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St. Kilda, Past and Present
Chapter X. - Diseases of the Islanders

WITH the view of obtaining the most authentic information on the subject of the diseases of the St Kildans, I have analysed the causes of death and other relative particulars in the register kept by the Rev. Neil M'Kenzie during his residence on the island (1830-44), now in the custody of the Registrar-General; also the duplicate registers of deaths in St Kilda, pertaining to the fifteen years ending 1870, kept under the provisions of Lord Elcho’s important statute, and the returns subsequently transmitted by the registrar to Edinburgh up to the end of 1876 — embracing in all a period of about thirty-four years, if we deduct the interval between the close of Mr M'Kenzie’s record and the commencement of the new system of registration. My attention has been called to an interesting article on the Diseases of St Kilda, by Mr John E. Morgan, already referred to, in the ‘British and Foreign Medico - Chirurgical Review’ for January 1862. Mr Morgan, who is a member of the Royal College of Physicians, Manchester, appears to have made a partial analysis somewhat similar to my own; and I shall avail myself of some of the opinions and conjectures which his paper contains.

From a note prefixed to Mr M'Kenzie’s register, it appears that he went to St Kilda on the 3d of July 1830, as a missionary from the Society for Propagating Christian Knowledge—and finding that no record was kept of baptisms, marriages, and deaths, he determined to supply the omission while he remained on the island. He was translated to Duror, in Appin, in 1844, visited St Kilda in 1845, and again in 1847, and is now minister of the parish of Kilchrenan, in Argyllshire. The register in question embraces 72 baptisms between 4th July 1830 and 18th July 1851—22 marriages between 20th August 1830 and 10th July* 1849—and 68 deaths between 18th July 1830 and 31st October 1846. Three of the deaths, as well as a few of the baptisms and marriages, occurred after Mr M'Kenzie’s departure in 1844. The following table exhibits the comparative mortality of the two sexes from the various causes specified by Mr M‘Kenzie :—

Shortly after the passing of the Scottish Registration Act, the Registrar-General suggested to Mr Macleod— afterwards Sir John Macpherson Macleod, K.C.S.I.— the proprietor of St Kilda, the expediency of having a registrar appointed in the island; and both that gentleman and his factor, Mr Norman M'Raild, entered very cordially into the proposal. Accordingly, in the year 1856, St Kilda was formally constituted a registration district by the sheriff, on the application of Mr Macleod, as sole heritor; and Mr Duncan Kennedy, then Free Church catechist in the island, was appointed to the post of registrar. He left St Kilda about the middle of the year 1863, and was succeeded in the office by the Rev. A. Cameron, who took up his abode in the island in the month of September following. About two years later (October 1865), the Rev. John M‘Kay supplied the place of Mr Cameron, and now acts as registrar. In one of his letters to the Registrar-General, Mr M'Raild mentions that St Kilda is “not overlooked”3 by the poor-law authorities of the parish of Harris, to which it belongs— adding, however, that “ meantime the proprietor directs me to make up the want of the inhabitants.”

Owing to the limited population and the rarity of communication with the island, an arrangement was made, in terms of which the duplicate registers of births, deaths, and marriages in St Kilda should be transmitted to the central office every ten years, instead of annually, as in the case of other districts.4 Accordingly, when the census of St Kilda was taken by Mr Grigor, as examiner of the district embracing the Hebrides,, in the summers of 1861 and 1871, he collated the registers for the five and ten preceding years respectively, and transmitted the duplicates to the Registrar-General. Since 1871, as already indicated, the registrar has made periodical returns of the births, deaths, and marriages. During the twenty-one years ended 31st December 1876, the births amounted to 56 (32 males and 24 females), and the deaths to 64 (37 females and 27 males), being at the rate of rather more than births and 3 deaths annually. Of the 56 births, 3 were illegitimate, in the years 1862, 1864, and 1876 respectively, the last being an adulterous case.

The causes of death and the ages of the deceased are stated below. The seven deaths by drowning occurred 3d April 1863, at the loss of the “ Dargavel,” already referred to. The death of one of the males who perished on the occasion does not appear to have been registered. It will be observed that the total infantile mortality amounted to 41—26 males and 15 females.

From these tables it will be seen that in a total mortality of 132, the infantile mortality, during the two periods of 16 and 21 years collectively, amounted to 76 cases, of which no fewer than fifty-two—or more than double—were males, the remaining 24 being females. Of the 76 deaths, 35 occurred during the 16 years ended 1846, and 41 during the 21 years ended 1876. Taking the population of the island in 1841 (105) as the basis of comparison for the mortality of the earlier period, and the population of 1871 (71) as that for the later period, it would appear that the infantile mortality was less during the earlier than during the later period, being in the one case at the annual rate of rather more than 2 per cent (2.08), and in the other exactly 2^ per cent (2.75), or 208 and 275 deaths respectively in a population of 10,000. During the 37 years in question, the number of deaths from eight-day sickness has been remarkably equal—viz., a fraction above 2 deaths annually, ranging from a minimum of 1 to a maximum of 4.

