[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.
[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.
[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 haveescaped the noticeof the commission.
[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 haveescaped the noticeof 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 thetreatmentof cholera—it is not truethat they have reccommendedspecifics, 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 judiciouslyPt_1[Pg 48]point at the application ofdryheat, 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.
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 intwoways, or in one way, tallied with the facts? We were desired to believe that in India, Persia, &c., "the contagiontravelled," 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) forinsusceptibilityon 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 numbersoughtto 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 vainPt_1[Pg 49]speculations.Nowthe matter may be reduced to the simple rules of arithmetic, viz.:—if, as "contagionistspar 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 thisrusehas 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 mostfoully and unjustlyupon 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 oftheship (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 ofexpecting the arrivalof 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 alwaysshirked; 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, thatit has travelledto such or such a place,or has arrivedat such or such places, for it isthe causeof 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 thiscasse-tête, thebest guesswill 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 purchasedPt_1[Pg 50](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.
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 moonis notmade of green cheese, but one must provewhat it ismade 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.
Pt_1[Pg 51]"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]
[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.
[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 idleopinionsandreportsare 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'articleHomme; 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 admittingfactsfor 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 ourPt_1[Pg 52]yielding with ill-timed complaisance toany authoritywithout observing this very necessary preliminary.
One word, and with all due respect, before closing, on the subject of Dr. James Johnson's "contingentcontagion," which, though occurring in some diseases, and extremelyfeasiblein 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 ofplaces, 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 oftCorrupts 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;Pt_1[Pg 53]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'sbest endeavourshave not been ableto make itcommunicable by any manner of means.
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 andcommunicabilityof 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 atIganie," 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 atIganie, 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 differentemployésattached 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 getPt_1[Pg 54]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 [usuallyhealthy 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 positivelynot to be madecommunicable from the sick?
Honour still be to those of the profession who, from conscientious and honorable motives, have changed from non-contagionists to contagionists inPt_1[Pg 55]regard to this disease; and all that should be demanded is, that theiropinionsmay 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,plentyof 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 prevailedon one sideof 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 whereagueattacks 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 whichPt_1[Pg 56]some particularly strong are still furnishedby 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 theembarrassment] 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 particularregularityin 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 questionis Indian cholera, because the symptoms are precisely similar—the other that itis 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 fallenon the firstwho 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 mostPt_1[Pg 57]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 makeother arrangementswith 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 theWindsor Expressof the 12th November, by Dr. Fergusson, Inspector General of Hospitals, a gentleman of great experience, and who has given thecoup de graceto 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 bethe 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.
Pt_2[Pg 3]
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 theWindsor 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.
Pt_2[Pg 4]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.
[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.
[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 mustPt_2[Pg 5]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 thesefomiteslong 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 changesPt_2[Pg 6]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 healthin the neighbourhoodof 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.
[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.
[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 pestilencePt_2[Pg 7]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.
[19]Parliament voted a reward of £5000 to Doctor Carmichael Smith for the discovery.
[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 thatPt_2[Pg 8]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.
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 theWindsor 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 diseasePt_2[Pg 9]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 divisionPt_2[Pg 10]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 almostPt_2[Pg 11]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 theQuarterly 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 thePt_2[Pg 12]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,Pt_2[Pg 13]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.