repeat, is one of the surest evidences of the prevalence of an epidemic disease.

*

"The introduction of the pestilence into Astracan in 1830," says Dr. Copland, "was traced to a vessel which arrived from Baku, at that time affected with Cholera." But then the question at once suggests itself whence came the disease to Baku ? But it is needless to argue where we have no data that can be depended upon; and Dr. C. must excuse us for not attaching the slightest value to the evidence of the clergyman, which he quotes at great length, respecting the mode of its importation into a town of the name of Saratoff. He does not mention any thing about its introduction into Moscow. Sir W. Crichton, we may remark, has related with marvellous exactitude, the precise course, step by step, of the onward-advancing pestilence from the shores of the Caspian to this city, but candidly acknowledges that it could never be distinctly ascertained who conveyed it into its bosom.* "When the Cholera reached Moscow" we quote from the official Report of Dr. Albers, who was sent by the Prussian government to Russia-"all the physicians there were persuaded of its contagious (infectious) nature; but the experience gained in the course of the epidemic, has produced an entirely opposite conviction. During the epidemic it is certain that about 40,000 inhabitants quitted Moscow, of whom a large number never performed quarantine; and, notwithstanding this fact, no case is on record of the Cholera having been transferred from Moscow to other places; it is equally certain that, in no situation appointed for quarantine, any case of the disease has occurred. In many houses, it happened that one individual attacked by Cholera was attended indiscriminately by all the relatives, and yet did the disease not spread to any of them. The nurses, also, as well as the physicians, escaped." Now this statement is made by a gentleman who professes himself an infectionist; although he candidly admits that "the infection of the Cholera differs from the nature of all known infections, and seems to approach nearest to that of Typhus." We may observe that both Dr. Albers and Sir W. Crichton most emphatically stated, that not a single authentic instance could be shown of the disease being propagated by fomites, such as articles of dress or furniture, or indeed by any inanimate objects at all; and the committee of Russian physicans, established at Moscow by order of the Czar, gave in an official report to the following effect: "The members of the Medical

and

* In the communication of Dr. Walker from Moscow to the British Government, we find the following statement -

"In Moscow, by far the greater part of the medical men are of opinion that the disease is not contagious (infectious), but produced by some peculiar state of the atmosphere, not cognisable by either our senses or by instruments; that this was proved by almost every person in the city feeling during the time some inconvenience or other, which wanted only the exciting cause of catching cold, or of some irregularity of diet, to bring on Cholera; that very few of those imme diately about the patients were taken ill; that persons had put on the clothes of patients who were very ill or had died of Cholera, had lain in their beds, or even alongside of corpses, had bathed in the same water where very bad Cholera patients had been bathed just before, and that none of these persons were taken ill."

1847.] Its Appearance at Moscow and St. Petersburg.

483

Council have been convinced by their own experience, as also by the reports of the physicians of the hospitals, that, after being in frequent and even habitual communication with the sick, their own clothes have never communicated the disease to any one, even without employing means of purification.”

While the Moscow physicians were, almost to a man, non-infectionists, most of their Petersburg brethren at first adopted the opposite side of the question. Dr. Copland simply informs us that "the introduction of the pestilence into St. Petersburg is referred, by Drs. Barry and Russell, to the arrival of vessels from places on the Volga, where it prevailed;" and he goes on to state that, "in that capital, the infectious nature of the disease was shown not only by the mode in which it was propagated in various quarters, and by its introduction into and extension through the prisons and hospitals of the city, but also by its exclusion from some places by a rigid insulation." Among other convincing proofs, he mentions an instance where the pestilence was confined to one side of a village by the street being barricaded on the side where it had not reached, and all communication between the two sides of the village being interrupted! This, is one of "the many facts of the same description now before me." It is somewhat strange that he has not alluded to the opinions of any of the permanently resident physicians of the Russian metropolis. The late Sir George Lefevre, physician to the British Embassy there, and who had very ample opportunities of seeing the Cholera, has stated, (in the pamphlet which he published at the time,) that he had no rational grounds for believing it to be contagious (infectious). During the prevalence of the epidemic, a general indisposition pervaded the whole population. After alluding to the idea of the infectionists, that the disease had been imported by a bargeman, Sir George very shrewdly asks: "How was it that none of this man's companions, exposed to the same causes, should have been attacked also ?"—and then he adds, "When, upon enquiry, it was found that, within the space of three days, the disease broke out in a dozen parts of the town widely-separated from each other, the supporters of contagion awaited further evidence, and the anti-contagionists increased with the increase of the disease."

