Epidemic

“ The Progress of an Epidemic That it is at least as difficult to stay a moral infection as a physical one; that such a disease will spread with the malignity and rapidity of the Plague; that the contagion, when it has once made head, will spare no pursuit or condition, but will lay hold on people in the soundest health, and become developed in the most unlikely constitutions: is a fact as firmly established by experience as that we human creatures breathe an atmosphere. ”

“ And speaking of disease, let me give you another fact that should be widely known. Every obnoxious epidemic with which our city has been visited in the last twenty years has originated here—ship fever, relapsing fever and small-pox—and so, getting a lodgment in the body politic, have poured their malignant poisons into the blood and diseased the whole. Death has found his way into the homes of hundreds of our best citizens through the door opened for him here.”
“Can this be so?” exclaimed Mr. Dinneford. ”

“ When any large proportion are down at once, the doctors call it an epidemic, and it is attributed to a “wave”—an epizootic or influenza wave, for example, according as the victims are horses or men (the poor animals depend upon the elevated race for their habits, and never have disease except these are unphysiological) ,—when, in fact, the so-called epidemic, whether it be10 scarlet or yellow fever, diphtheria, or what not, is the result chiefly of the uniformly bad living habits of our people and their consequent predisposition to sickness. ”

“ Sect. 12.—Form of the Disease.
The notions of contemporary writers respecting the phenomena and the course of the sweating epidemic are, it is true, individually unsatisfactory and defective [331] ; yet collectively, we may gather from them a lively and complete picture of its effect on the human frame; especially from the German observers, who reported truly and honestly their own, as well as the general experience of their age; for the English had up to that period described little more than the external appearances of this epidemic, which had already attacked them for the fourth time. ”

“ Surely the places where dangerous infectious diseases are constantly propagated on a gigantic scale, and disseminated therefrom into the bodies of millions of animals and mankind, should be the very possible or probable source of epidemic disease. ”

“ To realise the horror of the Plague, let us imagine an epidemic as contagious and as infectious as influenza was some few years ago spreading everywhere, the great majority of its victims dying in the most terrible sufferings. ”

“ In a common source epidemic, as where members of a population contract a non-contagious disease from a poisoned well, the disease spreads only by exposure to the common source. If one eliminates the source, or closes the contaminated well, the epidemic is stopped. ”

“ We talk of the infection of a fever, but we often forget that prejudices are infinitely more infectious. The poor man, ill-fed, ill-housed, ill-clad, destitute, heart-sick, and weary, falls victim to the first epidemic that crosses his path. ”

“ Whether this be true or not, it is very certain that when an epidemic is threatened or prevailing, the people who are constantly talking about and discussing the disease, the newspapers which daily report its progress and fatality, and the doctors and nurses who ventilate their experiences, who predict evil, speak ominously and enjoin all sorts of precautions, [241] are themselves fomenters and carriers of the disease, infectious centers to the whole community. ”

“ That the epidemic current of disease wherever men exist and congregate together, must, in the first instance, resemble the contagious so strongly as to make it impossible to distinguish the one from the other, must be self-evident ”

“ Facts such as these help us to understand the production and propagation of disease through the medium of an infected atmosphere, whether on a large scale, as in the case of an epidemic which rapidly extends over a nation or a continent, or on a small scale, in the sick chamber, the dissecting room, the church, and the church-yard. ”

“ Examples are furnished in the small-pox, the plague, the measles, and, if we may include diseases not febrile, the leprosy, the itch, and the venereal disease. The latter, on the other hand, are not always in existence, they are called forth from nonentity by the causes of general diseases or epidemic constitutions, and they disappear again after the extinction of the epidemic diseases by which they were bred; they likewise vary in their development and their course in each particular epidemic. ”

“ If an epidemic begin in a definite locality and spread from that locality, and if there is no loss of infectivity on the part of the organism, it is demonstrable that a similar proportion of the population should be attacked in each zone as the epidemic spreads outward. ”

“ It is beyond dispute, that the plague appears in a different manner in different countries; and that it appears differently in the same country in different years: for we find most other diseases alter more or less, according to the constitution and disposition of the air in the same climate: for, some years, fevers are epidemic, and very mortal: other years, they are epidemic, but not mortal ”

“ The disease attacked the most robust and strong, and spread without interruption over the entire kingdom, from east to west. In a very short period vast numbers of the population fell victims to this strange epidemic. ”

“ Galen explains under this head that the term epidemic is not applied to any one disease, but that when many cases of any disease occur at the same time in a place, the disease is called an epidemic; and that when it is remarkably fatal it is called a plague. ”

“ The means employed to put a stop to the epidemic embraced the instruction of the population against their superstitious beliefs, the discouragement of the exciting religious exercises, exorcisms, and pilgrimages, the isolation of the sick and their dispersion into neighboring districts, so as to prevent them from making a spectacle of themselves, and the institution of a regular medical visitation. The epidemic character of the disease was arrested, and the attacks suffered by the patients became less frequent and violent ”

“ It would appear, however, that to reconcile conflicting opinions, various modern writers of experience and talent have endeavoured to show that epidemic diseases, not contagious at their commencement, may acquire that character from confined air, filth, and other accumulations. ”

“ The modern mind can readily imagine how much disease was bred through this utter disregard of the laws of hygiene. Epidemics, particularly of smallpox, occurred with appalling frequency, and even when there was no epidemic the death-rate was immense. ”

“ For those who seem to be the most original in their inauguration of periods are only such as have been favourably placed by birth and education to imbibe the floating creeds of the whole race. They resemble the first cases of an epidemic, which become the centres of infection and propagate disease. ”

