108

REMARKS

ON THE

CHOLERA MORBUS.

By ALPHA, M.D.

(Concluded from page 43.)

IT need scarcely be said how much it be-hooves all medical men to keep in view thesubject of the wide-spreading cholera, andnot to suffer themselves to be led from anattentive consideration of all that apper-tains to it, by the great political questionswhich at present convulse the whole king-dom.

I totally disagree with Dr. Macmichael,as I believe most people will, that the no-tion of contagion in many diseases is " farfrom beingnatural and obvious to the mind;"for, since the time that contagious proper-ties have been generally allowed to belongto certain diseases, there has been a strongdisposition to consider this as the most na-tural and obvious mode of explaining thespreading of other diseases. A person seesevidence of the transmission, mediate as

well as immediate, of small-pox, from oneperson to another ; and, in other diseases,the origin of which may be involved in ob-scnrity, he is greatly prone to assign a si-milar cause which may seem to reconcilethings so satisfactorily to his mind. Formy part, I admit that I can more easilycomprehend the propagation of certain epi- idemics by contagion, than I can by anyother means, when unaccompanied by sensibleatmospheric changes; and if I reject con-tagion in cholera, it is because whatever wehave in the shape of fair evidence, is quiteconclusive as to the non-existence of anysuch principle. Indeed abundance of evi-dence now lies before the public, from va-rious sources, in proof of the saying ofFontenelle beiug fully applicable to the

question of cholera—" When a thing isaccounted for in two ways, the truth is

usually on the side most opposed to appear-ances." How well mistaken opinions as tr)contagion in cholera are illustrated in a

pamphlet which has just appeared from Dr.Zoubkoff, of Moscow. This gentleman, it ap-pears, had been a firm believer in contagion,until the experience afforded him duringthe prevalence of the disease in that cityproved the contrary. He tells us (p. 10),that in the hospital (Yakimanka) he saw, to his great astonishment, that all the at-tendants, all the soldieis, handled the sick,supported their heads while they vomited,placed them in the bath, and buried thedead ; always without precaution, and al-

wavs without being attacked by cholera."llë saw that even the breath of cholera pa-

tients was inhaled by others with impu-nity ; he saw, that throughout the districtof which he had charge, the disease didnot spread through the crowded buildings,or in families where some had been attacked,and that exposure to exciting causes de-termined the attack in manv instances. He

i saw all this, gives the public the benefit ofthe copious notes which he made of detailsas to persons, places, &c., and now ridi-cules the idea of contagion in cholera.Grant to the advocates of contagion in cho-lera but all the data they require, aud theywill afterwards prove every disease whichcan be mentioned to be contagious. Hun-dreds of people, we will say, for instance,come daily from a sickly district to a healthyone, and yet no disease for some time ap-pears ; but at last an

" inexplicable condi-tion of the air," and " not appreciable byany of our senses " (admitted by Dr. Mae-michael and others as liable to occur, butonly in aid of contagion), takes place; casesbegin to appear about a particular day, andnothing is now more easy than to make outdetails of arrivals, there being a wide fieldfor selection; and even how individuals hadspoken to persons subsequently attacked-had stopped at their doors-had passedtheir houses, &c. : causation is at once con-nected with antecedence, at least for a time,by the people at large, who see their go-vernment putting on cordons and quaran-tines, and the most vague public rumourbecomes an assumed fact. We even find,as may be seen in the quotation given fromDr. Walker’s report, that contagionists aredriven to the " somehow’or other " modeof the introduction of cholera by individuals;so that it may be deplored, with respect tothis disease, in the words of Bacon, that" men of learning are too frequently led,from ignorance or credulity, to avail them-selves of mere rumours or svhispera of ex-perience as confirmation, and sometimes asthe very ground-work, of their philosophy,ascribing to them the same authority as if

they rested upon legitimate testimony.Like to a government which should rewu-late its measures, not by official informationof its accredited ambassadors, but by the

gossipings of newsmongers in the streets.Such, in truth, is the manner in which theinterests of philosophy, as far as experienceis concerned, have hitherto been adminis-tered. Nothing is to be found which hasbeen duly investigated,—nothing which hasbeen verified by a careful examination ofproof."

