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+The Project Gutenberg EBook of Letters on the Cholera Morbus., by 
+James Gillkrest and William Fergusson
+
+This eBook is for the use of anyone anywhere at no cost and with
+almost no restrictions whatsoever.  You may copy it, give it away or
+re-use it under the terms of the Project Gutenberg License included
+with this eBook or online at www.gutenberg.org
+
+
+Title: Letters on the Cholera Morbus.
+       Containing ample evidence that this disease, under whatever
+       name known, cannot be transmitted from the persons of those
+       labouring under it to other individuals, by contact--through
+       the medium of inanimate substances--or through the medium
+       of the atmosphere; and that all restrictions, by cordons
+       and quarantine regulations, are, as far as regards this
+       disease, not merely useless, but highly injurious to the
+       community.
+
+Author: James Gillkrest
+        William Fergusson
+
+Release Date: February 20, 2009 [EBook #28147]
+
+Language: English
+
+Character set encoding: ISO-8859-1
+
+*** START OF THIS PROJECT GUTENBERG EBOOK LETTERS ON THE CHOLERA MORBUS. ***
+
+
+
+
+Produced by Bryan Ness, C. St. Charleskindt, and the Online
+Distributed Proofreading Team at https://www.pgdp.net (This
+file was produced from images generously made available
+by The Internet Archive/American Libraries.)
+
+
+
+
+
+
+
+
+
+Transcriber's Note
+
+This text does not refer to epidemic cholera. The term "cholera morbus"
+was used in the 19th and early 20th centuries to describe both
+non-epidemic cholera and gastrointestinal diseases that mimicked
+cholera. The term "cholera morbus" is found in older references but is
+not in current scientific use. The condition "cholera morbus" is now
+referred to as "acute gastroenteritis."
+
+Spelling variations and inconsistencies have been retained to match the
+original text. Only such cases which strongly indicated the presence
+of inadvertent typographical error have been corrected; a detailed list
+of these corrections can be found at the end of this text.
+
+This ebook consists of two separate parts. The first from 1831 ("LETTERS
+ON THE CHOLERA MORBUS.") contains Letters I-X; and the second from 1832
+("LETTERS ON THE CHOLERA MORBUS, &c. &c. &c.") contains Letters I-III
+and a Postscript. Transcriber's Notes at the end of the text refer to
+"Pt_1" and "Pt_2" for ease of navigation.
+
+
+
+
+LETTERS
+
+ON THE
+
+CHOLERA MORBUS.
+
+CONTAINING
+
+AMPLE EVIDENCE THAT THIS DISEASE, UNDER WHATEVER NAME KNOWN, CANNOT BE
+TRANSMITTED FROM THE PERSONS OF THOSE LABOURING UNDER IT TO OTHER
+INDIVIDUALS, BY CONTACT--THROUGH THE MEDIUM OF INANIMATE SUBSTANCES--OR
+THROUGH THE MEDIUM OF THE ATMOSPHERE; AND THAT ALL RESTRICTIONS, BY
+CORDONS AND QUARANTINE REGULATIONS, ARE, AS FAR AS REGARDS THIS DISEASE,
+NOT MERELY USELESS, BUT HIGHLY INJURIOUS TO THE COMMUNITY.
+
+
+_By a Professional Man of Thirty Years experience, in various parts of
+the World._
+
+
+LONDON:
+
+NICHOLS AND SONS, PRINTERS, EARL'S COURT, CRANBOURN STREET LEICESTER
+SQUARE.
+
+1831.
+
+
+
+
+The first series of these Letters, consisting of five, appeared in the
+months of September and October of the present year; five others,
+written in a more popular form, were inserted in a Newspaper from time
+to time, in the course of this month:--a few additions and alterations,
+preparatory to their appearance in the shape of a pamphlet, have been
+made.
+
+If, at a moment like the present, they prove in any manner useful to the
+public, the writer will feel great satisfaction.
+
+
+November 26th, 1831.
+
+
+
+
+LETTERS ON THE CHOLERA MORBUS;
+
+SHEWING THAT IT IS
+
+NOT A COMMUNICABLE DISEASE.
+
+
+
+
+LETTER I.
+
+
+If we view the progress of this terrific malady, as it tends to
+disorganise society wherever it shows itself, as it causes the
+destruction of human life on an extensive scale, or as it cramps
+commerce, and causes vast expense in the maintenance of quarantine and
+cordon establishments, no subject can surely be, at this moment, of
+deeper interest. It is to be regretted, indeed, that, in this country,
+political questions (of great magnitude certainly), should have
+prevented the legislature, and society at large, from examining, with
+due severity, all the data connected with cholera, in order to avert,
+should we unhappily be afflicted with an epidemic visitation of this
+disease, that state of confusion, bordering on anarchy, which we find
+has occurred in some of those countries where it has this year appeared.
+
+Were this letter intended for the eyes of medical men only, it would
+be unnecessary to say that, during epidemics, the safety of thousands
+rests upon the solution of these simple questions:--Is the disease
+communicable to a healthy person, from the body of another person
+labouring under it, either _directly_, by touching him, or _indirectly_,
+by touching any substance (as clothes, &c.) which might have been in
+contact with him, or by inhaling the air about his person, either during
+his illness or after death?--Or is it, on the other hand, a disease
+with the appearance and progress of which sick persons, individually
+or collectively, have no influence, the sole cause of its presence
+depending on unknown states of the atmosphere, or on terrestrial
+emanations, or on a principle, _aura_, or whatever else it may be
+called, elicited under certain circumstances, from both the earth and
+air?--In the one case we have what the French, very generally I believe,
+term _mediate_ and _immediate_ contagion, while the term _infection_
+would seem to be reserved by some of the most distinguished of
+their physicians for the production of diseases by a deteriorated
+atmosphere:--much confusion would certainly be avoided by this adoption
+of terms.[1] Now it is evident, that incalculable mischief must arise
+when a community acts upon erroneous decisions on the above questions;
+for, if we proceed in our measures on the principle of the disease not
+being either directly or indirectly transmissible, and that it should,
+nevertheless, be so in fact, we shall consign many to the grave, by
+not advising measures of separation between those in health, and
+the persons, clothes, &c., of the sick. On the other hand, should
+governments and the heads of families, act on the principle of the
+disease being transmissible from person to person, while the fact may
+be, that the disease is produced in each person by his breathing the
+deteriorated atmosphere of a certain limited surface, the calamity in
+this case must be very great; for, as has happened on the Continent
+lately, cordons may be established to prevent flight, _when flight, in
+certain cases, would seem to be the only means of safety to many_; and
+families, under a false impression, may be induced to shut themselves
+up in localities, where "every breeze is bane."
+
+[Footnote 1: As medical men in this Country employ the word _infection_
+and _contagion_ in various senses, I shall, generally substitute
+_transmissible_ or _communicable_, to avoid obscurity.]
+
+Hence then the importance, to the state and to individuals, of a rigid
+investigation of these subjects. It is matter of general regret, I
+believe, among medical men, that hitherto the question of cholera has
+not always been handled in this country with due impartiality. Even
+some honest men, from erroneous views as to what they consider "the
+safe side" of the question, and forgetting that the safe side can
+only be that on which truth lies (for then the people will know
+_what_ to do in the event of an epidemic), openly favour the side of
+_communicability_, contrary to their inward conviction; while the good
+people of the quarantine have been stoutly at work in making out that
+precautions are as necessary in the cholera as in plague. Meantime our
+merchants, and indeed the whole nation, are filled with astonishment,
+on discovering that neighbouring states enforce a quarantine against
+ships from the British dominions, when those states find that cases of
+disease are reported to them as occurring among us, resembling more
+or less those which we have so loudly, and I must add prematurely,
+declared to be transmissible. It is quite true that, however decidedly
+the question may be set at rest in this country, our commerce, should
+we act upon the principle, of the disease not being transmissible,
+would be subject to vexatious measures, at least for a time, on the
+part of other states; but let England take the lead in instituting a
+full inquiry into the whole subject, by a Committee of the House of
+Commons; and if the question be decided against quarantines and
+cordons by that body, other countries will quickly follow the example,
+and explode them as being much worse than useless, as far as their
+application to cholera may be concerned. It is very remarkable how, in
+these matters, one country shapes its course by what seems to be the
+rule in others; and, as far as the point merely affects commerce,
+without regard to ulterior considerations, it is not very surprising
+that this should be the case; but it is not till an epidemic shall
+have actually made its appearance among us, that the consequences of
+the temporising, or the precipitation, of medical men can appear in
+all their horrors. Let no man hesitate to retract an opinion already
+declared, on a question of the highest importance to society, if he
+should see good reason for doing so, after a patient and unbiassed
+reconsideration of all the facts. We are bound, in every way, to act
+with good faith towards the public, and erroneous views, in which
+that public is concerned, ought to be declared as soon as discovered.
+To show how erroneous some of the data are from which people are
+likely to have drawn conclusions, is the main cause of my wish to
+occupy the attention of the public; and in doing this, it is certainly
+not my wish to give offence to respectable persons, though I may have
+occasion to notice their errors or omissions.
+
+Previous to proceeding to the consideration of other points, it may be
+observed, that all doubt is at an end as to the identity of the Indian,
+Russian, Prussian, and Austrian epidemic cholera; no greater difference
+being observed in the grades of the disease in any two of those
+countries, than is to be found at different times, or in different
+places, in each of them respectively. At the risk of being considered a
+very incompetent judge, if nothing worse, I shall not hesitate to say,
+that if the same assemblage, or grouping of symptoms be admitted as
+constituting the same disease, it may at any time be established, to the
+entire satisfaction of an unprejudiced tribunal, that cases of cholera,
+not unfrequently proving fatal, and corresponding in every particular to
+the average of cases as they have appeared in the above countries, have
+been frequently remarked as occurring in other countries including
+England; and yet no cordon or quarantine regulations, on the presumption
+of the disease spreading by "contagion." For my own part, without
+referring to events out of Europe, I have been long quite familiar, and
+I know several others who are equally so, with cholera, in which a
+perfect similarity to the symptoms of the Indian or Russian cholera has
+existed: the collapse--the deadly coldness with a clammy skin--the
+irritability of the stomach, and prodigious discharge from the bowels
+of an opaque serous fluid (untinged with bile in the slightest
+degree)--with a corresponding shrinking of flesh and integuments--the
+pulseless and livid extremities--the ghastly aspect of countenance and
+sinking of the eyes--the restlessness so great, that the patient has not
+been able to remain for a moment in any one position--yet, with all
+this, nobody dreamt of the disease being communicable; no precautions
+were taken on those occasions "to prevent the spreading of the disease,"
+and no epidemics followed. In the _Glasgow Herald_ of the 5th ult., will
+be found a paper by Mr. Marshall, (a gentleman who seems to reason with
+great acuteness), which illustrates this part of our subject. This
+gentleman appears to have had a good deal of experience in Ceylon when
+the disease raged there, and I shall have occasion to refer hereafter to
+his statements, which I consider of great value. Nobody can be so absurd
+as to expect, that in the instances to which I refer, _all_ the symptoms
+which have ever been enumerated, should have occurred in each case; for
+neither in India nor any-where else could all the grave symptoms be
+possibly united in any one case; for instance, great retching, and a
+profuse serous discharge from the bowels, have very commonly occurred
+where the disease has terminated fatally: yet it is not less certain,
+that even in the epidemics of the same year, death has often taken place
+in India more speedily where the stomach and bowels have been but little
+affected, or not at all. To those who give the subject of cholera all
+the attention which it merits, the consideration of some of those cases
+which have, within the last few weeks, appeared in the journals of this
+country, cannot fail to prove of high interest, and must inspire the
+public with confidence, inasmuch as they show, _beyond all doubt_, that
+the disease called cholera, as it has appeared in this country, and
+however perfectly its symptoms may resemble the epidemic cholera of
+other countries, _is not_ communicable. On some of those cases so
+properly placed before the public, I shall perhaps be soon able to offer
+a few remarks: meanwhile, I shall here give the abstract of a case, the
+details of which have not as yet, I believe, appeared, and which must
+greatly strengthen people in their opinion, that these cholera cases,
+however formidable the symptoms, and though they sometimes end rapidly
+in death, still do not possess the property of communicating the disease
+to others. I do not mean to state that I have myself seen the case, the
+details of which I am about to give, but aware of the accuracy of the
+gentleman who has forwarded them to me, I can say, that although the
+communication was not made by the medical gentleman in charge of the
+patient, the utmost reliance may be placed on the fidelity of those
+details:--
+
+Thursday, August 11th, 1831, Martin M'Neal, aged 42, of the 7th
+Fusileers, stationed at Hull, was attacked at a little before four A.M.,
+with severe purging and vomiting--when seen by his surgeon at about four
+o'clock, was labouring under spasms of the abdominal muscles, and of the
+calves of the legs. What he had vomited was considered as being merely
+the contents of the stomach, and, as the tongue was not observed to be
+stained of a yellow colour, it was inferred that no bile had been thrown
+up. He took seventy drops of laudanum, and diluents were ordered.
+Half-past six, seen again by the surgeon, who was informed that he had
+vomited the tea which he had taken; no appearance of bile in what he had
+thrown up; watery stools, with a small quantity of feculent matter;
+thirst; the spasms in abdomen and legs continued; countenance not
+expressive of anxiety; skin temperate; pulse 68 and soft; the forehead
+covered with moisture. Ordered ten grains of calomel, with two of opium,
+which were rejected by the stomach, though not immediately.
+
+Eight o'clock A.M. The features sinking, the temperature of the body now
+below the natural standard, especially the extremities; pulse small;
+tongue cold and moist; a great deal of retching, and a fluid vomited
+resembling barley-water, but more viscid; constant inclination to go to
+stool, but passed nothing; the spasms more violent and continued; a
+state of collapse the most terrific succeeded. At nine o'clock, only a
+very feeble action of the heart could be ascertained as going on, even
+with the aid of the stethoscope; the body cold, and covered with a
+clammy sweat, the features greatly sunk; the face discoloured; the lips
+blue; the tongue moist, and very cold; the hands and feet blue, cold,
+and shrivelled, as if they had been soaked in water, like washerwomen's
+hands; no pulsation to be detected throughout the whole extent of
+the upper or lower extremities; the voice changed, and power of
+utterance diminished. He replied to questions with reluctance, and in
+monosyllables; the spasms became more violent, the abdomen being, to
+the feel, as hard as a board, and the legs drawn up; cold as the body
+was, he could not bear the application of heat, and he threw off the
+bed-clothes; passed no urine since first seen; the eyes became glassy
+and fixed; the spasms like those of tetanus or hydrophobia; the
+restlessness so great, that it required restraint to keep him for ever
+so short a time in any one position. A vein having been opened in one
+of his arms, from 16 to 20 ounces of blood were drawn with the greatest
+difficulty. During the flowing of the blood, there was great writhing of
+the body, and the spasms were very severe--friction had been arduously
+employed, and at ten A.M. he took a draught containing two and a half
+drachms of laudanum, and the vomiting having ceased, he fell asleep. At
+two P.M. re-action took place, so as to give hopes of recovery. At four
+P.M. the coldness of the body, discoloration, &c., returned, but without
+a return of the vomiting or spasms. At about half-past eight he died,
+after a few convulsive sobs.
+
+On a post-mortem examination, polypi were found in the ventricles of
+the heart, and the cavæ were filled with dark blood. Some red patches
+were noticed on the mucuous membrane; but the communication forwarded
+to me does not specify on what precise part of the stomach or
+intestinal canal; and my friend does not appear to attach much
+importance to them, from their common occurrence in a variety of other
+diseases. It remains to be noticed, that the above man had been at a
+fair in the neighbourhood on the 9th (two days preceding his attack),
+where, as is stated, he ate freely of fruit, and got intoxicated. On
+the 10th he also went to the fair, but was seen to go to bed sober
+that night. The disease did not spread to others, either by direct
+or indirect contact with this patient.
+
+Now let us be frank, and instead of temporising with the question, take
+up in one hand the paper on "cholera spasmodica" just issued, for our
+guidance, from the College of Physicians by the London Board of Health,
+and in the other, this case of Martin M'Neal (far from being a singular
+case this year, in most of the important symptoms),--let the symptoms be
+compared by those who are desirous that the truth should be ascertained,
+or by those who are not, and if distinctions can be made out, I must
+ever after follow the philosophy of the man who doubted his own
+existence. The case, as it bears on certain questions connected with
+cholera, _is worth volumes of what has been said on the same subject_.
+Let it be examined by the most fastidious, and the complete identity
+cannot be got rid of, even to the _blue_ skin, the _shrivelled fingers_,
+the _cold tongue_, the _change in voice_, and the _suppression of
+urine_, considered in some of the descriptions to be found in the
+pamphlet issued by the Board of Health, as so characteristic of the
+"Indian" cholera; and this, too, under a "constitution of the
+atmosphere" so remarkably disposed to favour the production of cholera
+of one kind or other, that Dr. Gooch, were he alive, or any close
+reasoner like him, must be satisfied, that were this remarkable form of
+the disease communicable, no circumstance was absent which can at all
+be considered essential to its propagation. As the symptoms in the case
+of M'Neal, were, perhaps, more characteristically grouped than in any
+other case which has been recorded in this country, so it has also in
+all probability occurred, that more individuals had been in contact with
+him during his illness and after his death, as the facility in obtaining
+persons to attend the sick, rub their bodies, &c., must be vastly
+greater in the army than in ordinary life; so that in such cases it is
+not a question of one or two escaping, but of _many_, which is always
+the great test.
+
+Of the College of Physicians we are all bound to speak with every
+feeling of respect, but had the document transmitted by that learned
+body to our government, on the 9th of June last, expressed only a
+"philosophic doubt," instead of making an assertion, the question
+relative to the contagion or non-contagion of the disease, now making
+ravages in various parts of Europe, would be less shackled among us.
+People are naturally little disposed to place themselves, with the
+knowledge they may have obtained from experience and other sources, in
+opposition to such a body as the College: but as, in their letter to
+government of the 18th of June, they profess their readiness, should it
+be necessary, to "re-consider" their opinion, we, who see reason to
+differ from them, may be excused for publishing our remarks. It seems
+surprising enough that, in their letter to government of the 9th of
+June, the College should have given as a reason for their decision
+as to the disease being infectious (meaning, evidently, what some call
+contagious, or transmissible from _persons_)--"having no other means of
+judging of the nature and symptoms of the cholera than those furnished
+by the documents submitted to us." Now, according to the printed
+parliamentary papers, among the documents here referred to as having
+been sent by the Council to the College, was one from Sir William
+Crichton, Physician in Ordinary to the Emperor of Russia, in which a
+clear account is given of the symptoms as they presented themselves in
+that country; and, if the College had previously doubted of the identity
+of the Russian and Indian cholera, a comparison of the symptoms, as they
+were detailed by Sir William, with those described in various places in
+the _three volumes_ of printed Reports on the cholera of India, in the
+college library, must at once have established the point in the
+affirmative. In fact, we know, that the evidence of Dr. Russell, given
+before the College, when he heard Sir William's description of the
+disease read, fully proved this identity to the satisfaction of the
+College. Had the vast mass of information contained in the India
+Reports, together with the information since accumulated by our Army
+Medical Department, been consulted, all which are highly creditable to
+those concerned in drawing them up, and contain incomparably better
+evidence, that is, evidence more to be relied on, than any which can be
+procured from Russia or any other part of the world--had these sources
+of information been consulted, as many think they should in all fairness
+have been, the College would probably have spoken more doubtingly as
+to cholera, in any form, possessing the property of propagating itself
+from person to person. Much of what passes current in favour of the
+communication of cholera rests, I perceive, on statements the most
+vague, assertions in a general way, as to the security of those who shut
+themselves up, &c. To show how little reliance is to be placed on such
+statements, even when they come from what ought to be good authority,
+let us take an instance which happened in the case of yellow fever.
+Doctor, now Sir William Pym, superintendent of the quarantine
+department, published a book on this disease in 1815, in which he
+stated, that the people shut up in a dock-yard, during the epidemic of
+1814, in Gibraltar, escaped the disease, and Mr. William Fraser, also of
+the quarantine, and who was on the spot, made a similar statement. Now,
+we all believed this in England for several years, when a publication
+appeared from Dr. O'Halloran, of the medical department of Gibraltar
+garrison, in which he stated that he had made inquiries from the
+authorities at that place, and that he discovered the whole statement to
+have been without the smallest foundation, and furnishes the particulars
+of cases which occurred in the dock-yard, among which were some deaths;
+this has never since been replied to--so much as a caution in the
+selection of proofs.
+
+To show, further, how absurdly statements respecting the efficacy of
+cordons will sometimes be made, it may be mentioned that M. D'Argout,
+French minister of public works, standing up in his place in the
+chamber, _on the 3rd instant_ (_Septr._), and producing his estimates
+for additional cordons, &c., stated, by way of proving the efficacy of
+such establishments, that in Prussia, where, according to him, cordon
+precautions had been pre-eminently rigorous, and where "_le territoire
+a été defendu pied à pied_," such special enforcement of the regulations
+was attended with "_assez de succès_:" in the meantime the next mail
+brings us the official announcement (_dated Berlin, Sept. 1_) of the
+disease having made its appearance there!
+
+To conclude, for the present: if there be one reason more than another
+why the question of cholera should be scrutinized by the highest
+tribunal--a parliamentary committee--it is, that in the "papers" just
+issued by the Board of Health, the following passage occurs (page
+36):--"But in the event of such removal not being practicable, on
+account of extreme illness or otherwise, the prevention of all
+intercourse with the sick, even of the family of the person attacked,
+must be rigidly observed, unless," &c. There are some who can duly
+appreciate all the consequences of this; but let us hope that the
+question is still open to further evidence, in order to ascertain
+whether it be really necessary that, in the event of a cholera epidemic,
+
+"The living shall fly from
+The sick they should cherish."
+
+
+
+
+LETTER II.
+
+
+In my last letter I adverted to the opinion forwarded to his Majesty's
+Council on the 9th of June last from the College of Physicians, in which
+the cholera, now so prevalent in many parts of Europe, was declared to
+be communicable from person to person. We saw that they admitted in that
+letter (see page 16 of the Parliamentary Papers on Cholera) the limited
+nature of the proofs upon which their opinion was formed; but I had not
+the reasons which I supposed I had for concluding, that because they
+used the words "ready to reconsider," in their communication of the 18th
+of same month to the Council, they intended to _reconsider_ the whole
+question. Indeed this seems now obvious enough, as one of the Fellows of
+the College who signed the Report from that body on the 9th of June
+(Dr. Macmichael) has published a pamphlet in support of the opinion
+already given, in the shape of a letter addressed to the President of the
+College, whose views, Dr. Macmichael tells us, _entirely coincide_ with
+his own; so that there is now too much reason to apprehend that in this
+quarter the door is closed. Contagionist as I am, in regard to those
+diseases where there is evidence of contagion, I find nothing in Dr.
+Macmichael's letter which can make an impression on those who are at all
+in the habit of investigating such subjects,[2] and who, dismissing such
+inductions as those which he seems to consider legitimate, rely solely
+on facts rigorously examined. He must surely be aware that most of the
+points which he seems to think ought to have such influence in leading
+the public to believe in the contagion of cholera, might equally apply
+to the influenza which this year prevailed in Europe, and last year in
+China, &c.; or to the influenza of 1803, which traversed over continents
+and oceans, _sometimes in the wind's eye, sometimes not_, as frequently
+mentioned by the late Professor Gregory of Edinburgh. Who will now stand
+up and try to maintain that the disease in those epidemics was
+propagated from person to person? Could more have been made of so bad a
+cause as contagion in cholera, few perhaps could have succeeded better
+than Dr. Macmichael, and no discourtesy shall be offered him by me,
+though he does sometimes loose his temper, and say, among other things
+not over civil, nor quite _comme il faut_, from a Fellow of the College,
+that all who do not agree with him as to contagion "will fully abandon
+all the ordinary maxims of prudence, and remain obstinately blind to the
+dictates of common sense!"--_fort, mais peu philosophique Monsieur le
+Docteur_. The time has gone by when ingenious men of the profession,
+like Dr. Macmichael, might argue common sense out of us; it will not
+even serve any purpose now that other names are so studiously introduced
+as _entirely coinciding_ with Dr. Macmichael; for, in these days of
+reform in every thing, _opinions_, will only be set down at their just
+value by those who pay attention to the subject.
+
+[Footnote 2: I presume that I shall not be misunderstood when I say,
+_Would that the cholera were contagious_--for then we might have every
+reasonable hope of staying the progress of the calamity by those cordon
+and quarantine regulations which are now not merely useless, but the
+bane of society, when applied to cholera or other non-contagious
+diseases.]
+
+Referring once more to the Report of the 9th of June, made by the
+College to the Council, and signed by the President as well as by
+Dr. Macmichael, the cholera was there pronounced to be a communicable
+disease, when they had, as they freely admit, "no other means of judging
+of the nature and symptoms of the cholera than those furnished by the
+documents submitted to them." The documents submitted were the
+following, as appears from the collection of papers published by order
+of Parliament:--Two reports made to our government by Dr. Walker, from
+Russia; a report from Petersburgh by Dr. Albers, a Prussian physician;
+and a report, with inclosures, regarding Russian quarantine regulations,
+from St. Petersburg, by Sir W. Creighton. Dr. Walker, who was sent from
+St. Petersburg to Moscow, by our ambassador at the former place; states,
+in his first report, dated in March, that the medical men seemed to
+differ on the subject of contagion, but adds, "I may so far state, that
+by far the greater number of medical men are disposed to think it not
+contagious." He says, that on his arrival at Moscow, the cholera was
+almost extinct there; that in twelve days he had been able to see only
+twenty-four cases, and that he had no means of forming an opinion of
+his own as to contagion. In a second report, dated in April from St.
+Petersburg, this gentleman repeats his former statement as to the
+majority of the Moscow medical men not believing the disease to be
+contagious (or, as the College prefer terming it, infectious), and gives
+the grounds on which their belief is formed, on which he makes some
+observations. He seems extremely fair, for while he states that,
+according to his information, a peculiar state of the atmosphere "was
+proved by almost every person in the city (Moscow), feeling, during the
+time, some inconvenience or other, which wanted only the exciting cause
+of catching cold, or of some irregularity in diet, to bring on cholera;"
+that "very few of those immediately about the patients were taken ill;"
+that he "did not learn that the contagionists in Moscow had any strong
+particular instances to prove the communication of the disease from one
+individual to another;" and that he had "heard of several instances
+brought forward in support of the opinion (contagion), but they are not
+fair ones:" he yet mentions where exceptions seem to have taken place as
+to hospital attendants not being attacked, but he has neglected to tell
+us (a very common omission in similar statements), whether or not the
+hospitals in which attendants were attacked were situated in or near
+places where the atmosphere seemed _equally productive of the disease
+in those not employed in attending on sick_. This clearly makes all the
+difference, for there is no earthly reason why people about the sick
+should not be attacked, if they breathe the same atmosphere which would
+seem to have so particular an effect in producing the disease in others;
+indeed there are good reasons why, during an epidemic, attendants should
+be attacked in greater proportion; for the constant fatigue, night-work,
+&c., must greatly predispose them to disease of any kind, while the
+great additional number always required on those occasions, precludes
+the supposition of the majority so employed being _seasoned_ hospital
+attendants, having constitutions impenetrable to contagion. Those
+questions are _now_ well understood as to yellow fever, about which so
+much misconception had once existed. The proofs by disinterested authors
+(by which I mean those unconnected with quarantine establishments, or
+who are not governed by the _expediency_ of the case) in the West
+Indies, America, and other places, show this in a clear light; but the
+proofs which have for some time past appeared in various journals
+respecting the occurrences at Gibraltar, during the epidemic of 1828,
+are particularly illustrative. By the testimony of three or four
+writers, we find that _within certain points_, those in attendance on
+sick, in houses as well as hospitals, were attacked with the fever, in
+common with those who were not in attendance on sick; but that, where
+people remained at ever so short a distance beyond those points, during
+the epidemic influence, _not a single instance_ occurred of their being
+attacked, though great numbers had been in the closest contact with the
+sick, and frequently too, it would appear, under circumstances when
+contagion, had it existed, was not impeded in its usual course by a very
+free atmosphere:--_sick individuals, for instance, lying in a small
+house, hut, or tent, surrounded, during a longer or shorter space of
+time, by their relatives, &c._ A full exposure of some very curious
+mis-statements on these points, made by our medical chief of the
+quarantine, will be found from the pen of the surgeon of the 23d
+regiment, in the _Edinburgh Medical and Surgical Journal_, No. 106.[3]
+Those who are acquainted with the progress of cholera in India, must be
+aware how a difference in the height of places, or of a few hundred
+yards (_indeed sometimes of a few yards_) distance, has been observed to
+make all the difference between great suffering and complete
+immunity:--the printed and manuscript reports from India furnish a vast
+number of instances of this kind; and, incredible as it may appear, they
+furnish instances where, _notwithstanding the freest intercourse_, there
+has been an abrupt line of demarcation observed, beyond which the
+disease did not prevail. A most remarkable instance of this occurred in
+the King's 14th regiment, in 1819, during a cholera epidemic, when the
+light company of the regiment escaped almost untouched, owing to no
+other apparent cause than that they occupied the extremity of a range of
+barrack in which all the other companies were stationed! so that there
+would truly seem to be more things "on earth than are dreamt of in the
+philosophy" of contagionists. This seems so remarkable an event, that
+the circumstance should be more particularly stated:--"The disease
+commenced in the eastern wing of the barracks, and proceeded in a
+westerly direction, but suddenly stopped at the 9th company; the
+light infantry escaping with one or two slight cases only."--(_Bengal
+Rep._ 311.) It appears (_loc. cit._) that 221 attacks took place in the
+other nine companies. We find (_Bombay Rep._ p. 11.) that, from a little
+difference in situation, two cavalry regiments in a camp were altogether
+exempt from the disease, while all the other regiments were attacked.
+Previous to closing these remarks, which seemed to me called for on
+Dr. Walker's second Report, it is fair to state, that in certain Russian
+towns which he names, he found that the medical men and others were
+convinced that the cholera was brought to them "_somehow or other_," an
+impression quite common in like cases, as we learn from Humboldt, and
+less to be wondered at in Russia than most places which could be
+mentioned. It will not be a misemployment of time to consider now the
+next document laid before the College, to enable them to form their
+opinion,--the Report of Dr. Albers, dated in March, and sent from St.
+Petersburg;--this gentleman, who was at the head of a commission sent
+by the Prussian government to Moscow, states, that at St. Petersburgh,
+_where the disease did not then reign_, the authorities and physicians
+were contagionists; but at Moscow, where it had committed such ravages,
+"almost all strenuously maintain that cholera is not contagious." The
+following extract seems to merit particular attention:--
+
+"When the cholera first reached Moscow, all the physicians of this city
+were persuaded of its contagious nature, but the experience gained in
+the course of the epidemic, has produced an entirely opposite
+conviction. They found that it was impossible for any length of time
+completely to isolate such a city as Moscow, containing 300,000
+inhabitants, and having a circumference of nearly seven miles (versts?),
+and perceived daily the frequent frustrations of the measures adopted.
+During the epidemic, it is certain that upwards of 40,000 inhabitants
+quitted Moscow, of whom a large number never performed quarantine; and
+notwithstanding this fact, _no case is on record of the cholera having
+been transferred from Moscow to other places_, and it is equally
+certain, that in _no situation_ appointed for quarantine, _any case of
+cholera has occurred_. That the distemper is not contagious, has been
+yet more ascertained by the experience gathered in this city (Moscow).
+In many houses it happened, that one individual attacked by cholera was
+attended indiscriminately by all the relatives, and yet did the disease
+not spread to any of the inmates. It was finally found, that not only
+the nurses continued free of the distemper, but also that they
+promiscuously attended the sick chamber, and visited their friends,
+without in the least communicating the disease. There are even cases
+fully authenticated, that nurses, to quiet timid females labouring under
+cholera, have shared their beds during the nights, and that they,
+notwithstanding, have escaped uninjured in the same manner as physicians
+in hospitals have, without any bad consequences, made use of warm water
+used (a moment before) by cholera patients for bathing.
+
+[Footnote 3: The writer of this, who may be known by application at
+the printer's, when the present excitement is at an end, is not only
+prepared to show, _on a fitting occasion_, the correctness of the
+statements of Dr. Smith as well as those by Dr. O'Halloran just
+referred to--but also, that in the investigations, in 1828, connected
+with the question of yellow fever at Gibraltar, facts were perverted
+in the most scandalous manner, in order to prove the disease imported
+and contagious:--that individuals had been suborned:--that persons had
+been in the habit of putting leading questions to witnesses:--that
+those who gave false evidence have been, in a particular manner,
+remunerated:--that threats were held out:--and, in short, that
+occurrences of a nature to excite the indignation of mankind, took
+place on that occasion; and merited a punishment, not less severe,
+than a Naval Officer who should give, designedly, a false bearing and
+distance of rocks.]
+
+"These, and numerous other examples which, during the epidemic (we
+ought, perhaps, to call it endemic) became known to every inhabitant of
+Moscow, have confirmed the conviction of the non-infectious nature of
+the disease, a conviction in which their personal safety was so much
+concerned.
+
+"It is also highly worthy of observation, that all those who stand up
+for contagion, _have not witnessed_ the cholera, which is, therefore,
+especially objected to their opinion by their opponents." He closes by
+the observation, "The result of my own daily experience, therefore,
+perfectly agrees with the above-stated principle, namely, notwithstanding
+all my inquiries, I _have met with no instance which could render it at
+all probable that the cholera is disseminated by inanimate objects_." The
+words in italics are as in the Parliamentary papers on Cholera, pp. 8 and
+9. Here is something to help to guide people in forming opinions, and to
+help governments on quarantine questions; but owing to a portion of the
+"perverseness" which Dr. Macmichael in anger talks about, Dr. Albers
+still _speculates_ upon cholera being contagious, and the College, it
+would seem, take up his speculations and sink his very important facts.
+Sir William Creighton's Report gives what puports to be an extract from
+a memorial of his on cholera, given in to the St. Petersburg Medical
+Council, tending to establish the contagious character of the disease;
+and with this a report by the extraordinary committee appointed by the
+Emperor to inquire into the Moscow epidemic. The disease had not appeared
+at St. Petersburg when he drew up his Memorial, and it does not appear
+from any-thing which can be seen in the extracts he furnishes, that he
+had personal knowledge of any part of what he relates. He gives the
+reported progress of the disease on the Volga and the Don, but is
+extremely deficient exactly where one might have expected that, from the
+greater efficiency of police authorities, &c., his information on
+contagion would have been more precise, viz., the introduction of the
+disease into Moscow, which could not, it would seem have been by material
+objects, for, according to the Committee, composed "of the most eminent
+public officers,"--"the opinion of those who do not admit the possibility
+of contagion by means of material objects, has for its support both the
+majority of voices, and the scrupulous observance of facts. The members
+of the Medical Council have been convinced by their own experience, as
+also by the reports of the physicians of the hospitals, that, after
+having been in frequent and even habitual communication with the sick,
+their own clothes have never communicated the disease to any one, even
+without employing means of purification. Convalescents have continued to
+wear clothes which they wore during the disease--even furs--without
+having them purified, and they have had no relapse. At the opening of
+bodies of persons who had died of cholera, to the minute inspection of
+which four or five hours a day for nearly a month were devoted, neither
+those who attended at their operations, nor any of the assisting
+physicians, nor any of the attendants, caught the infection, although,
+with the exception of the first day, scarcely any precautions were used.
+But what appears still more conclusive, a physician who had received
+several wounds in separating the flesh, continued his operations, having
+only touched the injured parts with caustic. A drunken invalid having
+also wounded himself, had an abscess, which doubtless showed the
+pernicious action of the dead flesh, but the cholera morbus did not
+attack him. In fine, foreign _Savans_, such as Moreau de Jonnés and
+Gravier, who have recognized, in various relations, the contagious nature
+of the cholera morbus, do not admit its propagation by means of goods and
+merchandise." (_Parl. Papers on Chol._ p. 13.) With the above documents
+the Council transmitted to the College a short description of the process
+of cleaning hemp in the Russian ports; and, lastly, the copy of a
+letter to the clerk of the Council from our ever-vigilant, though
+never-sufficiently-to-be-remunerated, head guardian of the quarantine
+department, who, taking the alarm, very properly recommends, as in duty
+bound, that a stir be forthwith made in all the pools, and creeks, and
+bays, &c., of the united kingdom, in order that all those notoriously
+"susceptible" old offenders, skins, hemp, flax, rags, &c., may be
+prevented from carrying into execution their felonious intention of
+covering the landing of a dire enemy. In truth, from the grave as well
+as from the sublime, there often seems to be "but a step;" and in
+reading over this gentleman's suggestions about _susceptibles_ and
+_non-susceptibles_, one may fancy himself, instead of being in the
+land of thinking people, to be in the land of Egypt, where, as we are
+informed (Madden, 1825), the sage matrons discuss the point, whether a
+cat be not a better vehicle for contagion than a dog:--a horse may be
+trusted, they say, but as to an ass, he is the most incorrigible of
+contagion smugglers;--of fresh bread we never need be afraid, but the
+susceptibility of butcher's meat is quite an established thing:--or we
+might fancy ourselves transported to regions of romance, where it is
+matter of profound deliberation, whether an egg shall be broken at the
+large or the small end. Such things are too bad for the nineteenth
+century; and in England, too, with her enlightened parliament! But until
+these questions are better examined, our guardian must bestir himself
+about articles susceptible of cholera contagion, while he enjoys his
+good quarantine pay, his good half pay from another department as I
+believe, and withall, if we are not misinformed, a smart pension from
+the Gibraltar revenue, for what granted nobody can tell.
+
+The documents above referred to, would appear then to be the whole on
+which the College admit that they formed their opinions, and people may
+now judge whether the verdict be according to the evidence, or whether
+it be not something in the _lucus a non lucendo_ mode of drawing
+conclusions:--most persons will probably think that, on such evidence,
+there might at least have been a qualified opinion. It appears, however,
+that having come to _a decision_ on the 9th of June, that the disease
+was communicable from person to person, they in three days after,
+approved of persons being sent to Russia to find out whether they had
+decided rightly or not. Are we now to expect that, should the occasion
+need, they will heroically make war against their own declared opinion?
+For my part I expect from them all that should be expected from men; and
+the liberal part of the world will not fail to see from this, that I do
+not despair of even Dr. Macmichael, being still open to conviction. Let
+it not be for a moment understood that, in any-thing which has been
+said, or which may remain to be said respecting this gentleman, or in
+any-thing which may be hereafter said respecting Dr. Bisset Hawkins's
+work, I mean to insinuate that contagion in cholera is not with them a
+matter of conscience; but I certainly do mean to say that their zeal has
+manifestly warped their judgment; and not only this, but that it has
+prevented them from laying statements before the public on the cholera
+questions with all the impartiality we might have expected from
+gentlemen of their character in the profession.
+
+In Dr. Macmichael's pamphlet, consisting of thirty-two pages, and
+professing to be a consideration of the question, "Is cholera
+contagious?" we scarcely find the disease mentioned till we come to page
+25; the pages up to this being occupied chiefly by a recapitulation of
+opinions formerly given "on the progress of opinion upon the subject of
+contagion;"--on the opinions of old writers as to the contagion of
+plague, small-pox, measles, &c.:--he would infer that whereas small-pox
+and certain other diseases have, by more accurate observations made in
+comparatively modern times, been taken from the place they once held,
+and ranged among diseases decidedly contagious, so ought cholera also
+to be now pronounced contagious! As an inducement to us to adopt this
+as good logic, he assures us that the list of diseases deemed contagious
+by wise men is on the increase--that non-contagionists are _perverse_
+people, _blunderers_, and so forth! As to his epithets, it shall only be
+said that among the disbelievers of contagion in cholera, and certain
+other diseases probably reputed contagious by Dr. Macmichael, are to be
+found hundreds possessing as much candour, as cultivated minds, and as
+much practical knowledge of their profession, as any contagionists,
+whether they be Fellows of a College or not; but as to the statement
+of Dr. Macmichael, is it true that we have been adding to the list of
+contagious diseases? Not within the last fifty years certainly. Even the
+influenza of 1803 was, if I mistake not greatly, termed, very generally,
+"infectious catarrh," but what professional man would term the influenza
+of 1831 so? Are there not yet remaining traces of the generally exploded
+doctrine of even contagion in ague, at one time attempted to be
+maintained? M. Adouard, of Paris, still indeed holds out. Do we not know
+that Portal, at one period of his life at least, would not, for fear of
+"infection," open the body of a person who had died of phthisis? Where
+is the medical man now to be found who would set up such a plea? or
+where, except in countries doomed to eternal barbarism, are patients
+labouring under consumption avoided now, as they were in several parts
+of the world at one time, just as if they laboured under plague, and all
+for the simpleton's reason that the disease _often runs through
+families_? What disinterested man will, on due examination of all that
+has been written on yellow fever, stand up now in support of its being a
+contagious disease, of which some thirty or forty years ago there was so
+general a belief? On croup, and a few more diseases, many still think it
+_wise to doubt_. Is dysentery, known to make such ravages sometimes,
+especially in armies, considered now, as at one time, to be contagious?
+If Dr. Macmichael's pamphlet was intended altogether for readers not of
+the profession, _which seems very probable_, his purposes will perhaps
+be answered, at least for a time, but I do not see how it can make an
+impression on medical men. Why not have been a little more candid when
+quoting Sydenham on small-pox, &c. and have quoted what that author says
+of the disease which he (Dr. M.) professes to write about,--the cholera?
+The public would have means of judging how far the disease which was
+prevalent in 1669, resembled the "cholera spasmodica," &c., of late
+years. Many insist upon an identity (Orton among others), and yet
+Sydenham saw no reason for suspecting a communicable property. It might
+have been more to the point had Dr. Macmichael, instead of quoting old
+authorities on small-pox, measles, &c. quoted some authorities to
+disprove that Orton and others are wrong when they state it as their
+belief that some of those old epidemics in Europe, about which so much
+obscurity hangs, were nothing more or less than the cholera spasmodica.
+Mead's short sketch of the "sweating sickness" does not seem very
+inapplicable:--"Excessive fainting and inquietude inward burnings,
+headach, sweating, vomiting, and diarrhoea."[4] In the letter to the
+President of the College we see no small anxiety to prove that the
+malignant cholera is of modern origin also in India, for the proofs from
+Hindoo authorities, as given in the volume of _Madras Reports_, are
+slighted. These Reports, as well as those of the other presidencies,
+are exceedingly scarce, but whoever can obtain access to them will find
+in the translations at pp. 253 and 255 (not at page 3, as quoted by
+Dr. Macmichael), enough probably to satisfy him that cholera is the
+disease alluded to there. But I think that we have at page 31 of
+Dr. Macmichael's letter, no small proof of a peculiarity of opinion, when
+we find that he there states that the evidence in the _Madras Reports_
+of the existence of epidemics of malignant cholera in India, on several
+occasions previous to 1817, rests on imperfect records, and that the
+description of the disease is too vague to prove the identity with the
+modern spasmodic cholera; for in this opinion he seems, as far as I have
+been able to discover, to stand alone among writers on cholera;--indeed
+it seems established, _on the fullest authority_, that cholera, in the
+same form in which it has appeared epidemically of late years, has
+committed ravages in India on more than one occasion formerly:--this is
+fully admitted by Mr. Orton, an East India practitioner, who is one of
+the few contagionists.
+
+[Footnote 4: If the progress of the sweating sickness was similar to
+that of cholera, the advice of the King to Wolsey was sound; for instead
+of recommending him to rely on any-thing like cordon systems, or to shut
+himself up surrounded by his guards, he tells him (see _Ellis's_
+letters) to "fly to _clene_ air incontinently," on the approach of the
+disease. I use the words _approach of the disease_ occasionally, as it
+is a manner of expression in general use, but it is far from being
+strictly applicable when I speak of cholera; _the cause_ of the disease
+it is which I admit travels or springs up at points, and not the disease
+itself in the persons of individuals, or its germs in inanimate
+substances.]
+
+For one piece of tact the author of the letter deserves great credit;
+for whereas his College collectively, when forming their opinion on the
+questions proposed to them by the Council, seemed to throw all India
+records overboard,--he, in his individual capacity, as author of the
+letter, sends after them all the Russian reports in support of
+contagion; for anxious as he is to prove his point, not a word do we get
+of the _on dits_ so current in Russia about persons being attacked with
+the disease from smelling to hemp arrived from such or such a place;
+from having looked at a boatman who had been up the Volga or down the
+Volga, &c. &c.: all which statements, when duty inquired into, prove to
+be unsupported by any thing in the shape of respectable authority, and
+this is now, in all probability, pretty generally known to be the case,
+as Dr. Macmichael must be quite aware of.
+
+To the medical gentlemen of India who have been concerned in the
+official reports, which do them, _en masse_, so much credit, Dr.
+Macmichael is little disposed to be complimentary; and, indeed, he seems
+to insinuate that those were rather stupid fellows who did not come to
+what he is pleased to consider "a just and right conclusion," as to
+contagion; he thinks, however, that he has got a few of "the most
+candid" to join in his belief. We shall see whether he had better
+reason to look towards the Ganges and Beema for a confirmation of his
+doctrines, than he had toward the Don or the Volga. How does the case
+stand with respect to one of the gentlemen whom he quotes,--Mr. Jukes,
+of the Bombay Establishment? This gentleman, like all who speak of
+cholera, mentions circumstances as to the progress of the disease
+which he cannot comprehend, and Dr. Macmichael shows us what those
+circumstances are; but Dr. Macmichael does not exhibit to us _what does_
+come perfectly within Mr. Jukes's comprehension, but which is not quite
+so suitable to the doctor's purpose. This omission I shall take the
+liberty to supply from an official letter from Mr. Jukes in the Bombay
+Reports:--"I have had no reason to think it has been contagious here,
+neither myself nor any of my assistants, who have been constantly
+amongst the sick, nor any of the hospital attendants, have had the
+disease. It has not gone through families when one has become affected.
+It is very unlike contagion too, in many particulars." &c.--(_Bombay
+Reports_, page 172.)--Ought we not to be a little surprised that so
+great an admirer of candour, as Dr. Macmichael seems to be, should,
+while so anxious to give every information to his readers, calculated to
+throw light upon the subject of cholera, omits the above important
+paragraph, which we find, by the way _immediately precedes_ the one upon
+opinions and difficulties which he quotes from the same gentleman? But
+let us examine what the amount of force is, which can be obtained from
+that part of Mr. Jukes's paper, which it does please Dr. Macmichael to
+quote:--"If it be something general in the atmosphere, why has it not
+hitherto made its appearance in some two distinct parts of the province
+at the same time? Nothing of this kind has, I believe, been observed. It
+still seems creeping from village to village, rages for a few days, and
+then begins to decline." I find myself unable, at this moment, to
+ascertain the extent of Mr. Jukes's means of obtaining information as
+to what was passing in other parts of his province; but I think the
+following quotation, on which I am just now able to lay my hand, will
+not only satisfactorily meet what is here stated, but must, in the
+public opinion, be treasured, as it serves at once to displace most
+erroneous ideas long prevalent, and which, I believe, greatly influenced
+men's decisions as to contagion:--"It may, then, first be remarked,
+that the rise and progress of the disorder were attended by such
+circumstances as showed it to be entirely independent of contagion for
+its propagation. Thus we have seen that it arose at nearly one and the
+same time in many different places, and that in the same month, nay,
+in the same week, it was raging in the unconnected and far-distant
+districts of Behar and Dacca." (Bengal Reports, p. 125.) Again (p. 9),
+that in Bengal "it at once raged simultaneously in various and remote
+quarters, without displaying a predilection for any one tract or
+district more than for another; or any thing like regularity of
+succesion in the chain of its operations." In support of what is stated
+in these extracts, the fullest details are given as to dates and places;
+and at page 9 of those Reports, a curious fact is given, "That the large
+and populous city of Moorshedabad, from extent and local position
+apparently very favourably circumstanced for the attacks of the
+epidemic, should have escaped with comparatively little loss, whilst all
+around was so severely scourged." This seems to have been pretty similar
+to what is now taking place with respect to the city of Thorn, which
+remains free from cholera, though the communication is open with divers
+infected places in every direction. Should Thorn still be attacked by
+the disease (as it sooner or later will, in all human probability), the
+contagionists _par métier_ will try to establish a case of hemp or
+hare-skin importation, I have no doubt. I wonder much that Dr.
+Macmichael or Dr. B. Hawkins, when favouring us with eastern quotations,
+did not give the public the opinion of Dr. Davy, who is so well known
+in Europe, and who saw the cholera in Ceylon; his conjecture (quite
+accessible, I believe, to every medical man in London) may perhaps be
+as valuable as that of any other person. The following is a copy of
+it:--"The cause of the disease is not any sensible change in the
+atmosphere; yet, considering the progress of the disease, its epidemic
+nature, the immense extent of country it has spread over, we can hardly
+refuse to acknowledge that its cause, though imperceptible, though yet
+unknown, does exist in the atmosphere. It may be extricated from the
+bowels of the earth, as miasmata were formerly supposed to be; it may
+be generated in the air, it may have the properties of radiant matter,
+and, like heat and light, it may be capable of passing through space
+unimpeded by currents; like electricity, it may be capable of moving
+from place to place in an imperceptible moment of time." Dr. Davy is an
+army physician, and the report of which this is an extract, may be seen
+at the Army Medical Office, a place which, of late years, has become a
+magazine of medical information of the most valuable kind in Europe.
+There is this difference between army and other information on cholera,
+that (whether in the King's or E. I. Company's service) the statements
+given by the medical gentlemen have their accuracy more or less
+guaranteed by a certain system of military control over the documents
+they draw up: thus, in the circumstance already noticed as having
+occurred in the 14th regiment, we have every reason to rely upon its
+accuracy, which we could not have in a similar statement among the
+population of any country; and we have, I think, no reason to believe
+that in pronouncing the cholera of Ceylon not contagious, Dr. Davy, as
+well as two other gentlemen of high character and experience (Drs.
+Farrel and Marshall), have not gone upon such data as may bear scrutiny.
+
+
+
+
+LETTER III.
+
+
+Having given, in my last letter, Dr. Davy's views as to the cause of
+cholera, I may so far remark just now regarding them, that they are not
+new, or peculiar to him; and that it may be well, before Dr. Macmichael
+or others pronounce them vague, that they should inquire whether some
+of those causes have not been assigned for the production of certain
+epidemics, by one of the soundest heads of Dr. Macmichael's college--Dr.
+Prout, who seems, if we have not greatly mistaken him, to have been led
+to the opinion by some experiments of Herschell, detailed in the
+Philosophical Transactions of the year 1824. They should recollect that
+other competent persons devoted to researches on such subjects (Sir R.
+Phillips among the number) admit _specific local atmospheres_ (not at
+all _malaria_ in the usual sense of the term), produced by irregular
+streams of specific atoms from the interior of the earth, and "arising
+from the action and re-action of so heterogeneous a mass." For my part
+I feel no greater difficulty in understanding how our bodies, "fearfully
+and wonderfully made" as we are, should be influenced by those actions,
+re-actions, and combinations, to which Sir Richard refers, and of
+"whose origin and progress the life and observation of man can have no
+cognizance," than how they are influenced by other invisible agents,
+the existence of which I am compelled to admit.--If the writer of the
+article on cholera in the _Westminster Review_, for October, 1831, do
+not find all his objections met by these observations, I must only refer
+him to the _quid divinum_ of Hippocrates:--but I must protest against
+logic such has been employed by certain members of our Board of Health,
+who lately, on the examination of gentlemen of the profession who
+had served in India, and who had declared the disease not to be
+communicable, came to the conclusion that it must, nevertheless, be
+so, as those gentlemen could not show _what it was_ owing to.
+
+Most extraordinary certainly it does appear, that while Dr. Macmichael
+goes to the trouble of giving us (p. 27) the views of _a captain_ (!) as
+to the progress of cholera at a certain place in India, he should have
+refrained altogether from referring, on the point of contagion or
+non-contagion, to the report of such a person as Dr. Davy, or to the
+reports of this gentleman's colleagues at Ceylon, Drs. Farrell and
+Marshall. Had Dr. Macmichael added a little to his extract from Capt.
+Sykes, by informing us of what that gentleman states as to the great
+mortality ("350 in one day") in the town of Punderpoor, "when the
+disease first commenced its ravages there," people would have means of
+judging how unlike this was to a contagious disease creeping from person
+to person in its commencement.
+
+It is painful to be obliged to comment on the manner in which Dr. Bisset
+Hawkins has handled the questions relative to the Ceylon epidemic, which
+seems far from being impartial; for, while he quotes (p. 172) Dr. Davy,
+"a medical officer well known in the scientific world," as stating that
+the cause of the disease is not in any _sensible_ changes in the state
+of the atmosphere, he breaks off suddenly at the word _atmosphere_,
+proceeds to talk of the changes in the muscles and blood of persons who
+die of the disease, and passing over the part quoted from Dr. Davy, near
+the close of my last letter, Dr. Hawkins leaves his readers to draw a
+very natural conclusion--that, as Dr. Davy admitted that there were no
+prevalent _sensible_ states of the atmosphere to which the cholera could
+be attributed, _he, therefore_, believed it to have been propagated by
+contagion, an inference which we now see must be quite wide of the mark.
+Dr. Hawkins had, it appears, like many other medical gentlemen, access
+to the reports from Ceylon, &c., in the office of the chief of the army
+medical department in London, and it is to be regretted I think that,
+with respect to one of the Ceylon reports, he only tells us (p. 174)
+that "Mr. Staff-Surgeon Marshall reports from Candy, that of fifty cases
+which had occurred, forty died." Why more had not been quoted from a
+gentleman who had such ample means of witnessing the disease in its very
+worst form, I must leave to others to say; but, referring again to the
+highly interesting letter from Mr. Marshall on cholera, which appeared
+in the _Glasgow Herald_, of the 5th of August last, and in which, from
+many important observations which every body interested in cholera
+should read and study, the following remarks will be found:--"In no one
+instance did it seem to prevail among people residing in the same house
+or barracks, so as to excite a suspicion that the contact of the sick
+with the healthy contributed to its propagation." "The Indian Cholera,
+as it is sometimes called, appears not to be essentially different from
+cholera as it occurs in this and all other countries." "I consider it,
+therefore, impossible for a medical practitioner to speak decisively
+from having seen one, or even a few cases of cholera in this country,
+and to say whether they are precursors of '_the epidemic_ cholera' or
+not. That the disease is ever propagated by means of personal contact,
+or by the clothes of the sick, has not, as far as I know, been
+satisfactorily proved. The quality of contagion was never attributed
+to the disease in Ceylon, and I believe no-where did it occur in
+greater severity. I am aware that an attempt has been made to distinguish
+the ordinary cholera of this country from the 'epidemic cholera,' by means
+of the colour or quality of the discharges from the bowels. In the
+former it is said the discharge is chiefly bile, while in the latter it
+is said to bear no traces of bile, but to be colourless and watery. How
+far is this alleged diagnosis well founded? I am disposed to believe
+that, in all severe cases of cholera, whether it be the cholera of this
+country, or the epidemic cholera, the secretion of bile is either
+suppressed, or the fluid is retained in the gall-bladder." Mr. Marshall,
+it may be observed, is the gentleman who was selected by the late
+Secretary at War, in consequence of his known intelligence, to remodel
+the regulations relative to military pensioners; and I understand that,
+in consequence of the manner in which he executed that very important
+duty, he has since been promoted. After what appears from the above
+quotations, how perfectly unwarrantable must the assertion of Dr. Bisset
+Hawkins seem, that "from the Coromandel coast it seems to have been
+transported by sea to Ceylon!"
+
+We shall, I think, be able to see that the assumption of Drs. Macmichael
+and Hawkins, as to the importation of the disease into the Mauritius
+from Ceylon, is equally groundless with that of its alledged importation
+into the latter island; and here we have to notice the same want of
+candour on the part of those gentlemen, in not having furnished that
+public, which they professed to enlighten on the subject of cholera,
+with those proofs within their reach best calculated to display the
+truth; be it a part of my duty to supply the omissions of these
+gentlemen in this respect. The following is a copy of a letter
+accompanying the medical commission report at that island forwarded
+to General Darling, the then commanding officer, by the senior medical
+gentleman there.
+
+"Port Louis, Nov. 23, 1819.
+
+"I have the honour of transmitting the reports of the French and
+English medical gentlemen on the prevalent disease; both classes of the
+profession seem to be unanimous in not supposing it contagious, or of
+foreign introduction. From the disease pervading classes _who have
+nothing in common but the air they breathe_, it can be believed that the
+cause may exist in the atmosphere. A similar disease prevailed in this
+island in 1775, after a long dry season."
+
+(Signed) W. A. BURKE,
+Inspector of Hospitals.
+
+In the reports referred to in the above letter, there is the most ample
+evidence of the true cholera having appeared at different points in the
+colony _before the_ arrival of the Topaze frigate, the ship _accused_ by
+contagionists _par métier_, of having introduced the disease; so that,
+contrary to what Dr. Macmichael supposes, those who disbelieve the
+communicability of cholera, have no necessity whatever in this case for
+pleading a coinsidency between the breaking out of the disease, and the
+arrival of the frigate; indeed, his friend Dr. Hawkins seems to be aware
+of this, when he is obliged to have recourse to such an argument as that
+"it is, at all events, clear that the disease had not been _epidemic_ at
+the Mauritius before the arrival from Ceylon;" so that the beginning of
+an epidemic is to be excluded from forming a part or parcel of the
+epidemic! Why is it that in medicine alone such modes of reasoning are
+ever ventured upon!
+
+We know, from the history of cholera in India, that not only ships lying
+in certain harbours have had the disease appear on board, but even
+vessels sailing down one coast have suffered from it, while sailing up
+another has freed them from it, without the nonsense of going into
+harbour to "expurgate." Now, with respect to the _Topaze_, it appears
+that while lying in harbour in Ceylon, the disease broke out on
+board her; that after she got into "_clene air_" at sea, the disease
+disappeared, seventeen cases only having occurred from the time she left
+the island, and she arrived at the Mauritius, as Dr. Hawkins admits,
+without any appearance whatever of the cholera on board. On the day
+after her arrival, she sent several cases ("chronic dysentry, hepatitis,
+and general debility") to hospital, but not one of cholera; neither did
+any case occur on board during her stay there, at anchor a mile and a
+half from shore, and constantly communicating with shore,[5] while a
+considerable number of deaths took place from cholera _in the merchant
+vessels anchored near shore_.
+
+[Footnote 5: Somebody is said to have seen a man on board with vomiting
+and spasms, on the day before she moved to this anchorage, but the
+surgeon of the ship has not stated this.]
+
+As to the introduction of cholera from the Mauritius into Bourbon, where
+it appeared but very partially, Dr. Macmichael very properly does not
+say one word. There was abundance of "precaution" work, it is said,
+and those who choose, are at liberty to give credit to the story of
+its having been smuggled on shore by some negro slaves landed from a
+Mauritius vessel. As to the _precautions_ to which the writer in _The
+Westminster Review_ attributes the non-extension of the disease in this
+island, hundreds of instances are recorded, in addition to those which
+we have already quoted, of the disease stopping short, without cordons
+or precautions of any kind--one remarkable instance is mentioned by Dr.
+Annesley, where, _without seclusion_, the disease did not reach the
+ground occupied by two cavalry regiments, although it made ravages in
+all the other regiments in the same camp.
+
+We have, perhaps, a right to demand from those gentlemen who display
+such peculiar tact in the discovery of ships by which the cholera has,
+at divers times, been imported into continents and islands, the names
+of those ships which brought to this country, in the course of the
+present year, the "_contagion_" which has produced, at so many
+different points, cases of severe cholera, causing death in some
+instances, and in which the identity with the "Indian cholera," the
+"Russian cholera," &c., has been so _perfect_, that all the "perverse
+ingenuity" of man cannot point out a difference. If it cannot be shown
+that in this, we non-contagionists in cholera are in error, people
+will surely see reason for abandoning the cause of cordons, &c., in
+this disease,--a cause which, in truth, now rests mainly for support
+upon a sort of conventional understanding, unconnected altogether, it
+would appear, with the facts of the case, and entered into, we are
+bound to suppose, before the full extent of the mischief likely to
+arise from it had been taken into consideration. Admitting for a
+moment that a case of cholera possessing contagious properties could
+be imported into this country this year, will anybody say that a
+"constitution of the atmosphere" favourable to its communicability to
+healthy individuals, has not existed _in a very high degree_:--can a
+spot be named in which cholera, generally of a mild grade, has not
+prevailed? And if contagionists cannot point out a difference between
+some of the severe cases to which public attention has been drawn, and
+the most marked cases of the Indian or Russian cholera, I think that
+now there should be an end to all argument in support of their cause.
+Without at all going to the extent which might be warranted, I would
+beg to be informed of the names of the ships by which the contagion
+was brought, which caused the illness of the following individuals; or
+if they be allowed, as I presume must be the case, not to have been
+infected at all in this way, all that has been said regarding the
+identity of the foreign and severe form of the home disease, must be
+shown to be without foundation:--the detailed case of Patrick Geary,
+which occurred in the Westminster Hospital,--the fatal case of Mr.
+Wright, surgeon, 29, Berwick-street,--the cases, some of them fatal,
+which occurred at Port Glasgow, and regarding which, a special inquiry
+was instituted,--a case in Guy's Hospital, which caused some anxiety
+about the middle of July last,--a case reported in a medical
+periodical in August last, as having occurred in Ireland,--the fatal
+case, as reported in my first letter, of Martin M'Neal,[6]--a second
+case reported in a medical periodical in August,--a fatal case on the
+12th of August last at Sunderland, reported upon to the Home Secretary
+by the mayor of that town,--three cases reported in No. 421 of THE
+LANCET,--a very remarkable case duly reported upon in September,
+from the Military Hospital at Stoke, near Davenport, and a case with
+thorough "congee stools," spasms, &c. (the details of which I may
+hereafter forward), which occurred at Winchester on the 22d of
+September, in the 19th Foot, in a man of regular habits, and of _the
+nature_ of which case the medical gentleman in charge had no doubt.
+
+[Footnote 6: The same Army Medical gentleman, who had been sent to Port
+Glasgow, was sent to Hull to report upon this case:--he arrived there
+too late, but having seen the details of the case, he admitted that he
+saw no reason to declare them different from those which occurred in the
+Indian cholera.]
+
+I quite agree with those who are of opinion, that in this and most other
+countries, cases may be every year met with exhibiting symptoms similar
+to those which have presented themselves in any one of the above.
+Instead of amusing us, when next writing upon cholera, with a quotation
+about small-pox from Rhazes, bearing nonsense upon the face of it, some
+of those who maintain the contagious property of Indian or any other
+cholera, may probably take the trouble to give the information on the
+above cases, so greatly required for the purpose of enlightening the
+public.
+
+I must now beg to return to an examination of one or two more of the
+_very select_ quotations made by Dr. Macmichael, with the view, as
+he is pleased to tell us, of placing the statements on both sides
+in juxtaposition. He is well pleased to give us from Dr. Taylor,
+assistant-surgeon,--what indeed never amounted to more than report, and
+of the truth or falsehood of which this gentleman does not pretend to
+say he had any knowledge himself,--that a traveller passing from the
+Deacan to Bombay, found the disease prevailing at Panwell, through which
+he passed, and so took it on with him to Bombay; but whether the man had
+the disease, or whether he took its germs with him in some very
+susceptible article of dress, is not stated by Dr. Taylor; however, he
+states (what we are only surprised does not happen oftener in those
+cases, when we consider similarity of constitution--of habits--of site
+or aspect of their dwellings, &c.) that several members of a family, and
+neighbours "were attacked within a very short period of each other;" but
+when Dr. Taylor goes on to say, "In bringing forward these facts,
+however, it may be proper at the same time to state, that of the
+forty-four assistants employed under me, only three were seized with the
+complaint;" he gets out of favour at once, and his observation is called
+"unlucky," being but a _negative_ proof, and Dr. Macmichael adds, what
+everybody must agree with him in, that positive instances of contagion
+must outweigh all negative proofs:--to be sure:--but Dr. Macmichael's
+saying this, does not show that positive proofs exist. Give us but
+positive proofs, give even but a _few_, which surely may be done, if
+the disease be really communicable, and where contagion has been so
+ardently sought after by all sorts of _attachés_ and _employés_ of the
+cordon and quarantine systems in the different countries on the
+Continent. We could produce no mean authority to show, that _a long
+succession of negative proofs_ must be received as amounting to a moral
+certainty; and what greater proof can we have of non-contagion in any
+disease, than we have in the fact regarding epidemic cholera, as well
+as yellow fever, that attendants on the sick are not more liable than
+others to be attacked? Regard should, of course, always be paid, in
+taking this point into consideration, to what has been already noticed
+in my second letter, or the inferences must be most erroneous. Dr.
+Macmichael quotes the statement of Dr. Burrell, 65th regiment (and takes
+care to put the quotation in italics too), that at Seroor, in 1818,
+"almost every attendant in hospital had had the disease. There are about
+thirty attendants in hospitals." Now, along with hundreds of other
+instances, what does Dr. French, of the 49th regiment, say, in his
+Report of 1829? That no medical man, servant, or individual of any kind,
+in attendance on the sick, was taken ill at Berhampore, when the cholera
+prevailed there that year, and refers, to his Report for 1825, in which
+he remarked the same thing in the hospital of the 67th regiment at
+Poonah; contrary, as he observes, to what occurred some years before in
+the 65th regiment at Seroor, about forty miles distant. In the two
+instances quoted by Dr. French, and in that by Dr. Burrell, all those
+about the sick stood in the same relation towards them, and all the
+difference will be found probably to have been, that the hospital of the
+65th _was within the limit of the deteriorated atmosphere, where the
+cause existed equally (as in the case of ague and yellow fever) whether
+persons were present or not_.
+
+In Egypt there is not, it is true, a "cruel and inhuman desertion" of
+the unfortunate plague patients; for, among other reasons, being
+predestinarians, they think it makes no sort of difference whether
+they attend on the sick or not. Those who act upon the principle of
+cholera being a highly contagious disease, may perhaps consider it
+necessary to recommend, among their _precautions_, that the medical
+men and attendants should be enveloped in those hideous dresses used
+in some countries by those who approach plague patients[7]--fancy, in
+the case of a sick female, or even of a man of pretty good nerves, the
+effect of but half the precautions one hears of, as proper to be
+observed. It is quite a mistake to suppose that the sick have not been
+sometimes abandoned during the prevalence of epidemics; and that too
+in cases where medical men had very erroneously voted the disease
+contagious:--among other horrid things arising out of mistaken views,
+who that has ever read it, can forget the account given by Dr.
+Halloran, of the wretched yellow-fever patient in Spain, who, with a
+rope tied round him, was dragged along for some distance by a guard,
+when he was put into a shed, where he was suffered to die, without
+even water to quench his thirst? I admit that, even with the views of
+non-contagionists, difficulties obviously present themselves in regard
+to the safety of those about the sick, when the latter are in such a
+state as will not admit of their removal to a more auspicious spot
+from that in which there is reason to believe they inhaled the noxious
+atmosphere. From what has been observed in India and other places,
+however, there is often sufficient warning in a feeling of _malaise_,
+&c., and the distance to favoured spots, where people may be observed
+not to be attacked, may be very short,--sometimes, as we have seen,
+but a few yards, so that a removal of the patient, _with his friends_,
+may be practicable, in a vast number of cases, previous to the setting
+in of the more serious symptoms.
+
+[Footnote 7: Since writing the above, I find that this scene has
+actually occurred lately at Dantzic where a few miserable medical men
+illustrated their doctrines of contagion, by skulking at a certain
+distance about the sick, dressed up in oil skins, like the disgusting
+figures we see in books, of the Marseilles doctors in the Lazaretto.
+(See Sun Newspaper, 22nd, Nov.)]
+
+I shall conclude this by cursorily referring to two circumstances which
+have within a short time occurred on the Continent, and which seem to me
+to be of no small importance in regard to cholera questions. It appears
+that the committee appointed by the French Chamber of Deputies to
+inquire into the questions connected with voting an additional sum to
+meet cordon and quarantine expenses, in the event of the cholera making
+its appearance in or near France, have made their report to the Chamber.
+They declare that in India the cholera was proved not to have been
+transmissible; and that in regard to Russia, it was not introduced, as
+always contended for by some persons:--they refer to the city of Thorn
+as exempt from the disease, though free from cordons, and in the midst
+of a country where it prevails, while the disease appeared in St.
+Petersburg and Moscow, notwithstanding their cordons, and even in
+Prussia, where sanatory laws where executed "_avec une punctualité et
+une rigeur ailleurs inconnues_." The money is nevertheless granted;
+it is always a good thing to have, but they have set one curious
+_condition_ upon its being granted, which displays consummate tact,
+for it is to be employed solely in disbursements of a particular nature
+(_dépenses materielles_), including, it may be presumed, temporary
+hospitals, &c.; and that it is by no means ("_nullement_") to go into
+the pockets of individuals.
+
+The other circumstance to which I allude is that, like Russia and
+Austria, Prussia has found that quarantines and cordons do not check
+the progress of cholera. The king declares that the appearance of the
+disease in his provinces, has thrown _new light_ on the question; he
+specifies certain restrictions as to intercourse, which were forthwith
+to be removed, and declares his intention to modify the whole. In
+short, it is quite plain that, as Dr. Johnson has it in his last
+journal,--those regulations will, "_in more countries than Russia,
+be useless to all but those employed in executing them_."
+
+
+
+
+LETTER IV.
+
+
+It need scarcely be said how much it behooves all medical men to keep
+in view the subject of the wide-spreading cholera, and not to suffer
+themselves to be led from an attentive consideration of all that
+appertains to it, by the great political questions which at present
+convulse the whole kingdom.
+
+I totally disagree with Dr. Macmichael, as I believe most people will,
+that the notion of _contagion_ in many diseases is "far from being
+natural and obvious to the mind;" for, since the time that contagious
+properties have been generally allowed to belong to certain diseases,
+there has been a strong disposition to consider this as the most natural
+and obvious mode of explaining the spreading of other diseases. A person
+sees evidence of the transmission, _mediate_ as well as _immediate_,
+of small-pox, from one person to another; and, in other diseases, the
+origin of which may be involved in obscurity, he is greatly prone
+to assign a similar cause which may seem to reconcile things so
+satisfactorily to his mind. Indeed there seems, in many parts of the
+world, a degree of _popularity_ as to quarantine regulations, which
+is well understood and turned to proper account by the initiated in
+the mysteries of that department:--for what more common than the
+expression--"we cannot be too careful in our attempts to _keep out_
+such or such a disease?" For my part, I admit that I can more easily
+comprehend the propagation of certain epidemics by contagion, than I
+can by any other means, _when unaccompanied by sensible atmospheric
+changes_; and if I reject contagion in cholera, it is because whatever
+we have in the shape of fair evidence, is quite conclusive as to the
+non-existence of any such principle. Indeed abundance of evidence now
+lies before the public, from various sources, in proof of the saying of
+Fontenelle being fully applicable to the question of cholera--"When a
+thing is accounted for in two ways, the truth is usually on the side
+most opposed to _appearances_." How well mistaken opinions as to
+contagion in cholera are illustrated in a pamphlet which has just
+appeared from Dr. Zoubkoff of Moscow! This gentleman, it appears, has
+been a firm believer in contagion, until the experience afforded him
+during the prevalence of the disease in that city proved the contrary.
+He tells us (p. 10), that in the hospital (Yakimanka) he saw "_to his
+great astonishment_, that all the attendants, all the soldiers, handled
+the sick, supported their heads while they vomited, placed them in the
+bath, and buried the dead; always without precaution, and always without
+being attacked by cholera." He saw that even the breath of cholera
+patients was inhaled by others with impunity; he saw, that throughout
+the district of which he had charge, the disease did not spread through
+the crowded buildings, or in families where some had been attacked, and
+that exposure to exciting causes _determined_ the attack in many
+instances. He saw all this, gives the public the benefit of the copious
+notes which he made of details as to persons, places, &c., and now
+ridicules the idea of contagion in cholera. Grant to the advocates of
+contagion in cholera but all the data they require, and they will
+afterwards prove every disease which can be mentioned to be contagious.
+Hundreds of people, we will say, for instance, come daily from a sickly
+district to a healthy one, and yet no disease for some time appears; but
+at last an "inexplicable condition of the air," and "not appreciable by
+any of our senses" (admitted by Dr. Macmichael and others as liable to
+occur, but _only in aid_ of contagion), take place; cases begin to
+appear about a particular day, and nothing is now more easy than to make
+out details of arrivals, there being a wide field for selection; and
+even how individuals had spoken to persons subsequently attacked--had
+stopped at their doors--had passed their houses, &c.[8] Causation is at
+once connected with antecedence, at least for a time, by the people at
+large, who see their government putting on cordons and quarantines,
+and the most vague public rumour becomes an assumed fact. We even
+find, as may be seen in the quotation given from Dr. Walker's report,
+that contagionists are driven to the "somehow or other" mode of the
+introduction of cholera by individuals; so that it may be deplored, with
+respect to this disease, in the words of Bacon, that "men of learning
+are too frequently led, from ignorance or credulity, to avail themselves
+of mere rumours or whispers of experience as confirmation, and sometimes
+as the very ground-work, of their philosophy, ascribing to them the same
+authority as if they rested upon legitimate testimony. Like to a
+government which should regulate its measures, not by official
+information of its accredited ambassadors, but by the gossipings of
+newsmongers in the streets. Such, in truth, is the manner in which the
+interests of philosophy, as far as experience is concerned, have
+hitherto been administered. Nothing is to be found which has been duly
+investigated,--nothing which has been verified by a careful examination
+of proof."
+
+[Footnote 8: Since the above was written it has been very clearly shewn
+how easily proofs of _this kind_ may be furnished to all disposed to
+receive them. We perceive that a disease officially announced as _the
+true_ cholera, has existed for nearly a month past at Sunderland, and
+that among the thousands of people who left it within that time, nothing
+could be more easy, had the disease appeared epidemically in other parts
+of England, than to point out the _particular individual_ who had
+"brought it" in some way or other; and this is the manner in which all
+the fables about the propagation of cholera from one district to another
+have gained credence. (Nov. 24th.)]
+
+In their efforts to make out their case, there would seem to be no end
+to the contradictions and inconsistencies into which the advocates
+of contagion in cholera are led. At one moment we are required to
+believe that the disease may be transmitted through the medium of an
+unpurified letter, over seas and continents, to individuals residing
+in countries widely differing in climate, while, in the next, we are
+told--regarding the numberless instances of persons of all habits who
+remain unattacked though in close contact with the diseased--that the
+constitution of the atmosphere necessary for the germination of the
+contagion is not present; and this, although we see the disease
+attacking all indiscriminately, those who are not near the sick as
+well as those who are at a very short distance, as on the opposite
+side of a ravine, of a rivulet, of a barrack, or even of a road. They
+assume that wherever the disease appears, _three_ causes must be in
+operation--contagion--peculiar states of atmosphere (heat now clearly
+proved not _essential_, as at one time believed)--and susceptibility
+in the habit of the individual. However unphilosophical it is held to
+be to multiply causes, the advocates of contagion are not likely to
+reduce the number, as this would at once cramp them in their pleadings
+before a court where sophistry is not always quickly detected. Those
+who see irresistible motives for dismissing all idea of contagion,
+look, on the contrary, for the production of cholera, to sources,
+admitted from remote times to have a powerful influence on our
+systems, though invisible--though not to be detected by the ingenuity
+of man, and though proved to exist only by their effects.
+
+Many who do not believe that cholera can be propagated by contagion
+under ordinary circumstances, have still a strong impression that by
+crowding patients together, as in hospitals or in a ship, the
+disease may acquire contagious properties. Now we find that when the
+_experimentum crucis_ of extensive experience is contrasted with the
+feasibility of this, cholera, like ague, has not been rendered one bit
+more contagious by crowding patients together than it has been shown to
+be under other circumstances. We do not require to be told that placing
+many persons together in ill-ventilated places, whether they labour
+under ague, or catarrh, or rheumatism, or cholera, as well as where no
+disease at all exists among them, as in the Calcutta black-hole affair,
+and other instances, which might be quoted, _fever_, of a malignant
+form, is likely to be the consequence, but assuredly not ague, or
+catarrh, or rheumatism, or cholera. On this point we are furnished with
+details by Dr. Zoubkoff, of Moscow, in addition to the many previously
+on record. It may be here mentioned that, on a point which I have
+already referred to, this gentleman says (p. 43), "I shall merely
+observe that at Moscow, where the police are remarked for their
+activity, they cannot yet ascertain who was the first individual
+attacked with cholera. It was believed at one time that the disease
+first showed itself on the 17th of September; afterwards the 15th was
+fixed upon, and at last persons went so far back as August and July."
+As this gentleman _had been_ a contagionist, occupied a very responsible
+situation during the Moscow epidemic, and quotes time and place in
+support of his assertions, I consider his memoir more worthy of
+translation than fifty of your Keraudrens.
+
+Respecting those mysterious visitations which from time to time
+afflict mankind, it may be stated that we have a remarkable instance
+in the "_dandy_" or "_dangy_" disease of the West India Islands,
+which, of late years, has attracted the notice of the profession as
+being quite a new malady, though nobody, as far as I am aware of, has
+ever stated it to have been an imported one. We find also that within
+the last three years a disease, quite novel in its characters, has
+been very prevalent in the neighbourhood of Paris. It has proved fatal
+in many instances, and the physicians, unable to assign it a place
+under the head of previously-described disease, have been obliged
+to invent the term "Acrodynia" for it. I am not aware that even
+M. Pariset, the medical chief of quarantine in France, ever supposed
+this disease to have been _imported_, and to this hour the cause of
+its appearance remains in as much obscurity among the Savans of Paris,
+as that of the epidemic cholera.
+
+Considering all the evidence on the subject of cholera in India, in
+Russia, Prussia, and Austria, one cannot help feeling greatly astonished
+on perceiving that Dr. Macmichael (p. 31 of his pamphlet) insinuates
+that the spreading of the disease in Europe has been owing to the views
+of the subject taken by the medical men of India.
+
+In turning now more particularly to the work, or rather compilation,
+of Dr. Bisset Hawkins, let us see whether we cannot discover among what
+he terms "marks of haste" in getting it up for "the curiosity of the
+public" (_curiosity_, Dr. Hawkins!), some omissions of a very important
+nature on the subject of a disease respecting which, we presume, he
+wished to enlighten the public. And first, glancing back to cholera in
+the Mauritius, Dr. Hawkins might, had he not been so pressed for time,
+have referred to the appearance of cholera in 1829, at Grandport in that
+island; when, as duly and officially ascertained, it could not be a
+question of importation by any ship whatever. The facility with which he
+supplies us with "facts,"--the _false facts_ reprobated by Bacon, and
+said by Cullen to produce more mischief in our profession than false
+theories--is quite surprising; he tells us, point blank (p. 31),
+speaking of India, that "when cholera is once established in a marching
+regiment, it continues its course in spite of change of position, food,
+or other circumstances!" Never did a medical man make an assertion more
+unpardonable, especially if he applies the term _marching regiment_ as
+it is usually applied. Dr. Hawkins leads us to suppose that he has
+examined the India reports on cholera. What then are we to think when we
+find in that for Bengal the following most interesting and conclusive
+statements ever placed on record? Respecting the Grand Army under the
+Marquis of Hastings, consisting of 11,500 fighting men, and encamped in
+November 1817 on the banks of the Sinde, the official report states that
+the disease "as it were in an instant gained fresh vigour, and at once
+burst forth with irresistible violence in every direction. Unsubjected
+to the laws of contact, and proximity of situation, which had been
+observed to mark and retard the course of other pestilences, it
+surpassed the plague in the width of its range, and outstripped the most
+fatal diseases hitherto known, in the destructive rapidity of its
+progress. Previously to the 14th it had overspread every part of the
+camp, sparing neither sex nor age, in the undistinguishing virulence of
+its attacks."--"From the 14th to the 20th or 22d, the mortality had
+become so general as to depress the stoutest spirits. The sick were
+already so numerous, and still pouring in so quickly from every quarter,
+that the medical men, although night and day at their posts, were no
+longer able to administer to their necessities. The whole camp then put
+on the appearance of a hospital. The noise and bustle almost inseparable
+from the intercourse of large bodies of people had nearly subsided.
+Nothing was to be seen but individuals anxiously hurrying from one
+division of a camp to another, to inquire after the fate of their dead
+or dying companions, and melancholy groups of natives bearing the
+biers of their departed relatives to the river. At length even this
+consolation was denied to them, for the mortality latterly became so
+great that there was neither time nor hands to carry off the bodies,
+which were then thrown into the neighbouring ravines, or hastily
+committed to the earth on the spots on which they had expired." Let us
+now inquire how this appalling mortality was arrested;--the report goes
+on to inform us:--"It was clear that such a frightful state of things
+could not last long, and that unless some immediate check were given to
+the disorder, it must soon depopulate the camp. It was therefore wisely
+determined by the Commander-in-chief _to move in search of a healthier
+soil and of purer air_," which they found when they "crossed the clear
+stream of the Bitwah, and upon its high and dry banks at Erich soon got
+rid of the pestilence, and met with returning health." Now just fancy
+epidemic cholera a disease transmissible by "susceptible articles," and
+what an inexhaustible stock must this large army, with its thousands of
+followers, have long carried about with them; but, instead of this, they
+were soon in a condition to take the field. Against the above historical
+fact men of ingenuity may advance what they please. There is no doubt
+that, in the above instance, severe cases of cholera occurred _during
+the move_, the poison taken into the system on the inauspicious spot,
+not having produced its effects at once; it is needless to point out
+what occurs in this respect in remittent and intermittent fevers. The
+India reports furnish further evidence of mere removal producing health,
+where cholera had previously existed. Mr. Bell, a gentleman who had
+served in India, and who has lately written upon the disease,[9] informs
+us (p. 84), that "removing a camp a few miles, has frequently put an
+entire and immediate stop to the occurrence of new cases; and when the
+disease prevailed destructively in a village, the natives often got rid
+of it by deserting their houses for a time, though in doing so they
+necessarily exposed themselves to many discomforts, which, _cæteris
+paribus_, we should be inclined to consider exciting causes of an
+infectious or contagious epidemic." We even find that troops have, as
+it may be said, _out-marched_ the disease, or rather the cause of the
+disease; that is, moved with rapidity over an extensive surface where
+the atmosphere was impure, and thereby escaped--on the principle that
+travellers are in the habit of passing as quickly as they can across the
+pontine marshes. Mr. Bell says, "In July, 1819, I marched from Madras in
+medical charge of a large party of young officers who had just arrived
+in India, and who were on their way to join regiments in the interior of
+the country. There was also a detachment of Sepoys, and the usual number
+of attendants and camp-followers of such a party in India. The cholera
+prevailed at Madras when we left it. Until the 5th day's march (fifty
+miles from Madras) no cases of the disease occurred. On that day several
+of the party were attacked on the line of march; and, during the next
+three stages, we continued to have additional cases. Cholera prevailed
+in the countries through which we were passing. In consultation with the
+commanding officer of the detachment, it was determined that we should
+_leave the disease behind us_; and as we were informed that the country
+beyond the Ghauts was free from it, we marched, without a halt, until we
+reached the high table land of Mysore. The consequence was, that we left
+the disease at Vellore eighty-seven miles from Madras, and we had none
+of it until we had marched seventy miles further (seven stages), when we
+again found it at one of our appointed places of encampment; but our
+camp was, in consequence, pushed on a few miles, and only one case, a
+fatal one, occurred in the detachment; the man was attacked on the line
+of march. We again left the disease, and were free from it during the
+next 115 miles of travelling; we then had it during three stages, and
+found many villages deserted. We once more left it, and reached our
+journey's end, 260 miles further, without again meeting it. Thus, in a
+journey of 560 miles, this detachment was exposed to, and left the
+disease behind it, four different times; and on none of those occasions
+did a single case occur beyond the tainted spots." What a lesson for
+Dr. Hawkins! But _for whom_ could Dr. Hawkins have written his _curious_
+book? Hear Mr. Bell in respect to the common error of the disease
+following high roads and navigable rivers only:--"I have known the
+disease to prevail for several weeks at a village in the Southern
+Mahratta country, within a few miles of the principal station of the
+district, and then leave that division of the country entirely; or,
+perhaps, cases would occur at some distant point. In travelling on
+circuit with the Judge of that district, I have found the disease
+prevailing destructively in a small and secluded village, while no cases
+were reported from any other part of the district." What is further
+stated by Mr. Bell will tend to explain why so much delusion has existed
+with regard to the progress of the disease being remarkably in the
+direction of lines of commerce, or great intercourse:--"When travelling
+on circuit, I have found the disease prevailing in a district _before
+any report had been made of the fact, notwithstanding the most positive
+orders on the subject_; and I am persuaded, that were any of the
+instances adduced in support of the statement under consideration
+strictly inquired into, it would be found that the usual apathy of the
+natives of India had prevented their noticing the existence of the
+disease until the fact was brought prominently forward by the presence
+of Europeans. It should also be brought to mind, that cholera asphyxia
+is not a new disease to these natives, but seems to be, in many places,
+almost endemical, whilst it is well known that strangers, in such
+circumstances, become more obnoxious to the disease than the inhabitants
+of the country. Moreover, travellers have superadded to the remote cause
+of the disease, fatigue and road discomforts, which are not trifling in
+a country where there are neither inns nor carriages." (p. 89.) Cholera
+only attacks a certain proportion of a population, and is it wonderful
+that we should hear more of epidemic on high roads, where the population
+is greatest? High roads too are often along the course of rivers; and
+is there not some reason for believing, that there is often along the
+course of rivers, whether navigable or not, certain conditions of the
+atmosphere unfavourable to health? When Dr. Hawkins stated, as we find
+at p. 131 he has done, that where the inhabitants of certain hilly
+ranges in India escaped the disease, "these have been said to have
+interdicted all intercourse with the people below," he should have
+quoted some respectable authority, for otherwise, should we unhappily be
+visited by this disease, the people of our plains may one day wage an
+unjust war against the sturdy Highlanders or Welsh mountaineers.[10]
+Little do the discussers of politics dream of the high interest of
+this part of the cholera question, and little can they conceive the
+unnecessary afflictions which the doctrine of the contagionists are
+calculated to bring on the nation. Let no part of the public suppose for
+a moment that this is a question concerning medical men more than it
+does them; _all_ are _very_ deeply concerned, the heads of families more
+especially so.
+
+[Footnote 9: This is by far the best work yet published in England on
+the cholera, but it is to be regretted that the author has not alluded
+to the works of gentlemen who have a priority of claim to some of the
+opinions he has published: I think that, in particular, Mr. Orton's
+book, printed in India, should have been noticed.]
+
+[Footnote 10: Something of this kind would have infallibly taken place,
+had certain insane proposals lately made respecting the _shutting in_
+of the people of Sunderland, been carried into effect.]
+
+We see that the identity of the European and Indian epidemic cholera is
+admitted on all sides; we have abundant proof that whatever can be said
+as to the progress of the disease, its anomalies, &c., in the former
+country, have been also noted respecting it in the latter; and Dr.
+Hawkins, when he put forth his book, had most assuredly abundant
+materials upon which to form a rational opinion. It is by no small
+effort, therefore, that I can prevent all the respect due to him from
+evaporating, when he declares, at page 165, that "the disease in India
+was _probably_ communicable from person to person, and that in Europe it
+has _undeniably_ proved so." But Dr. Hawkins is a Fellow of the College
+of Physicians, and we must not press this point further than to wish
+others to recollect that he has told us that he drew up his book in
+haste; and, moreover, that he wished to gratify the _curiosity_ of the
+public. The Riga story about the hemp and the fifteen labourers I shall
+leave in good hands, the British Consul's at that city, who was required
+to draw up, for his government, a statement of the progress, &c. of
+the cholera there, of which the following is an extract:--
+
+"The fact of non-contagion seems determined, as far as a question can
+be so, which must rest solely upon negative evidence. The strongest
+possible proof is, the circumstance, that not one of the persons
+employed in removing the dead bodies (which is done without any
+precaution) has been taken ill. _The statement of fifteen labourers
+being attacked, while opening a pack of hemp, is a notorious falsehood._
+Some physicians incline to the opinion, that the disease may sometimes
+be caught by infection, where the habit of body of the individual is
+predisposed to receive it; the majority of the faculty, however,
+maintain a contrary doctrine, and the result of the hospital practice
+is in their favour. There are 78 persons employed in the principal
+hospital here; of these only two have been attacked, one of whom was an
+'_Inspecteur de Salle_,' and not in immediate attendance upon the sick.
