« AnteriorContinuar »
23. Assist. Surg. primary symp-hiccup in one fatal case
Kurrar, August. Generally wa
24. Assist. Surg. Whyte, (iterùm.)
25. Assist. Surg. Henderson, (iter.)
26. Mr. Surgeon Craw, (iterùm.) Seroor, Aug.
tery stools first
feverish re." infectious under
some very limited
peculiarity of constitution"
This concludes our tabular analysis of the individual reports. It will be seen on attentively referring to it, that although the reports are forty in number, the reporters are not so numerous, some gentlemen having forwarded to the central board, so many as two, three, or even more communications. Of the 22 reporters 10 give no opinion on the contagiousness or non-contagiousness of the disease. Now of those who give no opinion it is probable that the majority were non-contagionists, for this reasonthat the contagionists were vastly in the minority throughout India, and they who entertain a general opinion are less likely to state it explicitly, than those who have found reasons for espousing peculiar and less commonly-received notions. Mr. Anderson, for instance, remarks that," the idea of its (the cholera's) contagious nature is entertained by so few, and with so little reason, that it scarce merits notice."*
To pursue our comparison. Four are doubtful; one of the quartett, Dr. Taylor, appearing to incline against contagion, as he observes that none of the hospital attendants were attacked; whilst another, Dr. Burrell, leaning perhaps a little the other way, as he says he would be cautious in reporting the disease not infectious. Three are contagionists. Of these, one is nonprofessional, indeed unprofessional, namely, Captain Sykes. This gentleman, in answer to the observation that hospital attendants generally escaped, replies that he is convinced he would have had the disease, if he had not taken remedies to prevent it! He also feels certain that it could be proved to have been imported into every village, if persons were to set about it. This latter is a very judicious conclusion, and must have been dictated by a spirit, not altogether unprophetic. We know that, give a high-cholerist rope, and send him to Paris, he would prove to demonstration that the cook of Marshal Lobau was infected by M. Magendie, or the mate of a Calais steamer, who coming from Dover or the Thames, must, of course, have a pocket-full of cholera, to be disseminated from the said pouch or pocket throughout the circle of his acquaintance, or of all so unfortunate as to set foot upon his vessel.
To return. Ten are decidedly non-contagionists. The list then stands thus no opinion, 10-doubtful, 4-contagionists, 3-non-contagionists, 10; 3 contagionists, in short, out of 22.
With respect to the premonitory diarrhoea, and the consecutive fever, the
table speaks for itself, and settles the question of perfect identity between cholera in England and cholera in Bombay. Yet what signify facts? We have no doubt, whatever, that persons will be found to persist in swearing to that identity, by asserting that diarrhoea and fever, as general rules, are no novel features; nay, more, that the Indian Reports will prove it.
Having disposed of these gentlemen thus, we redeem our promise of extracting a few of the more interesting circumstances from their reports. And first, of the mortality in Bombay. The following list comprises the amount of cases, of deaths under treatment, and of those ascertained by the police, where no treatment would seem to have been resorted to. The latter are probably below the actual numbers, and one-third or one-fourth may be added to them. The population of Bombay may amount to between 200 and 220 thousand, say 210,000. The number of ascertained cases 15,945, or 7 per cent.
Proportion of deaths in those cases where medicine was administered, 6.4 per cent."
The latter statement evinces the disproportion between the mortality of India and Europe. The following extract from the report of Mr. Whyte will display the influence of locality and of temperature, as well as the obscure connexion between the prevalence of cholera and fever.
"The Cholera Morbus made its first appearance here in the lines of the foot artillery, and attacked in succession every other corps, except the 4th light cavalry and 22d dragoons, which from situation or some other cause have hitherto escaped. I am the more inclined to think, that these corps owe their exemption to locality, from the following circumstance. — The Madras dooly bearers were encamped at the W. end of cantonment hill, between it and the nulla which separates the cavalry from the infantry lines; and while in that situation, several were attacked by the disease, and three or four died. At the request of the Assistant Surgeon of the 22d dragoons, whose duty it was to attend them, they were removed to a situation near the lines of that corps, that he might be at hand to afford them the most speedy aid; and since their removal, I understand no fresh cases of cholera have occurred. Since the epidemic showed itself here, the days have been exceedingly close and sultry, aud about sunset a piercing cold wind has set in from the S. W.: this wind blows down the channel of the nulla mentioned above, turns the corner of cantonment hill, and blows over the cantonments. From want of a thermometer, I could not judge accurately of the degree of heat; but from my sensations, I think its range must have been extensive. The class of people which has principally suffered from this disease, is composed of the poor, badly clothed, or
fed, and those of a debilitated constitution; or else of men, in whom the perspiratory process has been highly excited during the day, whether by violent exercise or exposure to the sun; and in this way sometimes the stoutest and healthiest men suffer. While this disease bears all the characters of an epidemic, undoubtedly depending upon some peculiar and unknown properties in the atmosphere, it appears to be more readily caused by currents of that atmosphere blowing from particular quarters; and what is of great practical importance, a situation sheltered from these currents, a situation for example, in the lee of a hill, is particularly free from the influence of this epidemic. It appears to me that, in some constitutions, this cold wind, instead of producing Cholera, causes a regular attack of ague and fever. You will observe by the abstract of the 7th, that 18 cases of fever were admitted last week, although the period of their admission was not the springs, when that disease commonly shews itself: in few of these men did more than one fit occur. The above impression was made stronger on my mind, from what took place in my own person. After all my perspiratory pores had been kept open some time, in a crowded hospital, on going across the parade, I was suddenly seized with a cold shivering and trembling fit, which lasted some time after my return home. All my thoughts were fixed on Cholera. By means of the pediluvium and mulled port wine, however, I restored warmth and comfortable feelings, but suffered a smart febrile attack after going to bed, which kept me hot and restless during the night; but from which I, in the morning, arose free though languid. I think, that had my constitution been so predisposed, the same cause which produced fever, would have brought on cholera morbus." 13.
The same gentleman offers us an instance of that rather rara avis, a spontaneous cure, or something like it.
"I at first thought, that in a disease of so much violence, there was no such thing as a spontaneous cure; but a man who had been affected three days, was brought to the hospital this morning, in whom the spasms had almost entirely gone off, and whose pulse could be felt at the wrist, although from the description he must have sustained a violent attack, and he had taken no medicine." 20.
Mr. Daw relates a curious instance of the escape of one body of men, probably from prudential conduct, whilst another body, less cautious, suffered severely.
"Two bodies of men, one of nearly three hundred, and the other about one hundred (this is very nearly the numbers but not exact) were in adjoining situations, when the disease broke out in the place where these troops were. The 100 men immediately determined, that, by great temperance and care, and by not exposing themselves unnecessarily, and in particular by avoiding the night air, to endeavour to escape the disease. It succeeded so well that only one man had an attack of it; while the other body of men, the 300 who took no such precaution, lost one-tenth of their whole number. You may think from the manner in which I have written this, that I have no distinct information as to numbers; but had I time, I could easily procure the exact statement, which I am quite certain would very nearly agree with what I have said from memory." 31.
Such has been the capriciousness of cholera that one or two instances of this kind are worth little, at least as foundations for reasoning. During the prevalence of cholera over the small island of Salsett, some villages escaped. Two months after the disease had disappeared from the island, it broke out in one of those same villages, and destroyed 23 out of a popula tion of 80. Had quarantine been adopted in the first instance, to it the original escape, and to its infraction the subsequent desolation would no