It may be inferred, from what I have stated at the close of my letter of yesterday, that if a Commission be appointed, I look forward to its being shewn, as clear as the sun at noon day, that the most complete illusion has existed, and, on the part of many, still exists, with regard to the term Indian or Asiatic cholera; for a form of cholera possessing characters quite peculiar to the disease in that country, and unknown, till very lately, in other countries, has never existed there. Cholera, from a cause as inscrutable, perhaps, as the cause of life itself, has prevailed there, and in other parts of the world, in its severest forms, and to a greater extent than previously recorded; but, whether we speak of the mild form, or of a severe form, proceeding or not to the destruction of life, the symptoms have everywhere been precisely the same. In this country it has been over and over again remarked, that, so far back as 1669, the spasmodic cholera prevailed epidemically under the observation of Dr.Sydenham, who records it. For many years after the time of Dr.Cullen, who frequently promulgated opinions founded on those of some fancy author rather than on his own observation, it was very much the fashion to speak of redundancy of bile, or of acrid bile, as the cause of the whole train of symptoms in this disease; but, since the attention of medical men has been more particularly drawn to the subject, practitioners may be found in every town in England who can inform you that, in severe cases of cholera, they have generally observed that no bile whatever has appeared till the patient began to get better. Abundance of cases of this kind are furnished by the different medical journals of this year. In fifty-two cases of cholera which passed under my observation in the year 1828, the absence of bile was always most remarkable. I made my observations with extraordinary care. Pt_1
[Pg 45] One of the cases proved fatal, in which the group of symptoms deemed characteristic of the Indian or Indo-Russian cholera, was most perfect, and in the mass, the symptoms were as aggravated as they have often been observed to be in India;—in several, spasms, coldness of the body, and even convulsions, having been present.

To those who have attended to the subject of cholera, nothing can be more absurd than to hear people say such or such a case cannot be the true cholera, or the Indian cholera, or the Russian cholera, because all the symptoms ever mentioned are not present: as if, in the epidemic cholera of India and other places, even some of the symptoms considered the most prominent (as spasms, and the disturbance of the stomach and bowels) were not often absent, and that too in some of the most rapidly, fatal cases! I feel persuaded that much injustice is done to a gentleman lately sent to Sunderland, in attributing to him the very ridiculous opinion, that because the disease did not spread, it was therefore not identical with the Indian cholera. No person is justified in speaking of the cholera of India as a disease sui gineris, and in which a certain group of severe symptoms are always present, when evidence, such as the following is on record:—"On the 22nd instant, when the men had been duly warned of their danger from not reporting themselves sooner, I got into hospital a different description of cases, viz.—men with a full pulse, hot skin," &c. (Dr.Burrell to Dr.Milne, Seroor, 27th of July,1818)—"But I must tell you that we have, too, cases of common cholera." (Mr.Craw, Seroor—Bengal Report, p.48)—"The cases which terminated favourably presented very different symptoms [from the low form of the disease.] As I saw the men immediately after they were attacked, they came to me with a quick full pulse, and in several instances pain in the head; there was no sweating."—"in several cases bile appeared from the first in considerable quantities in the egesta; and these were more manageable than those in which no bile was ejected, although the spasms and vomiting (the most distressing symptoms of the complaint) were equally violent." (Mr.Campbell, Seroor,—see Orton, 2nded. p.18)—"In conclusion, I am happy to inform you that, for the last three days the disease has been evidently on the decline, and, during that period, most of the cases have assumed a different and much milder type, and, comparatively, are little dangerous. It approaches somewhat to fever; the patient complains of severe pain in the legs, sometimes vomiting a watery fluid, and sometimes bile." (White—Bengal Reports, p.68.)

The same gentleman afterwards observes, "The disease continues to present a milder aspect, and now occurs but rarely: loss of pulse and coldness are seldom observed."

On the decline of a particular epidemic, Mr.Alardyce observed many cases in the 34thregiment, with bilious discharges throughout. (Orton, 1stEd.128). Finally, referring to the work of Mr.Orton, a gentleman who served in India, and who, being a contagionist, will be considered, I suppose, not bad authority by those who are of his opinion, we find the following declaration. (p.26, 1stEd.) "My own experience has been very conclusive with regard to the sthenic form of the disease. Pt_1
[Pg 46] I have found a very considerable number of cases exhibiting, singly, or in partial combination, every possible degree, and almost every kind of increased action."—"Very full, hard, and quick pulse, hot skin, and flushed surface; evacuations of bile, [you are requested to note this, reader] both by vomiting and stool, from the commencement of the attack. And, finally, I have seen some of those cases passing into the low form of the disease."—"The inference from these facts is plain, however opposite these two forms of disease may appear, there is no essential or general difference between them." After such authorities, and what has elsewhere been shewn, can any cavelling be for one moment permitted as to the cholera in Sunderland not being of the same nature as that of India? It may be now clearly seen that in India as in Sunderland, the same variety of grades occurred in the disease.