+I am assured that the other hospitals offer the same results, but as I
+cannot obtain equally authentic information respecting them, I confine
+myself to this statement, on which you may rely. On the other hand, in
+private families, several instances have occurred where the illness of
+one individual has been followed by that of others: but, generally, only
+where the first case has proved fatal, and the survivors have given way
+to grief and alarm. Mercenary attendants have seldom been attacked,
+and, as mental agitation is proved to be one of the principal agents
+in propagating or generating the disease, these isolated cases are
+attributed to that cause rather than infection.
+
+"It is impossible to trace the origin of the disease to the barks;
+indeed it had not manifested itself at the place whence they come till
+after it had broken out here. The nearest point infected was Schowlen
+(at a distance of 200 wersts), and it appeared simultaneously in three
+different places at Riga, without touching the interjacent country. The
+first cases were two stone-masons, working in the Petersburg suburbs, a
+person in the citadel, and a lady resident in the town. None of these
+persons had had the slightest communication with the crews of barks, or
+other strangers, and the quarter inhabited by people of that description
+was later attacked, though it has ultimately suffered most.
+
+"None of the medical men entertain the slightest doubt of the action of
+atmospheric influence--so many undeniable instances of the spontaneous
+generation of the disease having occurred. Half the town has been
+visited by diarrhoea, and the slightest deviation from the regimen now
+prescribed (consisting principally in abstinence from acids, fruit,
+beer, &c.) invariably produces an attack of that nature, and, generally,
+cholera: fright, and intoxication, produce the same effect.
+
+"Numerous instances could be produced of persons in perfect health, some
+of whom had not left their rooms since the breaking out of the disease,
+having been attacked by cholera, almost instantaneously after having
+imprudently indulged in sour milk, cucumbers, &c. It is a curious
+circumstance, bearing on this question, that several individuals coming
+from Riga have died at Wenden, and other parts of Livonia, without a
+single inhabitant catching the disease; on the other hand, it spreads in
+Courland, and on the Prussian frontier, notwithstanding every effort to
+check its progress. The intemperance of the Russians during the holidays
+has swelled the number of fresh cases, the progressive diminution of
+which had previously led us to look forward to a speedy termination of
+the calamity." This is a pretty fair specimen of the _undeniable_ manner
+in which cholera is proved to be contagious in Europe, and we shall, for
+the present, leave Dr. Hawkins in possession of the full enjoyment of
+such proofs.
+
+Some attempt was made at Sunderland, to establish that, in the case
+which I mentioned in my last as having proved fatal there, the disease
+had been imported from foreign parts, but due inquiry having been made
+by the collector of the customs, this proved to be unfounded; the man's
+name was Robert Henry, a pilot:--he died _on the 14th of August_.[11]
+
+[Footnote 11: In a former letter I alluded to cases of cholera which
+appeared this year at Port Glasgow; I find that the highly interesting
+details of those cases have been just published:--_they should be read
+by everybody who takes the smallest interest in the important questions
+connected with the cholera_. The London publishers are Whittaker and
+Co.]
+
+Abroad we find that, unhappily, the cholera has made its appearance at
+Hamburgh; official information to this effect arrived from our Consul
+at that place, on Tuesday the 11th inst. (October). The absurdity of
+cordons and quarantines is becoming daily more evident. By accounts
+from Vienna, dated the 26th September, the Imperial Aulic Council had
+directed certain lines of cordon to be broken up, seeing, as is stated,
+that they were inefficacious; and by accounts of the same date, the
+Emperor had promised his people not to establish cordons between certain
+states.
+
+We find at the close of a pamphlet on cholera, lately published by Mr.
+Searle, a gentleman who served in India, and who was in Warsaw during
+the greater part of the epidemic which prevailed there this year, the
+following statement:--"I have only to add, that after all I have heard,
+either in India or in Poland, after all I have read, seen, or thought
+upon the subject, I arrive at this conclusion, that the disease is not
+contagious."
+
+In confirmation of the opinion of Mr. Searle, we have now the evidence
+of the medical commission sent by the French government to Poland.
+Dr. Londe, President of that commission, arrived in Paris some days ago.
+He announced to the minister in whose department the quarantine lies,
+as well as to M. Hèly D'Oissel, President of the Superior Council of
+Health, that it was proved in Poland, entirely to his satisfaction,
+as well as to the satisfaction of his five colleagues, that the cholera
+_is not a contagious disease_.
+
+The Minister of War also sent _four_ medical men to Warsaw. Three of
+them have already declared against contagion; so it may be presumed that
+the day is not far distant when those true plagues of society, cordons
+and quarantines against cholera, shall be abolished. Hear the opinion of
+a medical Journalist in France,--after describing, a few days ago, the
+quarantine and cordon regulations in force in that country:--"But what
+effect is to be produced by these extraordinary measures, this immense
+display of means, and all these obstructions to the intercourse of
+communities, against a disease not contagious; a disease propagating
+itself epidemically; and which nothing has hitherto been able to arrest?
+To increase its ravages a hundred-fold,--to ruin the country, and to
+make the people revolt against measures which draw down on them misery
+and death at the same time." What honest man would not _now_ wish that
+in this country the cholera question were placed _in Chancery_; where,
+I have no doubt, it would be quickly disposed of. I shall merely add,
+that the ten medical men sent from France to Poland, for the purpose
+of studying the nature of cholera, have all remained unattacked by the
+disease.
+
+October 15, 1831.
+
+
+
+
+LETTER V.
+
+
+It was well and wisely said, that to know any-thing thoroughly, it must
+be known in all its details; and, to gain the confidence of the public
+in the belief of non-contagion in cholera, it is in vain that they are
+informed that certain alleged facts, brought forward industriously
+by contagionists, are quite groundless, unless proofs are given showing
+this to be the case. The public must, in short, have those alleged
+instances of contagion which have gained currency circumstantially
+disproved, or they will still listen to a doctrine leading to the
+disorganization of the community wherever it is acted upon. It is
+solely upon this ground that these letters have any claim to attention.
+Dr. James Johnson, of London, has, since my last letter, publicly
+contradicted, with all the bluntness and energy of honest conviction,
+the statement by Sir Gilbert Blane, Drs. Macmichael, Hawkins, &c., as to
+the importation of the cholera into the Mauritius by the Topaze frigate;
+but _evidence_ is what people want on these occasions, and, relative to
+the case in question, probably the public will consider what is to be
+found in my third and fourth letters, quite conclusive. Having again
+mentioned the Mauritius, I cannot refrain from expressing my great
+surprise that Mr. Kennedy, who has lately published on cholera, should
+give, with the view of showing "the dread and confusion existing at the
+time," a proclamation by General Darling, while he does not furnish a
+word about the result of the proceedings instituted by that officer, as
+detailed in my third letter, relative to the non-contagious nature of
+the disease, a point of all others the most important to the public. As
+to accounts regarding the confusion caused by the appearance of epidemic
+cholera, we have had no lack of them in the public papers during many
+months past, from quarters nearer home.
+
+Regarding a statement made by Dr. Hawkins in his book on cholera, viz.
+"That Moreau de Jonnés has taken great pains to prove that the disease
+was imported into the Russian province of Orenburg," Dr. H. omits to
+tell us how completely he failed in the endeavour. In the _Edinburgh
+Medical and Surgical Journal_ for July, 1831, there is a review of a
+memoir by Professor Lichtenstädt, of St. Petersburg, in which M.
+Moreau's speculations are put to flight. From the efforts of this
+_pains-taking_ gentleman (M. Moreau) in the cause of contagion in
+cholera, as well as yellow-fever, he seems to be considered in this
+country as a medical man; but this is not the case: he raised himself by
+merit, not only to military rank, but also to literary distinction, and
+is a member of the Academy of Sciences, where he displays an imagination
+the most vivid, but as to the sober tact necessary for the investigation
+of such questions as those connected with the contagion or non-contagion
+of cholera and yellow-fever, he is considered _below par_. He saw the
+yellow-fever in 1802-3, at Martinique, while _aid-de-camp_ to the
+Governor, and still adheres to the errors respecting it which he imbibed
+in his youth, and when he was misled by occurrences taking place _within
+a malaria boundary_, where hundreds of instances are always at hand,
+furnishing the sort of _post hoc propter hoc_ evidence of contagion with
+which some people are satisfied, but which is not one bit less absurd,
+than if a good lady, living in the marshes of Kent, were to insist upon
+it, that her daughter Eliza took the ague from her daughter Jane,
+because they lived together. Strange to say, however, M. Casimir Perier,
+the Prime Minister of France, seems to be guided, according to French
+journals, by the opinions of this gentleman on cholera, instead of by
+different medical commissions sent to Warsaw, &c.
+
+The question of contagion in cholera has been now put to the test in
+every possible way, let us view it for a moment, as compared with what
+has occurred in regard to typhus at the London Fever Hospital, according
+to that excellent observer Dr. Tweedie, physician to the establishment.
+Doubts, as we all know, have been of late years raised as to the
+contagion of typhus, but I believe nothing that has as yet appeared is
+so well calculated to remove those doubts as the statements by this
+gentleman (_see "Illustrations of Fever"_), where he shows that it has
+been remarked for a series of years that "the resident medical officers,
+matrons, porters, laundresses, and domestic servants not connected with
+the wards, and every female who has ever performed the duties of a
+nurse, have one and all been the subjects of fever,"--while, _in the
+Small-Pox Hospital_, which adjoins it, according to the statements of
+the physician, "no case of genuine fever has occurred among the medical
+officers or domestics of that institution for the last eight years." Had
+typhus been produced in the attendants by _malaria_ of the locality,
+those persons in the service of the neighbouring Small-Pox Hospital
+should also have been attacked to a greater or less extent, it is
+reasonable to suppose, within the period mentioned. Now let this be
+compared with all that has been stated respecting attendants on cholera
+patients, and let it be compared with the following excellent fact in
+illustration, showing how numbers labouring under the disease, and
+brought from the inauspicious spot where they were attacked to a place
+occupied by healthy troops, did not, _even under the disadvantage of a
+confined space_, communicate the disease to a single individual:--"It
+has been remarked by many practitioners, that although they had brought
+cholera patients into crowded wards of hospitals, no case of the disease
+occurred among the sick previously in hospital, or among the hospital
+attendants. My own experience enables me fully to confirm this. The
+Military Hospital at Dharwar, an oblong apartment of about 90 feet by
+20, was within the fort, and the lines of the garrison were about a mile
+distant outside of the walls of the fort. On two different occasions (in
+1820 and 1821), when the disease prevailed epidemically among the troops
+of that station, while I was in medical charge of the garrison, but
+while no cases had occurred in the fort within which the hospital was
+situated, the patients were brought at once from their quarters to the
+hospital, which, on each occasion, was crowded with sick labouring under
+other disorders. No attempt was made to separate the cholera patients.
+On one of these occasions, no case of cholera occurred within the
+hospital; on the other, one of the sick was attacked, but he was a
+convalescent sepoy, who had not been prevented from leaving the fort
+during the day. The disease, on each of those occasions, was confined
+to a particular subdivision of the lines, and none of those within the
+fort were attacked." (_Bell on Cholera_, p. 92.)
+
+I have already quoted from Dr. Zoubkoff of Moscow, once a believer in
+contagion; every word in his pamphlet is precious; let but the following
+be read, and who will then say that "the seclusion of the sick should be
+insisted on?"--"The individuals of the hospitals, including soldiers and
+attendants on the sick, were about thirty-two in number, who, excepting
+the medical men, had never attended any sick; we all handled, more or
+less, the bodies of the patients, the corpses, and the clothes of the
+sick; have had our hands covered with their cold sweat, and steeped in
+the bath while the patients were in it; have inhaled their breath and
+the vapours of their baths; have tasted the drinks contained in their
+vessels, all without taking any kind of precaution, and all without
+having suffered any ill effects. We received into our hospital
+sixty-five cholera patients, and I appeal to the testimony of the
+thirty-six survivors, whether we took any precautions in putting them
+into the bath or in handling them--whether we were not seated sometimes
+on the bed of one, sometimes on that of another, talking to them. On
+returning home directly from the hospital, and without using chloride
+of lime, or changing my clothes, I sat down to table with my family, and
+received the caresses of my children, firmly convinced that I did not
+bring them a fatal poison either in my clothes or in my breath. Nobody
+shut his door either against me or my colleagues; nobody was afraid to
+touch the hand of the physician who came direct from an hospital--that
+hand which had just before wiped the perspiration from the brow of
+cholera patients. From the time that people had experience of the
+disease, nobody that I am aware of shunned the sick." Who, after this,
+can read over with common patience directions for the separation of a
+cholera patient from his friends, as if "_an accursed thing_?" or who
+(_il faut trancher le mot_) will now follow those directions?
+
+As to the good Sir Gilbert Blane, who has distributed far and wide a
+circular containing a description the most _naïve_ on record, of the
+epidemic cholera, hard must be the heart which could refuse making
+the allowance which he claims for himself and his memoir; and though
+he brands those who see, in his account of the marchings and
+counter-marchings of the disease, nothing on a level with the
+intellect of the present age, as a parcel of prejudiced imbeciles,
+we must still feel towards him all the respect due to a parent arrived
+at a time of life when things are not as they were wont to be,
+_nec mens, nec ætas_. I may be among those he accuses of sometimes
+employing "unintelligible jargon," but shall not retort while I confess
+my inability to understand such expressions as "some obscure occurrence
+of unwholesome circumstances" which seem to have, according to him,
+both "brought" the disease to Jessore in 1817, and produced it there
+at the same time. Sir Gilbert marks out for the public what he
+considers as forming one of the principal differences between the
+English and Indian cholera, viz. that in the latter the discharges
+"consist of a liquid resembling thin gruel, in the English disease
+they are feculent and bilious." Now if he has read the India reports,
+he must have found abundance of evidence showing that sometimes there
+were _even bilious stools_[12] not at all like what he describes; and,
+again, if he is in the habit of reading the journals, he must have
+found _abundant_ evidence of malignant cholera with discharges like
+water-gruel in this country. As to the French Consul at Aleppo having
+escaped with 200 other individuals confined to his residence, I shall
+only say, as it is Sir Gilbert Blane who relates the circumstance,
+that he _forgot_ to mention that the aforesaid persons had retired to
+a residence _outside_ the city; which, permits me to assure you, Sir
+Gilbert, just makes all the difference in hundreds of cases:--they
+happened to retire to "_clene air_;" and had they carried 50 ague
+cases or 50 cholera cases with them (it matters not one atom which),
+the result would have been exactly the same. The mention of Barcelona
+and the yellow-fever, by Sir Gilbert, was, as Dr. Macmichael would
+term it, rather _unlucky_ for his cause, though probably lucky for
+humanity; for it cannot be too generally known that, during the
+yellow-fever epidemic there in 1821, more than 60,000 people left the
+city, and spread themselves all over Spain, without a single instance
+of the disease having been communicated, WHILE, AT BARCELONETTA, THE
+INFAMOUS CORDON SYSTEM PREVENTED THE UNFORTUNATE INHABITANTS FROM
+GOING BEYOND THE WALLS, AND THE CONSEQUENCES OF SHUTTING THEM UP WERE
+MOST HORRID.
+
+[Footnote 12: See Orton on Cholera, who is most explicit upon this
+point, and cites from the India Reports:--so that the distinctions
+attempted to be drawn in this respect between the "cholera of India,"
+and that of other countries, are, after all, _quite untenable_.]
+
+Little need be said respecting the pure assumptions of Sir Gilbert as
+to the movements of the malady by land and by water, for those vague and
+hacknied statements have been again and again refuted; but we may remark
+that whereas all former accounts respecting the cholera in 1817, in the
+army of the Marquis of Hastings, state that the disease broke out
+somewhat suddenly in the camp on the banks of the Sinde, Sir Gilbert,
+without deigning to give his authority, makes the army set out for
+"Upper India accompanied by this epidemic." We find that Mr. Kennedy,
+another advocate for contagion in cholera, differs from Sir Gilbert as
+to the disease having accompanied the grand army on the march; for he
+says the appearance of the malady was announced in camp in the early
+part of November, when "the first cases excited little alarm." In
+referring, in a former letter, to the sickness in the above army, I
+showed from the text of the Bengal report, how a change of position
+produced a return of health in the troops; but Mr. Kennedy states that
+the disease had greatly declined a few days before the removal, so that
+it had lost "its infecting power." Nevertheless it appears by this
+gentleman's account, a little farther on, that "in their progressive
+movement the grounds which they occupied during the night as temporary
+encampments were generally found in the morning, strewed with the dead
+like a field of battle"! This gentleman tells us that he has laid down a
+law of "increase and decline appertaining to cholera," by which, and the
+assistance of _currents of contagion_, it would appear all these things
+are reconciled wonderfully. Several of the points upon which he grounds
+his belief of contagion have been already touched upon in these letters,
+and the rest, considering the state of the cholera question in Europe
+just now, may be allowed to pass at whatever value the public may, after
+due examination, think it is entitled to. Let it be borne in mind that
+all contagionists who speak of the cholera in the army of the Marquis of
+Hastings, forget to tell us that though many thousand native followers
+had fled from that army during the epidemic, the disease did not appear
+in the towns situated in the surrounding country, _till the following
+year_, as may be seen at a glance by reference to Mr. Kennedy's and
+other maps.
+
+We have another contagionist in the field--a writer in the _Foreign
+Quarterly Review_, the value of whose observations may appear from his
+statement, that "in 1828 the disease broke out in Orenburg, and was
+supposed [_supposed_!] to have been introduced by the caravans which
+arrive there from Upper Asia, or [_or_, nothing like a second string] by
+the Kingiss-Cossacks, who are adjoining this town, and were said [_were
+said_!] to have been about this time affected with the disease." This
+single extract furnishes an excellent specimen of the sort of _proofs_
+which the contagionists, to a man, seem to be satisfied with as to the
+cholera being "carried" from place to place. This gentleman must surely
+be under some very erroneous impression, when he states that, "According
+to the reports of the Medical Board of Ceylon, the disease made its
+appearance in 1819 at Jaffnah in Ceylon, imported from Palamcottah, with
+which Jaffnah holds constant intercourse, and thence it was propagated
+over the island." Now there is every reason to believe that a reference
+to the documents from Ceylon will shew that no report as to the
+importation of the disease was ever drawn up, for Drs. Farrel and Davy,
+as well as Messrs. Marshall, Nicholson, and others, who served in that
+island, are, to this hour, clearly against contagion. But as the writer
+tells us that he is furnished with unpublished documents respecting the
+cholera at St. Petersburg, by the chief of the medical department of the
+quarantine in this country, we do not think it necessary to say one word
+more--_ex pede Herculem_.
+
+I rejoice to observe that Dr. James Johnson has, at last, _spoken out_
+upon the quarantine question; and I trust that others will now follow
+his example. It is only to be regretted, that a gentleman possessing
+such influence with the public as Dr. Johnson does, should have so long
+with-held his powerful aid on the occasion; but his motives were, I am
+quite sure, most conscientious; and I believe that he, as well as
+others, might have been prevented by a feeling of delicacy from going
+beyond a certain point.
+
+Since my last letter a code of regulations, in the anticipation of
+cholera, has been published by the Board of Health. _Let our prayers be
+offered up with fervency tenfold greater than before, that our land may
+not be afflicted with this dire malady._ The following statement,
+however, may not be altogether useless at this moment. According to the
+_Journal des Debats_ of the 24th instant, the Emperor of Austria, in a
+letter to his High Chancellor, dated Schoenbrunn, October 10th, and
+published in the _Austrian Observer_ of the 12th, formally makes the
+most magnanimous declaration to his people, THAT HE HAD COMMITTED AN
+ERROR IN ADOPTING THE VEXATIOUS AND WORSE-THAN USELESS QUARANTINE AND
+CORDON REGULATIONS AGAINST CHOLERA; that he did so before the nature of
+the disease was so fully understood; admits that those regulations have
+been found, after full experience, to have produced consequences more
+calamitous than those arising from the disease itself ("_plus funeste
+encore que les maux que provenaient de la maladie elle-même_.") He
+kindly makes excuses for still maintaining a modified quarantine system
+at certain points, in consequence, as he states, of the opinions still
+existing in the dominions of some of his neighbours, _for otherwise his
+commercial relations would be broken off. To secure his maritime
+intercourse, he must do as they do!_ We find that as _all_ the Prussian
+cordons have been dissolved, _their vessels_ are excluded from entrance
+into certain places on the Elbe. What a horrid state of things! But, as
+a reference will shew, this was one of the things stated in my first
+letter as likely to occur: it is surely a fit subject for immediate
+arrangement between governments. In the mean time, we cannot but profit
+by the great lesson just received from Austria.
+
+I shall add no more on the present occasion, than that my last
+information from Edinburgh notifies the death, from _Scotch cholera_,
+of two respectable females in that city, after an illness of only a few
+hours.
+
+
+
+
+LETTER VI.
+
+
+At a moment when the subject of cholera has become so deeply
+interesting, the good of the public can surely not be better consulted
+by the press than when it devotes its columns (even to the exclusion of
+some political and other questions of importance) to details of plain
+facts connected with the contagious or non-contagious nature of that
+malady--a _question beyond all others regarding it, of most importance_,
+for upon it must hinge all sanatory or conservative regulations, and a
+mistake must, in the event of an epidemic breaking out, directly involve
+thousands in ruin. In the case of felony, where but the life of a single
+individual is at stake--nay, not only in the case of felony, but in the
+case of a simple misdemeanour, or even in the simple case of debt--we
+see the questions of yes or no examined by the Judges of the land with
+due rigour; while, on the point to which I refer, and which affects
+so deeply the dearest interests of whole communities, evidence has
+been acted upon so vague as to make some people fancy that we have
+retrograded to the age of witchcraft. Be it recollected that we shall
+not have the same excuse as some of our continental neighbours had for
+running into frightful errors--for we have their dear-bought experience
+laid broadly before us; and to profit duly by it, it only requires a
+scrutiny by a tribunal, wholly, if you please, non-medical, such as may
+be formed within an hour in this metropolis; nothing short of this will
+do. All, till then, will be vacillation; and when the enemy does come in
+force, we shall find ourselves just as much at a loss how to act as our
+continental neighbours were on the first appearance of cholera among
+them; I say after its first appearance, for we find that they all
+discovered, plainly enough latterly, what was best to be done. Small
+indeed may be the chance of the present order of things as to
+quarantines, the separation of persons attacked, &c., being changed
+by anything which I can offer; but, having many years experience of
+disease--having had no small share of experience in this disease in
+particular, and having, perhaps, paid as much attention to all that has
+been said about it as any man living, I should be wanting in my duty
+towards God and man did I not protest, most loudly, against those
+regulations, which shall have for their base, an assumption, that a
+being affected with cholera can, IN ANY MANNER WHATEVER, transmit, or
+communicate, the disease to others, _however close or long continued the
+intercourse may be_; because such doctrine is totally in opposition to
+all the fair or solid evidence now before the public;--because it is
+calculated, in numberless instances, to predispose the constitution
+to the disease, by exciting terror equal to that in the case of
+plague;--because it is teaching us Christians to do what Jews, and
+others, never do, to abandon the being who has so many ties upon our
+affections;--because the desertion of friends and relatives, and the
+being left solely in charge, perhaps, of a feeble and aged hireling (if
+even such can be got, which I much doubt when terror is so held out,)
+must tend directly to depress those functions which, from the nature of
+the disease, it should be our great effort to support;--finally, because
+a proper and unbiassed examination of the question will shew, that all
+these horrors are likely to arise out of regulations which may, with
+equal justice, be applied to ague, to the remittent fevers of some
+countries, or to the Devonshire cholic, as to cholera.
+
+Happily, it is not yet too late to set about correcting erroneous
+opinions, pregnant with overwhelming mischief, for hitherto the measures
+acted upon have only affected our commerce and finances to a certain
+extent; but it appears to me that not a moment should be lost, in order
+to prevent a public panic; and, in order to prevent those calamities
+which, in addition to the effects of the disease itself, occurred, as we
+have seen, on the Continent. Let then, I say, a Commission be forthwith
+appointed, composed of persons accustomed to weigh evidence in other
+cases, and who will not be likely to give more than its due weight to
+the authority of any individuals. Let this be done, and, in the
+decision, we shall be sure to obtain all that human wisdom can arrive at
+on so important a subject; and the public cannot hesitate to submit to
+whatever may afterwards be proposed. It will then be seen whether the
+London Board of Health have decided as wisely as they have hastily. For
+my part, I shall for ever reject what may be held as evidence in human
+affairs, if it be not shewn that an individual attending another
+labouring under cholera, runs no further risk of being infected than
+an individual attending an ague patient does of being infected by this
+latter disease. What a blessing (in case of our being visited by an
+epidemic) should this turn out to be the decision of those whose
+opinions would be more likely to be regarded by the public than mine
+are likely to be.
+
+Many, I am quite aware, are the professional men of experience now in
+this country, who feel with me on this occasion, but who, in deference
+to views emanating from authority, refrain from coming forward:--let me
+entreat them, however, to consider the importance of their suggestions
+to the community at large, at this moment; and let me beg of them to
+come forward and implore government to institute a special commission
+for the re-consideration of measures, founded on evidence the most vague
+that it is possible to conceive; or, perhaps, I should rather say,
+_against_ whatever deserves the name of evidence. Every feeling should
+be sacrificed, by professional men, for the public good; we must even
+run the greatest risk of incurring the displeasure of those of our
+friends who are in the Board of Health. That we do run some risk is
+pretty plain, from the conduct of a vile journalist closely connected
+with an individual of a paid party, who has threatened us unbelievers in
+generally-exploded doctrines, with a fate nothing short of that which
+overwhelmed some of the inhabitants of Pompeii.
+
+Let me ask why _all_ the documents of importance forwarded to the Board
+of Health are not published in the collection just issued? Why are those
+forwarded by _the Medical Gentleman sent to Dantzic_ not published.[13]
+Why has not an important document forwarded by our Consul at Riga not
+been published? Above all, why has not allusion been made in their
+papers to those cases of PURE SPASMODIC CHOLERA, which have occurred in
+various parts of England within the last five months, and the details
+of which has been faithfully transmitted to them. If those cases be
+inquired into thoroughly and impartially, and that several of them be
+not found to be PERFECTLY IDENTIC with the epidemic cholera of India,
+of Russia, &c., I hereby promise the public to disclose my name, and
+to suffer all the ignomy of a person making false statements. Indeed,
+I may confidently assure the public, that in at least one case which
+occurred about two months ago, the opinion of a gentleman who had
+practiced in India, and who had investigated the history of the
+symptoms, the identity with those of Asiatic cholera, was not denied.
+The establishment of this point is of itself sufficient to overthrow
+all supposition as to the importation of the disease.
+
+[Footnote 13: Since the above was written, I find that this gentleman
+has adduced the strongest proofs possible against contagion.]
+
+In the case of Richard Martin, whose death occurred at Sunderland about
+two months ago--in the case of Martin M'Neal, of the 7th Fusileers,
+which occurred at Hull, on the 11th of August last--in the cases at Port
+Glasgow, as detailed in a pamphlet by Dr. Marshall of that place--as
+well as several other cases which occurred throughout the year, and the
+details of many of which are in possession of the Board of Health--the
+advocates, "_par metier_," of contagion in cholera, have not a loop-hole
+to creep out at. Take but a few of the symptoms in one of those cases
+as taken down by the Medical Gentleman in charge,--"The body was cold,
+and covered by a clammy sweat--the features completely sunk--_the lips
+blue_, the face discoloured--tongue moist and very cold--the hands and
+feet blue, cold, and as if steeped in water, like a washerwoman's hand;
+the extremities cold to the axillæ and groins, and no pulse discoverable
+lower; the voice changed, and the speech short and laborious. He
+answered with reluctance, and in monosyllables." This man had the pale
+dejections, and several other symptoms, considered so characteristic of
+the Asiatic cholera; yet no spreading took place from him, nor ever will
+in similar cases. With the exception of the vomiting and purging, there
+is, in the state of patients labouring under this form of cholera, a
+great similarity to the first stage of the malignant fevers of the
+Pontine Marshes, and many other places, and the patient need not be one
+bit the more avoided. Let this be, therefore, no small consolation, when
+we find that, by the official news of this day, five more deaths have
+occurred at Sunderland.
+
+Nov. 9, 1831.
+
+
+
+
+LETTER VII.
+
+
+It may be inferred, from what I have stated at the close of my letter
+of yesterday, that if a Commission be appointed, I look forward to its
+being shewn, as clear as the sun at noon day, that the most complete
+illusion has existed, and, on the part of many, still exists, with
+regard to the term _Indian_ or _Asiatic_ cholera; for a form of cholera
+possessing characters quite peculiar to the disease in that country, and
+unknown, till very lately, in other countries, _has never existed
+there_. Cholera, from a cause as inscrutable, perhaps, as the cause of
+life itself, has prevailed there, and in other parts of the world, in
+its severest forms, and to a greater extent than previously recorded;
+but, whether we speak of the mild form, or of a severe form, proceeding
+or not to the destruction of life, the symptoms have everywhere been
+precisely the same. In this country it has been over and over again
+remarked, that, so far back as 1669, the spasmodic cholera prevailed
+epidemically under the observation of Dr. Sydenham, who records it. For
+many years after the time of Dr. Cullen, who frequently promulgated
+opinions founded on those of some fancy author rather than on his own
+observation, it was very much the fashion to speak of redundancy of
+bile, or of acrid bile, as the cause of the whole train of symptoms in
+this disease; but, since the attention of medical men has been more
+particularly drawn to the subject, practitioners may be found in every
+town in England who can inform you that, in severe cases of cholera,
+they have generally observed that no bile whatever has appeared till
+the patient began to get better. Abundance of cases of this kind are
+furnished by the different medical journals of this year. In fifty-two
+cases of cholera which passed under my observation in the year 1828, the
+_absence_ of bile was always most remarkable. I made my observations
+with extraordinary care. One of the cases proved fatal, in which the
+group of symptoms deemed characteristic of the Indian or Indo-Russian
+cholera, was most perfect, and in the mass, the symptoms were as
+aggravated as they have often been observed to be in India;--in several,
+spasms, coldness of the body, and even convulsions, having been present.
+
+To those who have attended to the subject of cholera, nothing can be
+more absurd than to hear people say such or such a case cannot be _the
+true_ cholera, or the Indian cholera, or the Russian cholera, because
+_all_ the symptoms ever mentioned are not present: as if, in the
+epidemic cholera of India and other places, even some of the symptoms
+considered the most prominent (as spasms, and the disturbance of the
+stomach and bowels) were not often absent, and that too in some of the
+most rapidly, fatal cases! I feel persuaded that much injustice is done
+to a gentleman lately sent to Sunderland, in attributing to him the
+very ridiculous opinion, _that because_ the disease did not spread, it
+was _therefore_ not identical with the Indian cholera. No person is
+justified in speaking of the cholera of India as a disease _sui
+gineris_, and in which a certain group of severe symptoms are always
+present, when evidence, such as the following is on record:--"On the
+22nd instant, when the men had been duly warned of their danger from not
+reporting themselves sooner, I got into hospital a different description
+of cases, viz.--men with a full pulse, hot skin," &c. (_Dr. Burrell to
+Dr. Milne, Seroor, 27th of July, 1818_)--"But I must tell you that we
+have, too, cases of common cholera." (_Mr. Craw, Seroor--Bengal Report,
+p. 48_)--"The cases which terminated favourably presented very different
+symptoms [from the low form of the disease.] As I saw the men
+immediately after they were attacked, they came to me with a quick
+_full_ pulse, and in several instances pain in the head; there was no
+sweating."--"in several cases _bile_ appeared from the first in
+considerable quantities in the egesta; and these were more manageable
+than those in which no bile was ejected, although the spasms and
+vomiting (the most distressing symptoms of the complaint) were equally
+violent." (_Mr. Campbell, Seroor,--see Orton, 2nd ed. p. 18_)--"In
+conclusion, I am happy to inform you that, for the last three days the
+disease has been evidently on the decline, and, during that period, most
+of the cases have assumed a different and much milder type, and,
+comparatively, are little dangerous. It approaches somewhat to fever;
+the patient complains of severe pain in the legs, sometimes vomiting
+a watery fluid, and sometimes bile." (_White--Bengal Reports, p. 68._)
+
+The same gentleman afterwards observes, "The disease continues to
+present a milder aspect, and now occurs but rarely: loss of pulse and
+coldness are seldom observed."
+
+On the decline of a particular epidemic, Mr. Alardyce observed many
+cases in the 34th regiment, with _bilious_ discharges throughout.
+(Orton, 1st Ed. 128). Finally, referring to the work of Mr. Orton, a
+gentleman who served in India, and who, being a contagionist, will be
+considered, I suppose, not bad authority by those who are of his
+opinion, we find the following declaration. (p. 26, 1st Ed.) "My own
+experience has been very conclusive with regard to the sthenic form of
+the disease. I have found a very considerable number of cases
+exhibiting, singly, or in partial combination, every possible degree,
+and almost every kind of increased action."--"Very full, hard, and quick
+pulse, hot skin, and flushed surface; evacuations of bile, [you are
+requested to note this, reader] both by vomiting and stool, from the
+commencement of the attack. And, finally, I have seen some of those
+cases passing into the low form of the disease."--"The inference from
+these facts is plain, however opposite these two forms of disease may
+appear, _there is no essential or general difference between them_."
+After such authorities, and what has elsewhere been shewn, can any
+cavelling be for one moment permitted as to the cholera in Sunderland
+not being of the same nature as that of India? It may be now clearly
+seen that in India as in Sunderland, the same variety of grades occurred
+in the disease.
+
+In making my communications for the benefit of the public, it is my wish
+to spare the feelings of Sir Gilbert Blane; but as he persists in giving
+as facts often refuted tales of contagion, in order to uphold doctrines
+which he must observe are tumbling into ruins in all directions, it
+becomes necessary that his work of mischief should no longer remain
+unnoticed.
+
+Not a single circumstance which he quotes relative to the marchings
+and the voyages of the contagion of cholera will bear the slightest
+examination; and yet he has detailed them as if, on his simple
+assertion, they were to be received as things proved, and, consequently,
+as so many points to be held in view when the public are in search of
+rules whereby they may be guided. The examination of his assumed facts
+for one short hour, by a competent tribunal, would prove this to be the
+case; here it is impossible to enter upon them all: but let us just
+refer to his _management_ of the question relative to the importation of
+the disease into the Mauritius by the _Topaze_ frigate, which he says
+was not believed there to be the case--and _why_ was it not believed?
+Sir Gilbert takes special care not to tell the public, but they now have
+the reason from me, at page 22.
+
+If a commission be appointed, half an hour will suffice to place before
+them, from the medical office in Berkeley-street, the reports alluded to
+from the Mauritius, by which it is made apparent that long before the
+arrival of the aforesaid frigate, the disease had shown itself in the
+Mauritius.[14] What is the public to think of us and our profession,
+when vague statements are daily attempted to be passed as facts, by
+contagionists _enragés_? One more short reference to Sir Gilbert's
+facts.--While referring to the progress of cholera in India, &c. from
+1817, he says, in a note, "it is remarkable enough that while the great
+oriental epidemic appeared thus on the eastern extremity of the
+Mediterranean, the great western pestilence, the yellow fever, was
+raging in its western extremity, Gibraltar, Malaga, Barcelona, Leghorn,
+&c." Now, it is a historical fact, that, at Gibraltar, this disease did
+not appear between 1814 and 1828--_and at Leghorn not since 1804_! At
+Malaga, I believe, it did not prevail since 1814! So we have here a
+pretty good specimen of the accuracy of some of those who undertake to
+come forward as guides to the public on an occasion of great urgency and
+peril. By some of Sir Gilbert's abettors, we are assured that his "facts
+are perfectly reconcileable with the hypothesis of the cholera being of
+an infectious nature." A fig for all hypothesis just now! Let us have
+something like the old English trial by jury. May I be allowed to
+introduce a fresh evidence to the public notice, in addition to the
+thousand-and-one whose testimony is already recorded. He is worthy of
+belief for two good reasons in particular; the one because he still
+(unable to explain what can never be explained, perhaps), calls himself
+a contagionist, and, in the next place, the statements being from a
+high official personage, he could not offer them unless true to his
+Government, as hundreds might have it in their power to contradict them
+if not accurate. My witness is not a Doctor, but a _Duke_--the Duke de
+_Mortemar_, lately Ambassador from the French Court to St. Petersburg,
+who has just published a pamphlet on cholera, a few short extracts
+from which, but those most important ones, I shall here give. Read
+them!--people of all classes, read them over and over again! "An
+important truth seems to be proved by what we shall here relate,
+which is, that woods seem to diminish the influence of cholera, and
+that cantons in the middle of thick woods, and placed in the centre
+of infected countries, have altogether escaped the devastating
+calamity!"--"The island of Kristofsky, placed in the centre of the
+populous islands of St. Petersburg, communicating with each other by
+two magnificent bridges, and with the city by thousands of boats, which
+carried every day, and particularly on Sundays, a great number of people
+to this charming spot. The island of Kristofsky, we say, _was preserved
+completely from attacks of the cholera_; there was not a _single_ person
+ill of the disease in three villages upon it." He continues to state
+particulars, which, for want of time, cannot be here given, and
+adds--"To what is this salubrity of Kristofsky, inhabited by the same
+sort of people as St. Petersburg, to be attributed, fed in the same
+manner, and following a similar _regime_,--communicating with each other
+daily, if it be not to the influence of the superb forest which shelters
+it? The firs, which are magnificent as well as abundant, surround the
+houses."[15] He notices that the town is low and humid, and that "it is
+made filthy every Sunday by the great numbers who resort to it, and who
+gorge themselves with intoxicating drink." In a third letter I shall be
+able to furnish further extracts from this most interesting pamphlet.
+
+[Footnote 14: I am aware that very lately certain memoranda have been
+referred to from the surgeon, but this is merely an expiring effort, and
+of no avail against the official Report drawn up.]
+
+[Footnote 15: As these most remarkable circumstances have not appeared
+in the statements of our Russian medical commission, we must either
+presume that the Duke is not correct, or that those facts have _escaped
+the notice_ of the commission.]
+
+In a letter lately inserted in a newspaper, the greatest injustice
+is done to the Board of Health by the comments made on their
+recommendations for the _treatment_ of cholera--_it is not true_ that
+they have reccommended _specifics_, and I must add my feeble voice in
+full approbation of all they have suggested on this point. Let the
+public remark that they most judiciously point at the application of
+_dry_ heat, not baths, which always greatly distress the patient, and,
+indeed, have sometimes been observed (that is, where the coldness and
+debility are very great) to accelerate a fatal issue. Of all the
+arrangements to which a humane public can direct their attention, there
+is nothing so essential as warmth. I would, therefore, humbly beg to
+suggest, that funds for the purpose of purchasing coals for gratuitous
+issue to the poor should be at once established in all directions. Too
+much, I think, has been said about ventilation and washing, and too
+little about this.
+
+November 10th.
+
+
+
+
+LETTER VIII.
+
+
+Already has the problem of the contagious or non-contagious nature of
+this disease been solved upon our own land; and as sophistry can no
+longer erect impediments to the due distribution of the resources of
+this pre-eminently humane nation, it is to be hoped that not an hour
+will be lost in shaping the arrangements accordingly. What now becomes
+of the doctrine of a poison, piercing and rapid as the sun's rays,
+emanating from the bodies of the sick--nay, from the bodies of those who
+are not sick, but who have been near them or near their houses? In the
+occurrences at Newcastle and Sunderland, how has the fifty times refuted
+doctrine of the disease spreading from a point in _two_ ways, or in one
+way, tallied with the facts? We were desired to believe that in India,
+Persia, &c., "the contagion _travelled_," as the expression is, very
+slow, because this entity of men's brains was obliged to wend its way
+with the march of a regiment, or with the slow caravan: now, however,
+when fifty facilities for the most rapid conveyance have been afforded
+every hour since its first appearance, it will not put itself one bit
+out of its usual course. And then what dangers to the attendants on the
+sick to the members of the same family--to the washerwomen--to the
+clergymen--to the buriers of the dead--even to those who passed the door
+of the poor sufferer! Well, what of all this has occurred? Why it has
+occurred that this doctrine, supported by many who were honest, but had
+not duly examined alleged facts, and by others, I regret to say, whose
+interests guided their statements--that the absurdity of this doctrine
+has now been displayed in the broad light of day. Make allowance (even
+in this year of great notoriety for susceptibility to cholera in the
+people at large in this country) for _insusceptibility_ on the part of
+numbers who came into contact at Sunderland and Newcastle, with the
+persons of cholera patients, with their beds, their furniture, their
+clothes, &c., yet, if there had ever been the slightest foundation
+for the assertions of the contagionists, what numbers _ought_ to have
+been contaminated, in all directions over the face of the country,
+even within the first few days, considering the wonderful degree of
+intercourse kept up between all parts. But we find that, as in Austria
+and Prussia, "_la maladie de la terre_" is not disposed here to
+accommodate itself to vain speculations. _Now_ the matter may be
+reduced to the simple rules of arithmetic, viz.:--if, as "contagionists
+_par metier_" say, the poison from the body of one individual be, in
+the twinkling of an eye, and in more ways than one, transmitted to
+the bodies of a certain number who have been near him, &c., how many
+thousands, or tens of thousands, in every direction, should, in a
+multiplied series of communications and transmissions, be now affected?
+
+Those who have watched the course of matters connected with cholera in
+this country, have not failed to perceive, for some time past, the
+intent and purport of the assertion so industriously put forth--that the
+disease might be introduced by people in perfect health; and we have
+just seen how this _ruse_ has been attempted to be played off at
+Sunderland, as the history of such matters informs us has been done
+before in other instances, and public vengeance invoked most _foully and
+unjustly_ upon the heads of guiltless persons in the Custom House or
+Quarantine Department, for "permitting a breach of regulations;" but the
+several pure cases of spasmodic cholera, in many parts of England
+besides Sunderland, long before--months before--the arrival of _the_
+ship (as shewn in a former letter) leave no pretence for any supposition
+of this kind.
+
+I request that the public may particularly remark, that, frequently as
+those cases have been cited as proofs of the absurdity of _expecting the
+arrival_ of the disease by a ship, THEIR IDENTITY HAS NEVER ONCE BEEN
+DISPUTED BY THOSE MOST ANXIOUS TO PROVE THEIR CASE. No; the point has,
+in common parlance, been always _shirked_; for whoever should doubt it,
+would only hold himself up to the ridicule of the profession, and to
+admit it would be to give up the importation farce.
+
+Others have remarked before me that, though a very common, it is a very
+erroneous mode of expression, to say of cholera, that _it has travelled_
+to such or such a place, _or has arrived_ at such or such places, for it
+is _the cause_ of the malady which is found to prevail, for a longer or
+shorter time, at those different points. It cannot be expected that
+people should explain such matters, for, with regard to them, our
+knowledge seems to be in its infancy, and "we want a sense for atoms."
+However, as people's minds are a good deal occupied upon the point,
+and as many are driven to the idea of contagion in the face even of
+evidence, from not being able to make any thing of this _casse-tête_,
+the _best guess_ will probably be found in the quotation from Dr. Davy,
+at page 19.
+
+I perceive that the Berlin Gazette is humanely occupied in recommending
+others to profit by the mistakes regarding contagion which occurred in
+that country:--"Dr. Sacks, in No. 38 of his Cholera Journal, published
+here, has again shewn, against Dr. Rush, the fallibility of the doctrine
+of contagion, as well as the mischievous impracticability of the
+attempts founded on it to arrest the progress of the disorder by cutting
+off the communications. It is to be hoped that the alarm so methodically
+excited by scientific and magisterial authority in the countries to the
+west of us [!!] will cease, after the ample experience which we have
+dearly purchased (with some popular tumults), and that the system of
+incommunication will be at once done away with by all enlightened
+governments, after what has passed among us."--I am sure, good people,
+nobody can yet say whether those calling themselves scientific, will
+allow us to profit by your sad experience; but I believe that the people
+of Sunderland are not to be shut in, but allowed to remove, if they
+choose, in spite of silly speculations.
+
+It may not be uninteresting to mention here, that there are no
+quarantines and no choleras in Bohemia or Hanover.
+
+
+
+
+LETTER IX.
+
+
+The following statement from the Duke de Mortemar will be considered
+probably, very curious, considering that, as already stated, he seems
+to believe in something like contagion--and for no earthly reason, one
+may suppose, than from his inability to satisfy himself of the existence
+of another cause--as if it were not sufficient to prove that in reality
+the moon _is not_ made of green cheese, but one must prove _what it is_
+made of! But, to the quotation--"The conviction now established, that
+intercourse with sick produces no increase of danger, should henceforth
+diminish the dread of this calamity (the cholera). It differs from the
+plague in this, that it does not, by its sole appearance, take away
+all hope of help, and destroy all the ties of family and affection.
+Henceforth those attacked will not be abandoned without aid and
+consolation; and separation or removal to hospital, the source of
+despair, will no longer increase the danger. The sick may in future be
+attended without fears for one's self, or for those with whom we live."
+How delightful is the simplicity of truth! Why, Sir, a morceau like
+this, and from an honourable man, let him call himself contagionist or
+what he may, is more precious at this moment than Persian turkois or
+Grecian gems. Make me an example, men say, of the culprits "who let
+the cholera morbus into Sunderland," concealed in "susceptible"
+articles!--yes, and that we may be on a level in other matters, destroy
+me some half dozen witches, too, as we were wont to do of yore. But
+let us have more tidings from Russia to comfort the country of our
+affections in the hour of her affliction, when so much craft and
+subtlety is on foot to scare her. Dr. Lefevre, physician to our embassy
+at St. Petersburg, has just given to the public an account of his
+observations there during the epidemic, from which the following
+extracts are made:--
+
+"As far as my practice is concerned both in the quarter allotted to me,
+and also in private houses in different parts of the town, I have no
+proof whatever that the disease is contagious.
+
+"The first patient I saw was upon the third day of the epidemic, and
+upon strict inquiry I could not trace the least connexion between the
+patient, or those who were about her person, with that part of the town
+where it first appeared--a distance of several versts.
+
+"As regards the attendants of the sick, in no one instance have I found
+them affected by the disease, though in many cases they paid the most
+assiduous attention, watched day and night by the beds of the afflicted,
+and administered to all their wants.
+
+"I knew four sisters watch anxiously over a fifth severely attacked with
+cholera, and yet receive no injury from their care.
+
+"In one case I attended a carpenter in a large room, where there were at
+least thirty men, who all slept on the floor among the shavings; and,
+though it was a severe and fatal case, no other instance occurred among
+his companions.
+
+"In private practice, among those in easy circumstances, I have known
+the wife attend the husband, the husband the wife, parents their
+children, children their parents, and in fatal cases, where, from long
+attendance and anxiety of mind, we might conceive the influence of
+predisposition to operate, in no instance have I found the disease
+communicated to the attendants."--p. 32, 33.
+
+"The present disease has borne throughout the character of an epidemic,
+and when the proofs advanced in proof of its contagion have been
+minutely examined, they have been generally found incorrect; whereas
+it is clear and open to every inquirer, that the cholera did not occur
+in many places which had the greatest intercourse with St. Petersburg
+at the height of the malady, and that it broke out in many others which
+have been subjected to the strictest quarantine."--p. 34.[16]
+
+[Footnote 16: It is remarkable enough that Aretæus, who lived, according
+to some authors, in the first century, gives exactly the same reason
+which Dr. Lefevre does for the suppression of urine in cholera. So true
+it is, that that symptom, considered as one of the characteristics of
+the Indian cholera, was observed in ancient times.]
+
+Hear all this, Legislators! Boards of Health throughout the country,
+hear it! Then you will be able to judge how exceedingly frivolous the
+idle _opinions_ and _reports_ are which you have obtruded so
+industriously upon your notice.
+
+But one more short quotation from Dr. Lefevre, a gentleman certainly
+not among the number of those who stand denounced before the
+professional world as unworthy of belief. He says:--"As for many
+reports which have been circulated, and which, _primâ facie_, seem to
+militate against the statement [communication to attendants, &c.]. I
+have endeavoured to pay the most impartial attention to them; but I
+have never found, upon thorough investigation, that their correctness
+could be relied upon: and in many instances I have ascertained them to
+be designedly false."--DESIGNEDLY FALSE! Alas! _toute ça on trouve
+dans l'article_ HOMME; and any body who chooses to investigate, as
+I have done, the history of epidemics, will find that falsehoods foul
+have been resorted to--shamelessly resorted to--by persons having a
+direct interest in maintaining certain views. Enough, then, has been
+said to put Boards of Health, &c. on their guard against admitting
+_facts_ for their guidance from any quarter whatever, if the purity
+of the source be not right well established. There is too much at stake
+just now to permit of our yielding with ill-timed complaisance to
+_any authority_ without observing this very necessary preliminary.
+
+One word, and with all due respect, before closing, on the subject of
+Dr. James Johnson's "_contingent_ contagion," which, though occurring
+in some diseases, and extremely _feasible_ in regard to others, will,
+if he goes over the evidence again, I am sure, be shown not to apply to
+cholera, which is strictly a disease of _places_, not persons, and can
+no more be generated by individuals than ague itself can. I can only say
+of it, with the philosophic poet, that--
+
+--------------------"A secret venom oft
+Corrupts the air, the water, and the land."
+
+Mr. Searle, an English gentleman, well known for his work on cholera,
+has just returned from Warsaw, where he had the charge of the principal
+cholera hospital during the epidemic. The statements of this gentleman
+respecting contagion, being now published, I am induced from their high
+interest to give them here:--
+
+"I have only to add my most entire conviction that the disease is not
+contagious, or, in other words, communicable from one person to another
+in the ordinary sense of the words--a conviction, which, is founded not
+only upon the nature of the disease, but also upon observations made
+with reference to the subject, during a period of no less than fourteen
+years. Facts, however, being deservedly of more weight than mere
+opinions, I beg leave to adduce the following, in the hope of relieving
+the minds of the timid from that groundless alarm, which might otherwise
+not only interfere with or prevent the proper attendance upon the sick,
+but becomes itself a pre-disposing or exciting cause of the disease; all
+parties agreeing that of all the debilitating agencies operating upon
+the human system, there is no one which tends to render it so peculiarly
+susceptible of disease, and of cholera in particular, than fear.
+
+"The facts referred to are these:--during two months of the period, that
+I was physician to the principal hospital at Warsaw, devoted to the
+reception and treatment of this disease, out of about thirty persons
+attached to the hospital, the greater number of them were in constant
+attendance upon the sick, which latter were, to the number of from
+thirty to sixty, constantly under treatment; there were, therefore,
+patients in every stage of the disease. Several of these attendants,
+slept every night in the same apartments with the sick, on the beds
+which happened to be unoccupied, with all the windows and doors
+frequently closed. These men, too, were further employed in assisting
+at the dissection of, and sewing up of, the bodies of such as were
+examined, which were very numerous; cleansing also the dissecting-room,
+and burying the dead. And yet, notwithstanding all this, only one,
+during the period of two months, was attacked by the disease, and this
+an habitual drunkard, under circumstances, which entirely negative
+contagion, (supposing it to exist), as he had nothing whatever to do
+with the persons of the sick, though he occasionally assisted at the
+interment of the dead. He was merely a subordinate assistant to the
+apothecary, who occupied a detached building with some of the families
+of the attendants; all of whom likewise escaped the disease. This man,
+I repeat, was the only one attacked, and then under the following
+circumstances."
+
+Here Mr. S. relates how this man, having been intoxicated for several
+days--was, as a punishment locked up almost naked in a damp room for two
+nights, having previously been severely beaten.
+
+From the foregoing facts, and others pretty similar in all parts of the
+world where this disease has prevailed, we are, I think, fairly called
+upon to discard all special pleading, and to admit that man's _best
+endeavours_ have not been able _to make it_ communicable by any manner
+of means.
+
+
+
+
+LETTER X.
+
+
+At a meeting held some days ago by the members of the Royal Academy of
+Medicine of Paris, Dr. Londe (President of the French Medical Commission
+sent to Poland to investigate the nature of the cholera) stated, with
+regard to the questions of the origin and _communicability_ of the
+disease, that it appeared by a document to which he referred, that
+1st. "The cholera did not exist in the Russian corps which fought at
+_Iganie_," the place where the first battle with the Poles took place.
+2d. "That the two thousand Russian prisoners taken on that occasion, and
+observed at Praga for ten days under the most perfect separation, [_dans
+un isolement complet_] did not give a single case of cholera." 3d. "That
+the corps [of the Polish army] which was not at _Iganie_, had more cases
+of cholera than those which were there." Dr. Londe stated cases of the
+spontaneous development of the disease in different individuals--of a
+French Lady confined to her bed, during two months previous to her
+attack of cholera, of which she died in twenty-two hours--of a woman of
+a religious order, who had been confined to her bed for six months, and
+while crossing a balcony, the aspect of which was to the Vistula, was
+attacked with cholera, and died within four hours. Dr. Londe, among
+other proofs that the disease was not transmissible, or, as some prefer
+calling it, not communicable, stated, "the immunity of wounded and
+others mixed with the cholera patients in the hospitals; the immunity of
+medical men, of attendants, of inspectors, and of the families of the
+different _employés_ attached to the service of cholera patients;
+the example of a porter, who died of the disease, without his wife or
+children, who slept in the same bed with him, having been attacked; the
+example of three women attacked (two of whom died, and one recovered),
+and the children at their breasts, one of six months, and the other two
+of twelve, not contracting the disease."
+
+At a subsequent meeting of the Academy, a letter from Dr. Gaymard, one
+of the Commission to St. Petersburg, was read, in which it was stated,
+while referring to the comparative mortality at different points there,
+that, "The cause of this enormous difference was, that the authorities
+wished to isolate the sick--[Observe this well reader]--and even send
+them out of the city; now the hospital is on a steep mountain, and, to
+get to it, the carriages were obliged to take a long circuit through a
+sandy road, which occupied an hour at least; and if we add to the
+exposure to the air, the fatigue of this removal, and the time which
+elapsed after the invasion of the disease, the deplorable state of the
+patient on his arrival, and the great mortality may be accounted for."
+
+"The progress of the disease was the same as in other places; it was at
+the moment when it arrived at its height, and when, consequently, the
+greatest intercourse [Observe reader!] took place with the sick, that
+the number of attacks wonderfully diminished all at once (_tout à
+coup_), and without any appreciable cause. The points of the city most
+distant from each other were invaded. Numbers of families crowded
+[_entassés_] who had given aid to cholera patients, remained free from
+the disease, while persons isolated in high and healthy situations
+[_usually_ healthy meant of course] were attacked. It especially
+attacked the poorer classes, and those given to spirituous liquors.
+Scarcely twenty persons in easy circumstances were attacked, and even
+the greater part of these had deviated from a regular system."
+
+The inferences drawn, according to a medical journal, from the whole
+of Dr. Gaymard's communication, are--
+
+"1. That the system of sanatory measures, adopted in Russia, did not
+any where stop the disease.
+
+"2. That without entering on the question as to the advantages to be
+derived from a moral influence arising out of sanatory cordons, placed
+round a vast state like France, these measures are to be regarded as
+useless in the interior, in towns, and round houses.
+
+"3. That nothing has been able to obstruct the progressive advance of
+the disease in a direction from India westward.
+
+"4. That the formation of temporary hospitals, and domiciliary succour,
+are the only measures which can alleviate this great scourge."
+
+A letter from Dr. Gaymard to Dr. Keraudren was read at the meeting of
+the Academy, in which it was stated, that in an Hospital at Moscow, in
+which Dr. Delauny was employed from the month of December, 1830, to
+the end of December, 1831, 587 cholera patients, and 860 cases of
+other diseases, were treated--"Not one of the latter was attacked
+with cholera, although the hospital consists of one building, the
+coridors communicating with each other, and the same linen serving
+indiscriminately for all. The attendants did not prove to be more
+liable to attacks. The relatives were suffered to visit their friends
+in hospital, and this step produced the best impression on the
+populace, who remained calm. They can establish at Moscow, that there
+was not the smallest analogy between the cholera and the plague which
+ravaged that city in the reign of Catharine." Dr. Gaymard declares,
+that, having gone to Russia without preconceived ideas on the subject,
+"he is convinced that interior quarrantines, and the isolation of
+houses and of sick in towns, has been accompanied by disastrous
+consequences." Is there yet enough of evidence to shew that this
+disease is positively _not to be made_ communicable from the sick?
+
+Honour still be to those of the profession who, from conscientious and
+honorable motives, have changed from non-contagionists to contagionists
+in regard to this disease; and all that should be demanded is, that
+their _opinions_ may not for one moment be suffered to outweigh, on
+an occasion of vital importance, the great mass of evidence now on
+record quite in accordance with that just stated. One gentleman of
+unquestionable respectability gives as a reason (seemingly his very
+strongest) for a change of opinion, that he has been credibly informed
+that when the cholera broke out on one side of the street in a certain
+village in Russia, a medical man had a barrier put up by which the
+communication with the other side was cut off, and the disease thus,
+happily, prevented from extending. Now, admitting to the full extent the
+appearance of the disease on one side of the village only--a thing by
+the way hitherto as little proved as many others on the contagion side
+of the question--still, if there be any one thing more striking than
+another, in the history of the progress of cholera, it is this very
+circumstance of opposite rows of houses, or of barracks, or bazaars, or
+lines of camp, being free, while the disease raged in the others, and
+without any sort of barricading or restriction of intercourse. If people
+choose to take the trouble to look for the evidence, _plenty_ of such is
+recorded. Now just consider for one moment how this famous Russian story
+stands: had the barricading begun early, the matter would have stood an
+examination a little better; but this man of good intentions never
+thought of his barriers till the one-sided progress of the disease had
+been manifest enough, _without them_:--and then consider how the
+communication had existed between both rows before those barriers were
+put up, and how impossible it was, unless by a file of soldiers, to have
+debarred all communication:--let all this be considered, and probably
+the case will stand at its true value, which is, if I may take the
+liberty of saying so,--just nothing at all. Let us bear in mind the
+circumstance already quoted from the East India records,--of one company
+of the 14th Regiment, at the extreme end of a barrack, escaping the
+disease, almost wholly, while it raged in the other nine; and this
+without a barrier too. But such circumstances are by no means of rare
+occurrence in other diseases arising from deteriorated atmosphere. Mr.
+Wilson, a naval surgeon, has shewn how yellow fever has prevailed _on
+one side_ of a ship, and I have had pointed out to me, by a person who
+lived near it for thirty years, a spot on this our earth where _ague_
+attacks only those inhabiting the houses in one particular line, and
+without any difference as to elevation or other appreciable cause,
+except that the sun's rays do not impinge equally on both ranges in the
+morning and evening.
+
+The advancement of the cause of truth has, no doubt, suffered some check
+in this country, by the announcement that another gentleman of great
+respectability (Mr. Orton) finds his belief as to non-contagion in
+cholera a good deal shaken: but we find that this change has not arisen
+from further personal knowledge of the disease, and if it be from any
+representations regarding occurrences in Europe, connected with cholera,
+we have seen how, from almost all quarters, the evidence lies quite on
+the side of his first opinions. Whatever the change may be owing to, we
+should continue, as in other cases, not to give an undue preference even
+to opinions coming from him, to well authenticated facts--facts, among
+which some particularly strong are still furnished _by himself_, even in
+the second edition of his book:--"It must be admitted that, in a vast
+number of instances in India, those persons [medical men and attendants]
+have suffered no more from the complaint than if they had been attending
+so many wounded men. This is a fact which, however embarrassing to
+the medical inquirer, [for our part we cannot see the _embarrassment_]
+is highly consolatory in a practical point of view, both to him and
+to all whose close intercourse with the sick is imperatively
+required."--(_p. 316_)--"We are therefore forced to the conclusion,
+however, at variance with the common laws of contagion, that in this
+disease,--at least in India, the most intimate intercourse with the sick
+is not, in general, productive of more infection than the average quantity
+throughout the community." (_p. 326_). Let us contrast the statements in
+the following paragraphs:--"For in all its long and various courses, it
+may be traced from place to place, and has never, as far as our information
+extends, started up at distant periods of time and space, leaving any
+considerable intervening tracts of country untouched." (p. 329)--"All
+attempts to trace the epidemic to its origin at a point, appears to have
+failed, and to have shewn that it had not one, but various local sources
+in the level and alluvial, the marshy and jungly tract of country which
+forms the delta of the Ganges, and extends from thence to the
+Burraumposter." (p. 329) Now let us observe what follows regarding the
+particular _regularity_ in the progress of the disease, as just
+mentioned:--"Another instance of irregularity in its course, even in
+those provinces where it appears to have been most regular, is stated
+[now pray observe] in its having skipped from Verdoopatly to a village
+near Palamacotta, leaving a distance of sixty miles at first
+unaffected." (p. 332)!!--This is not the way to obtain proselytes I
+presume.
+
+The situation of our medical brethren at Sunderland is most perplexing,
+and demands the kindest consideration on the part of the country at
+large; but let nothing which has occurred disturb the harmony so
+essential to the general welfare of that place, should their combined
+efforts be hereafter required on any occasion of public calamity. In
+truth both parties may be said to be right--the one in stating that
+the disease in question _is Indian cholera_, because the symptoms are
+precisely similar--the other that it _is not Indian cholera_, because
+it exists in Sunderland, and without having been imported--IN NEITHER
+COUNTRY IS IT COMMUNICABLE FROM ONE PERSON TO ANOTHER, as is now plainly
+shown upon evidence of a nature which will bear any investigation; and
+if blame, on account of injury to commerce, be fairly attributable to
+any, it is to those who, all the world over, pronounced this disease, on
+grounds the most untenable, a disease of a contagious or communicable
+nature. Let the Sunderland Board of Health not imagine that their
+situation is new, for similar odium has fallen _on the first_ who told
+the plain truth, in other instances--at Tortosa, a few years ago, the
+first physician who announced the appearance of the yellow fever, was,
+according to different writers, _stoned to death_; and at Barcelona, in
+1821, a similar fate had well nigh occurred to Dr. Bahi, one of the
+most eminent men there--we need not, I presume, fear that a scene of
+this kind will take place in this country,--though the cries of "no
+cholera!" and "down with Ogden!" have been heard.
+
+One word as to observations regarding the needlessness of discussing the
+contagion question: the truth is, that the cleanliness and comfort of
+the people excepted, you can no more make _other arrangements_ with
+propriety, till this point be settled, than a General can near the enemy
+by whom he is threatened, till it be ascertained whether that enemy be
+cavalry or infantry.
+
+My object in these letters is not to obtrude opinions upon the public,
+being well aware that they cannot be so well entitled as those of many
+others, to attention; but I wish to place before the public, for their
+consideration, a collection of facts which I think are likely to be of
+no small importance at a moment like the present. In addition to the
+many authorities referred to in the foregoing pages, I would beg to
+call the public attention to a paper in the _Windsor Express_ of the
+12th November, by Dr. Fergusson, Inspector General of Hospitals, a
+gentleman of great experience, and who has given the _coup de grace_
+to the opinion of contagion in cholera. Indeed the opinion now seems
+to be virtually abandoned; for, as to quarantine on our ships from
+Sunderland, it is, perhaps, a thing that cannot be avoided, if the main
+consideration be _the expediency of the case_, until an arrangement
+between leading nations takes place. We have seen, in regard to Austria,
+how the matter stands, and our ships from every port in the country
+would be refused admission into foreign ports, if we did not subject
+those from Sunderland to quarantine; which state of things, it is hoped,
+will now be soon put an end to.
+
+
+FINIS.
+
+
+Nichols and Sons, Printers,
+Cranbourn-street, Leicester-square.
+
+
+
+
+WINDSOR:
+PRINTED BY R. OXLEY, AT THE EXPRESS OFFICE.
+
+
+
+
+LETTERS
+
+ON THE
+
+CHOLERA MORBUS,
+
+&c. &c. &c.
+
+
+WINDSOR, FEB. 9, 1832.
+
+Salus populi suprema lex.
+
+
+In writing the following letters, which I have given in the order of
+their respective dates, I was actuated by the state of the public mind
+at the time in regard to the dreaded disease of which they principally
+treat. The two first were addressed to the Editor of the WINDSOR
+EXPRESS, and the third to a Medical Society here, of which I am a
+member. The contemplation of the subject has beguiled many hours of
+sickness and bodily pain, and I now commit the result to the press in a
+more connected form, from the same motives, I believe, that influence
+other writers--zeal in the cause of truth, whatever that may turn out to
+be, and predilection for what has flowed from my own pen, not however
+without the desire and belief, that what I have thus written may prove
+useful in the discussion of a question which has in no small degree
+agitated our three kingdoms, and most deeply interested every civilized
+nation on the face of the earth.
+
+No one, unless he can take it upon him to define the true nature of
+this new malignant Cholera Morbus, can be warranted utterly to deny
+the existence of contagion, but he may at the least be permitted to
+say, that if contagion do exist at all, it must be the weakest in
+its powers of diffusion, and the safest to approach of any that has
+ever yet been known amongst diseases. Amateur physicians from the
+Continent, and from every part of the United Kingdoms, eager and keen
+for Cholera, and more numerous than the patients themselves, beset and
+surrounded the sick in Sunderland with all the fearless self-exposing
+zeal of the missionary character, yet no one could contrive, even in
+the foulest dens of that sea-port, to produce the disease in his own
+person, or to carry it in his saturated clothing to the healthier
+quarters of the town where he himself had his lodging.[17] Surely
+if the disease had been typhus fever, or any other capable of
+contaminating the atmosphere of a sick apartment, or giving out
+infection more directly from the body of a patient, the result must
+have been different; its course, notwithstanding, has been most
+unaccountably and peculiarly its own--slow and sure for the most part,
+the infected wave has rolled on from its tropical origin in the far
+distant east, to the borders of the arctic circle in the west--not
+unfrequently in the face of the strongest winds, as if the blighting
+action of those atmospherical currents had prepared the surface of the
+earth, as well as the human body for the reception and deposition of
+the poison; but so far from always following the stream and line of
+population as has been attempted to be shown, it has often run
+directly counter to both, seldom or never desolating the large cities
+of Europe, like the plague and other true contagions, but rather
+wasting its fury upon encampments of troops, as in the east, or the
+villages and hamlets of thickly peopled rural districts.
+
+[Footnote 17: The numbers were so great (to which I should probably
+have added one had my health permitted) as actually to make gala day in
+Sunderland, and to call forth a public expression of regret at their
+departure.]
+
+That it could have been descried on no other than the above line must be
+self-evident, but to say that it has followed it in the manner that a
+contagious disease ought to have done, in our own country for instance,
+is at variance with the fact. From Sunderland and Newcastle to the south,
+the ways were open, the stream of population dense and continuous, the
+conveyances innumerable, the communications uninterrupted and constant.
+Towards the thinly-peopled north how different the aspect,--townships
+rare, the country often high, cold, and dreary, in many parts of the line
+without inhabitants or the dwellings of man for many miles together,
+yet does the disease suddenly alight at Haddington, a hundred miles off,
+without having touched the towns of Berwick, Dunbar, or any of the
+intermediate places. It is said to have been carried there by vagrant
+paupers from Sunderland. Can this be true? Could any such with the
+disease upon them in any shape, have encountered such a winter journey
+without leaving traces of it in their course?[18] or, if they carried
+it in their clothing, the winds of the hills must have disinfected
+these _fomites_ long before their arrival. No contagionist, however
+unscrupulous and enthusiastic, nor quarantine authority however vigilant,
+can pretend to say how the disease has been introduced at the different
+points of Sunderland, Haddington, and Kirkintulloch,--no more than he can
+tell why it has appeared at Doncaster, Portsmouth, and an infinity of
+other places without spreading. Even now, it lingers at the gates of
+the great open cities of Edinburgh and Glasgow, as if like a malarious
+disease, (which I by no means say that it is) it better found its food
+in the hamlet and the tent, in fact, amongst the inhabitants of ground
+tenements, than in paved towns and stone buildings. We must go farther
+and acknowledge, that for many months past our atmosphere has been
+tainted with the miasm or poison of Cholera Morbus, as manifested by
+unusual cases of the disease almost everywhere, and that these harbingers
+of the pestilence only wanted such an ally as the drunken jubilee at
+Gateshead, or atmospherical conditions and changes of which we know
+nothing, to give it current and power. That the epidemic current of
+disease wherever men exist and congregate together, must, in the first
+instance, resemble the contagious so strongly as to make it impossible to
+distinguish the one from the other, must be self-evident; and it is only
+after the touchstone has been applied, and proof of non-communicability
+been obtained, as at Sunderland, that the impartial observer can be
+enabled to discern the difference.--Still, however, must he be puzzled
+with the inexplicable phenomena of this strange pestilence, but if he
+feel himself at a loss for an argument against contagion, he has only to
+turn to one of the most recent communications from the Central Board of
+Health, where he will find that "That the subsidiary force under Col.
+Adams, which arrived in perfect health _in the neighbourhood_ of a
+village of India infected with Cholera, had seventy cases of the disease
+the night of its arrival, and twenty deaths the next day," as if the
+march under a tropical sun, and the encampment upon malarious ground, or
+beneath a poisoned atmosphere, were all to go for nothing; and that the
+neighbourhood of an infected village, with which it is not stated that
+they held communication, had in that instantaneous manner alone, produced
+the disease. This is surely drawing too largely upon our credulity, and
+practising upon our fears beyond the mark.
+
+[Footnote 18: The Cholera in this country would appear always to travel
+with the pedestrian, and to eschew the stage coach even as an outside
+passenger.]
+
+The anti-contagionist, in acknowledging his ignorance, leaves the
+question open to examination; but the contagionist has solved the
+problem to his own mind, and closed the field of investigation, without,
+however, ceasing to denounce the antagonist who would disturb a
+conclusion which has given him so much contentment.--Let us here
+examine, for a moment, who in this case best befriends his fellow men.
+The latter, in vindication of a principle which he cannot prove, would
+shut the book of enquiry, sacrifice and abandon the sick, (for to this
+it must ever come the moment pestilential contagion is proclaimed,)
+extinguish human sympathy in panic fear, and sever every tie of domestic
+life,--the other would wait for proofs before he proclaimed the ban, and
+even then, with pestilence steaming before him, would doubt whether
+that pestilence could be best extinguished, or whether it would not be
+aggravated into ten-fold virulence, by excommunicating the sick.
+
+In my first letter I have endeavoured to unveil the mystery and fallacy
+of fumigations, for which our government has paid so dear,[19] and
+in place of the chemical disinfectants so much extolled, of the
+applicability of which we know nothing, and which have always failed
+whenever they were depended upon, have recommended the simple and sure
+ones of heat, light, water, and air, with one exception, the elements
+of our forefathers, which combined always with all possible purity of
+atmosphere, person, and habitation, have been found as sure and certain
+in effect as they are practical and easy of application.
+
+[Footnote 19: Parliament voted a reward of £5000 to Doctor Carmichael
+Smith for the discovery.]
+
+Of our quarantine laws I have spoken freely, because I believe their
+present application, in many instances, to be unnecessary cruel and
+mischievous. Too long have they been regarded as an engine of State,
+connected with vested interests and official patronage, against which
+it was unsafe to murmur, however pernicious they might be to commerce,
+or discreditable to a country laying claim to medical knowledge. The
+regulation for preventing the importation of tropical yellow fever,
+(which is altogether a malarious disease of the highest temperature of
+heat and unwholesome locality,) into England or even into Gibraltar,
+stands eminent for absurdity. It has long been denounced by abler pens
+than mine, and I know not how it can be farther exposed, unless we could
+induce the inhabitants of our West India Colonies to enforce the lex
+talionis, and institute quarantines, which they might do with the same
+or better reason, against the importation of pleurises and catarrhs from
+the colder regions of Europe; a practical joke of this kind has been
+known to succeed after reason, argument, and evidence, amounting to the
+most palpable demonstration, had proved of no avail.
+
+While I have thus impugned the authority of boards and missions, and
+establishments, I trust it never can be imputed to me that I could
+have intended any, the smallest personal allusion, to the eminent and
+estimable men of whom they are composed,--all such I utterly disclaim;
+and to the individual, in particular, who presided over our mission to
+Russia, who has been my colleague in the public service, and whose
+friendship I have enjoyed from early youth, during a period of more
+than forty years, I would here, were it the proper place, pay the
+tribute of respect which the usefulness of his life, and excellence
+of his character, deserves.
+
+
+
+
+LETTER I.
+
+TO THE EDITOR OF THE WINDSOR EXPRESS.
+
+
+Sir,--Being well aware of the handsome manner in which you have always
+opened the columns of your liberal journal to correspondents upon every
+subject of public interest, I make no further apology for addressing
+through the WINDSOR EXPRESS, some observations to the inhabitants of
+Windsor and its neighbourhood upon the all-engrossing subject of Cholera
+Morbus.
+
+That pestilence, despite of quarantine laws, boards of health, and
+sanatory regulations, has now avowedly reached our shores, and we may be
+permitted at last to acknowledge the presence of the enemy--to describe
+to the affrighted people the true nature of the terrors with which he is
+clothed--and to point out how these can be best combatted or avoided.
+
+That the seeds of his fury have long been sown amongst us may be proved,
+and will be proved, ere long, by reference to fatal cases of unwonted
+Cholera Morbus appearing, occasionally during the last six months, in
+London, Port Glasgow, Abingdon, Hull, and many other places, which, as
+it did not spread, have been passed unheeded by our health conservators;
+but, had the poison then been sufficiently matured to give it epidemic
+current, would have been blazed forth as imported pestilence. Some one
+or other of the ships constantly arriving from the north of Europe could
+easily have been fixed upon as acting the part of Pandora's box, and
+smugglers from her dispatched instanter to carry the disease into the
+inland quarters of the kingdom. I write in this manner, not from
+petulance, but from the analogy of the yellow fever, where this very
+game I am now describing, has so often been played with success in the
+south of Europe; and will be played off again, for so long as lucrative
+boards of health and gainful quarantine establishments, with extensive
+influence and patronage, shall continue to be resorted to for protection
+against a non-existent--an impossible contagion.
+
+But to the disease in question.--It must have had a spontaneous origin
+somewhere, and that origin has been clearly traced to a populous
+unhealthy town in the East Indies--no infection was ever pretended to
+have been carried there, yet, it devastated with uncontroulable fury,
+extending from district to district, but in the most irregular and
+unaccountable manner, sparing the unwholesome localities in its
+immediate neighbourhood, yet attacking the more salubrious at a
+distance--passing by the most populous towns in its direct course at
+one time, but returning to them in fury at another, staying in none,
+however crowded, yet attacking all some time or other, until almost
+every part of the Indian peninsula had experienced its visitation.
+
+There is an old term, as old as the good old English physician,
+Sydenham--_constitution of the atmosphere_--and to what else than to
+some inscrutable condition of the element in which we live, and breathe,
+and have our being--in fact to an atmospheric poison beyond our ken,
+can we ascribe the terrific gambols of such a destroyer. 'Tis on record,
+that when our armies were serving in the pestilential districts of
+India, hundreds, without any noticeable warning, would be taken ill in
+the course of a single night, and thousands in the course of a few days,
+in one wing of the army, while the other wing, upon different ground,
+and consequently under a different current of atmosphere, although in
+the course of the regular necessary communication between troops in the
+field, would remain perfectly free from the disease. It would then cease
+as suddenly and unaccountably as it began,--attacking, weeks after, the
+previously unscathed division of the army, or not attacking it at all
+at the time, yet returning at a distant interval, when all traces of the
+former epidemic had ceased, and committing the same devastation. Now,
+will any man, not utterly blinded by prejudice, candidly reviewing
+these facts, pretend to say, that this could be a personal contagion,
+cognizable by, and amenable to, any of the known or even supposable laws
+of infection--that the hundreds of the night infected one another, or
+that the thousands of the few days owed their disease to personal
+communication,--as well affect to believe that the African Simoon, which
+prostrates the caravan, and leaves the bones of the traveller to whiten
+in the sandy desert, could be a visitation of imported pestilence.
+
+It may then be asked, have we no protection against this fearful plague?
+No means of warding it off? Certainly none against its visitation! It
+will come--it will go; we can neither keep it out, or retain it, if we
+wished, amongst us. The region of its influence is above us and beyond
+our controul; and we might as well pretend to arrest the influx of the
+swallows in summer, and the woodcocks in the winter season, by cordons
+of troops and quarantine regulations, as by such means to stay the
+influence, of an atmospheric poison; but in our moral courage, in our
+improved civilization, in the perfecting of our medical and health
+police, in the generous charitable spirit of the higher orders,
+assisting the poorer classes of the community, in the better condition
+of those classes themselves, compared with the poor of other countries,
+and in the devoted courage and assistance of the medical profession
+every where, we shall have the best resources. Trusting to these, it has
+been found that, in countries far less favoured than ours, wherever the
+impending pestilence has only threatened a visitation, there the panic
+has been terrible, and people have even died of fear; but when it
+actually arrived, and they were obliged to look it in the face, they
+found, that by putting their trust in what I have just laid down, they
+were in comparative safety; that, the destitute, the uncleanly, above
+all, the intemperate and the debauched, were almost its only victims;
+that the epidemic poison, whatever it might be, had strength to prevail
+only against those who had been previously unnerved by fear, or weakened
+by debauchery; and that moral courage, generous but temperate living,
+and regularity of habits in every respect, proved nearly a certain
+safe-guard. They found further, that quarantine regulations were worse
+than useless--that the gigantic military organization of Russia--the
+rigorous military despotism of Prussia--and the all-searching police of
+Austria, with their walled towns, and guards and gates, and cordons of
+troops, were powerless against this unseen pestilence, and that as soon
+as the quarantine laws were relaxed, and free communication allowed, the
+disease assumed a milder character, and speedily disappeared.
+
+I say, then, confidently, that Cholera Morbus never will commit ravages
+in this country, beyond the bounds of the worst purlieus of society,
+unless it be fostered into infectious, pestilential activity, by the
+absurd, however well-meant, measures of the conservative boards of
+health, such as have been just recommended in what has always been
+esteemed the most influential, best-informed journal of England, I mean
+the QUARTERLY REVIEW. If the writer of the article who recommends the
+enforcement of the ancient quarantine laws in all their strictness, be
+a medical man, he surely ought to know, that wherever human beings are
+confined and congregated together in undue numbers, more especially if
+they be in a state of disease, there the matter of contagion, the
+typhoid principle, the septic (putrefactive) human poison or by what
+other name it may be called, is infallibly generated and extends itself,
+but in its own impure atmosphere only, as a personal infection to those
+who approach it, under the form and features of the prevailing epidemic,
+whatever that may be. Hence we have all heard of contagious pleurisies,
+catarrhs, dysenteries, ulcers, &c., and if the doctrines of that writer
+be received, we shall soon also hear of contagious Cholera Morbus with
+a vengeance. His exhortations would go to shut up the sick from human
+intercourse, to proclaim the ban of society against them, and under the
+most pitiable circumstances of bodily distress, to proscribe them as
+objects of terror and danger, instead of being as they actually are,
+helpless innocuous fellow creatures, calling loudly for our promptest
+succour and commiseration in their utmost need. They would go further to
+array man against his fellow man in all the cruel selfishness of panic
+terror, sever the dearest domestic ties, paralize commerce, suspend
+manufactures, and destroy the subsistance of thousands, and all for the
+gratification of a prejudice which has been proved to be utterly
+baseless in every country of Europe from Archangel to Hamburgh and
+Sunderland. Happily for our country, these measures are now as absurd
+and impracticable as they would be tyrannical and unjust. They could not
+be borne even under the despotic military sway of Prussia and Russia,
+and in this free country it would be impossible to enforce them for a
+single week. The very attempt would at once, throughout the whole land,
+produce confusion and misery incalculable.
+
+I say, on the contrary, throw open their dwellings to the free air
+of heaven, the best cordial and diluent of foul atmosphere in every
+disease--let their fellow townsmen hasten to carry them food,
+fuel, cordials, cloathing, and bedding, speak to them the words of
+consolation, and should they have fear to approach the sick, I take
+it upon me to say, they will be accompanied by any and every medical
+practitioner of the place, who, in their presence, will minister to the
+afflicted, inspire their breath, and perform every other professional
+office of humanity, without the smallest fear or risk of infection; for
+they read the daily records of their profession, where it has been
+proved to them, that in the open but crowded hospitals of Warsaw, under
+the most embarrassing circumstances of warfare and disease, out of a
+hundred medical men, with their assistants and attendants, frequenting
+the sick wards of Cholera, not one took the disease; that, for the sake
+of proving its nature, they even went so far as to clothe themselves
+with the vestments of the dying, to sleep in the beds of the recently
+dead, and to innoculate themselves in every way with the blood and
+fluids of the worst cases, without, in a single instance, producing
+Cholera Morbus.[20] The accounts may not, indeed, cannot be the same
+from every other quarter, for medical men must be as liable to fall
+under the influence of an atmospherical epidemic disease as other
+classes of the community; but the above fact is alone sufficient to
+prove that it cannot be a personal contagion.
+
+[Footnote 20: Vide Medical Gazette.]
+
+Even should that worst of true contagions, the plague of the Levant,
+which every nation is bound to guard against, despite of all our
+precautions, be introduced amongst us, measures better calculated for
+the destruction of a community, could scarcely be devised, than the
+ancient quarantine regulations; for they certainly would convert every
+house proscribed by their mark, into a den and focus of the most
+concentrated pestilential contagion, ensuring fearful retribution upon
+those who had thus so blindly shut them up. The mark alone, besides
+being equivalent to a sentence of death upon all the inmates, would
+effect all this--the sick would be left to die unassisted, unpurified,
+uncleansed amidst their accumulated contagion, and the dead, as has
+happened before, lie unburied or scarcely covered in, till they
+putrified in pestiferous heaps. Most certainly it would be proper and
+beneficial, even a duty, for all who could afford the means, and were
+not detained by public duties, to fly the place, and equally proper for
+the other residents who continued in health, to segregate themselves as
+they best could.--Plenty of free labour amongst those who must ever work
+for their daily bread, would still remain for all municipal purposes,
+and these our rulers, so far from consenting thus to proscribe the sick,
+should employ openly in giving them every succour and aid, under the
+direction and with instructions of safety from a well arranged medical
+police. It would not be difficult to show, that the mortality, during
+the last great plague in London, was increased a hundred fold, by
+following the very measures now recommended in these regulations; and,
+that the barbarous predestinarian Turk, in the very head quarters of the
+plague itself, who despises all regulation, but attends his sick friend
+to the last, never yet brought down upon his country such calamitous
+visitations of pestilence, as enlightened Christian nations have
+inflicted upon themselves, by ill-judged laws. The Turk, to be sure, by
+rejecting all precaution, and admitting, without scruple, infection into
+his ports, sees Constantinople invaded by the plague every year; but,
+when not preposterously interfered with, it passes away, even amongst
+that wretched population, like a common epidemic, without leaving any
+remarkable traces of devastation behind it: and surely to establish and
+make a pest-house of the dwelling of every patient who might be
+discovered or even suspected to be ill, would be most preposterous.
+The writing on the wall would not be more apalling to the people, and
+scarcely less fatal to the object, than the cry of mad dog in the
+streets, with this difference, that when the dog was killed, the scene
+would be closed, but the proscribed patient would remain, even in his
+death and after it, to avenge the wrong.
+
+But sufficient to the day is the evil thereof, the question is now of
+Cholera Morbus; I am willing to meet any objection, and the most obvious
+one that can be offered to me, (if it be not an imported disease) is its
+first appearance in our commercial sea-ports. To this I might answer,
+that it has been hovering over us, making occasional stoops, for the
+last six months, even in the most inland parts of the country; but I
+will waive that advantage, and meet it on plainer grounds of argument
+and truth.--An atmospherical poison must evidently possess the greatest
+influence, where it finds the human race under the most unfavourable
+circumstances of living, habits, locality, and condition. Now, where can
+these be met with so obviously as in our large sea-port towns on the
+lowest levels of the country, and in their crowded alleys, always near
+to the harbour for the shipping? There the disease, if its seeds existed
+in the atmosphere, would be most likely to break out in preference to
+all other situations; and if at the time of its so appearing, ships
+should arrive, as they are constantly doing from all parts of the world,
+whose crews, according to the custom of sailors, plunge instantly into
+drunkenness and debauchery, and present as it were, ready prepared, the
+very subjects the pestilence was waiting for; how easy then, for an
+alarmed or prejudiced board of health to point out the supposed
+importing vessel, and freight her with a cargo of the new pestilence
+from any part of the world they may choose to fix upon. This is no
+imaginary case; it was for long of annual occurrence with respect to the
+yellow fever, both in the West Indies and North America. "There our
+thoughtless intemperate sailors were not only the first to suffer from
+the epidemic, in its course or about to begin, but they were denounced
+as the importers, by the prejudiced vulgar, and the accusation was
+loudly re-echoed even amongst the better informed, by all who wished to
+make themselves believe that pestilence could not be a native product
+of their own atmosphere and habitations."
+
+Before I have done, I feel called upon to say a few words upon the
+efficacy of fumigation as a preservative against Cholera Morbus and
+other infectious diseases. In regard to the first the question is
+settled. In Russia, throughout Germany, and I believe everywhere else in
+Europe, they were productive of no good, they did mischief, and were
+therefore discontinued. This has been verified by reports from the seats
+of the disease everywhere. In regard to other contagions I can speak,
+not without knowledge, at least not without experience, for it was the
+business and the duty of my military life, during a long course of
+years, to see them practised in ships, barracks, hospitals, and
+cantonements, and I can truly declare I never saw contagion in the
+smallest degree arrested by them, and that disease never failed to
+spread, and follow its course unobstructed, and unimpeded by their use.
+In the well-conditioned houses of the affluent where ventilation and
+cleanliness are matters of habit and domestic discipline, they may be a
+harmless plaything during the prevalence of scarlet fever and such like
+infections, or even do a little good by inspiring the attendants with
+confidence, however false, as a preservative against contagion; but in
+the confined dwellings of the poor they are positively mischievous,
+because they cannot be used without shutting out the wholesome
+atmospheric air, and substituting for it a factitious gas, which for
+aught we know, or can know of the nature of the contagious vapour,
+whether acid, alkaline, or anything else, may actually be adding to its
+deleterious principle instead of neutralising it: but in thus striking
+away a prop from the confidence of the poor, I thank God I can furnish
+them with other preservatives and disinfectants, which I take it upon me
+to say, they will find as simple and practicable as they are infallible.
+For the first, the liberal use of cold water and observance of free
+ventilation, with slaked lime to wash the walls, and quick lime when
+they can get it, to purify their dung heaps and necessaries, are among
+the best; but when actually infected, then heat is the only purificator
+yet known of an infected dwelling. Let boiling water be plentifully used
+to every part of the house and article of furniture to which it can be
+made applicable. Let portable iron stoves, filled with ignited charcoal
+only, be placed in the apartment closely shut, and the heat kept up for
+a few hours to any safe degree of not less than 120° Farenheit, and let
+foul infected beds and mattresses be placed in a baker's oven heated to
+the same,[21] and my life for it no infection can after that possibly
+adhere to houses, clothes, or furniture. The living fountain of
+infection from the patient himself, constantly giving out the fresh
+material, cannot of course be so closed, but whether he lives or dies,
+if the above be observed, he will leave no infection behind him.[22]
+
+[Footnote 21: The oven on that account need not lose character with
+bread-eaters, for according to the old adage, Omne vitium per ignem
+excoquitur.]
+
+[Footnote 22: Light too, more especially when assisted by a current
+of atmospheric air, is a true and sure disinfectant, but it is not so
+applicable as heat in the common contagions, from requiring an exposure
+of the infected substances for days together, or even a longer period,
+before it can be made effective.]
