THE CAUSE AND GENERATION OF CHOLERA.
" Going into the pantry, he found the bread was not weighed out, as Is always done in union-houses. He saw no supply of salt in the dinner-room; but saw boys with sea in bags, bartering it for potatoes.' —Evidence of 31r. Winch at the Inquest on the Tooting Children. Spectator, 20th January 1849.
TO TILE EDITOR OF TRE SPECTATOR.
105, Pall Mall, 30th January 1849. Sea—The Tooting tragedy, appalling as it is in all its scenes and rising up to its catastrophe in a climax of horrors physical and moral, bids fair nevertheless to be bereft of its ample instruction, its impressive lesson, and its solemn warn- ing. The public indignation wholly concentred upon the stone-hearted indiffer- ence of parish Guardians, who farmed out the bodies of their pauper children to the lowest bidder, and upon the trading cruelty exhibited by that bidder, who first starved the children and then whacked" them for holding up their little hands against starvation, is led away from the fact, that these revolting revela- tions are not and cannot be the real generating cause of the Asiatic cholera. Cholera has more than once ravaged and is again ravaging countries entirely free from a similar reproach; and consequently, although the 1,400 children pent up at Tooting are effectually dispersed, no longer to see each other die in the pro- portion of 180 victims to 300 seized, no nearer approach has been made than be- fore towards shielding from the attacks of the same fell destroyer those numerous classes of the community who are predisposed to its influence as constantly and certainly as the Tooting orphans; but who, unlike them, are without the chance of having their decimation exposed before a coroner's inquest, traced to the heads and hearts of the real authors, and visited upon the persons of those authors by an unanimous verdict of " manslaughter." -It is this wandering from the vital point of the altogether extraneous existence of the Asiatic cholera, which induces me to trespass on your columns, in the hope that the public attention may yet be brought back to it, and may pause calmly to consider, unswayed by wrath or indignation, what is really known of this alto- gether modern and mysterious disease. The constant, uniform, unvarying, and indisputable facts exhibited by the his- tory of the Asiatic cholera are—that it first broke out in 1817, about thirty years ago, in the province of Jessore, an inland province of British India, situated. nearly in the heart of Lower Bengal: that, after carrying off in a few weeks a countless multitude of the population, it spread over the whole of British India like a conflagration ; everywhere consuming the hapless Natives, whose food in general is of the poorest kind, and almost exclusively vegetable: that European skill and medicine proved powerless in arresting the scourge, or even in checking its progress for a moment: that from British India in the South-east, the pesti- lence advanced regularly to the North-west of Asia, devastated that continent, thence it entered Europe, marched across this continent in the same direction, dealing everywhere death and destruction in a few hours: that in 1832 it crossed the sea to England; where its effects, although not so deadly as in foreign coun- tries, proved equally irresistible upon the vast majority of persons seized: that from England it took its desolating career over France and the South of Europe, until its final visitations embraced the whole world.
