The Stourbridge Observer, Cradley Heath, Halesowen & District Chronicle.
Stourbridge, West Midlands, England, 1872-04-27 00:00:00

THE PROSPECTS OF CHOLERA.

At the monthly meeting of the Association of
Medical Officers of Health, held in Loudon, on Satur-
day evening, Mr. Netter Radcliffe read a paper, entitled
"The Prospects of Cholera," and based upon the in-
formation which has been obtained concerning the
prevalence and progress of the disease since the autumn
of 1869.
At that period, according to a historical sketch
which formed the first mot of the paper, cholera reap-
peared in the city of Kieff, after basing been entirely
absent, for more than twelve months. From the city
it spread to the surrounding places, and in the course
of it year it invaded nearly every part of Russia in
Europe, extending its ravages in &marked manner along
lines of railway and other chanaeLs of human inter-
course. There were several instances in which it
was conveyed from St. Petersburg., by conscripts and
other passengers, to railway stations in the provinces,
insomuch that it was found necessary to make arrange-
ments at some of the larger stations for the reception of
any cases that might occur among the persons waiting
or arriving there. From Russia the disease was carried
both by land and sea, by railway passengers vid
Konigsberg, and by steamers or other ships to various
ports on the Baltic, whence again it was conveyed in
at least two instances to Hartlepool, and in one to Nova
Scotia. It was taken also from Odessa to Constanti-
nople, where it occasioned a great mortality.
Coincidently with the presence of the disease in
Russia, it prevailed also in the Pashalik of Bagdad,
and followed the lines of caravans through Central
Arabia, by way of Medina and Mecca, until it reached
Gonforlah and other ports on the Red Sea. Mr.
Radcliffe traced out all these various migrations with
much minuteness, giving the dates of outbreaks at
each place, and, as far as it could be ascertained,
the prevalence and mortality, and then proceeded OM
follows :
- - - • -• • •

I now come to a question which haa more Immediate in-
terest for us at this moment,—namely, what is the prropect
of this country suffering Scorn or escaping an epidemic
during the present year This question may be regarded
from two distinct points of view ; first, with reference to the
phenomena of tire recent diffusion of cholera 04 tire Coo- '
tment and in Arabia ; secondly. with r,ference to the con-
ditions existing among ourselves, which are capable of
promoting or retarding the progress of the disease.
As far as regards the first branch of the snidest, I would
remark that the circumstances of the recent diffusion
approxtinate very closely to thi.se of ISSI. 55. Then, as now,
the early cases appeared at first to have been due to re-
crudescence of a preceding and unexhausted epidemic ;
hut it is probable that in both the phenomena ef re-
crudescence masked the more important presence of
fresh migrations of cholera into Europe from India by way
of Persia. The outbreak of 1852.5, not only in Europe, but in
other parts of the world, was one of the most extensive on
record ; and, mourning a parallelism between the initial phe-

nomeua of development and progress of that outbreak:
those of the outbreak of 1169-71, it may be inferred that
future course of the latter will be somewhat similar, as re
magnitude, to the course of the former. The prob
that the diffusion of 1418 71 was essentially eine ml.
epidemic of cholera is Increased by the consideration
during its progress in Europe last year cholera became largely
diffused in the Pasholik of Bagdad, and spread thence into
Eastern and Northern Arabia, and to the eastern shore of
the Red Sea. Further, there hoe been only one instance in
Europe, that of 18:..9, of the occurrence of what has been
aptly termed by ludiaa physicians a " regional diffusion" of
the malady. In that year cholera, apparently Brat showing
Itself in an active form in Hamburg, and prevaillag there
with considerable severity, broke out at various points of
Western Europe, from Helsingfors to Southern Spain, and
extended also into Morocco. Numerous cases were Imported
from the Continent to this Country : but with the excep-
tion of the three slight outbreaks at Wick, Glass Houghton,
and on the lichen at Southampton the disease did not ex-
tend. Assuming that the recent diffusi m may be of a similar
cheroot...l- to that of 1979, it would he lnipossilde to n I.ecisst
Its future ; but the extent and universility of its prevalence
in Russia, as well as the other considerations which have
been meotioned, appear almost to shut out the hope that
It may prove to be regional only, and support the view that
It is part of a general, and as yet tuicompleted, diffusion.
On the whole, therefore, a comparison of the events of
1869-71 with those of previous outbreaks in ,Europe ren-
ders it probable that there will be a further octet,
shin of the &tease in the course of the present year.
The diffusion of cholera in Arabia, and lie presence on the
east coast of the Black Sea, should give rise to serious dis-
quietude for In this direction Rio pt is threatened with the
.lisease, and through Egypt the basin of the Mediterranean
and the whole of Soot, ern Europe. Great danger was appre-
hended from the assemblage of pilgrims at Mecca in March,
but it is now reported—l trust accurately, although no
official confirmation of the report has been received—that
this year's pilgrimage has passed without an outbreaik not-
withstanding the asserted presence of the disease in Mecca
earlier in the year.

