The Press.
London, England, 1854-04-22 00:00:00

WARNINGS AGAINST CHOLERA.

THE Board of Health have issued a notification,
which was published in Tuesday's Gazette, conveying
a serious warning to all boards of guardians, local
boards of health, and other authorities entrusted with
sanitary arrangements, against placing security in the
present apparent disappearance of epidemic cholera.
It is of the last importance, continues the naitica-
don, to bear in mind that a similar decline of the
pestilence took place at corresponding periods of its
progress on both its former visitations.
The attack of 1t431 was premonitory of a more severe and
wide-spread outbreak in 18.12.

The epidemic of 1848, which in the autumn of that year
numbered nearly one thousand victims in the metropolis,
almost wholly disappeared in the spring, yet returned with
redoubled violence in the summer, destroyed nearly two
thousand persons weekly for several weeks in succession,
and produced, including deaths from diarrhoea, a total mor-
tality of more than 17,000.
In like manner, the outbreak of last autumn, which com-
menced with greater virulence than the epidemic of 1848,
and destroyed in the metropolis during the first months of
its course double the number of victims, has been followed
by a lull, which has been more complete than that of 1849.
But within the last month the disease has again become
more active, and a gradual increase has taken place in the
number of deaths, raising, for this month, the total deaths
in England and Scotland to twice the amount of the corre•
sponding period of 1849. The analogy of the preceding
visitations therefore justifies the apprehension that the dis-
ease, instead of having ceased, is in its period of incubation,
and that the epidemic, in its decided form and full force, is
yet to come.
The modifications in its character which the pestilence
has recently exhibited are of a nature to render it doubly
necessary that the first indications of its appearance in a
locality should be vigilantly watched. In the majority of
the places which it has hitherto attacked it has seized its
victims more suddenly and hurried them through its fatal
course with greater rapidity than on any preceding visita-
tion.

One stage of the disease, formerly well marked, and of
the utmost value with reference to the z:pportunity afforded
for the application of the means of prevention, is now
generally much shorter in duration, and often even sup-
pressed, namely, that denoted by the term " approaching
cholera." Premonitory diarrhoea does still indeed exist,
but that also is commonly of shorter duration, and passes
more directly and rapidly into cholera, and cholera itself
into collapse.
During its first visitation in 1831 and 1832 the attacks of
the epidemic, with few exceptions, were confined to the
poorer portions of the population residing in the most neg-
lected and unhealthy districts. In 1848 and 1849 it was
fatal to larger numbers of the middle classes inhabiting
better-conditioned localities and houses. As far as the
disease has yet advanced, the proportion of the better class
attacked is still greater than in 1849.
In that year, among the total number of persons who
perished by the epidemic in the metropolis, 81 per cent.
were labourers and artisans, and 15 per cent. were trades-
men ; but in the places in which the disease has lately pre-
vailed, the proportion of deaths among labourers and
artisans has been only 72 per cent., while the mortality
amongst tradesmen has reached 24 per cent. In like man-
ner, in the epidemic of 1849, the proportion of the deaths
of the gentry and professional persons to the total deaths
was 2.0 per cent., but recently it has risen to 3.2 per cent.
In other countries the disease has not spared the highest
classes, and, if the safeguards against it are neglected, there
is no reason why it should in our own.
It is furtherindicative of an increasing activity and in-
tensity in the pestilence that while the interval between
its first and second visitations was sixteen years, the interval
between its second and third visitations has been only four
years ; and that its second visitation was far more extensive
and mortal than the first. In the absense of more efficient
precautions against it, there appears no reasonable ground
for the expectation that the third will be less extensive and
mortal than the second. . .

The board then proceed at great length to insiston
the importance of precautionary measures, and to urge
the benefits which may be expected to follow the
adoption of sanitary precautions.