Report on the outbreak of the plague at Sydney, 1900 / by the Chief Medical Officer of the Government and President of the Board of Health.

  • Thompson, J. Ashburton (John Ashburton), 1848-1915.
Date:
1900
Catalogue details

Licence: In copyright

Credit: Report on the outbreak of the plague at Sydney, 1900 / by the Chief Medical Officer of the Government and President of the Board of Health. Source: Wellcome Collection.

Provider: This material has been provided by King’s College London. The original may be consulted at King’s College London.

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    It must bo remembered that the time represented by the colour black was consider- able (thirty days exclusive of Case 1) and that elucidation of the place of infection lay in reality with the circumstances surrounding the earlier cases of this period; and then, secondly, that the nature of our possible source of local infection had been established at an early date. It did not consist in an infection of the soil; no other reason in support of that supposition coukl be given than an assumed automatic commencement of specific infectivity of it, which, of course, is absurd. On the other hand it was already known to bo present in the rats of the locality. Now rats are not confined in place, but can wander, aad in accordance with their known habits Avere sure to occupy a wider area, or to migrate to different areas as time went on; and hence the black s])ots on Diagram B are concentrated about the original focus of infection only as regards the earlier numbers of the series, and even then Avitli exception of Cases 4', 6, and 7. In fact, towards the end of the series indigenous cases began to appear at points rather far removed from the original focus (Case 20 at Ptowe-street, City, 22 at Windmill-street, City, 23 at Walker- street, on the Hedfern focus); and then, as time went on, cases began to be met with in Avhich, although in some instances the patient was employed in or close to the original focus of infection, his case could not reasonably be referred to his place of employment on account of cessation of the neighbourhood it indicated to furnish a succession of fresh cases—because, in short, that focus had ceased to be dangerous. Also, other cases in persons who never had been near the original focus, and who had not been away from their place of residence, began to be met with in appreciable proportion (women and children especially), and with the neighbourhoods in which these occurred some of the cases just before referred to were associated. It became apparent, after careful study of all the circumstances, that fresh foci of infection had become established, and that it was no longer possible (as at first it had been) to assert a priori that wherever a patient might be found it would j)robably be ascertained on inquiry that he was in some way associated with the eastern side of Darling Harbour. The dissociation of these later cases l)oth in place of residence and in personal communication continued to be as conspicuous as at first; if they lived in the same neighbourhood still their houses were more or less distant from €ach other, and although they might all possibly have encountered each other in the streets, by far the most often they were unacquainted. Consequently these neighbourhoods gradually became distinguish- able, and entitled to be designated fresh foci; and as soon as this conclusion presented itself the same relation between them and the presence of diseased rats in them was observed, as had been first observed at the original focus. In many cases the evidence consisted merely in the reported observation of an unusual number of rats, and of dead rats, or of the death of rats in unusual places— under floors, in cupboards, or outhouses, &c. ; but in some casesj elsewhere mentioned more particularly, it consisted in actual detection of plague in sick or dead rats, or (in one case) in a cat. Thus Diagram C, which represents the probable place of infection, was constructed from the whole of the facts concerning each case, after they had been weighed. It is in reality, therefore, an expression of opinion—very carefully formed, it is true, but not to be taken in all respects as a representation of ascertained fact; and that is the reason Avhy Diagrams A and B (which state ascertained facts only) are presented along v/ith Diagram C. On Diagram C the black dots are shown almost entirely gathered together on the eastern side of Darling Harbour, and at the northern end of that shore. Cases 4 and 7 still occupy the positions originally assigned them—in other words have still to be regarded as indigenous to those places, or, at least, as having no personal connection with the original focus; and now Case 23 appears at Walker-street, Eedfern, due west of the five dots indicating Case 7. It is the first in immediate relation to Case 7, and the garbage tip at Moore Park, and is seen to have belonged to a considerable collection of cases which occurred thereabouts at later dates. And thus, perhaps, a hint of a possible source of the infection received by Case 6 (Diagram A) is indicated; far as he lived from any area known at the date of his attack to be infected, he attended Bnllanaming-street School, and to reach it crossed the area on which Case 23 occurred. To later extension from that area are also ascribed the cases to the north which are marked about the words Surry Hills, east from Redfern terminus. These patients had no concern with Darling Harbour, nor even with any neighbourino; part of the City.
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