Report on the Typhus Epidemic in Upper Silesia

CLASSICS IN SOCIAL MEDICINE Report on the Typhus 1 Epidemic in Upper Silesia

Rudolf Virchow (Archiv. für Patholog. Anatomie u. Physiologie u. für klin. Medicin, 1848, Vol. II, Nos. 1 and 2)

At the beginning of this year reports on the effective intervention. On the 18th of February outbreak of a disastrous disease in Upper Silesia, the writer of this report was also commissioned by which up to that time had appeared in the the Minister of Education to visit the area ravaged newspapers only sporadically, increased in by typhus. Mr. Barez "would be too heavily frequency and urgency. The Prussian Minister for engaged to have the leisure to carry out a close Religious, Educational and Medical Affairs, investigation of the epidemic in the interest of nevertheless, not only did not receive from the science. Yet it was important for those medical local medical authorities any reports on the nature authorities who were under the jurisdiction of the of the malady but not even notification of its Minister that the epidemic occurring with such presence. Thus, when the press published violence be investigated in a manner as thorough increasingly horrible details on this so-called and promising of success as possible." I was hunger-typhus, when the whole of Germany was charged with this investigation. Consequently Mr. resounding with a cry for help for the inhabitants Barez and myself started out together on the 20th of the Rybnik and Pless districts stricken by of February; we arrived at Ratibor on the 22nd and starvation and pestilence, and when finally even continued to Rybnik on the 23rd; from there we the Ministry of the Interior was forced to emerge visited Radlin and Loslau on the 24th, Geikowitz from the apathy with which it had so far met the and Smollna on the 25th, went to Pless by way of demands of the civil authorities, the Minister of Sohrau on the 26th, and visited Lonkau on the Education finally ordered the chief medical privy 28th. Mr. Barez then returned to Berlin on the 29th councilor Dr. Barez “to travel to Upper Silesia so by way of Nicolai and Gleiwitz, while I returned as to obtain detailed information regarding the to Sohrau and remained there up to the 7th of outbreak of the typhus epidemic, and the measures March. On that day I returned to Rybnik, reached taken against it, and to assist the authorities Gleiwitz on the 8th and arrived in Berlin on the concerned in word and deed whenever necessary.” 10th. The Minister of the Interior, however, refused to The information I was able to gather during empower Mr. Barez with authority for any this journey was necessarily incomplete in many respects, and the following report does not claim Originally published in Archiv. fü r patholog. Anatomie u. to be a complete or even adequate description of Physiol ogie u. für klin. Medicin, 1848 . This English the epidemic. However, the extraordinary translation is from Volume 1 of Virchow, Rudolf, uniformity of the Upper Silesian conditions, the Collected Essays in Public Health and Epidemiology , great conformity in the symptomatology of the edited and with a foreword by L. J. Rather, published in 1985 by Watson Publishing International, Sagamore disease, the large number of persons affected Beach, MA. Watson Publishing International retains simultaneously in the same place, and lastly the sole copyright to this translation which it has kindly exceedingly friendly reception by the local given us to reprint. All endnotes are from the original physicians and the willing support of the local translation.

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authorities, to both of whom I wish to express my Gorzitz in a slight depression (853'). On the right heartfelt thanks, made it possible to grasp quite bank of the Oder, whose water level lies at an clearly the most essential points despite the short elevation of 673' at the confluence of the Olsa, the duration of my stay. I would have wished to high plateau falls away rather steeply to the wide provide decisive answers to some of the and fertile valley of the Oder. particularly important questions, but the political The irregularities of the surface are due in part uprisings that had in the meanwhile broken out to the rise of mountain chains and partly to made it mandatory for me to participate in the subsequent erosion. To the north between Kosel manifestations in the capital. I also knew that in and Great Strehlitz we meet the mighty and order truly to resolve these questions, I would isolated basalt elevation of the Anna mountains; to have to wait for another suitable opportunity, the south at the boundary between Galicia and which I did not know would ever arise. With the Hungary, towards the Bukowina, there run, in an large number of physicians who have since been east-west direction, the younger ridges of the sent to Upper Silesia, there certainly will be some Carpathians, whose lovely blue summits (for who will complete the data I assembled wherever instance the Lissahora) are seen in both districts they show lacunae and who will rectify them from almost every point in unlimited succession. whenever they are erroneous. To await the return Continuing an account of geological relationships, of these physicians did not seem advisable, we encounter the Sudeten Mountains in the west, because the interest of the medical profession in and the Sendomir Mountains in the east. The this question requires prompt satisfaction. I have whole of the tableland of Upper Silesia is already in part discharged my duty in this respect understood to be a huge alluvial basin. It is, in the form of a lecture, which I read on the 15th therefore, only natural that we see older mountain of March before the Society for Scientific formations emerge to the surface in many places, Medicine, the outline of which I follow here also. or find them buried at a small depth. Graywacke, bituminous coal, red sandstone and shell CHAPTER 1: THE LAND AND ITS INHABITANTS limestone, Jurassic formations, particularly clay- Upper Silesia (administrative region of iron stone, upon which follow the peculiar tertiary Oppeln) comprises that part of Silesia south of the formation of the gypsum and marl mountains (to rivers Neisse and Stober. The districts of Rybnik which also belongs the rock salt of Wieliczka) and Pless constitute its southernmost portion, almost always form the bottom of alluvial land which lies directly at the borders of Galicia and whose mean thickness has been calculated to be Austrian Silesia between 36° and 37° eastern 11-13 [Prussian mining] "fathoms" [=22-26 m]. In longitude and 49°9' and 50°3' northern latitude, its superficial layer this alluvium consists between the upper courses of the rivers Oder and alternately of clay and a coarse, frequently Vistula, covering an area of about 35 square miles. ferriferous gravel, which was apparently formed The country is a torn and deeply-cut high by washing out of the clay. 3 The former is tableland, with an elevation above the Baltic of widespread especially in the southwestern parts, about 900-1000'. 2 The watershed between the Oder around Sohrau and towards the Austrian border, and the Vistula, which runs midway through it, is the latter prevails in the eastern and northern parts. in general not conspicuous. In the area of Sohrau, Both are usually easy to recognize from the nature where it consists of alluvial soil, it reaches a height of the woodland trees, which here are nearly of only 948'. It is gently inclined towards both always conifers, whereas toward Radlin, Loslau, sides, especially eastwards, to the valley of the etc. there grow beautiful deciduous trees (even Vistula (Pless district), while to the west it is oaks). But almost nowhere is the formation at the formed by a range of hills, which rises until surface wholly suitable for agriculture, as the Pschow (1008') and continues south to Great clayey or loamy soil is generally impermeable to

