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Cholera: Characteristics Progress Fatality- Origin Course in India-Appears at Bombay Ceylon - ChinaArabia - Persia - Syria-Java - Russia - Poland - Germany-Hamburgh- England - Ireland - France - Canada New York-Philadelphia Washington - Albany- BufCincinnati - New Orleans.
THE year 1832 will be long remembered in the United States, as the era of the first appearance of the Indian or spasmodic cholera upon the western continent. This extraordinary disease, which, after having been subjected to the observation of the medical profession in the old and in the new world, seems almost as little understood as when first it appeared in India, had long been spoken of as one of the most formidable diseases of the Asiatic continent; and within a few years past, it had forced itself more particularly upon the attention of Christendom, by its advance towards the northern portion of Europe.
The suddenness of its attack; the shortness of its duration; its malignancy, and the difficulty of cure; all combined to impress the public mind with an undefined but overwhelming apprehension of a pestilence, of which nothing was known except that its approach was gradual and sure, and that while no effectual remedy
could be prescribed by medical skill, certain death must ensue unless some relief was afforded. This disorder, though it sometimes attacked its victims in the streets, and when walking or riding, more frequently manifested itself in the night, and towards the approach of day. The person was suddenly seized with a sense of nausea and oppression, or of exhaustion in the stomach, followed by a commotion of the bowels. This was sometimes so instantaneous, that it seemed as if he had been struck by a musket shot. A feeling of coldness immediately pervaded the body, and vomiting and purging took place simultaneously. This commotion was generally attended with pain, though sometimes the patient was merely exhausted. An insatiate thirst then ensued, and a general listlessness and languor began to manifest themselves -the pulse contracted, and at the same time became more rapid - the skin lost its natural warmth, and the patient began to complain of in
creasing rigor and of a buzzing in the ears, and manifested great drowsiness. The abdominal muscles were contracted, and spasms ensued, more particularly affect ing the muscles of the feet and the hands, but sometimes those of the body.
An unnatural perspiration appeared on the skin, and the temperature of the body continued to sink the voice became feeble, the countenance pallid, the skin shrivelled, the eyes invested with a livid circle, the tongue cold, the pulse tremulous, until the victim sunk, (with a mind generally tranquil and undisturbed,) from the rapid exhaustion of the physical powers. About one third of those attacked fell under the violence of the disorder, within twelve and many within four hours. The efforts of the healing faculty were directed to restore the natural secretions, which seemed to be totally suspended, and if that could be accomplished, hopes were entertained of the patient's recovery; otherwise his fate was certain. No rational opinion could be formed concerning the natural causes of this visitation upon the human race. Athough it originated in Hindostan, it had extended itself to other countries, and had raged alike in the islands of the Indian ocean and in the interior of the Asiatic continent, until, passing over the lofty chain of the Caucasian mountains, it established itself in the heart of the Russian empire. Even the frosts of a northern winter, which had put an end to other plagues, although it diminished its power, did not destroy this pestilential miasına,
that slowly but gradually advanced from the spot of its origin to the centre of Europe, in spite of all the precautions of governments, and regardless of the rules, that human wisdom had assigned as the laws of its communication and progress.
In some countries warmth and moisture were deemed to be the causes of the epidemic; but when it raged in the depth of an arctic winter, it was concluded that other agents must be regarded as having some efficacy in its production. Filth, which in most cases had aggravated the severity of the attack, did not seem in London to have produced such an effect.
It advanced along the channels of human intercourse, but no investigation could discover the mode of communication; and numberless instances were adduced, shewing, that it was not easily communicated by any intercourse between man and man. The healing faculty was equally at a loss, as to the means of prevention and cure. Quarantines were generally condemned by its members, as futile and unnecessary; and yet the appearance of the disease was so invariably preceded by intercourse with places already infected, that the almost unanimous testimony of physicians failed to satisfy the community, that the cholera was not a contagious disorder. The treatment, which at one place was considered successful, was condemned by subsequent experience as positively injurious; and all that medical science had gained by the appearance of the cholera in Europe, after long and close
observation, was a conviction, that it was a complaint which had not been witnessed before; that it began, where other diseases terminated-in death—and that it was beyond their skill either to prevent or to cure.— Temperance, cleanliness and courage were recommended as the surest safeguards, and sudorifics as the best remedies; but all their care and skill did not prevent its being a terrible scourge to the places laying in its destined course, nor could they save but little more than half of the objects of its attack.
As an epidemic, this spasmodic cholera is a plague of modern origin. In Hindostan spasmodic cholera has probably always existed, as a comparatively mild disease, affecting at certain seasons a small number of individuals in various parts of the country. But there is no evidence to show that it ever bore the epidemic character, previous to the beginning of August, 1817, when it suddenly broke out with unprecedented malignity. Commencing among the inhabitants of Jessore, a town 100 miles northeast of Calcutta, in less than a month it travelled along the course of the river to that city, having desolated the intervening villages. Before the expiration of August, the native population of Calcutta were attacked, and early in September the disease was also manifested among the Europeans.
