Plague : papers relating to the modern history and recent progress of Levantine plague / prepared from the time to time by direction of the president of the Local Government Board, with other papers ; sented to both House of Parliament by Command of Her Majesty.
- Radcliffe, Netten.
- Date:
- 1879
Licence: Public Domain Mark
Credit: Plague : papers relating to the modern history and recent progress of Levantine plague / prepared from the time to time by direction of the president of the Local Government Board, with other papers ; sented to both House of Parliament by Command of Her Majesty. Source: Wellcome Collection.
Provider: This material has been provided by Royal College of Physicians, London. The original may be consulted at Royal College of Physicians, London.
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![Some persons have conceived the idea that a marsh-miasm might be the exciting cause of this pestilence, but Dr. Cabiadis refutes this idea by quoting the immunity from plague enjoyed by Bussorah and Kerbela, two of the dampest cities in Mesopotamia, and both of them surrounded by marshes. Kerbela, in fact, stands on an island in the midst of a marsh, the waters of which reach up to its very walls. Midhat Pasha, when Governor-General of Bagdad, built a fine new quarter at its south-west end ; the whole of it, however, has now fallen down in consequence of the foundations being embedded in a slushy soil. Kerbela, therefore, according to the malaria hypothesis ought to be a spot favourable to the development of plague, and yet it has not been visited by that epidemic, notwithstanding that all the surrounding villages have been more or less attacked by it, and that persons suffering from the plague have gone to Kerbela and died there. Some persons have fancied that eating diseased cameVs meat might have caused the outbreak in Mesopotamia. In order to find out whether there were any truth in this assertion Dr. Cabiadis made a careful inquiry, but failed to discover any evidence in corroboration of it. He therefore infers that diseased camel's meat, like that of any other diseased animal, might predispose to an attack of plague, but not engender the malady. Proximate cause.—The most palpable and evident of all the causes which predispose an individual to an attack of plague during an epidemic outbreak, is poverty. No other malady shows the influence of this factor in so striking a degree ; so much so, indeed, that Dr. Cabiadis styles the plague miserioi morbus. In his experience he found that the poor were seldom spared ; the wealthy hardly ever attacked. Cholera also has a preference for the poor, but at the same time it spares not the rich, whereas plague attacks exclusively the poor. Here, again, Kerbela presents a striking proof of this fact. Its inhabitants are the most prosperous section of the whole population of Irak- Arabi (Turkish Arabia), and even its poorest classes can at all times live on a meat diet. Its streets are narrow and crooked, but the houses are spacious and well aired. Hillah is the very reverse of this: its houses are low, confined, and very imperfectly ventilated ; they are, moreover, generally encumbered with a horse, with poultry, and with two or three buffaloes. These animals constitute the resources whence the lower classes of Hillah derive a livelihood by selling milk and eggs to the wealthier inhabitants, while they themselves limit their own nourishment to barley bread, dates, and onions, with sometimes fish in a putrescent state. It is needless to add that Hillah suffered severely from the plague. Prophylactic Measures.—The most effectual means for the protection of a community against the propagation of plague—the isolation of the sick, the destruction by fire of their clothes, and, the whitewashing with lime and free ventilating of the domiciles in which cases of plague occur. The plague reappeared in only one out of 350 houses which had been whitewashed after an outbreak of plague in them, whilst its reappearance in houses that had merely been abandoned for a time, after an attack of that disease, but which had not been whitewashed, was of frequent occurrence. The other disinfectants tried, such as siilphur fumigations, lighting fires, and throwing a solution of sulphate of iron into the drains, gave no decided results, except when associated with the white- washing and airing of the infected house. Cordons Sanitaires.—Dr. Cabiadis believes that cordons sanitaires, properly enforced, are ex- tremely useful in checking the extension of an outbreak of plague. The greatest vigilance, however, is required to render them efficient, because the persons put to guard these cordons often allow passengers to evade them, either through neglect of their duties, or through the persuasive influence of bribes. He strongly condemns, however, the practice adopted at one time in Bagdad of shutting up persons smitten with the plague in their houses, and placing guards roxmd them to prevent com- munication with the rest of the population. The fear of this harsh and xmreasonable measure, caused the inhabitants to conceal the existence of the malady, and even to bury inside the house those who succumbed from it; thus, deceiving the authorities, and helping to intensify and propagate the evil it was intended to mitigate. Treatment.—Dr. Cabiadis can offer no suggestions worthy of trust, as to the best mode of treating J)] ague. The remedies chiefly tried at Bagdad and at Hillah, were leeches, and mercurial frictions to the swellings, combined with the internal administration of phenic acid, or sulphate of quinine. In some cases these remedies were thought to do good, while in others they proved useless, if not detri- mental, and Dr. Cabiadis is convinced that we know as little about the cure of this disease as we do about its essence. He concludes his interesting notes on this subject by expressing astonishment and regret that no public hospital exists in Bagdad, an extensive city of ] 50,000 inhabitants.* A large military hospital was built there by Midhat Pasha, on a fine and healthy site, but no use has been made of it. He therefore suggests that the Government should turn it into a civil hospital for the benefit of the people of Bagdad. Constantinople, February 10th 1879. E. D. Dickson, Physician to the British Embassy. * Population of Bagdad— Shiah Mohammedans Jews Christians (chieflyChaldeans) Soonnee Mohammedans - 30^000 Total - 150,000](https://iiif.wellcomecollection.org/image/b24751388_0062.jp2/full/800%2C/0/default.jpg)
