Notes on the measures adopted by Government in 1775 to 1786 to check the St. Paul's Bay Disease

 

By Andrew William Cochrane

 

[Originally published by the Literary and Historical Society of Quebec in Transactions, Original Series, Vol. 4, No. 3 (1855)]

 

(Read 6th March, 1841.)

 

About the year 1773, the attention of the Government of Lower Canada was drawn to the increasing ravages of a peculiar disease, which, originating at Mal Baie, had spread to other parts of the Province. A. tradition exists, that it was imported into Mal Baie, by a detachment of Scotch troops who were either sent there on service, or were thrown there by some accident of navigation some years before; but, there will appear much reason, in the sequel, to doubt the correctness of the supposition. The fact that most militates against it, is the spread of the disease, in a manner resembling more nearly an epidemic than a contagion, to remote parts of the Province, between which and Mal Baie there could not then have been much communication.

 

The great resemblance of the disorder to some forms of syphilis, and it disgusting character, led the unhappy sufferers, who were aware of that resemblance, to conceal their condition as long as possible, while those who were not aware of it, looked upon the symptoms as the result of scorbutic humours, and trusted to ordinary remedies, or to time, for relief; and, from both these causes, in addition to the remoteness of the ; parish where the disorder first made its appearance, and the want of medical assistance on the spot; the evil was unknown, until it had reached such a height as to require the attention of Government.

 

The characteristics of the disease are stated in a printed description, circulated by Government, some time in 1785, with directions for cure. (See Appendix, No. 1.)

 

Shortly after it first attracted the attention of Government, in 1775, General Carleton, the then Governor, sent a surgeon's-mate, of the 7th Regiment, to St. Paul's Bay, with instructions to administer medical relief, gratis, to the persons infected with the disease. The officer was recalled to Quebec, the same year, upon the invasion of the Province, by the Americans, and dying here the following summer, General Carleton then appointed Mr. Badelard (who had been surgeon of a French corps) to be Hospital or Surgeon's-mate to the Garrison of Quebec, with a view to employ him in the same service. Mr. Badelard was ordered, from time to time, by General Carleton, and after his departure, in 1778, by General Haldimand, to repair to Saint Paul's Bay, and other Parishes, as occasion required, where he treated the persons infected with the disorder with success. When the reduction of the Hospital Establishment took place, in l782, General Haldimand still continued Mr. Badelard, on the Staff of the Garrison, for the same service, and that gentleman visited different parishes, remaining in some a week or a fortnight at a time, to attend to infected persons. In 1783, the subject was taken up in Legislative Council, who, during the Session of that year, represented to the Governor, by an Address, "The anxiety and concern which the alarming progress of this disorder, then commonly called the St. Paul's Bay disease, had caused in the Province, and while they acknowledged their sense of the measures which His Excellency's humanity and attention to the welfare of the I people had induced him to take, in order to remedy the evil, they requested, that by means of the clergy or otherwise, a list might be obtained of those infected in the different parishes, and pledged themselves to support such measures as should be taken by the Government to arrest the evil." In March, 1784, the Governor informed them, that by the returns of the clergy, it appeared, that the number of persons infected was less than had been supposed; and that the poor, in the parishes near Quebec, had been attended and treated by his orders, and that the same measures should be continued. In March, 1785, General Haldimand having then quitted the Government, his successor, General Hamilton, informed the Council, that he had employed a person, (Dr. James Bowman) to go through the country parishes, and take the necessary means to extirpate the disease. (See Instructions, 18th April, 1785, Appendix, No. 2.) The Roman Catholic Bishop, at the request of the Government, addressed a circular to the Clergy on the subject, sending them copies of the printed paper already referred to, describing the disease and the method of cure. Dr. Bowman, in the course of the following summer, visited most of the parishes in the Province, and, in almost all of them, according to his account, found persons infected with the disease. In 1786, he repeated his visit to many of the parishes, and his Returns to Government, for the two years, exhibited the following results:—

 

Visited 1785: 5,801

Visited 1786: 4,606

Difference between increase in some Parishes: 673

And decrease in others: 124

= 549 + 5801 = 6,350

Doubtful: 90

Total supplied with medicine: 6,440

Of whom returned as cured, in 1786: 807

 

The abstract, shewing these results, was formed upon certificates, sent by the Clergy, of the persons to whom medicines J had been supplied under Dr. Bowman's directions; but, upon his presenting his account against Government, for this service, in which he charges five shillings a head for each person so supplied, amounting, with travelling charges, postages, and personal remuneration, to about £2.500, the Government saw reason to institute a close investigation into the extent of the services actually rendered by him in 1785; and, it appeared, that there was reason to doubt whether they had been as extensive as he had represented ; that he had supplied medicines, in some places, where no sickness existed, and that he could not have visited at all, other places mentioned in his return, that in most cases visits must have been so short, as not to allow of sufficient enquiry and examination, (since he travelled, by his own account, 800 leagues in four months of 1785 and, in one instance, administered advice and medicines to 500 persons, in two days, in parishes some leagues apart); and, that in other cases, the Clergy gave him certificates of medicines being furnished, upon his mere promise to send them.

