Report on the mortality of cholera in England, 1848-49.
- General Register Office Northern Ireland
- Date:
- 1852
Licence: Public Domain Mark
Credit: Report on the mortality of cholera in England, 1848-49. Source: Wellcome Collection.
Provider: This material has been provided by King’s College London. The original may be consulted at King’s College London.
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![the most frequently fixed ; they give rise, when placed on the skin, particularly where the epidermis is removed, to their peculiar diseases; but contagion is not invariably the result of their contact; indeed, in several of them it is the exception rather than the rule. Either there is no matter in the organization susceptible of transformation, or the specific transformation is overpowered by the vital energies; for in every case, if the morbific principle (zymine) tends to impart its movement to the organization, the organization, animated by the natural forces, has a tendency to continue its own processes, and to impart its conservative movements to all the organic matters which are brought within its sphere. Varioline is converted in the cow (as Mr. Seeley has shown) into vacciniue, and cow-pox affords an interesting illustration of the modifications which diseases undergo, and which may be imparted to them, by changes in their exciters. Vaccinine taken from the cow effects the transformation of the materics morbi in man almost as completely as varioline ; but it reproduces vaccinine; and in the process is never fatal, never produces the variolous fever, and its vapour is never infectious like that of varioline. The mild form of small-pox which appears in persons modified by previous vaccination, or which follows small-pox inoculation, is an equally good example of the changes induced in diseases by the actual constitution of the individual, and the mode of infection. Syphilis, erysipelas, necusia, metria, rubeola, scarlatina, and the other zymotic diseases, also put on different forms ; which may be referred to the state of the exciter, the mode of its application, the matter on which the exciter acts, or the vitality of the patient. A modification of cholerine, or of enterine, probably produces diarrhoea. Louis considers dothinenteria (his Jievre typhoide) a different disease from the typhus of this country, and points out the ulcerations, particularly of the glands of Peyer, with the correlative phenomena, and the rose-spots disappearing under pressure, as establishing its distinct character.* The differences in certain cases are unquestionable, and may be expressed by dothinenteria and typhus : but the two forms of the disease occur in this country ; the characters are frequently mixed ; and they are not greater than are observed in scarlatina simplex, and scarlatina maligna, with black incrus- tations, and gangrenous inflammation of the throat—in the erythema and phlegmonous erysipelas of Mr. Lawrence, or in the varieties of other diseases. The blood which pervades the whole system is the primary seat of zymotic diseases ; but this does not diminish the importance of the local phenomena with which they commence, proceed, or terminate; for they affect (as poisons do) particular organs more extensively and frequently than others, give rise to specific pathological formations or secretions, and derive their character from the lesions and affected organs. The heat disengaged in these diseases suggested the term fever, derived from ferveo, as fermentum is from fervimentum. Some zymotic diseases recur, others happen only once in life, or if they happen twice, it is the exception: this has been explained on the hypothesis that some but not all kinds of matter (zymin) are reproduced in the organization after they have been destroyed by transformation (zymosis) in attacks of disease. The tendency of zymotic diseases to increase and decline in activity, is one of their most remarkable properties ; and the suddenness of their outbreaks, with the great mortality of which they were the cause, excited at an early period the attention and solicitude of mankind. This tendency is indicated by the terms epidemic and endemic ; the latter serving to designate diseases which are excited by miasmata, and prevail in proportion to the quantity of miasm developed ; the former, epidemic, denoting the diseases transmitted from man to man, independently of locality, or oidy dependent on locality, temperature, and moisture, as adventitious circumstances. For statistical purposes, the epidemic, endemic, and contagious diseases, have been classed under one head, as they may all be excited by organic matter in a state of pathological transformation. Ague is not contagious, and is apt to recur; it therefore apparently approaches the class of toxical diseases ; but I feel inclined rather to consider it a zymotic disease, in which, to use the language of Liebig, the exciter is destroyed as soon as it is reproduced ; and this view is confirmed by the analogies of remittent fever, or yellow fever, so intimately allied in some respects with ague, in others with plague, and apparently contagious (though this is disputed) in certain circumstances. Scurvy is a transformation induced by the want or inadequate supply of vegetable food. It formerly decimated the English navy, and is now met with in certain prisons. Scabies and porrigo (both con- tagious diseases) are ascribed to an insect (acarus scabiei) and a low form of independent organization. The mode in which zymotic diseases are propagated has offered the ground of an interesting comparison between their diffusion, blight of vegetables, and the generation of animalcules. Sydenham referred, in the following passage, to zymotic diseases, which were so rife in Loudon, formerly, as to divert attention from pure inttammalions ; and, as they approach nearer than other diseases to the definition of species in natural history, justify the comparison which he has instituted :— “ If the humours are retained in the body beyond the due time, either (1) because nature cannot digest and afterwards expel them, or (2) from their having contracted a morbific taint from a particular consti- tution of the air, or (3) lastly, from their being infected with some poison: by these, 1 say, and the like causes, these humours are worked up into a substantial form or species, that discovers itself by particular symptoms, agreeable to its peculiar essence; and these symptoms, notwithstanding they may, for want of attention, seem to arise either from the nature of the part in which the humour is lrxlged, or from the humour itself before it assumed this species, are in reality disorders that proceed from the essence of the species newly raised to this pitch [zymine]; so that every specific disease arises from some specific exaltation, or peculiar quality of some humour [zymtn] contained in a living body. Undei this kind may be comprehended most diseases which have a certain form or appearance; nature in fact observing • Louts.—Flevre typhoide. Vol. ii. p. 311.](https://iiif.wellcomecollection.org/image/b21308251_0100.jp2/full/800%2C/0/default.jpg)
