“Other measures of a more coercive nature may be rendered expedient for the common safety, if unfortunately so fatal a disease should ever show itself in this country, in the terrific way in which it has appeared in various parts of Europe; and it may become necessary to draw troops or a strong body of police around infected places, so as utterly to exclude the inhabitants from all intercourse with the country: and we feel sure that what is demanded for the common safety of the state, will always be acquiesced in with a willing submission to the necessity which imposes it.”
This announcement by the English physicians of 1831 was published throughout the land in the form of an Order of the King in Council. But the strong good sense of the public averted many of the mischiefs which these scientific advisers would have produced, had their counsels been carried into execution. The preventive measures which were eventually adopted by them consisted in prohibiting intercourse between one town and another by sea, and permitting it by land; thus, communication between London and Edinburgh by stage coach was perfectly free and uninterrupted, while communication between those capitals by sea was prohibited with such rigour that no interest, however powerful, could procure an exemption. Francis Jeffrey—at this time holding the high office of Lord Advocate of Scotland, and whose influence, from his personal and official connections, was very great—was unable to obtain permission for his faithful servant, in the last stage of dropsy, to go from London to Leith by water, lest he should carry with him to his native country, by that mode of conveyance, not the dropsy, which he had—but the cholera, which he had not.
“You will be sorry,” writes Jeffrey to Miss Cockburn, “to hear that poor old Fergus is so ill that I fear he will die very soon. I have made great efforts to get him shipped off to Scotland, where he most wishes to go; but the quarantine regulations are so absurdly severe, that, in spite of all my influence with the Privy Council, I have not been able to get a passage for him, and he is quite unable to travel by land; he has decided water in the chest, and swelling in all his limbs. The doctors say he may die any day, and that it is scarcely possible he can recover.”—Cockburn’s Life of Jeffrey, p. 247.
These examples are not adduced for the purpose of casting obloquy on Sir Henry Halford, Dr Maton, and the other eminent physicians their colleagues, who vainly attempted to reduce to practice in the nineteenth century, the standard but obsolete doctrines taught, almost universally, in the medical schools in the country; but solely for the purpose of displaying the state of the science of Public Health in the year 1831–2, as far as the physicians of highest reputation and largest practice may be taken as its exponents.—Origin and Progress of Sanitary Reform, by T. Jones Howell.
The consideration of the common properties of pestilence, under whatever form or name it may occur, has led to the general conclusion that the true safeguards against pestilential diseases are not quarantine regulations, but sanitary measures—that is to say, measures which tend to prevent or remove certain conditions, without which pestilential diseases appear to be incapable of existing.
The whole machinery of quarantine is based on the assumption that by an absolute interdiction of communication with the sick, either by the person or by infected articles, it can prevent the introduction of epidemic disease into an unaffected community.
But this assumption overlooks the essential condition on which epidemic disease depends, namely,—the presence of an epidemic atmosphere, without which it is now generally admitted that no contagion, whether imported or native, can cause a disease to spread epidemically. Allowing, therefore, to contagion all the influence which any one supposes it to possess, and to quarantine all the control over it which it claims, there remains the condition, the primary and essential condition, which confessedly it cannot reach, namely, the epidemic atmosphere.
Experience affords evidence that the influence of an epidemic atmosphere may exist over thousands of square miles, and yet affect only particular localities. The cases of cholera which have occurred in numerous and widely distant parts of England and Scotland mark the presence of the epidemic influence; yet over this extended area cholera has fixed itself and prevailed as an epidemic only in very few places. Why has it localized itself in these particular places? Probably because it has there found conditions of a specific kind, either local or personal, or both. It follows that our true course is to make diligent search for all localizing circumstances, and to remove them, so as to render the locality untenantable for the epidemic. But quarantine makes no such search, and leaves all localizing conditions untouched and unthought of.
Hence the signal failure of quarantine as a means of prevention, with reference at least to the most prevalent epidemics, in all the nations of Europe in which it has been tried in modern times; and hence the general relaxation, and in some instances the total abandonment, of the system of quarantine, with reference to several diseases against which it was formerly rigidly enforced, and the growing distrust in the supposition that measures of this kind really afford protection against the introduction of any epidemic disease into any country.
The influence of great epidemics is not limited to human beings; it extends to all classes of domestic animals.