Letters on the Cholera Morbus. / Containing ample evidence that this disease, under whatever / name known, cannot be transmitted from the persons of those / labouring under it to other individuals, by contact—through / the medium of inanimate substances—or through the medium / of the atmosphere; and that all restrictions, by cordons / and quarantine regulations, are, as far as regards this / disease, not merely useless, but highly injurious to the / community.

by J. Gillkrest; William Fergusson

In the reports referred to in the above letter, there is the most ample evidence of the true cholera having appeared at different points in the colony before the arrival of the Topaze frigate, the ship accused by contagionists par métier, of having introduced the disease; so that, contrary to what Dr. Macmichael supposes, those who disbelieve the communicability of cholera, have no necessity whatever in this case for pleading a coinsidency between the breaking out of the disease, and the arrival of the frigate; indeed, his friend Dr. Hawkins seems to be aware of this, when he is obliged to have recourse to such an argument as that "it is, at all events, clear that the disease had not been epidemic at the Mauritius before the arrival from Ceylon;" so that the beginning of an epidemic is to be excluded from forming a part or parcel of the epidemic! Why is it that in medicine alone such modes of reasoning are ever ventured upon!

We know, from the history of cholera in India, that not only ships lying in certain harbours have had the disease appear on board, but even vessels sailing down one coast have suffered from it, while sailing up another has freed them from it, without the nonsense of going into harbour to "expurgate." Now, with respect to the Topaze, it appears that while lying in harbour in Ceylon, the disease broke out on board her; that after she got into "clene air" at sea, the disease disappeared, seventeen cases only having occurred from the time she left the island, and she arrived at the Mauritius, as Dr. Hawkins admits, without any appearance whatever of the cholera on board. On the day after her arrival, she sent several cases ("chronic dysentry, hepatitis, and general debility") to hospital, but not one of cholera; neither did any case occur on board during her stay there, at anchor a mile and a half from shore, and constantly communicating with shore,[5] while a considerable number of deaths took place from cholera in the merchant vessels anchored near shore.

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

[Pt_1
[Pg 23] As to the introduction of cholera from the Mauritius into Bourbon, where it appeared but very partially, Dr. Macmichael very properly does not say one word. There was abundance of "precaution" work, it is said, and those who choose, are at liberty to give credit to the story of its having been smuggled on shore by some negro slaves landed from a Mauritius vessel. As to the precautions to which the writer in The Westminster Review attributes the non-extension of the disease in this island, hundreds of instances are recorded, in addition to those which we have already quoted, of the disease stopping short, without cordons or precautions of any kind—one remarkable instance is mentioned by Dr. Annesley, where, without seclusion, the disease did not reach the ground occupied by two cavalry regiments, although it made ravages in all the other regiments in the same camp.

We have, perhaps, a right to demand from those gentlemen who display such peculiar tact in the discovery of ships by which the cholera has, at divers times, been imported into continents and islands, the names of those ships which brought to this country, in the course of the present year, the "contagion" which has produced, at so many different points, cases of severe cholera, causing death in some instances, and in which the identity with the "Indian cholera," the "Russian cholera," &c., has been so perfect, that all the "perverse ingenuity" of man cannot point out a difference. If it cannot be shown that in this, we non-contagionists in cholera are in error, people will surely see reason for abandoning the cause of cordons, &c., in this disease,—a cause which, in truth, now rests mainly for support upon a sort of conventional understanding, unconnected altogether, it would appear, with the facts of the case, and entered into, we are bound to suppose, before the full extent of the mischief likely to arise from it had been taken into consideration. Admitting for a moment that a case of cholera possessing contagious properties could be imported into this country this year, will anybody say that a "constitution of the atmosphere" favourable to its communicability to healthy individuals, has not existed in a very high degree:—can a spot be named in which cholera, generally of a mild grade, has not prevailed? And if contagionists cannot point out a difference between some of the severe cases to which public attention has been drawn, and the most marked cases of the Indian or Russian cholera, I think that now there should be an end to all argument in support of their cause. Without at all going to the extent which might be warranted, I would beg to be informed of the names of the ships by which the contagion was brought, which caused the illness of the following individuals; or if they be allowed, as I presume must be the case, not to have been infected at all in this way, all that has been said regarding the identity of the foreign and severe form of the home disease, must be shown to be without foundation:—the detailed case of Patrick Geary, which occurred in the Westminster Hospital,—the fatal case of Mr. Wright, surgeon, 29, Berwick-street,—the cases, some of them fatal, which occurred at Port Glasgow, and regarding which, a special inquiry was instituted,—a case in Guy's Hospital, which caused some anxiety about

