Source: Snow, John. Medical Times and
Gazette 9 (12 August 1854): 170. [ltr. to ed., 5 August 1854]
Cholera in the Baltic Fleet
Medical Times and Gazette
(12 August 1854): 170
To the Editor of the Medical Times and Gazette.
Sir,--I have for some time been halting between two opinions respecting the manner in which the cholera had been introduced into the Baltic fleet,--whether by the capture of prizes which might have had cholera on board, or by drinking the water of the Baltic containing the evacuations of the cholera patients at St. Petersburg and Cronstadt.
A paragraph in your Journal of to-day [5 August 1854], page 152, inclines me, however, to adopt the latter opinion. The paragraph is as follows:--"The only ships which suffered from cholera are those which proceeded up to Cronstadt. The smaller vessels, especially the paddle squadron, have enjoyed a high standard of health," etc. They were the smaller steamers, I believe, that have been engaged in the capture of prizes, and not the large ships that proceeded up to Cronstadt, where the cholera was prevailing. These ships, we know, had no communication with the shore at Cronstadt, or with the enemy's shipping; and as experience is, in my opinion, entirely opposed to the view that the morbid matter of cholera passes through the atmosphere, except for a very limited distance, and that very rarely, the method I have pointed out is probably that by which the cholera was introduced. I am not able to say positively that the water of the Baltic was used on board the ships, and this is one reason of my writing, as I think it desirable that the point should be clearly ascertained. It has been publicly stated that the water in the upper part of the Baltic is quite fresh in the early part of summer, and that it was unnecessary to spend time in obtaining water from the shore. I have also been privately told that the sailors prefer the Baltic water to that which has been stored, and which tastes of the cask.
If the fleet in the Baltic had succeeded in avoiding the cholera, it is probable that London would have escaped the present epidemic of the disease, for the trade with the Baltic is suspended, and the communication between the Thames and that sea is almost confined to the fleet. Although we cannot trace the commencement of the present epidemic in London to an individual case, as the epidemic of 1848-1849 can be traced to John Harnold, of the steam-ship Elba, we know that the first cases occurred in persons residing, or being employed on board the shipping in the river, and among others near the river side. The cholera also appeared about the same time in an emigrant-ship and a troop-ship, soon after leaving the Thames. The following occurs in the last return of the Registrar-General:--
"In the same sub-district (St. James, Bermondsey,) at 10, Marine-street, on 24th July, a mate-mariner, aged 34 years, 'Asiatic cholera (101 hours,) after premonitory diarrhœa (16½ hours.)' The medical attendant states:--'This patient was chief-mate to a steam-vessel taking stores to and bringing home invalids from the Baltic fleet. Three weeks ago he brought home in his cabin the soiled linen of an officer who had been ill. The linen was washed at his house and returned.'"
This was not one of the first cases, and therefore I do not quote is as actually introducing the cholera into London, but only to show the kind of intercourse that has been going on between the Baltic and the Thames. It is probable that a few simple regulations respecting this intercourse might have kept London free from the cholera, and inflicted no hardship on anybody; but, unfortunately, the chief advisers of Government in sanitary matters have had their minds occupied about drain-pipes and bad smells, and have neglected the specialities connected with the propagation of individual diseases.
As regards the evidence which I conclude that the materies morbi of cholera is contained in the evacuations of the patients, and that it may retain its power of communicating the disease after being diluted with large quantities of water, I beg to refer the reader to former papers in the Medical Times and Gazette.* (*Med. Gaz., 1849, Vol XLIV, p. 730, etc.: Med. Times, Dec. 1851; Med. Times and Gaz., 1853, Vol. VII., p. 367.) I will, at present, only notice an objection which has been made to the latter part of my view,--that relating to the water. It has been said, that the cholera poison would be rendered inert by the large dilution, or, if not, that every one drinking the contaminated water should have the disease. One answer meets both parts of the objection. A substance cannot be diluted beyond the ultimate particles of which it consists. The morbid matter of cholera, like the pus of small-pox and other morbid poisons, owes its properties, no doubt, to cells; and there is no more reason why diluting with water should necessarily destroy their activity, than that it should destroy the ova of fishes; and there is also no reason why every one who dips a pail into the water should draw a prize.--I am, etc.
John Snow, M.D.
Sackville-street, Aug. 5
[The full paragraph on p. 152 of the 5 August number reads as follows:
"Health of the Baltic Fleet.--The only ships which sufered from cholera are those which proceeded up to Cronstadt. The smaller vessels, especially the paddle squadron, have enjoyed a high standard of health, the per centage of sick not averaging more than 2½. Sulphuric acid has been extensively tried. It was much liked by the patients, and taken, freely diluted, greedily. We are promised full accounts of its effects in future letters."]
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