In proof of the singular salubrity of Brazil, we need only state that, until within the last four years, although its provinces have been at intervals visited by revolutions, wars, and famine, the country has hitherto escaped from all those epidemic and endemic scourges—yellow fever, cholera, influenza, typhus, and dysentery—which have so frequently desolated other, and the fairest regions of the globe. In this favoured land the solar heat proves scarcely less influential and salutary to animal than to vegetable life; and years of subsequent exhaustion can never entirely efface from the recollection of the European sojourner the buoyancy of spirit, unclouded mind, and exquisite appreciation of mere animal existence which marked the first years of his residence in Brazil. These vivid sensations may be in part determined by the novelty and splendour of a New World, its brilliant skies, perpetual verdure, and the variety, luxuriance, and beauty of its vegetable life; but they are chiefly due to the direct influence of the heat and light of a tropical sun, supplying a new and powerful stimulus to the performance of all the functions of animal and organic life. The medal, unfortunately, has its reverse: this favourable condition of the animal economy proves, as in vegetable life under similar circumstances, but of limited duration; and from five to seven years may be set down as the average period at which a tropical residence begins to affect the European constitution to such an extent as to influence longevity or injure health; the precise epoch being determined by the constitution, occupation, predisposition, and habits of the individual. It should be here stated that the month of April is that best suited to the stranger’s arrival in Brazil, as affording time for his gradual acclimatisation to the summer heat of December, January, and February; though we may observe, and the fact is singular, that the European suffers but little inconvenience from the highest temperature during the first years of his residence, just as the Brazilian seldom complains of the winter cold on his first arrival in Europe. The chief objection to the climate is, in addition to high temperature, its great humidity; shown in the rapid decomposition of all organized, and certain inorganic matter, the quick oxidation of metals, deliquescence of salts, destruction of wood, &c. &c.; and after a certain interval, the depression of moral and physical energy in man. The deleterious effects of this condition of atmosphere on the animal economy is happily tempered, if not entirely corrected in Brazil, by the general equability of its climate, and the influence of a cool and never-failing breeze, so that a stagnant, or even calm, state of the atmosphere is almost entirely unknown. Were this otherwise, the chief cities of Brazil inundated by the most offensive animal and vegetable exhalations,[73] and with an almost total neglect of those policial and sanatory regulations so essential to the public health in other countries, would, we are satisfied, prove no less fatal to man than the charnel houses of Africa and the West Indies.
In estimating, however, the influence of climate on the public health, the moral and physical condition of the people demands especial consideration. The Brazilian is in general well-formed, compact, and of healthy organization, but not of athletic frame. His intellectual faculties are acute, though little developed by cultivation. Descended from European ancestors, he has still a considerable admixture of African, and some native American blood. He is indolent by nature, and indisposed for active exertion or industry; but he is protected against the evil influence of the former on his health by a simple and abstemious diet, and the injurious consequences of the latter to his social position are obviated by the fact that the four great wants of the humbler classes in Europe press but lightly on the Brazilian. Fuel he scarcely requires, clothing but little; his primitive habitation is simply constructed, and one day’s labour will amply provide for the moderate demands of the whole week. With passions naturally quick, he is nevertheless placable; his disposition is kindly; the future rarely disturbs him with its doubts, or the past with its regrets: the struggles and vicissitudes of European life are unknown. The contentions of party, the yearnings of ambition, the bitterness of fanaticism, never disturb his repose; and after gliding down the stream of time, unscathed by the tumultuous passions and harassing cares which so frequently embitter the existence and undermine the constitution of man in other countries, he meets at length the inevitable doom, if not with philosophy, at least with resignation, satisfied of his claims to eternal felicity in the confident assurance of an infallible church.
