Wilmington journal. [volume] (Wilmington, N.C.) 1844-1895, 1866-02-15
LFronp the Richmond Medical Journal

Cholera, olace more, attracts the attention and
excites tears OF the civilized world. The approach
of disease SO fatal should arouse all the talent
and energy OF our profession to prevent its ac-
If PosslDie and if not to moderate its extern
sion and mitigate its severity, when it does make
it's appearance.
MY present object will be. not to attempt svs-
tematic treatlse On the subject but to present such
salient points, AID discuss such general principles
as will lead to practical results.
The history OF, cholera corresponds very closely
with that u mos other great epidemics Like the
comet, 1t mas It's cycle, and encrcles the earth
very much In the same track, once every sixteen
or eighteen yeats. Like some monstrous bird of
prey, IL hestleuf for years about the mouths of
the Ganges' pl9ming its wings, and testing their
strength by Occasional flights, until at last, con-
sclous OF power, 1t winged its course over CONT
nents ana oceans, when, its circuit completed it
returned to ITS nest in the East, there to rest for
series ol years and again prepare for its mission
of Death Ieraversing great rivers, overlapping
the hlghest mountains, and crossing the widest
oceans, 1t everywhere defed and scorned the fee
BILE efforts Of man to stay its progress In every
region OF Country traversed by the shadow of its
wings, 1t left the fatal marks of its passage and
wherever, entlced by the abundance of food, pre-
pared tor its sustenance, it tarried for season.
carnival OF death was speedily inaugurated.-
Whether assisted by favorable, opposed by ad-
verse winds, whether resting in sunshine or breast
ing the storm, its still onward break
ing through all barriers and penetrating every
stronghold, designed by the ingenuity of man,
for its exclusion.
] In considering the history of such disease the
first important questions which present them
selves are, first, What is its cause and second
How is this cause propagated?
In answer to the first question, various hypoth-
eses have been offered but one of them is rem
dered even probable, much less certain by any
weight of testimony or any demonstrate facts.-
They all alike unsatisfactory; and it is to be
feared that the mystery of its essential cause
never be revealed Some have attributed it to
animacula others to different species of fungi,
whilst others have imagined it to be caused by the
absence of ozone from the atmosphere. These
different hypothesis mentioned, not for the
purpose of refuting any of them, but merely
as illustration of the obscurity which attends
the subject. Whilst the essence of the poison may
never be determined, we can yet reach reasona-
BILE conclusion as to its mode of propagation, by
carefully observing and nalyzing the facts con-
nected with its history.
And first, is cholera contagious disease? This
question has divided the profession and very pro-
perly elected many facts, and much able discus
sion both sides, upon it's determination de-
pend many points of the first practical impor-
lance.
The propagation of animal poisons, universally
acknowledged to be contagious, seem to be gov
erned by different laws, in different diseases In
gononhoea actual and intimate contact, with pure
ly local development of specific infamation con-
stitutes the general rule In syphilis and CLAN
ders, intimate contact followed by absorption of
the poison, and its reproduction within the blood,
giving rise to local manifestations of constitution
al disease, furnish some of the laws which govern
their popagation These, and many others which
may conform to the same general laws, constitute
class of purely and exclusively contagious diseases
No one would contend that cholera belongs to this
class.
There is another family of contagious diseases,
governed by certain uniform laws, to which must
be accorded wide latitude. In this are included
small pOx measles, scarlatina and some others.
Of this class Watson in his Practice of Medicine,
says: Like different human faces, all the COM
plants belonging to this group, have the of
features, and thereforea mutualresemblance; while
the separate hneaments differ MUCH in their
character and relative circumstances, to give to
each disease its distinctive aspect" It will be
necessary to describe some of these features in
order to determine whether cholera presents them,
and consequently whetehr tits to be included III the
same category.
First.-The diseases of this class capable, at
all times of being extended by individual contact
or proximity The distance at which the poison
thrown off from one body, will affect another, no
doubt varies with varying circumstances In small
pox the most contag of the GLASS; with cool,
pure atmosphere it is ascertained to be very hmi
ted
| Second-The poison of these diseases has the
property of reproduction within the living system
They are called by authors, emphatically, bIOOdds
eases, and such, have ecedefned periods Of incu
bcdion The shortest time allotted to this period,
after exposure, is seven, and the longest fifteen
days. If disease be developed either before af-
error in the date of exposure than to shorten or
lengthen the period of incubation.
| Thlrd.-These diseases, when not fatal, pass
through regular stages in definite periods of time
to steady convaescence. We have the chill the
three days's fever, the time for the maturation
and the time for the decline of the eruption, and
finally the throwing off of the effete poison, and
the end of the disease.
FOurth.-An diseases of this class pass through
these stages, in despite of any effort made to cut
them short, by the resources of art So uni
versally is this law recognized by the profession,
that any physician, who should attempt to cut
short any one of them by the use of heroic rene
dies, would be considered trfing with the lives
of his patients.
| Fifth.-Added to the property of reproduction
within the blood these poisons have also the prop
erty of propagating themselves through the atmos-
phere under certain unknown conditions, and of
thus becoming epidemic. This would seem to con-
stltute them connecting link between the ex-
clusively epidemic diseases.
| Sixth.-When not epidemic, these diseases
spread gradually from some centre, and affect
equally the most of those exposed to the conta-
gon, unless they en- JOY the protection of some pro-
phylaxis:
of this GLASS; furnishes immunity from any sub
sequent attack. Those who have the pits of small
pox reflected from their mirrors, seldom fear to
become nurses to persons laboring under the dis
ease.
Eighth Incomplete isolation of the sick effectu-
ally prevents the extension of these diseases whilst
the neglect of this precaution insures their indef
mite propation Bysuccessive individual exposures,
a dozen subjects may extend the disease through
more than a hundred days. Immunity is not Sc
cured by change of atmosphere varying seasons
OF the year, different periods of life or strength of
constitution.
These of the prominent and uniform