The next thing of consequence is the destruction of the bed-clothes and effects of the deceased; of which Dr. Smith says, “Before the Hankey put to sea, all the bedding of the sick was thrown overboard or destroyed; the ship was washed from stem to stern, both above and below, with salt water; and the purification was completed by fumigating her with tar, pitch and gun-powder. In this clean condition they bade farewel to Bulama on the 22d of November, 1792; but, in attempting to pass through the channel near to the entrance into the open sea, in a dark and foggy night, they got aground on a sand-bank, upon the north side of the island of Formosa or Warang, belonging to the Bijugas, who are represented as cannibals. The extreme terror excited by this accident was not calculated to improve the health of the people on board the Hankey; so that, when it became necessary to take measures for their security and deliverance, only four men were found in a condition to do duty, and all of these had intermittents. With them, however, and his lady, Mr. Paiba set off, in an open boat, for Bissao, to obtain assistance from the Portuguese settlement. Thither he arrived, rowing through rains and fogs, in a leaky boat, after being out two nights and a day; and having obtained such help as he could, returned to the Hankey, got her off, and carried her to Bissao. On the passage there eight persons died who belonged to this ship. At Bissao they refitted, and the Hankey was a second time purified as completely as she had been before leaving Bulama.”
In answer to all this Dr. Chisholm again declares, “that the bedding and effects of the deceased were preserved on board the Hankey, and constituted the seminium of the infection. Capt. William Liddle, of the ship General Mathew, saw them on board; and it was in consequence of that gentleman’s representation that the lieutenant governor, Mr. Home, entered into a strict investigation of the matter; the general result of which I have given; and the authenticity of it may be depended on. Capt. Liddle is now resident in London, and Mr. Byles, the governor’s secretary, is now resident commissary at Grenada; and these gentlemen will readily testify to the truth of my statement. The destructive articles I have mentioned were not thrown overboard till the Hankey arrived in Grenville Bay, when they were destroyed at the request of Mr. Prendfoot, the gentleman who chartered the ship for England.”
Dr. Chisholm is likewise charged with having mis-stated the case of a Capt. Remington, said to be the first who suffered by the fever in Grenada. The words in Dr. Chisholm’s Essay are, “A Capt. Remington, an intimate acquaintance of Capt. Coxe’s, was the first person who visited the Hankey after her arrival in St. George’s bay. This person went on board of her in the evening after she anchored, and remained three days; at the end of which time he left St. George’s, and proceeded in a drogher (a coasting vessel) to Grenville bay, where his ship, the Adventure lay. He was seized with the malignant pestilential fever on the passage; and the violence of the symptoms increased so rapidly, as, on the third day, to put an end to his existence.” In opposition to this Dr. Smith gives the following statement from Mr. Paiba: “He (Capt. Remington) had been all day and all night coming from Grenville bay, and had been wet through. He slept on board in his clothes; and went in an open boat the next day back to his ship: enough to kill any one in that climate.” Dr. Chisholm replies “that the above statement is not correct, nor founded on fact; Dr. Chisholm’s evidence for what he said was founded on the information of captains of vessels, who knew all the circumstances of his visit to the Hankey; and of Dr. Stewart, an eminent practitioner, who attended him at Grenville bay, when he landed there. Lastly, that the idea of his having returned to Grenville bay in an open boat, is absurd; nothing of the kind having been ever attempted.”
From this tedious account it is plain that the evidence relative to the importation of the fever into Grenada by the Hankey is quite contradictory, and subversive of itself, because we are unable to judge between the two disputants. A further consideration of it would lead us entirely from the subject of this treatise, into an endless dispute about which of the two parties had spoken the truth. Setting aside therefore the whole of the evidence on both sides as insufficient, we shall now proceed to give an account of the symptoms of the distemper as described by Dr. Chisholm, and to which description there has never been any objection made.
