The Sun.
London, England, 1845-10-16 00:00:00

THE AFRICAN FEVER.

(From the Medical Gazette.)
In our last number we referred to the arrival of a vessel
from the coast of Africa, having on board a disease repre-
sented to be the African fever, which had caused great mor-
tality among the crew. No less than 66 persons had diet,
including the two medical officers. We expressed no doubt
that immediate relief would be afforded by Government to
the survivors, who were thus left in a most helpless condi-
tion; but it appears that the excessive fear of contagion
caused the strictest quarantine to be observed, and in the
first instance the plan adopted by the Lord Mayor and Alder-
men in the great plague of London in 1665 was enforced—
e., the healthy were compelled to remain shut up with the
diseased; We confess we were hardly prepared for this mode
of dealing with a fever-stricken ship in the 19th century;
for, even admitting the contagious nature of the malady,
methods would have easily suggested themselves for imme-
diately separating the diseased from the healthy, and remov-
ing the whole of the survivors from the pestilential atmos-
phere in which they were confined.
The delay in adopting measures of isolation was, we under-
stand, occasioned by the absence from town of the chief
quarantine officer at the time the intelligence was received.
It is to be regretted that there is not a medical officer at all
our great naval stations empowered to act immediately in
such emergencies.
We have probably never before had the African fever
brought so near to our coasts as in this instance; and it
may be worth while, therefore, to inquire into a few cir-
cumstances connected with it. The most accurate observa-
tions which have been made on this formidable malady are
those of Dr. M'William and Dr. Pritchett, who accompanied
the late Niger expedition. From the account given by Dr.
M'William, we learn that all who, composed the expedition
were exposed to the same influences, and nearly all were at-
trcked with the fever. Two only of the four medical
officers who died had been in attendance on fever patients
Dr. Pritchett, Mr. Thomson, Mr. Stirling, and Dr. Stanger
were among the few who escaped being seized with fever,
although they were in constant intercourse with the sick, and
Dr. M'William himself was the last person in the Albert who
was attacked. The nurses on board this vessel were among
the latest taken ill, and one escaped altogether. In short,
there was no fact which came under the observation of this
experienced medical officer which afforded the slightest evi-
that the disease was communicated from one person to
another. _ _ _ _ _

-..-...-..
These facts appear to show clearly that the malady must
have owed its diffusion to endemic influence, and not to con-
tagion. It is well known that in the equipment of these
vessels special provisions were made not only for insuring a
free circulation of air below decks, but also as far as possible for
purifying it, or of depriving it of noxious matters. There is,
however, good reason to believe, from the fatal progress of
the disease, that these had no influence in counteracting the
effects of the endemic poison. We learn from Dr. M'William's
account, that some circumstances were actually favourable to
the propagation of fever by contagion : the upper deck was
much lumbered, in a degree to prevent the free circulation of
the air; and the same cause prevented it from being tho-
roughly cleaned. In the decks below many men were neces-
sarily crowded together in sleeping under a very high tem-
perature ; for the thermometer was seldom below 84 degrees.
The steam apparatus created an unavoidable source of heat,
which was constantly being diffused throughout the vessel
by the active conducting powers of the metal (iron) of which
she was composed. It might be supposed that this would
rather lead to the cooling of the vessel by its immersion in
water; but the water of the river was seldom below 83 de-
grees. Under these circumstances, we think it pretty evident
that had the fever been contagious some proofs of its possess-
ing this character would have been most probably obtained.
There can, however, be no doubt that the great mortality
which attended the disease, was in great part to be ascribed
to the vital energies of the men becoming reduced by these
depressing influences.
In the absence of any medical history of the progress of
the malady on board the recently arrived vessel, it is out of
our power to form a conjecture whether the deaths on the
homeward voyage, and those which have taken place off
Portsmouth, were due to the African fever or its sequelx. If
to the former, the disease may, like the worst form of typhus
fever, have acquired a contagious character from confine-
ment, want of ventilation, or proper medical or hygienic
treatment, an evil which was only likely to be increased by
the plan pursued under the quarantine laws, at the first ar-
rival of the ship. The remedy would have been to have iso-
lated the effected, and placed them at once under medical
treatment, whereby all danger of the diffusion of the disease
would have been prevented.* It does not appear probable,
however, that the genuine African fever would have lain so
long latent; the facts observed in the Niger expedition show
that the period of latency is about from 16 to 21 days ; and
it may turn out, therefore, that instead of fresh cases of fever
occuring on board this ill-fated ship during the latter part of
the voyage, they may have been merely sequences of the
malady, aggravated in their effects by the unhealthy state of
the vessel.
It has been long known that those who recover from this
disease are liable to suffer from lesions of the mucous mem-
branes of the bowels, which are caused by the fever. Hae-
morrhage, hrematemesis, and dysentery have supervened
long after the fever has passed away, and have destroyed
life. Within a short period all these matters will have been
cleared up to the satisfaction of the public and profession ;
since Sir William Pym, Superintendent-General of Quaran-
tine, and Mr. Arnott, of the Middlesex Hospital, have been
appointed to investigate the matter; and their report is, we
understand, more favourable than the intelligence already
received would have led us to anticipate.
This does, not, however, remove the objections to our
quarantine regulations, which loudly call for some modifica-
tion. We are not prepared to say, after the sad experience
of the pestilential cholera, that fearful maladies derived from
endemic causes in one quarter of the globe, may not diffuse
themselves by a property strongly analogous to, if not iden-
tical with, contagion ; but we believe it to be not only a eel-
fish but a dangerous policy to shut up the diseased under
such circumstances. The poison is only likely to acquire
thereby a more virulent action ; and, like the gaol-fever at
the Black Assizes, cut off all who come within its sphere.
Moral causes, it is well known, have an important influence
in bringing on an attack, so that the locking up the healthy
with the affected for the period required by the quarantine
laws, is virtually consiging the former to destruction.
We have made these remarks, as the subject is of present
interest. The history of the African fever, as given by Dr.
M'kVilliam, shows it to be a disease most insidious in its
attacks, most fatal in its progress, and at present apparently
beyond the reach of medical treatment:l- The bare possibi-
lity of so fearful a malady becoming imported into his coun-
try, and spreading itself by contagion, is thereforet a subject
which deserves the close attention of the medical profession.
The above remarks were made before we had seen the re-
port to the Amiralty by Sir W. Pym and Mr. Arnott. We
are glad to find that energetic measures have been taken,
and that, on the arrival of the Eclair at Standgate• creek,
such precautions were adopted as prudence would suggest.
Those who had escaped from the attack of the fever (41)
were removed to a clean vessel, and convalescents to another,
At present there are only two men confined to bed with the
fever, but no fresh case has occurred since the 29th ultimo.
The report, we think, leaves it clear that the fever has, in
this instance certainly, spread by contagion. In the report
we have no detailed account of the symptoms; but it is ex-
pressly stated that the disease was marked by the occurrence
of "black vomit," the first fatal case being that of a man
who was brought on board after having been three days on
shore. Soon afterwards eighteen persons were attacked with
fever and black vomit, and thirteen died ! The disease may,
therefore, be some severe modification of the coast fever; for
Dr. M‘William expressly states that, "in no case of the river
fever was there the slightest appearance of ' black vomit.'
Bilious vomiting was common in the early stage of the
disease." We shall take care to report any facts that may
further transpire with respect to the disease. In the mean-
time, there is every reason to believe, as the report states,
that its progress is arrested.