During the same period, the deaths of four young men are attributed to “ fall over rocks,” and three deaths (all males) are assigned, in Mr M'Kenzie’s register, to “ boat cough,” to which, as well as to some of the other causes specified in the tables, reference will afterwards be made.

In St Kilda, as elsewhere, it may be reasonably concluded that the health of the inhabitants is more or less affected by the character of their climate, habits, and occupations, and the nature of their food and condition of their dwellings; and, at least in the case of the most prevalent diseases, it certainly appears that one or more of these circumstances exercise no inconsiderable influence. Probably the most remarkable of the St Kilda diseases is the “eight-day sickness,” or infantile lockjaw (trismus nascentium), known in some parts of Ireland under the name of "nine-day fits.” It receives its English name from the circumstance of its victims being usually attacked on the eighth or ninth day after birth ; but, as shown in one of the preceding tables, the fatal issue occurs as early as the fourth day, and as late as the twenty-second day, after birth. This disease is not referred to by Martin, but it is distinctly mentioned by Macaulay, who states that “the St Kilda infants are peculiarly subject to an extraordinary kind of sickness. On the fourth or fifth day after their birth, many of them give up sucking; on the seventh their gums are so clenched together that it is impossible to get anything down their throats. Soon after this symptom appears, they are seized with convulsive fits, and, after struggling against excessive torments till their strength is exhausted, die generally on the eighth day.” Mr Morgan refers to the evidence of the “nurse of the isles-women,” who herself lost twelve out of fourteen children born alive. In these, and in all the other fatal cases which she had known during a period of thirty years, the children were all “proper bairns” up to the fifth or sixth day after birth. The same writer describes the various symptoms in detail, directing special attention to the relaxed condition of the jaw. The nurse informed him that when once the jaw falls, all hope is lost—adding, “I have never seen a child come round when that happened.”

In the fifth volume of the 'British and Foreign Medico-Chirurgical Review’ we are told, on the authority of a gentleman who visited St Kilda in 1838, that the disease proves fatal to eight out of every ten children born alive. Mr M'Raild, the factor for the late proprietor, in a letter addressed to the Registrar-General, gives even a higher proportion — viz., nine out of . ten. According to Mr Morgan’s calculations, on the other hand, the deaths from trismus since 1830 have only amounted to five out of nine—the disease proving fatal, in the great majority of cases, between the fifth and tenth day after birth. This mortality, however, is said to be far exceeded in the West-mann Islands, off the coast of Iceland. In the appendix to Sir George Mackenzie’s ‘Travels in Iceland’ it is stated, on the authority of Sir Henry Holland, with reference to Heimacy, one of the group, that the population, then amounting to less than two hundred, was “almost entirely supported by emigration from the mainland, scarcely a single instance having been known, during the twenty years preceding his visit, of a child surviving the period of infancy.’’ In a relative table, he shows that out of 185 deaths, 75 took place on the seventh day, 22 on the sixth, 18 on the ninth, and 16 on the fifth and eighth—the second and twenty-first days being the earliest and latest respectively on which the disease terminated fatally. Dr Arthur Mitchell,1 on the other hand, asserts, that while the Westmann mortality from trismus, over a period of twenty years, amounted to 64^per cent, that of St Kilda was more than 3 per cent higher. “Out of 125 children,” he says, “the offspring of the 14 married couples residing on the island in i860, no less than 84 died within the first fourteen days of life, or, in other words, 67.2 per cent . . . The pestilential lanes of our great cities present no picture so dark as this. It is doubtful if it is anywhere surpassed, unless in some of the foundling hospitals of the Continent.” One of the remarkable results of this abnormal infant mortality, referred to by Dr Mitchell, is the increased fecundity of the mothers. “One woman in St Kilda, at the age of thirty, has given birth to 8 children, of whom 2 live; while two others have borne 14 each, or 28 in all, of whom 24 are in their graves.” The absence of children about the cottages of the remote island has struck many visitors,—a circumstance which naturally recalls the old Gaelic saying that “ a house without the cry of bairns is like a farm without kye or sheep.” Being aware that a disease called “yiW-nights’ sickness,” somewhat similar to trismus, was believed to prevail in the parishes of Barvas and Uig, on the west coast of Lewis—the former being about 80, and the latter about 60 miles distant from St Kilda—I have prepared the following tabular statement from the registers of deaths pertaining to these two parishes, for the six years ended 1874. Crediting all the juvenile deaths in the table to trismus, it appears that out of the 446 deaths which occurred in Barvas during the six years in question, they only amounted to 51, or at the annual rate of 0.171 per cent of the population as at 1871; while in Uig, during the same period, in a total mortality of 169, they amounted to only 16, or 0.124 per cent, or 17 and 12 deaths respectively in a population of 10,000—in both cases, a very different proportion from that which is exhibited by the registers of St Kilda.

