ARMY MEDICAL LIBRARY 

WASHINGTON' 

I'oimiil* 'l 18:{»; 

Section Number .3/^9 0 







I jul ii«B6 ! 









REPORT ON THE Cpfoemtrfc- CfjoLrra fHorbus, AS IT VISITED THE TERRITORIES SUBJECT TO THE PRESIDENCY OF BENGAL, In the Years 1817, 1818, and 1819. DRAWN UP BY ORDER OF THE GOVERNMENT, UNDER THE SUPERINTENDENCE OF THK MEDICAL BOARD. -> _ JAMES JAMESON, y^ssistant Surgeon and Secretary to the Board. Calcutta: PRINTED AT THE GOVKRNM ENT GAZKTTK PRESS, BY A. G. BALFOUR, NO. 1, MIBSIOM HOW. 1820. 



ew'^tc^ro/v woctfisov iw/iy^ovzuzro yivLcuut. our& ycte targot %qkovv ro tpotcv Oioccxwovtzs ys/'jotu, — ovr& cttXri avdo&micc Tiyyri ovhif/jia. ________ 7s<y'iroj Uj\v ovv tzoi aurou <vg eKxrrrog yiyvcutrzet, xoti iurooc, xat ih<vTr ts,t $, ccp" oro-j zIko? r t v yv/zadcu ayro, xou rag airtccg ctanvag vof/jt'tft roffuvrqg /AZTuQokrjg tKUvag uvcti (Hwctfjbip ig rS [Azra<TT7J(rai cyjtv* lyat 5s oJSv re \yiyviro ?J£&/, kou up* J'v ay rig ffxoxuv, ilirori xal av^ig wgnAntf (JboiXiffr ay eyjoi r) wgouhug ayvoiiv, rcr.u- Qovxvdid. 'c,vy/£a.<p* €. 

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CONTENTS. jr I tzjut &•¦•••••••••••••• •••••• ••••••.•••••«•<••.••• l Introduction. ..... t xxix Section. I. — RfJ£ and Progress of the Disease, , 1 — , H #r — Of the Symptoms of the Diseas x 38 . 1 1 1. — Appearances after Death, G6 IV. — Proximate Cause of the Disease, 74* V.— Remote Cause oJ the Disease, 85 — — — VI. — Contagious Nature of tJie Disease, 123 1 VII. — Predisposing and Exciting Causes of the Disease, 119 VIII.- — Mortality caused by the Dis ease , lob. • IX. — Of some Peculiarities of the Disease, 185 '¦ X. — Treatment of the Disease, ... 196 Appendix — Cases, 257 







!VERNMENT being desirous that I should be preserved of the EpLl:m. : ; ;, has recently visited Ilindostr-i , instrnctm issued to the Medical Board to draw gport of its history and gem \\A appear- As this could only be done, by ;&gt;btainiid carefully digesting, the collective cxce of a large number of individuals, con( with the disease ; it was resolved, to all the Members of the Me.lical_ IXjaurtto contribute such fact 3 as they might conducive to the ends in view. 

The following letter was accordingly transmitted to every individual borne on the list. The form by queries was preferred, as pointing out, in a clear and distinct manner, the nature of the information wanted ; and thus relieving the individual observer from the uncertainty, into which he might be thrown, were it left entirely to his own judgment, to determine, what he should withhold, and what contribute to thg general stock. 

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Sir, 

lie Medical Board being called upon by jrnment to draw up for publication, a reon the rise, progress* and symptoms of the emick, which has recently visited these inces; have directed me to request, that will have the goodness to communicate to , with all practicable » convenience, such mation as you may possess on the subject ie proposed enquiry. 

The main objects of the enquiry being to discover, if possible, the hidden causes, which first originated, and afterwards gave such wide range to the disorder ; and to elucidate the laws, by which its progress was regulated ; the Board would wish chiefly to direct your attention to the facts bearing upon these points. They are sufficiently aware, that the springs of epidemical diseases, have hitKcrto escaped tiie ingenuity and penetration of medical men ; and that even the most patient investigation, will in til'; present case, in all probability, only add one more, to the innumerable instances of our ignorance and shortsightedness, regarding these abstruse operations of nature. But this at least will be effected, by instituting a minute research into the history of the disease. The general body of the medical profession will be put in possession of a correct narrative of the cir. 



instances, which marked the origin and pro* rress of a malady, perhaps more destructive in its effects, and more extensive in its influence, than any other recorded in the annals of this country ; and in the event of the future recurrence of such a pestilence, our professional brethren on this establishment will escape the feel? ings of apprehension and uncertainty, which it so generally produced on the late occasion ; and be prepared to meet it with the most approved means of treatment. 

It is by no means the intention of the Board to- discourage you from giving a detailed description of the disease ; or from transmitting to them notes of such cases as you may have kept with minuteness and accuracy. But the points, to< which they would desire more particularly to beg your attention, as in theix opinion the most essential to ascertain the nature and history of the disorder, are the state of the atmosphere, previous to,, and during the time of its prevalence ; the circumstances attending its rise, increase, decrease, or Kearance, in a tract of country, town, or , camp or cantonment; the classes of pervhich it seemed particularly disposed to and the peculiarities in the modes of 1 circumstances for the time being, of those aU To these may be added some re* 

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marks on the best means of resisting the dis« order ; on its fatality, whether as to the mortality caused by it in particular districts, or to the proportion of deaths amongst a given number of persons seized, &c, &c. 

E appears adviseable, for the sake of distinct* to placa these various subjects of invest!., .1 i::idev separate heads; ani a numb :r of es is accordingly subjoined; to which it 13 1, that you will iind no difficulty in, returnitioiactory answers. 

Buery, 1. When did the Cholera Morbus appear in the tract of country, cantonment, imp, coming under your observation ? 

2. How long did it remain in that district, cantonment, or camp ? 

EWhat was the pre\ ailing state of the weafor some time before its appearance ; dv* its prevalence ; and at the period of its dis« arance ? State the result of your observant" you have kept any) on the barometrical ihcrmometrical changes, which may have rred during the intervening period. 

4. What direction did it seem disposed to take, in passing through the camp or district ? 

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5. Did it affect all parts equally and indis- 

criminately? 

16. Were the localities of tho parts or villajs more especially subjected to its influence, toh as general experience has shewn to be, ith respect to the miasmata arising from puid animal and vegetable exhalations, particurly obnoxious to endemical diseases ? 

7- Did it leave any spots untouched ? and what circumstances in them appeared to ftkrei -a the inhabitants from its influence ? 

S. After wholly leaving a division of country, camp, or village, did it ever recur? and if so, under what peculiarities of weather, or localjtiei of situation? 

9. During its prevalence in any spot, was any one class of persons more liable to its attacks than another? and if so, by what peculiftritfes of lilb, as to diet, calling, habits, scite of habitation, age, sex, or caste, was this class distinguished from those less within its influ- 

KWhat might have been the average mor^ amongst a given number seized? Did ry at diScrcat reasons of the Epidemick P 

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Ewas the disease more violent in the early, in the latter part of its progress ? 

11. Can you form any estimate, or probable conjecture, as to the «uiij total of mortality pro duced in the tract coming under your observa- 

I. What appearances were presented oa ng the bodies of those, who sunk under the >c in its different stages ? 

BOf those attacked, did a greater number er, of such as took medicine, than of those lid not ? 

KWhat mode of cure was most generally sf ul ? 

¦ Did bleeding appear to produce bcnefi- Fects? and in what number of those whose were opened, was it found possible to make ood flow ? 

BDid calomel given in the first instance, one, appear to have any specific effect, in \g the irritable or spasmodic state of the 



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the Native practitioners ? and have you any information of the success, with which these were reported to have been used ? 

18. What were the usual sequelae of the disease, as to constitutional effects, in severe cases ? 

19. Did any instance of relapse, or secondary attack, come under your notice, after reco\ c* ry had been well established, and the bodily strength restored ? 

20. Have you any reason to suspect, that the disease was contagious ? 

21. Were animals affected by the disorder ? and if so, what descriptions ? 

22. Did it appear to you, that the Epidemick exerted any influence in lessening the frequency, or in modifying t he symptoms, of fevers, and other disorders common to this country? 

Although the Board have thought it necessary thus to specify, under separate heads, those questions, which have appeared to them most momentous to a complete illustration of the maikr under investigation ; they will gladly receive from you such information, on points that may have escaped their notice, an you may think pro* pgr to impart to them, 

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In conclusion, the Board, without further pressing the great importance of the subject upoi your observation, place perfect reliance oil your professional zeal ; and entertain no doubt 1 * if, that, actuated by a just regard for the interests of humanity, and the reputation of the Department to which you belong, you will take the foregoing queries into .your most serious consideration; and hy the results of your deliberation, enable them to perform the task allotted to them,' with credit to themselves^ and to the service over which they the good fortune to preside. 

I have the honor, &c. 

Medical Board Office, > the Oth October, 1818. j 

Tho foregoing appeal was not so productive light nave keen expected. Of two hundred end thirty-eight individuals, to whom the letter v.as addressed, replies were received, from one hundred and twenty-four only. — Of these, twentyflur answered merely to state their inability, in any way, to assist the Board, in the proposed enquiry — The remaining hundred communicated much valuable information ; the whole of which it has been attempted to embody in the subjoined report. 

In performing this task, it was earnestly v ii Hod, that no fact should be stated* without 

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mention being at the same time made, of the aiv thority, upon which it rested ; and no general reasoning, or point of theory advanced, but with the name of the person from whom it wafl derived. It was hoped, that the share, which each had contributed to the general performance iVoulcl thus be manifest ; and that no complaints could be fairly made of partiality, or unjust iiviglect. But it was soon found, that the adoption of .this plan would inevitably lead to prolixity an I .confusion. The facts were so numerous, that, .if each were to be stated with its authority, Jkhe work would be swelled out to a most unreasonable size. They were often of a contradictory and imperfect nature.; so that the inference deducible from them, was to be obtained, partly from one person, and partly from another. Jrhe inferences to be drawn from the facts, were »ften different from those made by the person Stating the facts ; or they had not at all occurred} to him ; or they were such, as could only- be made, from a comparison of his facts with others, with which he was unacquainted. Besides, that after all the facts had been stated, each on its proper authority, it would still have been necessary, for one individual to have combined and analyzed them ; so as obtain from the whole some general principles, and precise notions, as to the true nature of the disease. All would have else been 

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!usion and perplexity ; and the body of intellce thrown together, however it might, in a lin sense, be said, to exhibit the results of ge-1 experience, would never have formed a plain unembarrassed narrative of the progress and arances of the Epidemick. 

It was therefore determined to abandon this method ; and in its stead, to adopt the form of a digest or compendium of all the facts within reach. In doing this, the mode of describing diseases, usually adhered to by practical writers, has been followed, with as little deviation as possible ; that is, the symptoms have been treated of first; then the causes, proximate, remote, predisposing and exciting ; then the mortality caused by the disease ; then some peculiarities observed by it ; and lastly the method of cure. To the whole have been prefixed an introduction describing the rise and progress of the Epidemick* ; and a sketch of the Weather in Bengal, and in the Upper Provinces, during several years antecedent to its appearance. 

In discussing the matters comprised under these various heads, it has been carefully endeavored, to adduce the whole of the facts seemingly bearing upon them ; and no pains have been spared, to collect from every accessible quarter, such collateral evidence, as appeared likely to assist in their elucidation. The object of the Essay being 

* It has been since thought better to throw this into the body of the work. 

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purely practical, every bias to theory and general speculation has been cautiously avoided. No lengthened hypothetical reasonings have been entered into; and where any thing seemingly con- 

jectural has been hazarded, it has been, either in the way of plain deduction from established facts, or of striking analogy with similar circumstances, 

the truth of which is universally admitted. The 

subjoined Table contains the names, designations, and places of experience of all the gentlemen, who have contributed to the formation of the work. Amongst so large a number, it cannot but have happened that the communications must be of very different degrees of value. All could 

not have the same field of observation ; some from accident or would im» prove their opportunities more than others. But, it would be invidious to specify the quan« turn or value of the information communicated by 

different individuals ; even if the step were not rendered unnecessary; by a constant reference in the body of the work to the situations principal. |y visited by the Epidemick, connected with the specification in the annexed table of the Medical Officers, whose experience was chiefly derived from such situations. It may however be stated generally, that the intelligence regarding both the habits and treatment of the disorder, imparted by the Staff attached to the Left and Hansi Division/?, the Rajpootanu Force, and above all, the Centre Division of the Army, cannot be to« 

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highly estimated. The Surgeons of the Centre Division have the principal merit, of clearly establishing the great utility of blood-letting, under certain circumstances ; which had been previously left doubtful by the uncertain results of the practice in Calcutta, and other quarters.* 

It has been a prevalent opinion throughout the country, that the Epidemick was essentially different in nature from the Cholera Morbus of the Schools. — This is no doubt true, if hy Cholera is meant only, the disorder occuring sporadically during hot weather in the higher latitudes, and usually accompanied with bilious vomiting* But it should be recollected, that the word Cholera is a generic term; comprehending many species or varieties of disease, all more or less differing from each other in their diagnostic^ symptoms. 

* Besides the information derived from the general source, a valuable addition of facts has been obtained from the official reports communicated to the Board, from time tp time, since the rise of the Epidemick, by Mr. Superintending Surgeon Dyer, and Mr. Superintending Surgeon Reddie. — The opinions of the latter Gentleman, which are always entitled to much respect, are in the present instance particularly deserving of regard, from his having enjoyed very extensive opportunities of witnessing the disorder in the Left Division and P»ajpootanu Force j and made the best use of them. 

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If it were consistent with the scope of this Report, it might be easily shewn, that a disease similar in ail its appearances to that, which ravaged these provinces, has been known from the remotest antiquity ; and accurately described by the medical writers of every age.* 

* There is no detailed description of Cholera in Hippocrates or Galen ; but that the disease was perfectly yrc\\ known to them is evident from a frequent reference 

to it in various parts of their works. It is however, described by Aretaeus, Ccelius Aurelianus, and Paul us Aegineta. Aretaeus Lib. 11. Cap. 5, says: " Cholera is a most acute disorder ; for in it the matter, which had 

been congested in the gullet and upper part of thestoinach is ejected by vomiting; while all that had been iwimming in the stomach and intestines is passed downwards. The fluids passed by the mouth are at first like Water ,• those by the anus, stercoreous, liquid, and of foul smell ; but if these are helped off by clysters, the motions are Jtrst like phlegm, then bilious. The disorder is light at first, without pain. Afterwards, however, constriction of the iEsophagus and Cardia, and violent pain of the belly, supervene. Should the disease still increase, the patient grows faint ; tjie limbs lpse their strength ; the mind is greatly depressed ; there is abhorrence of food ; the sinews are contracted ; the muscles of the arms and legs cramped ; and the fingers and toes twisted. Vertigo and hiccough arise; the nails grow blue ; the extremities cold ; and the whole body is shaken with rigors. When it comes to the height, then he is covered with sweat; bile is poured 

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14 

PREFACE. 

The disorder, as it lately visited India, was new in this alone, that there it, for the first time, assumed the Epidemical form ; and by the uni- 

dically affected and the urine suppressed ; the voice is lost, and the pulse is exceedingly feeble. Death at length ensues; miserable and full of torments, from convulsion, and empty strangulated vomiting" And Aurelian Lib. 111. Cap. xx. "The attack is frequently preceded by disordered stomach, tension, anxiety, tossing, watchfulness, torment of the bowels ; with noise, pain of the belly, and looseness, belching, nausea, flow of the saliva, and oppression of the praecordia. At the commencement of the attack, there is vomiting, first of corrupted food, then of humor, and yellow bile, then of stuff like the white of an egg, then green and ceruginous, and lastly black. Along with these humors there are others white t like spittle. The pulse becomes contracted ; the joints grovv cold ; and the countenance dark. — There is great heat, and insa« tiable thirst ; hurried breathing ; contraction of the limbs ; and tension of the sinews, and calves of the logs and arms. The pra?cordia are drawn upwards, wilh pain like that of the Iliac Passion. Sometime; the ejections from the mouth arc Woody. The counten mcc is collapsed ; the eyes are red ; and there is hiccough towards the eiid." The reader must not imagine, that with the Ancients bile had generally the contracted signification in which it is accepted by the Moderns. With them it was connected with all the vanities of the humoral pathology, and to quote an expression of Galen, Wls M of infinite variety of colours, from pale to jet black." With us it would sound ridiculous to speak cftranspaneral 



and grievous scourge, than it had hitherto 

appesir from the following quotation from Celsus. In his eleventh Chapter, Book fourth, on the diseases of the Intestines, he S3ys : " And first we must make men* tion of Cholera ; because it seems to be a morbid affection common to both stomach and intestines. — For there is at one and the same time a vomiting and purgng, together with inflation ; the intestines are tormented ; bile flows upwards nnd downwards, at Jlrst like boater, then liko the wishings of recent flesh ; sometimes thite, sometimes black, or of various colour. Whercbre, from ih:it name [XoX?; oile] the Greeks have called he rtiliMp C/rj!rtu." He then goes on to state the other 

Symptoms. In like mnnner Avicenna p. p. 492 and 502, Edit. Home, 1.393, distinctly meniiousthe watery vomiting, purging, spasms, loss of pulse, cold sweats, &c. and he is Ipiiowed by several hundred Asiatic writers on physic. Without collecting further authorities the reader may be referred to Bontius, Sydenham, Iliverius, Hoffman, Cleghorn, Sauvages ; and above all, to the excellent acfcounts of Girdleslone (Essays p. 51) Curtis (Diseases of India, p. 44) and Johnson (Influence of Tropical Climates m. 396.) It is curious, that the disease is unknown in 1 * though, there is there the same prevalence of SoutU East wiuds, ami great inequality of diurnal and nocturnal temperature, which have been in other quartern cb•erved to accompany and accelerate its progress. Vide Prosper Alpiuus, Chap. 7 and Bth. The disorder is unquestionably the Cholera Morbus of Sydenham, the Cholera Spontanea of Sauvages, the Spasmodic Cholera, Cramp, or Mort de Chien of Curtis, and Johnson. The Malady de¦cribed by Dr. Girdlestone, differed in this, from the present Epidemic!*, that purging dots not appear to have been 

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been, — It had long existed partially in these Settlements, and previously to its late appearance, had been faithfully delineated by three Medical Officers in His Majesty's Service, Drs. Girdlestone, Curtis, and Johnson. At no time however, as far as can be learnt from strict enq-iiry, did it prevail generally over the country, pn iously to the autumn of 1817.* Sometimes indeed, it broke out with such extreme violence in particular spots, as to raise great apprehension, lest it should spread in the manner of a pestilence. But no sooner had the peculiar circumstances, which gave rise to it in those quarters, ceased to exist, than the disorder rapidly declined ; and left the places in the vicinity untouched — Some of these instances are too remarkable to be passed over unnoticed, in an essay of this sort. 

Rie first, which we shall mention, took place urdvrar about thirty-five years ago. — It is nknown to our readers, that this is the spot, lich the waters of the Ganges first issue the mountains into the plains. It is held 

* We have examined the Native histories of Ferishtu and Ghoolam Hoosein, which contain an acconnt of Indian af- Juirs from (lie time of the 3\loohummeda!i Conquest to the close of Mr. Hastings' Government ; but although they ad* tert to the occurrence of frequent famine and plagues, they do not once mention Cholera ; a uroug proof, that it never 

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very sacred by the Hindoos ; and every year at the full Moon of April, but more especially every twelfth year,* an immense concourse of people assembles near it, for the purpose of ablution in the holy stream. It so happened, that the year 1783 was one of the twelfth years deemed peculiarly propitious ; and that the body of jpilgrims then collected was unusually great, amounting, it is believed, to between one and two millions. It is the custom of the pilgrims torepair to the bed of the river, where they pass fjie night with little, if any, shelter: many persons being crowded together under the cover ©f a single blanket thrown out as an awning. The temperature is very variable : the days being hot and the nights cold, with heavy dews, and sudden chilly blasts from the clefts in the mouii• On the present occasion these causes! were sufficient to generate the Cholera ; which broke out soon after the commencement of the ceremonies, and raged with such fury, that, in less than eight days, it is said to have cut oif above twen• During April of every twelfth year, the Sun is in Aquarius. Tins Sign is by the Natives called Koombh ; and the fair of this year, the fair of the Koomb'h. i One manuscript iv our postegsiou says : " the disease fcroke out ou the springing up of au Easterly or land wind during a hot nl-ht, and carried off innumerable persons." 

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ty Uiousand victims. But so confined was Its influence, that it did not reach the village of Juwalapore, only seven miles distant ; and ceased immediately upon the concourse breaking up, on the last day of tlie festival. 

The next instance, which we shall quote, occurred two years before, in the Northern Circars: the narrow belt of land extending North and South from Ganjam to Cliicacole, along the sea coast, and bounded by high hills to the West, and by the sea to the East. A Division of Bengal Troops, consisting of about five thousand men, was proceeding, under the Command of Colonel Pearse of the Artillery, in the spring of 1781, to join Sir Eyre Coote's Army on the Coa3t. It would appear, that a disease resembling Cholera had been prevalent in that part of the country some time before their arrival: and that they got it at Ganjam on the22d of March. It assailed them with almost inconceivable fury. Men in perfect health dropt down by dozens ; and those even less severely affected were generally dead, or past recovery, within less than an hour. The spasms of the extremities and trunk were dreadful; and distressing vomiting and purging were present in all. Besides those who died, above five hundred were admitted into Hosdisease 

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continued unabated, and more than one half of the Army was now ill. Hitherto the Commanding Officer had struggled forward ; hoping to reach more healthy ground ; but it was now found impossible to move further. Almost all the servants and Camp followers had deserted; and although the greater part of the train and magazine had been left behind, there was no longer sufficient carriage to convey the sick. The scene was most distressing. To use the words of Colonel Pearse, " Death raged in the camp with horror not to be described ; and all expected to be devoured by the pestilence. In vain I studied to discover the cause of our misfortune, I attributed it to poison ; but at length found, that there had been a pestilential disorder raging in the parts through which our first marches lay, and that part of our Camp was already drinking the air of death and destruction." The road was strewed with the dead ; and the Detachment was scattered through a space- of more than thirty miles. The sick in Hospital now amounted to 1143. It was therefore determined to halt a few days at Itchapore ; the inhabitants of which gave up part of the town for the accommodation of tlje Troops. The good effects of this step were immediate and striking. The hopes to the sick began to revive; the deaths became fewer; and no. more fiesh cases were admitted* By the 29th the 

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sick were diminished to 908 ; and oti the first of the following month, the army was enabled to recommence its march : leaving about 800 con. valescents behind. The total number of deaths is not stated ; but it is learnt from oral communication with individuals who were present with the Detachment, not to have fallen short of seven hundred men. As was generally the case in the several Divisions visited by the late Epidemick, the disease first attacked the camp followers ; then the Sepoys ; and lastly the Europeans. But few Officers were affected; and of these only one died. It is clear, that the disorder was totally new to all persons in Camp. It was at first attributed to fatigue and irregular living ; then to poison. The bodies of such as died presented strong appearances of poison. — It was likewise discovered, that the natives of those districts used Euphorbium instead of Soap in washing, and that the troops unwittingly drank the water of the ponds impregnated with it.— 'But when it was found that the disease did not decrease, upon proper precautions being taken in this respect ; it was with greater justice referred to the heavy dews and great vicissitudes of the weather, connected with the peculiar situation of the troops. — They had been marching almost incessantly for six days, through sand and salt water ; and were 



move. A Violent wind blew day and night along the whole shore ; and although it was not quite so strong at night, it was then accompanied with such a penetrating moisture, as to wet through the thickest woollen cloaths. — The troops were besides, in no condition to withstand the inclemency of the season. — They had no tents ; and few possessed even a blanket to shelter them on getting to their ground. They generally marched in the night ; and many suffered by incautiously lying down, while warm from exercise, and falling asleep, exposed to the influence of a damp and noxious atmosphere. — The mode of treating the sick is not mentioned in any of the documents to which access has been obtained. — It is however stated in one of Colonel Pearse's dispatches, that not an ounce of opium was used in the Army ; and tradition gives reason to fear, that Emeticks of Tartarized Antimony were too freely 

* The occurrence of the disease on this occasion is noticed in a letter dated the 27th April, 1781, from the Supreme Government to the Court of Directors; and the destruction which it caused fa tin's Detachment, mentioned in terms of becoming regret. After adverting to its progress fa the Ci rears, the letter thus proceeds : " The disease to which we allude, has not bocn confined to the Country near Ganjam. It afterwards found its way to this place (Calcutta); and after chiefly affecting the Native Inhabitants, so as to occasion a great mortality during 

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22 

PREFACE. 

There seems to be something in the situation and climate of the Northern Circars, which peculiarly disposes to the production of Cholera - for we find that a second Detachment of Bengal troops marching under Colonel Cockerell for Seringapatam, in the spring of 1790, was affected in a similar way with that of Colonel Pearse, This Detachment moved from the vicinity of the Soobanreeka River in the end of March. As it proceeded Southward, the weather became warmer. A fresh Southerly wind prevailed during the day ; increasing in strength as the Sun ascended to the meridian ; gradually becoming moderate as it declined ; and dying away with $he close of the evening.-— A calm night succeed" ed ; close and sultry in the early part ; and damp and chill, with heavy dew, and slight Easterly wind from the Sea, towards morning. The atmosphere was during the day overshadowed with 

the period of a fortnight, it is now generally abated, and pursuing its course to the northward." It would have been interesting to have traced this disease, as it seemed to put on the Epidemical form, but every attempt to discover its further progress has proved fruitless. Even the few facts regarding it however, which have come to light, hud they been known sufficiently early, would have required, that the assumptions in the text, as to the previous existence of the disorder, should have been at least softened down. But access was not had to the letter, until this report had gone before Government* 



thick white clouds ; and loaded with vapours. The Cholera commenced late in March ; but was not general till the 15th of April, when its activity was heightened by a heavy squall of wind and rain, which over-took the Detachment at Manikpatam, an the North side of the Chilka Lake. From this time till the middle of June, when the Detachment had passed Ell ore, and the weather had become more moderate, from frequent falls of rain, the disease proved very fata!. As in Colonel Pearse's Division, the troops had no tents, and were sheltered from the inclemency of the night only by the thin coveriiig of a country blanket stretched across a bamboo ridge pole; and even this comfort was not possessed by the camp followers. The troops were much harassed by long marches, on a sandy soil frequently not affording water ; and from the difficulty of dragging the guns over very bad roads, they sometimes did not reach their ground until sunset. In the middle of the day the thermometer rose as high as 124. The disorder was characterised by precisely the same symptoms, which marked the late Epidemick. It began with violent pain and spasm of the stomach and bowels ; which were followed by purging, vomiting, and all the signs of extreme debility. Luckily laudanum and cordials were resorted to for it* cure ; and it did less mischief, than in the- former Detachment. 

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As far as has been ascertained, these are the only instances, in which the disease could at ail be said to have assumed the epidemical form, prior to 18 17. It is indeed rumoured, that it overran the Province ofίundlekund about forty years ago ; and was exceedingly destructive in Bengal some time near the end of the last century. But if it were so, how does it happen, that no record has been preserved of its destructive effects, and that the oldest Inhabitants, when applied to, can give no specific information on the subject ? The truth, is, that as an Epldemick the disease is quite new. Let us hope, that like other pestilences, with which Providence has from time to time been pleased to afflict mankind, it will prove only of temporary duration; and that these Provinces will soon regain their wonted salubrity. 

Kcjl Board Office, Calcutta ; > st July, 1819. ) 

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cipally contributed the information contained in the following Report. ? . S Principal Scati of Names. Appointments. kttnninhc*. Sup^. Surgn. A.Gibli, Me«rut, - - - - Meerut. Do. do. I. Hamilton, - Benares, ----- Chunar District. Do. do. A. Ojjilvte, - Kurnal, - - - - Brigr. Arnold* Forec s Hansi. Do. do. J. Dyer, - Cawnpore, - - » Nagpore Force. Do. do. G. Reddie, - Rajpootana, - - - Left Divti. ar.d Raj* pootanu Force. Do. do. A. Dickson, - Saugor, - - - Muttra. King's Surgu. I. F. Smet, - - 11. M. 3t!i Lt. Drags. Meerut. Do. do. R. Spencrr, - H. M. 2 1st do. do. - River and Cawnpore. Do. do.Thos.Jackson, H. M. Ist Bn. nth Regt. of Foot. - Mesrut. Co.'s Surgn. Thos. Yeh^ - - Benares, - - - Benares. Do. do. S. Durham, - Medical Depot, Cawnpore, - - Cawnpore. Do. do. Chas. Hunter, Bth N. I. - - - - Centre Division, Do. do. Js. Johnston, Furruckabad, - - Futtigwh. Dir, do. W. L. Grant, Moorshedabad, - - Moorshedabad. do. J. llidges, - 3d N. C. Centre Division. Do. do. J. Lungstafi^ 2d Bh. 25th N. I. - Centre Division and Oude. P>. do. Js. Gibb, - StuJ Poosa, - - Tirhoot. Do. do. David Todd, Dacca, - - - Dacca. Do. do. John Swiney, Garrison Fort William, Calcutta. Do. do. Peter Breton, Rainghur Bn. - - Sumbhulpore. Do. do. I*. Williams, Bth N. C. ... Eltwah Frontier. Do. do. George Skip- ) N j C March from Kishentoni • - • J ( gunge to Allahabad. Do. do. Colin Camp- )g^ C Cco tr. a«d Left Di*)e"» "» )e - » - ) C visions. Do. da. K. Impey, . Cavalry Depot, | Cawnpore. 



- S PftIKCIFAL Seats or Names. AtMOWPrnv, Expehiknck. 

Co.'s Surgeon G. G. Campbell, - - Medical Depot, Agra. Agra. Do. do. S.Ludlovr, - Delhi Residency, ¦ Delhi. Do. do. Thos. Tweedie, - - - - 7th N. C. • -. - - Mooltaye. Do. do. John Marrfinll, - - • 4thίegt.N.C. - * KisheiKr.nje. Do. do. Oswald Hunter> .... eth R. N. C. - - Buxar, Do. do. David Renton, - - - lstί. N. C. - - - Mullje. . Do. do. Thos. Ciichton, 2dίn. 3dN. I. - - Centre Division* King's Acting Surgn. Badenach, - - - H.M. 59th R. of Foot, Calcutta. King's Asst. Surgn. I. Fawcett, - - 11. M. 24th R. of Foot Dinapore. Do. do. If. Owen, - H. M. Ist Bn. 87th R. of Foot - - Centre Division. Corn's. Asst. Surgn. Js. Mellis. - - Nmklea, - - • - Nudd™. Do. do. A. Hall, - - lstίn. lstN. I. • Malwa. Do. do. Wm. Farqtihar, - - - Agra, Agra. Do. do. P. M ithew, - 2d Bn. 2 lit NI, • - Sooltanpore Oudr. Do. do. G. O. Gardner, - - - Backergunge, - - - Backergunge. Do. do. J. Castle, - Ht Bn. 6th N. I. - Malwa. Do. do. Andrew Brown, - - Bullooah . .- - Bullooah. Do. do. Chs. Stuart, - Jungle Mehauls, - - Rajshahy. Do. do. J.John Hogg, Garrison Monghyr, - Moiighyr. Do. do. J. Adams, - Ally Ghur, - - - Coel. Do. do. Robert Ty tler Allahabad, - - JemoreandAUahabaJ. J)o. do. George Baillie, . - - ilesy. Court of Holkar Malwa. Do. do. Jamc* Gricr- Doing duty Ist Bn. » O n, 15th N. I. - • Lucknoir. 