With one solitary exception, in every country which the Asiatic cholera suc- cessively overran its virulence seemed to wear itself out, and after a time more or less brief it abated, and in all of them its ravanr,es altogether ceased. The remark- able exception to this rule is British India. In that devoted country the cholera never dies: it has never ceased to rage in some part, from the hour of its first ap- pearance until the present time; and it is from British India, its perpetual seat— where every year exhibits some province containing a million or more of Natives ravaged by a more destructive mortality than that which made a charnel-house of the Tooting refuge—that the pestilence has again radiated ; again traversing the whole of North-western Asia and North-western Europe as it did before; until, after halting longer than usual in Russia it crossed simultaneously over to Hull and Leith, and has again manifested itself in London and in this country at the lapse of seventeen years, with nearly the same resistless intensity which charac- terized its appearance in 1832. It is plain, therefore, from these facts, that the superficial causes to which the Asiatic cholera is ascribed fail altogether in explaining its generation. Existing as the disease does in different countries situated wide apart, both in the torrid and in every region of the temperate zone; ravaging the population in turn where the thermometer stands at 110 degrees and at 200 below zero; spreading under every variety of climate, and under the most opposite atmospheric influences, pre- vailing in the Tropics during the violent periodical rains and in the dry and ele- vated steppes of Persia and Russia, where rain rarely falls —nothing can be more clear than that heat or cold, moisture or dryness, or the mere diversities of cli- mate or soil, cannot be the sole predisposing causes which generate the Asiatic cholera in the human body. As to open cesspools and uncovered drains, they existed for centuries in England before it travelled from India; nor did the miasma of the river Thames, although fertile in fever, e7er before produce Asiatic cholera. As to the want of cleanliness being the cause, the natives of India have ever been remarkable for their scrupulous daily ablutions ; nor can inadequate ventilation explain its perennial ravages among them, seeing that they dwell chiefly in the open air. This being the deduction arrived at from a wide and impartial observa- tion of the pbacnomena it presents, we are surely bound to inquire whether there is no other source to which the Asiatic cholera may rationally- be traced. A re- cent discovery in practical medicine, resulting from the refined analysis of the chemist, may lead by analogy to the detection of this source, and prove that the generating cause is no other than the vitiation, or the actual poisoning, of the mass of blood in the human body. The discovery in question is related in the Companion to the British Alinanack for 1849. ("On the Progress of Organic Chemistry," p. 64.) " Liebig, in his late work on the Chemistry of Food,' showed that, amongst the inorganic constituents of the flesh of animals, potassium was the distinguish- ing ingredient. This was contrary to the blood, en which the metal sodium was found in largest quantities. The statement of this fact led to a series of obser- vations by Dr. Garrod, of London; which are likely to have an important prac- tical bearing on the treatment of a very destructive disease. Shortly after the publication of Liebig's analysis, Garrod had his attention turned to the occurrence of scurvy in three public institutions in this country. On examining the dietaries of these establishments, they were not found to be deficient in good wholesome food; at the same time it was observed, that even where the dietaries were lower than these, no scurvy bad occurred. This led to the examination of
the inorganic constituents of the various dietaries, when it was found that those articles of diet which formed the dietaries of the establishments where scurvy had occurred, contained much less potash than those where scurvy had not ap- peared. This led to an analysis of the blood of patients labouring under scurvy; when it was found deficient in potash. This step was still further followed by the
treatment with potash of a person labouring under scurvy, Who got entirely well; and the examination of those substances, such as lemon-juice, and various other agents, which are known to arrest the progress of scurvy; when it was found that they also contained large quantities of potash." The passage in Liebig which led Dr. Garrod to his truly important discovery is as follows. "The constant occurrence of chloride of sodium (common salt) and
phosphate of soda in the blood, and that of phosphate of potash and chloride of potassium in the juice of flesh, justifies the assumption that both facts are alto. gether indispensable for the processes carried on in the blood and in the fluid of the muscles. Proceeding on this assumption, the necessity of adding common
salt to the food of many animals is easily explained, as well as the share which that salt takes in the-formation of blood, and in the respiratory process." (Che- mistry of Food, p. 108-9.) To explain the latter process, Liebig shows that a double decomposition takes place of the two salts, which imparts to the blood its alkalinity. He then observes—" Through the blood, the carbonic acid formed in the body is conveyed out of it, and the alkaline quality of the blood has a very decided share in its property of taking up carbonic acid ; as, on the other hand
the chemical nature of the compound, on which the alkaline reaction of the blood depends, exerts the most marked influence on the power of the blood, again to give off the carbonic acid which it had absorbed." (P.112.) Liebig further remarks, that inland plants contain no soda, and little common salt; while the same plants in maritime districts contain potash and soda. Reasoning from the facts here stated, and from the proofs established analyti- cally and synthetically, that a deficiency of potash in the food is the generating cause of a malady still occasionally so destructive to life as the scurvy, we should,
even as unprofessional persons, be morally assured a priori, that an habitual pri- vation of common salt, the substance shown tabs indispensable to the health of
the blood and to the vital action of respiration would be certain of eventually
engendering some fatal distemper among a population exposed to the want. In- dicative as the want would presumably be, either that carbonic acid was not
duly eliminated from the body, or that the blood had not the power to give off through the lungs the quantity of this active poison it had absorbed in circula- ting through the body, we should be prepared to hear that the distemper would assume some sudden and violent form. Applying this reasoning to results, we find that the Asiatic cholera first broke out among the population of Jessore; an inland population subsisting almost wholly on vegetable food of local growth, which as human food is deprived of an essential organic constituent, and therefore rendered necessarily dependent upon receiving from an external source an abun- dant supply of common salt necessary for health and life. In such a population, a distemper of the character of cholera would be predicated to appear the more certainly, if the predisposition to engender it had been long and systematically induced by their being forcibly reduced to a privation of salt.