In their efforts to make out their case,there would seem to be no end to the con-tradictions and inconsistencies into whichthe advocates of contagion in cholera areled. At one moment we are required to be-lieve that the disease may be transmitted

109

through the medium of an unpurified letter,orer seas and continents, to individuals re-siding in countries widely differing in cli-mate, while, in the next, we are told-re-garding the numberless instances of personsof all habits who remain unattacked thoughin close contact with the diseased—that theconstitution of the atmosphere necessary fort!ie germination of the contagion is not pre-sent; and this, although we see the diseaseattacking all indiscriminately, those whoare not near the sick as well as those who,re, at a very short distance, as on the oppo-rate side of a ravine, of a rivulet, of a bar-rack, or even of a road. They assume thatwherever the disease appears, three causesmust be in operation—contagion—peculiarstates of atmosphere (heat now clearlyproved not essential, as at one time be-lieved)—and susceptibility in the habit ofthe individual. However unphilosophicalit is held to be to multiply causes, the ad-_vocates of contagion are not likely to re-duce the number, as this would at once

cramp them in their pleadings before a

court where sophistry is not always quicklydetected. Those who spe hresistible mo-tives for dismissing all idea of contagion,look, on the contrary, for the productionof cholera, to sources, admitted from re-mote times to have a powerful influence onour systems, though invisible-though notto be detected by the ingenuity of man, andthough proved to exist only by their effects.Many who do not believe that cholera

cnn be propagated bv contagion under

ordinary circumstances, have still a strongimpression that by crowding’ patients to-gether, as in hospitals or in a ship, thedisease may ucquire contagious properties.Now we find that when the eJperimentumcrucis of extensive experience is contrastedwith the feasibility of this, cholera, likeague, has not been rendered one bit more

contagious by crowding patients togetherthan it has been shown to be under othercircumstances. We do not require to betold that placing many persons together inill-ventilated places, whether they labourunder ague, or catarrh, or rheumatism, orcholera, as well as where no disease at allexists among them, as in the Calcuttablack-hole ailair, and other instances whichmight be quoted, fever, of a malignantform, is likely to be the consequence, butassuredly not ague, or catarrh, or rheuma-tism, or cholera. On this point we are

furnished with details by Dr. Zoubkoff, ofMoscow, in addition to ttie many previouslyuu record. It may be here mentioned that,on a point which I have already referredto, thus gentleman says (p. 43), " I shallnerrlv observe that at Moscow, where thepolice are remarked for their activity, theycannot yet ascertain who was the tirst in-

dividual attacked with cholera. It was be-lieved at one time that the disease firstshowed itself on the 17th of September ;afterwards the 15th was fixed upon, and atlast persons went so far back as Augustand July." As this gentleman had been acontagiomst, occupied a very responsiblesituation during the Moscow epidemic, and

I quotes time and place in support of his as-sertions, I consider his memoir more worthyof translation than fifty of your Keraudrens.

Respecting those mysterious visitationswhich from time to time afflict mankind, itmay be stated that we have a remarkableinstance in the " dandy" or " dangy" dis-ease of the West India islands, which, oflate years, has attracted the notice of theprofession as being 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 within the last threeyears a disease, quite novel in its ebarac-ters, has been very prevalent in the neigh-bourhood of Paris. It has proved fatal inmany instances, and the physicians, unableto assign it a place under the head of pre-viously-described disease, have been ob-

liged to invent the term " Acrodynia" for it.I am not aware that even M. Pariset, themedical chief of quarantine in France, eversupposed this disease to have been imported,and to this hour the cause of its appearanceremains in as much obscurity among the Sa-vans of Paris, as that of the epidemiccholera.

