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The late General Board of Health directed one of their medical inspectors, Dr. Waller Lewis, to make minute inquiry as to the relative effects produced by the use of pure spring water, and that of the Water Company, during the epidemic of cholera in Newcastle; and it is much to be regretted that the inquiry was not carried out. To have conducted the inquiry through the whole of Newcastle and Gateshead would not have entailed a quarter as much labour as my investigations in Lambeth, Newington, and the Borough. Dr. Lewis called on Mr. Main, the secretary of the Water Company, and they made an inquiry in certain houses, taken at random, through three streets, and also in Greenhow Terrace, where a severe outbreak of cholera had occurred, although it was not supplied by the Company, but had what was reported to be good spring water. Dr. Lewis gave up the inquiry because he could not find two places exactly alike in all their physical conditions,—one place supplied with spring water, the other by the Company. He made no report of what he had done; but Mr. Main sent a paper on the subject of this commenced inquiry to the Pathological Society of Newcastle, an abstract of which appeared in the “Medical Times and Gazette”.

By adding Greenhow Terrace to the streets partly supplied by the Company, and by including cases of cholera, fatal or otherwise, with those of mere diarrhœa, Mr. Main was able to show a result apparently in favour of the Company’s water. He was good enough, however, to send me a copy of his paper, which contains the details of the inquiry as far as it extended; and I found, on perusing it, that, leaving out Greenhow Terrace, which is not supplied by the Company at all, there was no case of cholera, either fatal or otherwise, and no case, even of approaching cholera, in any house which was not supplied with the Company’s water. All the deaths and all the cholera occurred in the houses having this water, whilst in the houses having only pump-water, there was simply diarrhœa. In the workhouse, supplied by the Water Company, and having five hundred and forty inmates, there were twelve cases of cholera, or approaching cholera, and seven deaths; whilst in the military barracks, supplied from wells on the premises, and having five hundred and nineteen inmates, although there was a good deal of harmless diarrhæa, there was no cholera, nor any case of approaching cholera.

CHOLERA AT MOSCOW.

The communication of cholera by means of the water is well illustrated by the instance of Moscow, which was severely visited by that disease in 1830; but much less severely in the second epidemic. Subsequently to 1830 the greater part of the town, which is situated to the north of the Moscow river, obtained a supply of excellent water, conducted in pipes from springs at a distance; and the cholera in 1847 was chiefly confined to those parts of the town which lie to the south of the river, to which the new supply of water did not extend, and where the people had still only impure river water to drink.[[25]]

The above instances are probably sufficient to illustrate the widely-spread influence which the pollution of the drinking water exerts in the propagation of cholera.

DIFFUSION OF THE CHOLERA POISON IN WATER.

After the Registrar-General alluded, in the “Weekly Return” of 14th October last, to the very conclusive investigation of the effects of polluted water in the south districts of London, there was a leading article, in nearly all the medical periodicals,[[26]] fully admitting the influence of the water on the mortality from cholera. It may therefore be safely concluded that this influence is pretty generally admitted by the profession. It must not be disguised, however, that medical men are not yet generally convinced that the disease is actually communicated from person to person by the morbid matter being swallowed in the drinking water, or otherwise. It used to be the custom of medical authors to speak of three kinds of causes of a disease, viz. predisposing, exciting, and proximate causes. The proximate causes have been given up, as being the diseases themselves; but authors still divide causes into predisposing and exciting ones. It may be remarked, however, that in treating of certain communicable diseases, the cause of which is thoroughly understood, as syphilis and the itch, predisposing causes are never mentioned; and that they are rarely alluded to in treating of small-pox, measles, and scarlet fever, whilst they continue to be appealed to in explanation of the various continued fevers.[[27]] Now many medical men, whilst they admit the influence of polluted water on the prevalence of cholera, believe that it acts by predisposing or preparing the system to be acted on by some unknown cause of the disease existing in the atmosphere or elsewhere. The following amongst other reasons prove, however, that opinion cannot long halt here, and that, if the effect of contaminated water be admitted, it must lead to the conclusion that it acts by containing the true and specific cause of the malady.

In my inquiries in the south districts of London I met with several instances in which persons, especially maidservants and young men, died of cholera within a few days after coming from the country to a house supplied with water by the Southwark and Vauxhall Company. The Registrar of Waterloo Road (2nd) remarked as follows on this point, on 26th August last:—“This is the third successive case of fatal cholera, where the patients have recently come from the country. Similar instances have frequently attracted the Registrar’s notice.” I found that the houses in which these cases occurred were supplied by the above-named Company. The outbreak of cholera in the Baltic fleet, related at page [36], occurred within forty-eight hours after the polluted water had been taken on board. And lastly, if the contaminated water merely acted by predisposing or preparing the system to be affected by some other cause, it would be impossible to explain why nearly all the persons drinking it should be attacked together, in cases where a pump-well or some other limited supply is polluted, while the population around experience no increase of the malady.

All the evidence proving the communication of cholera through the medium of water, confirms that with which I set out, of its communication in the crowded habitations of the poor, in coal-mines and other places, by the hands getting soiled with the evacuations of the patients, and by small quantities of these evacuations being swallowed with the food, as paint is swallowed by house painters of uncleanly habits, who contract lead-colic in this way.