+
+It is now time to bring this tedious letter to a close; I shall be
+happy, through the same channel, to give any information, or answer any
+inquiries that may be authenticated by the signature of the writer; but
+anonymous writing of any kind, I shall not consider myself bound to
+notice. Should the dreaded disease spread its ravages throughout our
+population, I may then, at some future early opportunity, trusting to
+your indulgence, trespass again upon your columns with further
+communications on this most interesting subject.
+
+WILLIAM FERGUSSON,
+Inspector-General of Hospitals.
+
+P.S.--Throughout the foregoing letter, I have used the words contagion
+and infection as precisely synonymous terms, meaning communicability
+of disease from one person to another.
+
+_November 9, 1831._
+
+
+
+
+LETTER II.
+
+TO THE EDITOR OF THE WINDSOR EXPRESS.
+
+
+Sir,--In my last letter, I treated of the practicability of guarding
+our country against the now European and Continental disease, malignant
+Cholera Morbus, by quarantine regulations. In the present one, it is
+my intention still in a popular manner to scrutinise more deeply,
+the doctrine of imported contagions; to point out, if I can, those
+true contagions which can be warded off by our own exertions, in
+contradistinction to others which are altogether beyond our controul;
+and here it may be as well to premise, that when I use the term
+epidemic, I mean atmospheric influence, endemic-terrestrial influence,
+or emanation from the soil; and by pestilential, I mean the spread of
+malignant disease without any reference to its source. The terms
+contagion and infection have already been explained.
+
+It must be evident, that legislative precaution can only be made
+applicable to the first of these. The last being unchangeable by human
+authority, are not to be assailed by any decrees we can fulminate
+against them; and if it can be shown, which it has been by our best and
+latest reports, that Cholera Morbus eminently and indisputably belongs
+to that class--that the strictest cordons of armed men could not avail
+to save the towns of the continent, nor the strictest quarantine our
+own shores, from its invasion--it surely must be time to cease those
+vain attempts, to lay down the arms that have proved so useless, and
+turn our undivided attention, now that it has fairly got amongst us,
+to conservative police, and the treatment of the disease; but as the
+contagionists still insist that it was imported from Hamburgh to
+Sunderland, it behoves us to clear away this preliminary difficulty
+before proceeding to other points of the enquiry.
+
+I take it for granted, that ships proceeding from Sunderland to Hamburgh
+could only be colliers, and that according to the custom of such
+vessels, they returned, as they do from the port of London, light; and I
+admit, that on or about the time of their return, Cholera Morbus, under
+the severe form which characterises the Asiatic disease, made its
+appearance in that port, presenting a fair _prima facie_ case of
+imported contagion; but as at the period of its thus breaking out in
+Sunderland, a case equally as fatal and severe shewed itself, according
+to the public accounts, in the upper part of Newcastle, 10 miles off;
+another equally well-marked, in a healthy quarter in Edinburgh; a third,
+not long before in Rugby, in the very centre of the kingdom; and a
+fourth in Sunderland itself, as far back as the month of August, as
+well as many others in different parts of the country;[23] it became
+incumbent on the quarantine authorities, indeed upon all men interested
+in the question, whether contagionists or otherwise, to shew the true
+state of these vessels, as well as of the cases above alluded to, and
+whether the Cholera Morbus had ever been on board of them, either at
+Hamburgh or during the homeward voyage, so as by any possibility they
+could have introduced the disease into an English port. Now will any
+person pretend to say that this has been done, or that it could not have
+been done, or deny that it was a measure, which, if properly executed,
+would have thrown light upon the true character of the disease, not only
+for the information of our own government but of every government in
+Europe; that deputations from the Board of Health, backed and supported
+by all the power and machinery of government, with the suspected ships
+locked up in quarantine, and the persons of the crews actually in their
+power, could not have verified to the very letter, the history of every
+hour and day of their health, from the moment of their arrival at
+Hamburgh till their return into port? This measure was so obviously and
+imperiously called for, as constituting the only rational ground on
+which the importing contagionists could stand, or their opponents meet
+them in argument, that after having waited in vain for the report, I
+raised my own feeble voice in the only department to which I had access,
+urging an immediate, though then late, investigation. No good cause,
+having truth for its basis, could have been so overlooked, and without
+unfairness or illiberality, we are irresistibly forced to the
+conclusion, that had the enquiry (the only one, by the bye, worth
+pursuing, as bearing directly on the question at issue) been pushed to
+the proof, it would have shown the utter nullity of quarantine guards
+against atmospherical pestilence, the thorough baselessness of the
+doctrine of importation.
+
+[Footnote 23: Two of a type most unusual for this country, and the
+Winter Season, have occurred in the vale of the Thames, not far from
+here, which, as they both recovered, and the disease did not spread in
+any way, were very properly allowed to pass without sounding any alarm,
+but the gentleman who attended one of the cases, and had been familiar
+with the disease in India, at once recognized it again, in its principal
+distinguishing features.]
+
+Without entering into the miserable disputes on this subject,
+which, amidst a tissue of fable and prejudice, self-interest and
+misrepresentation, have so often disgraced the medical profession at
+Gibraltar; I shall now proceed to shew, by reference to general causes,
+how baseless and mischievous have been the same doctrines and authority
+when exercised in that part of the British dominions:--
+
+Within the last thirty years, yellow fever has, at least four times,
+invaded the fortress of Gibraltar; during which time also, the
+population of its over-crowded town has more than quadrupled, presenting
+as fair a field, for the generation within, or reception from without,
+of imported pestilence as can well be imagined,--yet plague, the truest
+of all contagions, typhus fever, and other infectious diseases, have
+never prevailed, as far as I know, amongst them. The plague of the
+Levant has not been there, I believe, for 150 years; yet Gibraltar, the
+free port of the Mediterranean, open to every flag, stands directly in
+the course of the only maritime outlet, from its abode and birth-place
+in the east, being in fact, to use the language of the road, the
+house of call for the commerce of all nations coming from the upper
+Mediterranean. Now, can there be a more obvious inference from all this,
+than that the plague, being a true contagion, may be kept off without
+difficulty, by ordinary quarantine precautions; but the other being an
+endemic malarious disease, generated during particular seasons, within
+the garrison itself, and the offspring of its own soil, is altogether
+beyond their controul. The malarious or marsh poison, which in our
+colder latitudes produces common ague, in the warmer, remittent fever,
+and in unfavourable southern localities of Europe, (such as those of
+crowded towns, where the heat has been steadily for some time of an
+intertropical degree)--true yellow fever, which is no more than the
+highest grade of malarious disease; but this has never occurred in
+European towns, unless during the driest seasons--seasons actually
+blighted by drought, when hot withering land winds have destroyed
+surface vegetation, and as in the locality of Gibraltar, have left the
+low-lying becalmed, and leeward town to corrupt without perflation or
+ventilation amidst its own accumulated exhalations. I know not how I
+can better illustrate the situation of Gibraltar in these pestiferous
+seasons, than by a quotation from a report of my own on the Island of
+Guadaloupe, in the year 1816, which, though written without any possible
+reference to the question at issue, has become more apposite than
+anything else I could advance; "all regular currents of wind have the
+effect of dispersing malaria; when this purifying influence is
+with-held, either through the circumstances of season, or when it
+cannot be made to sweep the land on account of the intervention of
+high hills, the consequences are most fatal. The leeward shores of
+Guadaloupe, for a course of nearly 30 miles, under the shelter of a very
+steep ridge of volcanic mountains, never felt the sea breeze, nor any
+breeze but the night land-wind from the mountains; _and though the soil,
+which I have often examined, is a remarkably open, dry and pure one,
+being mostly sand and gravel, altogether, and positively without marsh,
+in the most dangerous places, it is inconceivably pestiferous throughout
+the whole tract, and in no place more so than the bare sandy beach near
+the high-water mark_. The coloured people alone ever venture to inhabit
+it; and when they see strangers tarrying on the shore after nightfall,
+they never fail to warn them of their danger. The same remark holds good
+in regard to the greater part of the leeward coasts of Martinique, _and
+the leeward alluvial bases and recesses[24] of hills, in whatever port
+of the torrid zone they may be placed_, with the exception, probably of
+the immediate sites of towns, where the pavements prevent the rain-water
+being absorbed into the soil, and hold it up to speedy evaporation."
+Now, conceive a populous crowded town placed in this situation, and you
+have exactly what Gibraltar and the other towns of Spain and North
+America, liable to yellow fever, must become in such seasons as I have
+above described, only, that as they grow more populous and crowded, the
+danger must be greater, and its visitations more frequent, unless the
+internal health police be made to keep pace in improvement, with the
+increasing population.
+
+[Footnote 24: The leeward niches and recesses of hills, however dry and
+rocky, become in these seasons of drought, absolute dens of malaria,
+this will be found proven in my reports made especially of the islands
+of Dominique and Trinidad, which may be seen at the Army Medical Board
+Office.]
+
+Now in the name of injured commerce--of the deluded people of
+England--of medical science--of truth and humanity--what occasion can
+their be to institute an expensive quarantine against such a state of
+things as this, which can only be mitigated by domestic health police;
+or why conjure up the unreal phantom of an imported plague, to delude
+the unhappy sufferers, as much in regard to the true nature of the
+disease, as to the measures best calculated for their own preservation;
+when it must be evident that the pestilence has sprung from amidst
+themselves, and that had it been an external contagion in any degree,
+the ordinary quarantine, as in case of the plague, would certainly have
+kept it off; but the question of the contagion of yellow fever, so
+important to commerce and humanity; and which, like the Cholera, has
+more than once been used to alarm the coasts of England, demands yet
+further investigation.
+
+For nearly 40 years have the medical departments of our army and navy
+been furnished with evidence, from beyond the Atlantic, that this
+disease possessed no contagious property whatever. These proofs now lie
+recorded by hundreds in their respective offices, and I take it upon me
+to say, they will not be found contradicted by more than one out of a
+hundred, amongst all the reports from the West Indies, which is as much
+the birth-place of the yellow fever, as Egypt is of the plague: yet, in
+the face of such a mass of evidence, as great or greater probably than
+ever was accumulated upon any medical question, has our Government been
+deluded, to vex commerce with unnecessary restraints, to inflict
+needless cruelties upon commercial communities, (for what cruelty can be
+greater than after destroying their means of subsistence by quarantine
+laws, to pen them up in a den of pestilence, there to perish without
+escape, amidst their own malarious poison?) and to burden the country
+with the costs of expensive quarantine establishments. Surely if these
+departments had done their duty, or will now do it, in so far as to
+furnish our rulers with an abstract of that evidence, with or without
+their own opinions, for opinions are as dust in the balance when put in
+competition with recorded facts, it must be impossible that the delusion
+could be suffered to endure for another year; or should they unluckily
+fail thereby to produce conviction on Government, they can refer to the
+records of commerce, and of our transport departments, which will shew,
+if enquiry be made, that no ship, however deeply infected before she
+left the port, (and all ships were uniformly so infected wherever the
+pestilence raged) ever yet produced, or was able to carry a case of
+yellow fever beyond the boundaries of the tropics, on the homeward
+voyage, and that therefore the stories of conveying it beyond seas to
+Gibraltar, must have been absolutely chimerical. It would indeed, have
+been a work of supererrogation, little called for, for I think I have
+fully shown that Gibraltar must be abundantly qualified to manufacture
+yellow fever for herself.
+
+No less chimerical will be the attempt to shut out Cholera Morbus from
+our shores by quarantine laws, because throughout Europe, ready
+prepared, alarmed, and in arms against it, they have succeeded nowhere;
+whereas, had it been a true contagion and nothing else, they must, with
+ordinary care, have succeeded everywhere; the disease, as if in mockery,
+broke through the cordons of armed men, sweeping over the walls of
+fortified towns, and following its course, even across seas, to the
+shores of Britain; and yet we are still pretending to oppose it with
+these foiled weapons.
+
+We are indeed told, by authority, that its appearance in towns has
+always been coincident with the arrival of barges from inland, or by
+ships from the sea, but if it be not shown at the same time that the
+crews of these barges had been infected with the disease, or if, as at
+Sunderland, no person on board the ships can be identified as having
+introduced it, while we know that the disease actually was there two
+months before, we may well ask at what time of the year barges and ships
+do not arrive in a commercial seaport, or where an epidemic disease,
+during pestiferous seasons could be more likely to break out than where
+the most likely subjects are thrown into the most likely places for its
+explosion, such as newly arrived sailors in an unwholesome seaport,
+where the license of the shore, or the despondency of quarantine
+imprisonment must equally dispose them to become its victims.--Besides,
+what kind of quarantine can we possibly establish with the smallest
+chance of being successful against men who have not got, and never had
+the disease. Merchandise has been declared incapable of conveying the
+infection,[25] and are we to interdict the hulls and rigging of Vessels
+bearing healthy crews, or are we to shut our ports at once against all
+commerce with the North of Europe, and would this prove successful if we
+did? a reference to a familiar epidemic will I think at once answer this
+question.
+
+[Footnote 25: Vide Russian Ukase.]
+
+It is only three months ago that the epidemic Catarrh or Influenza
+spread throughout the land, travelling like the Cholera in India, when
+it went up the monsoon, without regard to the East wind; and what could
+be more likely than the blighting drying process of such a wind, in
+either the one or the other case, to prepare the body for falling under
+the influence of whatever disease might be afloat in the atmosphere.
+In general this passing disease can be distinctly traced, as having
+affected our continental neighbours on the other side of the channel
+before ourselves: now can it be supposed that any quarantine could have
+prevented its first invasion, or arrested its farther progress amongst
+us. How ridiculous would have been the attempt, and yet with the
+experience of all Europe before us, have we been enacting that very part
+with the Cholera Morbus: but further, the same authority which calls for
+the establishment of quarantine in our ports, tells us that neither
+proximity nor contact with the sick,[26] is requisite for the production
+of the disease: now can anything further be wanting beyond this
+admission, to prove that it must be an epidemic atmospherical poison,
+and not a personal contagion, and that, under such circumstances, the
+establishment of quarantine against persons and goods, would manifestly
+be absurd and uncalled for. So fully satisfied has the Austrian
+Government been made by experience, of the futility and cruelty of such
+quarantines, that the Emperor apologises to his subjects for having
+inflicted them. The King of Prussia makes a similar _amende_, and the
+Emperor of Russia convinced by the same experience, abolished or greatly
+relaxed his quarantines several mouths ago.
+
+[Footnote 26: Vide Reports from Russia.]
+
+I am by no means prepared to assert, because I cannot possibly know to
+the contrary, although from the analogy of other disease I do not
+believe it, that the Cholera Morbus may not become contagious under
+certain conditions of the atmosphere, but these cannot be made subject
+to quarantine laws, and I am fully prepared to acknowledge, that as in
+the case of other epidemics, it may be made contagious through defective
+police; but independent of these, it possesses other powers and
+qualities of self-diffusion, which we can neither understand nor
+controul. Such, however, is not the case with that other phantom of
+our quarantine laws--the yellow fever--which can never, under any
+circumstances of atmosphere, without the aid of the last be made a
+contagious disease. I speak thus decisively from my experience of its
+character, as one of the survivors of the St. Domingo war, where, in a
+period of little more than four years, nearly 700 British commissioned
+officers, and 30,000 men were swept away by its virulence; as also from
+subsequent experience, after an interval of 20 years, when in the course
+of time and service, I became principal medical officer of the windward
+and leeward colonies, and in that capacity, surveyed and reported upon
+the whole of these transatlantic possessions.
+
+It was my intention, in these times of panic, to designate to my
+countrymen, in as far as I could, the true essential intrinsic
+contagions of the British Isles, (for such there are, and terrible ones
+too,) which prevail under all circumstances of season, atmosphere, and
+locality, as contradistinguished from the factitious ones, of our own
+creating, and the imaginary or false which often spread epidemically,
+(for there may be an epidemic as well as contagious current of
+disease)[27] although they possess no contagious property whatever; as
+well as the foreign contagions, which if we relax in due precaution,
+may, at any time, be introduced amongst us--but the unreasonable length
+of this letter, for a newspaper communication, warns me to stop.
+
+[Footnote 27: For as long as men congregate together, and every
+supposable degree of communication must of necessity be constantly
+taking place amongst them, to distinguish a spreading epidemic from a
+contagious disease when it first breaks out, must obviously be a matter
+of impossibility; and upon this point the contagionists and their
+antagonists may rail for ever,--the one will see nothing but contagion,
+whether in the dead or the living body, and the other will refer every
+fresh case to atmospheric or terrestrial influence, and both with as
+much apparent reason as they possibly could desire: but the candid
+impartial investigator, who waits to observe the course of the disease
+before coming to a conclusion, and refers to the facts furnished in the
+Cholera Hospitals of Warsaw and the sick quarters of Sunderland, will
+never be deceived in regard to its real nature, nor propagate the
+appalling belief that Cholera Morbus can be made a transportable and
+transmissible contagion.]
+
+I have written thus earnestly, because I deeply feel what I have here
+put down. It is possible I may have made mistakes, but if I have, they
+are not intentional, and I shall be happy to be corrected, for I do
+not live at the head quarters of communication, and my broken health
+prevents my frequenting in person, the field of investigation. In
+candour I ought to declare, that the establishment of quarantine against
+this new and hideous pestilence in the first instance, was the most
+sacred duty of Government, but now that its true character has been made
+known, and the futility of quarantine restrictions demonstrated, I feel
+equally bound, as one of the lieges, to enter my humble protest against
+their continuance.
+
+Should I write again, I shall still adopt the same popular style,
+for no other can be adapted to a newspaper communication, and the
+subject-matter is as interesting to the public, and every head of a
+family, as it can be to the professional reader; and, in thus making
+use of your columns, as I can have no motive but that of ardent
+research after truth, I know that I may always rely upon your
+assistance and co-operation.
+
+WILLIAM FERGUSSON,
+Inspector-General of Hospitals.
+
+_Windsor, Nov. 26, 1831._
+
+
+
+
+LETTER III.
+
+TO THE MEDICAL SOCIETY OF WINDSOR.
+
+
+In this paper it is my intention to treat of the contagious diseases of
+the British Isles, as well as to offer to the Society some observations
+on malignant Cholera Morbus, and the mode of its propagation from the
+tropical regions, where it first arose, to the colder latitudes of
+Europe.
+
+Having already published two letters on this last part of my subject,
+I need not here take up your time in recapitulating their contents, but
+proceed to the consideration of some remaining points of the enquiry;
+which I find I have either overlooked, or not been so explicit in
+illustration, as I otherwise might, had I been addressing a body of
+professional men, instead of the community where I live, with the view
+of _disabusing_ their minds from the effects of irrational panic, and
+opening their eyes to what I deemed true measures of preservation
+against the impending disease; and here I may as well add that when I
+wrote in a newspaper and adopted the style suited to such a channel of
+communication, I knew none so likely to attract the attention of those
+influential men, who might possess the power and the will, when
+disabused of prejudice, to enforce proper laws, instead of running the
+course that had already been imposed upon them, by men interested in the
+upholding of our quarantine establishments, or by prejudiced, however
+well meaning, Boards of Health.
+
+In looking over those letters, I find that the points most open to
+dispute are the course of the disease throughout the Indian peninsula,
+and its progress to the frontiers of Russia; as well as its supposed
+infectious nature, and mode of propagation by human intercourse. In
+regard to the first, there is no contagionist however avowed and
+uncompromising, who does not admit that this erratic disease did not
+often wander from its straight line when the most promising fields lay
+directly before it; or stop short most unaccountably in its progress,
+when the richest harvest of victims seemed actually within its
+jaws--that its course was circuitous when, according to the laws of
+contagion, it ought to have been straight,--that it refused its prey
+at one time, and returned to it at another, in a manner that showed its
+progress was governed by laws which we could neither understand nor
+controul; and if we search the reports of contagionist writers, we
+shall find fully as much, and as strong evidence of its progress being
+independent of human intercourse, as of its being propagated and
+governed by the laws of contagion.[28]
+
+[Footnote 28: Vide Orton, Kennedy, &c.]
+
+To the question, which has so often been triumphantly asked, of its
+progress to the Russian frontiers being conducted by caravans along the
+great highways of human intercourse, and what else than contagion could
+cause it to be so carried? An admirable journalist has already replied
+by asking in his turn, on what other line than amongst the haunts of men
+could we possibly have found, or detected a human disease? And surely
+the question is most pertinent, for in those barbarous regions that
+interpose between Russia and India, where the wolf and the robber hold
+divided alternate sway, and isolated man dares not fix his habitation,
+but must congregate for safety; where else than in those great
+thoroughfares could the disease have found its food; or if beyond these,
+man, almost as ignorant and as savage as the wolf, could have been
+found; who under such circumstances would have recognised, described,
+and testified to its existence? Even at Sunderland, amongst ourselves,
+its existence was long hotly disputed by the learned of the faculty; and
+the fatalist barbarian of these regions would have dismissed the enquiry
+with a prayer of resignation, while he bowed his head to the grave, or
+if his strength permitted, with a stroke of his dagger against the
+impious enquirer who had dared to interfere with the immutable decrees
+of fate. The stories too of its importation into Russia, are exactly the
+same as have come to us from our own Gibraltar, in the case of the
+yellow fever, and may be expected to come from every other quarter where
+a well paid officious quarantine is established to find infection in
+its own defence, and to trace its course in proof of their own services
+and utility. Under such circumstances, this well gotten up drama of
+importation may be rehearsed in every epidemic, adapted in all its parts
+to every place and every disease, they wish to make contagious. First
+will be presented, as at Gibraltar, the actual importers--their course
+traced--the disease identified--its reception denounced, and quarantine
+established; and this will go down until sober minded disinterested men
+become engaged in the enquiry, when it will turn out in all probability,
+that the importers, as at Sunderland, never had the disease--that it was
+in the place long before their arrival--that in its supposed course, it
+either had no existence, or had long ceased--in fact that the
+importation was a fable, the product either of design or an alarmed
+imagination. On this point I shall not here farther dwell, but proceed
+to the still keenly disputed question of its contagious, or
+non-contagious nature.
+
+Amongst all those who have advocated the affirmative side of the
+question, an anonymous writer in the LANCET, of Nov. 19th. seems to me
+the ablest special pleader of his party, and the best informed on the
+subject, which he has grappled with a degree of acumen and power that
+must at once have secured him the victory, in any cause that had truth
+for its basis, or that could have stood by itself; but strong and
+scornful as he is, he has himself furnished the weapons for his own
+defeat, and has only to be correctly quoted in his own words, for answer
+to the most imposing and powerful of his arguments. I take it for
+granted, that no one will give credit to instantaneous infection, at
+first sight, but allow that an interval must elapse between the
+reception of the virus, and explosion of the disease. Kennedy and the
+best of the contagionist authors, have fixed the intervening time from
+two days to a longer uncertain period; yet that writer (in the LANCET)
+proceeds to tell us, in proof of the virulence of the contagion, that
+when twenty healthy reapers went into the harvest field at Swedia, near
+Tripoli, and one of them at mid-day was struck down with the disease, he
+then instantly, as if, instead of being prostrate on the ground, he had
+run a muck for the propagation of Cholera Morbus, infected all the rest,
+so that the whole were down within three hours, and all were dead before
+the following morning.[29]--All this too in the open air. Another writer
+of note relates that when a healthy ship on the outward voyage arrived
+in Madras Roads, her people were seized with Cholera Morbus that very
+morning; but they go further than this, and command us to believe in its
+contagious powers, without sight at all, quoting the report from our
+Commissioners in Russia, where it is officially announced "that neither
+the presence, nor contact of the patient is necessary to communicate the
+disease." Surely in candour we may be allowed to say that when they
+limit their views to contagion alone, they have attributed powers to it,
+which it never did, and never can possess. That some other principle,
+besides their favourite one, must have been in operation, as well in the
+field of Swedia, when it struck down the reapers, as when it blighted
+our armies in the East, for these sudden bursts and explosions of
+pestilence are incompatible with the laws and progress of natural
+contagion,--that if, under a tropical temperature, which dissipates all
+infection, there be contagion in the disease, their must also be other
+powers of diffusion hitherto inscrutable, incomprehensible, and
+uncontroulable,--that their doctrine of contagion exclusively, is
+superficial narrow, and intolerant, and their arguments in support of
+it, no more than a delusion of prejudice, a piece of consummate special
+pleading to make the worse appear the better reason.[30]
+
+[Footnote 29: The precise words are "20 peasants of Swedia, robust,
+vigorous, and in the flower of life, were labouring at the harvest work,
+when on the 9th. of July, at noon, one was suddenly attacked, and the
+others in a short time showed symptoms of the disorder. In three hours,
+the entire band was exhausted; before sunset many had ceased to live,
+and by the morrow there was no survivor."]
+
+[Footnote 30: The remainder of the paper, as presented to the Society,
+treated of Typhus fever, and other matter, that had no reference to the
+disease in question.]
+
+Before concluding these observations, I would wish to make a few remarks
+upon some points of the enquiry which have been either too cursorily
+passed over, or not noticed at all; and first of its supposed attraction
+for, and adherence to the lines and courses of rivers whether navigable
+or otherwise. I do not think this quality of the disease has been
+assumed on grounds sufficient to justify anything like an exclusive
+preference. Along these lines, no doubt, it has very frequently been
+found, because a malarious, a terrestrial, a contagious, or indeed any
+other disease, would for many reasons, best prevail on the lowest levels
+of the country, or the deepest lines on its surface, like the vallies of
+rivers, provided the food on which it fed--population--there abounded.
+It would be difficult almost anywhere to point out a populous city
+unconnected with the sea, rivers, or canals, the water population of
+which, from their habits of life and occupations, everywhere crowded,
+dirty, careless, and exposed, must always afford ready materials for
+any epidemic to work upon, and this may have given currency to the
+prevailing opinion; but I rather believe, when enquiry comes to be made,
+it will be found that the worst ravages of Cholera Morbus have been
+experienced in the great level open plains of Upper Germany, and the
+boundless jungly districts of India, remote from, or at least
+unconnected with water communication, denoting thereby atmospheric
+influence and agency, rather than any other.
+
+Another consideration of some importance is the burial of the dead,
+which according to published reports, has in some places been enforced
+in so hurried a manner as deeply to wound the feelings of surviving
+relatives, and in others to give rise to the horrid suspicion of
+premature interment. Can this have been necessary in any disease, even
+allowing it to be contagious, or was it wise and dignified in the
+medical profession to make this concession to popular prejudice, at all
+times when excited, so unmanageable and troublesome. Although we cannot
+analyse the matter of contagion, we surely know enough of it to feel
+assured, that it must be a production and exhalation from the living
+body, arising out of certain processes going on there, in other words
+out of the disease itself, which disease must cease along with the life
+of the patient, and the exhalation be furnished no longer--that during
+life it was sublimed, so as to leave the body and become diffused around
+through the agency of the animal heat, created by the functions of
+respiration and circulation of the blood, which being foreclosed and the
+supplies cut off, all that remained of it floating before death in the
+atmosphere, must be condensed upon the cold corpse and lie harmless.[31]
+It must also be evident that when putrefaction begins, no production of
+what belonged to the living body can remain unchanged, but must undergo
+the transformation in form, substance and quality, ordained for all
+things; for putrefaction, although it may possibly produce a disease
+after its own character, is not pestilence, nor even compatible with it
+in the case of specific diseases.
+
+[Footnote 31: Even when a living product, we are authorised to believe,
+from observations made upon the plague, that it cannot be propelled to
+a greater distance than a few feet from the body of the patient--that it
+is heavier than common air, settling down in a remarkable manner upon
+the sick bed, and saturating the lower strata of the atmosphere in the
+sick apartment.]
+
+The puerile stories, therefore, of infection being taken from following
+a coffined corpse to the grave, without reference to the state of
+grief, fear, and fatigue, not improbably, of drunkenness, in the
+mourners, must be unworthy of attention. I am no friend to the absurdly
+long interval which in this country is allowed to elapse,[32] even in
+the hottest weather, between death and burial; but still more do I
+deprecate the indecent haste which would give sanction to panic, and
+incur the risk or even the suspicion of interment before dissolution.
+In regard to separate burying grounds, should the disease come to
+spread, I am sure no one will expect, after what has just been said,
+that I should attempt to argue the question seriously, nor enter a
+protest against the further gratuitous wrong of withholding the rites
+of sepulture in consecrated ground from the victims of an epidemic or
+even a contagious disease.--Nothing could warrant such a measure but
+want of room in the ordinary churchyards, where police should never be
+allowed to interfere with the rights and feelings or property, of the
+living, unless to ensure the privacy of funerals; nothing being so
+appalling to an alarmed people as the spectacle of death in their
+streets, or so trying to the health of the mourners, as tedious funeral
+ceremonies amidst a crowd of people.
+
+[Footnote 32: After sending these letters to the press, I saw in the
+public prints that the Bishop of the Diocese had forbidden the funerals
+of the dead from Cholera to be received in the churches of London.
+Instead of thus forbidding a part, better have the whole of the service
+performed there (where crowds do not come) under cover from the weather,
+than in the open churchyard, where the mourners uncovered, are exposed
+in every way to damp and cold, and the jostling of the mob; better still
+have all the service deemed necessary, performed at the residence of
+the deceased.]
+
+Were I called upon to criticise what I have now written, and to
+review all that I have seen, read, and heard on the subject, I would
+conscientiously declare that the importation of Cholera Morbus into
+England or anywhere else, had been clearly negatived, and its
+non-contagious character almost as clearly established, always however
+with the proviso and exception of the possibility of its being made a
+temporary contingent contagion, amidst filth and poverty, and impurity
+of atmosphere, from overcrowding and accumulation of sick, but neither
+transmissible nor transportable out of its own locality, through human
+intercourse. As the disease, like all the other great plagues, which at
+various periods have desolated the earth, evidently came from the east,
+it would be most desirable in pursuing our investigation, to have a
+clear knowledge of the mode of its introduction into Russia on the
+eastern boundary of Europe. Unfortunately we can place no dependence
+upon the reports that have been published to prove importation there,
+which are lame and contradictory, although coming from the avowed
+partizans of contagion; but even had they been better gotten up, we
+could not, unless they had been confirmed by the experience of other
+nations, have received them with implicit reliance.
+
+The Russian Employé of the provinces, _mendacior Parthis_, not from
+greater innate moral depravity than others, but from the corruptions
+of a despotic government which compel him to live under the rod of a
+master, amidst a superstitious barbarous population, whose dangerous
+prejudices he dare not offend, can only give utterance to what his
+tyrants command. Even at the more civilized capital of Petersburgh, the
+mob rose in arms to murder the foreign physicians when they did not act
+according to their liking. Could the truth then be heard on such a
+field, or what native officer would venture to impugn the authority
+of his rulers, proclaiming contagion? If he did, he must cease to live
+in the official sense of the word. Throughout Europe, from east to
+west, the disease has followed its own route according to its own
+incomprehensible laws, despite of every obstacle and precaution. We have
+the authority of our own Central Board for believing that the disease
+cannot be conveyed by merchandize of any kind, and that of our mission
+to Russia for greatly doubting whether it can adhere to personal
+clothing or bedding; and will it be pretended that human beings,
+labouring under such a distemper in any form, could have been the
+vehicles of spreading it in a straight line for thousands of miles
+throughout civilized nations, armed and prepared to defend themselves
+against its inroads,--they tried, but in vain. We, too, may strive to
+discover the demon of the pestilence amidst the clouds of the climate,
+or the winds of Heaven. He remains hidden to our view; and until better
+revealed, it only remains for us to exercise towards our fellow men
+those duties which humanity prompts, civilization teaches, and religion
+enjoins.
+
+
+
+
+POSTSCRIPT.
+
+
+My friend, Doctor Stanford, of the Medical Staff, now settled here, has
+given me the following valuable information, which my own observation
+confirms, regarding the agency of panic, in promoting the diffusion of
+epidemic disease. He happened to be serving with part of the British
+army, at Cadiz, when an eruption of yellow fever took place there, in
+the autumn of 1813, and as usually happens amongst medical men, the
+first time they have seen that fever, some of them were staunch
+contagionists, and impressed that belief upon the corps to which they
+belonged. In all these the disease was most fatal to great numbers. The
+men being half dead with fear, before they were taken ill, speedily
+became its victims, to the great terror and danger of their surviving
+comrades; but in the other regiments, where no alarm had been sounded,
+the soldiers took the chances of the epidemic with the same steady
+courage they would have faced the bullets of the enemy, in the lottery
+of battle; escaping an attack for the most part altogether, or if
+seized, recovering from it in a large proportion. From this picture let
+us take a lesson, in case the impending epidemic should ever come to
+spread in the populous towns of England, and the cry of contagion be
+proclaimed in their streets. The very word will spread terror and dismay
+throughout the people, causing multitudes to be infected, who would
+otherwise, in all probability, have escaped an attack, and afterwards
+consign them to death in despair, when they find themselves the marked
+and fated victims of a new plague. Whatever they see around them, must
+confirm and aggravate their despair, for desertion and excommunication
+in all dangerous diseases, too certainly seal the fate of the patient.
+It will be vain to tell them that hireling attendance has been
+provided,--the life of the Choleraic depends upon the instant aid--the
+able bodied willing aid of affectionate friends, who will devote
+themselves to the task, and persevere indefatigably to the last. If
+these be driven from his bed, his last stay is gone, for without their
+active co-operation the best prescription of the physician is only so
+much waste paper. What, let me ask, must have been the fate of the
+patient, and what the consequent panic, if the case of Cholera that
+occurred in London, a month ago at the Barracks of the Foot Guards,
+had been proclaimed, and treated as a contagion? The poor fellow was
+promptly surrounded by his fearless comrades, who with their kind hands
+recalled and preserved the vital heat on the surface, by persevering in
+the affectionate duty of rubbing him for many hours; but had the Medical
+Staff of the regiment been true contagionists, they must, as in duty
+bound, have commanded, and compelled every one of them to fly the
+infection. It depended upon them, to have spread around a far wilder
+and more dangerous contagion than that of Cholera Morbus, or any other
+disease,--the contagion of fear--and from what occurred at Cadiz, as
+above related, it is to be hoped our medical men will now see how much
+they will have it in their power, when Cholera comes, to pronounce, or
+to withhold sentence of desolation upon a community. The word Contagion
+will be the word of doom, for then the healthy will fly their homes,
+and the sick be deserted; but a countenance and bearing, devoid of that
+groundless fear, will at once command the aid, and inspire the hopes
+that are powerful to save in the most desperate diseases.
+
+It is stated, in a Scotch newspaper, that two poor travellers, passing
+from Kirkintulloch to Falkirk, ran the risque of being stoned to death
+by the populace of the latter place, and were saved from the immolation
+only by escaping into a house; and in an Irish one, that some
+shipwrecked sailors incurred a similar danger. Such barbarities
+must, in the nature of things, be practised every where under a reign
+of terror, however humane or christianized the people may be--even the
+fatalism of the Turk would not be proof against it. In Spain they have
+been enacted in all their horrors (thanks to the quarantine laws) upon
+the unfortunate victims of yellow fever;[33] and we shall soon see them
+repeated amongst ourselves, unless the plain truth be promulgated by
+authority to the people. Let them be told if such be the pleasure of
+our rulers, (for it is not worth while disputing the point), that
+Cholera Morbus is a contagion, but of so safe a nature in regard to
+communicability, that not one in a hundred, or even a thousand, take
+the disease,--that in this country, besides being a transient passing
+disease, which according to certain laws and peculiarities of its own,
+will assuredly take its departure in no long time; it is limited almost
+always to particular spots and localities--that it is in their own
+power, while it remains, to correct the infectious atmosphere of these
+spots, by attention to health police--that they may fearlessly approach
+their sick friends with impunity, for that the danger resides in the
+above atmosphere, and not in the person of the patient; and that in all
+situations they may defy it, for as long as they observe sobriety of
+life and regularity of habits. Thus will public confidence be restored,
+and thus be verified the homely adage of, "honesty, in all human
+affairs, being ever the best policy"; for the concealment, or perversion
+of the truth, however much it may be made to serve the purposes of the
+passing day, can never ultimately promote the ends of good government
+and true humanity, but must lead, sooner or later, to the exposure of
+the delusion, or what would be far worse, to the perpetuation of error
+and prejudice, and grossest abuse of the people, in regard to those
+interests committed to our charge.
+
+[Footnote 33: Vide O'Halloran, upon the Yellow Fever in Spain.]
+
+       *       *       *       *       *
+
+Doctor Henry, of Manchester, has, in a late paper, published some most
+interesting experiments, upon the disinfecting power of heat. He found
+that the vaccine virus was deprived of its infecting quality, at 140°
+of Farenheit, and that the contagions of Scarlatina, and Typhus fever,
+from fomites, were certainly dissipated and destroyed, at the dry heat
+of boiling water. In regard to these last, he might surely have ventured
+to fix the standard of safety at a greatly lower temperature; for if the
+grosser vaccine matter could be rendered inert at 140°, there can be
+little doubt of the subtile gaseous emanations, which constitute the
+aerial contagions, being dissipated by the same agent, at an inferior
+degree. In the absence of direct experiment, we may venture to infer,
+that 120° would suffice, to nullify these last. Such, at least, has been
+the belief of those, who have been employed to purify ships, barracks,
+and hospitals, from contagion, and I should think it must have been
+founded on experience.[34]
+
+[Footnote 34: As far back as the years 1796-7-8, this fact was familiar
+to us in the St. Domingo war, only we were satisfied with a minimum heat
+of 120°, from a belief that a temperature of that height, as it
+coagulated the ova of insects (the cock roach for instance), and was
+otherwise incompatible with insect life, would avail to dissipate
+contagion.]
+
+He does not treat of the disinfecting property of light, although such
+an agent was well worthy of his notice; for the power, which in closely
+stopped bottles can deprive Cayenne Pepper of its sting--render our
+Prussic Acid as harmless as cream, and convert the strongest medicinal
+powders into so much powder of _post_, can also avail to destroy the
+matter and principle of Contagion. In fact, no other is used for
+purifying goods, at our Lazzarettoes, where suspected articles of
+merchandise, after some nugatory fumigations, are simply exposed to
+light and air with such certain effect, that there is not, I believe,
+in this country, any record of infection being propagated from them
+afterwards. The experiments of Doctor Henry are as simple and beautiful
+in themselves, as they promise to be useful and important, for now even
+the horrible contagion of hospital gangrene would appear to be under
+the controul of the pure agent he has been describing; and the principle
+now established of light and heat, the grand vivifying powers of the
+creation, being the sure and true preservers of the creature, man, from
+the poisons generated even by himself, and otherwise around him, calls
+for our admiration and gratitude, as shewing that these agents and
+emanations of Almighty power can be made, in the hands of the practical
+philosopher, to serve the purposes of domestic science, and in as far
+as we can see, to fulfil, at least in that respect, the best intentions
+of the Creator.
+
+
+WINDSOR:
+PRINTED RY R. OXLEY, AT THE EXPRESS OFFICE.
+
+
+
+
+Transcriber's Note
+
+Spelling variations have been retained in this ebook to match the
+original text, e.g., quarrantines & quarantines, shew & show,
+Farrell & Farrel, control & controul, employe & employé, coridors,
+land wind & land-wind, reccommended & recommended, versts & wersts,
+clothing & cloathing, apalling & appalling, prima facie & primâ facie,
+alledged, and par metier & par métier.
+
+Placement of footnote markers has been regularized to be located
+outside of neighboring punctuation.
+
+The following typographical corrections have been made to this text:
+
+
+PART I
+
+   Foot 1: Removed stray comma (As medical men in this Country employ)
+   Page 6: Changed possesss to possess (still do not possess)
+  Page 13: Removed superfluous quote marks (Petersburg;--this gentleman)
+  Page 19: Removed duplicate word 'of' (has become a magazine of)
+  Page 19: Changed . to , (the cause of cholera,)
+  Page 21: Changed , to . (&c., in the office)
+  Page 22: Changed Mauritus to Mauritius (at the Mauritius before)
+  Page 22: Added . to Dr (Dr. Hawkins admits)
+  Page 24: Changed . to , (Martin M'Neal[6],)
+  Page 24: Changed knowlege to knowledge (any knowledge himself)
+  Page 26: Changed circustances to circumstances (two circumstances)
+  Page 28: Removed duplicate word 'a' (at least for a time)
+  Page 32: Changed intercouse to intercourse (or great intercourse)
+  Page 33: Added . to Dr (and Dr. Hawkins)
+  Foot 11: Changed importan to important (in the important)
+  Page 39: Moved misplaced comma (at Barcelonetta, the)
+  Page 45: Changed teminated to terminated (terminated favourably)
+  Page 46: Removed stray hyphen (he persists in giving)
+  Page 50: Moved misplaced period (this calamity (the cholera).)
+  Page 51: Changed çaon to 'ça on' (toute ça on trouve)
+  Page 53: Deleted superfluous end-quotes (took place.)
+  Page 53: Changed confied to confined (been confined to her bed)
+  Page 53: Changed macron to aigu accent (_employés_ attached)
+  Page 53: Changed authorties to authorities (authorities wished)
+  Page 54: Changed dimished to diminished (diminished all at once)
+  Page 54: Changed á to à (tout à coup)
+  Page 54: Changed entassès to entassés (crowded [_entassés_])
+  Page 54: Changed Franec to France (state like France)
+  Page 56: Added missing end-quotes (to the Burraumposter.")
+  Page 57: Changed em-dash to hyphen (Leicester-square)
+
+PART II
+
+  Page 11: Changed typhoi'd to typhoid (the typhoid principle)
+  Page 15: Changed affluuent to affluent (houses of the affluent)
+  Page 17: Changed 'in' to 'In' (In my last letter)
+  Page 21: Changed absorded to absorbed (absorbed into the soil)
+  Page 22: Changed 'in' to 'it' (would certainly have kept it)
+  Page 24: Changed procees to process (drying process)
+  Page 26: Changed saered to sacred (the most sacred duty)
+  Page 30: Added missing ending punctuation (following morning.)
+  Page 31: Removed duplicate word always (always afford)
+
+
+
+
+
+End of the Project Gutenberg EBook of Letters on the Cholera Morbus., by 
+James Gillkrest and William Fergusson
+
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+<pre>
+
+The Project Gutenberg EBook of Letters on the Cholera Morbus., by 
+James Gillkrest and William Fergusson
+
+This eBook is for the use of anyone anywhere at no cost and with
+almost no restrictions whatsoever.  You may copy it, give it away or
+re-use it under the terms of the Project Gutenberg License included
+with this eBook or online at www.gutenberg.org
+
+
+Title: Letters on the Cholera Morbus.
+       Containing ample evidence that this disease, under whatever
+              name known, cannot be transmitted from the persons of those
+              labouring under it to other individuals, by contact--through
+              the medium of inanimate substances--or through the medium
+              of the atmosphere; and that all restrictions, by cordons
+              and quarantine regulations, are, as far as regards this
+              disease, not merely useless, but highly injurious to the
+              community.
+
+Author: James Gillkrest
+        William Fergusson
+
+Release Date: February 20, 2009 [EBook #28147]
+
+Language: English
+
+Character set encoding: ISO-8859-1
+
+*** START OF THIS PROJECT GUTENBERG EBOOK LETTERS ON THE CHOLERA MORBUS. ***
+
+
+
+
+Produced by Bryan Ness, C. St. Charleskindt, and the Online
+Distributed Proofreading Team at https://www.pgdp.net (This
+file was produced from images generously made available
+by The Internet Archive/American Libraries.)
+
+
+
+
+
+
+</pre>
+
+
+<div class="tnote">
+<h3>Transcriber's Note</h3>
+
+<p>This text does not refer to epidemic cholera. The term "cholera morbus"
+was used in the 19th and early 20th centuries to describe both
+non-epidemic cholera and gastrointestinal diseases that mimicked
+cholera. The term "cholera morbus" is found in older references but is
+not in current scientific use. The condition "cholera morbus" is now
+referred to as "acute gastroenteritis."</p>
+
+<p>Spelling variations and inconsistencies have been retained
+to match the original text. Only such cases which strongly indicated the
+presence of inadvertent typographical error have been corrected; a detailed
+list of these corrections can be found
+<a href="#Transcribers_Note2">at the end of this text</a>.</p>
+
+<p>This ebook consists of two separate parts. The first from 1831 ("LETTERS
+ON THE CHOLERA MORBUS.") contains Letters&nbsp;I-X; and the second from 1832
+("LETTERS ON THE CHOLERA MORBUS, &amp;c.&nbsp;&amp;c.&nbsp;&amp;c.") contains
+Letters&nbsp;I-III and a Postscript. For ease of navigation in the HTML
+document, the notations "Pt_1" and "Pt_2" have been added directly above
+original page numbers.
+</p>
+</div>
+
+<hr class="major" />
+
+<h1>LETTERS
+<br />
+<br />
+<span class="size50">ON THE</span>
+<br />
+<br />
+CHOLERA MORBUS.</h1>
+
+<hr class="spacer" />
+
+<div class="center size90">CONTAINING</div>
+
+<hr class="spacer" />
+
+<div class="hang size90">
+AMPLE EVIDENCE THAT THIS DISEASE, UNDER WHATEVER NAME KNOWN, CANNOT
+BE TRANSMITTED FROM THE PERSONS OF THOSE LABOURING UNDER IT TO OTHER
+INDIVIDUALS, BY CONTACT&mdash;THROUGH THE MEDIUM OF INANIMATE
+SUBSTANCES&mdash;OR THROUGH THE MEDIUM OF THE ATMOSPHERE; AND THAT ALL
+RESTRICTIONS, BY CORDONS AND QUARANTINE REGULATIONS, ARE, AS FAR AS
+REGARDS THIS DISEASE, NOT MERELY USELESS, BUT HIGHLY INJURIOUS TO THE
+COMMUNITY.
+</div>
+
+<hr class="bigspacer" />
+
+<div class="center">
+<i>By a Professional Man of Thirty Years experience, in various parts of
+the World.</i>
+
+<hr class="bigspacer" />
+
+LONDON:<br />
+<span class="size75">NICHOLS AND SONS, PRINTERS, EARL'S COURT,
+CRANBOURN STREET LEICESTER SQUARE.</span>
+
+<hr class="spacer" />
+
+1831.
+</div>
+
+<hr class="major" />
+
+<p>The first series of these Letters, consisting of five, appeared in the
+months of September and October of the present year; five others,
+written in a more popular form, were inserted in a Newspaper from time
+to time, in the course of this month:&mdash;a few additions and alterations,
+preparatory to their appearance in the shape of a pamphlet, have been
+made.</p>
+
+<p>If, at a moment like the present, they prove in any manner useful to the
+public, the writer will feel great satisfaction.</p>
+
+<hr class="spacer" />
+
+<p class="lind">November&nbsp;26th,&nbsp;1831.</p>
+
+<hr class="major" />
+
+<div>
+<!-- Page 3 -->
+
+<span class="pagenum1"><a name="Page_3_Part_1" id="Page_3_Part_1">Pt_1<br />[Pg 3]</a></span>
+</div>
+
+<h1><a name="PART_1" id="PART_1"></a>
+<span class="size80">LETTERS ON THE CHOLERA MORBUS;</span>
+<br />
+<br />
+<span class="size40">SHEWING THAT IT IS</span>
+<br />
+<br />
+<span class="size80">NOT A COMMUNICABLE DISEASE.</span></h1>
+
+<hr class="spacer" />
+
+<h2><a name="LETTER_I_Part_1" id="LETTER_I_Part_1"></a>LETTER I.</h2>
+
+<p>If we view the progress of this terrific malady, as it tends to
+disorganise society wherever it shows itself, as it causes the
+destruction of human life on an extensive scale, or as it cramps
+commerce, and causes vast expense in the maintenance of quarantine and
+cordon establishments, no subject can surely be, at this moment, of
+deeper interest. It is to be regretted, indeed, that, in this country,
+political questions (of great magnitude certainly), should have
+prevented the legislature, and society at large, from examining, with
+due severity, all the data connected with cholera, in order to avert,
+should we unhappily be afflicted with an epidemic visitation of this
+disease, that state of confusion, bordering on anarchy, which we find
+has occurred in some of those countries where it has this year appeared.</p>
+
+<p>Were this letter intended for the eyes of medical men only, it would be
+unnecessary to say that, during epidemics, the safety of thousands rests
+upon the solution of these simple questions:&mdash;Is the disease
+communicable to a healthy person, from the body of another person
+labouring under it, either <i>directly</i>, by touching him, or <i>indirectly</i>,
+by touching any substance (as clothes, &amp;c.) which might have been in
+contact with him, or by inhaling the air about his person, either during
+his illness or after death?&mdash;Or is it, on the other hand, a disease with
+the appearance and progress of which sick persons, individually or
+collectively, have no influence, the sole cause of its presence
+depending on unknown states of the atmosphere, or on terrestrial
+emanations, or on a principle, <i>aura</i>, or whatever else it may be
+called, elicited under certain circumstances, from both the earth and
+air?&mdash;In the one case we have what the French, very generally I believe,
+term <i>mediate</i> and <i>immediate</i> contagion, while the term <i>infection</i>
+would seem to be reserved by some of the most distinguished of their
+physicians for the production of diseases by a deteriorated
+atmosphere:&mdash;much confusion would certainly be avoided by this adoption
+of terms.<a name="FNanchor_1_1" id="FNanchor_1_1"></a><a href="#Footnote_1_1" class="fnanchor">[1]</a> Now
+it is evident, that incalculable mischief must arise when a
+
+<!-- Page 4 -->
+
+<span class="pagenum1"><a name="Page_4_Part_1" id="Page_4_Part_1">Pt_1<br />[Pg 4]</a></span>
+
+community acts upon erroneous decisions on the above questions;
+for, if we proceed in our measures on the principle of the disease not
+being either directly or indirectly transmissible, and that it should,
+nevertheless, be so in fact, we shall consign many to the grave, by not
+advising measures of separation between those in health, and the
+persons, clothes, &amp;c., of the sick. On the other hand, should
+governments and the heads of families, act on the principle of the
+disease being transmissible from person to person, while the fact may
+be, that the disease is produced in each person by his breathing the
+deteriorated atmosphere of a certain limited surface, the calamity in
+this case must be very great; for, as has happened on the Continent
+lately, cordons may be established to prevent flight, <i>when flight, in
+certain cases, would seem to be the only means of safety to many</i>; and
+families, under a false impression, may be induced to shut themselves up
+in localities, where "every breeze is bane."</p>
+
+<div class="footnote">
+<p>
+<a name="Footnote_1_1" id="Footnote_1_1"></a>
+<a href="#FNanchor_1_1"><span class="label">[1]</span></a>
+
+As medical men in this Country employ the word <i>infection</i>
+and <i>contagion</i> in various senses, I shall, generally substitute
+<i>transmissible</i> or <i>communicable</i>, to avoid obscurity.
+</p>
+</div>
+
+<p>Hence then the importance, to the state and to individuals, of a rigid
+investigation of these subjects. It is matter of general regret, I
+believe, among medical men, that hitherto the question of cholera has
+not always been handled in this country with due impartiality. Even some
+honest men, from erroneous views as to what they consider "the safe
+side" of the question, and forgetting that the safe side can only be
+that on which truth lies (for then the people will know <i>what</i> to do in
+the event of an epidemic), openly favour the side of <i>communicability</i>,
+contrary to their inward conviction; while the good people of the
+quarantine have been stoutly at work in making out that precautions are
+as necessary in the cholera as in plague. Meantime our merchants, and
+indeed the whole nation, are filled with astonishment, on discovering
+that neighbouring states enforce a quarantine against ships from the
+British dominions, when those states find that cases of disease are
+reported to them as occurring among us, resembling more or less those
+which we have so loudly, and I must add prematurely, declared to be
+transmissible. It is quite true that, however decidedly the question may
+be set at rest in this country, our commerce, should we act upon the
+principle, of the disease not being transmissible, would be subject to
+vexatious measures, at least for a time, on the part of other states;
+but let England take the lead in instituting a full inquiry into the
+whole subject, by a Committee of the House of Commons; and if the
+question be decided against quarantines and cordons by that body, other
+countries will quickly follow the example, and explode them as being
+much worse than useless, as far as their application to cholera may be
+concerned. It is very remarkable how, in these matters, one country
+shapes its course by what seems to be the rule in others; and, as far as
+the point merely affects commerce, without regard to ulterior
+considerations, it is not very surprising that this should be the case;
+but it is not till an epidemic shall have actually made its appearance
+among us, that the consequences of the temporising, or the
+precipitation, of medical men can appear in all their horrors. Let no
+man hesitate to retract an opinion already declared, on a question of
+the highest importance to society, if he should see good reason for
+doing so, after a patient and unbiassed reconsideration of all the
+facts. We are bound, in every way, to act with good faith towards the
+public, and erroneous
+
+<!-- Page 5 -->
+
+<span class="pagenum1"><a name="Page_5_Part_1" id="Page_5_Part_1">Pt_1<br />[Pg 5]</a></span>
+
+views, in which that public is concerned, ought
+to be declared as soon as discovered. To show how erroneous some of the
+data are from which people are likely to have drawn conclusions, is the
+main cause of my wish to occupy the attention of the public; and in
+doing this, it is certainly not my wish to give offence to respectable
+persons, though I may have occasion to notice their errors or omissions.</p>
+
+<p>Previous to proceeding to the consideration of other points, it may be
+observed, that all doubt is at an end as to the identity of the Indian,
+Russian, Prussian, and Austrian epidemic cholera; no greater difference
+being observed in the grades of the disease in any two of those
+countries, than is to be found at different times, or in different
+places, in each of them respectively. At the risk of being considered a
+very incompetent judge, if nothing worse, I shall not hesitate to say,
+that if the same assemblage, or grouping of symptoms be admitted as
+constituting the same disease, it may at any time be established, to the
+entire satisfaction of an unprejudiced tribunal, that cases of cholera,
+not unfrequently proving fatal, and corresponding in every particular to
+the average of cases as they have appeared in the above countries, have
+been frequently remarked as occurring in other countries including
+England; and yet no cordon or quarantine regulations, on the presumption
+of the disease spreading by "contagion." For my own part, without
+referring to events out of Europe, I have been long quite familiar, and
+I know several others who are equally so, with cholera, in which a
+perfect similarity to the symptoms of the Indian or Russian cholera has
+existed: the collapse&mdash;the deadly coldness with a clammy skin&mdash;the
+irritability of the stomach, and prodigious discharge from the bowels of
+an opaque serous fluid (untinged with bile in the slightest
+degree)&mdash;with a corresponding shrinking of flesh and integuments&mdash;the
+pulseless and livid extremities&mdash;the ghastly aspect of countenance and
+sinking of the eyes&mdash;the restlessness so great, that the patient has not
+been able to remain for a moment in any one position&mdash;yet, with all
+this, nobody dreamt of the disease being communicable; no precautions
+were taken on those occasions "to prevent the spreading of the disease,"
+and no epidemics followed. In the <i>Glasgow Herald</i> of the 5th&nbsp;ult., will
+be found a paper by Mr.&nbsp;Marshall, (a gentleman who seems to reason with
+great acuteness), which illustrates this part of our subject. This
+gentleman appears to have had a good deal of experience in Ceylon when
+the disease raged there, and I shall have occasion to refer hereafter to
+his statements, which I consider of great value. Nobody can be so absurd
+as to expect, that in the instances to which I refer, <i>all</i> the symptoms
+which have ever been enumerated, should have occurred in each case; for
+neither in India nor any-where else could all the grave symptoms be
+possibly united in any one case; for instance, great retching, and a
+profuse serous discharge from the bowels, have very commonly occurred
+where the disease has terminated fatally: yet it is not less certain,
+that even in the epidemics of the same year, death has often taken place
+in India more speedily where the stomach and bowels have been but little
+affected, or not at all. To those who give the subject of cholera all
+the attention which it merits, the
+
+<!-- Page 6 -->
+
+<span class="pagenum1"><a name="Page_6_Part_1" id="Page_6_Part_1">Pt_1<br />[Pg 6]</a></span>
+
+consideration of some of those cases
+which have, within the last few weeks, appeared in the journals of this
+country, cannot fail to prove of high interest, and must inspire the
+public with confidence, inasmuch as they show, <i>beyond all doubt</i>, that
+the disease called cholera, as it has appeared in this country, and
+however perfectly its symptoms may resemble the epidemic cholera of
+other countries, <i>is not</i> communicable. On some of those cases so
+properly placed before the public, I shall perhaps be soon able to offer
+a few remarks: meanwhile, I shall here give the abstract of a case, the
+details of which have not as yet, I believe, appeared, and which must
+greatly strengthen people in their opinion, that these cholera cases,
+however formidable the symptoms, and though they sometimes end rapidly
+in death, still do not possess the property of communicating the disease
+to others. I do not mean to state that I have myself seen the case, the
+details of which I am about to give, but aware of the accuracy of the
+gentleman who has forwarded them to me, I can say, that although the
+communication was not made by the medical gentleman in charge of the
+patient, the utmost reliance may be placed on the fidelity of those
+details:&mdash;</p>
+
+<p>Thursday, August&nbsp;11th,&nbsp;1831, Martin M'Neal, aged&nbsp;42, of the
+7th&nbsp;Fusileers, stationed at Hull, was attacked at a little before
+four&nbsp;<span class="smcap">a.m.</span>,
+with severe purging and vomiting&mdash;when seen by his surgeon at about
+four&nbsp;o'clock, was labouring under spasms of the abdominal muscles, and of the
+calves of the legs. What he had vomited was considered as being merely
+the contents of the stomach, and, as the tongue was not observed to be
+stained of a yellow colour, it was inferred that no bile had been thrown
+up. He took seventy drops of laudanum, and diluents were ordered.
+Half-past six, seen again by the surgeon, who was informed that he had
+vomited the tea which he had taken; no appearance of bile in what he had
+thrown up; watery stools, with a small quantity of feculent matter;
+thirst; the spasms in abdomen and legs continued; countenance not
+expressive of anxiety; skin temperate; pulse 68 and soft; the forehead
+covered with moisture. Ordered ten grains of calomel, with two of opium,
+which were rejected by the stomach, though not immediately.</p>
+
+<p>Eight&nbsp;o'clock&nbsp;<span class="smcap">a.m.</span> The features sinking, the temperature of the body now
+below the natural standard, especially the extremities; pulse small;
+tongue cold and moist; a great deal of retching, and a fluid vomited
+resembling barley-water, but more viscid; constant inclination to go to
+stool, but passed nothing; the spasms more violent and continued; a
+state of collapse the most terrific succeeded. At nine o'clock, only a
+very feeble action of the heart could be ascertained as going on, even
+with the aid of the stethoscope; the body cold, and covered with a
+clammy sweat, the features greatly sunk; the face discoloured; the lips
+blue; the tongue moist, and very cold; the hands and feet blue, cold,
+and shrivelled, as if they had been soaked in water, like washerwomen's
+hands; no pulsation to be detected throughout the whole extent of the
+upper or lower extremities; the voice changed, and power of utterance
+diminished. He replied to questions with reluctance, and in
+monosyllables;
+
+<!-- Page 7 -->
+
+<span class="pagenum1"><a name="Page_7_Part_1" id="Page_7_Part_1">Pt_1<br />[Pg 7]</a></span>
+
+the spasms became more violent, the abdomen being, to
+the feel, as hard as a board, and the legs drawn up; cold as the body
+was, he could not bear the application of heat, and he threw off the
+bed-clothes; passed no urine since first seen; the eyes became glassy
+and fixed; the spasms like those of tetanus or hydrophobia; the
+restlessness so great, that it required restraint to keep him for ever
+so short a time in any one position. A vein having been opened in one of
+his arms, from 16 to 20 ounces of blood were drawn with the greatest
+difficulty. During the flowing of the blood, there was great writhing of
+the body, and the spasms were very severe&mdash;friction had been arduously
+employed, and at ten&nbsp;<span class="smcap">a.m.</span> he took a draught containing two and a half
+drachms of laudanum, and the vomiting having ceased, he fell asleep. At
+two&nbsp;<span class="smcap">p.m.</span> re-action took place, so as to give hopes of recovery. At
+four&nbsp;<span class="smcap">p.m.</span> the coldness of the body, discoloration, &amp;c., returned, but without
+a return of the vomiting or spasms. At about half-past eight he died,
+after a few convulsive sobs.</p>
+
+<p>On a post-mortem examination, polypi were found in the ventricles of the
+heart, and the cav&aelig; were filled with dark blood. Some red patches were
+noticed on the mucuous membrane; but the communication forwarded to me
+does not specify on what precise part of the stomach or intestinal
+canal; and my friend does not appear to attach much importance to them,
+from their common occurrence in a variety of other diseases. It remains
+to be noticed, that the above man had been at a fair in the
+neighbourhood on the 9th (two days preceding his attack), where, as is
+stated, he ate freely of fruit, and got intoxicated. On the 10th he also
+went to the fair, but was seen to go to bed sober that night. The
+disease did not spread to others, either by direct or indirect contact
+with this patient.</p>
+
+<p>Now let us be frank, and instead of temporising with the question, take
+up in one hand the paper on "cholera spasmodica" just issued, for our
+guidance, from the College of Physicians by the London Board of Health,
+and in the other, this case of Martin M'Neal (far from being a singular
+case this year, in most of the important symptoms),&mdash;let the symptoms be
+compared by those who are desirous that the truth should be ascertained,
+or by those who are not, and if distinctions can be made out, I must
+ever after follow the philosophy of the man who doubted his own
+existence. The case, as it bears on certain questions connected with
+cholera, <i>is worth volumes of what has been said on the same subject</i>.
+Let it be examined by the most fastidious, and the complete identity
+cannot be got rid of, even to the <i>blue</i> skin, the <i>shrivelled fingers</i>,
+the <i>cold tongue</i>, the <i>change in voice</i>, and the <i>suppression of
+urine</i>, considered in some of the descriptions to be found in the
+pamphlet issued by the Board of Health, as so characteristic of the
+"Indian" cholera; and this, too, under a "constitution of the
+atmosphere" so remarkably disposed to favour the production of cholera
+of one kind or other, that Dr.&nbsp;Gooch, were he alive, or any close
+reasoner like him, must be satisfied, that were this remarkable form of
+the disease communicable, no circumstance was absent which can at all be
+considered essential to its propagation. As the symptoms in the case of
+M'Neal, were, perhaps, more
+
+<!-- Page 8 -->
+
+<span class="pagenum1"><a name="Page_8_Part_1" id="Page_8_Part_1">Pt_1<br />[Pg 8]</a></span>
+
+characteristically grouped than in any
+other case which has been recorded in this country, so it has also in
+all probability occurred, that more individuals had been in contact with
+him during his illness and after his death, as the facility in obtaining
+persons to attend the sick, rub their bodies, &amp;c., must be vastly
+greater in the army than in ordinary life; so that in such cases it is
+not a question of one or two escaping, but of <i>many</i>, which is always
+the great test.</p>
+
+<p>Of the College of Physicians we are all bound to speak with every
+feeling of respect, but had the document transmitted by that learned
+body to our government, on the 9th of June last, expressed only a
+"philosophic doubt," instead of making an assertion, the question
+relative to the contagion or non-contagion of the disease, now making
+ravages in various parts of Europe, would be less shackled among us.
+People are naturally little disposed to place themselves, with the
+knowledge they may have obtained from experience and other sources, in
+opposition to such a body as the College: but as, in their letter to
+government of the 18th of June, they profess their readiness, should it
+be necessary, to "re-consider" their opinion, we, who see reason to
+differ from them, may be excused for publishing our remarks. It seems
+surprising enough that, in their letter to government of the 9th of June,
+the College should have given as a reason for their decision as to
+the disease being infectious (meaning, evidently, what some call
+contagious, or transmissible from <i>persons</i>)&mdash;"having no other means of
+judging of the nature and symptoms of the cholera than those furnished
+by the documents submitted to us." Now, according to the printed
+parliamentary papers, among the documents here referred to as having
+been sent by the Council to the College, was one from Sir William
+Crichton, Physician in Ordinary to the Emperor of Russia, in which a
+clear account is given of the symptoms as they presented themselves in
+that country; and, if the College had previously doubted of the identity
+of the Russian and Indian cholera, a comparison of the symptoms, as they
+were detailed by Sir William, with those described in various places in
+the <i>three volumes</i> of printed Reports on the cholera of India, in the
+college library, must at once have established the point in the
+affirmative. In fact, we know, that the evidence of Dr.&nbsp;Russell, given
+before the College, when he heard Sir William's description of the
+disease read, fully proved this identity to the satisfaction of the
+College. Had the vast mass of information contained in the India
+Reports, together with the information since accumulated by our Army
+Medical Department, been consulted, all which are highly creditable to
+those concerned in drawing them up, and contain incomparably better
+evidence, that is, evidence more to be relied on, than any which can be
+procured from Russia or any other part of the world&mdash;had these sources
+of information been consulted, as many think they should in all fairness
+have been, the College would probably have spoken more doubtingly as to
+cholera, in any form, possessing the property of propagating itself from
+person to person. Much of what passes current in favour of the
+communication of cholera rests, I perceive, on statements the most
+vague, assertions in a general way, as to the security of those who shut
+themselves up, &amp;c. To show how little
+
+<!-- Page 9 -->
+
+<span class="pagenum1"><a name="Page_9_Part_1" id="Page_9_Part_1">Pt_1<br />[Pg 9]</a></span>
+
+reliance is to be placed on such
+statements, even when they come from what ought to be good authority,
+let us take an instance which happened in the case of yellow fever.
+Doctor, now Sir&nbsp;William Pym, superintendent of the quarantine
+department, published a book on this disease in 1815, in which he
+stated, that the people shut up in a dock-yard, during the epidemic
+of 1814, in Gibraltar, escaped the disease, and Mr.&nbsp;William Fraser, also of
+the quarantine, and who was on the spot, made a similar statement. Now,
+we all believed this in England for several years, when a publication
+appeared from Dr.&nbsp;O'Halloran, of the medical department of Gibraltar
+garrison, in which he stated that he had made inquiries from the
+authorities at that place, and that he discovered the whole statement to
+have been without the smallest foundation, and furnishes the particulars
+of cases which occurred in the dock-yard, among which were some deaths;
+this has never since been replied to&mdash;so much as a caution in the
+selection of proofs.</p>
+
+<p>To show, further, how absurdly statements respecting the efficacy of
+cordons will sometimes be made, it may be mentioned that M.&nbsp;D'Argout,
+French minister of public works, standing up in his place in the
+chamber, <i>on the 3rd instant</i> (<i>Septr.</i>), and producing his estimates
+for additional cordons, &amp;c., stated, by way of proving the efficacy of
+such establishments, that in Prussia, where, according to him, cordon
+precautions had been pre-eminently rigorous, and where "<i>le territoire a
+&eacute;t&eacute; defendu pied &agrave; pied</i>," such special enforcement of the regulations
+was attended with "<i>assez de succ&egrave;s</i>:" in the meantime the next mail
+brings us the official announcement (<i>dated Berlin, Sept.&nbsp;1</i>) of the
+disease having made its appearance there!</p>
+
+<p>To conclude, for the present: if there be one reason more than another
+why the question of cholera should be scrutinized by the highest
+tribunal&mdash;a parliamentary committee&mdash;it is, that in the "papers" just
+issued by the Board of Health, the following passage occurs
+(page&nbsp;36):&mdash;"But in the event of such removal not being practicable, on
+account of extreme illness or otherwise, the prevention of all
+intercourse with the sick, even of the family of the person attacked,
+must be rigidly observed, unless," &amp;c. There are some who can duly
+appreciate all the consequences of this; but let us hope that the
+question is still open to further evidence, in order to ascertain
+whether it be really necessary that, in the event of a cholera epidemic,</p>
+
+<p class="centerverse">
+"The living shall fly from<br />
+The sick they should cherish."
+</p>
+
+<hr class="major" />
+
+<h2><a name="LETTER_II_Part_1" id="LETTER_II_Part_1"></a>LETTER II.</h2>
+
+<p>In my last letter I adverted to the opinion forwarded to his Majesty's
+Council on the 9th of June last from the College of Physicians, in which
+the cholera, now so prevalent in many parts of Europe, was declared to
+be communicable from person to person. We saw that they admitted in that
+letter (see page&nbsp;16 of the Parliamentary Papers on Cholera) the limited
+nature of the proofs upon which their opinion was formed; but I had not
+the reasons which I supposed I had for concluding, that because
+
+<!-- Page 10 -->
+
+<span class="pagenum1"><a name="Page_10_Part_1" id="Page_10_Part_1">Pt_1<br />[Pg 10]</a></span>
+
+they used the words "ready to reconsider," in their communication of the 18th
+of same month to the Council, they intended to <i>reconsider</i> the whole
+question. Indeed this seems now obvious enough, as one of the Fellows of
+the College who signed the Report from that body on the 9th of June
+(Dr.&nbsp;Macmichael) has published a pamphlet in support of the opinion already
+given, in the shape of a letter addressed to the President of the
+College, whose views, Dr.&nbsp;Macmichael tells us, <i>entirely coincide</i> with
+his own; so that there is now too much reason to apprehend that in this
+quarter the door is closed. Contagionist as I am, in regard to those
+diseases where there is evidence of contagion, I find nothing in
+Dr.&nbsp;Macmichael's letter which can make an impression on those who are at all
+in the habit of investigating such
+subjects,<a name="FNanchor_2_2" id="FNanchor_2_2"></a><a href="#Footnote_2_2" class="fnanchor">[2]</a> and
+who, dismissing such
+inductions as those which he seems to consider legitimate, rely solely
+on facts rigorously examined. He must surely be aware that most of the
+points which he seems to think ought to have such influence in leading
+the public to believe in the contagion of cholera, might equally apply
+to the influenza which this year prevailed in Europe, and last year in
+China, &amp;c.; or to the influenza of 1803, which traversed over continents
+and oceans, <i>sometimes in the wind's eye, sometimes not</i>, as frequently
+mentioned by the late Professor Gregory of Edinburgh. Who will now stand
+up and try to maintain that the disease in those epidemics was
+propagated from person to person? Could more have been made of so bad a
+cause as contagion in cholera, few perhaps could have succeeded better
+than Dr.&nbsp;Macmichael, and no discourtesy shall be offered him by me,
+though he does sometimes loose his temper, and say, among other things
+not over civil, nor quite <i>comme il faut</i>, from a Fellow of the College,
+that all who do not agree with him as to contagion "will fully abandon
+all the ordinary maxims of prudence, and remain obstinately blind to the
+dictates of common sense!"&mdash;<i>fort, mais peu philosophique Monsieur le
+Docteur</i>. The time has gone by when ingenious men of the profession,
+like Dr.&nbsp;Macmichael, might argue common sense out of us; it will not
+even serve any purpose now that other names are so studiously introduced
+as <i>entirely coinciding</i> with Dr.&nbsp;Macmichael; for, in these days of
+reform in every thing, <i>opinions</i>, will only be set down at their just
+value by those who pay attention to the subject.</p>
+
+<div class="footnote">
+<p>
+<a name="Footnote_2_2" id="Footnote_2_2"></a>
+<a href="#FNanchor_2_2"><span class="label">[2]</span></a>
+
+I presume that I shall not be misunderstood when I say,
+<i>Would that the cholera were contagious</i>&mdash;for then we might have every
+reasonable hope of staying the progress of the calamity by those cordon
+and quarantine regulations which are now not merely useless, but the
+bane of society, when applied to cholera or other non-contagious
+diseases.
+</p>
+</div>
+
+<p>Referring once more to the Report of the 9th of June, made by the
+College to the Council, and signed by the President as well as by
+Dr.&nbsp;Macmichael, the cholera was there pronounced to be a communicable
+disease, when they had, as they freely admit, "no other means of judging
+of the nature and symptoms of the cholera than those furnished by the
+documents submitted to them." The documents submitted were the
+following, as appears from the collection of papers published by order
+of Parliament:&mdash;Two reports made to our government by Dr.&nbsp;Walker, from
+Russia; a report from Petersburgh by Dr.&nbsp;Albers, a Prussian physician;
+and
+
+<!-- Page 11 -->
+
+<span class="pagenum1"><a name="Page_11_Part_1" id="Page_11_Part_1">Pt_1<br />[Pg 11]</a></span>
+
+a report, with inclosures, regarding Russian quarantine regulations,
+from St.&nbsp;Petersburg, by Sir&nbsp;W. Creighton. Dr.&nbsp;Walker, who was sent from
+St.&nbsp;Petersburg to Moscow, by our ambassador at the former place; states,
+in his first report, dated in March, that the medical men seemed to
+differ on the subject of contagion, but adds, "I may so far state, that
+by far the greater number of medical men are disposed to think it not
+contagious." He says, that on his arrival at Moscow, the cholera was
+almost extinct there; that in twelve days he had been able to see only
+twenty-four cases, and that he had no means of forming an opinion of his
+own as to contagion. In a second report, dated in April from
+St.&nbsp;Petersburg, this gentleman repeats his former statement as to the
+majority of the Moscow medical men not believing the disease to be
+contagious (or, as the College prefer terming it, infectious), and gives
+the grounds on which their belief is formed, on which he makes some
+observations. He seems extremely fair, for while he states that,
+according to his information, a peculiar state of the atmosphere "was
+proved by almost every person in the city (Moscow), feeling, during the
+time, some inconvenience or other, which wanted only the exciting cause
+of catching cold, or of some irregularity in diet, to bring on cholera;"
+that "very few of those immediately about the patients were taken ill;"
+that he "did not learn that the contagionists in Moscow had any strong
+particular instances to prove the communication of the disease from one
+individual to another;" and that he had "heard of several instances
+brought forward in support of the opinion (contagion), but they are not
+fair ones:" he yet mentions where exceptions seem to have taken place as
+to hospital attendants not being attacked, but he has neglected to tell
+us (a very common omission in similar statements), whether or not the
+hospitals in which attendants were attacked were situated in or near
+places where the atmosphere seemed <i>equally productive of the disease in
+those not employed in attending on sick</i>. This clearly makes all the
+difference, for there is no earthly reason why people about the sick
+should not be attacked, if they breathe the same atmosphere which would
+seem to have so particular an effect in producing the disease in others;
+indeed there are good reasons why, during an epidemic, attendants should
+be attacked in greater proportion; for the constant fatigue, night-work,
+&amp;c., must greatly predispose them to disease of any kind, while the
+great additional number always required on those occasions, precludes
+the supposition of the majority so employed being <i>seasoned</i> hospital
+attendants, having constitutions impenetrable to contagion. Those
+questions are <i>now</i> well understood as to yellow fever, about which so
+much misconception had once existed. The proofs by disinterested authors
+(by which I mean those unconnected with quarantine establishments, or
+who are not governed by the <i>expediency</i> of the case) in the West
+Indies, America, and other places, show this in a clear light; but the
+proofs which have for some time past appeared in various journals
+respecting the occurrences at Gibraltar, during the epidemic of 1828,
+are particularly illustrative. By the testimony of three or four
+writers, we find that <i>within certain points</i>, those in attendance on
+sick, in houses as well as hospitals, were attacked with the fever, in
+common with those who were not in attendance on sick; but that, where
+people remained at ever so short a distance beyond
+
+<!-- Page 12 -->
+
+<span class="pagenum1"><a name="Page_12_Part_1" id="Page_12_Part_1">Pt_1<br />[Pg 12]</a></span>
+
+those points, during
+the epidemic influence, <i>not a single instance</i> occurred of their being
+attacked, though great numbers had been in the closest contact with the
+sick, and frequently too, it would appear, under circumstances when
+contagion, had it existed, was not impeded in its usual course by a very
+free atmosphere:&mdash;<i>sick individuals, for instance, lying in a small
+house, hut, or tent, surrounded, during a longer or shorter space of
+time, by their relatives, &amp;c.</i> A full exposure of some very curious
+mis-statements on these points, made by our medical chief of the
+quarantine, will be found from the pen of the surgeon of the
+23d&nbsp;regiment, in the <i>Edinburgh Medical and Surgical Journal</i>,
+No.&nbsp;106.<a name="FNanchor_3_3" id="FNanchor_3_3"></a><a href="#Footnote_3_3" class="fnanchor">[3]</a> Those
+who are acquainted with the progress of cholera in India, must be
+aware how a difference in the height of places, or of a few hundred
+yards (<i>indeed sometimes of a few yards</i>) distance, has been observed to
+make all the difference between great suffering and complete
+immunity:&mdash;the printed and manuscript reports from India furnish a vast
+number of instances of this kind; and, incredible as it may appear, they
+furnish instances where, <i>notwithstanding the freest intercourse</i>, there
+has been an abrupt line of demarcation observed, beyond which the
+disease did not prevail. A most remarkable instance of this occurred in
+the King's 14th&nbsp;regiment, in 1819, during a cholera epidemic, when the
+light company of the regiment escaped almost untouched, owing to no
+other apparent cause than that they occupied the extremity of a range of
+barrack in which all the other companies were stationed! so that there
+would truly seem to be more things "on earth than are dreamt of in the
+philosophy" of contagionists. This seems so remarkable an event, that
+the circumstance should be more particularly stated:&mdash;"The disease
+commenced in the eastern wing of the barracks, and proceeded in a
+westerly direction, but suddenly stopped at the 9th&nbsp;company; the light
+infantry escaping with one or two slight cases only."&mdash;(<i>Bengal
+Rep.</i>&nbsp;311.) It appears (<i>loc.&nbsp;cit.</i>) that 221 attacks took place in the other
+nine companies. We find (<i>Bombay Rep.</i> p.&nbsp;11.) that, from a little
+difference in situation, two cavalry regiments in a camp were altogether
+exempt from the disease, while all the other regiments were attacked.
+Previous to closing these remarks, which seemed to me called for on
+Dr.&nbsp;Walker's second Report, it is fair to state, that in certain Russian
+towns which he names, he found that the medical men and others were
+convinced that the cholera was brought to them "<i>somehow or other</i>," an
+impression quite common in like cases, as we learn from Humboldt, and
+less to be wondered at in Russia than most places which could be
+mentioned.
+
+<!-- Page 13 -->
+
+<span class="pagenum1"><a name="Page_13_Part_1" id="Page_13_Part_1">Pt_1<br />[Pg 13]</a></span>
+
+It will not be a misemployment of time to consider now the
+next document laid before the College, to enable them to form their
+opinion,&mdash;the Report of Dr.&nbsp;Albers, dated in March, and sent from
+St.&nbsp;Petersburg;&mdash;this gentleman, who was at the head of a commission sent by
+the Prussian government to Moscow, states, that at St.&nbsp;Petersburgh,
+<i>where the disease did not then reign</i>, the authorities and physicians
+were contagionists; but at Moscow, where it had committed such ravages,
+"almost all strenuously maintain that cholera is not contagious." The
+following extract seems to merit particular attention:&mdash;</p>
+
+<p>"When the cholera first reached Moscow, all the physicians of this city
+were persuaded of its contagious nature, but the experience gained in
+the course of the epidemic, has produced an entirely opposite
+conviction. They found that it was impossible for any length of time
+completely to isolate such a city as Moscow, containing 300,000
+inhabitants, and having a circumference of nearly seven miles (versts?),
+and perceived daily the frequent frustrations of the measures adopted.
+During the epidemic, it is certain that upwards of 40,000 inhabitants
+quitted Moscow, of whom a large number never performed quarantine; and
+notwithstanding this fact, <i>no case is on record of the cholera having
+been transferred from Moscow to other places</i>, and it is equally
+certain, that in <i>no situation</i> appointed for quarantine, <i>any case of
+cholera has occurred</i>. That the distemper is not contagious, has been
+yet more ascertained by the experience gathered in this city (Moscow).
+In many houses it happened, that one individual attacked by cholera was
+attended indiscriminately by all the relatives, and yet did the disease
+not spread to any of the inmates. It was finally found, that not only
+the nurses continued free of the distemper, but also that they
+promiscuously attended the sick chamber, and visited their friends,
+without in the least communicating the disease. There are even cases
+fully authenticated, that nurses, to quiet timid females labouring under
+cholera, have shared their beds during the nights, and that they,
+notwithstanding, have escaped uninjured in the same manner as physicians
+in hospitals have, without any bad consequences, made use of warm water
+used (a moment before) by cholera patients for bathing.</p>
+
+<div class="footnote">
+<p>
+<a name="Footnote_3_3" id="Footnote_3_3"></a>
+<a href="#FNanchor_3_3"><span class="label">[3]</span></a>
+
+The writer of this, who may be known by application at the
+printer's, when the present excitement is at an end, is not only
+prepared to show, <i>on a fitting occasion</i>, the correctness of the
+statements of Dr.&nbsp;Smith as well as those by Dr.&nbsp;O'Halloran just referred
+to&mdash;but also, that in the investigations, in 1828, connected with the
+question of yellow fever at Gibraltar, facts were perverted in the most
+scandalous manner, in order to prove the disease imported and
+contagious:&mdash;that individuals had been suborned:&mdash;that persons had been
+in the habit of putting leading questions to witnesses:&mdash;that those who
+gave false evidence have been, in a particular manner,
+remunerated:&mdash;that threats were held out:&mdash;and, in short, that
+occurrences of a nature to excite the indignation of mankind, took place
+on that occasion; and merited a punishment, not less severe, than a
+Naval Officer who should give, designedly, a false bearing and distance
+of rocks.
+</p>
+</div>
+
+<p>"These, and numerous other examples which, during the epidemic (we
+ought, perhaps, to call it endemic) became known to every inhabitant of
+Moscow, have confirmed the conviction of the non-infectious nature of
+the disease, a conviction in which their personal safety was so much
+concerned.</p>
+
+<p>"It is also highly worthy of observation, that all those who stand up
+for contagion, <i>have not witnessed</i> the cholera, which is, therefore,
+especially objected to their opinion by their opponents." He closes by
+the observation, "The result of my own daily experience, therefore,
+perfectly agrees with the above-stated principle, namely,
+notwithstanding all my inquiries, I <i>have met with no instance which
+could render it at all probable that the cholera is disseminated by
+inanimate objects</i>." The words in italics are as in the Parliamentary
+papers on Cholera, pp.&nbsp;8 and&nbsp;9. Here is something to help to guide
+people in forming opinions, and to help governments on quarantine
+questions; but owing to a portion of the "perverseness" which
+Dr.&nbsp;Macmichael in anger talks about, Dr.&nbsp;Albers still
+
+<!-- Page 14 -->
+
+<span class="pagenum1"><a name="Page_14_Part_1" id="Page_14_Part_1">Pt_1<br />[Pg 14]</a></span>
+
+<i>speculates</i> upon
+cholera being contagious, and the College, it would seem, take up his
+speculations and sink his very important facts. Sir William Creighton's
+Report gives what puports to be an extract from a memorial of his on
+cholera, given in to the St.&nbsp;Petersburg Medical Council, tending to
+establish the contagious character of the disease; and with this a
+report by the extraordinary committee appointed by the Emperor to
+inquire into the Moscow epidemic. The disease had not appeared at
+St.&nbsp;Petersburg when he drew up his Memorial, and it does not appear from
+any-thing which can be seen in the extracts he furnishes, that he had
+personal knowledge of any part of what he relates. He gives the reported
+progress of the disease on the Volga and the Don, but is extremely
+deficient exactly where one might have expected that, from the greater
+efficiency of police authorities, &amp;c., his information on contagion
+would have been more precise, viz., the introduction of the disease into
+Moscow, which could not, it would seem have been by material objects,
+for, according to the Committee, composed "of the most eminent public
+officers,"&mdash;"the opinion of those who do not admit the possibility of
+contagion by means of material objects, has for its support both the
+majority of voices, and the scrupulous observance of facts. The members
+of the Medical Council have been convinced by their own experience, as
+also by the reports of the physicians of the hospitals, that, after
+having been in frequent and even habitual communication with the sick,
+their own clothes have never communicated the disease to any one, even
+without employing means of purification. Convalescents have continued to
+wear clothes which they wore during the disease&mdash;even furs&mdash;without
+having them purified, and they have had no relapse. At the opening of
+bodies of persons who had died of cholera, to the minute inspection of
+which four or five hours a day for nearly a month were devoted, neither
+those who attended at their operations, nor any of the assisting
+physicians, nor any of the attendants, caught the infection, although,
+with the exception of the first day, scarcely any precautions were used.
+But what appears still more conclusive, a physician who had received
+several wounds in separating the flesh, continued his operations, having
+only touched the injured parts with caustic. A drunken invalid having
+also wounded himself, had an abscess, which doubtless showed the
+pernicious action of the dead flesh, but the cholera morbus did not
+attack him. In fine, foreign <i>Savans</i>, such as Moreau de&nbsp;Jonn&eacute;s and
+Gravier, who have recognized, in various relations, the contagious
+nature of the cholera morbus, do not admit its propagation by means of
+goods and merchandise." (<i>Parl. Papers on Chol.</i> p.&nbsp;13.) With the above
+documents the Council transmitted to the College a short description of
+the process of cleaning hemp in the Russian ports; and, lastly, the copy
+of a letter to the clerk of the Council from our ever-vigilant, though
+never-sufficiently-to-be-remunerated, head guardian of the quarantine
+department, who, taking the alarm, very properly recommends, as in duty
+bound, that a stir be forthwith made in all the pools, and creeks, and
+bays, &amp;c., of the united kingdom, in order that all those notoriously
+"susceptible" old offenders, skins, hemp, flax, rags, &amp;c., may be
+prevented from carrying into execution their felonious intention of
+covering the landing of a dire enemy. In truth, from the grave as well
+as from the sublime, there often seems to be "but a step;" and in
+reading
+
+<!-- Page 15 -->
+
+<span class="pagenum1"><a name="Page_15_Part_1" id="Page_15_Part_1">Pt_1<br />[Pg 15]</a></span>
+
+over this gentleman's suggestions about <i>susceptibles</i> and
+<i>non-susceptibles</i>, one may fancy himself, instead of being in the land
+of thinking people, to be in the land of Egypt, where, as we are
+informed (Madden,&nbsp;1825), the sage matrons discuss the point, whether a
+cat be not a better vehicle for contagion than a dog:&mdash;a horse may be
+trusted, they say, but as to an ass, he is the most incorrigible of
+contagion smugglers;&mdash;of fresh bread we never need be afraid, but the
+susceptibility of butcher's meat is quite an established thing:&mdash;or we
+might fancy ourselves transported to regions of romance, where it is
+matter of profound deliberation, whether an egg shall be broken at the
+large or the small end. Such things are too bad for the nineteenth
+century; and in England, too, with her enlightened parliament! But until
+these questions are better examined, our guardian must bestir himself
+about articles susceptible of cholera contagion, while he enjoys his
+good quarantine pay, his good half pay from another department as I
+believe, and withall, if we are not misinformed, a smart pension from
+the Gibraltar revenue, for what granted nobody can tell.</p>
+
+<p>The documents above referred to, would appear then to be the whole on
+which the College admit that they formed their opinions, and people may
+now judge whether the verdict be according to the evidence, or whether
+it be not something in the <i>lucus a non lucendo</i> mode of drawing
+conclusions:&mdash;most persons will probably think that, on such evidence,
+there might at least have been a qualified opinion. It appears, however,
+that having come to <i>a decision</i> on the 9th of June, that the disease
+was communicable from person to person, they in three days after,
+approved of persons being sent to Russia to find out whether they had
+decided rightly or not. Are we now to expect that, should the occasion
+need, they will heroically make war against their own declared opinion?