Considering all the evidence on the suh-ject of cholera in India, in Russia, Prussia,and Austria, one can scarcely suppress hisindignation on perceiving that Dr. Mac-michael (p. 31 of his pamphlet) insinuatesthat the spreading of the disease in Europehas been owing to the views of the subjecttaken by the medical men of India.

In turning now more particularly to thework, or rather compilation, of Dr. BissetHawkins, let us see whether we cannot dis-cover among what he terms " marks ofhaste " in getting it up for "the curiosityof the public" (curiosity, Dr. Hawkins !),some omissions of a very important natureon the subject of a disease respecting whichwe presume he wished to enlighten thepublic. And first, glancing back to cholerain the Mauritius, Dr. Hawkins might, hadhe not been so pressed for time, have re-ferred to the appearance of cholera in 1829,at Grandport in that island ; when, as dulyand officially ascertained, it could not be a

question of importation by any ship what-ever. The facility with which lie suppliesus with "facts,"—the false facts reprobatedby Bacon, and said by Cullen to producemore mischief in our profession than falsetheories-is quite surprising ; he tells us,

point blank (p. 31), speaking of India, that

110

" when cholera is once established in a

marching regiment, it continues its coursein spite of change of position, food, or othercircumstances " ! Never did a medical manmake an assertion more unpardonable, espe-cially if he applies the term marching regi-ment as it is usually applied. But we havehim distinct enough as to change of position.Dr. Hawkins leads us to suppose that hehas examined the India reports on cho-lera. What then are we to think when wefind in that for Bengal the following mostinteresting and conclusive statements everplaced on record ? Respecting the GrandArmy under the Marquis of Hastings, con-sisting of 11,500 fightingmen, and encamp-ed in November 1817 on the banks of theSinde, the official report states that the dis-ease " as it were in an instant gained freshvigour, and at once burst forth with irre-sistible violence in every direction. Un-

subjected to the laws of contact, and proxi-mity of situation, which had been observedto mark and retard the course of other pes-tilences, it surpassed the plague in thewidth of its range, and outstripped the mostfatal diseases hitherto known, in the de-structive rapidity of its progress. Pre-

viously to the 14th it had overspread everypart of the camp, sparing neither sex norage, in the undistinguishing virulence of itsattacks."-" From the 14th to the 20th or22d, the mortality had become so generalas to depress the stoutest spirits. The sickwere already so numerous, and still pouringin so quickly from every quarter, that themedical men, although night and day at

their posts, were no longer able to adminis-ter to their necessities. The whole campthen put on the appearance of a hospital.The noise and bustle almost inseparablefrom the intercourse of large bodies of peo-ple had nearly subsided. Nothing was tobe seen but individuals anxiously hurryingfrom one division of a camp to another, toinquire after the fate of their dead or dyingcompanions, and melancholy groups of na-tives bearing the biers of their departedrelatives to the river. At length even thisconsolation was denied to them, for the mor-tality latterly became so great that therewas neither time nor hands to carry off thebodies, which were then thrown into theneighbouring ravines, or hastily committedto the earth on the spots on which they hadexpired." Let us now inquire how this

appalling mortality was arrested ;-the re-port t goes on to inform us : :-° It was cleaithat such a frightful state of things could notlast long, and that unless some immediatecheck were given to the disorder, it mustsoon depopulate the camp. It was thereforewiselv determined bv the Commander-in-chief to more in search of a healthier soil andof purer air,’’ which they found when they

