It is true that the measures in question cannot be completed without much labour, and opposition, extending over uncertain periods of time, but they must ultimately become part of the hygienic economy of the land, if we would avoid the imputation of being criminally accessory to the death of thousands, and do our duty honestly to our neighbours. Unlike the other, which as they must be effected by individuals and families will depend on improvements in the intellectual and moral condition of the persons themselves, these can be achieved authoratively by the Magistrates. Both classes of reformatory measures are required to show what may yet be done for the welfare of the people, and how incalculably the people can contribute to it themselves, especially in respect of health; but while only one of them is at the command of power, that one should no longer be neglected. Had all been done which might have been done in this way, it may be asserted fearlessly that cholera would not have exerted the fatal power which it did in 1832, and which it is exerting in 1849; and that other epidemics which have prevailed in the period would have had fewer victims.

Unsatisfactory and reproachful however as the sanitary condition of the country is, when it appears how much it might be improved by the moral, social and physical reforms alluded to above, it is excellent when compared with what it was at former periods of our history. On looking back to the terrible epidemics, which in the thirteenth, fourteenth, fifteenth, sixteenth, and even so late as the seventeenth century, under the names of pestilence, black death, sweating sickness, and plague ravaged this, and other portions of Europe, we find such was the destructive power of disease then, that the most sickly seasons recorded for nearly two-hundred years have been, in comparison with them, seasons of health and enjoyment. The questions which suggest themselves as to the cause of difference will be variously answered. Amid the obscurity which involves the subject, one thing however is evident, and seems to offer a sufficient explanation of the difference, namely, the miserable condition of the people in those remote periods relatively to the present, the results of ignorance, apathy, licence and oppression—periodical recurrence of famine—wretched habitations, wretchedly kept—and the total want of sewerage, with accumulations of filthy decomposing substances, producing corruption in every corner and at every turning, sufficient to poison every living thing in their neighbourhood.

Since those disastrous times much, especially of late, has been done to preserve the health of the people, but much remains to be done, and, looking at the spirit in which the subject is taken up, and the arguments furnished from without to illustrate and enforce it, especially the urgent ones supplied by the daily lists of death from cholera, much more it is hoped, will be done speedily. If the legislature executive, and people at large would co-operate heartily and systematically, each doing their proper part to further the work—if stagnant fluids on and near the surface, and poisonous exhalations from decomposing vegetable and animal matter were prevented—if the dwelling places of the poor were sufficiently large, properly ventilated and cleansed, while the inhabitants conducted themselves industriously and morally, the effect, though it might not realize expectation, would unquestionably be great. The sanitary state of the people might then as far surpass that of the present time, as it does that of the fourteenth and fifteenth centuries: and this age in respect of health, would occupy a middle station between the dark ages which are past, and the practically enlightened age which is to come, and ought to come speedily. The essential cause of cholera, and of other febrile endemics might be brought into existence, but without indulging in idle visions, it may be predicted that they would be comparatively harmless, in as much as they would be deprived of the concurrent, fostering agencies, from which they derive their prevalence, and chief instruments of destruction. And not only would cholera and other endemic diseases, whether prevailing epedemically, or occurring rarely, be checked and mitigated, but other forms of disease would be lessened, while constitutional health would be invigorated. Such great ends are surely worthy of great means zealously employed.

POSTSCRIPT.

14th September, 1849.

In addition to the 12 fatal cases of cholera recorded in the text, one occurred late on the 3lst of August. The subject was received at 6 P.M. of that day, in a state of complete collapse, and died six hours after admission.

During the currency of the month there have been admitted 12 cases of cholera, two of which, being in a state of profound collapse, terminated speedily in death; 5 cases of bilious cholera which are doing well; 10 cases of febrile diarrhœa which are doing well; and one case of colic with spasms of the extremities.

The number of cases of cholera, and of allied affections, excluding fevers, and adopting the nomenclature proposed above, between the 4th July and this date, are as under.

CHOLERAABILIOSA.

Cases.

Cured

Dead.

Remain, covalescent orimproving.

49

26

15

8

CHOLERABILIOSA.

25

19

0

6

FEBRILEDIARRHŒA.

53

44

0

9

CONVULSIVECOLIC.

11

10

0

1

Further experience has confirmed the opinion that the means specified at the commencement of this paper constitute fit and remedial treatment in the formidable division of cholera to which they especially refer; and established the conviction that when the impression is not overpoweringly severe at the onset, and when sinking has not made great progress, a large proportion of patients will pass safely through the disease, under their use, if perseveringly and unswervingly employed. Latterly the opiate draught administered on admission has been omitted, the treatment consisting almost exclusively of calomel, turpentine draughts, and turpentine enemata, with friction when required. A rubefacient, consisting of strong mercurial, and cantharides ointment, each one ounce, with half-an-ounce of oil of turpentine, well mixed, has been used with effect. The calomel, and turpentine draughts have generally been given every half hour, at first, in violent cases, and less frequently as the symptoms subsided, being suspended when tendency to collapse was overcome, or when bilious vomiting set in.