36
REPLIES TO QUERIES ON THE TREATMENT OF EPIDEMIC CHOLERA. [ Appendix
Query No. 4,—continued.
"kucha" wells or "jurah" dug in the sand, and made the people use the water thus obtained,
and the disease from that time began to abate. It is believed in this province (Malligaum)
that water from deep wells is less likely to occasion sickness than water from streams or
"nullahs."
Peterkin, J., Surgeon Major, Mad. I.—The chlorides and carbonates in small quantities
produce little really deleterious effects; sulphates may be more or less laxative ; the nitrates
per se are no more injurious, but their presence indicates the existence of animal organic
matters, which have a prejudicial effect encouraging to dysentery, typhoid, &c. Impregnation
with vegetable matters is in this country supposed often to lead to intermittent and remittent
fevers. In 1843 I was travelling through the "Kirwal Jungles" in the month of October,
and arriving at my halting place one morning a considerable time before my servants, I was
tempted to drink rather copiously of a beautiful limpid clear stream in the middle of the jungle.
I had been watched by a native guard stationed a short distance below, and in the course of the
day the native officer in command informed me that I should certainly get jungle fever, as
no one used that water without doing so. I was so attacked about 12 days after, whether
owing to that or the journey through the jungle I cannot tell; but I am inclined to think
the draughts of that water were not the cause, for it was clear, limpid, cool, and void of smell,
taste or colour.
Thom, W., Deputy Inspector General, Bom. I.—When serving as Assistant Surgeon at the
Warley depot some years ago, I had in two cases what to my mind showed most forcibly the
analogy between typhus and cholera. These men were brought into hospital from the same
barrack room, both having been as it were suddenly struck down by some powerful poison;
they presented all the appearance of cholera in its worst form. There was no vomitting or
purging, the poison having been too powerful for this. They both proved rapidly fatal, and it
was only within a few minutes of death in the one case and about half an hour in the other,
that the petechial spots appeared. These cases made a forcible impression on my mind, and I
perfectly well recollect remarking at the time to the apothecary, that in India they would be
yet down as cases of cholera, but occurring in England they are called typhus.
Wilson, R., Assistant Surgeon, Mad. I.—The influence of pure water I believe can hardly
be overrated in the prevention of zymotic disease generally. Wells should be so constructed
as to prevent all surface drainage from being mixed with the drinking water. The people of
the district, however, prefer the river water, or that from channels which convey the river water
to the rice fields, for drinking purposes, and this water is much polluted along its course before
it reaches Tinnevelly or Palamcottah. The filthy clothes of all the villages along its course are
washed in the river ; the people use the river and channel banks as a place of convenience every
morning, and then they bathe and wash in the river ; a slight shower of rain washes all this
bank filth into the river, and yet the people use this water in preference. For the last
nine years, I have observed that a visitation of cholera occurs annually in this and the Madura
district in the mouths of November and December, and breaks out immediately after the rains
of the north-east monsoon; whether this depends upon people drinking impure water I can-
not of course with certainty say, yet I believe so long as this custom of drinking defiled water
prevails, the annual visitation of cholera will also continue to appear in this part of India.
Query No. 7.—The influence of latrines on the spread of the disease.
Brown, J. B. S., Surgeon, Ben. I.—From my own experience, I have never had reason to
believe that cholera is communicable from the evacuations in consequence of any cholera poison
they may contain. Believing, as I do, that cholera is caused by a poison in the air which
acts primarily on the blood, I cannot understand how the poison of cholera can be in the eva-
cuations. But granting that the cholera poison is in the discharges, is there any real evidence
to prove that the disease is diffused by means of air and water? Suppose we take 20 ounces of
a cholera evacuation (by this I mean genuine "congee water" evacuation, free from any
bilious or fæcal matter), and thoroughly evaporate it, what amount of solid residuum, which
doubtless will contain the cholera poison if present, may we expect to obtain? And granting
that this residuum contained the most virulent cholera poison, is it according to common sense
to believe that a poison so disintegrated and so thoroughly divided and sub-divided into the
smallest quantities by the action of the wind, &c., could have the slightest influence for evil,
and could causo cholera to break out on a sudden amongst a population spread over a large
expanse of country. Besides would not the cholera evacuations follow the rule of other animal
matters (fluid and solid) when separated from the body, i. e., would they not putrefy, and would
not the process of putrefaction thoroughly destroy any cholera poison they might contain.
Again, if a poison was generated by the putrefactive process, would this poison be the poison
of cholera? It is somewhere mentioned in "Copland's Practice of Medicine" I think, that
during an outbreak of cholera in Warsaw, some medical men drank cholera vomit without
experiencing the slightest bad effects; this proves that cholera poison is either not present in
the matter ejected from the stomach, or if it is present, that it cannot be absorbed by mucous
membrane.
Kennedy, J., Deputy Inspector General, Mad. I.—Increases the spread. All evacuations
from cholera patients should be disinfected, removed, and buried.