+For my part I expect from them all that should be expected from men; and
+the liberal part of the world will not fail to see from this, that I do
+not despair of even Dr.&nbsp;Macmichael, being still open to conviction. Let
+it not be for a moment understood that, in any-thing which has been
+said, or which may remain to be said respecting this gentleman, or in
+any-thing which may be hereafter said respecting Dr.&nbsp;Bisset Hawkins's
+work, I mean to insinuate that contagion in cholera is not with them a
+matter of conscience; but I certainly do mean to say that their zeal has
+manifestly warped their judgment; and not only this, but that it has
+prevented them from laying statements before the public on the cholera
+questions with all the impartiality we might have expected from
+gentlemen of their character in the profession.</p>
+
+<p>In Dr.&nbsp;Macmichael's pamphlet, consisting of thirty-two pages, and
+professing to be a consideration of the question, "Is cholera
+contagious?" we scarcely find the disease mentioned till we come to page&nbsp;25;
+the pages up to this being occupied chiefly by a recapitulation of
+opinions formerly given "on the progress of opinion upon the subject of
+contagion;"&mdash;on the opinions of old writers as to the contagion of
+plague, small-pox, measles, &amp;c.:&mdash;he would infer that whereas small-pox
+and certain other diseases have, by more accurate observations made in
+comparatively modern times, been taken from the place they once held,
+and
+
+<!-- Page 16 -->
+
+<span class="pagenum1"><a name="Page_16_Part_1" id="Page_16_Part_1">Pt_1<br />[Pg 16]</a></span>
+
+ranged among diseases decidedly contagious, so ought cholera also to
+be now pronounced contagious! As an inducement to us to adopt this as
+good logic, he assures us that the list of diseases deemed contagious by
+wise men is on the increase&mdash;that non-contagionists are <i>perverse</i>
+people, <i>blunderers</i>, and so forth! As to his epithets, it shall only be
+said that among the disbelievers of contagion in cholera, and certain
+other diseases probably reputed contagious by Dr.&nbsp;Macmichael, are to be
+found hundreds possessing as much candour, as cultivated minds, and as
+much practical knowledge of their profession, as any contagionists,
+whether they be Fellows of a College or not; but as to the statement of
+Dr.&nbsp;Macmichael, is it true that we have been adding to the list of
+contagious diseases? Not within the last fifty years certainly. Even the
+influenza of 1803 was, if I mistake not greatly, termed, very generally,
+"infectious catarrh," but what professional man would term the influenza
+of 1831 so? Are there not yet remaining traces of the generally exploded
+doctrine of even contagion in ague, at one time attempted to be
+maintained? M.&nbsp;Adouard, of Paris, still indeed holds out. Do we not know
+that Portal, at one period of his life at least, would not, for fear of
+"infection," open the body of a person who had died of phthisis? Where
+is the medical man now to be found who would set up such a plea? or
+where, except in countries doomed to eternal barbarism, are patients
+labouring under consumption avoided now, as they were in several parts
+of the world at one time, just as if they laboured under plague, and all
+for the simpleton's reason that the disease <i>often runs through
+families</i>? What disinterested man will, on due examination of all that
+has been written on yellow fever, stand up now in support of its being a
+contagious disease, of which some thirty or forty years ago there was so
+general a belief? On croup, and a few more diseases, many still think it
+<i>wise to doubt</i>. Is dysentery, known to make such ravages sometimes,
+especially in armies, considered now, as at one time, to be contagious?
+If Dr.&nbsp;Macmichael's pamphlet was intended altogether for readers not of
+the profession, <i>which seems very probable</i>, his purposes will perhaps
+be answered, at least for a time, but I do not see how it can make an
+impression on medical men. Why not have been a little more candid when
+quoting Sydenham on small-pox, &amp;c. and have quoted what that author says
+of the disease which he (Dr.&nbsp;M.) professes to write about,&mdash;the cholera?
+The public would have means of judging how far the disease which was
+prevalent in 1669, resembled the "cholera spasmodica," &amp;c., of late
+years. Many insist upon an identity (Orton among others), and yet
+Sydenham saw no reason for suspecting a communicable property. It might
+have been more to the point had Dr.&nbsp;Macmichael, instead of quoting old
+authorities on small-pox, measles, &amp;c. quoted some authorities to
+disprove that Orton and others are wrong when they state it as their
+belief that some of those old epidemics in Europe, about which so much
+obscurity hangs, were nothing more or less than the cholera spasmodica.
+Mead's short sketch of the "sweating sickness" does not seem very
+inapplicable:&mdash;"Excessive fainting and inquietude inward burnings,
+headach, sweating, vomiting, and
+
+<!-- Page 17 -->
+
+<span class="pagenum1"><a name="Page_17_Part_1" id="Page_17_Part_1">Pt_1<br />[Pg 17]</a></span>
+
+diarrh&oelig;a."<a name="FNanchor_4_4" id="FNanchor_4_4"></a><a href="#Footnote_4_4" class="fnanchor">[4]</a> In
+the letter to the
+President of the College we see no small anxiety to prove that the
+malignant cholera is of modern origin also in India, for the proofs from
+Hindoo authorities, as given in the volume of <i>Madras Reports</i>, are
+slighted. These Reports, as well as those of the other presidencies, are
+exceedingly scarce, but whoever can obtain access to them will find in
+the translations at pp.&nbsp;253 and&nbsp;255 (not at page&nbsp;3, as quoted by
+Dr.&nbsp;Macmichael), enough probably to satisfy him that cholera is the disease
+alluded to there. But I think that we have at page&nbsp;31 of
+Dr.&nbsp;Macmichael's letter, no small proof of a peculiarity of opinion, when we
+find that he there states that the evidence in the <i>Madras Reports</i> of
+the existence of epidemics of malignant cholera in India, on several
+occasions previous to 1817, rests on imperfect records, and that the
+description of the disease is too vague to prove the identity with the
+modern spasmodic cholera; for in this opinion he seems, as far as I have
+been able to discover, to stand alone among writers on cholera;&mdash;indeed
+it seems established, <i>on the fullest authority</i>, that cholera, in the
+same form in which it has appeared epidemically of late years, has
+committed ravages in India on more than one occasion formerly:&mdash;this is
+fully admitted by Mr.&nbsp;Orton, an East India practitioner, who is one of
+the few contagionists.</p>
+
+<div class="footnote">
+<p>
+<a name="Footnote_4_4" id="Footnote_4_4"></a>
+<a href="#FNanchor_4_4"><span class="label">[4]</span></a>
+
+If the progress of the sweating sickness was similar to
+that of cholera, the advice of the King to Wolsey was sound; for instead
+of recommending him to rely on any-thing like cordon systems, or to shut
+himself up surrounded by his guards, he tells him (see <i>Ellis's</i>
+letters) to "fly to <i>clene</i> air incontinently," on the approach of the
+disease. I use the words <i>approach of the disease</i> occasionally, as it
+is a manner of expression in general use, but it is far from being
+strictly applicable when I speak of cholera; <i>the cause</i> of the disease
+it is which I admit travels or springs up at points, and not the disease
+itself in the persons of individuals, or its germs in inanimate
+substances.
+</p>
+</div>
+
+<p>For one piece of tact the author of the letter deserves great credit;
+for whereas his College collectively, when forming their opinion on the
+questions proposed to them by the Council, seemed to throw all India
+records overboard,&mdash;he, in his individual capacity, as author of the
+letter, sends after them all the Russian reports in support of
+contagion; for anxious as he is to prove his point, not a word do we get
+of the <i>on&nbsp;dits</i> so current in Russia about persons being attacked with
+the disease from smelling to hemp arrived from such or such a place;
+from having looked at a boatman who had been up the Volga or down the
+Volga, &amp;c.&nbsp;&amp;c.: all which statements, when duty inquired into, prove to
+be unsupported by any thing in the shape of respectable authority, and
+this is now, in all probability, pretty generally known to be the case,
+as Dr.&nbsp;Macmichael must be quite aware of.</p>
+
+<p>To the medical gentlemen of India who have been concerned in the
+official reports, which do them, <i>en&nbsp;masse</i>, so much credit,
+Dr.&nbsp;Macmichael is little disposed to be complimentary; and, indeed, he seems
+to insinuate that those were rather stupid fellows who did not come to
+what he is pleased to consider "a just and right conclusion," as to
+contagion; he thinks, however, that he has got a few of "the most
+candid" to join in his belief. We shall see whether he had better
+reason to
+
+<!-- Page 18 -->
+
+<span class="pagenum1"><a name="Page_18_Part_1" id="Page_18_Part_1">Pt_1<br />[Pg 18]</a></span>
+
+look towards the Ganges and Beema for a confirmation of his
+doctrines, than he had toward the Don or the Volga. How does the case
+stand with respect to one of the gentlemen whom he quotes,&mdash;Mr.&nbsp;Jukes,
+of the Bombay Establishment? This gentleman, like all who speak of
+cholera, mentions circumstances as to the progress of the disease which
+he cannot comprehend, and Dr.&nbsp;Macmichael shows us what those
+circumstances are; but Dr.&nbsp;Macmichael does not exhibit to us <i>what does</i>
+come perfectly within Mr.&nbsp;Jukes's comprehension, but which is not quite
+so suitable to the doctor's purpose. This omission I shall take the
+liberty to supply from an official letter from Mr.&nbsp;Jukes in the Bombay
+Reports:&mdash;"I have had no reason to think it has been contagious here,
+neither myself nor any of my assistants, who have been constantly
+amongst the sick, nor any of the hospital attendants, have had the
+disease. It has not gone through families when one has become affected.
+It is very unlike contagion too, in many particulars." &amp;c.&mdash;(<i>Bombay
+Reports</i>, page&nbsp;172.)&mdash;Ought we not to be a little surprised that so
+great an admirer of candour, as Dr.&nbsp;Macmichael seems to be, should,
+while so anxious to give every information to his readers, calculated to
+throw light upon the subject of cholera, omits the above important
+paragraph, which we find, by the way <i>immediately precedes</i> the one upon
+opinions and difficulties which he quotes from the same gentleman? But
+let us examine what the amount of force is, which can be obtained from
+that part of Mr.&nbsp;Jukes's paper, which it does please Dr.&nbsp;Macmichael to
+quote:&mdash;"If it be something general in the atmosphere, why has it not
+hitherto made its appearance in some two distinct parts of the province
+at the same time? Nothing of this kind has, I believe, been observed. It
+still seems creeping from village to village, rages for a few days, and
+then begins to decline." I find myself unable, at this moment, to
+ascertain the extent of Mr.&nbsp;Jukes's means of obtaining information as to
+what was passing in other parts of his province; but I think the
+following quotation, on which I am just now able to lay my hand, will
+not only satisfactorily meet what is here stated, but must, in the
+public opinion, be treasured, as it serves at once to displace most
+erroneous ideas long prevalent, and which, I believe, greatly influenced
+men's decisions as to contagion:&mdash;"It may, then, first be remarked, that
+the rise and progress of the disorder were attended by such
+circumstances as showed it to be entirely independent of contagion for
+its propagation. Thus we have seen that it arose at nearly one and the
+same time in many different places, and that in the same month, nay, in
+the same week, it was raging in the unconnected and far-distant
+districts of Behar and Dacca." (Bengal Reports, p.&nbsp;125.) Again (p.&nbsp;9),
+that in Bengal "it at once raged simultaneously in various and remote
+quarters, without displaying a predilection for any one tract or
+district more than for another; or any thing like regularity of
+succesion in the chain of its operations." In support of what is stated
+in these extracts, the fullest details are given as to dates and places;
+and at page&nbsp;9 of those Reports, a curious fact is given, "That the large
+and populous city of Moorshedabad, from extent and local position
+apparently very favourably circumstanced for the attacks
+
+<!-- Page 19 -->
+
+<span class="pagenum1"><a name="Page_19_Part_1" id="Page_19_Part_1">Pt_1<br />[Pg 19]</a></span>
+
+of the epidemic, should have escaped with comparatively little loss, whilst all
+around was so severely scourged." This seems to have been pretty similar
+to what is now taking place with respect to the city of Thorn, which
+remains free from cholera, though the communication is open with divers
+infected places in every direction. Should Thorn still be attacked by
+the disease (as it sooner or later will, in all human probability), the
+contagionists <i>par m&eacute;tier</i> will try to establish a case of hemp or
+hare-skin importation, I have no doubt. I wonder much that
+Dr.&nbsp;Macmichael or Dr.&nbsp;B. Hawkins, when favouring us with eastern quotations,
+did not give the public the opinion of Dr.&nbsp;Davy, who is so well known in
+Europe, and who saw the cholera in Ceylon; his conjecture (quite
+accessible, I believe, to every medical man in London) may perhaps be as
+valuable as that of any other person. The following is a copy of
+it:&mdash;"The cause of the disease is not any sensible change in the
+atmosphere; yet, considering the progress of the disease, its epidemic
+nature, the immense extent of country it has spread over, we can hardly
+refuse to acknowledge that its cause, though imperceptible, though yet
+unknown, does exist in the atmosphere. It may be extricated from the
+bowels of the earth, as miasmata were formerly supposed to be; it may be
+generated in the air, it may have the properties of radiant matter, and,
+like heat and light, it may be capable of passing through space
+unimpeded by currents; like electricity, it may be capable of moving
+from place to place in an imperceptible moment of time." Dr.&nbsp;Davy is an
+army physician, and the report of which this is an extract, may be seen
+at the Army Medical Office, a place which, of late years, has become a
+magazine of medical information of the most valuable kind in Europe.
+There is this difference between army and other information on cholera,
+that (whether in the King's or E.&nbsp;I.&nbsp;Company's service) the statements
+given by the medical gentlemen have their accuracy more or less
+guaranteed by a certain system of military control over the documents
+they draw up: thus, in the circumstance already noticed as having
+occurred in the 14th&nbsp;regiment, we have every reason to rely upon its
+accuracy, which we could not have in a similar statement among the
+population of any country; and we have, I think, no reason to believe
+that in pronouncing the cholera of Ceylon not contagious, Dr.&nbsp;Davy, as
+well as two other gentlemen of high character and experience
+(Drs.&nbsp;Farrel and Marshall), have not gone upon such data as may bear scrutiny.</p>
+
+<hr class="major" />
+
+<h2><a name="LETTER_III_Part_1" id="LETTER_III_Part_1"></a>LETTER III.</h2>
+
+<p>Having given, in my last letter, Dr.&nbsp;Davy's views as to the cause of
+cholera, I may so far remark just now regarding them, that they are not
+new, or peculiar to him; and that it may be well, before Dr.&nbsp;Macmichael
+or others pronounce them vague, that they should inquire whether some of
+those causes have not been assigned for the production of certain
+epidemics,
+
+<!-- Page 20 -->
+
+<span class="pagenum1"><a name="Page_20_Part_1" id="Page_20_Part_1">Pt_1<br />[Pg 20]</a></span>
+
+by one of the soundest heads of Dr.&nbsp;Macmichael's
+college&mdash;Dr.&nbsp;Prout, who seems, if we have not greatly mistaken him, to have been led
+to the opinion by some experiments of Herschell, detailed in the
+Philosophical Transactions of the year 1824. They should recollect that
+other competent persons devoted to researches on such subjects (Sir&nbsp;R.
+Phillips among the number) admit <i>specific local atmospheres</i> (not at
+all <i>malaria</i> in the usual sense of the term), produced by irregular
+streams of specific atoms from the interior of the earth, and "arising
+from the action and re-action of so heterogeneous a mass." For my part I
+feel no greater difficulty in understanding how our bodies, "fearfully
+and wonderfully made" as we are, should be influenced by those actions,
+re-actions, and combinations, to which Sir Richard refers, and of "whose
+origin and progress the life and observation of man can have no
+cognizance," than how they are influenced by other invisible agents, the
+existence of which I am compelled to admit.&mdash;If the writer of the
+article on cholera in the <i>Westminster Review</i>, for October,&nbsp;1831, do
+not find all his objections met by these observations, I must only refer
+him to the <i>quid divinum</i> of Hippocrates:&mdash;but I must protest against
+logic such has been employed by certain members of our Board of Health,
+who lately, on the examination of gentlemen of the profession who had
+served in India, and who had declared the disease not to be
+communicable, came to the conclusion that it must, nevertheless, be so,
+as those gentlemen could not show <i>what it was</i> owing to.</p>
+
+<p>Most extraordinary certainly it does appear, that while Dr.&nbsp;Macmichael
+goes to the trouble of giving us (p.&nbsp;27) the views of <i>a captain</i> (!) as
+to the progress of cholera at a certain place in India, he should have
+refrained altogether from referring, on the point of contagion or
+non-contagion, to the report of such a person as Dr.&nbsp;Davy, or to the
+reports of this gentleman's colleagues at Ceylon, Drs.&nbsp;Farrell and
+Marshall. Had Dr.&nbsp;Macmichael added a little to his extract from
+Capt.&nbsp;Sykes, by informing us of what that gentleman states as to the great
+mortality ("350 in one day") in the town of Punderpoor, "when the
+disease first commenced its ravages there," people would have means of
+judging how unlike this was to a contagious disease creeping from person
+to person in its commencement.</p>
+
+<p>It is painful to be obliged to comment on the manner in which Dr.&nbsp;Bisset
+Hawkins has handled the questions relative to the Ceylon epidemic, which
+seems far from being impartial; for, while he quotes (p.&nbsp;172) Dr.&nbsp;Davy,
+"a medical officer well known in the scientific world," as stating that
+the cause of the disease is not in any <i>sensible</i> changes in the state
+of the atmosphere, he breaks off suddenly at the word <i>atmosphere</i>,
+proceeds to talk of the changes in the muscles and blood of persons who
+die of the disease, and passing over the part quoted from Dr.&nbsp;Davy, near
+the close of my last letter, Dr.&nbsp;Hawkins leaves his readers to draw a
+very natural conclusion&mdash;that, as Dr.&nbsp;Davy admitted that there were no
+prevalent <i>sensible</i> states of the atmosphere to which the cholera could
+be attributed, <i>he, therefore</i>, believed it to have been propagated by
+contagion, an inference which we now see must be quite wide of the mark.
+Dr.&nbsp;Hawkins had, it appears, like many other medical gentlemen, access
+to the
+
+<!-- Page 21 -->
+
+<span class="pagenum1"><a name="Page_21_Part_1" id="Page_21_Part_1">Pt_1<br />[Pg 21]</a></span>
+
+reports from Ceylon, &amp;c., in the office of the chief of the army
+medical department in London, and it is to be regretted I think that,
+with respect to one of the Ceylon reports, he only tells us (p.&nbsp;174)
+that "Mr.&nbsp;Staff-Surgeon Marshall reports from Candy, that of fifty cases
+which had occurred, forty died." Why more had not been quoted from a
+gentleman who had such ample means of witnessing the disease in its very
+worst form, I must leave to others to say; but, referring again to the
+highly interesting letter from Mr.&nbsp;Marshall on cholera, which appeared
+in the <i>Glasgow Herald</i>, of the 5th of August last, and in which, from
+many important observations which every body interested in cholera
+should read and study, the following remarks will be found:&mdash;"In no one
+instance did it seem to prevail among people residing in the same house
+or barracks, so as to excite a suspicion that the contact of the sick
+with the healthy contributed to its propagation." "The Indian Cholera,
+as it is sometimes called, appears not to be essentially different from
+cholera as it occurs in this and all other countries." "I consider it,
+therefore, impossible for a medical practitioner to speak decisively
+from having seen one, or even a few cases of cholera in this country,
+and to say whether they are precursors of '<i>the epidemic</i> cholera' or
+not. That the disease is ever propagated by means of personal contact,
+or by the clothes of the sick, has not, as far as I know, been
+satisfactorily proved. The quality of contagion was never attributed to
+the disease in Ceylon, and I believe no-where did it occur in greater
+severity. I am aware that an attempt has been made to distinguish the
+ordinary cholera of this country from the 'epidemic cholera,' by means
+of the colour or quality of the discharges from the bowels. In the
+former it is said the discharge is chiefly bile, while in the latter it
+is said to bear no traces of bile, but to be colourless and watery. How
+far is this alleged diagnosis well founded? I am disposed to believe
+that, in all severe cases of cholera, whether it be the cholera of this
+country, or the epidemic cholera, the secretion of bile is either
+suppressed, or the fluid is retained in the gall-bladder." Mr.&nbsp;Marshall,
+it may be observed, is the gentleman who was selected by the late
+Secretary at War, in consequence of his known intelligence, to remodel
+the regulations relative to military pensioners; and I understand that,
+in consequence of the manner in which he executed that very important
+duty, he has since been promoted. After what appears from the above
+quotations, how perfectly unwarrantable must the assertion of Dr.&nbsp;Bisset
+Hawkins seem, that "from the Coromandel coast it seems to have been
+transported by sea to Ceylon!"</p>
+
+<p>We shall, I think, be able to see that the assumption of Drs.&nbsp;Macmichael
+and Hawkins, as to the importation of the disease into the Mauritius
+from Ceylon, is equally groundless with that of its alledged importation
+into the latter island; and here we have to notice the same want of
+candour on the part of those gentlemen, in not having furnished that
+public, which they professed to enlighten on the subject of cholera,
+with those proofs within their reach best calculated to display the
+truth; be it a part of my duty to supply the omissions of these
+gentlemen in this respect. The following is a copy of a letter
+accompanying the medical commission
+
+<!-- Page 22 -->
+
+<span class="pagenum1"><a name="Page_22_Part_1" id="Page_22_Part_1">Pt_1<br />[Pg 22]</a></span>
+
+report at that island forwarded to
+General Darling, the then commanding officer, by the senior medical
+gentleman there.</p>
+
+<div class="signr">
+"Port Louis, Nov.&nbsp;23,&nbsp;1819.
+</div>
+
+<p>"I have the honour of transmitting the reports of the French and English
+medical gentlemen on the prevalent disease; both classes of the
+profession seem to be unanimous in not supposing it contagious, or of
+foreign introduction. From the disease pervading classes <i>who have
+nothing in common but the air they breathe</i>, it can be believed that the
+cause may exist in the atmosphere. A similar disease prevailed in this
+island in 1775, after a long dry season."</p>
+
+<div class="center">
+(Signed)
+</div>
+
+<div class="signr">
+<span class="smcap signrind">W.&nbsp;A. Burke,</span>
+<br />
+Inspector of Hospitals.
+</div>
+
+<p>In the reports referred to in the above letter, there is the most ample
+evidence of the true cholera having appeared at different points in the
+colony <i>before the</i> arrival of the Topaze frigate, the ship <i>accused</i> by
+contagionists <i>par m&eacute;tier</i>, of having introduced the disease; so that,
+contrary to what Dr.&nbsp;Macmichael supposes, those who disbelieve the
+communicability of cholera, have no necessity whatever in this case for
+pleading a coinsidency between the breaking out of the disease, and the
+arrival of the frigate; indeed, his friend Dr.&nbsp;Hawkins seems to be aware
+of this, when he is obliged to have recourse to such an argument as that
+"it is, at all events, clear that the disease had not been <i>epidemic</i> at
+the Mauritius before the arrival from Ceylon;" so that the beginning of
+an epidemic is to be excluded from forming a part or parcel of the
+epidemic! Why is it that in medicine alone such modes of reasoning are
+ever ventured upon!</p>
+
+<p>We know, from the history of cholera in India, that not only ships lying
+in certain harbours have had the disease appear on board, but even
+vessels sailing down one coast have suffered from it, while sailing up
+another has freed them from it, without the nonsense of going into
+harbour to "expurgate." Now, with respect to the <i>Topaze</i>, it appears
+that while lying in harbour in Ceylon, the disease broke out on board
+her; that after she got into "<i>clene air</i>" at sea, the disease
+disappeared, seventeen cases only having occurred from the time she left
+the island, and she arrived at the Mauritius, as Dr.&nbsp;Hawkins admits,
+without any appearance whatever of the cholera on board. On the day
+after her arrival, she sent several cases ("chronic dysentry, hepatitis,
+and general debility") to hospital, but not one of cholera; neither did
+any case occur on board during her stay there, at anchor a mile and a
+half from shore, and constantly communicating with
+shore,<a name="FNanchor_5_5" id="FNanchor_5_5"></a><a href="#Footnote_5_5" class="fnanchor">[5]</a> while
+a considerable number of deaths took place from cholera <i>in the merchant
+vessels anchored near shore</i>.</p>
+
+<div class="footnote">
+<p>
+<a name="Footnote_5_5" id="Footnote_5_5"></a>
+<a href="#FNanchor_5_5"><span class="label">[5]</span></a>
+
+Somebody is said to have seen a man on board with vomiting
+and spasms, on the day before she moved to this anchorage, but the
+surgeon of the ship has not stated this.
+</p>
+</div>
+
+<p>
+<!-- Page 23 -->
+
+<span class="pagenum1"><a name="Page_23_Part_1" id="Page_23_Part_1">Pt_1<br />[Pg 23]</a></span>
+
+As to the introduction of cholera from the Mauritius into Bourbon, where
+it appeared but very partially, Dr.&nbsp;Macmichael very properly does not
+say one word. There was abundance of "precaution" work, it is said, and
+those who choose, are at liberty to give credit to the story of its
+having been smuggled on shore by some negro slaves landed from a
+Mauritius vessel. As to the <i>precautions</i> to which the writer in <i>The
+Westminster Review</i> attributes the non-extension of the disease in this
+island, hundreds of instances are recorded, in addition to those which
+we have already quoted, of the disease stopping short, without cordons
+or precautions of any kind&mdash;one remarkable instance is mentioned by
+Dr.&nbsp;Annesley, where, <i>without seclusion</i>, the disease did not reach the
+ground occupied by two cavalry regiments, although it made ravages in
+all the other regiments in the same camp.</p>
+
+<p>We have, perhaps, a right to demand from those gentlemen who display
+such peculiar tact in the discovery of ships by which the cholera has,
+at divers times, been imported into continents and islands, the names of
+those ships which brought to this country, in the course of the present
+year, the "<i>contagion</i>" which has produced, at so many different points,
+cases of severe cholera, causing death in some instances, and in which
+the identity with the "Indian cholera," the "Russian cholera," &amp;c., has
+been so <i>perfect</i>, that all the "perverse ingenuity" of man cannot point
+out a difference. If it cannot be shown that in this, we
+non-contagionists in cholera are in error, people will surely see reason
+for abandoning the cause of cordons, &amp;c., in this disease,&mdash;a cause
+which, in truth, now rests mainly for support upon a sort of
+conventional understanding, unconnected altogether, it would appear,
+with the facts of the case, and entered into, we are bound to suppose,
+before the full extent of the mischief likely to arise from it had been
+taken into consideration. Admitting for a moment that a case of cholera
+possessing contagious properties could be imported into this country
+this year, will anybody say that a "constitution of the atmosphere"
+favourable to its communicability to healthy individuals, has not
+existed <i>in a very high degree</i>:&mdash;can a spot be named in which cholera,
+generally of a mild grade, has not prevailed? And if contagionists
+cannot point out a difference between some of the severe cases to which
+public attention has been drawn, and the most marked cases of the Indian
+or Russian cholera, I think that now there should be an end to all
+argument in support of their cause. Without at all going to the extent
+which might be warranted, I would beg to be informed of the names of the
+ships by which the contagion was brought, which caused the illness of
+the following individuals; or if they be allowed, as I presume must be
+the case, not to have been infected at all in this way, all that has
+been said regarding the identity of the foreign and severe form of the
+home disease, must be shown to be without foundation:&mdash;the detailed case
+of Patrick Geary, which occurred in the Westminster Hospital,&mdash;the fatal
+case of Mr.&nbsp;Wright, surgeon, 29,&nbsp;Berwick-street,&mdash;the cases, some of
+them fatal, which occurred at Port Glasgow, and regarding which, a
+special inquiry was instituted,&mdash;a case in Guy's Hospital, which caused
+some anxiety about
+
+<!-- Page 24 -->
+
+<span class="pagenum1"><a name="Page_24_Part_1" id="Page_24_Part_1">Pt_1<br />[Pg 24]</a></span>
+
+the middle of July last,&mdash;a case reported in a
+medical periodical in August last, as having occurred in Ireland,&mdash;the
+fatal case, as reported in my first letter, of Martin
+M'Neal,<a name="FNanchor_6_6" id="FNanchor_6_6"></a><a href="#Footnote_6_6" class="fnanchor">[6]</a>&mdash;a
+second case reported in a medical periodical in August,&mdash;a fatal case on
+the 12th of August last at Sunderland, reported upon to the Home
+Secretary by the mayor of that town,&mdash;three cases reported in No.&nbsp;421 of
+<span class="smcap">The Lancet</span>,&mdash;a very remarkable case duly reported upon in September,
+from the Military Hospital at Stoke, near Davenport, and a case with
+thorough "congee stools," spasms, &amp;c. (the details of which I may
+hereafter forward), which occurred at Winchester on the 22d of September,
+in the 19th&nbsp;Foot, in a man of regular habits, and of <i>the
+nature</i> of which case the medical gentleman in charge had no doubt.</p>
+
+<div class="footnote">
+<p>
+<a name="Footnote_6_6" id="Footnote_6_6"></a>
+<a href="#FNanchor_6_6"><span class="label">[6]</span></a>
+
+The same Army Medical gentleman, who had been sent to Port
+Glasgow, was sent to Hull to report upon this case:&mdash;he arrived there
+too late, but having seen the details of the case, he admitted that he
+saw no reason to declare them different from those which occurred in the
+Indian cholera.
+</p>
+</div>
+
+<p>I quite agree with those who are of opinion, that in this and most other
+countries, cases may be every year met with exhibiting symptoms similar
+to those which have presented themselves in any one of the above.
+Instead of amusing us, when next writing upon cholera, with a quotation
+about small-pox from Rhazes, bearing nonsense upon the face of it, some
+of those who maintain the contagious property of Indian or any other
+cholera, may probably take the trouble to give the information on the
+above cases, so greatly required for the purpose of enlightening the
+public.</p>
+
+<p>I must now beg to return to an examination of one or two more of the
+<i>very select</i> quotations made by Dr.&nbsp;Macmichael, with the view, as he is
+pleased to tell us, of placing the statements on both sides in
+juxtaposition. He is well pleased to give us from Dr.&nbsp;Taylor,
+assistant-surgeon,&mdash;what indeed never amounted to more than report, and
+of the truth or falsehood of which this gentleman does not pretend to
+say he had any knowlege himself,&mdash;that a traveller passing from the
+Deacan to Bombay, found the disease prevailing at Panwell, through which
+he passed, and so took it on with him to Bombay; but whether the man had
+the disease, or whether he took its germs with him in some very
+susceptible article of dress, is not stated by Dr.&nbsp;Taylor; however, he
+states (what we are only surprised does not happen oftener in those
+cases, when we consider similarity of constitution&mdash;of habits&mdash;of site
+or aspect of their dwellings, &amp;c.) that several members of a family, and
+neighbours "were attacked within a very short period of each other;" but
+when Dr.&nbsp;Taylor goes on to say, "In bringing forward these facts,
+however, it may be proper at the same time to state, that of the
+forty-four assistants employed under me, only three were seized with the
+complaint;" he gets out of favour at once, and his observation is called
+"unlucky," being but a <i>negative</i> proof, and Dr.&nbsp;Macmichael adds, what
+everybody must agree with him in, that positive instances of contagion
+must outweigh all negative proofs:&mdash;to be sure:&mdash;but Dr.&nbsp;Macmichael's
+saying this, does not show that positive proofs exist. Give us but
+positive proofs, give
+
+<!-- Page 25 -->
+
+<span class="pagenum1"><a name="Page_25_Part_1" id="Page_25_Part_1">Pt_1<br />[Pg 25]</a></span>
+
+even but a <i>few</i>, which surely may be done, if
+the disease be really communicable, and where contagion has been so
+ardently sought after by all sorts of <i>attach&eacute;s</i> and <i>employ&eacute;s</i> of the
+cordon and quarantine systems in the different countries on the
+Continent. We could produce no mean authority to show, that <i>a long
+succession of negative proofs</i> must be received as amounting to a moral
+certainty; and what greater proof can we have of non-contagion in any
+disease, than we have in the fact regarding epidemic cholera, as well as
+yellow fever, that attendants on the sick are not more liable than
+others to be attacked? Regard should, of course, always be paid, in
+taking this point into consideration, to what has been already noticed
+in my second letter, or the inferences must be most erroneous.
+Dr.&nbsp;Macmichael quotes the statement of Dr.&nbsp;Burrell, 65th&nbsp;regiment (and takes
+care to put the quotation in italics too), that at Seroor, in 1818,
+"almost every attendant in hospital had had the disease. There are about
+thirty attendants in hospitals." Now, along with hundreds of other
+instances, what does Dr.&nbsp;French, of the 49th&nbsp;regiment, say, in his
+Report of&nbsp;1829? That no medical man, servant, or individual of any kind,
+in attendance on the sick, was taken ill at Berhampore, when the cholera
+prevailed there that year, and refers, to his Report for 1825, in which
+he remarked the same thing in the hospital of the 67th&nbsp;regiment at
+Poonah; contrary, as he observes, to what occurred some years before in
+the 65th&nbsp;regiment at Seroor, about forty miles distant. In the two
+instances quoted by Dr.&nbsp;French, and in that by Dr.&nbsp;Burrell, all those
+about the sick stood in the same relation towards them, and all the
+difference will be found probably to have been, that the hospital of
+the 65th <i>was within the limit of the deteriorated atmosphere, where the
+cause existed equally (as in the case of ague and yellow fever) whether
+persons were present or not</i>.</p>
+
+<p>In Egypt there is not, it is true, a "cruel and inhuman desertion" of
+the unfortunate plague patients; for, among other reasons, being
+predestinarians, they think it makes no sort of difference whether they
+attend on the sick or not. Those who act upon the principle of cholera
+being a highly contagious disease, may perhaps consider it necessary to
+recommend, among their <i>precautions</i>, that the medical men and
+attendants should be enveloped in those hideous dresses used in some
+countries by those who approach plague
+patients<a name="FNanchor_7_7" id="FNanchor_7_7"></a><a href="#Footnote_7_7" class="fnanchor">[7]</a>&mdash;fancy,
+in the case of a sick female, or even of a man of pretty good nerves, the effect of
+but half the precautions one hears of, as proper to be observed. It is
+quite a mistake to suppose that the sick have not been sometimes
+abandoned during the prevalence of epidemics; and that too in cases
+where medical men had very erroneously voted the disease
+contagious:&mdash;among other horrid things arising
+
+<!-- Page 26 -->
+
+<span class="pagenum1"><a name="Page_26_Part_1" id="Page_26_Part_1">Pt_1<br />[Pg 26]</a></span>
+
+out of mistaken views,
+who that has ever read it, can forget the account given by Dr.&nbsp;Halloran,
+of the wretched yellow-fever patient in Spain, who, with a rope tied
+round him, was dragged along for some distance by a guard, when he was
+put into a shed, where he was suffered to die, without even water to
+quench his thirst? I admit that, even with the views of
+non-contagionists, difficulties obviously present themselves in regard
+to the safety of those about the sick, when the latter are in such a
+state as will not admit of their removal to a more auspicious spot from
+that in which there is reason to believe they inhaled the noxious
+atmosphere. From what has been observed in India and other places,
+however, there is often sufficient warning in a feeling of <i>malaise</i>,
+&amp;c., and the distance to favoured spots, where people may be observed
+not to be attacked, may be very short,&mdash;sometimes, as we have seen, but
+a few yards, so that a removal of the patient, <i>with his friends</i>, may
+be practicable, in a vast number of cases, previous to the setting in of
+the more serious symptoms.</p>
+
+<div class="footnote">
+<p>
+<a name="Footnote_7_7" id="Footnote_7_7"></a>
+<a href="#FNanchor_7_7"><span class="label">[7]</span></a>
+
+Since writing the above, I find that this scene has
+actually occurred lately at Dantzic where a few miserable medical men
+illustrated their doctrines of contagion, by skulking at a certain
+distance about the sick, dressed up in oil skins, like the disgusting
+figures we see in books, of the Marseilles doctors in the Lazaretto.
+(See Sun Newspaper, 22nd,&nbsp;Nov.)
+</p>
+</div>
+
+<p>I shall conclude this by cursorily referring to two circumstances which
+have within a short time occurred on the Continent, and which seem to me
+to be of no small importance in regard to cholera questions. It appears
+that the committee appointed by the French Chamber of Deputies to
+inquire into the questions connected with voting an additional sum to
+meet cordon and quarantine expenses, in the event of the cholera making
+its appearance in or near France, have made their report to the Chamber.
+They declare that in India the cholera was proved not to have been
+transmissible; and that in regard to Russia, it was not introduced, as
+always contended for by some persons:&mdash;they refer to the city of Thorn
+as exempt from the disease, though free from cordons, and in the midst
+of a country where it prevails, while the disease appeared in
+St.&nbsp;Petersburg and Moscow, notwithstanding their cordons, and even in
+Prussia, where sanatory laws where executed "<i>avec une punctualit&eacute;
+et une rigeur ailleurs inconnues</i>." The money is nevertheless granted; it
+is always a good thing to have, but they have set one curious
+<i>condition</i> upon its being granted, which displays consummate tact, for
+it is to be employed solely in disbursements of a particular nature
+(<i>d&eacute;penses materielles</i>), including, it may be presumed, temporary
+hospitals, &amp;c.; and that it is by no means ("<i>nullement</i>") to go into
+the pockets of individuals.</p>
+
+<p>The other circumstance to which I allude is that, like Russia and
+Austria, Prussia has found that quarantines and cordons do not check the
+progress of cholera. The king declares that the appearance of the
+disease in his provinces, has thrown <i>new light</i> on the question; he
+specifies certain restrictions as to intercourse, which were forthwith
+to be removed, and declares his intention to modify the whole. In short,
+it is quite plain that, as Dr.&nbsp;Johnson has it in his last
+journal,&mdash;those regulations will, "<i>in more countries than Russia, be
+useless to all but those employed in executing them</i>."</p>
+
+<hr class="major" />
+
+<div>
+<!-- Page 27 -->
+
+<span class="pagenum1"><a name="Page_27_Part_1" id="Page_27_Part_1">Pt_1<br />[Pg 27]</a></span>
+</div>
+
+<h2><a name="LETTER_IV_Part_1" id="LETTER_IV_Part_1"></a>LETTER IV.</h2>
+
+<p>It need scarcely be said how much it behooves all medical men to keep in
+view the subject of the wide-spreading cholera, and not to suffer
+themselves to be led from an attentive consideration of all that
+appertains to it, by the great political questions which at present
+convulse the whole kingdom.</p>
+
+<p>I totally disagree with Dr.&nbsp;Macmichael, as I believe most people will,
+that the notion of <i>contagion</i> in many diseases is "far from being
+natural and obvious to the mind;" for, since the time that contagious
+properties have been generally allowed to belong to certain diseases,
+there has been a strong disposition to consider this as the most natural
+and obvious mode of explaining the spreading of other diseases. A person
+sees evidence of the transmission, <i>mediate</i> as well as <i>immediate</i>, of
+small-pox, from one person to another; and, in other diseases, the
+origin of which may be involved in obscurity, he is greatly prone to
+assign a similar cause which may seem to reconcile things so
+satisfactorily to his mind. Indeed there seems, in many parts of the
+world, a degree of <i>popularity</i> as to quarantine regulations, which is
+well understood and turned to proper account by the initiated in the
+mysteries of that department:&mdash;for what more common than the
+expression&mdash;"we cannot be too careful in our attempts to <i>keep out</i> such
+or such a disease?" For my part, I admit that I can more easily
+comprehend the propagation of certain epidemics by contagion, than I can
+by any other means, <i>when unaccompanied by sensible atmospheric
+changes</i>; and if I reject contagion in cholera, it is because whatever
+we have in the shape of fair evidence, is quite conclusive as to the
+non-existence of any such principle. Indeed abundance of evidence now
+lies before the public, from various sources, in proof of the saying of
+Fontenelle being fully applicable to the question of cholera&mdash;"When a
+thing is accounted for in two ways, the truth is usually on the side
+most opposed to <i>appearances</i>." How well mistaken opinions as to
+contagion in cholera are illustrated in a pamphlet which has just
+appeared from Dr.&nbsp;Zoubkoff of Moscow! This gentleman, it appears, has
+been a firm believer in contagion, until the experience afforded him
+during the prevalence of the disease in that city proved the contrary.
+He tells us (p.&nbsp;10), that in the hospital (Yakimanka) he saw "<i>to his
+great astonishment</i>, that all the attendants, all the soldiers, handled
+the sick, supported their heads while they vomited, placed them in the
+bath, and buried the dead; always without precaution, and always without
+being attacked by cholera." He saw that even the breath of cholera
+patients was inhaled by others with impunity; he saw, that throughout
+the district of which he had charge, the disease did not spread through
+the crowded buildings, or in families where some had been attacked, and
+that exposure to exciting causes <i>determined</i> the attack in many
+instances. He saw all this, gives the public the benefit of the copious
+notes which he made of details as to
+
+<!-- Page 28 -->
+
+<span class="pagenum1"><a name="Page_28_Part_1" id="Page_28_Part_1">Pt_1<br />[Pg 28]</a></span>
+
+persons, places, &amp;c., and now
+ridicules the idea of contagion in cholera. Grant to the advocates of
+contagion in cholera but all the data they require, and they will
+afterwards prove every disease which can be mentioned to be contagious.
+Hundreds of people, we will say, for instance, come daily from a sickly
+district to a healthy one, and yet no disease for some time appears; but
+at last an "inexplicable condition of the air," and "not appreciable by
+any of our senses" (admitted by Dr.&nbsp;Macmichael and others as liable to
+occur, but <i>only in aid</i> of contagion), take place; cases begin to
+appear about a particular day, and nothing is now more easy than to make
+out details of arrivals, there being a wide field for selection; and
+even how individuals had spoken to persons subsequently attacked&mdash;had
+stopped at their doors&mdash;had passed their
+houses, &amp;c.<a name="FNanchor_8_8" id="FNanchor_8_8"></a><a href="#Footnote_8_8" class="fnanchor">[8]</a> Causation
+is at once
+connected with antecedence, at least for a time, by the people at
+large, who see their government putting on cordons and quarantines, and
+the most vague public rumour becomes an assumed fact. We even find, as
+may be seen in the quotation given from Dr.&nbsp;Walker's report, that
+contagionists are driven to the "somehow or other" mode of the
+introduction of cholera by individuals; so that it may be deplored, with
+respect to this disease, in the words of Bacon, that "men of learning
+are too frequently led, from ignorance or credulity, to avail themselves
+of mere rumours or whispers of experience as confirmation, and sometimes
+as the very ground-work, of their philosophy, ascribing to them the same
+authority as if they rested upon legitimate testimony. Like to a
+government which should regulate its measures, not by official
+information of its accredited ambassadors, but by the gossipings of
+newsmongers in the streets. Such, in truth, is the manner in which the
+interests of philosophy, as far as experience is concerned, have
+hitherto been administered. Nothing is to be found which has been duly
+investigated,&mdash;nothing which has been verified by a careful examination
+of proof."</p>
+
+<div class="footnote">
+<p>
+<a name="Footnote_8_8" id="Footnote_8_8"></a>
+<a href="#FNanchor_8_8"><span class="label">[8]</span></a>
+
+Since the above was written it has been very clearly shewn
+how easily proofs of <i>this kind</i> may be furnished to all disposed to
+receive them. We perceive that a disease officially announced as <i>the
+true</i> cholera, has existed for nearly a month past at Sunderland, and
+that among the thousands of people who left it within that time, nothing
+could be more easy, had the disease appeared epidemically in other parts
+of England, than to point out the <i>particular individual</i> who had
+"brought it" in some way or other; and this is the manner in which all
+the fables about the propagation of cholera from one district to another
+have gained credence. (Nov.&nbsp;24th.)
+</p>
+</div>
+
+<p>In their efforts to make out their case, there would seem to be no end
+to the contradictions and inconsistencies into which the advocates of
+contagion in cholera are led. At one moment we are required to believe
+that the disease may be transmitted through the medium of an unpurified
+letter, over seas and continents, to individuals residing in countries
+widely differing in climate, while, in the next, we are told&mdash;regarding
+the numberless instances of persons of all habits who remain unattacked
+though in close contact with the diseased&mdash;that the constitution of the
+atmosphere necessary for the germination of the contagion is not
+present; and
+
+<!-- Page 29 -->
+
+<span class="pagenum1"><a name="Page_29_Part_1" id="Page_29_Part_1">Pt_1<br />[Pg 29]</a></span>
+
+this, although we see the disease attacking all
+indiscriminately, those who are not near the sick as well as those who
+are at a very short distance, as on the opposite side of a ravine, of a
+rivulet, of a barrack, or even of a road. They assume that wherever the
+disease appears, <i>three</i> causes must be in
+operation&mdash;contagion&mdash;peculiar states of atmosphere (heat now clearly
+proved not <i>essential</i>, as at one time believed)&mdash;and susceptibility in
+the habit of the individual. However unphilosophical it is held to be to
+multiply causes, the advocates of contagion are not likely to reduce the
+number, as this would at once cramp them in their pleadings before a
+court where sophistry is not always quickly detected. Those who see
+irresistible motives for dismissing all idea of contagion, look, on the
+contrary, for the production of cholera, to sources, admitted from
+remote times to have a powerful influence on our systems, though
+invisible&mdash;though not to be detected by the ingenuity of man, and though
+proved to exist only by their effects.</p>
+
+<p>Many who do not believe that cholera can be propagated by contagion
+under ordinary circumstances, have still a strong impression that by
+crowding patients together, as in hospitals or in a ship, the disease
+may acquire contagious properties. Now we find that when the
+<i>experimentum crucis</i> of extensive experience is contrasted with the
+feasibility of this, cholera, like ague, has not been rendered one bit
+more contagious by crowding patients together than it has been shown to
+be under other circumstances. We do not require to be told that placing
+many persons together in ill-ventilated places, whether they labour
+under ague, or catarrh, or rheumatism, or cholera, as well as where no
+disease at all exists among them, as in the Calcutta black-hole affair,
+and other instances, which might be quoted, <i>fever</i>, of a malignant
+form, is likely to be the consequence, but assuredly not ague, or
+catarrh, or rheumatism, or cholera. On this point we are furnished with
+details by Dr.&nbsp;Zoubkoff, of Moscow, in addition to the many previously
+on record. It may be here mentioned that, on a point which I have
+already referred to, this gentleman says (p.&nbsp;43), "I shall merely
+observe that at Moscow, where the police are remarked for their
+activity, they cannot yet ascertain who was the first individual
+attacked with cholera. It was believed at one time that the disease
+first showed itself on the 17th of September; afterwards the 15th was
+fixed upon, and at last persons went so far back as August and July." As
+this gentleman <i>had been</i> a contagionist, occupied a very responsible
+situation during the Moscow epidemic, and quotes time and place in
+support of his assertions, I consider his memoir more worthy of
+translation than fifty of your Keraudrens.</p>
+
+<p>Respecting those mysterious visitations which from time to time afflict
+mankind, it may be stated that we have a remarkable instance in the
+"<i>dandy</i>" or "<i>dangy</i>" disease of the West India Islands, which, of late
+years, has attracted the notice of the profession as being quite a new
+malady, though nobody, as far as I am aware of, has ever stated it to
+have been an imported one. We find also that within the last three years
+a disease, quite novel in its characters, has been very prevalent in the
+neighbourhood of Paris. It has proved fatal in many instances, and the
+
+<!-- Page 30 -->
+
+<span class="pagenum1"><a name="Page_30_Part_1" id="Page_30_Part_1">Pt_1<br />[Pg 30]</a></span>
+
+physicians, unable to assign it a place under the head of
+previously-described disease, have been obliged to invent the term
+"Acrodynia" for it. I am not aware that even M.&nbsp;Pariset, the medical
+chief of quarantine in France, ever supposed this disease to have been
+<i>imported</i>, and to this hour the cause of its appearance remains in as
+much obscurity among the Savans of Paris, as that of the epidemic
+cholera.</p>
+
+<p>Considering all the evidence on the subject of cholera in India, in
+Russia, Prussia, and Austria, one cannot help feeling greatly astonished
+on perceiving that Dr.&nbsp;Macmichael (p.&nbsp;31 of his pamphlet) insinuates
+that the spreading of the disease in Europe has been owing to the views
+of the subject taken by the medical men of India.</p>
+
+<p>In turning now more particularly to the work, or rather compilation, of
+Dr.&nbsp;Bisset Hawkins, let us see whether we cannot discover among what he
+terms "marks of haste" in getting it up for "the curiosity of the
+public" (<i>curiosity</i>, Dr.&nbsp;Hawkins!), some omissions of a very important
+nature on the subject of a disease respecting which, we presume, he
+wished to enlighten the public. And first, glancing back to cholera in
+the Mauritius, Dr.&nbsp;Hawkins might, had he not been so pressed for time,
+have referred to the appearance of cholera in 1829, at Grandport in that
+island; when, as duly and officially ascertained, it could not be a
+question of importation by any ship whatever. The facility with which he
+supplies us with "facts,"&mdash;the <i>false facts</i> reprobated by Bacon, and
+said by Cullen to produce more mischief in our profession than false
+theories&mdash;is quite surprising; he tells us, point blank (p.&nbsp;31),
+speaking of India, that "when cholera is once established in a marching
+regiment, it continues its course in spite of change of position, food,
+or other circumstances!" Never did a medical man make an assertion more
+unpardonable, especially if he applies the term <i>marching regiment</i> as
+it is usually applied. Dr.&nbsp;Hawkins leads us to suppose that he has
+examined the India reports on cholera. What then are we to think when we
+find in that for Bengal the following most interesting and conclusive
+statements ever placed on record? Respecting the Grand Army under the
+Marquis of Hastings, consisting of 11,500 fighting men, and encamped in
+November&nbsp;1817 on the banks of the Sinde, the official report states that
+the disease "as it were in an instant gained fresh vigour, and at once
+burst forth with irresistible violence in every direction. Unsubjected
+to the laws of contact, and proximity of situation, which had been
+observed to mark and retard the course of other pestilences, it
+surpassed the plague in the width of its range, and outstripped the most
+fatal diseases hitherto known, in the destructive rapidity of its
+progress. Previously to the 14th it had overspread every part of the
+camp, sparing neither sex nor age, in the undistinguishing virulence of
+its attacks."&mdash;"From the 14th to the 20th or&nbsp;22d, the mortality had
+become so general as to depress the stoutest spirits. The sick were
+already so numerous, and still pouring in so quickly from every quarter,
+that the medical men, although night and day at their posts, were no
+longer able to administer to their necessities. The whole camp then put
+on the appearance of a hospital. The noise and bustle almost inseparable
+from the intercourse of large bodies of people had
+
+<!-- Page 31 -->
+
+<span class="pagenum1"><a name="Page_31_Part_1" id="Page_31_Part_1">Pt_1<br />[Pg 31]</a></span>
+
+nearly subsided.
+Nothing was to be seen but individuals anxiously hurrying from one
+division of a camp to another, to inquire after the fate of their dead
+or dying companions, and melancholy groups of natives bearing the biers
+of their departed relatives to the river. At length even this
+consolation was denied to them, for the mortality latterly became so
+great that there was neither time nor hands to carry off the bodies,
+which were then thrown into the neighbouring ravines, or hastily
+committed to the earth on the spots on which they had expired." Let us
+now inquire how this appalling mortality was arrested;&mdash;the report goes
+on to inform us:&mdash;"It was clear that such a frightful state of things
+could not last long, and that unless some immediate check were given to
+the disorder, it must soon depopulate the camp. It was therefore wisely
+determined by the Commander-in-chief <i>to move in search of a healthier
+soil and of purer air</i>," which they found when they "crossed the clear
+stream of the Bitwah, and upon its high and dry banks at Erich soon got
+rid of the pestilence, and met with returning health." Now just fancy
+epidemic cholera a disease transmissible by "susceptible articles," and
+what an inexhaustible stock must this large army, with its thousands of
+followers, have long carried about with them; but, instead of this, they
+were soon in a condition to take the field. Against the above historical
+fact men of ingenuity may advance what they please. There is no doubt
+that, in the above instance, severe cases of cholera occurred <i>during
+the move</i>, the poison taken into the system on the inauspicious spot,
+not having produced its effects at once; it is needless to point out
+what occurs in this respect in remittent and intermittent fevers. The
+India reports furnish further evidence of mere removal producing health,
+where cholera had previously existed. Mr.&nbsp;Bell, a gentleman who had
+served in India, and who has lately written upon the
+disease,<a name="FNanchor_9_9" id="FNanchor_9_9"></a><a href="#Footnote_9_9" class="fnanchor">[9]</a> informs
+us (p.&nbsp;84), that "removing a camp a few miles, has frequently put an
+entire and immediate stop to the occurrence of new cases; and when the
+disease prevailed destructively in a village, the natives often got rid
+of it by deserting their houses for a time, though in doing so they
+necessarily exposed themselves to many discomforts, which, <i>c&aelig;teris
+paribus</i>, we should be inclined to consider exciting causes of an
+infectious or contagious epidemic." We even find that troops have, as it
+may be said, <i>out-marched</i> the disease, or rather the cause of the
+disease; that is, moved with rapidity over an extensive surface where
+the atmosphere was impure, and thereby escaped&mdash;on the principle that
+travellers are in the habit of passing as quickly as they can across the
+pontine marshes. Mr.&nbsp;Bell says, "In July,&nbsp;1819, I marched from Madras in
+medical charge of a large party of young officers who had just arrived
+in India, and who were on their way to join regiments in the interior of
+the country. There was also a detachment of Sepoys, and the usual number
+of attendants and camp-followers of such a party in India. The cholera
+prevailed at Madras when we left it. Until
+
+<!-- Page 32 -->
+
+<span class="pagenum1"><a name="Page_32_Part_1" id="Page_32_Part_1">Pt_1<br />[Pg 32]</a></span>
+
+the 5th day's march (fifty
+miles from Madras) no cases of the disease occurred. On that day several
+of the party were attacked on the line of march; and, during the next
+three stages, we continued to have additional cases. Cholera prevailed
+in the countries through which we were passing. In consultation with the
+commanding officer of the detachment, it was determined that we should
+<i>leave the disease behind us</i>; and as we were informed that the country
+beyond the Ghauts was free from it, we marched, without a halt, until we
+reached the high table land of Mysore. The consequence was, that we left
+the disease at Vellore eighty-seven miles from Madras, and we had none
+of it until we had marched seventy miles further (seven stages), when we
+again found it at one of our appointed places of encampment; but our
+camp was, in consequence, pushed on a few miles, and only one case, a
+fatal one, occurred in the detachment; the man was attacked on the line
+of march. We again left the disease, and were free from it during the
+next 115 miles of travelling; we then had it during three stages, and
+found many villages deserted. We once more left it, and reached our
+journey's end, 260 miles further, without again meeting it. Thus, in a
+journey of 560 miles, this detachment was exposed to, and left the
+disease behind it, four different times; and on none of those occasions
+did a single case occur beyond the tainted spots." What a lesson for
+Dr.&nbsp;Hawkins! But <i>for whom</i> could Dr.&nbsp;Hawkins have written his <i>curious</i>
+book? Hear Mr.&nbsp;Bell in respect to the common error of the disease
+following high roads and navigable rivers only:&mdash;"I have known the
+disease to prevail for several weeks at a village in the Southern
+Mahratta country, within a few miles of the principal station of the
+district, and then leave that division of the country entirely; or,
+perhaps, cases would occur at some distant point. In travelling on
+circuit with the Judge of that district, I have found the disease
+prevailing destructively in a small and secluded village, while no cases
+were reported from any other part of the district." What is further
+stated by Mr.&nbsp;Bell will tend to explain why so much delusion has existed
+with regard to the progress of the disease being remarkably in the
+direction of lines of commerce, or great intercourse:&mdash;"When travelling
+on circuit, I have found the disease prevailing in a district <i>before
+any report had been made of the fact, notwithstanding the most positive
+orders on the subject</i>; and I am persuaded, that were any of the
+instances adduced in support of the statement under consideration
+strictly inquired into, it would be found that the usual apathy of the
+natives of India had prevented their noticing the existence of the
+disease until the fact was brought prominently forward by the presence
+of Europeans. It should also be brought to mind, that cholera asphyxia
+is not a new disease to these natives, but seems to be, in many places,
+almost endemical, whilst it is well known that strangers, in such
+circumstances, become more obnoxious to the disease than the inhabitants
+of the country. Moreover, travellers have superadded to the remote cause
+of the disease, fatigue and road discomforts, which are not trifling in
+a country where there are neither inns nor carriages." (p.&nbsp;89.) Cholera
+only attacks a certain proportion of a population, and is it wonderful
+that we should hear more of epidemic on high roads, where the population
+is greatest? High
+
+<!-- Page 33 -->
+
+<span class="pagenum1"><a name="Page_33_Part_1" id="Page_33_Part_1">Pt_1<br />[Pg 33]</a></span>
+
+roads too are often along the course of rivers; and
+is there not some reason for believing, that there is often along the
+course of rivers, whether navigable or not, certain conditions of the
+atmosphere unfavourable to health? When Dr.&nbsp;Hawkins stated, as we find
+at p.&nbsp;131 he has done, that where the inhabitants of certain hilly
+ranges in India escaped the disease, "these have been said to have
+interdicted all intercourse with the people below," he should have
+quoted some respectable authority, for otherwise, should we unhappily be
+visited by this disease, the people of our plains may one day wage an
+unjust war against the sturdy Highlanders or Welsh
+mountaineers.<a name="FNanchor_10_10" id="FNanchor_10_10"></a><a href="#Footnote_10_10" class="fnanchor">[10]</a>
+Little do the discussers of politics dream of the high interest of this
+part of the cholera question, and little can they conceive the
+unnecessary afflictions which the doctrine of the contagionists are
+calculated to bring on the nation. Let no part of the public suppose for
+a moment that this is a question concerning medical men more than it
+does them; <i>all</i> are <i>very</i> deeply concerned, the heads of families more
+especially so.</p>
+
+<div class="footnote">
+<p>
+<a name="Footnote_9_9" id="Footnote_9_9"></a>
+<a href="#FNanchor_9_9"><span class="label">[9]</span></a>
+
+This is by far the best work yet published in England on
+the cholera, but it is to be regretted that the author has not alluded
+to the works of gentlemen who have a priority of claim to some of the
+opinions he has published: I think that, in particular, Mr.&nbsp;Orton's
+book, printed in India, should have been noticed.
+</p>
+</div>
+
+<div class="footnote">
+<p>
+<a name="Footnote_10_10" id="Footnote_10_10"></a>
+<a href="#FNanchor_10_10"><span class="label">[10]</span></a>
+
+Something of this kind would have infallibly taken place,
+had certain insane proposals lately made respecting the <i>shutting in</i> of
+the people of Sunderland, been carried into effect.
+</p>
+</div>
+
+<p>We see that the identity of the European and Indian epidemic cholera is
+admitted on all sides; we have abundant proof that whatever can be said
+as to the progress of the disease, its anomalies, &amp;c., in the former
+country, have been also noted respecting it in the latter; and
+Dr.&nbsp;Hawkins, when he put forth his book, had most assuredly abundant
+materials upon which to form a rational opinion. It is by no small
+effort, therefore, that I can prevent all the respect due to him from
+evaporating, when he declares, at page&nbsp;165, that "the disease in India
+was <i>probably</i> communicable from person to person, and that in Europe it
+has <i>undeniably</i> proved so." But Dr.&nbsp;Hawkins is a Fellow of the College
+of Physicians, and we must not press this point further than to wish
+others to recollect that he has told us that he drew up his book in
+haste; and, moreover, that he wished to gratify the <i>curiosity</i> of the
+public. The Riga story about the hemp and the fifteen labourers I shall
+leave in good hands, the British Consul's at that city, who was required
+to draw up, for his government, a statement of the progress, &amp;c. of the
+cholera there, of which the following is an extract:&mdash;</p>
+
+<p>"The fact of non-contagion seems determined, as far as a question can be
+so, which must rest solely upon negative evidence. The strongest
+possible proof is, the circumstance, that not one of the persons
+employed in removing the dead bodies (which is done without any
+precaution) has been taken ill. <i>The statement of fifteen labourers
+being attacked, while opening a pack of hemp, is a notorious falsehood.</i>
+Some physicians incline to the opinion, that the disease may sometimes
+be caught by infection, where the habit of body of the individual is
+predisposed to receive it; the majority of the faculty, however,
+maintain a contrary doctrine, and the result of the hospital practice is
+in their favour. There are 78 persons employed
+
+<!-- Page 34 -->
+
+<span class="pagenum1"><a name="Page_34_Part_1" id="Page_34_Part_1">Pt_1<br />[Pg 34]</a></span>
+
+in the principal
+hospital here; of these only two have been attacked, one of whom was an
+'<i>Inspecteur de&nbsp;Salle</i>,' and not in immediate attendance upon the sick.
+I am assured that the other hospitals offer the same results, but as I
+cannot obtain equally authentic information respecting them, I confine
+myself to this statement, on which you may rely. On the other hand, in
+private families, several instances have occurred where the illness of
+one individual has been followed by that of others: but, generally, only
+where the first case has proved fatal, and the survivors have given way
+to grief and alarm. Mercenary attendants have seldom been attacked, and,
+as mental agitation is proved to be one of the principal agents in
+propagating or generating the disease, these isolated cases are
+attributed to that cause rather than infection.</p>
+
+<p>"It is impossible to trace the origin of the disease to the barks;
+indeed it had not manifested itself at the place whence they come till
+after it had broken out here. The nearest point infected was Schowlen
+(at a distance of 200 wersts), and it appeared simultaneously in three
+different places at Riga, without touching the interjacent country. The
+first cases were two stone-masons, working in the Petersburg suburbs, a
+person in the citadel, and a lady resident in the town. None of these
+persons had had the slightest communication with the crews of barks, or
+other strangers, and the quarter inhabited by people of that description
+was later attacked, though it has ultimately suffered most.</p>
+
+<p>"None of the medical men entertain the slightest doubt of the action of
+atmospheric influence&mdash;so many undeniable instances of the spontaneous
+generation of the disease having occurred. Half the town has been
+visited by diarrh&oelig;a, and the slightest deviation from the regimen now
+prescribed (consisting principally in abstinence from acids, fruit,
+beer, &amp;c.) invariably produces an attack of that nature, and, generally,
+cholera: fright, and intoxication, produce the same effect.</p>
+
+<p>"Numerous instances could be produced of persons in perfect health, some
+of whom had not left their rooms since the breaking out of the disease,
+having been attacked by cholera, almost instantaneously after having
+imprudently indulged in sour milk, cucumbers, &amp;c. It is a curious
+circumstance, bearing on this question, that several individuals coming
+from Riga have died at Wenden, and other parts of Livonia, without a
+single inhabitant catching the disease; on the other hand, it spreads in
+Courland, and on the Prussian frontier, notwithstanding every effort to
+check its progress. The intemperance of the Russians during the holidays
+has swelled the number of fresh cases, the progressive diminution of
+which had previously led us to look forward to a speedy termination of
+the calamity." This is a pretty fair specimen of the <i>undeniable</i> manner
+in which cholera is proved to be contagious in Europe, and we shall, for
+the present, leave Dr.&nbsp;Hawkins in possession of the full enjoyment of
+such proofs.</p>
+
+<p>Some attempt was made at Sunderland, to establish that, in the case
+which I mentioned in my last as having proved fatal there, the disease
+had been imported from foreign parts, but due inquiry having been made
+by
+
+<!-- Page 35 -->
+
+<span class="pagenum1"><a name="Page_35_Part_1" id="Page_35_Part_1">Pt_1<br />[Pg 35]</a></span>
+
+the collector of the customs, this proved to be unfounded; the man's
+name was Robert Henry, a pilot:&mdash;he died <i>on the 14th
+of August</i>.<a name="FNanchor_11_11" id="FNanchor_11_11"></a><a href="#Footnote_11_11" class="fnanchor">[11]</a>
+</p>
+
+<div class="footnote">
+<p>
+<a name="Footnote_11_11" id="Footnote_11_11"></a>
+<a href="#FNanchor_11_11"><span class="label">[11]</span></a>
+
+In a former letter I alluded to cases of cholera which
+appeared this year at Port Glasgow; I find that the highly interesting
+details of those cases have been just published:&mdash;<i>they should be read
+by everybody who takes the smallest interest in the important questions
+connected with the cholera</i>. The London publishers are Whittaker and&nbsp;Co.
+</p>
+</div>
+
+<p>Abroad we find that, unhappily, the cholera has made its appearance at
+Hamburgh; official information to this effect arrived from our Consul at
+that place, on Tuesday the 11th&nbsp;inst. (October). The absurdity of
+cordons and quarantines is becoming daily more evident. By accounts from
+Vienna, dated the 26th&nbsp;September, the Imperial Aulic Council had
+directed certain lines of cordon to be broken up, seeing, as is stated,
+that they were inefficacious; and by accounts of the same date, the
+Emperor had promised his people not to establish cordons between certain
+states.</p>
+
+<p>We find at the close of a pamphlet on cholera, lately published by
+Mr.&nbsp;Searle, a gentleman who served in India, and who was in Warsaw during
+the greater part of the epidemic which prevailed there this year, the
+following statement:&mdash;"I have only to add, that after all I have heard,
+either in India or in Poland, after all I have read, seen, or thought
+upon the subject, I arrive at this conclusion, that the disease is not
+contagious."</p>
+
+<p>In confirmation of the opinion of Mr.&nbsp;Searle, we have now the evidence
+of the medical commission sent by the French government to Poland.
+Dr.&nbsp;Londe, President of that commission, arrived in Paris some days ago. He
+announced to the minister in whose department the quarantine lies, as
+well as to M.&nbsp;H&egrave;ly D'Oissel, President of the Superior Council of
+Health, that it was proved in Poland, entirely to his satisfaction, as
+well as to the satisfaction of his five colleagues, that the cholera <i>is
+not a contagious disease</i>.</p>
+
+<p>The Minister of War also sent <i>four</i> medical men to Warsaw. Three of
+them have already declared against contagion; so it may be presumed that
+the day is not far distant when those true plagues of society, cordons
+and quarantines against cholera, shall be abolished. Hear the opinion of
+a medical Journalist in France,&mdash;after describing, a few days ago, the
+quarantine and cordon regulations in force in that country:&mdash;"But what
+effect is to be produced by these extraordinary measures, this immense
+display of means, and all these obstructions to the intercourse of
+communities, against a disease not contagious; a disease propagating
+itself epidemically; and which nothing has hitherto been able to arrest?
+To increase its ravages a hundred-fold,&mdash;to ruin the country, and to
+make the people revolt against measures which draw down on them misery
+and death at the same time." What honest man would not <i>now</i> wish that
+in this country the cholera question were placed <i>in Chancery</i>; where, I
+have no doubt, it would be quickly disposed of. I shall merely add, that
+the ten medical men sent from France to Poland, for the purpose of
+studying the nature of cholera, have all remained unattacked by the
+disease.</p>
+
+<div class="signr">
+October&nbsp;15,&nbsp;1831.
+</div>
+
+<hr class="major" />
+
+<div>
+<!-- Page 36 -->
+
+<span class="pagenum1"><a name="Page_36_Part_1" id="Page_36_Part_1">Pt_1<br />[Pg 36]</a></span>
+</div>
+
+<h2><a name="LETTER_V_Part_1" id="LETTER_V_Part_1"></a>LETTER V.</h2>
+
+<p>It was well and wisely said, that to know any-thing thoroughly, it must
+be known in all its details; and, to gain the confidence of the public
+in the belief of non-contagion in cholera, it is in vain that they are
+informed that certain alleged facts, brought forward industriously by
+contagionists, are quite groundless, unless proofs are given showing
+this to be the case. The public must, in short, have those alleged
+instances of contagion which have gained currency circumstantially
+disproved, or they will still listen to a doctrine leading to the
+disorganization of the community wherever it is acted upon. It is solely
+upon this ground that these letters have any claim to attention.
+Dr.&nbsp;James Johnson, of London, has, since my last letter, publicly
+contradicted, with all the bluntness and energy of honest conviction,
+the statement by Sir Gilbert Blane, Drs.&nbsp;Macmichael, Hawkins, &amp;c., as to
+the importation of the cholera into the Mauritius by the Topaze frigate;
+but <i>evidence</i> is what people want on these occasions, and, relative to
+the case in question, probably the public will consider what is to be
+found in my third and fourth letters, quite conclusive. Having again
+mentioned the Mauritius, I cannot refrain from expressing my great
+surprise that Mr.&nbsp;Kennedy, who has lately published on cholera, should
+give, with the view of showing "the dread and confusion existing at the
+time," a proclamation by General Darling, while he does not furnish a
+word about the result of the proceedings instituted by that officer, as
+detailed in my third letter, relative to the non-contagious nature of
+the disease, a point of all others the most important to the public. As
+to accounts regarding the confusion caused by the appearance of epidemic
+cholera, we have had no lack of them in the public papers during many
+months past, from quarters nearer home.</p>
+
+<p>Regarding a statement made by Dr.&nbsp;Hawkins in his book on cholera, viz.
+"That Moreau de&nbsp;Jonn&eacute;s has taken great pains to prove that the disease
+was imported into the Russian province of Orenburg," Dr.&nbsp;H. omits to
+tell us how completely he failed in the endeavour. In the <i>Edinburgh
+Medical and Surgical Journal</i> for July,&nbsp;1831, there is a review of a
+memoir by Professor Lichtenst&auml;dt, of St.&nbsp;Petersburg, in which
+M.&nbsp;Moreau's speculations are put to flight. From the efforts of this
+<i>pains-taking</i> gentleman (M.&nbsp;Moreau) in the cause of contagion in
+cholera, as well as yellow-fever, he seems to be considered in this
+country as a medical man; but this is not the case: he raised himself by
+merit, not only to military rank, but also to literary distinction, and
+is a member of the Academy of Sciences, where he displays an imagination
+the most vivid, but as to the sober tact necessary for the investigation
+of such questions as those connected with the contagion or non-contagion
+of cholera and yellow-fever, he is considered <i>below par</i>. He saw the
+yellow-fever in 1802-3, at Martinique, while <i>aid-de-camp</i> to the
+Governor, and still adheres to the errors respecting it which he imbibed
+in his youth, and when he was misled by occurrences taking place <i>within
+a malaria boundary</i>, where hundreds of instances are always
+
+<!-- Page 37 -->
+
+<span class="pagenum1"><a name="Page_37_Part_1" id="Page_37_Part_1">Pt_1<br />[Pg 37]</a></span>
+
+at hand, furnishing the sort of <i>post hoc propter hoc</i> evidence of contagion
+with which some people are satisfied, but which is not one bit less absurd,
+than if a good lady, living in the marshes of Kent, were to insist upon
+it, that her daughter Eliza took the ague from her daughter Jane,
+because they lived together. Strange to say, however, M.&nbsp;Casimir Perier,
+the Prime Minister of France, seems to be guided, according to French
+journals, by the opinions of this gentleman on cholera, instead of by
+different medical commissions sent to Warsaw, &amp;c.</p>
+
+<p>The question of contagion in cholera has been now put to the test in
+every possible way, let us view it for a moment, as compared with what
+has occurred in regard to typhus at the London Fever Hospital, according
+to that excellent observer Dr.&nbsp;Tweedie, physician to the establishment.
+Doubts, as we all know, have been of late years raised as to the
+contagion of typhus, but I believe nothing that has as yet appeared is
+so well calculated to remove those doubts as the statements by this
+gentleman (<i>see "Illustrations of Fever"</i>), where he shows that it has
+been remarked for a series of years that "the resident medical officers,
+matrons, porters, laundresses, and domestic servants not connected with
+the wards, and every female who has ever performed the duties of a
+nurse, have one and all been the subjects of fever,"&mdash;while, <i>in the
+Small-Pox Hospital</i>, which adjoins it, according to the statements of
+the physician, "no case of genuine fever has occurred among the medical
+officers or domestics of that institution for the last eight years." Had
+typhus been produced in the attendants by <i>malaria</i> of the locality,
+those persons in the service of the neighbouring Small-Pox Hospital
+should also have been attacked to a greater or less extent, it is
+reasonable to suppose, within the period mentioned. Now let this be
+compared with all that has been stated respecting attendants on cholera
+patients, and let it be compared with the following excellent fact in
+illustration, showing how numbers labouring under the disease, and
+brought from the inauspicious spot where they were attacked to a place
+occupied by healthy troops, did not, <i>even under the disadvantage of a
+confined space</i>, communicate the disease to a single individual:&mdash;"It
+has been remarked by many practitioners, that although they had brought
+cholera patients into crowded wards of hospitals, no case of the disease
+occurred among the sick previously in hospital, or among the hospital
+attendants. My own experience enables me fully to confirm this. The
+Military Hospital at Dharwar, an oblong apartment of about 90 feet
+by 20, was within the fort, and the lines of the garrison were about a mile
+distant outside of the walls of the fort. On two different occasions
+(in 1820 and 1821), when the disease prevailed epidemically among the troops
+of that station, while I was in medical charge of the garrison, but
+while no cases had occurred in the fort within which the hospital was
+situated, the patients were brought at once from their quarters to the
+hospital, which, on each occasion, was crowded with sick labouring under
+other disorders. No attempt was made to separate the cholera patients.
+On one of these occasions, no case of cholera occurred within the
+hospital; on the other, one of the sick was attacked, but he was a
+convalescent sepoy, who had not been prevented from leaving the fort
+during the day. The disease, on
+
+<!-- Page 38 -->
+
+<span class="pagenum1"><a name="Page_38_Part_1" id="Page_38_Part_1">Pt_1<br />[Pg 38]</a></span>
+
+each of those occasions, was confined
+to a particular subdivision of the lines, and none of those within the
+fort were attacked." (<i>Bell on Cholera</i>, p.&nbsp;92.)</p>
+
+<p>I have already quoted from Dr.&nbsp;Zoubkoff of Moscow, once a believer in
+contagion; every word in his pamphlet is precious; let but the following
+be read, and who will then say that "the seclusion of the sick should be
+insisted on?"&mdash;"The individuals of the hospitals, including soldiers and
+attendants on the sick, were about thirty-two in number, who, excepting
+the medical men, had never attended any sick; we all handled, more or
+less, the bodies of the patients, the corpses, and the clothes of the
+sick; have had our hands covered with their cold sweat, and steeped in
+the bath while the patients were in it; have inhaled their breath and
+the vapours of their baths; have tasted the drinks contained in their
+vessels, all without taking any kind of precaution, and all without
+having suffered any ill effects. We received into our hospital
+sixty-five cholera patients, and I appeal to the testimony of the
+thirty-six survivors, whether we took any precautions in putting them
+into the bath or in handling them&mdash;whether we were not seated sometimes
+on the bed of one, sometimes on that of another, talking to them. On
+returning home directly from the hospital, and without using chloride of
+lime, or changing my clothes, I sat down to table with my family, and
+received the caresses of my children, firmly convinced that I did not
+bring them a fatal poison either in my clothes or in my breath. Nobody
+shut his door either against me or my colleagues; nobody was afraid to
+touch the hand of the physician who came direct from an hospital&mdash;that
+hand which had just before wiped the perspiration from the brow of
+cholera patients. From the time that people had experience of the
+disease, nobody that I am aware of shunned the sick." Who, after this,
+can read over with common patience directions for the separation of a
+cholera patient from his friends, as if "<i>an accursed thing</i>?" or who
+(<i>il faut trancher le&nbsp;mot</i>) will now follow those directions?</p>
+
+<p>As to the good Sir Gilbert Blane, who has distributed far and wide a
+circular containing a description the most <i>na&iuml;ve</i> on record, of the
+epidemic cholera, hard must be the heart which could refuse making the
+allowance which he claims for himself and his memoir; and though he
+brands those who see, in his account of the marchings and
+counter-marchings of the disease, nothing on a level with the intellect
+of the present age, as a parcel of prejudiced imbeciles, we must still
+feel towards him all the respect due to a parent arrived at a time of
+life when things are not as they were wont to be, <i>nec mens, nec&nbsp;&aelig;tas</i>.
+I may be among those he accuses of sometimes employing "unintelligible
+jargon," but shall not retort while I confess my inability to understand
+such expressions as "some obscure occurrence of unwholesome
+circumstances" which seem to have, according to him, both "brought" the
+disease to Jessore in 1817, and produced it there at the same time. Sir
+Gilbert marks out for the public what he considers as forming one of the
+principal differences between the English and Indian cholera, viz. that
+in the latter the discharges "consist of a liquid resembling thin gruel,
+in the English disease they are feculent and bilious." Now if he has
+read the
+
+<!-- Page 39 -->
+
+<span class="pagenum1"><a name="Page_39_Part_1" id="Page_39_Part_1">Pt_1<br />[Pg 39]</a></span>
+
+India reports, he must have found abundance of evidence
+showing that sometimes there were <i>even bilious
+stools</i><a name="FNanchor_12_12" id="FNanchor_12_12"></a><a href="#Footnote_12_12" class="fnanchor">[12]</a> not
+at all like what he describes; and, again, if he is in the habit of reading the
+journals, he must have found <i>abundant</i> evidence of malignant cholera
+with discharges like water-gruel in this country. As to the French
+Consul at Aleppo having escaped with 200 other individuals confined to
+his residence, I shall only say, as it is Sir Gilbert Blane who relates
+the circumstance, that he <i>forgot</i> to mention that the aforesaid persons
+had retired to a residence <i>outside</i> the city; which, permits me to
+assure you, Sir Gilbert, just makes all the difference in hundreds of
+cases:&mdash;they happened to retire to "<i>clene air</i>;" and had they carried
+50 ague cases or 50 cholera cases with them (it matters not one atom
+which), the result would have been exactly the same. The mention of
+Barcelona and the yellow-fever, by Sir Gilbert, was, as Dr.&nbsp;Macmichael
+would term it, rather <i>unlucky</i> for his cause, though probably lucky for
+humanity; for it cannot be too generally known that, during the
+yellow-fever epidemic there in 1821, more than 60,000 people left the
+city, and spread themselves all over Spain, without a single instance of
+the disease having been communicated, <span class="smcap">while, at Barcelonetta, the
+infamous cordon system prevented the unfortunate inhabitants from going
+beyond the walls, and the consequences of shutting them up were most
+horrid</span>.</p>
+
+<div class="footnote">
+<p>
+<a name="Footnote_12_12" id="Footnote_12_12"></a>
+<a href="#FNanchor_12_12"><span class="label">[12]</span></a>
+
+See Orton on Cholera, who is most explicit upon this
+point, and cites from the India Reports:&mdash;so that the distinctions
+attempted to be drawn in this respect between the "cholera of India,"
+and that of other countries, are, after all, <i>quite untenable</i>.
+</p>
+</div>
+
+<p>Little need be said respecting the pure assumptions of Sir Gilbert as to
+the movements of the malady by land and by water, for those vague and
+hacknied statements have been again and again refuted; but we may remark
+that whereas all former accounts respecting the cholera in 1817, in the
+army of the Marquis of Hastings, state that the disease broke out
+somewhat suddenly in the camp on the banks of the Sinde, Sir Gilbert,
+without deigning to give his authority, makes the army set out for
+"Upper India accompanied by this epidemic." We find that Mr.&nbsp;Kennedy,
+another advocate for contagion in cholera, differs from Sir&nbsp;Gilbert as
+to the disease having accompanied the grand army on the march; for he
+says the appearance of the malady was announced in camp in the early
+part of November, when "the first cases excited little alarm." In
+referring, in a former letter, to the sickness in the above army, I
+showed from the text of the Bengal report, how a change of position
+produced a return of health in the troops; but Mr.&nbsp;Kennedy states that
+the disease had greatly declined a few days before the removal, so that
+it had lost "its infecting power." Nevertheless it appears by this
+gentleman's account, a little farther on, that "in their progressive
+movement the grounds which they occupied during the night as temporary
+encampments were generally found in the morning, strewed with the dead
+like a field of battle"! This gentleman tells us that he has laid down a
+law of "increase and decline appertaining to cholera," by which, and the
+assistance of <i>currents of contagion</i>,
+
+<!-- Page 40 -->
+
+<span class="pagenum1"><a name="Page_40_Part_1" id="Page_40_Part_1">Pt_1<br />[Pg 40]</a></span>
+
+it would appear all these things
+are reconciled wonderfully. Several of the points upon which he grounds
+his belief of contagion have been already touched upon in these letters,
+and the rest, considering the state of the cholera question in Europe
+just now, may be allowed to pass at whatever value the public may, after
+due examination, think it is entitled to. Let it be borne in mind that
+all contagionists who speak of the cholera in the army of the Marquis of
+Hastings, forget to tell us that though many thousand native followers
+had fled from that army during the epidemic, the disease did not appear
+in the towns situated in the surrounding country, <i>till the following
+year</i>, as may be seen at a glance by reference to Mr.&nbsp;Kennedy's and
+other maps.</p>
+
+<p>We have another contagionist in the field&mdash;a writer in the <i>Foreign
+Quarterly Review</i>, the value of whose observations may appear from his
+statement, that "in&nbsp;1828 the disease broke out in Orenburg, and was
+supposed [<i>supposed</i>!] to have been introduced by the caravans which
+arrive there from Upper Asia, or [<i>or</i>, nothing like a second string] by
+the Kingiss-Cossacks, who are adjoining this town, and were said [<i>were
+said</i>!] to have been about this time affected with the disease." This
+single extract furnishes an excellent specimen of the sort of <i>proofs</i>
+which the contagionists, to a man, seem to be satisfied with as to the
+cholera being "carried" from place to place. This gentleman must surely
+be under some very erroneous impression, when he states that, "According
+to the reports of the Medical Board of Ceylon, the disease made its
+appearance in 1819 at Jaffnah in Ceylon, imported from Palamcottah, with
+which Jaffnah holds constant intercourse, and thence it was propagated
+over the island." Now there is every reason to believe that a reference
+to the documents from Ceylon will shew that no report as to the
+importation of the disease was ever drawn up, for Drs.&nbsp;Farrel and Davy,
+as well as Messrs. Marshall, Nicholson, and others, who served in that
+island, are, to this hour, clearly against contagion. But as the writer
+tells us that he is furnished with unpublished documents respecting the
+cholera at St.&nbsp;Petersburg, by the chief of the medical department of the
+quarantine in this country, we do not think it necessary to say one word
+more&mdash;<i>ex pede Herculem</i>.</p>
+
+<p>I rejoice to observe that Dr.&nbsp;James Johnson has, at last, <i>spoken out</i>
+upon the quarantine question; and I trust that others will now follow
+his example. It is only to be regretted, that a gentleman possessing
+such influence with the public as Dr.&nbsp;Johnson does, should have so long
+with-held his powerful aid on the occasion; but his motives were, I am
+quite sure, most conscientious; and I believe that he, as well as
+others, might have been prevented by a feeling of delicacy from going
+beyond a certain point.</p>
+
+<p>Since my last letter a code of regulations, in the anticipation of
+cholera, has been published by the Board of Health. <i>Let our prayers be
+offered up with fervency tenfold greater than before, that our land may
+not be afflicted with this dire malady.</i> The following statement,
+however, may not be altogether useless at this moment. According to the
+<i>Journal des Debats</i> of the 24th instant, the Emperor of Austria, in a
+letter to his High Chancellor, dated Sch&oelig;nbrunn, October&nbsp;10th, and
+published in the
+
+<!-- Page 41 -->
+
+<span class="pagenum1"><a name="Page_41_Part_1" id="Page_41_Part_1">Pt_1<br />[Pg 41]</a></span>
+
+<i>Austrian Observer</i> of the 12th, formally makes the
+most magnanimous declaration to his people, <span class="smcap">that he had committed an
+error in adopting the vexatious and worse-than useless quarantine and
+cordon regulations against cholera</span>; that he did so before the nature of
+the disease was so fully understood; admits that those regulations have
+been found, after full experience, to have produced consequences more
+calamitous than those arising from the disease itself ("<i>plus funeste
+encore que les maux que provenaient de la maladie elle-m&ecirc;me</i>.") He
+kindly makes excuses for still maintaining a modified quarantine system
+at certain points, in consequence, as he states, of the opinions still
+existing in the dominions of some of his neighbours, <i>for otherwise his
+commercial relations would be broken off. To secure his maritime
+intercourse, he must do as they do!</i> We find that as <i>all</i> the Prussian
+cordons have been dissolved, <i>their vessels</i> are excluded from entrance
+into certain places on the Elbe. What a horrid state of things! But, as
+a reference will shew, this was one of the things stated in my first
+letter as likely to occur: it is surely a fit subject for immediate
+arrangement between governments. In the mean time, we cannot but profit
+by the great lesson just received from Austria.</p>
+
+<p>I shall add no more on the present occasion, than that my last
+information from Edinburgh notifies the death, from <i>Scotch cholera</i>, of
+two respectable females in that city, after an illness of only a few
+hours.</p>
+
+<hr class="major" />
+
+<h2><a name="LETTER_VI_Part_1" id="LETTER_VI_Part_1"></a>LETTER VI.</h2>
+
+<p>At a moment when the subject of cholera has become so deeply
+interesting, the good of the public can surely not be better consulted
+by the press than when it devotes its columns (even to the exclusion of
+some political and other questions of importance) to details of plain
+facts connected with the contagious or non-contagious nature of that
+malady&mdash;a <i>question beyond all others regarding it, of most importance</i>,
+for upon it must hinge all sanatory or conservative regulations, and a
+mistake must, in the event of an epidemic breaking out, directly involve
+thousands in ruin. In the case of felony, where but the life of a single
+individual is at stake&mdash;nay, not only in the case of felony, but in the
+case of a simple misdemeanour, or even in the simple case of debt&mdash;we
+see the questions of yes or no examined by the Judges of the land with
+due rigour; while, on the point to which I refer, and which affects so
+deeply the dearest interests of whole communities, evidence has been
+acted upon so vague as to make some people fancy that we have
+retrograded to the age of witchcraft. Be it recollected that we shall
+not have the same excuse as some of our continental neighbours had for
+running into frightful errors&mdash;for we have their dear-bought experience
+laid broadly before us; and to profit duly by it, it only requires a
+scrutiny by a tribunal, wholly, if you please, non-medical, such as may
+be formed within an hour
+
+<!-- Page 42 -->
+
+<span class="pagenum1"><a name="Page_42_Part_1" id="Page_42_Part_1">Pt_1<br />[Pg 42]</a></span>
+
+in this metropolis; nothing short of this will
+do. All, till then, will be vacillation; and when the enemy does come in
+force, we shall find ourselves just as much at a loss how to act as our
+continental neighbours were on the first appearance of cholera among
+them; I say after its first appearance, for we find that they all
+discovered, plainly enough latterly, what was best to be done. Small
+indeed may be the chance of the present order of things as to
+quarantines, the separation of persons attacked, &amp;c., being changed by
+anything which I can offer; but, having many years experience of
+disease&mdash;having had no small share of experience in this disease in
+particular, and having, perhaps, paid as much attention to all that has
+been said about it as any man living, I should be wanting in my duty
+towards God and man did I not protest, most loudly, against those
+regulations, which shall have for their base, an assumption, that a
+being affected with cholera can, <span class="smcap">in any manner whatever</span>, transmit, or
+communicate, the disease to others, <i>however close or long continued the
+intercourse may be</i>; because such doctrine is totally in opposition to
+all the fair or solid evidence now before the public;&mdash;because it is
+calculated, in numberless instances, to predispose the constitution to
+the disease, by exciting terror equal to that in the case of
+plague;&mdash;because it is teaching us Christians to do what Jews, and
+others, never do, to abandon the being who has so many ties upon our
+affections;&mdash;because the desertion of friends and relatives, and the
+being left solely in charge, perhaps, of a feeble and aged hireling (if
+even such can be got, which I much doubt when terror is so held out,)
+must tend directly to depress those functions which, from the nature of
+the disease, it should be our great effort to support;&mdash;finally, because
+a proper and unbiassed examination of the question will shew, that all
+these horrors are likely to arise out of regulations which may, with
+equal justice, be applied to ague, to the remittent fevers of some
+countries, or to the Devonshire cholic, as to cholera.</p>
+
+<p>Happily, it is not yet too late to set about correcting erroneous
+opinions, pregnant with overwhelming mischief, for hitherto the measures
+acted upon have only affected our commerce and finances to a certain
+extent; but it appears to me that not a moment should be lost, in order
+to prevent a public panic; and, in order to prevent those calamities
+which, in addition to the effects of the disease itself, occurred, as we
+have seen, on the Continent. Let then, I say, a Commission be forthwith
+appointed, composed of persons accustomed to weigh evidence in other
+cases, and who will not be likely to give more than its due weight to
+the authority of any individuals. Let this be done, and, in the
+decision, we shall be sure to obtain all that human wisdom can arrive at
+on so important a subject; and the public cannot hesitate to submit to
+whatever may afterwards be proposed. It will then be seen whether the
+London Board of Health have decided as wisely as they have hastily. For
+my part, I shall for ever reject what may be held as evidence in human
+affairs, if it be not shewn that an individual attending another
+labouring under cholera, runs no further risk of being infected than an
+individual attending an ague patient does of being infected by this
+latter disease. What a blessing (in case of our being visited by an
+epidemic) should this turn out
+
+<!-- Page 43 -->
+
+<span class="pagenum1"><a name="Page_43_Part_1" id="Page_43_Part_1">Pt_1<br />[Pg 43]</a></span>
+
+to be the decision of those whose
+opinions would be more likely to be regarded by the public than mine are
+likely to be.</p>
+
+<p>Many, I am quite aware, are the professional men of experience now in
+this country, who feel with me on this occasion, but who, in deference
+to views emanating from authority, refrain from coming forward:&mdash;let me
+entreat them, however, to consider the importance of their suggestions
+to the community at large, at this moment; and let me beg of them to
+come forward and implore government to institute a special commission
+for the re-consideration of measures, founded on evidence the most vague
+that it is possible to conceive; or, perhaps, I should rather say,
+<i>against</i> whatever deserves the name of evidence. Every feeling should
+be sacrificed, by professional men, for the public good; we must even
+run the greatest risk of incurring the displeasure of those of our
+friends who are in the Board of Health. That we do run some risk is
+pretty plain, from the conduct of a vile journalist closely connected
+with an individual of a paid party, who has threatened us unbelievers in
+generally-exploded doctrines, with a fate nothing short of that which
+overwhelmed some of the inhabitants of Pompeii.</p>
+
+<p>Let me ask why <i>all</i> the documents of importance forwarded to the Board
+of Health are not published in the collection just issued? Why are those
+forwarded by <i>the Medical Gentleman sent to Dantzic</i> not
+published.<a name="FNanchor_13_13" id="FNanchor_13_13"></a><a href="#Footnote_13_13" class="fnanchor">[13]</a> Why
+has not an important document forwarded by our Consul at Riga not
+been published? Above all, why has not allusion been made in their
+papers to those cases of <span class="smcap">pure spasmodic cholera</span>, which have occurred in
+various parts of England within the last five months, and the details of
+which has been faithfully transmitted to them. If those cases be
+inquired into thoroughly and impartially, and that several of them be
+not found to be <span class="smcap">perfectly identic</span> with the epidemic cholera of India, of
+Russia, &amp;c., I hereby promise the public to disclose my name, and to
+suffer all the ignomy of a person making false statements. Indeed, I may
+confidently assure the public, that in at least one case which occurred
+about two months ago, the opinion of a gentleman who had practiced in
+India, and who had investigated the history of the symptoms, the
+identity with those of Asiatic cholera, was not denied. The
+establishment of this point is of itself sufficient to overthrow all
+supposition as to the importation of the disease.</p>
+
+<div class="footnote">
+<p>
+<a name="Footnote_13_13" id="Footnote_13_13"></a>
+<a href="#FNanchor_13_13"><span class="label">[13]</span></a>
+
+Since the above was written, I find that this gentleman
+has adduced the strongest proofs possible against contagion.