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atmospheric water. 4 regularly turn into long and persistent rains, which Most of the valleys, especially in the district of in a short time bring down large amounts of Rybnik, are erosion valleys, often quite deep, so precipitation. I myself had the opportunity to that they not only cut through the sedimentary observe how rapid and important are the changes deposits, but also sometimes expose on their edges taking place in the air masses. In the first two layers of the tertiary gypsum formation. As a rule weeks that I spent in the area the weather was very the slopes of the valleys are rather steep, the pleasant, the air being mostly clear and warm, valleys relatively wide, with a stream flowing quite spring-like. Suddenly at the end of the through them, and the remaining part of the second week snow flurries occurred with ground is covered with wet greensward. increasing intensity, covering the ground with a Occasionally we find extensive marshes. Lakes, layer of snow several feet deep in a few days. At even large ones, are not rare; their beaches are the same time the frost was so intense that on mostly flat, so that they appear to the eye of the roads, which had just been bottomless, i.e. on North German used to higher hilly slopes rather which traffic by carriage was almost impossible, like ephemeral water collections in shallow sledges were circulating everywhere a few days depressions of the ground. The gradient of the later. On the 8th, I traveled to Gleiwitz by sledge small streams, especially toward the Vistula, is not during a strong snow flurry with a whistling NNW great and since the Vistula itself has a very low wind. On the following day, while on my way to inclination in its upper part and since this river, as Breslau by railway I saw the snow cover becoming well as the Oder, very rapidly receives enormous thinner the further north I traveled. Beyond amounts of water in the proximity of the Breslau I found snow only in some depressions in Carpathians, water is being dammed up in these the ground, and in the Mark [= the Prussian valleys quite frequently with extensive flooding of province of Brandenburg] none was to be seen. the adjoining meadows. From this description it would appear that all The considerable elevation of the land and the factors contributing to an increase in the humidity great proximity and the direction of so massive a of the ground and air are present. While the mountain range as the Carpathians cancel out the impermeability of the soil and the slight damming influence, which the southern position of this up of the flowing waters constitute a recurrent, and district (Pless lies nearly at the latitude of Mainz) then commonly long lasting, source of surface should exert on the temperature of the air. The rye evaporation, the frequent and persisting harvest commonly coincides with the harvest in atmospheric precipitations at relatively low air areas of Pomerania which lie 4° further north, i.e. temperatures cause a constant renewal of the fluid at the end of July and beginning of August, and lost by evaporation. the difference in temperature is so great that in the Let us now observe the inhabitants of this Oder valley at Ratibor a difference of 8 days is country. All Upper Silesia is Polish. As soon as noted in agricultural activities. The direction of the one has crossed the Stober, communication with Carpathian foothills from west to east seems to be the rural population and the poorer townsmen will particularly unfavorable in this respect. While the be impossible for persons not thoroughly warm equatorial winds are partly stopped by the conversant with the Polish language, and only mountains and partly cooled by the snow masses interpreters can provide scanty help. This situation that usually remain on the ground up to May, the generally prevails on the right bank of the Oder. Arctic air currents, which blow at a lower On the left bank numerous German elements are atmospheric level, rebound from the mountains interspersed. This population represents the which rise directly from the plains and accumulate lamentable remnants of the old Silesian before them. I was informed that the rainsqualls population, as it has been preserved in these that come with a northwestern wind almost peripheral regions of German influence. We

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remind the reader that from the end of the sixth brothers in Pomerania and Prussia have so century onwards members of the Slavonic tribes, a completely lost. The span was long enough to heretofore unknown race, invaded the areas which destroy their national consciousness, to corrupt had been vacated by the German tribes emigrating their language and to break their spirit, so that the toward the west and south, and that, while to the main part of the population has conferred on them left of the Oder and around the Elbe there spread the disparaging name of Water-Polacks: but their Czechs, Wends, Luticians and Obotrits, Lechitic appearance, which has been described to me as Slavs took possession of the vast plains being completely similar to that of the Polish comprising the riverain areas of the Vistula limited population on the lower Vistula, still clearly shows to the west by the Oder. The name Poland is not their descent. Nowhere do we meet the derived from the word pole, meaning plain, characteristic physiognomy of the Russians, which without cause, for what is more characteristic for is so frequently called typicalIy Slavonic, and their land than these unlimited plains, which which serves as a reminder that these extend from the Carpathians to the shores of the representatives of Asiatism are the neighbors of Baltic Sea, and over which are widely scattered the Mongolians. Everywhere we see good-looking erratic blocks that have been carried from the faces with a very light skin, blue eyes and blond Scandinavian mountain ranges to the foot of the hair 5; these handsome features are certainly altered Carpathians? When, at the end of the first at an early age by cares and uncleanliness, but are millennium of the Christian era, Boleslav I. frequently exhibited in children of rare loveliness. Chrobri established the Polish empire, Silesia was Their way of life also reminds us of Poland an integral part of it, and only in 1163 did the 4th proper: their dress, their houses, their social Boleslav leave the area to his nephew as a separate conditions, their uncleanliness and indolence are realm. By continuous subdivision it was split into nowhere so closely similar as in the lower strata of 18 dukedoms by the XIVth century. But the the Polish nation. In particular as regards the two Luxemburgian emperors were acquiring one last named characteristics it would be hard to find portion after the other for the Bohemian crown, them surpassed anywhere. The Upper Silesian in until in 1339 the entire land of Poland was general does not wash himself at all, but leaves it formally ceded to Bohemia, together with which it to celestial providence to free his body later fell to the Austrian rulers. The last Silesian occasionally by a heavy shower of rain from the Duke (of Liegnitz, Brieg and Wolau) of the crusts of dirt accumulated on it. Vermin of all Piastian house only died in 1675. It is well known kinds, especially lice, are permanent guests on his that from his succession there arose the Silesian body. As great as this squalor is the sloth of the wars which brought the greatest part of the country people, their antipathy for mental and physical under Prussian rule, and there began the exertion, their overwhelming penchant for idleness unfortunate conflict of sovereignty between the or rather for lying around, which, coupled with a two great German powers which has again been completely canine subservience, is so repulsive to taken up in our days, and which is taking on so any free man accustomed to work that he feels complicated a form in German political life disgust rather than pity. A comparison of the through the admixture of foreign nationalities. Upper Silesian with the Neapolitan beggars holds About 700 years thus have passed since Silesia true in some respects only as long as one remains was separated from Poland; the greater part of the on the surface, but loses all weight as soon as one country has been completely Germanized by considers them more closely. German colonization and by the power of German The Lower Silesians attribute this aversion to culture. For Upper Silesia, however, 700 years did work sometimes to the debilitation of the people not suffice to obliterate the Polish national resulting from bad nutrition, and sometimes to a character of its inhabitants, which their racial national tendency for inaction. The former view is

