669

THE LANCET.

London, Saturday, February 4, 1832.

CONTINUATION OF THE HISTORY OF THE CHOLERA.

HISTORY

OF THE PROGRESS OF THE

MALIGNANT CHOLERA

IN

ENGLAND AND SCOTLAND.

SINCE the publication of the lengthenedarticle on the general history of the choleraof India and Europe, with which -we pre-sented the readers of this journal on the 19th of November, 1831, we have anxiouslylooked for the opportunity of placing beforethem, a compendious statement of the addi-tional knowledge of the disease acquiredthrough its unfortunate prevalence in Eng-land, and the adjoining districts of North

Britain. Facts of paramount practical inte-rest preclude any further delay in the execu-tion of this important object. Three months Ihaving barely elapsed since the arrival ofthe pestilence on our shores, it has alreadytraversed a large surface of the country ; it

has braved the reduced temperature of a

Northumberland winter ; it has cut off

one thousand victims, and attacked thricethat number of individuals, and it is now

exercising its fatal virulence in the centreof the metropolis of Scotland. _

The readers of the voluminous article al-

luded to will remember, that in its pages we e

carefully traced the successive irruptionsof the cholera, from the Ganges to the Wear,marking, as we proceeded, the numerous ap’palling events which signalized the variousstages of it progress. We drew from the la-

bours of the Anglo-Russian Commissioners,a picture of the seme iology of the maladyas they witnessed it in the North of Europe,and we derived from the researches of the

Indian writers the physiological explana-tions which these symptoms received from

the actual state of our knowledge regarding

the normal functions of human life. Thirdly,we collected, from every source, almost in-numerable data regarding the anatomical

pathology of the disease. Fourthly, weentered minutely into the controversy re-garding its mode of propagation, and show-ed, by insurmountable and multitudinousfacts, that, upon every principle of reason,we are bound to consider human intercourse

as the chief agent of its dissemination. In

the fifth place, we gave an ample summaryof every mode of practice employed in thetreatment of the disorder previous to the pe-riod when we wrote, specifying the effects ofeach mode on the amount of mortality; and,lastly, we dwelt emphatically on the natureof the sanitary measures which were sanc-tioned by the deductions from the facts

which the article recorded. On each of

these divisions we now proceed to bea

stow a few remarks, embodying the in-

formation which the prevalence of cholerain Great Britain has added to our previousstore.

IMPORTATION INTO &KSLAND.

It is not our intention to enter minutely,

in ’this place on the serious questions re-garding the origin of the calamity in this

country. Whatever be the truth, it still,

we lament to say, remains enveloped in theclouds of local dispute, and grovelling sub-

serviency to pecuniary interests, among

many whose profession should have giventhem a different bias. Thus much is, how,

ever, satisfactorily ascertained, that the

quarantine reg2alations in the port of Sunder-land were, for weeks before the official an-

nouncement of the introduction of the

malady, so loosely, so negligently, observed,that mole than one practitioner of the town

openly expressed his conviction that the

cholera would there find its first and its

easiest entrance. It is also a notorious fact

that more than one case of cholera occurred

before the, publication of the official an-

nouncement; and we have, further, strongreason to believe that chests of clothes be.

tJ70 PU OGHESS OF CJIOI.E UA IN EWaI.AKD .

should not huve touched at all upon this

branch of th e har assi ng subject , had "'0 not

felt .it our so le mn duty , as an nota ors of

even ts 8n,1 ca te re rs for the futu re histori al1

an d observer of th o disease, to hold u(l the

occurrences for th e- i r reprob"ti on and guit!.

unce, and show them, th at i f SOIllO portion of

the medical press of tho dnr r urlllilte,1 th

circum stuuce to esc"pe with out tlte ';""01'0 t

cen sure, tho whole wa s not equ allr sil en t.

."n OHJtl:s S I~ SU :O;lJ }: a t . A ~ D .

Of rh ' eur licr evcuis and pr ogre ss of the

cholera in Sunderl und after its introduction,

a pamphl et" now before us 1I1iords an in­st ructive picture, \ \' ,. condenso here tI"

author 's account of thu ori gi nal C:lS l' S of

tl", dise use, se parat ing them from all col.

lateral circumsta nces respecting mode orpropagat iou, t reatm eut , \.: tc ,

" The follo wi ng informat ion relative tothe firs t " ppellr:Jnce of wh at by mnnv WMconaidured to be the As iutic chole ra , i ll

' u llll ~ rl a nd and its lll' i~hbourheo, I, wa..corumuui euted to me bX D r. II gd"lI, UllO ofthe inspect ors ap pointod hy th ~ 1I0ard "fJIeulth 01 Su nd urluud, t il exumi ne nnd verifvthe cases of diseuse given in rho daily ofh­cial reports . E arly in the morning oft\ ugu t th e Bth , tlt il , a man named Arnott,ret. ,10, was nt tucked by a di' ease d o 'elyresem bl ing cholera . aflll I' e di ed at the endof tw el ve hours , JIe was a 'l uarrrman, iadecent c ircum stances , and resided at Paltion,on the rive r \\' ear, uhou t two mile. fromSunde rland . T wo days afterwards a poth'rnumed All ison, li vi ng' at Sou th wick , 011 thenorth side of thu ri ver, suffered seyerel)'from a d isease sim ilar to that which de.st royed Arnott , wi th whom he W 8 not con­nected ; Alli son reco\'Cred . On the r-nhof Au gust , Robert l leu ry , of Fi, her 's -r? ,,' ,Sunde rland, died ufu-r an illness of thlrt.'·hours, his sy mptoms du ring the illness r ,.se mb ling those of ch olera.

.. An othe r cas,', s imi lar to the formerones in i ts ch arac ter, occurred in Hi hop­\\' eanuou th e nr lv in Octohor ; thi s did nottur rn iuute fatall ;' ; and from th is t imu noothe r case was .;oticod as being in UIl)" de ..gree sus picions , u ntil the ~6 th of 0 ,to b,'I'.wh en the firs l death from acknowled 'c d,cholera look place, T his WlI: the ca 0 1

the (·hlor S proat, wh o was a keelman,~

• Ubscrvntion on r.holern, made dU llnI:'.R .;;;tto Sundertnnd, Undf"flakcN hy d i rt ~c t io n of 1 1~ "rmingh nm T . I. Honrd o f ll rnlth. IIlplbe ~~u :--ur.No v. nud n ee., If31. n y G IWI W tc .\ A.MI. ' 1 .eell, &c. ts, u. pp. 63. LUlIdull: l .ungW:W.

longing to person s deceased from c holera at

po rts infected in the Baltic, found their way

into Su nd erland so early as Au gu st Ias t., T he

excelle nt privnte. charact er and the known

benevole nce of some of the individuals

whom any in quiry into the facts " l\e"cd

m i ht princi pally Implicat e, have ge ner ated

a degree of reluctance to move UpOll the

subject . It is , con 'equcntly , ,'ory probable

that no det ailed authentic information re ­

ga rd ing it will ever be ob tained . Balauced us

the evide nce is at \lr se nt , we mu st , how ev e r.

co nc lud e that the importl/tim' i uto unde rlnnd

of th o blu e cholera has not li S ye t he..n l'rm'ed,

but th at i t is rendered highly pr obable .

Wher e is thero, in the wh ole hi story of

diseuse, lin exu mple of a mala dy t rav ell ing

wi tltout IlIllllun uill acr oss a wi de t ract of

Bell, selecting on e par t icu lar po rt for it s

e nt ra nce in to a curtain country ; confin ing

i tu "lITly in l1umlou to n ci rcle of ground not

on e hundred }'Imls i di amet er, and th en

creeping on s lowl j in var ious d ir ecti ons 1

The occurrence is uupreceden ted in the

c1;ronology of diseuse, ami impossible ac­

cordi ng to th e recogn ised physical attrib u tes

of th e ai r we breath e, and of th e ter re , tr ial

s ur faces wh ich wu in ha bit .