26 





. S Principal Seats oT Names. Appointments. < ExrSnittocM. 

Co.'sAsst.Snr.G.Lainbe, lstίampora Local B. Omit. Do. do. Js. Ranken - Snrgn. Poll. Agent, Loodiana. - - - Jeynore. Do, tlo. E. Macdonald, - - - ~'d Bn. 24th X, T. - Lfthnrgaon. Do. do. John Lamb, - MaUla, - - - - Malda. Do. do. P. Halket, - Ist Bn. OJth N. I. - Itajpootanu Toxce x Do. do. Wm. Hogg, Hooghly, - - « Juaiipore. Do. do. George Lawsou, - lstίn. sth N. I, - Delhi, Do. do. Edward Muston, - - Sarun, • t Chupra, Do.do.Janaes Thomson, - - -«d Bn. 26th K. T. - Ilansi Force. Do. lio. John Moriion, - - - Tirhoot, - • MoozuflTerpore, Do. do. J.J.Patterson, 2d Bn. 3oth X. I. - Midnapore. Do. do- R. Brown, - Doing duty H Bn. Bth N. I. - - Left Division. D->. do. George G. Spilsbnry, - - 2d Bn. 15th N.I. - Cawnpore. Do, do. Andrew Murniy, ... - «d Bn. Ist N. I. - - Centre Division. Do. do. do. Harding, - Cawnpore, - - Cawnpore. Do. do. Chas. Kenny, - Doing duty ArtMiery, Kurnal, - - Left Division. Do. do. John Allen, - Ist Bn. 14th N.I. - Left Division. Do. do. John Tytler, - Chnmparim Light Infy. Bn. - - - Patna. Do. do. Wm. Jackson, 2d Bn. 1 lth N. I - Centre Division. Do. do. Chas. Kay, - Ist Bn. 2Sth N.I. - Left Division. Do. do. A. Srratton, - Ist Bn. 16th N.I - Cliittagong. Do. do. John Gr ay, - Body Guard, - Oude. Do. do. I. M. Duvidson, - - - - Purnea, * - Purnea. D.. VTtbb, l^t Bn. 24th X.I. - Etayah. Do. do. I »-.tsou, Bijiuux's, - - Benares. 

27 







28 

. S PaiNCirai. Skats or Appointments. j Exfrtwrai. 

Names. 

Co.'sAst.Sur.YV.Ltslie, M— ill. - - Mecrut. Do. do. Alexr. Maclean, - - Coramijsion, Cuttaek, Calcutta Do. do.Clis. Hickman, Golundauze, - Centre Division, Do. do. Thos. Halej', Artillery, Agra, - ShkjchtnpOfC Dl\ do. T. E. Baker, - Garrison Asst. Surgn. Buxar, - - Futtigiuh, Do. do. Thos. Stod. dart, - - Artillery, Benares, - Allahabad. Do. do. Alexr. Garden, Medl. Store keeper, Nagpore Sub. Force, NagpoM Force, Do. do. C. E. Everest Resy. Katniamlhoo, - N.tpal. Do. do. W. Gerard, Ist Bn. 26tli 11. N. I. Biuullekund. Do. do. John Row, - ad Bu. 29th ltegt. - Hansi Force. Do. do. G. N. Cheek, Gya, ... Centre Division. Do. do. C. S. Curling, Pioneer Corps, 2i£ Ceylon Vol. Bn. - Centre Division, Do. do. C. B. Francis, 2d Bn. 9th N. I. • Mirzapore. Do. do. John Grant, lid Bu. 4thN. I. - Sumbhulporc. Do. do.Octavius Wray 'Al Bn. Hthί. N. L' Berhampor*. Do. do. 11. Smith, - Ist Bn. Artillery, - StUgwDietriati Da. do. John Turner, Bunhvan. Do.dc. T. Henderson, Juanpore, - - Tjpptrah. Do. do. John Adam, Artillery, Nagport Sub. Force, Clionar. Do. do. Wm, Dyer, - Doing duty Btli Dns. Hansi Division. Do. do. P. Sutcr, - Gardiner's Ilorsu, - Khassgmijj«. Dr>. do. Colin Maclaclilan, - - - 3d Rohillah Horsp, Centre Division. De. do.M. Mendes, - Doing duty 2d Rohilla Horse, - - Variou 1 !. Do. do. John Glas, - Bhaugul-pore, - - Bhaugulpore. Do. do. John Macίae, Chittisgong, - . Chitta^ong, I >o. do. Henry Young, 84 Purgunnalis, - Calcutta. Do. do. George Bal- Jard, .... Baulcah, - ~ Bittleihi 







IN attempting to write a description of the Epidemick, which has of late so severely afflicted the Continent of India, it may not be amiss to give some account of the Weather, which preceded its appearance ; in order, that it may be seen, in what respects it differed from that usually prevalent during similar periods of former years ; and how far the general insalubrity of the air, was fairly attributable to such difference. 

It must be confessed, that researches of this nature have hitherto proved but little satisfacory. Long experience has shewn, that the noxous qualities of the atmosphere, giving rise to epidemics during particular seasons, can rarely, f ever, be traced to any irregularities in its manifest and sensible properties ; and the enquiies of the most sagacious observers, in matters of o abstruse a nature, have generally terminated in an honest confession of their ignorance, or in a poor endeavour to conceal it under some specious, but unmeaning name. — Hence, among the* ' 

i 



ancients, those wild speculations regarding the untoward influence of the heavenly bodies ; the malignant conjunction of the planets ; and the too near approximation of a comet to our globe ; which easily gained credit with the simplicity of the darker ages. Hence, too, the theories of an undue distribution of the electric and magnetic fluids ; of a latent alteration in the bo web of the earth ; of the distant agency of volcanic eruptions, and earthquakes ; and many others equally visionary, with which it has been attempted to appease the curiosity, and relieve the suspense, of these more enlightened days. 

But, as it is only by the accumulation of large bodies of facts, that we can expect to arrive at any satisfactory conclusions in matters of science ; and as the seasons, which we are about to describe, were certainly diversified by very unusual irregularities j we should scarce be jus. tified in passing them over, entirely unnoticed. It will still be left to the reader to determine in his own mind, what connection they had with the subsequent sickness ; and what influence, if any, they exerted upon the rise and progress of the Epidemick. Before describing the nature of these irregularities, it will be necessary, for the sake of subsequent comparison, to premise a few words on the kind of Weather usually prevalent throughout the year, on this side of India, 

30 





INTRODUCTION. 

31 

In Bengal, and in the Central and Northern Provinces of Hindostan, the seasons, obedient to the course of the sun, generally succeed each other with an undeviating regularity, quite unknown in the variable climates of the old world. Taking their names from the quality, which peculiarly characterises their march, they have, by common acceptation, been divided into the cold, the hot, and the rainy season. 

tThe Cold Season commences with November, d ends in February.— About the middle of October the weather begins perceptibly to change. — The day 3 are still oppressively c; but the mornings and evenings gra- Uy become cool. The wind, which ing the preceding months had blown generally from the South and East, now begins to come round to the "West and North ; and to carry along with it the heavy masses of clouds, which almost constantly float about, and obscure the horizon, during the whole of the - Kains. The atmosphere, from being very damp and watery, grows dry and elastic ; and the heavens begin to brighten a little. But these appearances are not yet uniform ; the sky still at § becomes gloomy and overcast; and showers, accompanied by thunder and ng, shew that the South East Monsoon t yet finally taken its leave. 

f 8 



In November, the weather becomes delightfully fair and pleasant. A cold sharp wind ntfw blows steadily from the North. The air is dry, clear, pure, and serene ; the vault of heaven is of a beautiful deep azure colour ; and in general not a cloud is to be seen. The nights are clear,, with heavy dews. The Thermometer* in the shade ranges throughout the month from 66 to 86 ; the mean heat about 74 j medium altitude of the Barometer 29' 98. 

As December comes on, a considerable change takes place. Although the middle of the day, and the afternoon, be clear and fine ; a haze generally towards evening collects round the horizon ; and obscures the setting sun. As the night advances, thick fogs, sometimes general, sometimes partial, begin to collect ; and do not disperse until morning. As they are broken up by the influence of the sun's rays, their vapours rise and form grey masses of clouds ; which render the early part of the day hot and unpleasant, and do not disappear until it is far advanced. These fogs do not by any means occur every night* Sometimes, though rarely, the whole month passes over without them ; ordinarily they appear only three or four times ; sometimes during 

* Throughout this Essay the thermometer is spoken of only in the shade. 

32 





several nights successively. As in November, the North and West are the prevailing winds. They are very sharp, but blow steadiJy, never rising to a gale, nor falling to a perfect lull. Tbe range of the Thermometer is from 06 to 78 ; Knean temperature about 70j altitude of the meter 30' 01. 

During January much the same weather prevails. The air is serene and piercingly cold. The wind blows steadily, and perhaps more forcibly, from the North and North-west than in December. Fogs are still very frequent, and sometimes so thick, that scarcely any object is visi* ble until a late hour of the morning ; and every thing exposed to the external air becomes wet, and covered with drops of moisture. They may often be seen rolling in large dense bodies in opposite directions. During the clear nights, heavy dews fall The range of the Thermometer is from 47 to 75 ; the mean heat about 68 j altitude of the Barometer 29* 99- 

EThe weather keeps very pleasant until the bond week of February ; when the middle of the day grows warm ; and the change of the wind to the South and East, and the collection of clouds in the horizon, with threatenings of thunder gusts, portend the approach of the Hot 

33 





INTRODUCTION. 

34 

KM. At night the air is raw and cold ; and lornings are foggy. The Thermometer ranges 65 to 82 ; the mean heat 76 ; altitude of meter 30- S. 

Sometimes, a few heavy and refreshing showers fall about Christmas ; but the whole of the Cold Season is generally marked by the total absence cfrain. It is remarkable how invigorating the cold bracing wind of the North, and the pura clastic air, and clear sky of these months prove to the European constitution : harassed and broken down by the previous long continuance of moist and oppressive weather. The appetite and strength, which had long before failed, now return ; and the whole frame becomes light and springy. Vegetable nature partakes of the generally salubrious effects of the season; and garden plants and exoticks, at all other times killed by the excessive heats, now grow with freshness and vigour. 

iie Hot Season may be considered to set in r with March. The sun now becomes very irful ; and the days are warm and even hot. r are, however, prevented from being oppres>y the strong and steady winds uniformly ing from the South. Fogs are yet not mmon in the mornings j and as th^y 



INTRODUCTION. 

35 

dear up, go to the North to form, with the thick, dispersed, masses of clouds, that are constantly drifted along the horizon by the wind, materials for the approaching storms. These storms, which by the inhabitants are termed north westers, do not however, generally occur till towards the middle and end of the month. They are usually preceded during several days by cloudy mornings, and strong gales. Then for one or two evenings comes on distant thunder, with strong gusts of wind, but without rain. Towards the afternoon of the day in which the storm is to occur, the wind, which during the morning and forenoon had been continued and boisterous, begins to fail, and at length settles into a dead calm. The air becomes oppressively sultry. The clouds gather in the North West ; and form a deep, dense, lowering, bank. Vivid lightning, accompanied with heavy thunder, and gradually advancing nearer and nearer, indicates the immediate approach of the storm. At length, the calm is suddenly interrupted by a tremendous burst of wind, and by clouds of dust, which darken the horizon. Then follow torrents of rain, with close and heavy thunder ; and these are soon succeeded by a serene sky, and cool air. Epearance however, of these sudden corns is not always the same — sometimes a 



36 

INTRODUCTION. 

the place of the heavy fall of rain ; sometimes there is no rain, even when the fury of the wind, and quantity of the lightning are excessive. The general time of their coming on is about sun-set ; they rarely occur earlier than six in the afternoon, or later than midnight. When the days keep clear, and the wind moderate, heavy dews fall at night ; but in blowing weather, there is no dew : the moisture as it settles, being carried off by the wind. Range of the Thermometer from 73 to 86 ; mean temperature 79 ; al. titude of Barometer 29° 86 : the fall in the mercury being ascribable to the prevailing high winds, and increasing rarefaction of the air. 

April has generally blowing weather through* out. The prevailing wind is still the South. The atmosphere is sometimes clear, generally hazy, with much dust, and thick loose clouds continually moving to the North. The weather is hot, but pleasant, till towards the end of the month ; when the nights become close and sultry. The general closeness however, is from time to time relieved by thunder storms, and seasonable tails of rain. The wind usually becomes hot to the feel about the 20th ; and so continues to the end of the succeeding month. Kange of the Thermometer from 78 to 91 $ 



May is the most disagreeable month in the year. In the commencement there is high wind at times ; but during the greater part of the month the weather is exceedingly close, still, and oppressive. The nights especially are sultry. There is little or no wind in the mornings ; which are thick and hazy, with low, gloomy, scattered masses, of clouds. But as the sun rises, a breeze springs up from the South, and keeps gradually freshening until the evening, when it again fades away. The air is hot, but inelastic ; and as it does not carry off the per•piration, leaves the body moist and clammy. The dejection and lassitude now universally produced by the great-heats, are however fortunately removed by the frequent recurrence of violent North-westers, with their usual accompaniments of thunder and rain. There are no fogs during April or May. The Thermometer ranges from 81 to 93 ; mean heat 86 ; Barometrical altitude 29° 60. 

In some years, but not always, nor even generally, between the 15th and 25th of the month, the Horizon becomes overshadowed with dark thick clouds from the South East quarter ; and much rain falls during several days ; constituting what are called the lesser rains. But more comjnonly, the close muggy weather continues 

S 

37 





INTRODUCTION". 

38 

with little interruption, until the end of the first, or the beginning of the second week of June ; when the veering round of the wind towards the East ; the occurrence of thunder in the evening ; and the constant cloudy state of the atmosphere, indicate the approach of the regular rains. These commence from the 4th to the 18th of June; and continue with frequent variations during the four following months. At first, they set in with thunder showers, sometimes heavy, sometimes light, generally from the South and East. Then follow several days of very heavy rai^n ; during which the sun is completely hid from view. Then there is a shew of fair weather, with sunshine, and beautiful clear nights ; but this is of very uncertain duration ; and liable to be interrupted with scarcely any previous warning. The heavy rain rarely keeps up for more than forty eight hours at a time ; then gradually diminishing to drizzling, and at length giving way to fair weather. There is at frequent' intervals, during the whole period of their continuance, much vivid lightning ; with violent thunder storms, and strong gusts of wind. The wind frequently changes from East, to South, and West : rarely to North. Its return to the East, and ilxiiig steadily in that quarter, is usually accompanied with heavy rain. 





•nenced, the atmosphere becomes manifestly cooler ; and the weather in general very pleasant ; the only exceptions being now and then a sultry night ; and the dead oppressive calm, which sometimes precedes a storm. From the dust and other particles floating about in the atmosphere being carried away by the successive showers, the sky during the intervals becomes beautifully clear ; the sun shines with great splendour ; and the nights are bright, with innumerable stars. There is very little variation of the atmospherical temperature throughout the season. The Thermometer ranges from 77 to 88 or 90 ; the mean heat being 81, or perhaps a degree or two higher. The air from the con* stant rain becomes surcharged with moisture %. and every thing exposed to it gets damp and mouldy. There is consequently little alternation in the Barometer. The mean altitude is about 29 : 45. It is higher at night than in the morning, and lowest at midday. 

In September the Barometer Is observed to a little ; but there is little perceptible change he weather, till the middle of October. The i then begins to abate. The showers are er in number ; and though heavy, of short ition. The wind gets very variable. There still frequent shews of thunder and light. 

g 2 

39 





ning ; but they generally pass off without produ6» ing rain. The days are yet sultry; but the mornings and evenings begin to grow cool ; and the increasing clearness and elasticity of the air, nvith the coming on of dews at night, presage the speedy accession of the cold season. At length the veering round of the wind to the West-ndrth-west quarter, the disappearance of clouds and vapours from the horizon, the sharp* ness and dryness of the air, the rapid rise of the Barometer, and concomitant fall of the Thermo* meter, towards the end of the month, evince the entire departure of the Rains. The total quantity of rain falling during the season varies much in different years. In Bengal the average has been fixed at 70 inches. 

The effect produced upon the fade of nature, by the change from the destructive heats of April and May, to the refreshening days of June, js immediate and striking. The whole of the vegetable kingdom, which had drooped during the previous long drought, is brought into speedy and active life ; and the ground, from being parched and bare, is soon covered with a luxuriant carpet of green. The animal kingdom shares in the favorable revolution ; and all space is filled with myriads of insects, just called into existence. The rivers, wells, and tanks are speet 

40 





Ailf filled to their margins. In the lower parts of Bengal, the face of the country is scon covered with water ; often to such depth, that a passage may now "be made in boats between places, which during the cold and hot season lay high and dry. 

So much has been already written upon the diseases endemial in this climate, that it will be sufficient for our purpose, merely to enumerate their names ; and to specify the seasons, in which their several species are most prevalent. The Cold Weather brings with it the ailments usually produced by marked alternations ©f heat and moisture ; and Cattarhs, Intermittent Fevers, Rheumatisms, and Diarrhoeas are then common. The Bilious Remittent Fever comes on with the great heats of April and May, and predominates till August and September ; when it gradually gives way to Bilious Dysentery and Bloody Flux. Acute Inflammation of the Liver is met with in all Seasons, but is perhaps most common in the early part of the Rains. Besides many disorders common to it with other climates, Bengal is in a particular manner noted for the production of Enlarged Spleen, and other distressing diseases ; which however, as beiug of a chronick and sporadick kind, it is hardly to our present purpose to mention. 

41 









Cold Season 

It will be observed, that the foregoing notice's are more applicable to Bengal and the Lower Provinces, than to the central and upper parts of India. In the latter, the seasons are considerably modified. The Cold Weather begins earlier, and lasts longer; and is far more sharp, dry, and invigorating. It is very rarely accompanied with fogs. Throughout the Hot Months, the wind during the day and earlier part of the night blows strongly from the West ; and is so dry and fiery, that it parches up the whole country. The Raing set in late, and though sometimes vehement whilst they last, are of shorter duration. 

The changes which have taken place in the course and succession of the Seasons within the last few years in every part of Bengal, and its dependencies, have been so striking, as to have not merely attracted the notice of attentive observers, but to have become a frequent topick of common conversation. In noting the nature of these deviations, it will be necessary to begin pretty far back. 

In the year 181.5, a ratny season, marked by an excessive fall of rain, great inundations, and the bursting of the Ganges, Soane, and Coossee rivers from their beds ; was succeeded by a damp, unpleasant cold weather, with unusually fire* quent dense fogs in December and January, 

42 







43 

1816. Hot Weather. AprJ. May. 

RaJnj t - j . 

The following hot weather was remarkable, «r the late and scanty appearance of the usual under storms; and consequent great heats and drought Although several North Westers occurred during April and May, they were very partial in extent; and generally unaccompanied with rain. On the 15th of April 1816, a little before midday, a shock of an earthquake was felt in Calcutta. Towards the end of May, the weather had become so oppressive, that the Thermometer sometimes rose as high as 98; an unusual height in Bengal; and many individuals, both Europeans and Natives, dropped down dead 

in the streets. 

Much the same kind of weather was experien* ced in the Upper Provinces. A severe Cold Season, followed by excessive drought, gave rise to great sickness amongst the Natives ; and by destroying the spring (Rubbee) crop of grain, prepared for the succeeding general scarcity. 

In the Lower Provinces the dreadful sultry weather continued untiithe 14th of June, when the rains commenced. They kept up moderately in Calcutta and its vicinity, during the latter eof June, and the whole of July. A second i of an earthquake was on the night of the 





Ausust 

S.i A. sober. 

11th July, felt slightly at the Presidency, and more perceptibly at Moorshedabad. Towards the latter part of August, and the beginning of September, the rain became exceedingly scanty, and the days and nights oppressively hot in Calcutta ; and in the western parts of the province of Bengal, the drought was so uncommon, as to dry up the rivers,, and give rise to apprehensions for the safety of^the rice crop. Then, about the end of the first week of September, this unwonted drought gave way, and was succeeded by very heavy rain, which lasted all the month, and cau» sed a greater and more general inundation than had occurred within the recollection of the oldest inhabitants. 

The effect of these sudden and unusual extremes, was very discernible in the unwholesome condition of the atmosphere then present ; and in the kind of the prevailing complaints. 

Instead of acute dysentery, and the other inflammatory diseases generally predominant at this period, it was remarked by the medical men, that the only cases falling under their notice were low fevers, and other disorders of the typhoid type. Of this a remarkable proof was exhibited in the occurrence of infectious Malignant Sore Throat : a disease previously known only by name in this quarter of the globe. 

44 





Upper Province::. Rain*. July. August. September. 

In the Upper Provinces, the extraordinary scantiness ot the Rams was yet more remarkable j and was attended by more deplorable results. In the month of July a few showers fell; but they were partial and of short continuance. More generally, from Benares upward*, —Oude, the Districts within the Dooab, and those west of the Jumna, were dried up by the long continued and unceasing heats. The parching westerly wind kept blowing throughout August, and the first fort- night of September. Not a shower fell; and so excessive was the heat, that tatties were in use at Futtighur, Coel, and other stations, during the whole of this period. Since 1803, the memorable year of the commencement of Lord Lake's camliigns, no such season had been experienced. s in Calcutta, and about the same time, this long jriod of drought was succeeded by heavy and cessant rains for many days; and the whole 

face of the country was laid under water.. 

It was not to be expected, that so great a deviation from the common course of nature, and such extraordinary and sudden extremes, should prove wholesome to the human constitution. t* accordingly find, that the sickness, before ted to have crept in amongst the Natives, had ?v become general; and, before the end 

h 

45 





46 

nfinoDUCTioif. 

of August, was raging epidemically in almost every town and city between Patna and Saharunpore. It exhibited itself in the shape of a bilious remittent fever, of a violent inflammatory type ; accompanied, like the yellow fever of the West Indies, with suffusion of the skin ; and, unless when cut short in the commencement by bleeding and other powerful auxiliaries, rapidly running its course ; and in spite of every remedy, terminating fatally at the end of two or three days. — The width of its range precluded the possibility of its being referred to any causes purely local j and that it was not kept up by infection alone, was proved by the indiscriminate nature of its attacks. It seized equally Europeans and Natives j and as readily entered the open and spacious house of the Officer and Civil Servant, as the crowded barrack of the Soldier, or low filthy hovel of the Native — The mortality produced by it in Delhi, Saharunpore, Futtighur, Benares, and other large Cities, was very great. In Delhi, of two Natives Corps alone, there were five hundred men at once sick in Hospital. In Dinapore, and at Ramnuggur, the troops suffered severely. Of the European Flank Battalion, 648 strong, stationed at Allahabad, 305 men were attacked during October ; early in November there were at one time 180 rank and file, and twenty women and children, on the sick list; and 



in the whole, only 70 men of the seven Companies of which the Corps consisted, escaped the disease. But Cawnpore was the principal seat of its ravages, amongst Europeans. — Of four King's Corps, the 24th Regiment of Light Dragoons, 7-35 strong, and the 14th, 66th and 87th Regiments of Foot, 852, 813 and 702 strong, then in cantonments, there were from first to last nearly 1000 persons taken ill. — The disease here began in August, prevailed during the three succeeding months, and did not finally withdraw until the setting in of the Cold Weather in December. It was at its height in September and October. Kight or ten, and sometimes even fifteen men, then died daily. The 87th and 66th Regiments Buffered dreadfully. From the time of their reaching the station they lost nearly four hundred men. The former corps is stated to have had 519 in Hospital at once j to have buried 21 persons (including women and children) in one day, and upwards of 90 of its number within a month. This is a degree of mortality, far exceeding any thing then on record in the medical annals of Bengal. 

The effects produced by so unparalleled a state of sickness will be best understood, from the following description written at the moment. " The 



47 





48 



December. 

be conceived at the commencement of the Cold Season. Every family was suffering in some of its members. All social intercourse was interrupted; and the only communication between separate families, consisted in visits of condolence and consolation. Of numerous Native villages* nearly the whole population was ill at one and the same moment ; and many of the shops were shut for want of people to attend them. The banks of the river were covered at all times with the dead and the dying : such had been the ravages of this dire distemper. — " It has been stated, that the disease abated in December. So early as the end of November, its attacks had become less frequent, and its symptoms milder; but relapse* were still common ; and it was very difficult to counteract the extreme debility invariably conse* quent on the atttack. 

A similar mortality, preceded by great scarcity of grain, prevailed about the same time in Cutch, iSindh, and the other States bordering on the western side of India. By the natives it was ascribed to the plague, and said so to have depopulated scvoral cities, that the living were unable to bury the dead. — Throughout Upper Hindostan, it wa* observed that horned cattle were very sickly at this period. Their bodies could be seen strewed in vast numbers in the pastures, by passing tnivcjlc^. 



Cold Set«o»: 



December 

If it should be thought, that the general sickness characterising this period lias been too long dwelt upon, as being different in kind, and therefore unconnected with that marking the following year ; it must be remembered, that all that is attempted to be proved in this essay, is the existence of a distempered state of the air, in all probability dependent on the irregularities of the season previously to the breaking out of the great Epidemick; and, that it is only by the patient investigation of minute details, we can hope to discover the causei producing the difference in the vitious constitution of the succeeding years. 

The ensuing Cold Season, both in'the Lower and Upper Provinces, was raw, damp, and unpleasant ; and throughout cloudy, with frequent falls of 

rain. 

In Calcutta November was marked by unusu- aliy frequent logs ; succeeded by warm days, and light variable Minds. During the month there were nine foggy mornings. Two days were cloudy; the remainder clear. —The Thermometer generally ranging between 70 and 77 at 10 A. M. 

In December the same kind of weather prevailed — There occurred sixteen ibggy nights; on two occasions five nights in succession—The days were still warm, and clear; with moderate breeze^i*wa the North and West-Range of the -MRSSSS: ter from 66 to 71, / 31*10 

49 







January, 

rebruarj, 



The early and middle parts of January w ere cool and pleasant, with fewer fogs than in the former months. — The prevailing wind was northirty, with more clear than cloudy days ; and the Thermometer stood much as in December. — On the 28th, light winds chiefly from the South, with very thick fogs, and sultry days, supervened, and so continued the rest of the month, 

The singular deviations from the ordinary course of the seasons, which marked the remaining part of the year, now began ; and February had much more the appearance of an autumnal, than of a cold weather month j — for it commenced raining heavily on the night of the Ist ; and go continued every third or fourth day till the end of the month. A reference to the annexed Tables will shew, that it rained excessively on the Ist, 2nd, 4th, 11th, 18th, 20th, 21st and 22nd. The reremainder of the month was cloudy ; with high winds from the North and East. There were two foggy mornings.-— The Thermometer flue tuati ng from 67 to 73. 

March differed from the preceding month, only in the frequency of thunder storms, during nearly its whole course. Much, and very heavy rain, still continued to fall ; and there was a constant alternation of cloudy and clear weather, 

50 





Ith winds varying greatly in strength, and latter almost always from the South. On the 21st ere was an exceedingly violent thunder am il storm, followed by torrents of rain; whic eatly injured the spring grain crop, and th w sown Indigo lands, and destroyed the bios m of the Mango, and all other fruit trees then bloom.* — The air, though cool, was raw anc pleasant. — Thermometer from 68 to 82. 

•The same kind of weather obtained during the whole of the season all over this side of India; and from Loodianah to the Presidency there was scarce a district or village in which the prospects of the (Rubbee) harvest were not blasted by heavy falls of rain, and long continued humidity of the atmosphere. — The following extracts from a meteorological journal kept during a journey by writer from Allahabad to Calcutta, will shew, that the Middle Provinces by no means escaped the general dreariness of the season. — February 4th, Jumna Ghaut, Allahabad. Morningcold and misty : wind South East. Temp. 5o at sun-rise, 71 at 2 P. M. — Off Benares. 9th, little wind easterly and cloudy. — 1 1 th, above Ghazeepore.— Wind fresh from the East; day gloomy, cloudy, raw, and uncomfortable. — 12th, Ghazeepore. Morning misty, raw and cold; day close and cloudy; little wind, chiefly from the South.— l3th, Uuxar. Very little wind, variable. Temp, becoming lii^her; at sunrise 63, at 3. P. M. 76 ; slight exertion produces perspiration. — 14th, strong wind veering from North East to North West ; much rain. — 15th, a great deal of rain during the last evening and night, which 

51 







There was nothing remarkable m the diseases of this period. — Europeans and Natives were now generally uncommonly healthy. — Among the former, chronic dysentery and rheumatism, were the prevailing complaints : on the 80th, however, an European soldier belonging to His Majesty's 59th Regiment, then in Garrison at Fort William, was attacked by Cholera Morbus, and in spite of every remedy, died in thirty-Six hours. 

April was generally cloudy, with strong southerly winds, and frequent thunder siorms and North Westers ; in this resembling the regular appearances of other seasons more than any preceding month. — On the 1 8th there was a heavy 

were very disagreeable. Now cloudy with litde wind.— 16th, morning foggy, cold and raw; wind N. N. East. — 18th, Dinapore. Lightning, thunder and raia yesterday evening; now cloudy and calm. — 19th, Fatna. Rainy, stormy, raw, and cold ; Temp. 61 at sun-rise, 66 at 3P. M. ; wind E. N. E. — 20th, Violent wind and much rain ; cloudy and cold. — 2Ud, Monghyr. Thunder, lightning, and rain. — 25th. Cold, raw, wind from North East. — 26th, llajamahel, Rainy, cold, and disagreeable; wind South East. — March 2d. Muttabhunga. Rained incessantly since six. this morning ; day very cold, gloomy and raw ; wind fresh, South East. — 3(1. Rained and blew all night; cloudy and disagreeable.— 4th. Morning foggy; Temp : 6C— sth. Morning fo^gjr jtnd raw. 

52 





May, 

Eof rain ; and from that time to the end of the ith, the air was dry, and mostly clear. The ther was uncommonly cool till the 27th : the Krmometer not having once risen higher than On the 27th the heat was 91 ; and it kept o nearly the same point during tlie three folng days. A few cases of fever occurred, esally among new comers, about the middle of month ; but generally there was yet very little disease in the Settlement. 

The first week of May was hot ; sometimes with little wind. On the 3rd there was a strong gale, with rain from the East; on the sth a Northwester ; and on the 6th more rain. — During the two following weeks nothing extraordinary occurred ; the Southerly winds kept blowing moderately, with frequent showers. — On the 17th there was a strong gale, with rain from the South East ; followed by cloudy weather, which brought on a severe Northwester in the evening of the 24th. Up to this period the air was cooler than usual to the feel ; although the Thermometer generally stood at 82 at sun-rise, and 90 at 3 P.M. 

