John Wilson

“ Whether the last named agent—defective drainage and its consequences—constitutes any thing positive to the essential cause of the disease, or is necessarily connected with it, or whether it only co-operates with those specified before it, in lowering the standard of health, by the production in excess of hydrogen and other gases, injurious to life, and thereby predisposes the body, through augmented susceptibility, for the action of the essential cause cannot be determined. ”

“ How does it happen that persons living in the same room with, and constantly handling and helping patients in all stages of the disease, so constantly escape its power, if it be not only readily communicable by the person to healthy persons, who are in juxtaposition with its subjects for a short time, but capable of being propagated by their clothes, in distant places, after undefined periods? ”

“ 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 ”

“ Such simultaneous eruptions of disease, in different distant places, appear incompatible with the hypothesis of contagion—irreconcileable with the belief that it arises from, and is communicated by one body to another, either directly or indirectly, either by recent emanations from a diseased body acting speedily on proximate healthy bodies, or by the same emanations, in a concrete form—called formites—acting on distant healthy bodies, after uncertain lapses of time. ”

“ It is equally certain, that if an auxiliary accelerating agent is a desideratum in the precipitous fevers of the West Indies, it is much more so in dealing with the yet more precipitous disease under consideration. Looking at the matter in this light; believing that calomel, as it is commonly administered, in the worst and most suddenly fatal cases of cholera, seldom passes beyond the stomach; and being satisfied that to act as a remedy it must enter the circulation, and reach secreting extremities, the method of treatment specified above was adopted. ”

“ There is reason to conclude that the cholera now widely diffused over the United Kingdom, is not an imported product of any foreign country, near or remote, but is as much the product of the places and the circumstances of the subjects where it exists, as is ague, or bronchocele.
Spasm is not peculiar nor essential to it; for severe spasms often accompany bilious cholera; and in the worst forms of this disease cramps are not violent nor continued. Spasmodic cholera, consequently, is not a proper designation. ”

“ 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. ”

“ 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. ”

“ Although the pro-contagionist might not be moved by facts and inferences like these, he would perhaps be disposed to ask the man propounding them, some such question as the following.—As you do not admit that contagion is the cause of cholera, what in your opinion is the cause? ”

“ The enlarged and disinterested consideration of men having authority, independent of the conflicting interests, and removed from the prejudiced opinions, affecting particular places, who look to the welfare of the whole, must do the work, if it be ever done effectually. Enlightened and benevolent men in parliament and out of it have not been scared from the undertaking by the obstacles real and fictitious in the way. ”

“ Asiatic cholera is the most common designation, and appears to be the most incorrect, inasmuch as it assumes that the disease is an import from Asia, while there is strong reason to conclude that it has no more claim to be called Asiatic than American. ”

“ Swampy undrained soils, the banks of rivers, the margins of harbours, and other low lying localities, with places where organic remains are artificially accumulated, or allowed to accumulate, prove the most prolific positions in the production of cholera, as well as of periodic fever. ”

“ In the Minden, hospital ship at Hong Kong, in 1843, when periodic fever and flux were prevalent and highly fatal, a man, convalescing from an attack of the latter, was suddenly seized with unquestionable symptoms of cholera, which ran its destructive course in a few hours. ”

“ Something emanating from the surface of the earth, on the spot, or not far from the place where its subjects are resident?—something so subtle as to be imperceptible by the senses, and hitherto beyond the scrutiny of chemists and meteorologists. ”

“ The essential cause of cholera—the causa sine qua non est—as well as of other things in nature with what are more familiar, is, and perhaps ever will be, beyond the reach of human penetration; and were its nature and properties ascertained, such knowledge might contribute p. 29little or nothing to our means of resisting its effects. But while this ignorance exists, and candour requires its confession, there is none respecting the associated concurrent agents, through whose influence it acquires extended prevalence and augmented fatal force. ”

“ If it be true, as it is believed to be, that they are affected by cholera in a degree scarcely, if at all, exceeding that of persons in the same social condition otherwise employed, the fact would appear to furnish a strong general argument against the contagious nature of the disease. ”

“ Before such admission can be held necessary, it must be shown that the disease which attacked the nurse was not derived from places outside the Hospital, which he was allowed to visit, or from the cause diffused in the air of the neighbourhood, in less or greater concentration, and manifesting its powers relatively to the degree of concentration, and the force of pre-disposing co-operating agents.
It would be unsafe to assert that cholera can never, under any circumstances become contagious ”