" crossed the clear stream of the Bitwah,and upon its high and dry banks at Erichsoon got rid of the pestilence, and met withreturning health." Now just fancy epi.demic cholera a disease transmissible by"susceptible articles," and what an inexhaus-tible stock must this large army, with itsthousands of followers, have long carriedabout with them! Against the above his-torical fact men of ingenuity may advancewhat they please. There is no doubt that,in the above instance, severe cases of cho.lera occurred during the move, the poisontaken into the system on the inauspiciousspot not having produced its effects at

once ; it is needless to point out what occursin this respect in remittent and intermittentfevers. The India reports furnish furtherevidence of mere removal producing health,where cholera had previously existed. Mr.Bell, a gentleman who had served in India,and who has lately written upon the dis-ease, * informs us (p. 84), that "removinga camp a few miles, has frequently put anentire and immediate stop to the occurrenceof new cases ; and when the disease pre-vailed destructively in a village, the nativesoften got rid of it by deserting their housesfor a time, though in doing so they neces-sarily exposed themselves to many discom-forts, which, cceteris paribus, we should beinclined to consider exciting causes of aninfectious or contagious epidemic." Weeven find that troops have, as it may besaid, out-marched the disease, or rather thecause of the disease ; that is, moved withrapidity over an extensive surface wherethe atmosphere was impure, and therebyescaped-on the principle that travellersare in the habit of passing as quickly as

they can, across the pontine marshes. Mr.Bell says, "In July, 1819, I marched fromMadras in medical charge of a large party of

young officers who had just arrived in India,and who were on their way to join regi-ments in the interior of the country. Therewas also a detachment of Sepoys, and theusual number of attendants and camp-followers of such a party in India. Thecholera prevailed at Madras when we leftit. Until the 5th day’s march (fifty milesfrom Madras) no cases of the diseaseoccurred. On that day several of the partywere attacked on the line of march ; and,during the next three stages, we continuedto have additional cases. Cholera prevailedin the country through which we were pass-ing. In consultation with the commandingofficer of the detachment, it was determined

* This is by far the best work yet published in Eng-land on the cholera, but it is to be regretted that theauthor has not alluded to the works 01 gentlemenwho have a priority of claim to some of the opinionshe has published : I think that, in particular, Mr.Orton’s book, printed in India, should have beennoticed..

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that we should leare the disease behind us;and as we were informed that the countrybeyond the Ghauts was free from it, wemarched, without a halt, until we reachedthe high table land of Mysore. The conse-

quence was, that we left the disease at

1’ellore, 87 miles from Madras, and we hadnone of it until we had marched 70 milesfurther (seven stages), when we again foundit at one of our appointed places of encamp-ment ; but our camp was, in consequence,pushed on a few miles, and only one case,a fatal one, occurred in the detachment :the man was attacked on the line ofmarch. We again left the disease, andwere free from it during the next 115miles of travelling; we then had it duringthree stages, and found many villages de-serted. We once more left it, and reachedour journey’s end, 260 miles further, with-out again meeting it. Thus, in a jour-ney of 560 miles, this detachment was ex-posed to, and left the disease behind it,four different times ; and on none of thoseoccasions did a single case occur beyondthe tainted spots." What a lesson for Dr.Hawkins! But for whom could Dr. Haw-kins have written his curious book ? Hearllr. Bell in respect to the common error ofthe disease following high roads and navi-gable rivers only:-" I have known thedisease to prevail for several weeks at avillage in the Southern Mahratta country.within a few miles of the principal stationof the district, and then leave that divisionof the country entirely; or, perhaps, caseswould occur at some distant point. In

travelling on circuit with the Judge of thatdistrict, I have found the disease prevailing Idestructively in a small and secluded vil- ’,lage, while no cases were reported from

any other part of the district." What isfurther stated by Mr. Bell will tend to ex-plain why so much delusion has existedwith regard to the progress of the diseasebeing remarkably in the direction of linesof commerce, orgreat intercourse: -- ‘ Whentravelling on circuit, I have found the dis-ease prevailing in a district before any reporthad been made of the fact, notwithstandingtiie most positive order°s on the subject ; and Iam persuaded, that were any of the instancesadduced in support of the statement underconsideration strictly inquired into; itwould be found that the usual apathy of thenatives of India had prevented their notic-ing the existence of the disease until thefdct was brought prominently forward bythe presence of Europeans. It should alsobe brought to mind, that cholera asphyxiais not a new disease to these natives, buteems to be, in many places, almost endemi-cal, whilst it is well known that strangers,in -such circumstances, become more obnox-ious to the disease than the inhabitants of

