TOPICS OF THE DAY.
DOCTORS RUSSELL and BARRY are, it seems, about to favour the public with a continuation of their Report and Observations on this absorbing subject. In the meanwhile, the Globe of Thursday evening has supplied us with the conclusions to which these gentle- men have come in respect of the object of their medical tour. They are as follows.
" First—That the germs of the disease were brought to St. Petersburg by the boats and barks which arrived from the interior this year previ- ously to the 14th (26th) of June. " Second—That those germs were diffused and the disease propagated in two ways; one, which may be called personal, by the dispersion over the whole city immediately after the arrival of several thousand passen- gers and boatmen, who had come from infected places, or had been ex- posed to infection in the passage or on board these vessels. The other, which may be termed atmospheric, by emanations from the barks, and their contents suspended in and carried by the currents of air to susceptible per- sons, independently of direct communication. "Third—That the germs of the same disease were carried to Cronstadt, and propagated there by boats and lighters which had been loaded di- rectly from the barks already mentioned, by persons who had recent communication with these barks, or had been in their immediate neighbour- hood.
" Fourth—That the disease was introduced to all the villages round St. Petersburg, in which we have been able to obtain authentic intelligence of its progress, by persons directly from the city, or from other infected places. " Fifth—That neither the near approach nor the immediate contact of an infected individual were indispensible to the infection of a healthy individual susceptible of the disease at the moment.
" Sixth—That the epidemic of St. Petersburg did not possess those ab- solute and indiscriminate communicable qualities attached to the plague and small-pox, and that the risk of the infection incurred by the healthy had been accompanied by shelter from currents of air passing through sources of infection.
' Seventh—That in a generally infected atmosphere, the additional danger of infection incurred by approaching one or more individuals labouring under this disease, was not greater than would accrue from ap- proaching one or more typhus patients under similar circumstances.
" Eighth—That under favourable circumstances of body and mind, per- sonal seclusion did not afford protection against the disease, more particularly if that seclusion had been accompanied by shelter from currents of air pass- ing through sources of infection.
"Ninth—That those continued exempt from the disease who retired from and avoided communication with infected places, and those who re- sided to windward of, and those who were protected from the currents of air passing through such places: that the next in point of immunity were those who, though living in the midst of general infection, avoided large accumulations of sick placed in confined atmospheres—the young, the vigorous—those who could afford to live well, yet live temperately. In short, those who were placed under circumstances the most favourable to health, cheerfulness, and comfort of every kind."
The Globe, in giving to its readers the quintessence of Rus- SELL'S and Baaay's investigations, indulges in a humorous lamentation over the conflicting theories of physicians in general, with an appendix of extreme bitterness against certain very pas- sionate gentlemen who deny that the cholera is contagious. We share, m a moderate way, the Globe's objection to passion,— though we cannot allow that, among doctors who disagree, passion is invariably confined to one side ; but even were it confined to the anti-contagconists,—who take, we admit, the disagreeable side of the argument, and have commonly too little respect for the fears and the fancies of humanity,—still, we are disposed to think, non- sense is not a whit more respectable than passion. Now—we whis- per it with deference—the above conclusions of Doctors RUSSELL and BARRY, which our contemporary lauds, look to us as like sheer nonsense as any argument of the anti-conta,g:ionist species we ever happened to investigate. Whether a disease is or is not communi- cable by personal contact, or by breathing the same air that is breathed by the sick, is a matter which, we may suppose, admits of at least an approximate proof; but when to this source of infection is added, infection produced " by currents of air passing over barks and their contents," it seems evident that the object of the writer is to prop up a theory, which, without so unintelligible a hypothesis, could not be supported. Doctors RUSSELL and BARRY go to St. Petersburg to inspect the cholera, and they find cases where the patients have been placed in contact with other patients ; and so far all is clear before them ; but they find other cases in which no contact had existed. The plain conclusion in such a case, would be, that cholera might be self-generated at St. Petersburg, as it pretty notoriously was at Jessore ; and that it was also communi- cable from one patient to another. But this double origin—though we believe it holds true not only of cholera, but of many other diseases—is destructive of the main principle of the contagious theory ; and hence the necessity for a hypothesis of cholera cling- ing to the deck and timbers of a Russian barge, until it arrive at some fated village or town to which it may be wafted by aerial currents.
