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"Propagation of cholera"

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Times
(26 September 1885): 6, col. B

Courtesy of Michigan State University Libraries, the Times Digital Archive.

To the editor of the Times.

Sir,--In a letter to the Times of the 21st inst., under the heading "Madrid--Main Sewers and Cholera," the writer says:--I have read theories propounded by undeniably able men as to the causes of fever and cholera; but upon refection they have failed to convince me. I heard the late Dr. Snow on cholera excreta tainted water being necessary to the production of cholera. I, however, have seen that theory disproven on a great scale."

The late Dr. Snow never held such a theory as that which is here ascribed to him. He did, indeed, prove by a catena [chain, or series] of incontrovertible facts that cholera was largely propagated by water thus tainted; but, so far from maintaining that this condition was "necessary to the production of cholera," he devotes several pages of his book--On the Mode of Communication of Cholera--to the pointing out of modes of propagation otherwise than by water.

I trust that, in justice to the memory of one who shortened his own life in his arduous labours for the preservation of the lives of others, you will allow me space for this correction of a serious apprehension with regard to his teaching.

I am, Sir, yours faithfully,

Thomas Snow.

Underbarrow Parsonage, Kendal, Sept. 23.

[PVJ--I've transcribed extracts from the letter to which Thomas Snow objected, as follows:]

"Madrid--Main Sewers and Cholera"

Letter to the Editor by "R.R.," in reply to remarks sent by the Times' Special Correspondent dated 10 September.

R.R.'s letter begins on p.13, col. F, continued on p. 14, col. A.

. . . . . . .

"But to Madrid and cholera. I am not going to define the causes of cholera, but will state a few negatives. I do not believe that polluted sites are the cause, or that polluted waters are the cause. I do not believe one bit in microbes, but then this may be because I never saw one and know nothing about them. I, however, firmly believe in the necessity of having clean sites and clean water, added to which, unpolluted air. I have read theories propounded by undeniably able men as to the causes of fever and cholera; but upon reflection they have failed to convince me. I heard the late Dr. Snow on cholera excreta tainted water being necessary to the production of cholera. I, however, have seen that theory disproven on a great scale. It has been my official duty since 1849 to inspect and report on the condition of towns in which cholera has prevailed, beginning with Alnwick, in Northumberland, and then Whitehaven, Newcastle-upon-Tyne, North Shields, Gateshead, . . . and the British hospitals on the Bosphorus, as also the site of the British army in the Crimea. As a member of the Army Sanitary Committee, I have read the abstracts of the sanitary condition of British India made by Dr. John Sutherland for the Commission, so that consequently I have been very stupid if I have not learned something; but I freely confess that I do not feel myself in a position to promulgate any definite theory as to the cause of cholera. There are, however, some natural phenomena which apparently influence an outbreak of the disease, and which bear inferentially on this outbreak of cholera at Madrid. I will take towns situate in England to illustrate my remarks . . . . Cholera prevailed severely at Wolverhampton and Bilston, but not at Birmingham. . . . In Bilston one-tenth of the inhabitants died of cholera in outbreak of that disease, and the ejecta passed to the Bilston brook, a tributary of the River Tame, which at this time supplied water unfiltered to Birmingham, and yet it did not produce cholera. Individuals smitten with cholera were taken into Birmingham to die; but, nevertheless, the disease did not spread. I looked carefully to see if I could discover any apparent cause for the exemption of Birmingham in the streets, houses, or habits of the people, but found none. It then occurred to me to examine the sites of Birmingham and Wolverhampton, and I noted that in Birmingham the fall of the ground and the outflow of sewage was to the north and east, whereas at Wolverhampton the fall was to the south and west. I knew that north and east winds were usually dry, and that south and west winds were usually moist and wet. I also knew that, taking a year, north and east winds would not blow more than one-third of the year, but that south and west winds would blow two-thirds of the year, and would be moist, vapour-bearing. I have since learnt that moist south winds are considered injurious, as being blighting and unwholesome. . . . Can the differences in the sites of Birmingham and Wolverhampton have had anything to do with cholera?

With respect to Madrid, it must be observed that the fall of the sewers is to the south, that the elongated foul open conduit is on the south, and that cholera commenced in this quarter of the city. I state facts which may be taken for what they are worth. Foul sewers and drains which generate sewage gases and which are connected to houses may be a cause of disease; foul open water-courses, such as the one described, may be a cause of nuisance, and not a cause of disease, such as [13/14] cholera. As a rule, exposed stinks are comparatively harmless. The deadly evil is within the dens, called houses, where a debased and demoralized population, having worn constitutions, live, ill clothed, ill fed, and unwashed from their cradle to their graves--here disease finds victims and here settles cholera. . . ."

[R.R.'s reasoning is characteristic of non-contagionist sanitarians who, whether in Snow's time were dismissive of a special animal poison in the dejecta of cholera victims as the like morbid agent in cholera, or after the emergence of germ theory, certain cholera microbes.

R.R. was also a disease generalist since he believes that any sewer gases, whether or not cholera was present, entering houses and then inhaled by "a debased and demoralized population" could result in disease, including cholera. Individuals with robust constitutions were able to withstand the disease-elements in such gases; those with comprised physical constitutions could probably not. PVJ]


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