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.

    14/142 (page 10)
    Staff Surgeon Williams, in his report from Barbadoes during this quarter, alludes to the rains continuing much longer than usual. *'In former seasons, *' the fall of rain has been, I believe, generally found to lessen very consider- ably, if not wholly to cease, by the month of September; but to judge from present appearances (Oct. 13th), there is no reason to expect an immediate cessation of the wet season, as the fall is now quite as frequent and abundant as at any period of tiie last quarter. During September there was a great '* deal of lightning and thunder, and there was a considerable prevalence of southerly winds, much more than is, I think, usual. Before proceeding to relate the history of the visitation of epidemic cholera in Jamaica, it will be useful to notice, first, some very interesting circumstances in the health of the troops in the other British West India islands, and more particularly in Barbadoes, where several fatal cases of apparently the malignant disease occurred prior to the appearance of the pestilence in Jamaica. The facts are of course derived from the official reports of the medical officers. During the quarter from the beginning of July to the end of September 1850, there was a greater amount than usual of febrile and bowel complaints among not only the troops, but also the civil population, in most of the Windward and Leeward Islands. Although these disorders were generally of a slight descrip- tion, the peculiarity was observed everywhere, that an extraordinary *' degree of debility was left which made convalescence tedious and protracted, with a predisposition to relapse, such as the mild character of the previous symptoms would not have led one to expect. That the quarter was certainly a sickly one, appears from the fact that, whereas in the corresponding quarter of ]84'9 the admissions into the military hospitals were 30 per cent, of the well, and the deaths amounted to 1^ of the sick, the former were now 42 per cent., and the latter were If. Of the deaths, three if not four were produced by attacks of malignant cholera ; two in Barbadoes, and one in St. Vincent. The cir- cumstances of the cases are these :—On the 8th of July, a soldier of the 66th regiment, of intemperate habits, was admitted from the lower floor of the iron ' barracks (Barbadoes) in a state of collapse, and with all the characteristic symptoms of the disease, including suppression of urine, &c. He died in 12 hours. The post-mortem appearances, including the contracted urinary bladder and tarry condition of the blood, confirmed the diagnosis which had been formed during life. No other case occurred in this regiment. Two months subsequently, however, two well-marked cases, one of which proved fatal, took place in the 34th regiment. The first was on the 12th of September; the other on the 19th. In the former, the patient had been affected with diarrhoea for two or three weeks before the attack, which he survived only eleven or twelve hours. The symptoms during life and the appearances on dissection could leave no doubt as to the nature (^f the disease. In the second case the symp- toms were exactly alike, only less severe. No urine was voided for 36 hours. The convalescence was extremely slow. Besides these two cases, one of four fatal fever cases recorded during this quarter terminated by a choleraic seizure. Prior, however, to the occurrence of any of these attacks of malignant cho- lera in the 34th, a fatal case of what is set down in the returns as convul- sions took place among the troops at Barbadoes at the beginning of August. The case is a singular one; the chief symptoms being violent spasms of the abdominal muscles, followed by extreme exhaustion. He was brought to the hospital at midnight. At that time, there had been no vomiting or purging; nor did these symptoms supervene until shortly before death on the following day. No peculiar appearances were found on dissection.* It is worthy of notice that, besides numerous cases of diarrhoea during this- quarter in the 31th and 66th regiments, there Avere a good many of severe colic, and several of acute dysentery, but that all the black troops remained nearly exempt. There seems, therefore, to have been something peculiar in the con- stitution of the white troops, rendering them in an especial degree liable to * Ca?es of this description used to be of frequent occurrence in some parts of the East Indies. They have been described under the name of spasmodic affections by Girdlestone, Clark, and other writers of the last century, as bearing a close analogy to the cholera. The spasms, says Dr.Clark (Obs. on Dis. in Long Voyages to Hot Countries, 1792), indeed differ from those which accompany the cholera, in not being attended with purging. But if we conceive a patient attacked with cholera to be seized at the same time with strong spasmodic contractions of the muscles of the *' abdomen, and of the intestines themselves, which is actually the case in the distemper under con- sideration, constipation must be in general the consequence.