Ratio of deaths in native population, 1 in 13.4

So much for the outbreak and course of the fever in Porto Sal Rey. The reader must now have his attention directed to what was going on, in a very early part of its career, at the town or village of Rabil, which is divided into two districts, known by the names Cabeçada and Boaventura. Here it is necessary to state that of the men, upwards of 40 in number, who were employed on board the Eclair during her stay at Boa Vista, and all or most of whom returned every night to their homes, not one appears to have suffered either before or for a considerable time after the departure of the steamer, save one man from Cabeçada, Luis Pathi, whose case is thus given by Dr. Mc William :

"He returned to his house when the vessel sailed, and on the following day went to Moradinha (or Santa Cruz), a hamlet on the south-east side of the Rabil ravine, to attend the feast of the Exaltation of the Holy Cross. This festival is observed on the 14th of September, and its celebration sometimes continues three or four days longer. While engaged in the dance on the third or fourth day of the feast, he was suddenly taken ill, and at once put to bed, where he remained several days; at the end of this time he was conveyed to his own house in Cabeçada, where he was confined three weeks longer. He had general fever, pain of back, &c., but no black vomit. His daughter, a girl of twelve years of age, was attacked on the tenth or eleventh day after his return to Cabeçada, and died in three days, with suppression of urine and black vomit. Another daughter, seven years old, was next seized, and died in four days; a boy eleven years of age was next taken ill, and died on the fifth day with symptoms similar to those of his sisters. His wife was attacked the same day the boy died; the disease in her case was protracted to fifteen days' duration, and was marked in its last stage, as it had been in the cases of her children, by black vomit.

"Such was the ominous commencement of the fever in the populous district, Cabeçada.”* P. 89.

* It thus seems that the fatal case of Pathi's daughter occurred some days before that of Anna Gallinha in Porto Sal Rey. Here it may be right to state that although Pathi, as we have seen, sickened at Moradinha, and remained there in bed for several days before returning to his own house at Cabeçada, yet no other case of fever occurred in the former place until the month of December, when a woman came sick from Rabil, and died shortly afterwards.

1847]

As it appeared at Boa Vista.

225

It is scarcely necessary to follow the course of the pestilence in this place. All the evidence goes to shew that it originated from the family of Pathi. His house was situated in the most crowded part of Cabeçada, and adjoining to it were the houses of Manoel Fachina, Joaquim Marques, Joaquim Pathi, and Manoel Rosa, who, after Luis Pathi's illness, were the first sufferers in Rabil. The disease soon appeared in the other parts of the town, more especially in the south-western direction.

The fever was most fatal in Cabeçada in the months of November and December, and in Boaventura from the middle of November to January. Some cases appeared in February and March. Dr. M. saw two as late as the beginning of April; but the disease was then in a mild form.

We shall not pursue the outbreak and spread of the fever in the other villages on the island. Suffice it to say that, in Dr. McWilliam's opinion, "the disease could in each case be clearly traced to one or two individuals coming from an infected district, and affecting first the inmates of the house they remained at, next the visitors, and gradually extending on the whole of the inhabitants. In fact, it may be said that, in each town and village on the island, the disease first appeared in a single house, which became an irradiating focus for its dispersion in all quarters."

The fever was supposed to have ceased entirely throughout the island by the end of April; but, three weeks or so afterwards, it again made its appearance at Moradinha, the village where Luis Pathi was taken ill, but in which the mortality had been remarkably small during the prevalence of the epidemic. Dr. McWilliam at once proceeded to the spot, and he found two persons, a girl of 14 years of age and a man about 35, with all the symptoms of a most malignant fever. His description of these symptoms is so vivid that we must not fail to give it :

"The countenance of the girl, a dark mulatto, was of a dirty lemon colour, shining through the natural darkness of the skin, made it resemble very much that of a light bronzed statue. A very strong fætor issued from the body, which tainted the room and drove us back from the door until the window was opened. She had complained much of pain along the spine, and still pointed to her head as the seat of pain. She had been bled in the arm by one of the neighbours, and all around the wound was of a greenish colour, swollen, and putrid. In the angles of the mouth there was dark frothy blood. She had had black vomiting; but this symptom had for some hours ceased. The urine was black, as were also the fæces. The former had been voided in very small quantities. Pulse small, irregular. She had been ill seven or eight days.

