Address delivered at the opening meeting of the Debating Society of Army Medical Officers, Aldershot, April 2nd, 1883 / by Robert Lawson.

Lawson, Robert

Date:: 1883

Credit: Address delivered at the opening meeting of the Debating Society of Army Medical Officers, Aldershot, April 2nd, 1883 / by Robert Lawson. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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$1865, which remained isolated that year, but was followed by the epidemic in 1866, is to be explained in the same way. Sometimes the disease does not advance as an epidemic beyond the area it occupied in its first year there, but the following year the countries to the northward have an unusual number of sporadic cases of malignant cholera, together with much simple cholera and diarrhoea with cramps and vomiting; the cholera epidemic in the South of Europe in 1867 was followed by such an outbreak in this country in 186P, and a similar one occurred at Copenhagen that year. In this camp in 1868 the troops under canvas had a good deal of this diarrhoea and some ordinary summer cholera at the end of July and beginning of August, and a soldier of 2/6th regiment was attacked with well characterised malignant cholera on 12th August, and died of it on the 13th. Another set of conditions under which ordinary summer cholera, interspersed with sporadic cases of the malignant form, became unusually numerous—and even three considerable groups of the latter description of cases occurred—took place in 1859. At this time cholera was prevalent in the west of the Mediterranean, and in summer was epidemic in Belgium, Holland, Hamburg, and on to Sweden. The deaths from cholera in London, which in 1858 were 49 per million living, rose to 71 in 1859, and fell to 18 per million in 1860 ; and in 1859 three groups of the malignant form of the disease presented themselves ; at the Coast Guard station at Woolston, near Southampton; at Glass Houghton, in the parish of Castleford, near Pontefract; and at Wick, in the North of Scotland. You will notice particularly in all these cases (and more could have been given) the increase of the ordinary summer cholera, the greater frequency of the sporadic cases of the malignant form, and the occurrence of small outbreaks of the latter all taking place together, on the approach of cholera as an epidemic. From these facts you will perceive that cholera, as an epidemic, is not a thing of one station, or even one country, but involves large geographical areas in the same year, and successive areas in consecutive years. Its essential factors must therefore operate over spaces of equal extent, with the power of occupying fresh ground year after year as we see it do, constituting epidemic influence, in short, as has already been shown to affect small-pox. It must not be concluded, however, that the epidemic influence in small-pox and m cholera are the same; not only may the epidemic element in each consist of more factors than one, but in the case of small-pox it has been clearly established that the materies morhi is largely augmented in quantity in the system of each person who is attacked and this can be communicated to healthy persons readily, so as to excite the_disease m them. As regards cholera, however, this certainty of an increase of the cause of the disease in the system of those labour- ing under it is wanthig, and the belief tliat cholera evacuations$