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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![i lie same uniform method in producing and bringing diseases to a height or crisis as she does in the pro- duction or growth of plants or animals: for, as every plant or animal is possessed of peculiar properties, so is it likewise in every exaltation of any humour, after its being come to a species or disease. We have a clear proof of this every day, in those kinds of excrescences that grow on trees and shrubs (occasioned by the ill quality of the nutritious juice, or other causes), in the form of moss, mistletoe, mushrooms, and the like ; all which are manifestly different essences or species from the tree or shrub that bears them.”— Sydenham’s Works, trans. by G. Wallis. Sydenham’s methods of treatment were adopted by him, and recommended as the results of experi- mental investigation. However their use might have been suggested, their efficacy was determined by their apparent influence on the recovery of patients; but, in his exposition of therapeutic principles, he keeps constantly in view his theory of “ commotion” (commotio) ; “a general term which he chooses in order to prevent all fruitless dispute about words that might arise from the use of ‘ fermentation,’ or ‘ ebullition’ (fermentatio vel ebullitio), which, though they may seem harsh and metaphorical to some, are capable of a commodious interpretation.” Thus, in speaking of “continued fever,” he says, “ with regard to this disease, 1 judge that the genuine indications are to keep the commotion of the blood [zymosis] within such bounds as suit the design of nature, so as to prevent its rising too high on one side, whence dangerous symptoms might follow ; or sinking too low on the other, whereby either the exclusion of the morbific matter might be hindered, or the endeavour of the blood affecting a new state be frustrated. The early medical observers have directed attention to the analogies zymotic diseases have with com- bustion, fermentation, putrefaction, and poisoning. These analogies have been, to a certain extent, confirmed by the researches of modem chemistry; and Liebig has been led by the study of organic transformations, —fermentation, putrefaction, decay,—to develop a theory invented by the greatest practical physicians to explain the phenomena of zymotic diseases. Liebig observes, “ that physicians had referred formerly to fermentation merely by way of illustration from which it is evident that he had not had time to consult the English medical classics on this head, or he would have discovered not, indeed, an anticipation of his own generalizations, but a theory very similar to his own,—the basis of their pathology,— founded upon enlarged views, and well calculated to prepare the way for his researches and the researches of other chemists. Morton, in his Pyretologia, calls the principles which it has been proposed in a previous page to designate generally zymine, “fermentum venenatumand the following definition is printed in italics in the intro- duction, and applied in the subsequent chapters of his work to the explanation of all the “ inorbi univer- sales acuti ”— * * * “ fomitem febriferum ('the ‘ fermentum venenatum’ of a previous sentence) asseramus esse—Deleterium quid in spirituum systemate delitescens, quod fermenti ad instar eos adoriens atque oestro primum exagitans, deinde humoribus secundo quasi momento, varias mutationes atque qualitates morbosas nobis sensibiles impertit.” This, he adds, is his general hypothesis—“ nostram generalem hypothesin.” Here we have (1) the “ deleterium quid ” communicating its action like a ferment to (2) the latent assumed constituents (spirituum systems*), and by a secondary impulse, as it were, producing perceptible transformations (mutationes) in the blood, tissue, and secretions. The sentence also recalls a principle in physics, which Liebig has quoted in the words of Laplace and Berthollet, and to which he appears to think all chemical transformations maybe referred:—'“A molecule, set in motion by any power, can impart its own motion to another molecule with which it may be in contact.” The three great cotemporaries, Sydenham, Morton, and Willis, lived in London when plague and epidemic diseases prevailed, and much as they differed or were mistaken, on some points, all announced more or less clearly the zymotic hypothesis. They were not, it must be borne in mind, mere chemiafric theorists; they had studied diseased action as assiduously and with as much sagacity as modern chemists have studied fermentation; Willis was a great anatomist; Sydenham and Morton have left original pathological delineations which have never been surpassed, and laid down plans of treatment which are still followed. * Morton adopted the hypothesis of animal spirits from Kernel, and though it enabled him to explain many pheno- mena happily, lie did not fail to fall into absurdities, (for so we must now call them,) by employing it to explain every- thing ; still such passages as the following admit of a scientific coustructiou, and are another proof that the exploded theories of ingenious men always contain traces of important truths. Spiritus animales esse to evepyprircov seu primum prineipium activum, et quasi fermentum universale totius corporis a quo sanguis et liumores varie agitantur, etimmutantur, non dubito. T. 2, p. 7, 8. Willis employed the chemical theory and the few chemical facts known in the seventeenth century with still greater rashness in his treatises de fermentaoone and de febribus ; yet he has many felicitous ant cipations of modern deductions, and Liebig will admit that in the following passages the Oxford professor referred to fermentation i'or something more than an illustiation. He is speaking of small-pox, measles, (and scarlatina.) Convenit enim homini umrii, soli, et semel variolis aut morbilis affici. (p. 165.) ***** jsta diathesis, seu naturalis praedispositio, quae genus humanum ad hunc morbum inclinat, videtur esse labes q rued am seu impuritas sanguinis, inter prima feel us rudimenta in utero concepta. ***** Licet autem qenenata hujus morbi semtna ut plurimum semel, et unied cegritudine soleut difflari; quandoque tamen accidit, ut parte miasmatis adhunc relicta, bis, aut ter aegri in hunc affectum inciderint * * * Causa evident, quae haec semina fermrntutma commovet, et saepissime in actum deducit, triplex assignatur, scilicet, cuntayium aliunde susceptum, disposilio aiiris, ac immudim sanguinis, et humvrum perturbatio. Cuntagio hunc morbum in alios serpere, lateque grassari, quotidiana experientia manifestum est: scilicet a curpnre infecto continue deceduni ejfluvia qua ab aliis curpnribus su.cepta stutim, instnr veneni cum sanguine fermentescunt, et Semina ejusdem uffectus latentia, ipsisque homogenea suscitant, et in hujus morbi ideam disponunt: nec solum contacto, sed ad distans miasma communicator. * * * peculiaris aeris dispositio : hinc saepissime popularis evadit ac per totas regiones, urbes, vicosque passim destEvit, p. 166. He adds that the “ immodica sanguinis, et humorum perturbatio” may arise from immoderate exercise or excesses,— Opera Medica et Physica, 1676. 2 9](https://iiif.wellcomecollection.org/image/b21308251_0101.jp2/full/800%2C/0/default.jpg)