On the 25th of this month, at least fifteen or twenty days earlier than ordinary, the rains set in ; and there was almost continual rain, with variable winds, close weather, and heavy clouds 

1 

53 









till its close. — As yet there was no interruption to the previous healthiness of the city. — Slight fevers, and bowel complaints filled up the sick list ; and hardly an instance of hepatitis came under notice. 

From the 4th of June to the close of the month 

? 

there was scarcely a fair day ; on many days the rain poured incessantly in torrents ; and the season now began to be reckoned a very wet one. The rivers became high, and the tanks were already filled with water. — The mornings got cool ; and the heat of the day moderate. — Thermometer ranging from 78 to 86 ; steady Southerly winds, without storms or thunder and lightning. Fevers still continued to prevail moderately ; with dysentery, and now and then a case of hepatitis. 

In July there was hardly a dry day.— An immense quantity of rain fell; and before the end of the month the river was quite full, and the country nearly under water. — .The sky was almost constantly cloudy ; the atmosphere generally cool and pleasant ; at times close and sultry.— • Thermometrical range from 80 to 87 ; medium heat 83 : 33 j winds variable, generally moderate.— The prevailing diseases, although still of unusually limited extent, now became more se« verej requiring more active treatment than be* 

54 





August 

September 

fore.— To fever, hepatitis, and flux, acute rheumatism was now added, and proved rather trou* blesome, 

From the Ist to the 10th of August excessively heavy and almost incessant rain continued to fall ; on the Bth, 9th, 10th and Uth, it poured in torrents, and without interruption.— The we*« ther was generally cloudy and calm, with South Easterly winds ; temperature rarely higher than 85 ; often as low as 81. — The middle of the month was hot and oppressive ; and the nights mltry, and exceedingly disagreeable. — >TheThei> mometer then fluctuated between 81 and 87; and there was little wind, generally South West. From the 22d it rained every day, but except OO the 31st not very heavily, till the close of the month ; with variable winds, mostly from the South and East. 

Amongst Europeans the only complaints yet noticed were slight fevers, severe cases of Etysen* tery, and hepatitis ; but the Natives now for the first time began to suffer severely from the Epi* demic Cholera. 

tin the early part of September, the weather ntinued close, sultry, and unsettled, with frequent showers ; but previously to the 7th the water in the tanks had fallen nearly a foot : a clear 

i 2 

55 





proof, that the general body of rain given out by the clouds was now beginning to diminish. There was much rain, with variable winds throughout the remainder of the month. — From the 16th, although the days kept hot, the mornings began to get pleasant ; and the atmosphere at times to be freed from clouds ; so that in the middle and latter part, there were several clear days, with bright sun, and consequent great evaporation.— The mortality had now become exceedingly great, amongst the Natives, and was no doubt increased by this, amongst other causes.* On the 28th there was a fog. At this period there was no remarkable variation in the atmospherical heat. The Thermometer ranged from 82 to 89 ; at sunrise it generally stood at 84. 

Ec usual endemial diseases, fever, flux, and itis, were this month rather common. The > were generally slight, seldom needing the t. — The dysenteries were, as & usual in hot climates, mostly connected with inflammation in the liver; and sometimes terminated in abscess 

* On the 15th of this month the existence of the Epidemiek in Calcutta, was first officially brought to the notice of Government, in a letter from the Chief Magistrate ; and the disorder stated to bo raging with extreme violence, especially in the loir parts of the Town and Suburbs. 

56 





fthat viscus, and consequent death. Upon the ole it was observed, that in Calcutta, from the nmencement of the preceding hot season, unthe end of August, there was les3 sickness, especially amongst Europeans ; and that the symptoms of the disorders principally attacking them, were milder, than during similar periods of many preceding years.* Was this ascribable to the low temperature then generally prevalent ; and to the humid and cloudy state of the atmosphere proving congenial to the European constitution, from its approximation to the cold and raw climate of European countries ? 

Several cases of Cholera occurred among3t Europeans on the sth September ; and from that day forward, the disease became daily more frequent. Why it reached them at this peculiar moment, cannot be discovered from the most accurate scrutiny of the meteorological observations for that period. From these it appears, that the first three days of the month were cloudy, withshowers, and moderate breezes, from the ?How little the general "health of the European inhabitants suffered, is proved by the returns of his Majesty's 59th Regiment. This corps averaged throughout the year 582; its deaths were 16, or 1 in $$t ; an ei'ceetiingly small proportion, speak ; ng favorably both of the climate and of the interior economy of the Regiment. Of the deaths only two were from Cholera. From this (Jisftjse however, they suffered severely next sp^rm^. 

57 





58 

i-VTRODUCTION'. 

October, 

South East ; and that from the 4th to the 14th, the weather was constantly rainy; with fresh gales from the same quarter. And the fluctuations of the Barometer and Thermometer were during the whole time so small, as scarcely to deserve being noted down. 

The weather kept unusually close, stagnating, and oppressive, during the whole of October. In the early part of the month, there was little wind, generally from the South ; with an atmos-. phere sometimes cloudy, sometimes clear ; frequent showers, and occasional heavy falls of lain : the Thermometer ranging from 82 to 88. From the 9th to the 17th there was a glimpse of fair weather, with light variable winds, and mostly clear sky. Then, late on the day of the 17th, the wind changed round to the North East ; and blowing hard, brought from that quarter a deluge of rain; which lasted without a moment's cessation for twenty-seven hours ; again filled the tanks ; and laid the face of the country under water. The reduction caused in the atmospherical temperature by this change was sudden and great. The Thermometer at once fell from 87 to 71 ; and during the 18th and 19th did not again get higher than 74. On the 19th the wind returned to its usual station in the 



INTRODUCTION. 

59 

Novemb«r, 

the month, there was an unusually watery, cloudy, atmosphere; with little rain : the Ihermometer meanwhile ranging between JS and 86 ; and the weather proving sultry and disagreeable. Excepting that Cholera had become more frequent, there was no remarkable difference between the disorders of this and the preceding months. Perhaps acute dysentery and Rheumatism were more frequent. 

The weather should now, according to the common course of things, hare become cool, settled, and fair; but the continuance of a cloudy sky, and of unwonted humidity and warmth in the air, and the frequent recurrence of rain throughout the month of November, proved, that the remainder of the year was to proceed with the same strange unseasonableness, and insalubrity, which marked the early parts of its course. The wind getting round to the West, a good deal of rain fell on the 4th and sth ; attended by a considerable fall in the mercury. The days were then pleasant, with variable winds, and sky, till the 23d ; when a storm came on from the North West, and was followed by a heavy fall of rain. The Thermometer, which had hitherto ranged from 71 to 81, now sunk several degrees ; and did not a^ain go beyond 7^l during the remainder of the month* 



Eveek of the month was distinguished cloudy weather ; with North Easterly un on the 29th, and a thick fog 

Bilious fever, requiring bleeding, was common in the early part, and intermittents in the end of this month. Fluxes prevailed throughout ; and were sometimes severe. The diminution in the atmospherical temperature, which took place in the early part of the month, was probably the occasion of the returning comparative healthiness of the city, noticed at this period. On the 10th we find it stated, in a publick letter from the Medical Board to Government, that the Epidemick was beginning to give way to the favorable change in the season ; and the official returns shew, that the disease, from that time until the middle of the succeeding February, although still alive, was in a very languishing 

Before proceeding further in this sketch, it will be useful to advert shortly to the state of the weather during the foregoing period, in the other districts of Bengal, and in Upper India ; in order that we may see, whether in them the regular procession of the seasons was equally interrupted, as in Calcutta, and its immediate 

60 





61 

INTRODUCTION. 

In the districts of Jessore, Backergunge, Nuddeea, and every other portion of the Gangetic Delta, there had been a long protraction of very heavy rain ; and nearly the whole country, especially in the lower division of the province, was one sheet of water before the middle of August. In Nuddeea the whole year had been rainy, and damp. Rain fell in eight different days in February ; and four in March. In every week of April and May, there was a succession of thunderstorms and rain. The river began to rise in May ; much earlier than usual. The Rainy Season was extraordinarily wet. Lakes and tanks, which, in former seasons, remained dry a great part of the year, soon filled ; and kept so for a long time. It was calculated, that in the whole, 120 inches of water fell. In the Eastern division of Bengal, the season wore a different appearance. In the Dacca district, the rains were confined to June, and the first ten days of July. Hardly a drop of rain fell in August, and September ; usually very wet months. The inundation from the river was four feet short of its usual height. The same irregularity obtained in Sylhct, and the other tracts washed by the tributary streams of the Burumpooter. From the end of August not a single shower occurred till the sth of October, when torrents poured. 

k 



December 





In the Middle Provinces there was nothing very peculiar in the progress of the Rains ; but in the districts of Cawnpore and of Bundlekund, and generally throughout Upper India, they were observed to be remarkably scanty. 

We shall now return to the regular course of our observations on the season at Calcutta. Throughout December, it was clear, pleasant, and cool weather ; but warmer than it ought to have been at that period of the year. Rain oc« curredonthe Ist; and fog on the 28th j and the rest was serene. Winds generally Northerly, and moderate j — Thermometer varying from 61 to 76. To the complaints of the preceding month, were now added agues and diarrhoeas ; but they were not violent or numerous. 

Of the succeeding year, January had an alter* nation of cool and pleasant, with close and hot weather j generally clear, with light Northerly winds. It was foggy on the 1 lth, 20th and 30th ; and there was rain on the 17th and 31st. The Thermometer ranged from 62 to 78. The dews at night were very heavy. During the four last days, the weather was warm j with Southerly wind and cloudy sky — Nothing remarkable ill the complaints prevailin r ilurii)"" the month* 

62 





February. 

March, 

The first part of February was cool and clear, with moderate winds, chiefly from the North and West ; and frequent thick fogs. From the 19th the wind settled in the South ; the Thermometer rapidly rose from JO to 80 j and the Hot Season might then be said to have set in. On the 25 th there was a North Wester ; and on the 27th and 28th much rain. This sudden change about the 20th of the month, is worthy of particular notice ; because it was at this very time, that the Epidemick, after dying away in November and December, and being nearly extinct during January, again took head ; and amongst the Natives raged with indiscriminate violence, until the end of the following July. It now attacked Europeans and Natives with equal readiness ; and as if it had gained fresh malignancy, by lying for a time dormant,* did not so readily yield to medicine as before. 

March, like its predecessor in the former year, was marked by very uncertain and unseasonable 

weather. Up to the 12th, the winds were variable, Northerly, West and South Westerly ; generally moderate. The atmosphere partly clear ; partly cloudy and hazy ; with much rain on the 4th 

sth, and night of the 6th ; and the temperature mostly 70 at sun-rise, and 76 at noon. On the 12th, the wind set in steadily frctm the South • 

12 

63 





64 

INTRODUCTION. 



and at 3 o'clock of that day the mercury rose to 87. On the 15th there was a thick fog ; on the 17th fog; on the 18th, 19th, 20th, fclstj 220\ 23d, 26th, 27th, 28th, and 29th much rain ; with strong gales mostly from the South and West. On the evening of the 28th, it blew a hurricane from the same quarter. There was log on the mornings of the 25th, the 29th, and the 31st; with Northerly wind during the latter day. During this time the Thermometer fluctuated, at sunrise between 74 and 80 ; at 3 P. M. between 80 and 88. There was much general sickness in this period of great irregularity. Bowel complaints were especially frequent. The Ej.i-demick was now more common than ever amongst Europeans ; and fresh cases were every hour pouring into the hospitals. 

The early part of April, was cloudy, with frequent strong gales from the South East ; and warm unpleasant weather. — There was a North Wester on the 4-th : the only one during the month. — Rain fell on the 4th and 13th. About the 15th the wind settled steadily in the South ; and blew hot from that time to the end of the month. — The Thermometer fluctuated between 80 and 89. — The diseases of this month were generally mild ; few fatal cases of Fever; some of Dysentery. — The Epidemick had now declined among Europeans. 



May 

June 

July 

August 

September. 

in May ; with Southerly winds and cloudy sky throughout ; and several storms, without rain from the North West. — A shower or two fell about the middle of the month ; but these did little to lessen the temperature of the air ; and the nights and mornings kept close and sultry, with a foul, hazy, atmosphere. — The Thermometer varying from 86 at sun-rise, to 92 at 3 P. M. The prevailing complaints were much as in the former month ; except that acute Dysentery was unusually frequent for the season of the year. 

The rains set in early in June. — As the weather now began to get more steady and regular in the vicinity of Calcutta ; and as from this time the seasons, after so long a period of extraordinary deviation, seemed inclined to return to their ordinary course j and to abide by the laws marking their natural progress and succession ; the reader need no longer be harassed by a dry detail of the varieties of each succeeding month. It will be sufficient to state concisely their general appearances ; referring him for particulars to the annexed Tables. The Rains were seasonable and pleasant. — An average quantity of rain fell during June and July ; in August and September the quantity was perhaps in excess. But during the whole period, it was distributed 

65 





66 

INTRODUCTION. 



rr 





.February 

M:irch 

April. 

deluge, nor long continued drought.— -Early in 

October the weather cleared up ; and gradually gave place to the Cold Season j which was mild in the beginning, moderate in the middle, and unusually cold towards the conclusion. Then came, rather suddenly, a fortnight of unexpectedly warm weather in February ; succeeded by a hot month of March, with frequent fogs, few North Westers, an J hardly any rain. — April was, on the contrary, unusually cloudy ; with frequent storm?, heavy rain, and strong gales from the South East and North East ; hot unpleasant days, and cold chilly nights. — Thermometer ranging from 76 to 86 The 7th, Bth, 11th, 17th, 18th, 19th, 2 1st, 22d, and 23d, were rainy days. Very heavy falls on the 7th and 23d ; on the 22d constant rain. These details are entered into, because this falling back of the weather to its old irregularity, had an immediate effect in reviving the Epiclemick, both among Europeans and Natives ; and led to serious apprehensions, lest it were again about to run a new and fatal course, as it did after the short lull during ths Cold Weather of the preceding year.*— Many cases, and some deaths, occurred during the first twenty days of ths month ; but the disease was more tractable than during its former visits; and again withdrew, as the month of May brought round steady Southerly winds, and settled weather. 

* The s;une unsteady weather and sudden vicissitude 



Of the pit-ceding Rains it may be remarked!, that in every part of the Upper Provinces they were much heavier, and generally set in earlier, than for many years before.-— In the Dooab, the districts in the vicinity of Delhi, Jeypore and the other Rajpootanah States, and in Nagpore and the tracts bordering on the Nerbudda, they were unusually violent ; and continued long, with little intermission. They at length, gave way to an unusually severe, and healthy Cold Season ; in -which the Thermometer, even as low down as the northern extremity of Bengal, fell during several nights to the freezing point; and for many days in January did not rise higher than 37* • at eight in the morning : a degree of cold usually quite unknown to that part of the Country. 

EThis sketch of the Weather being now brought a conclusion, some apology may be necessafor its prolixity and minuteness of detail. — It ight, indeed, have been wished, to make it less 

of temperature probably extended all over Bengal ; as the Medical Returns, for this month, shew that the Epidemick was at this time, and during the preceding month, on foot, in Sylhet, Mymensiug, Dacca, Backergunge, Cuttack, Balasore, Midnapoie, Jungle Mehauls # Hoogly, Nuddeea, Rhaugulpore, Patna, Chunar, and tUeir respective neighbourhoods. At this period too, the disease appeared at Hoshungabad, the head quarters of the Nerbudda Field Force ; and in Major Agnew's 

67 





dry and tedious 1 --* But it was only by entering largely into particulars, and by minutely following the successive variations of each period, and thus affording the reader an opportunity of comparing them with the fluctuations in the healthiness of those periods, that we could hope to trace a connection between the generation of the prevailing pestilence, and the preceding irregularities in the season. How far this has been successfully done, must be left to the reader's judgment, when he shall have perused the account of the rise of the Epidemick now about to be given. — This, at least, he will not doubt, that there was a remarkable coincidence between the extraordinary irregularities manifested throughout India in 1816 and 1817, and the rise of the Epidemick; and that its subsequent abatements and revivals, were in some measure dependent on corresponding vicissitudes in the itate of the Weather. 

68 





69 

INTRODUCTION. 

, Register of the Weather in Calcutta, statins; the height «f the Beromttrr and Thermomrter 'rrf 10 o'Worf: A. Tf 

From Ist Maj 1818, the observations are noted M Noon. Barr. Ther I Winds, &c. 29:66 90 Mod. S. cloudy dry N. Wr. 7n7 n 87 • ¦ 86 S. E. 77 85 Dry N. Wr. 70 86 # 66 P7 Strong, 6r 87 63 87 6' B8 Fresh, 65 8R Light, 65 89 5< 89 4T 88 Var. J 5v 86 Strong S. rain, 50 90 57 90 Rain, 48 89 59 90 44 91 51 90 Mod. 0 50 90 51 00 55 90 64 no Barr. raised 0. 20 59 90 65 90 73 90 / In. wr. 79 89 Clear, 15 89 -6 90 Cloudy. 

1" Avtrage. 29:55 37 **'. 63 84 77 Moon ([ First quarter; O Full; <L Last quarter; © New. * These Tables ir.ay oe compared with the Meteorological Journals for 1784-5, published by Mr. Henry Trail in the Appendix >o the _'d Volume Transactions o'i the Asiatick So.iety, and tor 1785-6 published by Col. Peai if, ia the l£t Volume uftlie same work: both of vhidti appear to have been healthy year*. _____ — «__ __™-^-»_ 

1817 3arr. Ther. Winds, &c. ¦.!9:61 8 5 Mod. S. Clear, O V! 65 Fresh, 74 86 Strong ; cloudy ; gslefrom E. 77 82 Fresh, 75 83 IN. Wr. 78 82 Rain, 7 5 83 Mod. S. E. 73 84 S. d 70 £5 [Clear. 70 86 70 87 Light, • 69 88 Moil. 65 S7 Fresh, 61 86 Strong, 51 87 Cloudy, 47 86 # 47 84 Fresh S. E. rain, gale from S-E. 50 86 fa 83 Cloudy, 57 83 S. Clear, 59 8 5 Cloudy,* 6S 86 Mod. var. 65 86 55 85 W. clear serere N. Wr. ) 54 86 Vtir. rain from W. 73 83 Heavy rain, 69 8S Rain, 64 8 5 Cloudy, 61 84 Much rain, 6'J 82 Cloudy, O 57 82 Rain, 

Date Barr. I'her 1 Winds, &c. May 1 29:G5 85 Strong Somberly & Cloudy. 2 65 85 Ditto ditto ditto, 3 71 85 Ditto ilittr. ditto, 4 64 85 Ditto ditto ditto, 5 62 85 Ditto ditto ditto, > 6 64 86 7 63 85 Mod. S. and Clear, 8 63 87 Strong S. 9\ 67 86 S. 10 64 85 S. 111 1 52 87 S. O 12 48 87 S. tiHzy, 13 51 87 S. cloudy, 14 38 87 Mod. S. 15 37 88 S. 16 41 89 jS. 17 47 89 'S. 18 50 89 Strong S. 19 62 89 S. d 20 61 89 S. '21 SSI S3 S. slight rain, • ' 9f 50 88 8. Clondy, 23 47 88 Mod. S. I •• 24 ' 55 88 S. 25 sn\ 88 l.itylit S. severe storm & rain, 26 53, 86 Var. Cloudy, SO H7 N. W. and rain, # 88] 54! Bfi 20 Ml 86 Mod. S. 51 511 SO Rrin. 



70 

INTRODUCTION, 

1818 Barr. Ther. 1 Winds, At. 199:96 90 Mod. S. rain, 71 89 Cloudy, 67 R8 Rain, ' 69 88 Cloudy, O 6,3 88 Fresh, rain, 67 86 S. E. 66 86 Cloudy, 73 90 Strong S. 8o 91 Heavy rain, 84 R7 Cloudy, 79 90 7*l 90 > 91 90 I Clear, 69 91 jHeavy rain and N. Wr. 67 87 ,Fresh, cloudy, 64 88 Rai" N. Wr. 70 87 Cloudy, 63 87 Rain, , O 60 86 59 84 Heavy rain, 6 1 83 64 82 66 84 Cloudy, 63 84 Clear, Q * 58 1 88 Cloudy, 6 I 87 Mod. rain, C 87 s'. 85 55 S6 I 



1817 IBarr. Ther. Winds, &c. 29:5, 84 Mod. S. ii. cloudy, ! 41 84 55 86 Fresh, 55 86 Mod. rain, 54 S7 44 87 Fresh, C 33 86 N. E. much rain, 39 83 E. 47 82 44 80 40 82 Mod. S. rain, 38 83 39 85 Cloudy, 59 85 VaV. 36 £4 Rain, $ 52 84 Much rain, 28 81 35 79 Freeh S. 50 80 Rain, 60 85 61 84 Strong, clouds, 52 85 > 50 85 4 4 86 Rain, 37 83 Much rain, 27 83 Fresh, 37 83 Rain, 45 83 Much rain, 45 82 Rail), ¦ O I 48 84 

1816 Dat< R:irr. ITher. I Winds, Ac. June, 1 29M9 85 Light, var. cloudy, 2 49 87 3 50 66 N. Wr. > 4 48 88 • 5 41 90 S. 6 43 90 Fre*h S. E. 7 43 91 8 46 90 Strong S. 9 «9 91 Storm and rain from N. W. 10 40 89 Mod. S. cloudy O 11 38 89 Fresh, IS 45 89 Strong, 13 49 90 14 S3 89 Var. rain from W. 15 55 87 Fresh S. cloudy, 16 49 87 Mod. Tar. 17 46 88 S. 18 52 88 f 19 51 87 Var. rain, 20 45 87 Very dourly, 21 37 87 Fresh N.E.and rain, 22 34 85 E. 23 39 84 '24 42 80 Light, -25 5\ 83 Fresh S. £ 26 6<> 85 Strong, cloudy, 27 56 85 Rain, 28 50 8 4 Cloudy, 29 43 84 Very strong & rain from N.WJ 



INTRODUCTION. 

71 

Average. ... i.'9:39 82 9 29 59 83 83 84 

1818 Barr. Tlier. W>.nd«, &c. 29:56 P6 Mod. S. cloudy, 50 85 Rain, 56 fj Cloudy, 9 54 K4 Fresh, S. W. heavy rain, 52 8! Strong, W. 4f 82 S. W. 4', 80 S> 81 Var. .6 83 Cloudy, 50 «2 Mod. much rain, 39\ 82 Freih, S. cloudy, > 54 81 Strong, rain, 67 8<! Fresh, 73 81 Mod. 7: 84 Cloudy, 7 85 75 £5 Fresh, clear, $* 86 Q «T« T 6 7 Cloudy, TJ 8? Rain, 0. 86 6! 85 66. 87 Mod. 66 86 f ! 70 87 Var. raia, 65 R6 60 84 Cloudy, 80 80 

1817 Barr. Ther I Winds, Ac. 29:52 85 iFresh, 8. cbuily, 51 84 JS. W. 48 83 (Heavy rain, 43 81 Mod. var. much rain, • 46 82 fj 84 Cloudy, 4 53 84 Fresh, S. 47 80 Mod. var. much rain, 4i 83 tight, clear, 46 84 Ctoudv, 49 84 Mod. S. rain, 47 82 Much rain, 41 83 Rain, 39 84 Fresh, S. E. cloudy, 3 85 Ruin, I 28 85 E. 2<: 85 21 83 Strong, much rain, 40 82 Fresh, rain, 37 85 M. E. much rain, 58 85 31 85 S. E. 30 84 4 If. 35 84 Bftod cloudy, 35 85 Rain. 3T 85 " Q 35 85 29 84 Cloudy, 59. 84 I Var. rain, 

ISIS Date Barr. flier. Winds, &c. July J 29:54 84 Fresh, S. cloudy &rain. fog in £ 41 83 Light, rain, [»'ght. 5 44 84 S. £. slight rain, 1 4 43 85 Fresh E. 5 35 84 N.E. 6 41 84 E. 7 44 85 Mod. S. E. 8 57 85 9 34 8 5 Light, cloudy, O 10 25 85 Fresh, N. W. much rain, 11 16 82 Strong, \9 Vi 81 Mod. S. E. rain, 15 32 81 14 40 82 Cloudy, 15 48 82 Rain, 16 38 83 Light, var. 17 33 83 Mod.S. f 18 35 62 19 42 82 20 46 82 a I 4v S3 Light, rain, 22 5O 84 23 4-2 83 Rain, 24 45 82 Much rain/ 25 44 81 f 26 57 80 Strong S. W. 27 42 82 S. light, rain, 28 45 8~ Cloudy, •29 43 84 Rain, 30 46 83 Mod. heavy rain, 31 52 8' Fivsh rain, } 



INTRODUCTION. 

72 

Average. ... 29:45 Bi:^2 'jy:so 8 1:57 

1818 Bitrr. l'her. I Winds, Sec. 29: 8 1 8C JMod. ft. cloudy, 71 86 ' • 66 82 Fresh, var. rain, 7: 84 Mod 74 80' |Light, rloudy, 67 87 Mod. var. rain, 64 86 o 61 86; : S. 66 80 S. W. . 67 85 3. 63 8S Cloudy, 58 86 Fresh rain, 66 85 Mod. rain, 75 66 S. W. 75 B4 S. E. •Jr, SS [Fresh. O 

1817 jTher. Winds, &c. J9:31 84 Fresh, N. cloudy, 23 84 8. rain, :44 85 Mod. clou.ly, 55 85 3. E. rein, 5'J 85 g 50 81 Slight rain, 56 8 4 Cloudy, 58 81 Much'rairi, 64 83 Fresh, Co 81 Strong, S. W. 56 80 55 81 Rain, 5.3 85 W. 0 53 84 Cloudy, 55 85 \ T . W. rain, 5R 85 Mod. W. 61 sfc iLiehe, clear. 5X 87 Itnin, 63 80 ) 65 8- Mod. S. W. dear, 61 87 Fresh, S. 57 j 87 Mod. 55 87 S. E. raio, 50 80 E. 48 86 I 51 85 3t 85 S. E. O 37 86 S. W-21 85 Var. 36 85 S. E. 41 8 1 Much rain, 

1816 Datelίarr. ITher. I Winds, &c. August. .... li29:sij 83 Light, S. cloudy, 2I 4i I 84 Fresh, 3 47 83 Light, S. E. slight rain, 4 47 83 g 45 1 84 Erethraia, 7 56 84 E. 8 55 84 O 9 33 8 4 10 40 84 11 46 85 Liffht, 18 48 81 NN T ."E. 13 50 85 E. 14 50 84 ¦ 15 46 82 Fresh, S. E. heavy rain, 16 46 82 S. <[ IT 50 84 18 5\ 84 Mod. S. E. 19 52 8 1 Rain, 20 4y 84 Light, slight rain, 21 47 85 Cloudy, '2'J 45 85 23 44 87 24 39 86 Fresh, S. W. rain, i 25 37 84 S. E. 26 41 1 81 Light, vr.riable, 27 45 85 Cloudy, 28 52 85 W. 29 sf. 86 30 54 86 S. W. I 31 48 87 Mod. . 



INTRODUCTION, 

73 

I Avrmt'e. ~ 'JS: O'O 84: l<> 2": G'J 84: s<i t.i-.vti '"""" ' * I 

Barr.-jTher.j Winds, Ac. 29:73 85 Mod. S. £. rain, 76 86 72 82 Fresh, much rain, 66 84 S. 66 82 76 83 S E. • 79 83 Cloudy, 71 85 Raiv, ) 67 83 6i 82 Strong, S. W. much rain, li 82 Fresh, cloudy, 86 84 3. rain, 80 85 # 78 83 S. E. much rain, «6 84 - Clear, 88 8 5 H-wn, 86 84 Mod. clcuclj, 82 85' R. 85 85. •>. raia, ) 87 85 Joud; , fo{. 84 35 C 83 R-2 Hoavy rain, 77 84 E. rain, 78 84 7-3 84 73 85 Cloudy, 7R 85 S. E. " 80 «6 E. rain, 84 SI Much rain. O 

1817 Barr. Ther ..j Wi.idt, &c. 29:45 84 JMod. 8. E. -cloudy, 41 85 Rain, 2* 57 Cloudy, 53 86 Strong rain, < 37 15 40 85 Fresh, 47 84 « 84 Much rain, 61 84 63 85 Rail), .# 61 B5 Maeh rain, 6. 80 6i p: Light, clouly, 5! 81 57 Btf V;ir. rain, 57 86 Cloudy, ) 7C 67 Rain, 7<> 86 Mod. heavy rain, 7 4 85 S. E. cloudy, 79 85 S. W. tiear, 85 85 Fresli, 76 84 75 8S Strong, S, E. very heavy r«in 74 8J Fi-esli. S. clear, ~[Q 8( 80 Var. cloudy, 7C 84 Light, clear, fog. 75 86 Rain, 

ISI6 Date Barr. Tlier. Winds, &c. Sfpiember.' 1 29:48 8 7 Lisht, S. W. dear, 2 47 88 Fr«!l, W. Hazy, •" 55 89 Mod. cloudy, 4 .59 88 S. VV. 59| 88 Heavy rain from, E. t> 57 87 S. rain, Q T 53 84 Fresh, ,8 57 84 E. much rain, 9 60 84 Mod. rain, !O 63 84 S. E. il 61 84 Var. much rain, '2 56 85 E. rain, ''5 55 85 14 50 85 Fre»h, much rain, 15 47 84 Rain, ( 16 56 1 84 Heavy rain, 17 67 ( 84 Cloudy, 18 68 S4 Henvy rain, 19 67 84 N. E. 20 72 83 Clear, 21 74 84 22 74 84 23 6H 85 S. E. cloudy, 24 63 82 Mod. E. constant rain, 25 61 80 Much rain, 2G 65 80 Fresh S. £. r*in, 27 66 82 28 67 81 y 29 57 81 Heavy rain, 70 62 81 Strong. S. W. 



74 

INTRODUCTION. 

[ Ay- .-:..e ... -29 :B'J SSISH ~ ga: To 55:43 ~' j. 

