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 bothnon-epidemic cholera and gastrointestinal diseases that mimickedcholera. The term "cholera morbus" is found in older references but isnot in current scientific use. The condition "cholera morbus" is nowreferred to as "acute gastroenteritis. "

Spelling variations and inconsistencies have been retained to match theoriginal text. Only such cases which strongly indicated the presenceof inadvertent typographical error have been corrected; a detailed listof these corrections can be found at the end of this text. 

This ebook consists of two separate parts. The first from 1831 ("LETTERSON THE CHOLERA MORBUS. ") contains Letters I-X; and the second from 1832("LETTERS ON THE CHOLERA MORBUS, &c. &c. &c. ") contains Letters I-IIIand 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 BETRANSMITTED FROM THE PERSONS OF THOSE LABOURING UNDER IT TO OTHERINDIVIDUALS, BY CONTACT--THROUGH THE MEDIUM OF INANIMATE SUBSTANCES--ORTHROUGH THE MEDIUM OF THE ATMOSPHERE; AND THAT ALL RESTRICTIONS, BYCORDONS 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 ofthe World. _

LONDON:

NICHOLS AND SONS, PRINTERS, EARL'S COURT, CRANBOURN STREET LEICESTERSQUARE. 

1831. 

The first series of these Letters, consisting of five, appeared in themonths of September and October of the present year; five others, written in a more popular form, were inserted in a Newspaper from timeto time, in the course of this month:--a few additions and alterations, preparatory to their appearance in the shape of a pamphlet, have beenmade. 

If, at a moment like the present, they prove in any manner useful to thepublic, 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 todisorganise society wherever it shows itself, as it causes thedestruction of human life on an extensive scale, or as it crampscommerce, and causes vast expense in the maintenance of quarantine andcordon establishments, no subject can surely be, at this moment, ofdeeper interest. It is to be regretted, indeed, that, in this country, political questions (of great magnitude certainly), should haveprevented the legislature, and society at large, from examining, withdue severity, all the data connected with cholera, in order to avert, should we unhappily be afflicted with an epidemic visitation of thisdisease, that state of confusion, bordering on anarchy, which we findhas occurred in some of those countries where it has this year appeared. 

Were this letter intended for the eyes of medical men only, it wouldbe unnecessary to say that, during epidemics, the safety of thousandsrests upon the solution of these simple questions:--Is the diseasecommunicable to a healthy person, from the body of another personlabouring under it, either _directly_, by touching him, or _indirectly_, by touching any substance (as clothes, &c. ) which might have been incontact with him, or by inhaling the air about his person, either duringhis illness or after death?--Or is it, on the other hand, a diseasewith the appearance and progress of which sick persons, individuallyor collectively, have no influence, the sole cause of its presencedepending on unknown states of the atmosphere, or on terrestrialemanations, or on a principle, _aura_, or whatever else it may becalled, elicited under certain circumstances, from both the earth andair?--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 oftheir physicians for the production of diseases by a deterioratedatmosphere:--much confusion would certainly be avoided by this adoptionof terms. [1] Now it is evident, that incalculable mischief must arisewhen a community acts upon erroneous decisions on the above questions;for, if we proceed in our measures on the principle of the disease notbeing either directly or indirectly transmissible, and that it should, nevertheless, be so in fact, we shall consign many to the grave, bynot advising measures of separation between those in health, andthe persons, clothes, &c. , of the sick. On the other hand, shouldgovernments and the heads of families, act on the principle of thedisease being transmissible from person to person, while the fact maybe, that the disease is produced in each person by his breathing thedeteriorated atmosphere of a certain limited surface, the calamity inthis case must be very great; for, as has happened on the Continentlately, cordons may be established to prevent flight, _when flight, incertain cases, would seem to be the only means of safety to many_; andfamilies, under a false impression, may be induced to shut themselvesup 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 rigidinvestigation of these subjects. It is matter of general regret, Ibelieve, among medical men, that hitherto the question of cholera hasnot always been handled in this country with due impartiality. Evensome honest men, from erroneous views as to what they consider "thesafe side" of the question, and forgetting that the safe side canonly 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 goodpeople of the quarantine have been stoutly at work in making out thatprecautions are as necessary in the cholera as in plague. Meantime ourmerchants, and indeed the whole nation, are filled with astonishment, on discovering that neighbouring states enforce a quarantine againstships from the British dominions, when those states find that cases ofdisease are reported to them as occurring among us, resembling moreor less those which we have so loudly, and I must add prematurely, declared to be transmissible. It is quite true that, however decidedlythe question may be set at rest in this country, our commerce, shouldwe act upon the principle, of the disease not being transmissible, would be subject to vexatious measures, at least for a time, on thepart of other states; but let England take the lead in instituting afull inquiry into the whole subject, by a Committee of the House ofCommons; and if the question be decided against quarantines andcordons by that body, other countries will quickly follow the example, and explode them as being much worse than useless, as far as theirapplication to cholera may be concerned. It is very remarkable how, inthese matters, one country shapes its course by what seems to be therule in others; and, as far as the point merely affects commerce, without regard to ulterior considerations, it is not very surprisingthat this should be the case; but it is not till an epidemic shallhave actually made its appearance among us, that the consequences ofthe temporising, or the precipitation, of medical men can appear inall their horrors. Let no man hesitate to retract an opinion alreadydeclared, on a question of the highest importance to society, if heshould see good reason for doing so, after a patient and unbiassedreconsideration of all the facts. We are bound, in every way, to actwith good faith towards the public, and erroneous views, in whichthat public is concerned, ought to be declared as soon as discovered. To show how erroneous some of the data are from which people arelikely to have drawn conclusions, is the main cause of my wish tooccupy the attention of the public; and in doing this, it is certainlynot my wish to give offence to respectable persons, though I may haveoccasion to notice their errors or omissions. 

Previous to proceeding to the consideration of other points, it may beobserved, that all doubt is at an end as to the identity of the Indian, Russian, Prussian, and Austrian epidemic cholera; no greater differencebeing observed in the grades of the disease in any two of thosecountries, than is to be found at different times, or in differentplaces, in each of them respectively. At the risk of being considered avery incompetent judge, if nothing worse, I shall not hesitate to say, that if the same assemblage, or grouping of symptoms be admitted asconstituting the same disease, it may at any time be established, to theentire satisfaction of an unprejudiced tribunal, that cases of cholera, not unfrequently proving fatal, and corresponding in every particular tothe average of cases as they have appeared in the above countries, havebeen frequently remarked as occurring in other countries includingEngland; and yet no cordon or quarantine regulations, on the presumptionof the disease spreading by "contagion. " For my own part, withoutreferring to events out of Europe, I have been long quite familiar, andI know several others who are equally so, with cholera, in which aperfect similarity to the symptoms of the Indian or Russian cholera hasexisted: the collapse--the deadly coldness with a clammy skin--theirritability of the stomach, and prodigious discharge from the bowelsof an opaque serous fluid (untinged with bile in the slightestdegree)--with a corresponding shrinking of flesh and integuments--thepulseless and livid extremities--the ghastly aspect of countenance andsinking of the eyes--the restlessness so great, that the patient has notbeen able to remain for a moment in any one position--yet, with allthis, nobody dreamt of the disease being communicable; no precautionswere taken on those occasions "to prevent the spreading of the disease, "and no epidemics followed. In the _Glasgow Herald_ of the 5th ult. , willbe found a paper by Mr. Marshall, (a gentleman who seems to reason withgreat acuteness), which illustrates this part of our subject. Thisgentleman appears to have had a good deal of experience in Ceylon whenthe disease raged there, and I shall have occasion to refer hereafter tohis statements, which I consider of great value. Nobody can be so absurdas to expect, that in the instances to which I refer, _all_ the symptomswhich have ever been enumerated, should have occurred in each case; forneither in India nor any-where else could all the grave symptoms bepossibly united in any one case; for instance, great retching, and aprofuse serous discharge from the bowels, have very commonly occurredwhere the disease has terminated fatally: yet it is not less certain, that even in the epidemics of the same year, death has often taken placein India more speedily where the stomach and bowels have been but littleaffected, or not at all. To those who give the subject of cholera allthe attention which it merits, the consideration of some of those caseswhich have, within the last few weeks, appeared in the journals of thiscountry, cannot fail to prove of high interest, and must inspire thepublic with confidence, inasmuch as they show, _beyond all doubt_, thatthe disease called cholera, as it has appeared in this country, andhowever perfectly its symptoms may resemble the epidemic cholera ofother countries, _is not_ communicable. On some of those cases soproperly placed before the public, I shall perhaps be soon able to offera few remarks: meanwhile, I shall here give the abstract of a case, thedetails of which have not as yet, I believe, appeared, and which mustgreatly strengthen people in their opinion, that these cholera cases, however formidable the symptoms, and though they sometimes end rapidlyin death, still do not possess the property of communicating the diseaseto others. I do not mean to state that I have myself seen the case, thedetails of which I am about to give, but aware of the accuracy of thegentleman who has forwarded them to me, I can say, that although thecommunication was not made by the medical gentleman in charge of thepatient, the utmost reliance may be placed on the fidelity of thosedetails:--

Thursday, August 11th, 1831, Martin M'Neal, aged 42, of the 7thFusileers, stationed at Hull, was attacked at a little before four A. M. , with severe purging and vomiting--when seen by his surgeon at about fouro'clock, was labouring under spasms of the abdominal muscles, and of thecalves of the legs. What he had vomited was considered as being merelythe contents of the stomach, and, as the tongue was not observed to bestained of a yellow colour, it was inferred that no bile had been thrownup. He took seventy drops of laudanum, and diluents were ordered. Half-past six, seen again by the surgeon, who was informed that he hadvomited the tea which he had taken; no appearance of bile in what he hadthrown up; watery stools, with a small quantity of feculent matter;thirst; the spasms in abdomen and legs continued; countenance notexpressive of anxiety; skin temperate; pulse 68 and soft; the foreheadcovered 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 nowbelow the natural standard, especially the extremities; pulse small;tongue cold and moist; a great deal of retching, and a fluid vomitedresembling barley-water, but more viscid; constant inclination to go tostool, but passed nothing; the spasms more violent and continued; astate of collapse the most terrific succeeded. At nine o'clock, only avery feeble action of the heart could be ascertained as going on, evenwith the aid of the stethoscope; the body cold, and covered with aclammy sweat, the features greatly sunk; the face discoloured; the lipsblue; the tongue moist, and very cold; the hands and feet blue, cold, and shrivelled, as if they had been soaked in water, like washerwomen'shands; no pulsation to be detected throughout the whole extent ofthe upper or lower extremities; the voice changed, and power ofutterance diminished. He replied to questions with reluctance, and inmonosyllables; the spasms became more violent, the abdomen being, tothe feel, as hard as a board, and the legs drawn up; cold as the bodywas, he could not bear the application of heat, and he threw off thebed-clothes; passed no urine since first seen; the eyes became glassyand fixed; the spasms like those of tetanus or hydrophobia; therestlessness so great, that it required restraint to keep him for everso short a time in any one position. A vein having been opened in oneof his arms, from 16 to 20 ounces of blood were drawn with the greatestdifficulty. During the flowing of the blood, there was great writhing ofthe body, and the spasms were very severe--friction had been arduouslyemployed, and at ten A. M. He took a draught containing two and a halfdrachms of laudanum, and the vomiting having ceased, he fell asleep. Attwo P. M. Re-action took place, so as to give hopes of recovery. At fourP. M. The coldness of the body, discoloration, &c. , returned, but withouta 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 ofthe heart, and the cavæ were filled with dark blood. Some red patcheswere noticed on the mucuous membrane; but the communication forwardedto me does not specify on what precise part of the stomach orintestinal canal; and my friend does not appear to attach muchimportance to them, from their common occurrence in a variety of otherdiseases. It remains to be noticed, that the above man had been at afair in the neighbourhood on the 9th (two days preceding his attack), where, as is stated, he ate freely of fruit, and got intoxicated. Onthe 10th he also went to the fair, but was seen to go to bed soberthat night. The disease did not spread to others, either by director indirect contact with this patient. 

Now let us be frank, and instead of temporising with the question, takeup in one hand the paper on "cholera spasmodica" just issued, for ourguidance, 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 singularcase this year, in most of the important symptoms), --let the symptoms becompared 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 mustever after follow the philosophy of the man who doubted his ownexistence. The case, as it bears on certain questions connected withcholera, _is worth volumes of what has been said on the same subject_. Let it be examined by the most fastidious, and the complete identitycannot be got rid of, even to the _blue_ skin, the _shrivelled fingers_, the _cold tongue_, the _change in voice_, and the _suppression ofurine_, considered in some of the descriptions to be found in thepamphlet issued by the Board of Health, as so characteristic of the"Indian" cholera; and this, too, under a "constitution of theatmosphere" so remarkably disposed to favour the production of choleraof one kind or other, that Dr. Gooch, were he alive, or any closereasoner like him, must be satisfied, that were this remarkable form ofthe disease communicable, no circumstance was absent which can at allbe considered essential to its propagation. As the symptoms in the caseof M'Neal, were, perhaps, more characteristically grouped than in anyother case which has been recorded in this country, so it has also inall probability occurred, that more individuals had been in contact withhim during his illness and after his death, as the facility in obtainingpersons to attend the sick, rub their bodies, &c. , must be vastlygreater in the army than in ordinary life; so that in such cases it isnot a question of one or two escaping, but of _many_, which is alwaysthe great test. 

Of the College of Physicians we are all bound to speak with everyfeeling of respect, but had the document transmitted by that learnedbody to our government, on the 9th of June last, expressed only a"philosophic doubt, " instead of making an assertion, the questionrelative to the contagion or non-contagion of the disease, now makingravages in various parts of Europe, would be less shackled among us. People are naturally little disposed to place themselves, with theknowledge they may have obtained from experience and other sources, inopposition to such a body as the College: but as, in their letter togovernment of the 18th of June, they profess their readiness, should itbe necessary, to "re-consider" their opinion, we, who see reason todiffer from them, may be excused for publishing our remarks. It seemssurprising enough that, in their letter to government of the 9th ofJune, the College should have given as a reason for their decisionas to the disease being infectious (meaning, evidently, what some callcontagious, or transmissible from _persons_)--"having no other means ofjudging of the nature and symptoms of the cholera than those furnishedby the documents submitted to us. " Now, according to the printedparliamentary papers, among the documents here referred to as havingbeen sent by the Council to the College, was one from Sir WilliamCrichton, Physician in Ordinary to the Emperor of Russia, in which aclear account is given of the symptoms as they presented themselves inthat country; and, if the College had previously doubted of the identityof the Russian and Indian cholera, a comparison of the symptoms, as theywere detailed by Sir William, with those described in various places inthe _three volumes_ of printed Reports on the cholera of India, in thecollege library, must at once have established the point in theaffirmative. In fact, we know, that the evidence of Dr. Russell, givenbefore the College, when he heard Sir William's description of thedisease read, fully proved this identity to the satisfaction of theCollege. Had the vast mass of information contained in the IndiaReports, together with the information since accumulated by our ArmyMedical Department, been consulted, all which are highly creditable tothose concerned in drawing them up, and contain incomparably betterevidence, that is, evidence more to be relied on, than any which can beprocured from Russia or any other part of the world--had these sourcesof information been consulted, as many think they should in all fairnesshave been, the College would probably have spoken more doubtingly asto cholera, in any form, possessing the property of propagating itselffrom person to person. Much of what passes current in favour of thecommunication of cholera rests, I perceive, on statements the mostvague, assertions in a general way, as to the security of those who shutthemselves up, &c. To show how little reliance is to be placed on suchstatements, 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 quarantinedepartment, published a book on this disease in 1815, in which hestated, that the people shut up in a dock-yard, during the epidemic of1814, in Gibraltar, escaped the disease, and Mr. William Fraser, also ofthe quarantine, and who was on the spot, made a similar statement. Now, we all believed this in England for several years, when a publicationappeared from Dr. O'Halloran, of the medical department of Gibraltargarrison, in which he stated that he had made inquiries from theauthorities at that place, and that he discovered the whole statement tohave been without the smallest foundation, and furnishes the particularsof 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 theselection of proofs. 

To show, further, how absurdly statements respecting the efficacy ofcordons will sometimes be made, it may be mentioned that M. D'Argout, French minister of public works, standing up in his place in thechamber, _on the 3rd instant_ (_Septr. _), and producing his estimatesfor additional cordons, &c. , stated, by way of proving the efficacy ofsuch establishments, that in Prussia, where, according to him, cordonprecautions had been pre-eminently rigorous, and where "_le territoirea été defendu pied à pied_, " such special enforcement of the regulationswas attended with "_assez de succès_:" in the meantime the next mailbrings us the official announcement (_dated Berlin, Sept. 1_) of thedisease having made its appearance there!

To conclude, for the present: if there be one reason more than anotherwhy the question of cholera should be scrutinized by the highesttribunal--a parliamentary committee--it is, that in the "papers" justissued by the Board of Health, the following passage occurs (page36):--"But in the event of such removal not being practicable, onaccount of extreme illness or otherwise, the prevention of allintercourse with the sick, even of the family of the person attacked, must be rigidly observed, unless, " &c. There are some who can dulyappreciate all the consequences of this; but let us hope that thequestion is still open to further evidence, in order to ascertainwhether it be really necessary that, in the event of a cholera epidemic, "The living shall fly fromThe sick they should cherish. "

LETTER II. 

In my last letter I adverted to the opinion forwarded to his Majesty'sCouncil on the 9th of June last from the College of Physicians, in whichthe cholera, now so prevalent in many parts of Europe, was declared tobe communicable from person to person. We saw that they admitted in thatletter (see page 16 of the Parliamentary Papers on Cholera) the limitednature of the proofs upon which their opinion was formed; but I had notthe reasons which I supposed I had for concluding, that because theyused the words "ready to reconsider, " in their communication of the 18thof same month to the Council, they intended to _reconsider_ the wholequestion. Indeed this seems now obvious enough, as one of the Fellows ofthe College who signed the Report from that body on the 9th of June(Dr. Macmichael) has published a pamphlet in support of the opinionalready given, in the shape of a letter addressed to the President of theCollege, whose views, Dr. Macmichael tells us, _entirely coincide_ withhis own; so that there is now too much reason to apprehend that in thisquarter the door is closed. Contagionist as I am, in regard to thosediseases where there is evidence of contagion, I find nothing in Dr. Macmichael's letter which can make an impression on those who are at allin the habit of investigating such subjects, [2] and who, dismissing suchinductions as those which he seems to consider legitimate, rely solelyon facts rigorously examined. He must surely be aware that most of thepoints which he seems to think ought to have such influence in leadingthe public to believe in the contagion of cholera, might equally applyto the influenza which this year prevailed in Europe, and last year inChina, &c. ; or to the influenza of 1803, which traversed over continentsand oceans, _sometimes in the wind's eye, sometimes not_, as frequentlymentioned by the late Professor Gregory of Edinburgh. Who will now standup and try to maintain that the disease in those epidemics waspropagated from person to person? Could more have been made of so bad acause as contagion in cholera, few perhaps could have succeeded betterthan Dr. Macmichael, and no discourtesy shall be offered him by me, though he does sometimes loose his temper, and say, among other thingsnot 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 abandonall the ordinary maxims of prudence, and remain obstinately blind to thedictates of common sense!"--_fort, mais peu philosophique Monsieur leDocteur_. The time has gone by when ingenious men of the profession, like Dr. Macmichael, might argue common sense out of us; it will noteven serve any purpose now that other names are so studiously introducedas _entirely coinciding_ with Dr. Macmichael; for, in these days ofreform in every thing, _opinions_, will only be set down at their justvalue 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 everyreasonable hope of staying the progress of the calamity by those cordonand quarantine regulations which are now not merely useless, but thebane of society, when applied to cholera or other non-contagiousdiseases. ]

Referring once more to the Report of the 9th of June, made by theCollege to the Council, and signed by the President as well as byDr. Macmichael, the cholera was there pronounced to be a communicabledisease, when they had, as they freely admit, "no other means of judgingof the nature and symptoms of the cholera than those furnished by thedocuments submitted to them. " The documents submitted were thefollowing, as appears from the collection of papers published by orderof Parliament:--Two reports made to our government by Dr. Walker, fromRussia; 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 fromSt. Petersburg to Moscow, by our ambassador at the former place; states, in his first report, dated in March, that the medical men seemed todiffer on the subject of contagion, but adds, "I may so far state, thatby far the greater number of medical men are disposed to think it notcontagious. " He says, that on his arrival at Moscow, the cholera wasalmost extinct there; that in twelve days he had been able to see onlytwenty-four cases, and that he had no means of forming an opinion ofhis own as to contagion. In a second report, dated in April from St. Petersburg, this gentleman repeats his former statement as to themajority of the Moscow medical men not believing the disease to becontagious (or, as the College prefer terming it, infectious), and givesthe grounds on which their belief is formed, on which he makes someobservations. He seems extremely fair, for while he states that, according to his information, a peculiar state of the atmosphere "wasproved by almost every person in the city (Moscow), feeling, during thetime, some inconvenience or other, which wanted only the exciting causeof 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 strongparticular instances to prove the communication of the disease from oneindividual to another;" and that he had "heard of several instancesbrought forward in support of the opinion (contagion), but they are notfair ones:" he yet mentions where exceptions seem to have taken place asto hospital attendants not being attacked, but he has neglected to tellus (a very common omission in similar statements), whether or not thehospitals in which attendants were attacked were situated in or nearplaces where the atmosphere seemed _equally productive of the diseasein those not employed in attending on sick_. This clearly makes all thedifference, for there is no earthly reason why people about the sickshould not be attacked, if they breathe the same atmosphere which wouldseem to have so particular an effect in producing the disease in others;indeed there are good reasons why, during an epidemic, attendants shouldbe attacked in greater proportion; for the constant fatigue, night-work, &c. , must greatly predispose them to disease of any kind, while thegreat additional number always required on those occasions, precludesthe supposition of the majority so employed being _seasoned_ hospitalattendants, having constitutions impenetrable to contagion. Thosequestions are _now_ well understood as to yellow fever, about which somuch misconception had once existed. The proofs by disinterested authors(by which I mean those unconnected with quarantine establishments, orwho are not governed by the _expediency_ of the case) in the WestIndies, America, and other places, show this in a clear light; but theproofs which have for some time past appeared in various journalsrespecting the occurrences at Gibraltar, during the epidemic of 1828, are particularly illustrative. By the testimony of three or fourwriters, we find that _within certain points_, those in attendance onsick, in houses as well as hospitals, were attacked with the fever, incommon with those who were not in attendance on sick; but that, wherepeople remained at ever so short a distance beyond those points, duringthe epidemic influence, _not a single instance_ occurred of their beingattacked, though great numbers had been in the closest contact with thesick, and frequently too, it would appear, under circumstances whencontagion, had it existed, was not impeded in its usual course by a veryfree atmosphere:--_sick individuals, for instance, lying in a smallhouse, hut, or tent, surrounded, during a longer or shorter space oftime, by their relatives, &c. _ A full exposure of some very curiousmis-statements on these points, made by our medical chief of thequarantine, will be found from the pen of the surgeon of the 23dregiment, in the _Edinburgh Medical and Surgical Journal_, No. 106. [3]Those who are acquainted with the progress of cholera in India, must beaware how a difference in the height of places, or of a few hundredyards (_indeed sometimes of a few yards_) distance, has been observed tomake all the difference between great suffering and completeimmunity:--the printed and manuscript reports from India furnish a vastnumber of instances of this kind; and, incredible as it may appear, theyfurnish instances where, _notwithstanding the freest intercourse_, therehas been an abrupt line of demarcation observed, beyond which thedisease did not prevail. A most remarkable instance of this occurred inthe King's 14th regiment, in 1819, during a cholera epidemic, when thelight company of the regiment escaped almost untouched, owing to noother apparent cause than that they occupied the extremity of a range ofbarrack in which all the other companies were stationed! so that therewould truly seem to be more things "on earth than are dreamt of in thephilosophy" of contagionists. This seems so remarkable an event, thatthe circumstance should be more particularly stated:--"The diseasecommenced in the eastern wing of the barracks, and proceeded in awesterly direction, but suddenly stopped at the 9th company; thelight infantry escaping with one or two slight cases only. "--(_BengalRep. _ 311. ) It appears (_loc. Cit. _) that 221 attacks took place in theother nine companies. We find (_Bombay Rep. _ p. 11. ) that, from a littledifference in situation, two cavalry regiments in a camp were altogetherexempt from the disease, while all the other regiments were attacked. Previous to closing these remarks, which seemed to me called for onDr. Walker's second Report, it is fair to state, that in certain Russiantowns which he names, he found that the medical men and others wereconvinced that the cholera was brought to them "_somehow or other_, " animpression quite common in like cases, as we learn from Humboldt, andless to be wondered at in Russia than most places which could bementioned. It will not be a misemployment of time to consider now thenext document laid before the College, to enable them to form theiropinion, --the Report of Dr. Albers, dated in March, and sent from St. Petersburg;--this gentleman, who was at the head of a commission sentby the Prussian government to Moscow, states, that at St. Petersburgh, _where the disease did not then reign_, the authorities and physicianswere contagionists; but at Moscow, where it had committed such ravages, "almost all strenuously maintain that cholera is not contagious. " Thefollowing extract seems to merit particular attention:--

"When the cholera first reached Moscow, all the physicians of this citywere persuaded of its contagious nature, but the experience gained inthe course of the epidemic, has produced an entirely oppositeconviction. They found that it was impossible for any length of timecompletely to isolate such a city as Moscow, containing 300, 000inhabitants, 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 inhabitantsquitted Moscow, of whom a large number never performed quarantine; andnotwithstanding this fact, _no case is on record of the cholera havingbeen transferred from Moscow to other places_, and it is equallycertain, that in _no situation_ appointed for quarantine, _any case ofcholera has occurred_. That the distemper is not contagious, has beenyet more ascertained by the experience gathered in this city (Moscow). In many houses it happened, that one individual attacked by cholera wasattended indiscriminately by all the relatives, and yet did the diseasenot spread to any of the inmates. It was finally found, that not onlythe nurses continued free of the distemper, but also that theypromiscuously attended the sick chamber, and visited their friends, without in the least communicating the disease. There are even casesfully authenticated, that nurses, to quiet timid females labouring undercholera, have shared their beds during the nights, and that they, notwithstanding, have escaped uninjured in the same manner as physiciansin hospitals have, without any bad consequences, made use of warm waterused (a moment before) by cholera patients for bathing. 