...ak and
.1 that the
, se regards
probability
, migrating
' that,

-
Concerning the state of this country I wiuld observe that
all previous diffusions of cholera have been heralded by
leaser outbreaks in the years preceding them. Last year
there was no outbreak of cholera in England, but whether
we may hope to escape in like manner during the year to I
come is a matter on which I will not venture a prediction.
With regard to the conditions favourable to the develop-
ment and propagation of the disease, I think it may be said
tin ,t its too probable Invasion of England may be contem-
plated without any excessive anxiety if only local authorities
'and upon the "If" must turn the whole gist of my remarks)
can be induced to take precautionary measures in anticipa-
tion of the evil. Speaking generally, the greater or less im-
provements which were carried out, either in the water supply
or in the abatement of nuisances, in the principal cholera '
fields of previous epidemics, between 165, and 18,10, have
been continued Mace the last-named period ; and the condi-
tions which chiefly (evenr the development and propaga-
tion of cholera never existed among us to so small au en.
tent as at the present time. Thus, for example, in the
metropolis the danger of choleraic infection of the popula-
tion through its water supply, the greatest of all the
dangers to which that population has been exposed on
former occasions, so far as it arises from causes which are
known to have played a part In previous epidemics, has now
been removed by the completion of works which secure the
comparative purity of the water delivered by the companies.
At no previous time have the arrangements for the removal
of nuisance, from the metiopolla or for dealing with in-
fections diaeme been more completely organiznd. Judging
from the experience of 1006 it may reasonably be Merced
that, unless from some accidental oversight or unforseen
circumstance, or (ruin a failure of the local authorities
to exert the powers which the law has placed in their hands,
if cholera should visit London in the course of the
present year, it will not assume, except in very circum-
scribed areas, the disastrous proportions of former outbreaks.
The amended Sanitary Law of 1,66 gave to local authorities
largely increased powers with regard to the abatement of
romances and to the provision of hospital accomino nation
for cases of infectious disease so that such authorities are
now placed, with reference to cholera, in a position which !
they have never before held. The law now empowers them t
to take all essential precautions for the protection of the I
populations under their control, and throws the euthe re- j
sponsibility of taking these precautions upon them. Nay I
more, the Sanitary Act gave further powers for meeting
an epidemic of cholera as soon as certain sections
were put in force by an Order in Council, which
Order was duly issued on the 25th of July, 1811.
Whether, therefore, we regard the general sanitary state of
the kingdom or the state of the law in respect to infectious
diseases, the threatened invasion of cholera may be
templated with less dread than in the ease of any previous
epidemic. A cardinal condition of comparative Immunity,
however, will be proper action on the part of local authorities
for the exercise of the important powers committed to them.
The excellent and energetic measures taken last year, under
the Order already referred to, by the authorities in tite
greater number of the ports liable to receive cholera from
the Continent may be received, it Is to be hoped, as an
earnest of like wisdom and promptitude generally through-
out the king.doni.
Mr. limieliffe's paper was followed by a discussion,
sustained chiefly by Inspector-General Murray, Dr. de
Remy, the Sanitary Commissioner of the Pnnjab, and
Dr. 13uchauan ; by all of whom the views of the
author were supported.
Dr. Murray hod been led by his observations in
India to believe that the epidemic of last year was only
one of the stages of the ordinary progress of the disease
from India to Europe, and he cited some curious
era oples of the way in which the rate of progress of
cholera was accelerated by a railway—now, in fact, it
travelled at the same pace as the travelling public.
Dr. de 'terry insisted very strongly that cholera
never travelled, and objected to the word as mislead-
ing. It was only carried by man or roan's beloogiugs,
and went from place to place with him and his mer-
chandise, or in the water channels which he had
polluted. Dr. de Renzy drew a graphic picture of the
wattr pollution in all the cantonments of the Punjab,
and described minutely the filthy state of things
existing at Peshawur and Mean Meer. Ile said
that he hail gone carefully over the question of
water supply in India with the late Lord Mayo,
, who had been fully impressed with its great im-
portance, and had intended to bring all the weight
of his influence to bear upon the carrying out of
improvements in this respuit. With reference to
human communication, Dr. de Renzy pointed out that
the rail and roadway from Calcutta and the Lower
Provinces to the Punjab must be regarded as the cause
of the now constantly recurring epidemics of cholera by
which the Province was impoverished and demoralized.
Scarcely three years now passed without such a visita-
tion, while formerly the intervals between epidemics
had been az much as five and twenty years; and the
natives, even among the better classes, attrilmted the
change to the permission of cow-killing by the English.
Dr. Buchanan recalled to the meeting the time, not
so far distant, when the propagation of cholera was
supposed to be due to all manner of cosmic, atmospheric,
or other vaguely-described and incomprehensible in-
fluences, and congratulated his hearers on having now
reached a solid basis of fact and knowledge upon
which further observations might be built with security.