\\' e shall not dw ell a t anr length on th e

d isgr acefu l e xurnplos of the suborn ati on of

medi cal opinion, am i the rockl essness and

a varice of a kno t of mercan ti le specula tors,

exhib ited d ur ing th o ea rl." periods of the

Su nde rland e pide mic . W hat now mu st be

tho feel in gs of tho m un-i-con v ict ed e ither

of gross and unox umpl ed ig nornn ce, or of

, " q uall)' sha me ful venali ty - who, wi th

bared facos , erec t a nd consp ic uous befor e

t ho wor ld , con t inue d to deny the e xistence

o f an unu sual malady, n nt il the ch oked

g rnve -y nrds o f their town bor e witn ess to

th o deplorable litct ! What , We repeat,

m ust he th ei r foelin gs now , when, as the 1''', ­

sib le r es ult s of thei r obst inacy or knavery,

one thousand of th eir fellow-creatures IUI\' e,

w ith in th ree months , fitlluu Yic t ims to

th o pcst ilcnco ! DUI en ough of this: WU

on the ad

672 NEWCASTLE, AND GATESHEAD.

places, began to suffer. The precise dates ofthe irruptions in these districts have notbeen authentically published, or, indeed,we believe, at all ascertained.

NEW CASTLE, GATESHEAD, AND THEIR

NEIGHBOURHOOD.

The towns of Newcastle and Gatesheadnow commenced to attract the attention ofthe public. Some days after the earliest oc-currence of cholera in Sunderland, a man

named Oswald Reay died, under symptomswhich, though doubtful at the time, can nolonger be mistaken as denoting the diseasein its worst form. Dropping cases now suc-ceeded throughout the town ; a man namedJordan died in a few hours, and his caseoccasioned much controversy, the mer-

chants, as usual, exclaiming it was not thedisease. The sensible, experienced, mem-bers of the medical profession too clearlyperceived the truth. Dr. MACWHIRTERand others declared their conviction of the

identity of the diseases; but all doubt wassoon destined to be at an end, and on the1. 1 th of December a daily official report wasfirst issued.In Newcastle, as in Sunderland, the dis- Bease was at first confined to the hanks of the le

river, and accordingly we tindthat Sand-gate-street, a long and narrow windingstreet along the left bank of the Tyne,was, with the lanes running from it, chieflyinfested. It is perfectly unnecessary for usto dwell minutely on the events which

marked the prevalence of the malady in thisplace, so closely analogous were they to

those observed in Sunderland. The popula-tion of Newcastle is estimated at 70,000, thetotal of cases up to the 30th January, 888 ;total deaths, 284. The observations re-

specting the class of persons seized in Sun-derland, apply equally to Newcastle; andup to the 25th December the usual rate ofseizures had been from one to fifteen daily.But at this time one of those appallingevents so frequent in the history of thismalady, involved the population of Neiv-castle and its suburbs in despair, and

spread alarm over the entire kingdom.We allude to the remarkable irruption at

Gateshead, respecting which we extract

the following notice, from another clever

pamphlet, by a gentleman of long experience

in the malady, then a Visitor at Newcas-tle.*

.

" Gateshead lies on the right bank of theTyne, opposite to Newcastle, with whichit is connected by a bridge. The populationof the town of Gateshead is probably 10,000,and of the whole parish 15,000. The com-munication between the towns isnecessarilyvery great. Up to the 25th December onlytwo cases of cholera had occurred at Gates-head, although the disease had prevailed atNewcastle for eighteen days. On the even-ing of the 25th December cases began to befrequent, and by ten o’olock on Mondaymorning, forty had been seized, and ten haddied. At ten o’clock on the 27th (Tuesday),there had been ninety-nine cases and forty-two deaths from the Sunday evening’. Ivisited patients in Gateshead-fell, threemiles from the town, on Tuesday morning.In one small village there had been tencases and five deaths."

In Gateshead, up to the 30th of January,there had been attacked 391 persons ; died141.

Around Gateshead and Newcastle, the

villages, especially to the North, now suf-fered severely. In some of the colliery ham-lets, such as Walker and Seg-hill, the diseasewas especially malignant. In Newburn, a

place of trifling extent, about five miles fromNewcastle, the disease appeared in the se-cond week of January, and up to the 29th

of January, 292 cases have taken place, and55 deaths. In this irruption, the rector andsome other persons of comparative opulencefell its ready victims.The movements and ravages of the cho-

lera in the adjacent villages scarcely pre-sent any feature worthy of express contem-plation. The district of Houghton-le-Spring, however, forms a remarkable excep-tion, for here, according to the daily reports,and the correspondence of Dr. MACANNand Messrs. BULLEN and CATON with theCentral Board, out of a population of about2,000 persons (principally in the townshipof Hetton, population 999), there were 333cases, and 70 deaths. The inhabitants of

Houghton-le-Spring are in remarkably com.fortable circumstances, and, on the average,conspicuous for their regular, industrious,and steady habits.

In North Shields, at the mouth of the

* Essay on Cholera, &c. as observed in India,Sunderland, Gateshead, Newcastle. By JAMESADAIR LAWRIE, M,D. 8vo. pp. 74. Longman, &c.London,1832.

673PROGRESS OF CHOLERA IN HADDINGTON,Tyne, the cholera prevailed from a veryearly period of its arrival in England, butthe seizures were very few, amounting onlyto 144 cases (43 deaths) out of a popula-tion of about 25,000 persons.

Such is a rapid view of the progress andravages of cholera in England, up to theperiod at which we write. Besides the caseswe have mentioned, some straggling’ exam-ples of the malady have occurred : namely,one at Doncaster, two at Howick, two at

Morpeth, and two at Durham. Several

cases, besides" took place on board the sliipsin quarantine in Stangate Creek, and St.

Margaret’s Hope, and others in vessels atsea, and in the offings of Hull, Lowestoff,and of other ports on the coast betweenDundee and the Medway. The precise num-ber of these cases we have not ascertained.

SCOTLAND.

Forsaking now the continuous routes andcreeping pace which had characterised itsprogress during the early weeks of its ex-istence in this country, we find the diseasebounding over an interval of nearly onehundred miles, and appearing suddenly in