“ That there are predisposing causes to epidemic disorders, especially to the plague, the most fatal of them all, is not denied. These prepare the body for receiving the infection, but they will not, without that infection, produce the disorder. Of these causes so many are to be found in the conduct of mankind themselves, that we scarcely need to look for them any where else. ”

“ If the disease prevails extensively over a wide region of country, it is attributed without dispute to an epidemic influence. If it prevails in a single locality, as in a hospital, and not elsewhere, this is considered proof that some local cause is there active in its production. ”

“ For, towards the chemical constitution of local atmospheres, it seems that the several principles of epidemic diseases stand in the same sort of fixed respective relations, as do the several principles of infective fevers towards certain elements in the blood of individual persons. Just as the infective ferment acts on man, so appears the epidemic ferment to act on locality. ”

“ They had seen cases themselves, and could therefore distinguish by their odour those who were suffering from the true sweating epidemic, from those who were seized with fever arising from panic. They were constantly besieged by persons asking questions and seeking assistance; and when the disease was at its greatest height, the streets were quite illuminated at night by the lights of the relatives of the patients [291] , who were running in all directions in a state of distraction. ”

“ What are the causes of Epidemic, Endemic, and Infectious Diseases? The occurrence of Epidemic Cholera last year in this country, awakened a spirit of enquiry. Where there is unrest, whatever may be the cause, there also is disquiet and discontent. ”

“ Of all these notions and views regarding the plague, whose development we have represented, there are two especially, which are prominent in historical importance:—1st, The opinion of learned physicians, that the pestilence, or epidemic constitution, is the parent of various kinds of disease ”

“ To determine to a day when epidemics which have been long in preparation have broken out, is, even for an observer who is present, exceedingly difficult, nay, sometimes, under the most favourable circumstances, impossible; for there occur in these visitations, certain transitions into the epidemic form, of diseases which are allied to it, as well as a gradual conversion into it of morbid phenomena, which have usually begun some time before. Unless we are greatly mistaken, such was the case in the pestilence of which we are now treating ”

“ What kind of infection can that be which has befallen men on both sides of the Alps within the same short time in the 12th century as in the 19th? And what kind of infection is it which has outlived so many changes in the great pestilences of mankind, has seen the extinction of plague and the rise of cholera, and all other variations, most of them for the better, in the reigning types of epidemic sickness? ”

“ But of this I am confident, that the general rule is, that persons who attend the sick and dying, in cases of epidemic disease of a mortal type, with a fearless and cheerful mind, escape; while the timid, who are alarmed and have an implicit belief in the danger of contagion, succumb. ”

“ It is indeed extremely difficult, in view of the low level of development to which the science of Epidemics, in general no less than in particular, has as yet attained, to show this as applicable in any given case, more especially if it is a question of the epidemic condition of some disease of which the pathological relations themselves are far from being as yet adequately known. ”

“ All we can say is, we know into what dwellings cholera and fever will not come, however 'epidemic' the year; we can put towns and districts into such a state that the epidemic, like the mediæval witch, is exorcised, so that it cannot come near them. ”

“ It is indeed no easy matter to discover who was the first person affected with an epidemic, as no body chooses to own that either they, or any of their relatives were the authors of mischief, however involuntary, to the community. ”

“ The former, when once formed, whether in diseased persons or inanimate substances (fomites) , are always in existence, and are but called into activity by those causes of general disease (epidemic constitutions) which are favourable to their propagation; and it is to be remarked that under all circumstances, and at all times, they excite the same unchangeable diseases, and, varying only in particular ramifications or degenerations and mild forms, never lose their proper essence. ”

“ He don't allow them to have but two hacks now, and sometimes only one.'
'Well,' said I, 'if you are so light-hearted and jolly in ordinary times, what must you be in an epidemic?'
He shook his head.
'No, you're off, there. We don't like to see an epidemic. An epidemic don't pay. ”

“ We observe in camps and hospitals, that those people whose dirty employments subject them in a particular manner to a depravation of their habits, seldom193 escape the present epidemic; and this gives rise to the vulgar expression, and very incorrect notion, of catching the disease. And we observe that others from the slightest deviation from regularity lose the power by which the body resists diseases, and they are also attacked. ”

“ Finally, it is an observation universally made, and which may be regarded as established, ‘that the origin of epidemic diseases may often be referred to the putrefaction of great masses of animal and vegetable matters; that miasmic diseases are found epidemic, where decomposition of organic substances constantly goes on, in marshy and damp districts. ”

“ Experience appears to show that without this antecedent preparatory stage, affecting more or less the entire population of a town or district, the occurrence of an epidemic is impossible—the epidemic being, in fact, the last or, so to speak, the retributive stage of a succession of antecedent phenomena extending over months or years, and all traceable to the culpable neglect of natural laws. ”

“ When a great number of people are affected in a community by the same dis-ease in a short period of time it is said to be an epidemic. An epidemic is said to obtain when dis-ease breaks out suddenly and involves a number of persons at one time. ”

“ In rare instances the epidemics are heralded by scattered cases. But as a rule this disease attacks simultaneously great numbers of the inhabitants of affected districts, so that, when the epidemic is severe, the sick are in a short time to be counted by thousands and business is paralyzed as by a blow. Epidemics rapidly reach their height, and subside almost as suddenly as they began. ”

“ Such distinctions will appear to be more important and necessary for the prevention and mitigation of epidemic pestilence or disease, when properly considered, inasmuch as the predisposing causes, which are in a great degree under our control, are always in existence or operation to a greater or less extent, while the exciting causes may be said to be of only occasional occurrence. ”