Cholera in Jamaica / copy of a letter from C. Macaulay esq., Assistant Secretary to the Board of Health, to F. Peel esq., Under Secretary of State.

  • Great Britain. General Board of Health.
Date:
1853
Catalogue details

Licence: Public Domain Mark

Credit: Cholera in Jamaica / copy of a letter from C. Macaulay esq., Assistant Secretary to the Board of Health, to F. Peel esq., Under Secretary of State. 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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    APPENDIX. APPENDIX (A.) A Message from his Excellency the Governor, enclosing Copy of a Letter addressed to his Excellency by Dr. Gavin Milroy, one of the Medical Inspectors recently sent out by Her Majesty's Government to the West Indies. [Sent down to the Honourable House of Assembly, April 22, 1851.] Mr. Speaker. I am commanded by his Excellency the Governor to lay before this Honourable House a copy of a report which has been made in the form of a letter addressed to his Excellency by Dr. Gavin Milroy, one of the medical inspectors recently sent out by Her Majesty's Government to the West Indies, as the result of his observations during a tour of inspection through the island of Jamaica. (Copy.) Sir, Kingston, March 31, 1851. Having completed the tour of inspection round the island, according to the route which yom' Excellency was pleased to recommend, it now becomes my duty to submit to your consideration the general results of my observations and inquiries, more especially in reference to the causes Avhich have, in my opinion, mainly contributed to render the visi- tation of cholera so virulent and fatal in Jamaica; and at the same time to suggest such measures as seem to me best suited to prevent, under the Divine blessing, the recurrence of a like disaster, and to ameliorate the general sanitary condition of the country. It does not belong to my present communication to give any account of the mode of the introduction, or of the circumstances connected with the earliest manifestation, of the pestilence in the island, nor to trace its progress from where it first appeared to other places, as I have not yet commenced the inspection of Port Royal, Kingston, or Spanish Town. The cholera has exhibited in Jamaica exactly the same leading characters, which it has displayed in the different countries of Asia and Europe which it has visited; not only the eame symptoms, and the same terrible virulence when unopposed in its early or premo- nitory stage, but also the same preference for certain sorts of localities and dwellings, and a like excessive fatality in such localities and dwellings, while others, which are differently situated or conditioned, iiave nearly or altogether escaped. Whatever obscurity may hang over the primary cause of the disease, and however little we are acquainted with the laws which regulate its diffusion or migratory course, whether upon a great or a more limited scale, universal experience has most clearly made known,— and it is this which concerns us most, and which should mainly engage our attention,—that, whenever the choleraic poison is abroad in the atmosphere of a district, there are certain local causes or conditions which will inevitably favour its development, and give activity and force to its operation. It is on a right appreciation of the influence of these local circumstances, with a view to their correction or removal, in conjunction with the pro- vision of proper medical assistance to the mass of the people when attacked, that any reasonable hope can be entertained of greatly lessening the ravages or arresting the progress of a disease like cholera. By far the most potent of the favouring causes is an impure or contaminated state of the atmosphere which is breathed. The contamination may proceed from one of two sources: —1. Either from the admixture of the effluvia arising from decomposing animal and vegetable matters, whether the decomposition be attended with any offensive smell or not; 2. Or from the very changes which the respiration of living beings is continually effecting in the air around them, and which necessitates its constant renewal for the support of life. It is of importance that this twofold source of atmospheric impurity be steadily kept in view, in all inquiries respecting the outbreak and spread of epidemic diseases. Both causes are very often, nay generally, associated together in full force in the dwellings of the poor; but in public institutions, such as prisons, lunatic asylums, &c., the action of one is usually predominant. The overcrowding in such places, and the utter want of proper ventilation, too clearly shows how little attention has usually been paid to one of the most important points in the preservation of public health. The general result of my observations in the towns and villages in Jamaica, which I have visited, with respect to the influence of putrescent effluvia in localising the cholera, and in aggravating its virulence, is entirely in accordance with the large mass of evidence on the subject contained in the report of the General Board of Health in England, a good many copies of which I have circulated among the medical practitioners in different parts of the island, and from the general knowledge of whose contents much advantage may be anticipated. Without citing any particular instances, I may remark that the main stress of the disease has almost invariably fallen upon those spots or localities which are the most filthy and neglected, and where most nuisances exist. In a hot climate, where the process of decomposition is much more rapid, and the amount of decaying matter is much greater