Scotland, in the town of Haddington, situ-ated in the North Tyne, 16 miles south ofEdinburgh. The first case in this townoccurred on the 17th of December; theman attacked resided in a filthy close, by theriver side; he was a man of dissipatedhabits, and died on the 20th December.This case was followed immediately byseveral others in the same locality, all on theriver side. The population of Haddington is5,600 persons. For the first ten days therewere but 56 cases ; on the 28th and 29th,however, a sudden exacerbation of the epi-demic took place, and on the latter dayseveral very respectable persons were at-

tacked and perished; of these we may par-ticularize the Procurator Fiscal of the countyand an eminent schoolmaster of the town,both of whom died after a few hours’illness.The latest accounts up to the time when we

write, give the cases at Haddington as 75,and the deaths as 41.The village of Tranent, in Haddington-

shire, shows us the next irruption of thedisorder. By the official correspondence,published in the 2nd number of the CholeraGazette, it appears that on the morning ofthe 15th of Jan., a boy died of cholera in the

village of Tranent, after an illness of a fewhours; the same day the sister, set. 25, ofthe first patient, died. On further inquiryit was found that an old woman had diedunder similar symptoms on the llth, andher son, set. 40, was seized on the 15th,and died next day. On the 16th the father ofthe boy and of the young woman, Nos. 1 and2, was also attacked; after this the disease

spread extensively, affecting chiefly beggarsand intemperate persons, and in many in-

stances attacking, in succession, members ofthe same family, or inhabitants of the samehouse. Tranent is about seven miles westfrom Haddington, on the great post-road toEdinburgh ; it contains about 1,700 inhabit-ants, chiefly composed of colliers and otherlabouring people. Up to the accounts re-ceived this day (2nd February) there hadoccurred 106 cases and 41 deaths.Tranent and Preston Pans are contiguous

parishes; the latter is celebrated in history,and in the Waverley Novels, as the scene ofthe murderous conflict between the forcesof Charles Stuart and the Southron army.On the 20th of January the disease showeditself here, three cases having taken placeat its western extremity. The first case

was that of a collier, set. 30; the secondhis child, aged 2. The following day thecoffin-maker who made the coffins for Nos.1 and 2, was attacked, as were also two

children of a widow who assisted the fa-

mily of the first cases during their distress.The districts of Tranent and Preston Pans

lie close upon the south, cr Edinburgh shore,of the Frith of Forth, and form part of achain of villages situated at short stagesbetween the capital of Scotland and thesouth headland of the Forth. Advancing toEdinburgh, at a distance of about 3 miles,Musselburgh, Portobello, and Leith, occurin succession at short intervals towards the

capital. The first of these places must nowengage our attention.

The village of Musselburgh forms one ofthe numerous fishing districts so plenteouslyscattered over the shores of Haddington,Lothian, and Fife, and is inhabited chiefly bya singular class of people, fishers exclusivelyby trade, and the reputed progeny of Dutchcolonists on the Scottish coast. They inter-marry only amongst themselves, have theirown minister of religion, and preserve avariety of primitive .and singular customs.

674 TRANENT, AND MUSSELBURGH.

The females still maintain the picturesqueand curious costume of the Flemish. Theyconstitute, as we have observed, the chief

part of the population of Musselburgh, whichis composed of one long, wide, and straightstreet, of perhaps 300 houses. The utmost

degree of friendly intercourse exists amongall the inhabitants, so that the village maybe, without exaggeration, regarded as one

domestic establishment, and the villagersas members of the same family.According to the official reports, the first

case of cholera occurred on Wednesday, the18th of January. It was followed next dayby nine other cases, three of which died inthe course of the day; next day, at 3 p. M.,seventeen fresh cases were reported, and

six deaths. From this time the disease continued to rage with a severity only pa- ralleled in this country by the irruption atGateshead, and by the reports up to the 2dof February had attained the frightful heightof 219 cases and 93 deaths, out of a popula-tion of about 1,500 persons ; so rapid wasthe mortality, that a pit was necessarily dugfor the general reception of the dead, andthe grave-digger became one of its earliesttenants.

Having approached thus closely to themetropolis of the North, the appearance ofthe malady therein was hourly expected,and accordingly we find, that on Friday the27th of January, a man who went to Mus.selburgh to visit a sick relation, was at-tacked in the West Bow. Another case oc-curred next day in a woman, in Anderson’s-close, same street, and a third in Skinner’s-close, in the High-street. The disease hadnot extended much farther when the last ireports were received. The authoritieshave issued directions for the closure of thetheatres, and suspension of evening servicein the churches; and according to a privateletter received this evening, by an eminentmercantile house in the city, the HighSchool has been closed, Herriot’s and Wat-son’s Hospitals have been placed in a stateof seclusion, and the University shut upfor a time. The bedding and apparel ofthe first patients were destroyed, and the

families removed WITH THEIR OWN CONSENTto Queensbury-house, a spacious building,once a ducal residence, and some yearssince converted into an asylum for patientslabouring under fever. To this admirable

step we shall advert at greater length, underthe head of Sanitary Measures.The narration of another remarkable fact

shall close our itinerary of the English andScottish visitation of this awful disease.On the 22nd of January the disease brokeout at Kirkintilloch, a small but opulentvillage within seven miles of Glasgow, andsituated on the Grand Junction canal, whichruns from the Frith of Forth to the Clyde,crossing the kingdom from East to West,and receiving tributary branches from Mus-selburgh, Tranent, and numerous othertowns and villages around the metropolis.The nonulation amounts but to 2.000 npr-

sons, yet by the accounts received on the31st January, 37 cases had occurred, 12 ofwhich had proved fatal. The utmost alarmwas felt in the great city of Glasgow, thegigantic commerce of which, it is feared,must be considerably cramped by the nearapproach of the disorder.

MODE OF EXTENSION.

We have. thus given a rapid but sufficientsketch of the successive irruptions of the

cholera, not dwelling for a moment on thequestion regarding the manner of its exten-sion. To this we now proceed succinctlyto advert; but we must preface our re-

marks by a swift recapitulation of the sta-tistical facts connected with its progress be-fore its arrival in England, which we re-corded in our first article on the subject.

In our article of November 19, we inves-tigated the manner of dissemination of thismalady by two separate modes of reasoning,the most conclusive which logicians can

command. We first showed that a travel-ling disease, or one which appears overenormous surfaces of the earth in a succes.sion of periods from a certain point, canonly be propagated,

1st, By a vitiated or imperfect state ofthe air.

2dly, By exhalations from the earth.. 3dly, By variations in the electric attri-butes of the earth or atmosphere.

4thly, By variations in the physical attri.

butes of the air, such as its degree of heator cold, moisture or dryness, &c.

5thly, By human communication occur-ring under various modifications; and,

6thly and lastly, By some unknown cause.We next proceeded to examine each of

675MODE OF EXTENSION OF CHOLERA

these causes in detail. Inquiring into thefirst, we found that by the geographical andchronological history of the epidemic, it

was inadequate to account for its dissemina-tion. We saw that it proceeded over nu-merous territories in direct opposition to

the monsoon, and when accompanied by themonsoon, that its march was not accelerated.There are many other collateral reasons to

strengthen this evidence, which we havenot space to recapitulate here.

Neither was the second of the possiblecauses less opposed by irresistible, geo-graphical, established, facts; one of whichalone we shall adduce, namely, that whilethe surface of the earth and water was

" hermetically sealed" by the ice of a

Moscow winter, cholera raged therein withits most destructive power. There werealso cited multitudes of additional facts, forwhich we must refer to our previous paper.That variations of the electricity of the

air or earth, were the agents in spreadingthe disease, was shown to be untrue, by the equal fury with which the cholera pre-vailed under diametrically opposite con-ditions of electricity of both these bodies.The same remark applies to the iufluence ofastronomical changes. ’

Variations of heat and cold, moisture anddryness, altitude or lowness of level, wereproved to be insufficient when we saw in thehistory of the disease that the virulenceof the cholera was equal in the Indian

Ocean and Siberia; in the deltas of the

Ganges, Nile, and Volga, and over the

limestone scalps of Tartary and the sandsof the Arabian deserts ; on the summit of

Catmandou, the Caucasus and Carpathians,and in the marshes of the Sunderbunds, and

Mesopotamian meadows.Again; that intemperance of habit, or

national customs, or deficient or depravedfood, had nothing to do with the expeditionof the malady from place to place, was

proved by the contemplation of the numerouscountries it devastated; the inhabitants ofsome of which observe the strictest sobriety,the customs in most of which totally differ ;and by the fact that the most plenteousharvest, or the pinchng failure of the crops,were alike deprived of influence on its

progress.What causes, then, remain unsiftep.

