An Enquiry Into the Origin and Intimate Nature of Malaria

by active 1795-1858 Thomas Wilson

Challice.

Sir,—The Board of Health of Marseilles are about to establish quarantine regulations of ten days’ and fifteen days’ duration at that port, because “a dreadful plague rages at Bengazzi, in Tripoli, and is extending along the coast to Alexandria.” Individuals are to be confined ten days, and in certain cases fifteen days. Letters are to be purified, &c., and some 1500 Piedmontese labourers are likely to be disturbed and thrown out of work if the proposed quarantine regulations are established. And so this is the sum total of sanitary experience for the last ten years! The French authorities saw all quarantine regulations broken down during the Crimean war; in fact, joined the British in abolishing a quarantine at Smyrna, at Galipoli, at Constantinople, at Sinope, at Samsoon, at Trebizonde, at Malta, and even at Marseilles, and indeed at all other ports and places used by the transports and by the armies in alliance.

The armies certainly did not escape fever and cholera in their most terrible forms. The French, the British, and the Sardinians alike suffered, both in the field and in hospital, at the commencement. The British alone, however, by means of sanitary works and regulations, reduced cholera attacks to a minimum, and almost abolished fever. A few simple alterations to the sewers from the great hospitals on the Bosphorus and other places; ventilation—in many instances by simply breaking the top squares of windows; regular scavenging without and cleansing within the works of the hospitals, and the regular use of the lime-wash brush, emptied the hospital wards of fever patients. Surface cleansing at Balaklava, and regular scavenging both the shores and water of the harbour; covering the shallow graves with gravel and earth; scavenging the camp, and daily disinfecting all latrines, soon reduced the British army mortality below home or barrack life and service. The French neglected these things, or blundered in their execution, as the 5000 deaths per month in the hospitals on the Bosphorus, from hospital and camp fever alone, during the last three months of the war, testify. That certain diseases are contagious, such as scarlatina, measles, small-pox, &c., few will deny. That plague and cholera are equally contagious many doubt. Sanitary works and regulations of a very primitive and simple kind can certainly check the contagibility of cholera, as witness the experience in Newcastle-upon-Tyne and Tynemouth, in London, in many other English towns and districts, and in the British hospitals and camps throughout the Crimean campaign. The lesson taught by experience ought to be this:—Let the Board of Health at Marseilles cleanse the town, cause all the foul rooms to be ventilated and lime-washed, disinfect the foul cesspools and sewage, and cut it off by “interception” from the harbour and docks, and they may bid defiance to plague from any quarter. It may be imported in silks, &c., but it will not spread. Let there be a sanitary staff for the harbour, and another for the town, armed with brooms, barrows, and lime-wash brushes, in place of sidearms and muskets, and persons may land at once to go about their business, and merchandize may be forwarded to its destination without fear of consequences. During periods of epidemics there can be cholera without dirt; improper food and mental and bodily exhaustion may bring on isolated cases; but to have cholera rampant there must be numbers of human beings fouling air, earth, and water, and habitually living contrary to known sanitary laws and entirely neglecting sanitary precautions.

Civil Engineer.

August 14, 1858.

Note 7.—Mud, Water, and Air.

The presence of water and a suitable temperature are indispensable conditions of the oxidizing process of decay, just as they are necessary to putrefaction and fermentation. The sides of ponds and ditches being covered by water during the winter months, in the spring the air becoming warmer and drier, the water diminishes, the decay of vegetable seeds, plants, and all woody fibres enter now into putrefaction, communicating the process to each other, and by the transmission of decomposition from one particle to another, a great number of plants give out various gases to the atmosphere while decaying upon mud, rise into the air, meeting other gases, and then, floating about, they compose and decompose each other. Hence the bad odour from the mud-banks of the Thames, near the outfalls of the sewage.

Note 8.

I have known fevers cured by a change of the sleeping room from the south to the north aspect, and still more readily by removing from one side of the street to the other. All should avoid dwelling near canals, ponds, or ditches habitually covered with a white froth; this is formed, in fact, of gases rising through humus swimming on the water, and contains living beings as well as fermentable substances.

It is important to men who work and sleep in the same house to have the day or working-rooms to the north, where the sun never enters, and to sleep in a room to the east or south. A room to the west, looking to the west, is not healthy, particularly in summer months, being the hottest in the evening. Gnats, moths, and flies collect there, and are at least harassing, if not hurtful, particularly to infants.