From the preceding account of Brazil and its inhabitants, we would be led to conclude, à priori, that disease would there assume a mild and tractable character; and this inference we find fully borne out, until within the last twenty years, by the medical and general history of the country. Within the last thirty years, however, vast changes—moral, social, and political—have been developed in Brazil, and it interests alike the philosopher and the physician to mark how profoundly these changes have already impressed and modified the manners, habits, and diseases—nay, even the physiognomy of its people. After a brief struggle, the establishment of Brazil as an independent empire was effected in 1823; and since that epoch the country and its population have undergone a series of remarkable and comprehensive political and social changes. From the strict and simple forms of despotic government they have passed, at a bound, to one almost of license; including household suffrage, popular legislative assemblies (imperial and provincial), open courts of law, trial by jury, local justices, and a national guard elected on popular principles. This sudden and premature concession of political privileges to a people yet in the infancy of civilization has been naturally attended by great and numerous evils, mingled, it must be admitted, with many and great advantages. In the intoxication of a new-born freedom, the empire has committed numerous excesses; province has been arrayed against province, in a succession of intestine broils; the laws have been inefficiently or corruptly administered; and a lax morality has but too generally pervaded the whole community. On the other hand, an extensive and well-organized system of national education has been established throughout the empire; the slumbering intellectual powers of the nation have been aroused; wealth and intelligence developed; political and military ambition awakened; commercial enterprise created; agriculture revived; and of all those mighty powers which move and mould societies, the controlling influence of religion has alone remained stationary. The priesthood, deprived of wealth, power, and influence, has utterly-lost its prestige, unless, perhaps, with the very lowest classes of the community—a question of curious speculation as regards the cause, and of vast importance as regards its future results on the character and institutions of the Brazilian people. In addition to the foregoing rapid transition of society into new forms and combinations of social existence, we find the face of the country changed by the march of civilization and agricultural improvement,—woods cleared, roads opened, internal and external navigation developed, population largely increased, and the great maritime cities of the empire assuming an importance second to none, and superior to most, of the cities of the new world.
Coeval with these great and rapidly advancing changes, we can already discern some of those evils too commonly attendant on increased wealth, luxury, and intelligence: anxieties, excesses, passions are largely multiplied, and the medical observer cannot fail to distinguish, amongst certain ranks of the hitherto contented and indolent Brazilians, unequivocal traces of that premature ‘wear and tear,’ so strongly and painfully characteristic of high civilization. It now only remains that we should briefly notice the extent to which certain great classes of disease have been influenced and modified by the preceding moral and physical agencies. This is chiefly manifested in the increasing number of cerebral and pulmonary maladies, and diseases of the heart and great vessels. Insanity has also become much more frequent than formerly, though still rare as compared with other nations; which, indeed, might be inferred from the fact that the ‘Mad Doctor’ is a species of the profession as yet unknown to Brazil. Suppurative inflammation of the liver has increased, but of all the acute diseases, fevers have been the most profoundly modified; they partake much more generally of the low, or asthenic character, and assume the remittent and continued type, and are greatly more fatal in their results than formerly. This naturally brings us to the important question of the ‘yellow fever,’ which for the last four or five years has ravaged the great maritime cities of the empire. Its origin has given rise to the most conflicting views, amongst the best observers;—for example, Dr. Pennell of Rio, and Dr. Paterson of Bahia, both men of undoubted talent and great professional experience, entertain precisely opposite opinions; the former contending for the indigenous, the latter for the foreign origin of the disease; and both offer cogent arguments and striking facts in support of these opposite conclusions. The scope of this work does not admit of medical discussion, yet as the facts observed by Dr. Pennell are highly important, and as his conclusions entirely coincide with our own experience, we will condense them here. Dr. Pennell states that for some years the fevers of the country had been clearly changing their character, that the genuine remittent had been little seen for three years; that it was replaced in 1847, ’48, and ’49, by a fever of its own class, popularly known as the ‘polka fever,’ but in reality a remittent; and that this fever was, in its turn, superseded by the ‘yellow fever,’ a disease with similar features: he adds the following words, ‘coincident with these and other changes in the diseases of Brazil, the climate, in its broad features, has altered strangely: thunder-storms, formerly of daily occurrence, at a certain hour, during the summer, are now but seldom heard, &c.,’ and concludes, ‘that bilious remittent and yellow fever are essentially the same disease,’—a proposition entirely in accordance with my own experience in Brazil and other countries. The abettors of the foreign origin of yellow fever insist that it was imported by a certain ship from New Orleans into Bahia, and thence diffused throughout the empire; whilst the facts adduced by Dr. Pennell go far to establish, as already stated, its indigenous parentage. In support of this opinion we have the strong additional fact that, for the last forty years, there has existed uncontrolled by any efficient quarantine laws, an extensive intercourse with the United States, Africa, and the West Indies, the very hot-beds of yellow fever; and yet, up to 1849, Brazil remained perfectly healthy. Can we then in reason believe, if the disease be deemed really importable, that the maritime cities of Brazil could, under such circumstances, have escaped infection for a period of forty years? It is moreover important to know that several of the older writers, as Rocha Pita in 1666, Père Labat in 1686, Fereira da Rosa in 1694, have recorded the appearance of epidemics closely resembling the yellow fever, and which, after persisting for some years and desolating several of the large cities on the coast, finally passed away. Some seventy years ago, the capital itself was visited by an epidemic fever no less fatal to the population than that from which it now suffers.
