On the mode of communication of cholera / by John Snow.

  • John Snow
Date:
1855
Catalogue details

Licence: Public Domain Mark

Credit: On the mode of communication of cholera / by John Snow. Source: Wellcome Collection.

    22/214 (page 10)
    we have no right thus to limit the way in which a dis’ ease may be propagated, for the communicable diseases of which we have a correct knowledge spread in very dif- ferent manners. The itch, and certain other diseases of the skin, are propagated in one way; syphilis, in another way; and intestinal worms in a third way, quite distinct from either of the others. A consideration of the pathology of cholera is capable of indicating to us the manner in which the disease is communicated. If it were ushered in by fever, or any other general constitutional disorder, then we should be furnished with no clue to the way in which the morbid poison enters the system ; whether, for instance, by the alimentary canal, by the lungs, or in some other manner, but should be left to determine this point by circum- stances unconnected with the pathology of the disease. But from all that I have been able to learn of cholera, both from my own observations and the descriptions of others, I conclude that cholera invariably commences with the affection of the alimentary canal. The disease often proceeds with so little feeling of general illness, that the patient does not consider himself in danger, or even apply for advice, till the malady is far advanced. In a few cases, indeed, there are dizziness, faintness, and a feeling of sinking, before discharges from the stomach or bowels actually take place ; but there can be no doubt that these symptoms depend on the exudation from the mucous membrane, which is soon afterwards copiously evacuated. This is only what occurs in certain cases of haemorrhage into the alimentary canal, where all the symptoms of loss of blood are present before that fluid shows itself in the evacuations. In those rare cases, called cholera sicca,” in which no purging takes place, the intestines have been found distended with the excretion peculiar to the dis-