Mr Woodward and Dr Hennen - General George Don and Mr Martin
Hugh Frazer and Dr Gilpin - Dr Gardiner and Dr Burnett
Raphael Nahon and Jacinto Reys - Andrew Reys and Joseph Reys
Santiago and Francisco Prospero - Dr Grey and Staff-Surgeon Glasse
The 1831 publication of the Edinburgh Medical and Surgical Journal carried an article in which Romaine Amiel, the Surgeon of the 12th Regiment and a resident for many years in Gibraltar answered questions put to him by the Army Medical Board. They referred to the 1828 yellow fever epidemic at Gibraltar. (See LINK)
Gibraltar from the Neutral Ground showing "fever houses" ( probably late 19th century - Unknown)
Quite apart from Amiel's interesting comments as regards of his thoughts on the origin and progression of the epidemic, he also offers a source of historically interesting material on what Gibraltar was like in the early 19th century - especially in so far as public hygiene was concerned. The following are selected quotes from the Journal with comments where appropriate.
Query - What was the civil and military population of the garrison during these years, I827 and 1828?
Answer - I believe the civil population of Gibraltar might have been computed at 18,000 during the years 1827 and 1828, and the military at about 5000, including the women and children. The census taken in 1826 carried the civil population to 15,480, and the one taken in January 1829, at the close of the late epidemic, to 15,470.
Query - How were the garrison and inhabitants supplied with provisions in each year, plentifully or scantily?
Answer -The provisions have generally been abundant during these two years, and cheaper than at former periods. The troops were constantly supplied with wholesome food and with fresh meat three or four times in the week.
Query - Was there any deficiency of water during these years, in the wells or tanks? Report on the state of the tanks.
Answer - Water was formerly an article scarce and expensive in this garrison. But since 1814, every house which has been built has had a tank constructed in it. The number of these tanks, which now amount to about 250 or 300, affords a supply of tolerably good water; and we had rain enough during the two above-mentioned years to have prevented a deficiency in this respect; but the poorer classes have seldom access to those tanks, and must purchase water obtained from wells in the garrison, or on the Neutral Ground, which, at the latter part of the summer, is frequently thick and muddy, and at all times rather brackish.
Water collecting tanks and donkey carrying water in barrels for those without - the local custom was to put an eel inside the tank to eat whatever fell or grew in it. It was supposed to keep the water clean ( Early 20th century - Unknown )
Query - What was the state of the public sewers, and was any marked difference observed in the cleanliness or filth of the streets, houses, etc? Report at large on this subject.
Answer - l am not sufficiently acquainted with the construction and state of the public sewers in general, to submit correct and satisfactory remarks on this subject; but on referring to an official statement of Mr Woodward’s, surveyor of the Revenue Works, I find that the drains in the lower part of the town have but little declivity, and receive the soil and other filth from those in the upper part, into which the privies of the several houses discharge their contents.
The consequence is that either by direct winds from the west, or eddy winds from the east, the foul air is blown up from the line wall; and in hot weather, the streets and houses are filled with air so offensive and fetid, as frequently to make the people sick. The whole surface of the drains is covered with night soil, which, from the want of water to clean them, becomes in the warm weather an expanded ridge of rotten matter near the surface of the ground; and the offensive effluvia, disseminated over the whole place, cannot have escaped even superficial observation.
During the late epidemic the air was particularly offensive, and great numbers of rats were found dead in the drains. At their outlets on the line-wall, and in many places where Mr W. had occasion to direct their opening, he always noticed that they contained a great deal of filth, particularly at the lower part of the town.
It appears that, previous to the year 1814 there were very few drains in Gibraltar; and, for want of them, large accumulations of filth called Dirt's-depôts were established in various parts of the town. In 1815, the reconstruction of the drains took place, and, since that time, they have been continued at various periods up the hill-side; and the gullies have been covered, which undoubtedly is an improvement in the state of the drains.
In rainy weather, they have sufficient declivity to be cleared of their contents; but this cannot be the case in dry weather. In I828, the drains were much filled with filth, and it may be remembered that there was in the month of July some rain. On the 1st of August heavy showers fell . . . there was more rain, which brought the con- tents into action, so that the effluvia arising from them were very like those arising from the dirt deposits in 1814.
As to the state of the drains more particularly belonging to the barracks occupied by the 12th regiment, with the condition of which it has been my duty to make myself acquainted, I can state, that, both in the town-range and King's Bastion, they appear to have been, and continue to be defective. In the lower square of the town range, the drain from the soil-pit was choked up, and burst open a short time before the regiment was sent to camp: and, in the King's Bastion, the sewers at the north and south, probably from a want of sufficient declivity, frequently allow the corrupt substances to accumulate at their entrances, and emit during the summer months exhalations highly offensive, which, in several instances, have been complained of by the men, and reported to the authorities.