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correct in part, though not to an extent and with an in Spain, has the Catholic clergy achieved a more exclusiveness that would explain the whole picture absolute enslavement of the people than it did from that factor alone. As for the latter view, it here: the priest is the absolute master of this would be outrageously unjust to place the true people, which is at his order like a gang of serfs. cause of these traits in the Polish nation, that great- The history of their conversion from brandy is an hearted nation capable of every sacrifice. Even even more brilliant example of this spiritual though German diligence may perhaps be rare bondage than that told by Father Matthew of the among the Poles, it should nevertheless not be Irish. The Upper Silesian is addicted in the forgotten under what conditions, under how long extreme to the use of spirits. In the evenings, when and heavy a pressure, this unhappy people has the people are returning from the town markets, groaned. Let us consider these conditions more the highways were literally strewn with drunks, closely for a moment, as they will be important men and women alike. Even the child at its later in our exposition. mother's breast was given brandy. In the course of The Polish language, which is exclusively a single year Father Stephan (Brzozowski) used by the Upper Silesian, is certainly not the succeeded in converting all these tipplers in one least of the causes for the depths to which he has stroke. Of course all means were used, legal and sunk. For 700 years after their separation from the illegal, spiritual and temporal; canonical penalties mother nation, this population has taken no part, and corporal punishment were used with impunity; however slight, in the development, which has but the conversion succeeded in the end, and the taken place in that nation; nor have they gained vow was generally taken and kept (compare the anything from German culture, since they had no essay of Prof. Kuh in the Med. Vereinszeitung of connecting link with it whatsoever. Only in later 1848, No.8). How great trust was placed in the times was it attempted to Germanize them by way clergy has also become evident in the present of the schools. But the methods, which the epidemic. Many trustworthy persons have assured government applied to this end, contained in me that the people had been facing death with a themselves the seed of their failure. German certain confidence, as death would relieve them of schoolmasters with as limited a knowledge as this miserable life and assure them of possible were sent into Polish country and it was compensation by heavenly joys. When someone up to the teacher and to his pupils mutually to became ill he did not look to the physician but to teach each other their mother tongues. The usual the priest. For if the holy sacraments would not result of this procedure was that the teacher finally help, what could these miserable medicines learned Polish, but the student no German. Thus achieve? This state of mind the administrative the German language did not spread; the Polish hierarchy well knew how to use at the beginning language maintained the upper hand, and in the of the epidemic, and, according to general opinion midst of the country there are numerous families in the districts, the government medical councilor with German names and German physiognomy in Oppeln, Mr. Lorinser, did everything calculated who do not understand a single word of German. to encourage these tendencies. It is difficult to Hardly a book was available to the people, apart decide whether this was done intentionally, or from the prayer book, and so it came about that because of a reprehensible ignorance of local there are more than half a million people here who conditions. But one of the two must have been the totally lack any consciousness of the inner case. Or how could it otherwise be explained that development of the nation and any trace of cultural at a time when every educated person in these history, because, in a dreadful way, they possess districts publicly and urgently clamored for no development and have no culture. physicians, the official line was that they were not The Catholic hierarchy has been the second needed and that the people did not want them? obstacle. Nowhere, except in Ireland and formerly (Compare the essay by Prof. Kuh in the

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Wochenschrift für die ges. Heilkunde, 1848, No. would be interested in keeping the churchyard in 10.) Almost nothing was done on the part of the such a proximity, would certainly be against it. Be government. In its stead the monk-hospitallers of it clear that I do not wish to accuse individual Breslau and Pilchowitz turned up under their members of the clergy of having made a cruel and spiritual leader Dr. Künzer. The press was full of inhuman use of their spiritual powers, but no one praise, and wherever they went they brought help can deny that so powerful a hierarchy, which the and gifts in the name of mother church. In spite of people obeyed so blindly, could have fostered a the admirable zeal of these men, their effect was certain mental development in the people, had it so quite limited. Two of them were surgeons; the wished. But it lies in the interest of mother church others had entered spiritual orders from different to keep the people bigoted, stupid and dependent. professions, such as the military, etc., and were Upper Silesia is only a new example in the long totally incapable of medical judgment. Since they series of old ones, among which Spain, Mexico moved from village to village, weeks often passed and Ireland head the list. As for the local Catholic before they came back to the first village; often clergy, it differed greatly from the Evangelical they never returned, and their appearance had then clergy in its personal willingness and zeal to make been that of an angel of salvation. Starting from great sacrifices, up to bodily immolation, in the the moment when the Breslau Committee, which interests of the hungry and the ill, while among the had received gifts from all over Germany, began Protestants, Pastor Wolf in Rybnik for instance, organized activity in the districts, when its refused to visit his parishioners abed with typhus delegates, Prince Biron of Courland and Prof. in Sohrau to provide spiritual consolation. Kuh, themselves visited the districts, when However, all this self-sacrifice, the personal merit physicians were commandeered from all parts of of which I readily recognize and praise, cannot the country and local committees were established, atone for the immense guilt of having allowed a all support had to be withdrawn from these great nation to sink so deeply into ignorance, religious institutions. In consequence the activity superstition and sloth. of the spiritual brothers gradually came to rest and The drawbacks of bureaucracy, which Prussia the confidence of the people in the physicians had felt so deeply in other respects were relatively grew. Only now did Mr. Lorinser also dispatch the less prominent in Upper Silesia. Where it is to be physicians who had placed themselves at his blamed for this disaster, its faults were rather disposal. True enough, he had himself previously negative ones. It is the curse of humanity that it visited the districts, though in a roundabout way learns to tolerate even the most horrible situations which unfortunately prevented him from meeting by habituation, that it forgets the most shameful the Minister, Count Stolberg, who had been sent happenings in the daily shame of events, and that by the King, privy councilor Barez, etc. But when it can hardly understand when individuals aim to he gave a talk about the measures to be taken destroy this infamy. The educated people in those against the epidemic at the meeting of physicians districts and with them the authorities, whose at Nicolai, Professor Kuh could reply that the willingness and activity I moreover readily admit, Breslau Committee had already taken all these became so dulled by the daily sight of this sunken measures. When Mr. Lorinser then came to nation, they became so indifferent in regard to Sohrau, and the provisional director of the city their sufferings that, when at last help had been council, Mr. von Woisky, urgently recommended promised and tendered from all sides, there arose a the transfer of the churchyard which was almost general complaint that the people would be located in the city and contained more than 600 in spoiled. When those who had nothing, absolutely part only superficially buried cadavers in an area nothing, to eat were allotted one pound of flour of some 40 square feet, he declared this to be quite daily, it was feared that they would be spoiled! unnecessary, in particular as the church, which Can one imagine something more frightful than