the country. Moreover, travellers have suoperadded to the remote cause of the disease,fatigue and road discomforts, which are nottrifling in a country where there are neitherinns nor carriages." (p. 89.) Cholera onlyattacks a certain proportion of a population,and is it wonderful that we should hear moreof an epidemic on high roads, where thepopulation is greatest ? High roads too areoften along the course of rivers ; and isthere not some reason for believing, thatthere is often along the course of rivers,whether navigable or not, certain conditionsof the atmosphere unfavourable to health?When Dr. Hawkins stated, as we find at

page 131 he has done, that where the in-habitants of certain hilly ranges in Indiaescaped the disease, " these have beensaid to have interdicted all intercourse withthe people below," he should have quotedsome respectable authority, for otherwiseshould we unhappily be visited by this dis-ease, the people of our plains may one daywage an unjust war against the sturdy High-landers or Welsh mountaineers. Little dothe discussers of politics dream of the highinterest of this part of the cholera question,and little can they conceive the unnecessaryafflictions which the doctrine of the conta-gionists are calculated to bring on the na-tion. Let no part of the public suppose fora moment that this is a question concerningmedical men more than it does the public.This is absurd; all are very deeply con-cerned, the heads of families more espe-cially so.We see that the identity of the European

and Indian epidemic cholera is admitted onall sides; we have abundant proof that what-ever can be’ said as to the progress of thedisease, its anomalies, &c., in the former

country, have been also noted respecting itin the latter; and Dr. Hawkins, when heput forth his book, had most assuredlyabundant materials upon which to form arational opinion. It is by no small effort,therefore, that I can prevent all the re-

spect due to him from evaporating, whenhe declares, at page 165, that " the diseasein India was probably communicable fromperson to person, and that in Europe it hasundeniably proved so." But Dr. Hawkinsis a Fellow of the College of Physicians,and we must not press this point furtherthan to wish others to recollect, that he hastold us that he drew up his book in haste ;and, moreover, that he wished to gratifythe curiosity of the public. The Riga storyabout the hemp and the fifteen labourers I

shall leave in good hands, the British Con-sul’s at that city, who was required to drawup, for his government, a statement of theprogress, &c. of the cholera there, of whichthe following is an extract :-

F The fact of non-contagion seems deter-

112

mined, as far as a question can be so whichmust rest solely upon negative evidence.The strongest possible proof is, the circum-stance, that not one of the persons employedin removing the dead bodies (which is donewithout any precaution) has been taken ill.The statement of fifteen labourers being at-tacked, lchile opening a hnck of hemp, is a

notorious falsehood. Some physicians inclineto the opinion, that the disease may some-times be caught by infection, where thehabit of body of the individual is predis-posed to receive it ; the majority of thefaculty, however, maintain a contrary doc-trine, and the result of the hospital practiceis in their favour. There are 78 personsemployed in the principal hospital here ;of these only two have been attacked, oneof whom was an ’ Inspecteur de Salle,’ andnot in immediate attendance upon the sick.1 am assured that the other hospitals offerthe same results, but as I cannot obtain

equally authentic information respecting’ ,,

them, I confine myself to this statement, onwhich you may rely. On the other hand,in private families, several instances haveoccurred where the illness of one individualhas been followed by that of others : but,generally, only where the first case has

proved fatal, and the survivors have givenway to grief and alarm. illereenary attend-ants have seldom been attacked, and, as

mental agitation is proved to be one of theprincipal agents in propagating or generat-ing the disease, these isolated cases are at-tributed to that cause rather than infection.