King's Bastion ( 1844 - George Lothian Hall ) (See LINK)
The drains about the south end of the building, where the Regimental Hospital is established, are likewise in a very defective state. They have been frequently choked up; and their opening in the kitchen, and in the centre of a very small yard, forms a permanent source of disagreeable, and, I may venture to say, pernicious exhalations.
In illustration of this it may be remarked, that the first hospital servant taken ill during the late epidemic was the cook of the establishment who slept in that kitchen, and the disease has been very severe amongst those who have been successively employed on the same duty. With respect to the cleanliness or filth in the streets or houses, I have not observed any particular difference between this and the preceding years.
In other words the place was as dirty as ever - this despite the creation of the Paving and Scavenger Committee and the much vaunted drainage system set up by General George Don. (See LINK) For the definitive description of Gibraltar's infamous Dirt's-depôts read Robert Montgomery Martin's British Colonial Library. (See LINK) The next few questions - which I have omitted - were about comparisons between the fever in the West Indies and Gibraltar.
Query - When and where, (i. e.) in what street or house, did you first observe the epidemic at Gibraltar; and was its progress clearly traced from any one point?
Answer - The first patient of the late epidemic, whom I personally saw, was a lance-sergeant (of Company No. I.) quartered at the King's Bastion. He was admitted into the Twelfth Hospital on the 2d September, and died on the 5th. But, from what I have been able to learn, the first cases of this fever had appeared about the latter end of August, in District No. 24; and this information is completely borne out by the official communication of the late Dr Hennen to his Excellency the Lieutenant-Governor dated 29th August 1828, an extract of which I take the liberty to subjoin:-
"I have the honour to state for your Excellency's information that, within the present week I have personally visited . . . five cases . . . which has made its appearance in a neighbourhood at the back of Hargrave’s Parade . .. Independent of these cases, which occurred amongst the poorer class of inhabitants, three or four of the family of Mr Martin, chief-clerk in the Civil Secretary's Office, have been attended in a similar disease by Mr Hugh Frazer, surgeon of the Civil Hospital; and it is not a little remarkable, that the fatal case seen by me occurred in a woman who was a servant of Mr Martin."
Hargrave's Parade ( 19th century - Unknown )
Query - Who were the first attacked with epidemic, consistent with your own knowledge, as separated from general report? Were they soldiers, sailors, inhabitants, as merchants or their families, or Jews, Moors, Spanish, or other foreigners . . . The period when the person had resided on the Rock should be noticed; and if recently arrived from another station, that should be noticed, and its healthiness adverted to?
Answer-As far as I could ascertain, the first cases of the late epidemic occurred in individuals of the lower class, residing in District, No. 24. My first patient . . was a lance-serjeant, who had been four years and a-half in the garrison, and who . . .had been disorderly, and in a state of intoxication, two days previous to his admission into the Hospital.
District 24
. . . in 1818, the neighbourhood of Boyd’s-Buildings was, as in 1804 (see LINK) the first spot on -which the disease made its appearance in Gibraltar; and, as early as the 6th of July, a highly suspicious case of fever, which proved rapidly fatal, was met in the person of a ferryman, who lived in that unfortunate situation; but it was on the 10th of September that Dr Gilpin, the principal medical officer, reported officially to the Board of Health, that cases of fever of a very serious type had, within a few days, become prevalent in town, and that masons, porters, bakers, and people exposed to hard labour, had been principally attacked.
In a footnote the editor describes Boyd's Buildings that as "a covered space of 29,200 superficial feet, and stood about 200 feet above the level of the sea, in the central part of the town, on a ground which appears originally to have been washed from the mountain down two gullies, at the bottom of which they were situated, and the streams of which they obstructed in the rain. These buildings were formally subdivided into small dirty, and ill-ventilated tenements, into which individuals of the lower class were generally crowded to an excess, and were considered for a long time as the filthiest spot in Gibraltar. They have since been replaced by roomy and commodious houses, perhaps the best built in the whole garrison."
Boyd's Building was at the corner of Governor's Street and Library Ramp - just next dooor to the Garrison Library ( See LINK)
The first case of black vomit which I personally observed during that season occurred about the beginning of September, in a gardener who lived at the south end of the South Barracks. He was a Genoese, and had for some time resided in Gibraltar. In 1814 the cases which first alarmed the garrison occurred about the 18th of August on the hill side, at Cavallero’s Buildings, situate close to Arengo‘s-Gully, (see LINKJ) and at the top of the central part of the town.
These buildings competed at the time with Boyd's for want of cleanliness. They were inhabited by about 300 Portuguese of the lower order, and, close to them, there was an accumulation of filth, (one of the dirt's deposits . . . ) which emitted a very offensive stench, and attracted an incredible swarm of flies, which, infecting the whole neigbourhood, became at the time the subject of general observation and surprise.
I may assert, indeed, without fear of the correctness of the assertion being questioned, that, whenever the epidemic has appeared in Gibraltar, it has always commenced in the filthiest spot, among the lower and more disorderly class of inhabitants; and that this was the case in the late visitation . . .