In making my communications for the benefit of the public, it is my wish to spare the feelings of Sir Gilbert Blane; but as he persists in giving as facts often refuted tales of contagion, in order to uphold doctrines which he must observe are tumbling into ruins in all directions, it becomes necessary that his work of mischief should no longer remain unnoticed.

Not a single circumstance which he quotes relative to the marchings and the voyages of the contagion of cholera will bear the slightest examination; and yet he has detailed them as if, on his simple assertion, they were to be received as things proved, and, consequently, as so many points to be held in view when the public are in search of rules whereby they may be guided. The examination of his assumed facts for one short hour, by a competent tribunal, would prove this to be the case; here it is impossible to enter upon them all: but let us just refer to his management of the question relative to the importation of the disease into the Mauritius by the Topaze frigate, which he says was not believed there to be the case—and why was it not believed? Sir Gilbert takes special care not to tell the public, but they now have the reason from me, at page22.

If a commission be appointed, half an hour will suffice to place before them, from the medical office in Berkeley-street, the reports alluded to from the Mauritius, by which it is made apparent that long before the arrival of the aforesaid frigate, the disease had shown itself in the Mauritius.[14] What is the public to think of us and our profession, when vague statements are daily attempted to be passed as facts, by contagionists enragÉs? One more short reference to Sir Gilbert's facts.—While referring to the progress of cholera in India,&c. from 1817, he says, in a note, "it is remarkable enough that while the great oriental epidemic appeared thus on the eastern extremity of the Mediterranean, the great western pestilence, the yellow fever, was raging in its western extremity, Gibraltar, Malaga, Barcelona, Leghorn, &c." Now, it is a historical fact, that, at Gibraltar, this disease did not appear between 1814 and 1828—and at Leghorn Pt_1
[Pg 47] not since1804! At Malaga, I believe, it did not prevail since1814! So we have here a pretty good specimen of the accuracy of some of those who undertake to come forward as guides to the public on an occasion of great urgency and peril. By some of Sir Gilbert's abettors, we are assured that his "facts are perfectly reconcileable with the hypothesis of the cholera being of an infectious nature." A fig for all hypothesis just now! Let us have something like the old English trial by jury. May I be allowed to introduce a fresh evidence to the public notice, in addition to the thousand-and-one whose testimony is already recorded. He is worthy of belief for two good reasons in particular; the one because he still (unable to explain what can never be explained, perhaps), calls himself a contagionist, and, in the next place, the statements being from a high official personage, he could not offer them unless true to his Government, as hundreds might have it in their power to contradict them if not accurate. My witness is not a Doctor, but a Duke—the Duke deMortemar, lately Ambassador from the French Court to St.Petersburg, who has just published a pamphlet on cholera, a few short extracts from which, but those most important ones, I shall here give. Read them!—people of all classes, read them over and over again! "An important truth seems to be proved by what we shall here relate, which is, that woods seem to diminish the influence of cholera, and that cantons in the middle of thick woods, and placed in the centre of infected countries, have altogether escaped the devastating calamity!"—"The island of Kristofsky, placed in the centre of the populous islands of St.Petersburg, communicating with each other by two magnificent bridges, and with the city by thousands of boats, which carried every day, and particularly on Sundays, a great number of people to this charming spot. The island of Kristofsky, we say, was preserved completely from attacks of the cholera; there was not a single person ill of the disease in three villages upon it." He continues to state particulars, which, for want of time, cannot be here given, and adds—"To what is this salubrity of Kristofsky, inhabited by the same sort of people as St.Petersburg, to be attributed, fed in the same manner, and following a similar regime,—communicating with each other daily, if it be not to the influence of the superb forest which shelters it? The firs, which are magnificent as well as abundant, surround the houses."[15] He notices that the town is low and humid, and that "it is made filthy every Sunday by the great numbers who resort to it, and who gorge themselves with intoxicating drink." In a third letter I shall be able to furnish further extracts from this most interesting pamphlet.

[14] I am aware that very lately certain memoranda have been referred to from the surgeon, but this is merely an expiring effort, and of no avail against the official Report drawn up.