From the above and other facts, we are firmly convinced that the yellow fever which now afflicts Brazil is not an imported disease, but owes its origin to certain obscure atmospheric disturbances, embracing variations of temperature, hygrometric influence, electrical tension, atmospheric pressure, &c.; and judging from the previous history of Brazil, we believe that these unfavourable conditions are but temporary and will pass away, and that the country will again resume its former character of unparalleled salubrity amongst the tropical regions of the globe.[74]
Prophylactic Measures.—A few words on the precautions to be adopted by temporary as well as permanent residents in Brazil may perhaps prove useful. In the first place, all the ordinary hygienic laws should be attended to; the habitation selected should be in a dry locality, on a moderate elevation, and well ventilated, but at the same time protected against strong currents of wind; lengthened or direct exposure to the sun’s rays should be avoided, and all sudden vicissitudes of temperature guarded against. Loose waistcoats without sleeves, of fine flannel, should be worn next the skin, during the day, but never slept in; sleeping in the open air or unprotected, should be avoided. After exposure to rain, the clothes should be immediately changed; after exhaustion by exercise, or from any other cause, collapse or chill must be carefully guarded against, by avoiding for a time exposure to the cool breeze or by taking some slight stimulant, as coffee, wine, or a little spirits. Spirits, otherwise, should be altogether avoided, and wine resorted to only at dinner, in great moderation, and by those accustomed to its use. Generally, animal food should be used only at dinner; no supper; and no stimulating drinks, however diluted, should be taken between meals. Ripe fruit may be used before breakfast, and after the middle of the day, but never after the principal meal. Moderation IN EVERY SENSE must be observed. When compelled to go out early in the morning, the individual should take some support. In warm and swampy districts, over fatigue, or prolonged exposure to the sun, cannot be too carefully avoided, and the use of quinine, in moderate doses, should never be neglected; the cold bath, or cold sponging, every morning on getting out of bed, should be constantly resorted to. The sleeping apartments should be cool and well ventilated, but not exposed to strong currents of air.
Of all the above principles, refreshing sleep is the most efficient preservative to the European constitution against the inroads of tropical disease; but unless the above rules are pretty closely observed, sound and refreshing sleep in equatorial latitudes is unattainable. The morale must never be lost sight of, and a calm and cheerful disposition of mind should be especially encouraged. The above prophylactic measures apply with equal or greater force to the European seaman on arrival in Brazil. In addition, awnings by day and by night are absolutely indispensable to health. Fatigue and dockyard duties, and watering expeditions, should never be permitted during the mid-day heat, nor should the seaman ever be permitted to sleep out of his vessel. The high importance of this latter injunction will be obvious from the fact that a difference of fifty degrees will be found often to obtain between the heat of a mid-day tropical sun and the air near the earth’s surface at sun-rise. Surely, then, we need not evoke the phantom Malaria to account for the sudden supervention of malignant or fatal disease in seamen, or others, exposed during sleep to such great and sudden transitions of temperature, especially when their animal and organic powers have been depressed by previous exertion and profuse perspiration under a tropical sun, aided, too often, by intemperance and other excesses.
Nec Deus intersit nisi dignus vindice nodus.
Finally, we are profoundly convinced, by long and large observation, that if the foregoing principles are attended to, the most formidable localities of southern climates may be encountered with impunity, and especially as regards that dreaded, but visionary enemy, Malaria or marsh poison.[75]