[Footnote 3: The writer of this, who may be known by application atthe printer's, when the present excitement is at an end, is not onlyprepared to show, _on a fitting occasion_, the correctness of thestatements of Dr. Smith as well as those by Dr. O'Halloran justreferred to--but also, that in the investigations, in 1828, connectedwith the question of yellow fever at Gibraltar, facts were pervertedin the most scandalous manner, in order to prove the disease importedand contagious:--that individuals had been suborned:--that persons hadbeen in the habit of putting leading questions to witnesses:--thatthose who gave false evidence have been, in a particular manner, remunerated:--that threats were held out:--and, in short, thatoccurrences of a nature to excite the indignation of mankind, tookplace on that occasion; and merited a punishment, not less severe, than a Naval Officer who should give, designedly, a false bearing anddistance of rocks. ]

"These, and numerous other examples which, during the epidemic (weought, perhaps, to call it endemic) became known to every inhabitant ofMoscow, have confirmed the conviction of the non-infectious nature ofthe disease, a conviction in which their personal safety was so muchconcerned. 

"It is also highly worthy of observation, that all those who stand upfor contagion, _have not witnessed_ the cholera, which is, therefore, especially objected to their opinion by their opponents. " He closes bythe observation, "The result of my own daily experience, therefore, perfectly agrees with the above-stated principle, namely, notwithstandingall my inquiries, I _have met with no instance which could render it atall probable that the cholera is disseminated by inanimate objects_. " Thewords in italics are as in the Parliamentary papers on Cholera, pp. 8 and9. Here is something to help to guide people in forming opinions, and tohelp governments on quarantine questions; but owing to a portion of the"perverseness" which Dr. Macmichael in anger talks about, Dr. Albersstill _speculates_ upon cholera being contagious, and the College, itwould seem, take up his speculations and sink his very important facts. Sir William Creighton's Report gives what puports to be an extract froma memorial of his on cholera, given in to the St. Petersburg MedicalCouncil, tending to establish the contagious character of the disease;and with this a report by the extraordinary committee appointed by theEmperor to inquire into the Moscow epidemic. The disease had not appearedat St. Petersburg when he drew up his Memorial, and it does not appearfrom any-thing which can be seen in the extracts he furnishes, that hehad personal knowledge of any part of what he relates. He gives thereported progress of the disease on the Volga and the Don, but isextremely deficient exactly where one might have expected that, from thegreater efficiency of police authorities, &c. , his information oncontagion would have been more precise, viz. , the introduction of thedisease into Moscow, which could not, it would seem have been by materialobjects, for, according to the Committee, composed "of the most eminentpublic officers, "--"the opinion of those who do not admit the possibilityof contagion by means of material objects, has for its support both themajority of voices, and the scrupulous observance of facts. The membersof the Medical Council have been convinced by their own experience, asalso by the reports of the physicians of the hospitals, that, afterhaving been in frequent and even habitual communication with the sick, their own clothes have never communicated the disease to any one, evenwithout employing means of purification. Convalescents have continued towear clothes which they wore during the disease--even furs--withouthaving them purified, and they have had no relapse. At the opening ofbodies of persons who had died of cholera, to the minute inspection ofwhich four or five hours a day for nearly a month were devoted, neitherthose who attended at their operations, nor any of the assistingphysicians, 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 receivedseveral wounds in separating the flesh, continued his operations, havingonly touched the injured parts with caustic. A drunken invalid havingalso wounded himself, had an abscess, which doubtless showed thepernicious action of the dead flesh, but the cholera morbus did notattack him. In fine, foreign _Savans_, such as Moreau de Jonnés andGravier, who have recognized, in various relations, the contagious natureof the cholera morbus, do not admit its propagation by means of goods andmerchandise. " (_Parl. Papers on Chol. _ p. 13. ) With the above documentsthe Council transmitted to the College a short description of the processof cleaning hemp in the Russian ports; and, lastly, the copy of aletter to the clerk of the Council from our ever-vigilant, thoughnever-sufficiently-to-be-remunerated, head guardian of the quarantinedepartment, who, taking the alarm, very properly recommends, as in dutybound, that a stir be forthwith made in all the pools, and creeks, andbays, &c. , of the united kingdom, in order that all those notoriously"susceptible" old offenders, skins, hemp, flax, rags, &c. , may beprevented from carrying into execution their felonious intention ofcovering the landing of a dire enemy. In truth, from the grave as wellas from the sublime, there often seems to be "but a step;" and inreading over this gentleman's suggestions about _susceptibles_ and_non-susceptibles_, one may fancy himself, instead of being in theland of thinking people, to be in the land of Egypt, where, as we areinformed (Madden, 1825), the sage matrons discuss the point, whether acat be not a better vehicle for contagion than a dog:--a horse may betrusted, they say, but as to an ass, he is the most incorrigible ofcontagion smugglers;--of fresh bread we never need be afraid, but thesusceptibility of butcher's meat is quite an established thing:--or wemight fancy ourselves transported to regions of romance, where it ismatter of profound deliberation, whether an egg shall be broken at thelarge or the small end. Such things are too bad for the nineteenthcentury; and in England, too, with her enlightened parliament! But untilthese questions are better examined, our guardian must bestir himselfabout articles susceptible of cholera contagion, while he enjoys hisgood quarantine pay, his good half pay from another department as Ibelieve, and withall, if we are not misinformed, a smart pension fromthe Gibraltar revenue, for what granted nobody can tell. 

The documents above referred to, would appear then to be the whole onwhich the College admit that they formed their opinions, and people maynow judge whether the verdict be according to the evidence, or whetherit be not something in the _lucus a non lucendo_ mode of drawingconclusions:--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 diseasewas communicable from person to person, they in three days after, approved of persons being sent to Russia to find out whether they haddecided rightly or not. Are we now to expect that, should the occasionneed, they will heroically make war against their own declared opinion?For my part I expect from them all that should be expected from men; andthe liberal part of the world will not fail to see from this, that I donot despair of even Dr. Macmichael, being still open to conviction. Letit not be for a moment understood that, in any-thing which has beensaid, or which may remain to be said respecting this gentleman, or inany-thing which may be hereafter said respecting Dr. Bisset Hawkins'swork, I mean to insinuate that contagion in cholera is not with them amatter of conscience; but I certainly do mean to say that their zeal hasmanifestly warped their judgment; and not only this, but that it hasprevented them from laying statements before the public on the choleraquestions with all the impartiality we might have expected fromgentlemen of their character in the profession. 

In Dr. Macmichael's pamphlet, consisting of thirty-two pages, andprofessing to be a consideration of the question, "Is choleracontagious?" we scarcely find the disease mentioned till we come to page25; the pages up to this being occupied chiefly by a recapitulation ofopinions formerly given "on the progress of opinion upon the subject ofcontagion;"--on the opinions of old writers as to the contagion ofplague, small-pox, measles, &c. :--he would infer that whereas small-poxand certain other diseases have, by more accurate observations made incomparatively modern times, been taken from the place they once held, and ranged among diseases decidedly contagious, so ought cholera alsoto be now pronounced contagious! As an inducement to us to adopt thisas good logic, he assures us that the list of diseases deemed contagiousby wise men is on the increase--that non-contagionists are _perverse_people, _blunderers_, and so forth! As to his epithets, it shall only besaid that among the disbelievers of contagion in cholera, and certainother diseases probably reputed contagious by Dr. Macmichael, are to befound hundreds possessing as much candour, as cultivated minds, and asmuch practical knowledge of their profession, as any contagionists, whether they be Fellows of a College or not; but as to the statementof Dr. Macmichael, is it true that we have been adding to the list ofcontagious diseases? Not within the last fifty years certainly. Even theinfluenza of 1803 was, if I mistake not greatly, termed, very generally, "infectious catarrh, " but what professional man would term the influenzaof 1831 so? Are there not yet remaining traces of the generally explodeddoctrine of even contagion in ague, at one time attempted to bemaintained? M. Adouard, of Paris, still indeed holds out. Do we not knowthat 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? Whereis the medical man now to be found who would set up such a plea? orwhere, except in countries doomed to eternal barbarism, are patientslabouring under consumption avoided now, as they were in several partsof the world at one time, just as if they laboured under plague, and allfor the simpleton's reason that the disease _often runs throughfamilies_? What disinterested man will, on due examination of all thathas been written on yellow fever, stand up now in support of its being acontagious disease, of which some thirty or forty years ago there was sogeneral 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 ofthe profession, _which seems very probable_, his purposes will perhapsbe answered, at least for a time, but I do not see how it can make animpression on medical men. Why not have been a little more candid whenquoting Sydenham on small-pox, &c. And have quoted what that author saysof the disease which he (Dr. M. ) professes to write about, --the cholera?The public would have means of judging how far the disease which wasprevalent in 1669, resembled the "cholera spasmodica, " &c. , of lateyears. Many insist upon an identity (Orton among others), and yetSydenham saw no reason for suspecting a communicable property. It mighthave been more to the point had Dr. Macmichael, instead of quoting oldauthorities on small-pox, measles, &c. Quoted some authorities todisprove that Orton and others are wrong when they state it as theirbelief that some of those old epidemics in Europe, about which so muchobscurity hangs, were nothing more or less than the cholera spasmodica. Mead's short sketch of the "sweating sickness" does not seem veryinapplicable:--"Excessive fainting and inquietude inward burnings, headach, sweating, vomiting, and diarrhoea. "[4] In the letter to thePresident of the College we see no small anxiety to prove that themalignant cholera is of modern origin also in India, for the proofs fromHindoo authorities, as given in the volume of _Madras Reports_, areslighted. These Reports, as well as those of the other presidencies, are exceedingly scarce, but whoever can obtain access to them will findin the translations at pp. 253 and 255 (not at page 3, as quoted byDr. Macmichael), enough probably to satisfy him that cholera is thedisease alluded to there. But I think that we have at page 31 ofDr. Macmichael's letter, no small proof of a peculiarity of opinion, whenwe find that he there states that the evidence in the _Madras Reports_of the existence of epidemics of malignant cholera in India, on severaloccasions previous to 1817, rests on imperfect records, and that thedescription of the disease is too vague to prove the identity with themodern spasmodic cholera; for in this opinion he seems, as far as I havebeen able to discover, to stand alone among writers on cholera;--indeedit seems established, _on the fullest authority_, that cholera, in thesame form in which it has appeared epidemically of late years, hascommitted ravages in India on more than one occasion formerly:--this isfully admitted by Mr. Orton, an East India practitioner, who is one ofthe few contagionists. 

[Footnote 4: If the progress of the sweating sickness was similar tothat of cholera, the advice of the King to Wolsey was sound; for insteadof recommending him to rely on any-thing like cordon systems, or to shuthimself up surrounded by his guards, he tells him (see _Ellis's_letters) to "fly to _clene_ air incontinently, " on the approach of thedisease. I use the words _approach of the disease_ occasionally, as itis a manner of expression in general use, but it is far from beingstrictly applicable when I speak of cholera; _the cause_ of the diseaseit is which I admit travels or springs up at points, and not the diseaseitself in the persons of individuals, or its germs in inanimatesubstances. ]

For one piece of tact the author of the letter deserves great credit;for whereas his College collectively, when forming their opinion on thequestions proposed to them by the Council, seemed to throw all Indiarecords overboard, --he, in his individual capacity, as author of theletter, sends after them all the Russian reports in support ofcontagion; for anxious as he is to prove his point, not a word do we getof the _on dits_ so current in Russia about persons being attacked withthe 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 theVolga, &c. &c. : all which statements, when duty inquired into, prove tobe unsupported by any thing in the shape of respectable authority, andthis 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 theofficial reports, which do them, _en masse_, so much credit, Dr. Macmichael is little disposed to be complimentary; and, indeed, he seemsto insinuate that those were rather stupid fellows who did not come towhat he is pleased to consider "a just and right conclusion, " as tocontagion; he thinks, however, that he has got a few of "the mostcandid" to join in his belief. We shall see whether he had betterreason to look towards the Ganges and Beema for a confirmation of hisdoctrines, than he had toward the Don or the Volga. How does the casestand with respect to one of the gentlemen whom he quotes, --Mr. Jukes, of the Bombay Establishment? This gentleman, like all who speak ofcholera, mentions circumstances as to the progress of the diseasewhich he cannot comprehend, and Dr. Macmichael shows us what thosecircumstances are; but Dr. Macmichael does not exhibit to us _what does_come perfectly within Mr. Jukes's comprehension, but which is not quiteso suitable to the doctor's purpose. This omission I shall take theliberty to supply from an official letter from Mr. Jukes in the BombayReports:--"I have had no reason to think it has been contagious here, neither myself nor any of my assistants, who have been constantlyamongst the sick, nor any of the hospital attendants, have had thedisease. It has not gone through families when one has become affected. It is very unlike contagion too, in many particulars. " &c. --(_BombayReports_, page 172. )--Ought we not to be a little surprised that sogreat an admirer of candour, as Dr. Macmichael seems to be, should, while so anxious to give every information to his readers, calculated tothrow light upon the subject of cholera, omits the above importantparagraph, which we find, by the way _immediately precedes_ the one uponopinions and difficulties which he quotes from the same gentleman? Butlet us examine what the amount of force is, which can be obtained fromthat part of Mr. Jukes's paper, which it does please Dr. Macmichael toquote:--"If it be something general in the atmosphere, why has it nothitherto made its appearance in some two distinct parts of the provinceat the same time? Nothing of this kind has, I believe, been observed. Itstill seems creeping from village to village, rages for a few days, andthen begins to decline. " I find myself unable, at this moment, toascertain the extent of Mr. Jukes's means of obtaining information asto what was passing in other parts of his province; but I think thefollowing quotation, on which I am just now able to lay my hand, willnot only satisfactorily meet what is here stated, but must, in thepublic opinion, be treasured, as it serves at once to displace mosterroneous ideas long prevalent, and which, I believe, greatly influencedmen's decisions as to contagion:--"It may, then, first be remarked, that the rise and progress of the disorder were attended by suchcircumstances as showed it to be entirely independent of contagion forits propagation. Thus we have seen that it arose at nearly one and thesame time in many different places, and that in the same month, nay, in the same week, it was raging in the unconnected and far-distantdistricts of Behar and Dacca. " (Bengal Reports, p. 125. ) Again (p. 9), that in Bengal "it at once raged simultaneously in various and remotequarters, without displaying a predilection for any one tract ordistrict more than for another; or any thing like regularity ofsuccesion in the chain of its operations. " In support of what is statedin 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 largeand populous city of Moorshedabad, from extent and local positionapparently very favourably circumstanced for the attacks of theepidemic, should have escaped with comparatively little loss, whilst allaround was so severely scourged. " This seems to have been pretty similarto what is now taking place with respect to the city of Thorn, whichremains free from cholera, though the communication is open with diversinfected places in every direction. Should Thorn still be attacked bythe disease (as it sooner or later will, in all human probability), thecontagionists _par métier_ will try to establish a case of hemp orhare-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 knownin Europe, and who saw the cholera in Ceylon; his conjecture (quiteaccessible, I believe, to every medical man in London) may perhaps beas valuable as that of any other person. The following is a copy ofit:--"The cause of the disease is not any sensible change in theatmosphere; yet, considering the progress of the disease, its epidemicnature, the immense extent of country it has spread over, we can hardlyrefuse to acknowledge that its cause, though imperceptible, though yetunknown, does exist in the atmosphere. It may be extricated from thebowels of the earth, as miasmata were formerly supposed to be; it maybe generated in the air, it may have the properties of radiant matter, and, like heat and light, it may be capable of passing through spaceunimpeded by currents; like electricity, it may be capable of movingfrom place to place in an imperceptible moment of time. " Dr. Davy is anarmy physician, and the report of which this is an extract, may be seenat the Army Medical Office, a place which, of late years, has become amagazine 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 statementsgiven by the medical gentlemen have their accuracy more or lessguaranteed by a certain system of military control over the documentsthey draw up: thus, in the circumstance already noticed as havingoccurred in the 14th regiment, we have every reason to rely upon itsaccuracy, which we could not have in a similar statement among thepopulation of any country; and we have, I think, no reason to believethat in pronouncing the cholera of Ceylon not contagious, Dr. Davy, aswell 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 ofcholera, I may so far remark just now regarding them, that they are notnew, or peculiar to him; and that it may be well, before Dr. Macmichaelor others pronounce them vague, that they should inquire whether someof those causes have not been assigned for the production of certainepidemics, 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 ledto the opinion by some experiments of Herschell, detailed in thePhilosophical Transactions of the year 1824. They should recollect thatother competent persons devoted to researches on such subjects (Sir R. Phillips among the number) admit _specific local atmospheres_ (not atall _malaria_ in the usual sense of the term), produced by irregularstreams of specific atoms from the interior of the earth, and "arisingfrom the action and re-action of so heterogeneous a mass. " For my partI feel no greater difficulty in understanding how our bodies, "fearfullyand 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 nocognizance, " than how they are influenced by other invisible agents, the existence of which I am compelled to admit. --If the writer of thearticle on cholera in the _Westminster Review_, for October, 1831, donot find all his objections met by these observations, I must only referhim to the _quid divinum_ of Hippocrates:--but I must protest againstlogic such has been employed by certain members of our Board of Health, who lately, on the examination of gentlemen of the profession whohad served in India, and who had declared the disease not to becommunicable, came to the conclusion that it must, nevertheless, beso, as those gentlemen could not show _what it was_ owing to. 

Most extraordinary certainly it does appear, that while Dr. Macmichaelgoes to the trouble of giving us (p. 27) the views of _a captain_ (!) asto the progress of cholera at a certain place in India, he should haverefrained altogether from referring, on the point of contagion ornon-contagion, to the report of such a person as Dr. Davy, or to thereports of this gentleman's colleagues at Ceylon, Drs. Farrell andMarshall. Had Dr. Macmichael added a little to his extract from Capt. Sykes, by informing us of what that gentleman states as to the greatmortality ("350 in one day") in the town of Punderpoor, "when thedisease first commenced its ravages there, " people would have means ofjudging how unlike this was to a contagious disease creeping from personto person in its commencement. 

It is painful to be obliged to comment on the manner in which Dr. BissetHawkins has handled the questions relative to the Ceylon epidemic, whichseems far from being impartial; for, while he quotes (p. 172) Dr. Davy, "a medical officer well known in the scientific world, " as stating thatthe cause of the disease is not in any _sensible_ changes in the stateof the atmosphere, he breaks off suddenly at the word _atmosphere_, proceeds to talk of the changes in the muscles and blood of persons whodie of the disease, and passing over the part quoted from Dr. Davy, nearthe close of my last letter, Dr. Hawkins leaves his readers to draw avery natural conclusion--that, as Dr. Davy admitted that there were noprevalent _sensible_ states of the atmosphere to which the cholera couldbe attributed, _he, therefore_, believed it to have been propagated bycontagion, an inference which we now see must be quite wide of the mark. Dr. Hawkins had, it appears, like many other medical gentlemen, accessto the reports from Ceylon, &c. , in the office of the chief of the armymedical 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 caseswhich had occurred, forty died. " Why more had not been quoted from agentleman who had such ample means of witnessing the disease in its veryworst form, I must leave to others to say; but, referring again to thehighly interesting letter from Mr. Marshall on cholera, which appearedin the _Glasgow Herald_, of the 5th of August last, and in which, frommany important observations which every body interested in cholerashould read and study, the following remarks will be found:--"In no oneinstance did it seem to prevail among people residing in the same houseor barracks, so as to excite a suspicion that the contact of the sickwith the healthy contributed to its propagation. " "The Indian Cholera, as it is sometimes called, appears not to be essentially different fromcholera as it occurs in this and all other countries. " "I consider it, therefore, impossible for a medical practitioner to speak decisivelyfrom having seen one, or even a few cases of cholera in this country, and to say whether they are precursors of '_the epidemic_ cholera' ornot. 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, beensatisfactorily proved. The quality of contagion was never attributedto the disease in Ceylon, and I believe no-where did it occur ingreater severity. I am aware that an attempt has been made to distinguishthe ordinary cholera of this country from the 'epidemic cholera, ' by meansof the colour or quality of the discharges from the bowels. In theformer it is said the discharge is chiefly bile, while in the latter itis said to bear no traces of bile, but to be colourless and watery. Howfar is this alleged diagnosis well founded? I am disposed to believethat, in all severe cases of cholera, whether it be the cholera of thiscountry, or the epidemic cholera, the secretion of bile is eithersuppressed, or the fluid is retained in the gall-bladder. " Mr. Marshall, it may be observed, is the gentleman who was selected by the lateSecretary at War, in consequence of his known intelligence, to remodelthe regulations relative to military pensioners; and I understand that, in consequence of the manner in which he executed that very importantduty, he has since been promoted. After what appears from the abovequotations, how perfectly unwarrantable must the assertion of Dr. BissetHawkins seem, that "from the Coromandel coast it seems to have beentransported by sea to Ceylon!"

