TOPICS OF THE DAY.

IS CHOLERA IN LONDON—AND WHAT IS IT?

THE Cholera has at length been officially reported as existing among us. Our movements, which had previously been languid,, are now accelerated amazingly : from St. Stephen's downward, all is bustle ; and it would be hard to decide whether the drawers of bills or the spinners of paragraphs are most active. The Ministry are to blame. If an enlargement of the powers of the Privy Council be necessary now, was it not equally necessary

three months ago ? Has the disease altered its nature, or gained in virulence, by a shift of scene ? Are the lives and safety of the inhabitants of Ratcliffe Highway more valuable, in the eyes of reason and humanity, than those of the inhabitants of' Sunder- land ? Had the bill which has been hurried through the two Houses of Parliament, with a zeal that partakes more of the old woman than the statesman, been offered to our calm consideration in December, many valuable facts might have been elicited, and many important inferences deduced, in the course of its discussion. The Medical Boards—for there have been two at least—are as blameable as the Ministry. Instead of deliberate and cautious in- duction, the first Board came to a sweeping judgment founded on

the grossest ignorance of the disease of which they pretended to treat; and save forth a set of rules, in consequence, which will

long remain a signal example of the most egregious folly that has, for a century at least, disgraced the character of any body arrogating to itself the name of scientific. The second Board, perceiving that their predecessors had gone rather too far, were prudently determined to avoid so perilous an example. The first set talked a great deal and did nothing ; the second neither talked nor acted. Save and except a daily report of places and cases,

furnished for the first two or three weeks to the newspapers by a Mr. MACLEAN or his deputy, clerks to the Board,—and after-

wards, even that task being found too heavy for two men to per- form, printed and sold to all purchasers by Mr. VACHER of Par- liament Street,—with the exception of this tabular report, we are not aware that a solitary fact remains to prove the second

Board's existence. All that concerned the importation of the dis- ease, if imported—its contagiousness, or non-contagiousness—its- cure—its repression—has been collected and published by private' individuals. There has, indeed, been a thing published called a Cholera Gazette, in which eases and cures, real or pretended, have been given in most admired confusion : but from whatever source the Cholera Gazette may have gleaned its miscellaneous intelligence, it is not a public job.

The IndianCholera, Spasmodic Cholera, or, to call it by its last acquired name, the Blue Cholera,* has been designated a plague— a pest—a scourge; it has been described as a new disease, as highly infectious; its spread has been referred to its infectious na- ture alone; and as a consequence from this doctrine, land quaran- tine, sea quarantine, isolation, separate hospitals, and various other regulations have been adopted or recommended to stay it. We deny most decidedly that there is the slightest ground for ap- plying to it the terms plague or pest, in the sense which the mul- titude attach to these names. We equally deny that there is any decided proof of its novelty ; of its being communicable; of its dif- fusion having been the result of infection ; and, by consequence, we deny that any thing in the nature of cordons, great or small, will prevent its diffusion.

First, of its title to the name of plague. This term is applied, of course, from a comparison of the mortality- occasioned by cho- lera compared with other diseases.

In considering this point, we shall not go farther than our own shores. It would be absurd to draw conclusions either for or against the mortality of Cholera, assuming it to be the same dis- ease, from its ravages on the Continent of Europe, or ill India, finder circumstances wholly different. Of the various towns in England that Cholera has visited, Newcastle seems the one on which a fair argument may most readily be founded. Its popula- tion is duly mixed; neither miners, nor mariners, nor any of the labouring classes preponderate. The site of the town, the nature of its police, the planners and habits of the people, offer average results. Now, what has been the mortality of Cholera in New- castle, where, from the reports of the last three weeks, it may be considered as having run its course? The population of Newcastle amounts, according to the census of last year, to 42,760. By the daily Cholera reports, the number of cases that have proved fatal is 294. The proportion of the deaths to the population is 1 to 140. Now, by the same census, the population of London within the bills of mortality is 760,000. The number of deaths from Con- sumption, during the year 1831, within the bills, was 4,807,— giving a proportion of 1 to 158. So that the proportion of the fatality of Cholera, that all-alarming disease, to one to which we and our fathers have been habituated for centuries past, is no more than as 158 to 140, or about 8 to 7. We count it of very great importance to impress this fact on the public attention, not only because we consider the small number of deaths from Cholera to be quite decisiveof the question of contagion, but because we know that the public alarm has been excited and propagated'. chiefly by representations of the sweeping nature of the disease.

