Saturday, 3 March 2012

Edwin Chadwick - Disease (1842)

"Dr. Copeland, in his evidence before the Committee of the House of Commons, adduced the following remarkable case, stated to be of fever* communicated after death :

About two years ago (says he) I was called, in the course of my profession, to see a gentleman, advanced in life, well known to many members in this house and intimately known to the Speaker, This gentleman one Sunday went into a dissenting chapel, where the principal part of the hearers, as they died, were buried in the ground or vaults underneath. I was called to him on Tuesday evening, and I found him labouring under symptoms of malignant fever ; either on that visit or the visit immediately following, on questioning him on the circumstances which could have given rise to this very malignant form of fever, for it was then so malignant that its fatal issue was evident, he said that he had gone on the Sunday before (this being on the Tuesday afternoon) to this dissenting chapel, and on going up the steps to the chapel he felt a rush of foul air issuing from the grated openings existing on each side of the steps ; the effect upon him was instantaneous ; it produced a feeling of sinking, with nausea, and so great debility, that he scarcely could get into the chapel. He remained a short time, and finding this feeling increase he went out, went home, was obliged to go to bed, and there he remained. When I saw him he had, up to the time of my ascertaining the origin of his complaint, slept with his wife ; he died eight days afterwards ; his wife caught the disease and died in eight days also, having experienced the  same symptoms. These two instances illustrated the form of fever arising from those particular causes. Means of counteraction were used, and the fever did not extend to any other members of the family. Assuming that that individual had gone into a crowded hospital with that fever, it probably would have become a contagious fever. The disease would have propagated itself most likely to others, provided those others exposed to the infection were pre-disposed to the infection, or if the apartments where they were confined were not fully ventilated, but in most cases where the emanations from the sick are duly diluted by fresh air, they are rendered innocuous. It is rarely that I have found the effects from dead animal matter so very decisive as in this case, because in the usual circumstances of burying in towns the fetid or foul air exhaled from the dead is generally so diluted and scattered by the wind, as to produce only a general ill effect upon those predisposed ; it affects the health of the community by lowering the vital powers, weakening the digestive processes, but without producing any prominent or specific disease.”


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