The final eighteen pages are given over to as discussion as to the origins of the disease and its symptoms, and treatment and who seemed to have been more or less likely to have suffered from it. Amiel also answered questions on the effects of the same epidemic on the populations of nearby Spanish towns. Although Amiel belonged to that species of medical men of the day who did not believe the disease to be contagious it is hard to tell what it was that he thought caused it. Local filth was certainly high on his agenda but I think he suspected that this was not the real cause. During the remainder of this article I will restrict myself to quoting any of his answers which specifically mention a named individual.
. . . Dr Gardiner, surgeon to the Naval Hospital, and member of the Board of Health established in this garrison in I813, said, in a communication to Dr Burnett, then Physician to the Fleet, “ That the disease did not spread from any focus, but broke out in fifty different places at once." . . .
Raphael Nahon . . . he had taken refuge on the Neutral Ground . . . in a shed with his family (seventeen in number) and died there on the 2nd of November . .
An overcrowded Neutral Ground with temporary civilian village and camps for soldiers and wives (1830's - Piaget et Lailavoix )
I was at that time desired now and then to visit some inhabitants labouring under a fever presenting the same symptoms; especially in the neighbourhood of Scud-Hill. On the 20th October, I was called to see Jacinto Reys, a carpenter in the dock-yard, attacked with fever. He had been working three or four days on board the San Juan, lying in the Mole, where he was taken ill. . . .
On the 22d of October, Andrew Reys, an elder brother of the patient, who lived in a neighbouring house, and had been in the habit of visiting him frequently, was taken ill with the same leading symptoms; and in the course of three days, the mother, the grandmother, a child, and a person who lived on the same floor, were taken ill of a fever resenting the same symptoms as Jacinto Reys.
Andrew Reys died of that fever on the 26th of October; the rest of the family were sent to perform quarantine on the Neutral Ground, and sentries were placed around the houses they had left, to prevent any intercourse of the inhabitants, with that spot. . . . A younger brother, however, named Joseph Reys, fourteen years old, who had been very healthy on the Neutral Ground, was, three days after returning to his house, seized with a fever which presented the same symptoms as his brothers, but in a more aggravated form. On the third day a vomiting of a black matter came on, and he died on the fourth day . . .
. . . the circumstance of two Genoese, Santiago and Francisco Prospero, having been taken ill in the neighbourhood, and on the same day . . . without having had any communication with the Reys’s family, disproved such assertion; and considering that the small district where those fevers broke out was then so filthy, crowded, and unventilated, as to have induced the Lieutenant-Governor to order nine sheds to be removed from a space of ground not exceeding 3000 superficial feet, it appears highly probable, that the disease had originated in that spot, from local and domestic causes.
A housing survey in 1816 found that there were only 48 houses in the South and that the sewers and drainage in the area were in a dreadful condition. Ironically the opening of the Alameda Gardens in 1816 and the fact that on the whole this part of Gibraltar was much less overcrowded than the town itself led most visitors to think of it as a rather attractive - even romantic place.
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The romantic view - South Barracks on the far left, the South Mole on the right and not a drain in sight (1825 - John Varley )
. . . at the commencement of September, two gardeners died in the south, one opposite Cooper's Buildings, and the other near the South Barracks . . .
Dr Grey, physician to the Mediterranean Fleet, and for some years to the Naval Hospital in this garrison, after having stated, in a report to the Transport Board, that the bilious remittent fever is more or less endemic in Gibraltar during the summer and autumnal months . . .
Staff-Surgeon Glasse, whose veracity is so well known in this garrison, where he had resided ten years, says in a document which has been published, “During the autumn, I have been in the habit of solitary cases of fever attended with black vomiting and other severe symptoms." . . .Amiel ends his question and answer ordeal - which took place in Gibraltar on the 24th February 1839 - as follows.
. . . it is a disease of an endemial character, produced by local causes . . .This character of the disease, founded on the evidence of facts, leads to the inference, that cordons of troops, or any sanitary measures which tend to keep the population within an infected district, will only aggravate the evil, and be attended with that fear and consternation so fatal in every epidemic; and that the progress of the disease may only be effectually checked by restoring, if possible, the healthfulness of the locality, and at any rate, by a speedy removal from the source of sickliness.It would take more than half a century to find out exactly what the problem was.
Generally the most notable aspect of this question and answer session is the reluctance of either the interrogator or the interrogated to blame the British administration for anything. One can accept that the real cause of the disease - or at any rate its vector, the Aedes aegypti mosquito, was unknown and that even if it had been known it would have been difficult to do anything about it at the time. What is less acceptable is that almost everybody with any medical authority - whether they subscribed to contagious or the non-contagious theories - were all convinced that the generalised filth found in the Garrison at the time had something to do with it and that this was entirely the fault of the poorer members of the civilian population.
No blame whatsoever was apportioned to those British administrators who should have done something about it but did not - including General Don who was and still is considered as the one of the best Governor Gibraltar has ever had - This type of Pontius Pilate washing of hands is not unique to Amiel - rather it permeates just about the entire literature of the day.