Читать книгу Letters on the Cholera Morbus. - Fergusson William - Страница 3

Having given, in my last letter, Dr. Davy's views as to the cause of cholera, I may so far remark just now regarding them, that they are not new, or peculiar to him; and that it may be well, before Dr. Macmichael or others pronounce them vague, that they should inquire whether some of those causes have not been assigned for the production of certain epidemics, by one of the soundest heads of Dr. Macmichael's college – Dr. Prout, who seems, if we have not greatly mistaken him, to have been led to the opinion by some experiments of Herschell, detailed in the Philosophical Transactions of the year 1824. They should recollect that other competent persons devoted to researches on such subjects (Sir R. Phillips among the number) admit specific local atmospheres (not at all malaria in the usual sense of the term), produced by irregular streams of specific atoms from the interior of the earth, and "arising from the action and re-action of so heterogeneous a mass." For my part I feel no greater difficulty in understanding how our bodies, "fearfully and wonderfully made" as we are, should be influenced by those actions, re-actions, and combinations, to which Sir Richard refers, and of "whose origin and progress the life and observation of man can have no cognizance," than how they are influenced by other invisible agents, the existence of which I am compelled to admit. – If the writer of the article on cholera in the Westminster Review, for October, 1831, do not find all his objections met by these observations, I must only refer him to the quid divinum of Hippocrates: – but I must protest against logic such has been employed by certain members of our Board of Health, who lately, on the examination of gentlemen of the profession who had served in India, and who had declared the disease not to be communicable, came to the conclusion that it must, nevertheless, be so, as those gentlemen could not show what it was owing to.

Most extraordinary certainly it does appear, that while Dr. Macmichael goes to the trouble of giving us (p. 27) the views of a captain (!) as to the progress of cholera at a certain place in India, he should have refrained altogether from referring, on the point of contagion or non-contagion, to the report of such a person as Dr. Davy, or to the reports of this gentleman's colleagues at Ceylon, Drs. Farrell and Marshall. Had Dr. Macmichael added a little to his extract from Capt. Sykes, by informing us of what that gentleman states as to the great mortality ("350 in one day") in the town of Punderpoor, "when the disease first commenced its ravages there," people would have means of judging how unlike this was to a contagious disease creeping from person to person in its commencement.

It is painful to be obliged to comment on the manner in which Dr. Bisset Hawkins has handled the questions relative to the Ceylon epidemic, which seems far from being impartial; for, while he quotes (p. 172) Dr. Davy, "a medical officer well known in the scientific world," as stating that the cause of the disease is not in any sensible changes in the state of the atmosphere, he breaks off suddenly at the word atmosphere, proceeds to talk of the changes in the muscles and blood of persons who die of the disease, and passing over the part quoted from Dr. Davy, near the close of my last letter, Dr. Hawkins leaves his readers to draw a very natural conclusion – that, as Dr. Davy admitted that there were no prevalent sensible states of the atmosphere to which the cholera could be attributed, he, therefore, believed it to have been propagated by contagion, an inference which we now see must be quite wide of the mark. Dr. Hawkins had, it appears, like many other medical gentlemen, access to the reports from Ceylon, &c., in the office of the chief of the army medical department in London, and it is to be regretted I think that, with respect to one of the Ceylon reports, he only tells us (p. 174) that "Mr. Staff-Surgeon Marshall reports from Candy, that of fifty cases which had occurred, forty died." Why more had not been quoted from a gentleman who had such ample means of witnessing the disease in its very worst form, I must leave to others to say; but, referring again to the highly interesting letter from Mr. Marshall on cholera, which appeared in the Glasgow Herald, of the 5th of August last, and in which, from many important observations which every body interested in cholera should read and study, the following remarks will be found: – "In no one instance did it seem to prevail among people residing in the same house or barracks, so as to excite a suspicion that the contact of the sick with the healthy contributed to its propagation." "The Indian Cholera, as it is sometimes called, appears not to be essentially different from cholera as it occurs in this and all other countries." "I consider it, therefore, impossible for a medical practitioner to speak decisively from having seen one, or even a few cases of cholera in this country, and to say whether they are precursors of 'the epidemic cholera' or not. That the disease is ever propagated by means of personal contact, or by the clothes of the sick, has not, as far as I know, been satisfactorily proved. The quality of contagion was never attributed to the disease in Ceylon, and I believe no-where did it occur in greater severity. I am aware that an attempt has been made to distinguish the ordinary cholera of this country from the 'epidemic cholera,' by means of the colour or quality of the discharges from the bowels. In the former it is said the discharge is chiefly bile, while in the latter it is said to bear no traces of bile, but to be colourless and watery. How far is this alleged diagnosis well founded? I am disposed to believe that, in all severe cases of cholera, whether it be the cholera of this country, or the epidemic cholera, the secretion of bile is either suppressed, or the fluid is retained in the gall-bladder." Mr. Marshall, it may be observed, is the gentleman who was selected by the late Secretary at War, in consequence of his known intelligence, to remodel the regulations relative to military pensioners; and I understand that, in consequence of the manner in which he executed that very important duty, he has since been promoted. After what appears from the above quotations, how perfectly unwarrantable must the assertion of Dr. Bisset Hawkins seem, that "from the Coromandel coast it seems to have been transported by sea to Ceylon!"

We shall, I think, be able to see that the assumption of Drs. Macmichael and Hawkins, as to the importation of the disease into the Mauritius from Ceylon, is equally groundless with that of its alledged importation into the latter island; and here we have to notice the same want of candour on the part of those gentlemen, in not having furnished that public, which they professed to enlighten on the subject of cholera, with those proofs within their reach best calculated to display the truth; be it a part of my duty to supply the omissions of these gentlemen in this respect. The following is a copy of a letter accompanying the medical commission report at that island forwarded to General Darling, the then commanding officer, by the senior medical gentleman there.