“Was there any marked or unusual distress at that period?—Not that I remember.
“Do you find in the course of your experience that the diminution of food is followed by fever?—Not as a general cause, I should say. If these two persons, casually exposed to the contagion of fever, the one in full vigour, and with a full stomach, the other with an empty stomach, the person with the empty stomach would be the most obnoxious to its influence. In my experience, however, intemperance is a much more frequent antecedent to fever than destitution or want of food.
“Have you ever observed that habits of intemperance are created by distress of mind?—Such cases may occur, but I have not observed them, and I think it does not operate as a general cause.
“What are the chief remedies which your experience in this district would lead you to recommend for the prevention of fever and contagious diseases?—The promotion of cleanly habits amongst the poor; the promotion of sewerage and drainage; having proper supplies of water laid on in the houses; the removal of privies from improper situations. I could point out in our neighbourhood many houses, and some courts, that ought to be pulled down as wholly unfit for human habitation.
“What is the personal state of the labouring classes in your district?—Generally extremely filthy. I have said that I could almost smell from what street a man came who came to my surgery: I do not think the poor themselves are conscious of it, but the smell to other persons must be extremely offensive. I certainly think that the want of personal cleanliness, and of cleanliness in their rooms, and the prevalence of fever, stand in the relation of cause and effect.
“Your colleague has pointed out that the want of proper and convenient supplies of water is an antecedent to the filth and the fever. Does your experience enable you to concur with him?—My experience entirely agrees with his on that point.”
The late Dr. Cowan, of Glasgow, and the great majority of the medical officers, assign the foremost place to these physical agencies as antecedents to fever.
The medical controversy as to the causes of fever; as to whether it is caused by filth and vitiated atmosphere, or whether the state of the atmosphere is a predisposing cause to the reception of the fever, or the means of propagating that disease, which has really some other superior, independent, or specific cause, does not appear to be one that for practical purposes need be considered, except that its effect is prejudicial in diverting attention from the practical means of prevention.
Dr. Bancroft, one of the controversialists cited by Dr. Davidson, observes,—
“That fever often exists in them” (gaols) “cannot be denied; but this circumstance can afford no evidence of its being generated therein, any more than the multiplication of vermin in such places could demonstrate the spontaneous generation of these and other insects by the nastiness which favours the deposition and hatching of their eggs.”