doubt, even among the contagionists of those countries; and as the importers trace the fevers of Spain to the new world, they must admit them to be governed by the same laws on one as on the other side of the Atlantic. As for expecting any thing like scientific information or independence of opinion from the Spanish practitioners themselves, it is quite useless. The degraded state of medicine in Spain is ably and forcibly drawn by Don Matéos, of Madrid, in his "Philosophy of Legislation," from which we shall make a few extracts for the edification of those few in this country who place implicit faith in the contagion creed of their Spanish brethren.

"Why then does medicine continue among the Spaniards in a state of infancy, bordering on barbarism? It is because the most noble and useful of professions is there regarded as a vile trade or contemptible occupation! It is because medical students, reduced by turns to mendicity or servitude, are classed with the apprentices of masons and shoemakers! That man must be imbued with a more than ordinary philanthropy, who could dedicate genius or talent to a profession so unjustly, so unwisely dishonoured."

"The importance of public hygiene is generally acknowledged; but its utility is not sufficiently appreciated. Governments have not duly estimated the value of medical philosophers; and it is to a neglect of their council, that our prisons, barracks, and hospitals have become, in turns, the most frightful depôts of pestilence, and too often the graves of their wretched inhabitants! The practice of interment in churches is an abomination; it is to burn an incense on the altars of the Almighty, the odour of which may spread infection like pestilential miasmata!"

Don Matéos ranks himself among the anti-contagionists, and asserts that the dreadful fevers which devastated Madrid in 1803-4, presented the characters of inflammation-were rarely of a putrid nature-and required the constant operation of antiphlogistics, particularly blood-letting, which was of singular efficacy. The picture which this enlightened Spaniard draws of a public hospital is frightfully melancholy to contemplate.

"Figure to yourself," says he, "a vast edifice, whose architecture is calculated to astonish by its majesty, or please by its elegance, but whose construction is devoid of every thing that can contribute

to salubrity! The medical officers are never consulted in any part of the fabrication or internal economy of the institution. Under the appellation of HEALERS (guérisseurs) the physicians, badly paid, and little respected, sink into insignificance, and become as careless and negligent as the host of menial attendants. The miserable patient, who hopes for succour and consolation from his doctor, can scarcely address him when he is passed by without an answer! Charged with the office of visiting a great number of sick, the physician sees little or no sickness. The food and the medicines most slovenly prepared, are still more negligently distributed. The linen, and other furniture of the kind, are bad in quality, and not regularly changed. The atmosphere of the wards is impregnated with fetid exhalations, and no means of ventilation or purification are put in force to remedy the evil. In vain does the unhappy patient look around for some sensible being who may com niserate his sufferings -wherever he turns his eyes, the 'most doleful objects are presented to his view. Abandoned by their parents or friends, overwhelmed with chagrin and sickness, some are poisoned by the blunders of the stupid apothecary, while others fall victims to the ignorance of the surgeon, who having made three or four unsuccessful attempts on the vein, in the fifth goes dash into the artery!"

Don Matéos concludes his work by deploring the profound state of abjection into which the nealing art is plunged in Spain.

"Will it be believed," says he, "that in the Universities the Professors of Divinity, of Law; nay, even the Tutors themselves, would blush to be seen in company with the Professors of Medicine! The most petty artisan would be despised by his fraternity if he brought up his son as a Physician! The Government promotes, with all its influence, this strange perversion of ideas, this worse than Vandalism! It heaps humiliations on the heads of those benefactors of mankind; and seems to fear lest the learned Physician and Philanthropist should unmask sacrilegious abuses, and lay open those crimes which, though authorized, are not the less detestable."

After reading these extracts, will professional men on this side of the Channel expect to reap any other information from the health officers of Andalusia than what may happen to suit the views of their Government? No, indeed! The doctrine of importation will, of course, be the doctrine of Government, and it will be that vociferated by the healthofficers in its employ.

We now come to Mr. O'Halloran's work. Our readers are aware that in our last number we gave an account of Dr. Jackson's essay on the same epidemic, wherein was

* One of our cotemporaries has hinted that we have not given quite a fair representation of Dr. Jackson's work or sentiments; but we appeal to the