ANÁLISIS DE LOS OBJETIVOS ESPECIFICOS

In early 1829 the explorer Charles Sturt returned from an expedition into the north west of New South Wales and brought back with him what was probably the first indication of a second epidemic of smallpox among the Aboriginal populations. He and his party had traced the course of the Macquarie River into the interior and had reached the Darling River near the present town of Bourke. On February 5th while he was following the Darling southward he encountered a group of seventy Aboriginal huts which appeared to Sturt to be permanent habitations. Further on he encountered a group

of Barundji which he believed to be the inhabitants of the village. Sturt and his party were approached by an elderly male. Sturt recorded:

As his tribe gathered around him, the old chief threw a melancholy glance upon them, and endeavoured, as much as he could, to explain the cause of that affliction which, as I had rightly judged, weighed heavily upon him. It appeared, then, that a violent cutaneous disease raged throughout the tribe, that was sweeping them off in great numbers. He called several young men to Mr. Hume and myself, who had been attacked by this singular malady (Sturt 1833 vol I: 93)

Four or five days later while resting in camp another group of about seventy approached Sturt's party. The women and children of the group passed the camp by, but Sturt noticed that several of the men who came nearer were afflicted with what he believed to be the same 'violent cutaneous eruptions' he had just recently seen. Sturt believed that this disease was smallpox (1838: 147). He was of the opinion that it was causing a severe decline in the population as the numbers of Barundji he saw on the Darling River bore no comparison to the size and numbers of the huts he had seen (ibid: 105).

Further indications that a second epidemic of smallpox was occurring among the Aboriginal populations west of the Great Dividing Range were brought to the notice of the Colonial Government in 1830 (Mair 1831). In August of that year five Wiradjuri were observed by a local pastoralist, Andrew Brown, suffering from what was thought to be smallpox. Two were described as being in the incipient stages of the disease and the other three in the more advanced stages. One of these was later seen with smallpox sequelae on his body, and when questioned he indicated that the others had died. Two months later, in October, the same symptoms, together with a high mortality were again reported among the Wiradjuri. The disease was active until at least December (Mair 1831). In August of 1831 the same symptoms were again witnessed by Brown in three

Wiradjuri who had been in contact with others recently arrived from the Lachlan River to the south. The disease was reported to be causing high mortality among the Lachlan River Wiradjuri, many of whom were fleeing the region.

A further indication that the disease was smallpox was recorded by Mair (1831). A European family residing near Bathurst was struck with the infection (Mair 1831). Four of the family showed eruptive and febrile symptoms and one, a two year old female, died. The first of the symptoms to appear was the rapid onset of fever to be followed by the successive stages of the rash reaching the confluent stage after ten days. The child's eyes were closed after the sixth day and the eruptions extended over most of her torso, feet, face. The eruptions were particularly severe on the gums, lips and tongue. The mother described the disease as being like a number of scalds running into each other and a discharge emanating from them (Mair 1831). The disease had arisen after the family had sheltered in their house a Wiradjuri child, whose parents had died from a disease with similar symptoms, and who likewise later died of the same disease.

A concerned New South Wales administration sent Dr John Mair, a military physician attached to the 39th Regiment, to investigate and report on the disease in October 1831. Mair was too late to witness first-hand the disease among the Wiradjuri but from accounts by eyewitnesses, whom he deemed to be credible observers, he pieced together the symptoms of the disease (Mair 1831). While there appeared to be a variety of forms of the disease in different individuals, the following description of the clinical symptoms were common to all. The initial pre-eruptive stages were characterised by a general malaise and fever lasting from 2 to 8 days accompanied by loss of appetite, headaches, chest and abdominal pains. The eruptive stage followed, with focal lesions of small 'red spots' (papules) resembling 'flea bites' commencing on the face and gradually spreading over the head, breast and extremities. Enanthema occurred at this time with

lesions developing on the tongue and lips. The rash spread and in many instances the soles of the feet were observed to be studded with lesions. After the eruption had developed, usually observed to have occurred in twenty-four hours, the fever subsided. At this time the patient experienced pain in the throat, most likely from enanthema on the pharynx, making it difficult to swallow solid foods. After three to eight days the 'red spots' developed into raised vesicles containing a milky fluid in some, and in others a 'yellowish' or 'straw coloured' fluid. At their height the lesions were the size of a 'small or large pea'. At this stage it was recognized by observers, who were familiar with smallpox in England, to be that disease. Scabs formed from the vesicles at different periods according to the length of time it took to reach maturation. These were occasionally confluent on the nose and cheeks and frequently left permanent scars or indurations on the skin. Mair observed these on some of the subjects and stated they 'cannot be distinguished from the pits of Small Pox'.