For the purpose of further comparison, I annex another table, showing the number of children under 3 months of age who died from tetanus1 in Scotland and its five groups of districts during each of the three years ended 1873.* It is questionable whether any useful conclusions can be drawn from the figures, beyond the general fact that the proportion of these deaths was very much larger in the insular districts than in the rest of Scotland. During the three years in question, the total number of infantile deaths from tetanus appears to have been 48, of which occurred in the insular districts, with an estimated population of 131,418. If the mortality had been in the same proportion in the rest of Scotland, with a popula-of 3,267,807, instead of 37 deaths, as indicated in the table, there would have been no fewer than 273.

As to the cause of this remarkable disease in St Kilda, various explanations have been offered. According to some, the excessive mortality arises from the mismanagement of the umbilical cord at birth, while others consider that it is produced by the infants being exposed to sudden alternations of temperature. We have already seen, however, that the climate of St Kilda is remarkably mild and equable; and Mr Morgan informs us that the treatment of new-born children is precisely the same as that which is followed on the west coast generally. But he is very much inclined to think that the chief cause of the mortality is a vitiated atmosphere dependent on deficient ventilation; and he asserts, moreover, that imperfect ventilation is a condition which exists in other places where the disease prevails. Although externally very similar to ordinary huts in all parts of the Scottish Highlands, the former houses of St Kilda were in some respects essentially different. In almost every instance, there was no hole in the roof for the escape of smoke; and the walls, instead of being constructed of unhewn stones loosely piled together, and more or less pervious to the atmosphere, consisted, as already explained, of a double stone dyke, separated by an interval of eighteen or twenty inches, which was completely filled with closely-packed layers of sod, with a view to the indoor manufacture of soot, which they use as a manure. Within these rude fabrics the inmates may be said to have been hermetically sealed, and their unfortunate infants were thus debarred from the invigorating influences of the purest air in this quarter of the globe. The very unsatisfactory condition of the former cottages of St Kilda is referred to in the report on the census of 1851, where it is stated that, through the ignorance of the inhabitants, they are “dirtier than the dens of wild animals.” In a letter which he contributed to the *Scotsman* in August

1875, Mr Sands erroneously states that the eight-day sickness has only recently appeared in the island, and, instead of pointing to the older houses as the cause of the disease, suggests that the zinc roofs of the modem cottages may have something to do with it Their comparative deficiency in warmth has also been indicated as having a possible connection with the fatal malady.

Dr Collins’s well-known ‘Treatise on Midwifery’ contains some interesting particulars relative to the disease in question. It embraces a record of the 16,654 children born in the Dublin Hospital during the seven years ended 1833, of whom 284 died before the mother left the institution. Of the 284, 37 died from trismus nascen-Hum, “a disease,” he says, “of much interest to the medical practitioner, from its obstinate resistance to all modes of treatment.” He mentions, as the result of the experience of one of his predecessors, Dr Clarke, that at the end of the year 1782, out of 17,650 live births in the hospital, 2944 children died within the first fortnight— i.e., nearly every sixth child, or about 17 per cent; and about 19 out of every 20 died of nine-day Jits. . As the foul and vitiated state of the air in the wards was supposed to be the principal cause of this alarming mortality, an attempt was made to introduce a counteraction, apertures being formed in the ceiling of each ward (since changed for air-tubes passing to the roof), while small holes were made through the tops of the window-frames and of the doors opening into the galleries. The result of this simple process was a free circulation of air; and out of 8033 subsequent births, 419 children died = about 1 in ig}4, or from 5 to 6—instead of 17— per cent. Dr Collins considers that extreme vigilance as to cleanliness, combined with free ventilation, might banish the frightful disease from lying-in hospitals. The mode in which trismus attacks the children is described in Dr Clarke’s relative treatise in the third volume of the ‘Transactions of the Royal Irish Academy.’ Dissection appears to have thrown no light on the pathology of the disease. No treatment hitherto adopted, including calomel, opium, tobacco, oil of turpentine, tartar emetic, leeching and warm bath, has produced a shade of relief. -Accordingly, prevention is the only alternative where cure seems to be hopeless. The following tables have been prepared from Dr Collins’s statements, in order to show the particulars connected with the 37 deaths from trismus which occurred during his mastership. The diminution in the mortality exhibited in table No. III. is attributed to the removal of impure air. The total number of deaths was, no doubt, in the inconsiderable proportion of 1 in 450; but for the last four years (1830-i833), it was only 1 in 666.