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the idea that somebody would be spoiled by a convinced that such cases occurred only small handout of flour, mere flour alone, and that exceptionally. Want was greatest in the royal others would fear such a thing? This habituation to domains in the districts of Rybnik, and, as our misery, this hardening of feeling toward the legislation gives the functionaries of these sufferings of others is so general in the districts, domains the greatest direct authority, the that I would be the last to attack the local conditions in them were therefore the worst for the authorities because they did not attend to the people too. Admittedly, it would have been a very dispatch of their partly quite serious and urgent difficult enterprise to raise from its stagnation a reports with greater urgency and determination. people neglected and oppressed by the hierarchy What Prussian civil servant would not be silenced for centuries. The means and efforts applied in when always getting negative replies and regular such an undertaking would have had to be refusals from Oppeln, from Breslau, from Berlin? grandiose, but success would then have offered But the people have overthrown the Ministry of correspondingly great satisfaction. Men who know Bodelschwingh, chief president, von Wedell had the Upper Silesians very well and are able to to leave Breslau in cowardly and ignominious evaluate their capacity for development, such as flight, and if the government at Oppeln still stands, Professors Göppert and Purkinje in Breslau, chief this is due only to its unimportance and to Upper mining councilor von Carnall, etc., authoritatively Silesian nonchalance. District president von attest their cultural potential. But as the schools, Durant sent repeated direct requests from Rybnik communications, agriculture, and industrial to the Minister, which is strictly against protocol activities were in disarray, no development from (!), urgently pointing out the imminent emergency within could be expected. This country's wealth in in the autumn of 1847. With what results? The mining products, such as bituminous coal, clay district offices, which were already burdened with iron stone, calamine and gypsum, is so great that debts a year ago, were told to look out for the transport alone of these products, locally themselves. When two delegates of the Oppeln known under the name of "vecturance," supports a government happened to meet in Rybnik in the large part of the population. Of course, the course of their official duties one of them had been individual carter, with his small and weak horses charged with stimulating private charity for and small carts can move only limited freight, and combating the famine, while the other was charged his earnings are but a pittance. Nevertheless, many with raising the rates of taxation. For in the first people thus make a living. Would it not have been meeting of the general provincial diet, it had been the duty of the government to improve the roads? proposed for the purpose of a fairer distribution of In spite of the urgency of such improvement taxes that the rates should be raised for the higher nothing has been done, and when I was in Upper taxation groups and be reduced for the lower Silesia the roads formed nothing but a continuous groups. I was told that the government thereupon morass. Formerly the industrial activities in the was instructed to implement this policy, but with towns, in particular the fabrication of linen goods the limitation of maintaining the lower rates as and cloth, used to be rather Important; In Sohrau they were. Thus, even though the authorities alone there existed 150 weavers looms for linen, committed many blunders up to the last, the main supporting 600 persons. These products were reproach it must bear is that they did nothing at the exclusively sold in the free state of Cracow. With proper time and that they initiated measures that the incorporation of this territory into the Austrian were quite insufficient and only when it was much empire, this industry abruptly stopped. too late for many. I have occasionally heard stories Simultaneously another source of livelihood was of the executive levying of taxes that put to shame cut off. The lakes and ponds in the Pless and even the infamous scenes reported from Ireland. Rybnik districts are extraordinarily rich in fish. However, upon assiduous inquiry, I have become Enormous quantities of these fish were transported

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to Warsaw by way of the Vistula so that, some when the rewards of their labor were their own, owners of fish ponds derived from them a yearly who never knew the joys of possession, never had income of up to 3000 thalers. When Cracow the satisfaction of deserved earnings, who had became Austrian, the high customs duties assigned never received wages for the onerous work they to the fish killed this trade. These short hints will did, but who always saw the fruit of their labors suffice to show how the government has rendered falling into the pockets of the landowners? It is impossible the mental and material development quite natural that such an unhappy nation has of these people through the most preposterous relinquished the very idea of permanent property, neglect of this country, and by its equally dilatory and that they learned not to care for the morrow, internal and external politics. Finally, we must but only for the day. After so many days of work consider the relationships existing between the spent only for the benefit of others, what was more rural population and the great landed proprietors, natural than to spend the one day that was their which mainly centers on the matter of robotage own for resting in idleness and for slumbering on [villeinage]. I can deal with the subject briefly, as their beloved oven? What else was more natural it has been discussed repeatedly and with candor than that the work for the landlords, which brought in the press. In Upper Silesia, more than in any in nothing, was done carelessly, and that energetic other part of the eastern provinces of Prussia, we activity could be inspired only by special have an aristocracy with enormous holdings of incitements? Such a stimulation was furnished in land, which more than in any other part of Prussia particular by the brandy to which they were stays away from its properties, after the example passionately devoted, and which was a source of of the Irish gentry. Many of them dissipate huge oblivion and of momentary joyous elevation. All sums in the various capitals (Breslau, Vienna, reports by local inhabitants agree that when, with Berlin, etc.) or outside of Germany, moneys that the vow of abstinence, this consolation was lost, are constantly withdrawn from the country. But the indolence of the people increased and all joy how can prosperity be developed in a land, which disappeared. When finally, 2 years ago, new always gives up the yield of its activities to other legislation brought about exemption from bond regions abroad? A part of the rural population has services by the cession of fields and the like to the been liberated from their most pressing burdens landowners, when this nation, downtrodden and towards their landlords by past legislation, and subjugated for centuries, or rather since the their material position is somewhat improved. But beginning of its emergence in history, at last saw until very recently the greater part of the common the dawning of its personal liberty, could one people, in particular the large number of so-called expect such a people to greet this day as would a cottagers, still had to endure all the misfortunes of strong man who, being imprisoned by an inimical the robot. These unfortunate people had to render power, and in full consciousness of his liberty, compulsory service to the landlord proprietors as sees the doors of his prison burst open? What else house servants for 5-6 days a week, and there could a nation used to spending its free time in barely remained one day in which they could take sluggishness do than to devote its days that now care of their small field and their family (compare were all free to laziness, idleness and sloth? No the Breslauer Zeitung, 1848, No. 59, supplement one was there to act as their friend, their teacher, 1). What could they achieve in one day in the or their guardian and to support, instruct, and week, in 52 days a year? What they achieved per guide them in their first steps on the new road, no week, per year, was barely sufficient to satisfy the one to show them the significance of liberty and primary necessities of life in that week or that independence, no one to teach them that wealth year. And what can one expect of people who have and education are the daughters of work and the been fighting for their existence in such abject mother of well-being. Previously it had been in the misery for centuries and have never seen a time interest of the landlords, who needed the hands