Mair's conclusions were, however, not unchallenged. Dr George Busby (1831) was also requested by the Government to furnish particulars on the epidemic. In a report to the Inspector of Colonial Hospitals, Sydney, he concluded that the disease was varicella and not smallpox. Busby's observations, however, were not as extensive as Mair's. He saw only two Wiradjuri from the Bathurst district showing clinical symptoms but could not determine the nature of their affliction. He based his diagnosis solely on the symptoms he monitored in a European male, Titman, who was confined in the Bathurst Hospital on August 6 1831 under Busby's care. Titman was 40 years old and had been living in the same house as an Aboriginal person who had caught the disease and later died. He informed Busby that he had suffered from smallpox as a boy, being one of a family of six, all of whom had the disease at the same time. Titman's symptoms were generally milder than those described by Mair in the Wiradjuri. He complained of headache, pains in the back and limbs, lassitude, loss of appetite, nausea, and fever.

Primary fever was, however, severe and lasted until the eruptive phase which was followed by secondary fever. The vesicles appeared earlier, achieved maturity quickly, covering most of the body, and were particularly numerous on the face, shoulders, back, and lateral surfaces of the legs. The symptoms lasted for fourteen days terminating in full recovery (Busby 1831).

Busby's diagnosis was that the disease he had observed was not small pox but varicella. His view was based firstly on the modified nature of the symptoms and secondly on Titman's previous infection with smallpox. In response to the prevailing epidemic among the Aboriginal population he concluded:

I am, upon the whole, at present disposed to regard the eruptive disease lately prevalent among the black natives in this district as varicella, but possessing by no means a malignant character, nor likely, under ordinary circumstances of comfort and attention attainable in civilized society, to prove fatal in more than a few instances; the mortality it has occasioned among the blacks being sufficiently accounted for by the unfavourable circumstances in which they are placed (Busby 1831).

Mair (1831), on the other hand, saw it as a case of secondary modified smallpox because it passed through the regular stages, albeit quickly, of ordinary smallpox. He also examined the patient about six weeks after his discharge from hospital. He described the skin on Titman's face having a `mottled appearance of red and white, burning scales were separating from it, and numerous small pits or depressions could be discerned' some of which were recent and others older which further strengthened his diagnosis.

Busby's conclusion that the disease affecting the Wiradjuri was varicella was supported by the Inspector of Colonial Hospitals, Dr. James Bowman. Bowman (1831) disputed Mair's diagnosis of smallpox and cast doubts upon the reliability and integrity of

his witnesses. Writing to the Colonial Secretary he claimed that Mair and Imlay were incorrect in their diagnosis and had formed their opinions that the disease was smallpox from information they received from persons incapable of determining so important a point, despite Mair's assertions to the contrary . Bowman also suggested the disease among the Wiradjuri was not smallpox but varicella which, while common in the colony at that time was of little threat. He called it 'native pock' (incorrectly believed by some to be a local form of varicella).

He presented these arguments to the Governor and members of the Executive Council of the colony in December 1831 (Thompson 1831). The Council readily agreed with Bowman and passed over the whole matter of the epidemic apart from recommending a Government notice should be published stating that suspicion had arisen as to the current prevalence of smallpox. They recommended that voluntary vaccination could be obtained from any of the Colonial Surgeons. They also agreed that measures should be taken 'generally to induce the Aboriginal Natives also to submit to vaccination' (Thompson 1831).

Mair (1831) reported varied clinical symptoms among the Aboriginal populations. Among those in the Wellington Valley the vesicles began to coalesce on the face during the eruptive stage to be followed in a day or two by excessive salivation. An escaped convict who had lived among these people before, and during the epidemic, described 'water pouring from the mouth as they lay on the ground' (Mair 1831). About the tenth or twelfth day after the initial symptoms were noticed, many patients were seen to experience convulsions and the fluid discharge from the mouth became more bloody and viscid in appearance. The bloody discharge from the mouth and its late onset may be indicative of bleeding from the oral mucous membranes, a symptom of the more fatal

haemorrhagic type of variola major (Benenson 1976: 444, 1990: 395; Fenner et al. 1988: 38, 138-9).

Among the Wiradjuri living on the Lachlan River and Wellington Valley regions, death generally resulted after the third day of the eruptive stage. Mair (1831) reported that secondary fever was seldom observed amongst these groups, and when it did occur he suggested it was due to local low ambient temperatures. The rarity of secondary fever, which usually begins on the seventh or eighth days in severe cases (Fenner et al. 1988: 22), can be explained by the early fatality of most of the victims. Many were reported to have died at the very onset of the disease before the beginning of the eruptive stage.

Most of the eye-witnesses consulted by Mair remarked that the disease proved chiefly fatal to adults and elderly, and seldom to children even though their length of exposure to infected individuals was the same. It was, however, reported to Mair by several of the observers that many adults who bore pockmarks on their skin, evidence of a previous exposure to smallpox, escaped the disease altogether.

The usual duration of the disease was stated to be between fourteen to twenty- one days in cases where the patient survived and was restored to health. Many patients who did survive were unable to walk for a considerable time due to the separation of the epidermis from the sole of the feet. In other survivors more of the characteristic forms of smallpox sequelae were present. Severe keratitis and/or corneal ulcerations were reported in several victims who recovered from the infection. Brown stated:

... I found one middle aged woman who had lost her sight altogether by it, one who had lost an eye, and two children male and female who had each been deprived of an eye by it (Mair 1831).