[Pt_1
[Pg 24] the middle of July last,—a case reported in a medical periodical in August last, as having occurred in Ireland,—the fatal case, as reported in my first letter, of Martin M'Neal,[6]—a second case reported in a medical periodical in August,—a fatal case on the 12th of August last at Sunderland, reported upon to the Home Secretary by the mayor of that town,—three cases reported in No. 421 of The Lancet,—a very remarkable case duly reported upon in September, from the Military Hospital at Stoke, near Davenport, and a case with thorough "congee stools," spasms, &c. (the details of which I may hereafter forward), which occurred at Winchester on the 22d of September, in the 19th Foot, in a man of regular habits, and of the nature of which case the medical gentleman in charge had no doubt.

[6] The same Army Medical gentleman, who had been sent to Port Glasgow, was sent to Hull to report upon this case:—he arrived there too late, but having seen the details of the case, he admitted that he saw no reason to declare them different from those which occurred in the Indian cholera.

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

I must now beg to return to an examination of one or two more of the very select quotations made by Dr. Macmichael, with the view, as he is pleased to tell us, of placing the statements on both sides in juxtaposition. He is well pleased to give us from Dr. Taylor, assistant-surgeon,—what indeed never amounted to more than report, and of the truth or falsehood of which this gentleman does not pretend to say he had any knowlege himself,—that a traveller passing from the Deacan to Bombay, found the disease prevailing at Panwell, through which he passed, and so took it on with him to Bombay; but whether the man had the disease, or whether he took its germs with him in some very susceptible article of dress, is not stated by Dr. Taylor; however, he states (what we are only surprised does not happen oftener in those cases, when we consider similarity of constitution—of habits—of site or aspect of their dwellings, &c.) that several members of a family, and neighbours "were attacked within a very short period of each other;" but when Dr. Taylor goes on to say, "In bringing forward these facts, however, it may be proper at the same time to state, that of the forty-four assistants employed under me, only three were seized with the complaint;" he gets out of favour at once, and his observation is called "unlucky," being but a negative proof, and Dr. Macmichael adds, what everybody must agree with him in, that positive instances of contagion must outweigh all negative proofs:—to be sure:—but Dr. Macmichael's saying this, does not show that positive proofs exist. Give us but positive proofs, give

[Pt_1
[Pg 25] even but a few, which surely may be done, if the disease be really communicable, and where contagion has been so ardently sought after by all sorts of attachés and employés of the cordon and quarantine systems in the different countries on the Continent. We could produce no mean authority to show, that a long succession of negative proofs must be received as amounting to a moral certainty; and what greater proof can we have of non-contagion in any disease, than we have in the fact regarding epidemic cholera, as well as yellow fever, that attendants on the sick are not more liable than others to be attacked? Regard should, of course, always be paid, in taking this point into consideration, to what has been already noticed in my second letter, or the inferences must be most erroneous. Dr. Macmichael quotes the statement of Dr. Burrell, 65th regiment (and takes care to put the quotation in italics too), that at Seroor, in 1818, "almost every attendant in hospital had had the disease. There are about thirty attendants in hospitals." Now, along with hundreds of other instances, what does Dr. French, of the 49th regiment, say, in his Report of 1829? That no medical man, servant, or individual of any kind, in attendance on the sick, was taken ill at Berhampore, when the cholera prevailed there that year, and refers, to his Report for 1825, in which he remarked the same thing in the hospital of the 67th regiment at Poonah; contrary, as he observes, to what occurred some years before in the 65th regiment at Seroor, about forty miles distant. In the two instances quoted by Dr. French, and in that by Dr. Burrell, all those about the sick stood in the same relation towards them, and all the difference will be found probably to have been, that the hospital of the 65th was within the limit of the deteriorated atmosphere, where the cause existed equally (as in the case of ague and yellow fever) whether persons were present or not.