Barr. I Hit r. I VVnids, &c. 2<r. 76 7«> Fiesl», S. W. much rain, , 76 85 S. rain, 7s. B'^ S. E elnudy, 80 P4 '.'ivfch, cloudy, 78 86 Mod. S. W. clear, ) 8! 86 c Mod.' N. W. cV.r, •94 85 N. Ml 85 95 8! IN. E. cloudy, i>o:os 85J cj *c| - 29:97' 8C 99 85| 0 &t& t; l 84]Pr«afa, 

1817 Barr. Tlier. I \V md», &c. 29:78 85 I Mod. var. raia, 81 85 79 8.5 Fresh, S. C 7t> 83 S. E. uukli ruin^. 73 82 Mod. clear, 8C 84 S. 7 5 bG Fresh, 75 86 Rain, 77 85 Mod. clrar, (J I • 14 8 5 Lijjht, rar. 7P S6 79 86 82 86 85 86 S. E. 83 86 "resli, S. cloudy, SO 84 Ram, ) 55 71 Hard, N. E. much rain, 62 74 Fres!:, S. cloudy, •5 8o Mod. var. 75 80 S. W. ?J 81 Va.. clear, 75 81 N. W. 13 82 74 82 O 73 85 S. W. cloudy, P0 85 78 8C 81 S5 S. rain, 74 86 Cloudy, 7^l 84 

1816 Dm. Barr. jTlirr | Wind*, &c. October. ... | .;-;;66 81 Ilighl. I llnglj. 2 70 82 S. W. rain, fog, 3 7 8 2 \V. clear, 4 If 5J Fresh, 7! 85 (Mod. 5 77 85 \. W. O '.1 77 15 W. Hourly, t- 7 85 V W. dear, IC 74 86 U ft 86 Light, N. W. It 13 85 13 8< K5 Fog. 14 95 84 /r 5 93 85 W. rlouJr, iG 8* 84 S. W. 17 84 83 is 85 83 Clear, ly 8< P3 'W. cloudy, 20 82 85 Variably 21 78 8.3 Mod. N. E. 93 82 SI 24 8o 81 25 87 81 Clear, 26 90 79 Mod. N. W. •2- 96 79 Fresh, 2; 91 78 2) U 89 78 to 90 78 |Mod. e'oudy, 31 90 79 I 



75 

IHTttODUCTION. 

, Average. ... 29:89 75:53 '.T-: 3: 76:55 .50: '.79:3 

1811 Ba*r, i'her. J Winds, &c. J9:97 85 Mod. N. t. clear, 04 82 N. 06 82 94 82 Var. fog. 90 82 98 81 r;O4 80 05 SO 02 81 Light, cloudy, J2 82 N. E. 06 8! Q 04 81 NT. ¦ 04 so Fresh, clear, orj 79 oc 79 Light, var. cloudy, 05 81 10 so N. clear, 00 78 00 77 j Fresh, t O< 7T 0" 7o 0<) 77 29:98 76 30:08 75 O? 75 01 75 a OS 74 Light, 00 75 IHtllJ, 

iBir Barr. Ther. I Winds, See. ¦29: "9 84 Mod. S. cloudy, 77 81 N. W. clear, & 81 82 YV. cloudy, 77 81 Rain, tr<9 78 Fresh, N. clear, 9r 78 50:01 77 29:96 78 N. E. • I 8' 7S i-iclit. var. cloudy, !86 79 Mod. N. 85 77 Clear, so 75 Fresh, R" 75 *i 77 J 8." 76 Mod. \V. S5 76 S.- W. I 80 77 ;3. E. cloudy, 73 76 I 74 77 r-iii rar. N. W. much rail,. 81 7 5 SI. E. clear, O 83 71 V. W. ! sr 70 \ T . E. clouJy, ¦ 8< C:T 1 B. 70 j GO 74 >lod. rain and thick fog. • 80 74 

Date Barr. Ther. Winds, <5Lc lovember. ) 29: 90 78 Light, N. W. clear, 2 £>4 80 hv. cloudy, 3| 98 79 Mod. S. W. clear, 4 9? 78 5 89 79 N. W. O 6 85 77 1 85 78 N. i> 87 76 Fresh,. • 9 87 75 10 92 75 Cloudy, • 1 88 74 Clear, 12 SI 74 Mod. variable, 13 77 74 N. W. log. nitfit # 14 -87 75 Ditto, 15 92 74 16 92 74 17 91 75 3. W. fog. 18 86 78 S. thick fog. 19 90 78 Fog. # 20 92 77 21 88 77 22 9Z 77 23 98 76 S. W. fog. 24 97 75 JJ, W. •°S 90 74 •2€ 92 74 y 21 SO 5 73 Fresh, N. E. hf. 87 69 29 88 68 N. W. 50 90 69 W. fo». 



76 

INTRODUCTION. 

¦ Average. ... 29:92 68:48 29: 9O 7O:O9 / 

1818 Barr. JTher. AVinds, Sec. 30:03 76 Light, N. clear, OS 76 jVar. hazy, foj. 05 77 I 00 76 Clear, fog, !29:9S 77 ' Bazy, } {•50:00 77 Clou I'}',1 '}', J29:98 80 98 78 -0:0* 75 Mod. N. clear, 04 75 Fieih, 01 77 Mod. cloiuly, O 05 75 S. cloudy, 05 72 08 Fresh, N. W. clear, OR 70 OR 70 [ 06 70 03 71 Mod. Hiisy, 07 71 OR 72 C'ear, 15 71 Cloudy, 16 "72 19 72 Lipht, clear, fog. 0 Id 7? Cloudy, 10 72 Mod. 11 71 Clear, 08 78 

1817 Barr. jTher. Winds, &c. 29:87. 74 Mod. S. E. -din, 88 73 N T . E. CIOIIO7, C 87 7.5 N. W.,clew,' 88 71 Fresh, 90 70 88 70 90 70 88 71 Mod. var. • • 86 71 N. S» 72 90 71 91 70 Freib, 91 70 90 70 Mod. N. E. clondy, 93 70 J 9.9 C 9 Light, clear, .05 70 9* 67 Fresh, N. 95 65 95 P5 £»6 65 y5 67 90 6S Light, O 88 69 86 70 j 93 69 87 71 N. ft, 90 73 W. fog. 90 74 96 74 N. W, 81 71 d 

1816 Date Barr. Thtr. Winds, fte. 1 December, i 29:90 69 Mod. W. clear, fog. 2 88 71 3 SO 69 Light, 4 97 71 5 97 71 Q 6 94 7! Mod. N. W. 7 99 70 Fresh, N. 8 30: 03 70 9 29:96 69 10 92 70 1! 93 69 Light, N.W. light clouds and 12 94 68 X[ [fog.l 13 92 69 Mod. 14 90 67 Fresh, N. dear, 15 86 66 16 80 66 Mod ?ariable, fog. 17 86 67 18 91 67 M. W. 19 91 67 S. \V. • 20 90 68 2! 96 6$ 2. ?0 68 \V. tt 95 68 24 95 69 Foe. 25 96 69 26 94 69 N. W. y 2: 87 67 28 90 69 29 98 68 N". 30 98 67 51 S9 66 Fog. 



INTRODUCTION". 

77 

I Average.... '2iKit6 67:83 29:90 68:24 — 

1819 Harr. Ther. WiivK, &c. 3O:og 71 Mod. N. dear, fog. 0? 73 29:99 72 . J 9G 73 Var. 97 73 ClouJy, thick fog. 97 75 Fog. SO; co 70 Fresh, N. clear, u'9:9? 67 97 94 72 Mod. var. to*. 88 72 919 1 69 Fresh, 95 68 j 9-~ 67 Mod. var. cloudy, 90 65 N. clear, 95 65 Fresh, 97 65 9- 68 94 69 Mod. jf) S7 69 30:01 67 02 69 

ISIS Barr. jTher. WinJs, Sec. 20:96 70 Mod. N. W. clear, 98 6S Fresh. N. 30:01 67 00 67 -.'9:9.5 69 Lijht, N. W. ~O: 00 69 29:95 69 , Q 94 68 90 70 89 70 88 70 Fojrgy, 88 70 Var." 93 72 97 71 y 92 7O Mod. N. ° 87 70 ;Cloiu!v, j 80 69 54 67 Clear, 90 65 55 C 6 Foggy, 80 69 Light, B'i 69 O 8'- '68 Fresh, N. E. 90 67 V. cloudy, 91 68 N. VV. " 94 67 94 68 Mod. var. cloudy, •9 70 S. E. clear, 92 72 ( I &1 72 Cloudy, foggy, 76 75 Rain," 

1817 Date Rarr. jThei. Winds, &c. January. ... i 29: 9R 6s Mod. _\ T . cl-^r, fog. 2 9" 69 Cloudy, 3 97' 67 Clear, Q 4 931 68 5 87 69 Fresh, S. W. cloudy, 6 92 67 ff. W. clear, 7 97 68 N. 8 95 68 9 95 68 Fog. 10 98 68 Cloudr, <[ 11 "0:03 67 Clear,' 1*29i9? 68 15 30: 03 67 14} 02 65 15 ; 09:99 6? 16 9.5 |5 17 92 66 CifHftif, # *8 92 68 Clear,' 19|30:0i fifi 2O| 03 64 21. 'if: 95 67 Mod. cloudy, 22:2fi:or* 66 >I. W. clear, 83 92 68 24 88 70 Fresh, S. VV. fog. 25 91 69 N. cloudy, ) ?<i 96 69 Clear, 27 9S 68 Mod. . 28 95 69 5. W. cloudy, ¦29 95 72 Lifiht, var. thick foj. 30 97 72 Frei,h, S. 31 96 72 Mod. thicV fojr. 



78 

INTRODUCTION. 

18)9 Barr. Titer. Winds, ifcc. Mod. N. clear, 30:03 71 Frebh, y 16 71 09 74 Mod. var. 01 74 Fog. 01 73 ¦ N. 01 7 5 Fresh, O-l 73 06 71 Var. O 06 71 05 72 Mod. OC 74 Fos. 2»:9." 76 Cloudy, 89 77 Clear, thick, fog. 86 82 Fresh, 90 SO 8 9 78 Cloudy, f 90 79 N. »9 76 Clear, 30 :05 75 00 77 05 78 00 81 Mod. S. 0 29:90 82 Fresh, cloudy, 98 80 ."0:07 73 N". clear, 00 77 

Ay r?.g». ?. 29:89 71: 2 29:8 1 72: Ij 

1813 i Rnrr. Ther Winds, ftc ft: 93 6R Strong, N. W. clear, 9P &6 9? 66 90 68 Mod. var. To*. £ 90 71 *r W. cloudy, PS 73 W. 91 70 9C 70 Fresh, N. clear, 87 71 8-1 71 Mod. var. 87 70 S thick fog. J 8~ 69 Cloudy, 90 71 92 7" Clear, 8C 72 V<ir. fbf, . 68 71 Cloudy, 67 73 S. clear, fog. 73 72 76 78 O 73 78 Fresh, cloudy, fog. 78 80 Strong, 74 SO Clear," 7". 80 Cloudy, N. W. 80 79 84 79 Heavy rain, 83 77 Frosh var. rain, (J 

1817 Date Ei.rr. Ther Winds, ftc. February.... 1 2^:95 7.5 Mod, S.tbsi. heavy rain at \"iu. f 85 73 Cloudy, heavy rain, O 3 91 75 Fnsh,*E. 4 PS 71 Mnch rain, 3 30: OS 68 K. Cloudy, 6 0! 67 Clear,. 7 00 €8 8 00 69 9 01 69 MoJ. var. cloudy, fog. <[ 10 29:9^ 71 l! 94 71 Rain, IS 87 73 Cloudy, i" 96 a s. 14 91 76 15 89 74 Fresh, E. 16 91 72 N. E. $ 17 89 73 18 S6 7" S. W. heavy rain and winl, 19 84 71 tf. cloudy, so so 71 IMod. var. N. W. much rain, -1 90 71 Ftesii rain, 22 70 70 Much rain, i 2." S6 67 N. cloudy, 24 8." 67 Mod. clear, y 25 8c 70 Cloudy, 26 84 72 27 8o 70 Var. 



79 

INTRODUCTION". 

I Averse.... 29:81 75:14 i\ 79 7"8~: 10 / 

1819 Barr. ITher. 1 Winds, &c. 29:90 80 Fresh, S. clear, 919 1 82 Fog. 96 82 9" 82 Mod. ) 89 84 J PO 8 > Light fog. 90 84 89 83 Mod. fog. 87 83 88 82 Var. 90 84 o 94 84 S. cloudy, 95 8 3 StrOUg, 87 84 89 84 92 85 96 63 IN. W. ( 88 82 jClear, 81* 84 I S3 83 Cloudy, 87 81 Fre»h, 90 85 86 86 Clear, Q 79 86 Strong, cloudy, 71 86 N. W. 77 84 Clear, 81 85 83 86 

1313 Barr. Ther. Winds, &c. I 29:84 ,75 Fresh var. cloudy, 88 75 ML E. 85 75 85 73 Rain, 79 74 N T . W. si 75 dear, 86 74 W. Q 86 74 S. W. 80 78 Mod. hazy, 77 75 n5n 5 75 69 78 Fresh, S. clear, 74 n 7.* 82 81 Cloudy, thick fog. J 60 82 Clear," 81 81 Mod. fog. 74 81 Ham, S.E. 66 81 Cloudy, storm of rain, N. E. 7<i 82 Strong ditto, N. W. HO 00 IN. W. much rain, Bfi 78 1 Ditto ditto, O SC SO Rain, 86 73 Clear, 85 GO Cloudy, 81 81 Mod. var. rain, 84 79 N. E. 70 31 Var. Gale from S.W.& rr a in, 7-1 80 S. rain, ([ 75 80 8, R2 [dltnuly, 

1817 Date Barr. ITher. Winds, Sec. Marcb 129:86 73 Fresh, N. E. cle..r, 2 80 7 5 Var. constant heavy rain, 3 80 67 Much rain, O 4 83 6a Mod. var. clear, 5 84 69 Si W. 6 87 73 Fresh, 7 83 73 S. I 86 76 Cloudy, 9 08 75 N. W. 10 78 77 Clear, N. W. C 11 80 76 Mod. var. If 84 77 S. cloudy, N. W. 13 87 71 W. 14 90 76 S. W. 15 93 76 Fresh, N. dry, N. W. 16 91 75 Mod. N. W. 17 88 76 Fresh, S. clear, 18 60 78 Strong rain, N. W. Q 19 7-1 76 Var. inucli rain, 20 75 74 Fresh, S. E. clear, 21 80 77 Var. severe storm of rain. ti 84 75 S. clear, 23 78 74 Mod N. W. •24 78 76 Fresh, S. 25 76 78 Cloudy, ¦2b 70 80 Clear, N. W. J 27 70 81 Rain, 28 76 78 Mod. cloudy, 29 73 78 Fresh, clear, 30 71 80 Cloudy, 31 60 82 |S*v?re N. W. 



INTRODUCTION". 

80 

i Aviraee. ... •_;¦>: cr> «rs: ? 

1819 Barr. Ther. WiivU, &c. 21': 60 85 Fresh, S. clear, 86 91 • ) 83 67 80 87 Strong, 72 87 jCloudy, 85 87 I 93 84 |Var.- much ra'ti, 95 80 .Fresli, S. rain, 90 81 J Clear, 84, 84 'Cloudy, O -8 85 Rain, 88 8" Mod. clouJy, 87 95 Fifsh, 72 8o Strong, 71 87 72 87 19, 87 Rain, N. W. 90 85 Var. .90 83 80 86 Mod. cloudy, 79 86 Fresh, E. rain, 77 82 Coustant rain, 60 78 Var. much rain, 70 79 S. cloudy, £ 74 79 73 85 75 IBS 80 86 Mod. S. E. 83 87 iFrpsli, 7fi! S8 IS. 

1818 Barr. Ther.l Wind*, &c. :9:88 82 Mod. var. cloudy, 89 83 N. E. S7 S3 80 84 N. W. 82 81 Fresh, cloudy, 68 80 Mod.var. clear, 15 83 Cloudy, 8T 81 S. 7ft 84 |Pl>sh, ' Ml 83 Clear, 75 84 Var. rl...idv. Gale, S. W. 73 79 Rain, ditto" ditto, 73 SO Cloud v, | •7 81 Gale, 8. K. 70 j 81 67 85 Strong, S. 7- 8 4 1 74 85 I 65 86 53 86 O 63 86 | f4 86 Clenr, 66 87 70 87 69 86 ClCudy, 67 87 C 69 88 70 88 71 87 

1817 Date j Barr. jTher. j Winds, Ac. April I C 9:8." 80 iLight, «. cloudy, 3 78 S2 S. W. cloudy, N. IV. 4 84 81 W. clear, 5 84 85 6 77 84 C h n7 y, 7 70 S5 Mod. 8 72 84 Fresh, c!ear, C 9 68 84 10 75 84 Strong clou.?s, ; 11 75 82 Clear, fo^y, 12 71 84 Clouds, dry, tf. W. 15 68 82 Clear, 14 CS fi2 1.51 .5 67 83 Cloudy, N. W. 16 67 85 17 68 84 Fresh, clear, "8 71 84 Mud. cloudy, sev. Thunder! 19 77 F4 Var. [storm,! tO 72 81 Sev. N. W. II 70 82 Fresh, S. clear, >S 64 83 Strong. 13 67 82 Hard, g, p.. cloudy, 24 60 84 Strong, S. > 25(i 56 84 26 56 85 Hard, 27 55 85 Mod. clear, 28 58 85 Fresh, cloudy, 29 62 85 5Q 64| 35 Clear. _j 



\ktaU <>/ the TKefmometer in the llospttal »f flit Majtstt/A ¦241 h U*ht Dragoons, during the Month of SeptntA l| bet; 1817. , Catvnpore, Ist Oftnbrr, 1817. | ti £ Kfhaiks. ' I. i "° 11 — i 1— ¦ I 1 «4 no 90 Wind Easterly, sultry, 8 85 9* 90 Ditto ditto, 84 92 90 Wind Westerly, ditto, 4 84 94 92 Ditto ditto, | 84 92 90 Wind Easterly, ditto, 6 86 94 92 Ditto ditto, 85 9.5 92 Ditto ditto, 8 85 93 92 Ditto uitto» 9 85 93 92 Ditto ditto, 10 84 92 92 Ditto ditto, ' 1 1 84 > fio 85 Wind Westerly, much rain in the 12 8-2 86 88 Wd. Ey. Coo!, some rain, [afternoon, 1.3 82 86 88 Ditto cloudy, 14 82 88 89 Ditto ditto, 15 ! 82 90 89 Ditto clear, 16 84 92 92 Ditto sultry, 17 86 94 93 Ditto ditto, 18 86 94 93 Ditto ditto, 19 86 96 93 Ditto ditto, 20 84 94 92 Ditto ditto, 21 85 95 92 Ditto ditt), '>o 8 5 9.5 91 Ditto ditto, t§ 84 91 90 Ditto ditto, 2 4 ;, 0 86 Wd. variable, afternoon rain, gj 8 a 90 88 vVd. Wy. afternoon, strong wind, I 26 ! 83 91 90 Ditto sultry, 83 90 89 Wd. Ey. ditto, I 28 82 90 89 Ditto ditto, I »>9 82 pi 90 Ditto ditto, [andrar.i, I {to ;?3 33 We *- W V diur, afternoon Ey. VVd.] 

81 





DOAB. \Stalf of the Thermometer in the Hospital of Hit Mfijfxl\f\ I 24M Light Dragoons, during the Month cf Octobtrl ; Camp, J/n/Iwan, Ist November, 1817-! . ijL i 1 Remarks. j [ 182 88 86 Wind Easterly, clear, 1 I 82 86 85 Ditto cloudy, 5 80 86 85 Dittotio. afternoon much ruin, ¦ 4 78 88 B<S JDitto ditto few drops, I. I 5 79 *8 8« Ditto ditto, If I 6 80 89 88 Ditto forenoon little rnin, !l: I 7 80 88 86 D>>. afternoon cloudy, 1 tttlr raiiij '•I ' | 90 88 Ditto clear and sultry, ' s 9 89 R8 Wind Westerly, ditto ditto, -J 10 T! 90 88 Ditto ditto, i tl 76 92 90 Ditto ditto, I" 5 12 76 93 90 Ditto ditto, j 13 73 94 91 Ditto ditto, i 14 78 91 co Ditto ditto, \ 15 79 95 91 Ditto ditto, ; 16 79 89 88 Ditto ditto, i f 17 78 90 88 Ditto ditto, I 18 91 89 Ditto ditto, JC 19 88 ; 86 Wind Easterly, strong, 80 • 76 89 86 Ditto sultry, 21 75 92 90 Wmd Westerly and hot, 0f 75 96 ] Q0 Ditto ditto, IS 1 S3 75 98 96 Ditto ditto, i* <M 24 76 9S 90 Ditto ditto, Jo I 25 96 £S Ditto ditto, 26 98 94 Ditto ditto, jj i 87 68 P8 88 Ditto ditto, ; 66 99 89 Ditto ditto, 23 64 99 j 89 Ditto ditto, |30 «* 96 86 Ditto ditto, 1 U 31 6* 96 R* Ditto ditto, 

82 





INTJIOOUCTION. ¦ 

83 

Jfnndfrfotnd Cm Ire Division vf tht Army\ JMrtforoiof-irnt Table Jf>r I\vr(mbtr, IHI7, Ih'iakt of T/ier,nomcfrr. « -> ». -•» "^ ~* { 1 6! 94 75 WestfrljbyN. 2 61 92 78 Ditto, 3 56 89 90 ! Ditto, I 4 54 88 63 Ditto, 5 56 90 63 Ditto, 6 SO 90 C 8 Ditto, 7 , 45 90 6" Eagerly, 8 4 7 88 (!S W. by N. 9 50 8 7 68 Ditto, 10 50 86 OH Ditto, 11. 50 84 68 Ditto, 1* 51 84 «8 Easterly, 19 57 86 68 Ditto, 14 56 V 8 68 Ditto, 15 r,B 90 68 Ditto, 1 6 58 <>0 C 3 Soutli East, 17 56 88 68 W. by N. 18 M 84 68 Ditto, ly 52 8 4 6^ Ditto, 20 50 84 C 8 Ditto, 21 52 90 6-t Ditto, C 2 52 84 • 66 Ditto, 93 52 GO 64 Ditto, 24 52 82 68 Ditt'i, 25 44 82 66 Ditto, 26 52 82 62 Ditto, 27 56 82 62 Easterly, 28 42 78 «0 Ditto, 29 42 76 60 Ditto, "o 44 ' 7fi 6f> I Westerly. Jj 



liundlekund ('nitre Divixti* of the Army I Meteorological Table for December, 1817. I Height of) i lnerino- I meter. I I 46 78 (JoJN. W. I 9 16 78 62 Ditto, I 3 46 78 G-llDitto, I 4 46 78 62 Ditto, III I 5 46 78 6'i Westerly, I 6 J6 72 62 Ditto, I 7 -iG I S6 G2iDitto, 8 46 86 GO Ditto, CIo«ily, I 9 46i76 60 Ditto, Jlo Ufijao 60 Ditto, Clear. 11 1 1 1 4 41804 1 80 60 Ditto, JI.3J4C 82 62 ClouJy, |14!5O 86 64 N. W. Ditto wind, h:gli, 15154 76 64 Ditto, |16|48 72 58 N. Clear, wind high, 17 41 70!54 N. W. Ditto, JlB 40 7f 54 Calm and serene, 19;38 75 i 6 Cloudy, i'oNo 72 56 Ditto, il 40 74 58 Easterly, Ditto, 92H4 72 58 Slight shower in the afternoon, 5.3|04 70 .58 Several showers during (benight, J4414; 72 .58 Heavy clew ami thick fop in the morning, p}s 50 72 60 >J. E. Wind high, Thunderstorm, [and raw, 126 .58 70 68 Showers and wind various, evening Thuuier J7|o"o 74 68 N. W. Thick for; & mild ruin, evening heavy showers j laBi6'> 64 61 Ditto ditto perfectly cloudy to near sun set, 129 4768 54 Westerly, Cloudy and v»ind various, |.to|i4 70 6i ( Easterly, Heavy dew. this morning and some clouds, b'l 4^ 72 5$ North,* Clear. _' I 

84 







Q> "<* 'i* - 1 ' **^ *"* 

RISE AND PROGRESS 

or the 

EPIDEMICK. 

THE disease termed by Nosologists Cho lera Morbus, being in the higher latitudes chiefly confined to the latter part of Summer and the beginning of Autumn; and manifestly originating in the great heats peculiar to that period of the year ; it might have been expectec to occur commonly in countries placed within the tropics. — It has accordingly been found that a disorder, possessing the principal charac teristics of that disease, has prevailed more or less endemically, during the Hot and Rainy Sea sons of every successive year, in the Lower Pro vincss of Hindostan. 

Previously, however, to the year 1817» when for the first time within the memory of man, tha 

A 



littndhkun.fi ('mire. Oivislcui of the /trmy\ — Meteorological Table for December, 1817. J 'tgrli oj her moso* IVindi. Kkuaxk:*. i7B S o|N. W. 1? ?I II 78 64jDitto, § »"J ; 78 6y Wester 'y» ¦:--^-»'«6 62|Ditto' "^ 86 GO Ditto, Cloudy, ; ao 60 Ditto, ' Clear. ; 82 62 Cloudy, i 86 04 N. W. Ditto wind, high, ii 76 64 Ditto, i 72 58 N. Clear, wind high, 70 54 N. W\ Ditto, ) 7i" >4 «. Calm and serene, -25>74 58 Easterly, Ditto, 1 72 58 Slight shower in the afternoon, ?"o"e?'t 70 58 ? Several showers during themghf, 78 58 Heavy dew ami thick fop in the morning, ) 72 GO N. E. Wind high, Thunder storm, [and rahij *m 70 68 Showers and vrind various, evening ThuiHeij q )7468N. W. Thick foz& mild rain, evening heavy showeiJ » 64 61 Ditto ditto perfectly cloudy to near sun set, I 768 54 iVesterly, Cloudy and v»ind vtrious, M7O6V Easterly, Heavy dew thik luui'itui^ and some clouds, I 

86 







fit r* *r I'tf* *r* *^ 

RISE AND PROGRESS 

or the 

EPIDEMICK. 

THE disease termed by Nosologists Cholera Morbus, being in the higher latitudes chiefly confined to the latter part of Summer, and the beginning of Autumn ; and manifestly originating in the great heats peculiar to that period of the year ; it might have been expected to occur commonly in countries placed within the tropics. — It has accordingly been found, tliat a disorder; possessing the principal characteristics of that disease, has prevailed more or Enically, during the Hot and Rainy Searery successive year, in. the Lower Pro* 

Previously, however, to the year 1817* when for the first time within the msmory of man, that 

A 



2 



a&e assumed the epidemical form; the re of its influence was very limited, and its destructive effects inconsiderable. Its attacks were chiefly limited to the lower classes of the; inhabitants ; whose constitutions had been debi. litated by poor, ungenerous diet, and by hard labour in the sun; and who were badly clothed and frequently exposed in low and foul situations to the cold and damp air cf the night.- — It rarely appeared in the dry and equable months of the Cod and Hot Weather ; and although cases were now and then met with during every part of the Rains, it always shewed itself in greatest vigour towards the autumnal solstice ; when tho declination of the sun was still inconsiderable ; when the air was surcharged with moisture; and when the alternations of atmospherical temperature were sudden and frequent. As the Cold Season came round, and brought with it, a clear atmos. 5, and cool, dry and steady weather ; the disease became of less frequent occurrence ; and at length altogether withdrew. — The better criptions of Natives, those who were well fed and sufficiently clad, who ventured little into the sun, and inhabited high, dry, and freely ventilated ... ¦, were but little subject to its influence; and so rarely did it reach the European portion of the community, that of two gentlemen in immediate charge } one for ten and the other for of the General Hospital for Europeans 



im 

i.-.-dJr'n. 

Jessort, 

at the Presidency, neither had Been a single case of the disorder} until it QC€une4 epidami. ..../ 

throughout uiese Frovinces. 

The disease, which has bsen thus stated to be endemical in Bengal ; and to prevail more Or less daring certain parts of each year ; shewed itself sooner, and was perhaps more common in the first six months of 1317, than in former years.— - 

The Rains, it has been seen, set in that season at eait a month earlier than usual ; and from the *eport3 of the medical officers on the spot, Ch-o - era would seem to have occurred in an unusual 

degree in some parts of Nuddeea and. othei tricts in May and June. But as its attacks were yet restricted to particular places, and net very commonly fatal j it does not appear to Lave excited much attention, until the middJft o£ August, when the rapidity of its progress, and its general extension, began to crests universal a* 

On the 23th of that month it was reported to Government, that the disease had suddenly appeared epidemically in Jesscre, a populous town situated in the centre of the Delta of the Ganges; that it was attacking all elates indiscriminately; and was cutting oif from twenty to thirty persons daily ; and that the inhabitants, astonished and terrified at llio unaccpufltajate sr.a very dcs- 

A 2 

3 





tractive nature of its attacks, \7ere Hying in crowds from the place, as the only means of escaping impending death. — So little was the nature of the new pestilence yet understood 5 and such was -the extreme consternation produced by it, that the Civil Courts of the District were shut; and a stop put for a time to business of every description. Although the general emigration which took place from the city, would seem to have had a decidedly beneficial effect on the state of its health, by diminishing that density of population, which has been since invariably found to be a powerful auxiliary to the Epidemick ; yet such was the energy of the disease in this its first onset, and so fatally destructive was it of human life, that in this district alone, it is report* ed to have within the space of a few weeks, cut off more than six thousand of the inhabitants. 

It is necessary to be thus particular regarding the breaking out of the disorder at Jessorc; because from the alarming nature of the circumstances, which attended its appearance in that quarter ; connected with its rapid and general spread as an Epidemick over almost every portion of the Lower Provinces, accompanying or immediately following that appearance ; an idea then arose, and has since obtained very general belief, that Jessore was the place, in which the disease primarily originated, and whence, as from a fu- 

4 





Behar, Dacca Cities of Pattin. Dacca. Ui- 

napoie, 

Is, its pestilential virus, of whatever nature, lanated, to the surrounding districts. What ved to give validity to this conjecture, was an inion then entertained, and since industriously >pagated, that the Jomes, or specific poison procins: the disease, had its rise, not in any vited state of the atmosphere, or other cause of general operation, but in circumstances of a Eely local nature : such as the use of rancid and biighied grain. 

It is nevertheless certain, that nothing could be more erroneous than this notion of the local origin of the Epidemick. For, not to speak of its frequent occurrence, so early as May in some parts of Nuddea, and other districts already adverted to, it is quite clear from the statements of the medical staff, written separately and without interchange of knowledge or communication, that, more than a month previously to Jessore's becoming affected, the disease had begun to prevail epidemically in the distant Provinces of Behar and Dacca ; and that before the expiration of the first week in August, rt had firmly established itself in many other parts of Bengal. Thus it is distinctly stated to have broken out in the City of Patna on the 11th of July; to have spread to the contiguous station of Dmapore, and the adjacent villages early in August ; and to have remained without intermission in that neigi:« 

5 





¦; 



Siiiiergong. 

Nufai:)g.ung- 

KUbMfiurb. 

tSylh 

Chuta^ong. 

Bhauguipore. 