In Jessore, as throughout British India' inland and maritime salt is a strict monopoly of the East India Company, and afavourite resource for taxation. Any na-
five detected in making a grain of salt for his own use is instantly seriously lined, or imprisoned for months. Specimens of the kind of salt which the Company suffer to be used in India were handed round for inspection at a public meeting held in London in May 1847, and elicited general surprise and disgust. The chairman, Mr. Wilbraham, late Member for South Cheshire, asked whether any per- son present would permit such stuff to be used in his house? Of such salt, bad
as it was' it cost, he said, a common labourer in India two months' wages, or one
sixth of his earnings, to obtain a bushel. So much for the quantity which the native with his wages of 261. a day can procure. Of its quality, the following is the description given in a memorial signed by 400 of the educated classes of Amore in 1843, twenty-six years after the cholera had been yearly decimating their families. "The monopoly of salt has caused vast misery to the country. The East India Company buy salt for 16d. to 18d. the mound, and sell it at 8s. or 9s. At the time of storing the salt, their native servants for their gain mix up one fourth of earth with it, while the merchants and dealers who afterwards purchase
it also add their share; BO that at last the people who are obliged to buy it for
consumption, find it one fourth salt and the rest earth. They are sometimes obliged to pay even higher rates 10s. to 128. a mound, for this horrible stuff." local European witness, referred to at the same meeting, thus describes the Company's salt monopoly. (" Missions in Bengal," by the Reverend J. J. Weft- brecht, p.26.) "One part of the revenue of Government arises from a monopoly of salt. Owing to this the poor natives can enjoy this necessary but sparingly; and whilst the coffers of the East India Company are thus replenished, hundreds of thousands of poor an weak Hindoos are debarred from the enjoyment, which the selfishness of their conquerors withholds from them. Thus they suffer from the privation of a healthful aliment, which under different arrangements they might plentifully enjoy. I have sometimes wondered at the grey colour of the salt in common use, till I discovered that the Native merchants who buy it from Govern- ment mix it with ashes, to increase their profits; and thus the poor are doubly de- ceived. And while one monopoly (of the Company) stints 100 millions of Hin- does of an essential ingredient in their food, a second, viz, that of opium, is poisoning 300 millions of souls belonging to a distant nation," (China). The testimony of this eye-witness showed, that at that time "hundreds of thousands of Natives were debarred" the use of salt. In 1844-5, the Directors raised their selling price 25 per cent. 111.proof of the nature and character of the Asiatic cholera, showing that it is an active animal poison exhaled from all the outer, and inner surfaces of the human body, and that this poison is arrested and destroyed by the diffusion in the air of a dwelling, of chlorine gas, the active constituent of salt, I adduce the evi- dence of a distinguished English chemist, Mr. William Ilerapath. In a letter dated Bristol, 11th October 1847, addressed to the Times, when the present ad- vent -of the cholera was threatening, he says—" During the visitation of this horrible malady in 1832, I laid myself out, as a chemist, for a close examination into the cause, mode of propagation, and check for it. For some time I attended almost daily at the cholera hospitals, and experimented in every way I could think of upon the dead and living subjects, their contents and ejects, the atmosphere surrounding them, and their articles of clothing. The conclusions I arrived at, I forward for the information of those who have not bad the same opportunities. "1. The cause of cholera is a putrid animal poison, capable of being recognized by the smell by some persons emanating from and surrounding the dead or living cholera subject, or articles persons, "2. The poison is not sulphuretted hydrogen, nor hydrosulphuret of ammonia, as it does not decompose salts of lead or zinc and when passed through Lignite of silver, it only forms a red-solution when exposed to light.