Again, how does the following fact, related upon the high authority of the French medical embassy that was sent to Russia to investigate the nature, &c. of the pestilence, accord with the doctrine of its spreading by infection?-Kristofsky island, which is situated in the centre of the populous islands of St. Petersburg, and communicates with them by two magnificent bridges, and with the town by a thousand barges, which bring every day shoals of people to enjoy the pleasant walks there, remained entirely exempt from the pestilence during the whole of the time. that it prevailed in the town. Almost all the French players retired to Kristofsky, and not one of them suffered; while, out of the small number of their companions who remained in the town, several died from the disease. The French reporters attribute the exemption of this island to the quantity of wood upon it, acting as a screen against the malarious air in the neighbourhood. Similar observations have been made in Italy on the subject of Intermittent Fevers; and Dr. Rush has remarked the same respecting Yellow Fever.

We must not forget to mention that the Russian government were speedily convinced of the utter inefficacy of any quarantine or other restrictive measures to check the diffusion of the Cholera, and that, ere long, it utterly abandoned all such vain attempts. Drs. Russell and Barry were, at first, of opinion that the disease was transportable by clothes and other material objects; but they became convinced of the fallacy of this notion. And here, before we further notice the advance of the pestilence into Europe, let us look for a moment at its invasion of Egypt.

In August 1831, the pestilence, which had raged at Mecca in the preceding June, broke out at Cairo with dreadful violence. The terror and desolation that ensued were truly alarming, Clot-Bey, who gave a very interesting account of the invasion in the Annales de Medecine Physiologique, has declared his conviction that the dissemination of the disease was not transmitted by infection from one person to another, but only conveyed through the medium of the atmosphere. The reasons he gave for this opinion were-1, the nearly simultaneous outbreak of the pestilence in distant parts; 2, the non-immunity of the harems; 3, the non-immunity of the ships in the harbour at Alexandria, notwithstanding the suspension of all intercourse with the shore; 4, the immunity of some villages and districts in free communication with infected places; 5, the paucity of attacks among the servants at the hospitals; 6, the frightful rapidity with which the pestilence reached its acme of destructiveness (it acquired its maximum of intensity in four or five days, and, after lasting for nearly a month, quickly subsided altogether); and 7, the almost universal prevalence of the disease in some one of its forms among the inhabitants. Clot-Bey candidly admits that Cholera, like other epidemic diseases, may, under certain circumstances, acquire an infectious character.

Dr. Copland does not make any mention of the disease at Dantzic. We shall supply the omission by quoting from the Official Report of that experienced physician, Dr. Hamett, who was sent there by our own Government to make observations. The opening statement of his Report stands thus:

"It remains a problem to this day, in what manner the Cholera Morbus originated in and about Dantzic; certainly it is not proved to have been brought hither from Russia or Poland by men or merchandise; because no ship had arrived at Dantzic from any Russian port previous to its appearance, and the intercourse with Poland had ceased since the beginning of Winter. The first symptoms of cholera showed themselves indeed in such a peculiar manner as almost to exclude even the suspicion of its importation; and it is reasonable to conclude, that the disease originated here in some manner that has, as yet, not been explained. This is corroborated by the statements of several physicians, viz. that cases similar to cholera had been observed previous to the arrival of any vessel from Russia; and that the weather had been so remarkably unsettled since the commencement of Spring, that malignant diseases might be reasonably anticipated."

But, not satisfied with recording his own observations, Dr. Hamett applied to several of the leading physicians of Dantzic for their opinions. These are given in full in his valuable report, and well deserve perusal. They unanimously repudiate the doctrine of infection.*

* The Substance' of the Official Medical Reports upon the Epidemic called Cholera, which prevailed among the poor at Dantzic between the end of May and the beginning of September 1831. By John Hamett, M.D. p. 190. Highley, 1832.

1847.]

How did it reach this Country?

485

From Dantzic we pass on to Berlin. Dr. Copland merely quotes the opinion of a young physician there, Dr. Becker, that "the disease was introduced into that city by the vessels navigating the river Spree, which runs through the city;" but his evidence is far from being satisfactory. Nothing is said of Vienna or Hamburg, nor of the opinions of the medical men in those cities as to how the disease came to them. Dr. Vivenot, one of the most experienced physicians of the Austrian metropolis, published an elaborate document at the time, to show that the disease was certainly not propagated by infection; and, with regard to the appearance of the pestilence in one portion of the Emperor's dominions, Dr. Craigie has informed us:

"The example of the kingdom of Hungary is perhaps still more forcible. Never, perhaps, was such a rigid and perfect system of non-intercourse enforced as that which was instituted on the southern, northern, and eastern boundaries of Hungary, when the disease appeared in Poland. Every defile of the Carpathian mountains was guarded with strong military posts, and watched with the utmost vigilance. Neither human beings, goods, nor brute-beasts, except, perhaps, an occasional wolf or bear, could penetrate into the Hungarian territories, unless at the muzzle of the firelock or the point of the lance. Yet how vain these precautions proved was evinced in the course of a few weeks. For the disease appeared on the Hungarian side of the Carpathian chain, in the month of June, and spread most rapidly through the towns situate on the banks of the rivers of that well-watered country. It will not do in this case to say that the sanitary lines were broken, in the ordinary sense. Broken they no doubt were; but by no human power."

