Report on the sanitary condition of Malta and Gozo with reference to the epidemic cholera in 1865 / by Dr. Sutherland.
- John Sutherland
- Date:
- 1867
Licence: Public Domain Mark
Credit: Report on the sanitary condition of Malta and Gozo with reference to the epidemic cholera in 1865 / by Dr. Sutherland. 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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![know under what precise circumstances cholera broke out, whether it came suddenly, oi- whether it was preceded by any altered condition of the public health. We have no account of the first cases of the disease, or of how they originated. There is, in fact, an almost total blank in our knowledge at the very point where exact information is of the greatest importance. This deficiency is nothing more than has always existed in our information about these Eastern epidemics, and there is no rea?on to hope for the advent of more enlightened views regarding them, until we are enabled to keep an account current, so to speak, of the condition of public health in those epidemic centres where pestilences make their first appearance. Under present circumstances it is not surprising that hypothetical considerations should enter so largely into popular beliefs regarding the mode of propagation ol' epidemic diseases. But the time has certainly arrived for establishing more exact methods of inquiry, and for separating what is true from what is supposititious in their history. The first intimation, for instance, of cholera in Arabia was contained in private letteis and newspaper paragraphs, announcing an outbreak of pestilence among pilgrims at Mecca, which had destroyed 20,000 persons during the first three weeks in May 1865. The first official notice of cholera in Egypt received by the Government of Malta w&s contained in a telegram from the consul at Alexandria on June 14th. Admitting the facts to be correct, one cannot help regretting that they convey so little real information as to the history of the disease. There are, it is true, some other facts which I shall presently mention, bearing on the progress of the disease from Mecca to Alexandria in the line of pilgrim caravans; but when we are told from another source that a letter from Alexandria ascribes the cholera there to fatigue and sun exposure, and that the malady has appeared up the country almost simultaneously at widely distant points,* we feel how much is yet to be learned before we arrive at reliable facts regarding the earlier history of the epidemic. There appears to be little doubt that much of the prevailing uncertainty regarding disputed points in the history of all epidemic outbreaks is really the result of want of information ; so that almost any form of hypothetical doctrine may find support in occurrences alleged in its behalf. The danger in all such cases where the history is necessarily incomplete is mistaking coincidences for effects, a result which can only be avoided in future by adopting a more rational and systematic mode of enquiry. Great epidemics have generally been preceded more or less by marked disturbances in the health of men and animals. Epidemic diseases of different kinds and epizootics have not imfrequently co-existed at such periods, and from the information I have been able to obtain, the epidemic years 1865-66 have been no exceptions to the rule. It is unnecessary to do more than merely to allude to the existence of severe and fatal forms of fever and cattle plague which were so prevalent in various parts of Europe before cholera appeared, as indications of this disturbance. In Arabia there is reason for believing that the usual premonitions were not absent : for in the month of March and April 1865, a fatal form of Typhus appears to have prevailed at Mecca, Medina, and Djedda, which carried off nearly 50 persons a day in each of the first two cities.f About the same period an epizootic disease prevailed over nearly the whole of the eastern shores of the Mediterranean. Of this fact we have official evidence in the minutes of the Malta Board of Health of April 29th 1865, prohibiting the importation of cattle from Egypt, Syria, Smyrna, Spain, Dalmatia and Sicily.J At a later period, in the middle of June, at the date when quarantine was established at Malta, small pox is also stated to have existed at Suez, while cholera was committing ravages at Djedda.§ * Gibraltar Chronicle, 27tli June 1865. f A letter from Djedda of the 3rd April says, that considerable havoc has lately been made by typhus in that city, but, fortunately, not to the same extent as at Iilecca and Medina. At each of these last places nearly 50 persons die daily, and grave apprehensions are experienced lest the evil should spread still further when the crowds of pilgrims arrive.—(Malta Times and United Service Gazette, 2lth April, 1865.) :j: Official reports having been laid before the Board of Health stating that the cattle disease still exists in Egypt, Syria, Smyrna, Spain, Dalmatia, and Sicily, the Board, having fully considered the said reports, beg to recommend that the importation of cattle from these places be prohibited.—{Blinute of Malta Board of Health, 29th April 1865.) § It is stated that cholera has broken out at Djedda among the pilgrims returning from Mecca, and (hat small-pox is raging at Sv.ez.-^(Multa Observer, I5th June I860.) The co-exislence of ,'.:mail-])ox witii cholera has also been observed in India {vide Report of Generp.l Board of HerUh on 1l;c- ch'rici ;i of lo4H—ii)..)](https://iiif.wellcomecollection.org/image/b24749655_0013.jp2/full/800%2C/0/default.jpg)