"The man had nearly the same symptoms, but in a milder degree, and he had not been affected with black vomit." P. 94.

The girl died next day; the man gradually recovered. He appeared to have been benefited by the use of small and repeated doses of Quinine. Dr. M. learned that there had been two other fatal cases of the fever in Moradinha, some days before it was discovered that the disease existed there. Four fresh cases occurred between the 1st and 3rd of June. "In none of them," says Dr. M., and we particularly invite the reader's attention to this remark, was there black vomit; they soon passed from the continued to the remittent form, and all recovered under the use of quinine, mild aperients, and nourishing diet."

Nevertheless, it is but right to mention that Dr. M. has remarked, in NEW SERIES, NO. XI.--VI.

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his concluding observations, that "remittents and intermittents were much less common among the convalescent than I had expected."

The account, given of the re-appearance of the fever at Moradinha, is as follows:

"A girl called Maria dos Prazeres was the first person attacked at Moradinha on this occasion. She had visited Joao Gallego and the other eastern villages on the 15th of May, and returned to Moradinha where she was laid up with fever on the 20th of the same month. Her mother who slept with her one night after she was taken ill, was also attacked on the 26th and died on the 29th, after three

days' illness. The girl whom we saw was called Perpetua. She had visited Maria, soon after which she was seized with fever, and died with the symptoms which have been already described, on the morning of the 1st of June.

"The disease did not extend to Rabil or any of the other villages, and on the 13th of June the whole of the remaining patients were convalescent; and when I left the island on the 15th of July last, there had been no case of fever for thirty-three days, and no deaths had occurred since the 1st of June, or during a period of forty-five days." P. 95.

The following table shews the total amount of the actual and of the relative mortality among the different classes of the inhabitants of the island of Boa Vista, during the prevalence of the fever.

Ratio of Mortality

Amongst Portuguese, Spaniards, and French, who were

exposed to the Fever

English and Americans

Native population-Slaves

Free

Average mortality of native population

* To this number we must add 3 more out of the eight additional cases, which occurred at Moradinha between the 20th of May and the 3rd of June.

1847]

As it appeared at Boa Vista.

227

Dr. McWilliam found it quite impossible to ascertain, with any degree of correctness, the number of persons attacked in the several villages; but, from the best information he could obtain, he believed that about twothirds of the whole population of the island was affected by the fever.

When he left the island at the end of the second week in July, no case of fever, as we have seen, had occurred for upwards of four weeks, and no death for six weeks. The disease had not, in any one instance, extended to any of the other islands of the Cape de Verd group. A rigorous quarantine had been kept up, during the whole time, against Boa Vista. It was stated in Dr. Stewart's report that yellow fever existed at Porto Praya in San Jago, while the 'Eclair' was at Boa Vista. This statement, we are told by Dr. McWilliam, is not correct. The only fever at that time existing in San Jago was the usual endemic remittent, which prevails there every season during and after the rains; nor was it then more severe than ordinary.

There cannot be a doubt but that the fatality of the epidemic at Boa Vista was not a little aggravated by the great scarcity of provisions which had existed in the island for some months, and by the utter want of any medical assistance whatsoever during the greater part of the prevalence of the fever. The poverty and the destitution of the people, the filthy state of the streets and of the houses, the presence of a quantity of stagnant putrid water in the immediate vicinity of the town of Porto Sal Rey, in conjunction too with the very great heat of the weather, must all have contributed to render the febrific poison more fatally malignant.

The mortality occurred chiefly among persons of from 12 to 35 years of age, and death took place generally between the third and seventh days. "Of second attacks," says Dr. M., "I could only find five cases at all clearly established; from the little appreciation that the people have of time, it is not possible to arrive at the exact intervals between the attacks."