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they exploited, to whom the strength of these from the last source of pleasure that had remained hands represented the equivalent of capital, to available to this afflicted people. How great a prevent the total pauperization and starvation of promise, then, does such a success hold when the owners of these hands. But with the abolition measured against the possibility of fighting for of the bond service of manual labor, there was no true values, for positive means of enjoyment, for further material incentive for taking measures the real treasures of mankind! Would it not be an against impoverishment and hunger. Now impressive sight indeed if this abject population everyone was to look out for himself! For the which has carried the heaviest of shackles for fraternity of power presupposes common interests! centuries, rose up for the first time like a young Returning to our earlier question, i.e., whether the giant lifting up his head and stretching his filth and sloth of the Upper Silesian are Polish powerful limbs! Surely it would be worth the national traits: in the light of the above while of a benevolent and clear-sighted politician information, which compares well with the to attempt the solution of such a problem. testimony of Johannes Ronge, a man who has Medicine, as a social science, as the science of lived in Upper Silesia for a long time (Deutscher human beings, has the obligation to raise such Zuschauer, 1848, No. 10), we can only reply in the problems and to attempt their theoretical solution; negative. It might be possible that the burden of the politician, the practical anthropologist, must circumstances has produced similar sad results in find the means for their actual solution. We shall other members of this unlucky nation; this I do not return later to this point. know and cannot judge. But my own observations Before we now deal with the epidemic, there have convinced me, and in my view justifiably so, remain some observations about the housing and that the Upper Silesians would not be found nutrition of the Upper Silesian. lacking in either industry or intelligence if the As regards the houses, in the countryside as trouble were taken to awaken their dormant well as on the outskirts of the cities they qualities. Corporally and spiritually weak, the correspond to the low cultural conditions of the people need guidance, a sort of tutelary control. people. Without exception they are blockhouses, Wealth, education and liberty depend on one the walls consisting of beams placed one upon the another and thus, conversely, do hunger, ignorance other and smeared with clay on the inside and and servitude, as Struve has very correctly pointed sometimes also on the outside; the roofs are made out (in the Deutscher Zuschauer). If these people of straw. Chimney stacks are found nearly were shown, by example and through their own everywhere; the windows are mostly small and are experience, how wealth arises from work, if they only rarely made to open. Only the wealthy have were taught to develop needs by allowing them to separate stables and barns. The house usually enjoy earthly and spiritual goods, if one allowed comprises living quarters, stable and store rooms. them to take part in the culture, in the great The living space is usually small, about 6 or 8-12 movement of the nations, they would not fail to feet square, mostly 5-6 feet high; the floor is made emerge from their condition of dependency, of loam, the ceiling of boards, with the beams disinterest and indolence in a short time and thus projecting underneath. The stove with its many to furnish a further example of the powers and accessories, takes up a great part of the place; elevation of the human intellect. The sudden among the accessories worthy of mention are: the conversion of so large a population from the worst so-called 'gipsy stove,' which serves for cooking, kind of intemperance to the most complete and a higher platform built of bricks, on which abstinence from spirits, has shown, as Kuh has so part of the occupants spend their leisure hours and well expressed it, "that the original nobility of the sleep. The best part of the remaining space, if the human nature is never completely obscured." This family is prosperous enough, is taken up by a cow, victory, now, was a deprivation, an abstention or a cow with a calf. The remainder is occupied by

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scanty furnishings, among which may be consists, and with which the walls are covered, is mentioned a hand-mill and bedsteads mostly commonly so moist that fungi abundantly grow on furnished with feather cushions. There are almost it. I have even seen habitations into which the never enough beds for the number of inhabitants, melting snow had penetrated, covering the floor who in such houses commonly range between 6 with 1" of water, without the residents thinking of and 14. The remainder of the family sleeps on top removing it; they had merely covered it with of the stove, on the benches by the stove, or on boards! Under the main bed there is, in many straw on the floor. The only ornaments in these cases, a cellar-like pit for storing potatoes and the rooms consist in hosts of pictures of the saints, like, which contributes to corrupt the air. which are well framed and usually hang in long It must be assumed that the greater parts of rows above the windows. From this short these conditions are of very long standing. But description it will be easy to imagine the poverty some of them, such as the great overcrowding of and the shortcomings of these dwellings. The the dwellings, have greatly increased in the last effluvia of so many people and of the cattle, the few years. District magistrate Mr. Durant was kind steam that rises in the atmosphere at the enough to provide me with the official register for temperatures of 18-20°R (=22½-25°C), which are rural buildings and that for the inhabitants of the maintained during the winter months, produce a Rybnik district for the years 1834 and 1847, which headache in those not accustomed to it within a clearly exposes the crowding as follows: very short time. The loam of which the floor Year 1834 Year 1847 1. Churches and Schools 30 76 2. State and municipal houses 100 22 3. Homesteads 5,544 6,396 4. Factories and warehouses 258 231 5. Stables, barns and sheds 3,454 4,260 Totals 9,386 10,985 Population incl. the towns 42,303 59,320

Taking only the houses serving as dwellings, houses in the towns. The intermediate stage that there was an increase of 852 houses in a period characterizes the German towns, the of 13 years, while the population increased by combination of the beams with walls, the 17,017 persons. In 1834 there were somewhat timber-frame buildings, are entirely absent, a less than 7½ persons per house, in 1847 sign that the population in general has never somewhat more than 9½, the increase of known this intermediate stage or culture, this domiciles to that of the population showing the gradual development of the requisites of social unfavorable ratio of 1:20. If the ratio of 1834 life, since the poorer part of the population has (1:7.5) is taken as normal, which, according to not yet reached and is still below that level, the facts mentioned, it is not, then so as to while the wealthier Germanized or immigrated maintain this proportion the number of houses part of the population has directly skipped it. should have increased by 2,268 up to 1847, Lastly, we must discuss the location of these whereas it in fact only increased by 852. It is houses. Nearly everywhere the villages and therefore clear that with every passing year towns are situated in valley lowlands, as in the hygienic conditions have become worse. plains of Northern Germany and elsewhere. The While the houses of the lower class church occupies the highest and most favorable everywhere conform to the primitive level of spot; then follow the houses of the wealthy, the block houses, there are adjacent well-built stone city proper, or in the country, the farmsteads;

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deepest down, sometimes in the middle of the scant. Potatoes were soon lacking in most pasture land, stand the hovels of the cottagers, households, and flour also; it did not take long and from the towns the suburbs extend far down before the poor were obliged to sell their cow; in into the valleys. At every flooding, whenever the short, cabbage alone remained for a while. As waters rise, these houses in the lower locations soon as stocks of green vegetables were are those most affected. As a rule, the spread of exhausted, people were obliged to use surrogates the villages and suburbs is relatively enormous. such as green clover, couch-grass, diseased and The individual houses are so far away from one rotten potatoes, etc. Many died of starvation another that a village of 1500 inhabitants is directly; many others fell into a state of atrophy commonly half a mile to one mile long. that was pitiable. Finally, the government Another essential point is the food of the intervened. Its help consisted in delivering flour people. It is usually said of the Upper Silesian, and salt. The amount of flour provided in the and this is the common phrase of the educated Rybnik districts was one pound per day per classes of these districts, that they live solely on person and in the Pless districts 1½ Ibs., as the potatoes. But according to the information that I opinions of the authorities and of the local have collected, partly from the people and partly committee regarding quantity were divergent. from experienced civil servants, among whom I What were these poor people to do with this shall mention only district magistrate Mr. von flour? They had nothing else, and no money to Hippel in Pless, this is not entirely accurate. buy any additional foodstuffs. Naturally, they Potatoes have indeed constituted the main staple fabricated dishes suited to their culinary art. since time immemorial, and the description of Mainly they made a sort of zur by mixing the quantity of potatoes that individuals are said together flour and water and adding to it some to have consumed borders on the incredible. leaven or vinegar, put this on top of the stove However two items must be mentioned besides: and ate it during the following days. In the milk and sauerkraut. In many cases the milk and second place they prepared a sort of bread its products (butter, cheese) are marketed, but (placzki ) by shaping the dough, after it had risen many people also drink milk; everyone has had a little, into a flat form and letting it dry buttermilk and the whey left after cheese externally on the oven. As anybody can imagine, making. Next to these, sauerkraut is a much neither the one nor the other seemed at all edible sought after food. I myself have seen large to us. The number of those who were estimated barrels of it in the houses of the well-to-do. to be in need of such help for about 6 months in Cereals have always been cultivated in small the district of Rybnik alone was about 20,000, amounts only, and bread proper has never been a i.e., 1/3 of the total population! For it was staple food. When starchy materials were used it unthinkable that this population could find was only as an additive to other foods, or poor within itself the means of its support. Apart from bread-like pastries were baked. Now and then I the relatively few who made a frugal living in have found a baking oven in the houses and mining and in transportation, it was not to be good, though coarse, bread, but this is in no way expected that agriculture and animal husbandry the rule. According to general consensus, the would provide adequate supplies for the favorite food of the Upper Silesian consisted of population until the following autumn. Seed was a dish containing all the named ingredients, i.e., lacking everywhere; the cows had mostly been sauerkraut, buttermilk, potatoes and flour called sold. But even if this had not been the case, it zur (pronounced jour ). Meat is eaten only very would have made little difference, as these exceptionally. branches of cultivation too were in the most To the extent that the famine spread and wretched state of neglect. Even animal became more acute, nourishment grew more husbandry furnished a special instigation to