Two; namely, human intercourse, and an un-known power, only recognisable by its effects.To determine to which of these we were toadhere, we then inquired whether therewere any directfacts on which the first pro.position could be established, and we found,and collected, a body of direct evidence inits support, which, to any rational being, wassufficient to convey the most steady andpermanent conviction.

A moment’s consideration of the precedingstatements is sufficient to show that wecannot reason correctly on this subject, ifwe limit our observations to one country orone set of people. We must take an ex-tended view, embracing all the territories ithas affected, and carefully noticing the

opposite conditions of external circum.stances under which it has prevailed. Heator cold, then, dryness or moisture, the stateof the wind, malarious exhalations, or a

depraved state of the air, cannot have beenthe agents in question in this country ; forthe disease obeys but one remote cause, andall these have been shown by voluminousstatistical facts to be uncounected with its

progress. We are therefore left to decidebetween human agency, or the operation ofan unknown cause. We proceed briefly toexamine to which we may more rationallyyield, according to the evidence this cotin-try has afforded, leaving out of considera-tion the direct testimony supplied by othernations.

In the first place, it is important to re-collect, that owing to the total absence of

any system ofmedical police in GreatBritain,the tracing of any epidemic must depend uponchance alone; upon the casual diligence andscientific zeal of individuals, generally speak-ing too much occupied with practical pur-suits to devote to such inquiries the timethey invariably require. Again, in all dis-eases, no matter how virulent their conta-

gion, or how universally acknowledged itsexistence, it has ever been a matter of theutmost difficulty to demonstrate unbrokenconcatenation in their irruptions. The his-

tories of plague, typhus fever, and small-pox, fully illustrate and sustain this position.

For the proof of the influence of humancommunication in these diseases, we are forthe most part contented to have recourse toa few remarkable and incontestable indivi-

676 IN ENGLAND AND SCOTLAND.

dual examples. Having obtained these, weare afforded a clue to escape from the intri-cacies of an epidemic, which is snatch-

ing off its victims on every side; and weare satisfied to attribute the occurrence of Imany obscure and untraced cases to theimperfection of our means of investigation. IOne remote cause having been satisfactorilyshown, the principles of reason, combined Iwith the evidence of pathology, forbid us to Iseek another, and require us to refer ano-malies to the agency of the multiplied col-lateral circumstances which either augmentor diminish the spreading of a disease andobscure its mode of dissemination.

If, then, in the history of the epidemicwe have just traced, we can show a few ex-amples of the occurrence of facts evidentlytraceable to human intercommunication, weshall rest satisfied with the irrefragableproof thus afforded, that cholera can spreadby contagion; and we shall patiently waituntil chance, or an improved system of in-vestigation, shall enable us to unravel the

anomalies which it presents, and which we e

may be now unable to explain.In all the towns and villages infected in

Great Britain, members of the same familiesor connexions, though residing in differenthouses, have been the peculiar victims of theepidemic, the disease not appearing simul.taneously, but in succession, in the personsaffected. The state of our columns does notpermit us to quote more than one exampleof these occurrences, but the daily journalsare crowded with their recital.

CASE 1.-SUNDERLAND, NOV. 21.-"W.Knell, aged 30, a pilot, living iit Mill-street.On the evening of November 20, he return-ed to his home, after having been out at

sea; his clothes were then very wet, and hehad fasted long. At nine o’clock in the

morning of the 21st, he was out of hishouse ; and soon after his return home he was attacked with cholera. When seenabout mid-day, his pulse was almost imper-ceptible, his hands and face blue, respira-tion difficult. countenance indicative of much

depression, and eyes sunk ; he had cramps, but the vomiting and purging with whichthe attack began had ceased. At two Io’clock P.M., he was remov ed to the CholeraHospital, where he died tranquilly in theevening. At the commencement of his illnesshe was attended by his mother, nITs. Knell, whoresided sometimes with him, sometimes with.her daughter, Mrs. Elliot, af Warren-street.

CASE 2.-NOV. 24. ° Isabella Elliot, agedfive years, a niece of the pilot Knell, resid-ing in Warren-street, was taken ill on Thurs-day morning (the 24th) with spasms, vo-miting, and purging. She was seen at teno’clock A.M. ; her extremities were thenvery cold, the countenance blue, eyesdeeply sunk, and vomiting of a fluid likerice-water continued. Four o’clock P.M.,

breathing difficult ; temperature of the ex-tremities and of the trunk increased ; painat the stomach; countenance still blue, butthe expression intelligent ; no cramps.Half-past ten P.M., the circulation restored ;

colour of the countenance improving; skinwarm.

25th, at noon.-,’ Skin warm; no vomit-ing ; purging continued; countenance livelyand expressive, but the eyes still sunk;other symptoms favourable. Nine o’clockP.M., eyes more lively ; face flushed, sur.face hot; respiration free; pulse rapid; isrestless and feverish.

27th, ten o’clock A.M.-" Pulse quick; isrestless; purging continues, conjunctivainjected. Seven o’clock P.M., breathingdifficult; skin hot; spasms of the abdomi.nal muscles, conjunctiva becoming opaque;lips dry ; gums covered with black sordes.Died at four o’clock in the morning of Mon-dav. the 28th.

CASE 3.—Nov.28. " Thomas Elliot, aged34 years, a pilot, living in Warren-street,the father of Isabella E. At two o’clock onMonday morning (the 28th) he was visitedbv Mr. Torbock and Mr. Ainsworth. El.liot was then in a state of general collapse,eyes sunk, and turned upwards, featuresshrunk, lips dry, breath cold, feeble voice,no pain in the chest, stomach, or bowels;occasional purging, under which he almostexpired; violent cramps in the legs; bandscold, and fingers shrunk in size; no pulse.Ten o’clock A.M., pulse now perceptible,cramps, vomiting, and purging, ceased ; ex-tremities and surface of the body warm;countenance still collapsed ; breathing’ diffi-cult. Two o’clock P.M., pulse increaaing inrapidity ; some fever.29th, ten o’clock A.M.-" The feverishstate has increased in intensity, has pain inthe head, and is restless.

30-" The fever has assumed the formof bad typhus ; has passed no urine. Ape.

rient medicine given to him.December 4.-" This patient graduallybecame worse, the delirium continuing, andthe conjunctiva becoming’ much injected,

but at no period was he unmanageable. On

Friday night he sank into a state of coma,from which he was with difficulty roused.; Elliot, his wife, and four children, lived in , a single room, an attic ; both the parents. slept with Isabella E. during her illness.On the 26th of November, the father was

677INFLUENCE OF CONTAGION.

out at sea, and returned home very wet.On the 27th, he did not complain of illness,but was seized with cholera in the followingnight.

" CASE 4. Dec. 7.-Mrs. Knell, aged 66years, residing now with her daughter, Mrs.Elliot, in Warren-street. She had been

slightly ailing for the last week. At eighto’clock last night she was attacked withvomiting, purging, and cramps ; the vomit-ing soon ceased, and there had been no

purging since six o’clock this morning.Twelve o’clock; her hands, legs, and body,generally cold ; the nails blue, voice hoarseand feeble, countenance pale and collapsed,eyes sunk, no pulse ; she lies quite motion-less, but is sensible, speaking a little, butonly when addressed. The temperature ofher room was 77°, of her hand 70°, of hermouth 86°. Brandy and ether were givento her, and heat applied to the body. Nore-action took place, and she died at eightP. M., remaining sensible to the last minute.