 

But, making large allowance for error and misrepresentation on his part, the return of the Clergy, showing the number of persons appearing to be infected with the disease, exhibit an

extraordinary proportion, in a population not then amounting to 120,000 souls. The largest number appear to have been found in the following parishes.

 

1785 1786

St. Paul's Bay                                                            328                 317

St. Thomas                                                    118                 183

St. Pierre, St. François, Rivière du Sud     120

St. Charles, St. Gervais                            231                 219

St. Marie, St. Joseph, St. François                    148

St. Nicholas, St. Antoine                             125

Yamaska                                                       228                 228

St. Ours                                                          163                 161

St. Charles                                                    156                 194

Blairfindie                                                      116                 128

St. Philip, La Tortue                                    178                 238

Vaudreuil                                                       106                 120

St. Martin, St.Rose                                              107                 133

Mascouche                                                    190                 190

St. Jacques, St.Roch                                              153

Boucherville                                                   112                 120

Repentigny, St. Sulpice                             205

Berthier                                                          248                 248

St. Cuthbert                                                   135                 149

Rivière du Loup                                       133

Deschambault                                                           70

 

The Parishes of Berthier (D. of Quebec), Batiscan, Champlain, St. Augustin, St. Foy, Two Lorettes, Charlesbourg, Beauport, St. Famille (I. of Orleans), St. François, do., St. Joachim and Isle Verte, and the Indian Villages, returned none infected.

 

1785 1786

Mal Baie                                                        only 9              23

St. Roch                                                         15                   22

St. François (T. R.)                                    6                      15

La Chine                                                        14                   14

Pointe Claire and St. Anne                         7                      26

St. Laurent                                                     17

Pointe du Lac                                                           7

T. Rivers and Cap Madeleine...             13

St. Geneviève and St. Stanislaus.                 17

Point aux Trembles, Ecureuils                    4

St. Jean (I. of Orleans)                                 4

St. Laurent (Do)                                       12

St. Anne, St. Fereol                                    7

 

It will be seen, by this enumeration, that the disease prevailed most in some parts of the Province, where, from the richness of the soil and the settlements having been long made, the inhabitants must have been far above the condition of poverty—and, that looking to the character of the localities, if on the one hand, it appears to have been most rife in places where the soil is alluvial, and the settlements are formed on ruins,—on the other hand, places so situated, either appear to have escaped entirely or to have but few cases, and that it made considerable progress in other places of an elevated locality.

 

Then with respect to the subjects attacked, it appears to have been equally capricious; sometimes a child at the breast was seized with it, the mother or nurse remaining well, and vice versà- no age was excepted; the manner of its propagation was equally obscure. It was supposed that it was taken, in some cases, by merely drinking out of the same cup, or using the same spoon with an infected person, or by the contact of clothes. It is denied, by many eminent medical authors, that the disease to which this disorder would seem to bear considerable resemblance, can be communicated by mere contact, without an abrasion of the skin; but, supposing that this disorder could be propagated by mere contact, how are we to account for the facts above referred to, and established by good evidence, that infants at the breast were attacked when the mother was not; and, how in the state of the Province at that time, when a communication hardly existed between St. Paul's Bay and the parishes of the Montreal District, are we to account for its spreading to localities so remote?

 

The methods of cure are indicated by the printed paper, circulated by Government, and it appears from other sources, that mercurial medicines, zinc, and preparations of hemlock, and large quantities of bark, were among those chiefly used. It is to be regretted, that the observations, made by Dr. Bowman, on the disease, and the notes of his treatment of it, in different cases, which he laid before the Government of that day, are not to be found. It appears, however, that there existed at the same period another disease, something resembling it, but not running the same course, which is described, by an intelligent Curé, as follows:—"Ce sont des ulcères, fixes ou mobiles ordinairement aux bras ou aux articulations des jarrets, d'où distille une humeur rougea tre et un peu purulente, accompagnée d'une cuisson très-douleureuse dans la partie ulcérée,des douleurs se font quelques fois sentir aux reins ou à l'estomac; les sujets sont sains d'ailleurs. Ce sont disent-ils des reliquats d'échauffaisons dont ils n'ont pu guérir depuis nombre d'années."