• As we have said elsewhere, we word 1 prefer, if a name must be given to this va- riety of a well-known disease, that of Cholera graroior: the common complaint may in that case be termed Cholera Wier. It is worth while to trace the history of a few of the other diseases of the metropolis, which an early copy of Mr. MARSHALL'S curious and interesting tables enables us to do.

The annual average number of fatal cases of Fever, from 1800 to 1810 was 1,700; from 1810 to 1820-1,000; from 1820 to 1830 —900 very nearly. As fever has decreased, inflammation has increased : the average of deaths from Inflammation, from 1800 to 1810, was only 610; from 1810 to 1820-780; from 1820 to 1830-1,970. This is an instance of what may be called the com- pensating process, which Nature is ever and anon having recourse to; opening, as it were, one of the sluices which serve to drain the world of its inhabitants, as circumstances or men's invention im- pede or shut up another. There are other instances in which a disease seems to have died out entirely.

There is an entry, in the year 1650, of a solitary case of what is called "Twisting and Griping of the Guts." This is presumed by our medical men to have been, what now bears the sonorous and less significant name of Cholera. For the first ten years, namely, from 1650 to 1660, the highest entry of Twisting and Griping is 446,—which, computing the population at 150,000,e is less than 1 in 300; in 1669, the number of deaths is 4,385,— rather more than 1 in 50, or about 3 deaths for 1 compared with modern Cholera. The disease varied, during the succeeding twenty years, from 3,500 to 2,500 per annum; it gradually de- clined from 1690 down to 1739; after which it does not again appear.

Smallpox fir 4t begins to be distinguished from Measles in 1701. In that year, the deaths, in a population, of 320,000, were 1,095. The deaths from Fever during the same year, were 2,902 ; from Consumption, 2,678. From 1700 to 1800, Smallpox deaths vary from 2,000 to 3,000 per annum; • occasionally, but not frequently, rising to 3,500, and sometimes falling to 1,000. Fever cases, until 1790, more frequently exceed 3,000 than fall short of it; in 1741, the number was 7,528,—or about 1 in 60 of the population ; the consequence, probably, of the terrible frost of 1740. Consumption has been very regular and very fatal. The number of cases in 1701 was 2,678; in 1751-4,182; in 1801-4,695. In 1701, the deaths from these three leading diseases amounted to 6,675, and the deaths from all other causes to 13,796; in 1751, the former was 8,399, the latter 12,629; in 1801, the one was 9,064, the other 10,310; so that, in this last year, Fever, Consumption, and Smallpox carried off very nearly one half of all those that died within the bills.

Let us recapitulate. The facts which we have cited prove- 1st, That in the course of our history, diseases have varied ex- ceedingly in intensity with reference to each other. 2nd, That among the most ordinary, and, however deplored, the least dreaded of our thousand ills there are several which are not less and in many cases more fatal, than cholera has yet proved to le.

And therefore, that those who represent Cholera as a plague—a pestilence—a scourge—have not the slightest warrant in fact for such a description of it.

Thus much for the mortality of the disease, which constitutes, to the far greater number of those whom the Medical Board and the Government have so needlessly alarmed, the grand object of terror. On the subject of its infectious nature, perhaps the best argument we can offer is simply to trace its progress in Great Britain.