In the most violent kind of this fever, according to our author, “the patient, without any previous complaint, suddenly becomes giddy; he loses his eye-sight; every thing seems to move round him with inconceivable velocity; he falls down almost insensible, and in that state remains near half an hour, or upwards. During this paroxysm the body feels cold, and is over-spread with cold sweat, which issues from every pore in astonishing abundance. On his recovery the cold goes off, and is instantly succeeded by intense heat, and quick, small, hard pulse; the head achs dreadfully, particularly the fore part; generally accompanied with pain in the right side and at the præcordia. The last, however, has never been acute, and may rather be called oppression than pain. The eyes are much inflamed, watery, protruded, and wildly rolling; the face much flushed; much heat is felt at the pit of the stomach, and that organ seems to be considerably affected by the frequent retching and vomiting which then come on. The patient soon after complains of intolerable pains in the small of his back and in the calves of his legs; but the latter appears to be most violent. During twelve, eighteen, twenty-four or thirty-six hours, these symptoms continue increasing, except the quickness and hardness of the pulse, which does not change materially during that time; and are then succeeded by general coldness, cold sweat, a greater or less degree of coma and delirium, or a state very much resembling intoxication. Life in this state is lengthened out to sixty or ninety hours from the first attack. A short interval of reason then takes place; the patient considers himself better, and is, for a moment, flattered with the prospect of recovery: but a fit as sudden and unexpected as the first comes on, during which he foams at the mouth, rolls his eyes dreadfully, and throws out and pulls back his extremities in quick succession. In general the patient expires in this fit; but some have recovered from it, and continued rational for a few hours longer, when a second fit has carried them off.”
This, without much deviation, was the general progress of the worst kind of the fever. In some, however, a comatose disposition showed itself from the very first; in others the disease began with short convulsive fits in frequent succession, followed by constant delirium and cold clammy sweat, without any intervening heat. In a few cases the first symptoms were coldness and shivering, as in other fevers.
The distinguishing symptoms were the uncommonly sudden attack, the remarkably acute pain in the loins and calves of the legs, the watery, inflamed and rolling eye, flushing of the face, tendency to coma, the pain generally confined to the forehead, and the peculiar cast of the delirium, during which the looks and actions of the patient very much resembled those of a person intoxicated. It was never furious in any other way than by making efforts to get out of bed; and these in a few instances rose so high that the patients got up, dressed themselves, and walked out a considerable way before they could be overpowered. “The strength during the delirium is to appearance surprisingly great, for it is frequently necessary to use the united efforts of two or three men to keep the patient in bed. This is, however, no more than a spasmodic affection of the muscles; for in reality the powers of the sick in this disease are reduced to the extreme of debility, as is seen in the convalescent state.”
The most unequivocal characteristic of this disease, however, according to our author, is the appearance of a kind of petechiæ, but which look rather like red or livid patches than what is commonly understood by that word. They were always the forerunners of death. In a few very violent cases the body was almost of a livid or black colour, but they were generally seated on the neck, shoulders and breast. Vibices also, like those in the plague, described p. [258], sometimes made their appearance, and were also a fatal presage.
Hæmorrhage occurred much more frequent and profuse in this than in any other acute distemper our author had met with. “In several instances, the immensity of blood discharged has evidently been the more immediate cause of death. The robust, plethoric and gross habits have been the most subject to it. It has taken place from the nostrils, mouth, anus, and urethra; sometimes from the canthi (corners) of the eyes; but never, I believe, from the ears or pores of the skin. The most profuse discharge has been from the nostrils and anus, and has frequently, amounted to three or four pounds at a time; the stools having been on those occasions entirely composed of pure blood. Towards the close of life, the blood thus discharged has appeared granulous, or like ichor, with a sediment of a black gritty substance, and has been so extremely offensive as to oblige all the attendants to keep at a considerable distance till the hæmorrhage ceased. Hæmorrhage, however, has never been critical, nor has it in any instance permanently relieved the head-ach or pain in the breast or side. . . . Nearly about the period that these profuse discharges came on, a rawness was felt on the whole of the interior surface of the nose, and on several parts of it little ulcers formed; on others, small eschars, which were remarkably itchy, but on being touched, or an attempt made to detach them from the membrane of the nose, were very painful, and bled. These disappeared in proportion to the patient’s recovery; and I have reason to suspect, that, when the issue of the disease was fatal, these little eschars became gangrenous.”
In this distemper there was always a tendency to coma after the first two days; and after the third, it certainly came on. On examining the heads of two who died convulsed after having been comatose for some time, a great quantity of serum was found in the brain; and, on narrowly inspecting the eyes of those who were afterwards seized with coma, the pupil was found manifestly dilated.