One of the Edinburgh death-registers for the year 1873 contains an entry relative to a male child who died, at the age of twelve days, from “ tetanus (trismus nascen-tium),” after four days’ illness. The following note of the medical attendant—a well-known and skilful practitioner —occurs immediately below the cause of death, in the sixth column of the register : “ This child was bom on board, and remained on board ship till it was taken ill.

The ship was loaded with bones and bone-ash—the atmosphere consequently impure. The child had never been in the open air. This is the only case I have seen for many years. As certified by J. S., M.D.”

In common with some other writers, Dr Arthur Mitchell considers that the mortality from trismus is intimately connected with the peculiar character of the houses; and he seems to have satisfied himself that there was nothing exceptional in the mode of dressing the umbilical cord to account for the results. He also declines to accept, as applicable to St Kilda, the explanation offered by Schleisner with reference to the infantile mortality of Iceland1 —viz., the use of birds’ excrements as fuel, and birds’ fat for lighting purposes; discrediting the idea that the consumption of fulmar-oil in the lamps of St Kilda has any connection with the disease in question. As already indicated, Mr Morgan attributes what may be termed the “slaughter of the innocents,” to the insanitary character of the domestic arrangements, and more especially to the indoor manufacture of manure—the former cabins of the inhabitants having been constructed, as already stated, without smoke-holes, with the view of preventing its escape, owing to the scarcity of manure. For twelve long months the soot was deposited in pitchy layers upon the inner surface of the roof, and collected in the manner already indicated. As stated by Mr W. H. Corfield of U niversity College, London, in a letter to the ' Times,’ towards the end of August 1871, this view of the matter is referred to in the ‘ First Report of the Health of Towns Commissioners/ published in 1844; and after mentioning the filthy habits of the St Kildans, Mr Cor-field expresses great surprise that nothing should have been done to improve their sanitary condition, and points to the fact of there being only one child in the island, at the time he wrote, in a population of seventy-one, and that one dying! A reply was sent by the owner of the island, in which he admitted the large infantile mortality. “What the cause of this is,” he says, “I have never been able to ascertain, but I am certain that it is not what Mr Corfield desires the public to ‘rest assured’ that it is. The state of things on the island is very different from what he imagines it to be. The inhabitants are well fed, well clothed, and, for a Hebridean peasantry, particularly well housed. I have no doubt that the habits of the people in respect of cleanliness admit of improvement; but the disgusting practice described in Mr Corfield’s letter — though something of the kind did prevail in former times —is unknown to the present generation." A few days afterwards, Rear-Admiral Otter, who frequently visited St Kilda, and to whom I have already more than once referred, wrote another letter to the ‘ Times,’ in which, after mentioning the proprietor’s other acts of kindness to the inhabitants, he specially alludes to the erection, about ten years previously, of a series of “ neat detached two-roomed cottages with zinc roofs, in lieu of the former houses.” He then proceeds as follows: “ As to the mortality of the children, I believe the cause can be traced to the oily nature of their food, consisting chiefly of seabirds, which build in incredible quantities on the different islands forming the group. The fulmar, which is found in no other place in the United Kingdom, is a peculiarly oleaginous bird, containing in its stomach a considerable amount of clear pinkish oil. . . . Though they have cows, potatoes, and meal, this is their chief article of food, and thus the system becomes so impregnated with fatty matter that it gives a peculiar odour to their persons, and the touch of their skin is like velvet The startling mortality of the children before the ninth or tenth day (which has not been over-rated), is caused by the strength of the mother’s milk while nursing; and to prove this theory, a child being born during our stay, the mother was kept on cocoa, meat, and biscuit, and the child throve well. Those that survive infancy grow up strong, healthy men and women, in spite of their intermarrying so much among themselves. As to the dirty state of their dwellings, it never struck me they were worse than their neighbours’ on the main islands, if so bad; and, in proof, the late Duke of Athole chose one of their cottages as his residence during a stormy night, instead of the manse.” Admiral Otter incidentally alludes to the frequent intermarriages of the St Kildans, which some persons have supposed may be calculated to produce the malady in question by having an unfavourable effect upon the offspring. If, however, these unions had any connection with the matter, it seems highly improbable that their injurious influence would terminate a few weeks after the occurrence of the births, seeing that the children which survive that period usually turn out healthy and vigorous.

Such, then, are the various explanations that have been offered with regard to the frequent occurrence of the eight-day sickness in St Kilda. It does not appear that since 1862, when the present improved cottages were erected, there has been the slightest reduction in the number of fatal cases ; and accordingly, we may reasonably conclude that a vitiated atmosphere is at least not the sole cause of the fatal malady. Doubtless, the insanitary conditions which pertained to the older habitations —now chiefly if not entirely used as cellars and byres— may have exercised a baneful influence upon infant life, and moreover, it is possible that these unfavourable conditions may have left a temporary mark on the constitutions of the adults of St Kilda; but I am disposed to acquiesce in Admiral Otter’s views regarding the effect of the oily food of the sea-birds upon the mother’s milk, and indirectly upon the health of her offspring.

