At a meeting held some days ago by the members of the Royal Academy of
Medicine of Paris, Dr. Londe (President of the French Medical Commission
sent to Poland to investigate the nature of the cholera) stated, with
regard to the questions of the origin and _communicability_ of the
disease, that it appeared by a document to which he referred, that
1st. "The cholera did not exist in the Russian corps which fought at
_Iganie_," the place where the first battle with the Poles took place.
2d. "That the two thousand Russian prisoners taken on that occasion, and
observed at Praga for ten days under the most perfect separation, [_dans
un isolement complet_] did not give a single case of cholera." 3d. "That
the corps [of the Polish army] which was not at _Iganie_, had more cases
of cholera than those which were there." Dr. Londe stated cases of the
spontaneous development of the disease in different individuals--of a
French Lady confined to her bed, during two months previous to her
attack of cholera, of which she died in twenty-two hours--of a woman of
a religious order, who had been confined to her bed for six months, and
while crossing a balcony, the aspect of which was to the Vistula, was
attacked with cholera, and died within four hours. Dr. Londe, among
other proofs that the disease was not transmissible, or, as some prefer
calling it, not communicable, stated, "the immunity of wounded and
others mixed with the cholera patients in the hospitals; the immunity of
medical men, of attendants, of inspectors, and of the families of the
different _employés_ attached to the service of cholera patients;
the example of a porter, who died of the disease, without his wife or
children, who slept in the same bed with him, having been attacked; the
example of three women attacked (two of whom died, and one recovered),
and the children at their breasts, one of six months, and the other two
of twelve, not contracting the disease."
At a subsequent meeting of the Academy, a letter from Dr. Gaymard, one
of the Commission to St. Petersburg, was read, in which it was stated,
while referring to the comparative mortality at different points there,
that, "The cause of this enormous difference was, that the authorities
wished to isolate the sick--[Observe this well reader]--and even send
them out of the city; now the hospital is on a steep mountain, and, to
get to it, the carriages were obliged to take a long circuit through a
sandy road, which occupied an hour at least; and if we add to the
exposure to the air, the fatigue of this removal, and the time which
elapsed after the invasion of the disease, the deplorable state of the
patient on his arrival, and the great mortality may be accounted for."
"The progress of the disease was the same as in other places; it was at
the moment when it arrived at its height, and when, consequently, the
greatest intercourse [Observe reader!] took place with the sick, that
the number of attacks wonderfully diminished all at once (_tout à
coup_), and without any appreciable cause. The points of the city most
distant from each other were invaded. Numbers of families crowded
[_entassés_] who had given aid to cholera patients, remained free from
the disease, while persons isolated in high and healthy situations
[_usually_ healthy meant of course] were attacked. It especially
attacked the poorer classes, and those given to spirituous liquors.
Scarcely twenty persons in easy circumstances were attacked, and even
the greater part of these had deviated from a regular system."
The inferences drawn, according to a medical journal, from the whole
of Dr. Gaymard's communication, are--
"1. That the system of sanatory measures, adopted in Russia, did not
any where stop the disease.
"2. That without entering on the question as to the advantages to be
derived from a moral influence arising out of sanatory cordons, placed
round a vast state like France, these measures are to be regarded as
useless in the interior, in towns, and round houses.
"3. That nothing has been able to obstruct the progressive advance of
the disease in a direction from India westward.
"4. That the formation of temporary hospitals, and domiciliary succour,
are the only measures which can alleviate this great scourge."
A letter from Dr. Gaymard to Dr. Keraudren was read at the meeting of
the Academy, in which it was stated, that in an Hospital at Moscow, in
which Dr. Delauny was employed from the month of December, 1830, to
the end of December, 1831, 587 cholera patients, and 860 cases of
other diseases, were treated--"Not one of the latter was attacked
with cholera, although the hospital consists of one building, the
coridors communicating with each other, and the same linen serving
indiscriminately for all. The attendants did not prove to be more
liable to attacks. The relatives were suffered to visit their friends
in hospital, and this step produced the best impression on the
populace, who remained calm. They can establish at Moscow, that there
was not the smallest analogy between the cholera and the plague which
ravaged that city in the reign of Catharine." Dr. Gaymard declares,
that, having gone to Russia without preconceived ideas on the subject,
"he is convinced that interior quarrantines, and the isolation of
houses and of sick in towns, has been accompanied by disastrous
consequences." Is there yet enough of evidence to shew that this
disease is positively _not to be made_ communicable from the sick?
Honour still be to those of the profession who, from conscientious and
honorable motives, have changed from non-contagionists to contagionists
in regard to this disease; and all that should be demanded is, that
their _opinions_ may not for one moment be suffered to outweigh, on
an occasion of vital importance, the great mass of evidence now on
record quite in accordance with that just stated. One gentleman of
unquestionable respectability gives as a reason (seemingly his very
strongest) for a change of opinion, that he has been credibly informed
that when the cholera broke out on one side of the street in a certain
village in Russia, a medical man had a barrier put up by which the
communication with the other side was cut off, and the disease thus,
happily, prevented from extending. Now, admitting to the full extent the
appearance of the disease on one side of the village only--a thing by
the way hitherto as little proved as many others on the contagion side
of the question--still, if there be any one thing more striking than
another, in the history of the progress of cholera, it is this very
circumstance of opposite rows of houses, or of barracks, or bazaars, or
lines of camp, being free, while the disease raged in the others, and
without any sort of barricading or restriction of intercourse. If people
choose to take the trouble to look for the evidence, _plenty_ of such is
recorded. Now just consider for one moment how this famous Russian story
stands: had the barricading begun early, the matter would have stood an
examination a little better; but this man of good intentions never
thought of his barriers till the one-sided progress of the disease had
been manifest enough, _without them_:--and then consider how the
communication had existed between both rows before those barriers were
put up, and how impossible it was, unless by a file of soldiers, to have
debarred all communication:--let all this be considered, and probably
the case will stand at its true value, which is, if I may take the
liberty of saying so,--just nothing at all. Let us bear in mind the
circumstance already quoted from the East India records,--of one company
of the 14th Regiment, at the extreme end of a barrack, escaping the
disease, almost wholly, while it raged in the other nine; and this
without a barrier too. But such circumstances are by no means of rare
occurrence in other diseases arising from deteriorated atmosphere. Mr.