“ 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. ”

“ In the spring of this year a custom house officer who had been on board a foreign vessel in the Thames, in which were cases of cholera, was soon after attacked by the disease, and died at Gravesend. A little later, a nurse who had attended a choleral patient in the Dreadnought Hospital ship was attacked by the disease and died. ”

“ They would turn fear into terror, and interfere with, or prevent the ordinary offices of humanity; p. 24thus, at the same time, supplying one of the most powerful predisposing causes of the disease, and fearfully augmenting the misery and danger of the affected. In such a state of things it would be impossible to persuade persons of character, like those who, without hesitation, undertook the duty of nursing the choleral patients in Haslar, to enter on similar service for eighteen-pence a day; nay, it might be impossible to persuade men to enter on such a forlorn hope by any consideration. ”

“ That Beith should evade the contagious power of cholera in 1832, when the disease was rife in its near neighbourhood, and fall under it in 1833, when there is no evidence of its being nearer than Glasgow in mitigated force and occurring rarely, is, to say the least, difficult to understand. ”

“ He must be a very ardent believer in the self-propagating power of cholera who would urge authority to shut up, and surround with guards, houses standing in many different parts of Gosport, Portsea, Portsmouth, and Southsea, and half the towns and villages of England. ”

“ With few exceptions they arrested the flux for a time, in most instances for a considerable time. So powerful, in fact, was their restraining power, that they did not require to be often repeated. Their controlling influence was unquestionably great.
Many years ago, while serving in the West Indies, and often looking anxiously but in vain, for the constitutional effects of mercury in the precipitous fever of that region, the writer was led to inquire whether some accessory agent might not be found to accelerate and determine the action of the mineral ”

“ The second class of reformatory measures required for the object in view must devolve on the legislature, and on authorities constituted by it, as all experience shows they cannot be entrusted to the voluntary efforts of individuals, or to those of municipal, or other local self-acting bodies. ”

“ They consist in whatever deranges healthy action, and impairs constitutional vigour—such as unwholesome insufficient or irregular supplies of food—over labour—crowded and defective ventilation—dissolute habits, including vicious indulgences in intoxicating drink, and want of personal and domestic cleanliness—apprehension, anxiety, and inordinate emotions of the mind; and defective drainage, including sewerage, with resulting accumulation of organic matters. ”

“ Such at least would be the general reply of the profession, and a more complete and unconditional confession of ignorance p. 25of every thing respecting the essence of a most powerful and wide spread cause of disease cannot be made. Though we know a good deal of the places most prolific in its production, as well as of the agents which co-operatively increase its force, we know it solely by its effects.
In very similar, if not precisely the same terms, it seems to the writer, should the question, what is the cause of cholera, be answered. ”

“ If the legislature executive, and people at large would co-operate heartily and systematically, p. 34each 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. ”

“ 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. ”

“ A good deal has been attempted, and something has been done, but much is wanting. The work is great, requires many labourers, and gives scope for the combined exertions of enlightened philanthropists of all kinds. ”

“ Pans with hot water were often applied to various parts of the body, but could seldom be long borne, or kept in place, from spasms or other causes of restlessness in the patient.
One remarkable and gratifying effect of the turpentine draughts consisted in what may be p. 7called their acceptability to the stomach. While aromatic and cordial mixtures were instantly rejected, they were generally retained for considerable periods. The turpentine injection had similar effects on the intestines, allaying irritation and checking discharges. ”

“ This is said without meaning to insinuate that one method of management is not better than another, or wishing to damp the inquiry in which so many men are now anxiously engaged, as to how more may be done than has yet been effected for choleral patients. ”

“ It attacks in one town a particular district, street, or portion of street, beyond which it does not travel. In another town it shows itself among distant portions of the inhabitants, leaving long spaces unscathed. Again, while one town suffers severely from it, another in the neighbourhood has not a single case then, or thereafter ”

“ Let them however, especially those in parliament persevere, leading others to join them as they assuredly will, disregarding the selfish and ignorant objections raised against their truly patriotic efforts, and they cannot fail of their reward. ”

“ It would be out of place to enlarge on such a subject here, but it may be allowable in passing to observe, that it behoves the more intelligent and wealthy members of the community, lay as well as clerical, to unite and help the more p. 30ignorant and needy in the great—vast as to results—reform, which it contemplates and embraces. ”

“ 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 p. ”