HMifbjr. 

lii like manner, after having in July appeared at Sunergong, a Town on the banks of a branch of the great river Megna, it thence proceeded, visiting the ghauts or publick ferries and grain markets in its way, to Nuraingunge and Dacca, where it arrived in the beginning of August. During the whole of July and August eight out of eighteen Police Departments into which zila Kishnagur or Nuddeea, on the east side of the Hoog]y v is divided, were also fully subject to its influence :, and it had about the middle of the latter month 

even found its way to the remote Province of 

et, which is separated from the eastern parts of Bengal Proper by the great Rivers Ganges and Burumpooter. On the 23d of August we find 

raging at Chittagong, far round the Eastei 

Easterti 

corner of the Bay of Bengal ; at the same mo 

merit in Rajshahy, a centrical district lying East 

of the Ganges; ana not a week afterwards, in the 

high and distant tracts of Bhaugulpore and 

Monghyr. The exact date of its appearance in 

* It appears from accounts received since tins sketch was drawn up, that the disease had ravaged Nuseerabadj 

a town in Moinensing in June ; and had even fa affected the South Eastern Division of that district, in the early part of the month 01 last days of May: following the couioc of the Burumpooter ; and irregularly attacking die villages on its banks? 



Calcutta 

Calcutta has r.ot been ascertained. — But tin is little doubt, that it visited some spots of the tqwn and suburbs as early as the beginning of '¦ uguat ; that it daily gained ground, and before the end of the month had widely spread its ravages, in a manner threatening to sweep off a large portion of th« Native population ; and that in the early part of September, even the European portion of the community was no longer secure from the concentrated activity of the poison. These facts are more than sufficient to shew the fallacy of every theory, which attempts to derive the disease froni any local source ; or to trace it to any one particular spot, as the centre from which it was emitted to the surrounding antries. — They prove, without the possibility of dispute . jroke out at very remote places at one tnd the a .2 time, or at the distance of sucb she-* . intervals, as to establish the impossibility of :iential virus being, in this 53, propagated by contagion, or . :e other known modes of successive production 4 aj its general diffusion was therefore referable to some cause of more universal operation.? * A few dates m:ty be marked of the principal places attacked in the early part of the progress of the Epidsmick, according to the order of their succession. — May 

7 







JJiniigepcre, &;:lasore and rf 1 i 

Soon after the middle of September, the disease, now strictly epidemical, extended itself in every direction ; within the short space of a few weeks stretching from the most easterly parts of Poorneea, Diuagepore, and Sylhet, to the extreme borders of Balasore arid Cuttack; and reaching from the mouths of the Ganges nearly as high as its junction with the Jumna, 

Within the area of several thousand miles, thus in so short a period brought under its influence, few towns or villages of any considerable size wholly escaped its attacks ; almost every spot being, notwithstanding the great irregularity of its course, and waywardness of its approach, sooner or later, and in a greater or less degree, subjected to its dreadful visitations. — The citits 

and June. One Thanna or police Division of Kishnagiu, and Mymensing generally. July. Eight Divisions of the forme** district ; Sunergong in the Dacca District; and on the 1 lih Patna. August. In the first week Calcutta, Dacca and Dinapore ; about the middle. Nattore; on the 1 7th, Sylhet ; on the 1 9th, Jessore ; and towards the erul of the month, Bhangulpore and Monghyr. September 15th. Balasore, Bunsaul, Burdwan; 17th, BuxarJ 28th, Chupra and Ghazeepore; in the latter part Moozufferpore. October, Baulea ; 1 5th, Berhamporej and Rungpore. It is only necessary to cast one's eye over the map to perceive immediately how irreconcilable these dates, aiul the intermediate distances are with the suspicion of local origin. 

8 





Burrisaul. Bardwan. Knngporr. Mal.la 

Cliupra. Tirhoot. Buxnr. 

Gliazeepoor 

Moonhedab»d. 

of Dacca, and Patna, the towns of Balasore, Burrisaul, Burdwan, Rungpore, Malda, Bhaugulpore, Chupra, and Moozufferpore, with the Military stations of Monghyr, Buxar, and Ghazeepore, all suffered severely : and throughout the whole extent of the Delta of the Ganges, and more especially in the tracts bordering on the Iloogly and the Jellinghy Rivers, so great was the mortality, that the bulk of the whole population was sensibly diminished by the dreadful ravages of the distemper. It is remarkable, that the large and populous city of Moorshedabad, from extent and local position apparently very favorably circumstanced for the attacks of the Epidemick, should have escaped with comparatively little loss, whilst all around was so severely scourged. 

It has already been shewn, that, so long as the Epidemick was confined to the Province of Bengal, it at once raged simultaneously in various and remote quarters, without displaying aprediliction for any one tract or district more than for another; or any thing like regularity of succession in the chain of its operations. As yet too, some of the peculiarities subsequently developed by it, and so unerringly marking its progress throughout the Upper Provinces, that they came almost to be considered as laws of the disease, had either not been called into existence, 

» 

9 





or were still of such feeble and uncertain operation, as to remain unobserved among the accu. muJated horrors of its attacks. Thus, although there was the same violence in the commence^ ment, and rapidity in the progress, of its visita. tions, they were yet unmarked by that earliness of declension, and entire subsidence, which afterwards generally formed so consolatory a part of their revolutions. — Nor could a town or tract of country, after having once fully undergone the scourge, yet congratulate itself on a probable immunity from its further assaults. — For, although generally milder in form, and less fatal in the latter period of its existence, it rarely altogether disappeared ; but seemed rather to keep hovering in the vicinity, as if in mere expectancy of some fresh cause to recommence its attacks with renewed vigour. 

The only spots on the Eastern side of the Ganges, beyond the precincts of Bengal, attacked by the Epidemick in the Autumn of 1817, were Moozufferpore, and Chupiah, the principal Stations of the Tirhoot and Sarun Districts ; and the cantonment of Ghazeepore ; — and in each of these places its attacks were confined to the towns themselves, or villages in their immediate vicinity : the great bulk of the adjoining country at" this TiprinH entirplv pspanintr the disease. 

10 





And now the Epidemick began to shew one of the most striking peculiarities which characterised its march. It no longer pushed its influence, without distinction or apparent choice, in all directions, and throughout every tract coming in its way. It began to affect particular lines, and to fix itself in particular divisions of Country ; wholly restricting itself for the time to the course of those lines and divisions. Instead of shooting up from Moozufferpore, Chupra, and Ghazeepore, through the contiguous districts of Gorruckpore and Jiounpore, to the provinces of Oude and Rohilkund, it wholly left that part of the Country ; and for many months confined itself to the tracts lying west of the Ganges and Jumna. Thus, from the beginning of November, when it quitted Moozufferpore, until the end of March, when it broke out in Allahabad, on the junction of the Ganges and Jumna, it does not appear, that any one spot of the immense tract stretching to the East of these rivers from the northern point of Saharuapore to the Southern boundary of Tirhoot, was visited by the disease.* It will be afterwards seen, that from Allahabad, a new stream of the pestilential virus, now apparently propagated by regular succession, issued in various directions, and made a great part of this tract suffer for its previous immunity. 

Bucknow may perhaps be brought forward as an ton to this general rule. A few cases of Cholerft 



11 





Mirzapore, 



Bundlekurri. Centre Divition of the Army. 

Although the Epidemick would seem to" have heset Zila Mirzapore, and to have slightly ap. peared at Oonchara, and in the Camp of His Majesty's 17th Regiment of Foot, and of the 2d Battalion Bth Regiment Native Infantry, at Mongawa, near the Northern extremity of Rewa, about the middle of November ; it did no great mischief, until in the end of the first week of that month, it reached the Centre Division of the Grand Army, then encamped, under the personal command of the Marquess of Hastings, near the banks of the Sinde in Bundlekund. 

It was here that the disease put forth all its strength, and assumed its most deadly and appalling form. It is uncertain whether it made its first approaches on the 6th, the 7th, or the Bth of the month. After creeping about, however, in its wonted insidious manner, for several days among the lower classes of the Camp followers ; it, as it were in an instant, gained fresh vigour, and at once burst forth with irresistible violence 

Morbus did certainly appear there in December and January ; but these were probably merely Sporadick ; as the disease afterwards visited the City with great violence in April and May, when it was prevailing epidemically in the neighbouring Country. So that, if the cases occurring in December belonged to the Epidemick, the City must have been twice visited by it ; a thing almost unknown during its stay in the Upper Provinces. 

12 





in every direction. Unsubjected to the laws of contact and proximity of situation, which had been observed to mark, and retard the course of other pestilences, it surpassed the plague in the width of its range ; and outstripped the most fatal diseases, hitherto known, in the destruc* tive rapidity of its progress. Previously to the 14th, it had overspread every part of the Camp ; sparing neither sex nor age in the undistinguishing virulence of its attacks. The old and the young, the European and the Native, fighting men and Camp followers, were alike subject to its visits ; and all equally sunk in a few hours under its most powerful grasp. From the 14th to the 20th or 22d, the mortality had become so general, as to depress the stoutest spirits. The sick were already so numerous, and still pouring in so quickly from every quarter, that the medical men, although night and day at their posts, were no longer able to administer to their necessities. The whole camp then put on the nppearance of a hospital. The noise and bustle almost inseparable from the intercourse of large bodies of people, had nearly subsided. Nothing was to be seen, but individuals anxiously hurrying from one division of the Camp to another, to inquire after the fate of their dead or dying companions ; and melancholy groups of Natives bearing the biers of their departed relatives to the river. At length, even this consolation was denied to 

13 





them ; for the mortality latterly became so great, that there was neither time nor hands to carry off the bodies ; which were then thrown into the neighbouring ravines, or hastily committed to the earth, on the spots in which they had expired, and even round the walls of the Officers' tents. All business had given way to solicitude for the suffering. Not a smile could be discerned, nor a sound heard, except the groans of the dying, and the wailing over the dead. Throughout the night especially, a gloomy silence, interrupted only by the well known dreadful sounds of poor wretches labouring under the distinguishing symptoms of the disease, universally prevailed # — The Natives thinking that their only safe- 

* Many ol the sick died before reaching the hospitals; and even their comrades whilst bearing them from the out posts to Medical aid, sunk themselves, suddenly seized by the disorder. — Never was the impressive )an¦rrua^e of Scripture more applicable than now : — "In the midst of life we arc in death". — All security of life was gone; and as youth and vigour afforded no safety, even the healthiest man could not in the morning tell, that he might not be a corpse before night. — Such was the dreadful effect of the scene, that even long after its occurrence, it could hardly be described without shudder* j nf r hy the eve-witnesses. — How fatal the sickness of this Division, had it continued much longer, might have proved in its political consequences, we have been told from the highest authority. In delineating the rise and progress of the late war, on his return to the Presfdencv. the Governor General thus spoke of the visitation of 

14 





ty lay in flight, had now begun to desert in great numbers ; and the highways and fields for many miles round, were strewed with the bodies of* those, who had left Camp with the disease upon them, and speedily sunk under its exhausting effects. It was clear, that such a frightful state of things could not last long; and that unless some immediate check were given to the disorder, it must soon depopulate the Camp. It was, therefore, wisely determined by the Commander in Chief* to move in search of a healthier soil, and of purer air. The Division, accordingly, on the 13th inarched in a South Easterly direction towards Talgong, and Sileia ; and after se\ eral intermediate halts, on the 19th crossed 

his Army. — '* The dreadful pestilence, which made such havoc iv the Dirision under my immediate command, forced me to quit the banks of the Sinde, and to seek a more favorable country for the recovery of my numerous fcick. 1 did not find this until I was fifty miles from the river which I quitted. — Fortunately the change of air was rapidly beneficial ; for, a very short time had passed when. I received intelligence of an invitation said to have been givea by Scindia to the Pindarries. — He was reported to have promised them, that if they would come so near to Gwalior, as to make his getting to them easy, he would break his Treaty, and join them with the Force, which he had at his capital. — The Pindarries were in full march for Gwalior, without meeting even a shew of impediment from the troops of Scindia stationed in their route ; tho' the co-operation of his Army for the extino 

15 





the clear stream of the Betwah, and upon its high and diy banks at Erich, soon got rid of the pestilence, and met with returning health. But its line of march, during the whole of this progressive movement, exhibited a most deplorable spectacle. Although every means had been ta. ken, by giving up the ammunition carts, and collecting elephants and draught cattle, to pro. cure sufficient carriage, the sick were found too numerous to be moved, and were in part necessarily left behind. And as many who left the carts, press, ed by the sudden calls of the disease, were una- 

We hurried back to the Sinde; but this time we chose a position nearer to Gwalior, than what we had before occupied — We were within thirty miles of the City, and our advanced guard was sent to occupy the passes thro' the hills which run at some distance South of Gwalior from the Sinde to the Chuuibul. — Those passes were the only route by which communication could take place between the Pindarries and Scindia : and I was nearer to support my advanced guard than the Maharajah was to attack it, could ho bring his mind to so desperate a .stake. — The Pindarries finding their hopes bailled and the passage stopped, attempted to retire ; but they had been followed close by our Divisions, were surprised, dispersed, and slaughtered in a number of small actions. In short they disappeared. And thus our objects were completed." — A few days' longer continuance of the Epidemick might, by entirely crippling this Division, have given a very different appearance to the face of aftairs, and prolonged the struggle to an indefinite pc« 

16 





hie to rise again ; and hundreds dropt down during every subsequent day's advance, and covered the roads with dead and dying; the ground of encampment, and line of march, presented the appearance of a field of battle, and of the track of an army retreating under every circumstance of discomfiture and distress. The exact amount of mortality during these few calamitous days could not, from the circumstances of confu? sion and general disorder, under which it took place, be ascertained with any degree of accuracy. From the Military returns however it ap. pears, that in this fatal week, of 11,500 fighting men of all descriptions,* 764 fell victims to the disorder; and of the camp followers, it was conjectured, that about 8,000, or one-tenth of the whole, was cut off. 

From the Division having shaken off the disease, shortly after reaching the elevated and salubrious banks of the Betwah,t it was generally 

* The number of fighting men in Camp is here a good deal overrated; for one Detachment left Camp before the commencement of the disorder; and another much larger as early as the 18th. — The two together amounted to nearly three thousand. 

f The disorder ceased to be Epidemick about the 22d or 23d. A few instances of mild attacks were after that seen daily till the end of the month. After the Bth of December not a case appeared. 

C 

17 





18 

ftISE AND PfIOCRXSS 

Slieeruur. 

believed, that it owed the recovery of its health solely to its change of ground and climate. But, without denying the salutary effects of such change, it may be reasonably doubted, whether the Epidemick could have existed much longer in Camp, even had it remained stationary on its original scite. For from this time forward, it began to evince that rapidity in its revolutions, and inaptitude to remain long in one place, which almost invariably characterised its future progress; and as will be hereafter seen, in no one of the several camps subsequently visited by it, did it continue in full vigour for more than ten or fifteen days. 

The Medical Staff attached to the Centre Pivision are quite divided in opinion, regarding the particular source of the Epidemick in that quarter. According to some, it commenced, so soon as the 2d of iNovember, at the bridge of boats at Sheergur, over which the army crossed, in passing from the Doab in the end of October; and was thence communicated to the Camp at Terayt,' by the Detachment left to guard tin? tete de pout. It will afterwards be attempted to be shewn, how far this conjecture was borne out by facts. A second opinion was, that the Division found the disease in the villages, on its route from the Jumna ; and a third, supported by an almost etjuai number of voices, that it sprung up spontaneously, from some unknown cause, in the centre of the Camp itself; and was thence imparted 



s^or. ft" 1"."-, Khwwfaft 

to the previously healthy towns in the vicinity. The probability seems to be, that the peculiar vitious state of the atmosphere, productive of the divscase, which had several months pre-existed in Lower India, was already beginning to reach the Upper Provinces ; and that, although not yet in sufficient force, to be called into activity by the comparatively slight causes afterwards sufficient for its excitement, it was nevertheless capable of being roused by the numerous circumstances favorable to its existence, presented by the immense body composing this Division of the Army. 

Be this as it may, it is quite certain, that after appearing in this quarter, the Epidemick, still I voiding the Eastern and Northern parts of the >untry, now decidedly took a South Westerly rection; and, after being propagated along the ;ds of the principal rivers and great roads, to most every town and village of Bundelkund id Saugor, was successively communicated to the ovinces of Berar, Malwah, and Khandeish, and tally to almost every portion of the Deccan. 

No reports having been received from the northern part of Bundelkund, it is impossible to trace its progress through that division of the district. -—In the South its route maybe more easily sketched — Having stretched from jelalpore, ontheίetwah, to the town of Kytah, and overrun the ityah. 

C 2 

19 





Banda, 

LoWgnon Hutta. 

ooreea 

Nagpore 

Ulnlsa. Bhopal, Ougeia, 

Mow 

Muhtdpore 

Bhanpora 

whole of the tract between the Dusawn and Cane rivers, it reached Banda in the end of March. There, and in the dependent district, it is reported to have destroyed 10,000 of the inhabi. tants. We now rind it proceeding in a westerly direction, along the banks of the Cane, to Lohargaon, Hutta, and Saugor ; in which neighbourhood, it remained with great virulence from the beginning of April till the middle of May. But though the inhabitants of Hutta and Saugor, and the dependencies of Nursingha and Puthoorea, smarted exceedingly under its inflictions, it is curious, that the troops serving in that quarter, and some of them living in the very centre of the pestilence, at that time, scarcely appeared sub. ject to its influence. 

From Saugor the virus diverged in two directions. One stream took a Southerly course towards Nagpore. The other went South West through Bhilsa, Bhopal, and Shoojawulpore to Ougein : doing infinite mischief in the whole of this line ; and, as it proceeded, taking in the post ofίurseeah, and Sir John Malcolm's Camp at Mow. It reached Jhanoor, three marches Soutli of Ougein, on the 4th of May ; was at Ougein itself on the 9th ; and at Muhedporeon the 12th. Thence, still keeping to the course of the Chumbool river, it successively attacked Sonara, Major Agnew's detachment at Bhanpora, and the camp of Holkar in the immediate vicinity. InJuuc 

20 





lvutiih 

Left Division of the Army. 

Jubbuipore. Mund In. 

Nurbudtla, 

it had got the length of Kotah ; where it is said to have cut off a hundred men a day, and to have produced such dismay, that the inhabitants were abandoning the city in distraction. Having here, however, got into the high and mountainous tract, which has invariably been found inimical to its existence, it seems now to have gradually died away. A proof of this is, its never having reached the States of Oodc-ypoor and Ajmeer. 

To return towards Saugor, and to trace the* current, which was stated to have taken a Southerly course ; and, which, after affecting the Left IJivision of the Army, and the Nerbudda Field Force, would appear to have extended through the States of Nagpore and Poonah to the Presidencies of Bombay and Madras : — The troops under Major General Marshall, during their march in a South Easterly direction from Saugor to Mundela, fell in with the disease, on the 9th of ApnJ, at Jubbulpore on -the Nurbudda; and suffered severely from it during the remainder of the month. The mortality caused by it, however, amongst the regular troops, bore no proportion with that, which had previously occurred in the Centre Division : for of 8,500 fighting men, only 195 were taken ill ; of whom no more than 49 died. 

Following the channel of the Nerbudda, in an 

21 





floshungnbad 

IMooltay. Nagpore. 

N^fpcreForce 



__, - , . . ,11- Tv Easterly direction, the disease next gained H<v shungabad ; and, apparently crossing the river at that place, proceeded in a Southerly course, through the town of Mooltay, td the city of Nagpore, where it arrived in the last week of May. Both of these places, and many of the villages intermediate between Iloslmngabad and Mooltay, were very severely visited by it ; and .Mooltay itself, although but an inconsiderable place, lost above five hundred of its inhabitant?. But, so singularly capricious was the disorder in this quarter, that it was not met with between Nagpore and Mooltay; a distance of 70 miles; and that Baitool, a large town in the direct road from the river to Mooltay, was entirely exempt from its visitations. 

The Nagpore Subsidiary Force under Colonel Adams, afforded the first striking instance of a large body of men coming into the pestilential medium, and from the previous enjoyment of perfect health, falling at once into a wretched state of sickiiness. This Division had, during the early part of May, been occupied in besieging the important Fortress of Chanda; but, although it hod undergone excessive fatigue, and met with a few casualties from constant expo* sure to the sun, it had nothing like marked dis. ease, until, on the morning of its last march on the return to Nugpore, it encamped at Gaongong: 

22 





Here it had hardly learnt, that the Epidemick was raging in the vicinity, when it began itself to experience its unwelcome visits. As usual, its first assaults were most severe. Many of those attacked, whilst loitering for water in the neighbouring rivulets, were brought in expiring ; some dead. Of 70 cases admitted during that night and the succeeding day, about I 2Q died. — On the Slst the instances of attack were equally numerous ; but in these, the exhaustion was not so sudden, and the subsequent symptoms were less severe. On the Ist of June, the Division moved from Nagpore towards the cantonments at Hoshungabad, The disease then gradually declined ; and almost entirely disappeared on the 17th and 18th, after some seasonable fulls of rain. The Madras Troops, composing part of the besieging force employed at Chandah, are reported to have suffered equally with their comrades from this side of India. As the Bengal returns proceed no further than Nagpore, it must be left to the proper authorities at the other Presidencies, to give an accurate record of the ravages of the Epidemick, as it stretched through the Deccan, and ranged along the Malabarand Coromandel Coasts*. — It may here, 

* This has been already in part done. A Report lias been issued by the Bombay Medical Board ; and is full of valuable facts. It will soon be followed by a corresponding paper from Madras, where the Epidemick has 

23 





24 

RISE AND FBOGRESS 

Jaulna 

K-ungabnd mednug- 



Boinb;.y 

«'>aU 

however, be generally mentioned, that, according to the prevalent opinion, the disease could be distinctly traced along the great road leading from Nagpore to Jaulna, and thence to Aurun. gabad and Ahmednuggur. — From this quarter, or perhaps from Chandore, and Nassuck on the Godavery, it was communicated to Bombay. — The city of Poona, and many of its dependent towns and villages, the province of Khandeish, the camps of Generals Doveton and Smith, and of Colonel McDowaK were visited by it in the course of July and August ; and at Punderpoor, whore it happened to shew itself during the celebration of a great fair, it is said to have laid low up wards of three thousand victims. It certainly penetrated to the southernmost point of the Peninsula* j and even passed over to the Island of Ceylon ; but, during the latter part of its progress, its course was singularly uncertain and erratic, and its symptoms fortunately much mitigated. 

We must now trace back our steps, and follow the Epidemick, during an almost equally long and devious path, which it pursued, from the junction of the Ganges and Jumna at Allahabad, through the greater part of the Northern Provinces. This point is fixed upon, because 

! It swept through Mysore in the following Cold "Weather ; and in the city of that name alone, cut off ten thousand ocr en- 



Cawnpore. 

Nujufgur. 

Bethoor, 

Shajehanpooi 

¦ the disease first established itself there in the* ¦ spring of 1818, and could thence be distinctly ¦traced successively to many of the Towns situat- Bedin the Doab, and on the Western bank of the ¦Jumna. It broke out suddenly in the town and jίdistrict of Allahabad in the end of March ; and ¦prevailed during several months with great malignancy: sweeping off nearly 10,000 of the inhabitants. The troops stationed, in the Fort and HCity were not affected until the middle of July ¦following, although holding daily and unrestrained intercourse with the townspeople. Keeping close to the banks of the Ganges, the JEpidemick entered Cawnpore on the Bth of April ; having previously visited the town of Nujufgur, lying about IS miles East of that City. L|Tt equally attacked the City, the Military Canton¦nents, the Civil Station of Bethoor, and the ad¦oining villages ; and remained in full force during fifteen or twenty days . But, the mortality Icaused by it was not very great, and it appeared ¦ittle disposed to extend far in that direction : fcareilly, Moradabad, and almost every other town ¦n the same line enjoying their wonted health. ¦The town and district of Shajehanpore form a temarkable exception to the general healthiness > lot' the Province of Barcilly. There, the disease •appeared" in July, and is reported to have killed upwards of five thousand of the inhabitants* 



D 

25 







26 

E taw ah 

Fattigur, 





Cod. 

On the Jumna, the Epidemic spared Culpae, and almost every intermediate village between it and Etawah. — The latter place it. reached late in May ; and,, after doing considera. ble mischief, it would appear to have thence, at once stretched across the Doab to Futtigur, visiting very few places on its route. It appeared in the lines of Futtigur on the 10th of June; and thence was communicated to the town. There it shewed little virulence of symptoms; and wholly subsided on the commencement of the Rains early in July. It is curious, that Muttra, situated considerably higher up the Jumna than Agra, should have had the disease in the beginning of June, whilst the latter place was not visited until the Ist of July. In Muttra, — a filthy and crowded City, — the disease was very virulent, and the mortality great. In Agra, — a dry a:id airy town, — the symptoms were mild, and the deaths few. The Cantonments attached to Agra remained nearly exempt ; but those at Muttra being low and near the banks of the river, partook of the general unhe^ithiness of the town, and lost many men. In both places, the Epidernick loitered for more than a month. It then, on the 11th of July, entered the town of Coal; whicii was alone affected in the Alligur district: the Jails, Cantonments, and the adjoining villages enjoying perfect immunity* We next find 







Delhi. 

the disease on the 20th at Delhi. Here it remained nearly a month, and committed very considerable havoc among the condensed population of an extensive city. Neither between Agra and Delhi, nor during its route from the latter place to Meerut, did the, disorder halt in any of the intermediate towns and villages. Since, of these many were placed very low, and much exposed to musses of animal and vegetable putrefaction, and every other source of miasmata and contagion, their immunity from attack could hardly be ascribed with justice to pi .-uiiar healthiness of situation. The reason rather seems to have been that, in this quarter, the Epidemick, whether from the pure and elastic air of the Northern Provinces being less favorable to its existence, than the thick damp climate of Bengal ; or from its beginning to give way to that general law of Nature, which requires that diseases, like all other things, should have their decrements, as well as their rise and increase ; or from some other hidden agency altogether unsuspected, was now beginning to die away, and could only be kept alive by strongly exciting causes : such as large bodies of men crowded together in Camps and Cities. Hence, we find, that between Delhi and Meerut, — a distance of thirty miles, populous and studded with considerable towns and villages, — not a case of the dis- 

D 2 



28 



Meerut 

Saharuppoor 

Tannah 

ease occurred ;* whilst the latter City, and th& Cantonments attached to it, suffered under it from the 28th of July to the 20th of August. Few were seized in the town, and fewer in the lines ; and in both the sum of mortality fell considerably short of three hundred. So likewise, between Meerut and Saharunpooi, the Epidemick kept dormant ; whilst the latter City, which is very low and filthy, filled with ruined buildings, and intersected by foul channels with oozy banks suffered considerably. The disease shewed itself in the town about the end of September ; was in full force about the middle of October ; and declined from that time until the last woek of the month, when it wholly disappeared. It may be, however, that the virus proceeded not in a centrical Hue from Delhi to Saharunpore, but along the coursu of the Jumna; as Tannah, a large town, only sixteen miles from the river, and twenty South of Saharunpore, was attacked before the latter place. 

The Epidemick cannot be traced farther North than Saharunpore. The high ridges of mountains, which in other quarters proved hostile to its propagation, here opposed its further pro- 

: * By a subsequent report it indeed appears, that the Epidemick slightly visited the towns of Ghaseeabad and Mooradnuggur ; but in them the cases were so few as hardly to affect the statement in the text. 







Ilansi Division. 

Ilansi. 

gress ; and saved the inhabitants of the hilly districts from a scourge, which, in their circumstances of poverty and nakedness, would probably have proved exceedingly fatal to them. 

On the 23d of July, a Detachment, consisting of a troop of the Horse Artillery Brigade, the Rocket troop, and 5 Companies of the Ist Battalion 25th Native Infantry, marched from Meerut to join the force collecting at Hansi under Brigadier Arnold, for service in the Bickancer and Bhatty countries. They rein lined perfectly healthy on their march to the Jumna, and during several subsequent days, in which they were encamped on its East bank. On the 29th they crossed the River, passed through Delhi (the disease being then at its height in the town) and encamped outside of its walls, about a mile to the West. On the 30th, they continued their March in a North-westerly direction ; and on the morning of the 31st, they were attacked by the Bpidcmick. — It continued unabated amongst them, until the (Jth ; when they joined the general camp at Hansi. Although one or two cases had occurred in this Force a day or two previously to the arrival of the Meerut Detachment, it was the unanimous belief of the Medical Staff serving with it, that from the latter, it got the disease in its epidemical form, What gives a colour of probability to this conjecture is, that the 



30 



KarnsuL Piiiuiiput, 

Iliisar 

Jet pore. 

disorder was not met within any of the villages lying in the immediate line of the route of the Detachment from Delhi to Hansi ; and certainly did not appear in the latter town until some time after its prevalence in Camp, and then but very slightly. — On the other hand, it was generally rumoured that, several intermediate place? between Delhi and Hansi, and between Delhi and Kurnaul, particularly Paniput, had been affected previously to Hansi being brought within the pestilential influence. It continued with the troops until the 12th of August; and accompanied them in their march in a W. N. W. direction to Futtihabad, Rhaimeea and Sirseca, and in their retrogade movement on His,sar. Of the whole Force, only about 250 men were attacked. The symptoms were comparatively mild; and the deaths few. The Epideinick did not reach Loocfeehana; and appears in this quarter to have been limited by the river Sutledge. 

From Dehli or Aiigurh the disease would seem to have spread in a South West direction Jo the principality of Jeypore j the capital of which it reached in the latter end of August. Here it was noil her malignant, nor general: its attacks being almost confined to the most wretched class of the inhabitants, and the whole mortality throughout the circumjacent country scarcely exceeding a thousand men. — On the 



Rajpootnnn Force. 

1 -?th September it began to abate in the city ; and on the 14 th it entered the camp of a detached Force commanded by Major Agnsw, at Titirya, twenty-five miles South West of Jeypore ; and there raged with very considerable virulence till the 2Sth, when it gradually abated. Qf 96 Europeans, and 4100 Natives composing the fighting part of this Force, the admissions were j 2Q2, of whom 122 died. The mortality amongst ] the camp followers could not rightly be ascertained. The Epidemick was no more heard of in this direction : neither the town, nor the valley of Aj nicer being affected; although another large division of the llajpootana Force was encamped in the latter, on similar ground, and under circumstances apparently in no wise differing, from those of their less fortunate comrades at Titirya. Having now gone round the circle described by the disease, and marked those places which had most reason to remember its unwelcome visits, we might bring this Sketch to a conclusion. Previously, however, to taking leave of this part of the subject, it will be necessary to advert shortly, to the appearance of the disorder in some parts of the Middle Provinces, which in point of time, or of the source whence the virus was communicated to them, could not well be ranged under any of the foregoing divisions. It has been stated that, towards the end of September, the Eoidemick annearpd in the town 

31 





32 



of Chupra and Moozuffurporc ; but that, at that time, the range of its operations in this quaff jr wan extremely partial, and almost confined to tho c towns themselves, and the villages in their immediate vicinity. It, however, re-appeared in May, and spread with extreme virulence over the whole district ofTirhoot ; causing a mortality computed at nearly ten thousand men, and subsiding only with the full setting in of the Rains. It would appear to have extended through the Tiraee, and to haveaffectfd the Military Cantonment at Mullye with considerable seventy. At the same time, the city of Benares was attacked, but with comparative lightness, considering the extent and crowded, close nature of the town. Jionpore, Sultanpore (Oude), Gorruckpore, Oudc, Fyzabad, Lucknow, arid other places situated near the Gogra and Goomiee rivers, were successively attacked in April and May. In Lucknow and Fyzabad it did much havoc ; and the inhabitants of Gorruckpore in the end of April suffered so greatly, that they quitted the city and sought for safety in the adjoining villages and groves. — The Troops and camp followers in personal attendance upon the Governor General, on his return from the Upper Provinces, again fell in with the Epideir.ick on the 20th, or 21st, of April ; but now its attacks were nearly restricted to such persons as had not been with the Centre Division of the Army in the preceding autumn. 