’ CASE 5. Dec. 10.-Alice Stafford, agedseven years, lives in Fisher’s-row, and is a

niece of the late pilots, Elliot and Knell.She was attacked with cholera last night ateleven o’clock, having been previously ingood health. The surface of her body verysoon became cold, and the fingers and nailsof an indigo colour. During the night shehad vomiting and purging of white fluids,like thin gruel. No re-action took place.Between nine and ten A.M. of the 10th shebecame insensible, and died at twelve.

" In addition to the five cases now de-tailed, another relative of this family fell avictim to the pestilence ; the person wasan uncle of the child Stafford; he livedin Deaning-street, Bishop- Wearmouth; wasseized with cholera on the 8th of November,and died after a few hours’ illness/’

In the preceding cases we have a chainof communication traced between the mem-

bers of the same family residing in three

different places.Again : the rate of mortality has been,

in this country, greatest in the villages and’hamlets wherein the inhabitants, thoughscattered over an extensive surface of

ground, and residing in different houses,have lived on the closest intimacy, generallyinduced by equality of rank and identity of ipursuits. Thus, in Newburn, out of a po- I

pulation of 5,000 persons, there were 296cases and 56 deaths. In Houghton-le-Spring, of a population of 2,000, there havebeen 339 cases, 71 deaths. In Tranent and

Prestonpans, of a population of 2;700 therehave been 164 cases and 48 deaths ; andin Musselburgh, 164 cases and 68 deaths.

Hence it appears that the amount of seizuresand mortality was, when compared withother places, in the inverse ratio to the

amount of population, and in direct ratioto the extent of intercourse between the

parties affected.4n the next place, we find that the indi-

viduals who by rank and pursuits wereshielded from intercourse with the personsinfected, did not themselves suffer from thedisease in the large towns. On the other hand,and we state this fact with emphasis, the me-dical men, with few exceptions,-all indeedwith whom we have met,-suffered froma symptom which is now known to be pre-liminary to this disease in a vast majorityof cases, but which is perfectly amenableto therapeutic measures-we mean the diar-rhœa—which of course attracted the imme-diate notice of the gentlemen alluded to, andwas arrested by timely attention.

Lastly ; we find, in nine-tenths of thetowns and villages infected, that the diseasecommenced with one, two, or three cases,and then gradually rose to its maximumextent.

Such are a few examples of the factswhich lead us to believe that the diseasecan be communicated by human intercourse,and such is the evidence on which the com-

municability of typhus fever, measles, andscarlatina, is admitted. But cholera, like

these diseases, presents of course anomaliesin its progress not invalidating the ques-tion of their contagious nature, but seemingto prove that infection is not the sole agentof their extension. We feel, however, notthe least doubt but that these anomaliesare principally referable to the influence ofinexplicable collateral circumstances, on the" period of incubation," or " latent period"which elapses between the receipt of thefirst cause of the malady and the develop-ment of its symptoms-an event which, asis shown by indisputable facts, may be ac-celerated or postponed by an infinite varietyof external agents, such as cold, heat, thestate of the a’r, regularity or irregularity ofhabits, the state of the mind, &c., &c.From this view, it appears to us, we

can derive a more satisfactory explanationof the irruption at Gateshead-on the 26thof December, a day on which the populaceindulge in every variety of dissipation-than

678 INFLUENCE OF CONTAGION.

we can by referring that event to the opera- readily described and discussed. It hastion of an unknown cause. Indeed, if we excited some astonishment, that if the ma-reflect on the number of the persons then lady was communicable by contagion, it

attacked, who in all probability were pre- should have dwelt so long in Sunderland

viously in the latent stage of the malady, without extending its ravages elsewhere.and the termination of which was doubtless How little this fact bears against the con-accelerated by the dissipation of the day; tagiousness of the disease may be gatheredand if we consider the number of per- from the circumstance, that the great plaguesons predisposed by the same influence to of London, which commenced in Long Acre,the receipt of the morbific cause, and the spent five weeks in that street before italmost instant development of its effects, extended itself to the city, and that itwe cannot be astonished that the numbers desolated the latter before it reached Shad-were so great and the mortality so ex- well and Ratcliffe. So remarkably exempt,cessive. indeed, were the inhabitants of the lat-The sudden appearance of the cholera at ter parish, that numbers of wealthy in-

Iladdington, in North Britain, is adduced by dividuals migrated thither from the westa recent writer as a proof that it was not end of London, imagining that the plagueconveyed by human into course. But it is would pass it by, and that the odour of tarmanifest that nothing more is proved by from the vessels in the neighbourhood af.that event, than what takes place in all forded a certain preservative.acknowledged contagious diseases, viz., that But the progress of the cholera towardsthe communication has not been traced. the North, and its slight extension in otherWe challenge the author in question to directions, are also adduced as evidenceshow us a solitary example of an epidemic against the hypothesis of contagion. Some

travelling like the cholera, and one not ac- have even gone so far as to endow the es-

knowledged to be contagious, appearing, sence of the cholera with a degree of obe-thus unexpectedly, at a distant point from dience to magnetic attraction! Had thethe nearest scene of its operations, and then builders of this vain hypothesis turned theirspreading slowly in the newly-visited dis- eyes to the geographical history of this dis-trict. No known cause but human inter- ease, they would have seen that every pointcourse could produce such an effect ; and as of the compass has, at some time or other,to the operation of the " ignotum quid," we seemed the special object of its journey; thatshould not deem ourselves justified in ad- while it was ascending to the North of themitting this, in the face of the conclusive Himalayas, and westward to the Penianfacts to which we have already directed at- Gulf, it broke forth in the Mauritius, and,tention. Besides, it must be remembered, along the Indian Archipelago, to the Souththat all the reasonings of the author alluded and East ; that it ascended the Volga, andto, are connected with his baseless no- then descended to its parallel the Don; in

tion, that little or no latent period exists fine, that it wandered in every directionin this disease. Dr. CRUrKSHANK, who where it found the most suitable materials,visited the first case in Haddington, could obeying the collateral, though secret, influ-not trace it to communication. Is the con- ence of circumstances, which render ano-clusion therefore legitimate, that no com- malous and perplexing the progress of allmunication existed 2 Let us remember the confessedly contagious diseases.constant intercourse between the town and The last objection to which we will replythe infected districts before we decide upon is a brief one, and will be as shortly no-the question, and let us ask ourselves- ticed. Why has the malady, if contagious,Would such evidence as Mr. BELL’s views died away at Sunderland and Gateshead

regarding the first Haddington case, be re- without annihilating the whole population? ?ceived in a court of justice, or in any prac- We shall account for this circumstancetical inquiry, as conclusive of the affirm- when we are informed why the plague ceasesative or negative of any proposition ? in the Levant on the vigil of the feast of St.The other objections to the view we pro- John.

fess to entertain on this question, may be We have now completed our notice of

679PRELIMINARY DIARRŒA.

this branch of the inquiry, satisfied that theprincipal obscurity winch remains to be

dispelled, relates to our want of knowledgeof the true nature of the collateral circum-stances which influence the spreading, orthe cessation, of contagious diseases. It is

devoutly to be hoped that our knowledge ofthis department of the subject will receiveample elucidation from the labours of the medical gentlemen who are now engaged in Iits investigation. We have to lament, that the published I,

accounts do not enable us to append to the

preceding itinerary, a view of the variouscircumstances essential to the completion ofthe medical statistics of the disease. All

the general accounts, however, agree, thatthe mortality has, in this country, been con-siderably greater among females than males.Since its commencement, the deaths havebeen, almost without variation, in the propor-tion of one to three of those attacked. Per-

sons in opulent circumstances are reportedto have been generally exempt, and intem-perate individuals particularly affected.We must observe, however, that beforethese general statements can be received aselucidatory of the history of the cholera,attention should be paid to the small pro-portion which the numbers of the opulentbear to those of the poorer classes in the in-fected districts, and also the great numbersof those who habitually indulge in the abuseof spirituous liquors.SYMPTOMS OF THE CHOLERA, AS IT HAS

APPEARED DI ENGLAND.

