On the mode of communication of cholera

by John Snow

The following passage is from the report of Mr. Cruikshanks on the outbreak of cholera in 1814, previously alluded to as occurring in a battalion on its march from Jaulnah to Trichinopoly.

“It was the belief of the natives, strenuously fostered and inculcated by their spiritual guides, that the epidemic was the immediate consequence of the wrath of Heaven, outraged and insulted by the pollution of certain sacred tanks, situated at the village of Cunnatore, in which sepoys of low caste and camp followers had indiscriminately bathed. Such we may not regard as affording a very satisfactory solution of the difficulty; yet it leads, I think, directly to the true point of inquiry. At Cunnatore, the force was so encamped, that while the 5th Native Infantry on the right had their supplies of water from wells, the puckallies of the 9th Native Infantry procured water for that battalion from tanks situated on low ground on the left of the line. The fact, that the disease first broke forth in a day or two after passing Cunnatore; the prevailing opinion of the natives, that it originated there, and that somehow it was connected with the tanks; a desire to discover some one cause confined in its influence and operation to one out of the two battalions; lastly, the difficulty or impossibility of lighting on any other; all these led to inquiry, and to ascertaining with a considerable degree of certainty, that each battalion was supplied with water from a source distinct from the other.”[^[9]] The cholera was said not to be at Cunnatore at the time the infantry were encamped there, but this was probably a mistake.

CHOLERA IN THE BLACK SEA FLEET.

The following quotation is from a letter by a medical officer in the Black Sea fleet, dated Baljik, August 23, 1854, and published in the Medical Times and Gazette of September 30th.

“A week after the return of the fleet to Baljik, on the 7th of August, about four thousand French troops encamped on the heights abreast our anchorage. These were part of the first division of the army that had marched to Kostenje, about ten days before. By it the first blood had been drawn on the part of the allied army. The loss in battle was small, but they had encountered an enemy more terrible than the Russians. The cholera had broken out among them, and attacking four hundred on the first night had destroyed sixty. The total loss had been something incredible. It was said, that out of eleven thousand men, not less than five thousand had perished in a few days. This dreadful calamity was attributed to drinking water from wells that had been poisoned by throwing in putrid carcases.

“Putting aside the question of intentional poisoning, which always presents itself as the most ready way of accounting for such destruction, perhaps some support to the theory, that water is the medium by which cholera poison is conveyed, may be found in this circumstance, and in another of which I was witness. These soldiers, wearied by marching from a focus of cholera infection, were seen, many of them, washing their persons and clothing in the stream from which all the French ships of war, and the majority of the English fleet, obtained their supply of water. This was going on on the 7th and 8th, and, on the nights of the 9th and 10th, the disease burst out with great violence among the crews of several ships.

“Some English ships were the first to suffer, on the night of the 9th, and they proceeded to sea next morning. On the night of the 10th, other English ships, and some of the French, began to suffer; and the latter in an almost unparalleled manner.

“The two admirals’ ships, Montebello and Ville de Paris, were terribly affected. On the previous day they had been in as healthy a state as usual; and in the night the cholera attacked, in the former, two hundred men, of whom forty lay dead in the morning; and in the Ville de Paris there were also many deaths. The French fleet sailed on the afternoon of the 11th; and the following morning saw the English ships also at sea.

“On this day (the 14th), about noon, the Britannia, which had left port in a favourable condition, was attacked suddenly, and in twenty hours upwards of fifty of her crew had expired. We knew nothing of the calamity that had overwhelmed our leader until the following morning, when ‘reports of the sick’ were sent from each ship to the admiral. By this time (the evening of the 16th), eighty had died, and more than two hundred remained in greater or less danger.

“The night of the 16th must have been one of great consternation on board her. The epidemic went on with unchecked violence; the officers were voluntarily attending on the sick; and the very few of the crew who had not been attacked, or who were not assisting their unfortunate messmates, were found quite insufficient to perform the duties of a ship when under sail; and the admiral, therefore, determined to return to Baljik, taking with him the Trafalgar and Albion, also badly affected.