Volume 1

A system of medicine / edited by J. Russell Reynolds.

Date:
1866-1879
Catalogue details

Licence: Public Domain Mark

Credit: A system of medicine / edited by J. Russell Reynolds. Source: Wellcome Collection.

    157/976 (page 137)
    well to mention some points in the natural history of Cholera not yet ^Health of Communities before and during Cholera Epidemics.—In Europe a prevalence of several zymotic diseases has been noticed m these periods; particularly typhus fever, influenza, and diarrhcea. le increase of fluxes was so great previous to the outbreak ot 1848 that Cholera in England was looked for long before its arrival. There was also an increase of typhus fever. Dangerous and fatal influenza pre- ceded the epidemics of 1832 and 1848. Diarrhcea is constantly present during Cholera. In London for the quarter ending September 30, 1849, ^notwithstanding the large mortality from Cholera, the deaths from typhus fever were nearly equal to those of the four preceding corresponding periods ; themselves of remarkably high mortality. In India, diarrhoea constantly prevails during epidemics, but the pre- cedence and concurrence of other zymotic diseases is not so well made out. Cholera, however, does not seem to banish them. From the above we seem justified in inferring that circumstances similar to those which favour Cholera promote also the spread of the other zymotic diseases. Limitation of Areas of Cholera.—This is sometimes singularly abrupt. It has been known to attack persons on one side of a street of a camp, or a town, only. In 1848-49 it attacked one side of a small village in Argyleshire, and confined itself exactly to one side of the town, which consisted only of one main street, divided into two equal parts by a toll bar, beyond which to the west not a single case occurred, though the inhabitants were in constant inter-communication. Dumdum, seven miles from Calcutta, often suffers severely, while Calcutta does not, and vice versa. One part of a ship may suffer and the other not. A wing of a building may be ravaged while the rest escape. The limitation to districts is sometimes remarkable, and was shown in the case of the 9th Lancers on its passage up the Ganges in 1842. The regiment travelled in boats, by wings, and at separate times. When the left wing reached Monghir, although there had been no communication with the shore, Cholera broke out in it, and continued with the detachment for about twelve days, until it had got beyond the infected districts. When the right wing reached Monghir, it, also, was attacked, and lost the disease exactly at the same place that the other did. The limited area of infection has been tested by the good effects of moving troops into camp when suffering from the disease. Numerous instances of this are on record ; among the latest some are afforded in the Cholera Commission Ileport for the outbreak of 1861. A move of a few miles is generally sufficient. Mode of Invasion of Localities.—We find that both in India and Europe it is often preceded by diarrhoea, sometimes for months as m England previous, to the outbreak of 1849. Then a few cases of o era appear, and in a short time the epidemic sets in severely At other times the extreme violence shows itself rapidly and suddenly alter the prevalence of a few cases for a few days, as at Kurrachee. Of