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not been either out of the village, or in contact with any one that had had cholera. The attack is
supposed to have originated from the patient having partaken largely of "Mathi meen," as, during the
night, she was seized with vomiting, subsequently purging, collapse and death on the following day.
From this solitary case, the disease seems to have assumed an epidemic character ; though, I have no
doubt, that all who subsequently were attacked were more or less rendered liable to attack from
having partaken of that fish, as also of straw paddy ; the latter a fermented rice. From the nominal
roll of the cases attacked, it will be seen that nearly all, at least the majority of all subsequently •
attacked, are in some way connected by family ties with No. 1 patient. I think there can be no
doubt that in several of the cases the disease was communicated by infection. The greater number
of the infected houses are close to each other, some only being divided by a compound and a road.
House No. 6 is in the direct line of the sea breeze, and not 150 yards from house No. 1. This patient
denies having partaken of the "Mathi meen," and also of having had any communication with any of the
other houses; but I am inclined to doubt the truth of the statement. Case No. 16 had long been in
bad health, and had, in my opinion, been suffering from either piles or vomiting of blood. She was
attacked with vomiting, and was purged four or five times, and being in a weak state of health, rapidly
became collapsed and died. I would scarcely feel inclined to put this down as a death from cholera,
as her low state of health was such as would at any time have rapidly succumbed to an acute attack
of diarrhoea.
The Hospital Assistant at Kollam has heartily entered into his duty, and I must state that to his
energetic carrying out of the orders sent him from the Sub-Collector's Office here is mainly due the
arrest of the disease at Kollam, as up to this date no fresh cases have been reported. Great benefit
has been obtained by at once sending Hospital Assistants to the infected districts, as their presence
has given confidence to the people, and tended greatly to allay their fear.
From the Sanitary Commissioner for Madras, to the Collector and Magistrate of Malabar, dated 25th
November 1870, No. 1,112.
In reply to your letter, No. 3, 157-E., of 19th current, I have the honour to state that the facts
before me, in regard to the late outbreak of cholera in Quilandy, are too scanty to allow me to offer an
opinion as to the influence of a sardine diet in producing the disease. The fresh fish is ordinarily, I
believe, quite wholesome ; but, if it were eaten in a condition of semi-putridity, I have no doubt it would
cause considerable derangement of the bowels, and predispose to cholera, or a choleraic form of
diarrhoea. I have addressed the Civil Surgeon of Tellicherry on the subject of the cholera outbreak,
and, when I get his reply, I shall be in a position to dispose more fully of your reference.
It was the opinion of Dr. Pearse, for some years Civil Surgeon of Calicut, that there was some
connexion between the mortality of fish along the coast and the ordinary coast cholera. The cause
of the sudden mortality of fish and stench of the sea on the Western Coast is not very clearly made
out. It has been supposed to depend on the bulk of fresh water discharged into the sea; but, against
this theory, there is the fact that the death of the fish does not always occur at the time when the
rivers are in highest flood. I am not aware if there has been any fish mortality this season, or, if so,
at what time it showed itself. It would be well to ascertain the facts, and I have asked the question
of the Civil Surgeon.
But in connexion with this sudden development of cholera at Quilandy, it must be noted that the
Travancore country, and more lately, places in Native Cochin, have been visited by true epidemic
cholera for some months past. The 'cholera in Travancore was undoubtedly the continuation of the
disease as it affected Madura and Tinnevelly. It would not cross the mountain barrier between
Tinnevelly and Travancore, but having passed from north to south to Cape Comorin, it travelled
round the rocky barrier, and then progressed up the coast from south to north. I think it not at all
unlikely the cholera now in your district is a direct continuation of the cholera which was lately
common at Quilon, Alleppy, and Kotyam ; but until I get the facts before me, it is not very easy to see
their relative importance.
Should this cholera be a continuation of the epidemic, it is quite possible that the district
will suffer generally ; and my reason for giving this opinion is that the disease has been absent in
epidemic form since 1865, and consequently a large number of persons must now be ready to receive
and develop the specific poison in their bodies, whenever the epidemic finds its way into the district.
If, however, the cholera should be connected with the use of putrid fish, it will probably be a
local disease confined mainly to villages on the coast line,