+</p>
+</div>
+
+<p>In the case of Richard Martin, whose death occurred at Sunderland about
+two months ago&mdash;in the case of Martin M'Neal, of the 7th&nbsp;Fusileers,
+which occurred at Hull, on the 11th of August last&mdash;in the cases at Port
+Glasgow, as detailed in a pamphlet by Dr.&nbsp;Marshall of that place&mdash;as
+well as several other cases which occurred throughout the year, and the
+details of many of which are in possession of the Board of Health&mdash;the
+advocates, "<i>par metier</i>," of contagion in cholera, have not a loop-hole
+to creep out at. Take but a few of the symptoms in one of
+
+<!-- Page 44 -->
+
+<span class="pagenum1"><a name="Page_44_Part_1" id="Page_44_Part_1">Pt_1<br />[Pg 44]</a></span>
+
+those cases
+as taken down by the Medical Gentleman in charge,&mdash;"The body was cold,
+and covered by a clammy sweat&mdash;the features completely sunk&mdash;<i>the lips
+blue</i>, the face discoloured&mdash;tongue moist and very cold&mdash;the hands and
+feet blue, cold, and as if steeped in water, like a washerwoman's hand;
+the extremities cold to the axill&aelig; and groins, and no pulse discoverable
+lower; the voice changed, and the speech short and laborious. He
+answered with reluctance, and in monosyllables." This man had the pale
+dejections, and several other symptoms, considered so characteristic of
+the Asiatic cholera; yet no spreading took place from him, nor ever will
+in similar cases. With the exception of the vomiting and purging, there
+is, in the state of patients labouring under this form of cholera, a
+great similarity to the first stage of the malignant fevers of the
+Pontine Marshes, and many other places, and the patient need not be one
+bit the more avoided. Let this be, therefore, no small consolation, when
+we find that, by the official news of this day, five more deaths have
+occurred at Sunderland.</p>
+
+<div class="signl">
+Nov.&nbsp;9,&nbsp;1831.
+</div>
+
+<hr class="major" />
+
+<h2><a name="LETTER_VII_Part_1" id="LETTER_VII_Part_1"></a>LETTER VII.</h2>
+
+<p>It may be inferred, from what I have stated at the close of my letter of
+yesterday, that if a Commission be appointed, I look forward to its
+being shewn, as clear as the sun at noon day, that the most complete
+illusion has existed, and, on the part of many, still exists, with
+regard to the term <i>Indian</i> or <i>Asiatic</i> cholera; for a form of cholera
+possessing characters quite peculiar to the disease in that country, and
+unknown, till very lately, in other countries, <i>has never existed
+there</i>. Cholera, from a cause as inscrutable, perhaps, as the cause of
+life itself, has prevailed there, and in other parts of the world, in
+its severest forms, and to a greater extent than previously recorded;
+but, whether we speak of the mild form, or of a severe form, proceeding
+or not to the destruction of life, the symptoms have everywhere been
+precisely the same. In this country it has been over and over again
+remarked, that, so far back as 1669, the spasmodic cholera prevailed
+epidemically under the observation of Dr.&nbsp;Sydenham, who records it. For
+many years after the time of Dr.&nbsp;Cullen, who frequently promulgated
+opinions founded on those of some fancy author rather than on his own
+observation, it was very much the fashion to speak of redundancy of
+bile, or of acrid bile, as the cause of the whole train of symptoms in
+this disease; but, since the attention of medical men has been more
+particularly drawn to the subject, practitioners may be found in every
+town in England who can inform you that, in severe cases of cholera,
+they have generally observed that no bile whatever has appeared till the
+patient began to get better. Abundance of cases of this kind are
+furnished by the different medical journals of this year. In fifty-two
+cases of cholera which passed under my observation in the year 1828, the
+<i>absence</i> of bile was always most remarkable. I made my observations
+with extraordinary care.
+
+<!-- Page 45 -->
+
+<span class="pagenum1"><a name="Page_45_Part_1" id="Page_45_Part_1">Pt_1<br />[Pg 45]</a></span>
+
+One of the cases proved fatal, in which the
+group of symptoms deemed characteristic of the Indian or Indo-Russian
+cholera, was most perfect, and in the mass, the symptoms were as
+aggravated as they have often been observed to be in India;&mdash;in several,
+spasms, coldness of the body, and even convulsions, having been present.</p>
+
+<p>To those who have attended to the subject of cholera, nothing can be
+more absurd than to hear people say such or such a case cannot be <i>the
+true</i> cholera, or the Indian cholera, or the Russian cholera, because
+<i>all</i> the symptoms ever mentioned are not present: as if, in the
+epidemic cholera of India and other places, even some of the symptoms
+considered the most prominent (as spasms, and the disturbance of the
+stomach and bowels) were not often absent, and that too in some of the
+most rapidly, fatal cases! I feel persuaded that much injustice is done
+to a gentleman lately sent to Sunderland, in attributing to him the very
+ridiculous opinion, <i>that because</i> the disease did not spread, it was
+<i>therefore</i> not identical with the Indian cholera. No person is
+justified in speaking of the cholera of India as a disease <i>sui gineris</i>,
+and in which a certain group of severe symptoms are always
+present, when evidence, such as the following is on record:&mdash;"On the
+22nd instant, when the men had been duly warned of their danger from not
+reporting themselves sooner, I got into hospital a different description
+of cases, viz.&mdash;men with a full pulse, hot skin," &amp;c. (<i>Dr.&nbsp;Burrell to
+Dr.&nbsp;Milne, Seroor, 27th of July,&nbsp;1818</i>)&mdash;"But I must tell you that we
+have, too, cases of common cholera." (<i>Mr.&nbsp;Craw, Seroor&mdash;Bengal Report,
+p.&nbsp;48</i>)&mdash;"The cases which terminated favourably presented very different
+symptoms [from the low form of the disease.] As I saw the men
+immediately after they were attacked, they came to me with a quick
+<i>full</i> pulse, and in several instances pain in the head; there was no
+sweating."&mdash;"in several cases <i>bile</i> appeared from the first in
+considerable quantities in the egesta; and these were more manageable
+than those in which no bile was ejected, although the spasms and
+vomiting (the most distressing symptoms of the complaint) were equally
+violent." (<i>Mr.&nbsp;Campbell, Seroor,&mdash;see Orton, 2nd&nbsp;ed. p.&nbsp;18</i>)&mdash;"In
+conclusion, I am happy to inform you that, for the last three days the
+disease has been evidently on the decline, and, during that period, most
+of the cases have assumed a different and much milder type, and,
+comparatively, are little dangerous. It approaches somewhat to fever;
+the patient complains of severe pain in the legs, sometimes vomiting a
+watery fluid, and sometimes bile." (<i>White&mdash;Bengal Reports, p.&nbsp;68.</i>)</p>
+
+<p>The same gentleman afterwards observes, "The disease continues to
+present a milder aspect, and now occurs but rarely: loss of pulse and
+coldness are seldom observed."</p>
+
+<p>On the decline of a particular epidemic, Mr.&nbsp;Alardyce observed many
+cases in the 34th&nbsp;regiment, with <i>bilious</i> discharges throughout.
+(Orton, 1st&nbsp;Ed.&nbsp;128). Finally, referring to the work of Mr.&nbsp;Orton, a
+gentleman who served in India, and who, being a contagionist, will be
+considered, I suppose, not bad authority by those who are of his
+opinion, we find the following declaration. (p.&nbsp;26, 1st&nbsp;Ed.) "My own
+experience has been very conclusive with regard to the sthenic form of
+the disease.
+
+<!-- Page 46 -->
+
+<span class="pagenum1"><a name="Page_46_Part_1" id="Page_46_Part_1">Pt_1<br />[Pg 46]</a></span>
+
+I have found a very considerable number of cases
+exhibiting, singly, or in partial combination, every possible degree,
+and almost every kind of increased action."&mdash;"Very full, hard, and quick
+pulse, hot skin, and flushed surface; evacuations of bile, [you are
+requested to note this, reader] both by vomiting and stool, from the
+commencement of the attack. And, finally, I have seen some of those
+cases passing into the low form of the disease."&mdash;"The inference from
+these facts is plain, however opposite these two forms of disease may
+appear, <i>there is no essential or general difference between them</i>."
+After such authorities, and what has elsewhere been shewn, can any
+cavelling be for one moment permitted as to the cholera in Sunderland
+not being of the same nature as that of India? It may be now clearly
+seen that in India as in Sunderland, the same variety of grades occurred
+in the disease.</p>
+
+<p>In making my communications for the benefit of the public, it is my wish
+to spare the feelings of Sir Gilbert Blane; but as he persists in giving
+as facts often refuted tales of contagion, in order to uphold doctrines
+which he must observe are tumbling into ruins in all directions, it
+becomes necessary that his work of mischief should no longer remain
+unnoticed.</p>
+
+<p>Not a single circumstance which he quotes relative to the marchings and
+the voyages of the contagion of cholera will bear the slightest
+examination; and yet he has detailed them as if, on his simple
+assertion, they were to be received as things proved, and, consequently,
+as so many points to be held in view when the public are in search of
+rules whereby they may be guided. The examination of his assumed facts
+for one short hour, by a competent tribunal, would prove this to be the
+case; here it is impossible to enter upon them all: but let us just
+refer to his <i>management</i> of the question relative to the importation of
+the disease into the Mauritius by the <i>Topaze</i> frigate, which he says
+was not believed there to be the case&mdash;and <i>why</i> was it not believed?
+Sir Gilbert takes special care not to tell the public, but they now have
+the reason from me, at page&nbsp;22.</p>
+
+<p>If a commission be appointed, half an hour will suffice to place before
+them, from the medical office in Berkeley-street, the reports alluded to
+from the Mauritius, by which it is made apparent that long before the
+arrival of the aforesaid frigate, the disease had shown itself in the
+Mauritius.<a name="FNanchor_14_14" id="FNanchor_14_14"></a><a href="#Footnote_14_14" class="fnanchor">[14]</a> What
+is the public to think of us and our profession,
+when vague statements are daily attempted to be passed as facts, by
+contagionists <i>enrag&eacute;s</i>? One more short reference to Sir Gilbert's
+facts.&mdash;While referring to the progress of cholera in India,&nbsp;&amp;c.
+from 1817, he says, in a note, "it is remarkable enough that while the great
+oriental epidemic appeared thus on the eastern extremity of the
+Mediterranean, the great western pestilence, the yellow fever, was
+raging in its western extremity, Gibraltar, Malaga, Barcelona, Leghorn,
+&amp;c." Now, it is a historical fact, that, at Gibraltar, this disease did
+not appear between 1814 and 1828&mdash;<i>and at Leghorn
+
+<!-- Page 47 -->
+
+<span class="pagenum1"><a name="Page_47_Part_1" id="Page_47_Part_1">Pt_1<br />[Pg 47]</a></span>
+
+not since&nbsp;1804</i>! At
+Malaga, I believe, it did not prevail since&nbsp;1814! So we have here a
+pretty good specimen of the accuracy of some of those who undertake to
+come forward as guides to the public on an occasion of great urgency and
+peril. By some of Sir Gilbert's abettors, we are assured that his "facts
+are perfectly reconcileable with the hypothesis of the cholera being of
+an infectious nature." A fig for all hypothesis just now! Let us have
+something like the old English trial by jury. May I be allowed to
+introduce a fresh evidence to the public notice, in addition to the
+thousand-and-one whose testimony is already recorded. He is worthy of
+belief for two good reasons in particular; the one because he still
+(unable to explain what can never be explained, perhaps), calls himself
+a contagionist, and, in the next place, the statements being from a high
+official personage, he could not offer them unless true to his
+Government, as hundreds might have it in their power to contradict them
+if not accurate. My witness is not a Doctor, but a <i>Duke</i>&mdash;the Duke
+de&nbsp;<i>Mortemar</i>, lately Ambassador from the French Court to St.&nbsp;Petersburg,
+who has just published a pamphlet on cholera, a few short extracts from
+which, but those most important ones, I shall here give. Read
+them!&mdash;people of all classes, read them over and over again! "An
+important truth seems to be proved by what we shall here relate, which
+is, that woods seem to diminish the influence of cholera, and that
+cantons in the middle of thick woods, and placed in the centre of
+infected countries, have altogether escaped the devastating
+calamity!"&mdash;"The island of Kristofsky, placed in the centre of the
+populous islands of St.&nbsp;Petersburg, communicating with each other by two
+magnificent bridges, and with the city by thousands of boats, which
+carried every day, and particularly on Sundays, a great number of people
+to this charming spot. The island of Kristofsky, we say, <i>was preserved
+completely from attacks of the cholera</i>; there was not a <i>single</i> person
+ill of the disease in three villages upon it." He continues to state
+particulars, which, for want of time, cannot be here given, and
+adds&mdash;"To what is this salubrity of Kristofsky, inhabited by the same
+sort of people as St.&nbsp;Petersburg, to be attributed, fed in the same
+manner, and following a similar <i>regime</i>,&mdash;communicating with each other
+daily, if it be not to the influence of the superb forest which shelters
+it? The firs, which are magnificent as well as abundant, surround the
+houses."<a name="FNanchor_15_15" id="FNanchor_15_15"></a><a href="#Footnote_15_15" class="fnanchor">[15]</a> He
+notices that the town is low and humid, and that "it is
+made filthy every Sunday by the great numbers who resort to it, and who
+gorge themselves with intoxicating drink." In a third letter I shall be
+able to furnish further extracts from this most interesting pamphlet.</p>
+
+<div class="footnote">
+<p>
+<a name="Footnote_14_14" id="Footnote_14_14"></a>
+<a href="#FNanchor_14_14"><span class="label">[14]</span></a>
+
+I am aware that very lately certain memoranda have been
+referred to from the surgeon, but this is merely an expiring effort, and
+of no avail against the official Report drawn up.
+</p>
+</div>
+
+<div class="footnote">
+<p>
+<a name="Footnote_15_15" id="Footnote_15_15"></a>
+<a href="#FNanchor_15_15"><span class="label">[15]</span></a>
+
+As these most remarkable circumstances have not appeared
+in the statements of our Russian medical commission, we must either
+presume that the Duke is not correct, or that those facts have <i>escaped
+the notice</i> of the commission.
+</p>
+</div>
+
+<p>In a letter lately inserted in a newspaper, the greatest injustice is
+done to the Board of Health by the comments made on their
+recommendations for the <i>treatment</i> of cholera&mdash;<i>it is not true</i> that
+they have reccommended <i>specifics</i>, and I must add my feeble voice in
+full approbation of all they have suggested on this point. Let the
+public remark that they most judiciously
+
+<!-- Page 48 -->
+
+<span class="pagenum1"><a name="Page_48_Part_1" id="Page_48_Part_1">Pt_1<br />[Pg 48]</a></span>
+
+point at the application of
+<i>dry</i> heat, not baths, which always greatly distress the patient, and,
+indeed, have sometimes been observed (that is, where the coldness and
+debility are very great) to accelerate a fatal issue. Of all the
+arrangements to which a humane public can direct their attention, there
+is nothing so essential as warmth. I would, therefore, humbly beg to
+suggest, that funds for the purpose of purchasing coals for gratuitous
+issue to the poor should be at once established in all directions. Too
+much, I think, has been said about ventilation and washing, and too
+little about this.</p>
+
+<div class="signl">
+November&nbsp;10th.
+</div>
+
+<hr class="major" />
+
+<h2><a name="LETTER_VIII_Part_1" id="LETTER_VIII_Part_1"></a>LETTER VIII.</h2>
+
+<p>Already has the problem of the contagious or non-contagious nature of
+this disease been solved upon our own land; and as sophistry can no
+longer erect impediments to the due distribution of the resources of
+this pre-eminently humane nation, it is to be hoped that not an hour
+will be lost in shaping the arrangements accordingly. What now becomes
+of the doctrine of a poison, piercing and rapid as the sun's rays,
+emanating from the bodies of the sick&mdash;nay, from the bodies of those who
+are not sick, but who have been near them or near their houses? In the
+occurrences at Newcastle and Sunderland, how has the fifty times refuted
+doctrine of the disease spreading from a point in <i>two</i> ways, or in one
+way, tallied with the facts? We were desired to believe that in India,
+Persia, &amp;c., "the contagion <i>travelled</i>," as the expression is, very
+slow, because this entity of men's brains was obliged to wend its way
+with the march of a regiment, or with the slow caravan: now, however,
+when fifty facilities for the most rapid conveyance have been afforded
+every hour since its first appearance, it will not put itself one bit
+out of its usual course. And then what dangers to the attendants on the
+sick to the members of the same family&mdash;to the washerwomen&mdash;to the
+clergymen&mdash;to the buriers of the dead&mdash;even to those who passed the door
+of the poor sufferer! Well, what of all this has occurred? Why it has
+occurred that this doctrine, supported by many who were honest, but had
+not duly examined alleged facts, and by others, I regret to say, whose
+interests guided their statements&mdash;that the absurdity of this doctrine
+has now been displayed in the broad light of day. Make allowance (even
+in this year of great notoriety for susceptibility to cholera in the
+people at large in this country) for <i>insusceptibility</i> on the part of
+numbers who came into contact at Sunderland and Newcastle, with the
+persons of cholera patients, with their beds, their furniture, their
+clothes, &amp;c., yet, if there had ever been the slightest foundation for
+the assertions of the contagionists, what numbers <i>ought</i> to have been
+contaminated, in all directions over the face of the country, even
+within the first few days, considering the wonderful degree of
+intercourse kept up between all parts. But we find that, as in Austria
+and Prussia, "<i>la&nbsp;maladie de la terre</i>" is not disposed here to
+accommodate itself to vain
+
+<!-- Page 49 -->
+
+<span class="pagenum1"><a name="Page_49_Part_1" id="Page_49_Part_1">Pt_1<br />[Pg 49]</a></span>
+
+speculations. <i>Now</i> the matter may be
+reduced to the simple rules of arithmetic, viz.:&mdash;if, as "contagionists
+<i>par metier</i>" say, the poison from the body of one individual be, in the
+twinkling of an eye, and in more ways than one, transmitted to the
+bodies of a certain number who have been near him, &amp;c., how many
+thousands, or tens of thousands, in every direction, should, in a
+multiplied series of communications and transmissions, be now affected?</p>
+
+<p>Those who have watched the course of matters connected with cholera in
+this country, have not failed to perceive, for some time past, the
+intent and purport of the assertion so industriously put forth&mdash;that the
+disease might be introduced by people in perfect health; and we have
+just seen how this <i>ruse</i> has been attempted to be played off at
+Sunderland, as the history of such matters informs us has been done
+before in other instances, and public vengeance invoked most <i>foully and
+unjustly</i> upon the heads of guiltless persons in the Custom House or
+Quarantine Department, for "permitting a breach of regulations;" but the
+several pure cases of spasmodic cholera, in many parts of England
+besides Sunderland, long before&mdash;months before&mdash;the arrival of <i>the</i>
+ship (as shewn in a former letter) leave no pretence for any supposition
+of this kind.</p>
+
+<p>I request that the public may particularly remark, that, frequently as
+those cases have been cited as proofs of the absurdity of <i>expecting the
+arrival</i> of the disease by a ship, <span class="smcap">their identity has never once been
+disputed by those most anxious to prove their case</span>. No; the point has,
+in common parlance, been always <i>shirked</i>; for whoever should doubt it,
+would only hold himself up to the ridicule of the profession, and to
+admit it would be to give up the importation farce.</p>
+
+<p>Others have remarked before me that, though a very common, it is a very
+erroneous mode of expression, to say of cholera, that <i>it has travelled</i>
+to such or such a place, <i>or has arrived</i> at such or such places, for it
+is <i>the cause</i> of the malady which is found to prevail, for a longer or
+shorter time, at those different points. It cannot be expected that
+people should explain such matters, for, with regard to them, our
+knowledge seems to be in its infancy, and "we want a sense for atoms."
+However, as people's minds are a good deal occupied upon the point, and
+as many are driven to the idea of contagion in the face even of
+evidence, from not being able to make any thing of this <i>casse-t&ecirc;te</i>,
+the <i>best guess</i> will probably be found in the quotation from Dr.&nbsp;Davy,
+at page&nbsp;19.</p>
+
+<p>I perceive that the Berlin Gazette is humanely occupied in recommending
+others to profit by the mistakes regarding contagion which occurred in
+that country:&mdash;"Dr.&nbsp;Sacks, in No.&nbsp;38 of his Cholera Journal, published
+here, has again shewn, against Dr.&nbsp;Rush, the fallibility of the doctrine
+of contagion, as well as the mischievous impracticability of the
+attempts founded on it to arrest the progress of the disorder by cutting
+off the communications. It is to be hoped that the alarm so methodically
+excited by scientific and magisterial authority in the countries to the
+west of&nbsp;us&nbsp;[!!] will cease, after the ample experience which we have
+dearly purchased
+
+<!-- Page 50 -->
+
+<span class="pagenum1"><a name="Page_50_Part_1" id="Page_50_Part_1">Pt_1<br />[Pg 50]</a></span>
+
+(with some popular tumults), and that the system of
+incommunication will be at once done away with by all enlightened
+governments, after what has passed among us."&mdash;I am sure, good people,
+nobody can yet say whether those calling themselves scientific, will
+allow us to profit by your sad experience; but I believe that the people
+of Sunderland are not to be shut in, but allowed to remove, if they
+choose, in spite of silly speculations.</p>
+
+<p>It may not be uninteresting to mention here, that there are no
+quarantines and no choleras in Bohemia or Hanover.</p>
+
+<hr class="major" />
+
+<h2><a name="LETTER_IX_Part_1" id="LETTER_IX_Part_1"></a>LETTER IX.</h2>
+
+<p>The following statement from the Duke de&nbsp;Mortemar will be considered
+probably, very curious, considering that, as already stated, he seems to
+believe in something like contagion&mdash;and for no earthly reason, one may
+suppose, than from his inability to satisfy himself of the existence of
+another cause&mdash;as if it were not sufficient to prove that in reality the
+moon <i>is not</i> made of green cheese, but one must prove <i>what it is</i> made
+of! But, to the quotation&mdash;"The conviction now established, that
+intercourse with sick produces no increase of danger, should henceforth
+diminish the dread of this calamity (the cholera). It differs from the
+plague in this, that it does not, by its sole appearance, take away all
+hope of help, and destroy all the ties of family and affection.
+Henceforth those attacked will not be abandoned without aid and
+consolation; and separation or removal to hospital, the source of
+despair, will no longer increase the danger. The sick may in future be
+attended without fears for one's self, or for those with whom we live."
+How delightful is the simplicity of truth! Why, Sir, a morceau like
+this, and from an honourable man, let him call himself contagionist or
+what he may, is more precious at this moment than Persian turkois or
+Grecian gems. Make me an example, men say, of the culprits "who let the
+cholera morbus into Sunderland," concealed in "susceptible"
+articles!&mdash;yes, and that we may be on a level in other matters, destroy
+me some half dozen witches, too, as we were wont to do of yore. But let
+us have more tidings from Russia to comfort the country of our
+affections in the hour of her affliction, when so much craft and
+subtlety is on foot to scare her. Dr.&nbsp;Lefevre, physician to our embassy
+at St.&nbsp;Petersburg, has just given to the public an account of his
+observations there during the epidemic, from which the following
+extracts are made:&mdash;</p>
+
+<p>"As far as my practice is concerned both in the quarter allotted to me,
+and also in private houses in different parts of the town, I have no
+proof whatever that the disease is contagious.</p>
+
+<p>"The first patient I saw was upon the third day of the epidemic, and
+upon strict inquiry I could not trace the least connexion between the
+patient, or those who were about her person, with that part of the town
+where it first appeared&mdash;a distance of several versts.</p>
+
+<p>
+<!-- Page 51 -->
+
+<span class="pagenum1"><a name="Page_51_Part_1" id="Page_51_Part_1">Pt_1<br />[Pg 51]</a></span>
+
+"As regards the attendants of the sick, in no one instance have I found
+them affected by the disease, though in many cases they paid the most
+assiduous attention, watched day and night by the beds of the afflicted,
+and administered to all their wants.</p>
+
+<p>"I knew four sisters watch anxiously over a fifth severely attacked with
+cholera, and yet receive no injury from their care.</p>
+
+<p>"In one case I attended a carpenter in a large room, where there were at
+least thirty men, who all slept on the floor among the shavings; and,
+though it was a severe and fatal case, no other instance occurred among
+his companions.</p>
+
+<p>"In private practice, among those in easy circumstances, I have known
+the wife attend the husband, the husband the wife, parents their
+children, children their parents, and in fatal cases, where, from long
+attendance and anxiety of mind, we might conceive the influence of
+predisposition to operate, in no instance have I found the disease
+communicated to the attendants."&mdash;p.&nbsp;32,&nbsp;33.</p>
+
+<p>"The present disease has borne throughout the character of an epidemic,
+and when the proofs advanced in proof of its contagion have been
+minutely examined, they have been generally found incorrect; whereas it
+is clear and open to every inquirer, that the cholera did not occur in
+many places which had the greatest intercourse with St.&nbsp;Petersburg at
+the height of the malady, and that it broke out in many others which
+have been subjected to the strictest
+quarantine."&mdash;p.&nbsp;34.<a name="FNanchor_16_16" id="FNanchor_16_16"></a><a href="#Footnote_16_16" class="fnanchor">[16]</a>
+</p>
+
+<div class="footnote">
+<p>
+<a name="Footnote_16_16" id="Footnote_16_16"></a>
+<a href="#FNanchor_16_16"><span class="label">[16]</span></a>
+
+It is remarkable enough that Aret&aelig;us, who lived, according
+to some authors, in the first century, gives exactly the same reason
+which Dr.&nbsp;Lefevre does for the suppression of urine in cholera. So true
+it is, that that symptom, considered as one of the characteristics of
+the Indian cholera, was observed in ancient times.
+</p>
+</div>
+
+<p>Hear all this, Legislators! Boards of Health throughout the country,
+hear it! Then you will be able to judge how exceedingly frivolous the
+idle <i>opinions</i> and <i>reports</i> are which you have obtruded so
+industriously upon your notice.</p>
+
+<p>But one more short quotation from Dr.&nbsp;Lefevre, a gentleman certainly not
+among the number of those who stand denounced before the professional
+world as unworthy of belief. He says:&mdash;"As for many reports which have
+been circulated, and which, <i>prim&acirc; facie</i>, seem to militate against the
+statement [communication to attendants, &amp;c.]. I have endeavoured to pay
+the most impartial attention to them; but I have never found, upon
+thorough investigation, that their correctness could be relied upon: and
+in many instances I have ascertained them to be designedly
+false."&mdash;<span class="smcap">Designedly false!</span> Alas! <i>toute &ccedil;a on trouve dans l'article</i>
+<span class="smcap">Homme</span>; and any body who chooses to investigate, as I have done, the
+history of epidemics, will find that falsehoods foul have been resorted
+to&mdash;shamelessly resorted to&mdash;by persons having a direct interest in
+maintaining certain views. Enough, then, has been said to put Boards of
+Health, &amp;c. on their guard against admitting <i>facts</i> for their guidance
+from any quarter whatever, if the purity of the source be not right well
+established. There is too much at stake just now to permit of our
+
+<!-- Page 52 -->
+
+<span class="pagenum1"><a name="Page_52_Part_1" id="Page_52_Part_1">Pt_1<br />[Pg 52]</a></span>
+
+yielding with ill-timed complaisance to <i>any authority</i> without
+observing this very necessary preliminary.</p>
+
+<p>One word, and with all due respect, before closing, on the subject of
+Dr.&nbsp;James Johnson's "<i>contingent</i> contagion," which, though occurring in
+some diseases, and extremely <i>feasible</i> in regard to others, will, if he
+goes over the evidence again, I am sure, be shown not to apply to
+cholera, which is strictly a disease of <i>places</i>, not persons, and can
+no more be generated by individuals than ague itself can. I can only say
+of it, with the philosophic poet, that&mdash;</p>
+
+<div class="indentverse">
+--------------------"A secret venom oft<br />
+Corrupts the air, the water, and the land."
+</div>
+
+<p>Mr.&nbsp;Searle, an English gentleman, well known for his work on cholera,
+has just returned from Warsaw, where he had the charge of the principal
+cholera hospital during the epidemic. The statements of this gentleman
+respecting contagion, being now published, I am induced from their high
+interest to give them here:&mdash;</p>
+
+<p>"I have only to add my most entire conviction that the disease is not
+contagious, or, in other words, communicable from one person to another
+in the ordinary sense of the words&mdash;a conviction, which, is founded not
+only upon the nature of the disease, but also upon observations made
+with reference to the subject, during a period of no less than fourteen
+years. Facts, however, being deservedly of more weight than mere
+opinions, I beg leave to adduce the following, in the hope of relieving
+the minds of the timid from that groundless alarm, which might otherwise
+not only interfere with or prevent the proper attendance upon the sick,
+but becomes itself a pre-disposing or exciting cause of the disease; all
+parties agreeing that of all the debilitating agencies operating upon
+the human system, there is no one which tends to render it so peculiarly
+susceptible of disease, and of cholera in particular, than fear.</p>
+
+<p>"The facts referred to are these:&mdash;during two months of the period, that
+I was physician to the principal hospital at Warsaw, devoted to the
+reception and treatment of this disease, out of about thirty persons
+attached to the hospital, the greater number of them were in constant
+attendance upon the sick, which latter were, to the number of from
+thirty to sixty, constantly under treatment; there were, therefore,
+patients in every stage of the disease. Several of these attendants,
+slept every night in the same apartments with the sick, on the beds
+which happened to be unoccupied, with all the windows and doors
+frequently closed. These men, too, were further employed in assisting at
+the dissection of, and sewing up of, the bodies of such as were
+examined, which were very numerous; cleansing also the dissecting-room,
+and burying the dead. And yet, notwithstanding all this, only one,
+during the period of two months, was attacked by the disease, and this
+an habitual drunkard, under circumstances, which entirely negative
+contagion, (supposing it to exist), as he had nothing whatever to do
+with the persons of the sick, though he occasionally assisted at the
+interment of the dead. He was merely a subordinate assistant to the
+apothecary, who occupied a detached building with some of the families
+of the attendants;
+
+<!-- Page 53 -->
+
+<span class="pagenum1"><a name="Page_53_Part_1" id="Page_53_Part_1">Pt_1<br />[Pg 53]</a></span>
+
+all of whom likewise escaped the disease. This man,
+I repeat, was the only one attacked, and then under the following
+circumstances."</p>
+
+<p>Here Mr.&nbsp;S. relates how this man, having been intoxicated for several
+days&mdash;was, as a punishment locked up almost naked in a damp room for two
+nights, having previously been severely beaten.</p>
+
+<p>From the foregoing facts, and others pretty similar in all parts of the
+world where this disease has prevailed, we are, I think, fairly called
+upon to discard all special pleading, and to admit that man's <i>best
+endeavours</i> have not been able <i>to make it</i> communicable by any manner
+of means.</p>
+
+<hr class="major" />
+
+<h2><a name="LETTER_X_Part_1" id="LETTER_X_Part_1"></a>LETTER X.</h2>
+
+<p>At a meeting held some days ago by the members of the Royal Academy of
+Medicine of Paris, Dr.&nbsp;Londe (President of the French Medical Commission
+sent to Poland to investigate the nature of the cholera) stated, with
+regard to the questions of the origin and <i>communicability</i> of the
+disease, that it appeared by a document to which he referred, that
+1st.&nbsp;"The cholera did not exist in the Russian corps which fought at
+<i>Iganie</i>," the place where the first battle with the Poles took place.
+2d.&nbsp;"That the two thousand Russian prisoners taken on that occasion, and
+observed at Praga for ten days under the most perfect separation, [<i>dans
+un isolement complet</i>] did not give a single case of cholera." 3d.&nbsp;"That
+the corps [of the Polish army] which was not at <i>Iganie</i>, had more cases
+of cholera than those which were there." Dr.&nbsp;Londe stated cases of the
+spontaneous development of the disease in different individuals&mdash;of a
+French Lady confined to her bed, during two months previous to her
+attack of cholera, of which she died in twenty-two hours&mdash;of a woman of
+a religious order, who had been confined to her bed for six months, and
+while crossing a balcony, the aspect of which was to the Vistula, was
+attacked with cholera, and died within four hours. Dr.&nbsp;Londe, among
+other proofs that the disease was not transmissible, or, as some prefer
+calling it, not communicable, stated, "the immunity of wounded and
+others mixed with the cholera patients in the hospitals; the immunity of
+medical men, of attendants, of inspectors, and of the families of the
+different <i>employ&eacute;s</i> attached to the service of cholera patients; the
+example of a porter, who died of the disease, without his wife or
+children, who slept in the same bed with him, having been attacked; the
+example of three women attacked (two of whom died, and one recovered),
+and the children at their breasts, one of six months, and the other two
+of twelve, not contracting the disease."</p>
+
+<p>At a subsequent meeting of the Academy, a letter from Dr.&nbsp;Gaymard, one
+of the Commission to St.&nbsp;Petersburg, was read, in which it was stated,
+while referring to the comparative mortality at different points there,
+that, "The cause of this enormous difference was, that the authorities
+wished to isolate the sick&mdash;[Observe this well reader]&mdash;and even send
+them out of the city; now the hospital is on a steep mountain, and, to
+get
+
+<!-- Page 54 -->
+
+<span class="pagenum1"><a name="Page_54_Part_1" id="Page_54_Part_1">Pt_1<br />[Pg 54]</a></span>
+
+to it, the carriages were obliged to take a long circuit through a
+sandy road, which occupied an hour at least; and if we add to the
+exposure to the air, the fatigue of this removal, and the time which
+elapsed after the invasion of the disease, the deplorable state of the
+patient on his arrival, and the great mortality may be accounted for."</p>
+
+<p>"The progress of the disease was the same as in other places; it was at
+the moment when it arrived at its height, and when, consequently, the
+greatest intercourse [Observe reader!] took place with the sick, that
+the number of attacks wonderfully diminished all at once (<i>tout &agrave;
+coup</i>), and without any appreciable cause. The points of the city most
+distant from each other were invaded. Numbers of families crowded
+[<i>entass&eacute;s</i>] who had given aid to cholera patients, remained free from
+the disease, while persons isolated in high and healthy situations
+[<i>usually</i> healthy meant of course] were attacked. It especially
+attacked the poorer classes, and those given to spirituous liquors.
+Scarcely twenty persons in easy circumstances were attacked, and even
+the greater part of these had deviated from a regular system."</p>
+
+<p>The inferences drawn, according to a medical journal, from the whole of
+Dr.&nbsp;Gaymard's communication, are&mdash;</p>
+
+<p>"1. That the system of sanatory measures, adopted in Russia, did not any
+where stop the disease.</p>
+
+<p>"2. That without entering on the question as to the advantages to be
+derived from a moral influence arising out of sanatory cordons, placed
+round a vast state like France, these measures are to be regarded as
+useless in the interior, in towns, and round houses.</p>
+
+<p>"3. That nothing has been able to obstruct the progressive advance of
+the disease in a direction from India westward.</p>
+
+<p>"4. That the formation of temporary hospitals, and domiciliary succour,
+are the only measures which can alleviate this great scourge."</p>
+
+<p>A letter from Dr.&nbsp;Gaymard to Dr.&nbsp;Keraudren was read at the meeting of
+the Academy, in which it was stated, that in an Hospital at Moscow, in
+which Dr.&nbsp;Delauny was employed from the month of December,&nbsp;1830, to the
+end of December,&nbsp;1831, 587&nbsp;cholera patients, and 860 cases of other
+diseases, were treated&mdash;"Not one of the latter was attacked with
+cholera, although the hospital consists of one building, the coridors
+communicating with each other, and the same linen serving
+indiscriminately for all. The attendants did not prove to be more liable
+to attacks. The relatives were suffered to visit their friends in
+hospital, and this step produced the best impression on the populace,
+who remained calm. They can establish at Moscow, that there was not the
+smallest analogy between the cholera and the plague which ravaged that
+city in the reign of Catharine." Dr.&nbsp;Gaymard declares, that, having gone
+to Russia without preconceived ideas on the subject, "he is convinced
+that interior quarrantines, and the isolation of houses and of sick in
+towns, has been accompanied by disastrous consequences." Is there yet
+enough of evidence to shew that this disease is positively <i>not to be
+made</i> communicable from the sick?</p>
+
+<p>Honour still be to those of the profession who, from conscientious and
+honorable motives, have changed from non-contagionists to contagionists in
+
+<!-- Page 55 -->
+
+<span class="pagenum1"><a name="Page_55_Part_1" id="Page_55_Part_1">Pt_1<br />[Pg 55]</a></span>
+
+regard to this disease; and all that should be demanded is, that
+their <i>opinions</i> may not for one moment be suffered to outweigh, on an
+occasion of vital importance, the great mass of evidence now on record
+quite in accordance with that just stated. One gentleman of
+unquestionable respectability gives as a reason (seemingly his very
+strongest) for a change of opinion, that he has been credibly informed
+that when the cholera broke out on one side of the street in a certain
+village in Russia, a medical man had a barrier put up by which the
+communication with the other side was cut off, and the disease thus,
+happily, prevented from extending. Now, admitting to the full extent the
+appearance of the disease on one side of the village only&mdash;a thing by
+the way hitherto as little proved as many others on the contagion side
+of the question&mdash;still, if there be any one thing more striking than
+another, in the history of the progress of cholera, it is this very
+circumstance of opposite rows of houses, or of barracks, or bazaars, or
+lines of camp, being free, while the disease raged in the others, and
+without any sort of barricading or restriction of intercourse. If people
+choose to take the trouble to look for the evidence, <i>plenty</i> of such is
+recorded. Now just consider for one moment how this famous Russian story
+stands: had the barricading begun early, the matter would have stood an
+examination a little better; but this man of good intentions never
+thought of his barriers till the one-sided progress of the disease had
+been manifest enough, <i>without them</i>:&mdash;and then consider how the
+communication had existed between both rows before those barriers were
+put up, and how impossible it was, unless by a file of soldiers, to have
+debarred all communication:&mdash;let all this be considered, and probably
+the case will stand at its true value, which is, if I may take the
+liberty of saying so,&mdash;just nothing at all. Let us bear in mind the
+circumstance already quoted from the East India records,&mdash;of one company
+of the 14th&nbsp;Regiment, at the extreme end of a barrack, escaping the
+disease, almost wholly, while it raged in the other nine; and this
+without a barrier too. But such circumstances are by no means of rare
+occurrence in other diseases arising from deteriorated atmosphere.
+Mr.&nbsp;Wilson, a naval surgeon, has shewn how yellow fever has prevailed <i>on
+one side</i> of a ship, and I have had pointed out to me, by a person who
+lived near it for thirty years, a spot on this our earth where <i>ague</i>
+attacks only those inhabiting the houses in one particular line, and
+without any difference as to elevation or other appreciable cause,
+except that the sun's rays do not impinge equally on both ranges in the
+morning and evening.</p>
+
+<p>The advancement of the cause of truth has, no doubt, suffered some check
+in this country, by the announcement that another gentleman of great
+respectability (Mr.&nbsp;Orton) finds his belief as to non-contagion in
+cholera a good deal shaken: but we find that this change has not arisen
+from further personal knowledge of the disease, and if it be from any
+representations regarding occurrences in Europe, connected with cholera,
+we have seen how, from almost all quarters, the evidence lies quite on
+the side of his first opinions. Whatever the change may be owing to, we
+should continue, as in other cases, not to give an undue preference even
+to opinions coming from him, to well authenticated facts&mdash;facts, among which
+
+<!-- Page 56 -->
+
+<span class="pagenum1"><a name="Page_56_Part_1" id="Page_56_Part_1">Pt_1<br />[Pg 56]</a></span>
+
+some particularly strong are still furnished <i>by himself</i>, even in
+the second edition of his book:&mdash;"It must be admitted that, in a vast
+number of instances in India, those persons [medical men and attendants]
+have suffered no more from the complaint than if they had been attending
+so many wounded men. This is a fact which, however embarrassing to the
+medical inquirer, [for our part we cannot see the <i>embarrassment</i>] is
+highly consolatory in a practical point of view, both to him and to all
+whose close intercourse with the sick is imperatively
+required."&mdash;(<i>p.&nbsp;316</i>)&mdash;"We are therefore forced to
+the conclusion, however, at variance
+with the common laws of contagion, that in this disease,&mdash;at least in
+India, the most intimate intercourse with the sick is not, in general,
+productive of more infection than the average quantity throughout the
+community." (<i>p.&nbsp;326</i>). Let us contrast the statements in the following
+paragraphs:&mdash;"For in all its long and various courses, it may be traced
+from place to place, and has never, as far as our information extends,
+started up at distant periods of time and space, leaving any
+considerable intervening tracts of country untouched." (p.&nbsp;329)&mdash;"All
+attempts to trace the epidemic to its origin at a point, appears to have
+failed, and to have shewn that it had not one, but various local sources
+in the level and alluvial, the marshy and jungly tract of country which
+forms the delta of the Ganges, and extends from thence to the
+Burraumposter." (p.&nbsp;329) Now let us observe what follows regarding the
+particular <i>regularity</i> in the progress of the disease, as just
+mentioned:&mdash;"Another instance of irregularity in its course, even in
+those provinces where it appears to have been most regular, is stated
+[now pray observe] in its having skipped from Verdoopatly to a village
+near Palamacotta, leaving a distance of sixty miles at first
+unaffected." (p.&nbsp;332)!!&mdash;This is not the way to obtain proselytes I
+presume.</p>
+
+<p>The situation of our medical brethren at Sunderland is most perplexing,
+and demands the kindest consideration on the part of the country at
+large; but let nothing which has occurred disturb the harmony so
+essential to the general welfare of that place, should their combined
+efforts be hereafter required on any occasion of public calamity. In
+truth both parties may be said to be right&mdash;the one in stating that the
+disease in question <i>is Indian cholera</i>, because the symptoms are
+precisely similar&mdash;the other that it <i>is not Indian cholera</i>, because it
+exists in Sunderland, and without having been imported&mdash;<span class="smcap">in neither
+country is it communicable from one person to another</span>, as is now plainly
+shown upon evidence of a nature which will bear any investigation; and
+if blame, on account of injury to commerce, be fairly attributable to
+any, it is to those who, all the world over, pronounced this disease, on
+grounds the most untenable, a disease of a contagious or communicable
+nature. Let the Sunderland Board of Health not imagine that their
+situation is new, for similar odium has fallen <i>on the first</i> who told
+the plain truth, in other instances&mdash;at Tortosa, a few years ago, the
+first physician who announced the appearance of the yellow fever, was,
+according to different writers, <i>stoned to death</i>; and at Barcelona,
+in 1821, a similar fate had well nigh occurred to Dr.&nbsp;Bahi, one of the most
+
+<!-- Page 57 -->
+
+<span class="pagenum1"><a name="Page_57_Part_1" id="Page_57_Part_1">Pt_1<br />[Pg 57]</a></span>
+
+eminent men there&mdash;we need not, I presume, fear that a scene of
+this kind will take place in this country,&mdash;though the cries of "no
+cholera!" and "down with Ogden!" have been heard.</p>
+
+<p>One word as to observations regarding the needlessness of discussing the
+contagion question: the truth is, that the cleanliness and comfort of
+the people excepted, you can no more make <i>other arrangements</i> with
+propriety, till this point be settled, than a General can near the enemy
+by whom he is threatened, till it be ascertained whether that enemy be
+cavalry or infantry.</p>
+
+<p>My object in these letters is not to obtrude opinions upon the public,
+being well aware that they cannot be so well entitled as those of many
+others, to attention; but I wish to place before the public, for their
+consideration, a collection of facts which I think are likely to be of
+no small importance at a moment like the present. In addition to the
+many authorities referred to in the foregoing pages, I would beg to call
+the public attention to a paper in the <i>Windsor Express</i> of the
+12th&nbsp;November, by Dr.&nbsp;Fergusson, Inspector General of Hospitals, a gentleman
+of great experience, and who has given the <i>coup de&nbsp;grace</i> to the
+opinion of contagion in cholera. Indeed the opinion now seems to be
+virtually abandoned; for, as to quarantine on our ships from Sunderland,
+it is, perhaps, a thing that cannot be avoided, if the main
+consideration be <i>the expediency of the case</i>, until an arrangement
+between leading nations takes place. We have seen, in regard to Austria,
+how the matter stands, and our ships from every port in the country
+would be refused admission into foreign ports, if we did not subject
+those from Sunderland to quarantine; which state of things, it is hoped,
+will now be soon put an end to.</p>
+
+<hr class="bigspacer" />
+
+<div class="center">FINIS.</div>
+
+<hr class="bigspacer" />
+
+<hr class="minor" />
+
+<div class="center size80">
+Nichols and Sons, Printers,<br />
+Cranbourn-street, Leicester-square.
+</div>
+
+<hr class="major" />
+
+<hr class="bigspacer" />
+
+<div class="center">
+<span class="size90">WINDSOR:</span><br />
+<span class="size80">PRINTED BY R.&nbsp;OXLEY, AT THE EXPRESS OFFICE.</span>
+</div>
+
+<hr class="major" />
+
+<div>
+<!-- Page 3 -->
+
+<span class="pagenum2"><a name="Page_3_Part_2" id="Page_3_Part_2">Pt_2<br />[Pg 3]</a></span>
+</div>
+
+<h1><a name="PART_2" id="PART_2"></a>
+LETTERS
+<br />
+<br />
+<span class="size40">ON THE</span>
+<br />
+<br />
+CHOLERA MORBUS,
+<br />
+<br />
+<span class="size50">&amp;c.&nbsp;&amp;c.&nbsp;&amp;c.</span></h1>
+
+<hr class="minor" />
+
+<div class="signr">
+<span class="smcap">Windsor, Feb.&nbsp;9,&nbsp;1832.</span>
+</div>
+
+<hr class="spacer" />
+
+<div class="center">
+Salus populi suprema Lex.
+</div>
+
+<hr class="spacer" />
+
+<p>In writing the following letters, which I have given in the order of
+their respective dates, I was actuated by the state of the public mind
+at the time in regard to the dreaded disease of which they principally
+treat. The two first were addressed to the Editor of the <span class="smcap">Windsor
+Express</span>, and the third to a Medical Society here, of which I am a
+member. The contemplation of the subject has beguiled many hours of
+sickness and bodily pain, and I now commit the result to the press in a
+more connected form, from the same motives, I believe, that influence
+other writers&mdash;zeal in the cause of truth, whatever that may turn out to
+be, and predilection for what has flowed from my own pen, not however
+without the desire and belief, that what I have thus written may prove
+useful in the discussion of a question which has in no small degree
+agitated our three kingdoms, and most deeply interested every civilized
+nation on the face of the earth.</p>
+
+<p>
+<!-- Page 4 -->
+
+<span class="pagenum2"><a name="Page_4_Part_2" id="Page_4_Part_2">Pt_2<br />[Pg 4]</a></span>
+
+No one, unless he can take it upon him to define the true nature of this
+new malignant Cholera Morbus, can be warranted utterly to deny the
+existence of contagion, but he may at the least be permitted to say,
+that if contagion do exist at all, it must be the weakest in its powers
+of diffusion, and the safest to approach of any that has ever yet been
+known amongst diseases. Amateur physicians from the Continent, and from
+every part of the United Kingdoms, eager and keen for Cholera, and more
+numerous than the patients themselves, beset and surrounded the sick in
+Sunderland with all the fearless self-exposing zeal of the missionary
+character, yet no one could contrive, even in the foulest dens of that
+sea-port, to produce the disease in his own person, or to carry it in
+his saturated clothing to the healthier quarters of the town where he
+himself had his
+lodging.<a name="FNanchor_17_17" id="FNanchor_17_17"></a><a href="#Footnote_17_17" class="fnanchor">[17]</a> Surely
+if the disease had been typhus
+fever, or any other capable of contaminating the atmosphere of a sick
+apartment, or giving out infection more directly from the body of a
+patient, the result must have been different; its course,
+notwithstanding, has been most unaccountably and peculiarly its
+own&mdash;slow and sure for the most part, the infected wave has rolled on
+from its tropical origin in the far distant east, to the borders of the
+arctic circle in the west&mdash;not unfrequently in the face of the strongest
+winds, as if the blighting action of those atmospherical currents had
+prepared the surface of the earth, as well as the human body for the
+reception and deposition of the poison; but so far from always following
+the stream and line of population as has been attempted to be shown, it
+has often run directly counter to both, seldom or never desolating the
+large cities of Europe, like the plague and other true contagions, but
+rather wasting its fury upon encampments of troops, as in the east, or
+the villages and hamlets of thickly peopled rural districts.</p>
+
+<div class="footnote">
+<p>
+<a name="Footnote_17_17" id="Footnote_17_17"></a>
+<a href="#FNanchor_17_17"><span class="label">[17]</span></a>
+
+The numbers were so great (to which I should probably have
+added one had my health permitted) as actually to make gala day in
+Sunderland, and to call forth a public expression of regret at their
+departure.
+</p>
+</div>
+
+<p>That it could have been descried on no other than the above line must
+
+<!-- Page 5 -->
+
+<span class="pagenum2"><a name="Page_5_Part_2" id="Page_5_Part_2">Pt_2<br />[Pg 5]</a></span>
+
+be self-evident, but to say that it has followed it in the manner that a
+contagious disease ought to have done, in our own country for instance,
+is at variance with the fact. From Sunderland and Newcastle to the
+south, the ways were open, the stream of population dense and
+continuous, the conveyances innumerable, the communications
+uninterrupted and constant. Towards the thinly-peopled north how
+different the aspect,&mdash;townships rare, the country often high, cold, and
+dreary, in many parts of the line without inhabitants or the dwellings
+of man for many miles together, yet does the disease suddenly alight at
+Haddington, a hundred miles off, without having touched the towns of
+Berwick, Dunbar, or any of the intermediate places. It is said to have
+been carried there by vagrant paupers from Sunderland. Can this be true?
+Could any such with the disease upon them in any shape, have encountered
+such a winter journey without leaving traces of it in their
+course?<a name="FNanchor_18_18" id="FNanchor_18_18"></a><a href="#Footnote_18_18" class="fnanchor">[18]</a> or,
+if they carried it in their clothing, the winds of the hills must
+have disinfected these <i>fomites</i> long before their arrival. No
+contagionist, however unscrupulous and enthusiastic, nor quarantine
+authority however vigilant, can pretend to say how the disease has been
+introduced at the different points of Sunderland, Haddington, and
+Kirkintulloch,&mdash;no more than he can tell why it has appeared at
+Doncaster, Portsmouth, and an infinity of other places without
+spreading. Even now, it lingers at the gates of the great open cities of
+Edinburgh and Glasgow, as if like a malarious disease, (which I by no
+means say that it is) it better found its food in the hamlet and the
+tent, in fact, amongst the inhabitants of ground tenements, than in
+paved towns and stone buildings. We must go farther and acknowledge,
+that for many months past our atmosphere has been tainted with the miasm
+or poison of Cholera Morbus, as manifested by unusual cases of the
+disease almost everywhere, and that these harbingers of the pestilence
+only wanted such an ally as the drunken jubilee at Gateshead, or
+atmospherical conditions and changes
+
+<!-- Page 6 -->
+
+<span class="pagenum2"><a name="Page_6_Part_2" id="Page_6_Part_2">Pt_2<br />[Pg 6]</a></span>
+
+of which we know nothing, to give
+it current and power. That the epidemic current of disease wherever men
+exist and congregate together, must, in the first instance, resemble the
+contagious so strongly as to make it impossible to distinguish the one
+from the other, must be self-evident; and it is only after the
+touchstone has been applied, and proof of non-communicability been
+obtained, as at Sunderland, that the impartial observer can be enabled
+to discern the difference.&mdash;Still, however, must he be puzzled with the
+inexplicable phenomena of this strange pestilence, but if he feel
+himself at a loss for an argument against contagion, he has only to turn
+to one of the most recent communications from the Central Board of
+Health, where he will find that "That the subsidiary force under
+Col.&nbsp;Adams, which arrived in perfect health <i>in the neighbourhood</i> of a
+village of India infected with Cholera, had seventy cases of the disease
+the night of its arrival, and twenty deaths the next day," as if the
+march under a tropical sun, and the encampment upon malarious ground, or
+beneath a poisoned atmosphere, were all to go for nothing; and that the
+neighbourhood of an infected village, with which it is not stated that
+they held communication, had in that instantaneous manner alone,
+produced the disease. This is surely drawing too largely upon our
+credulity, and practising upon our fears beyond the mark.</p>
+
+<div class="footnote">
+<p>
+<a name="Footnote_18_18" id="Footnote_18_18"></a>
+<a href="#FNanchor_18_18"><span class="label">[18]</span></a>
+
+The Cholera in this country would appear always to travel
+with the pedestrian, and to eschew the stage coach even as an outside
+passenger.
+</p>
+</div>
+
+<p>The anti-contagionist, in acknowledging his ignorance, leaves the
+question open to examination; but the contagionist has solved the
+problem to his own mind, and closed the field of investigation, without,
+however, ceasing to denounce the antagonist who would disturb a
+conclusion which has given him so much contentment.&mdash;Let us here
+examine, for a moment, who in this case best befriends his fellow men.
+The latter, in vindication of a principle which he cannot prove, would
+shut the book of enquiry, sacrifice and abandon the sick, (for to this
+it must ever come the moment pestilential contagion is proclaimed,)
+extinguish human sympathy in panic fear, and sever every tie of domestic
+life,&mdash;the other would wait for proofs before he proclaimed the ban, and
+even then, with pestilence
+
+<!-- Page 7 -->
+
+<span class="pagenum2"><a name="Page_7_Part_2" id="Page_7_Part_2">Pt_2<br />[Pg 7]</a></span>
+
+steaming before him, would doubt whether
+that pestilence could be best extinguished, or whether it would not be
+aggravated into ten-fold virulence, by excommunicating the sick.</p>
+
+<p>In my first letter I have endeavoured to unveil the mystery and fallacy
+of fumigations, for which our government has paid so
+dear,<a name="FNanchor_19_19" id="FNanchor_19_19"></a><a href="#Footnote_19_19" class="fnanchor">[19]</a> and
+in place of the chemical disinfectants so much extolled, of the
+applicability of which we know nothing, and which have always failed
+whenever they were depended upon, have recommended the simple and sure
+ones of heat, light, water, and air, with one exception, the elements of
+our forefathers, which combined always with all possible purity of
+atmosphere, person, and habitation, have been found as sure and certain
+in effect as they are practical and easy of application.</p>
+
+<div class="footnote">
+<p>
+<a name="Footnote_19_19" id="Footnote_19_19"></a>
+<a href="#FNanchor_19_19"><span class="label">[19]</span></a>
+
+Parliament voted a reward of &pound;5000 to Doctor Carmichael
+Smith for the discovery.
+</p>
+</div>
+
+<p>Of our quarantine laws I have spoken freely, because I believe their
+present application, in many instances, to be unnecessary cruel and
+mischievous. Too long have they been regarded as an engine of State,
+connected with vested interests and official patronage, against which it
+was unsafe to murmur, however pernicious they might be to commerce, or
+discreditable to a country laying claim to medical knowledge. The
+regulation for preventing the importation of tropical yellow fever,
+(which is altogether a malarious disease of the highest temperature of
+heat and unwholesome locality,) into England or even into Gibraltar,
+stands eminent for absurdity. It has long been denounced by abler pens
+than mine, and I know not how it can be farther exposed, unless we could
+induce the inhabitants of our West India Colonies to enforce the lex
+talionis, and institute quarantines, which they might do with the same
+or better reason, against the importation of pleurises and catarrhs from
+the colder regions of Europe; a practical joke of this kind has been
+known to succeed after reason, argument, and evidence, amounting to the
+most palpable demonstration, had proved of no avail.</p>
+
+<p>While I have thus impugned the authority of boards and missions, and
+establishments, I trust it never can be imputed to me that
+
+<!-- Page 8 -->
+
+<span class="pagenum2"><a name="Page_8_Part_2" id="Page_8_Part_2">Pt_2<br />[Pg 8]</a></span>
+
+I could have intended any, the smallest personal allusion, to the eminent and
+estimable men of whom they are composed,&mdash;all such I utterly disclaim;
+and to the individual, in particular, who presided over our mission to
+Russia, who has been my colleague in the public service, and whose
+friendship I have enjoyed from early youth, during a period of more than
+forty years, I would here, were it the proper place, pay the tribute of
+respect which the usefulness of his life, and excellence of his
+character, deserves.</p>
+
+<hr class="major" />
+
+<h2><a name="LETTER_I_Part_2" id="LETTER_I_Part_2"></a>LETTER I.
+<br />
+<span class="size75">TO THE EDITOR OF THE WINDSOR EXPRESS.</span>
+</h2>
+
+<p>Sir,&mdash;Being well aware of the handsome manner in which you have always
+opened the columns of your liberal journal to correspondents upon every
+subject of public interest, I make no further apology for addressing
+through the <span class="smcap">Windsor Express</span>, some observations to the inhabitants of
+Windsor and its neighbourhood upon the all-engrossing subject of Cholera
+Morbus.</p>
+
+<p>That pestilence, despite of quarantine laws, boards of health, and
+sanatory regulations, has now avowedly reached our shores, and we may be
+permitted at last to acknowledge the presence of the enemy&mdash;to describe
+to the affrighted people the true nature of the terrors with which he is
+clothed&mdash;and to point out how these can be best combatted or avoided.</p>
+
+<p>That the seeds of his fury have long been sown amongst us may be proved,
+and will be proved, ere long, by reference to fatal cases of unwonted
+Cholera Morbus appearing, occasionally during the last six months, in
+London, Port Glasgow, Abingdon, Hull, and many other places, which, as
+it did not spread, have been passed unheeded by our health conservators;
+but, had the poison then been sufficiently matured to give it epidemic
+current, would have been blazed forth as imported pestilence. Some one
+or other of the ships constantly arriving from the north of Europe could
+easily have been fixed upon as acting the part of Pandora's box, and
+smugglers from her dispatched instanter to carry the disease
+
+<!-- Page 9 -->
+
+<span class="pagenum2"><a name="Page_9_Part_2" id="Page_9_Part_2">Pt_2<br />[Pg 9]</a></span>
+
+into the inland quarters of the kingdom. I write in this manner, not from
+petulance, but from the analogy of the yellow fever, where this very
+game I am now describing, has so often been played with success in the
+south of Europe; and will be played off again, for so long as lucrative
+boards of health and gainful quarantine establishments, with extensive
+influence and patronage, shall continue to be resorted to for protection
+against a non-existent&mdash;an impossible contagion.</p>
+
+<p>But to the disease in question.&mdash;It must have had a spontaneous origin
+somewhere, and that origin has been clearly traced to a populous
+unhealthy town in the East Indies&mdash;no infection was ever pretended to
+have been carried there, yet, it devastated with uncontroulable fury,
+extending from district to district, but in the most irregular and
+unaccountable manner, sparing the unwholesome localities in its
+immediate neighbourhood, yet attacking the more salubrious at a
+distance&mdash;passing by the most populous towns in its direct course at one
+time, but returning to them in fury at another, staying in none, however
+crowded, yet attacking all some time or other, until almost every part
+of the Indian peninsula had experienced its visitation.</p>
+
+<p>There is an old term, as old as the good old English physician,
+Sydenham&mdash;<i>constitution of the atmosphere</i>&mdash;and to what else than to
+some inscrutable condition of the element in which we live, and breathe,
+and have our being&mdash;in fact to an atmospheric poison beyond our ken, can
+we ascribe the terrific gambols of such a destroyer. 'Tis on record,
+that when our armies were serving in the pestilential districts of
+India, hundreds, without any noticeable warning, would be taken ill in
+the course of a single night, and thousands in the course of a few days,
+in one wing of the army, while the other wing, upon different ground,
+and consequently under a different current of atmosphere, although in
+the course of the regular necessary communication between troops in the
+field, would remain perfectly free from the disease. It would then cease
+as suddenly and unaccountably as it began,&mdash;attacking, weeks after, the
+previously unscathed division
+
+<!-- Page 10 -->
+
+<span class="pagenum2"><a name="Page_10_Part_2" id="Page_10_Part_2">Pt_2<br />[Pg 10]</a></span>
+
+of the army, or not attacking it at all
+at the time, yet returning at a distant interval, when all traces of the
+former epidemic had ceased, and committing the same devastation. Now,
+will any man, not utterly blinded by prejudice, candidly reviewing these
+facts, pretend to say, that this could be a personal contagion,
+cognizable by, and amenable to, any of the known or even supposable laws
+of infection&mdash;that the hundreds of the night infected one another, or
+that the thousands of the few days owed their disease to personal
+communication,&mdash;as well affect to believe that the African Simoon, which
+prostrates the caravan, and leaves the bones of the traveller to whiten
+in the sandy desert, could be a visitation of imported pestilence.</p>
+
+<p>It may then be asked, have we no protection against this fearful plague?
+No means of warding it off? Certainly none against its visitation! It
+will come&mdash;it will go; we can neither keep it out, or retain it, if we
+wished, amongst us. The region of its influence is above us and beyond
+our controul; and we might as well pretend to arrest the influx of the
+swallows in summer, and the woodcocks in the winter season, by cordons
+of troops and quarantine regulations, as by such means to stay the
+influence, of an atmospheric poison; but in our moral courage, in our
+improved civilization, in the perfecting of our medical and health
+police, in the generous charitable spirit of the higher orders,
+assisting the poorer classes of the community, in the better condition
+of those classes themselves, compared with the poor of other countries,
+and in the devoted courage and assistance of the medical profession
+every where, we shall have the best resources. Trusting to these, it has
+been found that, in countries far less favoured than ours, wherever the
+impending pestilence has only threatened a visitation, there the panic
+has been terrible, and people have even died of fear; but when it
+actually arrived, and they were obliged to look it in the face, they
+found, that by putting their trust in what I have just laid down, they
+were in comparative safety; that, the destitute, the uncleanly, above
+all, the intemperate and the debauched, were almost
+
+<!-- Page 11 -->
+
+<span class="pagenum2"><a name="Page_11_Part_2" id="Page_11_Part_2">Pt_2<br />[Pg 11]</a></span>
+
+its only victims;
+that the epidemic poison, whatever it might be, had strength to prevail
+only against those who had been previously unnerved by fear, or weakened
+by debauchery; and that moral courage, generous but temperate living,
+and regularity of habits in every respect, proved nearly a certain
+safe-guard. They found further, that quarantine regulations were worse
+than useless&mdash;that the gigantic military organization of Russia&mdash;the
+rigorous military despotism of Prussia&mdash;and the all-searching police of
+Austria, with their walled towns, and guards and gates, and cordons of
+troops, were powerless against this unseen pestilence, and that as soon
+as the quarantine laws were relaxed, and free communication allowed, the
+disease assumed a milder character, and speedily disappeared.</p>
+
+<p>I say, then, confidently, that Cholera Morbus never will commit ravages
+in this country, beyond the bounds of the worst purlieus of society,
+unless it be fostered into infectious, pestilential activity, by the
+absurd, however well-meant, measures of the conservative boards of
+health, such as have been just recommended in what has always been
+esteemed the most influential, best-informed journal of England, I mean
+the <span class="smcap">Quarterly Review</span>. If the writer of the article who recommends the
+enforcement of the ancient quarantine laws in all their strictness, be a
+medical man, he surely ought to know, that wherever human beings are
+confined and congregated together in undue numbers, more especially if
+they be in a state of disease, there the matter of contagion, the
+typhoid principle, the septic (putrefactive) human poison or by what
+other name it may be called, is infallibly generated and extends itself,
+but in its own impure atmosphere only, as a personal infection to those
+who approach it, under the form and features of the prevailing epidemic,
+whatever that may be. Hence we have all heard of contagious pleurisies,
+catarrhs, dysenteries, ulcers, &amp;c., and if the doctrines of that writer
+be received, we shall soon also hear of contagious Cholera Morbus with a
+vengeance. His exhortations would go to shut up the sick from human
+intercourse, to proclaim the ban of society against them, and under the
+
+<!-- Page 12 -->
+
+<span class="pagenum2"><a name="Page_12_Part_2" id="Page_12_Part_2">Pt_2<br />[Pg 12]</a></span>
+
+most pitiable circumstances of bodily distress, to proscribe them as
+objects of terror and danger, instead of being as they actually are,
+helpless innocuous fellow creatures, calling loudly for our promptest
+succour and commiseration in their utmost need. They would go further to
+array man against his fellow man in all the cruel selfishness of panic
+terror, sever the dearest domestic ties, paralize commerce, suspend
+manufactures, and destroy the subsistance of thousands, and all for the
+gratification of a prejudice which has been proved to be utterly
+baseless in every country of Europe from Archangel to Hamburgh and
+Sunderland. Happily for our country, these measures are now as absurd
+and impracticable as they would be tyrannical and unjust. They could not
+be borne even under the despotic military sway of Prussia and Russia,
+and in this free country it would be impossible to enforce them for a
+single week. The very attempt would at once, throughout the whole land,
+produce confusion and misery incalculable.</p>
+
+<p>I say, on the contrary, throw open their dwellings to the free air of
+heaven, the best cordial and diluent of foul atmosphere in every
+disease&mdash;let their fellow townsmen hasten to carry them food, fuel,
+cordials, cloathing, and bedding, speak to them the words of
+consolation, and should they have fear to approach the sick, I take it
+upon me to say, they will be accompanied by any and every medical
+practitioner of the place, who, in their presence, will minister to the
+afflicted, inspire their breath, and perform every other professional
+office of humanity, without the smallest fear or risk of infection; for
+they read the daily records of their profession, where it has been
+proved to them, that in the open but crowded hospitals of Warsaw, under
+the most embarrassing circumstances of warfare and disease, out of a
+hundred medical men, with their assistants and attendants, frequenting
+the sick wards of Cholera, not one took the disease; that, for the sake
+of proving its nature, they even went so far as to clothe themselves
+with the vestments of the dying, to sleep in the beds of the recently
+dead, and to innoculate themselves in every way with the blood and
+fluids of the worst cases, without, in a single instance,
+
+<!-- Page 13 -->
+
+<span class="pagenum2"><a name="Page_13_Part_2" id="Page_13_Part_2">Pt_2<br />[Pg 13]</a></span>
+
+producing Cholera
+Morbus.<a name="FNanchor_20_20" id="FNanchor_20_20"></a><a href="#Footnote_20_20" class="fnanchor">[20]</a> The
+accounts may not, indeed, cannot be the same
+from every other quarter, for medical men must be as liable to fall
+under the influence of an atmospherical epidemic disease as other
+classes of the community; but the above fact is alone sufficient to
+prove that it cannot be a personal contagion.</p>
+
+<div class="footnote">
+<p>
+<a name="Footnote_20_20" id="Footnote_20_20"></a>
+<a href="#FNanchor_20_20"><span class="label">[20]</span></a>
+
+Vide Medical Gazette.
+</p>
+</div>
+
+<p>Even should that worst of true contagions, the plague of the Levant,
+which every nation is bound to guard against, despite of all our
+precautions, be introduced amongst us, measures better calculated for
+the destruction of a community, could scarcely be devised, than the
+ancient quarantine regulations; for they certainly would convert every
+house proscribed by their mark, into a den and focus of the most
+concentrated pestilential contagion, ensuring fearful retribution upon
+those who had thus so blindly shut them up. The mark alone, besides
+being equivalent to a sentence of death upon all the inmates, would
+effect all this&mdash;the sick would be left to die unassisted, unpurified,
+uncleansed amidst their accumulated contagion, and the dead, as has
+happened before, lie unburied or scarcely covered in, till they
+putrified in pestiferous heaps. Most certainly it would be proper and
+beneficial, even a duty, for all who could afford the means, and were
+not detained by public duties, to fly the place, and equally proper for
+the other residents who continued in health, to segregate themselves as
+they best could.&mdash;Plenty of free labour amongst those who must ever work
+for their daily bread, would still remain for all municipal purposes,
+and these our rulers, so far from consenting thus to proscribe the sick,
+should employ openly in giving them every succour and aid, under the
+direction and with instructions of safety from a well arranged medical
+police. It would not be difficult to show, that the mortality, during
+the last great plague in London, was increased a hundred fold, by
+following the very measures now recommended in these regulations; and,
+that the barbarous predestinarian Turk, in the very head quarters of the
+plague itself, who despises all regulation, but
+
+<!-- Page 14 -->
+
+<span class="pagenum2"><a name="Page_14_Part_2" id="Page_14_Part_2">Pt_2<br />[Pg 14]</a></span>
+
+attends his sick friend
+to the last, never yet brought down upon his country such calamitous
+visitations of pestilence, as enlightened Christian nations have
+inflicted upon themselves, by ill-judged laws. The Turk, to be sure, by
+rejecting all precaution, and admitting, without scruple, infection into
+his ports, sees Constantinople invaded by the plague every year; but,
+when not preposterously interfered with, it passes away, even amongst
+that wretched population, like a common epidemic, without leaving any
+remarkable traces of devastation behind it: and surely to establish and
+make a pest-house of the dwelling of every patient who might be
+discovered or even suspected to be ill, would be most preposterous. The
+writing on the wall would not be more apalling to the people, and
+scarcely less fatal to the object, than the cry of mad dog in the
+streets, with this difference, that when the dog was killed, the scene
+would be closed, but the proscribed patient would remain, even in his
+death and after it, to avenge the wrong.</p>
+
+<p>But sufficient to the day is the evil thereof, the question is now of
+Cholera Morbus; I am willing to meet any objection, and the most obvious
+one that can be offered to me, (if it be not an imported disease) is its
+first appearance in our commercial sea-ports. To this I might answer,
+that it has been hovering over us, making occasional stoops, for the
+last six months, even in the most inland parts of the country; but I
+will waive that advantage, and meet it on plainer grounds of argument
+and truth.&mdash;An atmospherical poison must evidently possess the greatest
+influence, where it finds the human race under the most unfavourable
+circumstances of living, habits, locality, and condition. Now, where can
+these be met with so obviously as in our large sea-port towns on the
+lowest levels of the country, and in their crowded alleys, always near
+to the harbour for the shipping? There the disease, if its seeds existed
+in the atmosphere, would be most likely to break out in preference to
+all other situations; and if at the time of its so appearing, ships
+should arrive, as they are constantly doing from all parts of the world,
+whose crews, according
+
+<!-- Page 15 -->
+
+<span class="pagenum2"><a name="Page_15_Part_2" id="Page_15_Part_2">Pt_2<br />[Pg 15]</a></span>
+
+to the custom of sailors, plunge instantly into
+drunkenness and debauchery, and present as it were, ready prepared, the
+very subjects the pestilence was waiting for; how easy then, for an
+alarmed or prejudiced board of health to point out the supposed
+importing vessel, and freight her with a cargo of the new pestilence
+from any part of the world they may choose to fix upon. This is no
+imaginary case; it was for long of annual occurrence with respect to the
+yellow fever, both in the West Indies and North America. "There our
+thoughtless intemperate sailors were not only the first to suffer from
+the epidemic, in its course or about to begin, but they were denounced
+as the importers, by the prejudiced vulgar, and the accusation was
+loudly re-echoed even amongst the better informed, by all who wished to
+make themselves believe that pestilence could not be a native product of
+their own atmosphere and habitations."</p>
+
+<p>Before I have done, I feel called upon to say a few words upon the
+efficacy of fumigation as a preservative against Cholera Morbus and
+other infectious diseases. In regard to the first the question is
+settled. In Russia, throughout Germany, and I believe everywhere else in
+Europe, they were productive of no good, they did mischief, and were
+therefore discontinued. This has been verified by reports from the seats
+of the disease everywhere. In regard to other contagions I can speak,
+not without knowledge, at least not without experience, for it was the
+business and the duty of my military life, during a long course of
+years, to see them practised in ships, barracks, hospitals, and
+cantonements, and I can truly declare I never saw contagion in the
+smallest degree arrested by them, and that disease never failed to
+spread, and follow its course unobstructed, and unimpeded by their use.
+In the well-conditioned houses of the affluent where ventilation and
+cleanliness are matters of habit and domestic discipline, they may be a
+harmless plaything during the prevalence of scarlet fever and such like
+infections, or even do a little good by inspiring the attendants with
+confidence, however false, as a preservative against contagion; but in
+the confined dwellings
+
+<!-- Page 16 -->
+
+<span class="pagenum2"><a name="Page_16_Part_2" id="Page_16_Part_2">Pt_2<br />[Pg 16]</a></span>
+
+of the poor they are positively mischievous,
+because they cannot be used without shutting out the wholesome
+atmospheric air, and substituting for it a factitious gas, which for
+aught we know, or can know of the nature of the contagious vapour,
+whether acid, alkaline, or anything else, may actually be adding to its
+deleterious principle instead of neutralising it: but in thus striking
+away a prop from the confidence of the poor, I thank God I can furnish
+them with other preservatives and disinfectants, which I take it upon me
+to say, they will find as simple and practicable as they are infallible.
+For the first, the liberal use of cold water and observance of free
+ventilation, with slaked lime to wash the walls, and quick lime when
+they can get it, to purify their dung heaps and necessaries, are among
+the best; but when actually infected, then heat is the only purificator
+yet known of an infected dwelling. Let boiling water be plentifully used
+to every part of the house and article of furniture to which it can be
+made applicable. Let portable iron stoves, filled with ignited charcoal
+only, be placed in the apartment closely shut, and the heat kept up for
+a few hours to any safe degree of not less than 120&deg;&nbsp;Farenheit, and let
+foul infected beds and mattresses be placed in a baker's oven heated to
+the same,<a name="FNanchor_21_21" id="FNanchor_21_21"></a><a href="#Footnote_21_21" class="fnanchor">[21]</a> and
+my life for it no infection can after that possibly
+adhere to houses, clothes, or furniture. The living fountain of
+infection from the patient himself, constantly giving out the fresh
+material, cannot of course be so closed, but whether he lives or dies,
+if the above be observed, he will leave no infection behind
+him.<a name="FNanchor_22_22" id="FNanchor_22_22"></a><a href="#Footnote_22_22" class="fnanchor">[22]</a>
+</p>
+
+<div class="footnote">
+<p>
+<a name="Footnote_21_21" id="Footnote_21_21"></a>
+<a href="#FNanchor_21_21"><span class="label">[21]</span></a>
+
+The oven on that account need not lose character with
+bread-eaters, for according to the old adage, Omne vitium per ignem
+excoquitur.
+</p>
+</div>
+
+<div class="footnote">
+<p>
+<a name="Footnote_22_22" id="Footnote_22_22"></a>
+<a href="#FNanchor_22_22"><span class="label">[22]</span></a>
+
+Light too, more especially when assisted by a current of
+atmospheric air, is a true and sure disinfectant, but it is not so
+applicable as heat in the common contagions, from requiring an exposure
+of the infected substances for days together, or even a longer period,
+before it can be made effective.
+</p>
+</div>
+
+<p>It is now time to bring this tedious letter to a close; I shall be
+happy, through the same channel, to give any information, or answer any
+inquiries that may be authenticated by the signature of the writer; but
+anonymous writing of any kind, I shall not consider
+
+<!-- Page 17 -->
+
+<span class="pagenum2"><a name="Page_17_Part_2" id="Page_17_Part_2">Pt_2<br />[Pg 17]</a></span>
+
+myself bound to
+notice. Should the dreaded disease spread its ravages throughout our
+population, I may then, at some future early opportunity, trusting to
+your indulgence, trespass again upon your columns with further
+communications on this most interesting subject.</p>
+
+<div class="signr">
+<span class="signrind">WILLIAM FERGUSSON,</span><br />
+Inspector-General of Hospitals.
+</div>
+
+<p>P.S.&mdash;Throughout the foregoing letter, I have used the words contagion
+and infection as precisely synonymous terms, meaning communicability of
+disease from one person to another.</p>
+
+<div class="signl">
+<i>November</i>&nbsp;9,&nbsp;1831.
+</div>
+
+<hr class="major" />
+
+<h2><a name="LETTER_II_Part_2" id="LETTER_II_Part_2"></a>LETTER II.
+<br />
+<span class="size75">TO THE EDITOR OF THE WINDSOR EXPRESS.</span>
+</h2>
+
+<p>Sir,&mdash;In my last letter,
+I treated of the practicability of guarding our
+country against the now European and Continental disease, malignant
+Cholera Morbus, by quarantine regulations. In the present one, it is my
+intention still in a popular manner to scrutinise more deeply, the
+doctrine of imported contagions; to point out, if I can, those true
+contagions which can be warded off by our own exertions, in
+contradistinction to others which are altogether beyond our controul;
+and here it may be as well to premise, that when I use the term
+epidemic, I mean atmospheric influence, endemic-terrestrial influence,
+or emanation from the soil; and by pestilential, I mean the spread of
+malignant disease without any reference to its source. The terms
+contagion and infection have already been explained.</p>
+
+<p>It must be evident, that legislative precaution can only be made
+applicable to the first of these. The last being unchangeable by human
+authority, are not to be assailed by any decrees we can fulminate
+against them; and if it can be shown, which it has been
+
+<!-- Page 18 -->
+
+<span class="pagenum2"><a name="Page_18_Part_2" id="Page_18_Part_2">Pt_2<br />[Pg 18]</a></span>
+
+by our best and
+latest reports, that Cholera Morbus eminently and indisputably belongs
+to that class&mdash;that the strictest cordons of armed men could not avail
+to save the towns of the continent, nor the strictest quarantine our own
+shores, from its invasion&mdash;it surely must be time to cease those vain
+attempts, to lay down the arms that have proved so useless, and turn our
+undivided attention, now that it has fairly got amongst us, to
+conservative police, and the treatment of the disease; but as the
+contagionists still insist that it was imported from Hamburgh to
+Sunderland, it behoves us to clear away this preliminary difficulty
+before proceeding to other points of the enquiry.</p>
+
+<p>I take it for granted, that ships proceeding from Sunderland to Hamburgh
+could only be colliers, and that according to the custom of such
+vessels, they returned, as they do from the port of London, light; and I
+admit, that on or about the time of their return, Cholera Morbus, under
+the severe form which characterises the Asiatic disease, made its
+appearance in that port, presenting a fair <i>prima facie</i> case of
+imported contagion; but as at the period of its thus breaking out in
+Sunderland, a case equally as fatal and severe shewed itself, according
+to the public accounts, in the upper part of Newcastle, 10&nbsp;miles off;
+another equally well-marked, in a healthy quarter in Edinburgh; a third,
+not long before in Rugby, in the very centre of the kingdom; and a
+fourth in Sunderland itself, as far back as the month of August, as well
+as many others in different parts of the
+country;<a name="FNanchor_23_23" id="FNanchor_23_23"></a><a href="#Footnote_23_23" class="fnanchor">[23]</a> it
+became incumbent on the quarantine authorities, indeed upon all men
+interested in the question, whether contagionists or otherwise, to shew
+the true state of these vessels, as well as of the cases above alluded to,
+and whether the Cholera Morbus had ever been on board of them, either at
+Hamburgh or during the homeward
+
+<!-- Page 19 -->
+
+<span class="pagenum2"><a name="Page_19_Part_2" id="Page_19_Part_2">Pt_2<br />[Pg 19]</a></span>
+
+voyage, so as by any possibility they
+could have introduced the disease into an English port. Now will any
+person pretend to say that this has been done, or that it could not have
+been done, or deny that it was a measure, which, if properly executed,
+would have thrown light upon the true character of the disease, not only
+for the information of our own government but of every government in
+Europe; that deputations from the Board of Health, backed and supported
+by all the power and machinery of government, with the suspected ships
+locked up in quarantine, and the persons of the crews actually in their
+power, could not have verified to the very letter, the history of every
+hour and day of their health, from the moment of their arrival at
+Hamburgh till their return into port? This measure was so obviously and
+imperiously called for, as constituting the only rational ground on
+which the importing contagionists could stand, or their opponents meet
+them in argument, that after having waited in vain for the report, I
+raised my own feeble voice in the only department to which I had access,
+urging an immediate, though then late, investigation. No good cause,
+having truth for its basis, could have been so overlooked, and without
+unfairness or illiberality, we are irresistibly forced to the
+conclusion, that had the enquiry (the only one, by the bye, worth
+pursuing, as bearing directly on the question at issue) been pushed to
+the proof, it would have shown the utter nullity of quarantine guards
+against atmospherical pestilence, the thorough baselessness of the
+doctrine of importation.</p>
+
+<div class="footnote">
+<p>
+<a name="Footnote_23_23" id="Footnote_23_23"></a>
+<a href="#FNanchor_23_23"><span class="label">[23]</span></a>
+
+Two of a type most unusual for this country, and the
+Winter Season, have occurred in the vale of the Thames, not far from
+here, which, as they both recovered, and the disease did not spread in
+any way, were very properly allowed to pass without sounding any alarm,
+but the gentleman who attended one of the cases, and had been familiar
+with the disease in India, at once recognized it again, in its principal
+distinguishing features.
+</p>
+</div>
+
+<p>Without entering into the miserable disputes on this subject, which,
+amidst a tissue of fable and prejudice, self-interest and
+misrepresentation, have so often disgraced the medical profession at
+Gibraltar; I shall now proceed to shew, by reference to general causes,
+how baseless and mischievous have been the same doctrines and authority
+when exercised in that part of the British dominions:&mdash;</p>
+
+<p>Within the last thirty years, yellow fever has, at least four times,
+invaded the fortress of Gibraltar; during which time also, the
+
+<!-- Page 20 -->
+
+<span class="pagenum2"><a name="Page_20_Part_2" id="Page_20_Part_2">Pt_2<br />[Pg 20]</a></span>
+
+population of its over-crowded town has more than quadrupled, presenting
+as fair a field, for the generation within, or reception from without,
+of imported pestilence as can well be imagined,&mdash;yet plague, the truest
+of all contagions, typhus fever, and other infectious diseases, have
+never prevailed, as far as I know, amongst them. The plague of the
+Levant has not been there, I believe, for 150 years; yet Gibraltar, the
+free port of the Mediterranean, open to every flag, stands directly in
+the course of the only maritime outlet, from its abode and birth-place
+in the east, being in fact, to use the language of the road, the house
+of call for the commerce of all nations coming from the upper
+Mediterranean. Now, can there be a more obvious inference from all this,
+than that the plague, being a true contagion, may be kept off without
+difficulty, by ordinary quarantine precautions; but the other being an
+endemic malarious disease, generated during particular seasons, within
+the garrison itself, and the offspring of its own soil, is altogether
+beyond their controul. The malarious or marsh poison, which in our
+colder latitudes produces common ague, in the warmer, remittent fever,
+and in unfavourable southern localities of Europe, (such as those of
+crowded towns, where the heat has been steadily for some time of an
+intertropical degree)&mdash;true yellow fever, which is no more than the
+highest grade of malarious disease; but this has never occurred in
+European towns, unless during the driest seasons&mdash;seasons actually
+blighted by drought, when hot withering land winds have destroyed
+surface vegetation, and as in the locality of Gibraltar, have left the
+low-lying becalmed, and leeward town to corrupt without perflation or
+ventilation amidst its own accumulated exhalations. I know not how I can
+better illustrate the situation of Gibraltar in these pestiferous
+seasons, than by a quotation from a report of my own on the Island of
+Guadaloupe, in the year 1816, which, though written without any possible
+reference to the question at issue, has become more apposite than
+anything else I could advance; "all regular currents of wind have the
+effect of dispersing malaria; when this purifying influence is
+with-held, either through
+
+<!-- Page 21 -->
+
+<span class="pagenum2"><a name="Page_21_Part_2" id="Page_21_Part_2">Pt_2<br />[Pg 21]</a></span>
+
+the circumstances of season, or when it
+cannot be made to sweep the land on account of the intervention of high
+hills, the consequences are most fatal. The leeward shores of
+Guadaloupe, for a course of nearly 30&nbsp;miles, under the shelter of a very
+steep ridge of volcanic mountains, never felt the sea breeze, nor any
+breeze but the night land-wind from the mountains; <i>and though the soil,
+which I have often examined, is a remarkably open, dry and pure one,
+being mostly sand and gravel, altogether, and positively without marsh,
+in the most dangerous places, it is inconceivably pestiferous throughout
+the whole tract, and in no place more so than the bare sandy beach near
+the high-water mark</i>. The coloured people alone ever venture to inhabit
+it; and when they see strangers tarrying on the shore after nightfall,
+they never fail to warn them of their danger. The same remark holds good
+in regard to the greater part of the leeward coasts of Martinique, <i>and
+the leeward alluvial bases and
+recesses<a name="FNanchor_24_24" id="FNanchor_24_24"></a><a href="#Footnote_24_24" class="fnanchor">[24]</a> of
+hills, in whatever port
+of the torrid zone they may be placed</i>, with the exception, probably of
+the immediate sites of towns, where the pavements prevent the rain-water
+being absorbed into the soil, and hold it up to speedy evaporation."
+Now, conceive a populous crowded town placed in this situation, and you
+have exactly what Gibraltar and the other towns of Spain and North
+America, liable to yellow fever, must become in such seasons as I have
+above described, only, that as they grow more populous and crowded, the
+danger must be greater, and its visitations more frequent, unless the
+internal health police be made to keep pace in improvement, with the
+increasing population.</p>
+
+<div class="footnote">
+<p>
+<a name="Footnote_24_24" id="Footnote_24_24"></a>
+<a href="#FNanchor_24_24"><span class="label">[24]</span></a>
+
+The leeward niches and recesses of hills, however dry and
+rocky, become in these seasons of drought, absolute dens of malaria,
+this will be found proven in my reports made especially of the islands
+of Dominique and Trinidad, which may be seen at the Army Medical Board
+Office.
