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CHAPTER IX.
INFLUENCE OF SANITATION ON CHOLERA.
Dr. Bryden's view.
210. In this section of my report I propose, briefly, to review some of the facts
of the past year, showing the influence which hygienic precautions have probably
played in the exemption of certain communities from cholera. I may state in the
commencement that, while agreeing with Dr. Bryden that an epidemic wave of
cholera from Bengal will spread over unoccupied country (seasonal and other
conditions being favourable to the preservation of the vitality
of the contagium), I by no means agree with him in the
cheerless doctrine he has laid down as to the inutility of sanitary precautions in
limiting the destructive powers of cholera. He remarks (page 226) :—
" What are called good sanitary conditions are not of themselves calculated to ensure our men
against cholera. If it be true that cholera is air-borne and conveyed in the purest of all aqueous media,
the conditions requisite for human infection are produced at the same time with epidemic advance ;
and hence local measures can be only comparatively successful, and are not absolutely calculated to
avert the consequences of invasion.
" I see no occasion to look to impurity of the aqueous medium as of supreme consequence, and the
search after special contamination, when every foot of grass-covered plain may retain the miasm,
decoys the mind from the simple truth. *
* We know well that some stations are worse than
others, because of their natural disadvantages, but we know also that in the very best, general sanita-
tion has not availed to prevent cholera."
Sanitary condition of
stations still imperfect.
211. I do not know what the sanitary condition of Bengal Military and
Civil stations may be, but they must be very perfect indeed, and
very different from what they were when the Cholera Commis-
sion of 1861 reported upon them, and a great contrast to any on this side of
India, if no fault can be found with them, either in regard to locality, drainage,
or water-supply. In the matter of water-supply alone, I am not aware of a
single station in India where the possibility of freedom from contamination by
cholera, or other contagium, can be absolutely guaranteed. A great deal has
been done, and is still doing, to improve the sanitary condition of our troops, but
to argue as if these conditions were already quite perfect, and that sanitary per-
fection, therefore, is powerless to preserve men during seasons of cholera invasion,
is at any rate premature, while every candid person must admit that the whole
question of the practical application of hygiene to troops is still in its infancy.
The theory of air-
borne cholera wanting
in proof.
212. The conclusion Dr. Bryden has arrived at, logically follows the theory of
an " air-borne" miasm, and it is only necessary that I should
remark here in regard to that theory, that it does not rest on
such a basis of fact as to commend itself to the credence of
men practically acquainted with the phenomena of Asiatic Cholera. On the con-
trary, many of the phenomena of every day occurrence in cholera epidemics
are wholly inexplicable on such a theory ; and, while they are so, there is not
much practical danger that we shall neglect the observance of common sense
precautions to guard against cholera. When it can be shown that cholera does
not move against a wind, and that there is a direct relation between the move-
ment of wind and the movement of cholera, it will be time enough for sanitarians
fco fold their hands and to admit the futility of their efforts, to mitigate the horrors
of a cholera invasion. Meanwhile it seems to me that much may be done to
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