*’ It is impossible to trace the origin ofthe disease to the barlcs ; indeed it had notmanifested itself at the place whence theycome till after it had broken out here.The nearest point infected was Schowlenat a distance of 200 wersts), and it appear-ed simultaneously in three different placesat Riga, without touching the interjacentcountry. The first cases were two stone-masons, working in the Petersburgh sub-urbs, a person in the citadel, and a ladyresident in the town. None of these per-sons had had the slightest communicationwith the crews of barks, or other strangers,and the quarter inhabited by people of thatdescription was later attacked, though ithas ultimately suffered most.

" None of the medical men entertain theslightest doubt of the action of atmosphericinfluence—so manv undeniable instances ofthe spontaneous generation of the disease

having occurred. Ha’f the town has beenvisited by diarrhoea, and the slightest devi-ation from the regimen now prescribed(consisting principally in abstinence fromacids, fruit, beer, &c.) invariably producesan attack of that nature, and, generally,cholera : fright, and intoxication, producethe same effect.

" Numerous instances could be producedof persons in perfect health, some of whomhad not left their rooms since the breakingout of the disease, having been attacked by

! cholera, almost instantaneously after havingimi)rudently indulged in sour milk, cucum-bers, &c. It is a curious circumstance,bearing on this question, that several indi-viduals coming’ from. Riga have died at

Vrenden, and other parts of Livonia, withouta single inhabitant catching the disease ; onthe other hand, it spreads in Courland andon the Prussiaa frontier notwithstandingevery effbrt to check its progress. The

intemperance of the Russians during theholidavs has swelled the number of freshcases, the progressive diminution of whichhad previously led us to look forward to aspeedy termination of the calamity." Thisis a pretty fair specimen of the undeniablemanner in which cholera is proved to be

contagious in Europe, and we shall, for thepresent, leave Dr. Hawkins in possessionof the full enjoyment of such proofs.

Respecting cholera in this country, a

case 1ms proved f.ttal here since my last,but regarding which I shall at presentsay no more. Some attempt was made atSunderland, to establish that, in the case

which I mentioned in my last as havingproved fatal there, the disease had been im-ported from foreign parts, but due inquiryhaving been made by the collector of thecustoms, this proved to be unfounded ; theman’s name was Robert Henry, a pilot ;-he died on the 14th of August.*Abroad we find that, unhappily, the cho.

lera has made its appearance at Hamburgh;official information to this effect arrivedfrom our Consul at that place, on Tuesdaythe llth inst. (October). The absurdity ofcordons and quarantines is becoming dailymore evident. By accounts from Vienna,dated the 26th Sept., the Imperial AulicCouncil had directed certain lines of cordonto be broken up, seeing, as is stated, thatthey were ineincacious ; and by accountsof the same date, the Emperor had promisedhis people not to establish cordons betweencertain states.We find at the close of a pamphlet on

cholera, lately published by Mr. Searle, agentleman who served in India, and whowas in Warsaw during the greater part ofthe epidemic which prevailed there thisyear, the following words :-" I have onlyto add, that after all I have heard, either inIndia or in Poland, after all I have read,seen, or thought upon the subject, I arrive

* In a former letter I alluded to cases of cholerawhich appeared this year at Port-Glasgow; I findthat the highly interesting details of tho,e caseshave been just published :-they should be cad byevery-body who takes the smallest interest in the

important questions connected with cholera. TheLondon publishers are Whittaker and Co.

113

!)t this conclusion, that the disease is notcontagious."