 

A pamphlet was published, in 1785 or 1786, at Montreal, on the disorder as it appeared there, with a statement of cases and their cure; and, when Dr. Nooth, a physician of eminence, belonging to the army, was at the head of the Military Hospital Department, in this country, a few years after Dr. Bowman was employed, and while his claims were still before the Government, Dr. Nooth's attention was called to the subject, by Government, and he approved of the course that had been pursued. It is believed, that he collected such information as could then be got on the subject, for the purpose of publishing it in England; but it is to be regretted, that the report he made upon it to the Provincial Government is not to be found. A few years ago, the existence of such disease, and its similarity, in many respects, to one known in the Highlands of Scotland by the name of the Sibbans, was noticed in a Medical Periodical Journal, published in Great Britain, and a hope was expressed, that further information on the subject might be obtained. The present, notes are thrown together in the same hope; and, it is believed that some gentleman of that profession to which the inquiry more particularly belongs, might do a service to science, by endeavouring, even now, to recover the information, on the subject, collected fifty years ago, which, probably still exists in this community in a written form, and might, by tracing the characters and analogies of the scourge which then visited the Province, furnish grounds for determining, whether it proceeded from accidental and imported causes, or from others, connected with the habits of life of the people, and which may, under the like conditions, come again into operation.

 

Appendix No. 1

 

"LES premières indications de ce funeste mal, se manifestent communément, par depetits ulcères sur les lèvres, la langue, l'intérieur de la bouche, &c. Ce sont de petites pustules, remplies d'une matière blanchâtre et purulente, qui renferment un poison si subtil, que sa plus petite portion est capable de communiquer l'infection; boire dans un verre, fu mer avec une pipe infectée de cette imtière vénéneuse, c'en est assez pour faire naître sur les lèvres une petite ampoule remplie de cette même matière, qui venant à se dégorger, dilate la plaie, corrode les chairs circonvoisines et forme un ulcère plus grand.

 

LE linge, les draps, les couvertes, les habits, &c. peuvent contenir assez de cette matière pour communiquer la contagion.

 

IL y a des tempéraments qui absorbent le poison et les ulcères paraissent guéris: mais ils reparaissent bientôt; et alors, le mal est à sa seconde période.

 

DE plus grands ulcères se forment à la bouche, à la gorge, aux parties et au fondement. Les glandes du gosier, des aisselles, de l'aisne, sont enflammées, et déchargent quelquefois du pus; souvent elles deviennent des tumeurs dures et insensibles, qui changent de place en les touchant. Bientôt les douleurs se font sentir, à la tête, aux épaules, aux bras, aux mains, aux cuisses, aux jambes, aux pieds. Pendant ce temps, le malade croit que ce sont ses os qui sont affectés. Ces maux augmentent, quelquefois, par l'exercice, dans les tems humides, et au lit, lorsqu'on commence à s'y échauffer, et diminuent de même vers le matin, lorsque la transpiration survient.

 

Le troisième degré de la maladie peut se reconnaître à des croûtes galeuses sur la peau, qui se montrent et disparaissent tout-à-tour. Bientôt les os du nez se pourrissent, ainsi que le palais, les dents, les gencives; surviennent des bosses, sur le crâne, sur les clavicules, aux os des jambes, aux bras et aux doigts des mains. On voit des ulcères sur tout le corps, qui, après avoir disparus, reviennent. Enfin, des douleurs de côté et de poitrine, la difficulté de respirer, la toux, le défaut d'appétit, la chute des cheveux, la perte de la vue, de l'ouïe, de l'odorat, sont les précurseurs de la mort.

 

Au reste, il ne faut pas s'y tromper: car quelquefois, les premières apparences du mal se montrent par les symptômes du second et même du troisième degré."

 

[The directions for cure are omitted, as the nature of the Médecines prescribed is not stated; and the other directions given are only such as relate to the care of the general health and habits.]

 

Appendix no. 2

 

Lieutenant Governor Hamilton’s Instructions

 

SIR,—You will in consequence of the authority hereby given you, proceed upon a progress through the several parishes of this government, with the design of administering your advice, and distributing the medicines necessary for the effectual cure of the disorder commonly known by the name of the St. Paul's Bay distemper.

 

You will keep an exact diary of your journey, and a correct 1 list of the parishes you shall have visited, with a faithful return of the persons who shall undergo your inspection, distinguishing their age, sex and condition, stating the progress of the disease of each, and procuring (if practicable) a certificate from the respective curates of the number whose cures shall have been undertaken by you. If any objects of distress shall occur to you in this progress, not immediately coming under the designation of the above named disorder, but wanting immediate relief, the extra ex-pence incurred by the relief of such objects shall be allowed you.