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idleness, as everyone took care of his own intensity. Autopsies were never made in the animal and there were therefore almost as many districts, so that a diagnosis from the anatomical herdsmen as there were animals. standpoint was not possible. Dr. Lemonius, I felt that these observations had to precede formerly active in Konigshütte, and now in the main report so as to make sure of full Beuthen (the district of Beuthen adjoins that of subsequent understanding. From the above, the Pless in the east) wrote to me: "In the few reader will have convinced himself that the autopsies that I did perform, I saw the complete condition of the Upper Silesian population was typhous process in a single case only, while in so horribly wretched, that if comment had been the others nothing more than a great flaccidity of restricted to a few words only, every outsider the intestine, in particular great bloodlessness, as would be sure to consider such an account as well as limpness of the abdominal organs in exaggerated. Yet conditions must be known, if general." Dr. Polkow in Ratibor told me that in the present epidemic is to be correctly evaluated. the past up to November 1847 he had seen the usual typhus with intestinal ulcerations; later CHAPTER 2. THE ENDEMIC DISEASES AND autopsies, however, had shown the intestinal THE DEVELOPMENT OF THE EPIDEMIC mucous membranes to be entirely free. Mr. Haber, a very skillful surgeon in Rybnik, claims From the unanimous reports of all local to have seen the same form of typhus in Upper physicians, typhous affections, malaria and the Silesian soldiers at Neisse, while in Rybnik dysenteries are the endemic diseases without autopsy had revealed ulcerations. Unfortunately which no year passes. As to malaria, it is so all these reports are not sufficiently definite for common that hardly anyone can be found who generally valid conclusions. In the future, has not suffered from it. It occurs at all seasons science will yet require from the Upper Silesian of the year, being especially common after physicians further essential clarification and floods in villages of low location. The common more exact observations. forms are of the tertian, more rarely of the I could not even determine a generally exact quartan type; the latter commonly ends with symptomatology for endemic typhus. Only Mr. dropsy; both frequently occur in combination Haber and Mr. Willim, both from Pilchowitz, with various complications (gastric, nervous, and Dr. Raschkow from Loslau, claimed to have etc.). The usual treatment applied by the people seen a measles-like exanthema, while all other themselves consists in the excessive physicians denied its presence. Violent fever consumption of buttermilk, after which, as I with extreme muscular debility and frequent have been universally assured, the fever soon bronchial catarrh were said to be common disappears. But nearly all persons whom I could symptoms; diarrheas and meteorism were examine more thoroughly had retained an present very rarely; exaltation of the nerves, enlarged spleen and a pale cachectic appearance. especially of cerebral activity, only The dysenteries usually appear in late exceptionally. These typhuses occur during the summer, occur in large numbers and are whole year, but with special frequency in spring frequently of the so-called inflammatory and autumn. According to Mr. Haber's character, so that they are often fatal. experience, they almost fail to occur in humid Information on the typhous affections are years during which there was much rain, while divergent. The majority of local physicians they usually break out very rapidly in families assert decidedly that it is not the usual that live in new houses in which the loam on the abdominal iIeo-typhoid ( fièvre typhoïde ); the walls and floors is not yet dry. According to Mr. abdominal symptoms were hardly noticeable and Kunze, the district physician, the typhuses those in the head also reached but feeble sometimes intensify to epidemic form, as, for

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example, in Rybnik 15 years ago. Among the correctness of this law have so far not produced exanthemic diseases, particularly measles is very very convincing results. In Holland and Belgium frequent and widespread. (the Rhine Delta of the natural historians), in Of special interest among the truly endemic France and in Brazil, malaria and tuberculosis affections is trichoma (plica polonica ) which are not infrequently found side by side in frequently occurs in the Vistula lowlands, but families. In Amsterdam, through the kindness of also further up on the right bank of the Oder. I my friend Dr. Schneevogt, in the Buiten- have myself seen the choicest cases of it in Gasthuys directed by him, I have had Lonkau and Sohrau. opportunity to see that persons with overt Despite a diet based on potatoes, and poor tuberculosis had also contracted malaria, which housing, scrofula and tuberculosis are very rare. had no effect on the course of the former Although I have seen an unusually large number disease. On the other hand, it appeared that cases of patients from the poorer classes in cities and of tuberculosis did develop during a terrible villages, in private homes, and in hospitals, I epidemic outbreak of malaria (1846-47) in the have never seen a single case of phthisis. The very nests of fever infection. In Rochefort, in information given by physicians is in complete one of the most severe malarial foci, A Lefèvre agreement with this. Exact statistical data for (Gaz. des hôp . 1845, Sept., No. 103) found 105 either incidence or mortality are not available. In cases of pulmonary tuberculosis and 27 cases of children, much enlarged abdomens are not rare; tuberculosis in other organs in 605 autopsies. however, they never are atrophic, nor are Apart from Boudin and others, to whom I shall enlarged glands ever seen (I naturally do not later return, only the Italian physicians speak of atrophic children with ascites, which I confirmed the exclusion principle. Particularly at have also seen). the congress of Italian scholars in 1846 the Reviewing these data, which, however problem was frequently vented. Buffalini finally incomplete they may be, can be considered such came to the conclusion that data to the contrary as they are as certain, I feel that some obvious could only have come from countries where reflections on the relation of the above intermittent fever was very benign, while mentioned diseases to one another and to local wherever malaria developed severely, had a long conditions might be added. duration and easily became pernicious, Apart from trichoma, the black history of antagonism was always observed. The Dutch which we must pass over, the endemic accessory example, however, contradicts this theory. But diseases of this same soil are malaria, typhuses we must ask ourselves whether there is no and dysentery, frequently side by side, mostly, intermediate solution to these conflicting data, however, occurring in such a manner that one or which after all, were obtained from observation. the other predominates at certain times; It seems to me that this is indeed possible by scrofulous and tuberculous diseases are equally exact and detailed observation of the rare. This simple listing will certainly remind relationships. When the army lists of everybody of the "law of exclusivity" between hospitalized cases and deaths are taken as a malaria and tuberculosis, mainly advanced by starting point, as in Boudin's cases, or statistical the natural history school, and recently also by data on large rural districts, as has been done in the young Vienna school, which has such great particular by the Italian doctors in regard to the practical importance. Without going into the Tuscan province Grossetto, it will not be details of the question, I think I must say this difficult to confirm the exclusion principle. For much, so as to preclude premature conclusions easily understandable reasons, tuberculosis does from my data. As is well known (although many not belong to the diseases affecting armies, and appear not to know it) exact examinations on the it never originates under the natural conditions