Tirhoot. 

Mullye. 

Bsnares. 

Junnpoor. inpoor. Gorruckpoor. Oude. : nil. Lucknow. 

ti.-irornorGe¦ •! »ii Camp, Ondf. — Gorruckpoor. 



.' In the foregoing pages the singular fact of the *virus shewing an unwillingness to ascend high |and mountainous tracts of Couatry, has been Jnoticed. — Thus it wholly avoided Kumaoon, Sphe Hilly Districts North of Hurdwar, and the jjjelevated stony belt which girds in the Rajpootajraa States to the North West. — But this rule was ¦not without exception ; for, in June it passed the Softy range of mountains guarding Napaul to the and visited Khatmandoo, Patun, and SBhatgoon in the subjacent valley ; and, in October following, it got from Sylhet to the independent countries of Kashar and Munnipore, 4du the eastern borders of Bengal. But, even fiere, it might be seen, that high lands were not tongenial to it ; for it had been raging with \ery great violence in the adjoining District of Sylhet, before it was enabled to over|icome the obstacles opposed to its progress by «Ahe intervening mountains. — The same causes ipnay be assigned for its partial occurrence %mong the Ramgur and Sirgooja Hills ; whilst HSoncpoor and Sumbhulpore were largely affect%d: apparently from Cuttack, along the course ¦bf the Mahanuddce. Such w 7 as the course of this singularly erratic mnd destructive malady. — Whether the virus, ¦laving put forth all its strength in its progress jathrough these provinces, has nearly worn itself ¦out; and may now be considered, as about wholly 

V 







to disappear ; or is yet existent in a dormant state, merely waiting for some favorable moment again to spring up with renewed strength in this, or some other country hitherto unvisited, it is not in the power of man to tell.* — From the 

* As no more favorable opportunity will hereafter occur, a few particulars may be here mentioned regarding the times of appearance and periods of duration of the Epidemick during its stay in Bengal. — It has been stated in the text, that it first broke out epidemically in Calcutta in August 1817; and that it continued prevailing in the city, with more or less violence, till the ensuing August. From that time until the following April, when it recurred wiih considerable violence on occasion of some variable, unseasonable weather, only a few cases came to notice. Now (May) it has again subsided ; but fresh instances of the malady are sure to occur, as a consequence of the sudden vicissitudes in the atmospherical heat and moisture, produced by every North Wester. — Itfai probably observed a like course in Jessore ; but its progress there cannot be exactly learnt, in consequence of the absence of a Medical Officer from that station for many months. — It appears, however, tha- K:e the beginning of the present year it has been stantly in existence, and destroying many p§rsons in the North and Eastern parts of the district.— ln the Backergunge district it remained until the end ol last year, since which time it would not appear to have done much injury.— ln Bullooah and the tracts near the mouth of the Ganges, it began in February, and terminated in June, 1818. — In different parts of My* Bnsing it has existed since June, 1817. So likewise in city and District of Dacca.— la Jipperab, after 

34 





35 

OF THE EPIDEMICK. 

disease, however, still continuing now and then to visit Calcutta and many other places in Bengal, although in an infinitely less degree than 

-wholly disappearh.,7 during the Cold Season, it returned in March 1818; and remained till the breaking up of the subsequent Rains, from which time it seems again to have retired. — in Sylhet its career has been singularly various. After retiring in October 1817, and being for several months dormant, it returned in the end of March, and subsisted till the setting in of the Rains, when it a second time nearly disappeared. But, about the middle of October, it suddenly increased all over the district to as great a degree, and with greater fatality, than on its first appearance. It gradually declined in December, and again withdrew in the end of the year. Finally, it made its fourth visit in the commencement of the present Hot Weather ; but not generally. — In Rajshahy, it prevailed most in September and October ; and disappeared about the middle of November, 1817. It again appeared in the following Hot Weather, and frequently proved fatal.— It commenced in August in the city of Mooshedabad, and has continued till now ; but always in a very mild shape. — In Nuddeea, as we have seen, it brgan generally in July and August. Towards the latter end of the yoar, it became less serere. With the heavy rains, which set in towards the end of the following February, it recurred in various parts of the District. As in Calcutta, it declined in August following, was very rare in the cold months, and again got head in the beginning of the present Hot Weather. — In Em a few cases happened early in the Rains. In ber the mortality caused by it was alarming ; and, at month until the end of the following year, few ssed without the disease appearing in some of the 

E 2 



formerly, it is to be feared, that the atmosphere has not regained its natural salubrity ; and, that such a continuation of unseasonable weather, as 

villages. It was particularly violent in the commencement and at the termination of the Hot Winds. Since January 1819, no account of its progress in that qunr* tev has been received. — In the district of Bhaugulpore it continued its ravages, without intermission, from August 1817, to May ISIB, when it considerably abated ; and from that time till now only occasional cases have occurred — At Monghyr it began in the latter end of August; decreased in October and November ; was not heard of In December; recurred partially in January and February ; increased much throughout the Hot Weather ; and finally altogether withdrew in September. In Behar it begun in August; nearly disappeared in the Cold Season, recurred about the 20th cf February ; and continued active till the ensuing November ; when it again nearly ceased ;to reappear in March and April. Of late the (disorder has appeared much in the South West parts of visiting severely Midnapore and Cuttack, y>hL;i it almost spared in the early parts of its course. — But it must not be supposed from the foregoing statement, that the disease now rages with that width of range, or generality of attack, which it took in the first year of its existence. In Calcutta certainly, and probably in almost iwry other part of the Lower Provinces, it is no longer strictly Epidemic. The case is this. A disposition to produce the disorder still exists in the atmosphere. This is brojght into play by sudden alterations of the weather. Then perhaps a dozen of cases, and two or three deaths occur ; the Settlement is immediately chrown into alarm ; and it is generally rumoured, that tiirf 

36 





has been seen to have preceded the first irruption of the Epidemick, is only required to renew it in its pristine strength. 

less, is that more individuals probably perished from the disease in one day in the autumn of 1817, than now do in a quarter of a year. It should, moreover, be recollect ted, that the disease is endemical in Bengal in the sultry periods of the year; and that were it not for the present scared state of the public mind, the few cases now occurring might, as in former years, pass nearly unnoticed. As it is, all is magnified by apprehension. As is quaintly observed by one of the Medical StaiF, " the disease, like some foul fiend is still wandering to and fro, and like the author of all mischief spreads universal terror before it."— The disorder having in April severely attacked several detachments of troops marching through the Cuttack and Midnnpore districts, a notion was entertained, that there was something in the vicinity of the Soobanreeka river, which divides these tracts near Balasore, connected with, and immediately leading to its rise. But this was quite a mistake ; for it was learnt upon enquiry, that the several divisions got the disorder equally readily in different parts of Cuttack ; and that it always broke out after a fall of rain, or other manifestly strong exciting cause. Besides, that the Epidemick has been long known at Balasore, and had visited several detachments vn the Cuttack jungles so far back as the Cold Weather, and Juggurnath lines in th» spring of the preceding year. 

37 





#• TJI* 1 /^ T^ T \T 

OF THE SYMPTOMS OF THE DISEASE, 

A VOMITING and purging of a pale and watery fluid, either concurring or alternating with each other, formed the leading symptoms of this disorder. 

The attack was generally ushered in by a feeling of fulness and pain in the stomach, and swelling of the abdomen j with sickness, and a desire to go to stool. Then came, almost immediately, vomiting and purging of a pale, thin fluid, without taste or smell ; great anxiety ; oppression, and sense of constriction about the heart and praecardia ; thirst and internal heat. These symptoms were accompanied, or quickly followed, by severe cramps ; generally beginning in the ringers and toes, and thence extending to the v/rists and fore arms, calves of the legs, iljjghs, abdomen, and lower part of the thorax. 

Together with these signs of general depression, the action of the heart and arteries was uniformly diminished. The pulse sunk rapidly at the wrists, and temples ; and at last could uo longer be felt, or was merely perceptible by a 



39 



|>light and indistinct fluttering. The respiration )ccame laborious and hurried, with sighing, and ong and frequently broken inspirations. As the >lood forsook the extreme vessels, and withdrew o the great cavities, the exterior surface of the >odygrew pale, shrunken, and cold. The skin >ecame clammy, dank and disagreeable to the eel ; bedewed with large drops of cold sweat; tnd discoloured of a leaden, bluish, purple, or livid hue. The countenance was greatly hanged ; the features were contracted, collapsd, and ghastly. — The eyes sunk in their ockets ; fixed and glassy ; covered with a thick lm ; heavy ; dull ; suffused j and surrounded by ark brown or black circles.— The lips livid, or f a purple colour. — The finger naiis blue ; the >alms of the hands white, bleached, and puccered into folds. — The mouth was dry and >arched ; the tongue bluish, or white and falering j and the voice hoarse and low. 

There was sudden and great prostration of strength. — The hands trembled j and the action of the voluntary muscles was uncertain and unsteady. — The patient could no longer stand or walk without assistance : He became as feeble as a child ; staggered like a drunken man ; and unless supported, sunk down like one in the last sta <r e of debility from fever 



In feeble habits, and where the disease attacked in extreme violence, the scene was soon closed. — The circulation and animal heat were never restored. — The spasms, vomiting, and purging were frequently renewed — The thirst continued incessant and unquenchable ; and was no sooner gratified by draughts of water, or other fluid, than dreadful retching ensued. — The burning heat, anguish, agitation, and restlessness continued unabated, At length, the patient, exhausted by the depressing influence of the malady, and the repeated large discharges, fell into a listless state ; and had no longer strength for either full vomiting or purging. A Jittle fluid was now only rejected by the mouth, as the abdominal muscles were thrown into spasm ; or passed off involuntarily downward^ as the body turned round in bed. — The patient remained deadly cold ; grew weaker and weaker; and insensibly sunk into death; or was carried off during a repetition of spasms : sometimes in one, but more frequently within four, six, or twelve hours. 

Such was the general appearance of the disease, where it cut off the patient in its earlier stages. — This state of collapse, sometimes however, lasted much longer before it ended in death: which it almost certainly portended. It was often attended by a remarkable degree of listlessness. I IIC DatiPllt seemed vvhollv iirinwjirp /yf his ex« 

40 





trene danger; or quite careless of its consequences. He wished to be left to himself; and, the spasms having now ceased, he lay motionless ; being only roused at long intervals, as the sickness recurred, or as his thirst reminded him to call out for water : The amazing eagerness with which he seized the vessel, and gulped down the fluid, when he knew it would be followed by instant vomiting, shewed how all was I burning within. 

Much variety, however, occurred in the kind, order, and sequence of the symptoms ; according as the virus of the disease happened to be more or less concentrated, or the individual offected of a strong or feeble constitution. Vomiting was the symptom of earliest and most frequent occurrence. Next came purging ; then the cramps, and spasms. Frequently, however, this order was reversed, and the purging and spasms took the lead of the vomiting. Sometimes the cramp preceded both. Sometimes there was no vomiting ; sometimes no purging j sometimes no spasm, throughout. Sometimes 

all these symptoms were simultaneous ; and the vomiting and purging took place together, as if Caused by sudden contraction of the alimentary canal in its whole extent. In some rare instances, the virulence of the disease was so powerful as to prove immediately destructive of life ; as if the circulation were at once arrested, and the 

F 

41 





vital powers wholly overwhelmed. In these cases, the patient fell down, as if struck by lightning ; and instantly expired. Others again, sunk after making one or two feeble efforts to Tomit, and drawing a long and anxious inspiration. Some recovered from the insensibility produced by the first shock, and afterwards went through the regular course of the disease. 

The irritability of stomach, and vomiting, i formed a very distressing part of the disorder. I They were generally preceded by a feeling of I giddiness and inclination to faint; by fullness, f tension, uneasiness and pain, especially about! the pylorus ; as if the contents of the stomai I were in vain soliciting a passage into the f duodenum. The fluid rejected was watery; l mostly tasteless ; transparent; or of a whey oil ash color. Sometimes, it was sour; green; dark I like infusion of tea; starchy ; mixed with mucus, I and viscid. In very rare instances, where the! vomiting was excessive or kept up for manyr hours, pure bile was thrown up ; but the disease was almost universally characterised throughout j.j its progress, by a total absence of this secretion from the whole course of the alimentary cfr'J nal. Sometimes, the food last taken in was;l thrown up before the commencement of the : watery discharges ; but this was not usually the case ; for, frequently, after death, indigested j lumps oi ingesta were found flouting in the j 

42 





43 

OF THE DISEASE. 

stomach \ clearly proving, that the action of that organ, however inordinate, v:as not always complete, or sufficient for its entire evacuation. The vehement, insatiable thirtt always present, tended greatly to aggravate the irritability of the stomach ; for it was hardly possible to keep the patient irom drinking large draughts of cold water, which were no sooner swallowed, than they were rejected with a quantity of phlegm or whitish fluid like gruel, solution of starch, or seethings of oatmeal. The vomiting proved by far the most intractable symptom of the disease; generally keeping up long after the looseness and spasms had subsided ; and, even in cases which terminated favorably, harrassing the patient, and retarding his recovery, during many days. 

The dejections were much of the same nature with what was passed upwards; generally watery, colourless, white or muddy ; sometimes red and bloody ; sometimes greenish and pulpy, like half digested vegetables. To those, who have not seen persons labouring under the disorder, it will not be easy to convey an idea of the enormous extent of these discharges. It seemed as if the whole fluids of the body would have been insufficient for their supply ; and, that they very tensibly diminished the mass of the blood, wa3 shewn by its thickness, and unwillingness to flow rpon a vein being opened j and by the 

F 9. 



check uniformly given to all the secretions. The evacuations were sometimes poured forth in a rapid and continued stream, as if from a sluice ; at other times ejected in small volume, as if from i syringe, by the violent action of the stomach and rectum. In no instance, was fceculent or bilious matter passed off in the commencement of the attack. 

The spasms usually began in the extremities, and thence gradually crept to the trunk ; sometimes, they were simultaneous in both j and sometimes, the order of succession was reversed; the abdomen being first affected, and then the hands and feet. They seldom amounted to general convulsion ; but seemed rather affections of individual muscles, and of particular sets of fibres in those muscles ; causing in them quick thrilling and quivering, and firmly stiffening and contorting the toes and fingers. In old men, and in persons of feeble habit, they were generally slight, and hardly perceivable by the eye of a bystander. Among Europeans, and among Natives of robust make, they were more severe. With them the bellies of the gastrocnemii sometimes became as firm and stiff as a board ;* and hard 

* Galen has noticed the greater violence of the spasms 5n this set of muscles. In his Sth Commentary on the Aphorisms of Hippocrates, he says, " Convulsive contractions frequently occur in those affected with Cholera; more especially of th« muscles of the calves ot the legs." 

44 





knots could be felt in the fleshy parts of many other muscles. The torture caused by these contractions was exceedingly great. The patient always complained of pain across the belly ; which was generally sore to the touch, and swelled from the scrobiculus cordis to the pubis ; sometimes hard knotted, and drawn back towards the spine.* The burning sensation of the stomach and bowels was always present ; and at times extended along the cardia and oesophagus to the throat and mouth. When the stomach itself was seized by spasm, the pain was excruciating ; and the patient screamed violently, and kept constantly tossing about. In some instances, the extreme violence of the spasm seemed in an early stage of the attack to destroy the nervous energy, and deprive the alimentary canal of all feeling ; so that fluids of the most acrid and fiery nature passed down without producing the slightest sensation. The diaphragm frequently partook of the convulsive action ; and gave rise to pain in the back and loins, and to severe hiccough, which shook the whole frame of the patient, and proved exceedingly distressing. Spasms of the intercostals and muscles of the neck were hardly ever seen ; but partial and complete trismus was not of very rare occurrence. 

* In some rare instances the spasms were general, and as violent as in tetanus, so that the patient could scarcely be secured by four or five people. In one very athletick man, the bleeding fillet burst, from contraction of the muscles of tlie arm. 

45 





46 



The disturbed state of the circulation Mas an early and ever present feature of the disease. Almost immediately after the stomach be. came affected, the blood forsook the surface of the body ; and rushed in to the heart and great cavities. This was proved by the livi. dity and icy coldness of the surface ; by the heat of the prascordia ; by the throbbing felt about the heart, and great vessels ; and by the disseo tion of those who died of the disease. The smaller arteries soon ceased to act; and the heart performed its functions imperfectly, and, with great apparent difficulty. The hurried respiration, tossing, anxiety, and frequent sighing and moaning, which invariably succeeded, were probably in part produced by the accumulation of blood in the chest; and by the ineffectual e£ forts of nature to restore the balance of the circulation, by propelling it to the extremities. 

The participation of the heart and arteries in the general derangement of the system was not, however, in all cases immediate or uniform. Sometimes, they seemed to be but little affected ; and the pulse could be felt beating regularly, and ol good volume, long after the irritability of stomach, and frequent spasms had evinced the violence of the disease. More generally, however, the action of the heart was speedily diminished j and within a space varying from fifteen minutes, to two, three., or fonr hours, the pulse gradually 



faile !, until it could no longer be distinguished ah the wrists or temples, or even under the axilla.* An almost imperceptible fluttering in the region of the heart, an attempt to retch, or a deep groan as the spasms attacked the vital parts, were then barely sufficient to prove, that life was not yet wholly extinguished. — The pulse, so long as it could be felt, was mostly very feeble and tremulous, regular, soft, and not very quick, usually ranging from 80 to 100. In a few instances, it rose to 140 or 150 shortly before death. Then it was distinct, small, feebta, and irregular ; sometimes very rapid, then slow for one or two beats. 

Along with the suspension of the general circulation, an almost entire cessation took place in the action of the secerning vessels. The saliva was dried up ; the mouth became dry and parchel ; and the tongue deeply furred : white, yellow, red, or brown. It was not easy to determine how soon the kidnies ceased to perform 

* Galen in his second Chapter on the Pulse, says* " In patients affected with Cholera the pulse is for the most part vermiculat ing; and at length scarcely distin» guishable, like the creeping of ants." And afterwards " a vermiculating pulse is when the artery has the feel of the gentle rise of a wave, as if worms were crawling in it; but when it falls to the lowest degree of feebleness, and is wilhal exceedingly quick, it is said to be formicattheir 

47 





office ; because what urine the patient made early in the disease, would be passed unobserved, during his frequent occasions to go to stool. But, there is reason to believe, that there was generally partial or complete ischuria; which, if the patient survived, frequently lasted several days : as was proved by his making no water, long after the purging had ceased, there was sometimes spasm of the kidnies along with their state of complete inaction, was concluded from the severe pain experienced in the Iliac regions. The retention of the urine being in some cases preceded by pain and irritation at the neck of the bladder, and over the pubis, it was at first imagined, that it might be cau« aed by a mere suppression ; but no fluid came away upon the catheter being passed. 

In this disease the head was less affected than any other part of the body. In some cases indeed, the early appearance of giddiness, swimming, blindness, pain over the eyes, redness of the conjunctiva, and contraction of the pupil, deafness and ringing in the ears, might have led to a supposition, that the brain was the primary seat of the disorder. — But these symptoms were by no means of general occurrence ; and the conjecture founded upon them was contradicted by the almost uniformly unclouded state of the mind in the early parts of the attack In the midst of all the agony, which he 

48 





endured, the patient was calm, and perfectly collected. At no time of his life probably, was lie more rational, and sensible to all that was going on around him. — In the latter stages of his illness, it is true, he sometimes began to wander, or sink into a hopeless stage of insensibility. But this is not be wondered at ; for then his sensorium was oppressed by an unusual congestion of blood in the brain ; and his mental and bodily powers were wholly exhausted by previous great suffering, and diminution of the circulatory fluid. 

It has been stated, that where the disease attacked in extreme violence, or seized persons of weakly habits, the energies of the system seemed to be at once exhausted ; and death occurred without any attempts at reaction. Where, however, the strength of the patient's constitution, or the efficacy of the curative means administered, although inadequate wholly to subdue the disorder, were yet sufficient to resist the violence of its onset ; nature made various efforts to rally ; and held out strong, but fallacious promises, of returning health. — In such cases, the heat was sometimes wholly, at other times partially restored : the forehead, chest, and abdomen in the latter case becoming warm ; whilst the limbs kept deadly cold. The pulse would return, grow moderate and even full ; the cramps and vomiting disappear ; the nausea diminish j and the stools become pitchy and fceculent. — And 

G 

49 





yet, with all these favorable appearances, the patient would suddenly relapse ; chills, hiccough, want of sleep, great anxiety and delirium would arise ; the vomiting, oppression, and insensibility return ; and in a few hours terminate in death. In these cases the eyes were not uncommonly fixed in their sockets some time before death. The patient stared vacantly ; and could not be roused from the lethargy into which he had fallen. Sometimes, again, the symptoms immediately preceding the closing of the scene, were some. what different. The anxiety and restlessness were heightened ; muttering delirium came on ; the breathing grew short, hurried, and stertorous ; and the sufferer sunk in the midst of the greatest mental and bodily anguish — Or he would suddenly expire as he turned in bed ; when the previous abatement of all bad symptoms, ami restoration of the circulation held out the fairest hopes of recoveiy. Nor was it very uncommon to see a patient in this state at once seized with universal cramp, which extinguished life in a mo. ment. Hence, many were found dead in their beds; when no previous intimation, by groan or other sign of distress, had been given to those lying along side, of their approaching fate. 

When the disease ran its full course, the symptoms were variously modified, according to variety in the type of the Epidemick or constitution of the individual affected. It will not be 

50 





cribed were present at all times, and in every case. In the several periods of its revolutions, arid in the infinite variety of individuals attacked, the disorder was of very different degrees of violence ; from simple vomiting and purging, with little or no cramp ; to universal spasm, incessant retching, and total depression of the vital powers. 

Among Natives generally, where the attack was exceedingly severe, the constitution sunk with scarce an attempt to rally ; and of those who recovered, the secondary stage was of short duration, and unaccompanied with much reaction. In the milder cases, the attack either was repelled by the unaided powers of life itself, or readily gave way to the simplest means of cure. The pathognomonic symptoms of the disease speedily abated ; the patient sunk into a profound and quiet sleep ; and the breaking out of a warm equable perspiration all over the body, evinced the restoration of the vital powers, and might be considered an almost infallible sign of recovery. In such cases, slight debility, and irregular action of the intestinal canal, were the only ill consequences of the attack; and a copious discharge of bile, or foeculent matter, either natural or procured by the exhibition of a single dose of a simple purgative, completed the cure. 

But, in the more violent forms of the disease, recovery was longer protracted ; and the sufferings of the patient were more severe. — After the most 



51 





52 

OF THE SYMPTOMS 

distressing- symptoms had been in great measure subdued, he was still harassed by constant thirst, irritability of stomach, pain and soreness of the Epigastrick region, watchfulness, and confused dreams. The stomach and bowels did not for a long time regain their usual tone; and the frequent occurrence of obstinate dysentery or diarrhoea proved, that almost irreparable mischief had been done to the whole of the ehylopocfic viscera. In these cases the debility was great, and of long duration ; and the strictest attention k required during many days, to prevent the Slit from sinking entirely. — Sometimes, the lity terminated in incurable dropsy.- — In n ':. instances, partial loss of vision ; in others, E taring, ensued. In one man paralysis of bladder and lower extremities, occurred /, Bi«d continued long after the cessation of the common symptoms of the disease, 

It was almost uniformly observed, that health was soonest restored in those cases in which foeculent, black, and acrid motions were early procured ; and that on the other hand, their absence was almost uniformly marked by feve. rishness, sour eructations, flatulence, constipation, and other signs of want of tone and sluggish action of the hepatic system. — Fevers of the remittent, and intermittent type were among the most frequent sequela? of the disorder ; but among natives, and especially those of weakly frame, llk v could nut be considered to form an 



essential part of the attack. They were hardly ever immediately superinduced upon the collapsed stage, and seemed rather an incidental affection, in bodies much predisposed to take on new forms of disease by great existing debility. 

When the disease ran its full course with Europeans, and with Natives of robust athletic make, the following appearances generally presented themselves. What may be termed the cold stage or state of collapse, usually lasted from twenty-four to forty-eight hours ; and was seldom pf more than three complete 

days duration. Throughout the first twentyfour hours, nearly all the symptoms of deadly oppression; the cold skin, and oozing of clammy sweat from every pore, the feeble pulse, occasional vomiting, purging, and cramps ; the thirst and anguish, continued undiminished. Then the system shewed symptoms of revival; the vital powers began to rally ; the circulation and heat to be restored ; and the spasms, sickness and desire to go to stool, to be considerably lessened. The warmth gradually returned; the pulse rose in strength, and fullness ; and then became sharp, and sometimes hard. The tongue got more deeply furred ; the thirst continued with less nausea. The stools were no longer like gruel or rice water ; they, usually between the third and sixth day, became first brown and watery; then dark green, black, and pitchy; 

53 





discharge immense loads of vitiated bile ; until with returning health, the secretions of the liver and other viscera gradually put on a natiu ral appearance. These discharges were generally hot, acrid, and passed with griping and tenesmus. Sometimes they were of a bright low colour ; and the surcharge of bile was jreat, as to be ejected in a pure stream from stomach. It was remarked that, where the motions consisted of a chocolate coloured fluid, with floculi swimming in it, the patient rarely 

The fever, which almost invariably attended this second stage of the disease, may be considered to have been rather the result of an effort in nature to recover herself from the rude shock, which she had sustained, than as forming any integrant and necessary part of the disorder itself. It partook much of the nature of the common bilious attacks of these latitudes. There was the hot dry skin ; the foul, deeply furred, dry tongue ; parched mouth ; thirst ; sick stomach ; depraved secretions; restlessness; watchfulness ; and quick variable pulse ; sometimes with delirium, stupor, and other marked affections of the brain. 

Generally, when the disorder proved fatal, after reaching this stage, the tongue, from being cream coloured, got brown, and sometimes 

54 





and lips were covered with sordes \ the state of the skin varied, chills alternating with heats ; the pulse became extremely quick, weak, and tremulous ; hiccough, catching of the breath, great restlessness, and deep moaning succeeded ; and the patient soon sunk, incoherent and insensible, under the debilitating effects of low nervous t'evQiy and frequent dark, tarry, alvine discharges. 

In other cases, this secondary period ran a somewhat different course. As the action of the heart and arteries was renewed, and the natural warmth of the body returned, an unusual degree of energy succeeded. The brain was evidently affected ; and the patient was quite insensible to the great danger into which he had fallen. The pulse rose as high as 120; great heat, especially over the large cavities, was complained of. — There was extreme agitation and distressing thirst. The patient continually called for cold water, to relieve the burning sensation of the abdomen. Sometimes, a warm perspiration broke out near the wrists and forehead, which afforded temporary relief to his sufferings. — To this state of excitement, that of collapse quickly succeeded. There was then great prostration of strength ; the bowels became quite torpid j severe pains occurred low down in the abdomen, near the scite of the rectum, which wera always aggravated upon 

55 





56 



Or LUG SLOlll^iCil HO \V CX.C IX wU SUiLI I I be y X\*o d Ii . I tural irritability was entirely gone, and the most nauseating medicine could be poured info jt without exciting vomiting. — It rarely occurred, that the patient survived the great sinking produced by this stage ; and even where good for. tune and the strength of his constitution carried him througli it, he suffered long after from debiiity and disordered bowels. 

The attacks of this disease sometimes came on at once, without previous warning ; sometimes various signs betokened their approach; according to the exi3ting state of the Epidemic, and of the individual affected. — In large cities and in camps, where the. disease existed in full force, and the virus was peculiarly concentrated, persons in previous perfect health were frequently seized in a moment, without any apparent cause. — Where again, the disorder prevailed in no very malignant form, healthy individuals were sometimes at once brought under its influence, from marked errors in diet, or sudden exposure to other powerful exciting causes. — "Where, however, neither of these circumstances obtained, the attack \n> usually preceded by various symptoms of derangement of the alimentary canal ; anorexia, nausea, sickness of stomach, and costivene^. To these, a looseness would perhaps succeed) which kept on for a day or two, till the patient 



pathognomonic signs of the disease, upon drinking a draught of cold water, or incautiously going from hot into cold air. — In many cases general lassitude and shivering preceded the attack.— »ln some persons, who, under the alarm produced by these ailments had recourse to purgatives, immense quantities of black bilious matter were passed off; shewing perhaps, previous deranged state of the hepatic functions. 

The general appearances of the disease being thus described, it will be right, before proceeding further, to speak shortly of the varieties assumed by it, in its different points of attack. This digression will not, however, occupy miich time ; for throughout its long and destructive track, and among the myriads whom it affected during its progress, the Epidemick exhibited per. haps less variety, and fewer discrepancies, than any general distemper to which the human body is 

To begin with Bengal. During the two years in which it more or less harassed Calcutta, it appeared in every degree of mildness and severity, amongst the various castes and classes of persons affected, in different periods and seasons — The only general remark that can, therefore, be made here, is that spasms, and subsequent reaction were moreremarkable among the Europeans ; immediate collapse and prostration of strength among the Natives. — It was more generally fatal perhaps in February 18 18, than 

H 

57 





in the preceding autumn ; and yielded less rea. dily to medicine. 

At Jessore, Backergunge, and Momensing, it has subsisted during an equal length of time, sometimes in greater, sometimes in less vigour ; but decidedly with greater and more general fatality, in the earlier months than now. In these districts and in the vicinity of Bullooah, near the mouth of the Ganges, at first hardly any of those attacked recovered without medicine. 

In Dacca, where it has been from July 181 7, to the present moment, without any period of entire intermission, there seems to have been nothing particular in the form generally assumed by it. 

In Sylhet it was far more destructive in the latter part of 1818, than it had been during the former year ; proving fatal in a much shorter space of time, and resisting the powers of remedies, which formerly effected a cure. If nothing curative was attempted for an hour, the case was then considered hopeless. 

From November, 1817, to November, 1818, in Tipperah the Epidemick exhibited considerable variety ; sometimes it was attended with no vomit. £ sometimes there was no pain in the bow. lor general spasmodic affection. — There Iways great prostration of strength. The 

58 





disease was milder towards the end, than in the commencement. In the other districts of Bengal there was nothing unusual in the appearances of the disease, 

At Chuprah, at first, the violence of the spasms chiefly attracted attention, latterly i^s type was modified. The distinctive marks of purging and vomiting still obtained j but the spasms were not so, severe or constant ; and the attack was not so sudden : being generally pre-*. ceded by a sense of indisposition, and pains about the abdomen and neck of the bladder. la both periods the egesta during the attack were similar ; but in the latter the voiding of worms was a common occurrence; and in cases, in which stools were procured by medicine, scybala generally came away. 

