CHOLERA, ITS CAUSE AND PREVENTION.

377 possible to say where the attack will commence; for, as in the WESTERN MEDICAL AND SURGICAL SOCIETY latter, blight will prevail in one part of the kingdom and not OF LONDON. in another-in one field, and not in the adjoining; and as FRIDAY, OCTOBER 7, 1853. among cattle the distemper will prevail in one district of a A SPECIAL meeting, convened by the president, was held country and not in another-on one farm, and not on the adthis eveningto consider the best method of investigating and joining, and even in one field and not in the next-so, also, mankind the cholera attacks at one moment a seaport, treating epidemic cholera, should it appear within the district amongst of the Society. The attendance of members was unusually at another an inland town; at one time a single house and not the adjoining: nay, so capricious is it in its visits, that it will large. The president, Dr. JAMES ARTHUR WLSON, on taking the seize on one inmate of a crowded room, or bed, and not their chair, stated f"’.,-, in consequence of the violent outbreak of companions. It is evident, then, that the disease is not concholera in Newcastle, and the existence of various indications ta[j1’ous, but the result of an atmospheric poison acting upon a that the metropolis would sooner or later be visited by it, he body predisposed to its influence. In an unhealthy season, a had thought it desirable that the Society should assemble a few years ago, the surveyor of Windsor Forest informed me in one night a narrow and long belt of woodland was struck fortnight earlier than their accustomed time of meeting, to take that several points into their consideration. The first question, of with blight, without affecting the adjoining trees, every leaf shrivelled up and destroyed; hence we may presume that course, would be-Have we cholera in the district ? If not in being the district, he could answer from his own experience, that it an electrical current produces the pestilence in all cases, though operating differently under different circumstances. For inwas on the very confines of it, having himself seen a fatal case two days previously in St. George’s Hospital. Then, Are there stance, may it not in one place so act upon a mass of vegetable as to cause instant decomposition and the malaria of any circumstances in the district likely to induce a visitation of matter, cholera? Under this head he could not but allude to the dis- typhus fever-while in a populous town, acting upon an accuof animal matter in a state of decomposition, produce graceful state of the still unclosed Ranelagh sewer, on the mulation of which occurred some of the very worst cases in 1849, Asiatic cholera ? Whether this be so or not, it is too late to and which was constantly the habitat of typhus and pesti- begin to clear out the hold of the ship whenthe enemy has lential fevers. And lastly, BThat was to be done with the fired a broadside into her; and therefore, if boards of guardians cholera when it did come? He explained the course taken by and parochial authorities have not cleared away all nuisances the Society in 1848 and 1849 to obtain records of cases, with before the cholera has commenced its voyages in a town, it is the view of throwing light on the history and pathology of the too late then to begin, lest they occasion a wider spread of the disease. Deeply regretting that it had not been more success- disease by diffusing the poison in the atmosphere. On its approach, then, instead of disturbing cesspools and other ful, he of course could not recommend the revival of a scheme noxious matter by removal, or inundation with water, the first which had failed; but he still hoped that some plan might be devised by which the Society would contribute its quota to the thing to be done should be to destroy or neutralize the poison the atmosphere; to disinfect the air in small dwellings and investigation of the coming epidemic. In reference to treat- in confined places; and to prevent the escape of noxious effluvia it was to be feared we were too much where we were ment, when the disease came upon us before, in 1831 and 1848. Still, from foul drains and putrid substances. For this purpose, as

banks

methods had been suggested for consideration-as, for example, the treatment by sulphuric acid. One thing, at all events, it was to be hoped we had learnt-not to be looking after specifics, but to treat cholera as we would any other disease, according to the circumstances and symptoms of each individual case. A most animated conversation ensued, and was maintained till after ten o’clock. It resulted in the appointment of two committees-one, to draw up a memorial to be presented to Lord Palmerston, on behalf of the Society, representing the injury to the health of the district resulting from the present state of the Ranelagh sewer; the other, to consider the best mode the Society could take of inquiring into the history, progress, pathology, and treatment of cholera in the district. It is intended that the latter committee, which consists of the president, Dr. Barclay, Dr. Fuller, Dr. Aldis, Mr. Haden, Mr. Martyn, Dr. Cumming, Dr. Murphy, Mr. Baines, Mr. Keen, and Dr. Seaton, should act in concert with the cholera committee of the Epidemiological Society. From the testimony of members present, it did not appear that any case of cholera had yet been seen in the western district. some new

Correspondence. "

Audi alteram

partem."

fire is the grand purifier of the elements, let fires be made in every house, and bonfires in every street; and let tar-barrels and resinous combustibles blaze in every court and alley until the plague be stayed." Offensive places should be covered with quick lime, and the poor strictly enjoined to throw their ashes daily over the surface of their cesspools, which will prevent bad odours arising. Foul and stagnant pools should not be cleared out in the summer season. I mention this more especially, because a few years ago a small pond on Eton Common, near a row of cottages, was cleaned out in the hot weather, and the filth thereof left to putrify on its sides; the consequence was, that typhus fever speedily invaded the inmates of every cottage adjoining. Animal and vegetable matter, therefore, in a state of decomposition, should not be disturbed in the summer, but covered over as far as possible to prevent evaporation, and carted away on the land in winter, when no evil will ensue. During the last visitation of cholera, I presented a, on the nature and treatment of the disease to the paper " General Board of Health," which contained the most successful mode of cure that has been adopted therein; it was, however, unnoticed by the Board. This year it has again been presented to their notice through the medium of the " Home Secretary;" I trust, therefore, that its merits over every other plan of treatment will be fully tested, for, from the fearful rate of mortality shown in the present epidemic, it is too evident that they have no remedy of their own. I am, Sir, your obedient servant, WILLIAM Moss, MOSS, Surgeon. Tunbridge Wells, Oct. 8, 1853.

CHOLERA, ITS CAUSE AND PREVENTION. To the Editor of THE LANCET. SIR,-As the Asiatic Cholera has again made its appearance in this country, may I beg insertion in your journal for the

CHLOROFORM IN CHOLERA; VOMITING. To the Editor of THE LANCET. observations on its cause and It is not the SiR,-At following prevention. present time, whatever promises to diminish in the power of man to arrest the course of the pestilence that the sufferings or dangers of cholera patients, must be intewalketh in darkness, P-o more than he can control the elements; resting to your readers. I trust, therefore, you will give inbut he can do much to mitigate the blow, and can, moreover, sertion to the following brief communication in your next by his observation on what has been the precursor of former number. It relates to what I believe is a totally novel and

visitations, anticipate its approach. The elements necessary for the production of Asiatic cholera would appear to be a combination of heat and moisture; these are never wanting in India, where it is an annual visitor, and constantly comes on after the rainy season. Now, in former visitations in this country it was always preceded by a wet summer-as in the present year-and was accompanied by an epidemic disease among cattle and vegetables. It is fair to infer, then, that it is a distempered condition of the atmosphere that affects alike the animal and the vegetable kingdom. Nevertheless, the enemy’s approach is so mysterious and irregular, that it is im-

certainly

most successful mode of

distressing symptoms

of

treating

one

cholera,-viz. vomiting.

of the most

Whosoever has seen anything of cholera must be aware that there are cases, not otherwise of the most malignant character, in which the vomiting is obstinate, and resists the influence of every sort of medicine. In such cases I have found the inhalation of chloroform most useful. The first patient in whose case I employed this method, had been ill several days; he had not been severely purged nor collapsed, but when I saw him, had vomited for twenty-four hours withHe had taken creosote and an effervescing out ceasing.