A somewhat similar opinion is entertained by Miss Macleod, who considers that there is a tendency to inflammation among the islanders, owing to the strong and oily character of their ordinary food. Instead of both mother and child being judiciously starved, the moment the latter is born stimulants are administered. During Miss Macleod’s recent sojourn on the island, she saw port-wine and cow’s milk poured down the throat of an infant of one day old! She at once stopped the procedure, and the child survives in a thriving condition. Unfortunately there is no properly qualified nurse in St Kilda. On Miss Macleod suggesting that an experienced woman ought to be procured, an old man calmly said—“If it’s God’s will that babies should die, nothing you can do will save them!” After her return to Dunvegan, Mrs .Macleod (her sister-in-law) wrote to ask whether one of the St Kilda women would come to the castle, with the view of learning English, and then proceeding to Edinburgh to receive a thorough medical education; but the generous proposal was declined, on the ground that all the women were afraid to leave their sea-girt home. Miss Macleod contemplates another visit to St Kilda in the course of next spring, and hopes to succeed in persuading one of them to accompany her to Skye. Apropos to the treatment of infants, Mrs M'Vean states in her Reminiscences that a St Kilda mother never thinks of providing clothing for her babe, until she sees whether or not it will survive the critical eighth day. Meanwhile, it is swaddled in coarse home-made flannel; and Captain Thomas considers that, on these occasions, the usual tendency of the mother is to smother the infant with blankets and other wraps.

Another very remarkable malady which occasionally prevails among the inhabitants of St Kilda is a species of influenza, locally termed “boat-cough,” “strangers’ cold” (cnatan na gait), or “the trouble,” by which the natives are almost always attacked shortly after the arrival of a vessel from the outer Hebrides. They allege that the illness is most severe when the visitors come from Harris, and that they suffer less when the vessel hails*from Glasgow or more distant ports. It is particularly referred to by both Martin and Macaulay, and also by most of the more recent writers on St Kilda, some of whom were eyewitnesses of its effects. Mr Wilson informs us that the Rev. Neil M'Kenzie confirmed the account of it which he had formerly read and disbelieved; and Mr Morgan gives some curious details of its character from actual observation. As already stated, about ten days before his visit to St Kilda in i860, H.M.S. “ Porcupine,” commanded by Captain Otter, and with the late Duke of Athole and Mr Hall Maxwell on boat'd, had visited the island; and a day or two after the departure of the vessel, “ the trouble ” made its appearance— the entire population being more or less affected by it. The same thing occurred after the arrival of the factor’s smack in 1876, and also on the landing of the Austrian crew in the present year. It usually begins with a cold sensation, pain and stiffness in the muscles of the jaw, aching in the head and bones, and great lassitude and depression—the ordinary symptoms of catarrh in an aggravated form—and is accompanied by a discharge from the nose, a rapid pulse, and a severe cough, which is particularly harassing during the night. The malady first attacks those persons who have come most closely into contact with the strangers, and then extends itself over the whole community. Mr Morgan saw an unfortunate little infant, not more than a fortnight oldr “ grievously tormented with it.” The fatal cases of boat-cough, although not absolutely, are relatively, numerous —three of the 68 deaths entered in the older register having been caused by the disorder. By some the seizure has been attributed to the circumstance of the inhabitants exposing themselves to cold, by rushing into the water to render assistance to strangers in landing on the island; but when we consider the hardships to which they are inured in the prosecution of their hazardous avocation of fowling, such an explanation cannot possibly be admitted. Others allege that the disease is consequent upon easterly winds, which, however, are the most unfavourable agencies for the approach of a vessel from the Hebrides. As already stated, a landing is most easily effected when the wind is contrary; and in the case of Martin’s party, whose visit was followed by an attack, the sailors were obliged to have recourse to their oars. This solution is suggested in a letter quoted by Boswell in his ‘ Life of Dr Johnson,’ in which the writer states that an ingenious friend—the Rev. Mr Christian of Docking—considered the cause to be a natural one, under the erroneous impression that the situation of St Kilda rendered a north-east wind indispensably necessary before a stranger could land. Hence he concluded that the epidemic was caused by the wind, and not by the visitor. Boswell also mentions that the celebrated Dr John Campbell endeavoured to account for it on physical principles—to wit, from the effect of effluvia from human bodies. The great moralist himself appears to have been somewhat sceptical upon the subject “How can there be a physical effect,” he said, “without a physical cause?”—jocularly adding, “the arrival of a shipfull of strangers would kill them; for, if one stranger gives them one cold, two strangers must give them two colds, and so in proportion.” On its being mentioned that the truth of the fact is annually proved by Macleod’s steward, on whose arrival all the inhabitants caught cold, he humorously answered: “ The steward always comes to demand something from them, and so they fall a-coughing! ”