We shall, I think, be able to see that the assumption of Drs. Macmichaeland Hawkins, as to the importation of the disease into the Mauritiusfrom Ceylon, is equally groundless with that of its alledged importationinto the latter island; and here we have to notice the same want ofcandour on the part of those gentlemen, in not having furnished thatpublic, which they professed to enlighten on the subject of cholera, with those proofs within their reach best calculated to display thetruth; be it a part of my duty to supply the omissions of thesegentlemen in this respect. The following is a copy of a letteraccompanying the medical commission report at that island forwardedto General Darling, the then commanding officer, by the senior medicalgentleman there. 

"Port Louis, Nov. 23, 1819. 

"I have the honour of transmitting the reports of the French andEnglish medical gentlemen on the prevalent disease; both classes of theprofession seem to be unanimous in not supposing it contagious, or offoreign introduction. From the disease pervading classes _who havenothing in common but the air they breathe_, it can be believed that thecause may exist in the atmosphere. A similar disease prevailed in thisisland 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 ampleevidence of the true cholera having appeared at different points in thecolony _before the_ arrival of the Topaze frigate, the ship _accused_ bycontagionists _par métier_, of having introduced the disease; so that, contrary to what Dr. Macmichael supposes, those who disbelieve thecommunicability of cholera, have no necessity whatever in this case forpleading a coinsidency between the breaking out of the disease, and thearrival of the frigate; indeed, his friend Dr. Hawkins seems to be awareof 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_ atthe Mauritius before the arrival from Ceylon;" so that the beginning ofan epidemic is to be excluded from forming a part or parcel of theepidemic! Why is it that in medicine alone such modes of reasoning areever ventured upon!

We know, from the history of cholera in India, that not only ships lyingin certain harbours have had the disease appear on board, but evenvessels sailing down one coast have suffered from it, while sailing upanother has freed them from it, without the nonsense of going intoharbour to "expurgate. " Now, with respect to the _Topaze_, it appearsthat while lying in harbour in Ceylon, the disease broke out onboard her; that after she got into "_clene air_" at sea, the diseasedisappeared, seventeen cases only having occurred from the time she leftthe island, and she arrived at the Mauritius, as Dr. Hawkins admits, without any appearance whatever of the cholera on board. On the dayafter her arrival, she sent several cases ("chronic dysentry, hepatitis, and general debility") to hospital, but not one of cholera; neither didany case occur on board during her stay there, at anchor a mile and ahalf from shore, and constantly communicating with shore, [5] while aconsiderable number of deaths took place from cholera _in the merchantvessels anchored near shore_. 

[Footnote 5: Somebody is said to have seen a man on board with vomitingand spasms, on the day before she moved to this anchorage, but thesurgeon of the ship has not stated this. ]

As to the introduction of cholera from the Mauritius into Bourbon, whereit appeared but very partially, Dr. Macmichael very properly does notsay one word. There was abundance of "precaution" work, it is said, and those who choose, are at liberty to give credit to the story ofits having been smuggled on shore by some negro slaves landed from aMauritius vessel. As to the _precautions_ to which the writer in _TheWestminster Review_ attributes the non-extension of the disease in thisisland, hundreds of instances are recorded, in addition to those whichwe have already quoted, of the disease stopping short, without cordonsor precautions of any kind--one remarkable instance is mentioned by Dr. Annesley, where, _without seclusion_, the disease did not reach theground occupied by two cavalry regiments, although it made ravages inall the other regiments in the same camp. 

We have, perhaps, a right to demand from those gentlemen who displaysuch peculiar tact in the discovery of ships by which the cholera has, at divers times, been imported into continents and islands, the namesof those ships which brought to this country, in the course of thepresent year, the "_contagion_" which has produced, at so manydifferent points, cases of severe cholera, causing death in someinstances, and in which the identity with the "Indian cholera, " the"Russian cholera, " &c. , has been so _perfect_, that all the "perverseingenuity" of man cannot point out a difference. If it cannot be shownthat in this, we non-contagionists in cholera are in error, peoplewill surely see reason for abandoning the cause of cordons, &c. , inthis disease, --a cause which, in truth, now rests mainly for supportupon a sort of conventional understanding, unconnected altogether, itwould appear, with the facts of the case, and entered into, we arebound to suppose, before the full extent of the mischief likely toarise from it had been taken into consideration. Admitting for amoment that a case of cholera possessing contagious properties couldbe imported into this country this year, will anybody say that a"constitution of the atmosphere" favourable to its communicability tohealthy individuals, has not existed _in a very high degree_:--can aspot be named in which cholera, generally of a mild grade, has notprevailed? And if contagionists cannot point out a difference betweensome of the severe cases to which public attention has been drawn, andthe most marked cases of the Indian or Russian cholera, I think thatnow 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 wouldbeg to be informed of the names of the ships by which the contagionwas brought, which caused the illness of the following individuals; orif they be allowed, as I presume must be the case, not to have beeninfected at all in this way, all that has been said regarding theidentity of the foreign and severe form of the home disease, must beshown 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 inquirywas instituted, --a case in Guy's Hospital, which caused some anxietyabout the middle of July last, --a case reported in a medicalperiodical in August last, as having occurred in Ireland, --the fatalcase, as reported in my first letter, of Martin M'Neal, [6]--a secondcase reported in a medical periodical in August, --a fatal case on the12th of August last at Sunderland, reported upon to the Home Secretaryby the mayor of that town, --three cases reported in No. 421 of THELANCET, --a very remarkable case duly reported upon in September, from the Military Hospital at Stoke, near Davenport, and a case withthorough "congee stools, " spasms, &c. (the details of which I mayhereafter forward), which occurred at Winchester on the 22d ofSeptember, in the 19th Foot, in a man of regular habits, and of _thenature_ of which case the medical gentleman in charge had no doubt. 

[Footnote 6: The same Army Medical gentleman, who had been sent to PortGlasgow, was sent to Hull to report upon this case:--he arrived theretoo late, but having seen the details of the case, he admitted that hesaw no reason to declare them different from those which occurred in theIndian cholera. ]

I quite agree with those who are of opinion, that in this and most othercountries, cases may be every year met with exhibiting symptoms similarto those which have presented themselves in any one of the above. Instead of amusing us, when next writing upon cholera, with a quotationabout small-pox from Rhazes, bearing nonsense upon the face of it, someof those who maintain the contagious property of Indian or any othercholera, may probably take the trouble to give the information on theabove cases, so greatly required for the purpose of enlightening thepublic. 

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, ashe is pleased to tell us, of placing the statements on both sidesin juxtaposition. He is well pleased to give us from Dr. Taylor, assistant-surgeon, --what indeed never amounted to more than report, andof the truth or falsehood of which this gentleman does not pretend tosay he had any knowledge himself, --that a traveller passing from theDeacan to Bombay, found the disease prevailing at Panwell, through whichhe passed, and so took it on with him to Bombay; but whether the man hadthe disease, or whether he took its germs with him in some verysusceptible article of dress, is not stated by Dr. Taylor; however, hestates (what we are only surprised does not happen oftener in thosecases, when we consider similarity of constitution--of habits--of siteor aspect of their dwellings, &c. ) that several members of a family, andneighbours "were attacked within a very short period of each other;" butwhen Dr. Taylor goes on to say, "In bringing forward these facts, however, it may be proper at the same time to state, that of theforty-four assistants employed under me, only three were seized with thecomplaint;" he gets out of favour at once, and his observation is called"unlucky, " being but a _negative_ proof, and Dr. Macmichael adds, whateverybody must agree with him in, that positive instances of contagionmust outweigh all negative proofs:--to be sure:--but Dr. Macmichael'ssaying this, does not show that positive proofs exist. Give us butpositive proofs, give even but a _few_, which surely may be done, ifthe disease be really communicable, and where contagion has been soardently sought after by all sorts of _attachés_ and _employés_ of thecordon and quarantine systems in the different countries on theContinent. We could produce no mean authority to show, that _a longsuccession of negative proofs_ must be received as amounting to a moralcertainty; and what greater proof can we have of non-contagion in anydisease, than we have in the fact regarding epidemic cholera, as wellas yellow fever, that attendants on the sick are not more liable thanothers to be attacked? Regard should, of course, always be paid, intaking this point into consideration, to what has been already noticedin my second letter, or the inferences must be most erroneous. Dr. Macmichael quotes the statement of Dr. Burrell, 65th regiment (and takescare to put the quotation in italics too), that at Seroor, in 1818, "almost every attendant in hospital had had the disease. There are aboutthirty attendants in hospitals. " Now, along with hundreds of otherinstances, what does Dr. French, of the 49th regiment, say, in hisReport of 1829? That no medical man, servant, or individual of any kind, in attendance on the sick, was taken ill at Berhampore, when the choleraprevailed there that year, and refers, to his Report for 1825, in whichhe remarked the same thing in the hospital of the 67th regiment atPoonah; contrary, as he observes, to what occurred some years before inthe 65th regiment at Seroor, about forty miles distant. In the twoinstances quoted by Dr. French, and in that by Dr. Burrell, all thoseabout the sick stood in the same relation towards them, and all thedifference will be found probably to have been, that the hospital of the65th _was within the limit of the deteriorated atmosphere, where thecause existed equally (as in the case of ague and yellow fever) whetherpersons were present or not_. 

In Egypt there is not, it is true, a "cruel and inhuman desertion" ofthe unfortunate plague patients; for, among other reasons, beingpredestinarians, they think it makes no sort of difference whetherthey attend on the sick or not. Those who act upon the principle ofcholera being a highly contagious disease, may perhaps consider itnecessary to recommend, among their _precautions_, that the medicalmen and attendants should be enveloped in those hideous dresses usedin some countries by those who approach plague patients[7]--fancy, inthe case of a sick female, or even of a man of pretty good nerves, theeffect of but half the precautions one hears of, as proper to beobserved. It is quite a mistake to suppose that the sick have not beensometimes abandoned during the prevalence of epidemics; and that tooin cases where medical men had very erroneously voted the diseasecontagious:--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 arope 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, withouteven water to quench his thirst? I admit that, even with the views ofnon-contagionists, difficulties obviously present themselves in regardto the safety of those about the sick, when the latter are in such astate as will not admit of their removal to a more auspicious spotfrom that in which there is reason to believe they inhaled the noxiousatmosphere. 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 observednot 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 settingin of the more serious symptoms. 

[Footnote 7: Since writing the above, I find that this scene hasactually occurred lately at Dantzic where a few miserable medical menillustrated their doctrines of contagion, by skulking at a certaindistance about the sick, dressed up in oil skins, like the disgustingfigures 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 whichhave within a short time occurred on the Continent, and which seem to meto be of no small importance in regard to cholera questions. It appearsthat the committee appointed by the French Chamber of Deputies toinquire into the questions connected with voting an additional sum tomeet cordon and quarantine expenses, in the event of the cholera makingits appearance in or near France, have made their report to the Chamber. They declare that in India the cholera was proved not to have beentransmissible; and that in regard to Russia, it was not introduced, asalways contended for by some persons:--they refer to the city of Thornas exempt from the disease, though free from cordons, and in the midstof a country where it prevails, while the disease appeared in St. Petersburg and Moscow, notwithstanding their cordons, and even inPrussia, where sanatory laws where executed "_avec une punctualité etune 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, temporaryhospitals, &c. ; and that it is by no means ("_nullement_") to go intothe pockets of individuals. 

The other circumstance to which I allude is that, like Russia andAustria, Prussia has found that quarantines and cordons do not checkthe progress of cholera. The king declares that the appearance of thedisease in his provinces, has thrown _new light_ on the question; hespecifies certain restrictions as to intercourse, which were forthwithto be removed, and declares his intention to modify the whole. Inshort, it is quite plain that, as Dr. Johnson has it in his lastjournal, --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 keepin view the subject of the wide-spreading cholera, and not to sufferthemselves to be led from an attentive consideration of all thatappertains to it, by the great political questions which at presentconvulse 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 beingnatural and obvious to the mind;" for, since the time that contagiousproperties have been generally allowed to belong to certain diseases, there has been a strong disposition to consider this as the most naturaland obvious mode of explaining the spreading of other diseases. A personsees evidence of the transmission, _mediate_ as well as _immediate_, of small-pox, from one person to another; and, in other diseases, theorigin of which may be involved in obscurity, he is greatly proneto assign a similar cause which may seem to reconcile things sosatisfactorily to his mind. Indeed there seems, in many parts of theworld, a degree of _popularity_ as to quarantine regulations, whichis well understood and turned to proper account by the initiated inthe mysteries of that department:--for what more common than theexpression--"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 easilycomprehend the propagation of certain epidemics by contagion, than Ican by any other means, _when unaccompanied by sensible atmosphericchanges_; and if I reject contagion in cholera, it is because whateverwe have in the shape of fair evidence, is quite conclusive as to thenon-existence of any such principle. Indeed abundance of evidence nowlies before the public, from various sources, in proof of the saying ofFontenelle being fully applicable to the question of cholera--"When athing is accounted for in two ways, the truth is usually on the sidemost opposed to _appearances_. " How well mistaken opinions as tocontagion in cholera are illustrated in a pamphlet which has justappeared from Dr. Zoubkoff of Moscow! This gentleman, it appears, hasbeen a firm believer in contagion, until the experience afforded himduring the prevalence of the disease in that city proved the contrary. He tells us (p. 10), that in the hospital (Yakimanka) he saw "_to hisgreat astonishment_, that all the attendants, all the soldiers, handledthe sick, supported their heads while they vomited, placed them in thebath, and buried the dead; always without precaution, and always withoutbeing attacked by cholera. " He saw that even the breath of cholerapatients was inhaled by others with impunity; he saw, that throughoutthe district of which he had charge, the disease did not spread throughthe crowded buildings, or in families where some had been attacked, andthat exposure to exciting causes _determined_ the attack in manyinstances. He saw all this, gives the public the benefit of the copiousnotes which he made of details as to persons, places, &c. , and nowridicules the idea of contagion in cholera. Grant to the advocates ofcontagion in cholera but all the data they require, and they willafterwards prove every disease which can be mentioned to be contagious. Hundreds of people, we will say, for instance, come daily from a sicklydistrict to a healthy one, and yet no disease for some time appears; butat last an "inexplicable condition of the air, " and "not appreciable byany of our senses" (admitted by Dr. Macmichael and others as liable tooccur, but _only in aid_ of contagion), take place; cases begin toappear about a particular day, and nothing is now more easy than to makeout details of arrivals, there being a wide field for selection; andeven how individuals had spoken to persons subsequently attacked--hadstopped at their doors--had passed their houses, &c. [8] Causation is atonce connected with antecedence, at least for a time, by the people atlarge, who see their government putting on cordons and quarantines, and the most vague public rumour becomes an assumed fact. We evenfind, as may be seen in the quotation given from Dr. Walker's report, that contagionists are driven to the "somehow or other" mode of theintroduction of cholera by individuals; so that it may be deplored, withrespect to this disease, in the words of Bacon, that "men of learningare too frequently led, from ignorance or credulity, to avail themselvesof mere rumours or whispers of experience as confirmation, and sometimesas the very ground-work, of their philosophy, ascribing to them the sameauthority as if they rested upon legitimate testimony. Like to agovernment which should regulate its measures, not by officialinformation of its accredited ambassadors, but by the gossipings ofnewsmongers in the streets. Such, in truth, is the manner in which theinterests of philosophy, as far as experience is concerned, havehitherto been administered. Nothing is to be found which has been dulyinvestigated, --nothing which has been verified by a careful examinationof proof. "

[Footnote 8: Since the above was written it has been very clearly shewnhow easily proofs of _this kind_ may be furnished to all disposed toreceive them. We perceive that a disease officially announced as _thetrue_ cholera, has existed for nearly a month past at Sunderland, andthat among the thousands of people who left it within that time, nothingcould be more easy, had the disease appeared epidemically in other partsof England, than to point out the _particular individual_ who had"brought it" in some way or other; and this is the manner in which allthe fables about the propagation of cholera from one district to anotherhave gained credence. (Nov. 24th. )]

In their efforts to make out their case, there would seem to be no endto the contradictions and inconsistencies into which the advocatesof contagion in cholera are led. At one moment we are required tobelieve that the disease may be transmitted through the medium of anunpurified letter, over seas and continents, to individuals residingin countries widely differing in climate, while, in the next, we aretold--regarding the numberless instances of persons of all habits whoremain unattacked though in close contact with the diseased--that theconstitution of the atmosphere necessary for the germination of thecontagion is not present; and this, although we see the diseaseattacking all indiscriminately, those who are not near the sick aswell as those who are at a very short distance, as on the oppositeside of a ravine, of a rivulet, of a barrack, or even of a road. Theyassume that wherever the disease appears, _three_ causes must be inoperation--contagion--peculiar states of atmosphere (heat now clearlyproved not _essential_, as at one time believed)--and susceptibilityin the habit of the individual. However unphilosophical it is held tobe to multiply causes, the advocates of contagion are not likely toreduce the number, as this would at once cramp them in their pleadingsbefore a court where sophistry is not always quickly detected. Thosewho 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 oursystems, though invisible--though not to be detected by the ingenuityof man, and though proved to exist only by their effects. 

Many who do not believe that cholera can be propagated by contagionunder ordinary circumstances, have still a strong impression that bycrowding patients together, as in hospitals or in a ship, thedisease may acquire contagious properties. Now we find that when the_experimentum crucis_ of extensive experience is contrasted with thefeasibility of this, cholera, like ague, has not been rendered one bitmore contagious by crowding patients together than it has been shown tobe under other circumstances. We do not require to be told that placingmany persons together in ill-ventilated places, whether they labourunder ague, or catarrh, or rheumatism, or cholera, as well as where nodisease at all exists among them, as in the Calcutta black-hole affair, and other instances, which might be quoted, _fever_, of a malignantform, is likely to be the consequence, but assuredly not ague, orcatarrh, or rheumatism, or cholera. On this point we are furnished withdetails by Dr. Zoubkoff, of Moscow, in addition to the many previouslyon record. It may be here mentioned that, on a point which I havealready referred to, this gentleman says (p. 43), "I shall merelyobserve that at Moscow, where the police are remarked for theiractivity, they cannot yet ascertain who was the first individualattacked with cholera. It was believed at one time that the diseasefirst showed itself on the 17th of September; afterwards the 15th wasfixed upon, and at last persons went so far back as August and July. "As this gentleman _had been_ a contagionist, occupied a very responsiblesituation during the Moscow epidemic, and quotes time and place insupport of his assertions, I consider his memoir more worthy oftranslation than fifty of your Keraudrens. 

