On the channels through which cholera is communicable / By John Murray.

  • Murray, John, 1809-1898.
Date:
1873
Catalogue details

Licence: Public Domain Mark

Credit: On the channels through which cholera is communicable / By John Murray. Source: Wellcome Collection.

Provider: This material has been provided by London School of Hygiene & Tropical Medicine Library & Archives Service. The original may be consulted at London School of Hygiene & Tropical Medicine Library & Archives Service.

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    tagious nature of the disease was assigned as a reason for incurring the expense of removing tlie prisoners from the jail at Agra during a very severe epidemic. Again, in i860, 61, 62, and 63, the same reason was assigned for incurring the expense of removing tlie European troops into camp during severe epidemics in those years. Similar views were supported by the Sanitary Commission in 1862, and they have since that time guided the measures adopted by the Government of India in regulating the precautionary treatment of the disease. The non-contagious nature of the disease was the prevailing opinion of the profession in Europe until the year 1865, when the severe epi- demic which desolated many countries attracted general attention, and was followed by the International Sanitary Commission at Constanti- nople. Since then the change of opinion has been very decided. There are few now who do not consider the disease transmissible, either directly or indirectly, from a cholera patient to a healthy subject; and this is one of the recognised definitions of a contagious disease. The objections to the contagious view of the question are now reduced to the remark that cholera is not so contagious as some other diseases ; or that it is not communicated in the same manner, but through some special channels as the air, subsoil-water, etc. That the course of the disease is influenced by the state of the various media through which the poison passes is evident; but that any one of these in a normal state is essential to the transmission of the disease is not proved, and the existence of an abnormal state has no further foundation than conjecture required to supply a deficiency in some theory. It is thought by some, whose opinions have great weight, that the locality in which the disease occurs offers the most important channel of communication. This is the popular belief of the natives of many parts of India, as they will sometimes desert their villages when the disease breaks out, and take refuge in the surrounding jungles, thus showing their idea that there is danger in the locality. With these preliminary remarks, I will now proceed to my subject, the channels of communication; and in the first place will trace the course of the poison from the diseased body of a cholera patient, through external agents, or media, to the healthy person in whom it excites the characteristic symptoms of the disease. I take it for granted that the symptoms of cholera are caused by the presence of a poison in the system, and that it is only when that is removed that health is re- stored. The restoration of health implies the elimination of the poison, either in an active or an inactive form. The ordinary channels of elimina- tion are the lungs, the skin, and the bowels, and through one or more of these it may be inferred that the poison leaves the body. As these are the channels through which foreign bodies find entrance, it may be presumed that through one or more of them the poison enters the system. That the bowels form one channel for exit, is evident from the characteristic profuse discharge from them ; and for entrance also, from the fact of the disease having been induced in a healthy person by swal- lowing the evacuations from a cholera-patient when mixed with drink- ing water or food. The opinion that the cholera poison exists in a most dangerous state in the evacuations has gained ground rapidly since the remarkable case of the Broad Street pump, recorded by Dr. Snow in 1854, and it is now universally accepted by the profession. Some authors of note suppose that the bowels are the only channel of elimination, and that, by disinfecting the evacuations, they can arrest the communication and dissemination of the disease. That the skin forms another channel of exit appears probable from