+</p>
+</div>
+
+<p>Now in the name of injured commerce&mdash;of the deluded people of
+England&mdash;of medical science&mdash;of truth and humanity&mdash;what occasion can
+their be to institute an expensive quarantine against such a state of
+things as this, which can only be mitigated by domestic
+
+<!-- Page 22 -->
+
+<span class="pagenum2"><a name="Page_22_Part_2" id="Page_22_Part_2">Pt_2<br />[Pg 22]</a></span>
+
+health police;
+or why conjure up the unreal phantom of an imported plague, to delude
+the unhappy sufferers, as much in regard to the true nature of the
+disease, as to the measures best calculated for their own preservation;
+when it must be evident that the pestilence has sprung from amidst
+themselves, and that had it been an external contagion in any degree,
+the ordinary quarantine, as in case of the plague, would certainly have
+kept it off; but the question of the contagion of yellow fever, so
+important to commerce and humanity; and which, like the Cholera, has
+more than once been used to alarm the coasts of England, demands yet
+further investigation.</p>
+
+<p>For nearly 40 years have the medical departments of our army and navy
+been furnished with evidence, from beyond the Atlantic, that this
+disease possessed no contagious property whatever. These proofs now lie
+recorded by hundreds in their respective offices, and I take it upon me
+to say, they will not be found contradicted by more than one out of a
+hundred, amongst all the reports from the West Indies, which is as much
+the birth-place of the yellow fever, as Egypt is of the plague: yet, in
+the face of such a mass of evidence, as great or greater probably than
+ever was accumulated upon any medical question, has our Government been
+deluded, to vex commerce with unnecessary restraints, to inflict
+needless cruelties upon commercial communities, (for what cruelty can be
+greater than after destroying their means of subsistence by quarantine
+laws, to pen them up in a den of pestilence, there to perish without
+escape, amidst their own malarious poison?) and to burden the country
+with the costs of expensive quarantine establishments. Surely if these
+departments had done their duty, or will now do it, in so far as to
+furnish our rulers with an abstract of that evidence, with or without
+their own opinions, for opinions are as dust in the balance when put in
+competition with recorded facts, it must be impossible that the delusion
+could be suffered to endure for another year; or should they unluckily
+fail thereby to produce conviction on Government, they can refer to the
+records of commerce, and of our transport departments,
+
+<!-- Page 23 -->
+
+<span class="pagenum2"><a name="Page_23_Part_2" id="Page_23_Part_2">Pt_2<br />[Pg 23]</a></span>
+
+which will shew,
+if enquiry be made, that no ship, however deeply infected before she
+left the port, (and all ships were uniformly so infected wherever the
+pestilence raged) ever yet produced, or was able to carry a case of
+yellow fever beyond the boundaries of the tropics, on the homeward
+voyage, and that therefore the stories of conveying it beyond seas to
+Gibraltar, must have been absolutely chimerical. It would indeed, have
+been a work of supererrogation, little called for, for I think I have
+fully shown that Gibraltar must be abundantly qualified to manufacture
+yellow fever for herself.</p>
+
+<p>No less chimerical will be the attempt to shut out Cholera Morbus from
+our shores by quarantine laws, because throughout Europe, ready
+prepared, alarmed, and in arms against it, they have succeeded nowhere;
+whereas, had it been a true contagion and nothing else, they must, with
+ordinary care, have succeeded everywhere; the disease, as if in mockery,
+broke through the cordons of armed men, sweeping over the walls of
+fortified towns, and following its course, even across seas, to the
+shores of Britain; and yet we are still pretending to oppose it with
+these foiled weapons.</p>
+
+<p>We are indeed told, by authority, that its appearance in towns has
+always been coincident with the arrival of barges from inland, or by
+ships from the sea, but if it be not shown at the same time that the
+crews of these barges had been infected with the disease, or if, as at
+Sunderland, no person on board the ships can be identified as having
+introduced it, while we know that the disease actually was there two
+months before, we may well ask at what time of the year barges and ships
+do not arrive in a commercial seaport, or where an epidemic disease,
+during pestiferous seasons could be more likely to break out than where
+the most likely subjects are thrown into the most likely places for its
+explosion, such as newly arrived sailors in an unwholesome seaport,
+where the license of the shore, or the despondency of quarantine
+imprisonment must equally dispose them to become its victims.&mdash;Besides,
+what kind of quarantine can we possibly establish with the
+
+<!-- Page 24 -->
+
+<span class="pagenum2"><a name="Page_24_Part_2" id="Page_24_Part_2">Pt_2<br />[Pg 24]</a></span>
+
+smallest chance of being successful against men who have not got, and never had
+the disease. Merchandise has been declared incapable of conveying the
+infection,<a name="FNanchor_25_25" id="FNanchor_25_25"></a><a href="#Footnote_25_25" class="fnanchor">[25]</a> and
+are we to interdict the hulls and rigging of Vessels
+bearing healthy crews, or are we to shut our ports at once against all
+commerce with the North of Europe, and would this prove successful if we
+did? a reference to a familiar epidemic will I think at once answer this
+question.</p>
+
+<div class="footnote">
+<p>
+<a name="Footnote_25_25" id="Footnote_25_25"></a>
+<a href="#FNanchor_25_25"><span class="label">[25]</span></a>
+
+Vide Russian Ukase.
+</p>
+</div>
+
+<p>It is only three months ago that the epidemic Catarrh or Influenza
+spread throughout the land, travelling like the Cholera in India, when
+it went up the monsoon, without regard to the East wind; and what could
+be more likely than the blighting drying process of such a wind, in
+either the one or the other case, to prepare the body for falling under
+the influence of whatever disease might be afloat in the atmosphere. In
+general this passing disease can be distinctly traced, as having
+affected our continental neighbours on the other side of the channel
+before ourselves: now can it be supposed that any quarantine could have
+prevented its first invasion, or arrested its farther progress amongst
+us. How ridiculous would have been the attempt, and yet with the
+experience of all Europe before us, have we been enacting that very part
+with the Cholera Morbus: but further, the same authority which calls for
+the establishment of quarantine in our ports, tells us that neither
+proximity nor contact with the
+sick,<a name="FNanchor_26_26" id="FNanchor_26_26"></a><a href="#Footnote_26_26" class="fnanchor">[26]</a> is
+requisite for the production
+of the disease: now can anything further be wanting beyond this
+admission, to prove that it must be an epidemic atmospherical poison,
+and not a personal contagion, and that, under such circumstances, the
+establishment of quarantine against persons and goods, would manifestly
+be absurd and uncalled for. So fully satisfied has the Austrian
+Government been made by experience, of the futility and cruelty of such
+quarantines, that the Emperor apologises to his subjects for having
+inflicted them. The King of Prussia makes a similar <i>amende</i>, and the
+Emperor of Russia convinced by the same experience, abolished or greatly
+relaxed his quarantines several mouths ago.</p>
+
+<div class="footnote">
+<p>
+<a name="Footnote_26_26" id="Footnote_26_26"></a>
+<a href="#FNanchor_26_26"><span class="label">[26]</span></a>
+
+Vide Reports from Russia.
+</p>
+</div>
+
+<p>
+<!-- Page 25 -->
+
+<span class="pagenum2"><a name="Page_25_Part_2" id="Page_25_Part_2">Pt_2<br />[Pg 25]</a></span>
+
+I am by no means prepared to assert, because I cannot possibly know to
+the contrary, although from the analogy of other disease I do not
+believe it, that the Cholera Morbus may not become contagious under
+certain conditions of the atmosphere, but these cannot be made subject
+to quarantine laws, and I am fully prepared to acknowledge, that as in
+the case of other epidemics, it may be made contagious through defective
+police; but independent of these, it possesses other powers and
+qualities of self-diffusion, which we can neither understand nor
+controul. Such, however, is not the case with that other phantom of our
+quarantine laws&mdash;the yellow fever&mdash;which can never, under any
+circumstances of atmosphere, without the aid of the last be made a
+contagious disease. I speak thus decisively from my experience of its
+character, as one of the survivors of the St.&nbsp;Domingo war, where, in a
+period of little more than four years, nearly 700 British commissioned
+officers, and 30,000 men were swept away by its virulence; as also from
+subsequent experience, after an interval of 20&nbsp;years, when in the course
+of time and service, I became principal medical officer of the windward
+and leeward colonies, and in that capacity, surveyed and reported upon
+the whole of these transatlantic possessions.</p>
+
+<p>It was my intention, in these times of panic, to designate to my
+countrymen, in as far as I could, the true essential intrinsic
+contagions of the British Isles, (for such there are, and terrible ones
+too,) which prevail under all circumstances of season, atmosphere, and
+locality, as contradistinguished from the factitious ones, of our own
+creating, and the imaginary or false which often spread epidemically,
+(for there may be an epidemic as well as contagious current of
+disease)<a name="FNanchor_27_27" id="FNanchor_27_27"></a><a href="#Footnote_27_27" class="fnanchor">[27]</a> although
+they possess no contagious
+
+<!-- Page 26 -->
+
+<span class="pagenum2"><a name="Page_26_Part_2" id="Page_26_Part_2">Pt_2<br />[Pg 26]</a></span>
+
+property whatever; as
+well as the foreign contagions, which if we relax in due precaution,
+may, at any time, be introduced amongst us&mdash;but the unreasonable length
+of this letter, for a newspaper communication, warns me to stop.</p>
+
+<div class="footnote">
+<p>
+<a name="Footnote_27_27" id="Footnote_27_27"></a>
+<a href="#FNanchor_27_27"><span class="label">[27]</span></a>
+
+For as long as men congregate together, and every
+supposable degree of communication must of necessity be constantly
+taking place amongst them, to distinguish a spreading epidemic from a
+contagious disease when it first breaks out, must obviously be a matter
+of impossibility; and upon this point the contagionists and their
+antagonists may rail for ever,&mdash;the one will see nothing but contagion,
+whether in the dead or the living body, and the other will refer every
+fresh case to atmospheric or terrestrial influence, and both with as
+much apparent reason as they possibly could desire: but the candid
+impartial investigator, who waits to observe the course of the disease
+before coming to a conclusion, and refers to the facts furnished in the
+Cholera Hospitals of Warsaw and the sick quarters of Sunderland, will
+never be deceived in regard to its real nature, nor propagate the
+appalling belief that Cholera Morbus can be made a transportable and
+transmissible contagion.
+</p>
+</div>
+
+<p>I have written thus earnestly, because I deeply feel what I have here
+put down. It is possible I may have made mistakes, but if I have, they
+are not intentional, and I shall be happy to be corrected, for I do not
+live at the head quarters of communication, and my broken health
+prevents my frequenting in person, the field of investigation. In
+candour I ought to declare, that the establishment of quarantine against
+this new and hideous pestilence in the first instance, was the most
+sacred duty of Government, but now that its true character has been made
+known, and the futility of quarantine restrictions demonstrated, I feel
+equally bound, as one of the lieges, to enter my humble protest against
+their continuance.</p>
+
+<p>Should I write again, I shall still adopt the same popular style, for no
+other can be adapted to a newspaper communication, and the
+subject-matter is as interesting to the public, and every head of a
+family, as it can be to the professional reader; and, in thus making use
+of your columns, as I can have no motive but that of ardent research
+after truth, I know that I may always rely upon your assistance and
+co-operation.</p>
+
+<div class="signr">
+<span class="signrind">WILLIAM FERGUSSON,</span><br />
+Inspector-General of Hospitals.
+</div>
+
+<div class="signl">
+<i>Windsor, Nov</i>.&nbsp;26,&nbsp;1831.
+</div>
+
+<hr class="major" />
+
+<div>
+<!-- Page 27 -->
+
+<span class="pagenum2"><a name="Page_27_Part_2" id="Page_27_Part_2">Pt_2<br />[Pg 27]</a></span>
+</div>
+
+<h2><a name="LETTER_III_Part_2" id="LETTER_III_Part_2"></a>LETTER III.
+<br />
+<span class="size75">TO THE MEDICAL SOCIETY OF WINDSOR.</span>
+</h2>
+
+<p>In this paper it is my intention to treat of the contagious diseases of
+the British Isles, as well as to offer to the Society some observations
+on malignant Cholera Morbus, and the mode of its propagation from the
+tropical regions, where it first arose, to the colder latitudes of
+Europe.</p>
+
+<p>Having already published two letters on this last part of my subject, I
+need not here take up your time in recapitulating their contents, but
+proceed to the consideration of some remaining points of the enquiry;
+which I find I have either overlooked, or not been so explicit in
+illustration, as I otherwise might, had I been addressing a body of
+professional men, instead of the community where I live, with the view
+of <i>disabusing</i> their minds from the effects of irrational panic, and
+opening their eyes to what I deemed true measures of preservation
+against the impending disease; and here I may as well add that when I
+wrote in a newspaper and adopted the style suited to such a channel of
+communication, I knew none so likely to attract the attention of those
+influential men, who might possess the power and the will, when
+disabused of prejudice, to enforce proper laws, instead of running the
+course that had already been imposed upon them, by men interested in the
+upholding of our quarantine establishments, or by prejudiced, however
+well meaning, Boards of Health.</p>
+
+<p>In looking over those letters, I find that the points most open to
+dispute are the course of the disease throughout the Indian peninsula,
+and its progress to the frontiers of Russia; as well as its supposed
+infectious nature, and mode of propagation by human intercourse. In
+regard to the first, there is no contagionist however avowed and
+uncompromising, who does not admit that this erratic disease did not
+often wander from its straight line when the most promising fields lay
+directly before it; or stop short most
+
+<!-- Page 28 -->
+
+<span class="pagenum2"><a name="Page_28_Part_2" id="Page_28_Part_2">Pt_2<br />[Pg 28]</a></span>
+
+unaccountably in its progress,
+when the richest harvest of victims seemed actually within its
+jaws&mdash;that its course was circuitous when, according to the laws of
+contagion, it ought to have been straight,&mdash;that it refused its prey at
+one time, and returned to it at another, in a manner that showed its
+progress was governed by laws which we could neither understand nor
+controul; and if we search the reports of contagionist writers, we shall
+find fully as much, and as strong evidence of its progress being
+independent of human intercourse, as of its being propagated and
+governed by the laws of
+contagion.<a name="FNanchor_28_28" id="FNanchor_28_28"></a><a href="#Footnote_28_28" class="fnanchor">[28]</a>
+</p>
+
+<div class="footnote">
+<p>
+<a name="Footnote_28_28" id="Footnote_28_28"></a>
+<a href="#FNanchor_28_28"><span class="label">[28]</span></a>
+
+Vide Orton, Kennedy,&nbsp;&amp;c.
+</p>
+</div>
+
+<p>To the question, which has so often been triumphantly asked, of its
+progress to the Russian frontiers being conducted by caravans along the
+great highways of human intercourse, and what else than contagion could
+cause it to be so carried? An admirable journalist has already replied
+by asking in his turn, on what other line than amongst the haunts of men
+could we possibly have found, or detected a human disease? And surely
+the question is most pertinent, for in those barbarous regions that
+interpose between Russia and India, where the wolf and the robber hold
+divided alternate sway, and isolated man dares not fix his habitation,
+but must congregate for safety; where else than in those great
+thoroughfares could the disease have found its food; or if beyond these,
+man, almost as ignorant and as savage as the wolf, could have been
+found; who under such circumstances would have recognised, described,
+and testified to its existence? Even at Sunderland, amongst ourselves,
+its existence was long hotly disputed by the learned of the faculty; and
+the fatalist barbarian of these regions would have dismissed the enquiry
+with a prayer of resignation, while he bowed his head to the grave, or
+if his strength permitted, with a stroke of his dagger against the
+impious enquirer who had dared to interfere with the immutable decrees
+of fate. The stories too of its importation into Russia, are exactly the
+same as have come to us from our own Gibraltar, in the case of
+
+<!-- Page 29 -->
+
+<span class="pagenum2"><a name="Page_29_Part_2" id="Page_29_Part_2">Pt_2<br />[Pg 29]</a></span>
+
+the yellow fever, and may be expected to come from every other quarter where
+a well paid officious quarantine is established to find infection in its
+own defence, and to trace its course in proof of their own services and
+utility. Under such circumstances, this well gotten up drama of
+importation may be rehearsed in every epidemic, adapted in all its parts
+to every place and every disease, they wish to make contagious. First
+will be presented, as at Gibraltar, the actual importers&mdash;their course
+traced&mdash;the disease identified&mdash;its reception denounced, and quarantine
+established; and this will go down until sober minded disinterested men
+become engaged in the enquiry, when it will turn out in all probability,
+that the importers, as at Sunderland, never had the disease&mdash;that it was
+in the place long before their arrival&mdash;that in its supposed course, it
+either had no existence, or had long ceased&mdash;in fact that the
+importation was a fable, the product either of design or an alarmed
+imagination. On this point I shall not here farther dwell, but proceed
+to the still keenly disputed question of its contagious, or
+non-contagious nature.</p>
+
+<p>Amongst all those who have advocated the affirmative side of the
+question, an anonymous writer in the
+<span class="smcap">Lancet</span>, of Nov.&nbsp;19th. seems to me
+the ablest special pleader of his party, and the best informed on the
+subject, which he has grappled with a degree of acumen and power that
+must at once have secured him the victory, in any cause that had truth
+for its basis, or that could have stood by itself; but strong and
+scornful as he is, he has himself furnished the weapons for his own
+defeat, and has only to be correctly quoted in his own words, for answer
+to the most imposing and powerful of his arguments. I take it for
+granted, that no one will give credit to instantaneous infection, at
+first sight, but allow that an interval must elapse between the
+reception of the virus, and explosion of the disease. Kennedy and the
+best of the contagionist authors, have fixed the intervening time from
+two days to a longer uncertain period; yet that writer (in the <span class="smcap">Lancet</span>)
+proceeds to tell us, in proof of the virulence of the contagion, that
+when twenty healthy reapers
+
+<!-- Page 30 -->
+
+<span class="pagenum2"><a name="Page_30_Part_2" id="Page_30_Part_2">Pt_2<br />[Pg 30]</a></span>
+
+went into the harvest field at Swedia, near
+Tripoli, and one of them at mid-day was struck down with the disease, he
+then instantly, as if, instead of being prostrate on the ground, he had
+run a muck for the propagation of Cholera Morbus, infected all the rest,
+so that the whole were down within three hours, and all were dead before
+the following
+morning.<a name="FNanchor_29_29" id="FNanchor_29_29"></a><a href="#Footnote_29_29" class="fnanchor">[29]</a>&mdash;All
+this too in the open air. Another writer
+of note relates that when a healthy ship on the outward voyage arrived
+in Madras Roads, her people were seized with Cholera Morbus that very
+morning; but they go further than this, and command us to believe in its
+contagious powers, without sight at all, quoting the report from our
+Commissioners in Russia, where it is officially announced "that neither
+the presence, nor contact of the patient is necessary to communicate the
+disease." Surely in candour we may be allowed to say that when they
+limit their views to contagion alone, they have attributed powers to it,
+which it never did, and never can possess. That some other principle,
+besides their favourite one, must have been in operation, as well in the
+field of Swedia, when it struck down the reapers, as when it blighted
+our armies in the East, for these sudden bursts and explosions of
+pestilence are incompatible with the laws and progress of natural
+contagion,&mdash;that if, under a tropical temperature, which dissipates all
+infection, there be contagion in the disease, their must also be other
+powers of diffusion hitherto inscrutable, incomprehensible, and
+uncontroulable,&mdash;that their doctrine of contagion exclusively, is
+superficial narrow, and intolerant, and their arguments in support of
+it, no more than a delusion of prejudice, a piece of consummate special
+pleading to make the worse appear the better
+reason.<a name="FNanchor_30_30" id="FNanchor_30_30"></a><a href="#Footnote_30_30" class="fnanchor">[30]</a>
+</p>
+
+<div class="footnote">
+<p>
+<a name="Footnote_29_29" id="Footnote_29_29"></a>
+<a href="#FNanchor_29_29"><span class="label">[29]</span></a>
+
+The precise words are "20 peasants of Swedia, robust,
+vigorous, and in the flower of life, were labouring at the harvest work,
+when on the 9th. of July, at noon, one was suddenly attacked, and the
+others in a short time showed symptoms of the disorder. In three hours,
+the entire band was exhausted; before sunset many had ceased to live,
+and by the morrow there was no survivor."
+</p>
+</div>
+
+<div class="footnote">
+<p>
+<a name="Footnote_30_30" id="Footnote_30_30"></a>
+<a href="#FNanchor_30_30"><span class="label">[30]</span></a>
+
+The remainder of the paper, as presented to the Society,
+treated of Typhus fever, and other matter, that had no reference to the
+disease in question.
+</p>
+</div>
+
+<p>
+<!-- Page 31 -->
+
+<span class="pagenum2"><a name="Page_31_Part_2" id="Page_31_Part_2">Pt_2<br />[Pg 31]</a></span>
+
+Before concluding these observations, I would wish to make a few remarks
+upon some points of the enquiry which have been either too cursorily
+passed over, or not noticed at all; and first of its supposed attraction
+for, and adherence to the lines and courses of rivers whether navigable
+or otherwise. I do not think this quality of the disease has been
+assumed on grounds sufficient to justify anything like an exclusive
+preference. Along these lines, no doubt, it has very frequently been
+found, because a malarious, a terrestrial, a contagious, or indeed any
+other disease, would for many reasons, best prevail on the lowest levels
+of the country, or the deepest lines on its surface, like the vallies of
+rivers, provided the food on which it fed&mdash;population&mdash;there abounded.
+It would be difficult almost anywhere to point out a populous city
+unconnected with the sea, rivers, or canals, the water population of
+which, from their habits of life and occupations, everywhere crowded,
+dirty, careless, and exposed, must always afford ready materials for any
+epidemic to work upon, and this may have given currency to the
+prevailing opinion; but I rather believe, when enquiry comes to be made,
+it will be found that the worst ravages of Cholera Morbus have been
+experienced in the great level open plains of Upper Germany, and the
+boundless jungly districts of India, remote from, or at least
+unconnected with water communication, denoting thereby atmospheric
+influence and agency, rather than any other.</p>
+
+<p>Another consideration of some importance is the burial of the dead,
+which according to published reports, has in some places been enforced
+in so hurried a manner as deeply to wound the feelings of surviving
+relatives, and in others to give rise to the horrid suspicion of
+premature interment. Can this have been necessary in any disease, even
+allowing it to be contagious, or was it wise and dignified in the
+medical profession to make this concession to popular prejudice, at all
+times when excited, so unmanageable and troublesome. Although we cannot
+analyse the matter of contagion, we surely know enough of it to feel
+assured, that it must be a production and exhalation from the living
+
+<!-- Page 32 -->
+
+<span class="pagenum2"><a name="Page_32_Part_2" id="Page_32_Part_2">Pt_2<br />[Pg 32]</a></span>
+
+body, arising out of certain processes going on there, in other words
+out of the disease itself, which disease must cease along with the life
+of the patient, and the exhalation be furnished no longer&mdash;that during
+life it was sublimed, so as to leave the body and become diffused around
+through the agency of the animal heat, created by the functions of
+respiration and circulation of the blood, which being foreclosed and the
+supplies cut off, all that remained of it floating before death in the
+atmosphere, must be condensed upon the cold corpse and lie
+harmless.<a name="FNanchor_31_31" id="FNanchor_31_31"></a><a href="#Footnote_31_31" class="fnanchor">[31]</a> It
+must also be evident that when putrefaction begins, no production of
+what belonged to the living body can remain unchanged, but must undergo
+the transformation in form, substance and quality, ordained for all
+things; for putrefaction, although it may possibly produce a disease
+after its own character, is not pestilence, nor even compatible with it
+in the case of specific diseases.</p>
+
+<div class="footnote">
+<p>
+<a name="Footnote_31_31" id="Footnote_31_31"></a>
+<a href="#FNanchor_31_31"><span class="label">[31]</span></a>
+
+Even when a living product, we are authorised to believe,
+from observations made upon the plague, that it cannot be propelled to a
+greater distance than a few feet from the body of the patient&mdash;that it
+is heavier than common air, settling down in a remarkable manner upon
+the sick bed, and saturating the lower strata of the atmosphere in the
+sick apartment.
+</p>
+</div>
+
+<p>The puerile stories, therefore, of infection being taken from following
+a coffined corpse to the grave, without reference to the state of grief,
+fear, and fatigue, not improbably, of drunkenness, in the mourners, must
+be unworthy of attention. I am no friend to the absurdly long interval
+which in this country is allowed to
+elapse,<a name="FNanchor_32_32" id="FNanchor_32_32"></a><a href="#Footnote_32_32" class="fnanchor">[32]</a> even
+in the hottest
+weather, between death and burial; but still more do I deprecate the
+indecent haste which would give sanction to panic, and incur the risk or
+even the suspicion of interment
+
+<!-- Page 33 -->
+
+<span class="pagenum2"><a name="Page_33_Part_2" id="Page_33_Part_2">Pt_2<br />[Pg 33]</a></span>
+
+before dissolution. In regard to
+separate burying grounds, should the disease come to spread, I am sure
+no one will expect, after what has just been said, that I should attempt
+to argue the question seriously, nor enter a protest against the further
+gratuitous wrong of withholding the rites of sepulture in consecrated
+ground from the victims of an epidemic or even a contagious
+disease.&mdash;Nothing could warrant such a measure but want of room in the
+ordinary churchyards, where police should never be allowed to interfere
+with the rights and feelings or property, of the living, unless to
+ensure the privacy of funerals; nothing being so appalling to an alarmed
+people as the spectacle of death in their streets, or so trying to the
+health of the mourners, as tedious funeral ceremonies amidst a crowd of
+people.</p>
+
+<div class="footnote">
+<p>
+<a name="Footnote_32_32" id="Footnote_32_32"></a>
+<a href="#FNanchor_32_32"><span class="label">[32]</span></a>
+
+After sending these letters to the press, I saw in the
+public prints that the Bishop of the Diocese had forbidden the funerals
+of the dead from Cholera to be received in the churches of London.
+Instead of thus forbidding a part, better have the whole of the service
+performed there (where crowds do not come) under cover from the weather,
+than in the open churchyard, where the mourners uncovered, are exposed
+in every way to damp and cold, and the jostling of the mob; better still
+have all the service deemed necessary, performed at the residence of the
+deceased.
+</p>
+</div>
+
+<p>Were I called upon to criticise what I have now written, and to review
+all that I have seen, read, and heard on the subject, I would
+conscientiously declare that the importation of Cholera Morbus into
+England or anywhere else, had been clearly negatived, and its
+non-contagious character almost as clearly established, always however
+with the proviso and exception of the possibility of its being made a
+temporary contingent contagion, amidst filth and poverty, and impurity
+of atmosphere, from overcrowding and accumulation of sick, but neither
+transmissible nor transportable out of its own locality, through human
+intercourse. As the disease, like all the other great plagues, which at
+various periods have desolated the earth, evidently came from the east,
+it would be most desirable in pursuing our investigation, to have a
+clear knowledge of the mode of its introduction into Russia on the
+eastern boundary of Europe. Unfortunately we can place no dependence
+upon the reports that have been published to prove importation there,
+which are lame and contradictory, although coming from the avowed
+partizans of contagion; but even had they been better gotten up, we
+could not, unless they had been confirmed by the experience of other
+nations, have received them with implicit reliance.</p>
+
+<p>The Russian Employ&eacute; of the provinces, <i>mendacior Parthis</i>, not
+
+<!-- Page 34 -->
+
+<span class="pagenum2"><a name="Page_34_Part_2" id="Page_34_Part_2">Pt_2<br />[Pg 34]</a></span>
+
+from greater innate moral depravity than others, but from the corruptions of
+a despotic government which compel him to live under the rod of a
+master, amidst a superstitious barbarous population, whose dangerous
+prejudices he dare not offend, can only give utterance to what his
+tyrants command. Even at the more civilized capital of Petersburgh, the
+mob rose in arms to murder the foreign physicians when they did not act
+according to their liking. Could the truth then be heard on such a
+field, or what native officer would venture to impugn the authority of
+his rulers, proclaiming contagion? If he did, he must cease to live in
+the official sense of the word. Throughout Europe, from east to west,
+the disease has followed its own route according to its own
+incomprehensible laws, despite of every obstacle and precaution. We have
+the authority of our own Central Board for believing that the disease
+cannot be conveyed by merchandize of any kind, and that of our mission
+to Russia for greatly doubting whether it can adhere to personal
+clothing or bedding; and will it be pretended that human beings,
+labouring under such a distemper in any form, could have been the
+vehicles of spreading it in a straight line for thousands of miles
+throughout civilized nations, armed and prepared to defend themselves
+against its inroads,&mdash;they tried, but in vain. We, too, may strive to
+discover the demon of the pestilence amidst the clouds of the climate,
+or the winds of Heaven. He remains hidden to our view; and until better
+revealed, it only remains for us to exercise towards our fellow men
+those duties which humanity prompts, civilization teaches, and religion
+enjoins.</p>
+
+<hr class="major" />
+
+<div>
+<!-- Page 35 -->
+
+<span class="pagenum2"><a name="Page_35_Part_2" id="Page_35_Part_2">Pt_2<br />[Pg 35]</a></span>
+</div>
+
+<h2><a name="POSTSCRIPT" id="POSTSCRIPT"></a>POSTSCRIPT.</h2>
+
+<p>My friend, Doctor Stanford, of the Medical Staff, now settled here, has
+given me the following valuable information, which my own observation
+confirms, regarding the agency of panic, in promoting the diffusion of
+epidemic disease. He happened to be serving with part of the British
+army, at Cadiz, when an eruption of yellow fever took place there, in
+the autumn of 1813, and as usually happens amongst medical men, the
+first time they have seen that fever, some of them were staunch
+contagionists, and impressed that belief upon the corps to which they
+belonged. In all these the disease was most fatal to great numbers. The
+men being half dead with fear, before they were taken ill, speedily
+became its victims, to the great terror and danger of their surviving
+comrades; but in the other regiments, where no alarm had been sounded,
+the soldiers took the chances of the epidemic with the same steady
+courage they would have faced the bullets of the enemy, in the lottery
+of battle; escaping an attack for the most part altogether, or if
+seized, recovering from it in a large proportion. From this picture let
+us take a lesson, in case the impending epidemic should ever come to
+spread in the populous towns of England, and the cry of contagion be
+proclaimed in their streets. The very word will spread terror and dismay
+throughout the people, causing multitudes to be infected, who would
+otherwise, in all probability, have escaped an attack, and afterwards
+consign them to death in despair, when they find themselves the marked
+and fated victims of a new plague. Whatever they see around them, must
+confirm and aggravate their despair, for desertion and excommunication
+in all dangerous diseases, too certainly seal the fate of the patient.
+It will be vain to tell them that hireling attendance has been
+provided,&mdash;the life of the Choleraic depends upon the instant aid&mdash;the
+able bodied willing aid of affectionate friends, who will devote
+themselves to the task, and persevere indefatigably to the last.
+
+<!-- Page 36 -->
+
+<span class="pagenum2"><a name="Page_36_Part_2" id="Page_36_Part_2">Pt_2<br />[Pg 36]</a></span>
+
+If these be driven from his bed, his last stay is gone, for without their
+active co-operation the best prescription of the physician is only so
+much waste paper. What, let me ask, must have been the fate of the
+patient, and what the consequent panic, if the case of Cholera that
+occurred in London, a month ago at the Barracks of the Foot Guards, had
+been proclaimed, and treated as a contagion? The poor fellow was
+promptly surrounded by his fearless comrades, who with their kind hands
+recalled and preserved the vital heat on the surface, by persevering in
+the affectionate duty of rubbing him for many hours; but had the Medical
+Staff of the regiment been true contagionists, they must, as in duty
+bound, have commanded, and compelled every one of them to fly the
+infection. It depended upon them, to have spread around a far wilder and
+more dangerous contagion than that of Cholera Morbus, or any other
+disease,&mdash;the contagion of fear&mdash;and from what occurred at Cadiz, as
+above related, it is to be hoped our medical men will now see how much
+they will have it in their power, when Cholera comes, to pronounce, or
+to withhold sentence of desolation upon a community. The word Contagion
+will be the word of doom, for then the healthy will fly their homes, and
+the sick be deserted; but a countenance and bearing, devoid of that
+groundless fear, will at once command the aid, and inspire the hopes
+that are powerful to save in the most desperate diseases.</p>
+
+<p>It is stated, in a Scotch newspaper, that two poor travellers, passing
+from Kirkintulloch to Falkirk, ran the risque of being stoned to death
+by the populace of the latter place, and were saved from the immolation
+only by escaping into a house; and in an Irish one, that some
+shipwrecked sailors incurred a similar danger. Such barbarities must, in
+the nature of things, be practised every where under a reign of terror,
+however humane or christianized the people may be&mdash;even the fatalism of
+the Turk would not be proof against it. In Spain they have been enacted
+in all their horrors (thanks to the quarantine laws) upon the
+unfortunate
+
+<!-- Page 37 -->
+
+<span class="pagenum2"><a name="Page_37_Part_2" id="Page_37_Part_2">Pt_2<br />[Pg 37]</a></span>
+
+victims of yellow
+fever;<a name="FNanchor_33_33" id="FNanchor_33_33"></a><a href="#Footnote_33_33" class="fnanchor">[33]</a> and
+we shall soon see them
+repeated amongst ourselves, unless the plain truth be promulgated by
+authority to the people. Let them be told if such be the pleasure of our
+rulers, (for it is not worth while disputing the point), that Cholera
+Morbus is a contagion, but of so safe a nature in regard to
+communicability, that not one in a hundred, or even a thousand, take the
+disease,&mdash;that in this country, besides being a transient passing
+disease, which according to certain laws and peculiarities of its own,
+will assuredly take its departure in no long time; it is limited almost
+always to particular spots and localities&mdash;that it is in their own
+power, while it remains, to correct the infectious atmosphere of these
+spots, by attention to health police&mdash;that they may fearlessly approach
+their sick friends with impunity, for that the danger resides in the
+above atmosphere, and not in the person of the patient; and that in all
+situations they may defy it, for as long as they observe sobriety of
+life and regularity of habits. Thus will public confidence be restored,
+and thus be verified the homely adage of, "honesty, in all human
+affairs, being ever the best policy"; for the concealment, or perversion
+of the truth, however much it may be made to serve the purposes of the
+passing day, can never ultimately promote the ends of good government
+and true humanity, but must lead, sooner or later, to the exposure of
+the delusion, or what would be far worse, to the perpetuation of error
+and prejudice, and grossest abuse of the people, in regard to those
+interests committed to our charge.</p>
+
+<div class="footnote">
+<p>
+<a name="Footnote_33_33" id="Footnote_33_33"></a>
+<a href="#FNanchor_33_33"><span class="label">[33]</span></a>
+
+Vide O'Halloran, upon the Yellow Fever in Spain.
+</p>
+</div>
+
+<hr class="minor" />
+
+<p>Doctor Henry, of Manchester, has, in a late paper, published some most
+interesting experiments, upon the disinfecting power of heat. He found
+that the vaccine virus was deprived of its infecting quality, at
+140&deg;&nbsp;of&nbsp;Farenheit, and that the contagions of
+
+<!-- Page 38 -->
+
+<span class="pagenum2"><a name="Page_38_Part_2" id="Page_38_Part_2">Pt_2<br />[Pg 38]</a></span>
+
+Scarlatina, and Typhus fever,
+from fomites, were certainly dissipated and destroyed, at the dry heat
+of boiling water. In regard to these last, he might surely have ventured
+to fix the standard of safety at a greatly lower temperature; for if the
+grosser vaccine matter could be rendered inert at 140&deg;, there can be
+little doubt of the subtile gaseous emanations, which constitute the
+aerial contagions, being dissipated by the same agent, at an inferior
+degree. In the absence of direct experiment, we may venture to infer,
+that 120&deg; would suffice, to nullify these last. Such, at least, has been
+the belief of those, who have been employed to purify ships, barracks,
+and hospitals, from contagion, and I should think it must have been
+founded on
+experience.<a name="FNanchor_34_34" id="FNanchor_34_34"></a><a href="#Footnote_34_34" class="fnanchor">[34]</a>
+</p>
+
+<div class="footnote">
+<p>
+<a name="Footnote_34_34" id="Footnote_34_34"></a>
+<a href="#FNanchor_34_34"><span class="label">[34]</span></a>
+
+As far back as the years 1796-7-8, this fact was familiar
+to us in the St.&nbsp;Domingo war, only we were satisfied with a minimum heat
+of 120&deg;, from a belief that a temperature of that height, as it
+coagulated the ova of insects (the cock roach for instance), and was
+otherwise incompatible with insect life, would avail to dissipate
+contagion.
+</p>
+</div>
+
+<p>He does not treat of the disinfecting property of light, although such
+an agent was well worthy of his notice; for the power, which in closely
+stopped bottles can deprive Cayenne Pepper of its sting&mdash;render our
+Prussic Acid as harmless as cream, and convert the strongest medicinal
+powders into so much powder of <i>post</i>, can also avail to destroy the
+matter and principle of Contagion. In fact, no other is used for
+purifying goods, at our Lazzarettoes, where suspected articles of
+merchandise, after some nugatory fumigations, are simply exposed to
+light and air with such certain effect, that there is not, I believe, in
+this country, any record of infection being propagated from them
+afterwards. The experiments of Doctor Henry are as simple and beautiful
+in themselves, as they promise to be useful and important, for now even
+the horrible contagion of hospital gangrene would appear to be under the
+controul of the pure agent he has been describing; and the principle now
+established of light and heat, the grand vivifying powers of the
+creation, being the sure and true preservers
+
+<!-- Page 39 -->
+
+<span class="pagenum2"><a name="Page_39_Part_2" id="Page_39_Part_2">Pt_2<br />[Pg 39]</a></span>
+
+of the creature, man, from
+the poisons generated even by himself, and otherwise around him, calls
+for our admiration and gratitude, as shewing that these agents and
+emanations of Almighty power can be made, in the hands of the practical
+philosopher, to serve the purposes of domestic science, and in as far as
+we can see, to fulfil, at least in that respect, the best intentions of
+the Creator.</p>
+
+<hr class="spacer" />
+
+<hr class="minor" />
+
+<div class="center">
+<span class="size90">WINDSOR:</span><br />
+<span class="size80">PRINTED BY R.&nbsp;OXLEY, AT THE EXPRESS OFFICE.</span>
+</div>
+
+<hr class="major" />
+
+<div class="tnote">
+<h3><a name="Transcribers_Note2" id="Transcribers_Note2"></a>Transcriber's Note</h3>
+
+<p>Spelling variations have been retained in this ebook to match the original text,
+e.g., quarrantines &amp; quarantines, shew &amp; show, Farrell &amp; Farrel,
+control &amp; controul, employe &amp; employ&eacute;, coridors,
+land wind &amp; land-wind, reccommended &amp; recommended, versts &amp; wersts,
+clothing &amp; cloathing, apalling &amp; appalling, prima facie &amp; prim&acirc; facie,
+alledged, and par metier &amp; par m&eacute;tier.</p>
+
+<p>Placement of footnote markers has been regularized to be located outside of neighboring
+punctuation.</p>
+
+<p>The following typographical corrections have been made to this text:</p>
+
+<p>PART I</p>
+
+<div>
+<table border="0" cellpadding="4" cellspacing="0" summary="Transcriber's Notes Part I">
+<tr><td class="left"><a href="#Footnote_1_1">Foot 1:</a></td><td class="right">Removed stray comma (As medical men in this Country employ)</td></tr>
+<tr><td class="left"><a href="#Page_6_Part_1">Page 6</a>:</td><td class="right">Changed possesss to possess (still do not possess)</td></tr>
+<tr><td class="left"><a href="#Page_13_Part_1">Page 13</a>:</td><td class="right">Removed superfluous quote marks (Petersburg;&mdash;this gentleman)</td></tr>
+<tr><td class="left"><a href="#Page_19_Part_1">Page 19</a>:</td><td class="right">Removed duplicate word 'of' (has become a magazine of)</td></tr>
+<tr><td class="left"><a href="#Page_19_Part_1">Page 19</a>:</td><td class="right">Changed . to , (the cause of cholera,)</td></tr>
+<tr><td class="left"><a href="#Page_21_Part_1">Page 21</a>:</td><td class="right">Changed , to . (&amp;c., in the office)</td></tr>
+<tr><td class="left"><a href="#Page_22_Part_1">Page 22</a>:</td><td class="right">Changed Mauritus to Mauritius (at the Mauritius before)</td></tr>
+<tr><td class="left"><a href="#Page_22_Part_1">Page 22</a>:</td><td class="right">Added . to Dr (Dr.&nbsp;Hawkins admits)</td></tr>
+<tr><td class="left"><a href="#Page_24_Part_1">Page 24</a>:</td><td class="right">Changed . to , (Martin M'Neal[6],)</td></tr>
+<tr><td class="left"><a href="#Page_24_Part_1">Page 24</a>:</td><td class="right">Changed knowlege to knowledge (any knowledge himself)</td></tr>
+<tr><td class="left"><a href="#Page_26_Part_1">Page 26</a>:</td><td class="right">Changed circustances to circumstances (two circumstances)</td></tr>
+<tr><td class="left"><a href="#Page_28_Part_1">Page 28</a>:</td><td class="right">Removed duplicate word 'a' (at least for a time)</td></tr>
+<tr><td class="left"><a href="#Page_32_Part_1">Page 32</a>:</td><td class="right">Changed intercouse to intercourse (or great intercourse)</td></tr>
+<tr><td class="left"><a href="#Page_33_Part_1">Page 33</a>:</td><td class="right">Added . to Dr (and Dr.&nbsp;Hawkins)</td></tr>
+<tr><td class="left"><a href="#Footnote_11_11">Foot 11:</a></td><td class="right">Changed importan to important (in the important)</td></tr>
+<tr><td class="left"><a href="#Page_39_Part_1">Page 39</a>:</td><td class="right">Moved misplaced comma (at Barcelonetta, the)</td></tr>
+<tr><td class="left"><a href="#Page_45_Part_1">Page 45</a>:</td><td class="right">Changed teminated to terminated (terminated favourably)</td></tr>
+<tr><td class="left"><a href="#Page_46_Part_1">Page 46</a>:</td><td class="right">Removed stray hyphen (he persists in giving)</td></tr>
+<tr><td class="left"><a href="#Page_50_Part_1">Page 50</a>:</td><td class="right">Moved misplaced period (this calamity (the cholera).)</td></tr>
+<tr><td class="left"><a href="#Page_51_Part_1">Page 51</a>:</td><td class="right">Changed &ccedil;aon to '&ccedil;a on' (toute &ccedil;a on trouve)</td></tr>
+<tr><td class="left"><a href="#Page_53_Part_1">Page 53</a>:</td><td class="right">Deleted superfluous end-quotes (took place.)</td></tr>
+<tr><td class="left"><a href="#Page_53_Part_1">Page 53</a>:</td><td class="right">Changed confied to confined (been confined to her bed)</td></tr>
+<tr><td class="left"><a href="#Page_53_Part_1">Page 53</a>:</td><td class="right">Changed macron to aigu accent (employ&eacute;s attached)</td></tr>
+<tr><td class="left"><a href="#Page_53_Part_1">Page 53</a>:</td><td class="right">Changed authorties to authorities (authorities wished)</td></tr>
+<tr><td class="left"><a href="#Page_54_Part_1">Page 54</a>:</td><td class="right">Changed dimished to diminished (diminished all at once)</td></tr>
+<tr><td class="left"><a href="#Page_54_Part_1">Page 54</a>:</td><td class="right">Changed &aacute; to &agrave; (tout &agrave; coup)</td></tr>
+<tr><td class="left"><a href="#Page_54_Part_1">Page 54</a>:</td><td class="right">Changed entass&egrave;s to entass&eacute;s (crowded [entass&eacute;s])</td></tr>
+<tr><td class="left"><a href="#Page_54_Part_1">Page 54</a>:</td><td class="right">Changed Franec to France (state like France)</td></tr>
+<tr><td class="left"><a href="#Page_56_Part_1">Page 56</a>:</td><td class="right">Added missing end-quotes (to the Burraumposter.")</td></tr>
+<tr><td class="left"><a href="#Page_57_Part_1">Page 57</a>:</td><td class="right">Changed em-dash to hyphen (Leicester-square)</td></tr>
+</table>
+</div>
+
+<p>PART II</p>
+
+<div>
+<table border="0" cellpadding="4" cellspacing="0" summary="Transcriber's Notes Part II">
+<tr><td class="left"><a href="#Page_11_Part_2">Page 11</a>:</td><td class="right">Changed typhoi'd to typhoid (the typhoid principle)</td></tr>
+<tr><td class="left"><a href="#Page_15_Part_2">Page 15</a>:</td><td class="right">Changed affluuent to affluent (houses of the affluent)</td></tr>
+<tr><td class="left"><a href="#Page_17_Part_2">Page 17</a>:</td><td class="right">Changed 'in' to 'In' (in my last letter)</td></tr>
+<tr><td class="left"><a href="#Page_21_Part_2">Page 21</a>:</td><td class="right">Changed absorded to absorbed (absorbed into the soil)</td></tr>
+<tr><td class="left"><a href="#Page_22_Part_2">Page 22</a>:</td><td class="right">Changed 'in' to 'it' (would certainly have kept it)</td></tr>
+<tr><td class="left"><a href="#Page_24_Part_2">Page 24</a>:</td><td class="right">Changed procees to process (drying process)</td></tr>
+<tr><td class="left"><a href="#Page_26_Part_2">Page 26</a>:</td><td class="right">Changed saered to sacred (the most sacred duty)</td></tr>
+<tr><td class="left"><a href="#Page_30_Part_2">Page 30</a>:</td><td class="right">Added missing ending punctuation (following morning.)</td></tr>
+<tr><td class="left"><a href="#Page_31_Part_2">Page 31</a>:</td><td class="right">Removed duplicate word always (always afford)</td></tr>
+</table>
+</div>
+
+</div>
+
+
+
+
+
+
+
+
+<pre>
+
+
+
+
+
+End of the Project Gutenberg EBook of Letters on the Cholera Morbus., by 
+James Gillkrest and William Fergusson
+
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+</pre>
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+</body>
+</html>
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+The Project Gutenberg EBook of Letters on the Cholera Morbus., by
+James Gillkrest and William Fergusson
+
+This eBook is for the use of anyone anywhere at no cost and with
+almost no restrictions whatsoever.  You may copy it, give it away or
+re-use it under the terms of the Project Gutenberg License included
+with this eBook or online at www.gutenberg.org
+
+
+Title: Letters on the Cholera Morbus.
+       Containing ample evidence that this disease, under whatever
+       name known, cannot be transmitted from the persons of those
+       labouring under it to other individuals, by contact--through
+       the medium of inanimate substances--or through the medium
+       of the atmosphere; and that all restrictions, by cordons
+       and quarantine regulations, are, as far as regards this
+       disease, not merely useless, but highly injurious to the
+       community.
+
+Author: James Gillkrest
+        William Fergusson
+
+Release Date: February 20, 2009 [EBook #28147]
+
+Language: English
+
+Character set encoding: ASCII
+
+*** START OF THIS PROJECT GUTENBERG EBOOK LETTERS ON THE CHOLERA MORBUS. ***
+
+
+
+
+Produced by Bryan Ness, C. St. Charleskindt, and the Online
+Distributed Proofreading Team at https://www.pgdp.net (This
+file was produced from images generously made available
+by The Internet Archive/American Libraries.)
+
+
+
+
+
+
+
+
+
+Transcriber's Note
+
+This text does not refer to epidemic cholera. The term "cholera morbus"
+was used in the 19th and early 20th centuries to describe both
+non-epidemic cholera and gastrointestinal diseases that mimicked
+cholera. The term "cholera morbus" is found in older references but is
+not in current scientific use. The condition "cholera morbus" is now
+referred to as "acute gastroenteritis."
+
+Spelling variations and inconsistencies have been retained to match the
+original text. Only such cases which strongly indicated the presence
+of inadvertent typographical error have been corrected; a detailed list
+of these corrections can be found at the end of this text.
+
+This ebook consists of two separate parts. The first from 1831 ("LETTERS
+ON THE CHOLERA MORBUS.") contains Letters I-X; and the second from 1832
+("LETTERS ON THE CHOLERA MORBUS, &c. &c. &c.") contains Letters I-III
+and a Postscript. Transcriber's Notes at the end of the text refer to
+"Pt_1" and "Pt_2" for ease of navigation.
+
+
+
+
+LETTERS
+
+ON THE
+
+CHOLERA MORBUS.
+
+CONTAINING
+
+AMPLE EVIDENCE THAT THIS DISEASE, UNDER WHATEVER NAME KNOWN, CANNOT BE
+TRANSMITTED FROM THE PERSONS OF THOSE LABOURING UNDER IT TO OTHER
+INDIVIDUALS, BY CONTACT--THROUGH THE MEDIUM OF INANIMATE SUBSTANCES--OR
+THROUGH THE MEDIUM OF THE ATMOSPHERE; AND THAT ALL RESTRICTIONS, BY
+CORDONS AND QUARANTINE REGULATIONS, ARE, AS FAR AS REGARDS THIS DISEASE,
+NOT MERELY USELESS, BUT HIGHLY INJURIOUS TO THE COMMUNITY.
+
+
+_By a Professional Man of Thirty Years experience, in various parts of
+the World._
+
+
+LONDON:
+
+NICHOLS AND SONS, PRINTERS, EARL'S COURT, CRANBOURN STREET LEICESTER
+SQUARE.
+
+1831.
+
+
+
+
+The first series of these Letters, consisting of five, appeared in the
+months of September and October of the present year; five others,
+written in a more popular form, were inserted in a Newspaper from time
+to time, in the course of this month:--a few additions and alterations,
+preparatory to their appearance in the shape of a pamphlet, have been
+made.
+
+If, at a moment like the present, they prove in any manner useful to the
+public, the writer will feel great satisfaction.
+
+
+November 26th, 1831.
+
+
+
+
+LETTERS ON THE CHOLERA MORBUS;
+
+SHEWING THAT IT IS
+
+NOT A COMMUNICABLE DISEASE.
+
+
+
+
+LETTER I.
+
+
+If we view the progress of this terrific malady, as it tends to
+disorganise society wherever it shows itself, as it causes the
+destruction of human life on an extensive scale, or as it cramps
+commerce, and causes vast expense in the maintenance of quarantine and
+cordon establishments, no subject can surely be, at this moment, of
+deeper interest. It is to be regretted, indeed, that, in this country,
+political questions (of great magnitude certainly), should have
+prevented the legislature, and society at large, from examining, with
+due severity, all the data connected with cholera, in order to avert,
+should we unhappily be afflicted with an epidemic visitation of this
+disease, that state of confusion, bordering on anarchy, which we find
+has occurred in some of those countries where it has this year appeared.
+
+Were this letter intended for the eyes of medical men only, it would
+be unnecessary to say that, during epidemics, the safety of thousands
+rests upon the solution of these simple questions:--Is the disease
+communicable to a healthy person, from the body of another person
+labouring under it, either _directly_, by touching him, or _indirectly_,
+by touching any substance (as clothes, &c.) which might have been in
+contact with him, or by inhaling the air about his person, either during
+his illness or after death?--Or is it, on the other hand, a disease
+with the appearance and progress of which sick persons, individually
+or collectively, have no influence, the sole cause of its presence
+depending on unknown states of the atmosphere, or on terrestrial
+emanations, or on a principle, _aura_, or whatever else it may be
+called, elicited under certain circumstances, from both the earth and
+air?--In the one case we have what the French, very generally I believe,
+term _mediate_ and _immediate_ contagion, while the term _infection_
+would seem to be reserved by some of the most distinguished of
+their physicians for the production of diseases by a deteriorated
+atmosphere:--much confusion would certainly be avoided by this adoption
+of terms.[1] Now it is evident, that incalculable mischief must arise
+when a community acts upon erroneous decisions on the above questions;
+for, if we proceed in our measures on the principle of the disease not
+being either directly or indirectly transmissible, and that it should,
+nevertheless, be so in fact, we shall consign many to the grave, by
+not advising measures of separation between those in health, and
+the persons, clothes, &c., of the sick. On the other hand, should
+governments and the heads of families, act on the principle of the
+disease being transmissible from person to person, while the fact may
+be, that the disease is produced in each person by his breathing the
+deteriorated atmosphere of a certain limited surface, the calamity in
+this case must be very great; for, as has happened on the Continent
+lately, cordons may be established to prevent flight, _when flight, in
+certain cases, would seem to be the only means of safety to many_; and
+families, under a false impression, may be induced to shut themselves
+up in localities, where "every breeze is bane."
+
+[Footnote 1: As medical men in this Country employ the word _infection_
+and _contagion_ in various senses, I shall, generally substitute
+_transmissible_ or _communicable_, to avoid obscurity.]
+
+Hence then the importance, to the state and to individuals, of a rigid
+investigation of these subjects. It is matter of general regret, I
+believe, among medical men, that hitherto the question of cholera has
+not always been handled in this country with due impartiality. Even
+some honest men, from erroneous views as to what they consider "the
+safe side" of the question, and forgetting that the safe side can
+only be that on which truth lies (for then the people will know
+_what_ to do in the event of an epidemic), openly favour the side of
+_communicability_, contrary to their inward conviction; while the good
+people of the quarantine have been stoutly at work in making out that
+precautions are as necessary in the cholera as in plague. Meantime our
+merchants, and indeed the whole nation, are filled with astonishment,
+on discovering that neighbouring states enforce a quarantine against
+ships from the British dominions, when those states find that cases of
+disease are reported to them as occurring among us, resembling more
+or less those which we have so loudly, and I must add prematurely,
+declared to be transmissible. It is quite true that, however decidedly
+the question may be set at rest in this country, our commerce, should
+we act upon the principle, of the disease not being transmissible,
+would be subject to vexatious measures, at least for a time, on the
+part of other states; but let England take the lead in instituting a
+full inquiry into the whole subject, by a Committee of the House of
+Commons; and if the question be decided against quarantines and
+cordons by that body, other countries will quickly follow the example,
+and explode them as being much worse than useless, as far as their
+application to cholera may be concerned. It is very remarkable how, in
+these matters, one country shapes its course by what seems to be the
+rule in others; and, as far as the point merely affects commerce,
+without regard to ulterior considerations, it is not very surprising
+that this should be the case; but it is not till an epidemic shall
+have actually made its appearance among us, that the consequences of
+the temporising, or the precipitation, of medical men can appear in
+all their horrors. Let no man hesitate to retract an opinion already
+declared, on a question of the highest importance to society, if he
+should see good reason for doing so, after a patient and unbiassed
+reconsideration of all the facts. We are bound, in every way, to act
+with good faith towards the public, and erroneous views, in which
+that public is concerned, ought to be declared as soon as discovered.
+To show how erroneous some of the data are from which people are
+likely to have drawn conclusions, is the main cause of my wish to
+occupy the attention of the public; and in doing this, it is certainly
+not my wish to give offence to respectable persons, though I may have
+occasion to notice their errors or omissions.
+
+Previous to proceeding to the consideration of other points, it may be
+observed, that all doubt is at an end as to the identity of the Indian,
+Russian, Prussian, and Austrian epidemic cholera; no greater difference
+being observed in the grades of the disease in any two of those
+countries, than is to be found at different times, or in different
+places, in each of them respectively. At the risk of being considered a
+very incompetent judge, if nothing worse, I shall not hesitate to say,
+that if the same assemblage, or grouping of symptoms be admitted as
+constituting the same disease, it may at any time be established, to the
+entire satisfaction of an unprejudiced tribunal, that cases of cholera,
+not unfrequently proving fatal, and corresponding in every particular to
+the average of cases as they have appeared in the above countries, have
+been frequently remarked as occurring in other countries including
+England; and yet no cordon or quarantine regulations, on the presumption
+of the disease spreading by "contagion." For my own part, without
+referring to events out of Europe, I have been long quite familiar, and
+I know several others who are equally so, with cholera, in which a
+perfect similarity to the symptoms of the Indian or Russian cholera has
+existed: the collapse--the deadly coldness with a clammy skin--the
+irritability of the stomach, and prodigious discharge from the bowels
+of an opaque serous fluid (untinged with bile in the slightest
+degree)--with a corresponding shrinking of flesh and integuments--the
+pulseless and livid extremities--the ghastly aspect of countenance and
+sinking of the eyes--the restlessness so great, that the patient has not
+been able to remain for a moment in any one position--yet, with all
+this, nobody dreamt of the disease being communicable; no precautions
+were taken on those occasions "to prevent the spreading of the disease,"
+and no epidemics followed. In the _Glasgow Herald_ of the 5th ult., will
+be found a paper by Mr. Marshall, (a gentleman who seems to reason with
+great acuteness), which illustrates this part of our subject. This
+gentleman appears to have had a good deal of experience in Ceylon when
+the disease raged there, and I shall have occasion to refer hereafter to
+his statements, which I consider of great value. Nobody can be so absurd
+as to expect, that in the instances to which I refer, _all_ the symptoms
+which have ever been enumerated, should have occurred in each case; for
+neither in India nor any-where else could all the grave symptoms be
+possibly united in any one case; for instance, great retching, and a
+profuse serous discharge from the bowels, have very commonly occurred
+where the disease has terminated fatally: yet it is not less certain,
+that even in the epidemics of the same year, death has often taken place
+in India more speedily where the stomach and bowels have been but little
+affected, or not at all. To those who give the subject of cholera all
+the attention which it merits, the consideration of some of those cases
+which have, within the last few weeks, appeared in the journals of this
+country, cannot fail to prove of high interest, and must inspire the
+public with confidence, inasmuch as they show, _beyond all doubt_, that
+the disease called cholera, as it has appeared in this country, and
+however perfectly its symptoms may resemble the epidemic cholera of
+other countries, _is not_ communicable. On some of those cases so
+properly placed before the public, I shall perhaps be soon able to offer
+a few remarks: meanwhile, I shall here give the abstract of a case, the
+details of which have not as yet, I believe, appeared, and which must
+greatly strengthen people in their opinion, that these cholera cases,
+however formidable the symptoms, and though they sometimes end rapidly
+in death, still do not possess the property of communicating the disease
+to others. I do not mean to state that I have myself seen the case, the
+details of which I am about to give, but aware of the accuracy of the
+gentleman who has forwarded them to me, I can say, that although the
+communication was not made by the medical gentleman in charge of the
+patient, the utmost reliance may be placed on the fidelity of those
+details:--
+
+Thursday, August 11th, 1831, Martin M'Neal, aged 42, of the 7th
+Fusileers, stationed at Hull, was attacked at a little before four A.M.,
+with severe purging and vomiting--when seen by his surgeon at about four
+o'clock, was labouring under spasms of the abdominal muscles, and of the
+calves of the legs. What he had vomited was considered as being merely
+the contents of the stomach, and, as the tongue was not observed to be
+stained of a yellow colour, it was inferred that no bile had been thrown
+up. He took seventy drops of laudanum, and diluents were ordered.
+Half-past six, seen again by the surgeon, who was informed that he had
+vomited the tea which he had taken; no appearance of bile in what he had
+thrown up; watery stools, with a small quantity of feculent matter;
+thirst; the spasms in abdomen and legs continued; countenance not
+expressive of anxiety; skin temperate; pulse 68 and soft; the forehead
+covered with moisture. Ordered ten grains of calomel, with two of opium,
+which were rejected by the stomach, though not immediately.
+
+Eight o'clock A.M. The features sinking, the temperature of the body now
+below the natural standard, especially the extremities; pulse small;
+tongue cold and moist; a great deal of retching, and a fluid vomited
+resembling barley-water, but more viscid; constant inclination to go to
+stool, but passed nothing; the spasms more violent and continued; a
+state of collapse the most terrific succeeded. At nine o'clock, only a
+very feeble action of the heart could be ascertained as going on, even
+with the aid of the stethoscope; the body cold, and covered with a
+clammy sweat, the features greatly sunk; the face discoloured; the lips
+blue; the tongue moist, and very cold; the hands and feet blue, cold,
+and shrivelled, as if they had been soaked in water, like washerwomen's
+hands; no pulsation to be detected throughout the whole extent of
+the upper or lower extremities; the voice changed, and power of
+utterance diminished. He replied to questions with reluctance, and in
+monosyllables; the spasms became more violent, the abdomen being, to
+the feel, as hard as a board, and the legs drawn up; cold as the body
+was, he could not bear the application of heat, and he threw off the
+bed-clothes; passed no urine since first seen; the eyes became glassy
+and fixed; the spasms like those of tetanus or hydrophobia; the
+restlessness so great, that it required restraint to keep him for ever
+so short a time in any one position. A vein having been opened in one
+of his arms, from 16 to 20 ounces of blood were drawn with the greatest
+difficulty. During the flowing of the blood, there was great writhing of
+the body, and the spasms were very severe--friction had been arduously
+employed, and at ten A.M. he took a draught containing two and a half
+drachms of laudanum, and the vomiting having ceased, he fell asleep. At
+two P.M. re-action took place, so as to give hopes of recovery. At four
+P.M. the coldness of the body, discoloration, &c., returned, but without
+a return of the vomiting or spasms. At about half-past eight he died,
+after a few convulsive sobs.
+
+On a post-mortem examination, polypi were found in the ventricles of
+the heart, and the cavae were filled with dark blood. Some red patches
+were noticed on the mucuous membrane; but the communication forwarded
+to me does not specify on what precise part of the stomach or
+intestinal canal; and my friend does not appear to attach much
+importance to them, from their common occurrence in a variety of other
+diseases. It remains to be noticed, that the above man had been at a
+fair in the neighbourhood on the 9th (two days preceding his attack),
+where, as is stated, he ate freely of fruit, and got intoxicated. On
+the 10th he also went to the fair, but was seen to go to bed sober
+that night. The disease did not spread to others, either by direct
+or indirect contact with this patient.
+
+Now let us be frank, and instead of temporising with the question, take
+up in one hand the paper on "cholera spasmodica" just issued, for our
+guidance, from the College of Physicians by the London Board of Health,
+and in the other, this case of Martin M'Neal (far from being a singular
+case this year, in most of the important symptoms),--let the symptoms be
+compared by those who are desirous that the truth should be ascertained,
+or by those who are not, and if distinctions can be made out, I must
+ever after follow the philosophy of the man who doubted his own
+existence. The case, as it bears on certain questions connected with
+cholera, _is worth volumes of what has been said on the same subject_.
+Let it be examined by the most fastidious, and the complete identity
+cannot be got rid of, even to the _blue_ skin, the _shrivelled fingers_,
+the _cold tongue_, the _change in voice_, and the _suppression of
+urine_, considered in some of the descriptions to be found in the
+pamphlet issued by the Board of Health, as so characteristic of the
+"Indian" cholera; and this, too, under a "constitution of the
+atmosphere" so remarkably disposed to favour the production of cholera
+of one kind or other, that Dr. Gooch, were he alive, or any close
+reasoner like him, must be satisfied, that were this remarkable form of
+the disease communicable, no circumstance was absent which can at all
+be considered essential to its propagation. As the symptoms in the case
+of M'Neal, were, perhaps, more characteristically grouped than in any
+other case which has been recorded in this country, so it has also in
+all probability occurred, that more individuals had been in contact with
+him during his illness and after his death, as the facility in obtaining
+persons to attend the sick, rub their bodies, &c., must be vastly
+greater in the army than in ordinary life; so that in such cases it is
+not a question of one or two escaping, but of _many_, which is always
+the great test.
+
+Of the College of Physicians we are all bound to speak with every
+feeling of respect, but had the document transmitted by that learned
+body to our government, on the 9th of June last, expressed only a
+"philosophic doubt," instead of making an assertion, the question
+relative to the contagion or non-contagion of the disease, now making
+ravages in various parts of Europe, would be less shackled among us.
+People are naturally little disposed to place themselves, with the
+knowledge they may have obtained from experience and other sources, in
+opposition to such a body as the College: but as, in their letter to
+government of the 18th of June, they profess their readiness, should it
+be necessary, to "re-consider" their opinion, we, who see reason to
+differ from them, may be excused for publishing our remarks. It seems
+surprising enough that, in their letter to government of the 9th of
+June, the College should have given as a reason for their decision
+as to the disease being infectious (meaning, evidently, what some call
+contagious, or transmissible from _persons_)--"having no other means of
+judging of the nature and symptoms of the cholera than those furnished
+by the documents submitted to us." Now, according to the printed
+parliamentary papers, among the documents here referred to as having
+been sent by the Council to the College, was one from Sir William
+Crichton, Physician in Ordinary to the Emperor of Russia, in which a
+clear account is given of the symptoms as they presented themselves in
+that country; and, if the College had previously doubted of the identity
+of the Russian and Indian cholera, a comparison of the symptoms, as they
+were detailed by Sir William, with those described in various places in
+the _three volumes_ of printed Reports on the cholera of India, in the
+college library, must at once have established the point in the
+affirmative. In fact, we know, that the evidence of Dr. Russell, given
+before the College, when he heard Sir William's description of the
+disease read, fully proved this identity to the satisfaction of the
+College. Had the vast mass of information contained in the India
+Reports, together with the information since accumulated by our Army
+Medical Department, been consulted, all which are highly creditable to
+those concerned in drawing them up, and contain incomparably better
+evidence, that is, evidence more to be relied on, than any which can be
+procured from Russia or any other part of the world--had these sources
+of information been consulted, as many think they should in all fairness
+have been, the College would probably have spoken more doubtingly as
+to cholera, in any form, possessing the property of propagating itself
+from person to person. Much of what passes current in favour of the
+communication of cholera rests, I perceive, on statements the most
+vague, assertions in a general way, as to the security of those who shut
+themselves up, &c. To show how little reliance is to be placed on such
+statements, even when they come from what ought to be good authority,
+let us take an instance which happened in the case of yellow fever.
+Doctor, now Sir William Pym, superintendent of the quarantine
+department, published a book on this disease in 1815, in which he
+stated, that the people shut up in a dock-yard, during the epidemic of
+1814, in Gibraltar, escaped the disease, and Mr. William Fraser, also of
+the quarantine, and who was on the spot, made a similar statement. Now,
+we all believed this in England for several years, when a publication
+appeared from Dr. O'Halloran, of the medical department of Gibraltar
+garrison, in which he stated that he had made inquiries from the
+authorities at that place, and that he discovered the whole statement to
+have been without the smallest foundation, and furnishes the particulars
+of cases which occurred in the dock-yard, among which were some deaths;
+this has never since been replied to--so much as a caution in the
+selection of proofs.
+
+To show, further, how absurdly statements respecting the efficacy of
+cordons will sometimes be made, it may be mentioned that M. D'Argout,
+French minister of public works, standing up in his place in the
+chamber, _on the 3rd instant_ (_Septr._), and producing his estimates
+for additional cordons, &c., stated, by way of proving the efficacy of
+such establishments, that in Prussia, where, according to him, cordon
+precautions had been pre-eminently rigorous, and where "_le territoire
+a ete defendu pied a pied_," such special enforcement of the regulations
+was attended with "_assez de succes_:" in the meantime the next mail
+brings us the official announcement (_dated Berlin, Sept. 1_) of the
+disease having made its appearance there!
+
+To conclude, for the present: if there be one reason more than another
+why the question of cholera should be scrutinized by the highest
+tribunal--a parliamentary committee--it is, that in the "papers" just
+issued by the Board of Health, the following passage occurs (page
+36):--"But in the event of such removal not being practicable, on
+account of extreme illness or otherwise, the prevention of all
+intercourse with the sick, even of the family of the person attacked,
+must be rigidly observed, unless," &c. There are some who can duly
+appreciate all the consequences of this; but let us hope that the
+question is still open to further evidence, in order to ascertain
+whether it be really necessary that, in the event of a cholera epidemic,
+
+"The living shall fly from
+The sick they should cherish."
+
+
+
+
+LETTER II.
+
+
+In my last letter I adverted to the opinion forwarded to his Majesty's
+Council on the 9th of June last from the College of Physicians, in which
+the cholera, now so prevalent in many parts of Europe, was declared to
+be communicable from person to person. We saw that they admitted in that
+letter (see page 16 of the Parliamentary Papers on Cholera) the limited
+nature of the proofs upon which their opinion was formed; but I had not
+the reasons which I supposed I had for concluding, that because they
+used the words "ready to reconsider," in their communication of the 18th
+of same month to the Council, they intended to _reconsider_ the whole
+question. Indeed this seems now obvious enough, as one of the Fellows of
+the College who signed the Report from that body on the 9th of June
+(Dr. Macmichael) has published a pamphlet in support of the opinion
+already given, in the shape of a letter addressed to the President of the
+College, whose views, Dr. Macmichael tells us, _entirely coincide_ with
+his own; so that there is now too much reason to apprehend that in this
+quarter the door is closed. Contagionist as I am, in regard to those
+diseases where there is evidence of contagion, I find nothing in Dr.
+Macmichael's letter which can make an impression on those who are at all
+in the habit of investigating such subjects,[2] and who, dismissing such
+inductions as those which he seems to consider legitimate, rely solely
+on facts rigorously examined. He must surely be aware that most of the
+points which he seems to think ought to have such influence in leading
+the public to believe in the contagion of cholera, might equally apply
+to the influenza which this year prevailed in Europe, and last year in
+China, &c.; or to the influenza of 1803, which traversed over continents
+and oceans, _sometimes in the wind's eye, sometimes not_, as frequently
+mentioned by the late Professor Gregory of Edinburgh. Who will now stand
+up and try to maintain that the disease in those epidemics was
+propagated from person to person? Could more have been made of so bad a
+cause as contagion in cholera, few perhaps could have succeeded better
+than Dr. Macmichael, and no discourtesy shall be offered him by me,
+though he does sometimes loose his temper, and say, among other things
+not over civil, nor quite _comme il faut_, from a Fellow of the College,
+that all who do not agree with him as to contagion "will fully abandon
+all the ordinary maxims of prudence, and remain obstinately blind to the
+dictates of common sense!"--_fort, mais peu philosophique Monsieur le
+Docteur_. The time has gone by when ingenious men of the profession,
+like Dr. Macmichael, might argue common sense out of us; it will not
+even serve any purpose now that other names are so studiously introduced
+as _entirely coinciding_ with Dr. Macmichael; for, in these days of
+reform in every thing, _opinions_, will only be set down at their just
+value by those who pay attention to the subject.
+
+[Footnote 2: I presume that I shall not be misunderstood when I say,
+_Would that the cholera were contagious_--for then we might have every
+reasonable hope of staying the progress of the calamity by those cordon
+and quarantine regulations which are now not merely useless, but the
+bane of society, when applied to cholera or other non-contagious
+diseases.]
+
+Referring once more to the Report of the 9th of June, made by the
+College to the Council, and signed by the President as well as by
+Dr. Macmichael, the cholera was there pronounced to be a communicable
+disease, when they had, as they freely admit, "no other means of judging
+of the nature and symptoms of the cholera than those furnished by the
+documents submitted to them." The documents submitted were the
+following, as appears from the collection of papers published by order
+of Parliament:--Two reports made to our government by Dr. Walker, from
+Russia; a report from Petersburgh by Dr. Albers, a Prussian physician;
+and a report, with inclosures, regarding Russian quarantine regulations,
+from St. Petersburg, by Sir W. Creighton. Dr. Walker, who was sent from
+St. Petersburg to Moscow, by our ambassador at the former place; states,
+in his first report, dated in March, that the medical men seemed to
+differ on the subject of contagion, but adds, "I may so far state, that
+by far the greater number of medical men are disposed to think it not
+contagious." He says, that on his arrival at Moscow, the cholera was
+almost extinct there; that in twelve days he had been able to see only
+twenty-four cases, and that he had no means of forming an opinion of
+his own as to contagion. In a second report, dated in April from St.
+Petersburg, this gentleman repeats his former statement as to the
+majority of the Moscow medical men not believing the disease to be
+contagious (or, as the College prefer terming it, infectious), and gives
+the grounds on which their belief is formed, on which he makes some
+observations. He seems extremely fair, for while he states that,
+according to his information, a peculiar state of the atmosphere "was
+proved by almost every person in the city (Moscow), feeling, during the
+time, some inconvenience or other, which wanted only the exciting cause
+of catching cold, or of some irregularity in diet, to bring on cholera;"
+that "very few of those immediately about the patients were taken ill;"
+that he "did not learn that the contagionists in Moscow had any strong
+particular instances to prove the communication of the disease from one
+individual to another;" and that he had "heard of several instances
+brought forward in support of the opinion (contagion), but they are not
+fair ones:" he yet mentions where exceptions seem to have taken place as
+to hospital attendants not being attacked, but he has neglected to tell
+us (a very common omission in similar statements), whether or not the
+hospitals in which attendants were attacked were situated in or near
+places where the atmosphere seemed _equally productive of the disease
+in those not employed in attending on sick_. This clearly makes all the
+difference, for there is no earthly reason why people about the sick
+should not be attacked, if they breathe the same atmosphere which would
+seem to have so particular an effect in producing the disease in others;
+indeed there are good reasons why, during an epidemic, attendants should
+be attacked in greater proportion; for the constant fatigue, night-work,
+&c., must greatly predispose them to disease of any kind, while the
+great additional number always required on those occasions, precludes
+the supposition of the majority so employed being _seasoned_ hospital
+attendants, having constitutions impenetrable to contagion. Those
+questions are _now_ well understood as to yellow fever, about which so
+much misconception had once existed. The proofs by disinterested authors
+(by which I mean those unconnected with quarantine establishments, or
+who are not governed by the _expediency_ of the case) in the West
+Indies, America, and other places, show this in a clear light; but the
+proofs which have for some time past appeared in various journals
+respecting the occurrences at Gibraltar, during the epidemic of 1828,
+are particularly illustrative. By the testimony of three or four
+writers, we find that _within certain points_, those in attendance on
+sick, in houses as well as hospitals, were attacked with the fever, in
+common with those who were not in attendance on sick; but that, where
+people remained at ever so short a distance beyond those points, during
+the epidemic influence, _not a single instance_ occurred of their being
+attacked, though great numbers had been in the closest contact with the
+sick, and frequently too, it would appear, under circumstances when
+contagion, had it existed, was not impeded in its usual course by a very
+free atmosphere:--_sick individuals, for instance, lying in a small
+house, hut, or tent, surrounded, during a longer or shorter space of
+time, by their relatives, &c._ A full exposure of some very curious
+mis-statements on these points, made by our medical chief of the
+quarantine, will be found from the pen of the surgeon of the 23d
+regiment, in the _Edinburgh Medical and Surgical Journal_, No. 106.[3]
+Those who are acquainted with the progress of cholera in India, must be
+aware how a difference in the height of places, or of a few hundred
+yards (_indeed sometimes of a few yards_) distance, has been observed to
+make all the difference between great suffering and complete
+immunity:--the printed and manuscript reports from India furnish a vast
+number of instances of this kind; and, incredible as it may appear, they
+furnish instances where, _notwithstanding the freest intercourse_, there
+has been an abrupt line of demarcation observed, beyond which the
+disease did not prevail. A most remarkable instance of this occurred in
+the King's 14th regiment, in 1819, during a cholera epidemic, when the
+light company of the regiment escaped almost untouched, owing to no
+other apparent cause than that they occupied the extremity of a range of
+barrack in which all the other companies were stationed! so that there
+would truly seem to be more things "on earth than are dreamt of in the
+philosophy" of contagionists. This seems so remarkable an event, that
+the circumstance should be more particularly stated:--"The disease
+commenced in the eastern wing of the barracks, and proceeded in a
+westerly direction, but suddenly stopped at the 9th company; the
+light infantry escaping with one or two slight cases only."--(_Bengal
+Rep._ 311.) It appears (_loc. cit._) that 221 attacks took place in the
+other nine companies. We find (_Bombay Rep._ p. 11.) that, from a little
+difference in situation, two cavalry regiments in a camp were altogether
+exempt from the disease, while all the other regiments were attacked.
+Previous to closing these remarks, which seemed to me called for on
+Dr. Walker's second Report, it is fair to state, that in certain Russian
+towns which he names, he found that the medical men and others were
+convinced that the cholera was brought to them "_somehow or other_," an
+impression quite common in like cases, as we learn from Humboldt, and
+less to be wondered at in Russia than most places which could be
+mentioned. It will not be a misemployment of time to consider now the
+next document laid before the College, to enable them to form their
+opinion,--the Report of Dr. Albers, dated in March, and sent from St.
+Petersburg;--this gentleman, who was at the head of a commission sent
+by the Prussian government to Moscow, states, that at St. Petersburgh,
+_where the disease did not then reign_, the authorities and physicians
+were contagionists; but at Moscow, where it had committed such ravages,
+"almost all strenuously maintain that cholera is not contagious." The
+following extract seems to merit particular attention:--
+
+"When the cholera first reached Moscow, all the physicians of this city
+were persuaded of its contagious nature, but the experience gained in
+the course of the epidemic, has produced an entirely opposite
+conviction. They found that it was impossible for any length of time
+completely to isolate such a city as Moscow, containing 300,000
+inhabitants, and having a circumference of nearly seven miles (versts?),
+and perceived daily the frequent frustrations of the measures adopted.
+During the epidemic, it is certain that upwards of 40,000 inhabitants
+quitted Moscow, of whom a large number never performed quarantine; and
+notwithstanding this fact, _no case is on record of the cholera having
+been transferred from Moscow to other places_, and it is equally
+certain, that in _no situation_ appointed for quarantine, _any case of
+cholera has occurred_. That the distemper is not contagious, has been
+yet more ascertained by the experience gathered in this city (Moscow).
+In many houses it happened, that one individual attacked by cholera was
+attended indiscriminately by all the relatives, and yet did the disease
+not spread to any of the inmates. It was finally found, that not only
+the nurses continued free of the distemper, but also that they
+promiscuously attended the sick chamber, and visited their friends,
+without in the least communicating the disease. There are even cases
+fully authenticated, that nurses, to quiet timid females labouring under
+cholera, have shared their beds during the nights, and that they,
+notwithstanding, have escaped uninjured in the same manner as physicians
+in hospitals have, without any bad consequences, made use of warm water
+used (a moment before) by cholera patients for bathing.
+
+[Footnote 3: The writer of this, who may be known by application at
+the printer's, when the present excitement is at an end, is not only
+prepared to show, _on a fitting occasion_, the correctness of the
+statements of Dr. Smith as well as those by Dr. O'Halloran just
+referred to--but also, that in the investigations, in 1828, connected
+with the question of yellow fever at Gibraltar, facts were perverted
+in the most scandalous manner, in order to prove the disease imported
+and contagious:--that individuals had been suborned:--that persons had
+been in the habit of putting leading questions to witnesses:--that
+those who gave false evidence have been, in a particular manner,
+remunerated:--that threats were held out:--and, in short, that
+occurrences of a nature to excite the indignation of mankind, took
+place on that occasion; and merited a punishment, not less severe,
+than a Naval Officer who should give, designedly, a false bearing and
+distance of rocks.]
+
+"These, and numerous other examples which, during the epidemic (we
+ought, perhaps, to call it endemic) became known to every inhabitant of
+Moscow, have confirmed the conviction of the non-infectious nature of
+the disease, a conviction in which their personal safety was so much
+concerned.
+
+"It is also highly worthy of observation, that all those who stand up
+for contagion, _have not witnessed_ the cholera, which is, therefore,
+especially objected to their opinion by their opponents." He closes by
+the observation, "The result of my own daily experience, therefore,
+perfectly agrees with the above-stated principle, namely, notwithstanding
+all my inquiries, I _have met with no instance which could render it at
+all probable that the cholera is disseminated by inanimate objects_." The
+words in italics are as in the Parliamentary papers on Cholera, pp. 8 and
+9. Here is something to help to guide people in forming opinions, and to
+help governments on quarantine questions; but owing to a portion of the
+"perverseness" which Dr. Macmichael in anger talks about, Dr. Albers
+still _speculates_ upon cholera being contagious, and the College, it
+would seem, take up his speculations and sink his very important facts.
+Sir William Creighton's Report gives what puports to be an extract from
+a memorial of his on cholera, given in to the St. Petersburg Medical
+Council, tending to establish the contagious character of the disease;
+and with this a report by the extraordinary committee appointed by the
+Emperor to inquire into the Moscow epidemic. The disease had not appeared
+at St. Petersburg when he drew up his Memorial, and it does not appear
+from any-thing which can be seen in the extracts he furnishes, that he
+had personal knowledge of any part of what he relates. He gives the
+reported progress of the disease on the Volga and the Don, but is
+extremely deficient exactly where one might have expected that, from the
+greater efficiency of police authorities, &c., his information on
+contagion would have been more precise, viz., the introduction of the
+disease into Moscow, which could not, it would seem have been by material
+objects, for, according to the Committee, composed "of the most eminent
+public officers,"--"the opinion of those who do not admit the possibility
+of contagion by means of material objects, has for its support both the
+majority of voices, and the scrupulous observance of facts. The members
+of the Medical Council have been convinced by their own experience, as
+also by the reports of the physicians of the hospitals, that, after
+having been in frequent and even habitual communication with the sick,
+their own clothes have never communicated the disease to any one, even
+without employing means of purification. Convalescents have continued to
+wear clothes which they wore during the disease--even furs--without
+having them purified, and they have had no relapse. At the opening of
+bodies of persons who had died of cholera, to the minute inspection of
+which four or five hours a day for nearly a month were devoted, neither
+those who attended at their operations, nor any of the assisting
+physicians, nor any of the attendants, caught the infection, although,
+with the exception of the first day, scarcely any precautions were used.
+But what appears still more conclusive, a physician who had received
+several wounds in separating the flesh, continued his operations, having
+only touched the injured parts with caustic. A drunken invalid having
+also wounded himself, had an abscess, which doubtless showed the
+pernicious action of the dead flesh, but the cholera morbus did not
+attack him. In fine, foreign _Savans_, such as Moreau de Jonnes and
+Gravier, who have recognized, in various relations, the contagious nature
+of the cholera morbus, do not admit its propagation by means of goods and
+merchandise." (_Parl. Papers on Chol._ p. 13.) With the above documents
+the Council transmitted to the College a short description of the process
+of cleaning hemp in the Russian ports; and, lastly, the copy of a
+letter to the clerk of the Council from our ever-vigilant, though
+never-sufficiently-to-be-remunerated, head guardian of the quarantine
+department, who, taking the alarm, very properly recommends, as in duty
+bound, that a stir be forthwith made in all the pools, and creeks, and
+bays, &c., of the united kingdom, in order that all those notoriously
+"susceptible" old offenders, skins, hemp, flax, rags, &c., may be
+prevented from carrying into execution their felonious intention of
+covering the landing of a dire enemy. In truth, from the grave as well
+as from the sublime, there often seems to be "but a step;" and in
+reading over this gentleman's suggestions about _susceptibles_ and
+_non-susceptibles_, one may fancy himself, instead of being in the
+land of thinking people, to be in the land of Egypt, where, as we are
+informed (Madden, 1825), the sage matrons discuss the point, whether a
+cat be not a better vehicle for contagion than a dog:--a horse may be
+trusted, they say, but as to an ass, he is the most incorrigible of
+contagion smugglers;--of fresh bread we never need be afraid, but the
+susceptibility of butcher's meat is quite an established thing:--or we
+might fancy ourselves transported to regions of romance, where it is
+matter of profound deliberation, whether an egg shall be broken at the
+large or the small end. Such things are too bad for the nineteenth
+century; and in England, too, with her enlightened parliament! But until
+these questions are better examined, our guardian must bestir himself
+about articles susceptible of cholera contagion, while he enjoys his
+good quarantine pay, his good half pay from another department as I
+believe, and withall, if we are not misinformed, a smart pension from
+the Gibraltar revenue, for what granted nobody can tell.
+
+The documents above referred to, would appear then to be the whole on
+which the College admit that they formed their opinions, and people may
+now judge whether the verdict be according to the evidence, or whether
+it be not something in the _lucus a non lucendo_ mode of drawing
+conclusions:--most persons will probably think that, on such evidence,
+there might at least have been a qualified opinion. It appears, however,
+that having come to _a decision_ on the 9th of June, that the disease
+was communicable from person to person, they in three days after,
+approved of persons being sent to Russia to find out whether they had
+decided rightly or not. Are we now to expect that, should the occasion
+need, they will heroically make war against their own declared opinion?
+For my part I expect from them all that should be expected from men; and
+the liberal part of the world will not fail to see from this, that I do
+not despair of even Dr. Macmichael, being still open to conviction. Let
+it not be for a moment understood that, in any-thing which has been
+said, or which may remain to be said respecting this gentleman, or in
+any-thing which may be hereafter said respecting Dr. Bisset Hawkins's
+work, I mean to insinuate that contagion in cholera is not with them a
+matter of conscience; but I certainly do mean to say that their zeal has
+manifestly warped their judgment; and not only this, but that it has
+prevented them from laying statements before the public on the cholera
+questions with all the impartiality we might have expected from
+gentlemen of their character in the profession.
+
+In Dr. Macmichael's pamphlet, consisting of thirty-two pages, and
+professing to be a consideration of the question, "Is cholera
+contagious?" we scarcely find the disease mentioned till we come to page
+25; the pages up to this being occupied chiefly by a recapitulation of
+opinions formerly given "on the progress of opinion upon the subject of
+contagion;"--on the opinions of old writers as to the contagion of
+plague, small-pox, measles, &c.:--he would infer that whereas small-pox
+and certain other diseases have, by more accurate observations made in
+comparatively modern times, been taken from the place they once held,
+and ranged among diseases decidedly contagious, so ought cholera also
+to be now pronounced contagious! As an inducement to us to adopt this
+as good logic, he assures us that the list of diseases deemed contagious
+by wise men is on the increase--that non-contagionists are _perverse_
+people, _blunderers_, and so forth! As to his epithets, it shall only be
+said that among the disbelievers of contagion in cholera, and certain
+other diseases probably reputed contagious by Dr. Macmichael, are to be
+found hundreds possessing as much candour, as cultivated minds, and as
+much practical knowledge of their profession, as any contagionists,
+whether they be Fellows of a College or not; but as to the statement
+of Dr. Macmichael, is it true that we have been adding to the list of
+contagious diseases? Not within the last fifty years certainly. Even the
+influenza of 1803 was, if I mistake not greatly, termed, very generally,
+"infectious catarrh," but what professional man would term the influenza
+of 1831 so? Are there not yet remaining traces of the generally exploded
+doctrine of even contagion in ague, at one time attempted to be
+maintained? M. Adouard, of Paris, still indeed holds out. Do we not know
+that Portal, at one period of his life at least, would not, for fear of
+"infection," open the body of a person who had died of phthisis? Where
+is the medical man now to be found who would set up such a plea? or
+where, except in countries doomed to eternal barbarism, are patients
+labouring under consumption avoided now, as they were in several parts
+of the world at one time, just as if they laboured under plague, and all
+for the simpleton's reason that the disease _often runs through
+families_? What disinterested man will, on due examination of all that
+has been written on yellow fever, stand up now in support of its being a
+contagious disease, of which some thirty or forty years ago there was so
+general a belief? On croup, and a few more diseases, many still think it
+_wise to doubt_. Is dysentery, known to make such ravages sometimes,
+especially in armies, considered now, as at one time, to be contagious?
+If Dr. Macmichael's pamphlet was intended altogether for readers not of
+the profession, _which seems very probable_, his purposes will perhaps
+be answered, at least for a time, but I do not see how it can make an
+impression on medical men. Why not have been a little more candid when
+quoting Sydenham on small-pox, &c. and have quoted what that author says
+of the disease which he (Dr. M.) professes to write about,--the cholera?
+The public would have means of judging how far the disease which was
+prevalent in 1669, resembled the "cholera spasmodica," &c., of late
+years. Many insist upon an identity (Orton among others), and yet
+Sydenham saw no reason for suspecting a communicable property. It might
+have been more to the point had Dr. Macmichael, instead of quoting old
+authorities on small-pox, measles, &c. quoted some authorities to
+disprove that Orton and others are wrong when they state it as their
+belief that some of those old epidemics in Europe, about which so much
+obscurity hangs, were nothing more or less than the cholera spasmodica.