At Dinapore, whilst the Epidemick destroyed numbers in its usual mode, it not unfrequently appeared in a different and equally fatal form ; in which vomiting and purging were wholly absent, and the body was universally affected by spasm. This form occurred equally among Europeans and Natives. 

In Tirhoot, spasm scarcely ever appeared ; and the pressing symptoms were general depression, and discharges from the bowels. — At Mullhye again, and other places on the Eastern frontier, cramp of the extremities was of common oc« 

H2 

59 





Between Patnaand Benares the symptoms to be chiefly combated were the immediate depres. sion of the vital powers, the languid circulation, and coldness of the surface. — At Benares, in the Hot Weather of 1818, the Epidemick appeared in its usual shape ; but in the ensuing Rains many persons died with the following symptoms. The individuals complained, generally after eating, of great pain of stomach, faintness, and a sense of sinking, as if life were quitting them ; and unless relieved by some stimulant, soon expired. — A great scarcity of grain then existed in the city; and the sufferers were generally of the poorer class, and debilitated by the want of nourishing food. 

At Cawnpore, and in the Doab and the districts East of the Ganges, the disorder kept its usual course ; and was generally followed by debility and slight bowel complaints. 

Iti the Centre Division of the Army, Europeans were generally affected in the following manner. They first complained of severe pain in the abdomen, particularly about the umbilicus. Then violent vomiting and purging of a fluid like rice water came on, and was followed by severe spasms in the extremities and muscles of the belly. — In some instances, the patients were suddenly attacked with cramps, without any discharge from the alimentary canal. — The countenance was ghastly in the extreme, in the commencement of 

60 





t attack. — Then succeeded the usual appeares of cold, clammy, blue skin; sunken eyes; veiled lingers ; want of pulse ; dry parched mouth, and thirst. — In some the pulse remained ; and was then quick, and of a wiry feel. — In almost all, there was complete ischuria, and in those who survived, no water was passed during r,ny days. — The contractions of the muscles the limbs were remarkably painful and distressing. Where curative means were not applied, or failed in giving relief, the patient usually perished within twenty-four hours. A curious symptom was sometimes observed immediately previous to dissolution. When fluid was administered to the sufferer, he collected it in the corner of his mouth, and then squirted it out with great violence ; and this at a time, when he was so exhausted as to be incapable of the slightest general exertion. The early symptoms among Natives were similar in kind, but less in degree. The spasms were feebler ; and the debility more striking. In many the exhaustion was so great, that they could not articulate. The abdominal muscles frequently remained relaxed and flaccid. In others they were, together with the viscera, and muscles of the upper and lower extremities, thrown into violent spasmodic action — The fingers and toes were blue and contracted, and their last phalanges curved inwards. The pulse in many could not be felt in the carotids — The buccinator muscles fell in ; and the whole face was hollow and haggard. — The 

61 





fluid ejected upwards was usually colourless j that downwards watery and muddy ; sometimes bilious. — Towards the last stage, a thick film came over the ball of the eye ; the tunica conjunctiva was suffused with red blood ; the coun. tenance assumed a sharp hippocratic appear* ance, and some hours before death was so de« pressed and altered, as not to be readily recog. nised.— 'The corpses of such as died, looked immediately after the breath was gone, like bodies that had been long dead ; so wan and shrunken were they. It was not however remarked, that pu. trefaction took place sooner than in such as die from ordinary ailments. As the powers of life were more readily destroyed in the weakly frames of the Natives, than in the European, with them death occurred proportionably earlier. Many accordingly died between the first and the twelfth hour of the attack. — It was singular, that neither with Europeans nor Natives were those symptoms of strong reaction, and subsequent fever, which, among the former at least, were of almost con, stant occurrence in the lower parts of India, observed.— Debility ; disordered tone of the stomach and liver; dysentery, and diarrhoea formed the usual sequelae. It} many recover was remarkably rapid ; and even in the severes cases, the constitution did not appear to hay suffered any permanent injury, and the patien generally regained his former health and strengt 

62 





In the Left Division of the Army, spasms and excruciating burning in the stomach were very generally present, with the other diagnostic signs of the disease. — Suffusion of bile, fever, chronic diarrhoea, and debility, were its ordinary consequences. 

In the Nagpore Division, the symptoms were extremely violent, and frequently carried off the patient in four or five hours. — 'The depression was always exceedingly great ; with dim glistening eyes ; headach over the eyebrows ; gnawing tightness of the stomach, burning and thirst. The spasms of the trunk and limbs were not uniformly present ; sometimes they w T ere slight, sometimes severe. — The vomiting and purging occurred together or alternately ; and in every degree of violence. — The pulse was sometimes full and steady ; at other times weak and intermitting ; and occasionally even a total cessation of arterial action took place. Strangury was not uncommon. The skin, though generally cold and moist, was somtimes dry and hot. — The only general after effect of the attack, was extreme debility. 

Among the troops of the Rajpootana Force, the disorder was more violent in the middle, than in the early or latter part of its visit. — In Europeans, and at first in Natives, the severity of the spasmodic affections of the extremities was chiefly remarkable ; the balance of the circulation was not greatly disturbed, and the pulse did not 

63 





rapidly fail. — Towards the middle period of ii g stay, the cramps were hardly to be observed among the Natives. The morbific agency was then so powerful as immediately to arrest the circulation, and produce entire exhaustion.— The total want of pulse, coldness of body and extremities, prostration of strength, and wrinkling of the skin of the hands and feet, were then the principal marks of a state, from which it was hardly possible to rouse the patient^ even when the vomiting and purging were allayed. — Latterly, the presence of the disorder was barely discernible in the slight evacuations and feeble twitches accompanying its attacks. Fever was a rare consequence of the disease. Extreme weakness ; irritable stomach ; irregular action of the bowels ; and in a very few cases dy. sentery, formed its usual sequin:. 

11 Jevpore the attack was always preceded by ral lassitude, frequently ending- in shivering that of an ague fit. — Then succeeded severe of belly, followed by vomiting and purging, ips, and the usual train of symptoms. A sness, lasting four or five days, sometimes i after the attack ; but generally the sufferers rered surprisingly fast : in some instances in f hours. 

In the Ilansi Division, the symptoms coincided with those enumerated in the general description. Vomiting was more violent in some ; purging in others.— Excessive restlessness, burning heat in 

64 





Powels, and spasm in the extremities, were nt in almost every case.— 'Of those who ered, many had to undergo fevers of the tent or intermittent type, before they re- J their health. — Bowel complaints were very rare 5 greater or less debility was present in 

Et Delhi, Meerut, Coel, Agra, and futtigur, as disease was generally milder, than in other 5 of the country, it ordinarily left no other ill ts than weakness, and disordered bowels. 

Having thus described the symptoms of this tremendous disorder, let us now see what were the effects produced by it in disorganising the human body, and deranging its most important 

1 

65 







APPEAR ANTES AFTER DEATH. 

Of those who died in Calcutta, it was believed, perhaps rather fancifully, that the bodies sooner underwent putrefaction than the remains of persons dying under the ordinary circumstances of mortality. — In many, a striking proof of the unna- Xl accumulation of blood in the great cavities, afforded by the thorax and abdomen continuing preternaturally warm for many hours, when the limbs were cold, livid, and stiff. 

The bodies of such as had sunk in the earlifr stages of the malady, frequently exhibited hardly any unhealthy appearance. This was more especially observable among Europeanof weak and sickly constitutions, and among Natives of the poorer classes. — On laving open the bodies of such persons, it was remarked, that the abdomen emitted a peculiar offensive odour, • •:• 



67 



jects.* In them there was not the slightest mark of previous increased vascular action throughout the whole intestinal canal ; which rather appeared paler than usual, and flabby; and was filled with an amazing quantity of whitish or muddy fluid; or empty and inflated with air. — Sometimes in the stomachthis fluid was found mixed with pieces of curdled matter, or lumps of indigested food. This appearance of relaxation was not confined to those in whom the spasmodic affections were absent. It occurred frequently where the cramps of the abdominal muscles had been violent; and the pain in the stomach excruciatingly severe. 

On laying open the abdomen of such as had lived some time after the commencement of the attack, and especially of Europeans and the stouter Natives, a different set of appearance was brought into view. — /The omentum and mass of intestines were often found displaced, andpreternaturally vascular : with partial adherence between the diaphragm, liver and surrounding viscera. — The colour of the intestines varied from deep rose, to a dark hue; according as the increa^. A vascular action had been arterial or venous. — In 

*In one case, that of a Gentleman *ho died after six hours illness, the three Medical men who opened the body were sensible of this peculiarity: and.aU were for a day or twoaiL'cted with vomiting, iooseness and other symptoms of disordered bowels. In this case there was no tnce of disease in the alimentary canal. 

I 2 



some instance 3 the outer surface of the stomach likewise, was florid, and its veins turgid with dark blood ; but this was not so in the generality of cases* 

This organ was, however, much contracted, and its substance hard and frequently thickened.—-On cutting into it, it was found sometimes empty, sometimes partially, and at others largely filled with fluid of various colour and consistence; thin and transparent, milky, green, dark, grumous, or muddy. Sometimes, this fluid was black, like lamp black ; sometimes it consisted of pure blood ; and at other times of blood mixed with bile. — On removing this the inner surface was frequently seen lined with coagulable lymph, bloody gelatine, or a muddy, glary, viscid matter; which on being washed away, brought the highly inflamed coats into view. Of these the appearance was various ; generally they were crossed by streaks of a deep red, interspersed with spots of inflammation made up of tissues of enlarged vessels. — Sometimes the inflammation was florid and bright coloured ; so as to give the whole inner surface of the organ the appearance of a minutely injected anatomical preparation.— In some instances, ulceration had begun, and the villous coat was partially abraded; in others incipient mortification had occurred, and the coats were puckered into net work, or drawn into folds, 

68 





The intestines were sometimes largely inflated 

with air ; at other times flattened, thickened, ami corrugated ; and sometimes partially contracted.—From violent action and reversed peristaltic motion previously to death, intus-susceptio of the large and small guts was of no unfrequent occurrence.—ln some instances this happened in two or three places ; and the portion of detained intestine was nearly a foot in length. On cutting into the intestines, the smaller guts were observed to be more inflamed than the larger. — The duodenum, and more particularly its upper portion, was generally similar in morbid appearance to the stomach ; corrugated, inflamed, with florid or deep red patches and streaks. — In cases of several days standing, the inner coat of the small guts was ulcerated, and they were filled with sanies, having portions of lymph floating in it. — Then the large intestines were lined with a dark, thick, pitchy stuff poured out from the liver, as it had begun to renew its action. — In such as died early, the fluid was limpid, or muddy, with cheesy matter at times floating in it. — In general neither bile nor fceces were seen in the intestinal canal. — The colon and rectum were frequently contracted a.nd inflamed, in their whole extent. — The former, more particularly near its sigmoid flexure, was sometimes not of the thickness of a finger. — The inner surface of the rectum near its termination in the anus was in some instances abraded * in nlmosf* 3il hifhlv vo.spnlir 

69 





The appearance of the liver was very various In most cases, and in nearly all young plethoric subjects, it was enlarged and gorged with blood; which flowed profusely and sometimes spouted up, on a scalpel being plunged into any part of it. — In a few, it was large, soft, pappy, light co. loured with greyish spots, and not much distended — In others again, it was collapsed and flaccid — In some rare cases suppuration was discovered to have taken place ; and a pint and a half oi'gooi pus was found in one, who had been ill only twelve hours, and who had not before complained. These appearances were probabiy accidental, 

The gall bladder was generally full of dark green or black bile ; sometimes it was empty, or loose, with a quantity of thin, pale, or light coloured fluid. — In many the liver and gall bladder had no mark of diseased action. — The Hepatic Duct was usually enlarged and relaxed ; the Ductus Communis generally contracted, and in several instances obstructed by gall stones. 

Tae spleen was of softer texture than usual ; uniformly enlarged and distended with bloed.— The kidnies presented no unusual appearance. The urinary bladder sometimes partook of the raj inflammation ; but it was usually quite ;.'}• and shrunk) so as to be raised with difficulty from the inner surface of the »v..' 

70 





The great venous trunks in the abdomen, and particularly the mesenteries, and vessels of the portal circle were uniformly enlarged and distended — The vena cava was sometimes thick and hard like a sausage. — The lacteals were turgid 

with chyle; so as frequently to have a tortuous knotty appearance. — In the thorax the same 

marks of great internal accumulation were present — The heart and great blood vessels were stuffed with clotted blood ; and the lungs were black, collapsed and preternaturally heavy. The i iiner surface of the cesophagas was sometimes inflamed and ulcerated. — In other respects the thoracic viscera were sound. 

The brain was generally of natural appearance; especially in those who died early. — In some cases there were various marks of venous congestion and incipient inflammation* — The Sinuses, and vessels leading to them were turgid with dark blood. Partial adhesions, and deposition of lymph, were observed to have taken place between the dura and pia mater, near the coronal suture, and towards the occiput. — Serous eifusion likewise occurred in a pear ter or less degree between the membranes, or in the ventricles. — In one or two rare instances the Sinuses had given way from over distension, and a great quantity of blood was found poured out on the surface of the brain. — In cases of persons affected with stupor previously to death, a 

71 





Sig the dura mater; and much serous effusion taken place throughout the cavity of the 1, with partial thickening and inflammation of neninges. 

This description may be closed with a short fecapitulation of the morbid appearances, as they were modified in situations in which there was a large field for observation. — In the Centre Division of the Army among Europeans they were very contradictory. — In many, particularly of such as died early, the stomach and intestinal canal were found full of muddy fluid, without the slightest mark of inflammation.— ln others the vessels of their inner coats were turgid, sometimes highly inflamed, ulcerated and gangrened. — The stomach was frequently thickened and contracted j and the small intestines full of hard knots from one portion being forced into another.— The liver was congested, inflamed, and darker than usual. — The gali bladder overloaded with dark bile ; the ducts distended and relaxed.— The thoracic and cerebral viscera sound. Among Natives the alimentary canal in its entire column vas uniformly seen full of a muddy fluid j and its inner surface lined with a clayey substance of the same nature. — The quantity of this earthy looking stuff was sometimes so large as in a manto plater the villous coat; and to leave a thick sodiment on passing through the sheet in 

72 





inflammation were occasionally observed ; but in most instances, no mark of increased vascular action was perceptible. — The liver was sound ; am the gall bladder filled with viscid pitchy bile.— Neither in Europeans, nor in Natives, was an tinge of that secretion discovered in the intest nal canal. — In the Jubbulpore Force the stomac nnd intestines were found filled with a linipic fluid ; and in some partially inflamed. — The h ver exhibited various appearances ; in some i was turgid, and easily lacerable; in others flabby and collapsed. — The gall bladder was in some distended with blackish, in others with dark yellow, inspissated bile ; and in others nearly empty — The contents oV the head and chest do not appear to have been examined. — In the Nagpore Force the interference of relatives generally prevented the inspection of the bodies of the dead. — In the Rajpootana Division the morbid appearances were nearly as described in. the Jubbulpore Force. — In the Kurnaul Division, the abdominal viscera generally appeared as if gorged with blood : the stomach was filled, and sometimes distended by muddy water. — In Europeans some marks of inflammation were observable ; but in Natives the surfaces of the stomach and intestines were perfectly pale. — The liver and gall bladder were healthy ; with bile of natural colour and consistence in the latter.— The spleen was of softer texture than usual. 

X 

73 







PROXIMATE CAUSE OF THE DISEASE, 

THE present report being intended to serve, rather as an useful repository of well ascertained facts, and practical deductions, than as a vehicle for theoretical reasonings, and hypothetical discussions; it will not be expected, that such fea. lures of the disease, as cannot be at all clearly developed, or only with very great difficulty, will here be dwelt upon at length. — Those points in the history and essence of the "Epidemick, which have reference to its remote and proximate causes, would seem to be of this description ; and may, therefore, be soon dismissed, as nearly incomprehensible and incapable of solution. But, as the mode of treatment, which we may chuse to follow, in combating the disease, will in some measure depend upon the notion we may form regarding its proximate cause, it will be well to ascertain, as far as possible, in what that consists.— Nothing more, however, than a distant approximation to the truth can be here looked for. 



75 

Or THE DISEASE. 

It may then be conjectured, that the stomach and small intestines are the primary seat of the morbid action in this disease. — That this is the case, might have been supposed from the analogy of its symptoms with those caused by violent lesions of these parts from the introduction of mineral and other poisons, and is proved by the whole history of the attack—^-The stomach, almost without exception, is the organ first affected.—The? patient complains of soreness, constriction, and pain in the Epigastrium j his belly Wells; he becomes sick; faint ; and then he vomits and purges. — All this is prior in time to the sinking of the pulse, and coldness of the extreme parts ; and in most cases, to the spasmodick affections. — Then, the stomach, throughout the whole course of the illness, continues to denand 

attention, as the part chiefly disordered. To it the sufferer invariably refers the intoerable pain, anguish, and burning heat, by which le is tormented. — Again, the irritability of this >rgan and consequent vomiting, are by far the nost obstinate parts of the disease ; and generaly keep up long after the spasms and other symptoms have been entirely subdued. — Moreover, the great share, which the stomach and small intestines have in the disordered action, is shewn >y the manner in which the fluid is ejected, and )y the appearances observed after death. — For it was frequently remarked, that the contents of the stomach were thrown out with violence, at a 

V a 



time when the abdominal muscles were in a re. Jaxed state ; and when, therefore, the spasmodic contraction was clearly referable to the organ itself — And after death its coats were found turgid, inflamed, and even ulcerated, and partially mortified : evidently from the high degree of excitement, and inordinate action into which i{ had been thrown during life. 

That the small intestines shared more largely in this action than the great guts, was proved by the greater vascularity of their coats ; the ft* quent introsusception caused by reversed peris, taltick motion ; the greater inflammation of their inner surface; and their generally containing more of the muddy fluid, which characterised 

That the depressed state of the circulatory power, and diminished action of the heart and arteries, were rather a consequence and symptom of the severe shock, which the system had received in one of its principal organs, than a primary affection, was rendered probable, by their being subsequent in appearance to the vomiting and purging ; by their gradually increasing with the increasing aggravation of those ,:.oms; and by their total absence, in some cases for several hours after the other signs ot tl 'isease had reached their height. — This too, was proved by no trace of inflammation or other j 

76 





77 



diseased appearance being discoverable in the heart or lungs ; excepting the distension of the Urge trunk* which was probably merely an effect of the disturbed state of the circulation, and consequent accumulation of blood in the centre — Besides, supposing the suspended state of the circulation to have constituted the essence of the disease, it will be found, that the cause assigned is wholly insufficient to account for the effects derived from it. — In syncope and other affections of the vital functions, the action of the heart and arteries is often either wholly, or partially suspended ; and yet no such consequences a* those distinguishing this disease are observed to follow. 

Nor, can the disorder be with greater reason ascribed to spasm of the extreme vessels ; for in the cold fit of agues, and other diseases of a like description, there is the same want of arterial action, and retirement of the blood from the surface, without the burning heat and great internal tumult of this disorder. The state of the skin and other symptoms would seem to shew, that the capillary vessels are in this disease rather in a state of atony or mere inaction, than of spasm. — For here there is none of that horripilation, dry skin, and shivering, which in the cold stage of intermittents are supposed to arise from, and to mark the presence of spasm. -The skin on the 



perspiration, as if the mouths of all the excretories were thrown wide open. — In like manner, the suspended state of the secretions seemed to depend mainly on inaction ; since the suppression or retention of urine, a most remarkable and al. most constant symptom of the disorder, was not attended by those fixed pains in the kidnies and ureters, which so invariably accompany the ati tack of nephritick complaints. 

It appears doubtful whether derangement in the hepatick system had any share in the pro. duction of cholera, either immediately, or in sympathetick connection with the skin. — The dissections shew, that the appearance of the liver was very various ; and from this, we may conclude, that the general turgidity of that viscus, as well as of the spleen, was merely owing to that general retrogression of the blood, which filled the large cavities, and swelled all the great trunks. But it will be said, that the stuffing of the gall bladder with thick green bile, evinced the previous disordered condition of this or^an. — To this objection it may be replied, that the appearance was not by any means universal ; for the cyst was often empty, or partially filled with pale, or light yellow, thin, fluid; besides that even when present, it might be accounted for in several ways, without our being obliged to suppose, that it indicated the agency of the 

78 





well known to every practitioner in India, that the secretion of dark ropy bile is a sure attendant on that gorged state of the organ, which we here imagine to be caused by an over accumulation of blood in the trunk ; and is invariably increased by the use of calomel ; a medicine largely administered in almost every case of cholera* 

But, the accumulation may be explained without having recourse to any theory of increased or disordered secretion in the liver. — It is only necessary to suppose, that the natural quantity of fluid was denied its usual passage into the intestines ; and that this must have have been the case, will be admitted by every one who reflects on the violent peristaltic motion and contraction of the duodenum always present in the disease, and the effect which they must necessarily have produced in compressing and shutting the mouth of the ductus choledochus. Hence regurgitation, and stagnation, and consequent thickening of the bile in the gall bladder. To all this may be added, that no one ever heard of affections of the liver giving rise to such a train of symptoms as characterize cholera, although that viscus is in these latitudes daily seen in every condition of morbid action, by all persons in extensive practice ; and that hundreds of individuals previously in perfect health were seized instantaneously with the disease, in all 

79 





C;ions in which the virus was much con. atcd. 

There is no reason to presume, that the brain was in this disorder otherwise affected than secondarily, from previous derangement of the primavfa and disturbance of the circulation. For generally to the very last, the intellectual powers continued wonderfully clear, amidst all the other suffering; which would not have been the case, if the disease had held its seat in the sensorium ; or had originated in any sudden depression, or other dis. turbancc of the nervous energy. — The head was rarely attacked in the commencement of the disorder ; the headach, suffused eyes, delirium and lethargy, and other signs of congestion, ail ordinarily came on late; and might justly be referred to the rilling of the cerebral circle, when the heart drooped, and there was no longer free play in the lungs; and to the exhaustion of the vital powers under great and unusual suffering. This conjecture was confirmed by the state of the contents of the skuil after death. — The brain and its membranes, in those who were early cut 6 were generally found hi a healthy condition; merely with some degree of congestion; Ist the great distension of all the vessels, the deposition of lymph, and watery effusion w'-ordinarily observed in those only, who died in the latter stage of the complaint. 

80 





Upon the supposition, that the stomach is the mam seat of this disease, it will not be difficult to account for the spasmodick affections so generally accompanying its progress ; for similaT symptoms are commonly present in violent lesions of this organ, produced by other causes. Thus, cramps in the bowels, and lumpy contractions of the abdominal muscles, are frequently observed in enteritis and gastritis ; and trismus andspasins of the extremities often form part of the train of symptoms induced by the introduction into the stomach of arsenic, sublimate, and nitric acid, or of large potations of bad spirituous liquors. Besides, it is an old axiom in physic, that " atony begets spasm ;" and in virtue of it we may allow, that here the contractions at first produced by irritation , are afterwards kept up by habit, and by the universal debility so speedily produced in this disorder. 

The preceding remarks would seem then to "warrant a conjecture, that the stomach and small guts, are the primary seat of lesion in Cholera. It remains to enquire of what nature this lesion is. By some it has been assumed to consist in a violent affection of the nerves distributed on their inner surface, superinducing great general disturbance of the nervous influence, and universal depression of the system. But, if this were the case, the symptoms in Cholera should be similar to those of other disorders 

L 

81 





manifestly aflecting the brain and sensorium by sympathy with the nerves of the stomach. — And yet how different are they from the drowsiness, Jos3 of memory and of voice, stupor, and univer. sal convulsions, which always speedily follow the application of narcotick substances to the inner coats of the stomach. — The appearances in Cholera have much greater resemblance to those of gastritis, ileus, and other inflammatory •and spasmodic affections of the alimentary canal, Thus in gastritis, there is the same burning pain in the region of the stomach* with soreness, distention, severe vomiting, and occasional purging, thirst, anxiety, restlessness, tossing of the body, great debility, watching, and quick contracted pidse ; and in the more violent degrees of the disease, fainting^, interrupted respiration, cold clammy sweats, hiccup, coldness of the extremi* ties and intermitting pulse. 

But, then it mast be admitted, that the appearances after death render it doubtful how far the primary affection in Cholera can partake of inflammation — For, it has been seen, above, that in the bodies of those who sunk at a very early stage of the attack, there were ordinarily none of those marks, which are supposed to characterise, and to be necessary to prove, the existence of previous inflammation: the whole column of the alimentary canal being found paler than natural. And in old md infirm pci* 

82 





tons, in whom there was little or no piethora of the circulatory system, and comparatively less vascular congestion, scarcely any inflammatory appearances were observed, even when the sufferers survived many hours, and had the disease in its utmost violence. — From these facts there is reason to conclude, that the great vascularity of the inner coats of the canal, the thickening of their substance, and the introsusceptio, discovered in the bodies of robust subjects, and generally of those who died late in the disease, were, perhaps, merely the effects of the previous violent straining and antiperistaltic motion ; and of the general congestion produced by venous accumulation ia 

But, if the primary morbid affection of the alimentary canal were neither vascular nor nervous, it will be asked, in what did it consist ? To this we can only reply, (which is in other words a confession of ignorance :) that like the pestilential virus, which produced it, it was of a peculiar and previously unknown nature j and evinced itself by symptoms of a novel and most alarming description. — Whether the enormous dicharges of muddy and pale fluid, were the effect of a new species of secretion, or of a general relaxation andgapingof the vessels lining the viscera, or merely of the squeezing and emptying of the lacteals caused by violent retrogade action in their canals, cannot perhaps be deter- 

T O 

83 





mined.-— -The contents of the lacteals would, however, seem to have been quite ina4equate to their supply ; and the supposition of a new secretion is hardly consistent with the suspension of that action in all its established organs throughout the body.* 

* We must, after all, agree with Celsus " that the disease is so divided between the stomach and intestines, as to make it difficult to determine to which part it most belongs." JJ. 4. qhap 11. 







SECTION V. 

OF THE RExMOTE CAUSE OF THE EPL DEMICK. 

WE have now arrived at a branch of our enquiry, in which, each step as we advance, presents new obstacles to our progress ; and the mass of testimony and of fact, upon which alone we could hope to build a reasonable theory, is sovarious and irreconcilably contradictory, as after the maturest deliberation, to leave us in the" midst of doubt and perplexity. Since the study of JMedical Science first began, physicians have irr vain attempted rationally to account for the origin of those general pestilences, which have from time to time desolated the different quarters' of die srlobc. Taught, however, bvthe constant defeat of their speculations, they would appear to have become at length convinced of the futility of all such enquiries ; and of late years to have abandoned the subject, as one of those over which nature has thrown an impenetrable veil* It is not with the hope of proving more successful than others, or of discovering the secret causes that generated the scourge of which we are now treating, that we venture to hazard an 



to be entirely beyond the range of our under, standing. All that is meant to be here attempt* Sis to shew the insufficiency of every hypo. ;is yet advanced, to account for the pheno* la of the disease j to prove rather in what its eration and dissemination did not consist, 1 in what they truly did ; and to explain c of the peculiar laws observed by it during progress throughout the country. 

From its being observed, that in the higher latitudes, a very warm atmosphex'e was essential to the production of sporadick cholera, and that on the coasts of Ceylon, and in other parts of India, ill which the disease has from time to time pre« vailed endemially, its attacks were manifestly brought on by great and quick fluctuations in the temperature of the air j it has been supposed, that nothing more was wanting to account for its rise Itese tracts as an eptdeinick, than the gene* xistence of similar vicissitudes. According* t has been held by many intelligent indivi-5 in this country, that the recent Epidemick solely caused by the extremely variable state lie weather, which obtained previously to and ie time of its commencement. — But, this sup;ion arises entirely from confounding the Re« j with the Exciting Causes of the disease. 

It is no doubt very true, that sudden changes 

86 





the disorder in situations in which it had not been* known previously to exist ; and reproduced it where, having previously existed, it had for sometime lain dormant. But, that all this was merely accessory, and that something else was necessary to the generation and continuance of the Epidemick is sufficiently clear from the following, amongst many other considerations. 

If changes in heat and moisture were alone requisite to the production of the disorder, then it ought always to appear, when such changes are in operation. And yet, that this is not the case, is proved by the whole history of this country. For such vicissitudes are inseparable from its climate ; and form an essential part of the revolutions of its seasons. Nevertheless, till the year IS 17, the disease had never been known as an Epidemick in any considerable part of its very extended limits. — Again, during the numerous campaigns, which have been undertaken since the first establishment of the British Empire in India, our soldiers, both European and Native, have been exposed times without number, to every possible variety of weather, during all seasons of the year, and at all hours of the day and night, without being subjected to the pestilence that nearly depopulated the camp of the Marquess of Hastings, — To choose only a few instances of recent occurrence. In the first year of Lord 

87 





88 

or-f Hr hemote cause 

early as "September; and' frequently marched during the whole day, when the heat was excej. save, and the temperature of the direct rays of the sun, probably, above 1.50. In Colonel Mon. son's retreat, again, the broken remains of the Division under his command were during m?uy cfeys of excessive rain, exposed to the weather, without food, shelter, or covering; and under every possible circumstance of mental and bodi. And yet in neither case had they t-he disease. In like manner, during the capture of Java in 1811, the soldiers were frequently exposed along the coasts to rain, heat, cold, change of food ; crowded to excels, sleeping in the sun by day, and in the dew by night, whilst a chilly land wind blew from the mountains- Still cholera was not the consequence. During the long period of disturbance, which preceded the last rupture with Poona, and the overthrow of the Muhratta Powers, the jaulfia Force v.as for several years almost constantly employed in the iield under canvas* ; and yet the disease was new to them when communicated in the s i mmer of 1318, from the neighbouring city of Xagpore.f 

So with the Force that marched under Colonel Close upon the Nerbudd;* in 1810, the thermometric.il - cisfVauks frequently amounted to 50 : and even 60: fg twenU four hours ; yet no Cholera followed. 

¦he instances quoted in the preface, of Colonels 



89 

OF THE IPIDEMICK. 

But, it may be said, that the long continued irregularities, and frequent unwholesome vicissitudes of the weather, which took place during he years immediately antecedent to the rise of he Epidemick, had debilitated the human conititution, and generally predisposed it to be morbidly affected by such exterior circumstanpes, as in former times passed over without maerially injuring it. But, even this conjecture will not hold good. — For the Medical Returns »hew, that several detachments and divisions of he Army underwent every species of exposure md fatigue during the period under review, without suffering from the disease ; and were yet virulently attacked, as soon as they came within the known sphere of its epidemical influence. This was strongly exemplified in the case of the ftagpore Subsidiary Force, which had not a :ase of the disease, whilst conducting the siege of Chanda ; during which the troops were exposed to he great heats of the day under a range of stony nils, and often, without shelter, to the dews of night ; and yet no sooner did they reach the confines of Nagpore, than it assailed them in ths manner of the plague. — So with the Left Division of the Army. — The troops composing this Division had been almost constantly moving rom the beginning of March ; and in the latknow, 

the only exceptions to this rule ; and their occurrence is too remote to admit of our discovering all the causes operating to produce the disease amongst them. M 



ter part of that month, and the first week of April, had undergone great privations and fa. lie, whilst conducting a heavy train of artillery, a numerous convoy of carts, in the cold the night and great heats of the day, >ugh a mountainous and difficult coun—Yet, they felt nothing of the Epidek, until they, on the 9th and 10th of April, :hed Jubbulpore, in which town it had been ng several weeks ; from which time they be. c numerously affected by it. 