The next department of the subject towhich we have to allude, embraces the

symptoms of the disease ; and here it givesus pleasure to record the important additionto our knowledge of this subject effected bythe zeal and attention, as well of the resi-dent practitioners in the various infecteddistricts, as of the numerous visitors theretoattracted.

,

The great and important addition to ourknowledge in this respect, relates to therecognition of ihe preliminary diarrhoea withwhich at least seven eighths of the cases inmost of the distriets have set in. An amplecollection of facts illustrative of this pointhas recently been published by the CentralBoard of Health, in the second number ofthe Cholera Gazette. We extract, in a con-

densed form, the report on this subject, by

Dr. MACANN, an active and talented officer,at present superintending the districts ofNorthumberland and Durham.’ 11 With reference to the questions whichhave been lately ad-dressed to me from theCentral Board, on the subject of diarrhceaas connected with cholera, I have now tostate, that my observations and inquiries,in this part of the country, Sunderland,Newcastle, and Gateshead, all concur in

leading me to adopt the following conclu-sions on that subject." ist. That the appearance or invasion

of the proper choleric symptoms, viz., thevomiting and purging of fluids,neither fecu-lent nor bilious, with cramps and prostra-tion, was preceded, in a great majority ofthe cases which have hitherto occurred, bya marked relaxation of the bowels, that is,by frequent fluid dejections, constitutingthe complaint denominated simple diar-rhoea.’ 2nd. That this diarrhoea, in a great

majority of cases, presented for a time nopeculiar character, so that no man couldtell, when called early to a patient labour-ing under it, whether alt attack of cholerawas impending or not.’ 3rd. That in many cases, however, the

dejections were, from an early period, mor,eanalogous to those which take place in cholerathan in diarrhcea, that is, were more fluid,whiter and less feculent than they usuallyare in the latter complaint; and that inmany of.the other cases they assumed moreor less of that character before the invasionor appearance of the proper choleric symp-toms already referred to." 4th. That cases of disease (as in para-

graph 2) have been met with in all classesof society, and been successfullv treated assimple diarrhcea, by the ordinary remedies,viz., milil laxatives, astringents, opium, &e." 5th. From the preceding observations it

would appear, that ill this country, hitherto,an attack of cholera has, generally speak-ing, been preceded by a relaxed state ofthe bowels; and that the dpjections con-nected therewith have, sooner or later, presented to the careful observer, some indi-cations of the danger to which the patientwas exposed." 6th. For this reason, an early and

assiduous attention to bowel complaintsof all kinds, even the most trifling, must,as a measure of precaution and safety, beof the highest importance to all personsresiding in or near infected districts."With respect to the other symptoms or

stages of the malady, little has been addedto the amount of the information alreadylaid before our readers. In elucidation of

the blue or collapse stage, we have ap-

680 CHEMICAL PATHOLOGY OF CHOLERA.

pended to this article a copy taken from a

drawing of a girl, named Henry, aged 14,who died in Sunderland, after a few hoursillness, and whose case was described in a’letter to the Editor of this journal (p. 402).The plate conveys a clear andunexaggeratedidea of the peculiar leaden hue of the face,hands, and feet ; the extraordinary shrink.ing of the features, the collapse of the eyes,and sudden metamorphosis of the plumpfeatures of youth into the shrivelled phy-siognomy of old age and disease, which thecholera not unfrequently effects in the

lapse of a few swift hours. The plate weaiow present our readers is the first whichhas been published in this country. M.

DALMAS, one of the French commissionersto Poland, has also laid before the Academiede 1lTedecine of Paris a series of platesillustrative of the peculiarities of physiog-nomy in the various stages of cholera.We believe, however, that that delineatedin our drawing is the only stage which

requires illustration.Before we proceed beyond the symptoms

of the disease, it is necessary to allude cur-

sorily to a point of some interest-namely,the question as to the identity of the pre-sent epidemic with the cholera which com-monly prevails in this country. tn our

first article, from a rigid analysis o f thesymptoms of both diseases, we concludedthat they were essentially different; for

while, in the disease to which we were longaccustomed, vomiting and purging wereinvariably present-and while symptoms ofirritation generally prevailed in the onset

of the attack-while preliminary diarrhceawas seldom if ever noticed, and consecu-tive fever never witnessed in the one but asan accidental complication ; in the cholera ofrecent introduction, vomiting’ and purgingare frequently absent during the most,marked stage, no symptoms of irritation are

perceptible, preliminary diarrhrea is almost of constant occurrence, and consecutive jfever occurs as a part of the disorder. Re-specting this subject some ingenious ob-servations have just issued from the pressfrom the pen of Mr. Thackrah of Leeds,*who witnessed a serious epidemic of En-

glish cholera in 1825, and who, from the

* Cholera, its Character and Treatment, &c. ByC. ’1’. Thackrah, Leeds. 8vo. pp. 60. Lond.Longman and Co. 1832.

cases he then observed, inclines to the ’be-lief in the identity of the diseases. Weregret, however, to be still compelled to

differ from so able and accurate an observer;but as we have not space at present to laythe part of his pamphlet before our readersin which he presses his views on this ques-tion, we are in justice and candour boundto recommend it to the general perusal ofthe profession, for it contains the best ac-count we have ever met with of the cholerawhich was epidemic in this country in 1825,and is consequently valuable as affording usthe means of fairly contrasting the two dis-eases.

But few opportunities have been affordedin this country for the improvement of ourknowledge of the anatomical pathology ofthe affection. Ora the whole, we believe thatnot more than a dozen of dissections havetaken place, and in these, no appearancesworthy of note have been detected. The

pathology of the malady has, however, beeninvestigated by another and perhaps a moreconclusive method; numerous analyses ofthe blood and dej ected matters having beenperformed, in Newcastle, by Dr. O’SHAUGH-NESSY, and of the blood, in Sunderland, byDr.. CLANNY. The results obtained by eachexperimentalist coincide in denoting an im-mense loss of water and deficiency of salinematter in the blood, while Dr. O’SHAUGH-NEssY has detected the materials which areabsent in the blood, in the peculiar dejectedfluids. This gentleman has, we understand,laid a voluminous report, describing his

experiments, before the Central Board ofHealth, and until its publication, we, ofcourse, do not feel ourselves competent toallude minutely to the probable inferencesto which his analyses may lead. Dr. CLANNYhaving, however, published his mode of

analysis of the blood, and having presentedus with a physiological explanation of the

disease founded on its results, we are boundto make both the process and the explana-tion, the subject of a few passing remarks.

Divesting Dr. CLANNY’S statements ofextraneous details, we find that in the

statement of the results of his analysis ofthe blood, FREE carbon is enumerated asone of its ingredients, and even the quan-tity thereof minutely specified ; and to the

prevalence of this FREE carbon in the bloodof cholera patients, most, if not all, of the

681TREATMENT OF CHOLERA IN ENGLAND.

symptoms of collapse and asphyxia are at-

tributed.