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of the countryside. But going into the cities and not only have I repeatedly heard from physicians particularly into the large cities, the true hotbeds in Holland about the transition of the of tuberculosis, the exclusion principle will very intermittent fevers into the typhous fevers ( febris frequently be found to be false. I said false intermittens into continua remittens ), but it has because natural laws, as I have previously also generally been observed in Upper Silesia pointed out, have no exceptions; if an apparent that previous malaria predisposes to typhus, exception is found to a natural law, one is which would be exactly the opposite of Boudin's mistaken in every case, since in that case it is not opinion. Lastly, I must point out that the the exception which is seemingly false but the observations of Mr. Haber, according to which law. In the spring and at the beginning of the typhuses are rare in humid years, also contradict summer of 1847 we had in Berlin, instead of the an observation of Boudin's, i.e., that desiccation typhus epidemic which usually occurs at this of swampy soil or its transformation to a pool season, an extremely extensive epidemic of will eradicate malaria and instead further malaria. The consumptives who were phthisis or typhus. hospitalized in large numbers at the Charité were Having referred the origin of the malarias, not spared, and I quite frequently had the dysenteries and typhous fevers to the endemic opportunity to see, in autopsies, the conditions, we must raise the question of what characteristic splenic tumors of malaria beside special causes must be assumed for each of these fresh tuberculosis of the lung. All observations diseases, of which causal relations these three so far gathered do, in my opinion, justify the diseases are thought to have with each other. conclusion that there exist malaria generating There is a general consensus of opinion that regions and conditions which cause tuberculosis, endemic 6 malaria is derived from a certain and that sometimes such conditions occur in miasma, a marsh-miasma; the latter, more those regions and sometimes they do not. exactly, is thought to consist of certain products Boudin ( Études de Geologie méd. sur la of decaying vegetation. In the dysenteries, phthisie pulmonaire et la fièvre typhoide, 1845 ) spoiled, particularly vegetable, substances have has even gone beyond the above mentioned also been incriminated as the source of the exclusion principle and, on the basis of disease, but in such a manner that, whereas we statistical tables, has established the principle must postulate for malaria a volatile miasma that phthisis and typhous afflictions are capable of penetrating through the respiratory relatively rare in areas where the primary cause mucous membranes, the dysenteric miasma of endemic malaria deeply modifies the human would be a permanent one which would gain organism, while in areas where these diseases access to the body by beverages or food. 7 As for occur frequently locally acquired malaria is rare the typhous affections, everyone knows how and mild; after a long residence in definitely often it was attempted to explain their origin by swampy countries people were immune to the intake of substances derived from rotting typhus ( compare Ann. d'hygiène publ. et de méd animal products created by the crowding of lég., 1845, Janv .). Thus that which was imputed many people in closed rooms, by the exhalations only to malaria was now extended to typhus from animal excrements or by direct also. However, the experience of the Upper putrefaction of the meat of different animals. If Silesian physicians directly contradicts this we take these views, which I do not intend to view. Boudin, though he does mainly speak of discuss here in detail, and apply them to Upper ileo-typhoid ( fièvre typhoïde ), also includes the Silesian conditions, i.e., see whether there do English 'typhus fever' in his argument, so that he exist factors in the above mentioned conditions cannot therefore exclude the Upper Silesian of the country and its inhabitants which would typhus. I would like to especially mention that support the possibility of such decompositions

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and the effect of their products on the human If these views on the endemic diseases of body, we find that this is in fact the case. Upper Silesia are correct, they would support the According to recent views in chemistry, rotting opinion defended by Brachet, i.e. that the requires the presence of an exciting and an malarial miasma is formed by the decomposition excitable substance; its occurrence depends on of vegetable substances, whereas that of the the degree of humidity and temperature. Rotting typhous affections is of animal origin (compare of vegetable substances consequently takes place Bouillaud, Traité des fièvres dites essentielles, wherever dead plant debris is found in humid 1826 , p. 351). After observing the prevailing soil; decomposition of animal products develops epidemic, we shall again discuss the degree of the more easily and intensively the more animal probability of the opinion presented. But I am substance is accumulated in a moist and warm saying here that a definitive opinion as to the room, and the more animal creatures remain questions raised will only be attained by long together in such a room for a long time. It is detailed studies of local conditions. I have not easily seen that such conditions are those been able to conduct such studies, as this would commonly present in Upper Silesia. The soil have involved staying in Upper Silesia for years. used for cultivation is almost exclusively very But it will be one of the noblest tasks of our moist because of its impermeability, coupled colleagues in Upper Silesia, and one worthy of with an abundance of rain. The valleys, the social significance of medicine, to develop consisting only of meadows and swamps, are the points which would permit the formulation frequently exposed to flooding. The houses are of legislation by providing definite small and humid, and overcrowded with people recommendations on how to deal with the and animals; the people stay indoors a great factors endangering the health of the inhabitants, deal, the temperature in the rooms always being in so far as this is possible under the conditions high (even in summer the air in these low rooms of our society, and in view of the natural must be very hot because of the presence of the conditions of the country. cooking stove and the impossibility of opening The year 1844, in which the apostle of the windows properly); finally, the people are temperance, Stephan Brzozowski, a Capuchin unclean and eat foods which undergo incomplete friar who had escaped from Russian Poland, fermentation, e.g. zur . Accordingly, we would exacted the vow of abstinence from spirits in the have to consider the great moisture of the soil as whole of Upper Silesia, was the last to yield a an essential factor for malaria; and, for the good harvest. In 1845 already there was a poor typhuses, the housing conditions and the food. harvest, especially of potatoes, so that the As regards dysentery, we cannot deny that the population later proposed the hypothesis that ingestion of unripe and indigestible vegetable God had wanted to punish them for despising his substances frequently causes sporadic cases in gift. Consequently, some have again begun to summer; we must, however, search for its drink spirits; the Catholic clergy released others general sources, as the enormous endemic from the vow, so that they should not drift to incidence sometimes attained by dysentery German catholicism, whose cradle, as is well cannot be satisfactorily explained thereby. In known, stood in this very area. In 1846, the year this connection I would like to point out in in which forced labor began to be abolished, the particular that the wells from which the people harvest failed to such an extent that public take their water are frequently superficial and assistance had to be given to the poor and that situated in the highest layers of the swampy the inhabitants of the district had to incur a debt ground in the low grassy valleys, so that the of 30,000 thalers. At that time the hand-outs of admixture of decomposing vegetable products flour first started. Month after month, as the from the latter can take place very easily. stocks of food further decreased, want increased;