The choleric barks are not, however, the only absurdity in these conclusions. We are told, in the third, that no one caught the in- fection unless he had been in the immediate neighbourhood of the generating point; while, from the fifth, we learn that a near ap- proach is by no means necessary; the sixth carries us still farther. We had contact and currents of air before, but it appears from this conclusion, that shelter from both is unavailing. A man may take the disease though he neither see nor touch a patient, and although no current of air from an infected place ever come nigh him ; nay, according to the eighth conclusion, the very fact of being sheltered. from. such a current will but augment his insecurity ! Alikiretwe are NA the,tegiong the causes of immunity are to be included, " living to windward and being protected from currents of air passing through infected places !" Is there any thing in the Unknown Tongue equal to this ? So much for the Doctors RUSSELL and BARRY,—excellent and learned physicians, it is to be supposed, from the office they hold, but, apparently, slenderly qualified for sifting evidence and drawing conclusions. The great question, however, is not whether cholera is conta- gious or not, but how are we to manage it, now that, notwith- standing all our attempts at barring out, it has come among us ? Of the way in which the quarantine has been kept, a good deal has been said. We honestly believe, that it has been kept as well as quarantine is ever kept. Common sense revolts so strongly against the confinement for three or four weeks of men in perfect health, without any obvious or intelligible reason, that they are never so confined. Where actual sickness is on board a vessel, we believe the regulations are pretty strictly insisted on ; where no sickness exists, they never have been, and never will be. The vessels by which it is alleged the cholera was brought to Sunder- land, only attracted attention after it broke out there ; no one thought of isolation before. We ourselves saw, on Tuesday last, four yellow flags floating in Ramsgate harbour, in the midst of three hundred vessels, without any visible means of preventing inter- course between all of them. If vessels coming from a suspected port were subjected to a medical inspection, and if such of their crews and passengers as were in health, after a careful ablution and fumigation if necessary, were permitted to take the mail as their letters are, the public would have all the security it ever can have, and no personal inconvenience would be the result. But the twenty-one clays' quarantine is an easier-applied remedy; it re- quires no thought—that bane to the peace both of the makers and executors of law.
'We who, being the greatest naval power in the world, and pos- sessing the most active and numerous coast guard, are most capa- ble of enforcing it, have seen the inutility of sea quarantine ; is land quarantine more efficacious ? Russia, with a population of ma- chines rather than free agents—an army which obeys and mur- murs not—functionaries disturbed by no considerations of reason or mercy towards the public or individuals—triedland quarantine, and failed. What is the conclusion from all this, but that cholera, be it contagious or non-contagious—whether it travel by " the highways of human intercourse," which the' one party aver, or as the crow flies, which is the opinion of the other—cannot be shut out by legal enactment—that it will be in if all the world gainsaid it? Does not every principle of reason, then, as well as of fear, dictate to us that we should prepare like men to grapple with the enemy whom our long balls cannot reach ? All the doctors seem to agree that filth, cold, damp, famine, or bad food, are predisposers to cholera. Let us, then, heartily and rationally, and in a kind spirit, set about the removal of filth where it is matter of public nuisance, and the counselling of its removal where it is purely domestic. The poor are the most per- suasible of all persons where they have no suspicion of the adviser. They will demur to the beadle, with his mop and pail and big looks; but let a respectable neighbour only point out calmly the danger to themselves and to others from accumulations of nasti- ness, and there will be an immediate flourishing of brooms among the laziest and most apathetic of the race of Maclarties that hive in Dyot Street. For cold and damp, and bad food, the remedy lies in the purses of the rich. Let them be freely opened. Flannel waistcoats for the men, flannel petticoats for the women, a blanket for their beds, a bag or two of coals for their chimnies, a bit of meat for their pots,—these are quarantine regulations which have never failed of effect, because those who are subjected to them have no interest in evading their application. Let us have boards of benevolence in the first place ; and let the boards of health fol- low when they are called for. The poorer