From January to May, 1818, the pestilence raged with extreme violence, extending its destructive influence across Bengal, from Silhet to Cuttack; and towards
the interior, from the mouth of the Ganges to its confluence with the Jumna, a space including 450 square miles. Leaving Bengal, the disease retired for some time to the western bank of the Ganges and Jumna. In its most malignant form it appeared at Benares, where in two months 15,000 persons perished. At Allahabad forty or fifty died daily. To other locations, situated on either bank, the disease soon spread, and the mortality was equally great. In the district of Gorrakpore, 30,000 were carried off in a month. Then suffered in succession Lucknow, Cawnpore, Delhi, Agra, Muttra, Meerat and Bareilly. The cholera now directed its course across the Deccan, advancing in many instances at the rate of fifteen or eighteen miles a day, and remaining at various posts during a period of from two to six weeks. In this way it reached Husseinabad, where the mortality was frightful for several days. It then followed the banks of the Nerbuddah to Tanah, and afterwards traversed to Aurungabad, and Poonah. Taking the direction of the coast, it arrived at Bombay, August, 1818, having crossed the Indian peninsula in twelve months from the date of its appearance in Calcutta.
While the interior of Hindostan was submitting to this infliction, the pestilence had spread along the coast of Malabar and Coromandel, reaching Madras the 8th of October. In its progress here, a new and alarming feature was developed. The possibility of transporting the contagion by
sea, was evinced in its transit from Coromandel to the island of Ceylon. In Candia, the capital, it broke out December, 1818, with even greater violence than upon the continent. By the 15th September, 1819, Mauritius was included in the islands infected. The disease did not appear until after the arrival of the Topaz frigate from Ceylon, where the epidemic was then raging. The vessel at the time of sailing seemed healthy, but during the passage the cholera had appeared among the crew. In the adjacent island of Bourbon, the disease began early in December, 1819. During the last six months of 1819, the cholera, pursuing its route to the south and east, had also invaded the Indo-Chinese peninsula. Siam received more than a proportional share of misfortune. The contagion marched on to Malaga and Singapore. By the end of April, it was announced on the northern coast of Java. During May it extended with violence in the interior of this island. Cochin-China and Tonquin were invaded in 1820. In December of the same year, it entered China, beginning its ravages at Canton. Pekin admitted the enemy in 1821, and during that and the following year, the mortality was so enormous, that coffins and other funeral requisites were necessarily furnished at the expense of the public treasury, for the interment of the poorer classes.
We shall now describe the course, which the epidemic took to the north and west from Bombay, towards the confines of Eu
rope; and the route by which at last it was enabled to traverse the Russian empire. In July, 1821, through the intercourse maintained by ships trading between Bombay and Muscat, in Arabia, the contagion was exported to the latter. Here the disease destroyed 60,000 persons. Many expired ten minutes after the infection. The cholera now spread to different parts of the Persian gulf to Busheer and Bassora.
From the Persian gulf the cholera extended, inland, in two directions, following the line of commercial intercourse. On one hand it ascended the Euphrates, traversing Mesopotamia, into Syria; and the Tigris, from Bassora to Bagdad; on the other, the disease was propagated into Persia. In the city of Shiraz, the population of which is 40,000, there died 16,000 in the first few days. Extending through Persia, the pestilence visited several districts in the north and south of the kingdom. Ispahan escaped the caravans from Shiraz being prohibited from entering the city. The route that was substituted, lay through Yezd. This town paid dearly for the visitation, as 7000 persons were afterwards swept away by the cholera. During the succeeding winter, the pestilence became dormant, both in Persia and Syria. In the spring of 1822, the Syrian and Persian streams of contagion had their frozen energies restored to activity. They quickly spread in their primitive vigor: Mosul, Beri, Achtab and Aleppo were infected. In Persia, during Septem
ber, the disease spread to the northward of Teheran, throughout all Kurdistan and Tauris. In the spring and autumn of 1823, Diarbekr and Antioch were attacked, and the disease ravaged many of the towns along the Asiatic side of the Mediterranean. It also extended in an opposite course, attaining in the month of August, Baku, upon the borders of the Caspian Sea. At length, in September, it reached the Russian city of Astracan, at the mouth of the Volga. It first broke out in the marine hospital. From the 25th of September to the 9th of October, there died 144 patients, nearly two thirds of all who had been attacked. Vigorous measures were enforced by the authorities for checking the contagion, but it continued to manifest itself until the severity of winter had set in. During the ensuing summer it did not
In 1822 it re-appeared in Java, and carried off 100,000 people. After visiting Ternat, Celebes and Banda, in 1823 it first reached Amboyna. Afterwards it committed great havoc in Timor. For several years the cholera pursued its destructive course through China. After desolating several cities in Mongolia it reached the frontiers of Siberia at the end of the year 1826.
After the first invasion Persia had several returns of cholera. In October 1829, a very serious inroad commenced in Teheran, the royal residence. But the occurrence of winter stopped its progress for the time.
The contagion, however, was again resuscitated towards the middle of June 1830, in the provinces of Mazanderan and Shirvan, upon the southern shore of the Caspian sea. From the latter it passed through the town of Taurus and destroyed five thousand of its inhabitants. Crossing the Russian frontier it rapidly advanced towards the interior. The eighth of August it entered' Tiflis. The population was soon diminished from thirty thousand to eight thousand, by deaths and migration to avoid the distemper. In the meantime, by the first of July the malady had reached Astracan. The contagion, in penetrating to the heart of the Russian empire, from Astracan, pursued the course of the Volga, which spread its navigable waters over the most populous provinces. Considerable havoc was made among the Cossacks of the Don. The capitals of the several districts, between that, and Moscow were ravaged in succession. In that city the appearance of the destroyer was announced the twentyeighth of September, having travelled from Astracan, a distance of 900 miles, in less than three months. In Moscow energetic measures were instantly instituted by the government, to afford every assistance to the sick and to oppose the progress of the malady. By the tenth of November 6506 cases were returned, and the deaths amounted to 2908, or more than a half. In this place it seemed to take up its quarters for the winter, and issuing thence in the spring of 1831,