Respecting those mysterious visitations which from time to timeafflict mankind, it may be stated that we have a remarkable instancein the "_dandy_" or "_dangy_" disease of the West India Islands, which, of late years, has attracted the notice of the profession asbeing quite a new malady, though nobody, as far as I am aware of, hasever stated it to have been an imported one. We find also that withinthe last three years a disease, quite novel in its characters, hasbeen very prevalent in the neighbourhood of Paris. It has proved fatalin many instances, and the physicians, unable to assign it a placeunder the head of previously-described disease, have been obligedto invent the term "Acrodynia" for it. I am not aware that evenM. Pariset, the medical chief of quarantine in France, ever supposedthis disease to have been _imported_, and to this hour the cause ofits 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, inRussia, Prussia, and Austria, one cannot help feeling greatly astonishedon perceiving that Dr. Macmichael (p. 31 of his pamphlet) insinuatesthat the spreading of the disease in Europe has been owing to the viewsof 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 whathe terms "marks of haste" in getting it up for "the curiosity of thepublic" (_curiosity_, Dr. Hawkins!), some omissions of a very importantnature on the subject of a disease respecting which, we presume, hewished to enlighten the public. And first, glancing back to cholera inthe Mauritius, Dr. Hawkins might, had he not been so pressed for time, have referred to the appearance of cholera in 1829, at Grandport in thatisland; when, as duly and officially ascertained, it could not be aquestion of importation by any ship whatever. The facility with which hesupplies us with "facts, "--the _false facts_ reprobated by Bacon, andsaid by Cullen to produce more mischief in our profession than falsetheories--is quite surprising; he tells us, point blank (p. 31), speaking of India, that "when cholera is once established in a marchingregiment, it continues its course in spite of change of position, food, or other circumstances!" Never did a medical man make an assertion moreunpardonable, especially if he applies the term _marching regiment_ asit is usually applied. Dr. Hawkins leads us to suppose that he hasexamined the India reports on cholera. What then are we to think when wefind in that for Bengal the following most interesting and conclusivestatements ever placed on record? Respecting the Grand Army under theMarquis of Hastings, consisting of 11, 500 fighting men, and encamped inNovember 1817 on the banks of the Sinde, the official report states thatthe disease "as it were in an instant gained fresh vigour, and at onceburst forth with irresistible violence in every direction. Unsubjectedto the laws of contact, and proximity of situation, which had beenobserved to mark and retard the course of other pestilences, itsurpassed the plague in the width of its range, and outstripped the mostfatal diseases hitherto known, in the destructive rapidity of itsprogress. Previously to the 14th it had overspread every part of thecamp, sparing neither sex nor age, in the undistinguishing virulence ofits attacks. "--"From the 14th to the 20th or 22d, the mortality hadbecome so general as to depress the stoutest spirits. The sick werealready so numerous, and still pouring in so quickly from every quarter, that the medical men, although night and day at their posts, were nolonger able to administer to their necessities. The whole camp then puton the appearance of a hospital. The noise and bustle almost inseparablefrom the intercourse of large bodies of people had nearly subsided. Nothing was to be seen but individuals anxiously hurrying from onedivision of a camp to another, to inquire after the fate of their deador dying companions, and melancholy groups of natives bearing thebiers of their departed relatives to the river. At length even thisconsolation was denied to them, for the mortality latterly became sogreat that there was neither time nor hands to carry off the bodies, which were then thrown into the neighbouring ravines, or hastilycommitted to the earth on the spots on which they had expired. " Let usnow inquire how this appalling mortality was arrested;--the report goeson to inform us:--"It was clear that such a frightful state of thingscould not last long, and that unless some immediate check were given tothe disorder, it must soon depopulate the camp. It was therefore wiselydetermined by the Commander-in-chief _to move in search of a healthiersoil and of purer air_, " which they found when they "crossed the clearstream of the Bitwah, and upon its high and dry banks at Erich soon gotrid of the pestilence, and met with returning health. " Now just fancyepidemic cholera a disease transmissible by "susceptible articles, " andwhat an inexhaustible stock must this large army, with its thousands offollowers, have long carried about with them; but, instead of this, theywere soon in a condition to take the field. Against the above historicalfact men of ingenuity may advance what they please. There is no doubtthat, in the above instance, severe cases of cholera occurred _duringthe move_, the poison taken into the system on the inauspicious spot, not having produced its effects at once; it is needless to point outwhat occurs in this respect in remittent and intermittent fevers. TheIndia reports furnish further evidence of mere removal producing health, where cholera had previously existed. Mr. Bell, a gentleman who hadserved in India, and who has lately written upon the disease, [9] informsus (p. 84), that "removing a camp a few miles, has frequently put anentire and immediate stop to the occurrence of new cases; and when thedisease prevailed destructively in a village, the natives often got ridof it by deserting their houses for a time, though in doing so theynecessarily exposed themselves to many discomforts, which, _cæterisparibus_, we should be inclined to consider exciting causes of aninfectious or contagious epidemic. " We even find that troops have, asit may be said, _out-marched_ the disease, or rather the cause of thedisease; that is, moved with rapidity over an extensive surface wherethe atmosphere was impure, and thereby escaped--on the principle thattravellers are in the habit of passing as quickly as they can across thepontine marshes. Mr. Bell says, "In July, 1819, I marched from Madras inmedical charge of a large party of young officers who had just arrivedin India, and who were on their way to join regiments in the interior ofthe country. There was also a detachment of Sepoys, and the usual numberof attendants and camp-followers of such a party in India. The choleraprevailed at Madras when we left it. Until the 5th day's march (fiftymiles from Madras) no cases of the disease occurred. On that day severalof the party were attacked on the line of march; and, during the nextthree stages, we continued to have additional cases. Cholera prevailedin the countries through which we were passing. In consultation with thecommanding officer of the detachment, it was determined that we should_leave the disease behind us_; and as we were informed that the countrybeyond the Ghauts was free from it, we marched, without a halt, until wereached the high table land of Mysore. The consequence was, that we leftthe disease at Vellore eighty-seven miles from Madras, and we had noneof it until we had marched seventy miles further (seven stages), when weagain found it at one of our appointed places of encampment; but ourcamp was, in consequence, pushed on a few miles, and only one case, afatal one, occurred in the detachment; the man was attacked on the lineof march. We again left the disease, and were free from it during thenext 115 miles of travelling; we then had it during three stages, andfound many villages deserted. We once more left it, and reached ourjourney's end, 260 miles further, without again meeting it. Thus, in ajourney of 560 miles, this detachment was exposed to, and left thedisease behind it, four different times; and on none of those occasionsdid a single case occur beyond the tainted spots. " What a lesson forDr. Hawkins! But _for whom_ could Dr. Hawkins have written his _curious_book? Hear Mr. Bell in respect to the common error of the diseasefollowing high roads and navigable rivers only:--"I have known thedisease to prevail for several weeks at a village in the SouthernMahratta country, within a few miles of the principal station of thedistrict, and then leave that division of the country entirely; or, perhaps, cases would occur at some distant point. In travelling oncircuit with the Judge of that district, I have found the diseaseprevailing destructively in a small and secluded village, while no caseswere reported from any other part of the district. " What is furtherstated by Mr. Bell will tend to explain why so much delusion has existedwith regard to the progress of the disease being remarkably in thedirection of lines of commerce, or great intercourse:--"When travellingon circuit, I have found the disease prevailing in a district _beforeany report had been made of the fact, notwithstanding the most positiveorders on the subject_; and I am persuaded, that were any of theinstances adduced in support of the statement under considerationstrictly inquired into, it would be found that the usual apathy of thenatives of India had prevented their noticing the existence of thedisease until the fact was brought prominently forward by the presenceof Europeans. It should also be brought to mind, that cholera asphyxiais not a new disease to these natives, but seems to be, in many places, almost endemical, whilst it is well known that strangers, in suchcircumstances, become more obnoxious to the disease than the inhabitantsof the country. Moreover, travellers have superadded to the remote causeof the disease, fatigue and road discomforts, which are not trifling ina country where there are neither inns nor carriages. " (p. 89. ) Choleraonly attacks a certain proportion of a population, and is it wonderfulthat we should hear more of epidemic on high roads, where the populationis greatest? High roads too are often along the course of rivers; andis there not some reason for believing, that there is often along thecourse of rivers, whether navigable or not, certain conditions of theatmosphere unfavourable to health? When Dr. Hawkins stated, as we findat p. 131 he has done, that where the inhabitants of certain hillyranges in India escaped the disease, "these have been said to haveinterdicted all intercourse with the people below, " he should havequoted some respectable authority, for otherwise, should we unhappily bevisited by this disease, the people of our plains may one day wage anunjust war against the sturdy Highlanders or Welsh mountaineers. [10]Little do the discussers of politics dream of the high interest ofthis part of the cholera question, and little can they conceive theunnecessary afflictions which the doctrine of the contagionists arecalculated to bring on the nation. Let no part of the public suppose fora moment that this is a question concerning medical men more than itdoes them; _all_ are _very_ deeply concerned, the heads of families moreespecially so. 

[Footnote 9: This is by far the best work yet published in England onthe cholera, but it is to be regretted that the author has not alludedto the works of gentlemen who have a priority of claim to some of theopinions he has published: I think that, in particular, Mr. Orton'sbook, 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 isadmitted on all sides; we have abundant proof that whatever can be saidas to the progress of the disease, its anomalies, &c. , in the formercountry, have been also noted respecting it in the latter; and Dr. Hawkins, when he put forth his book, had most assuredly abundantmaterials upon which to form a rational opinion. It is by no smalleffort, therefore, that I can prevent all the respect due to him fromevaporating, when he declares, at page 165, that "the disease in Indiawas _probably_ communicable from person to person, and that in Europe ithas _undeniably_ proved so. " But Dr. Hawkins is a Fellow of the Collegeof Physicians, and we must not press this point further than to wishothers to recollect that he has told us that he drew up his book inhaste; and, moreover, that he wished to gratify the _curiosity_ of thepublic. The Riga story about the hemp and the fifteen labourers I shallleave in good hands, the British Consul's at that city, who was requiredto draw up, for his government, a statement of the progress, &c. Ofthe cholera there, of which the following is an extract:--

"The fact of non-contagion seems determined, as far as a question canbe so, which must rest solely upon negative evidence. The strongestpossible proof is, the circumstance, that not one of the personsemployed in removing the dead bodies (which is done without anyprecaution) has been taken ill. _The statement of fifteen labourersbeing attacked, while opening a pack of hemp, is a notorious falsehood. _Some physicians incline to the opinion, that the disease may sometimesbe caught by infection, where the habit of body of the individual ispredisposed to receive it; the majority of the faculty, however, maintain a contrary doctrine, and the result of the hospital practiceis in their favour. There are 78 persons employed in the principalhospital 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 Icannot obtain equally authentic information respecting them, I confinemyself to this statement, on which you may rely. On the other hand, inprivate families, several instances have occurred where the illness ofone individual has been followed by that of others: but, generally, onlywhere the first case has proved fatal, and the survivors have given wayto grief and alarm. Mercenary attendants have seldom been attacked, and, as mental agitation is proved to be one of the principal agentsin propagating or generating the disease, these isolated cases areattributed 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 tillafter it had broken out here. The nearest point infected was Schowlen(at a distance of 200 wersts), and it appeared simultaneously in threedifferent places at Riga, without touching the interjacent country. Thefirst cases were two stone-masons, working in the Petersburg suburbs, aperson in the citadel, and a lady resident in the town. None of thesepersons had had the slightest communication with the crews of barks, orother strangers, and the quarter inhabited by people of that descriptionwas later attacked, though it has ultimately suffered most. 

"None of the medical men entertain the slightest doubt of the action ofatmospheric influence--so many undeniable instances of the spontaneousgeneration of the disease having occurred. Half the town has beenvisited by diarrhoea, and the slightest deviation from the regimen nowprescribed (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, someof whom had not left their rooms since the breaking out of the disease, having been attacked by cholera, almost instantaneously after havingimprudently indulged in sour milk, cucumbers, &c. It is a curiouscircumstance, bearing on this question, that several individuals comingfrom Riga have died at Wenden, and other parts of Livonia, without asingle inhabitant catching the disease; on the other hand, it spreads inCourland, and on the Prussian frontier, notwithstanding every effort tocheck its progress. The intemperance of the Russians during the holidayshas swelled the number of fresh cases, the progressive diminution ofwhich had previously led us to look forward to a speedy termination ofthe calamity. " This is a pretty fair specimen of the _undeniable_ mannerin which cholera is proved to be contagious in Europe, and we shall, forthe present, leave Dr. Hawkins in possession of the full enjoyment ofsuch proofs. 

Some attempt was made at Sunderland, to establish that, in the casewhich I mentioned in my last as having proved fatal there, the diseasehad been imported from foreign parts, but due inquiry having been madeby the collector of the customs, this proved to be unfounded; the man'sname 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 whichappeared this year at Port Glasgow; I find that the highly interestingdetails of those cases have been just published:--_they should be readby everybody who takes the smallest interest in the important questionsconnected with the cholera_. The London publishers are Whittaker andCo. ]

Abroad we find that, unhappily, the cholera has made its appearance atHamburgh; official information to this effect arrived from our Consulat that place, on Tuesday the 11th inst. (October). The absurdity ofcordons and quarantines is becoming daily more evident. By accountsfrom Vienna, dated the 26th September, the Imperial Aulic Council haddirected certain lines of cordon to be broken up, seeing, as is stated, that they were inefficacious; and by accounts of the same date, theEmperor had promised his people not to establish cordons between certainstates. 

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 duringthe greater part of the epidemic which prevailed there this year, thefollowing 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 thoughtupon the subject, I arrive at this conclusion, that the disease is notcontagious. "

In confirmation of the opinion of Mr. Searle, we have now the evidenceof 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 ofHealth, 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 ofthem have already declared against contagion; so it may be presumed thatthe day is not far distant when those true plagues of society, cordonsand quarantines against cholera, shall be abolished. Hear the opinion ofa medical Journalist in France, --after describing, a few days ago, thequarantine and cordon regulations in force in that country:--"But whateffect is to be produced by these extraordinary measures, this immensedisplay of means, and all these obstructions to the intercourse ofcommunities, against a disease not contagious; a disease propagatingitself epidemically; and which nothing has hitherto been able to arrest?To increase its ravages a hundred-fold, --to ruin the country, and tomake the people revolt against measures which draw down on them miseryand death at the same time. " What honest man would not _now_ wish thatin 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 purposeof studying the nature of cholera, have all remained unattacked by thedisease. 

October 15, 1831. 

LETTER V. 

It was well and wisely said, that to know any-thing thoroughly, it mustbe known in all its details; and, to gain the confidence of the publicin the belief of non-contagion in cholera, it is in vain that they areinformed that certain alleged facts, brought forward industriouslyby contagionists, are quite groundless, unless proofs are given showingthis to be the case. The public must, in short, have those allegedinstances of contagion which have gained currency circumstantiallydisproved, or they will still listen to a doctrine leading to thedisorganization of the community wherever it is acted upon. It issolely upon this ground that these letters have any claim to attention. Dr. James Johnson, of London, has, since my last letter, publiclycontradicted, with all the bluntness and energy of honest conviction, the statement by Sir Gilbert Blane, Drs. Macmichael, Hawkins, &c. , as tothe importation of the cholera into the Mauritius by the Topaze frigate;but _evidence_ is what people want on these occasions, and, relative tothe case in question, probably the public will consider what is to befound in my third and fourth letters, quite conclusive. Having againmentioned the Mauritius, I cannot refrain from expressing my greatsurprise that Mr. Kennedy, who has lately published on cholera, shouldgive, with the view of showing "the dread and confusion existing at thetime, " a proclamation by General Darling, while he does not furnish aword about the result of the proceedings instituted by that officer, asdetailed in my third letter, relative to the non-contagious nature ofthe disease, a point of all others the most important to the public. Asto accounts regarding the confusion caused by the appearance of epidemiccholera, we have had no lack of them in the public papers during manymonths 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 diseasewas imported into the Russian province of Orenburg, " Dr. H. Omits totell us how completely he failed in the endeavour. In the _EdinburghMedical and Surgical Journal_ for July, 1831, there is a review of amemoir 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 incholera, as well as yellow-fever, he seems to be considered in thiscountry as a medical man; but this is not the case: he raised himself bymerit, not only to military rank, but also to literary distinction, andis a member of the Academy of Sciences, where he displays an imaginationthe most vivid, but as to the sober tact necessary for the investigationof such questions as those connected with the contagion or non-contagionof cholera and yellow-fever, he is considered _below par_. He saw theyellow-fever in 1802-3, at Martinique, while _aid-de-camp_ to theGovernor, and still adheres to the errors respecting it which he imbibedin his youth, and when he was misled by occurrences taking place _withina malaria boundary_, where hundreds of instances are always at hand, furnishing the sort of _post hoc propter hoc_ evidence of contagion withwhich 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 uponit, 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 Frenchjournals, by the opinions of this gentleman on cholera, instead of bydifferent medical commissions sent to Warsaw, &c. 

The question of contagion in cholera has been now put to the test inevery possible way, let us view it for a moment, as compared with whathas occurred in regard to typhus at the London Fever Hospital, accordingto that excellent observer Dr. Tweedie, physician to the establishment. Doubts, as we all know, have been of late years raised as to thecontagion of typhus, but I believe nothing that has as yet appeared isso well calculated to remove those doubts as the statements by thisgentleman (_see "Illustrations of Fever"_), where he shows that it hasbeen remarked for a series of years that "the resident medical officers, matrons, porters, laundresses, and domestic servants not connected withthe wards, and every female who has ever performed the duties of anurse, have one and all been the subjects of fever, "--while, _in theSmall-Pox Hospital_, which adjoins it, according to the statements ofthe physician, "no case of genuine fever has occurred among the medicalofficers or domestics of that institution for the last eight years. " Hadtyphus been produced in the attendants by _malaria_ of the locality, those persons in the service of the neighbouring Small-Pox Hospitalshould also have been attacked to a greater or less extent, it isreasonable to suppose, within the period mentioned. Now let this becompared with all that has been stated respecting attendants on cholerapatients, and let it be compared with the following excellent fact inillustration, showing how numbers labouring under the disease, andbrought from the inauspicious spot where they were attacked to a placeoccupied by healthy troops, did not, _even under the disadvantage of aconfined space_, communicate the disease to a single individual:--"Ithas been remarked by many practitioners, that although they had broughtcholera patients into crowded wards of hospitals, no case of the diseaseoccurred among the sick previously in hospital, or among the hospitalattendants. My own experience enables me fully to confirm this. TheMilitary Hospital at Dharwar, an oblong apartment of about 90 feet by20, was within the fort, and the lines of the garrison were about a miledistant outside of the walls of the fort. On two different occasions (in1820 and 1821), when the disease prevailed epidemically among the troopsof that station, while I was in medical charge of the garrison, butwhile no cases had occurred in the fort within which the hospital wassituated, the patients were brought at once from their quarters to thehospital, which, on each occasion, was crowded with sick labouring underother disorders. No attempt was made to separate the cholera patients. On one of these occasions, no case of cholera occurred within thehospital; on the other, one of the sick was attacked, but he was aconvalescent sepoy, who had not been prevented from leaving the fortduring the day. The disease, on each of those occasions, was confinedto a particular subdivision of the lines, and none of those within thefort were attacked. " (_Bell on Cholera_, p. 92. )

I have already quoted from Dr. Zoubkoff of Moscow, once a believer incontagion; every word in his pamphlet is precious; let but the followingbe read, and who will then say that "the seclusion of the sick should beinsisted on?"--"The individuals of the hospitals, including soldiers andattendants on the sick, were about thirty-two in number, who, exceptingthe medical men, had never attended any sick; we all handled, more orless, the bodies of the patients, the corpses, and the clothes of thesick; have had our hands covered with their cold sweat, and steeped inthe bath while the patients were in it; have inhaled their breath andthe vapours of their baths; have tasted the drinks contained in theirvessels, all without taking any kind of precaution, and all withouthaving suffered any ill effects. We received into our hospitalsixty-five cholera patients, and I appeal to the testimony of thethirty-six survivors, whether we took any precautions in putting theminto the bath or in handling them--whether we were not seated sometimeson the bed of one, sometimes on that of another, talking to them. Onreturning home directly from the hospital, and without using chlorideof lime, or changing my clothes, I sat down to table with my family, andreceived the caresses of my children, firmly convinced that I did notbring them a fatal poison either in my clothes or in my breath. Nobodyshut his door either against me or my colleagues; nobody was afraid totouch the hand of the physician who came direct from an hospital--thathand which had just before wiped the perspiration from the brow ofcholera patients. From the time that people had experience of thedisease, nobody that I am aware of shunned the sick. " Who, after this, can read over with common patience directions for the separation of acholera 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 acircular containing a description the most _naïve_ on record, of theepidemic cholera, hard must be the heart which could refuse makingthe allowance which he claims for himself and his memoir; and thoughhe brands those who see, in his account of the marchings andcounter-marchings of the disease, nothing on a level with theintellect of the present age, as a parcel of prejudiced imbeciles, we must still feel towards him all the respect due to a parent arrivedat 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 sometimesemploying "unintelligible jargon, " but shall not retort while I confessmy inability to understand such expressions as "some obscure occurrenceof unwholesome circumstances" which seem to have, according to him, both "brought" the disease to Jessore in 1817, and produced it thereat the same time. Sir Gilbert marks out for the public what heconsiders as forming one of the principal differences between theEnglish and Indian cholera, viz. That in the latter the discharges"consist of a liquid resembling thin gruel, in the English diseasethey are feculent and bilious. " Now if he has read the India reports, he must have found abundance of evidence showing that sometimes therewere _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 havefound _abundant_ evidence of malignant cholera with discharges likewater-gruel in this country. As to the French Consul at Aleppo havingescaped with 200 other individuals confined to his residence, I shallonly say, as it is Sir Gilbert Blane who relates the circumstance, that he _forgot_ to mention that the aforesaid persons had retired toa residence _outside_ the city; which, permits me to assure you, SirGilbert, just makes all the difference in hundreds of cases:--theyhappened to retire to "_clene air_;" and had they carried 50 aguecases or 50 cholera cases with them (it matters not one atom which), the result would have been exactly the same. The mention of Barcelonaand the yellow-fever, by Sir Gilbert, was, as Dr. Macmichael wouldterm it, rather _unlucky_ for his cause, though probably lucky forhumanity; for it cannot be too generally known that, during theyellow-fever epidemic there in 1821, more than 60, 000 people left thecity, and spread themselves all over Spain, without a single instanceof the disease having been communicated, WHILE, AT BARCELONETTA, THEINFAMOUS CORDON SYSTEM PREVENTED THE UNFORTUNATE INHABITANTS FROMGOING BEYOND THE WALLS, AND THE CONSEQUENCES OF SHUTTING THEM UP WEREMOST HORRID. 

[Footnote 12: See Orton on Cholera, who is most explicit upon thispoint, and cites from the India Reports:--so that the distinctionsattempted 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 asto the movements of the malady by land and by water, for those vague andhacknied statements have been again and again refuted; but we may remarkthat whereas all former accounts respecting the cholera in 1817, in thearmy of the Marquis of Hastings, state that the disease broke outsomewhat 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 asto the disease having accompanied the grand army on the march; for hesays the appearance of the malady was announced in camp in the earlypart of November, when "the first cases excited little alarm. " Inreferring, in a former letter, to the sickness in the above army, Ishowed from the text of the Bengal report, how a change of positionproduced a return of health in the troops; but Mr. Kennedy states thatthe disease had greatly declined a few days before the removal, so thatit had lost "its infecting power. " Nevertheless it appears by thisgentleman's account, a little farther on, that "in their progressivemovement the grounds which they occupied during the night as temporaryencampments were generally found in the morning, strewed with the deadlike a field of battle"! This gentleman tells us that he has laid down alaw of "increase and decline appertaining to cholera, " by which, and theassistance of _currents of contagion_, it would appear all these thingsare reconciled wonderfully. Several of the points upon which he groundshis belief of contagion have been already touched upon in these letters, and the rest, considering the state of the cholera question in Europejust now, may be allowed to pass at whatever value the public may, afterdue examination, think it is entitled to. Let it be borne in mind thatall contagionists who speak of the cholera in the army of the Marquis ofHastings, forget to tell us that though many thousand native followershad fled from that army during the epidemic, the disease did not appearin the towns situated in the surrounding country, _till the followingyear_, as may be seen at a glance by reference to Mr. Kennedy's andother maps. 

We have another contagionist in the field--a writer in the _ForeignQuarterly Review_, the value of whose observations may appear from hisstatement, that "in 1828 the disease broke out in Orenburg, and wassupposed [_supposed_!] to have been introduced by the caravans whicharrive there from Upper Asia, or [_or_, nothing like a second string] bythe Kingiss-Cossacks, who are adjoining this town, and were said [_weresaid_!] to have been about this time affected with the disease. " Thissingle extract furnishes an excellent specimen of the sort of _proofs_which the contagionists, to a man, seem to be satisfied with as to thecholera being "carried" from place to place. This gentleman must surelybe under some very erroneous impression, when he states that, "Accordingto the reports of the Medical Board of Ceylon, the disease made itsappearance in 1819 at Jaffnah in Ceylon, imported from Palamcottah, withwhich Jaffnah holds constant intercourse, and thence it was propagatedover the island. " Now there is every reason to believe that a referenceto the documents from Ceylon will shew that no report as to theimportation of the disease was ever drawn up, for Drs. Farrel and Davy, as well as Messrs. Marshall, Nicholson, and others, who served in thatisland, are, to this hour, clearly against contagion. But as the writertells us that he is furnished with unpublished documents respecting thecholera at St. Petersburg, by the chief of the medical department of thequarantine in this country, we do not think it necessary to say one wordmore--_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 followhis example. It is only to be regretted, that a gentleman possessingsuch influence with the public as Dr. Johnson does, should have so longwith-held his powerful aid on the occasion; but his motives were, I amquite sure, most conscientious; and I believe that he, as well asothers, might have been prevented by a feeling of delicacy from goingbeyond a certain point. 

Since my last letter a code of regulations, in the anticipation ofcholera, has been published by the Board of Health. _Let our prayers beoffered up with fervency tenfold greater than before, that our land maynot 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 aletter to his High Chancellor, dated Schoenbrunn, October 10th, andpublished in the _Austrian Observer_ of the 12th, formally makes themost magnanimous declaration to his people, THAT HE HAD COMMITTED ANERROR IN ADOPTING THE VEXATIOUS AND WORSE-THAN USELESS QUARANTINE ANDCORDON REGULATIONS AGAINST CHOLERA; that he did so before the nature ofthe disease was so fully understood; admits that those regulations havebeen found, after full experience, to have produced consequences morecalamitous than those arising from the disease itself ("_plus funesteencore que les maux que provenaient de la maladie elle-même_. ") Hekindly makes excuses for still maintaining a modified quarantine systemat certain points, in consequence, as he states, of the opinions stillexisting in the dominions of some of his neighbours, _for otherwise hiscommercial relations would be broken off. To secure his maritimeintercourse, he must do as they do!_ We find that as _all_ the Prussiancordons have been dissolved, _their vessels_ are excluded from entranceinto certain places on the Elbe. What a horrid state of things! But, asa reference will shew, this was one of the things stated in my firstletter as likely to occur: it is surely a fit subject for immediatearrangement between governments. In the mean time, we cannot but profitby the great lesson just received from Austria. 

