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.

    168/976 (page 148)
    suppose that neither a miasm from without, nor a miasm from within, exclusively contains the specific poison ? Might it not he Jhat two factors are needed, the one some air-borne material or some dynamic modification of atmospheric elements coming from without, the other some local element: neither being potent unless united ? The peculiar atmosphere sweeps along hither and thither, and it is only when it meets with the other peculiar substance that the poison is generated. It may he that the Cholera evacuation is the most prolific of the peculiar local agents. Some general, not local law, seems to govern all Cholera epidemics. Contagion from Cholera discharges may operate, hut there must he something beyond this. Contagious diseases are not epidemics at all times, even in the same places. In Lower Bengal every year the native small-pox inoculators proceed to inoculate patients. The dis- ease in these cases rarely spreads. For years successively this may go on without evil results, and there is no uncontrolled diffusion ; hut every few years a wide-spreading epidemic of small-pox, which nothing seems to resist, sweeps over the land. There is nothing discoverably different in the epidemic and the common years—the same people, the same habits, the same places, the same filth, or the same absence of it. In all’ the seasons there is the poison, in all the seasons there is the susceptible population ; and yet how different the results ! It is not to be supposed that the mere amount of poison generated in times of confluent small-pox makes the difference; but even if so, how is it that in one year all the cases are confluent, in others discrete ? Why has the inoculated poison such a limited influence in favourable years? If there be poison in the Cholera stools, it may bear the same relation to Cholera epidemics that the inoculable virus of small- pox in healthy years bears to the destructive epidemics of the excep- tional ones ; in certain circumstances a sufficient cause—not the only one. Though it must be confessed that we do not know what is the exciting cause of Cholera, we may hope that we are grasping some of its laws. It is impossible to deny that it riots far and wide, inde- pendently of contagion; but we must admit that it may be spread in some way by human intercourse. This is perhaps more satisfactorily explained by the views of Dr. W. Budd, than by other modes of contagion. The influence of predisposing causes is certain, and it is undoubted that they may be rendered less active. It is to be hoped that the Sanitary Boards now permanently given to India by the recommendations of the Royal Commission on the Sanitary State of the Army in India, will do much to diminish the mortality of Cholera.