Let us now see what are the general deductions, which the conscientious and enlightened reporter has drawn from a calm and minute examination of all the facts connected with the memorable history of the "Eclair fever" throughout its entire course.

"Under ordinary circumstances, the fever which attacks ships' crews on the African coast is the common bilious remittent. Seldom if ever has it happened that a disease characterized by black vomit has at once broken out in a ship. This malignant symptom rarely occurs, even on shore, except during some of the more severe epidemic visitations. Judging, therefore, from the result of general experience, as well as from the medical reports, it seems to me to admit of no doubt that the disease which invaded the Eclair' in the latter end of May and early part of June 1845, was the usual endemic fever of the African coast, which although a most fatal disease, is not considered to be of an infectious or contagious nature. The mental despondency which seems to have pervaded the crew rendered them indeed peculiarly susceptible of disease, not only while on detached service in the boats up the river, but also on board the ship (around which the commonly recognized causes of fever were in great abundance), and on this account it is probable that the fever was of a more aggravated type than usual.

"At Sierra Leone, the irksome and unwholesome duty of cleaning the hold of the Albert,' as well as that of their own vessel; the unwonted exposure in some cases by day and night; the irregularities committed by men who had for

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some months been exposed to morbific influences; all combined to the development of a fever of a much more malignant nature than the usual endemic of the African rivers.

"Accordingly, several of the cases that occurred after the ship left Sierra Leone were marked by unequivocal black vomit-a symptom, as has been already mentioned, extremely rare in the endemic fever, and regarded by all who have served in hot climates, as a test of unusual malignancy.

"It is thus quite evident that the type of the fever changed materially for the worse during the passage from Sierra Leone to the Gambia and Boa Vista, There is also great reason to believe that it acquired still greater virulence while the crew were at the Fort. The house in which the sick were lodged there contains only one room at all well ventilated; and, judging from the evidence of Dr. Almeida, they must have been much crowded; at all events, the fact is beyond doubt, that the accession to the sick list and the mortality became much greater at this than they had been at any previous period. In short, from the endemic remittent of the African coast, the disease had, from a series of causes, been exalted to a concentrated remittent, or yellow fever." P. 105.

Such is Dr. McWilliam's deliberate opinion; an opinion, it will be perceived, in entire accordance with the whole of the reasonings and statements adduced in the early part of this article, which, it is but fair to ourselves to state, was written some time ere we had received Dr. M.'s report. The following passage cannot fail to be read with interest, as an interesting comment on much that has gone before.

"Sir William Pym and those who espouse his doctrines will contend that the fever of the Eclair' was from the first a contagious disorder, differing essentially from the remittent of the African coast. If a disease such as that described by Sir William Pym be really endemic on the coast, surely we ought to hear more of it, considering the large squadron which is now kept there.

·

"If it be assumed that the fever on board the Eclair' was the Bulam, and therefore primarily contagious, I would ask where was it contracted? Not at Seabar, for in that case we would expect other vessels that visited that part of the station to be affected with a similar disease. Was it at Sierra Leone? For if so, why were not some of the many Europeans from the numerous shipping there, attacked with a fever manifesting contagious qualities? And we know that while the Eclair' was there, there was nothing unusual either in the amount or nature of disease in the colony. The same may be said of the Gambia. Assuredly the remittent is quite destructive enough of human life; and in the late Niger Expedition, where its fatal effects were manifested in a terrible degree, there was no reason to believe that its spread was due to contagion. The whole of the surviving sick were landed at Fernando Po, after we got clear of the Niger, yet none of the residents there suffered in consequence, although many officers and men died at Clarence Cove. Why did this malignant disorder rage on board the Eclair' and not in other vessels that were with her? Simply because her circumstances were peculiar, and it is entirely to this peculiarity and unwonted

"You were, I understand, requested to see the people of the Eclair?'Yes, I was requested by the Governor to go to the Fort and see the sick of the 'Eclair' there.

"How did they seem to be lodged there?-They seemed to be extremely crowded. I could hardly pass between them. In one small room there were about twelve sick persons.

"How many sick were there altogether when you visited them at the Fort ?I should say about thirty, if not more."