I shall add no more on the present occasion, than that my lastinformation from Edinburgh notifies the death, from _Scotch cholera_, of two respectable females in that city, after an illness of only a fewhours. 

LETTER VI. 

At a moment when the subject of cholera has become so deeplyinteresting, the good of the public can surely not be better consultedby the press than when it devotes its columns (even to the exclusion ofsome political and other questions of importance) to details of plainfacts connected with the contagious or non-contagious nature of thatmalady--a _question beyond all others regarding it, of most importance_, for upon it must hinge all sanatory or conservative regulations, and amistake must, in the event of an epidemic breaking out, directly involvethousands in ruin. In the case of felony, where but the life of a singleindividual is at stake--nay, not only in the case of felony, but in thecase of a simple misdemeanour, or even in the simple case of debt--wesee the questions of yes or no examined by the Judges of the land withdue rigour; while, on the point to which I refer, and which affectsso deeply the dearest interests of whole communities, evidence hasbeen acted upon so vague as to make some people fancy that we haveretrograded to the age of witchcraft. Be it recollected that we shallnot have the same excuse as some of our continental neighbours had forrunning into frightful errors--for we have their dear-bought experiencelaid broadly before us; and to profit duly by it, it only requires ascrutiny by a tribunal, wholly, if you please, non-medical, such as maybe formed within an hour in this metropolis; nothing short of this willdo. All, till then, will be vacillation; and when the enemy does come inforce, we shall find ourselves just as much at a loss how to act as ourcontinental neighbours were on the first appearance of cholera amongthem; I say after its first appearance, for we find that they alldiscovered, plainly enough latterly, what was best to be done. Smallindeed may be the chance of the present order of things as toquarantines, the separation of persons attacked, &c. , being changedby anything which I can offer; but, having many years experience ofdisease--having had no small share of experience in this disease inparticular, and having, perhaps, paid as much attention to all that hasbeen said about it as any man living, I should be wanting in my dutytowards God and man did I not protest, most loudly, against thoseregulations, which shall have for their base, an assumption, that abeing affected with cholera can, IN ANY MANNER WHATEVER, transmit, orcommunicate, the disease to others, _however close or long continued theintercourse may be_; because such doctrine is totally in opposition toall the fair or solid evidence now before the public;--because it iscalculated, in numberless instances, to predispose the constitutionto the disease, by exciting terror equal to that in the case ofplague;--because it is teaching us Christians to do what Jews, andothers, never do, to abandon the being who has so many ties upon ouraffections;--because the desertion of friends and relatives, and thebeing left solely in charge, perhaps, of a feeble and aged hireling (ifeven 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 ofthe disease, it should be our great effort to support;--finally, becausea proper and unbiassed examination of the question will shew, that allthese horrors are likely to arise out of regulations which may, withequal justice, be applied to ague, to the remittent fevers of somecountries, or to the Devonshire cholic, as to cholera. 

Happily, it is not yet too late to set about correcting erroneousopinions, pregnant with overwhelming mischief, for hitherto the measuresacted upon have only affected our commerce and finances to a certainextent; but it appears to me that not a moment should be lost, in orderto prevent a public panic; and, in order to prevent those calamitieswhich, in addition to the effects of the disease itself, occurred, as wehave seen, on the Continent. Let then, I say, a Commission be forthwithappointed, composed of persons accustomed to weigh evidence in othercases, and who will not be likely to give more than its due weight tothe authority of any individuals. Let this be done, and, in thedecision, we shall be sure to obtain all that human wisdom can arrive aton so important a subject; and the public cannot hesitate to submit towhatever may afterwards be proposed. It will then be seen whether theLondon Board of Health have decided as wisely as they have hastily. Formy part, I shall for ever reject what may be held as evidence in humanaffairs, if it be not shewn that an individual attending anotherlabouring under cholera, runs no further risk of being infected thanan individual attending an ague patient does of being infected by thislatter disease. What a blessing (in case of our being visited by anepidemic) should this turn out to be the decision of those whoseopinions would be more likely to be regarded by the public than mineare likely to be. 

Many, I am quite aware, are the professional men of experience now inthis country, who feel with me on this occasion, but who, in deferenceto views emanating from authority, refrain from coming forward:--let meentreat them, however, to consider the importance of their suggestionsto the community at large, at this moment; and let me beg of them tocome forward and implore government to institute a special commissionfor the re-consideration of measures, founded on evidence the most vaguethat it is possible to conceive; or, perhaps, I should rather say, _against_ whatever deserves the name of evidence. Every feeling shouldbe sacrificed, by professional men, for the public good; we must evenrun the greatest risk of incurring the displeasure of those of ourfriends who are in the Board of Health. That we do run some risk ispretty plain, from the conduct of a vile journalist closely connectedwith an individual of a paid party, who has threatened us unbelievers ingenerally-exploded doctrines, with a fate nothing short of that whichoverwhelmed some of the inhabitants of Pompeii. 

Let me ask why _all_ the documents of importance forwarded to the Boardof Health are not published in the collection just issued? Why are thoseforwarded by _the Medical Gentleman sent to Dantzic_ not published. [13]Why has not an important document forwarded by our Consul at Riga notbeen published? Above all, why has not allusion been made in theirpapers to those cases of PURE SPASMODIC CHOLERA, which have occurred invarious parts of England within the last five months, and the detailsof which has been faithfully transmitted to them. If those cases beinquired into thoroughly and impartially, and that several of them benot found to be PERFECTLY IDENTIC with the epidemic cholera of India, of Russia, &c. , I hereby promise the public to disclose my name, andto suffer all the ignomy of a person making false statements. Indeed, I may confidently assure the public, that in at least one case whichoccurred about two months ago, the opinion of a gentleman who hadpracticed in India, and who had investigated the history of thesymptoms, the identity with those of Asiatic cholera, was not denied. The establishment of this point is of itself sufficient to overthrowall supposition as to the importation of the disease. 

[Footnote 13: Since the above was written, I find that this gentlemanhas adduced the strongest proofs possible against contagion. ]

In the case of Richard Martin, whose death occurred at Sunderland abouttwo 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 PortGlasgow, as detailed in a pamphlet by Dr. Marshall of that place--aswell as several other cases which occurred throughout the year, and thedetails of many of which are in possession of the Board of Health--theadvocates, "_par metier_, " of contagion in cholera, have not a loop-holeto creep out at. Take but a few of the symptoms in one of those casesas taken down by the Medical Gentleman in charge, --"The body was cold, and covered by a clammy sweat--the features completely sunk--_the lipsblue_, the face discoloured--tongue moist and very cold--the hands andfeet blue, cold, and as if steeped in water, like a washerwoman's hand;the extremities cold to the axillæ and groins, and no pulse discoverablelower; the voice changed, and the speech short and laborious. Heanswered with reluctance, and in monosyllables. " This man had the paledejections, and several other symptoms, considered so characteristic ofthe Asiatic cholera; yet no spreading took place from him, nor ever willin similar cases. With the exception of the vomiting and purging, thereis, in the state of patients labouring under this form of cholera, agreat similarity to the first stage of the malignant fevers of thePontine Marshes, and many other places, and the patient need not be onebit the more avoided. Let this be, therefore, no small consolation, whenwe find that, by the official news of this day, five more deaths haveoccurred at Sunderland. 

Nov. 9, 1831. 

LETTER VII. 

It may be inferred, from what I have stated at the close of my letterof yesterday, that if a Commission be appointed, I look forward to itsbeing shewn, as clear as the sun at noon day, that the most completeillusion has existed, and, on the part of many, still exists, withregard to the term _Indian_ or _Asiatic_ cholera; for a form of cholerapossessing characters quite peculiar to the disease in that country, andunknown, till very lately, in other countries, _has never existedthere_. Cholera, from a cause as inscrutable, perhaps, as the cause oflife itself, has prevailed there, and in other parts of the world, inits severest forms, and to a greater extent than previously recorded;but, whether we speak of the mild form, or of a severe form, proceedingor not to the destruction of life, the symptoms have everywhere beenprecisely the same. In this country it has been over and over againremarked, that, so far back as 1669, the spasmodic cholera prevailedepidemically under the observation of Dr. Sydenham, who records it. Formany years after the time of Dr. Cullen, who frequently promulgatedopinions founded on those of some fancy author rather than on his ownobservation, it was very much the fashion to speak of redundancy ofbile, or of acrid bile, as the cause of the whole train of symptoms inthis disease; but, since the attention of medical men has been moreparticularly drawn to the subject, practitioners may be found in everytown in England who can inform you that, in severe cases of cholera, they have generally observed that no bile whatever has appeared tillthe patient began to get better. Abundance of cases of this kind arefurnished by the different medical journals of this year. In fifty-twocases of cholera which passed under my observation in the year 1828, the_absence_ of bile was always most remarkable. I made my observationswith extraordinary care. One of the cases proved fatal, in which thegroup of symptoms deemed characteristic of the Indian or Indo-Russiancholera, was most perfect, and in the mass, the symptoms were asaggravated 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 bemore absurd than to hear people say such or such a case cannot be _thetrue_ cholera, or the Indian cholera, or the Russian cholera, because_all_ the symptoms ever mentioned are not present: as if, in theepidemic cholera of India and other places, even some of the symptomsconsidered the most prominent (as spasms, and the disturbance of thestomach and bowels) were not often absent, and that too in some of themost rapidly, fatal cases! I feel persuaded that much injustice is doneto a gentleman lately sent to Sunderland, in attributing to him thevery ridiculous opinion, _that because_ the disease did not spread, itwas _therefore_ not identical with the Indian cholera. No person isjustified in speaking of the cholera of India as a disease _suigineris_, and in which a certain group of severe symptoms are alwayspresent, when evidence, such as the following is on record:--"On the22nd instant, when the men had been duly warned of their danger from notreporting themselves sooner, I got into hospital a different descriptionof cases, viz. --men with a full pulse, hot skin, " &c. (_Dr. Burrell toDr. Milne, Seroor, 27th of July, 1818_)--"But I must tell you that wehave, too, cases of common cholera. " (_Mr. Craw, Seroor--Bengal Report, p. 48_)--"The cases which terminated favourably presented very differentsymptoms [from the low form of the disease. ] As I saw the menimmediately after they were attacked, they came to me with a quick_full_ pulse, and in several instances pain in the head; there was nosweating. "--"in several cases _bile_ appeared from the first inconsiderable quantities in the egesta; and these were more manageablethan those in which no bile was ejected, although the spasms andvomiting (the most distressing symptoms of the complaint) were equallyviolent. " (_Mr. Campbell, Seroor, --see Orton, 2nd ed. P. 18_)--"Inconclusion, I am happy to inform you that, for the last three days thedisease has been evidently on the decline, and, during that period, mostof 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 vomitinga watery fluid, and sometimes bile. " (_White--Bengal Reports, p. 68. _)

The same gentleman afterwards observes, "The disease continues topresent a milder aspect, and now occurs but rarely: loss of pulse andcoldness are seldom observed. "

On the decline of a particular epidemic, Mr. Alardyce observed manycases in the 34th regiment, with _bilious_ discharges throughout. (Orton, 1st Ed. 128). Finally, referring to the work of Mr. Orton, agentleman who served in India, and who, being a contagionist, will beconsidered, I suppose, not bad authority by those who are of hisopinion, we find the following declaration. (p. 26, 1st Ed. ) "My ownexperience has been very conclusive with regard to the sthenic form ofthe disease. I have found a very considerable number of casesexhibiting, singly, or in partial combination, every possible degree, and almost every kind of increased action. "--"Very full, hard, and quickpulse, hot skin, and flushed surface; evacuations of bile, [you arerequested to note this, reader] both by vomiting and stool, from thecommencement of the attack. And, finally, I have seen some of thosecases passing into the low form of the disease. "--"The inference fromthese facts is plain, however opposite these two forms of disease mayappear, _there is no essential or general difference between them_. "After such authorities, and what has elsewhere been shewn, can anycavelling be for one moment permitted as to the cholera in Sunderlandnot being of the same nature as that of India? It may be now clearlyseen that in India as in Sunderland, the same variety of grades occurredin the disease. 

In making my communications for the benefit of the public, it is my wishto spare the feelings of Sir Gilbert Blane; but as he persists in givingas facts often refuted tales of contagion, in order to uphold doctrineswhich he must observe are tumbling into ruins in all directions, itbecomes necessary that his work of mischief should no longer remainunnoticed. 

Not a single circumstance which he quotes relative to the marchingsand the voyages of the contagion of cholera will bear the slightestexamination; and yet he has detailed them as if, on his simpleassertion, 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 ofrules whereby they may be guided. The examination of his assumed factsfor one short hour, by a competent tribunal, would prove this to be thecase; here it is impossible to enter upon them all: but let us justrefer to his _management_ of the question relative to the importation ofthe disease into the Mauritius by the _Topaze_ frigate, which he sayswas 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 havethe reason from me, at page 22. 

If a commission be appointed, half an hour will suffice to place beforethem, from the medical office in Berkeley-street, the reports alluded tofrom the Mauritius, by which it is made apparent that long before thearrival of the aforesaid frigate, the disease had shown itself in theMauritius. [14] What is the public to think of us and our profession, when vague statements are daily attempted to be passed as facts, bycontagionists _enragés_? One more short reference to Sir Gilbert'sfacts. --While referring to the progress of cholera in India, &c. From1817, he says, in a note, "it is remarkable enough that while the greatoriental epidemic appeared thus on the eastern extremity of theMediterranean, the great western pestilence, the yellow fever, wasraging in its western extremity, Gibraltar, Malaga, Barcelona, Leghorn, &c. " Now, it is a historical fact, that, at Gibraltar, this disease didnot appear between 1814 and 1828--_and at Leghorn not since 1804_! AtMalaga, I believe, it did not prevail since 1814! So we have here apretty good specimen of the accuracy of some of those who undertake tocome forward as guides to the public on an occasion of great urgency andperil. By some of Sir Gilbert's abettors, we are assured that his "factsare perfectly reconcileable with the hypothesis of the cholera being ofan infectious nature. " A fig for all hypothesis just now! Let us havesomething like the old English trial by jury. May I be allowed tointroduce a fresh evidence to the public notice, in addition to thethousand-and-one whose testimony is already recorded. He is worthy ofbelief for two good reasons in particular; the one because he still(unable to explain what can never be explained, perhaps), calls himselfa contagionist, and, in the next place, the statements being from ahigh official personage, he could not offer them unless true to hisGovernment, as hundreds might have it in their power to contradict themif 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 extractsfrom which, but those most important ones, I shall here give. Readthem!--people of all classes, read them over and over again! "Animportant truth seems to be proved by what we shall here relate, which is, that woods seem to diminish the influence of cholera, andthat cantons in the middle of thick woods, and placed in the centreof infected countries, have altogether escaped the devastatingcalamity!"--"The island of Kristofsky, placed in the centre of thepopulous islands of St. Petersburg, communicating with each other bytwo magnificent bridges, and with the city by thousands of boats, whichcarried every day, and particularly on Sundays, a great number of peopleto this charming spot. The island of Kristofsky, we say, _was preservedcompletely from attacks of the cholera_; there was not a _single_ personill of the disease in three villages upon it. " He continues to stateparticulars, which, for want of time, cannot be here given, andadds--"To what is this salubrity of Kristofsky, inhabited by the samesort of people as St. Petersburg, to be attributed, fed in the samemanner, and following a similar _regime_, --communicating with each otherdaily, if it be not to the influence of the superb forest which sheltersit? The firs, which are magnificent as well as abundant, surround thehouses. "[15] He notices that the town is low and humid, and that "it ismade filthy every Sunday by the great numbers who resort to it, and whogorge themselves with intoxicating drink. " In a third letter I shall beable to furnish further extracts from this most interesting pamphlet. 

[Footnote 14: I am aware that very lately certain memoranda have beenreferred to from the surgeon, but this is merely an expiring effort, andof no avail against the official Report drawn up. ]

[Footnote 15: As these most remarkable circumstances have not appearedin the statements of our Russian medical commission, we must eitherpresume that the Duke is not correct, or that those facts have _escapedthe notice_ of the commission. ]

In a letter lately inserted in a newspaper, the greatest injusticeis done to the Board of Health by the comments made on theirrecommendations for the _treatment_ of cholera--_it is not true_ thatthey have reccommended _specifics_, and I must add my feeble voice infull approbation of all they have suggested on this point. Let thepublic 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 anddebility are very great) to accelerate a fatal issue. Of all thearrangements to which a humane public can direct their attention, thereis nothing so essential as warmth. I would, therefore, humbly beg tosuggest, that funds for the purpose of purchasing coals for gratuitousissue to the poor should be at once established in all directions. Toomuch, I think, has been said about ventilation and washing, and toolittle about this. 

November 10th. 

LETTER VIII. 

Already has the problem of the contagious or non-contagious nature ofthis disease been solved upon our own land; and as sophistry can nolonger erect impediments to the due distribution of the resources ofthis pre-eminently humane nation, it is to be hoped that not an hourwill be lost in shaping the arrangements accordingly. What now becomesof 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 whoare not sick, but who have been near them or near their houses? In theoccurrences at Newcastle and Sunderland, how has the fifty times refuteddoctrine of the disease spreading from a point in _two_ ways, or in oneway, tallied with the facts? We were desired to believe that in India, Persia, &c. , "the contagion _travelled_, " as the expression is, veryslow, because this entity of men's brains was obliged to wend its waywith the march of a regiment, or with the slow caravan: now, however, when fifty facilities for the most rapid conveyance have been affordedevery hour since its first appearance, it will not put itself one bitout of its usual course. And then what dangers to the attendants on thesick to the members of the same family--to the washerwomen--to theclergymen--to the buriers of the dead--even to those who passed the doorof the poor sufferer! Well, what of all this has occurred? Why it hasoccurred that this doctrine, supported by many who were honest, but hadnot duly examined alleged facts, and by others, I regret to say, whoseinterests guided their statements--that the absurdity of this doctrinehas now been displayed in the broad light of day. Make allowance (evenin this year of great notoriety for susceptibility to cholera in thepeople at large in this country) for _insusceptibility_ on the part ofnumbers who came into contact at Sunderland and Newcastle, with thepersons of cholera patients, with their beds, their furniture, theirclothes, &c. , yet, if there had ever been the slightest foundationfor the assertions of the contagionists, what numbers _ought_ to havebeen contaminated, in all directions over the face of the country, even within the first few days, considering the wonderful degree ofintercourse kept up between all parts. But we find that, as in Austriaand Prussia, "_la maladie de la terre_" is not disposed here toaccommodate itself to vain speculations. _Now_ the matter may bereduced to the simple rules of arithmetic, viz. :--if, as "contagionists_par metier_" say, the poison from the body of one individual be, inthe twinkling of an eye, and in more ways than one, transmitted tothe bodies of a certain number who have been near him, &c. , how manythousands, or tens of thousands, in every direction, should, in amultiplied series of communications and transmissions, be now affected?

Those who have watched the course of matters connected with cholera inthis country, have not failed to perceive, for some time past, theintent and purport of the assertion so industriously put forth--that thedisease might be introduced by people in perfect health; and we havejust seen how this _ruse_ has been attempted to be played off atSunderland, as the history of such matters informs us has been donebefore in other instances, and public vengeance invoked most _foully andunjustly_ upon the heads of guiltless persons in the Custom House orQuarantine Department, for "permitting a breach of regulations;" but theseveral pure cases of spasmodic cholera, in many parts of Englandbesides Sunderland, long before--months before--the arrival of _the_ship (as shewn in a former letter) leave no pretence for any suppositionof this kind. 

I request that the public may particularly remark, that, frequently asthose cases have been cited as proofs of the absurdity of _expecting thearrival_ of the disease by a ship, THEIR IDENTITY HAS NEVER ONCE BEENDISPUTED 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 toadmit it would be to give up the importation farce. 

Others have remarked before me that, though a very common, it is a veryerroneous 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 itis _the cause_ of the malady which is found to prevail, for a longer orshorter time, at those different points. It cannot be expected thatpeople should explain such matters, for, with regard to them, ourknowledge 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 ofevidence, 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 recommendingothers to profit by the mistakes regarding contagion which occurred inthat country:--"Dr. Sacks, in No. 38 of his Cholera Journal, publishedhere, has again shewn, against Dr. Rush, the fallibility of the doctrineof contagion, as well as the mischievous impracticability of theattempts founded on it to arrest the progress of the disorder by cuttingoff the communications. It is to be hoped that the alarm so methodicallyexcited by scientific and magisterial authority in the countries to thewest of us [!!] will cease, after the ample experience which we havedearly purchased (with some popular tumults), and that the system ofincommunication will be at once done away with by all enlightenedgovernments, after what has passed among us. "--I am sure, good people, nobody can yet say whether those calling themselves scientific, willallow us to profit by your sad experience; but I believe that the peopleof Sunderland are not to be shut in, but allowed to remove, if theychoose, in spite of silly speculations. 

It may not be uninteresting to mention here, that there are noquarantines and no choleras in Bohemia or Hanover. 

LETTER IX. 

The following statement from the Duke de Mortemar will be consideredprobably, very curious, considering that, as already stated, he seemsto believe in something like contagion--and for no earthly reason, onemay suppose, than from his inability to satisfy himself of the existenceof another cause--as if it were not sufficient to prove that in realitythe moon _is not_ made of green cheese, but one must prove _what it is_made of! But, to the quotation--"The conviction now established, thatintercourse with sick produces no increase of danger, should henceforthdiminish the dread of this calamity (the cholera). It differs from theplague in this, that it does not, by its sole appearance, take awayall hope of help, and destroy all the ties of family and affection. Henceforth those attacked will not be abandoned without aid andconsolation; and separation or removal to hospital, the source ofdespair, will no longer increase the danger. The sick may in future beattended without fears for one's self, or for those with whom we live. "How delightful is the simplicity of truth! Why, Sir, a morceau likethis, and from an honourable man, let him call himself contagionist orwhat he may, is more precious at this moment than Persian turkois orGrecian gems. Make me an example, men say, of the culprits "who letthe cholera morbus into Sunderland, " concealed in "susceptible"articles!--yes, and that we may be on a level in other matters, destroyme some half dozen witches, too, as we were wont to do of yore. Butlet us have more tidings from Russia to comfort the country of ouraffections in the hour of her affliction, when so much craft andsubtlety is on foot to scare her. Dr. Lefevre, physician to our embassyat St. Petersburg, has just given to the public an account of hisobservations there during the epidemic, from which the followingextracts 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 noproof whatever that the disease is contagious. 

"The first patient I saw was upon the third day of the epidemic, andupon strict inquiry I could not trace the least connexion between thepatient, or those who were about her person, with that part of the townwhere it first appeared--a distance of several versts. 

"As regards the attendants of the sick, in no one instance have I foundthem affected by the disease, though in many cases they paid the mostassiduous 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 withcholera, and yet receive no injury from their care. 