Wilson, a naval surgeon, has shewn how yellow fever has prevailed _on
one side_ of a ship, and I have had pointed out to me, by a person who
lived near it for thirty years, a spot on this our earth where _ague_
attacks only those inhabiting the houses in one particular line, and
without any difference as to elevation or other appreciable cause,
except that the sun's rays do not impinge equally on both ranges in the
morning and evening.
The advancement of the cause of truth has, no doubt, suffered some check
in this country, by the announcement that another gentleman of great
respectability (Mr. Orton) finds his belief as to non-contagion in
cholera a good deal shaken: but we find that this change has not arisen
from further personal knowledge of the disease, and if it be from any
representations regarding occurrences in Europe, connected with cholera,
we have seen how, from almost all quarters, the evidence lies quite on
the side of his first opinions. Whatever the change may be owing to, we
should continue, as in other cases, not to give an undue preference even
to opinions coming from him, to well authenticated facts--facts, among
which some particularly strong are still furnished _by himself_, even in
the second edition of his book:--"It must be admitted that, in a vast
number of instances in India, those persons [medical men and attendants]
have suffered no more from the complaint than if they had been attending
so many wounded men. This is a fact which, however embarrassing to
the medical inquirer, [for our part we cannot see the _embarrassment_]
is highly consolatory in a practical point of view, both to him and
to all whose close intercourse with the sick is imperatively
required."--(_p. 316_)--"We are therefore forced to the conclusion,
however, at variance with the common laws of contagion, that in this
disease,--at least in India, the most intimate intercourse with the sick
is not, in general, productive of more infection than the average quantity
throughout the community." (_p. 326_). Let us contrast the statements in
the following paragraphs:--"For in all its long and various courses, it
may be traced from place to place, and has never, as far as our information
extends, started up at distant periods of time and space, leaving any
considerable intervening tracts of country untouched." (p. 329)--"All
attempts to trace the epidemic to its origin at a point, appears to have
failed, and to have shewn that it had not one, but various local sources
in the level and alluvial, the marshy and jungly tract of country which
forms the delta of the Ganges, and extends from thence to the
Burraumposter." (p. 329) Now let us observe what follows regarding the
particular _regularity_ in the progress of the disease, as just
mentioned:--"Another instance of irregularity in its course, even in
those provinces where it appears to have been most regular, is stated
[now pray observe] in its having skipped from Verdoopatly to a village
near Palamacotta, leaving a distance of sixty miles at first
unaffected." (p. 332)!!--This is not the way to obtain proselytes I
presume.
The situation of our medical brethren at Sunderland is most perplexing,
and demands the kindest consideration on the part of the country at
large; but let nothing which has occurred disturb the harmony so
essential to the general welfare of that place, should their combined
efforts be hereafter required on any occasion of public calamity. In
truth both parties may be said to be right--the one in stating that
the disease in question _is Indian cholera_, because the symptoms are
precisely similar--the other that it _is not Indian cholera_, because
it exists in Sunderland, and without having been imported--IN NEITHER
COUNTRY IS IT COMMUNICABLE FROM ONE PERSON TO ANOTHER, as is now plainly
shown upon evidence of a nature which will bear any investigation; and
if blame, on account of injury to commerce, be fairly attributable to
any, it is to those who, all the world over, pronounced this disease, on
grounds the most untenable, a disease of a contagious or communicable
nature. Let the Sunderland Board of Health not imagine that their
situation is new, for similar odium has fallen _on the first_ who told
the plain truth, in other instances--at Tortosa, a few years ago, the
first physician who announced the appearance of the yellow fever, was,
according to different writers, _stoned to death_; and at Barcelona, in
1821, a similar fate had well nigh occurred to Dr. Bahi, one of the
most eminent men there--we need not, I presume, fear that a scene of
this kind will take place in this country,--though the cries of "no
cholera!" and "down with Ogden!" have been heard.
One word as to observations regarding the needlessness of discussing the
contagion question: the truth is, that the cleanliness and comfort of
the people excepted, you can no more make _other arrangements_ with
propriety, till this point be settled, than a General can near the enemy
by whom he is threatened, till it be ascertained whether that enemy be
cavalry or infantry.
My object in these letters is not to obtrude opinions upon the public,
being well aware that they cannot be so well entitled as those of many
others, to attention; but I wish to place before the public, for their
consideration, a collection of facts which I think are likely to be of
no small importance at a moment like the present. In addition to the
many authorities referred to in the foregoing pages, I would beg to
call the public attention to a paper in the _Windsor Express_ of the
12th November, by Dr. Fergusson, Inspector General of Hospitals, a
gentleman of great experience, and who has given the _coup de grace_
to the opinion of contagion in cholera. Indeed the opinion now seems
to be virtually abandoned; for, as to quarantine on our ships from
Sunderland, it is, perhaps, a thing that cannot be avoided, if the main
consideration be _the expediency of the case_, until an arrangement
between leading nations takes place. We have seen, in regard to Austria,
how the matter stands, and our ships from every port in the country
would be refused admission into foreign ports, if we did not subject
those from Sunderland to quarantine; which state of things, it is hoped,
will now be soon put an end to.