"3. It is only received into the living body through the lungs, and cannot be propagated by inoculation.
"4. Infection can be conveyed by articles of clothing, bedding, &c.; and from this oause washerwomen are more subject to it than other persons. "5. All persons are not equally liable to infection from equal exposure, and even , the same individual becomes more sensitive under certain circumstances.
"6. The poison is destroyed by chlorine gas and a heat of 300 degrees of Fahrenheit
"Remedy. A mixture of three parts of common salt and one of black oxide of manganese should be placed just inside the outer or street-door of the dwelling. house, and a little common vitriol poured upon it. The inward current of air will convey the chlorine gas to every part of the interior; and wherever the gas can be
smelt, the miasm is destroyed. I invariably passed fltrough an atmosphere of the gas on my return home, and kept it escaping in my residence during the con- tinuance ot the disease in this city.
" A Bristol druggist was kind enough to distribute from me 1,200 quantities of the anbstances necessary for the evolution of the gas, to applicants for three days, with instructions for the use; and I am happy to say that daring that time the. deaths fell front ten to one per day. Houses should be fumigated with it time, times a day."
Another correspondent of the Times, of the 16th September 1848, thus points out the free use of salt as an effectual preservative from cholera—" A writer in a weekly medical journal, who saw much of the cholera in 1832 and 1834, suggests a very simple, and, as he asserts, a very valuable prevention against the sus- ceptibility of the disease. The weakened state of the stomach, which, lie says, predisposes to cholera, is so decidedly obviated by eating freely of common salt with our meals, that it is believed that three-fourths of the cases which would otherwise occur, may be prevented by this simple addition to our food. The wri- ter recommends for an adult the ninth of an ounce (about a small teaspoonful) three times a day, at breakfast, dinner, tea, or supper."
In the Symptoms and Treatment of Asiatic or Malignant Cholera, pub- lished in 1834, by Dr. Marsden, of the Greville Street Hospital, there is appended the following table, page 55— Comparative View of the rarious Modes of Treatment adopted in Cholera, within the furl's-, diction of the City of London Board of Health; transmitted by Mr. F. de Grave.
Bees- Deaths Recoveries Oases Deaths. series, per cent, per cent.
Calomel and opium 196 .... 112 .... 84 . • .. 57.14 • • 42.86 Opium 81 Calomel 75 Stimulants 63 Combination of salts pro-1 posed by Dr. Stevens f Combination of salts used
at Greville Street Hoe- 26 • • • . 8 . • • . 18 . • • • 80.77 . • • • 69.32
pita Venous injection, in ditto 20 18 • . • 2 . • .. 90. .... 10.
The combination of salts which made Dr. Marsden's treatment so eminently. successful over seven other modes tried in 1832, was, common salt 2 drachms, carbonate of soda 1 scruple, oxyrnuriate of potash 7 grains. He also found the cramps of cholera "greatly relieved by a hot salt-water bath." (P. 43.) Such is- the experience in England of distinguished professional men of the efficacy of salt as a preventive of cholera, and of its curative power over the disease, whether ex- hibited internally or externally. Let us turn to the Continent. The Times of the 2d December 1847 details, from the Prussian Universal State Gazette of the 17th November, the progress of the cholera throughout the Russian empire. Among other facts exhibited, it is stated, "that in 1830, the pestilence spared the colony of &septa, although' the communication of the latter had never been prevented; a fact which cannot be ascribed to the position of Sarepta, for it nowise differs from that of the other localities watered by the Wolga. The inhabitants are industrious, in comfortable circumstances, and remarkable for their cleanliness and sobriety: they descend from a Merman colony founded in 1766, in a country full of' salt springs."