Now, our duty to our readers obliges usto state, that such an ingredient usfireecarbon has never yet been detected in blood

by any of the great chemists who havehitherto made that fluid the subject of

anal) sis. Physiologists, mere theoretical

physiologists, have ever and anon, it is true,fondly speculated on its presence, and

thence derived many hypotheses of greatingenuity. Again; according to the mode ofanalysis published by Dr. CLAKNY, no suchingredient is sought for, or even alluded to.We consequently cannot implicitly admiteither the experimental results or the patho-logical inferences of this gentleman, untilthis source of obscurity is satisfactorily ex.plained. We should also add, in further

justification of our doubts as to the accuracyof Dr. Clanny’s results, that owing to coagu-lation of the serum being alone recom-

mended by him, and no directions beinggiven for its evap.)I’ation to actual dryness,a considerably greater excess of solid mat-ters, and deficiency of water, is represented,than actually can exist.

In addition to the results already men-tioned, Dr. O’SHAUGHNESSY further assuresus, that his experiments fully disprovethe extravagant assertions of M. HERMANof Moscow, and that he has obtained ureafrom one of the specimens of cholera bloodon which he operated.As far as the preceding statements entitle

us to reason, it is obvious that we must refer

many of the symptoms of the malady tomechanical hyperccmia, or an inspissation ofthe blood, thus rendered too thick for

pulmonary circulation. That the lead-

ing symptoms may thus receive a satisfac-tory explanation, cannot be questioned ;and we therefore wait with anxiety thepublication in detail of the recent inquiries ;and their further prosecution by those

professional gentlemen now resident in thetheatre of the epidemic, to whom the de-partment of the chemical pathology ofcholera has been confided by the EdinburghBoard of Health.

TREATMENT.

The treatment of the disease next de-

mands notice; and here also it gives usmuch satisfaction to note the degree of im-provement which has taken place iu this de-

partment. By the adjustment of suitabletherapeutic measures to the preliminary diar-rhoea, hundreds of lives, we are satisfied,have already been saved ; and by the futuretreatment of this stage we entertain san-

guine hopes that the future amount of mor-tality will be materially diminished. It is;

unnecessary for us to dwell particularly oruthis topic. We have before stated, thatthe cholera diarrhaea was, while a prelimn-nary symptom, equally amenable to ordi-nary remedial measures with that diarrhosa,the proper treatment of which is familiar to.

every practitioner.In the management of the second, or-

collapse stage, some improvement has alsobeen effected, by the introduction of the useof mustard emetics, a practice first recom-mended by Dr. Gibson, at Sunderland, andput into operation by Dr. Lindsey. The,immediate restoration of the pulse has, in,

many cases, followed the action of the red-

medy, and the patient has passed through.an apparently hopeless cold stage. The,

mustard has doubtless, however, failed ill!

many cases, but in these it is questionable’whether any mode of medication could have’been successful; at any rate, the medicine’

promises to be of great utility, when admi-nistered at a sufficiently early period. Ae-

cordingly we find that the Central B<<>ard ofHealth has officially recommended the em-ployment of this emetic, in doses of three

teaspoonsful of mustard to half a pinl ofwarm-water. We should add, however,.that in children and other very young per-sons, and in individuals so paralysed by &Ugrave;eJdisease that their powers of deglutitioEh awimpaired, some caution should be observedin its administration. We offer this sug-gestion in consequence of having been in-formed, that in more than one case such

severe spasms of the glottis, and irritationof the muscles of the larynx, were induced.by the acrid powder, that the patients nearlyperished of instant suffocation. For the

same reason, the mustard should be very

cautiously mixed with its aqueous vehicle ;;for when hastily done, lumps are apt to

form in the mixture, containing little ’t>>l’-cels of di-y powders, which explode, like thepollen of a plant, when pressed by the iaus.cles engaged in the act of deglutition.The inhalation of oxygen gas, and. the in-

jectioll of the same into the rectupi, were

682 SANITARY MEASURES,

tried at Sunderland ; but the practice wasattended with no beneficial resulc. In New-castle Mr. B.HRD is stated to have used atobacco injection, in six cases, with greatadvantage ; but in another case treated thusby Dr. LAWRIE, almost instant death super-vened on the experiment. This circum-stance should evidently teach other practi-tioners the necessity of observing the ut-

most caution in the institution of these

peculiar clinical researches.In one severe case at Haddington, the

galvanic battery has been resorted to, andit is stated with the utmost success. We

are unwilling to check the feelings of plea-sure and security these solitary experimentsusually create in the public mind, but westill cannot admit, without further evidence,that the success in the Haddington case wasthe effect of the remedy employed.The next practical improvement in the

treatment of this disease seems to us of

considerable importance, especially whenwe view it in connexion with the recentchemical researches which we have alreadynoticed. We allude to the employment ofcopious injections of diluent fluids into therectum,-a measure first practised by Dr.GIBSON in one of the cholera hospitals inNewcastle, and since repeated with themost encouraging results. A communica-tion from Dr. CLANNY, inserted in this day’sLAXCET, bears upon this subject. It maybe interesting perhaps to state, that Syden-ham recommended the same process in the

treatment of the violent cholera he so ablydescribes.

It is foreign to our design in the con-struction of this supplementary article, toenter minutely into the details of all themethods of treatment yet employed in thiscountry. Having noticed the most remark-able, we must refer our readers to that partof the first paper which relates to the treat-

ment, and in which will be found the obser-vations which would now apply to the othermodes of practice adopted in Great Britainup to the period at which we write.

SANITARY MEASURES.&mdash;&mdash;BENEFIT OF COAST

QUARAN’I’INE.-CONCLUSION.

The government of the country havingwisely profited by the experience of other

nations, and declined to gratify the ellarita-

ble and economical desire, expressed so

loudly in certain quarters for the institutionof an inland system of cordons, quarantines,and lazarettoes, we are happily enabled tolimit our remarks on the subject of sanitarymeasures to the effects of the coast quaran-tine, and the nature of the local measuresadopted in the infected districts.

Concerning the first, we have no hesita-tion in recording our opinion, that to themeasures of quarantine observed for sometime past upon our coasts with reference tothe vessels from the rivers Wear andTyne,vexatious as it may have been to individualand local interests, is the metropolis stillindebted for its exemption from the disease;and the sum total of our commercial rela-tions beholden for the comparative freedomthey still maintain in the ports of othernations. We are aware that, in advancingthese opinions, we expose ourselves to mis-conception and obloquy, but we confidentlyturn to our remarks regarding the numbersof seizures and deaths on board of vessels inthe various quarantine stations, as one ofour chief reasons for maintaining the first;while, in the second, we are supportedby the simple fact, that had not the Sunder-land, Newcastle, and Shields vessels beenplaced in rigid quarantine, every port inGreat Britain would forthwith have beenso treated by the other powers with whichwe hold commercial intercourse. On

this point we need scarcely offer any fur-ther comment. An inconsiderate morningjournal has, day after day, eked out its

meagre columns with sneers at the exe-cutive for permitting inland, while theyprohibited maritime intercourse. Had the

writer in question known aught of the

sanitary history of Europe during the pre-ceding summer, he would have been satis-fied that a military cordon of 50,000 men,as disciplined as the best troops of Prussia,or of Great Britain, could no more effec-

tually have restrained inland intercourse inthis country, than Mrs. Partington couldhave kept out the tide by the employment ofher mop. But why not then give up mari-time restriction also? First, we replv, inaccordance with the general interest of thecountry as connected with the regulations offoreign powers ; and, secondly, on the sameprinciple which-if we expected a visitfrom midnight marauders in a house having

683SANITARY MEASURES.-CONCLUSION.

two windows, one of which could not be,secured-would induce us to barricade thatwhich admitted of fortification, and trust to iour personal vigilance for the protection ofthe other.Of the measures of local medical police

which have been practised in the infecteddistricts, a brief notice will prove sufficient.In Sunderland a cholera hospital was estab-lished, consisting of one large room, sub- Idivided by canvas curtains, and furnishedwith nurses and medicines, but destitute ofthat most essential requisite, a resident

medical attendant. Of this hospital it is

also necessary to remark, one great and most

important oversight committed in its ar-

rangement, and one which also existed inNewcast1e, viz.: that of the wards being uptwo flights of stairs, so that the patient wasobliged to be carried up in a a-ertical posi-tion, a proceeding on the danger of whichwe need not offer any remark. We trustthis notice will induce future providers ofhospitals to construct the wards on the gi-oundfloor alone.

