CHOLERA AND INFLUENZA.
Fxw records of human power are more striking than that pre. sented in the Second Report of the Metropolitan Sanatory Com. missioners. They 'may be said to show that they have those ter- rible visitants Cholera and Influenza within their grasp, and to have rendered both amenable to authority. The medical reader will refer to the Reports of the Commissioners, and to the origi, nal documents which they quote : it would be out of place here to attempt scientific precision, and we shall only endeavour to explain, in popular fashion, the kind of results that the Cem_ missioners have attained, and what remains to be done. With an industry minute and comprehensive, they have collated evidence from all quarters, abroad as well as at home; and the results are most important. The intimate nature of the two diseases, like that of all others, will probably be for ever hidden from our per. ception ; but the Commissioners have established the nature of the conditions which must be combined in order to the develop. ment of the maladies, and the still more important fact that some of those conditions are within human control ; so that if requt site authority be granted, it would be quite possible in this coun- try to forbid that combination of causes, and thus to prevent the existence of either of the formidable epidemics.
Cholera is by no means the sudden and irresistible disease which it is supposed to be : to describe it broadly and popularly, it is no more than the common disease diarrheas developed to monstrous form by a peculiar state of the atmosphere,—an accu- mulation of moist exhalations with sudden changes of tempera. ture. In like manner, Influenza may be described as ordinary catarrh or " cold," developed by similar causes to a fatal epidemic. Influenza visits the same spots as cholera, and has preceded, ac- companied, or followed other great mortal epidemics. Influenza is more fatal than cholera.
"Towards the latter end of November, influenza broke oat, and spread sud- denly to such an extent that it is estimated that within five or six weeks it at- tacked in London no less than 500,000 out of 2,100,000 .persons. Altogether, the excess of mortality in 1847 over the mortality of 1845 is 49,000; and in the Metropolis there were within eleven weeks 6,145 deaths above the ordinary num- ber,—an excess greater than the entire mortality produced by the cholera in the twenty-one weeks during which it prevailed in the year 1832.'
The frightful character of cholera is the rapidity with which it destroys: another cause of its fatal influence is that it often makes its approaches insidiously, without pain. But in its pre- monitory stage it is a disease that readily yields to medicine—to aromatics, opiates, and astringents. During the prevalence of cholera, the slightest manifestation of that premonitory disease should not for a moment be neglected: diarrhcea is inchoate cho- lera—cholera in its eurable stage.
The predisposing causes both to cholera anti influenza are hu. mid exhalations and sudden, alternations of temperature. Even the effects of temperature may be modified by human agency ; but in most habitable spots the humid exhalations are greatly to be controlled. London, which has been so severely scourged by cholera and influenza, is dotted, intersected, and surrounded by an immense aggregate of bad drains, open ditches, stagnant pools, waste grounds, marsh and forest lands—all active sources of pestilential miasmata : all those sources may be abolished ; and what is more, every improvement of that kind " pays," by the improvement of the neighbouring property. The general effect of the Commissioners' report, then, is, that the march of cholera may effectively be resisted by medical treat. ment, administered at the earliest stage of the disease; that is may be mitigated ; and that by diligence and compre- hensive measures the predisposing causes of both epidemics may be removed. In order to such a combination, it is necessary that each district at least should be brought within one harmonious plan of proceeding ; and that necessity applies with singular force to the Metropolis. Some attempts are still made to exclude cer- tain portions from the general authority ; the City Corporation, for some old prejudices or some blind fear of expense, desiring to retain its privilege of exemption. A deputation waited on Lord Morpeth, last week, to petition for the abandonment of the bill which is to bring the City within the general authority : but we are glad to see that Lord Morpeth was firm. He should not have consented even to delay : time, tide, and cholera, wait for no men; and no time should be lost in filling up that great hiatus which the City as yet presents in the plans for opening the campaign against " death-dealing pestilence." At all events, the delay should be very brief: if the City demands a little longer enjoy- ment of its right to forego and obstruct the measures for rendering the Metropolis more healthy, let the dangerous compliment be as much abridged as possible. It is to be hoped that Lord Mor- peth's proverbial good-nature will not go so far as to concede any obstructive delay to the literally pestilent heresy of the City. The Sanatory Commissioners, to whose appointment he so much contributed, have shown that, terrible as the two epidemics are, it is within human and even within official power to grapple with them effectively ; and the public will be very ill contented if the Corporation, however worshipful, be permitted to hinder the ad- vance of the public measures against those terrible enemies.
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