Reports and papers on cholera in England in 1893 / with an introduction by the Medical Officer of the Local Government Board.

  • Great Britain. Local Government Board.
Date:
1894
Catalogue details

Licence: Public Domain Mark

Credit: Reports and papers on cholera in England in 1893 / with an introduction by the Medical Officer of the Local Government Board. Source: Wellcome Collection.

Provider: This material has been provided by Royal College of Physicians, London. The original may be consulted at Royal College of Physicians, London.

    30/374 (page 24)
    that the Board received, on October 5th, the first intimation of the outbreak. Dr. Bui strode was immediately instructed to visit North Bierley, and a piece of the dead youth’s ileum was procured for bacteriological investigation. But the material had already assumed a gangrenous aspect, and what is, perhaps, more important, it was only secured late in the illness, and after the stage of re-action had supervened. Hence it is not astonish- ing that, although the microscopical appearances were extremely suspicious of cholera, confirmation of this suspicion, as the result of culture experiments, was not forthcoming. When, however, the sixth patient was taken ill, she was visited by Dr. Bulstrode, and some of her discharges were collected and despatched to Dr. Klein, with the result that Koch’s comma- bacillus was found in them on microscopic examination, this demonstration being subsequently confirmed by means of culti- vation. The seventh patient in this series began to suffer from diarrhoea on October 1st, and when visited medically on the 4th, was found to have vomiting and diarrhoea. She alone of this group of seven cases subsequently recovered, having at no time exhibited typical cholera discharges or collapse. This patient, an elderly woman who was a friend of the family, had also taken part in laying out the body of the youth’s mother. This limited outbreak of illness (Appendix A., No. 14) affords a story that is typical of Asiatic cholera. If it differs from occur- rences of cholera as heretofore observed in this country, it only does so by reason of its extreme severity and fatality. It is also somewhat singular in the fact that, unlike most attacks of similar suddenness or virulence, the infection was not due to a contami- nated water supply. Direct infection by reason of contact with an antecedent case seems to have been more than commonly potent for mischief ; for with the exception of one girl, whose movements could not be traced, all who took any part in nursing the sick or in preparing the dead for burial were attacked with the disease, and only one escaped death. From the etiological point of view there is but one link missing in the story. Nearly three weeks had elapsed between the date when diarrhoea was first recorded in the youth who suffered from the initial attack, and Dr. Bulstrode’s arrival in North Bierley; the patient in question had since the onset of his earliest symptoms been resident in two different counties; and both he and all but one of his near relations, from whom trustworthy information might have been forthcoming, had since died. Under these circumsta,nces it is not to be wondered at that no conclusion could be come to as to the source whence the infection had been derived. In this connexion it should also be remembered that one or more cases of reputed cholera had, at the date of the onset of diarrhoea in the youth concerned, already manifested themselves in 47 different sanitary districts of England, including 12 localities in the two counties referred to.