propagation of a disease from those who have seen but a little, and described only what they have seen; or from those who dispassionately investigate the origin, the cause, the phenomena, and the relation of all that has been observed and recorded, and cautiously weigh the evidence on either side of a disputed topic connected with it? The captain of a company, or even a colonel performs an important part, individually, in an army during a general engagement; but he can know little, personally, of the disposition, changes, and evolutions of all its parts, and of the plan of strategy, according to which it first acted, or was led to change its operations, in order to meet or conteract those of its opponent. Like the commander-in-chief of the whole army, we, who collect, compile, arrange, and digest facts, on both the one side and the other of a disputed subject-who observe closely what has occurred within the sphere of our own experiencewho compose, weigh and meditate upon the whole evidence, personal as well as testimonial, with our minds uninfluenced by prematurely conceived ideas, are the best suited to investigate and to conclude respecting them. Placed, by the number of accumulated facts, and by minds accustomed to view and to investigate the difficult operations of Nature, on the elevated table-land of human science, we may be admitted to be more able to take in a comprehensive view of the causes and nature of disease, and to come to accurate conclusions respecting it, than many of those who, as observation has shown, have drawn hasty inferences from a few and very imperfectly investigated occurrences."

Quitting now the testimony of East Indian authorities on the important subject which we have under consideration, we must invite the reader to accompany us in examining the evidence adduced by Dr. Copland and others respecting the transported infection of Cholera, after the pestilence had left the limits of Hindostan, and had entered upon that westward course of mysterious advance which it pursued until it reached the shores of America. Our author's notice of this part of his enquiry is intentionally very brief; "because," says he, "the identity of the malady in both hemispheres having been fully and generally admitted, and its infectious nature in India having been completely proved (!), it must necessarily possess the same character in Europe, unless counteracted by powerful means."

That the greater number of the instances enumerated by Dr. C. of the disease being supposed, or believed, or considered, or said, (for he very properly avoids making any strong assertion), to have been conveyed to different places by vessels from infected parts, and of the exemption of certain other places from its invasion, in consequence of quarantine and other precautions, are of the most questionable authenticity, must be apparent to every one. What will the reader think of such proofs as these?

M. Hubenthal states that a peasant having arrived from Arkatal, on the borders of Persia, at the village of Neskatshne, to visit an uncle, was seized upon the night of his arrival with the disease. The persons engaged in restoring the heat of the body by friction, &c., four in number, were attacked on the following day, and three of them died. Precautions were taken by the police to arrest the progress of the pestilence in the village, and it spread no further!"

Here is another proof:

"Dr. Meunier states that, at Bagdad, where a third of the inhabitants was attacked, none were affected but those who approached the sick! Dr. Reimann says, that there was not a single instance of a town or village in Russia which contracted the malady without previous communication with houses or persons affected!"

1847.]

Its Appearance at Astracan and Orenburg.

481

It would be altogether unprofitable to endeavour to arrive at any thing like a satisfactory conclusion on the point at issue, by quoting the conflicting opinions of different writers as to the manner in which the pestilence was at first introduced into Astracan and other towns in that remote region. We should not, however, omit to allude to the evidence of Mr. Cormick, who was at Tabriz in October, 1822, at which time the disease had reached the western boundary of Persia, and was steadily advancing in the same direction. This gentleman utterly repudiated the notion of the disease spreading by infection."

When the Cholera appeared at Astracan in 1823, the Russian Government resorted to restrictive measures to arrest its progress.t "Whether or not these measures (we quote from Dr. C.) were the cause of its disappearance may be difficult to determine; but it did disappear, and it was not till 1830 that it showed itself again in that city." Here, the reader will observe, there is a candid admission of doubt on the point mentioned; yet, strange to say, a few pages farther on, when combating the objections of the non-infectionists as to the utter inefficiency of any quarantine measures, our author does not hesitate boldly to affirm that "these succeeded for eight years in arresting its entrance into that place (Astracan") ! This is an easy way of settling a disputed point to one's own fancy.

We have already stated that the outbreak of the pestilence-after having been scarcely heard of for several years-in Orenburg in 1829, has been candidly admitted by almost every writer to be utterly unaccounted for. In the Russian Official Reports, Dr. Lichtenstadt has distinctly acknowledged that it was not possible to trace the invasion to any communication with infected places. The majority of the medical men in Orenburg, at first, denied that the disease was transmissible from one person to another; but several of them afterwards qualified this opinion, and declared for its infectiousness, although still professing their utter inability to explain how the disease arose, or whence it came. Dr. Lichtenstadt has informed us that none of the medical men, and scarcely any of the attendants upon the sick were attacked. It is also well worthy of notice, that a malarious condition of the atmosphere prevailed at Orenburg during, if not before, the outbreak of the pestilence there; as will be seen from the following statement of Dr. Onufriev, physician of the circle or district: "During the prevalence of the Epidemic, there was scarcely a single inhabitant of the city who had not some symptoms of disordered digestion. One complained of oppression and pain in the breast; another of headache, slight sickness, looseness of the bowels, and the like." This, we need scarcely

*Medico-Chirurgical Transactions, Vol. xii.

+ Dr. Craigie of Edinburgh, who wrote so much and so ably on Cholera in the Edinburgh Medical and Surgical Journal, which, for many years, he conducted with distinguished ability, informs us that—

"Each of these cities (Astracan, Moscow, and St. Petersburg) was placed under a rigid system of seclusion and separation from infected places, by means of strong lines of military posts and barriers, which, in the case of Moscow, were two-fold. Notwithstanding these precautions, however, the disease appeared in every one of these cities, and without the possibility of tracing it in any instance to unequivocal importation.

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; and 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

* 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 immediately 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 pestilenee 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 acmé 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.