class are at present set against the rich ; they are taught by " errant " scoundrels, who speak to their sufferings, that not only the upper but the middling classes are their natural ene- mies and oppressors. Let the rich by their gifts, and the middling classes by their labours of love, prove in the most effectual way the falsehood of this monstrous doctrine. Let them oppose to the oratory of the Rotunda the prevailing voice of warm-hearted Cha- rity; while HUNT declaims about political disabilities, let them apply a ready remedy to physical evils, and instead of noisy ap- plause bestowed on those who inveigh against the rich, there will be hisses as hearty as ever visited the ear of a boroughmonger or a political bishop. If when we have blankets for every bed, shoes and stockings for every pair of feet, and, as far as we can, a mor- sel for every mouth,—if when sewers are dug and cesspools drained, cholera does come to us, as perhaps it will, then we may safely say, even to that most formidable physical affliction, "Re- joice not against us, 0 our enemy !" On the subject of medical treatment, it belongs not to us to speak. When the disease has once shown itself, in a large town where there is a doctor in every street, common sense says that the wisest course is to call for his counsel. As, however, the cholera is extremely rapid in its strides, and as preliminary mea- sures of cure are quite capable of being taken by the members of the patient's family, we may be excused for giving from an excel- lent authority * the following simple directions.
" Although safety is scarcely to be hoped for in the absence of a pro- fessional man, it is nevertheless of great importance to point out to the
• " Letter to Sir Henry Raiford, by George Hamilton: Bell, late Residency; Sur! aeon at Tanjore." Illacknetogadinbtrgb.. friends of the patient what steps may be safely taken between the ac. cession of the disease and the arrival of the physician, The patient ought to be immediately placed in warm blankets, and surrounded with bottles of hot water, bags of hot sand or salt; and every other means of applying dry heat which may be within reach, ought to . be resorted to. The whole body ought to be rubbed with hot flannel, and the belly should be covered with mustard poultices, which should also be applied to the calves of the legs.
" I have seen so little good to result from the application of the hot- water bath, that, even if it should be at hand, I should not imt a patient Into it. One great objection to the application of hot water is the fatigue tvhich it occasions the patient, besides, that any benefit attending it is trenerally neutralized by the difficulty of drying the body, or by the eva- poration which takes place during that process.
" Laudanum is usually to he found in every house, and certainly ought to be so during the prevalence of this disease ; but the friends of the patient must be cautious of administering it in large doses without the sanction of a medical man. A tea-spoonful of laudanum, added to six table-spoonfuls of brandy, may be ,prepared, however ; and one table- spoonful of this mixture may be administered in half a wine glassful of hot water every quarter of an hour,—five drops of essence of peppermint and ten drops of sulphuric ether being. added to each dose of the brandy and laudanum. In case the stomach reject the liquid, pills containing three grains of camphor and half a grain of opium may be given; and if the irritability of the stomach be so great that it rejects all that is swallowed, a warm glyster of arrow-root, with a tea-spoonful of laudanum in it, should he injected into the bowels.
" As a measure of precaution, all these remedies ought to be at hand ; but in towns, of course, medical attendance will probably be obtained in time to admit of their being applied under sanction of a professional man.
" Early bleeding is of so much importance in this disease, that, if pos- sible, it should be resorted to even before the arrival of the reo.ular me- dical attendant of the family. The rule is to bleed until the blood, which is black and thick when a vein is first opened, assumes a red and more natural colour, and until the oppression of the patient is relieved. In the course of my practice I have always found that the danger is, that too small rather than too large a quantity of blood is removed."
With respect to hospitals for cholera, though we would not ad- vise their being dispensed with altogether, we fear, from the rapid course of the disease, they will be of small use. For the other rezulations of the Privy Council—their boards, their isolation, their surveillance—they are an utter abomination. Were they as practicable as they are the contrary, they would redissolve society into its savage elements, and perish in the process every spark of religion and humanity as well as reason. Luckily, however, though old women may make rules, rules will riot act of them-