EPIDEMIC CHOLERA OF INDIA OF 1875 AND 1876.
[ Section IV.
312
cholera patients, which was accidentally left in a bed-room. If the shield have these two
aspects,—if on the one side we in India see cholera as an earth-borne and air-driven miasm, and
if, on the other, it is as a typhus that it is introduced into England from the Baltic, or into
America from Germany,—then we need not dogmatically assert the identity of both sides of
the shield.
There has ever been present in my mind the story of the first introduction of cholera
into Edinburgh by the pedler, who brought cholera from the neighbouring town already in
-fected, and whose mother, who attended on him, was the first person in the city attacked; and
were I to deny the significance of the Halifax case, and other such cases of imported cholera,
I should probably err as widely as those who deny the truth of every deduction which I have
made on the subject of cholera in India.
An appeal to the possibility of the retardation of sanitary progress by unsound deduc
-tion is no essential part of the question at issue, and may be put
on one side for the time. A review of the whole matter leads
on to this, that if cholera be in every case a typhus by the time
it reaches America, then the conclusions of the Surgeon
General's report are justified; if it be not a typhus, as with us in
India it is not a typhus, then the general conclusion is unwarranted. I should prefer to see the
question studied scientifically in both aspects by American observers. The broad truth with
us is, that no aggregate of cases or outbreaks is the equivalent of an epidemic of cholera.
Holding the aspects of the epidemic to be natural aspects, and unchangeable from generation
to generation, it falls as a consequence, that I require foreign observers first of all to determine
what are the natural aspects of the epidemic in their special field of research. Even should it
be proved that there are no such natural aspects as we describe, and if cholera be a mere con
- t a g i o u s
d i s e a s e , I r e g a r d i t a s e s s e n t i a l t o a f i n i s h e d s t u d y t h a t t h e e n d e a v o u r s h o u l d b e m a d e
to grasp as a whole the aspects of a body of cholera covering a continent. It will never
satisfy observers in India to be told that an epidemic is a mere congeries of items, spread more
or less widely by facilities of communication, and capable of being restrained by measures taken
against outbreaks in communities or attacks in individuals. On every consideration I should
prefer that Dr. McClellan's deductions were correct, and were proved to be so. We hold the
one end of the chain, and that the links are continuous from India to America is not doubtful;
but that cholera as a disease has no characteristics beyond those which have familiarised them
- s e l v e s t o u s i n I n d i a , I d e c l i n e t o a f f i r m .
I cannot avoid noticing the circumstance that cholera broke
out in Syria on the very same day on which it appeared in Nasik,
the 22nd March 1875. I hold myself responsible for the facts
only as they appear quoted in the Lancet.
That these coincidences of 1869, 1872 and 1875 should have occurred, cannot but be re
-garded as antagonistic to a theory which recognises only the effects of human agency. We in
India knew nothing of the existence of Syrian cholera before the end of August; and then,
nothing beyond what was derived from mere newspaper reports. I should be wanting in faith
if I failed now to record my belief that the Syrian cholera of 22nd March 1875 was a true
homologue of our cholera of the same day; and that the re-vitalisation of the same cholera on
20th July was one and the same phenomenon in Syria, and in Northern and Western and
Southern India. In my estimate, it was one and the same cholera renewing its epidemic mani
-festation, which constrained Dr. Vost of Beirut to write, dating his letter 3rd August, impelled
Dr. Townsend to write, on 4th August, reporting the invasion of his province, the Madras
Government to telegraph to Simla the advent of the new epidemic, and the Government of
India to write to ask what this cholera meant, and what the end was likely to be.
The appearance and course of the cholera of Syria of 1875 is thus narrated by the
surgeon of St. John's hospital, Beirut, in the Lancet of 28th August, of the same year
—
"Near the close of 1874, or the beginning of 1875, a detachment of 400 or 500 Albanian
recruits was brought into camp at Hamath. They were in a bad sanitary condition at the time
of their arrival; but nothing of note occurred in their hospital until the 22nd of March, when
a case of cholera appeared. It was rapidly followed by fifteen others among the soldiers, and,
of the sixteen attacked, fifteen died. The disease then spread to the town and still continues,
after nearly four and a half months, with little abatement.
* * * * *
"During the month of April, Dr. Pestalozza, the physician of the quarantine department
in Beirut, visited Hamath, and pronounced the disease to be genuine Asiatic cholera. At the
time of its appearance there was no epidemic prevailing in either Europe, Western Asia, or
Africa. No traces of communication with India could be detected. There had been no cholera
for a year at Mecca or Jeddah or in Egypt, nor has there since appeared a trace of the disease
in those quarters. Persia is quite free from all taint, and there has been no outbreak in the
northern provinces of the Turkish Empire. Under these circumstances, and unless further in
- v e s t i g a t i o n s h a l l s h o w a d i s t i n c t f o r e i g n o r i g i n , t h e d i s e a s e i n H a m a t h m u s t b e r e g a r d e d a s
endemic at the outset.
* * * * *
" From the 20th July, cases closely resembling the Asiatic cholera have multiplied.
About the 28th, they became more numerous and pronounced, and at the present date (August
3rd) the epidemic may be said to be fairly inaugurated. It is also prevailing in Antioch,
Aleppo, Sughbeen (a village of Cœle-Syria), Hasbeiya, Tiberias, Safed, and many other
Conclusions from personal experi
-ence are founded on an inadequate
basis. It is essential that the study
should be systematic and followed
out as it is in India.
The cholera of 1875 beyond Hin
-dostan. The cholera of Syria of
1875 broke out on the same day as
in Western India.