In all the infected districts, the dead have,up to this time, been interred within twelvehours from their decease. This practice, hasbeen productive of much bitter feeling andanimosity towards the parties engaged incarrying it into execution. On the whole,however, we think the practice desirable;but we would suggest that the burials

should never be performed until at least tenhours have elapsed. The circulation ofsimilar pieces of scandal to that which re-cently figured in the Scottish papers willthus be effectually prevented.A most important measure of local me-

dical police, recommended by the CentralBoard, relates to the suppression of va-

grancy, the provision for beggars, and thedisinfection of wearing apparel by heating itto 212Q; the Board having very properlyabandoned the usual ridiculous practice ofchlorine ablutions.

But by far the most important step, andthe most likely to induce salutary effects,is that to which we have already alluded inconnexion with the Edinburgh disease ;we mean the removal of the families of

persons deceased of cholera to the Queens-berry hospital. We have no doubt thatthis practice will materially retard the ex-

tension of the malady in Edinburgh, andif sagaciously and judiciously imitated inother places, will effect an equally fortunateresult.

The last measure of sanitary police to

which we shall allude is the recommenda-tion just issued by the Central Board of

Health, relative to the organisation of cho-lera hospitals in London. The Board re-

commends :- .

"That each parish and district of thiscapital and suburbs should, without delay,provide-One or more houses to be used incase of necessity, as temporary cholera hos-pitals ; six beds complete in each ; a resi-dent nurse and assistant ; a mode of convey-ance for cholera patients, in which they maybe carried in a horisontal posture; and makesuch arrangements as to be able to commandthe services of a medical gentleman in eachhospital so soon as required."The prudence of this advice requires no

remark; we trust it will be at once adoptednot only throughout the metropolis, but inevery large town in extensive communecation with the districts now infected.

It now only remains for us briefly to

allude to the productions which have issuedfrom the press of this country since thepublication of our first narrative. Those

immediately connected with the British

epidemic we have already adverted to. Ofthe others, Mr. ORTON’S treatise on choleradeserves especial notice and approbation.It is, in truth, a masterly production, anddoes the highest credit to the author’s in-dustry, ability, and research. Many otherexcellent volumes stand on our list, besidesnumbers of pamphlets, small and large, andheaps of worthless productions, the full titlesof the whole of which would alone occupymore space than this article..We thus conclude our coup d’ceil of the

progress of the malady in Great Britainsince its first introduction. We haveomitted the notice of many circumstanceson which we could not enter at sufficient

length consistently with our space, and

which did not admit of being consideredin a cursory manner; and we now take

leave of the subject, not to return to it atsuch length until an equal period of timeshall have again elapsed. By the expirationof that interval we may predict, that shouldthe disease unhappily have spread in the

684 RELIGIOUS WARNING.

metropolis of the North, our knowledge ofall the obscure points in its history will,we hope, be as extensively improved as

human zeal and professional talent can

accomplish. The arrangements made in

Edinburgh for the scientific investigationof the disease, exceed in perfection any-thing of the kind hitherto attempted. Weheartily wish the eminent individuals there-in engaged, success in their researches, andimmunity from the effects of the dangerswith which they may be surrounded.

RELIGIOUS WARNING TO THE MEMBERS OF

THE LONDON MEDICAL SOCIETY.

A curious case of otitis in a child, inwhich the whole of the labyrinth of theinternal ear was thrown off, was related atthe last meeting of this Society, but wehave not loom for a report of it in our pre-sent Number.At the close of this meeting the following

singular proof of the contagious characterof the Rev. Mr. Irving’s newly-broacheddoctrines was exhibited. It appears that

amongst other converts to the belief in mo-dern prophecy, the power of working miracles, and an approaching manifestation ofthe Spirit of 6od on earth, is Mr. AMES-BURY, the surgeon, and generally-knownauthor of a work -1 On Fractures." This

gentleman is a member of the Soci,-ty, andwas present on the above occasion. Oneof the duties enjoined by the leaders of the" New Church on its disciples, is that ofwarning others " to flee from the wrath thatis to come," and of assuring the world, inthe words of the " prophets " at the ScotchChurch, that " HE will descend," and" thoroughly purge the floor of his garner."Accordingly, whenever an opportunity oc-curs of cautioning individuals and families,without using objectionable forwardness,the disciples of Mr. Irving do so, as thecommissioners of the Supreme Being. It

appears that this proceeding is not limitedto strictly private occasions, for on Mondayevening, on the verge of ten o’clock, Mr.Amesbury, labouring we doubt not underthe firmest conviction of the propriety andimperative nature of his mission, arose andsedately addressed the President to the fol-lowing effect :-

Mr. AMESBURY.&mdash;I have an importantmessage, Sir, to deliver to this Society, and’beg leave to be permitted to do so.

THE PRESIDENT, who appeared to beaware, from previous report probably, ofthe nature of the proffered communication,said,&mdash;However important its nature, Sir,

I submit to you whether it would not bemore befitting to make the communicationon another occasion, or, perhaps, whenthe members have left the room. [It issometimes usual for them to assemble afterthe meeting in an apartment below, afford-ing sufficient opportunity for the accom.

plishment of Mr. Amesbury’s purpose.],Mr. AMESBURY acquiesced, and the mem-

bers present, their curiosity being some.what excited, immediately afterwards re-tired to the room in question, where Mr.Amesbury declared himself to be commis.sioned to deliver " a message of grace andmercy;" and, after offering up a short prayerfor the opening of the hearts of his hearers,assured them that a great religious changewas at hand, and that " the gifts of the

Spirit were about to be renewed with signsand wonders," and he advised them to takecounsel before it was too late. We cannot

charge ourselves to state more preciselythe tenor of the speaker’s communication,but this was the spirit of it. On beingasked what proof he could afford them ofthe authenticity of his mission, Mr. Ames.bury merely said, we believe, that he wasassured of the truth and divine origin of allhe had made known. The proceeding wasgone through with gravity, but we are notaware that a conviction of the alleged" truths" was brought home to the mindsof any one present.

Since writing the above, we have heardthat the disciples of Mr. Irving are circula-ting the following statement as an additionalconfirmation of their averment that the in-dividuals who declaim in the " unknown

tongue," at the Scotch Church, are movedthereto by divine influence. It is said bythem &deg;&deg; that a medical man has declared thehuman thorax to be quite unequal to theefforts made by the speakers at the church,unless it were expressly strengthened bymiraculous agency, for that without suchintervention it would on those occasions be

instantly destroyed or deprived of life." Weunderstand that the medical gentleman onwhose authority this "testimony" is now

being generally quoted, is Mr. Amesbury,who suffers no opportunity of social inter-course to pass without admonishing thosein whose company he may be, after thefashion of his message to the members of

the above society.

CORRESPONDENTS, &c.

ERRATA in our present Number.-In Dr. Burnes’scase, p. 662, cot. 2, line 27, for " blade’11 read base;p. 663, in the engraving of the fork, the letter 13should be one inch from the point A.

ERRATUM.&mdash;In Mr. Coley’s paper, No. 43.5, col. 2,line 7 from the bottom, for &deg; os mal&aelig;," read os

max iltare superius.