"In one case I attended a carpenter in a large room, where there were atleast thirty men, who all slept on the floor among the shavings; and, though it was a severe and fatal case, no other instance occurred amonghis companions. 

"In private practice, among those in easy circumstances, I have knownthe wife attend the husband, the husband the wife, parents theirchildren, children their parents, and in fatal cases, where, from longattendance and anxiety of mind, we might conceive the influence ofpredisposition to operate, in no instance have I found the diseasecommunicated 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 beenminutely examined, they have been generally found incorrect; whereasit is clear and open to every inquirer, that the cholera did not occurin many places which had the greatest intercourse with St. Petersburgat the height of the malady, and that it broke out in many others whichhave been subjected to the strictest quarantine. "--p. 34. [16]

[Footnote 16: It is remarkable enough that Aretæus, who lived, accordingto some authors, in the first century, gives exactly the same reasonwhich Dr. Lefevre does for the suppression of urine in cholera. So trueit is, that that symptom, considered as one of the characteristics ofthe 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 theidle _opinions_ and _reports_ are which you have obtruded soindustriously upon your notice. 

But one more short quotation from Dr. Lefevre, a gentleman certainlynot among the number of those who stand denounced before theprofessional world as unworthy of belief. He says:--"As for manyreports which have been circulated, and which, _primâ facie_, seem tomilitate against the statement [communication to attendants, &c. ]. Ihave endeavoured to pay the most impartial attention to them; but Ihave never found, upon thorough investigation, that their correctnesscould be relied upon: and in many instances I have ascertained them tobe designedly false. "--DESIGNEDLY FALSE! Alas! _toute ça on trouvedans l'article_ HOMME; and any body who chooses to investigate, asI have done, the history of epidemics, will find that falsehoods foulhave been resorted to--shamelessly resorted to--by persons having adirect interest in maintaining certain views. Enough, then, has beensaid to put Boards of Health, &c. On their guard against admitting_facts_ for their guidance from any quarter whatever, if the purityof the source be not right well established. There is too much at stakejust 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 ofDr. James Johnson's "_contingent_ contagion, " which, though occurringin 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 tocholera, which is strictly a disease of _places_, not persons, and canno more be generated by individuals than ague itself can. I can only sayof 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 principalcholera hospital during the epidemic. The statements of this gentlemanrespecting contagion, being now published, I am induced from their highinterest to give them here:--

"I have only to add my most entire conviction that the disease is notcontagious, or, in other words, communicable from one person to anotherin the ordinary sense of the words--a conviction, which, is founded notonly upon the nature of the disease, but also upon observations madewith reference to the subject, during a period of no less than fourteenyears. Facts, however, being deservedly of more weight than mereopinions, I beg leave to adduce the following, in the hope of relievingthe minds of the timid from that groundless alarm, which might otherwisenot only interfere with or prevent the proper attendance upon the sick, but becomes itself a pre-disposing or exciting cause of the disease; allparties agreeing that of all the debilitating agencies operating uponthe human system, there is no one which tends to render it so peculiarlysusceptible of disease, and of cholera in particular, than fear. 

"The facts referred to are these:--during two months of the period, thatI was physician to the principal hospital at Warsaw, devoted to thereception and treatment of this disease, out of about thirty personsattached to the hospital, the greater number of them were in constantattendance upon the sick, which latter were, to the number of fromthirty 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 bedswhich happened to be unoccupied, with all the windows and doorsfrequently closed. These men, too, were further employed in assistingat the dissection of, and sewing up of, the bodies of such as wereexamined, 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 thisan habitual drunkard, under circumstances, which entirely negativecontagion, (supposing it to exist), as he had nothing whatever to dowith the persons of the sick, though he occasionally assisted at theinterment of the dead. He was merely a subordinate assistant to theapothecary, who occupied a detached building with some of the familiesof the attendants; all of whom likewise escaped the disease. This man, I repeat, was the only one attacked, and then under the followingcircumstances. "

Here Mr. S. Relates how this man, having been intoxicated for severaldays--was, as a punishment locked up almost naked in a damp room for twonights, having previously been severely beaten. 

From the foregoing facts, and others pretty similar in all parts of theworld where this disease has prevailed, we are, I think, fairly calledupon to discard all special pleading, and to admit that man's _bestendeavours_ have not been able _to make it_ communicable by any mannerof means. 

LETTER X. 

At a meeting held some days ago by the members of the Royal Academy ofMedicine of Paris, Dr. Londe (President of the French Medical Commissionsent to Poland to investigate the nature of the cholera) stated, withregard to the questions of the origin and _communicability_ of thedisease, that it appeared by a document to which he referred, that1st. "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, andobserved at Praga for ten days under the most perfect separation, [_dansun isolement complet_] did not give a single case of cholera. " 3d. "Thatthe corps [of the Polish army] which was not at _Iganie_, had more casesof cholera than those which were there. " Dr. Londe stated cases of thespontaneous development of the disease in different individuals--of aFrench Lady confined to her bed, during two months previous to herattack of cholera, of which she died in twenty-two hours--of a woman ofa religious order, who had been confined to her bed for six months, andwhile crossing a balcony, the aspect of which was to the Vistula, wasattacked with cholera, and died within four hours. Dr. Londe, amongother proofs that the disease was not transmissible, or, as some prefercalling it, not communicable, stated, "the immunity of wounded andothers mixed with the cholera patients in the hospitals; the immunity ofmedical men, of attendants, of inspectors, and of the families of thedifferent _employés_ attached to the service of cholera patients;the example of a porter, who died of the disease, without his wife orchildren, who slept in the same bed with him, having been attacked; theexample of three women attacked (two of whom died, and one recovered), and the children at their breasts, one of six months, and the other twoof twelve, not contracting the disease. "

At a subsequent meeting of the Academy, a letter from Dr. Gaymard, oneof 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 authoritieswished to isolate the sick--[Observe this well reader]--and even sendthem out of the city; now the hospital is on a steep mountain, and, toget to it, the carriages were obliged to take a long circuit through asandy road, which occupied an hour at least; and if we add to theexposure to the air, the fatigue of this removal, and the time whichelapsed after the invasion of the disease, the deplorable state of thepatient 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 atthe moment when it arrived at its height, and when, consequently, thegreatest intercourse [Observe reader!] took place with the sick, thatthe number of attacks wonderfully diminished all at once (_tout àcoup_), and without any appreciable cause. The points of the city mostdistant from each other were invaded. Numbers of families crowded[_entassés_] who had given aid to cholera patients, remained free fromthe disease, while persons isolated in high and healthy situations[_usually_ healthy meant of course] were attacked. It especiallyattacked the poorer classes, and those given to spirituous liquors. Scarcely twenty persons in easy circumstances were attacked, and eventhe greater part of these had deviated from a regular system. "

The inferences drawn, according to a medical journal, from the wholeof Dr. Gaymard's communication, are--

"1. That the system of sanatory measures, adopted in Russia, did notany where stop the disease. 

"2. That without entering on the question as to the advantages to bederived from a moral influence arising out of sanatory cordons, placedround a vast state like France, these measures are to be regarded asuseless in the interior, in towns, and round houses. 

"3. That nothing has been able to obstruct the progressive advance ofthe 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 ofthe Academy, in which it was stated, that in an Hospital at Moscow, inwhich Dr. Delauny was employed from the month of December, 1830, tothe end of December, 1831, 587 cholera patients, and 860 cases ofother diseases, were treated--"Not one of the latter was attackedwith cholera, although the hospital consists of one building, thecoridors communicating with each other, and the same linen servingindiscriminately for all. The attendants did not prove to be moreliable to attacks. The relatives were suffered to visit their friendsin hospital, and this step produced the best impression on thepopulace, who remained calm. They can establish at Moscow, that therewas not the smallest analogy between the cholera and the plague whichravaged 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 ofhouses and of sick in towns, has been accompanied by disastrousconsequences. " Is there yet enough of evidence to shew that thisdisease is positively _not to be made_ communicable from the sick?

Honour still be to those of the profession who, from conscientious andhonorable motives, have changed from non-contagionists to contagionistsin regard to this disease; and all that should be demanded is, thattheir _opinions_ may not for one moment be suffered to outweigh, onan occasion of vital importance, the great mass of evidence now onrecord quite in accordance with that just stated. One gentleman ofunquestionable respectability gives as a reason (seemingly his verystrongest) for a change of opinion, that he has been credibly informedthat when the cholera broke out on one side of the street in a certainvillage in Russia, a medical man had a barrier put up by which thecommunication with the other side was cut off, and the disease thus, happily, prevented from extending. Now, admitting to the full extent theappearance of the disease on one side of the village only--a thing bythe way hitherto as little proved as many others on the contagion sideof the question--still, if there be any one thing more striking thananother, in the history of the progress of cholera, it is this verycircumstance of opposite rows of houses, or of barracks, or bazaars, orlines of camp, being free, while the disease raged in the others, andwithout any sort of barricading or restriction of intercourse. If peoplechoose to take the trouble to look for the evidence, _plenty_ of such isrecorded. Now just consider for one moment how this famous Russian storystands: had the barricading begun early, the matter would have stood anexamination a little better; but this man of good intentions neverthought of his barriers till the one-sided progress of the disease hadbeen manifest enough, _without them_:--and then consider how thecommunication had existed between both rows before those barriers wereput up, and how impossible it was, unless by a file of soldiers, to havedebarred all communication:--let all this be considered, and probablythe case will stand at its true value, which is, if I may take theliberty of saying so, --just nothing at all. Let us bear in mind thecircumstance already quoted from the East India records, --of one companyof the 14th Regiment, at the extreme end of a barrack, escaping thedisease, almost wholly, while it raged in the other nine; and thiswithout a barrier too. But such circumstances are by no means of rareoccurrence in other diseases arising from deteriorated atmosphere. Mr. Wilson, a naval surgeon, has shewn how yellow fever has prevailed _onone side_ of a ship, and I have had pointed out to me, by a person wholived near it for thirty years, a spot on this our earth where _ague_attacks only those inhabiting the houses in one particular line, andwithout any difference as to elevation or other appreciable cause, except that the sun's rays do not impinge equally on both ranges in themorning and evening. 

The advancement of the cause of truth has, no doubt, suffered some checkin this country, by the announcement that another gentleman of greatrespectability (Mr. Orton) finds his belief as to non-contagion incholera a good deal shaken: but we find that this change has not arisenfrom further personal knowledge of the disease, and if it be from anyrepresentations regarding occurrences in Europe, connected with cholera, we have seen how, from almost all quarters, the evidence lies quite onthe side of his first opinions. Whatever the change may be owing to, weshould continue, as in other cases, not to give an undue preference evento opinions coming from him, to well authenticated facts--facts, amongwhich some particularly strong are still furnished _by himself_, even inthe second edition of his book:--"It must be admitted that, in a vastnumber of instances in India, those persons [medical men and attendants]have suffered no more from the complaint than if they had been attendingso many wounded men. This is a fact which, however embarrassing tothe medical inquirer, [for our part we cannot see the _embarrassment_]is highly consolatory in a practical point of view, both to him andto all whose close intercourse with the sick is imperativelyrequired. "--(_p. 316_)--"We are therefore forced to the conclusion, however, at variance with the common laws of contagion, that in thisdisease, --at least in India, the most intimate intercourse with the sickis not, in general, productive of more infection than the average quantitythroughout the community. " (_p. 326_). Let us contrast the statements inthe following paragraphs:--"For in all its long and various courses, itmay be traced from place to place, and has never, as far as our informationextends, started up at distant periods of time and space, leaving anyconsiderable intervening tracts of country untouched. " (p. 329)--"Allattempts to trace the epidemic to its origin at a point, appears to havefailed, and to have shewn that it had not one, but various local sourcesin the level and alluvial, the marshy and jungly tract of country whichforms the delta of the Ganges, and extends from thence to theBurraumposter. " (p. 329) Now let us observe what follows regarding theparticular _regularity_ in the progress of the disease, as justmentioned:--"Another instance of irregularity in its course, even inthose provinces where it appears to have been most regular, is stated[now pray observe] in its having skipped from Verdoopatly to a villagenear Palamacotta, leaving a distance of sixty miles at firstunaffected. " (p. 332)!!--This is not the way to obtain proselytes Ipresume. 

The situation of our medical brethren at Sunderland is most perplexing, and demands the kindest consideration on the part of the country atlarge; but let nothing which has occurred disturb the harmony soessential to the general welfare of that place, should their combinedefforts be hereafter required on any occasion of public calamity. Intruth both parties may be said to be right--the one in stating thatthe disease in question _is Indian cholera_, because the symptoms areprecisely similar--the other that it _is not Indian cholera_, becauseit exists in Sunderland, and without having been imported--IN NEITHERCOUNTRY IS IT COMMUNICABLE FROM ONE PERSON TO ANOTHER, as is now plainlyshown upon evidence of a nature which will bear any investigation; andif blame, on account of injury to commerce, be fairly attributable toany, it is to those who, all the world over, pronounced this disease, ongrounds the most untenable, a disease of a contagious or communicablenature. Let the Sunderland Board of Health not imagine that theirsituation is new, for similar odium has fallen _on the first_ who toldthe plain truth, in other instances--at Tortosa, a few years ago, thefirst physician who announced the appearance of the yellow fever, was, according to different writers, _stoned to death_; and at Barcelona, in1821, a similar fate had well nigh occurred to Dr. Bahi, one of themost eminent men there--we need not, I presume, fear that a scene ofthis kind will take place in this country, --though the cries of "nocholera!" and "down with Ogden!" have been heard. 

One word as to observations regarding the needlessness of discussing thecontagion question: the truth is, that the cleanliness and comfort ofthe people excepted, you can no more make _other arrangements_ withpropriety, till this point be settled, than a General can near the enemyby whom he is threatened, till it be ascertained whether that enemy becavalry 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 manyothers, to attention; but I wish to place before the public, for theirconsideration, a collection of facts which I think are likely to be ofno small importance at a moment like the present. In addition to themany authorities referred to in the foregoing pages, I would beg tocall the public attention to a paper in the _Windsor Express_ of the12th November, by Dr. Fergusson, Inspector General of Hospitals, agentleman of great experience, and who has given the _coup de grace_to the opinion of contagion in cholera. Indeed the opinion now seemsto be virtually abandoned; for, as to quarantine on our ships fromSunderland, it is, perhaps, a thing that cannot be avoided, if the mainconsideration be _the expediency of the case_, until an arrangementbetween leading nations takes place. We have seen, in regard to Austria, how the matter stands, and our ships from every port in the countrywould be refused admission into foreign ports, if we did not subjectthose 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 oftheir respective dates, I was actuated by the state of the public mindat the time in regard to the dreaded disease of which they principallytreat. The two first were addressed to the Editor of the WINDSOREXPRESS, and the third to a Medical Society here, of which I am amember. The contemplation of the subject has beguiled many hours ofsickness and bodily pain, and I now commit the result to the press in amore connected form, from the same motives, I believe, that influenceother writers--zeal in the cause of truth, whatever that may turn out tobe, and predilection for what has flowed from my own pen, not howeverwithout the desire and belief, that what I have thus written may proveuseful in the discussion of a question which has in no small degreeagitated our three kingdoms, and most deeply interested every civilizednation on the face of the earth. 

No one, unless he can take it upon him to define the true nature ofthis new malignant Cholera Morbus, can be warranted utterly to denythe existence of contagion, but he may at the least be permitted tosay, that if contagion do exist at all, it must be the weakest inits powers of diffusion, and the safest to approach of any that hasever yet been known amongst diseases. Amateur physicians from theContinent, and from every part of the United Kingdoms, eager and keenfor Cholera, and more numerous than the patients themselves, beset andsurrounded the sick in Sunderland with all the fearless self-exposingzeal of the missionary character, yet no one could contrive, even inthe foulest dens of that sea-port, to produce the disease in his ownperson, or to carry it in his saturated clothing to the healthierquarters of the town where he himself had his lodging. [17] Surelyif the disease had been typhus fever, or any other capable ofcontaminating the atmosphere of a sick apartment, or giving outinfection more directly from the body of a patient, the result musthave been different; its course, notwithstanding, has been mostunaccountably and peculiarly its own--slow and sure for the most part, the infected wave has rolled on from its tropical origin in the fardistant east, to the borders of the arctic circle in the west--notunfrequently in the face of the strongest winds, as if the blightingaction of those atmospherical currents had prepared the surface of theearth, as well as the human body for the reception and deposition ofthe poison; but so far from always following the stream and line ofpopulation as has been attempted to be shown, it has often rundirectly counter to both, seldom or never desolating the large citiesof Europe, like the plague and other true contagions, but ratherwasting its fury upon encampments of troops, as in the east, or thevillages and hamlets of thickly peopled rural districts. 

[Footnote 17: The numbers were so great (to which I should probablyhave added one had my health permitted) as actually to make gala day inSunderland, and to call forth a public expression of regret at theirdeparture. ]

That it could have been descried on no other than the above line must beself-evident, but to say that it has followed it in the manner that acontagious 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, theconveyances innumerable, the communications uninterrupted and constant. Towards the thinly-peopled north how different the aspect, --townshipsrare, the country often high, cold, and dreary, in many parts of the linewithout 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 theintermediate places. It is said to have been carried there by vagrantpaupers from Sunderland. Can this be true? Could any such with thedisease upon them in any shape, have encountered such a winter journeywithout leaving traces of it in their course?[18] or, if they carriedit in their clothing, the winds of the hills must have disinfectedthese _fomites_ long before their arrival. No contagionist, howeverunscrupulous and enthusiastic, nor quarantine authority however vigilant, can pretend to say how the disease has been introduced at the differentpoints of Sunderland, Haddington, and Kirkintulloch, --no more than he cantell why it has appeared at Doncaster, Portsmouth, and an infinity ofother places without spreading. Even now, it lingers at the gates ofthe great open cities of Edinburgh and Glasgow, as if like a malariousdisease, (which I by no means say that it is) it better found its foodin the hamlet and the tent, in fact, amongst the inhabitants of groundtenements, than in paved towns and stone buildings. We must go fartherand acknowledge, that for many months past our atmosphere has beentainted with the miasm or poison of Cholera Morbus, as manifested byunusual cases of the disease almost everywhere, and that these harbingersof the pestilence only wanted such an ally as the drunken jubilee atGateshead, or atmospherical conditions and changes of which we knownothing, to give it current and power. That the epidemic current ofdisease wherever men exist and congregate together, must, in the firstinstance, resemble the contagious so strongly as to make it impossible todistinguish the one from the other, must be self-evident; and it is onlyafter the touchstone has been applied, and proof of non-communicabilitybeen obtained, as at Sunderland, that the impartial observer can beenabled to discern the difference. --Still, however, must he be puzzledwith the inexplicable phenomena of this strange pestilence, but if hefeel himself at a loss for an argument against contagion, he has only toturn to one of the most recent communications from the Central Board ofHealth, where he will find that "That the subsidiary force under Col. Adams, which arrived in perfect health _in the neighbourhood_ of avillage of India infected with Cholera, had seventy cases of the diseasethe night of its arrival, and twenty deaths the next day, " as if themarch under a tropical sun, and the encampment upon malarious ground, orbeneath a poisoned atmosphere, were all to go for nothing; and that theneighbourhood of an infected village, with which it is not stated thatthey held communication, had in that instantaneous manner alone, producedthe disease. This is surely drawing too largely upon our credulity, andpractising upon our fears beyond the mark. 

[Footnote 18: The Cholera in this country would appear always to travelwith the pedestrian, and to eschew the stage coach even as an outsidepassenger. ]

The anti-contagionist, in acknowledging his ignorance, leaves thequestion open to examination; but the contagionist has solved theproblem to his own mind, and closed the field of investigation, without, however, ceasing to denounce the antagonist who would disturb aconclusion which has given him so much contentment. --Let us hereexamine, for a moment, who in this case best befriends his fellow men. The latter, in vindication of a principle which he cannot prove, wouldshut the book of enquiry, sacrifice and abandon the sick, (for to thisit must ever come the moment pestilential contagion is proclaimed, )extinguish human sympathy in panic fear, and sever every tie of domesticlife, --the other would wait for proofs before he proclaimed the ban, andeven then, with pestilence steaming before him, would doubt whetherthat pestilence could be best extinguished, or whether it would not beaggravated into ten-fold virulence, by excommunicating the sick. 

In my first letter I have endeavoured to unveil the mystery and fallacyof fumigations, for which our government has paid so dear, [19] andin place of the chemical disinfectants so much extolled, of theapplicability of which we know nothing, and which have always failedwhenever they were depended upon, have recommended the simple and sureones of heat, light, water, and air, with one exception, the elementsof our forefathers, which combined always with all possible purity ofatmosphere, person, and habitation, have been found as sure and certainin effect as they are practical and easy of application. 

[Footnote 19: Parliament voted a reward of £5000 to Doctor CarmichaelSmith for the discovery. ]

Of our quarantine laws I have spoken freely, because I believe theirpresent application, in many instances, to be unnecessary cruel andmischievous. Too long have they been regarded as an engine of State, connected with vested interests and official patronage, against whichit was unsafe to murmur, however pernicious they might be to commerce, or discreditable to a country laying claim to medical knowledge. Theregulation for preventing the importation of tropical yellow fever, (which is altogether a malarious disease of the highest temperature ofheat and unwholesome locality, ) into England or even into Gibraltar, stands eminent for absurdity. It has long been denounced by abler pensthan mine, and I know not how it can be farther exposed, unless we couldinduce the inhabitants of our West India Colonies to enforce the lextalionis, and institute quarantines, which they might do with the sameor better reason, against the importation of pleurises and catarrhs fromthe colder regions of Europe; a practical joke of this kind has beenknown to succeed after reason, argument, and evidence, amounting to themost palpable demonstration, had proved of no avail. 

While I have thus impugned the authority of boards and missions, andestablishments, I trust it never can be imputed to me that I couldhave intended any, the smallest personal allusion, to the eminent andestimable men of whom they are composed, --all such I utterly disclaim;and to the individual, in particular, who presided over our mission toRussia, who has been my colleague in the public service, and whosefriendship I have enjoyed from early youth, during a period of morethan forty years, I would here, were it the proper place, pay thetribute of respect which the usefulness of his life, and excellenceof his character, deserves. 

LETTER I. 

TO THE EDITOR OF THE WINDSOR EXPRESS. 

Sir, --Being well aware of the handsome manner in which you have alwaysopened the columns of your liberal journal to correspondents upon everysubject of public interest, I make no further apology for addressingthrough the WINDSOR EXPRESS, some observations to the inhabitants ofWindsor and its neighbourhood upon the all-engrossing subject of CholeraMorbus. 

That pestilence, despite of quarantine laws, boards of health, andsanatory regulations, has now avowedly reached our shores, and we may bepermitted at last to acknowledge the presence of the enemy--to describeto the affrighted people the true nature of the terrors with which he isclothed--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 unwontedCholera Morbus appearing, occasionally during the last six months, inLondon, Port Glasgow, Abingdon, Hull, and many other places, which, asit did not spread, have been passed unheeded by our health conservators;but, had the poison then been sufficiently matured to give it epidemiccurrent, would have been blazed forth as imported pestilence. Some oneor other of the ships constantly arriving from the north of Europe couldeasily have been fixed upon as acting the part of Pandora's box, andsmugglers from her dispatched instanter to carry the disease into theinland quarters of the kingdom. I write in this manner, not frompetulance, but from the analogy of the yellow fever, where this verygame I am now describing, has so often been played with success in thesouth of Europe; and will be played off again, for so long as lucrativeboards of health and gainful quarantine establishments, with extensiveinfluence and patronage, shall continue to be resorted to for protectionagainst a non-existent--an impossible contagion. 