The external symptoms of Cholera are—first, extreme debility; second, coldness, particularly of the extremities; third, shrinking of the muscular parts; fourth, blueness of colour; fifth, vomiting and purging of colourless fluids; sixth, severe cramps. But though nothing is easier than to tell over these symptoms, it is by no means so easy to distinguish *hat is cholera, from what is not. It hardly ever happens that all the above symptoms are com- bined in one patient; and, with perhaps the exception of the first, which is also an accompaniment of ordinary diarrhcea, it will sometimes happen that the patient dies without exhibiting any one of them. If, however, we find several occurring in the same person, it is no unfair conclusion, where death follows, to say that the case was one of Cholera. Taking, then, the symptoms and not the report of the Medical Board as proof of the disease, Cholera was in existence in London six months ago. We shall mention one case which we know to have occurred in the month of August. A female was seized with illness at four in the morning: a re- spectable practitioner, who visited her at six, found her in a state of collapse. The usual remedies—opium, brandy, and ether— were exhibited; but she continued to sink, and died in thirty hours. The blueness, as it is called, was very remarkable in this case; the extremities resembled those of a black person. If such a case were to occur to-morrow, it would be infallibly included in Monday's report—attributed to a visitto a patient or a visit from an old clothes man—and the cucumber, which the female in question had eaten for her supper, be set down as the exciting cause. If it be asked why a case like this was not published in August, we can only give the answer of the surgeon from whom we received it—" Why publish such a common case? They are always occur- rhwtt that time of the year." The next place where Cholera was heard of was at Newcastle— we allude to EAGER'S case. This was described as English Cho- lera,—as if there had been any difference between English and Indian. Then came the Sunderland cases, commencing on the i- 'Me population within the wallehas Increased at about the rate of 30,000 in ten yeare.thuaus the last 130 years. See Parliamentary Itepalta4c4343; 1881. 128 th October, which Dr. DUN, after long waiting for the light, determined to be the true Blue Cholera. From Sunderland, the disease went back to its old quarters, Newcastle; from Newcastle, passing over Chester-le-Street, to Durham, where it appears to have been effectually stopped. Turning next towards the North, it passed by Morpeth, Alnwick, Berwick, Dunbar, and, of all places in the world, lighted down at the village of Haddington. In a little miserable outskirt of this town, called the Mungate, divided from the main village by a stream of twenty or thirty yards broad, but communicating with it every hour of the day, the dis- ease remained cooped up for three or four weeks. The next place in which it made its appearance, was in Atheistaneford, a hamlet wholly away from the direction of all the main roads, and at about four miles distant from Haddington. We then heard of it at Whittingham, five or six miles east from both of these places; and next at Tranent, seven miles west. All this time Haddington was free. About a fortnight after Cholera had visited Tranent, it came, of a sudden, back to Haddington ; and in two days proved fatal to ten or twelve persons. In the mean time, it had appeared in Fisherrow, a suburb of Musselburgh; and when it had ravaged that suburb for a fortnight or three weeks, it turned back once more to visit Musselburgh itself, which it had so unaccountably left unnoticed in passing through. The next cases occurred in far distant points—at Hawick, forty-five miles south, and Kirkintil- loch, about the same distance west of Edinburgh. Rumour has since placed Cholera in Inverness, and lastly in Limerick. There was no traced or traceable infection in ally one of these visitations, more than there was in the Sunderland cases. These, it is now notorious, could not be derived from Hamburg vessels, inasmuch as there was not one vessel in Sunderland river at the time Cholera was first publicly announced there, that had not left Hamburg before the appearance of the disease in that city. It is true that those persons who, contrary to all fact as well as all logic, will yet contend that Cholera is infectious, tell us that the disease might in all these its desultory wanderings be carried from town to town by human beings, or by their apparel; and dare us to prove that it was not. But to what does their argument amount, except that the infection of Cholera is different from all others—that it is not communicated by the daily, hourly inter- course of hundreds with their next-door neighbours, but slides from town to town with silent, stealthy, unnoted steps ; resting in one spot, passing by another; now proceeding directly onward, now turning aside, now turning back ; at one time galloping, at another creeping? Neither smallpox nor any other acknowledged infectious disease was ever known to diffuse itself in this way : why then should we be called on to believe that to be true of Cho- lera which is false of all the rest?

The small number of persons affected with Cholera, in propor- tion to the population, seems even more decisive of the question of its infectiousness than the irregularity of its march. In Newcastle, the cases to the population have been as 1 to 50. Now we would like to see an instance in which, in the whole history of diseases, an infectious disease had shown such respect of persons. It is true, even in smallpox, some few escape,—perhaps one in fifty. But where is there an infectious disease, with the exception of Cholera, in which only one in fifty is attacked ? The contagion advocates tell us, in order that the infection may act, there must be susceptibility in the object—if no disease ensue from contact of the sick, or of their garments, the blame is not at- tributable to lack of infection, but to lack of susceptibility. In the same way, when Mr. LINING laid his hand on the young woman in Duke Street, it was from no want of penetrative power in the reverend gentleman that the luxation of her hip was not reduced, but of receptive power in the patient ; there was the faith of infec- tion, but not the faith of susceptibility ! Were the Cholera a mere abstraction, the attempt of the con- tagionists to establish the exception by tile rule, might be passed over without notice; but, acted on, as it is, by Boards, by Cabinets, and by Nations,—and issuing, as it must do, in the most appalling commercial difficulties,—it assumes a truly serious aspect, and calls for very serious consideration. In a few weeks, or even in one week, the whole of Great Britain may be in a state of qua- rantine. Whether the consequences of an entire suspension of British commerce may .be so heavily .felt by other nations, as in the end to induce them to adopt those rules of reason and prudence which we have so inconsiderately abandoned, we know not; but, in the mean time, our sufferings from Cholera will be the very least of our sufferings. In the most vigorous state of our trade, an instant stoppage in every one of its multifarious channels must have been productive of the greatest alarm and distraction; but after the languid state in which it has been for the last nine months, it threatens to be fatal.