In others secondary infections left the sufferer with ulcerations in different parts of the body where the smallpox lesions had occurred.

It had been noted by most of the eye witnesses of the epidemic that fatality occurred chiefly among adults and the aged, and seldom among children. In others who escaped infection it was observed that some had been exposed to smallpox before. Brown, who observed the disease first hand (Mair 1831), noted that it extended to most of the Aboriginal people he saw. He did, however, see three old men with 'evident marks' who informed him that they had been infected by the same disease when very young. Others who escaped infection had been vaccinated (or variolated) by European settlers, several years prior to the epidemic. During the epidemic Mair vaccinated many of the Aboriginal people he encountered. He met with little opposition among them, most of whom had come to realize the benefits that the simple procedure conferred in the face of the serious morbidity and mortality caused by the epidemic. After his return to Sydney, Mair sent supplies of recent and dried vaccine lymph to the Colonial Assistant Surgeon at Bathurst for future use (Mair 1831).

The government surveyor and explorer, Thomas Mitchell, also observed Aboriginal people suffering from the epidemic. On December 5, 1831 Mitchell and his expedition crossed the Liverpool Range, north of Bathurst, which at that time divided the settled from the unexplored districts of the colony. He recorded:

We reached at length, a water-course called "Currungai" and encamped upon its bank, beside the natives from Dart Brook, who had crossed the range before us, apparently to join some of their tribe, who lay at this place extremely ill, being affected with a virulent kind of small-pox. We found the helpless creatures, stretched on their backs, beside the water, under the shade of the wattle or mimosa trees, to avoid the intense heat of the sun. We gave them from our stock some medicine; and the wretched sufferers seemed to place the utmost confidence in its efficacy (Mitchell 1838 vol I: 26).

According to Mitchell these people he saw were from another region as they had little knowledge of the countryside they were now in. Mitchell continued his journey to the north reaching the Gwyder River but made no further mention of smallpox among the Aboriginal groups he encountered.

From these districts the epidemic spread along the river systems far in front of the colonial frontiers. First hand observations of the epidemic by Europeans were now no longer possible. From the upper Darling it spread downstream. In 1835 Mitchell was again exploring beyond the frontier following the southerly course of the Darling River. On May 28 while at his base camp at Bourke he was visited by a group of Aboriginal people. They consisted of four adult males, seven females, and children. Mitchell remarked that most of them had visible smallpox scarring 'but the marks were not larger than pin heads' (Mitchell 1838 vol I: 218). From Bourke, Mitchell and his expedition continued along the Darling River as far as Menindee, 190 Km above its junction with the River Murray. He turned back on July 12 after an affray with the Barkindji. He had seen smallpox scarring on many of the Aboriginal people during the journey. At Menindee he recorded:

These natives, as well as most others seen by us on the river, bore strong marks of the small-pox, or some such disease, which appeared to have been very destructive among them. The marks appeared chiefly on the nose, and did not exactly resemble those of the small-pox with us, inasmuch as the deep scars and grooves left the original surface and skin in isolated specks on these people, whereas the effects of small-pox with us appear in little isolated hollows, no parts of the higher surface being detached like islands, as they appeared on the noses of these natives (ibid: 261).

Mitchell may have observed the sequelae of confluent type smallpox. He was of the opinion that the disease had been severe and had caused a great mortality among the groups living along the Darling River.

The epidemic did not reach the Murray River populations until at least the second half of 1830. In January of that year Charles Sturt (1833 vol II), on his second expedition of exploration, began a journey down the Murrumbidgee and Murray rivers. He arrived at the termination of the river systems, at Lake Alexandrina in what was to be the colony of South Australia, on 9 February, passing the Darling River junction on his way. Sturt was an astute observer and documenter, describing the landscape, geology, the people and their state of health in some detail (Beale 1979). Along the Murray he noted that 'the most violent cutaneous eruptions' were affecting many of the Aboriginal people he encountered and remarked on their 'miserable state of disease and infirmity' (ibid: 148). Sturt was in two minds as to what the disease actually was, describing it in one instance as leprosy (ibid: 96) and in another as syphilis (ibid: 125). He made no suggestion, however, that it was due to smallpox, a disease he was surely familiar with among Europeans in Britain and had seen just one year before among the Aboriginal populations of the upper Darling. Nor did he mention seeing any Aboriginal people with smallpox-like sequelae that would have indicated a previous epidemic. In a later comment on smallpox (see below), however, Sturt makes a strong implication that the disease was smallpox. Sturt returned the way he had come, along the Murray and Murrumbidgee system and arrived back in Sydney in late May.

In 1830 the middle and lower Murray River corridor was well beyond the European frontier and the spread of smallpox went unobserved, and hence unrecorded by Europeans. There is, however, some indication that the epidemic had reached the