Captain V. Motchutski was officially employed by the Hessian Government to observe the cholera in 1847. An extract from his report is quoted in French in the Prussian State Gazette—" The following treatment was pursued in Southern Russia, and gave six cures out of nine seizures. If the patient vomited, he was made to swallow at a draught a tablespoonful of common salt dissolved in a glass of cold water; and the dose was repeated if the vomiting did not cease in an hoar." "In the town of Berdiansk," says the Paris Constitutionnel of the 2d December 1847, "situated on the Sea of Azoff, frictions were made with a sheet moistened with a strong solution of salt, and were often attended with a good re- sult. Baths in the water of salt marshes were very efficacious." In 1848, -Dr. Adair Crawford was deputed by the Government to St. Petersburg to report open. the cholera raging there; and in August the Sanatory Commission published "his Observatioos." Dr. Crawford states—" Common salt was used hogt. Peters- burg in 1831 as an emetic, in doses of two tablespoonsfula in about half-a-pint of hot water, and repeated if necessary: the salt was then continued in smaller doses about every hour. The results of this treatment were highly commended by the two practitioners who employed it, as checking generally the progress of the disease by promoting bilious vomiting. A similar plan was reported by Dr. Pith:lack to have been pursued by him with very great success in London in 1832."
To go back to India. I inherit in the South-western part of it a property where ray family has lived for more than fifty years. Upon it there is dwelling a labouring population of all ages and sexes, of about .2,000 persons, who were subjectlo my daily observation for many years. Every case of illness occurring among them was and is regularly reported. Amid this i
population, placed appa- rently in exactly the same external conditions as their neighbours n the adjoin- ing parishes, I am prepared to prove that in no instance did the cholera ever break out spontaneously, as it often did, and continues to do, among the latter; rarely when introduced did-it prove fatal, never fatal when the remedies kept at band were resorted to within two hours of the attack. Forcibly struck with this immunity (akin to that of the colony of Sarepta) enjoyed by my labourers and their families over their friends and neighbours around them, I gave to its exami- nation long and patient attention. The conclusion to which I was compelled to arrive in India was, that their remarkable exemption from the pestilence arose from no other assignable cause, than their being duly and _regularly sup-, plied with a sufficiency of salt requisite for health ; while the Natives, among whom the cholera broke out and raged more or less frequently, were often forced to go altogether without that necessary. That con- clusion every subsequent inquiry made in England has fortified into as deliberate conviction. In proof that it is not adopted for the nonce, I can refer to a pamphlet which I wrote in June 1847, before the pub- lication of iiebig's work on Food, and long before the return of the cholera to this country. In corroboration, I can cite the case of a friend who was saved from death when in the spasms of the disease in October last, by the external ap- plication of salt; and I cite this further remarkable confirmation, that although the Natives aronever free from it in India, therein rro instance on record of the cholera having been generated spontaneously, and breaking out among the many' thousand Coolies when they have left India, and have been transported to Mauritius and the numerous islands of the West Indies. From all these facts and observa- tions, I myself can no more doubt that the salt monopoly of the'EastIndia Com- pany is the real, primary, generating cause of the Asiatic cholera—that plague which is desolating the world—than I can doubt of my own existence. When generated, its propagation comes under the same mysterious law which diffuses and spreads abroad all epidemics—the smallpox, typhus, plague. But although I venture to declare my own sentiments thus strongly, because it would be a crime to withhold them after the hecatomb of little victims sacrificed- at Tooting, my only desire in the facts I have brought together is, to arouse the' attention of vigilant observers; and my only hope, -that intelligent practitioners will be led to test their accuracy by multiplied and varied experiments upon the blood and vital organs-of cholera victims.
In another letter I will show, with your leave, that the East India Company's salt monopoly is unnecessary as a tax, even if its imposition were susceptible of justification; and that it is consequently an engine of pure, gratuitous.; daily cruelty upon millions of-men. .