*

*

The introduction of the pestilence into our own country is declared by Dr. Copland to have been "certainly owing to the clothes and bedding of sailors, who died of it at Riga, or other northern continental ports, or during the voyage from those ports, having been too generally preserved and delivered up to their friends, upon the return of infected vessels to British ports." The authority on which he hazards this bold assertion, is the information which he received from "two masters of vessels," who furnished him with "several proofs of a most incontrovertible nature." "These masters," we are informed, "were, conformably with the then prevailing opinion, persuaded that the distemper could not be propagated by the clothes of those who had died of it; but facts soon afterwards occurred, which demonstrated to them the propagation of the malady in this manner, as well as by direct communication with the affected." Such is the evidence on which our author rests his own opinion! He makes no reference whatsoever to the published testimony of Drs. Brown and Ogden, Mr. Greenhow, and various other medical gentlemen, resident in Sunderland and its immediate vicinity, who have most emphatically assured us that not a jot or tittle of any thing like satisfactory evidence could be discovered as to how and when the pestilence was introduced to our shores. Dr. Brown, who has written ably on the subject, expressly declares that he had met with several cases which exhibited all the features of malignant Cholera one and two months before the arrival of any suspected vessel into the port of Sunderland. is scarcely necessary to enlarge upon this topic. In our simplicity we had fancied that there was not now a single medical man in this country who persisted in the doctrine of the importation of the pestilence among

But it

us by the foul clothes of sailors who had died of it. Dr. Copland does not take upon himself to say positively from what particular place the disease came to us; but he demonstrates the facility with which its infectious principle might be transported from place to place, by relating an occurrence which befel himself. It was this. After having spent some time in the first cholera hospital that was opened in Bermondsey, Dr. C. drove to Pentonville in an open carriage, and there visited two of his reOn his entrance into their apartment, they at once complained of an offensive odour proceeding from his clothes. He said nothing as to where he had been. Next day they were both seized with the early symptoms of the distemper, from which they ultimately recovered with difficulty. "Precautions were taken against the further extension of the malady in this house, and no case occurred in the vicinity until some months afterwards!" It was fortunate that our author's own household escaped, seeing that his cloths must surely have retained some portion at least of the pestiferous effluvia with which they were so highly charged. We presume that the preceding proof of the transmission of Cholera is the same with that which is recorded in a note in an earlier portion of the Dictionary, where the following still more remarkable instance of the infectiousness of the disease is recorded:

During the prevalence of Cholera in London, in 1832, a parrot, in the apartment of a person who had the disease, died with the symptoms of it. Due precautions having been used to prevent its extension to the rest of the family, no one else was affected by it. Some other birds, in different parts of the house, escaped."

We shall not detain our readers with noticing the observations of any private individuals with regard to the infectiousness or not of the Cholera, as it showed itself in any part of our own country; but it may be worth while very briefly to allude to the opinions and acts of those whose official position necessitated a public avowal.

In the course of the month of June, 1831, while the disease had not yet extended further east than Dantzic and Cracow, Sir William Pym, our Superintendent of Quarantine, addressed a letter to the British Government, recommending, among other immediate measures against the introduction of the Cholera, "that an order be issued prohibiting altogether the importation of every description of woollen rags," and suggesting at the same time that the College of Physicians should be called upon for their opinion" whether other goods deemed susceptible (such as hemp, and flax, wool, &c.) could be imported with safety, without quarantine purifications from parts where Cholera prevails."

The College declared in their report, which was signed by the late Sir H. Halford, and by Drs. Turner, Macmichael and Hawkins, that "the disease is of an infectious nature, and therefore does require that all persons coming from an infected quarter should be placed under a quarantine of at least fourteen days; but, as there was no proof that the disease has been propagated by means of inanimate objects, "we cannot bring," it is added, "ourselves to believe it necessary to adopt the fifth article (just quoted) of Sir William Pym's recommendations."

Within a week from the date of this letter, the President and Fellows addressed the Lords of the Privy Council, re-stating their belief that