Like the great lexicographer, Macculloch appears to have been utterly incredulous on the subject of the “strangers’ cough.” In hopes of hearing the whole island join in one universal “chorus of sneezing,” he watched with great anxiety; but no sneezing was heard, and none did cry, “ God bless him! ” He then ironically says that the perfection of faith is to believe against our senses, and that although the event could scarcely be concealed in the limited number of pocket-handkerchiefs which the islanders possessed, nevertheless, nobody doubted that it was an actual fact “Everybody had witnessed it, from Martin to Macaulay; everybody believed it, from Macaulay to the present day; the whole island—including the minister’s wife, then regent of St Kilda — was agreed upon it, and who, then, dared to doubt?” The Doctor appears to have expected to witness an immediate visitation. “ Everybody looked at every other’s nose; but not a drop of dew distilled, and not a sneeze consented to rouse St Kilda’s echoes.” He proceeds to quiz the would-be philosophers who must find a cause for everything. “It is all owing," say some of these wise personages, “to the east wind:" causa pro non causa; ’ because this is precisely the wind which prevents any boat from landing on the island." Among other humorous solutions he suggests the idea of strangers being naturally welcomed by a sneeze instead of a kiss of peace, a trifling superstitious vein in Johnson, who praised Macaulay for his magnanimity in venturing to chronicle so questionable a phenomenon.

Some persons have maintained that the boat-cough is an annual epidemic; but Mr Morgan assures us that, within the short space of eight weeks, three several outbreaks have been known to follow the arrival of as many boats. While acknowledging that the origin of contagious diseases is involved in great obscurity, the same writer suggests that the usual isolation of the inhabitants—who are under exceptional conditions both as regards diet and occupation—when followed by sudden contact with strangers, may exercise an infectious influence on the more susceptible of their number. A curious confirmation of this opinion will be found in Mr Bates’s interesting work, entitled ‘ The Naturalist on the River Amazon.’ Speaking of the gradual extinction of certain tribes friendly to the whites, who inhabit the country near Ega, he says : “ The principal cause of their decay in numbers seems to be a disease which always appears amongst them when a village is visited by people from the civilised settlements — a slow fever, accompanied by the symptoms of a common cold—‘de Jluxo,’ as the Brazilians term it, ending probably in consumption. The disorder has been known to break out when the visitors were entirely free from it—the simple contact of civilised men, in some mysterious way, being sufficient to create it.”

A still more recent as well as a more strictly parallel illustration of the occurrence of the malady in question, in another part of the globe, is contained in the account of the ‘Cruise of H.M.S. Galatea,’ in 1867-68, where the following statement occurs : “ Tristan d’Acunha1 is a remarkably healthy island; but it is a singular fact that any vessel touching there from St Helena invariably brings with it a disease resembling influenza. St Kilda, off the west coast of Scotland, is known to be also similarly afflicted whenever a party lands amongst the people from any vessel." With regard to St Kilda, pace Johnson and Macculloch, there can now be no doubt as to the fact of a visitation of influenza having hitherto been the apparent result of numerous visits from the outside world. Whatever may be the real cause of the mysterious ailment—whether it is produced by contagion, like certain other epidemic diseases, or by a feverish excitement arising from the contact of a higher with a lower civilisation—the actual occurrence of the distemper seems to be fully established, and the experiences of Ega and Tristan d’Acunha afford interesting illustrations of somewhat similar results in very different parts of the world.

Dysentery is another pretty frequent disease in St Kilda, and is supposed to be produced by severe intestinal irritation, arising from the continuous use of salted sea-fowl and coarse oatmeal, more especially the former. Seven of the 68 deaths recorded by Mr M'Kenzie—two males and five females—are attributed to that disease, which, however, does not appear in the later register. Possibly some of the deaths tabulated under the heads of “Unknown” or “Not specified” may have been caused by dysentery.