But to the disease in question. --It must have had a spontaneous originsomewhere, and that origin has been clearly traced to a populousunhealthy town in the East Indies--no infection was ever pretended tohave been carried there, yet, it devastated with uncontroulable fury, extending from district to district, but in the most irregular andunaccountable manner, sparing the unwholesome localities in itsimmediate neighbourhood, yet attacking the more salubrious at adistance--passing by the most populous towns in its direct course atone time, but returning to them in fury at another, staying in none, however crowded, yet attacking all some time or other, until almostevery 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 tosome 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 ofIndia, hundreds, without any noticeable warning, would be taken ill inthe 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 inthe course of the regular necessary communication between troops in thefield, would remain perfectly free from the disease. It would then ceaseas suddenly and unaccountably as it began, --attacking, weeks after, thepreviously unscathed division of the army, or not attacking it at allat the time, yet returning at a distant interval, when all traces of theformer epidemic had ceased, and committing the same devastation. Now, will any man, not utterly blinded by prejudice, candidly reviewingthese facts, pretend to say, that this could be a personal contagion, cognizable by, and amenable to, any of the known or even supposable lawsof infection--that the hundreds of the night infected one another, orthat the thousands of the few days owed their disease to personalcommunication, --as well affect to believe that the African Simoon, whichprostrates the caravan, and leaves the bones of the traveller to whitenin 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! Itwill come--it will go; we can neither keep it out, or retain it, if wewished, amongst us. The region of its influence is above us and beyondour controul; and we might as well pretend to arrest the influx of theswallows in summer, and the woodcocks in the winter season, by cordonsof troops and quarantine regulations, as by such means to stay theinfluence, of an atmospheric poison; but in our moral courage, in ourimproved civilization, in the perfecting of our medical and healthpolice, in the generous charitable spirit of the higher orders, assisting the poorer classes of the community, in the better conditionof those classes themselves, compared with the poor of other countries, and in the devoted courage and assistance of the medical professionevery where, we shall have the best resources. Trusting to these, it hasbeen found that, in countries far less favoured than ours, wherever theimpending pestilence has only threatened a visitation, there the panichas been terrible, and people have even died of fear; but when itactually arrived, and they were obliged to look it in the face, theyfound, that by putting their trust in what I have just laid down, theywere in comparative safety; that, the destitute, the uncleanly, aboveall, the intemperate and the debauched, were almost its only victims;that the epidemic poison, whatever it might be, had strength to prevailonly against those who had been previously unnerved by fear, or weakenedby debauchery; and that moral courage, generous but temperate living, and regularity of habits in every respect, proved nearly a certainsafe-guard. They found further, that quarantine regulations were worsethan useless--that the gigantic military organization of Russia--therigorous military despotism of Prussia--and the all-searching police ofAustria, with their walled towns, and guards and gates, and cordons oftroops, were powerless against this unseen pestilence, and that as soonas the quarantine laws were relaxed, and free communication allowed, thedisease assumed a milder character, and speedily disappeared. 

I say, then, confidently, that Cholera Morbus never will commit ravagesin this country, beyond the bounds of the worst purlieus of society, unless it be fostered into infectious, pestilential activity, by theabsurd, however well-meant, measures of the conservative boards ofhealth, such as have been just recommended in what has always beenesteemed the most influential, best-informed journal of England, I meanthe QUARTERLY REVIEW. If the writer of the article who recommends theenforcement of the ancient quarantine laws in all their strictness, bea medical man, he surely ought to know, that wherever human beings areconfined and congregated together in undue numbers, more especially ifthey be in a state of disease, there the matter of contagion, thetyphoid principle, the septic (putrefactive) human poison or by whatother name it may be called, is infallibly generated and extends itself, but in its own impure atmosphere only, as a personal infection to thosewho 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 writerbe received, we shall soon also hear of contagious Cholera Morbus witha vengeance. His exhortations would go to shut up the sick from humanintercourse, to proclaim the ban of society against them, and under themost pitiable circumstances of bodily distress, to proscribe them asobjects of terror and danger, instead of being as they actually are, helpless innocuous fellow creatures, calling loudly for our promptestsuccour and commiseration in their utmost need. They would go further toarray man against his fellow man in all the cruel selfishness of panicterror, sever the dearest domestic ties, paralize commerce, suspendmanufactures, and destroy the subsistance of thousands, and all for thegratification of a prejudice which has been proved to be utterlybaseless in every country of Europe from Archangel to Hamburgh andSunderland. Happily for our country, these measures are now as absurdand impracticable as they would be tyrannical and unjust. They could notbe borne even under the despotic military sway of Prussia and Russia, and in this free country it would be impossible to enforce them for asingle 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 airof heaven, the best cordial and diluent of foul atmosphere in everydisease--let their fellow townsmen hasten to carry them food, fuel, cordials, cloathing, and bedding, speak to them the words ofconsolation, and should they have fear to approach the sick, I takeit upon me to say, they will be accompanied by any and every medicalpractitioner of the place, who, in their presence, will minister to theafflicted, inspire their breath, and perform every other professionaloffice of humanity, without the smallest fear or risk of infection; forthey read the daily records of their profession, where it has beenproved to them, that in the open but crowded hospitals of Warsaw, underthe most embarrassing circumstances of warfare and disease, out of ahundred medical men, with their assistants and attendants, frequentingthe sick wards of Cholera, not one took the disease; that, for the sakeof proving its nature, they even went so far as to clothe themselveswith the vestments of the dying, to sleep in the beds of the recentlydead, and to innoculate themselves in every way with the blood andfluids of the worst cases, without, in a single instance, producingCholera Morbus. [20] The accounts may not, indeed, cannot be the samefrom every other quarter, for medical men must be as liable to fallunder the influence of an atmospherical epidemic disease as otherclasses of the community; but the above fact is alone sufficient toprove 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 ourprecautions, be introduced amongst us, measures better calculated forthe destruction of a community, could scarcely be devised, than theancient quarantine regulations; for they certainly would convert everyhouse proscribed by their mark, into a den and focus of the mostconcentrated pestilential contagion, ensuring fearful retribution uponthose who had thus so blindly shut them up. The mark alone, besidesbeing equivalent to a sentence of death upon all the inmates, wouldeffect all this--the sick would be left to die unassisted, unpurified, uncleansed amidst their accumulated contagion, and the dead, as hashappened before, lie unburied or scarcely covered in, till theyputrified in pestiferous heaps. Most certainly it would be proper andbeneficial, even a duty, for all who could afford the means, and werenot detained by public duties, to fly the place, and equally proper forthe other residents who continued in health, to segregate themselves asthey best could. --Plenty of free labour amongst those who must ever workfor 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 thedirection and with instructions of safety from a well arranged medicalpolice. It would not be difficult to show, that the mortality, duringthe last great plague in London, was increased a hundred fold, byfollowing the very measures now recommended in these regulations; and, that the barbarous predestinarian Turk, in the very head quarters of theplague itself, who despises all regulation, but attends his sick friendto the last, never yet brought down upon his country such calamitousvisitations of pestilence, as enlightened Christian nations haveinflicted upon themselves, by ill-judged laws. The Turk, to be sure, byrejecting all precaution, and admitting, without scruple, infection intohis ports, sees Constantinople invaded by the plague every year; but, when not preposterously interfered with, it passes away, even amongstthat wretched population, like a common epidemic, without leaving anyremarkable traces of devastation behind it: and surely to establish andmake a pest-house of the dwelling of every patient who might bediscovered or even suspected to be ill, would be most preposterous. The writing on the wall would not be more apalling to the people, andscarcely less fatal to the object, than the cry of mad dog in thestreets, with this difference, that when the dog was killed, the scenewould be closed, but the proscribed patient would remain, even in hisdeath and after it, to avenge the wrong. 

But sufficient to the day is the evil thereof, the question is now ofCholera Morbus; I am willing to meet any objection, and the most obviousone that can be offered to me, (if it be not an imported disease) is itsfirst appearance in our commercial sea-ports. To this I might answer, that it has been hovering over us, making occasional stoops, for thelast six months, even in the most inland parts of the country; but Iwill waive that advantage, and meet it on plainer grounds of argumentand truth. --An atmospherical poison must evidently possess the greatestinfluence, where it finds the human race under the most unfavourablecircumstances of living, habits, locality, and condition. Now, where canthese be met with so obviously as in our large sea-port towns on thelowest levels of the country, and in their crowded alleys, always nearto the harbour for the shipping? There the disease, if its seeds existedin the atmosphere, would be most likely to break out in preference toall other situations; and if at the time of its so appearing, shipsshould arrive, as they are constantly doing from all parts of the world, whose crews, according to the custom of sailors, plunge instantly intodrunkenness and debauchery, and present as it were, ready prepared, thevery subjects the pestilence was waiting for; how easy then, for analarmed or prejudiced board of health to point out the supposedimporting vessel, and freight her with a cargo of the new pestilencefrom any part of the world they may choose to fix upon. This is noimaginary case; it was for long of annual occurrence with respect to theyellow fever, both in the West Indies and North America. "There ourthoughtless intemperate sailors were not only the first to suffer fromthe epidemic, in its course or about to begin, but they were denouncedas the importers, by the prejudiced vulgar, and the accusation wasloudly re-echoed even amongst the better informed, by all who wished tomake themselves believe that pestilence could not be a native productof their own atmosphere and habitations. "

Before I have done, I feel called upon to say a few words upon theefficacy of fumigation as a preservative against Cholera Morbus andother infectious diseases. In regard to the first the question issettled. In Russia, throughout Germany, and I believe everywhere else inEurope, they were productive of no good, they did mischief, and weretherefore discontinued. This has been verified by reports from the seatsof the disease everywhere. In regard to other contagions I can speak, not without knowledge, at least not without experience, for it was thebusiness and the duty of my military life, during a long course ofyears, to see them practised in ships, barracks, hospitals, andcantonements, and I can truly declare I never saw contagion in thesmallest degree arrested by them, and that disease never failed tospread, and follow its course unobstructed, and unimpeded by their use. In the well-conditioned houses of the affluent where ventilation andcleanliness are matters of habit and domestic discipline, they may be aharmless plaything during the prevalence of scarlet fever and such likeinfections, or even do a little good by inspiring the attendants withconfidence, however false, as a preservative against contagion; but inthe confined dwellings of the poor they are positively mischievous, because they cannot be used without shutting out the wholesomeatmospheric air, and substituting for it a factitious gas, which foraught we know, or can know of the nature of the contagious vapour, whether acid, alkaline, or anything else, may actually be adding to itsdeleterious principle instead of neutralising it: but in thus strikingaway a prop from the confidence of the poor, I thank God I can furnishthem with other preservatives and disinfectants, which I take it upon meto say, they will find as simple and practicable as they are infallible. For the first, the liberal use of cold water and observance of freeventilation, with slaked lime to wash the walls, and quick lime whenthey can get it, to purify their dung heaps and necessaries, are amongthe best; but when actually infected, then heat is the only purificatoryet known of an infected dwelling. Let boiling water be plentifully usedto every part of the house and article of furniture to which it can bemade applicable. Let portable iron stoves, filled with ignited charcoalonly, be placed in the apartment closely shut, and the heat kept up fora few hours to any safe degree of not less than 120° Farenheit, and letfoul infected beds and mattresses be placed in a baker's oven heated tothe same, [21] and my life for it no infection can after that possiblyadhere to houses, clothes, or furniture. The living fountain ofinfection from the patient himself, constantly giving out the freshmaterial, 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 withbread-eaters, for according to the old adage, Omne vitium per ignemexcoquitur. ]

[Footnote 22: Light too, more especially when assisted by a currentof atmospheric air, is a true and sure disinfectant, but it is not soapplicable as heat in the common contagions, from requiring an exposureof 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 behappy, through the same channel, to give any information, or answer anyinquiries that may be authenticated by the signature of the writer; butanonymous writing of any kind, I shall not consider myself bound tonotice. Should the dreaded disease spread its ravages throughout ourpopulation, I may then, at some future early opportunity, trusting toyour indulgence, trespass again upon your columns with furthercommunications on this most interesting subject. 

WILLIAM FERGUSSON, Inspector-General of Hospitals. 

P. S. --Throughout the foregoing letter, I have used the words contagionand infection as precisely synonymous terms, meaning communicabilityof 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 guardingour country against the now European and Continental disease, malignantCholera Morbus, by quarantine regulations. In the present one, it ismy intention still in a popular manner to scrutinise more deeply, the doctrine of imported contagions; to point out, if I can, thosetrue contagions which can be warded off by our own exertions, incontradistinction to others which are altogether beyond our controul;and here it may be as well to premise, that when I use the termepidemic, I mean atmospheric influence, endemic-terrestrial influence, or emanation from the soil; and by pestilential, I mean the spread ofmalignant disease without any reference to its source. The termscontagion and infection have already been explained. 

It must be evident, that legislative precaution can only be madeapplicable to the first of these. The last being unchangeable by humanauthority, are not to be assailed by any decrees we can fulminateagainst them; and if it can be shown, which it has been by our best andlatest reports, that Cholera Morbus eminently and indisputably belongsto that class--that the strictest cordons of armed men could not availto save the towns of the continent, nor the strictest quarantine ourown shores, from its invasion--it surely must be time to cease thosevain attempts, to lay down the arms that have proved so useless, andturn our undivided attention, now that it has fairly got amongst us, to conservative police, and the treatment of the disease; but as thecontagionists still insist that it was imported from Hamburgh toSunderland, it behoves us to clear away this preliminary difficultybefore proceeding to other points of the enquiry. 

I take it for granted, that ships proceeding from Sunderland to Hamburghcould only be colliers, and that according to the custom of suchvessels, they returned, as they do from the port of London, light; and Iadmit, that on or about the time of their return, Cholera Morbus, underthe severe form which characterises the Asiatic disease, made itsappearance in that port, presenting a fair _prima facie_ case ofimported contagion; but as at the period of its thus breaking out inSunderland, a case equally as fatal and severe shewed itself, accordingto 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 afourth in Sunderland itself, as far back as the month of August, aswell as many others in different parts of the country;[23] it becameincumbent on the quarantine authorities, indeed upon all men interestedin the question, whether contagionists or otherwise, to shew the truestate of these vessels, as well as of the cases above alluded to, andwhether the Cholera Morbus had ever been on board of them, either atHamburgh or during the homeward voyage, so as by any possibility theycould have introduced the disease into an English port. Now will anyperson pretend to say that this has been done, or that it could not havebeen done, or deny that it was a measure, which, if properly executed, would have thrown light upon the true character of the disease, not onlyfor the information of our own government but of every government inEurope; that deputations from the Board of Health, backed and supportedby all the power and machinery of government, with the suspected shipslocked up in quarantine, and the persons of the crews actually in theirpower, could not have verified to the very letter, the history of everyhour and day of their health, from the moment of their arrival atHamburgh till their return into port? This measure was so obviously andimperiously called for, as constituting the only rational ground onwhich the importing contagionists could stand, or their opponents meetthem in argument, that after having waited in vain for the report, Iraised 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 withoutunfairness or illiberality, we are irresistibly forced to theconclusion, that had the enquiry (the only one, by the bye, worthpursuing, as bearing directly on the question at issue) been pushed tothe proof, it would have shown the utter nullity of quarantine guardsagainst atmospherical pestilence, the thorough baselessness of thedoctrine of importation. 

[Footnote 23: Two of a type most unusual for this country, and theWinter Season, have occurred in the vale of the Thames, not far fromhere, which, as they both recovered, and the disease did not spread inany way, were very properly allowed to pass without sounding any alarm, but the gentleman who attended one of the cases, and had been familiarwith the disease in India, at once recognized it again, in its principaldistinguishing features. ]

Without entering into the miserable disputes on this subject, which, amidst a tissue of fable and prejudice, self-interest andmisrepresentation, have so often disgraced the medical profession atGibraltar; I shall now proceed to shew, by reference to general causes, how baseless and mischievous have been the same doctrines and authoritywhen 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, thepopulation of its over-crowded town has more than quadrupled, presentingas fair a field, for the generation within, or reception from without, of imported pestilence as can well be imagined, --yet plague, the truestof all contagions, typhus fever, and other infectious diseases, havenever prevailed, as far as I know, amongst them. The plague of theLevant has not been there, I believe, for 150 years; yet Gibraltar, thefree port of the Mediterranean, open to every flag, stands directly inthe course of the only maritime outlet, from its abode and birth-placein the east, being in fact, to use the language of the road, thehouse of call for the commerce of all nations coming from the upperMediterranean. Now, can there be a more obvious inference from all this, than that the plague, being a true contagion, may be kept off withoutdifficulty, by ordinary quarantine precautions; but the other being anendemic malarious disease, generated during particular seasons, withinthe garrison itself, and the offspring of its own soil, is altogetherbeyond their controul. The malarious or marsh poison, which in ourcolder latitudes produces common ague, in the warmer, remittent fever, and in unfavourable southern localities of Europe, (such as those ofcrowded towns, where the heat has been steadily for some time of anintertropical degree)--true yellow fever, which is no more than thehighest grade of malarious disease; but this has never occurred inEuropean towns, unless during the driest seasons--seasons actuallyblighted by drought, when hot withering land winds have destroyedsurface vegetation, and as in the locality of Gibraltar, have left thelow-lying becalmed, and leeward town to corrupt without perflation orventilation amidst its own accumulated exhalations. I know not how Ican better illustrate the situation of Gibraltar in these pestiferousseasons, than by a quotation from a report of my own on the Island ofGuadaloupe, in the year 1816, which, though written without any possiblereference to the question at issue, has become more apposite thananything else I could advance; "all regular currents of wind have theeffect of dispersing malaria; when this purifying influence iswith-held, either through the circumstances of season, or when itcannot be made to sweep the land on account of the intervention ofhigh hills, the consequences are most fatal. The leeward shores ofGuadaloupe, for a course of nearly 30 miles, under the shelter of a verysteep ridge of volcanic mountains, never felt the sea breeze, nor anybreeze 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 throughoutthe whole tract, and in no place more so than the bare sandy beach nearthe high-water mark_. The coloured people alone ever venture to inhabitit; and when they see strangers tarrying on the shore after nightfall, they never fail to warn them of their danger. The same remark holds goodin regard to the greater part of the leeward coasts of Martinique, _andthe leeward alluvial bases and recesses[24] of hills, in whatever portof the torrid zone they may be placed_, with the exception, probably ofthe immediate sites of towns, where the pavements prevent the rain-waterbeing absorbed into the soil, and hold it up to speedy evaporation. "Now, conceive a populous crowded town placed in this situation, and youhave exactly what Gibraltar and the other towns of Spain and NorthAmerica, liable to yellow fever, must become in such seasons as I haveabove described, only, that as they grow more populous and crowded, thedanger must be greater, and its visitations more frequent, unless theinternal health police be made to keep pace in improvement, with theincreasing population. 

[Footnote 24: The leeward niches and recesses of hills, however dry androcky, become in these seasons of drought, absolute dens of malaria, this will be found proven in my reports made especially of the islandsof Dominique and Trinidad, which may be seen at the Army Medical BoardOffice. ]

Now in the name of injured commerce--of the deluded people ofEngland--of medical science--of truth and humanity--what occasion cantheir be to institute an expensive quarantine against such a state ofthings as this, which can only be mitigated by domestic health police;or why conjure up the unreal phantom of an imported plague, to deludethe unhappy sufferers, as much in regard to the true nature of thedisease, as to the measures best calculated for their own preservation;when it must be evident that the pestilence has sprung from amidstthemselves, and that had it been an external contagion in any degree, the ordinary quarantine, as in case of the plague, would certainly havekept it off; but the question of the contagion of yellow fever, soimportant to commerce and humanity; and which, like the Cholera, hasmore than once been used to alarm the coasts of England, demands yetfurther investigation. 

For nearly 40 years have the medical departments of our army and navybeen furnished with evidence, from beyond the Atlantic, that thisdisease possessed no contagious property whatever. These proofs now lierecorded by hundreds in their respective offices, and I take it upon meto say, they will not be found contradicted by more than one out of ahundred, amongst all the reports from the West Indies, which is as muchthe birth-place of the yellow fever, as Egypt is of the plague: yet, inthe face of such a mass of evidence, as great or greater probably thanever was accumulated upon any medical question, has our Government beendeluded, to vex commerce with unnecessary restraints, to inflictneedless cruelties upon commercial communities, (for what cruelty can begreater than after destroying their means of subsistence by quarantinelaws, to pen them up in a den of pestilence, there to perish withoutescape, amidst their own malarious poison?) and to burden the countrywith the costs of expensive quarantine establishments. Surely if thesedepartments had done their duty, or will now do it, in so far as tofurnish our rulers with an abstract of that evidence, with or withouttheir own opinions, for opinions are as dust in the balance when put incompetition with recorded facts, it must be impossible that the delusioncould be suffered to endure for another year; or should they unluckilyfail thereby to produce conviction on Government, they can refer to therecords of commerce, and of our transport departments, which will shew, if enquiry be made, that no ship, however deeply infected before sheleft the port, (and all ships were uniformly so infected wherever thepestilence raged) ever yet produced, or was able to carry a case ofyellow fever beyond the boundaries of the tropics, on the homewardvoyage, and that therefore the stories of conveying it beyond seas toGibraltar, must have been absolutely chimerical. It would indeed, havebeen a work of supererrogation, little called for, for I think I havefully shown that Gibraltar must be abundantly qualified to manufactureyellow fever for herself. 

No less chimerical will be the attempt to shut out Cholera Morbus fromour shores by quarantine laws, because throughout Europe, readyprepared, alarmed, and in arms against it, they have succeeded nowhere;whereas, had it been a true contagion and nothing else, they must, withordinary care, have succeeded everywhere; the disease, as if in mockery, broke through the cordons of armed men, sweeping over the walls offortified towns, and following its course, even across seas, to theshores of Britain; and yet we are still pretending to oppose it withthese foiled weapons. 

We are indeed told, by authority, that its appearance in towns hasalways been coincident with the arrival of barges from inland, or byships from the sea, but if it be not shown at the same time that thecrews of these barges had been infected with the disease, or if, as atSunderland, no person on board the ships can be identified as havingintroduced it, while we know that the disease actually was there twomonths before, we may well ask at what time of the year barges and shipsdo not arrive in a commercial seaport, or where an epidemic disease, during pestiferous seasons could be more likely to break out than wherethe most likely subjects are thrown into the most likely places for itsexplosion, such as newly arrived sailors in an unwholesome seaport, where the license of the shore, or the despondency of quarantineimprisonment must equally dispose them to become its victims. --Besides, what kind of quarantine can we possibly establish with the smallestchance of being successful against men who have not got, and never hadthe disease. Merchandise has been declared incapable of conveying theinfection, [25] and are we to interdict the hulls and rigging of Vesselsbearing healthy crews, or are we to shut our ports at once against allcommerce with the North of Europe, and would this prove successful if wedid? a reference to a familiar epidemic will I think at once answer thisquestion. 