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and in the summer of 1847 many of the After this the typhus epidemic gradually surrogates of which I have already spoken were began to develop. According to various reports it consumed (clover, grass, fungi, roots, etc.). would seem that typhus was present in the Meanwhile, deprivation had also overtaken the adjacent Austrian provinces (Galicia, Austrian poorer artisans in the cities, as the notorious Silesia, Moravia and Bohemia) before it cession of Cracow had taken place, and the rural appeared in the Prussian districts. But since the population, which was growing more Austrian press was not able to report anything impoverished by the day, had less and less about it we altogether lack exact information. It money to spend in the towns (compare the seems, however, as if the epidemic had caused excellent description by Kuh in the Med. Ztg., extraordinary devastation particularly in Galicia. No.8). Everyone remembers the high In the province of Wadowicz, which borders on temperatures of 1847. Such a temperature, the district of Pless, the number of deaths is however, as we have already seen, is good for concurrently given as from 60,000 to 80,000 by Upper Silesia: dry years bring large harvests. various sources. The district prefect (the same, The potatoes did indeed seem to develop who placed a prize of 10 gold florins on the extraordinarily well; they had produced heads of Polish agents) is known to have stated luxuriant foliage. Expectations were high. But that this was of no import! The epidemic first very soon the situation changed; heavy rains fell, spread in the Pless district, where it already with ensuing inundations; the potatoes became began in July; in the Rybnik and Ratibor diseased and the harvest failed totally. Mr. von districts it did not reach its greatest development Elsner in Great-Strehlitz, in the northern part of before September-October; in Loslau and Upper Silesia, has determined the mean yearly Rybnik itself it was not before December and rainfall for his place of residence as 25 Paris January that the full intensity of the epidemic inches, from 14 years of observations. This was felt. During January, February and March approximately corresponds to the average the epidemic gradually raised its head in 7 rainfall of Heidelberg. From the 10th of June to further districts (Gleiwitz, Beuthen, Lublinitz, the 16th of September, 1848, he measured 19.75 Great Strehlitz, Rosenberg, Kosel, Leobsch űtz), Paris inches, i.e., somewhat more than the yearly so that it afflicted more than 2/3 of Upper average for Berlin (19.6"). Silesia. During the first part of summer there The famine, naturally, had rapidly increased occurred an epidemic outbreak of dysentery to enormous proportions after the complete which, in distribution and violence, matched the failure of the harvest. District magistrate, Mr. severest of epidemics. Definite statistical von Durant, sent a report on the condition of the information is not available, as the number of crop and the threatening famine to the Minister the patients cannot be even approximately of the Interior, Mr. von Bodelschwingh, on estimated. But mortality can be assayed if we August 3 (Schles. Ztg., 1848, No. 44, Suppl. 2). compare the absolute numbers of deaths in that Nothing was done, however, because these year with past figures. The number of deaths in reports were taken as timorous souls, the district of Pless in 1847 exceeds that of exaggerations. Did not this same minister, when normal years (about 2000) by about 5000, a accompanying the king two years ago on his figure representing nearly 10% of the whole journey to Upper Silesia, in which they never population. The epidemic of dysentery also left the railway track and the palaces of the great affected the wealthy classes. At the same time landowners, shruggingly explain to the well- there was an epidemic outbreak of anthrax informed and well-meaning local dignitaries in among ruminants. Ratibor, Gleiwitz, and other cities, who described the prevailing state of distress, that

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things were not as bad as they chose to portray spots, in that the toughly adhesive coat of clay is them; he knew better, the government was well- carried by an utterly softened substrate and informed! When he finally did recognize that the markedly bends downward under the slightest of loads. These spots are aptly called “leather situation was desperate, help was so long bridges." delayed on account of the interruption of water 5. An old (barbarian) writer tells us of the Slavs: traffic in winter and of the time-consuming "Sunt enim Slavi proceri omnes ac robustissimi; bureaucratic correspondence that many people colorem nec summe candidum habet cutis nec flavum coma, neque is plane in nigram deficit, ac (how many no one knows) actually starved to subrufus est. (Procop. de bello Gothico III. c. 4)" death. The Breslau Committee which first had to 6. I wish to expressly state that, in the following, I beg for money from all over Germany was on am limiting the discussion to endemic malaria, the spot earlier than was the Government! 8 dysentery and typhous afflictions, and that I would not automatically concede that these considerations be directly transposed to the Endnotes etiology of all sporadic cases. 1. The reader, perceiving a certain lack of precision 7. I cannot refrain from quoting a case of Boudin's in the use of the term "typhus" in the text should (Gaz. méd., 1845, Oct., No. 40): In a quarter of bear in mind that, in the middle of the 19th Versailles that receives its water by piping from century, particularly in Germany, typhus the Trou-Salé, a severe endemic dysentery broke included a variety of fevers thought to affect the out, with periodical paroxysms that did not befall nervous system. Virchow himself believed the the inhabitant of other quarters, or those drinking "typhuses," now differentiated mainly into wine and water from the river Seine. "typhoid fever" and "typhus fever," to be variants Examination revealed that fishermen in the Trou- of essentially the same affection and frequently Salé had agitated the mud of the pond with their (though not always) attempted to distinguish nets. This was forbidden at once, Seine water between the "compound," abdominal form or was let into the pond and the dysentery stopped. ileotyphus (= typhoid fever) and the "simple." 8. Just as I was about to send this manuscript to the exanthematous or petechial (spotted) form (= printers I received a monograph written with typhus fever), to which the Upper Silesian great knowledge and in the finest spirits, entitled epidemic pertained. Remittent (recurrent) fevers The Hunger Pest in upper Silesia, an Illustration were also included. For further details on the of Upper Silesian and Prussian conditions, history and evolution of the concept of typhus Mannheim, 1984. Much as I regret not to have also compare with later chapters (XI, XII) (Ed.). been able to consider in my report many of the 2. In my description I mainly follow the almanac facts therein reported, I am on the other hand for the Upper Silesian Miner for the fiscal year greatly pleased to find a confirmation of its 1845 (second volume), edited by R. v. Carnall, accuracy in the agreement between that paper where the alluvial mountains of Upper Silesia and my report. Comparing the two, I note that are discussed on p. 27. the most I could be reproached with would be to 3. The opinion of Carnall seems to be supported in have been too mild in my judgments. In order to particular by the circumstance that the surface of correct this fault I most heartily recommend this the soil at the higher points is commonly formed paper to the reader. by clay and at the lower parts by fine gravel. 4. On the roads there readily form somewhat unsafe

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