In common with the Western Highlanders generally, the inhabitants of St Kilda enjoy a remarkable immunity from consumption and other tubercular diseases. Only two cases of deaths from consumption — both females advanced in life—appear among the 132 deaths embraced in the registers. Martin refers to the fact of the island being free from many diseases which are common in other parts of the world. “The distemper,” he says, “that most prevails here is a spotted fever, and that, too, confined to one tribe, to whom this disease is, as it were, become hereditary. Others are liable to fluxes, fevers, stitches, and the spleen, for all which they have but very few remedies. . . . The smallpox hath not been heard of in this place for several ages, except in one instance of two of the steward’s retinue, who not having been well recovered of it, upon their arrival here infected one man only.” I have already referred to the smallpox epidemic of 1724, which proved so disastrous to the inhabitants. So far as I am aware, it has not appeared in St Kilda since that date.8 Seventeen of the islanders, including all the children, were vaccinated by Dr Webster of Dunvegan in June 1873, and the rest of the inhabitants about three months later by Dr Murchison of North Harris, who was conveyed to St Kilda in H.M.S. “Jackal/' under the sanction of the authorities of the Admiralty. On the occasion of my visit to the island in July, three children were vaccinated by Dr M'Kellar of Obbe. Martin states that some thirteen years before he went to St Kilda, leprosy broke out among the islanders, and that two families were “labouring under the disease” at the time of his visit. He considers that the malady was in a large measure to be ascribed to their “gross feeding” on the fulmar and solan goose.

“Of peculiar diseases or disorders,” says Mr Muir, “to which the people are liable, we did not hear much. Rheumatism, swellings, ulcers, eruptions, sore throats, and other complaints of an inflammatory and cutaneous description, arising from frequent exposure and an unvaried diet, were, as might have been expected, common.” He considers, however, that both in their frequency and virulency these ailments are probably much abated from what they used to be, in consequence of the comfortable quality of the clothing already referred to. From the medical report furnished to Mr Macdiarmid by Staff-surgeon Scott of H.M.S. “Flirt,” I extract the following statement: “The ailment par excellence is rheumatism, as might be expected from the exposed nature of their island home. This disease is common to both sexes, and in a number is attended with pain in the cardiac region, with irregular heart’s action. Dyspepsia is also common; and it is noticeable that the teeth were in general short and square, as if they had been filed down. There were several cases of ear-disease, and there is a tendency to scrofula. One boy had disease of the bones of the leg. . . . Colds and coughs are common enough, but no case of phthisis presented itself. We saw only two cases of skin-disease, and these were trifling, for Nature seemed to have endowed them with very clean, smooth, epidermic coverings.” After a reference to the eight-day sickness, the reporter adds: "The children whom we saw were all healthy-looking. The medicines which would be of most use are those for cough and rheumatism; and for the latter, strong liniments would be the most appreciated.” In the preceding excerpt, dyspepsia is mentioned as a common ailment in St Kilda. An anonymous visitor to the island in August 1875 sent a short notice of his experiences to one of the Edinburgh newspapers, in which he specially referred to the prevalence of that disease, and attributed its occurrence to the constant use of dried fish. Mr Sands replied to the communication, stating that the islanders rarely partake of fish, and that he never heard of their being subject to dyspepsia. The same anonymous visitor mentions that the physician by whom his party was accompanied, had to prescribe for the various diseases consequent upon poor living and an utter ignorance of the laws of health, and that he left a large quantity of iodine and Gregory’s mixture with the islanders. On the occasion of the visit of the “Dunara Castle” in July, we happened to have no fewer than five distinguished medical practitioners on board, most of whom, I believe, gave suitable advice to all the invalids, real or imaginary, who solicited their aid. Martin tells us that, in his day, the inhabitants “ never had a potion of physic given them in their lives, nor know they anything of phlebotomy;” but in modern times, they appear to have rather a weakness for medicine, of which the proprietor sends an annual supply, in the shape of castor-oil, senna, salts, and various tonics. Captain Thomas informs me that the doctor of the “Porcupine” once attended a sick man in St Kilda, for whom he prepared a few ordinary pills. The patient, however, objected to take so small a quantity of physic, on the ground that “it was not a fit dose for a grown man”! A homoeopathic chemist would make a poor living in St Kilda.

Judging from the statement of Sir Robert Moray, violent deaths must formerly have been much more frequent in St Kilda than in recent times. “The men,” he says, “seldom grow old; and seldom was it ever known that any man died in his bed there, but was either drowned or broke his neck.” We have already seen that only four deaths appear in the records kept in the island since 1830, of which the cause is attributed to a “fall over the rocks,” while the only deaths from drowning were the eight that occurred in 1863, at the loss of the “ Dargavel,” already referred to.

Mr Morgan contrasts the vital statistics of St Kilda with those of the Faroe Islands, in which the habits of life are, in many respects, very similar to those of the St Kildans. From the conclusions at which he arrives, it appears that notwithstanding their nauseous food and the open sewers in the immediate neighbourhood of their huts, the Danish islanders are the longest-lived community with which we are acquainted—their annual rate of mortality being only 12.5 in every thousand persons. In St Kilda, on the other hand, the death-rate, during the ten years ending 1840, amounted to very nearly 61 in every thousand, or nearly twice as high as that of the most unhealthy of the manufacturing districts in England. If the abnormal infantile mortality could only be checked, there seems to be no reason why the death-rate of St Kilda should not ultimately approximate to that of Faroe. It must be borne in mind that the present startling results do not afford an illustration of what certain modem philosophers would term “the survival of the fittest.” The destroying angel finds his way to every cottage in the island within which an infant’s voice is heard—the strong as well as the weak proving victims to the scourge.

