Note on the epidemic connection of the cholera of Madras and Bombay with the cholera epidemics of the Bengal Presidency. / By James L. Bryden.

  • James Bryden
Date:
1871
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Licence: Public Domain Mark

Credit: Note on the epidemic connection of the cholera of Madras and Bombay with the cholera epidemics of the Bengal Presidency. / By James L. Bryden. Source: Wellcome Collection.

Provider: This material has been provided by Royal College of Physicians, London. The original may be consulted at Royal College of Physicians, London.

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    time when the cholera appeared it is stated that the atmosphere was generally cloudjj and the wind blew steadily from the south-west. There are many points to be taken into account before we can pronounce an opinion on this cholera of Jaulna of 3rd July, which was beyond doubt a detachment of the coming- epidemic thrown forward in advance of the general invading cholera of the middle of July; and we are not now in a position to estimate the actual truth. As far as Scott's narrative tells us, the cholera of Jaulna was a nine-day cholera, commencing on the 3rd and dead on the 11th July, and general during the time that it lasted, for various bodies of troops leaving Jaulna during the period suffered heavily after having been for some days on the march. I can judge of its significance only by the facts recorded, and by the parallels of modern times which seem to me to teach a similar lesson. I could offer many suggestions in explanation; I offer but one, namely, that this nine-day cholera of the 3rd July was not an invading cholera, but was a cholera which culminated at this date. We know the date at which in the area occupied in May 1818 a cholera is revitalised and adapted for epidemic invasion. It appears after the 20th June; and no doubt cholera was generally prevaihng in the spring area subsecjuent to the invasion of the second week of July. There was, apparently, no rainfall at Jaulna from the 20th June to the 3rd July when the cholera broke out; but we read—Since the middle of June, when several heavy showers had fallen, the weather had been cool and pleasant, the thermometer ranging from 80° to 88°, seldom varying more than 4° in twenty-four hours. If the showers of June were from the north, as is very likely to have been the case, and if with this meteorology cholera was introduced into the Jaulna district, .the 3rd July is the very date on which the cholera then distributed would culminate through- out the district, and the steady heat would in every way be conducive to its growth. The parallels which teach us that this explanation may possibly be the true one are the invasions of the Peshawur Valley in 1867 and 1869.* The cholera invading on 19th May 1867 culmi- nated in the first week of June, and the cholera of the first week of September 1869 culmi- nated universally on the evening of the 18th.t Regarding the third and last case to which Mr. Cornish invites attention, I have only to observe that the cholera occurred at first among camp-followers only, and that in all probability some conditions existed special to this body. The argument that the wind was blowing in Hoobly from the south-west at the date of this special attack, is of no weight as leading to the deduction .that at this time the district was invaded; for we I'ead in immediate context— Neither Hoobly nor any of its adjacent villages had at this time become affected. Of this we may be sure, that when Scott and Jameson say that ninety-nine out of each hundred cases were consistent with the presumption that the cholera of 1817-18 moved in subjection to aerial agencies, the failure to harmonise the facts observed in the hundredth case, is to be accounted for not by the antagonism of the facts, but by the inability of the observer correctly to determine the epidemic relations of what has occurred before him. 36. What I would recommend is, that the invasions of the Madras Presidency should be How the natural history of the recorded, as Scott has recorded the history of the epidemic of • epidemic should be studied in the 1818, and that the phenomena of advance should be mapped Madras and Bombay Presidencies. irrespective of theory. We find no difficulty in mapping out year by year in simple sketches, the area covered in our Presidency, and we know these, dia- grammatic as they are, to represent the truth as regards areas occupied. If they are incorrect, those who have a theory to snstain to which the details of geographical distribution as given are opposed, are at liberty to object to their accuracy. As they stand, they bear oat the definite proposition which I maintain, that cholera falls upon natural areas, and that these natural areas can for any year be definitely mapped out. Nature does not shape her epidemic lines to a theory which is false; either the lines are falsely delineated, or else they stand as representative of grand truths—whatever be the significance to be attached to the rigid and provincial demarcation. Tlie truths which I have mapped are either no truths at all, or else they place before our eyes epidemic facts of the broadest and most definite character. I offer no apology for my geographical delineations. I know that they stand true for all time to come, because they interpret to us the action of agencies which are natural and above human control. I am well aware that it is diflScult to put on one side, even for a time, the strongly impressed conviction that the movement of cholera cannot take place without the intervention of man. The study of three fundamental laws will, however, tend to lessen or remove this difficulty—• First, the law of the succession of epidemics. This teaches the doctrine universally admitted in India, that in what we recognise as a new epidemic, it is a fresh material which * Sequel, p. 50. t I have noticed the fact that the years 1813-14 were famine years in Northern India (Givdlestone, paras. 44 tO' 50), and I might have brought forward this as an additional illustration of famine in Northern India, coupled with an invading cholera in Madras ; for Jaulna was struck by cholera in 1814, in the epidemic preceding that of 1818. As in 1859, this tract was included in the May province. We know nothing of the monsoon extensions of the cholera of 1814, hence I have not included this invasion with those enumerated in the preceding paragraph. It is worth while to keep in view the possibility that the Jaulna District, immediately bordering on the area occupied by the inviding Cholera of May, may have received, in common with the districts lying to the north, a portion of the spring Cholera of 1818 ; in this case, the fact of the Cholera of 3rd July being a revitalised, and not an invading Cholera, would satisfac- torily account f<ir the phenomenon of manifestation in advance of the general invasion, and with the meteorobgy des- cribed as prevailing at the time of the outbreak.
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