In confirir.-ition of the opinion of Mr.Searle, we have now the evidence of themedical commission sent by the Frenchgonrnmcnt to Poland. Dr. Londe, presi-uent of that commission, arrived in Parissome days ago. He announced to the’minister un whose depM’tmetit the qua-routinc lies, as well as to M. Hèly D’OiS-sel, President of the Superior Council ofllealth, that it was proved in Poland, en-tirely to his satisfaction, as well as to thesvtuiaction of his five colleagues, that thecholera is not it contagious disease.The Minister at War also sent four medi-

cal men to Warsaw. Three of them have

already declared against contagion; so itnny be presumed that the day is not firdistant when those true plagues of society,curdons and quarantines against cholera,shall be abolished. Hear the opinion of amedical man in France, -after describino’, afew days ago, the quarantine and cordonrelations in force in that country:—’’But what. effect is to be produced bv these extraordinary measures, this immensedisplay of means, and all these obstructionsti the intercourse of communities, againsta disease not contagious a disease propa-gating itself epidemically, and which no-thing has hitherto been able to arrest ? Toincrease its ravages a hundred-fold,—tomin the country, and to make the peoplerevolt against measures which draw downon them misery and death at the sametnne." What honest man would not nowwish that in this country the cholera ques-tion were disposed of—in Chancery I shallmerely acid, that the ten medical men sentfrom France to Poland, for the purpose of

studying the nature of cholera, have all re-mained unattacked by the disease.October 13, 1331.

Erratum.—3d Letter, Oct. 8th, sixth linofrom top of 3d page, for " non-extinction

"

read non-extension.

ON THE

ATMOSPHERICAL AND TERRESTRIAL COMMO-

TIONS WHICH HAVE ACCOMPANIED

THE CHOLERA MORBUS

OF THE PRESENT PERIOD.

By T. FORSTER, M.D., Boreham, Essex.

As the opinions which I have givenforth in r,n-

I Essay on the AtmosphericalOrigin of Epidemic Disorders," publishedin 139, have been fully borne out, and

proved in a remarkable degree, by the phe-

nomena. of this present period, I have

thought that a simple statement of fact, in-cluding a comparison between the progressof the cholera morbus and the changeswhich are going on in our globe and its

atmosphere, might not be unacceptable tothe reader. They will tend also to removemany erroneous views of the nature, origin,and mode of propagation of cholera andother prevailing epidemics, and may, byexciting inquiry on the part of personsmore able and better qualified than myself,lead to a knowledge of the character andcauses of this important class of disease,more in unison with the state of science inthe present enlightened and improving age.

1. The doctrine that I have always main-tained is, that epidemics of whatever cha-racter, including the plague itself, were

the offspring of an unhealthy state of theprevailing air, and resulted from a derange-ment, more or less general, of the atmo-sphere.2. That this state of the atmosphere ma-

nifested itself in unusual and rapid changesof heat and cold, in unwonted meteors,whirlwinds, waterspouts, foys, and, in

short, all those phenomena which we call

atmospheric, but particularly a distribu-I tion of the temperature over the surface ofthe earth, in a manner often the reverse ofthe usual order of things.

3. ’That terrestrial commotions accompa-nied these vicissitudes, particularly vol-canoes, earthquakes, the overflowing ofrivers and torrents from mountains, andother signs that the changes in our globewhich geology proves to be always goingon, are taking place with an unusual degree

; of activity and force.:’ 4. That the epidemics which take place,. apparently in consequence of, or which atleast accompany, such changes, assume adiversity of character and symptoms at dif-ferent times, wholly inexplicable, but which

; proves, independent of the variety of pre-disposing causes, that the specific stimu-lant itself is very various on different oc-casions.

5. That many of the disorders thus ex-cited, pursue a course wholly incapable ofbeing arrested by any sanatory regulations ;but that, at the same tir.m, large cities aremore frequently attacked than small countryplaces ; while the infectious power of theair being augmented by the exhalationsfrom the bodies of the patients, those whocome into closer proximity or contact withthem, are the more likely to take the disor-der; and this circumstance gives the idea

I Of contagion, and is, in fact, a circumstancethat ought to suggest sanatory restrictionson unnecessary intercourse.

6. That more may be done to preventthan to cure such disorders, by attending to