Although in 1841 Mr Wilson found both sexes represented by three years beyond fourscore, in the persons of Finlay Macleod and Catherine Ferguson, the comparative longevity of the female population of St Kilda is a remarkable feature in their social condition. While the ages of the men rarely exceed sixty, the women not un-frequently reach the “ scriptural period.” Thus, at the census of 1861, although the males between 20 and 60 were slightly in excess of the females at the same age, the only persons above 60 were four females. At the last census, however, five males and only four females had passed the period of threescore years. Again, of the six deaths above 60 years of age in the registers pertaining to the twenty-one years ended 1876, one was that of a married male—his age being 63,—while the five other cases were females, aged respectively 75, 83, 84, 86, and 88—all widows except the oldest—two M‘Queens, two M'Crimmons, and one M'Kinnon. It has been very plausibly suggested that the shorter lives of the male population are the necessary consequence of their peculiar avocation. The St Kilda fowler is frequently suspended by a rope round his waist for several hours together, and the continued strain—both bodily and mental—not improbably induces congestion, and ultimately disease of some of the more important internal organs. With the view of checking such serious results, a leaf might be judiciously taken out of the book of the Faroe cragsmen, whose mode of fowling, as already mentioned, appears to be conducted on more scientific and safer principles than that which is adopted in St Kilda.

The Tristan d'Acunha group of islands, so named from the Portuguese navigator who discovered it early in the sixteenth century, lies in mid-ocean—lat 370 2' 48" S., long. 120 18' 30* W.—about 1300 miles south of St Helena and 1500 west of the Cape of Good Hope, nearly on a line between that Cape and Cape Horn, and is probably the most remote of human abodes. Like the St Kilda group, it comprises three islands—viz., Tristan, and two smaller islands called Inaccessible and Nightingale, each being about twenty miles distant from Tristan. The main island, which is almost circular and about seven miles in diameter, consists of a huge volcanic rock, rising perpendicularly some 3000 feet out of the sea, with a lofty cone on its summit ascending upwards of 5000 feet more, making the entire height of the island above sea-level 8300 feet! It is occupied by an interesting English colony, resembling in many respects the inhabitants of Pitcairn Island, to which reference has already been made. Temporarily occupied at different times by a few American sailors, it was formally taken possession of in the name of the British Government in 1817, the first “governor” being William Glass, a corporal of artillery and a native of Kelso, in Roxburghshire. The original settlers were Glass and his wife (a Cape creole) and their two children, besides John Nankivel and Samuel Burnell, natives of Plymouth. In 1824, the population amounted to 25, of whom only three were females; in 1836, to 42; and in 1852, to 85, all English by association, but not by birth and parentage, being of the mulatto caste. At that date the island was visited by Captain Denham in H.M.S. " Herald,” who considered that a more healthy place could not be found, none of the epidemical diseases having reached the settlers. Glass was then nearly 70 years of age, having, besides his wife, seven sons and eight daughters. In 1857, the Rev. W. F. Taylor, who had been sent to the island some years previously by the Society for the Propagation of the Gospel, went with about 45 of the inhabitants—the majority being women, then greatly in excess of the men—to the Cape; and about the same time, five families went to the United States. Before that exodus, the population had increased to 112. When the island was visited by the “Galatea” in 1867, the population amounted to 53, including seven unmarried girls, and the same number of eligible bachelors, none of whom, however, accepted the chaplain’s offer to unite them in the holy bonds of matrimony! Seven years later (1874), H.M.S. “Challenger” found a population of 84, the females being slightly in the majority— most of those who had left the island in 1857 and subsequently, having returned. From Mr Taylor’s account of the island, published in 1856, it appears that in his opinion the settlement must be abandoned. He alludes to the total disappearance of trees, involving the prospect of a great scarcity of fuel, and the consequent want of shelter for both animals and vegetables against the heavy gales to which the island is exposed. Another evil to which he refers is the large excess of females (now apparently reduced), the boys being continually enticed away by the whale-ships which touch at the island. He also alludes to the small quantity of arable land, the great distance of the island from other places, and the consequent difficulty of finding a profitable market. “I think,” he says, “it will be a happy day when this little lonely spot is once more left to those who probably always were, and now, in its present barren condition, certainly are its only fit inhabitants—the wild birds of the ocean.”

A graphic account of the “Challenger’s” visit to the Tristan group, ^including notices of the albatross, penguin, and other sea-birds, will be found in two papers contributed by Sir Wyville Thomson in "Good Words* for 1874.

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