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APPENDIX II.
From Assistant Surgeon J. A. ANDERSON, M.D., H. M.'s 18th Hussars, to the Sanitary
Commissioner for Madras, dated Seeunderabad, July 1871.
At your request I have the honour to submit my views on the recent outbreak of cholera in the
18th Hussars, and forward a diagram' of the Barracks, Hospital, and its vicinity. As you are aware one
side of a street in the bazaar, immediately behind the Hospital, was pulled down about three months ago,
in order to open up the place and allow of a free current of air, and which, in my mind, was the cause
of this outbreak, and my reasons for thinking so are as follows:—Namely, the bazaar is. I believe, one
of the longest inhabited in the cantonment, and, as remittent fever has been shown to be produced
by levelling old buildings, I see no reason why cholera should not, in like manner, be produced. Against
this it has been said, why should not the disease have been developed long before this, when the
buildings were standing, by the action of heat after the rains; but it is very well known in what a state
of filth some native dwellings are, the inside of the houses being seldom cleansed, and perhaps used
as urinals, &c., and as it is supposed that rain followed by heat is favourable to development of
cholera poison, especially when it acts on debris and feculent matter when disturbed after having
been left a long time undisturbed, I am of opinion that, while the houses were standing, the rain had
not penetrated sufficiently into the interior of the buildings so as to be injurious when the sun acted on it;
but when these foul habitations were pulled down, and the debris strewed for some distance along the
road, the germs of the poison were there, which being acted on by a few showers of rain, not heavy,
but sufficient for the development of the disease when acted on by the sun, which was most intensely
hot a few days before the epidemic made its appearance.* You will observe from the accompanying
notes from the Observatory the direction of the prevailing winds for some time before and after the
outbreak, from which you will see that, up to the 25th of May, the direction of the wind was north-
west, following which is the line of the greatest number of attacks and largest mortality. As regards
the barracks, the statistics which I shall now give are taken from the first thirty-five cases attacked,
and which were left in Hospital under my charge, when the Regiment marched out to camp. The
line, marked by an arrow in the diagram, passes through the Troop rooms in which the largest mortality
and greatest number of cases occurred. In E. Troop room there were eleven cases, of which seven were
fatal. In C. Troop room, which is in the same line and beside it, but at right angles to the current of
wind, there were only four cases, and all recovered. The next room, in which were the largest number
of attacks and deaths, is F. Troop, where, out of five cases four died, and the room marked on the dia-
gram 6th Troop, immediately adjoining this, is occupied by the Band; one fatal case occurred there.
In the room shown 5th Troop is occupied by about seventeen men to make more space in the other
rooms. In B. Troop five cases and one death, and in A. Troop, four cases and two deaths. In first
range of the Family Quarters one man and one child were attacked, and both were fatal.
Although, as you will observe, other Troop rooms were attacked than those following the direc-
tion of the wind, they were milder cases, and in my opinion may be due to side gusts of wind; but it
seems as if the greatest part of the poison expended itself on E. Troop room.
The first case occurred in Hospital very slightly out of the direction of the current of wind, and
this, although the first case and very severe, recovered, as only a small amount of poison may have
reached the Hospital by a similar side wind, and the ward in which it occurred was near the debris
and close to the current of wind.
It is supposed by some that the disease was brought into the Regiment, along the Masulipatam
road, by three natives who had the disease, but they were, I believe, not allowed to enter the canton-
ment,† and if this was the cause, why should not the first case have occurred in barracks which is
nearer the Masulipatam road than the Hospital, and if infection came from this direction, it would
come against the current of the wind,‡ and again when cholera attacks natives there is often a
certain amount of immunity amongst European Troops, .and vice versd.
Every year there is more or less cholera in the bazaars, and which very seldom attacks the
troops, and never to any extent; besides I think the few cases in the bazaar, and which were not
reported until after the outbreak in the 18th Hussars, and which number is only seventy-five attacks
and thirty-two deaths out of a population of about 40,000 from the 24th May to the 23rd June 1871,
could hardly have produced so fearful an outbreak in only one Regiment, without some endemic causes,
and it may not be unreasonable (in the absence of any other proof) to refer it to the one in question,
and I consider it is just possible that on the night of the 24th of May the cholera poison may
* There had been no rain at Secunderabad since 4th May.—W.R.C.
† Dr. Anderson was unacquainted with the fact, that three men died of cholera in the bazaar on the 20th
May.—W.R.C.
‡ This was actually the case. The disease advanced against the prevailing wind.—W.R.O.