[Footnote 25: Vide Russian Ukase. ]

It is only three months ago that the epidemic Catarrh or Influenzaspread throughout the land, travelling like the Cholera in India, whenit went up the monsoon, without regard to the East wind; and what couldbe more likely than the blighting drying process of such a wind, ineither the one or the other case, to prepare the body for falling underthe influence of whatever disease might be afloat in the atmosphere. In general this passing disease can be distinctly traced, as havingaffected our continental neighbours on the other side of the channelbefore ourselves: now can it be supposed that any quarantine could haveprevented its first invasion, or arrested its farther progress amongstus. How ridiculous would have been the attempt, and yet with theexperience of all Europe before us, have we been enacting that very partwith the Cholera Morbus: but further, the same authority which calls forthe establishment of quarantine in our ports, tells us that neitherproximity nor contact with the sick, [26] is requisite for the productionof the disease: now can anything further be wanting beyond thisadmission, to prove that it must be an epidemic atmospherical poison, and not a personal contagion, and that, under such circumstances, theestablishment of quarantine against persons and goods, would manifestlybe absurd and uncalled for. So fully satisfied has the AustrianGovernment been made by experience, of the futility and cruelty of suchquarantines, that the Emperor apologises to his subjects for havinginflicted them. The King of Prussia makes a similar _amende_, and theEmperor of Russia convinced by the same experience, abolished or greatlyrelaxed his quarantines several mouths ago. 

[Footnote 26: Vide Reports from Russia. ]

I am by no means prepared to assert, because I cannot possibly know tothe contrary, although from the analogy of other disease I do notbelieve it, that the Cholera Morbus may not become contagious undercertain conditions of the atmosphere, but these cannot be made subjectto quarantine laws, and I am fully prepared to acknowledge, that as inthe case of other epidemics, it may be made contagious through defectivepolice; but independent of these, it possesses other powers andqualities of self-diffusion, which we can neither understand norcontroul. Such, however, is not the case with that other phantom ofour quarantine laws--the yellow fever--which can never, under anycircumstances of atmosphere, without the aid of the last be made acontagious disease. I speak thus decisively from my experience of itscharacter, as one of the survivors of the St. Domingo war, where, in aperiod of little more than four years, nearly 700 British commissionedofficers, and 30, 000 men were swept away by its virulence; as also fromsubsequent experience, after an interval of 20 years, when in the courseof time and service, I became principal medical officer of the windwardand leeward colonies, and in that capacity, surveyed and reported uponthe whole of these transatlantic possessions. 

It was my intention, in these times of panic, to designate to mycountrymen, in as far as I could, the true essential intrinsiccontagions of the British Isles, (for such there are, and terrible onestoo, ) which prevail under all circumstances of season, atmosphere, andlocality, as contradistinguished from the factitious ones, of our owncreating, and the imaginary or false which often spread epidemically, (for there may be an epidemic as well as contagious current ofdisease)[27] although they possess no contagious property whatever; aswell as the foreign contagions, which if we relax in due precaution, may, at any time, be introduced amongst us--but the unreasonable lengthof this letter, for a newspaper communication, warns me to stop. 

[Footnote 27: For as long as men congregate together, and everysupposable degree of communication must of necessity be constantlytaking place amongst them, to distinguish a spreading epidemic from acontagious disease when it first breaks out, must obviously be a matterof impossibility; and upon this point the contagionists and theirantagonists may rail for ever, --the one will see nothing but contagion, whether in the dead or the living body, and the other will refer everyfresh case to atmospheric or terrestrial influence, and both with asmuch apparent reason as they possibly could desire: but the candidimpartial investigator, who waits to observe the course of the diseasebefore coming to a conclusion, and refers to the facts furnished in theCholera Hospitals of Warsaw and the sick quarters of Sunderland, willnever be deceived in regard to its real nature, nor propagate theappalling belief that Cholera Morbus can be made a transportable andtransmissible contagion. ]

I have written thus earnestly, because I deeply feel what I have hereput down. It is possible I may have made mistakes, but if I have, theyare not intentional, and I shall be happy to be corrected, for I donot live at the head quarters of communication, and my broken healthprevents my frequenting in person, the field of investigation. Incandour I ought to declare, that the establishment of quarantine againstthis new and hideous pestilence in the first instance, was the mostsacred duty of Government, but now that its true character has been madeknown, and the futility of quarantine restrictions demonstrated, I feelequally bound, as one of the lieges, to enter my humble protest againsttheir continuance. 

Should I write again, I shall still adopt the same popular style, for no other can be adapted to a newspaper communication, and thesubject-matter is as interesting to the public, and every head of afamily, as it can be to the professional reader; and, in thus makinguse of your columns, as I can have no motive but that of ardentresearch after truth, I know that I may always rely upon yourassistance 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 ofthe British Isles, as well as to offer to the Society some observationson malignant Cholera Morbus, and the mode of its propagation from thetropical regions, where it first arose, to the colder latitudes ofEurope. 

Having already published two letters on this last part of my subject, I need not here take up your time in recapitulating their contents, butproceed to the consideration of some remaining points of the enquiry;which I find I have either overlooked, or not been so explicit inillustration, as I otherwise might, had I been addressing a body ofprofessional men, instead of the community where I live, with the viewof _disabusing_ their minds from the effects of irrational panic, andopening their eyes to what I deemed true measures of preservationagainst the impending disease; and here I may as well add that when Iwrote in a newspaper and adopted the style suited to such a channel ofcommunication, I knew none so likely to attract the attention of thoseinfluential men, who might possess the power and the will, whendisabused of prejudice, to enforce proper laws, instead of running thecourse that had already been imposed upon them, by men interested in theupholding of our quarantine establishments, or by prejudiced, howeverwell meaning, Boards of Health. 

In looking over those letters, I find that the points most open todispute are the course of the disease throughout the Indian peninsula, and its progress to the frontiers of Russia; as well as its supposedinfectious nature, and mode of propagation by human intercourse. Inregard to the first, there is no contagionist however avowed anduncompromising, who does not admit that this erratic disease did notoften wander from its straight line when the most promising fields laydirectly before it; or stop short most unaccountably in its progress, when the richest harvest of victims seemed actually within itsjaws--that its course was circuitous when, according to the laws ofcontagion, it ought to have been straight, --that it refused its preyat one time, and returned to it at another, in a manner that showed itsprogress was governed by laws which we could neither understand norcontroul; and if we search the reports of contagionist writers, weshall find fully as much, and as strong evidence of its progress beingindependent of human intercourse, as of its being propagated andgoverned by the laws of contagion. [28]

[Footnote 28: Vide Orton, Kennedy, &c. ]

To the question, which has so often been triumphantly asked, of itsprogress to the Russian frontiers being conducted by caravans along thegreat highways of human intercourse, and what else than contagion couldcause it to be so carried? An admirable journalist has already repliedby asking in his turn, on what other line than amongst the haunts of mencould we possibly have found, or detected a human disease? And surelythe question is most pertinent, for in those barbarous regions thatinterpose between Russia and India, where the wolf and the robber holddivided alternate sway, and isolated man dares not fix his habitation, but must congregate for safety; where else than in those greatthoroughfares could the disease have found its food; or if beyond these, man, almost as ignorant and as savage as the wolf, could have beenfound; 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; andthe fatalist barbarian of these regions would have dismissed the enquirywith a prayer of resignation, while he bowed his head to the grave, orif his strength permitted, with a stroke of his dagger against theimpious enquirer who had dared to interfere with the immutable decreesof fate. The stories too of its importation into Russia, are exactly thesame as have come to us from our own Gibraltar, in the case of theyellow fever, and may be expected to come from every other quarter wherea well paid officious quarantine is established to find infection inits own defence, and to trace its course in proof of their own servicesand utility. Under such circumstances, this well gotten up drama ofimportation may be rehearsed in every epidemic, adapted in all its partsto every place and every disease, they wish to make contagious. Firstwill be presented, as at Gibraltar, the actual importers--their coursetraced--the disease identified--its reception denounced, and quarantineestablished; and this will go down until sober minded disinterested menbecome engaged in the enquiry, when it will turn out in all probability, that the importers, as at Sunderland, never had the disease--that it wasin the place long before their arrival--that in its supposed course, iteither had no existence, or had long ceased--in fact that theimportation was a fable, the product either of design or an alarmedimagination. On this point I shall not here farther dwell, but proceedto the still keenly disputed question of its contagious, ornon-contagious nature. 

Amongst all those who have advocated the affirmative side of thequestion, an anonymous writer in the LANCET, of Nov. 19th. Seems to methe ablest special pleader of his party, and the best informed on thesubject, which he has grappled with a degree of acumen and power thatmust at once have secured him the victory, in any cause that had truthfor its basis, or that could have stood by itself; but strong andscornful as he is, he has himself furnished the weapons for his owndefeat, and has only to be correctly quoted in his own words, for answerto the most imposing and powerful of his arguments. I take it forgranted, that no one will give credit to instantaneous infection, atfirst sight, but allow that an interval must elapse between thereception of the virus, and explosion of the disease. Kennedy and thebest of the contagionist authors, have fixed the intervening time fromtwo days to a longer uncertain period; yet that writer (in the LANCET)proceeds to tell us, in proof of the virulence of the contagion, thatwhen twenty healthy reapers went into the harvest field at Swedia, nearTripoli, and one of them at mid-day was struck down with the disease, hethen instantly, as if, instead of being prostrate on the ground, he hadrun 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 beforethe following morning. [29]--All this too in the open air. Another writerof note relates that when a healthy ship on the outward voyage arrivedin Madras Roads, her people were seized with Cholera Morbus that verymorning; but they go further than this, and command us to believe in itscontagious powers, without sight at all, quoting the report from ourCommissioners in Russia, where it is officially announced "that neitherthe presence, nor contact of the patient is necessary to communicate thedisease. " Surely in candour we may be allowed to say that when theylimit 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 thefield of Swedia, when it struck down the reapers, as when it blightedour armies in the East, for these sudden bursts and explosions ofpestilence are incompatible with the laws and progress of naturalcontagion, --that if, under a tropical temperature, which dissipates allinfection, there be contagion in the disease, their must also be otherpowers of diffusion hitherto inscrutable, incomprehensible, anduncontroulable, --that their doctrine of contagion exclusively, issuperficial narrow, and intolerant, and their arguments in support ofit, no more than a delusion of prejudice, a piece of consummate specialpleading 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 theothers 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 thedisease in question. ]

Before concluding these observations, I would wish to make a few remarksupon some points of the enquiry which have been either too cursorilypassed over, or not noticed at all; and first of its supposed attractionfor, and adherence to the lines and courses of rivers whether navigableor otherwise. I do not think this quality of the disease has beenassumed on grounds sufficient to justify anything like an exclusivepreference. Along these lines, no doubt, it has very frequently beenfound, because a malarious, a terrestrial, a contagious, or indeed anyother disease, would for many reasons, best prevail on the lowest levelsof the country, or the deepest lines on its surface, like the vallies ofrivers, provided the food on which it fed--population--there abounded. It would be difficult almost anywhere to point out a populous cityunconnected with the sea, rivers, or canals, the water population ofwhich, from their habits of life and occupations, everywhere crowded, dirty, careless, and exposed, must always afford ready materials forany epidemic to work upon, and this may have given currency to theprevailing opinion; but I rather believe, when enquiry comes to be made, it will be found that the worst ravages of Cholera Morbus have beenexperienced in the great level open plains of Upper Germany, and theboundless jungly districts of India, remote from, or at leastunconnected with water communication, denoting thereby atmosphericinfluence 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 enforcedin so hurried a manner as deeply to wound the feelings of survivingrelatives, and in others to give rise to the horrid suspicion ofpremature interment. Can this have been necessary in any disease, evenallowing it to be contagious, or was it wise and dignified in themedical profession to make this concession to popular prejudice, at alltimes when excited, so unmanageable and troublesome. Although we cannotanalyse the matter of contagion, we surely know enough of it to feelassured, that it must be a production and exhalation from the livingbody, arising out of certain processes going on there, in other wordsout of the disease itself, which disease must cease along with the lifeof the patient, and the exhalation be furnished no longer--that duringlife it was sublimed, so as to leave the body and become diffused aroundthrough the agency of the animal heat, created by the functions ofrespiration and circulation of the blood, which being foreclosed and thesupplies cut off, all that remained of it floating before death in theatmosphere, must be condensed upon the cold corpse and lie harmless. [31]It must also be evident that when putrefaction begins, no production ofwhat belonged to the living body can remain unchanged, but must undergothe transformation in form, substance and quality, ordained for allthings; for putrefaction, although it may possibly produce a diseaseafter its own character, is not pestilence, nor even compatible with itin 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 toa greater distance than a few feet from the body of the patient--that itis heavier than common air, settling down in a remarkable manner uponthe sick bed, and saturating the lower strata of the atmosphere in thesick apartment. ]

The puerile stories, therefore, of infection being taken from followinga coffined corpse to the grave, without reference to the state ofgrief, fear, and fatigue, not improbably, of drunkenness, in themourners, must be unworthy of attention. I am no friend to the absurdlylong interval which in this country is allowed to elapse, [32] even inthe hottest weather, between death and burial; but still more do Ideprecate the indecent haste which would give sanction to panic, andincur the risk or even the suspicion of interment before dissolution. In regard to separate burying grounds, should the disease come tospread, I am sure no one will expect, after what has just been said, that I should attempt to argue the question seriously, nor enter aprotest against the further gratuitous wrong of withholding the ritesof sepulture in consecrated ground from the victims of an epidemic oreven a contagious disease. --Nothing could warrant such a measure butwant of room in the ordinary churchyards, where police should never beallowed to interfere with the rights and feelings or property, of theliving, unless to ensure the privacy of funerals; nothing being soappalling to an alarmed people as the spectacle of death in theirstreets, or so trying to the health of the mourners, as tedious funeralceremonies amidst a crowd of people. 

[Footnote 32: After sending these letters to the press, I saw in thepublic prints that the Bishop of the Diocese had forbidden the funeralsof the dead from Cholera to be received in the churches of London. Instead of thus forbidding a part, better have the whole of the serviceperformed there (where crowds do not come) under cover from the weather, than in the open churchyard, where the mourners uncovered, are exposedin every way to damp and cold, and the jostling of the mob; better stillhave all the service deemed necessary, performed at the residence ofthe deceased. ]

Were I called upon to criticise what I have now written, and toreview all that I have seen, read, and heard on the subject, I wouldconscientiously declare that the importation of Cholera Morbus intoEngland or anywhere else, had been clearly negatived, and itsnon-contagious character almost as clearly established, always howeverwith the proviso and exception of the possibility of its being made atemporary contingent contagion, amidst filth and poverty, and impurityof atmosphere, from overcrowding and accumulation of sick, but neithertransmissible nor transportable out of its own locality, through humanintercourse. As the disease, like all the other great plagues, which atvarious periods have desolated the earth, evidently came from the east, it would be most desirable in pursuing our investigation, to have aclear knowledge of the mode of its introduction into Russia on theeastern boundary of Europe. Unfortunately we can place no dependenceupon the reports that have been published to prove importation there, which are lame and contradictory, although coming from the avowedpartizans of contagion; but even had they been better gotten up, wecould not, unless they had been confirmed by the experience of othernations, have received them with implicit reliance. 

The Russian Employé of the provinces, _mendacior Parthis_, not fromgreater innate moral depravity than others, but from the corruptionsof a despotic government which compel him to live under the rod of amaster, amidst a superstitious barbarous population, whose dangerousprejudices he dare not offend, can only give utterance to what histyrants command. Even at the more civilized capital of Petersburgh, themob rose in arms to murder the foreign physicians when they did not actaccording to their liking. Could the truth then be heard on such afield, or what native officer would venture to impugn the authorityof his rulers, proclaiming contagion? If he did, he must cease to livein the official sense of the word. Throughout Europe, from east towest, the disease has followed its own route according to its ownincomprehensible laws, despite of every obstacle and precaution. We havethe authority of our own Central Board for believing that the diseasecannot be conveyed by merchandize of any kind, and that of our missionto Russia for greatly doubting whether it can adhere to personalclothing or bedding; and will it be pretended that human beings, labouring under such a distemper in any form, could have been thevehicles of spreading it in a straight line for thousands of milesthroughout civilized nations, armed and prepared to defend themselvesagainst its inroads, --they tried, but in vain. We, too, may strive todiscover the demon of the pestilence amidst the clouds of the climate, or the winds of Heaven. He remains hidden to our view; and until betterrevealed, it only remains for us to exercise towards our fellow menthose duties which humanity prompts, civilization teaches, and religionenjoins. 

POSTSCRIPT. 

My friend, Doctor Stanford, of the Medical Staff, now settled here, hasgiven me the following valuable information, which my own observationconfirms, regarding the agency of panic, in promoting the diffusion ofepidemic disease. He happened to be serving with part of the Britisharmy, at Cadiz, when an eruption of yellow fever took place there, inthe autumn of 1813, and as usually happens amongst medical men, thefirst time they have seen that fever, some of them were staunchcontagionists, and impressed that belief upon the corps to which theybelonged. In all these the disease was most fatal to great numbers. Themen being half dead with fear, before they were taken ill, speedilybecame its victims, to the great terror and danger of their survivingcomrades; but in the other regiments, where no alarm had been sounded, the soldiers took the chances of the epidemic with the same steadycourage they would have faced the bullets of the enemy, in the lotteryof battle; escaping an attack for the most part altogether, or ifseized, recovering from it in a large proportion. From this picture letus take a lesson, in case the impending epidemic should ever come tospread in the populous towns of England, and the cry of contagion beproclaimed in their streets. The very word will spread terror and dismaythroughout the people, causing multitudes to be infected, who wouldotherwise, in all probability, have escaped an attack, and afterwardsconsign them to death in despair, when they find themselves the markedand fated victims of a new plague. Whatever they see around them, mustconfirm and aggravate their despair, for desertion and excommunicationin all dangerous diseases, too certainly seal the fate of the patient. It will be vain to tell them that hireling attendance has beenprovided, --the life of the Choleraic depends upon the instant aid--theable bodied willing aid of affectionate friends, who will devotethemselves to the task, and persevere indefatigably to the last. Ifthese be driven from his bed, his last stay is gone, for without theiractive co-operation the best prescription of the physician is only somuch waste paper. What, let me ask, must have been the fate of thepatient, and what the consequent panic, if the case of Cholera thatoccurred in London, a month ago at the Barracks of the Foot Guards, had been proclaimed, and treated as a contagion? The poor fellow waspromptly surrounded by his fearless comrades, who with their kind handsrecalled and preserved the vital heat on the surface, by persevering inthe affectionate duty of rubbing him for many hours; but had the MedicalStaff of the regiment been true contagionists, they must, as in dutybound, have commanded, and compelled every one of them to fly theinfection. It depended upon them, to have spread around a far wilderand more dangerous contagion than that of Cholera Morbus, or any otherdisease, --the contagion of fear--and from what occurred at Cadiz, asabove related, it is to be hoped our medical men will now see how muchthey will have it in their power, when Cholera comes, to pronounce, orto withhold sentence of desolation upon a community. The word Contagionwill 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 thatgroundless fear, will at once command the aid, and inspire the hopesthat are powerful to save in the most desperate diseases. 

It is stated, in a Scotch newspaper, that two poor travellers, passingfrom Kirkintulloch to Falkirk, ran the risque of being stoned to deathby the populace of the latter place, and were saved from the immolationonly by escaping into a house; and in an Irish one, that someshipwrecked sailors incurred a similar danger. Such barbaritiesmust, in the nature of things, be practised every where under a reignof terror, however humane or christianized the people may be--even thefatalism of the Turk would not be proof against it. In Spain they havebeen enacted in all their horrors (thanks to the quarantine laws) uponthe unfortunate victims of yellow fever;[33] and we shall soon see themrepeated amongst ourselves, unless the plain truth be promulgated byauthority to the people. Let them be told if such be the pleasure ofour rulers, (for it is not worth while disputing the point), thatCholera Morbus is a contagion, but of so safe a nature in regard tocommunicability, that not one in a hundred, or even a thousand, takethe disease, --that in this country, besides being a transient passingdisease, which according to certain laws and peculiarities of its own, will assuredly take its departure in no long time; it is limited almostalways to particular spots and localities--that it is in their ownpower, while it remains, to correct the infectious atmosphere of thesespots, by attention to health police--that they may fearlessly approachtheir sick friends with impunity, for that the danger resides in theabove atmosphere, and not in the person of the patient; and that in allsituations they may defy it, for as long as they observe sobriety oflife and regularity of habits. Thus will public confidence be restored, and thus be verified the homely adage of, "honesty, in all humanaffairs, being ever the best policy"; for the concealment, or perversionof the truth, however much it may be made to serve the purposes of thepassing day, can never ultimately promote the ends of good governmentand true humanity, but must lead, sooner or later, to the exposure ofthe delusion, or what would be far worse, to the perpetuation of errorand prejudice, and grossest abuse of the people, in regard to thoseinterests 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 mostinteresting experiments, upon the disinfecting power of heat. He foundthat 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 heatof boiling water. In regard to these last, he might surely have venturedto fix the standard of safety at a greatly lower temperature; for if thegrosser vaccine matter could be rendered inert at 140°, there can belittle doubt of the subtile gaseous emanations, which constitute theaerial contagions, being dissipated by the same agent, at an inferiordegree. In the absence of direct experiment, we may venture to infer, that 120° would suffice, to nullify these last. Such, at least, has beenthe belief of those, who have been employed to purify ships, barracks, and hospitals, from contagion, and I should think it must have beenfounded on experience. [34]

[Footnote 34: As far back as the years 1796-7-8, this fact was familiarto us in the St. Domingo war, only we were satisfied with a minimum heatof 120°, from a belief that a temperature of that height, as itcoagulated the ova of insects (the cock roach for instance), and wasotherwise incompatible with insect life, would avail to dissipatecontagion. ]

He does not treat of the disinfecting property of light, although suchan agent was well worthy of his notice; for the power, which in closelystopped bottles can deprive Cayenne Pepper of its sting--render ourPrussic Acid as harmless as cream, and convert the strongest medicinalpowders into so much powder of _post_, can also avail to destroy thematter and principle of Contagion. In fact, no other is used forpurifying goods, at our Lazzarettoes, where suspected articles ofmerchandise, after some nugatory fumigations, are simply exposed tolight and air with such certain effect, that there is not, I believe, in this country, any record of infection being propagated from themafterwards. The experiments of Doctor Henry are as simple and beautifulin themselves, as they promise to be useful and important, for now eventhe horrible contagion of hospital gangrene would appear to be underthe controul of the pure agent he has been describing; and the principlenow established of light and heat, the grand vivifying powers of thecreation, being the sure and true preservers of the creature, man, fromthe poisons generated even by himself, and otherwise around him, callsfor our admiration and gratitude, as shewing that these agents andemanations of Almighty power can be made, in the hands of the practicalphilosopher, to serve the purposes of domestic science, and in as faras we can see, to fulfil, at least in that respect, the best intentionsof the Creator. 

WINDSOR:PRINTED RY R. OXLEY, AT THE EXPRESS OFFICE. 

Transcriber's Note

Spelling variations have been retained in this ebook to match theoriginal 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 locatedoutside 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)