+Mead's short sketch of the "sweating sickness" does not seem very
+inapplicable:--"Excessive fainting and inquietude inward burnings,
+headach, sweating, vomiting, and diarrhoea."[4] In the letter to the
+President of the College we see no small anxiety to prove that the
+malignant cholera is of modern origin also in India, for the proofs from
+Hindoo authorities, as given in the volume of _Madras Reports_, are
+slighted. These Reports, as well as those of the other presidencies,
+are exceedingly scarce, but whoever can obtain access to them will find
+in the translations at pp. 253 and 255 (not at page 3, as quoted by
+Dr. Macmichael), enough probably to satisfy him that cholera is the
+disease alluded to there. But I think that we have at page 31 of
+Dr. Macmichael's letter, no small proof of a peculiarity of opinion, when
+we find that he there states that the evidence in the _Madras Reports_
+of the existence of epidemics of malignant cholera in India, on several
+occasions previous to 1817, rests on imperfect records, and that the
+description of the disease is too vague to prove the identity with the
+modern spasmodic cholera; for in this opinion he seems, as far as I have
+been able to discover, to stand alone among writers on cholera;--indeed
+it seems established, _on the fullest authority_, that cholera, in the
+same form in which it has appeared epidemically of late years, has
+committed ravages in India on more than one occasion formerly:--this is
+fully admitted by Mr. Orton, an East India practitioner, who is one of
+the few contagionists.
+
+[Footnote 4: If the progress of the sweating sickness was similar to
+that of cholera, the advice of the King to Wolsey was sound; for instead
+of recommending him to rely on any-thing like cordon systems, or to shut
+himself up surrounded by his guards, he tells him (see _Ellis's_
+letters) to "fly to _clene_ air incontinently," on the approach of the
+disease. I use the words _approach of the disease_ occasionally, as it
+is a manner of expression in general use, but it is far from being
+strictly applicable when I speak of cholera; _the cause_ of the disease
+it is which I admit travels or springs up at points, and not the disease
+itself in the persons of individuals, or its germs in inanimate
+substances.]
+
+For one piece of tact the author of the letter deserves great credit;
+for whereas his College collectively, when forming their opinion on the
+questions proposed to them by the Council, seemed to throw all India
+records overboard,--he, in his individual capacity, as author of the
+letter, sends after them all the Russian reports in support of
+contagion; for anxious as he is to prove his point, not a word do we get
+of the _on dits_ so current in Russia about persons being attacked with
+the disease from smelling to hemp arrived from such or such a place;
+from having looked at a boatman who had been up the Volga or down the
+Volga, &c. &c.: all which statements, when duty inquired into, prove to
+be unsupported by any thing in the shape of respectable authority, and
+this is now, in all probability, pretty generally known to be the case,
+as Dr. Macmichael must be quite aware of.
+
+To the medical gentlemen of India who have been concerned in the
+official reports, which do them, _en masse_, so much credit, Dr.
+Macmichael is little disposed to be complimentary; and, indeed, he seems
+to insinuate that those were rather stupid fellows who did not come to
+what he is pleased to consider "a just and right conclusion," as to
+contagion; he thinks, however, that he has got a few of "the most
+candid" to join in his belief. We shall see whether he had better
+reason to look towards the Ganges and Beema for a confirmation of his
+doctrines, than he had toward the Don or the Volga. How does the case
+stand with respect to one of the gentlemen whom he quotes,--Mr. Jukes,
+of the Bombay Establishment? This gentleman, like all who speak of
+cholera, mentions circumstances as to the progress of the disease
+which he cannot comprehend, and Dr. Macmichael shows us what those
+circumstances are; but Dr. Macmichael does not exhibit to us _what does_
+come perfectly within Mr. Jukes's comprehension, but which is not quite
+so suitable to the doctor's purpose. This omission I shall take the
+liberty to supply from an official letter from Mr. Jukes in the Bombay
+Reports:--"I have had no reason to think it has been contagious here,
+neither myself nor any of my assistants, who have been constantly
+amongst the sick, nor any of the hospital attendants, have had the
+disease. It has not gone through families when one has become affected.
+It is very unlike contagion too, in many particulars." &c.--(_Bombay
+Reports_, page 172.)--Ought we not to be a little surprised that so
+great an admirer of candour, as Dr. Macmichael seems to be, should,
+while so anxious to give every information to his readers, calculated to
+throw light upon the subject of cholera, omits the above important
+paragraph, which we find, by the way _immediately precedes_ the one upon
+opinions and difficulties which he quotes from the same gentleman? But
+let us examine what the amount of force is, which can be obtained from
+that part of Mr. Jukes's paper, which it does please Dr. Macmichael to
+quote:--"If it be something general in the atmosphere, why has it not
+hitherto made its appearance in some two distinct parts of the province
+at the same time? Nothing of this kind has, I believe, been observed. It
+still seems creeping from village to village, rages for a few days, and
+then begins to decline." I find myself unable, at this moment, to
+ascertain the extent of Mr. Jukes's means of obtaining information as
+to what was passing in other parts of his province; but I think the
+following quotation, on which I am just now able to lay my hand, will
+not only satisfactorily meet what is here stated, but must, in the
+public opinion, be treasured, as it serves at once to displace most
+erroneous ideas long prevalent, and which, I believe, greatly influenced
+men's decisions as to contagion:--"It may, then, first be remarked,
+that the rise and progress of the disorder were attended by such
+circumstances as showed it to be entirely independent of contagion for
+its propagation. Thus we have seen that it arose at nearly one and the
+same time in many different places, and that in the same month, nay,
+in the same week, it was raging in the unconnected and far-distant
+districts of Behar and Dacca." (Bengal Reports, p. 125.) Again (p. 9),
+that in Bengal "it at once raged simultaneously in various and remote
+quarters, without displaying a predilection for any one tract or
+district more than for another; or any thing like regularity of
+succesion in the chain of its operations." In support of what is stated
+in these extracts, the fullest details are given as to dates and places;
+and at page 9 of those Reports, a curious fact is given, "That the large
+and populous city of Moorshedabad, from extent and local position
+apparently very favourably circumstanced for the attacks of the
+epidemic, should have escaped with comparatively little loss, whilst all
+around was so severely scourged." This seems to have been pretty similar
+to what is now taking place with respect to the city of Thorn, which
+remains free from cholera, though the communication is open with divers
+infected places in every direction. Should Thorn still be attacked by
+the disease (as it sooner or later will, in all human probability), the
+contagionists _par metier_ will try to establish a case of hemp or
+hare-skin importation, I have no doubt. I wonder much that Dr.
+Macmichael or Dr. B. Hawkins, when favouring us with eastern quotations,
+did not give the public the opinion of Dr. Davy, who is so well known
+in Europe, and who saw the cholera in Ceylon; his conjecture (quite
+accessible, I believe, to every medical man in London) may perhaps be
+as valuable as that of any other person. The following is a copy of
+it:--"The cause of the disease is not any sensible change in the
+atmosphere; yet, considering the progress of the disease, its epidemic
+nature, the immense extent of country it has spread over, we can hardly
+refuse to acknowledge that its cause, though imperceptible, though yet
+unknown, does exist in the atmosphere. It may be extricated from the
+bowels of the earth, as miasmata were formerly supposed to be; it may
+be generated in the air, it may have the properties of radiant matter,
+and, like heat and light, it may be capable of passing through space
+unimpeded by currents; like electricity, it may be capable of moving
+from place to place in an imperceptible moment of time." Dr. Davy is an
+army physician, and the report of which this is an extract, may be seen
+at the Army Medical Office, a place which, of late years, has become a
+magazine of medical information of the most valuable kind in Europe.
+There is this difference between army and other information on cholera,
+that (whether in the King's or E. I. Company's service) the statements
+given by the medical gentlemen have their accuracy more or less
+guaranteed by a certain system of military control over the documents
+they draw up: thus, in the circumstance already noticed as having
+occurred in the 14th regiment, we have every reason to rely upon its
+accuracy, which we could not have in a similar statement among the
+population of any country; and we have, I think, no reason to believe
+that in pronouncing the cholera of Ceylon not contagious, Dr. Davy, as
+well as two other gentlemen of high character and experience (Drs.
+Farrel and Marshall), have not gone upon such data as may bear scrutiny.
+
+
+
+
+LETTER III.
+
+
+Having given, in my last letter, Dr. Davy's views as to the cause of
+cholera, I may so far remark just now regarding them, that they are not
+new, or peculiar to him; and that it may be well, before Dr. Macmichael
+or others pronounce them vague, that they should inquire whether some
+of those causes have not been assigned for the production of certain
+epidemics, by one of the soundest heads of Dr. Macmichael's college--Dr.
+Prout, who seems, if we have not greatly mistaken him, to have been led
+to the opinion by some experiments of Herschell, detailed in the
+Philosophical Transactions of the year 1824. They should recollect that
+other competent persons devoted to researches on such subjects (Sir R.
+Phillips among the number) admit _specific local atmospheres_ (not at
+all _malaria_ in the usual sense of the term), produced by irregular
+streams of specific atoms from the interior of the earth, and "arising
+from the action and re-action of so heterogeneous a mass." For my part
+I feel no greater difficulty in understanding how our bodies, "fearfully
+and wonderfully made" as we are, should be influenced by those actions,
+re-actions, and combinations, to which Sir Richard refers, and of
+"whose origin and progress the life and observation of man can have no
+cognizance," than how they are influenced by other invisible agents,
+the existence of which I am compelled to admit.--If the writer of the
+article on cholera in the _Westminster Review_, for October, 1831, do
+not find all his objections met by these observations, I must only refer
+him to the _quid divinum_ of Hippocrates:--but I must protest against
+logic such has been employed by certain members of our Board of Health,
+who lately, on the examination of gentlemen of the profession who
+had served in India, and who had declared the disease not to be
+communicable, came to the conclusion that it must, nevertheless, be
+so, as those gentlemen could not show _what it was_ owing to.
+
+Most extraordinary certainly it does appear, that while Dr. Macmichael
+goes to the trouble of giving us (p. 27) the views of _a captain_ (!) as
+to the progress of cholera at a certain place in India, he should have
+refrained altogether from referring, on the point of contagion or
+non-contagion, to the report of such a person as Dr. Davy, or to the
+reports of this gentleman's colleagues at Ceylon, Drs. Farrell and
+Marshall. Had Dr. Macmichael added a little to his extract from Capt.
+Sykes, by informing us of what that gentleman states as to the great
+mortality ("350 in one day") in the town of Punderpoor, "when the
+disease first commenced its ravages there," people would have means of
+judging how unlike this was to a contagious disease creeping from person
+to person in its commencement.
+
+It is painful to be obliged to comment on the manner in which Dr. Bisset
+Hawkins has handled the questions relative to the Ceylon epidemic, which
+seems far from being impartial; for, while he quotes (p. 172) Dr. Davy,
+"a medical officer well known in the scientific world," as stating that
+the cause of the disease is not in any _sensible_ changes in the state
+of the atmosphere, he breaks off suddenly at the word _atmosphere_,
+proceeds to talk of the changes in the muscles and blood of persons who
+die of the disease, and passing over the part quoted from Dr. Davy, near
+the close of my last letter, Dr. Hawkins leaves his readers to draw a
+very natural conclusion--that, as Dr. Davy admitted that there were no
+prevalent _sensible_ states of the atmosphere to which the cholera could
+be attributed, _he, therefore_, believed it to have been propagated by
+contagion, an inference which we now see must be quite wide of the mark.
+Dr. Hawkins had, it appears, like many other medical gentlemen, access
+to the reports from Ceylon, &c., in the office of the chief of the army
+medical department in London, and it is to be regretted I think that,
+with respect to one of the Ceylon reports, he only tells us (p. 174)
+that "Mr. Staff-Surgeon Marshall reports from Candy, that of fifty cases
+which had occurred, forty died." Why more had not been quoted from a
+gentleman who had such ample means of witnessing the disease in its very
+worst form, I must leave to others to say; but, referring again to the
+highly interesting letter from Mr. Marshall on cholera, which appeared
+in the _Glasgow Herald_, of the 5th of August last, and in which, from
+many important observations which every body interested in cholera
+should read and study, the following remarks will be found:--"In no one
+instance did it seem to prevail among people residing in the same house
+or barracks, so as to excite a suspicion that the contact of the sick
+with the healthy contributed to its propagation." "The Indian Cholera,
+as it is sometimes called, appears not to be essentially different from
+cholera as it occurs in this and all other countries." "I consider it,
+therefore, impossible for a medical practitioner to speak decisively
+from having seen one, or even a few cases of cholera in this country,
+and to say whether they are precursors of '_the epidemic_ cholera' or
+not. That the disease is ever propagated by means of personal contact,
+or by the clothes of the sick, has not, as far as I know, been
+satisfactorily proved. The quality of contagion was never attributed
+to the disease in Ceylon, and I believe no-where did it occur in
+greater severity. I am aware that an attempt has been made to distinguish
+the ordinary cholera of this country from the 'epidemic cholera,' by means
+of the colour or quality of the discharges from the bowels. In the
+former it is said the discharge is chiefly bile, while in the latter it
+is said to bear no traces of bile, but to be colourless and watery. How
+far is this alleged diagnosis well founded? I am disposed to believe
+that, in all severe cases of cholera, whether it be the cholera of this
+country, or the epidemic cholera, the secretion of bile is either
+suppressed, or the fluid is retained in the gall-bladder." Mr. Marshall,
+it may be observed, is the gentleman who was selected by the late
+Secretary at War, in consequence of his known intelligence, to remodel
+the regulations relative to military pensioners; and I understand that,
+in consequence of the manner in which he executed that very important
+duty, he has since been promoted. After what appears from the above
+quotations, how perfectly unwarrantable must the assertion of Dr. Bisset
+Hawkins seem, that "from the Coromandel coast it seems to have been
+transported by sea to Ceylon!"
+
+We shall, I think, be able to see that the assumption of Drs. Macmichael
+and Hawkins, as to the importation of the disease into the Mauritius
+from Ceylon, is equally groundless with that of its alledged importation
+into the latter island; and here we have to notice the same want of
+candour on the part of those gentlemen, in not having furnished that
+public, which they professed to enlighten on the subject of cholera,
+with those proofs within their reach best calculated to display the
+truth; be it a part of my duty to supply the omissions of these
+gentlemen in this respect. The following is a copy of a letter
+accompanying the medical commission report at that island forwarded
+to General Darling, the then commanding officer, by the senior medical
+gentleman there.
+
+"Port Louis, Nov. 23, 1819.
+
+"I have the honour of transmitting the reports of the French and
+English medical gentlemen on the prevalent disease; both classes of the
+profession seem to be unanimous in not supposing it contagious, or of
+foreign introduction. From the disease pervading classes _who have
+nothing in common but the air they breathe_, it can be believed that the
+cause may exist in the atmosphere. A similar disease prevailed in this
+island in 1775, after a long dry season."
+
+(Signed) W. A. BURKE,
+Inspector of Hospitals.
+
+In the reports referred to in the above letter, there is the most ample
+evidence of the true cholera having appeared at different points in the
+colony _before the_ arrival of the Topaze frigate, the ship _accused_ by
+contagionists _par metier_, of having introduced the disease; so that,
+contrary to what Dr. Macmichael supposes, those who disbelieve the
+communicability of cholera, have no necessity whatever in this case for
+pleading a coinsidency between the breaking out of the disease, and the
+arrival of the frigate; indeed, his friend Dr. Hawkins seems to be aware
+of this, when he is obliged to have recourse to such an argument as that
+"it is, at all events, clear that the disease had not been _epidemic_ at
+the Mauritius before the arrival from Ceylon;" so that the beginning of
+an epidemic is to be excluded from forming a part or parcel of the
+epidemic! Why is it that in medicine alone such modes of reasoning are
+ever ventured upon!
+
+We know, from the history of cholera in India, that not only ships lying
+in certain harbours have had the disease appear on board, but even
+vessels sailing down one coast have suffered from it, while sailing up
+another has freed them from it, without the nonsense of going into
+harbour to "expurgate." Now, with respect to the _Topaze_, it appears
+that while lying in harbour in Ceylon, the disease broke out on
+board her; that after she got into "_clene air_" at sea, the disease
+disappeared, seventeen cases only having occurred from the time she left
+the island, and she arrived at the Mauritius, as Dr. Hawkins admits,
+without any appearance whatever of the cholera on board. On the day
+after her arrival, she sent several cases ("chronic dysentry, hepatitis,
+and general debility") to hospital, but not one of cholera; neither did
+any case occur on board during her stay there, at anchor a mile and a
+half from shore, and constantly communicating with shore,[5] while a
+considerable number of deaths took place from cholera _in the merchant
+vessels anchored near shore_.
+
+[Footnote 5: Somebody is said to have seen a man on board with vomiting
+and spasms, on the day before she moved to this anchorage, but the
+surgeon of the ship has not stated this.]
+
+As to the introduction of cholera from the Mauritius into Bourbon, where
+it appeared but very partially, Dr. Macmichael very properly does not
+say one word. There was abundance of "precaution" work, it is said,
+and those who choose, are at liberty to give credit to the story of
+its having been smuggled on shore by some negro slaves landed from a
+Mauritius vessel. As to the _precautions_ to which the writer in _The
+Westminster Review_ attributes the non-extension of the disease in this
+island, hundreds of instances are recorded, in addition to those which
+we have already quoted, of the disease stopping short, without cordons
+or precautions of any kind--one remarkable instance is mentioned by Dr.
+Annesley, where, _without seclusion_, the disease did not reach the
+ground occupied by two cavalry regiments, although it made ravages in
+all the other regiments in the same camp.
+
+We have, perhaps, a right to demand from those gentlemen who display
+such peculiar tact in the discovery of ships by which the cholera has,
+at divers times, been imported into continents and islands, the names
+of those ships which brought to this country, in the course of the
+present year, the "_contagion_" which has produced, at so many
+different points, cases of severe cholera, causing death in some
+instances, and in which the identity with the "Indian cholera," the
+"Russian cholera," &c., has been so _perfect_, that all the "perverse
+ingenuity" of man cannot point out a difference. If it cannot be shown
+that in this, we non-contagionists in cholera are in error, people
+will surely see reason for abandoning the cause of cordons, &c., in
+this disease,--a cause which, in truth, now rests mainly for support
+upon a sort of conventional understanding, unconnected altogether, it
+would appear, with the facts of the case, and entered into, we are
+bound to suppose, before the full extent of the mischief likely to
+arise from it had been taken into consideration. Admitting for a
+moment that a case of cholera possessing contagious properties could
+be imported into this country this year, will anybody say that a
+"constitution of the atmosphere" favourable to its communicability to
+healthy individuals, has not existed _in a very high degree_:--can a
+spot be named in which cholera, generally of a mild grade, has not
+prevailed? And if contagionists cannot point out a difference between
+some of the severe cases to which public attention has been drawn, and
+the most marked cases of the Indian or Russian cholera, I think that
+now there should be an end to all argument in support of their cause.
+Without at all going to the extent which might be warranted, I would
+beg to be informed of the names of the ships by which the contagion
+was brought, which caused the illness of the following individuals; or
+if they be allowed, as I presume must be the case, not to have been
+infected at all in this way, all that has been said regarding the
+identity of the foreign and severe form of the home disease, must be
+shown to be without foundation:--the detailed case of Patrick Geary,
+which occurred in the Westminster Hospital,--the fatal case of Mr.
+Wright, surgeon, 29, Berwick-street,--the cases, some of them fatal,
+which occurred at Port Glasgow, and regarding which, a special inquiry
+was instituted,--a case in Guy's Hospital, which caused some anxiety
+about the middle of July last,--a case reported in a medical
+periodical in August last, as having occurred in Ireland,--the fatal
+case, as reported in my first letter, of Martin M'Neal,[6]--a second
+case reported in a medical periodical in August,--a fatal case on the
+12th of August last at Sunderland, reported upon to the Home Secretary
+by the mayor of that town,--three cases reported in No. 421 of THE
+LANCET,--a very remarkable case duly reported upon in September,
+from the Military Hospital at Stoke, near Davenport, and a case with
+thorough "congee stools," spasms, &c. (the details of which I may
+hereafter forward), which occurred at Winchester on the 22d of
+September, in the 19th Foot, in a man of regular habits, and of _the
+nature_ of which case the medical gentleman in charge had no doubt.
+
+[Footnote 6: The same Army Medical gentleman, who had been sent to Port
+Glasgow, was sent to Hull to report upon this case:--he arrived there
+too late, but having seen the details of the case, he admitted that he
+saw no reason to declare them different from those which occurred in the
+Indian cholera.]
+
+I quite agree with those who are of opinion, that in this and most other
+countries, cases may be every year met with exhibiting symptoms similar
+to those which have presented themselves in any one of the above.
+Instead of amusing us, when next writing upon cholera, with a quotation
+about small-pox from Rhazes, bearing nonsense upon the face of it, some
+of those who maintain the contagious property of Indian or any other
+cholera, may probably take the trouble to give the information on the
+above cases, so greatly required for the purpose of enlightening the
+public.
+
+I must now beg to return to an examination of one or two more of the
+_very select_ quotations made by Dr. Macmichael, with the view, as
+he is pleased to tell us, of placing the statements on both sides
+in juxtaposition. He is well pleased to give us from Dr. Taylor,
+assistant-surgeon,--what indeed never amounted to more than report, and
+of the truth or falsehood of which this gentleman does not pretend to
+say he had any knowledge himself,--that a traveller passing from the
+Deacan to Bombay, found the disease prevailing at Panwell, through which
+he passed, and so took it on with him to Bombay; but whether the man had
+the disease, or whether he took its germs with him in some very
+susceptible article of dress, is not stated by Dr. Taylor; however, he
+states (what we are only surprised does not happen oftener in those
+cases, when we consider similarity of constitution--of habits--of site
+or aspect of their dwellings, &c.) that several members of a family, and
+neighbours "were attacked within a very short period of each other;" but
+when Dr. Taylor goes on to say, "In bringing forward these facts,
+however, it may be proper at the same time to state, that of the
+forty-four assistants employed under me, only three were seized with the
+complaint;" he gets out of favour at once, and his observation is called
+"unlucky," being but a _negative_ proof, and Dr. Macmichael adds, what
+everybody must agree with him in, that positive instances of contagion
+must outweigh all negative proofs:--to be sure:--but Dr. Macmichael's
+saying this, does not show that positive proofs exist. Give us but
+positive proofs, give even but a _few_, which surely may be done, if
+the disease be really communicable, and where contagion has been so
+ardently sought after by all sorts of _attaches_ and _employes_ of the
+cordon and quarantine systems in the different countries on the
+Continent. We could produce no mean authority to show, that _a long
+succession of negative proofs_ must be received as amounting to a moral
+certainty; and what greater proof can we have of non-contagion in any
+disease, than we have in the fact regarding epidemic cholera, as well
+as yellow fever, that attendants on the sick are not more liable than
+others to be attacked? Regard should, of course, always be paid, in
+taking this point into consideration, to what has been already noticed
+in my second letter, or the inferences must be most erroneous. Dr.
+Macmichael quotes the statement of Dr. Burrell, 65th regiment (and takes
+care to put the quotation in italics too), that at Seroor, in 1818,
+"almost every attendant in hospital had had the disease. There are about
+thirty attendants in hospitals." Now, along with hundreds of other
+instances, what does Dr. French, of the 49th regiment, say, in his
+Report of 1829? That no medical man, servant, or individual of any kind,
+in attendance on the sick, was taken ill at Berhampore, when the cholera
+prevailed there that year, and refers, to his Report for 1825, in which
+he remarked the same thing in the hospital of the 67th regiment at
+Poonah; contrary, as he observes, to what occurred some years before in
+the 65th regiment at Seroor, about forty miles distant. In the two
+instances quoted by Dr. French, and in that by Dr. Burrell, all those
+about the sick stood in the same relation towards them, and all the
+difference will be found probably to have been, that the hospital of the
+65th _was within the limit of the deteriorated atmosphere, where the
+cause existed equally (as in the case of ague and yellow fever) whether
+persons were present or not_.
+
+In Egypt there is not, it is true, a "cruel and inhuman desertion" of
+the unfortunate plague patients; for, among other reasons, being
+predestinarians, they think it makes no sort of difference whether
+they attend on the sick or not. Those who act upon the principle of
+cholera being a highly contagious disease, may perhaps consider it
+necessary to recommend, among their _precautions_, that the medical
+men and attendants should be enveloped in those hideous dresses used
+in some countries by those who approach plague patients[7]--fancy, in
+the case of a sick female, or even of a man of pretty good nerves, the
+effect of but half the precautions one hears of, as proper to be
+observed. It is quite a mistake to suppose that the sick have not been
+sometimes abandoned during the prevalence of epidemics; and that too
+in cases where medical men had very erroneously voted the disease
+contagious:--among other horrid things arising out of mistaken views,
+who that has ever read it, can forget the account given by Dr.
+Halloran, of the wretched yellow-fever patient in Spain, who, with a
+rope tied round him, was dragged along for some distance by a guard,
+when he was put into a shed, where he was suffered to die, without
+even water to quench his thirst? I admit that, even with the views of
+non-contagionists, difficulties obviously present themselves in regard
+to the safety of those about the sick, when the latter are in such a
+state as will not admit of their removal to a more auspicious spot
+from that in which there is reason to believe they inhaled the noxious
+atmosphere. From what has been observed in India and other places,
+however, there is often sufficient warning in a feeling of _malaise_,
+&c., and the distance to favoured spots, where people may be observed
+not to be attacked, may be very short,--sometimes, as we have seen,
+but a few yards, so that a removal of the patient, _with his friends_,
+may be practicable, in a vast number of cases, previous to the setting
+in of the more serious symptoms.
+
+[Footnote 7: Since writing the above, I find that this scene has
+actually occurred lately at Dantzic where a few miserable medical men
+illustrated their doctrines of contagion, by skulking at a certain
+distance about the sick, dressed up in oil skins, like the disgusting
+figures we see in books, of the Marseilles doctors in the Lazaretto.
+(See Sun Newspaper, 22nd, Nov.)]
+
+I shall conclude this by cursorily referring to two circumstances which
+have within a short time occurred on the Continent, and which seem to me
+to be of no small importance in regard to cholera questions. It appears
+that the committee appointed by the French Chamber of Deputies to
+inquire into the questions connected with voting an additional sum to
+meet cordon and quarantine expenses, in the event of the cholera making
+its appearance in or near France, have made their report to the Chamber.
+They declare that in India the cholera was proved not to have been
+transmissible; and that in regard to Russia, it was not introduced, as
+always contended for by some persons:--they refer to the city of Thorn
+as exempt from the disease, though free from cordons, and in the midst
+of a country where it prevails, while the disease appeared in St.
+Petersburg and Moscow, notwithstanding their cordons, and even in
+Prussia, where sanatory laws where executed "_avec une punctualite et
+une rigeur ailleurs inconnues_." The money is nevertheless granted;
+it is always a good thing to have, but they have set one curious
+_condition_ upon its being granted, which displays consummate tact,
+for it is to be employed solely in disbursements of a particular nature
+(_depenses materielles_), including, it may be presumed, temporary
+hospitals, &c.; and that it is by no means ("_nullement_") to go into
+the pockets of individuals.
+
+The other circumstance to which I allude is that, like Russia and
+Austria, Prussia has found that quarantines and cordons do not check
+the progress of cholera. The king declares that the appearance of the
+disease in his provinces, has thrown _new light_ on the question; he
+specifies certain restrictions as to intercourse, which were forthwith
+to be removed, and declares his intention to modify the whole. In
+short, it is quite plain that, as Dr. Johnson has it in his last
+journal,--those regulations will, "_in more countries than Russia,
+be useless to all but those employed in executing them_."
+
+
+
+
+LETTER IV.
+
+
+It need scarcely be said how much it behooves all medical men to keep
+in view the subject of the wide-spreading cholera, and not to suffer
+themselves to be led from an attentive consideration of all that
+appertains to it, by the great political questions which at present
+convulse the whole kingdom.
+
+I totally disagree with Dr. Macmichael, as I believe most people will,
+that the notion of _contagion_ in many diseases is "far from being
+natural and obvious to the mind;" for, since the time that contagious
+properties have been generally allowed to belong to certain diseases,
+there has been a strong disposition to consider this as the most natural
+and obvious mode of explaining the spreading of other diseases. A person
+sees evidence of the transmission, _mediate_ as well as _immediate_,
+of small-pox, from one person to another; and, in other diseases, the
+origin of which may be involved in obscurity, he is greatly prone
+to assign a similar cause which may seem to reconcile things so
+satisfactorily to his mind. Indeed there seems, in many parts of the
+world, a degree of _popularity_ as to quarantine regulations, which
+is well understood and turned to proper account by the initiated in
+the mysteries of that department:--for what more common than the
+expression--"we cannot be too careful in our attempts to _keep out_
+such or such a disease?" For my part, I admit that I can more easily
+comprehend the propagation of certain epidemics by contagion, than I
+can by any other means, _when unaccompanied by sensible atmospheric
+changes_; and if I reject contagion in cholera, it is because whatever
+we have in the shape of fair evidence, is quite conclusive as to the
+non-existence of any such principle. Indeed abundance of evidence now
+lies before the public, from various sources, in proof of the saying of
+Fontenelle being fully applicable to the question of cholera--"When a
+thing is accounted for in two ways, the truth is usually on the side
+most opposed to _appearances_." How well mistaken opinions as to
+contagion in cholera are illustrated in a pamphlet which has just
+appeared from Dr. Zoubkoff of Moscow! This gentleman, it appears, has
+been a firm believer in contagion, until the experience afforded him
+during the prevalence of the disease in that city proved the contrary.
+He tells us (p. 10), that in the hospital (Yakimanka) he saw "_to his
+great astonishment_, that all the attendants, all the soldiers, handled
+the sick, supported their heads while they vomited, placed them in the
+bath, and buried the dead; always without precaution, and always without
+being attacked by cholera." He saw that even the breath of cholera
+patients was inhaled by others with impunity; he saw, that throughout
+the district of which he had charge, the disease did not spread through
+the crowded buildings, or in families where some had been attacked, and
+that exposure to exciting causes _determined_ the attack in many
+instances. He saw all this, gives the public the benefit of the copious
+notes which he made of details as to persons, places, &c., and now
+ridicules the idea of contagion in cholera. Grant to the advocates of
+contagion in cholera but all the data they require, and they will
+afterwards prove every disease which can be mentioned to be contagious.
+Hundreds of people, we will say, for instance, come daily from a sickly
+district to a healthy one, and yet no disease for some time appears; but
+at last an "inexplicable condition of the air," and "not appreciable by
+any of our senses" (admitted by Dr. Macmichael and others as liable to
+occur, but _only in aid_ of contagion), take place; cases begin to
+appear about a particular day, and nothing is now more easy than to make
+out details of arrivals, there being a wide field for selection; and
+even how individuals had spoken to persons subsequently attacked--had
+stopped at their doors--had passed their houses, &c.[8] Causation is at
+once connected with antecedence, at least for a time, by the people at
+large, who see their government putting on cordons and quarantines,
+and the most vague public rumour becomes an assumed fact. We even
+find, as may be seen in the quotation given from Dr. Walker's report,
+that contagionists are driven to the "somehow or other" mode of the
+introduction of cholera by individuals; so that it may be deplored, with
+respect to this disease, in the words of Bacon, that "men of learning
+are too frequently led, from ignorance or credulity, to avail themselves
+of mere rumours or whispers of experience as confirmation, and sometimes
+as the very ground-work, of their philosophy, ascribing to them the same
+authority as if they rested upon legitimate testimony. Like to a
+government which should regulate its measures, not by official
+information of its accredited ambassadors, but by the gossipings of
+newsmongers in the streets. Such, in truth, is the manner in which the
+interests of philosophy, as far as experience is concerned, have
+hitherto been administered. Nothing is to be found which has been duly
+investigated,--nothing which has been verified by a careful examination
+of proof."
+
+[Footnote 8: Since the above was written it has been very clearly shewn
+how easily proofs of _this kind_ may be furnished to all disposed to
+receive them. We perceive that a disease officially announced as _the
+true_ cholera, has existed for nearly a month past at Sunderland, and
+that among the thousands of people who left it within that time, nothing
+could be more easy, had the disease appeared epidemically in other parts
+of England, than to point out the _particular individual_ who had
+"brought it" in some way or other; and this is the manner in which all
+the fables about the propagation of cholera from one district to another
+have gained credence. (Nov. 24th.)]
+
+In their efforts to make out their case, there would seem to be no end
+to the contradictions and inconsistencies into which the advocates
+of contagion in cholera are led. At one moment we are required to
+believe that the disease may be transmitted through the medium of an
+unpurified letter, over seas and continents, to individuals residing
+in countries widely differing in climate, while, in the next, we are
+told--regarding the numberless instances of persons of all habits who
+remain unattacked though in close contact with the diseased--that the
+constitution of the atmosphere necessary for the germination of the
+contagion is not present; and this, although we see the disease
+attacking all indiscriminately, those who are not near the sick as
+well as those who are at a very short distance, as on the opposite
+side of a ravine, of a rivulet, of a barrack, or even of a road. They
+assume that wherever the disease appears, _three_ causes must be in
+operation--contagion--peculiar states of atmosphere (heat now clearly
+proved not _essential_, as at one time believed)--and susceptibility
+in the habit of the individual. However unphilosophical it is held to
+be to multiply causes, the advocates of contagion are not likely to
+reduce the number, as this would at once cramp them in their pleadings
+before a court where sophistry is not always quickly detected. Those
+who see irresistible motives for dismissing all idea of contagion,
+look, on the contrary, for the production of cholera, to sources,
+admitted from remote times to have a powerful influence on our
+systems, though invisible--though not to be detected by the ingenuity
+of man, and though proved to exist only by their effects.
+
+Many who do not believe that cholera can be propagated by contagion
+under ordinary circumstances, have still a strong impression that by
+crowding patients together, as in hospitals or in a ship, the
+disease may acquire contagious properties. Now we find that when the
+_experimentum crucis_ of extensive experience is contrasted with the
+feasibility of this, cholera, like ague, has not been rendered one bit
+more contagious by crowding patients together than it has been shown to
+be under other circumstances. We do not require to be told that placing
+many persons together in ill-ventilated places, whether they labour
+under ague, or catarrh, or rheumatism, or cholera, as well as where no
+disease at all exists among them, as in the Calcutta black-hole affair,
+and other instances, which might be quoted, _fever_, of a malignant
+form, is likely to be the consequence, but assuredly not ague, or
+catarrh, or rheumatism, or cholera. On this point we are furnished with
+details by Dr. Zoubkoff, of Moscow, in addition to the many previously
+on record. It may be here mentioned that, on a point which I have
+already referred to, this gentleman says (p. 43), "I shall merely
+observe that at Moscow, where the police are remarked for their
+activity, they cannot yet ascertain who was the first individual
+attacked with cholera. It was believed at one time that the disease
+first showed itself on the 17th of September; afterwards the 15th was
+fixed upon, and at last persons went so far back as August and July."
+As this gentleman _had been_ a contagionist, occupied a very responsible
+situation during the Moscow epidemic, and quotes time and place in
+support of his assertions, I consider his memoir more worthy of
+translation than fifty of your Keraudrens.
+
+Respecting those mysterious visitations which from time to time
+afflict mankind, it may be stated that we have a remarkable instance
+in the "_dandy_" or "_dangy_" disease of the West India Islands,
+which, of late years, has attracted the notice of the profession as
+being quite a new malady, though nobody, as far as I am aware of, has
+ever stated it to have been an imported one. We find also that within
+the last three years a disease, quite novel in its characters, has
+been very prevalent in the neighbourhood of Paris. It has proved fatal
+in many instances, and the physicians, unable to assign it a place
+under the head of previously-described disease, have been obliged
+to invent the term "Acrodynia" for it. I am not aware that even
+M. Pariset, the medical chief of quarantine in France, ever supposed
+this disease to have been _imported_, and to this hour the cause of
+its appearance remains in as much obscurity among the Savans of Paris,
+as that of the epidemic cholera.
+
+Considering all the evidence on the subject of cholera in India, in
+Russia, Prussia, and Austria, one cannot help feeling greatly astonished
+on perceiving that Dr. Macmichael (p. 31 of his pamphlet) insinuates
+that the spreading of the disease in Europe has been owing to the views
+of the subject taken by the medical men of India.
+
+In turning now more particularly to the work, or rather compilation,
+of Dr. Bisset Hawkins, let us see whether we cannot discover among what
+he terms "marks of haste" in getting it up for "the curiosity of the
+public" (_curiosity_, Dr. Hawkins!), some omissions of a very important
+nature on the subject of a disease respecting which, we presume, he
+wished to enlighten the public. And first, glancing back to cholera in
+the Mauritius, Dr. Hawkins might, had he not been so pressed for time,
+have referred to the appearance of cholera in 1829, at Grandport in that
+island; when, as duly and officially ascertained, it could not be a
+question of importation by any ship whatever. The facility with which he
+supplies us with "facts,"--the _false facts_ reprobated by Bacon, and
+said by Cullen to produce more mischief in our profession than false
+theories--is quite surprising; he tells us, point blank (p. 31),
+speaking of India, that "when cholera is once established in a marching
+regiment, it continues its course in spite of change of position, food,
+or other circumstances!" Never did a medical man make an assertion more
+unpardonable, especially if he applies the term _marching regiment_ as
+it is usually applied. Dr. Hawkins leads us to suppose that he has
+examined the India reports on cholera. What then are we to think when we
+find in that for Bengal the following most interesting and conclusive
+statements ever placed on record? Respecting the Grand Army under the
+Marquis of Hastings, consisting of 11,500 fighting men, and encamped in
+November 1817 on the banks of the Sinde, the official report states that
+the disease "as it were in an instant gained fresh vigour, and at once
+burst forth with irresistible violence in every direction. Unsubjected
+to the laws of contact, and proximity of situation, which had been
+observed to mark and retard the course of other pestilences, it
+surpassed the plague in the width of its range, and outstripped the most
+fatal diseases hitherto known, in the destructive rapidity of its
+progress. Previously to the 14th it had overspread every part of the
+camp, sparing neither sex nor age, in the undistinguishing virulence of
+its attacks."--"From the 14th to the 20th or 22d, the mortality had
+become so general as to depress the stoutest spirits. The sick were
+already so numerous, and still pouring in so quickly from every quarter,
+that the medical men, although night and day at their posts, were no
+longer able to administer to their necessities. The whole camp then put
+on the appearance of a hospital. The noise and bustle almost inseparable
+from the intercourse of large bodies of people had nearly subsided.
+Nothing was to be seen but individuals anxiously hurrying from one
+division of a camp to another, to inquire after the fate of their dead
+or dying companions, and melancholy groups of natives bearing the
+biers of their departed relatives to the river. At length even this
+consolation was denied to them, for the mortality latterly became so
+great that there was neither time nor hands to carry off the bodies,
+which were then thrown into the neighbouring ravines, or hastily
+committed to the earth on the spots on which they had expired." Let us
+now inquire how this appalling mortality was arrested;--the report goes
+on to inform us:--"It was clear that such a frightful state of things
+could not last long, and that unless some immediate check were given to
+the disorder, it must soon depopulate the camp. It was therefore wisely
+determined by the Commander-in-chief _to move in search of a healthier
+soil and of purer air_," which they found when they "crossed the clear
+stream of the Bitwah, and upon its high and dry banks at Erich soon got
+rid of the pestilence, and met with returning health." Now just fancy
+epidemic cholera a disease transmissible by "susceptible articles," and
+what an inexhaustible stock must this large army, with its thousands of
+followers, have long carried about with them; but, instead of this, they
+were soon in a condition to take the field. Against the above historical
+fact men of ingenuity may advance what they please. There is no doubt
+that, in the above instance, severe cases of cholera occurred _during
+the move_, the poison taken into the system on the inauspicious spot,
+not having produced its effects at once; it is needless to point out
+what occurs in this respect in remittent and intermittent fevers. The
+India reports furnish further evidence of mere removal producing health,
+where cholera had previously existed. Mr. Bell, a gentleman who had
+served in India, and who has lately written upon the disease,[9] informs
+us (p. 84), that "removing a camp a few miles, has frequently put an
+entire and immediate stop to the occurrence of new cases; and when the
+disease prevailed destructively in a village, the natives often got rid
+of it by deserting their houses for a time, though in doing so they
+necessarily exposed themselves to many discomforts, which, _caeteris
+paribus_, we should be inclined to consider exciting causes of an
+infectious or contagious epidemic." We even find that troops have, as
+it may be said, _out-marched_ the disease, or rather the cause of the
+disease; that is, moved with rapidity over an extensive surface where
+the atmosphere was impure, and thereby escaped--on the principle that
+travellers are in the habit of passing as quickly as they can across the
+pontine marshes. Mr. Bell says, "In July, 1819, I marched from Madras in
+medical charge of a large party of young officers who had just arrived
+in India, and who were on their way to join regiments in the interior of
+the country. There was also a detachment of Sepoys, and the usual number
+of attendants and camp-followers of such a party in India. The cholera
+prevailed at Madras when we left it. Until the 5th day's march (fifty
+miles from Madras) no cases of the disease occurred. On that day several
+of the party were attacked on the line of march; and, during the next
+three stages, we continued to have additional cases. Cholera prevailed
+in the countries through which we were passing. In consultation with the
+commanding officer of the detachment, it was determined that we should
+_leave the disease behind us_; and as we were informed that the country
+beyond the Ghauts was free from it, we marched, without a halt, until we
+reached the high table land of Mysore. The consequence was, that we left
+the disease at Vellore eighty-seven miles from Madras, and we had none
+of it until we had marched seventy miles further (seven stages), when we
+again found it at one of our appointed places of encampment; but our
+camp was, in consequence, pushed on a few miles, and only one case, a
+fatal one, occurred in the detachment; the man was attacked on the line
+of march. We again left the disease, and were free from it during the
+next 115 miles of travelling; we then had it during three stages, and
+found many villages deserted. We once more left it, and reached our
+journey's end, 260 miles further, without again meeting it. Thus, in a
+journey of 560 miles, this detachment was exposed to, and left the
+disease behind it, four different times; and on none of those occasions
+did a single case occur beyond the tainted spots." What a lesson for
+Dr. Hawkins! But _for whom_ could Dr. Hawkins have written his _curious_
+book? Hear Mr. Bell in respect to the common error of the disease
+following high roads and navigable rivers only:--"I have known the
+disease to prevail for several weeks at a village in the Southern
+Mahratta country, within a few miles of the principal station of the
+district, and then leave that division of the country entirely; or,
+perhaps, cases would occur at some distant point. In travelling on
+circuit with the Judge of that district, I have found the disease
+prevailing destructively in a small and secluded village, while no cases
+were reported from any other part of the district." What is further
+stated by Mr. Bell will tend to explain why so much delusion has existed
+with regard to the progress of the disease being remarkably in the
+direction of lines of commerce, or great intercourse:--"When travelling
+on circuit, I have found the disease prevailing in a district _before
+any report had been made of the fact, notwithstanding the most positive
+orders on the subject_; and I am persuaded, that were any of the
+instances adduced in support of the statement under consideration
+strictly inquired into, it would be found that the usual apathy of the
+natives of India had prevented their noticing the existence of the
+disease until the fact was brought prominently forward by the presence
+of Europeans. It should also be brought to mind, that cholera asphyxia
+is not a new disease to these natives, but seems to be, in many places,
+almost endemical, whilst it is well known that strangers, in such
+circumstances, become more obnoxious to the disease than the inhabitants
+of the country. Moreover, travellers have superadded to the remote cause
+of the disease, fatigue and road discomforts, which are not trifling in
+a country where there are neither inns nor carriages." (p. 89.) Cholera
+only attacks a certain proportion of a population, and is it wonderful
+that we should hear more of epidemic on high roads, where the population
+is greatest? High roads too are often along the course of rivers; and
+is there not some reason for believing, that there is often along the
+course of rivers, whether navigable or not, certain conditions of the
+atmosphere unfavourable to health? When Dr. Hawkins stated, as we find
+at p. 131 he has done, that where the inhabitants of certain hilly
+ranges in India escaped the disease, "these have been said to have
+interdicted all intercourse with the people below," he should have
+quoted some respectable authority, for otherwise, should we unhappily be
+visited by this disease, the people of our plains may one day wage an
+unjust war against the sturdy Highlanders or Welsh mountaineers.[10]
+Little do the discussers of politics dream of the high interest of
+this part of the cholera question, and little can they conceive the
+unnecessary afflictions which the doctrine of the contagionists are
+calculated to bring on the nation. Let no part of the public suppose for
+a moment that this is a question concerning medical men more than it
+does them; _all_ are _very_ deeply concerned, the heads of families more
+especially so.
+
+[Footnote 9: This is by far the best work yet published in England on
+the cholera, but it is to be regretted that the author has not alluded
+to the works of gentlemen who have a priority of claim to some of the
+opinions he has published: I think that, in particular, Mr. Orton's
+book, printed in India, should have been noticed.]
+
+[Footnote 10: Something of this kind would have infallibly taken place,
+had certain insane proposals lately made respecting the _shutting in_
+of the people of Sunderland, been carried into effect.]
+
+We see that the identity of the European and Indian epidemic cholera is
+admitted on all sides; we have abundant proof that whatever can be said
+as to the progress of the disease, its anomalies, &c., in the former
+country, have been also noted respecting it in the latter; and Dr.
+Hawkins, when he put forth his book, had most assuredly abundant
+materials upon which to form a rational opinion. It is by no small
+effort, therefore, that I can prevent all the respect due to him from
+evaporating, when he declares, at page 165, that "the disease in India
+was _probably_ communicable from person to person, and that in Europe it
+has _undeniably_ proved so." But Dr. Hawkins is a Fellow of the College
+of Physicians, and we must not press this point further than to wish
+others to recollect that he has told us that he drew up his book in
+haste; and, moreover, that he wished to gratify the _curiosity_ of the
+public. The Riga story about the hemp and the fifteen labourers I shall
+leave in good hands, the British Consul's at that city, who was required
+to draw up, for his government, a statement of the progress, &c. of
+the cholera there, of which the following is an extract:--
+
+"The fact of non-contagion seems determined, as far as a question can
+be so, which must rest solely upon negative evidence. The strongest
+possible proof is, the circumstance, that not one of the persons
+employed in removing the dead bodies (which is done without any
+precaution) has been taken ill. _The statement of fifteen labourers
+being attacked, while opening a pack of hemp, is a notorious falsehood._
+Some physicians incline to the opinion, that the disease may sometimes
+be caught by infection, where the habit of body of the individual is
+predisposed to receive it; the majority of the faculty, however,
+maintain a contrary doctrine, and the result of the hospital practice
+is in their favour. There are 78 persons employed in the principal
+hospital here; of these only two have been attacked, one of whom was an
+'_Inspecteur de Salle_,' and not in immediate attendance upon the sick.
+I am assured that the other hospitals offer the same results, but as I
+cannot obtain equally authentic information respecting them, I confine
+myself to this statement, on which you may rely. On the other hand, in
+private families, several instances have occurred where the illness of
+one individual has been followed by that of others: but, generally, only
+where the first case has proved fatal, and the survivors have given way
+to grief and alarm. Mercenary attendants have seldom been attacked,
+and, as mental agitation is proved to be one of the principal agents
+in propagating or generating the disease, these isolated cases are
+attributed to that cause rather than infection.
+
+"It is impossible to trace the origin of the disease to the barks;
+indeed it had not manifested itself at the place whence they come till
+after it had broken out here. The nearest point infected was Schowlen
+(at a distance of 200 wersts), and it appeared simultaneously in three
+different places at Riga, without touching the interjacent country. The
+first cases were two stone-masons, working in the Petersburg suburbs, a
+person in the citadel, and a lady resident in the town. None of these
+persons had had the slightest communication with the crews of barks, or
+other strangers, and the quarter inhabited by people of that description
+was later attacked, though it has ultimately suffered most.
+
+"None of the medical men entertain the slightest doubt of the action of
+atmospheric influence--so many undeniable instances of the spontaneous
+generation of the disease having occurred. Half the town has been
+visited by diarrhoea, and the slightest deviation from the regimen now
+prescribed (consisting principally in abstinence from acids, fruit,
+beer, &c.) invariably produces an attack of that nature, and, generally,
+cholera: fright, and intoxication, produce the same effect.
+
+"Numerous instances could be produced of persons in perfect health, some
+of whom had not left their rooms since the breaking out of the disease,
+having been attacked by cholera, almost instantaneously after having
+imprudently indulged in sour milk, cucumbers, &c. It is a curious
+circumstance, bearing on this question, that several individuals coming
+from Riga have died at Wenden, and other parts of Livonia, without a
+single inhabitant catching the disease; on the other hand, it spreads in
+Courland, and on the Prussian frontier, notwithstanding every effort to
+check its progress. The intemperance of the Russians during the holidays
+has swelled the number of fresh cases, the progressive diminution of
+which had previously led us to look forward to a speedy termination of
+the calamity." This is a pretty fair specimen of the _undeniable_ manner
+in which cholera is proved to be contagious in Europe, and we shall, for
+the present, leave Dr. Hawkins in possession of the full enjoyment of
+such proofs.
+
+Some attempt was made at Sunderland, to establish that, in the case
+which I mentioned in my last as having proved fatal there, the disease
+had been imported from foreign parts, but due inquiry having been made
+by the collector of the customs, this proved to be unfounded; the man's
+name was Robert Henry, a pilot:--he died _on the 14th of August_.[11]
+
+[Footnote 11: In a former letter I alluded to cases of cholera which
+appeared this year at Port Glasgow; I find that the highly interesting
+details of those cases have been just published:--_they should be read
+by everybody who takes the smallest interest in the important questions
+connected with the cholera_. The London publishers are Whittaker and
+Co.]
+
+Abroad we find that, unhappily, the cholera has made its appearance at
+Hamburgh; official information to this effect arrived from our Consul
+at that place, on Tuesday the 11th inst. (October). The absurdity of
+cordons and quarantines is becoming daily more evident. By accounts
+from Vienna, dated the 26th September, the Imperial Aulic Council had
+directed certain lines of cordon to be broken up, seeing, as is stated,
+that they were inefficacious; and by accounts of the same date, the
+Emperor had promised his people not to establish cordons between certain
+states.
+
+We find at the close of a pamphlet on cholera, lately published by Mr.
+Searle, a gentleman who served in India, and who was in Warsaw during
+the greater part of the epidemic which prevailed there this year, the
+following statement:--"I have only to add, that after all I have heard,
+either in India or in Poland, after all I have read, seen, or thought
+upon the subject, I arrive at this conclusion, that the disease is not
+contagious."
+
+In confirmation of the opinion of Mr. Searle, we have now the evidence
+of the medical commission sent by the French government to Poland.
+Dr. Londe, President of that commission, arrived in Paris some days ago.
+He announced to the minister in whose department the quarantine lies,
+as well as to M. Hely D'Oissel, President of the Superior Council of
+Health, that it was proved in Poland, entirely to his satisfaction,
+as well as to the satisfaction of his five colleagues, that the cholera
+_is not a contagious disease_.
+
+The Minister of War also sent _four_ medical men to Warsaw. Three of
+them have already declared against contagion; so it may be presumed that
+the day is not far distant when those true plagues of society, cordons
+and quarantines against cholera, shall be abolished. Hear the opinion of
+a medical Journalist in France,--after describing, a few days ago, the
+quarantine and cordon regulations in force in that country:--"But what
+effect is to be produced by these extraordinary measures, this immense
+display of means, and all these obstructions to the intercourse of
+communities, against a disease not contagious; a disease propagating
+itself epidemically; and which nothing has hitherto been able to arrest?
+To increase its ravages a hundred-fold,--to ruin the country, and to
+make the people revolt against measures which draw down on them misery
+and death at the same time." What honest man would not _now_ wish that
+in this country the cholera question were placed _in Chancery_; where,
+I have no doubt, it would be quickly disposed of. I shall merely add,
+that the ten medical men sent from France to Poland, for the purpose
+of studying the nature of cholera, have all remained unattacked by the
+disease.
+
+October 15, 1831.
+
+
+
+
+LETTER V.
+
+
+It was well and wisely said, that to know any-thing thoroughly, it must
+be known in all its details; and, to gain the confidence of the public
+in the belief of non-contagion in cholera, it is in vain that they are
+informed that certain alleged facts, brought forward industriously
+by contagionists, are quite groundless, unless proofs are given showing
+this to be the case. The public must, in short, have those alleged
+instances of contagion which have gained currency circumstantially
+disproved, or they will still listen to a doctrine leading to the
+disorganization of the community wherever it is acted upon. It is
+solely upon this ground that these letters have any claim to attention.
+Dr. James Johnson, of London, has, since my last letter, publicly
+contradicted, with all the bluntness and energy of honest conviction,
+the statement by Sir Gilbert Blane, Drs. Macmichael, Hawkins, &c., as to
+the importation of the cholera into the Mauritius by the Topaze frigate;
+but _evidence_ is what people want on these occasions, and, relative to
+the case in question, probably the public will consider what is to be
+found in my third and fourth letters, quite conclusive. Having again
+mentioned the Mauritius, I cannot refrain from expressing my great
+surprise that Mr. Kennedy, who has lately published on cholera, should
+give, with the view of showing "the dread and confusion existing at the
+time," a proclamation by General Darling, while he does not furnish a
+word about the result of the proceedings instituted by that officer, as
+detailed in my third letter, relative to the non-contagious nature of
+the disease, a point of all others the most important to the public. As
+to accounts regarding the confusion caused by the appearance of epidemic
+cholera, we have had no lack of them in the public papers during many
+months past, from quarters nearer home.
+
+Regarding a statement made by Dr. Hawkins in his book on cholera, viz.
+"That Moreau de Jonnes has taken great pains to prove that the disease
+was imported into the Russian province of Orenburg," Dr. H. omits to
+tell us how completely he failed in the endeavour. In the _Edinburgh
+Medical and Surgical Journal_ for July, 1831, there is a review of a
+memoir by Professor Lichtenstaedt, of St. Petersburg, in which M.
+Moreau's speculations are put to flight. From the efforts of this
+_pains-taking_ gentleman (M. Moreau) in the cause of contagion in
+cholera, as well as yellow-fever, he seems to be considered in this
+country as a medical man; but this is not the case: he raised himself by
+merit, not only to military rank, but also to literary distinction, and
+is a member of the Academy of Sciences, where he displays an imagination
+the most vivid, but as to the sober tact necessary for the investigation
+of such questions as those connected with the contagion or non-contagion
+of cholera and yellow-fever, he is considered _below par_. He saw the
+yellow-fever in 1802-3, at Martinique, while _aid-de-camp_ to the
+Governor, and still adheres to the errors respecting it which he imbibed
+in his youth, and when he was misled by occurrences taking place _within
+a malaria boundary_, where hundreds of instances are always at hand,
+furnishing the sort of _post hoc propter hoc_ evidence of contagion with
+which some people are satisfied, but which is not one bit less absurd,
+than if a good lady, living in the marshes of Kent, were to insist upon
+it, that her daughter Eliza took the ague from her daughter Jane,
+because they lived together. Strange to say, however, M. Casimir Perier,
+the Prime Minister of France, seems to be guided, according to French
+journals, by the opinions of this gentleman on cholera, instead of by
+different medical commissions sent to Warsaw, &c.
+
+The question of contagion in cholera has been now put to the test in
+every possible way, let us view it for a moment, as compared with what
+has occurred in regard to typhus at the London Fever Hospital, according
+to that excellent observer Dr. Tweedie, physician to the establishment.
+Doubts, as we all know, have been of late years raised as to the
+contagion of typhus, but I believe nothing that has as yet appeared is
+so well calculated to remove those doubts as the statements by this
+gentleman (_see "Illustrations of Fever"_), where he shows that it has
+been remarked for a series of years that "the resident medical officers,
+matrons, porters, laundresses, and domestic servants not connected with
+the wards, and every female who has ever performed the duties of a
+nurse, have one and all been the subjects of fever,"--while, _in the
+Small-Pox Hospital_, which adjoins it, according to the statements of
+the physician, "no case of genuine fever has occurred among the medical
+officers or domestics of that institution for the last eight years." Had
+typhus been produced in the attendants by _malaria_ of the locality,
+those persons in the service of the neighbouring Small-Pox Hospital
+should also have been attacked to a greater or less extent, it is
+reasonable to suppose, within the period mentioned. Now let this be
+compared with all that has been stated respecting attendants on cholera
+patients, and let it be compared with the following excellent fact in
+illustration, showing how numbers labouring under the disease, and
+brought from the inauspicious spot where they were attacked to a place
+occupied by healthy troops, did not, _even under the disadvantage of a
+confined space_, communicate the disease to a single individual:--"It
+has been remarked by many practitioners, that although they had brought
+cholera patients into crowded wards of hospitals, no case of the disease
+occurred among the sick previously in hospital, or among the hospital
+attendants. My own experience enables me fully to confirm this. The
+Military Hospital at Dharwar, an oblong apartment of about 90 feet by
+20, was within the fort, and the lines of the garrison were about a mile
+distant outside of the walls of the fort. On two different occasions (in
+1820 and 1821), when the disease prevailed epidemically among the troops
+of that station, while I was in medical charge of the garrison, but
+while no cases had occurred in the fort within which the hospital was
+situated, the patients were brought at once from their quarters to the
+hospital, which, on each occasion, was crowded with sick labouring under
+other disorders. No attempt was made to separate the cholera patients.
+On one of these occasions, no case of cholera occurred within the
+hospital; on the other, one of the sick was attacked, but he was a
+convalescent sepoy, who had not been prevented from leaving the fort
+during the day. The disease, on each of those occasions, was confined
+to a particular subdivision of the lines, and none of those within the
+fort were attacked." (_Bell on Cholera_, p. 92.)
+
+I have already quoted from Dr. Zoubkoff of Moscow, once a believer in
+contagion; every word in his pamphlet is precious; let but the following
+be read, and who will then say that "the seclusion of the sick should be
+insisted on?"--"The individuals of the hospitals, including soldiers and
+attendants on the sick, were about thirty-two in number, who, excepting
+the medical men, had never attended any sick; we all handled, more or
+less, the bodies of the patients, the corpses, and the clothes of the
+sick; have had our hands covered with their cold sweat, and steeped in
+the bath while the patients were in it; have inhaled their breath and
+the vapours of their baths; have tasted the drinks contained in their
+vessels, all without taking any kind of precaution, and all without
+having suffered any ill effects. We received into our hospital
+sixty-five cholera patients, and I appeal to the testimony of the
+thirty-six survivors, whether we took any precautions in putting them
+into the bath or in handling them--whether we were not seated sometimes
+on the bed of one, sometimes on that of another, talking to them. On
+returning home directly from the hospital, and without using chloride
+of lime, or changing my clothes, I sat down to table with my family, and
+received the caresses of my children, firmly convinced that I did not
+bring them a fatal poison either in my clothes or in my breath. Nobody
+shut his door either against me or my colleagues; nobody was afraid to
+touch the hand of the physician who came direct from an hospital--that
+hand which had just before wiped the perspiration from the brow of
+cholera patients. From the time that people had experience of the
+disease, nobody that I am aware of shunned the sick." Who, after this,
+can read over with common patience directions for the separation of a
+cholera patient from his friends, as if "_an accursed thing_?" or who
+(_il faut trancher le mot_) will now follow those directions?
+
+As to the good Sir Gilbert Blane, who has distributed far and wide a
+circular containing a description the most _naive_ on record, of the
+epidemic cholera, hard must be the heart which could refuse making
+the allowance which he claims for himself and his memoir; and though
+he brands those who see, in his account of the marchings and
+counter-marchings of the disease, nothing on a level with the
+intellect of the present age, as a parcel of prejudiced imbeciles,
+we must still feel towards him all the respect due to a parent arrived
+at a time of life when things are not as they were wont to be,
+_nec mens, nec aetas_. I may be among those he accuses of sometimes
+employing "unintelligible jargon," but shall not retort while I confess
+my inability to understand such expressions as "some obscure occurrence
+of unwholesome circumstances" which seem to have, according to him,
+both "brought" the disease to Jessore in 1817, and produced it there
+at the same time. Sir Gilbert marks out for the public what he
+considers as forming one of the principal differences between the
+English and Indian cholera, viz. that in the latter the discharges
+"consist of a liquid resembling thin gruel, in the English disease
+they are feculent and bilious." Now if he has read the India reports,
+he must have found abundance of evidence showing that sometimes there
+were _even bilious stools_[12] not at all like what he describes; and,
+again, if he is in the habit of reading the journals, he must have
+found _abundant_ evidence of malignant cholera with discharges like
+water-gruel in this country. As to the French Consul at Aleppo having
+escaped with 200 other individuals confined to his residence, I shall
+only say, as it is Sir Gilbert Blane who relates the circumstance,
+that he _forgot_ to mention that the aforesaid persons had retired to
+a residence _outside_ the city; which, permits me to assure you, Sir
+Gilbert, just makes all the difference in hundreds of cases:--they
+happened to retire to "_clene air_;" and had they carried 50 ague
+cases or 50 cholera cases with them (it matters not one atom which),
+the result would have been exactly the same. The mention of Barcelona
+and the yellow-fever, by Sir Gilbert, was, as Dr. Macmichael would
+term it, rather _unlucky_ for his cause, though probably lucky for
+humanity; for it cannot be too generally known that, during the
+yellow-fever epidemic there in 1821, more than 60,000 people left the
+city, and spread themselves all over Spain, without a single instance
+of the disease having been communicated, WHILE, AT BARCELONETTA, THE
+INFAMOUS CORDON SYSTEM PREVENTED THE UNFORTUNATE INHABITANTS FROM
+GOING BEYOND THE WALLS, AND THE CONSEQUENCES OF SHUTTING THEM UP WERE
+MOST HORRID.
+
+[Footnote 12: See Orton on Cholera, who is most explicit upon this
+point, and cites from the India Reports:--so that the distinctions
+attempted to be drawn in this respect between the "cholera of India,"
+and that of other countries, are, after all, _quite untenable_.]
+
+Little need be said respecting the pure assumptions of Sir Gilbert as
+to the movements of the malady by land and by water, for those vague and
+hacknied statements have been again and again refuted; but we may remark
+that whereas all former accounts respecting the cholera in 1817, in the
+army of the Marquis of Hastings, state that the disease broke out
+somewhat suddenly in the camp on the banks of the Sinde, Sir Gilbert,
+without deigning to give his authority, makes the army set out for
+"Upper India accompanied by this epidemic." We find that Mr. Kennedy,
+another advocate for contagion in cholera, differs from Sir Gilbert as
+to the disease having accompanied the grand army on the march; for he
+says the appearance of the malady was announced in camp in the early
+part of November, when "the first cases excited little alarm." In
+referring, in a former letter, to the sickness in the above army, I
+showed from the text of the Bengal report, how a change of position
+produced a return of health in the troops; but Mr. Kennedy states that
+the disease had greatly declined a few days before the removal, so that
+it had lost "its infecting power." Nevertheless it appears by this
+gentleman's account, a little farther on, that "in their progressive
+movement the grounds which they occupied during the night as temporary
+encampments were generally found in the morning, strewed with the dead
+like a field of battle"! This gentleman tells us that he has laid down a
+law of "increase and decline appertaining to cholera," by which, and the
+assistance of _currents of contagion_, it would appear all these things
+are reconciled wonderfully. Several of the points upon which he grounds
+his belief of contagion have been already touched upon in these letters,
+and the rest, considering the state of the cholera question in Europe
+just now, may be allowed to pass at whatever value the public may, after
+due examination, think it is entitled to. Let it be borne in mind that
+all contagionists who speak of the cholera in the army of the Marquis of
+Hastings, forget to tell us that though many thousand native followers
+had fled from that army during the epidemic, the disease did not appear
+in the towns situated in the surrounding country, _till the following
+year_, as may be seen at a glance by reference to Mr. Kennedy's and
+other maps.
+
+We have another contagionist in the field--a writer in the _Foreign
+Quarterly Review_, the value of whose observations may appear from his
+statement, that "in 1828 the disease broke out in Orenburg, and was
+supposed [_supposed_!] to have been introduced by the caravans which
+arrive there from Upper Asia, or [_or_, nothing like a second string] by
+the Kingiss-Cossacks, who are adjoining this town, and were said [_were
+said_!] to have been about this time affected with the disease." This
+single extract furnishes an excellent specimen of the sort of _proofs_
+which the contagionists, to a man, seem to be satisfied with as to the
+cholera being "carried" from place to place. This gentleman must surely
+be under some very erroneous impression, when he states that, "According
+to the reports of the Medical Board of Ceylon, the disease made its
+appearance in 1819 at Jaffnah in Ceylon, imported from Palamcottah, with
+which Jaffnah holds constant intercourse, and thence it was propagated
+over the island." Now there is every reason to believe that a reference
+to the documents from Ceylon will shew that no report as to the
+importation of the disease was ever drawn up, for Drs. Farrel and Davy,
+as well as Messrs. Marshall, Nicholson, and others, who served in that
+island, are, to this hour, clearly against contagion. But as the writer
+tells us that he is furnished with unpublished documents respecting the
+cholera at St. Petersburg, by the chief of the medical department of the
+quarantine in this country, we do not think it necessary to say one word
+more--_ex pede Herculem_.
+
+I rejoice to observe that Dr. James Johnson has, at last, _spoken out_
+upon the quarantine question; and I trust that others will now follow
+his example. It is only to be regretted, that a gentleman possessing
+such influence with the public as Dr. Johnson does, should have so long
+with-held his powerful aid on the occasion; but his motives were, I am
+quite sure, most conscientious; and I believe that he, as well as
+others, might have been prevented by a feeling of delicacy from going
+beyond a certain point.
+
+Since my last letter a code of regulations, in the anticipation of
+cholera, has been published by the Board of Health. _Let our prayers be
+offered up with fervency tenfold greater than before, that our land may
+not be afflicted with this dire malady._ The following statement,
+however, may not be altogether useless at this moment. According to the
+_Journal des Debats_ of the 24th instant, the Emperor of Austria, in a
+letter to his High Chancellor, dated Schoenbrunn, October 10th, and
+published in the _Austrian Observer_ of the 12th, formally makes the
+most magnanimous declaration to his people, THAT HE HAD COMMITTED AN
+ERROR IN ADOPTING THE VEXATIOUS AND WORSE-THAN USELESS QUARANTINE AND
+CORDON REGULATIONS AGAINST CHOLERA; that he did so before the nature of
+the disease was so fully understood; admits that those regulations have
+been found, after full experience, to have produced consequences more
+calamitous than those arising from the disease itself ("_plus funeste
+encore que les maux que provenaient de la maladie elle-meme_.") He
+kindly makes excuses for still maintaining a modified quarantine system
+at certain points, in consequence, as he states, of the opinions still
+existing in the dominions of some of his neighbours, _for otherwise his
+commercial relations would be broken off. To secure his maritime
+intercourse, he must do as they do!_ We find that as _all_ the Prussian
+cordons have been dissolved, _their vessels_ are excluded from entrance
+into certain places on the Elbe. What a horrid state of things! But, as
+a reference will shew, this was one of the things stated in my first
+letter as likely to occur: it is surely a fit subject for immediate
+arrangement between governments. In the mean time, we cannot but profit
+by the great lesson just received from Austria.
+
+I shall add no more on the present occasion, than that my last
+information from Edinburgh notifies the death, from _Scotch cholera_,
+of two respectable females in that city, after an illness of only a few
+hours.
+
+
+
+
+LETTER VI.
+
+
+At a moment when the subject of cholera has become so deeply
+interesting, the good of the public can surely not be better consulted
+by the press than when it devotes its columns (even to the exclusion of
+some political and other questions of importance) to details of plain
+facts connected with the contagious or non-contagious nature of that
+malady--a _question beyond all others regarding it, of most importance_,
+for upon it must hinge all sanatory or conservative regulations, and a
+mistake must, in the event of an epidemic breaking out, directly involve
+thousands in ruin. In the case of felony, where but the life of a single
+individual is at stake--nay, not only in the case of felony, but in the
+case of a simple misdemeanour, or even in the simple case of debt--we
+see the questions of yes or no examined by the Judges of the land with
+due rigour; while, on the point to which I refer, and which affects
+so deeply the dearest interests of whole communities, evidence has
+been acted upon so vague as to make some people fancy that we have
+retrograded to the age of witchcraft. Be it recollected that we shall
+not have the same excuse as some of our continental neighbours had for
+running into frightful errors--for we have their dear-bought experience
+laid broadly before us; and to profit duly by it, it only requires a
+scrutiny by a tribunal, wholly, if you please, non-medical, such as may
+be formed within an hour in this metropolis; nothing short of this will
+do. All, till then, will be vacillation; and when the enemy does come in
+force, we shall find ourselves just as much at a loss how to act as our
+continental neighbours were on the first appearance of cholera among
+them; I say after its first appearance, for we find that they all
+discovered, plainly enough latterly, what was best to be done. Small
+indeed may be the chance of the present order of things as to
+quarantines, the separation of persons attacked, &c., being changed
+by anything which I can offer; but, having many years experience of
+disease--having had no small share of experience in this disease in
+particular, and having, perhaps, paid as much attention to all that has
+been said about it as any man living, I should be wanting in my duty
+towards God and man did I not protest, most loudly, against those
+regulations, which shall have for their base, an assumption, that a
+being affected with cholera can, IN ANY MANNER WHATEVER, transmit, or
+communicate, the disease to others, _however close or long continued the
+intercourse may be_; because such doctrine is totally in opposition to
+all the fair or solid evidence now before the public;--because it is
+calculated, in numberless instances, to predispose the constitution
+to the disease, by exciting terror equal to that in the case of
+plague;--because it is teaching us Christians to do what Jews, and
+others, never do, to abandon the being who has so many ties upon our
+affections;--because the desertion of friends and relatives, and the
+being left solely in charge, perhaps, of a feeble and aged hireling (if
+even such can be got, which I much doubt when terror is so held out,)
+must tend directly to depress those functions which, from the nature of
+the disease, it should be our great effort to support;--finally, because
+a proper and unbiassed examination of the question will shew, that all
+these horrors are likely to arise out of regulations which may, with
+equal justice, be applied to ague, to the remittent fevers of some
+countries, or to the Devonshire cholic, as to cholera.
+
+Happily, it is not yet too late to set about correcting erroneous
+opinions, pregnant with overwhelming mischief, for hitherto the measures
+acted upon have only affected our commerce and finances to a certain
+extent; but it appears to me that not a moment should be lost, in order
+to prevent a public panic; and, in order to prevent those calamities
+which, in addition to the effects of the disease itself, occurred, as we
+have seen, on the Continent. Let then, I say, a Commission be forthwith
+appointed, composed of persons accustomed to weigh evidence in other
+cases, and who will not be likely to give more than its due weight to
+the authority of any individuals. Let this be done, and, in the
+decision, we shall be sure to obtain all that human wisdom can arrive at
+on so important a subject; and the public cannot hesitate to submit to
+whatever may afterwards be proposed. It will then be seen whether the
+London Board of Health have decided as wisely as they have hastily. For
+my part, I shall for ever reject what may be held as evidence in human
+affairs, if it be not shewn that an individual attending another
+labouring under cholera, runs no further risk of being infected than
+an individual attending an ague patient does of being infected by this
+latter disease. What a blessing (in case of our being visited by an
+epidemic) should this turn out to be the decision of those whose
+opinions would be more likely to be regarded by the public than mine
+are likely to be.
+
+Many, I am quite aware, are the professional men of experience now in
+this country, who feel with me on this occasion, but who, in deference
+to views emanating from authority, refrain from coming forward:--let me
+entreat them, however, to consider the importance of their suggestions
+to the community at large, at this moment; and let me beg of them to
+come forward and implore government to institute a special commission
+for the re-consideration of measures, founded on evidence the most vague
+that it is possible to conceive; or, perhaps, I should rather say,
+_against_ whatever deserves the name of evidence. Every feeling should
+be sacrificed, by professional men, for the public good; we must even
+run the greatest risk of incurring the displeasure of those of our
+friends who are in the Board of Health. That we do run some risk is
+pretty plain, from the conduct of a vile journalist closely connected
+with an individual of a paid party, who has threatened us unbelievers in
+generally-exploded doctrines, with a fate nothing short of that which
+overwhelmed some of the inhabitants of Pompeii.
+
+Let me ask why _all_ the documents of importance forwarded to the Board
+of Health are not published in the collection just issued? Why are those
+forwarded by _the Medical Gentleman sent to Dantzic_ not published.[13]
+Why has not an important document forwarded by our Consul at Riga not
+been published? Above all, why has not allusion been made in their
+papers to those cases of PURE SPASMODIC CHOLERA, which have occurred in
+various parts of England within the last five months, and the details
+of which has been faithfully transmitted to them. If those cases be
+inquired into thoroughly and impartially, and that several of them be
+not found to be PERFECTLY IDENTIC with the epidemic cholera of India,
+of Russia, &c., I hereby promise the public to disclose my name, and
+to suffer all the ignomy of a person making false statements. Indeed,
+I may confidently assure the public, that in at least one case which
+occurred about two months ago, the opinion of a gentleman who had
+practiced in India, and who had investigated the history of the
+symptoms, the identity with those of Asiatic cholera, was not denied.
+The establishment of this point is of itself sufficient to overthrow
+all supposition as to the importation of the disease.
+
+[Footnote 13: Since the above was written, I find that this gentleman
+has adduced the strongest proofs possible against contagion.]
+
+In the case of Richard Martin, whose death occurred at Sunderland about
+two months ago--in the case of Martin M'Neal, of the 7th Fusileers,
+which occurred at Hull, on the 11th of August last--in the cases at Port
+Glasgow, as detailed in a pamphlet by Dr. Marshall of that place--as
+well as several other cases which occurred throughout the year, and the
+details of many of which are in possession of the Board of Health--the
+advocates, "_par metier_," of contagion in cholera, have not a loop-hole
+to creep out at. Take but a few of the symptoms in one of those cases
+as taken down by the Medical Gentleman in charge,--"The body was cold,
+and covered by a clammy sweat--the features completely sunk--_the lips
+blue_, the face discoloured--tongue moist and very cold--the hands and
+feet blue, cold, and as if steeped in water, like a washerwoman's hand;
+the extremities cold to the axillae and groins, and no pulse discoverable
+lower; the voice changed, and the speech short and laborious. He
+answered with reluctance, and in monosyllables." This man had the pale
+dejections, and several other symptoms, considered so characteristic of
+the Asiatic cholera; yet no spreading took place from him, nor ever will
+in similar cases. With the exception of the vomiting and purging, there
+is, in the state of patients labouring under this form of cholera, a
+great similarity to the first stage of the malignant fevers of the
+Pontine Marshes, and many other places, and the patient need not be one
+bit the more avoided. Let this be, therefore, no small consolation, when
+we find that, by the official news of this day, five more deaths have
+occurred at Sunderland.
+
+Nov. 9, 1831.
+
+
+
+
+LETTER VII.
+
+
+It may be inferred, from what I have stated at the close of my letter
+of yesterday, that if a Commission be appointed, I look forward to its
+being shewn, as clear as the sun at noon day, that the most complete
+illusion has existed, and, on the part of many, still exists, with
+regard to the term _Indian_ or _Asiatic_ cholera; for a form of cholera
+possessing characters quite peculiar to the disease in that country, and
+unknown, till very lately, in other countries, _has never existed
+there_. Cholera, from a cause as inscrutable, perhaps, as the cause of
+life itself, has prevailed there, and in other parts of the world, in
+its severest forms, and to a greater extent than previously recorded;
+but, whether we speak of the mild form, or of a severe form, proceeding
+or not to the destruction of life, the symptoms have everywhere been
+precisely the same. In this country it has been over and over again
+remarked, that, so far back as 1669, the spasmodic cholera prevailed
+epidemically under the observation of Dr. Sydenham, who records it. For
+many years after the time of Dr. Cullen, who frequently promulgated
+opinions founded on those of some fancy author rather than on his own
+observation, it was very much the fashion to speak of redundancy of
+bile, or of acrid bile, as the cause of the whole train of symptoms in
+this disease; but, since the attention of medical men has been more
+particularly drawn to the subject, practitioners may be found in every
+town in England who can inform you that, in severe cases of cholera,
+they have generally observed that no bile whatever has appeared till
+the patient began to get better. Abundance of cases of this kind are
+furnished by the different medical journals of this year. In fifty-two
+cases of cholera which passed under my observation in the year 1828, the
+_absence_ of bile was always most remarkable. I made my observations
+with extraordinary care. One of the cases proved fatal, in which the
+group of symptoms deemed characteristic of the Indian or Indo-Russian
+cholera, was most perfect, and in the mass, the symptoms were as
+aggravated as they have often been observed to be in India;--in several,
+spasms, coldness of the body, and even convulsions, having been present.
+
+To those who have attended to the subject of cholera, nothing can be
+more absurd than to hear people say such or such a case cannot be _the
+true_ cholera, or the Indian cholera, or the Russian cholera, because
+_all_ the symptoms ever mentioned are not present: as if, in the
+epidemic cholera of India and other places, even some of the symptoms
+considered the most prominent (as spasms, and the disturbance of the
+stomach and bowels) were not often absent, and that too in some of the
+most rapidly, fatal cases! I feel persuaded that much injustice is done
+to a gentleman lately sent to Sunderland, in attributing to him the
+very ridiculous opinion, _that because_ the disease did not spread, it
+was _therefore_ not identical with the Indian cholera. No person is
+justified in speaking of the cholera of India as a disease _sui
+gineris_, and in which a certain group of severe symptoms are always
+present, when evidence, such as the following is on record:--"On the
+22nd instant, when the men had been duly warned of their danger from not
+reporting themselves sooner, I got into hospital a different description
+of cases, viz.--men with a full pulse, hot skin," &c. (_Dr. Burrell to
+Dr. Milne, Seroor, 27th of July, 1818_)--"But I must tell you that we
+have, too, cases of common cholera." (_Mr. Craw, Seroor--Bengal Report,
+p. 48_)--"The cases which terminated favourably presented very different
+symptoms [from the low form of the disease.] As I saw the men
+immediately after they were attacked, they came to me with a quick
+_full_ pulse, and in several instances pain in the head; there was no
+sweating."--"in several cases _bile_ appeared from the first in
+considerable quantities in the egesta; and these were more manageable
+than those in which no bile was ejected, although the spasms and
+vomiting (the most distressing symptoms of the complaint) were equally
+violent." (_Mr. Campbell, Seroor,--see Orton, 2nd ed. p. 18_)--"In
+conclusion, I am happy to inform you that, for the last three days the
+disease has been evidently on the decline, and, during that period, most
+of the cases have assumed a different and much milder type, and,
+comparatively, are little dangerous. It approaches somewhat to fever;
+the patient complains of severe pain in the legs, sometimes vomiting
+a watery fluid, and sometimes bile." (_White--Bengal Reports, p. 68._)
+
+The same gentleman afterwards observes, "The disease continues to
+present a milder aspect, and now occurs but rarely: loss of pulse and
+coldness are seldom observed."
+
+On the decline of a particular epidemic, Mr. Alardyce observed many
+cases in the 34th regiment, with _bilious_ discharges throughout.
+(Orton, 1st Ed. 128). Finally, referring to the work of Mr. Orton, a
+gentleman who served in India, and who, being a contagionist, will be
+considered, I suppose, not bad authority by those who are of his
+opinion, we find the following declaration. (p. 26, 1st Ed.) "My own
+experience has been very conclusive with regard to the sthenic form of
+the disease. I have found a very considerable number of cases
+exhibiting, singly, or in partial combination, every possible degree,
+and almost every kind of increased action."--"Very full, hard, and quick
+pulse, hot skin, and flushed surface; evacuations of bile, [you are
+requested to note this, reader] both by vomiting and stool, from the
+commencement of the attack. And, finally, I have seen some of those
+cases passing into the low form of the disease."--"The inference from
+these facts is plain, however opposite these two forms of disease may
+appear, _there is no essential or general difference between them_."
+After such authorities, and what has elsewhere been shewn, can any
+cavelling be for one moment permitted as to the cholera in Sunderland
+not being of the same nature as that of India? It may be now clearly
+seen that in India as in Sunderland, the same variety of grades occurred
+in the disease.
+
+In making my communications for the benefit of the public, it is my wish
+to spare the feelings of Sir Gilbert Blane; but as he persists in giving
+as facts often refuted tales of contagion, in order to uphold doctrines
+which he must observe are tumbling into ruins in all directions, it
+becomes necessary that his work of mischief should no longer remain
+unnoticed.
+
+Not a single circumstance which he quotes relative to the marchings
+and the voyages of the contagion of cholera will bear the slightest
+examination; and yet he has detailed them as if, on his simple
+assertion, they were to be received as things proved, and, consequently,
+as so many points to be held in view when the public are in search of
+rules whereby they may be guided. The examination of his assumed facts
+for one short hour, by a competent tribunal, would prove this to be the
+case; here it is impossible to enter upon them all: but let us just
+refer to his _management_ of the question relative to the importation of
+the disease into the Mauritius by the _Topaze_ frigate, which he says
+was not believed there to be the case--and _why_ was it not believed?
+Sir Gilbert takes special care not to tell the public, but they now have
+the reason from me, at page 22.
+
+If a commission be appointed, half an hour will suffice to place before
+them, from the medical office in Berkeley-street, the reports alluded to
+from the Mauritius, by which it is made apparent that long before the
+arrival of the aforesaid frigate, the disease had shown itself in the
+Mauritius.[14] What is the public to think of us and our profession,
+when vague statements are daily attempted to be passed as facts, by
+contagionists _enrages_? One more short reference to Sir Gilbert's
+facts.--While referring to the progress of cholera in India, &c. from
+1817, he says, in a note, "it is remarkable enough that while the great
+oriental epidemic appeared thus on the eastern extremity of the
+Mediterranean, the great western pestilence, the yellow fever, was
+raging in its western extremity, Gibraltar, Malaga, Barcelona, Leghorn,
+&c." Now, it is a historical fact, that, at Gibraltar, this disease did
+not appear between 1814 and 1828--_and at Leghorn not since 1804_! At
+Malaga, I believe, it did not prevail since 1814! So we have here a
+pretty good specimen of the accuracy of some of those who undertake to
+come forward as guides to the public on an occasion of great urgency and
+peril. By some of Sir Gilbert's abettors, we are assured that his "facts
+are perfectly reconcileable with the hypothesis of the cholera being of
+an infectious nature." A fig for all hypothesis just now! Let us have
+something like the old English trial by jury. May I be allowed to
+introduce a fresh evidence to the public notice, in addition to the
+thousand-and-one whose testimony is already recorded. He is worthy of
+belief for two good reasons in particular; the one because he still
+(unable to explain what can never be explained, perhaps), calls himself
+a contagionist, and, in the next place, the statements being from a
+high official personage, he could not offer them unless true to his
+Government, as hundreds might have it in their power to contradict them
+if not accurate. My witness is not a Doctor, but a _Duke_--the Duke de
+_Mortemar_, lately Ambassador from the French Court to St. Petersburg,
+who has just published a pamphlet on cholera, a few short extracts
+from which, but those most important ones, I shall here give. Read
+them!--people of all classes, read them over and over again! "An
+important truth seems to be proved by what we shall here relate,
+which is, that woods seem to diminish the influence of cholera, and
+that cantons in the middle of thick woods, and placed in the centre
+of infected countries, have altogether escaped the devastating
+calamity!"--"The island of Kristofsky, placed in the centre of the
+populous islands of St. Petersburg, communicating with each other by
+two magnificent bridges, and with the city by thousands of boats, which
+carried every day, and particularly on Sundays, a great number of people
+to this charming spot. The island of Kristofsky, we say, _was preserved
+completely from attacks of the cholera_; there was not a _single_ person
+ill of the disease in three villages upon it." He continues to state
+particulars, which, for want of time, cannot be here given, and
+adds--"To what is this salubrity of Kristofsky, inhabited by the same
+sort of people as St. Petersburg, to be attributed, fed in the same
+manner, and following a similar _regime_,--communicating with each other
+daily, if it be not to the influence of the superb forest which shelters
+it? The firs, which are magnificent as well as abundant, surround the
+houses."[15] He notices that the town is low and humid, and that "it is
+made filthy every Sunday by the great numbers who resort to it, and who
+gorge themselves with intoxicating drink." In a third letter I shall be
+able to furnish further extracts from this most interesting pamphlet.
+
+[Footnote 14: I am aware that very lately certain memoranda have been
+referred to from the surgeon, but this is merely an expiring effort, and
+of no avail against the official Report drawn up.]
+
+[Footnote 15: As these most remarkable circumstances have not appeared
+in the statements of our Russian medical commission, we must either
+presume that the Duke is not correct, or that those facts have _escaped
+the notice_ of the commission.]
+
+In a letter lately inserted in a newspaper, the greatest injustice
+is done to the Board of Health by the comments made on their
+recommendations for the _treatment_ of cholera--_it is not true_ that
+they have reccommended _specifics_, and I must add my feeble voice in
+full approbation of all they have suggested on this point. Let the
+public remark that they most judiciously point at the application of
+_dry_ heat, not baths, which always greatly distress the patient, and,
+indeed, have sometimes been observed (that is, where the coldness and
+debility are very great) to accelerate a fatal issue. Of all the
+arrangements to which a humane public can direct their attention, there
+is nothing so essential as warmth. I would, therefore, humbly beg to
+suggest, that funds for the purpose of purchasing coals for gratuitous
+issue to the poor should be at once established in all directions. Too
+much, I think, has been said about ventilation and washing, and too
+little about this.
+
+November 10th.
+
+
+
+
+LETTER VIII.
+
+
+Already has the problem of the contagious or non-contagious nature of
+this disease been solved upon our own land; and as sophistry can no
+longer erect impediments to the due distribution of the resources of
+this pre-eminently humane nation, it is to be hoped that not an hour
+will be lost in shaping the arrangements accordingly. What now becomes
+of the doctrine of a poison, piercing and rapid as the sun's rays,
+emanating from the bodies of the sick--nay, from the bodies of those who
+are not sick, but who have been near them or near their houses? In the
+occurrences at Newcastle and Sunderland, how has the fifty times refuted
+doctrine of the disease spreading from a point in _two_ ways, or in one
+way, tallied with the facts? We were desired to believe that in India,
+Persia, &c., "the contagion _travelled_," as the expression is, very
+slow, because this entity of men's brains was obliged to wend its way
+with the march of a regiment, or with the slow caravan: now, however,
+when fifty facilities for the most rapid conveyance have been afforded
+every hour since its first appearance, it will not put itself one bit
+out of its usual course. And then what dangers to the attendants on the
+sick to the members of the same family--to the washerwomen--to the
+clergymen--to the buriers of the dead--even to those who passed the door
+of the poor sufferer! Well, what of all this has occurred? Why it has
+occurred that this doctrine, supported by many who were honest, but had
+not duly examined alleged facts, and by others, I regret to say, whose
+interests guided their statements--that the absurdity of this doctrine
+has now been displayed in the broad light of day. Make allowance (even
+in this year of great notoriety for susceptibility to cholera in the
+people at large in this country) for _insusceptibility_ on the part of
+numbers who came into contact at Sunderland and Newcastle, with the
+persons of cholera patients, with their beds, their furniture, their
+clothes, &c., yet, if there had ever been the slightest foundation
+for the assertions of the contagionists, what numbers _ought_ to have
+been contaminated, in all directions over the face of the country,
+even within the first few days, considering the wonderful degree of
+intercourse kept up between all parts. But we find that, as in Austria
+and Prussia, "_la maladie de la terre_" is not disposed here to
+accommodate itself to vain speculations. _Now_ the matter may be
+reduced to the simple rules of arithmetic, viz.:--if, as "contagionists
+_par metier_" say, the poison from the body of one individual be, in
+the twinkling of an eye, and in more ways than one, transmitted to
+the bodies of a certain number who have been near him, &c., how many
+thousands, or tens of thousands, in every direction, should, in a
+multiplied series of communications and transmissions, be now affected?