 

You will endeavour by all means to conciliate the good will of the clergy, who may be at all times so instrumental in aiding your endeavours.

 

You will in your tour, make enquiry for, and examine into the properties of any medicinal springs whose waters may be salutary to the inhabitants: You will (if practicable) analyze them, and leave with the curate of the parish, where such springs may be found, an account in writing of their properties, and how they are to be used to advantage.

 

You will preserve copies of these notes that they may be published upon your return, for the benefit of the province at large.

 

You will collect materials for composing a complete history of the disorder, to be published when convenient.

 

The medicines and the extra expences of carriages, postage, stationary, and occasional charges incident to the situation of paupers, the journey, or to the faithful discharge of the trust reposed in you, shall be paid, on your having completed the object of your expedition, with the sum of two hundred guineas exclusive of those expences and charges.

 

Extract of a letter addressed about the year 1786 or 1787, by Charles Blake, Esq., M.D., formerly Surgeon of H. M. 34th regiment, to the Committee of Council on Police and Population, respecting the St. Paul's Bay disease. "I will now give you such an account of that complaint, which goes by the name of the St. Paul's disease, as my knowledge can afford.

 

"In the year 1776, His Excellency Genl. Carleton, (now Lord Dorchester) had many reports of the prevalence of this disease in most parts of Canada; and that there was a specific virus in it which made it differ from most diseases known. It was supposed from the similarity of its symptoms to be the same disease as that which was known in the Highlands of Scotland under the name of Sibbans or Sivvans:[1] The inhabitants of St. Paul's Bay declared it was received from a Scotch Pilot who lived a winter among them; and from thence some called it the Mal Ecossais; In other parts of Canada the people have conjectured that it was brought into the country many years ago, by a set of Indians who went by the name of Luesticreux (Sic.)

 

"But let its origin be what it will, it is enough for us to know that such a disease occupies too much of every part of Canada, from St. Paul's Bay to Machilimackinac.

 

"I was quartered in the town of Quebec in the year 1776, and finding the disease to be of an alarming nature, I offered to visit the places where it prevailed; but being then a surgeon in the 34th regiment, my wish could not be complied with and Mr. Menzies, a mate of the Hospital, was sent down to S. Paul's Bay to bring up some of the worst objects, for the inspection of the faculty at Quebec.

 

"After being fixed at Montreal, objects presented themselves daily with this disorder, and I reported the circumstance to the Grand Jury, who I believe made a representation to the Government at Quebec, but I am informed that is was stated to the Council that the disorder was decreasing, and in consequence nothing was done at that time ; but the disease is always in a progressive state ; and I beg to inform you now, that few Parishes are quite exempt from it, and as it has become so general, any plan to eradicate it must be on general principles.

 

"I have been told by a Priest that some have refused to confess that they had the disease, though the being deprived of absolution should be the consequence; but I imagine these prejudices would soon subside, if they saw people set heartily about doing them good.

"This disease is nothing more than a confirmed Syphilis, shewing itself in different ways in different parts of the body; and making anomalous symptoms and appearances accordingly.

"The habits of the Canadians facilitate its communication in various ways; they use the same cup, drink from the same bucket, often borrow one another's pipe to smoke, chew their infant's food and spit it into their mouths; they constantly spit on their floors and never clean them, and the lower class are generally regardless of cleanliness: All these circumstances help to communicate and keep up the disease, which may take effect any where that the skin happens to be broken.

 

"The disease being of the nature I have stated, it gives way to no remedy but mercury; and whatever impositions may be forced on the public mind as to its being a disease sui generis, or whatever mystery may be made about the disorder or the medicines for its cure, I aver that nothing but mercury will cure it; and as it gives way to nothing else but mercury, and as this raises an inflammation in some degree, how is it possible that it can be given with safety merely by delivering boxes of pills to the patients for their own administering, and leaving the action of the medicine, as well as the disease to a precarious issue? It is not only necessary to administer the medicine, but the effects and symptoms must be watched by some medical man, and after the medicine has taken effect, further attention is required to get it out of the system.

 

Mr. Sym, an eminent practitioner in Physic, at Montreal, told me that seven patients have come in one day for admission into the Hospital there, with swelled heads from the improper use of the mercury given to them by the Priests, agreeably to the directions left by Mr. Bowman. This may shew the Council that an evil exists where they acted with the most humane intentions; and I hope they will consider of some other plan."

 

(Signed) CHARLES BLAKE, SURGEON.