+
+Those who have watched the course of matters connected with cholera in
+this country, have not failed to perceive, for some time past, the
+intent and purport of the assertion so industriously put forth--that the
+disease might be introduced by people in perfect health; and we have
+just seen how this _ruse_ has been attempted to be played off at
+Sunderland, as the history of such matters informs us has been done
+before in other instances, and public vengeance invoked most _foully and
+unjustly_ upon the heads of guiltless persons in the Custom House or
+Quarantine Department, for "permitting a breach of regulations;" but the
+several pure cases of spasmodic cholera, in many parts of England
+besides Sunderland, long before--months before--the arrival of _the_
+ship (as shewn in a former letter) leave no pretence for any supposition
+of this kind.
+
+I request that the public may particularly remark, that, frequently as
+those cases have been cited as proofs of the absurdity of _expecting the
+arrival_ of the disease by a ship, THEIR IDENTITY HAS NEVER ONCE BEEN
+DISPUTED BY THOSE MOST ANXIOUS TO PROVE THEIR CASE. No; the point has,
+in common parlance, been always _shirked_; for whoever should doubt it,
+would only hold himself up to the ridicule of the profession, and to
+admit it would be to give up the importation farce.
+
+Others have remarked before me that, though a very common, it is a very
+erroneous mode of expression, to say of cholera, that _it has travelled_
+to such or such a place, _or has arrived_ at such or such places, for it
+is _the cause_ of the malady which is found to prevail, for a longer or
+shorter time, at those different points. It cannot be expected that
+people should explain such matters, for, with regard to them, our
+knowledge seems to be in its infancy, and "we want a sense for atoms."
+However, as people's minds are a good deal occupied upon the point,
+and as many are driven to the idea of contagion in the face even of
+evidence, from not being able to make any thing of this _casse-tete_,
+the _best guess_ will probably be found in the quotation from Dr. Davy,
+at page 19.
+
+I perceive that the Berlin Gazette is humanely occupied in recommending
+others to profit by the mistakes regarding contagion which occurred in
+that country:--"Dr. Sacks, in No. 38 of his Cholera Journal, published
+here, has again shewn, against Dr. Rush, the fallibility of the doctrine
+of contagion, as well as the mischievous impracticability of the
+attempts founded on it to arrest the progress of the disorder by cutting
+off the communications. It is to be hoped that the alarm so methodically
+excited by scientific and magisterial authority in the countries to the
+west of us [!!] will cease, after the ample experience which we have
+dearly purchased (with some popular tumults), and that the system of
+incommunication will be at once done away with by all enlightened
+governments, after what has passed among us."--I am sure, good people,
+nobody can yet say whether those calling themselves scientific, will
+allow us to profit by your sad experience; but I believe that the people
+of Sunderland are not to be shut in, but allowed to remove, if they
+choose, in spite of silly speculations.
+
+It may not be uninteresting to mention here, that there are no
+quarantines and no choleras in Bohemia or Hanover.
+
+
+
+
+LETTER IX.
+
+
+The following statement from the Duke de Mortemar will be considered
+probably, very curious, considering that, as already stated, he seems
+to believe in something like contagion--and for no earthly reason, one
+may suppose, than from his inability to satisfy himself of the existence
+of another cause--as if it were not sufficient to prove that in reality
+the moon _is not_ made of green cheese, but one must prove _what it is_
+made of! But, to the quotation--"The conviction now established, that
+intercourse with sick produces no increase of danger, should henceforth
+diminish the dread of this calamity (the cholera). It differs from the
+plague in this, that it does not, by its sole appearance, take away
+all hope of help, and destroy all the ties of family and affection.
+Henceforth those attacked will not be abandoned without aid and
+consolation; and separation or removal to hospital, the source of
+despair, will no longer increase the danger. The sick may in future be
+attended without fears for one's self, or for those with whom we live."
+How delightful is the simplicity of truth! Why, Sir, a morceau like
+this, and from an honourable man, let him call himself contagionist or
+what he may, is more precious at this moment than Persian turkois or
+Grecian gems. Make me an example, men say, of the culprits "who let
+the cholera morbus into Sunderland," concealed in "susceptible"
+articles!--yes, and that we may be on a level in other matters, destroy
+me some half dozen witches, too, as we were wont to do of yore. But
+let us have more tidings from Russia to comfort the country of our
+affections in the hour of her affliction, when so much craft and
+subtlety is on foot to scare her. Dr. Lefevre, physician to our embassy
+at St. Petersburg, has just given to the public an account of his
+observations there during the epidemic, from which the following
+extracts are made:--
+
+"As far as my practice is concerned both in the quarter allotted to me,
+and also in private houses in different parts of the town, I have no
+proof whatever that the disease is contagious.
+
+"The first patient I saw was upon the third day of the epidemic, and
+upon strict inquiry I could not trace the least connexion between the
+patient, or those who were about her person, with that part of the town
+where it first appeared--a distance of several versts.
+
+"As regards the attendants of the sick, in no one instance have I found
+them affected by the disease, though in many cases they paid the most
+assiduous attention, watched day and night by the beds of the afflicted,
+and administered to all their wants.
+
+"I knew four sisters watch anxiously over a fifth severely attacked with
+cholera, and yet receive no injury from their care.
+
+"In one case I attended a carpenter in a large room, where there were at
+least thirty men, who all slept on the floor among the shavings; and,
+though it was a severe and fatal case, no other instance occurred among
+his companions.
+
+"In private practice, among those in easy circumstances, I have known
+the wife attend the husband, the husband the wife, parents their
+children, children their parents, and in fatal cases, where, from long
+attendance and anxiety of mind, we might conceive the influence of
+predisposition to operate, in no instance have I found the disease
+communicated to the attendants."--p. 32, 33.
+
+"The present disease has borne throughout the character of an epidemic,
+and when the proofs advanced in proof of its contagion have been
+minutely examined, they have been generally found incorrect; whereas
+it is clear and open to every inquirer, that the cholera did not occur
+in many places which had the greatest intercourse with St. Petersburg
+at the height of the malady, and that it broke out in many others which
+have been subjected to the strictest quarantine."--p. 34.[16]
+
+[Footnote 16: It is remarkable enough that Aretaeus, who lived, according
+to some authors, in the first century, gives exactly the same reason
+which Dr. Lefevre does for the suppression of urine in cholera. So true
+it is, that that symptom, considered as one of the characteristics of
+the Indian cholera, was observed in ancient times.]
+
+Hear all this, Legislators! Boards of Health throughout the country,
+hear it! Then you will be able to judge how exceedingly frivolous the
+idle _opinions_ and _reports_ are which you have obtruded so
+industriously upon your notice.
+
+But one more short quotation from Dr. Lefevre, a gentleman certainly
+not among the number of those who stand denounced before the
+professional world as unworthy of belief. He says:--"As for many
+reports which have been circulated, and which, _prima facie_, seem to
+militate against the statement [communication to attendants, &c.]. I
+have endeavoured to pay the most impartial attention to them; but I
+have never found, upon thorough investigation, that their correctness
+could be relied upon: and in many instances I have ascertained them to
+be designedly false."--DESIGNEDLY FALSE! Alas! _toute ca on trouve
+dans l'article_ HOMME; and any body who chooses to investigate, as
+I have done, the history of epidemics, will find that falsehoods foul
+have been resorted to--shamelessly resorted to--by persons having a
+direct interest in maintaining certain views. Enough, then, has been
+said to put Boards of Health, &c. on their guard against admitting
+_facts_ for their guidance from any quarter whatever, if the purity
+of the source be not right well established. There is too much at stake
+just now to permit of our yielding with ill-timed complaisance to
+_any authority_ without observing this very necessary preliminary.
+
+One word, and with all due respect, before closing, on the subject of
+Dr. James Johnson's "_contingent_ contagion," which, though occurring
+in some diseases, and extremely _feasible_ in regard to others, will,
+if he goes over the evidence again, I am sure, be shown not to apply to
+cholera, which is strictly a disease of _places_, not persons, and can
+no more be generated by individuals than ague itself can. I can only say
+of it, with the philosophic poet, that--
+
+--------------------"A secret venom oft
+Corrupts the air, the water, and the land."
+
+Mr. Searle, an English gentleman, well known for his work on cholera,
+has just returned from Warsaw, where he had the charge of the principal
+cholera hospital during the epidemic. The statements of this gentleman
+respecting contagion, being now published, I am induced from their high
+interest to give them here:--
+
+"I have only to add my most entire conviction that the disease is not
+contagious, or, in other words, communicable from one person to another
+in the ordinary sense of the words--a conviction, which, is founded not
+only upon the nature of the disease, but also upon observations made
+with reference to the subject, during a period of no less than fourteen
+years. Facts, however, being deservedly of more weight than mere
+opinions, I beg leave to adduce the following, in the hope of relieving
+the minds of the timid from that groundless alarm, which might otherwise
+not only interfere with or prevent the proper attendance upon the sick,
+but becomes itself a pre-disposing or exciting cause of the disease; all
+parties agreeing that of all the debilitating agencies operating upon
+the human system, there is no one which tends to render it so peculiarly
+susceptible of disease, and of cholera in particular, than fear.
+
+"The facts referred to are these:--during two months of the period, that
+I was physician to the principal hospital at Warsaw, devoted to the
+reception and treatment of this disease, out of about thirty persons
+attached to the hospital, the greater number of them were in constant
+attendance upon the sick, which latter were, to the number of from
+thirty to sixty, constantly under treatment; there were, therefore,
+patients in every stage of the disease. Several of these attendants,
+slept every night in the same apartments with the sick, on the beds
+which happened to be unoccupied, with all the windows and doors
+frequently closed. These men, too, were further employed in assisting
+at the dissection of, and sewing up of, the bodies of such as were
+examined, which were very numerous; cleansing also the dissecting-room,
+and burying the dead. And yet, notwithstanding all this, only one,
+during the period of two months, was attacked by the disease, and this
+an habitual drunkard, under circumstances, which entirely negative
+contagion, (supposing it to exist), as he had nothing whatever to do
+with the persons of the sick, though he occasionally assisted at the
+interment of the dead. He was merely a subordinate assistant to the
+apothecary, who occupied a detached building with some of the families
+of the attendants; all of whom likewise escaped the disease. This man,
+I repeat, was the only one attacked, and then under the following
+circumstances."
+
+Here Mr. S. relates how this man, having been intoxicated for several
+days--was, as a punishment locked up almost naked in a damp room for two
+nights, having previously been severely beaten.
+
+From the foregoing facts, and others pretty similar in all parts of the
+world where this disease has prevailed, we are, I think, fairly called
+upon to discard all special pleading, and to admit that man's _best
+endeavours_ have not been able _to make it_ communicable by any manner
+of means.
+
+
+
+
+LETTER X.
+
+
+At a meeting held some days ago by the members of the Royal Academy of
+Medicine of Paris, Dr. Londe (President of the French Medical Commission
+sent to Poland to investigate the nature of the cholera) stated, with
+regard to the questions of the origin and _communicability_ of the
+disease, that it appeared by a document to which he referred, that
+1st. "The cholera did not exist in the Russian corps which fought at
+_Iganie_," the place where the first battle with the Poles took place.
+2d. "That the two thousand Russian prisoners taken on that occasion, and
+observed at Praga for ten days under the most perfect separation, [_dans
+un isolement complet_] did not give a single case of cholera." 3d. "That
+the corps [of the Polish army] which was not at _Iganie_, had more cases
+of cholera than those which were there." Dr. Londe stated cases of the
+spontaneous development of the disease in different individuals--of a
+French Lady confined to her bed, during two months previous to her
+attack of cholera, of which she died in twenty-two hours--of a woman of
+a religious order, who had been confined to her bed for six months, and
+while crossing a balcony, the aspect of which was to the Vistula, was
+attacked with cholera, and died within four hours. Dr. Londe, among
+other proofs that the disease was not transmissible, or, as some prefer
+calling it, not communicable, stated, "the immunity of wounded and
+others mixed with the cholera patients in the hospitals; the immunity of
+medical men, of attendants, of inspectors, and of the families of the
+different _employes_ attached to the service of cholera patients;
+the example of a porter, who died of the disease, without his wife or
+children, who slept in the same bed with him, having been attacked; the
+example of three women attacked (two of whom died, and one recovered),
+and the children at their breasts, one of six months, and the other two
+of twelve, not contracting the disease."
+
+At a subsequent meeting of the Academy, a letter from Dr. Gaymard, one
+of the Commission to St. Petersburg, was read, in which it was stated,
+while referring to the comparative mortality at different points there,
+that, "The cause of this enormous difference was, that the authorities
+wished to isolate the sick--[Observe this well reader]--and even send
+them out of the city; now the hospital is on a steep mountain, and, to
+get to it, the carriages were obliged to take a long circuit through a
+sandy road, which occupied an hour at least; and if we add to the
+exposure to the air, the fatigue of this removal, and the time which
+elapsed after the invasion of the disease, the deplorable state of the
+patient on his arrival, and the great mortality may be accounted for."
+
+"The progress of the disease was the same as in other places; it was at
+the moment when it arrived at its height, and when, consequently, the
+greatest intercourse [Observe reader!] took place with the sick, that
+the number of attacks wonderfully diminished all at once (_tout a
+coup_), and without any appreciable cause. The points of the city most
+distant from each other were invaded. Numbers of families crowded
+[_entasses_] who had given aid to cholera patients, remained free from
+the disease, while persons isolated in high and healthy situations
+[_usually_ healthy meant of course] were attacked. It especially
+attacked the poorer classes, and those given to spirituous liquors.
+Scarcely twenty persons in easy circumstances were attacked, and even
+the greater part of these had deviated from a regular system."
+
+The inferences drawn, according to a medical journal, from the whole
+of Dr. Gaymard's communication, are--
+
+"1. That the system of sanatory measures, adopted in Russia, did not
+any where stop the disease.
+
+"2. That without entering on the question as to the advantages to be
+derived from a moral influence arising out of sanatory cordons, placed
+round a vast state like France, these measures are to be regarded as
+useless in the interior, in towns, and round houses.
+
+"3. That nothing has been able to obstruct the progressive advance of
+the disease in a direction from India westward.
+
+"4. That the formation of temporary hospitals, and domiciliary succour,
+are the only measures which can alleviate this great scourge."
+
+A letter from Dr. Gaymard to Dr. Keraudren was read at the meeting of
+the Academy, in which it was stated, that in an Hospital at Moscow, in
+which Dr. Delauny was employed from the month of December, 1830, to
+the end of December, 1831, 587 cholera patients, and 860 cases of
+other diseases, were treated--"Not one of the latter was attacked
+with cholera, although the hospital consists of one building, the
+coridors communicating with each other, and the same linen serving
+indiscriminately for all. The attendants did not prove to be more
+liable to attacks. The relatives were suffered to visit their friends
+in hospital, and this step produced the best impression on the
+populace, who remained calm. They can establish at Moscow, that there
+was not the smallest analogy between the cholera and the plague which
+ravaged that city in the reign of Catharine." Dr. Gaymard declares,
+that, having gone to Russia without preconceived ideas on the subject,
+"he is convinced that interior quarrantines, and the isolation of
+houses and of sick in towns, has been accompanied by disastrous
+consequences." Is there yet enough of evidence to shew that this
+disease is positively _not to be made_ communicable from the sick?
+
+Honour still be to those of the profession who, from conscientious and
+honorable motives, have changed from non-contagionists to contagionists
+in regard to this disease; and all that should be demanded is, that
+their _opinions_ may not for one moment be suffered to outweigh, on
+an occasion of vital importance, the great mass of evidence now on
+record quite in accordance with that just stated. One gentleman of
+unquestionable respectability gives as a reason (seemingly his very
+strongest) for a change of opinion, that he has been credibly informed
+that when the cholera broke out on one side of the street in a certain
+village in Russia, a medical man had a barrier put up by which the
+communication with the other side was cut off, and the disease thus,
+happily, prevented from extending. Now, admitting to the full extent the
+appearance of the disease on one side of the village only--a thing by
+the way hitherto as little proved as many others on the contagion side
+of the question--still, if there be any one thing more striking than
+another, in the history of the progress of cholera, it is this very
+circumstance of opposite rows of houses, or of barracks, or bazaars, or
+lines of camp, being free, while the disease raged in the others, and
+without any sort of barricading or restriction of intercourse. If people
+choose to take the trouble to look for the evidence, _plenty_ of such is
+recorded. Now just consider for one moment how this famous Russian story
+stands: had the barricading begun early, the matter would have stood an
+examination a little better; but this man of good intentions never
+thought of his barriers till the one-sided progress of the disease had
+been manifest enough, _without them_:--and then consider how the
+communication had existed between both rows before those barriers were
+put up, and how impossible it was, unless by a file of soldiers, to have
+debarred all communication:--let all this be considered, and probably
+the case will stand at its true value, which is, if I may take the
+liberty of saying so,--just nothing at all. Let us bear in mind the
+circumstance already quoted from the East India records,--of one company
+of the 14th Regiment, at the extreme end of a barrack, escaping the
+disease, almost wholly, while it raged in the other nine; and this
+without a barrier too. But such circumstances are by no means of rare
+occurrence in other diseases arising from deteriorated atmosphere. Mr.
+Wilson, a naval surgeon, has shewn how yellow fever has prevailed _on
+one side_ of a ship, and I have had pointed out to me, by a person who
+lived near it for thirty years, a spot on this our earth where _ague_
+attacks only those inhabiting the houses in one particular line, and
+without any difference as to elevation or other appreciable cause,
+except that the sun's rays do not impinge equally on both ranges in the
+morning and evening.
+
+The advancement of the cause of truth has, no doubt, suffered some check
+in this country, by the announcement that another gentleman of great
+respectability (Mr. Orton) finds his belief as to non-contagion in
+cholera a good deal shaken: but we find that this change has not arisen
+from further personal knowledge of the disease, and if it be from any
+representations regarding occurrences in Europe, connected with cholera,
+we have seen how, from almost all quarters, the evidence lies quite on
+the side of his first opinions. Whatever the change may be owing to, we
+should continue, as in other cases, not to give an undue preference even
+to opinions coming from him, to well authenticated facts--facts, among
+which some particularly strong are still furnished _by himself_, even in
+the second edition of his book:--"It must be admitted that, in a vast
+number of instances in India, those persons [medical men and attendants]
+have suffered no more from the complaint than if they had been attending
+so many wounded men. This is a fact which, however embarrassing to
+the medical inquirer, [for our part we cannot see the _embarrassment_]
+is highly consolatory in a practical point of view, both to him and
+to all whose close intercourse with the sick is imperatively
+required."--(_p. 316_)--"We are therefore forced to the conclusion,
+however, at variance with the common laws of contagion, that in this
+disease,--at least in India, the most intimate intercourse with the sick
+is not, in general, productive of more infection than the average quantity
+throughout the community." (_p. 326_). Let us contrast the statements in
+the following paragraphs:--"For in all its long and various courses, it
+may be traced from place to place, and has never, as far as our information
+extends, started up at distant periods of time and space, leaving any
+considerable intervening tracts of country untouched." (p. 329)--"All
+attempts to trace the epidemic to its origin at a point, appears to have
+failed, and to have shewn that it had not one, but various local sources
+in the level and alluvial, the marshy and jungly tract of country which
+forms the delta of the Ganges, and extends from thence to the
+Burraumposter." (p. 329) Now let us observe what follows regarding the
+particular _regularity_ in the progress of the disease, as just
+mentioned:--"Another instance of irregularity in its course, even in
+those provinces where it appears to have been most regular, is stated
+[now pray observe] in its having skipped from Verdoopatly to a village
+near Palamacotta, leaving a distance of sixty miles at first
+unaffected." (p. 332)!!--This is not the way to obtain proselytes I
+presume.
+
+The situation of our medical brethren at Sunderland is most perplexing,
+and demands the kindest consideration on the part of the country at
+large; but let nothing which has occurred disturb the harmony so
+essential to the general welfare of that place, should their combined
+efforts be hereafter required on any occasion of public calamity. In
+truth both parties may be said to be right--the one in stating that
+the disease in question _is Indian cholera_, because the symptoms are
+precisely similar--the other that it _is not Indian cholera_, because
+it exists in Sunderland, and without having been imported--IN NEITHER
+COUNTRY IS IT COMMUNICABLE FROM ONE PERSON TO ANOTHER, as is now plainly
+shown upon evidence of a nature which will bear any investigation; and
+if blame, on account of injury to commerce, be fairly attributable to
+any, it is to those who, all the world over, pronounced this disease, on
+grounds the most untenable, a disease of a contagious or communicable
+nature. Let the Sunderland Board of Health not imagine that their
+situation is new, for similar odium has fallen _on the first_ who told
+the plain truth, in other instances--at Tortosa, a few years ago, the
+first physician who announced the appearance of the yellow fever, was,
+according to different writers, _stoned to death_; and at Barcelona, in
+1821, a similar fate had well nigh occurred to Dr. Bahi, one of the
+most eminent men there--we need not, I presume, fear that a scene of
+this kind will take place in this country,--though the cries of "no
+cholera!" and "down with Ogden!" have been heard.
+
+One word as to observations regarding the needlessness of discussing the
+contagion question: the truth is, that the cleanliness and comfort of
+the people excepted, you can no more make _other arrangements_ with
+propriety, till this point be settled, than a General can near the enemy
+by whom he is threatened, till it be ascertained whether that enemy be
+cavalry or infantry.
+
+My object in these letters is not to obtrude opinions upon the public,
+being well aware that they cannot be so well entitled as those of many
+others, to attention; but I wish to place before the public, for their
+consideration, a collection of facts which I think are likely to be of
+no small importance at a moment like the present. In addition to the
+many authorities referred to in the foregoing pages, I would beg to
+call the public attention to a paper in the _Windsor Express_ of the
+12th November, by Dr. Fergusson, Inspector General of Hospitals, a
+gentleman of great experience, and who has given the _coup de grace_
+to the opinion of contagion in cholera. Indeed the opinion now seems
+to be virtually abandoned; for, as to quarantine on our ships from
+Sunderland, it is, perhaps, a thing that cannot be avoided, if the main
+consideration be _the expediency of the case_, until an arrangement
+between leading nations takes place. We have seen, in regard to Austria,
+how the matter stands, and our ships from every port in the country
+would be refused admission into foreign ports, if we did not subject
+those from Sunderland to quarantine; which state of things, it is hoped,
+will now be soon put an end to.
+
+
+FINIS.
+
+
+Nichols and Sons, Printers,
+Cranbourn-street, Leicester-square.
+
+
+
+
+WINDSOR:
+PRINTED BY R. OXLEY, AT THE EXPRESS OFFICE.
+
+
+
+
+LETTERS
+
+ON THE
+
+CHOLERA MORBUS,
+
+&c. &c. &c.
+
+
+WINDSOR, FEB. 9, 1832.
+
+Salus populi suprema lex.
+
+
+In writing the following letters, which I have given in the order of
+their respective dates, I was actuated by the state of the public mind
+at the time in regard to the dreaded disease of which they principally
+treat. The two first were addressed to the Editor of the WINDSOR
+EXPRESS, and the third to a Medical Society here, of which I am a
+member. The contemplation of the subject has beguiled many hours of
+sickness and bodily pain, and I now commit the result to the press in a
+more connected form, from the same motives, I believe, that influence
+other writers--zeal in the cause of truth, whatever that may turn out to
+be, and predilection for what has flowed from my own pen, not however
+without the desire and belief, that what I have thus written may prove
+useful in the discussion of a question which has in no small degree
+agitated our three kingdoms, and most deeply interested every civilized
+nation on the face of the earth.
+
+No one, unless he can take it upon him to define the true nature of
+this new malignant Cholera Morbus, can be warranted utterly to deny
+the existence of contagion, but he may at the least be permitted to
+say, that if contagion do exist at all, it must be the weakest in
+its powers of diffusion, and the safest to approach of any that has
+ever yet been known amongst diseases. Amateur physicians from the
+Continent, and from every part of the United Kingdoms, eager and keen
+for Cholera, and more numerous than the patients themselves, beset and
+surrounded the sick in Sunderland with all the fearless self-exposing
+zeal of the missionary character, yet no one could contrive, even in
+the foulest dens of that sea-port, to produce the disease in his own
+person, or to carry it in his saturated clothing to the healthier
+quarters of the town where he himself had his lodging.[17] Surely
+if the disease had been typhus fever, or any other capable of
+contaminating the atmosphere of a sick apartment, or giving out
+infection more directly from the body of a patient, the result must
+have been different; its course, notwithstanding, has been most
+unaccountably and peculiarly its own--slow and sure for the most part,
+the infected wave has rolled on from its tropical origin in the far
+distant east, to the borders of the arctic circle in the west--not
+unfrequently in the face of the strongest winds, as if the blighting
+action of those atmospherical currents had prepared the surface of the
+earth, as well as the human body for the reception and deposition of
+the poison; but so far from always following the stream and line of
+population as has been attempted to be shown, it has often run
+directly counter to both, seldom or never desolating the large cities
+of Europe, like the plague and other true contagions, but rather
+wasting its fury upon encampments of troops, as in the east, or the
+villages and hamlets of thickly peopled rural districts.
+
+[Footnote 17: The numbers were so great (to which I should probably
+have added one had my health permitted) as actually to make gala day in
+Sunderland, and to call forth a public expression of regret at their
+departure.]
+
+That it could have been descried on no other than the above line must be
+self-evident, but to say that it has followed it in the manner that a
+contagious disease ought to have done, in our own country for instance,
+is at variance with the fact. From Sunderland and Newcastle to the south,
+the ways were open, the stream of population dense and continuous, the
+conveyances innumerable, the communications uninterrupted and constant.
+Towards the thinly-peopled north how different the aspect,--townships
+rare, the country often high, cold, and dreary, in many parts of the line
+without inhabitants or the dwellings of man for many miles together,
+yet does the disease suddenly alight at Haddington, a hundred miles off,
+without having touched the towns of Berwick, Dunbar, or any of the
+intermediate places. It is said to have been carried there by vagrant
+paupers from Sunderland. Can this be true? Could any such with the
+disease upon them in any shape, have encountered such a winter journey
+without leaving traces of it in their course?[18] or, if they carried
+it in their clothing, the winds of the hills must have disinfected
+these _fomites_ long before their arrival. No contagionist, however
+unscrupulous and enthusiastic, nor quarantine authority however vigilant,
+can pretend to say how the disease has been introduced at the different
+points of Sunderland, Haddington, and Kirkintulloch,--no more than he can
+tell why it has appeared at Doncaster, Portsmouth, and an infinity of
+other places without spreading. Even now, it lingers at the gates of
+the great open cities of Edinburgh and Glasgow, as if like a malarious
+disease, (which I by no means say that it is) it better found its food
+in the hamlet and the tent, in fact, amongst the inhabitants of ground
+tenements, than in paved towns and stone buildings. We must go farther
+and acknowledge, that for many months past our atmosphere has been
+tainted with the miasm or poison of Cholera Morbus, as manifested by
+unusual cases of the disease almost everywhere, and that these harbingers
+of the pestilence only wanted such an ally as the drunken jubilee at
+Gateshead, or atmospherical conditions and changes of which we know
+nothing, to give it current and power. That the epidemic current of
+disease wherever men exist and congregate together, must, in the first
+instance, resemble the contagious so strongly as to make it impossible to
+distinguish the one from the other, must be self-evident; and it is only
+after the touchstone has been applied, and proof of non-communicability
+been obtained, as at Sunderland, that the impartial observer can be
+enabled to discern the difference.--Still, however, must he be puzzled
+with the inexplicable phenomena of this strange pestilence, but if he
+feel himself at a loss for an argument against contagion, he has only to
+turn to one of the most recent communications from the Central Board of
+Health, where he will find that "That the subsidiary force under Col.
+Adams, which arrived in perfect health _in the neighbourhood_ of a
+village of India infected with Cholera, had seventy cases of the disease
+the night of its arrival, and twenty deaths the next day," as if the
+march under a tropical sun, and the encampment upon malarious ground, or
+beneath a poisoned atmosphere, were all to go for nothing; and that the
+neighbourhood of an infected village, with which it is not stated that
+they held communication, had in that instantaneous manner alone, produced
+the disease. This is surely drawing too largely upon our credulity, and
+practising upon our fears beyond the mark.
+
+[Footnote 18: The Cholera in this country would appear always to travel
+with the pedestrian, and to eschew the stage coach even as an outside
+passenger.]
+
+The anti-contagionist, in acknowledging his ignorance, leaves the
+question open to examination; but the contagionist has solved the
+problem to his own mind, and closed the field of investigation, without,
+however, ceasing to denounce the antagonist who would disturb a
+conclusion which has given him so much contentment.--Let us here
+examine, for a moment, who in this case best befriends his fellow men.
+The latter, in vindication of a principle which he cannot prove, would
+shut the book of enquiry, sacrifice and abandon the sick, (for to this
+it must ever come the moment pestilential contagion is proclaimed,)
+extinguish human sympathy in panic fear, and sever every tie of domestic
+life,--the other would wait for proofs before he proclaimed the ban, and
+even then, with pestilence steaming before him, would doubt whether
+that pestilence could be best extinguished, or whether it would not be
+aggravated into ten-fold virulence, by excommunicating the sick.
+
+In my first letter I have endeavoured to unveil the mystery and fallacy
+of fumigations, for which our government has paid so dear,[19] and
+in place of the chemical disinfectants so much extolled, of the
+applicability of which we know nothing, and which have always failed
+whenever they were depended upon, have recommended the simple and sure
+ones of heat, light, water, and air, with one exception, the elements
+of our forefathers, which combined always with all possible purity of
+atmosphere, person, and habitation, have been found as sure and certain
+in effect as they are practical and easy of application.
+
+[Footnote 19: Parliament voted a reward of L5000 to Doctor Carmichael
+Smith for the discovery.]
+
+Of our quarantine laws I have spoken freely, because I believe their
+present application, in many instances, to be unnecessary cruel and
+mischievous. Too long have they been regarded as an engine of State,
+connected with vested interests and official patronage, against which
+it was unsafe to murmur, however pernicious they might be to commerce,
+or discreditable to a country laying claim to medical knowledge. The
+regulation for preventing the importation of tropical yellow fever,
+(which is altogether a malarious disease of the highest temperature of
+heat and unwholesome locality,) into England or even into Gibraltar,
+stands eminent for absurdity. It has long been denounced by abler pens
+than mine, and I know not how it can be farther exposed, unless we could
+induce the inhabitants of our West India Colonies to enforce the lex
+talionis, and institute quarantines, which they might do with the same
+or better reason, against the importation of pleurises and catarrhs from
+the colder regions of Europe; a practical joke of this kind has been
+known to succeed after reason, argument, and evidence, amounting to the
+most palpable demonstration, had proved of no avail.
+
+While I have thus impugned the authority of boards and missions, and
+establishments, I trust it never can be imputed to me that I could
+have intended any, the smallest personal allusion, to the eminent and
+estimable men of whom they are composed,--all such I utterly disclaim;
+and to the individual, in particular, who presided over our mission to
+Russia, who has been my colleague in the public service, and whose
+friendship I have enjoyed from early youth, during a period of more
+than forty years, I would here, were it the proper place, pay the
+tribute of respect which the usefulness of his life, and excellence
+of his character, deserves.
+
+
+
+
+LETTER I.
+
+TO THE EDITOR OF THE WINDSOR EXPRESS.
+
+
+Sir,--Being well aware of the handsome manner in which you have always
+opened the columns of your liberal journal to correspondents upon every
+subject of public interest, I make no further apology for addressing
+through the WINDSOR EXPRESS, some observations to the inhabitants of
+Windsor and its neighbourhood upon the all-engrossing subject of Cholera
+Morbus.
+
+That pestilence, despite of quarantine laws, boards of health, and
+sanatory regulations, has now avowedly reached our shores, and we may be
+permitted at last to acknowledge the presence of the enemy--to describe
+to the affrighted people the true nature of the terrors with which he is
+clothed--and to point out how these can be best combatted or avoided.
+
+That the seeds of his fury have long been sown amongst us may be proved,
+and will be proved, ere long, by reference to fatal cases of unwonted
+Cholera Morbus appearing, occasionally during the last six months, in
+London, Port Glasgow, Abingdon, Hull, and many other places, which, as
+it did not spread, have been passed unheeded by our health conservators;
+but, had the poison then been sufficiently matured to give it epidemic
+current, would have been blazed forth as imported pestilence. Some one
+or other of the ships constantly arriving from the north of Europe could
+easily have been fixed upon as acting the part of Pandora's box, and
+smugglers from her dispatched instanter to carry the disease into the
+inland quarters of the kingdom. I write in this manner, not from
+petulance, but from the analogy of the yellow fever, where this very
+game I am now describing, has so often been played with success in the
+south of Europe; and will be played off again, for so long as lucrative
+boards of health and gainful quarantine establishments, with extensive
+influence and patronage, shall continue to be resorted to for protection
+against a non-existent--an impossible contagion.
+
+But to the disease in question.--It must have had a spontaneous origin
+somewhere, and that origin has been clearly traced to a populous
+unhealthy town in the East Indies--no infection was ever pretended to
+have been carried there, yet, it devastated with uncontroulable fury,
+extending from district to district, but in the most irregular and
+unaccountable manner, sparing the unwholesome localities in its
+immediate neighbourhood, yet attacking the more salubrious at a
+distance--passing by the most populous towns in its direct course at
+one time, but returning to them in fury at another, staying in none,
+however crowded, yet attacking all some time or other, until almost
+every part of the Indian peninsula had experienced its visitation.
+
+There is an old term, as old as the good old English physician,
+Sydenham--_constitution of the atmosphere_--and to what else than to
+some inscrutable condition of the element in which we live, and breathe,
+and have our being--in fact to an atmospheric poison beyond our ken,
+can we ascribe the terrific gambols of such a destroyer. 'Tis on record,
+that when our armies were serving in the pestilential districts of
+India, hundreds, without any noticeable warning, would be taken ill in
+the course of a single night, and thousands in the course of a few days,
+in one wing of the army, while the other wing, upon different ground,
+and consequently under a different current of atmosphere, although in
+the course of the regular necessary communication between troops in the
+field, would remain perfectly free from the disease. It would then cease
+as suddenly and unaccountably as it began,--attacking, weeks after, the
+previously unscathed division of the army, or not attacking it at all
+at the time, yet returning at a distant interval, when all traces of the
+former epidemic had ceased, and committing the same devastation. Now,
+will any man, not utterly blinded by prejudice, candidly reviewing
+these facts, pretend to say, that this could be a personal contagion,
+cognizable by, and amenable to, any of the known or even supposable laws
+of infection--that the hundreds of the night infected one another, or
+that the thousands of the few days owed their disease to personal
+communication,--as well affect to believe that the African Simoon, which
+prostrates the caravan, and leaves the bones of the traveller to whiten
+in the sandy desert, could be a visitation of imported pestilence.
+
+It may then be asked, have we no protection against this fearful plague?
+No means of warding it off? Certainly none against its visitation! It
+will come--it will go; we can neither keep it out, or retain it, if we
+wished, amongst us. The region of its influence is above us and beyond
+our controul; and we might as well pretend to arrest the influx of the
+swallows in summer, and the woodcocks in the winter season, by cordons
+of troops and quarantine regulations, as by such means to stay the
+influence, of an atmospheric poison; but in our moral courage, in our
+improved civilization, in the perfecting of our medical and health
+police, in the generous charitable spirit of the higher orders,
+assisting the poorer classes of the community, in the better condition
+of those classes themselves, compared with the poor of other countries,
+and in the devoted courage and assistance of the medical profession
+every where, we shall have the best resources. Trusting to these, it has
+been found that, in countries far less favoured than ours, wherever the
+impending pestilence has only threatened a visitation, there the panic
+has been terrible, and people have even died of fear; but when it
+actually arrived, and they were obliged to look it in the face, they
+found, that by putting their trust in what I have just laid down, they
+were in comparative safety; that, the destitute, the uncleanly, above
+all, the intemperate and the debauched, were almost its only victims;
+that the epidemic poison, whatever it might be, had strength to prevail
+only against those who had been previously unnerved by fear, or weakened
+by debauchery; and that moral courage, generous but temperate living,
+and regularity of habits in every respect, proved nearly a certain
+safe-guard. They found further, that quarantine regulations were worse
+than useless--that the gigantic military organization of Russia--the
+rigorous military despotism of Prussia--and the all-searching police of
+Austria, with their walled towns, and guards and gates, and cordons of
+troops, were powerless against this unseen pestilence, and that as soon
+as the quarantine laws were relaxed, and free communication allowed, the
+disease assumed a milder character, and speedily disappeared.
+
+I say, then, confidently, that Cholera Morbus never will commit ravages
+in this country, beyond the bounds of the worst purlieus of society,
+unless it be fostered into infectious, pestilential activity, by the
+absurd, however well-meant, measures of the conservative boards of
+health, such as have been just recommended in what has always been
+esteemed the most influential, best-informed journal of England, I mean
+the QUARTERLY REVIEW. If the writer of the article who recommends the
+enforcement of the ancient quarantine laws in all their strictness, be
+a medical man, he surely ought to know, that wherever human beings are
+confined and congregated together in undue numbers, more especially if
+they be in a state of disease, there the matter of contagion, the
+typhoid principle, the septic (putrefactive) human poison or by what
+other name it may be called, is infallibly generated and extends itself,
+but in its own impure atmosphere only, as a personal infection to those
+who approach it, under the form and features of the prevailing epidemic,
+whatever that may be. Hence we have all heard of contagious pleurisies,
+catarrhs, dysenteries, ulcers, &c., and if the doctrines of that writer
+be received, we shall soon also hear of contagious Cholera Morbus with
+a vengeance. His exhortations would go to shut up the sick from human
+intercourse, to proclaim the ban of society against them, and under the
+most pitiable circumstances of bodily distress, to proscribe them as
+objects of terror and danger, instead of being as they actually are,
+helpless innocuous fellow creatures, calling loudly for our promptest
+succour and commiseration in their utmost need. They would go further to
+array man against his fellow man in all the cruel selfishness of panic
+terror, sever the dearest domestic ties, paralize commerce, suspend
+manufactures, and destroy the subsistance of thousands, and all for the
+gratification of a prejudice which has been proved to be utterly
+baseless in every country of Europe from Archangel to Hamburgh and
+Sunderland. Happily for our country, these measures are now as absurd
+and impracticable as they would be tyrannical and unjust. They could not
+be borne even under the despotic military sway of Prussia and Russia,
+and in this free country it would be impossible to enforce them for a
+single week. The very attempt would at once, throughout the whole land,
+produce confusion and misery incalculable.
+
+I say, on the contrary, throw open their dwellings to the free air
+of heaven, the best cordial and diluent of foul atmosphere in every
+disease--let their fellow townsmen hasten to carry them food,
+fuel, cordials, cloathing, and bedding, speak to them the words of
+consolation, and should they have fear to approach the sick, I take
+it upon me to say, they will be accompanied by any and every medical
+practitioner of the place, who, in their presence, will minister to the
+afflicted, inspire their breath, and perform every other professional
+office of humanity, without the smallest fear or risk of infection; for
+they read the daily records of their profession, where it has been
+proved to them, that in the open but crowded hospitals of Warsaw, under
+the most embarrassing circumstances of warfare and disease, out of a
+hundred medical men, with their assistants and attendants, frequenting
+the sick wards of Cholera, not one took the disease; that, for the sake
+of proving its nature, they even went so far as to clothe themselves
+with the vestments of the dying, to sleep in the beds of the recently
+dead, and to innoculate themselves in every way with the blood and
+fluids of the worst cases, without, in a single instance, producing
+Cholera Morbus.[20] The accounts may not, indeed, cannot be the same
+from every other quarter, for medical men must be as liable to fall
+under the influence of an atmospherical epidemic disease as other
+classes of the community; but the above fact is alone sufficient to
+prove that it cannot be a personal contagion.
+
+[Footnote 20: Vide Medical Gazette.]
+
+Even should that worst of true contagions, the plague of the Levant,
+which every nation is bound to guard against, despite of all our
+precautions, be introduced amongst us, measures better calculated for
+the destruction of a community, could scarcely be devised, than the
+ancient quarantine regulations; for they certainly would convert every
+house proscribed by their mark, into a den and focus of the most
+concentrated pestilential contagion, ensuring fearful retribution upon
+those who had thus so blindly shut them up. The mark alone, besides
+being equivalent to a sentence of death upon all the inmates, would
+effect all this--the sick would be left to die unassisted, unpurified,
+uncleansed amidst their accumulated contagion, and the dead, as has
+happened before, lie unburied or scarcely covered in, till they
+putrified in pestiferous heaps. Most certainly it would be proper and
+beneficial, even a duty, for all who could afford the means, and were
+not detained by public duties, to fly the place, and equally proper for
+the other residents who continued in health, to segregate themselves as
+they best could.--Plenty of free labour amongst those who must ever work
+for their daily bread, would still remain for all municipal purposes,
+and these our rulers, so far from consenting thus to proscribe the sick,
+should employ openly in giving them every succour and aid, under the
+direction and with instructions of safety from a well arranged medical
+police. It would not be difficult to show, that the mortality, during
+the last great plague in London, was increased a hundred fold, by
+following the very measures now recommended in these regulations; and,
+that the barbarous predestinarian Turk, in the very head quarters of the
+plague itself, who despises all regulation, but attends his sick friend
+to the last, never yet brought down upon his country such calamitous
+visitations of pestilence, as enlightened Christian nations have
+inflicted upon themselves, by ill-judged laws. The Turk, to be sure, by
+rejecting all precaution, and admitting, without scruple, infection into
+his ports, sees Constantinople invaded by the plague every year; but,
+when not preposterously interfered with, it passes away, even amongst
+that wretched population, like a common epidemic, without leaving any
+remarkable traces of devastation behind it: and surely to establish and
+make a pest-house of the dwelling of every patient who might be
+discovered or even suspected to be ill, would be most preposterous.
+The writing on the wall would not be more apalling to the people, and
+scarcely less fatal to the object, than the cry of mad dog in the
+streets, with this difference, that when the dog was killed, the scene
+would be closed, but the proscribed patient would remain, even in his
+death and after it, to avenge the wrong.
+
+But sufficient to the day is the evil thereof, the question is now of
+Cholera Morbus; I am willing to meet any objection, and the most obvious
+one that can be offered to me, (if it be not an imported disease) is its
+first appearance in our commercial sea-ports. To this I might answer,
+that it has been hovering over us, making occasional stoops, for the
+last six months, even in the most inland parts of the country; but I
+will waive that advantage, and meet it on plainer grounds of argument
+and truth.--An atmospherical poison must evidently possess the greatest
+influence, where it finds the human race under the most unfavourable
+circumstances of living, habits, locality, and condition. Now, where can
+these be met with so obviously as in our large sea-port towns on the
+lowest levels of the country, and in their crowded alleys, always near
+to the harbour for the shipping? There the disease, if its seeds existed
+in the atmosphere, would be most likely to break out in preference to
+all other situations; and if at the time of its so appearing, ships
+should arrive, as they are constantly doing from all parts of the world,
+whose crews, according to the custom of sailors, plunge instantly into
+drunkenness and debauchery, and present as it were, ready prepared, the
+very subjects the pestilence was waiting for; how easy then, for an
+alarmed or prejudiced board of health to point out the supposed
+importing vessel, and freight her with a cargo of the new pestilence
+from any part of the world they may choose to fix upon. This is no
+imaginary case; it was for long of annual occurrence with respect to the
+yellow fever, both in the West Indies and North America. "There our
+thoughtless intemperate sailors were not only the first to suffer from
+the epidemic, in its course or about to begin, but they were denounced
+as the importers, by the prejudiced vulgar, and the accusation was
+loudly re-echoed even amongst the better informed, by all who wished to
+make themselves believe that pestilence could not be a native product
+of their own atmosphere and habitations."
+
+Before I have done, I feel called upon to say a few words upon the
+efficacy of fumigation as a preservative against Cholera Morbus and
+other infectious diseases. In regard to the first the question is
+settled. In Russia, throughout Germany, and I believe everywhere else in
+Europe, they were productive of no good, they did mischief, and were
+therefore discontinued. This has been verified by reports from the seats
+of the disease everywhere. In regard to other contagions I can speak,
+not without knowledge, at least not without experience, for it was the
+business and the duty of my military life, during a long course of
+years, to see them practised in ships, barracks, hospitals, and
+cantonements, and I can truly declare I never saw contagion in the
+smallest degree arrested by them, and that disease never failed to
+spread, and follow its course unobstructed, and unimpeded by their use.
+In the well-conditioned houses of the affluent where ventilation and
+cleanliness are matters of habit and domestic discipline, they may be a
+harmless plaything during the prevalence of scarlet fever and such like
+infections, or even do a little good by inspiring the attendants with
+confidence, however false, as a preservative against contagion; but in
+the confined dwellings of the poor they are positively mischievous,
+because they cannot be used without shutting out the wholesome
+atmospheric air, and substituting for it a factitious gas, which for
+aught we know, or can know of the nature of the contagious vapour,
+whether acid, alkaline, or anything else, may actually be adding to its
+deleterious principle instead of neutralising it: but in thus striking
+away a prop from the confidence of the poor, I thank God I can furnish
+them with other preservatives and disinfectants, which I take it upon me
+to say, they will find as simple and practicable as they are infallible.
+For the first, the liberal use of cold water and observance of free
+ventilation, with slaked lime to wash the walls, and quick lime when
+they can get it, to purify their dung heaps and necessaries, are among
+the best; but when actually infected, then heat is the only purificator
+yet known of an infected dwelling. Let boiling water be plentifully used
+to every part of the house and article of furniture to which it can be
+made applicable. Let portable iron stoves, filled with ignited charcoal
+only, be placed in the apartment closely shut, and the heat kept up for
+a few hours to any safe degree of not less than 120 deg. Farenheit, and
+let foul infected beds and mattresses be placed in a baker's oven heated
+to the same,[21] and my life for it no infection can after that possibly
+adhere to houses, clothes, or furniture. The living fountain of
+infection from the patient himself, constantly giving out the fresh
+material, cannot of course be so closed, but whether he lives or dies,
+if the above be observed, he will leave no infection behind him.[22]
+
+[Footnote 21: The oven on that account need not lose character with
+bread-eaters, for according to the old adage, Omne vitium per ignem
+excoquitur.]
+
+[Footnote 22: Light too, more especially when assisted by a current
+of atmospheric air, is a true and sure disinfectant, but it is not so
+applicable as heat in the common contagions, from requiring an exposure
+of the infected substances for days together, or even a longer period,
+before it can be made effective.]
+
+It is now time to bring this tedious letter to a close; I shall be
+happy, through the same channel, to give any information, or answer any
+inquiries that may be authenticated by the signature of the writer; but
+anonymous writing of any kind, I shall not consider myself bound to
+notice. Should the dreaded disease spread its ravages throughout our
+population, I may then, at some future early opportunity, trusting to
+your indulgence, trespass again upon your columns with further
+communications on this most interesting subject.
+
+WILLIAM FERGUSSON,
+Inspector-General of Hospitals.
+
+P.S.--Throughout the foregoing letter, I have used the words contagion
+and infection as precisely synonymous terms, meaning communicability
+of disease from one person to another.
+
+_November 9, 1831._
+
+
+
+
+LETTER II.
+
+TO THE EDITOR OF THE WINDSOR EXPRESS.
+
+
+Sir,--In my last letter, I treated of the practicability of guarding
+our country against the now European and Continental disease, malignant
+Cholera Morbus, by quarantine regulations. In the present one, it is
+my intention still in a popular manner to scrutinise more deeply,
+the doctrine of imported contagions; to point out, if I can, those
+true contagions which can be warded off by our own exertions, in
+contradistinction to others which are altogether beyond our controul;
+and here it may be as well to premise, that when I use the term
+epidemic, I mean atmospheric influence, endemic-terrestrial influence,
+or emanation from the soil; and by pestilential, I mean the spread of
+malignant disease without any reference to its source. The terms
+contagion and infection have already been explained.
+
+It must be evident, that legislative precaution can only be made
+applicable to the first of these. The last being unchangeable by human
+authority, are not to be assailed by any decrees we can fulminate
+against them; and if it can be shown, which it has been by our best and
+latest reports, that Cholera Morbus eminently and indisputably belongs
+to that class--that the strictest cordons of armed men could not avail
+to save the towns of the continent, nor the strictest quarantine our
+own shores, from its invasion--it surely must be time to cease those
+vain attempts, to lay down the arms that have proved so useless, and
+turn our undivided attention, now that it has fairly got amongst us,
+to conservative police, and the treatment of the disease; but as the
+contagionists still insist that it was imported from Hamburgh to
+Sunderland, it behoves us to clear away this preliminary difficulty
+before proceeding to other points of the enquiry.
+
+I take it for granted, that ships proceeding from Sunderland to Hamburgh
+could only be colliers, and that according to the custom of such
+vessels, they returned, as they do from the port of London, light; and I
+admit, that on or about the time of their return, Cholera Morbus, under
+the severe form which characterises the Asiatic disease, made its
+appearance in that port, presenting a fair _prima facie_ case of
+imported contagion; but as at the period of its thus breaking out in
+Sunderland, a case equally as fatal and severe shewed itself, according
+to the public accounts, in the upper part of Newcastle, 10 miles off;
+another equally well-marked, in a healthy quarter in Edinburgh; a third,
+not long before in Rugby, in the very centre of the kingdom; and a
+fourth in Sunderland itself, as far back as the month of August, as
+well as many others in different parts of the country;[23] it became
+incumbent on the quarantine authorities, indeed upon all men interested
+in the question, whether contagionists or otherwise, to shew the true
+state of these vessels, as well as of the cases above alluded to, and
+whether the Cholera Morbus had ever been on board of them, either at
+Hamburgh or during the homeward voyage, so as by any possibility they
+could have introduced the disease into an English port. Now will any
+person pretend to say that this has been done, or that it could not have
+been done, or deny that it was a measure, which, if properly executed,
+would have thrown light upon the true character of the disease, not only
+for the information of our own government but of every government in
+Europe; that deputations from the Board of Health, backed and supported
+by all the power and machinery of government, with the suspected ships
+locked up in quarantine, and the persons of the crews actually in their
+power, could not have verified to the very letter, the history of every
+hour and day of their health, from the moment of their arrival at
+Hamburgh till their return into port? This measure was so obviously and
+imperiously called for, as constituting the only rational ground on
+which the importing contagionists could stand, or their opponents meet
+them in argument, that after having waited in vain for the report, I
+raised my own feeble voice in the only department to which I had access,
+urging an immediate, though then late, investigation. No good cause,
+having truth for its basis, could have been so overlooked, and without
+unfairness or illiberality, we are irresistibly forced to the
+conclusion, that had the enquiry (the only one, by the bye, worth
+pursuing, as bearing directly on the question at issue) been pushed to
+the proof, it would have shown the utter nullity of quarantine guards
+against atmospherical pestilence, the thorough baselessness of the
+doctrine of importation.
+
+[Footnote 23: Two of a type most unusual for this country, and the
+Winter Season, have occurred in the vale of the Thames, not far from
+here, which, as they both recovered, and the disease did not spread in
+any way, were very properly allowed to pass without sounding any alarm,
+but the gentleman who attended one of the cases, and had been familiar
+with the disease in India, at once recognized it again, in its principal
+distinguishing features.]
+
+Without entering into the miserable disputes on this subject,
+which, amidst a tissue of fable and prejudice, self-interest and
+misrepresentation, have so often disgraced the medical profession at
+Gibraltar; I shall now proceed to shew, by reference to general causes,
+how baseless and mischievous have been the same doctrines and authority
+when exercised in that part of the British dominions:--
+
+Within the last thirty years, yellow fever has, at least four times,
+invaded the fortress of Gibraltar; during which time also, the
+population of its over-crowded town has more than quadrupled, presenting
+as fair a field, for the generation within, or reception from without,
+of imported pestilence as can well be imagined,--yet plague, the truest
+of all contagions, typhus fever, and other infectious diseases, have
+never prevailed, as far as I know, amongst them. The plague of the
+Levant has not been there, I believe, for 150 years; yet Gibraltar, the
+free port of the Mediterranean, open to every flag, stands directly in
+the course of the only maritime outlet, from its abode and birth-place
+in the east, being in fact, to use the language of the road, the
+house of call for the commerce of all nations coming from the upper
+Mediterranean. Now, can there be a more obvious inference from all this,
+than that the plague, being a true contagion, may be kept off without
+difficulty, by ordinary quarantine precautions; but the other being an
+endemic malarious disease, generated during particular seasons, within
+the garrison itself, and the offspring of its own soil, is altogether
+beyond their controul. The malarious or marsh poison, which in our
+colder latitudes produces common ague, in the warmer, remittent fever,
+and in unfavourable southern localities of Europe, (such as those of
+crowded towns, where the heat has been steadily for some time of an
+intertropical degree)--true yellow fever, which is no more than the
+highest grade of malarious disease; but this has never occurred in
+European towns, unless during the driest seasons--seasons actually
+blighted by drought, when hot withering land winds have destroyed
+surface vegetation, and as in the locality of Gibraltar, have left the
+low-lying becalmed, and leeward town to corrupt without perflation or
+ventilation amidst its own accumulated exhalations. I know not how I
+can better illustrate the situation of Gibraltar in these pestiferous
+seasons, than by a quotation from a report of my own on the Island of
+Guadaloupe, in the year 1816, which, though written without any possible
+reference to the question at issue, has become more apposite than
+anything else I could advance; "all regular currents of wind have the
+effect of dispersing malaria; when this purifying influence is
+with-held, either through the circumstances of season, or when it
+cannot be made to sweep the land on account of the intervention of
+high hills, the consequences are most fatal. The leeward shores of
+Guadaloupe, for a course of nearly 30 miles, under the shelter of a very
+steep ridge of volcanic mountains, never felt the sea breeze, nor any
+breeze but the night land-wind from the mountains; _and though the soil,
+which I have often examined, is a remarkably open, dry and pure one,
+being mostly sand and gravel, altogether, and positively without marsh,
+in the most dangerous places, it is inconceivably pestiferous throughout
+the whole tract, and in no place more so than the bare sandy beach near
+the high-water mark_. The coloured people alone ever venture to inhabit
+it; and when they see strangers tarrying on the shore after nightfall,
+they never fail to warn them of their danger. The same remark holds good
+in regard to the greater part of the leeward coasts of Martinique, _and
+the leeward alluvial bases and recesses[24] of hills, in whatever port
+of the torrid zone they may be placed_, with the exception, probably of
+the immediate sites of towns, where the pavements prevent the rain-water
+being absorbed into the soil, and hold it up to speedy evaporation."
+Now, conceive a populous crowded town placed in this situation, and you
+have exactly what Gibraltar and the other towns of Spain and North
+America, liable to yellow fever, must become in such seasons as I have
+above described, only, that as they grow more populous and crowded, the
+danger must be greater, and its visitations more frequent, unless the
+internal health police be made to keep pace in improvement, with the
+increasing population.
+
+[Footnote 24: The leeward niches and recesses of hills, however dry and
+rocky, become in these seasons of drought, absolute dens of malaria,
+this will be found proven in my reports made especially of the islands
+of Dominique and Trinidad, which may be seen at the Army Medical Board
+Office.]
+
+Now in the name of injured commerce--of the deluded people of
+England--of medical science--of truth and humanity--what occasion can
+their be to institute an expensive quarantine against such a state of
+things as this, which can only be mitigated by domestic health police;
+or why conjure up the unreal phantom of an imported plague, to delude
+the unhappy sufferers, as much in regard to the true nature of the
+disease, as to the measures best calculated for their own preservation;
+when it must be evident that the pestilence has sprung from amidst
+themselves, and that had it been an external contagion in any degree,
+the ordinary quarantine, as in case of the plague, would certainly have
+kept it off; but the question of the contagion of yellow fever, so
+important to commerce and humanity; and which, like the Cholera, has
+more than once been used to alarm the coasts of England, demands yet
+further investigation.
+
+For nearly 40 years have the medical departments of our army and navy
+been furnished with evidence, from beyond the Atlantic, that this
+disease possessed no contagious property whatever. These proofs now lie
+recorded by hundreds in their respective offices, and I take it upon me
+to say, they will not be found contradicted by more than one out of a
+hundred, amongst all the reports from the West Indies, which is as much
+the birth-place of the yellow fever, as Egypt is of the plague: yet, in
+the face of such a mass of evidence, as great or greater probably than
+ever was accumulated upon any medical question, has our Government been
+deluded, to vex commerce with unnecessary restraints, to inflict
+needless cruelties upon commercial communities, (for what cruelty can be
+greater than after destroying their means of subsistence by quarantine
+laws, to pen them up in a den of pestilence, there to perish without
+escape, amidst their own malarious poison?) and to burden the country
+with the costs of expensive quarantine establishments. Surely if these
+departments had done their duty, or will now do it, in so far as to
+furnish our rulers with an abstract of that evidence, with or without
+their own opinions, for opinions are as dust in the balance when put in
+competition with recorded facts, it must be impossible that the delusion
+could be suffered to endure for another year; or should they unluckily
+fail thereby to produce conviction on Government, they can refer to the
+records of commerce, and of our transport departments, which will shew,
+if enquiry be made, that no ship, however deeply infected before she
+left the port, (and all ships were uniformly so infected wherever the
+pestilence raged) ever yet produced, or was able to carry a case of
+yellow fever beyond the boundaries of the tropics, on the homeward
+voyage, and that therefore the stories of conveying it beyond seas to
+Gibraltar, must have been absolutely chimerical. It would indeed, have
+been a work of supererrogation, little called for, for I think I have
+fully shown that Gibraltar must be abundantly qualified to manufacture
+yellow fever for herself.
+
+No less chimerical will be the attempt to shut out Cholera Morbus from
+our shores by quarantine laws, because throughout Europe, ready
+prepared, alarmed, and in arms against it, they have succeeded nowhere;
+whereas, had it been a true contagion and nothing else, they must, with
+ordinary care, have succeeded everywhere; the disease, as if in mockery,
+broke through the cordons of armed men, sweeping over the walls of
+fortified towns, and following its course, even across seas, to the
+shores of Britain; and yet we are still pretending to oppose it with
+these foiled weapons.
+
+We are indeed told, by authority, that its appearance in towns has
+always been coincident with the arrival of barges from inland, or by
+ships from the sea, but if it be not shown at the same time that the
+crews of these barges had been infected with the disease, or if, as at
+Sunderland, no person on board the ships can be identified as having
+introduced it, while we know that the disease actually was there two
+months before, we may well ask at what time of the year barges and ships
+do not arrive in a commercial seaport, or where an epidemic disease,
+during pestiferous seasons could be more likely to break out than where
+the most likely subjects are thrown into the most likely places for its
+explosion, such as newly arrived sailors in an unwholesome seaport,
+where the license of the shore, or the despondency of quarantine
+imprisonment must equally dispose them to become its victims.--Besides,
+what kind of quarantine can we possibly establish with the smallest
+chance of being successful against men who have not got, and never had
+the disease. Merchandise has been declared incapable of conveying the
+infection,[25] and are we to interdict the hulls and rigging of Vessels
+bearing healthy crews, or are we to shut our ports at once against all
+commerce with the North of Europe, and would this prove successful if we
+did? a reference to a familiar epidemic will I think at once answer this
+question.
+
+[Footnote 25: Vide Russian Ukase.]
+
+It is only three months ago that the epidemic Catarrh or Influenza
+spread throughout the land, travelling like the Cholera in India, when
+it went up the monsoon, without regard to the East wind; and what could
+be more likely than the blighting drying process of such a wind, in
+either the one or the other case, to prepare the body for falling under
+the influence of whatever disease might be afloat in the atmosphere.
+In general this passing disease can be distinctly traced, as having
+affected our continental neighbours on the other side of the channel
+before ourselves: now can it be supposed that any quarantine could have
+prevented its first invasion, or arrested its farther progress amongst
+us. How ridiculous would have been the attempt, and yet with the
+experience of all Europe before us, have we been enacting that very part
+with the Cholera Morbus: but further, the same authority which calls for
+the establishment of quarantine in our ports, tells us that neither
+proximity nor contact with the sick,[26] is requisite for the production
+of the disease: now can anything further be wanting beyond this
+admission, to prove that it must be an epidemic atmospherical poison,
+and not a personal contagion, and that, under such circumstances, the
+establishment of quarantine against persons and goods, would manifestly
+be absurd and uncalled for. So fully satisfied has the Austrian
+Government been made by experience, of the futility and cruelty of such
+quarantines, that the Emperor apologises to his subjects for having
+inflicted them. The King of Prussia makes a similar _amende_, and the
+Emperor of Russia convinced by the same experience, abolished or greatly
+relaxed his quarantines several mouths ago.
+
+[Footnote 26: Vide Reports from Russia.]
+
+I am by no means prepared to assert, because I cannot possibly know to
+the contrary, although from the analogy of other disease I do not
+believe it, that the Cholera Morbus may not become contagious under
+certain conditions of the atmosphere, but these cannot be made subject
+to quarantine laws, and I am fully prepared to acknowledge, that as in
+the case of other epidemics, it may be made contagious through defective
+police; but independent of these, it possesses other powers and
+qualities of self-diffusion, which we can neither understand nor
+controul. Such, however, is not the case with that other phantom of
+our quarantine laws--the yellow fever--which can never, under any
+circumstances of atmosphere, without the aid of the last be made a
+contagious disease. I speak thus decisively from my experience of its
+character, as one of the survivors of the St. Domingo war, where, in a
+period of little more than four years, nearly 700 British commissioned
+officers, and 30,000 men were swept away by its virulence; as also from
+subsequent experience, after an interval of 20 years, when in the course
+of time and service, I became principal medical officer of the windward
+and leeward colonies, and in that capacity, surveyed and reported upon
+the whole of these transatlantic possessions.
+
+It was my intention, in these times of panic, to designate to my
+countrymen, in as far as I could, the true essential intrinsic
+contagions of the British Isles, (for such there are, and terrible ones
+too,) which prevail under all circumstances of season, atmosphere, and
+locality, as contradistinguished from the factitious ones, of our own
+creating, and the imaginary or false which often spread epidemically,
+(for there may be an epidemic as well as contagious current of
+disease)[27] although they possess no contagious property whatever; as
+well as the foreign contagions, which if we relax in due precaution,
+may, at any time, be introduced amongst us--but the unreasonable length
+of this letter, for a newspaper communication, warns me to stop.
+
+[Footnote 27: For as long as men congregate together, and every
+supposable degree of communication must of necessity be constantly
+taking place amongst them, to distinguish a spreading epidemic from a
+contagious disease when it first breaks out, must obviously be a matter
+of impossibility; and upon this point the contagionists and their
+antagonists may rail for ever,--the one will see nothing but contagion,
+whether in the dead or the living body, and the other will refer every
+fresh case to atmospheric or terrestrial influence, and both with as
+much apparent reason as they possibly could desire: but the candid
+impartial investigator, who waits to observe the course of the disease
+before coming to a conclusion, and refers to the facts furnished in the
+Cholera Hospitals of Warsaw and the sick quarters of Sunderland, will
+never be deceived in regard to its real nature, nor propagate the
+appalling belief that Cholera Morbus can be made a transportable and
+transmissible contagion.]
+
+I have written thus earnestly, because I deeply feel what I have here
+put down. It is possible I may have made mistakes, but if I have, they
+are not intentional, and I shall be happy to be corrected, for I do
+not live at the head quarters of communication, and my broken health
+prevents my frequenting in person, the field of investigation. In
+candour I ought to declare, that the establishment of quarantine against
+this new and hideous pestilence in the first instance, was the most
+sacred duty of Government, but now that its true character has been made
+known, and the futility of quarantine restrictions demonstrated, I feel
+equally bound, as one of the lieges, to enter my humble protest against
+their continuance.
+
+Should I write again, I shall still adopt the same popular style,
+for no other can be adapted to a newspaper communication, and the
+subject-matter is as interesting to the public, and every head of a
+family, as it can be to the professional reader; and, in thus making
+use of your columns, as I can have no motive but that of ardent
+research after truth, I know that I may always rely upon your
+assistance and co-operation.
+
+WILLIAM FERGUSSON,
+Inspector-General of Hospitals.
+
+_Windsor, Nov. 26, 1831._
+
+
+
+
+LETTER III.
+
+TO THE MEDICAL SOCIETY OF WINDSOR.
+
+
+In this paper it is my intention to treat of the contagious diseases of
+the British Isles, as well as to offer to the Society some observations
+on malignant Cholera Morbus, and the mode of its propagation from the
+tropical regions, where it first arose, to the colder latitudes of
+Europe.
+
+Having already published two letters on this last part of my subject,
+I need not here take up your time in recapitulating their contents, but
+proceed to the consideration of some remaining points of the enquiry;
+which I find I have either overlooked, or not been so explicit in
+illustration, as I otherwise might, had I been addressing a body of
+professional men, instead of the community where I live, with the view
+of _disabusing_ their minds from the effects of irrational panic, and
+opening their eyes to what I deemed true measures of preservation
+against the impending disease; and here I may as well add that when I
+wrote in a newspaper and adopted the style suited to such a channel of
+communication, I knew none so likely to attract the attention of those
+influential men, who might possess the power and the will, when
+disabused of prejudice, to enforce proper laws, instead of running the
+course that had already been imposed upon them, by men interested in the
+upholding of our quarantine establishments, or by prejudiced, however
+well meaning, Boards of Health.
+
+In looking over those letters, I find that the points most open to
+dispute are the course of the disease throughout the Indian peninsula,
+and its progress to the frontiers of Russia; as well as its supposed
+infectious nature, and mode of propagation by human intercourse. In
+regard to the first, there is no contagionist however avowed and
+uncompromising, who does not admit that this erratic disease did not
+often wander from its straight line when the most promising fields lay
+directly before it; or stop short most unaccountably in its progress,
+when the richest harvest of victims seemed actually within its
+jaws--that its course was circuitous when, according to the laws of
+contagion, it ought to have been straight,--that it refused its prey
+at one time, and returned to it at another, in a manner that showed its
+progress was governed by laws which we could neither understand nor
+controul; and if we search the reports of contagionist writers, we
+shall find fully as much, and as strong evidence of its progress being
+independent of human intercourse, as of its being propagated and
+governed by the laws of contagion.[28]
+
+[Footnote 28: Vide Orton, Kennedy, &c.]
+
+To the question, which has so often been triumphantly asked, of its
+progress to the Russian frontiers being conducted by caravans along the
+great highways of human intercourse, and what else than contagion could
+cause it to be so carried? An admirable journalist has already replied
+by asking in his turn, on what other line than amongst the haunts of men
+could we possibly have found, or detected a human disease? And surely
+the question is most pertinent, for in those barbarous regions that
+interpose between Russia and India, where the wolf and the robber hold
+divided alternate sway, and isolated man dares not fix his habitation,
+but must congregate for safety; where else than in those great
+thoroughfares could the disease have found its food; or if beyond these,
+man, almost as ignorant and as savage as the wolf, could have been
+found; who under such circumstances would have recognised, described,
+and testified to its existence? Even at Sunderland, amongst ourselves,
+its existence was long hotly disputed by the learned of the faculty; and
+the fatalist barbarian of these regions would have dismissed the enquiry
+with a prayer of resignation, while he bowed his head to the grave, or
+if his strength permitted, with a stroke of his dagger against the
+impious enquirer who had dared to interfere with the immutable decrees
+of fate. The stories too of its importation into Russia, are exactly the
+same as have come to us from our own Gibraltar, in the case of the
+yellow fever, and may be expected to come from every other quarter where
+a well paid officious quarantine is established to find infection in
+its own defence, and to trace its course in proof of their own services
+and utility. Under such circumstances, this well gotten up drama of
+importation may be rehearsed in every epidemic, adapted in all its parts
+to every place and every disease, they wish to make contagious. First
+will be presented, as at Gibraltar, the actual importers--their course
+traced--the disease identified--its reception denounced, and quarantine
+established; and this will go down until sober minded disinterested men
+become engaged in the enquiry, when it will turn out in all probability,
+that the importers, as at Sunderland, never had the disease--that it was
+in the place long before their arrival--that in its supposed course, it
+either had no existence, or had long ceased--in fact that the
+importation was a fable, the product either of design or an alarmed
+imagination. On this point I shall not here farther dwell, but proceed
+to the still keenly disputed question of its contagious, or
+non-contagious nature.
+
+Amongst all those who have advocated the affirmative side of the
+question, an anonymous writer in the LANCET, of Nov. 19th. seems to me
+the ablest special pleader of his party, and the best informed on the
+subject, which he has grappled with a degree of acumen and power that
+must at once have secured him the victory, in any cause that had truth
+for its basis, or that could have stood by itself; but strong and
+scornful as he is, he has himself furnished the weapons for his own
+defeat, and has only to be correctly quoted in his own words, for answer
+to the most imposing and powerful of his arguments. I take it for
+granted, that no one will give credit to instantaneous infection, at
+first sight, but allow that an interval must elapse between the
+reception of the virus, and explosion of the disease. Kennedy and the
+best of the contagionist authors, have fixed the intervening time from
+two days to a longer uncertain period; yet that writer (in the LANCET)
+proceeds to tell us, in proof of the virulence of the contagion, that
+when twenty healthy reapers went into the harvest field at Swedia, near
+Tripoli, and one of them at mid-day was struck down with the disease, he
+then instantly, as if, instead of being prostrate on the ground, he had
+run a muck for the propagation of Cholera Morbus, infected all the rest,
+so that the whole were down within three hours, and all were dead before
+the following morning.[29]--All this too in the open air. Another writer
+of note relates that when a healthy ship on the outward voyage arrived
+in Madras Roads, her people were seized with Cholera Morbus that very
+morning; but they go further than this, and command us to believe in its
+contagious powers, without sight at all, quoting the report from our
+Commissioners in Russia, where it is officially announced "that neither
+the presence, nor contact of the patient is necessary to communicate the
+disease." Surely in candour we may be allowed to say that when they
+limit their views to contagion alone, they have attributed powers to it,
+which it never did, and never can possess. That some other principle,
+besides their favourite one, must have been in operation, as well in the
+field of Swedia, when it struck down the reapers, as when it blighted
+our armies in the East, for these sudden bursts and explosions of
+pestilence are incompatible with the laws and progress of natural
+contagion,--that if, under a tropical temperature, which dissipates all
+infection, there be contagion in the disease, their must also be other
+powers of diffusion hitherto inscrutable, incomprehensible, and
+uncontroulable,--that their doctrine of contagion exclusively, is
+superficial narrow, and intolerant, and their arguments in support of
+it, no more than a delusion of prejudice, a piece of consummate special
+pleading to make the worse appear the better reason.[30]
+
+[Footnote 29: The precise words are "20 peasants of Swedia, robust,
+vigorous, and in the flower of life, were labouring at the harvest work,
+when on the 9th. of July, at noon, one was suddenly attacked, and the
+others in a short time showed symptoms of the disorder. In three hours,
+the entire band was exhausted; before sunset many had ceased to live,
+and by the morrow there was no survivor."]
+
+[Footnote 30: The remainder of the paper, as presented to the Society,
+treated of Typhus fever, and other matter, that had no reference to the
+disease in question.]
+
+Before concluding these observations, I would wish to make a few remarks
+upon some points of the enquiry which have been either too cursorily
+passed over, or not noticed at all; and first of its supposed attraction
+for, and adherence to the lines and courses of rivers whether navigable
+or otherwise. I do not think this quality of the disease has been
+assumed on grounds sufficient to justify anything like an exclusive
+preference. Along these lines, no doubt, it has very frequently been
+found, because a malarious, a terrestrial, a contagious, or indeed any
+other disease, would for many reasons, best prevail on the lowest levels
+of the country, or the deepest lines on its surface, like the vallies of
+rivers, provided the food on which it fed--population--there abounded.
+It would be difficult almost anywhere to point out a populous city
+unconnected with the sea, rivers, or canals, the water population of
+which, from their habits of life and occupations, everywhere crowded,
+dirty, careless, and exposed, must always afford ready materials for
+any epidemic to work upon, and this may have given currency to the
+prevailing opinion; but I rather believe, when enquiry comes to be made,
+it will be found that the worst ravages of Cholera Morbus have been
+experienced in the great level open plains of Upper Germany, and the
+boundless jungly districts of India, remote from, or at least
+unconnected with water communication, denoting thereby atmospheric
+influence and agency, rather than any other.
+
+Another consideration of some importance is the burial of the dead,
+which according to published reports, has in some places been enforced
+in so hurried a manner as deeply to wound the feelings of surviving
+relatives, and in others to give rise to the horrid suspicion of
+premature interment. Can this have been necessary in any disease, even
+allowing it to be contagious, or was it wise and dignified in the
+medical profession to make this concession to popular prejudice, at all
+times when excited, so unmanageable and troublesome. Although we cannot
+analyse the matter of contagion, we surely know enough of it to feel
+assured, that it must be a production and exhalation from the living
+body, arising out of certain processes going on there, in other words
+out of the disease itself, which disease must cease along with the life
+of the patient, and the exhalation be furnished no longer--that during
+life it was sublimed, so as to leave the body and become diffused around
+through the agency of the animal heat, created by the functions of
+respiration and circulation of the blood, which being foreclosed and the
+supplies cut off, all that remained of it floating before death in the
+atmosphere, must be condensed upon the cold corpse and lie harmless.[31]
+It must also be evident that when putrefaction begins, no production of
+what belonged to the living body can remain unchanged, but must undergo
+the transformation in form, substance and quality, ordained for all
+things; for putrefaction, although it may possibly produce a disease
+after its own character, is not pestilence, nor even compatible with it
+in the case of specific diseases.
+
+[Footnote 31: Even when a living product, we are authorised to believe,
+from observations made upon the plague, that it cannot be propelled to
+a greater distance than a few feet from the body of the patient--that it
+is heavier than common air, settling down in a remarkable manner upon
+the sick bed, and saturating the lower strata of the atmosphere in the
+sick apartment.]
+
+The puerile stories, therefore, of infection being taken from following
+a coffined corpse to the grave, without reference to the state of
+grief, fear, and fatigue, not improbably, of drunkenness, in the
+mourners, must be unworthy of attention. I am no friend to the absurdly
+long interval which in this country is allowed to elapse,[32] even in
+the hottest weather, between death and burial; but still more do I
+deprecate the indecent haste which would give sanction to panic, and
+incur the risk or even the suspicion of interment before dissolution.
+In regard to separate burying grounds, should the disease come to
+spread, I am sure no one will expect, after what has just been said,
+that I should attempt to argue the question seriously, nor enter a
+protest against the further gratuitous wrong of withholding the rites
+of sepulture in consecrated ground from the victims of an epidemic or
+even a contagious disease.--Nothing could warrant such a measure but
+want of room in the ordinary churchyards, where police should never be
+allowed to interfere with the rights and feelings or property, of the
+living, unless to ensure the privacy of funerals; nothing being so
+appalling to an alarmed people as the spectacle of death in their
+streets, or so trying to the health of the mourners, as tedious funeral
+ceremonies amidst a crowd of people.
+
+[Footnote 32: After sending these letters to the press, I saw in the
+public prints that the Bishop of the Diocese had forbidden the funerals
+of the dead from Cholera to be received in the churches of London.
+Instead of thus forbidding a part, better have the whole of the service
+performed there (where crowds do not come) under cover from the weather,
+than in the open churchyard, where the mourners uncovered, are exposed
+in every way to damp and cold, and the jostling of the mob; better still
+have all the service deemed necessary, performed at the residence of
+the deceased.]
+
+Were I called upon to criticise what I have now written, and to
+review all that I have seen, read, and heard on the subject, I would
+conscientiously declare that the importation of Cholera Morbus into
+England or anywhere else, had been clearly negatived, and its
+non-contagious character almost as clearly established, always however
+with the proviso and exception of the possibility of its being made a
+temporary contingent contagion, amidst filth and poverty, and impurity
+of atmosphere, from overcrowding and accumulation of sick, but neither
+transmissible nor transportable out of its own locality, through human
+intercourse. As the disease, like all the other great plagues, which at
+various periods have desolated the earth, evidently came from the east,
+it would be most desirable in pursuing our investigation, to have a
+clear knowledge of the mode of its introduction into Russia on the
+eastern boundary of Europe. Unfortunately we can place no dependence
+upon the reports that have been published to prove importation there,
+which are lame and contradictory, although coming from the avowed
+partizans of contagion; but even had they been better gotten up, we
+could not, unless they had been confirmed by the experience of other
+nations, have received them with implicit reliance.
+
+The Russian Employe of the provinces, _mendacior Parthis_, not from
+greater innate moral depravity than others, but from the corruptions
+of a despotic government which compel him to live under the rod of a
+master, amidst a superstitious barbarous population, whose dangerous
+prejudices he dare not offend, can only give utterance to what his
+tyrants command. Even at the more civilized capital of Petersburgh, the
+mob rose in arms to murder the foreign physicians when they did not act
+according to their liking. Could the truth then be heard on such a
+field, or what native officer would venture to impugn the authority
+of his rulers, proclaiming contagion? If he did, he must cease to live
+in the official sense of the word. Throughout Europe, from east to
+west, the disease has followed its own route according to its own
+incomprehensible laws, despite of every obstacle and precaution. We have
+the authority of our own Central Board for believing that the disease
+cannot be conveyed by merchandize of any kind, and that of our mission
+to Russia for greatly doubting whether it can adhere to personal
+clothing or bedding; and will it be pretended that human beings,
+labouring under such a distemper in any form, could have been the
+vehicles of spreading it in a straight line for thousands of miles
+throughout civilized nations, armed and prepared to defend themselves
+against its inroads,--they tried, but in vain. We, too, may strive to
+discover the demon of the pestilence amidst the clouds of the climate,
+or the winds of Heaven. He remains hidden to our view; and until better
+revealed, it only remains for us to exercise towards our fellow men
+those duties which humanity prompts, civilization teaches, and religion
+enjoins.
+
+
+
+
+POSTSCRIPT.
+
+
+My friend, Doctor Stanford, of the Medical Staff, now settled here, has
+given me the following valuable information, which my own observation
+confirms, regarding the agency of panic, in promoting the diffusion of
+epidemic disease. He happened to be serving with part of the British
+army, at Cadiz, when an eruption of yellow fever took place there, in
+the autumn of 1813, and as usually happens amongst medical men, the
+first time they have seen that fever, some of them were staunch
+contagionists, and impressed that belief upon the corps to which they
+belonged. In all these the disease was most fatal to great numbers. The
+men being half dead with fear, before they were taken ill, speedily
+became its victims, to the great terror and danger of their surviving
+comrades; but in the other regiments, where no alarm had been sounded,
+the soldiers took the chances of the epidemic with the same steady
+courage they would have faced the bullets of the enemy, in the lottery
+of battle; escaping an attack for the most part altogether, or if
+seized, recovering from it in a large proportion. From this picture let
+us take a lesson, in case the impending epidemic should ever come to
+spread in the populous towns of England, and the cry of contagion be
+proclaimed in their streets. The very word will spread terror and dismay
+throughout the people, causing multitudes to be infected, who would
+otherwise, in all probability, have escaped an attack, and afterwards
+consign them to death in despair, when they find themselves the marked
+and fated victims of a new plague. Whatever they see around them, must
+confirm and aggravate their despair, for desertion and excommunication
+in all dangerous diseases, too certainly seal the fate of the patient.
+It will be vain to tell them that hireling attendance has been
+provided,--the life of the Choleraic depends upon the instant aid--the
+able bodied willing aid of affectionate friends, who will devote
+themselves to the task, and persevere indefatigably to the last. If
+these be driven from his bed, his last stay is gone, for without their
+active co-operation the best prescription of the physician is only so
+much waste paper. What, let me ask, must have been the fate of the
+patient, and what the consequent panic, if the case of Cholera that
+occurred in London, a month ago at the Barracks of the Foot Guards,
+had been proclaimed, and treated as a contagion? The poor fellow was
+promptly surrounded by his fearless comrades, who with their kind hands
+recalled and preserved the vital heat on the surface, by persevering in
+the affectionate duty of rubbing him for many hours; but had the Medical
+Staff of the regiment been true contagionists, they must, as in duty
+bound, have commanded, and compelled every one of them to fly the
+infection. It depended upon them, to have spread around a far wilder
+and more dangerous contagion than that of Cholera Morbus, or any other
+disease,--the contagion of fear--and from what occurred at Cadiz, as
+above related, it is to be hoped our medical men will now see how much
+they will have it in their power, when Cholera comes, to pronounce, or
+to withhold sentence of desolation upon a community. The word Contagion
+will be the word of doom, for then the healthy will fly their homes,
+and the sick be deserted; but a countenance and bearing, devoid of that
+groundless fear, will at once command the aid, and inspire the hopes
+that are powerful to save in the most desperate diseases.
+
+It is stated, in a Scotch newspaper, that two poor travellers, passing
+from Kirkintulloch to Falkirk, ran the risque of being stoned to death
+by the populace of the latter place, and were saved from the immolation
+only by escaping into a house; and in an Irish one, that some
+shipwrecked sailors incurred a similar danger. Such barbarities
+must, in the nature of things, be practised every where under a reign
+of terror, however humane or christianized the people may be--even the
+fatalism of the Turk would not be proof against it. In Spain they have
+been enacted in all their horrors (thanks to the quarantine laws) upon
+the unfortunate victims of yellow fever;[33] and we shall soon see them
+repeated amongst ourselves, unless the plain truth be promulgated by
+authority to the people. Let them be told if such be the pleasure of
+our rulers, (for it is not worth while disputing the point), that
+Cholera Morbus is a contagion, but of so safe a nature in regard to
+communicability, that not one in a hundred, or even a thousand, take
+the disease,--that in this country, besides being a transient passing
+disease, which according to certain laws and peculiarities of its own,
+will assuredly take its departure in no long time; it is limited almost
+always to particular spots and localities--that it is in their own
+power, while it remains, to correct the infectious atmosphere of these
+spots, by attention to health police--that they may fearlessly approach
+their sick friends with impunity, for that the danger resides in the
+above atmosphere, and not in the person of the patient; and that in all
+situations they may defy it, for as long as they observe sobriety of
+life and regularity of habits. Thus will public confidence be restored,
+and thus be verified the homely adage of, "honesty, in all human
+affairs, being ever the best policy"; for the concealment, or perversion
+of the truth, however much it may be made to serve the purposes of the
+passing day, can never ultimately promote the ends of good government
+and true humanity, but must lead, sooner or later, to the exposure of
+the delusion, or what would be far worse, to the perpetuation of error
+and prejudice, and grossest abuse of the people, in regard to those
+interests committed to our charge.
+
+[Footnote 33: Vide O'Halloran, upon the Yellow Fever in Spain.]
+
+       *       *       *       *       *
+
+Doctor Henry, of Manchester, has, in a late paper, published some most
+interesting experiments, upon the disinfecting power of heat. He found
+that the vaccine virus was deprived of its infecting quality, at 140 deg.
+of Farenheit, and that the contagions of Scarlatina, and Typhus fever,
+from fomites, were certainly dissipated and destroyed, at the dry heat
+of boiling water. In regard to these last, he might surely have ventured
+to fix the standard of safety at a greatly lower temperature; for if the
+grosser vaccine matter could be rendered inert at 140 deg., there can be
+little doubt of the subtile gaseous emanations, which constitute the
+aerial contagions, being dissipated by the same agent, at an inferior
+degree. In the absence of direct experiment, we may venture to infer,
+that 120 deg. would suffice, to nullify these last. Such, at least, has
+been the belief of those, who have been employed to purify ships,
+barracks, and hospitals, from contagion, and I should think it must have
+been founded on experience.[34]
+
+[Footnote 34: As far back as the years 1796-7-8, this fact was familiar
+to us in the St. Domingo war, only we were satisfied with a minimum heat
+of 120 deg., from a belief that a temperature of that height, as it
+coagulated the ova of insects (the cock roach for instance), and was
+otherwise incompatible with insect life, would avail to dissipate
+contagion.]
+
+He does not treat of the disinfecting property of light, although such
+an agent was well worthy of his notice; for the power, which in closely
+stopped bottles can deprive Cayenne Pepper of its sting--render our
+Prussic Acid as harmless as cream, and convert the strongest medicinal
+powders into so much powder of _post_, can also avail to destroy the
+matter and principle of Contagion. In fact, no other is used for
+purifying goods, at our Lazzarettoes, where suspected articles of
+merchandise, after some nugatory fumigations, are simply exposed to
+light and air with such certain effect, that there is not, I believe,
+in this country, any record of infection being propagated from them
+afterwards. The experiments of Doctor Henry are as simple and beautiful
+in themselves, as they promise to be useful and important, for now even
+the horrible contagion of hospital gangrene would appear to be under
+the controul of the pure agent he has been describing; and the principle
+now established of light and heat, the grand vivifying powers of the
+creation, being the sure and true preservers of the creature, man, from
+the poisons generated even by himself, and otherwise around him, calls
+for our admiration and gratitude, as shewing that these agents and
+emanations of Almighty power can be made, in the hands of the practical
+philosopher, to serve the purposes of domestic science, and in as far
+as we can see, to fulfil, at least in that respect, the best intentions
+of the Creator.
+
+
+WINDSOR:
+PRINTED RY R. OXLEY, AT THE EXPRESS OFFICE.
+
+
+
+
+Transcriber's Note
+
+Spelling variations have been retained in this ebook to match the
+original text, e.g., quarrantines & quarantines, shew & show,
+Farrell & Farrel, control & controul, employe & employe, coridors,
+land wind & land-wind, reccommended & recommended, versts & wersts,
+clothing & cloathing, apalling & appalling, prima facie & prima facie,
+alledged, and par metier & par metier.
+
+Placement of footnote markers has been regularized to be located
+outside of neighboring punctuation.
+
+The following typographical corrections have been made to this text:
+
+
+PART I
+
+   Foot 1: Removed stray comma (As medical men in this Country employ)
+   Page 6: Changed possesss to possess (still do not possess)
+  Page 13: Removed superfluous quote marks (Petersburg;--this gentleman)
+  Page 19: Removed duplicate word 'of' (has become a magazine of)
+  Page 19: Changed . to , (the cause of cholera,)
+  Page 21: Changed , to . (&c., in the office)
+  Page 22: Changed Mauritus to Mauritius (at the Mauritius before)
+  Page 22: Added . to Dr (Dr. Hawkins admits)
+  Page 24: Changed . to , (Martin M'Neal[6],)
+  Page 24: Changed knowlege to knowledge (any knowledge himself)
+  Page 26: Changed circustances to circumstances (two circumstances)
+  Page 28: Removed duplicate word 'a' (at least for a time)
+  Page 32: Changed intercouse to intercourse (or great intercourse)
+  Page 33: Added . to Dr (and Dr. Hawkins)
+  Foot 11: Changed importan to important (in the important)
+  Page 39: Moved misplaced comma (at Barcelonetta, the)
+  Page 45: Changed teminated to terminated (terminated favourably)
+  Page 46: Removed stray hyphen (he persists in giving)
+  Page 50: Moved misplaced period (this calamity (the cholera).)
+  Page 51: Changed caon to 'ca on' (toute ca on trouve)
+  Page 53: Deleted superfluous end-quotes (took place.)
+  Page 53: Changed confied to confined (been confined to her bed)
+  Page 53: Changed macron to aigu accent (_employes_ attached)
+  Page 53: Changed authorties to authorities (authorities wished)
+  Page 54: Changed dimished to diminished (diminished all at once)
+  Page 54: Changed a to a (tout a coup)
+  Page 54: Changed entasses to entasses (crowded [_entasses_])
+  Page 54: Changed Franec to France (state like France)
+  Page 56: Added missing end-quotes (to the Burraumposter.")
+  Page 57: Changed em-dash to hyphen (Leicester-square)
+
+PART II
+
+  Page 11: Changed typhoi'd to typhoid (the typhoid principle)
+  Page 15: Changed affluuent to affluent (houses of the affluent)
+  Page 17: Changed 'in' to 'In' (In my last letter)
+  Page 21: Changed absorded to absorbed (absorbed into the soil)
+  Page 22: Changed 'in' to 'it' (would certainly have kept it)
+  Page 24: Changed procees to process (drying process)
+  Page 26: Changed saered to sacred (the most sacred duty)
+  Page 30: Added missing ending punctuation (following morning.)
+  Page 31: Removed duplicate word always (always afford)
+
+
+
+
+
+End of the Project Gutenberg EBook of Letters on the Cholera Morbus., by
+James Gillkrest and William Fergusson
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