Nor were rain and moisture, any more than mere alternations of heat and cold, alone sufficient to originate the disease. — For, nearly all the corps moving on Hansi and Hissar to form Brigadier Arnold's Force, must have met with rain during their advance from various points in the Doab. — The Ist Battalion 29th Regiment N* tive Infantry was, we know, exposed to excessively wet weather during the whole of its march from Aligur. — Still, it continued entirely exempt, till, at Hansi, it joined those corps, which had got the Epidemick on passing through Delhi. 

Ihese facts would of themselves be sufficient d away every hypothesis founded on the bethat the rise of the Epidemick was solely -able from variations ill the sensible erties of the atmosphere ; even were not whole history of its progress such as to 

90 





discountenance that belief. — But has it not m Bengal again and again risen and fallen, and reappeared, during all periods of the year, and under every possible variety of season, heat, cold, dryness, and moisture ?—ln? — In Upper India again, did it not in Benares, Bundlekund, Oude, and the Southern Districts of the Doab, rage virulently during the dry months of the Hot Weather ; whilst it appeared not in Delhi, nor in Meerut, nor in Jeypore, and the tracts in their vicinity, until the Rains had set in, and the air was loaded with moisture ? So, of the five camps visited by it, the Centre Division was attacked in the Cold Season j the Nagpore and Saugor Division, in the height of the Hot Winds ; and the Rajpootana and Kurnaul Divisions whilst it poured down rain* 

The hypothesis of the disease owing its origin to the use of particular sorts of food, or to the consumption of blighted, and poisonous grain, may be dismissed in a very few words, as wholly untenable — Such a proposition appears, indeed, at first sight to be in direct opposition to the common rules of reasoning, and the results of universal experience ; by which we are taught never to attribute very general effects to causes of partial operation. — Of the numerous tribes and religious castes spread over the extended surface of Hindostan, it is every where known, that the common articles of diet, are almost as various as the 



91 





different denominations under which they them* selves are ranged j and whatever mischief the eating of noxious rice, of the Ouse or any other crop, might cause amongst the Bengalese, with whom it formed a principal part of their food, it could hardly be expected to produce the same effects among the inhabitant* of Upper India, who rarely, if ever, use it. — It has accordingly been found, that the Epidemic!; has again and again visited the sailors of European ships ju3t entering the river, and previously to their having any communication with the shore ; and has often raged extensively among Sepoys and other classes of Natives, who had not tasted rice for months, or perhaps years, before they were attacked. — Final. ly, the disease has in towns and detachments of troops been frequently observed to arise, come to a height, and die away, wlulst the food general. ly employed continued exactly the same, before, during, and after its visit ; and that food sometimes not containing one particle, and sometimes again, chiefly composed of rice. — Besides, that the inadequacy of this and every other cause of partially local operation, for the production of the disorder, has been clearly established in the foregoing account of its rise and progress ; in which it is shewn, that it broke out simultaneously in many distant and unconnected spots.* 

* The theory here referred to, consisted in a belief, that the Epidemick was originally generated, and after- 

92 





It thus appearing, that no theory yet proposed will stand the test of scrutiny, the question, in what consisted the Remote Cause of the disease must be abandoned as placed beyond the reach of human curiosity : or as at least inscrutable in tht€ present state of our knowledge. — This much only has been shewn in the account of the weather 

wards wholly kept up, by the use of the blighted and noxious eaily Crop of Rice of 1817. The improbability of this hypothesis might be argued, from the extremely extensive course pursued by the disorder, and the likelihood, or certainty, of its having during that course visited many tracts, which the deleterious grain had never reached ; from the disease having suddenly, that is within a few hours, largely affected the inhabitants of several towns, as Agra and Futligur, in sucli manner, that its attacks were clearly referrible to corresponding sudden changes in the sensible properties of the atmosphere; and from olher like circumstances. But its truth would appear to be quite irreconcilable witbr the following well authenticated facts ; Ist. From the concurring and uncontradicted affirmation of many Officers, Military as woll as Medical, who served with the Nagpore Subsidiary Force, at the period of its being attacked by the Epidemick, it appears that Rice, so far frem being at that time the common food of any class of the troops, was very little used ; and that many individuals, who had not tasted a particle of it for months, or even years, were yet carried off by the disease. 2d. From the reports of the Officer at the head of the Commissariat Department with the Centre Division of the Army, it is learnt, that Rice so far from being common in camp, could not be procured but with/great difficulty, and at an 

93 





prefixed to this Report; that for several yeas prior to the commencement of theEpidemick,t« seasons had in a very extraordinary manner dj parted from their usual course ; that Easted winds had prevailed to an uncommon degree 

exorbitant price. — The Officers alone used it ; and ti. Commissariat Agents, although they wrote and sent pa pie in every direction, failed to obtain a supply, for tij use of such Sepoys as were inhabitants of Bengal Vn, per, who of all our Native troops, aic almost the on portion, which prefers Rice to Wheat. So that, while t Epidemick was raging with unheard of violence in cam; the Officers, that is the class whom we know to hai been of all others most exempt from the disease, wen the only persons who touched Rice. With the single o ception of Chuna or gram, which was sometimes gs from the neighbouring villager, all stores were here | sued by the Commissariat. The depot books for it Kgive the following list of issues : viz. Wheat, in, Chuna, Ghee, Salt, Huldee, and Tobacco; and** uthorised to state, that no change whatever toot in the kinds or sorts of grain given out during thi xide of the campaign. — In like manner, the Natives of the llajpootana and Hansi Force were supplied throughout, by the Commissariat. — The purshases were Wheat, Dall) &c. as above ; and there was no Rice in camp, excepting a small quantity kept in store for the use of the Europeans in the event of bread unexpectedly failing them. — The Left Division of the Grand Army alone was not regularly supplied by the Commissariat but it is learnt from the Ofiicer in charge of the Depart* ment in that quarter, that the troops and followers ofal. classes, chiefly used Ata, which was the principal article 

94 





I id, that at the period of its rise, the atmosphere I over Bengal was excessively humid, from the revious great and long continued falls of rain. — lit, whether this unseasonable and wet state of c weather, itself produced and constituted the tiated condition of the air ; or was a mere isual accompaniment and adjutory to some ore hidden means of corruption j it is not in ir power to determine. — It may, however, be rcarked, that the surface of Bengal was then in a indition very similar to that of Lower Egypt, 

IF supply in the Bazars. But, without taking into coiiiieration the results of experience, a simple reference to le period of the first rise of the Epidemick, as contrast-1 with that, at which the Ouse crop of Rice is reaped, ill prove, that the hypothesis under review was from the rst wholly untenable. The seed of the Ouse Rice i« own between the Ist and 20th day of June, according s the Rainy Season happens to commence early or late; nd the plant is cut from the middle of August to the liddle of September. Now from the first Section of Ins Report, it clearly appears, that the Epidemick first ¦>egan in Nuddeea and Mymensing in May; that it ¦raged extensively in June ; that in July it had reached ¦the far distant districts of Dacca, and Behar ; and that it ¦was generally prevalent throughout the whole of the I Lower Provinces in August and September. — It is al- I mo<:t unnecessary to point out the conclusion. — That the I Ouse Rice of the season could not be the cause of a distemper, which largely existed, when the plant was yet I green; nay had shewn itself, when the seed had not yet been thrown into the ground. 

95 





during the psriod of its annual inundation; and that Egypt and the neighbouring country of Ethiopia, " have been stigmatised in every age» as the original source and seminary of the plague." 

Having failed in discovering the primary agent in the generation of the pestilential venom, we should next enquire, by what means it would ap. pear to have been propagated ; and what cir. cumstances seemed most readily to bring it into action, in places in which the atmosphere was al. ready predisposed for its reception? 

Perhaps the most singular fact in the whole history of the disease, was the predilection which it shewed to spread in one particular direction.— From the remote period of its first appearance in the Eastern parts of Bengal, in the autumn of 18 17, to the hour of its arrival on the Malabar Coast, as has been seen in a preceding part of this report, its path was almost uniformly from East to West ; and, if we may be allowed so to express ourselves, it seemed so bent upon pursuing this Westerly course, that rather than deviate from it in an opposite direction, it would for a xvhile desert a tract of country, to which it afterwards returned under circumstances more con. genial to its disposition. — Thus, although itap- Kred in the beginning of November, 7, on both banks of the Jumna near Shergar, 

96 





it did not 1 hen shoot Eastward across the Doab; but, leaving all on that side of the river untouched, spread far and wide throiigh Bundlekund, and all the districts to the West. — In like manner, when it had reached Cawnpore in the following spring, it shewed a marked aversion for Bareilly and the other tracts east of the Ganges ; but readily stretched through the Doab to Agra, Coel, Delhi and Meerut ; and thence far to the West, by Hissar, Jeypore, and the detached camp of the Rajpootana Force. — To give another instance. — Although Allahabad* and the whole of that District, was largely afflicted in March, the infection was not thence communicated to Sooltanpore, Fyzabad, Oude, and the Districts bordering on the Gogra and Goomtee; but from the South East quarter, by the way of Tirhoot and Gorruckpore. — The case of the small Cantonment of Mulhye on the Eastern frontier of Tirhoot, which would seem to have received the disease from the West, and of one or two other places, in which the range of aberration was very limited, need not invalidate a rule deduced from an observance of a general course extending several thousand miles. 

From knowing, that during the existence of former pestilences, the diffusion of the virus cpuld be frequently traced to the motion of particular currents v of air, it was natural to look for an. explanation of this extraordinary retmlaritv of pro- 

N 

97 







cressipn in the prevailing course of the winds during that period. — Accordingly, upon refer. ence to the various reports of the rise of the disorder in different parts of the Country, it was discovered, that in a vast majority of instance! the wind was blowing from the East or South East quarter, at the time of its breaking out.- Thi3 may be stated to have been almost without ieption the case in Bengal ; throughout which Epidemick in the Rainy Season, wlien wind blows almost invariably from the South t.-— ln Calcutta, Nuddeea, and many other :es, indeed, the influence of particular directs in the wind was so evident, as to have at rik almost justified a prediction, that the asments and aggravations of the disorder would certainly correspond with their alternations,— Thus in Calcutta, it declined in virulence and frequency 4s the Northerly wind set in, in November 1817 f and again recurred with a South East wind in the following February. — Its reappear ance, again, in April 18 IS, was preceded by i continuance of wind from the North East : an uncommon quarter for that season of the year.— So in Nuddeea, the disease declined for a fey days on the wind blowing steadily from the North ; but no sooner had it again veered to the East, than it recommenced its ravages. — The same prevalence of Easterly and Southerly winds attended its progress through Tirhoot, Sarun, 





Sehar. and Shahabad;*— At Moozufferhore, Buxar, and Ghazeepore, this had been the prevailing wind for some time before its appearance.— lv the camp o? the Centre Division of the Army, the ?rind, which from the 21st of the preceding month had blown strongly from the West, suddenly changed round to the East quarter on the 7th November ; and there are grounds for believing, that from that day the disease raged in camp. — With the Left Division again, the wind ranged from East to South, from the Ist to the 14th of April. -The Epidemick was with them on the 9th, and abated as the wind came round to the West. — The state of the winds is unfortunate. Jy omitted in the returns from the Nagpore Force. — With the Raj pootana Force they are stated to have been variable ; but in Jeypbre, Brigadier Arnold's Camp, Agra, and other stations of Central India, they were Easterly during the prevalence of the disease. 

It must be admitted, that to this rule there 4 were several striking exceptions.— -Thus at Be« nafes, Juanpore, and other places visited by the disease in April and May, the hot Westerly winda blew during the whole period of it continuance , and at Futtygur it shewed itself on the morn* ing succeeding the occurrence of a severe North Wester: until then remaining unseen, although an Easterly wind had for a considerable time before existed. — Nay, in Delhi, the Epidemick broke 

N 2 

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out the moment the Easterly wind, which had been very unseasonably blowing during the previous months, gave way to Westerly breezes; and departed as they withdrew. 

These exceptions, however, were not very numerous ; and when placed in contrast with the in. numerable instances bearing towards the opposite point, are not of such magnitude as to overturn the general deduction, which we now venture to draw : that the appearance of the Epidemick in any particular place was usually accompanied or preceded by an Easterly wind j and that there was apparently some connection between the dissemi. nation of the pestilential virus, and the prevalence of currents from that quarter.* Of the nature of that connection we cannot speak certainly; nor can we tell, whether those currents, acting as a vehicle of the poisonous matter, carried it along with them" from one infected spot to another pre- Ssly healthy ; or acted merely from their su)r moisture, in the light of a strong exciting c, eliciting the disorder in places, where the > had previously existed, although it were yet brought into action. — In favour of the er supposition, the progress of the Epidemick, ie Upper Provinces may be cited j where the ise broke out in different places, at such in- 

Klie more frequent occurrence of the disease during n valence of youth Easterly winds, is noticed by iuu. 

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tervals of time, and in a manner so like regular succession, as almost to warrant a belief, that it was communicated from town to town, after the ordinary laws of consecutive propagation. — It would be mere repetition again to quote the numerous instances, in which the disease in this manner travelled from place to place. — A reference to a former Section will prove to the reader, that along the banks of the Jumna, and thence Westward to Jeypore, Bundlekund, and the Mahratta States, it seemed very constantly to spread in this manner; and will leave him almost satisfied, that there at least, the virus must have been diffused and propelled by the winds. — In Bengal on the other hand, it is hardly possible to conceive, that the Epidemick benciitted by any such mode of propagation. In that quarter, it got head at nearly one and the same time, in many distant parts of the Province ; and would appear to have been quite independent of all auxiliary means of dissemination.— lt may be conjectured, that as the Lower Provinces were unquestionably the primary seat and seminary of the disease; the whole encircling mass of the atmosphere was there in such a state of distemperature, that nothing beyond the common exciting causes was required, to set the virus in action in particular parts; -while in Upper India, the air, being less corrupt, required for the production of the EpidVmick, v an admixture of more vitiated currents, 

101 





Sli were borne along by the winds.— ln this of the case, the agency of the wind, settiiig the effect of its dampness, must be held to been purely mechanical.* 

To what cause are we to ascribe the marked disposition of the disease to follow the course of rivers? This tendency was observed in so many instances, that it can by no means be considered to have been accidental.— From the rise of the disorder on the banks of the Ganges and Burrum. pouter to its arrival at the mouths of tho Nerbud< da and Taptee, it excited the surprise of the Me. dical observer, — Thus from Sonergong in the Dacca District, where the Epidemick broke out in July, 1817, it crept along the banks of the Megna to Narair.gunj and Dacca; attaching itself chiefly to the ferries and market places in its vicinity. — In like manner, it afterwards step by step advanced up the Burrumpooter ; affecting during its transit the villages situated on both its margins. — Fiom the mouth of the Hooghly to its termination in the Ganges near Moorshe* 

* In the South of India the rise and progress of the Epidemick were thought to depend in some measure up* on the state of the Moon ; but a careful comparison of the tables of the weather prefixed to this Essay, with the periods at which the disease broke out in different parts of these provinces, has clearly shewn, that here at least, no connection could be traced between it* increatf and decrease, and those of that planet* 

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dabad, the same peculiarity was observable. .-The shipping at the New Anchorage, at Diamond Harbour, and along the whole channel as high as Hoogly was particularly affected ;• and almost every village adjacent to its banks buried many of its inhabits ts. — In the Bhaugulpore district the propensity was so strong, that the virus scarcely ever spread into the interior, whilst it almost depopulated the low lands near the Ganges. Again, ii) the autumn of 1817, Moo-2ufferpore, and the villages along the Gunduk river in Tirhoot, and the station of Chupra on a branch 01 the Ganges in Sarun, were alone visited ; while at a subsequent period the disease was thence communicated alon 1 the Gosrra to numerous cities in the North East quarter of our territories. — From Allahabad upwards, along 

• The Epidemick attacked the Honorable Company's shipping at Diamond Harbour and the New Anchorage •with its usual irregularity. The first cases appeared on board the Astell, lying at the former station, about the 20th September. The weather was moderate, with South Easterly winds, and showers of rain. Thermometer 84-. Then, in the first week of October, it got on board the Phcenix ; which was moored near '.he muddy, slimy shore of the river. The weather had now grown very sultry : the Thermometer averaging 86 night and day, and scarcely a breath of wind stirring. The first fatal instance at the New Anchorage occurred in the Warren Hastings on the 7th October. The weather had been cloudy, with variable winds, and occasional rain ; the 

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the channel of the twin branches there forming a junction, until the virus was lost under the hills, it wavered so little from the line of thoc-e rivers, that hardly a town or village lying remote from their course was brought within its inflij. ence. Without going further over our old ground, let us briefly state that the same rule held yet more unexceptionably in Rajpootana ; through the province of Bundlekund ; and all 

Thermometer varying from 86 to 88. The case of this vessel is somewhat singular. A seaman was attacked on the morning of the 10th and died at ten o'clock. In the afternoon a party went on shore on Saugur Island to bury him. On their return to the boat, the man who had been left in charge was found lying convulsed in it* bottom ; and died at four nex.t morning. Then the boatswain was seized, and after lingering .to the 15th, sunk under debility. During the ensuing five days ci«ht others were taken ill (whether of the burying party or not, is not mentioned) but in a slighter degree, and nil recovered by bleeding, anodynes, and calomel At this time, the other vessels had only one ortwe cases each; and the General Hewett remained perfectly healthy; which could only be accounted for, from her men not being allowed to go on shore, and wander in the n^arshy rice fields, and being otherwise carefully protected from the sun and damp. About the end of October the wind became Northerly, the air serene and cool, and the ships more healthy. The South East wind blows over a great tract of swamp and jungle, and always renders these stations very sickly during it? prevalence. 

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along the Nerbuida to the numerous branches of the Chumbul. 

If we enquire into the causes of this apparently extraordinary propensity, we shall find, that they are not of such difficult solution, as they would at first sight appear to be. — It is to be recollected* that in India, as in all other countries, the inhabitants flock to the neighbourhood of rivers for the purposes of commerce ; and that the greatest number of towns and cities will thus be found near navigable streams; whilst the banks of every rivulet affording the prospect of gaining a lively hood by fishing, will be crowded with villages. It is perfectly plain, that the population being more thickly gathered in such situations, must always suffer more, on occasion of any general mortality, than more thinly inhabited portions of the country. — This cause alone would appear sufficient to explain away the apparent anomaly no»v under consideration. But there is yet another reason of equal force. The vicinage of rivers, from the action of the sun upon the great body of water contained in their beds during the day, and from the influence of the water on the circumambient air during the night, must always be peculiarly subject to those vicissitudes of temperature, which are known so powerfully to influence the state of the Epidemick. — Heuce great evaporation by day, and falling of fogs and heavy dews by night ; and hence a constant in. 

O 

105 





106 

Of XiiE REIVIO IK vAli &£> 

terchange of hot and cold currents : all strong exciting causes of the disorder. — To all which, S3 add their low, muddy, sedgy banks, and Dther numerous sources of miasma usually d in their confines, we shall be at no loss to untfor the great sicklineas of those residing on their banks, without searching for any more hidden causes of the fact. 

It has been shewn in the beginning of this Section, that the rise of the Epidemick was in no way derivable, from any preceding ricissitudes in the sensible properties of the atmosphere, or other circumstances of purely local operation- It is nevertheless, certain, that the virus, being once on foot, its condition and mode of action were materially affected by such localities of situation, as were before inadequate to its produo ti on . Thus, there is abundant proof, that in high, dry, and generally salubrious spots, it was both less frequent in its appearance, and less general and fatal in its attacks, than in those, that were low and manifestly unwholesome. — This, indeed, might have been previously concluded, from a general observance of the different course pursued by it, in the low and stagnating climate ot Bengal, where having once gained ground, it tarried for years ; and in the pure and elasti atmosphere of the Upper Provinces, in which ¦was slowly received, and quickly lost.— But, it we trace it in its progress through different cities 



and tracts of country, we shall find this modification of its agency according to difference of situation, almost invariably taking place. — Jessore, the place in which the disorder first put on a very malignant form, is a crowded, dirty, ill ventilated town ; surrounded at all times by a thick jungle ; and in the Rains by an immense quantity of stagnant water.— Here accordingly, the disease did unspeakable mischief ; and its ravages were not diminished, till the inhabitants abandoned the city ; and thus got rid of those causes, which had a manifest effect in aggravating its virulence. — JSunergong, Dacca, and the other places in that neighbourhood severely visited by the disease, are completely encircled by clumps of trees, and heavy underwood, of various sorts. — But, in Sylhet the influence of situation was perhaps more remarkable than in any other quarter. — From the uniform result of queries sent round to the Police Officers of the different departments, into which the district is divided, it appeared, that the villages in which it raged most extensively, were considered by the Natives, as comparatively unhealthy, and obnoxious to fevers of the intermittent type -, being exposed to the effluvia arising from marshes and extensive lakes, in which the Zila abounds; particularly towards the South West Division, where the greatest number of victims fell. — The Sepoy Lines, on tht contrary, being placed from iixty to a hun. 

O2 

107 





108 



Kfeet above the general level of the country, scarcely any cases ; excepting such as oc. & in persons on guard at the different out 

In Calcutta, again, the disease was, from first to last, most prevalent in the lower parts of the town, and suburbs ; as the Bura Bazar, Simeleia, Dyahutta, and Suwah Bazar ; and in the suburbs, the Villages of Khidderpore, Bhuwanipore, Ma. nicktolla, Kurrya, Entally, Chitpore and Sealdah. — These dependencies are every where in. tersectedby pools, broad ditches, and channels; which, being imperfectly drained, are in the Rainy Season always full of stagnant water, and rank 

# Much of the sickness of Calcutta was no doubt owing to the general overcrowded state of its population; to the intermixture of Native with European habitations ; to the numerous collections of stagnant water, and filth of every sort, in many of its most centrical parts; to the depth and thickness of its boundary hedge to the North, East, and South; and to the immense quantitie* of trees and underwood spread over the whole of iti •cite. A knowledge of the extent of the population of the city is yet a desideratum ; no accurate census having hitherto been taken.— lt has been variously conjectured, at six hundred thousand, a million, and a million and a half. — There are however, strong grounds for believing, that within the last thirty years it has been trebled; and even doubled within thelast ten years. Several causes have concurred to occasion this rapid augmentation. As trade *nd mercantile enterprise ljave increased, and branched 



weeds. From this plentiful source of corruption, foul air is constantly given forth; and as all ventilation is obstructed by large groves of trees, vegetation of every description, it is there concentrated, until it becomes entirely unfit for the purposes of respiration. — The miserable condition of the generality of the inhabitants of theservillages is hardly to be imagined. — Each iiamlet is made up of many mud or straw huts, generally from six to twelve feet square, placed so close to each other, as to leave scarcely room 

.out into many new channels, the concourse of European settlers ha» become greater. — It may, perhaps, be assumed to have increased in a quadruple ratio within the last ten years; and more especially since the Trade was thrown open. When it is considered, that every European settler of any consequence attaches to his person from ten to fifty Natives, and gives employment perhaps to double that number; it will be acknowledged, that from thi* cause alone, a very sensible angmentation of the inhabitants must have arisen. — Then there is the rapid increase of Countryborn Christians, who too, have their followers, among whom must be reckoned, not only domestick servants, but persona to whom occupation is given out of doors.— Lastly, there is the large body of leafarino; men, variously connected with the vast quantity of shipping now employed in the port ; and of Native workmen engaged in the Dock-yards, Cotton fcciews, and other large establishments connected with its Trading interests.— The whole of the above descriptions, are in seme measure dependent upon, and increase in an equal ratio, with the European settlers.— But, what 

109 





to pass between. — In every one of these wretched hovels, a whole family, sometimes consisting «' six or eight persons, resides ; and not unfrequentljr cows, pigs and other domestic animals add to the filth and foul atmosphere in which they abound. The singularity is not, that persons so situated should be more than others subject to the info cnceofa prevailing Epidemick* but that tti,y should ever be free from maladies of thisdesciip* tion, — The higher classes of Natives, and Eu- 

may be strictly denominated the Native population of the city, has owed its great increase to other, and perimps more powerful causes. — So long as the stability iff the British Empire might be deemed precarious, weal? thy Natives felt perhaps some hesitation in placing their families and property, in what might be deemed, an in- Secure situation. — Every scruple of this sort has now disappeared ; our arms have triumphed over all opposition; the Native principalities have crumbled down; and Calcutta hat grown out of their wreck. It is now the capital of India; and to it people of every class and denomination repair, as to a place of perfect safety. Hence, it may be almost taken for granted, that iliis part of the population has lately gone on augmenting equally rapidly with that more immediately connected with Europeans ; and that the town, taken as a whole, now contains twice as many inhabitants, as it had in the endo! the last century.* Meanwhile, its limits remain precisely 

?It is the opinion of one of the most intelligent of our M^trates, 

that the population of the city within the Mali ratta Ditch, doe» not fall short of eight hundred thousand; and that during tl" d«y it is augmented to a million, from the influx of raechauicka W» labourer! ol all descriptions from the suburbs. 

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ropeans generally, inhabiting the better raised and more airy parts of the town, suffered proportionably less than the lower ranks. — A striking instance of the good effects of airiness in affording imnunity from attacks of the disease, occurred in the great Native Jail of Alypore. — Although this building contained several thousand pefKMftSj scarcely a case appeared in it ; whilst 

tli.' same. — The expedient fallen upon to avoid their extension, has been to erect five or six houses on the same spac: of ground, on which one formerly stood; so that to tT.o evils arising from over populousncss, have thus been added those of overcrowding. — A great mischief consrijiient on the intermixture of European and Native dwellings, has been the accumulation of filth in every vacant spuce. — Even the most centrical and valuable parts of the city are not free from this nuisance, — Immediately to the East of the Government House, and in rear of the Esplanade Row, and Cossitollah, there fs a stagnant pool, in which the whole neighbourhood deposit their filth, and whence a stench of the most noisome and injurious kin 1 frequently proceeds. — The rear of DurrumtoHah, the Lai and Bow Bazar, and of Kulingah ; and indeed the whole of the Native portion of the town, abounds in «uch sinks of putrefaction, and loudly calls for improvement — The proper authorities will best judge of the means calculated to remedy these evils; but it may not be improper to mention in this place one or two circumstances, the adoption of which would undoubtedly improve the salubrity and beauty of the city.— Ist, To open long and broad avenues from the Circular Road or outskirts of the town, to some distance into the country; aad thus to break up 

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the prisoners employed at the outposts, and la. bouring in the sun in cleansing drains during the day, and sleeping in mud buildings at night, were very sickly. — So the Native Insane Hos. pital built in a low swampy spot, and such parts of the shipping as lay near the slimy banks of the river, were likewise peculiarly subject to the disease, whilst on the other hand, the dry Jail of the Court of Requests, containing nearly four hundred debtors, continued nearly exempt. 

the present almost impenetrable bound hedge. — 2d, To form open, wide streets, with occasional squares and tanks, in the body of the city.— 3d, To break up the numerous nests of huts, in the European part of the city, by purchasing the ground on which they are now built, and allotting new ground in its stead in the suburbs. — Ith, To fill up all the unwholesome tanks and foul puddles and ditches. — sth, To improve the draining, if practicable, eth, To disuse the present European and Mossulman Burying Grounds, which lie exactly to windward of the most populous part of the city during the unhealthy season; and to form others to the North or North East of the town. Lastly, — To diminish the number of trees, j\iul thin the iunde in the town and suburbs. — Some measures of this sort will soon become imperiously ne« canary to prevent the city from becoming, under its dai- t increasing population, as proverbial for unhealthiness, Bntavia, or Spanish Town, Jamaica. — The communipf Calcutta is greatly indebted to that excellent and infatigahle Magistrate, the late Mr. Eliot, for the many great improvements introduced by him. It was under his superintendence that the city, which tea year* ago was * 







113 

«F THE PFIDEMICK. 

On proceeding upwards we shall observe the same unerring influence of situation. — In Nuddeea, high and dry places, and upper roomed houses, were more free thaa u\v and marshy spots, with luxuriant vegetation. — In the Barracks of the European Regiment at Berhampore, of twenty-four casualties, seventeen took place in the four Companies inhabiting the lower range.—- This range was very damp, and had in its vicinity to the North East an extensive swamp, from which an offensive stench proceeded. — The disease shewed no variety of appearance in Rajshahy, besause the town of Nattore, and almost every village in the District, are equally surrounded by ditches, full of stagnant water, and filth of every kind. But in Malda, only the villages lying in the flats near the Mahanuddee River were attacked. — In Bhaugulpore, all the lofty open country escaped, whilst those parts most subject to fevers, suffered severely, as Calcapore, Rajmahl, Peealapore, Tarapore, and Luchmunporo — The troops and followers in the cantonment of Carringur entirely escaped ; although two villages situated immediately on their boundary ditch suffered dreadfully. But the cantonments were seventy two feet above the villages. 

perfect swamp in the Rains, was first properly drained.— It is melancholy to reflect, thut he fell an early victim to the Epidemick, whilst maturing and carrying into effect those curaiive measures, which saved the lives of thousands. 

I' 



When the disease appeared first in Tirhoot, there had been a previous unusual inundation ; and the low villages near the- river were alone affected.—i So in Sarun, the disorder arose shortly after a branch of the Ganges had rapidly fallen, and left the town exposed to the noxious smell proceeding from its large oozy bank. — The only place, accordingly, left unaffected, was the Jail ; which was clean, airy, and situated in an open space at a distance from other buildings. The same favorable localities nearly saved the Tirhoot Jail. — In the dry and well ventilated cantonments of Mullhye, only three instances of the disease occurred ; while the neighbouring vil. lages, which were remarkable for their filthy and close state, were so sickly, as to be deserted by the inhabitants. So in Poorneea, the lines of the Provincial Battalion and Jail were quife exempt, when the disease was extensively fatal in the town. — In the valley of Napaul, all the villages enjoying a pure air on the slopes of the hills remained free ; whilst the towns of Khatmandoo, Patun, and Bhatgoon, in the vicinity of which there was much putrid matter, and many channels of stagnant water, were severely visited. — In Benares, the disease was chiefly confined to the lower classes of Natives living in wretched huts.— ln like manner, at Lucknow, the cantonments, built on a dry and sandy soil, tltvated lomewhat above the general surface d 

114 





115 

OF THI EPIDEMICS. 

the country, enjoyed nearly entire immunity ; when the low ani crowded city was greatly ravaged. — That nothing in the condition of the Sepoys themselves, was the cause of this good fortune, was very evident, both here and at Mullhye, by their becoming affected upon proceeding on guard to places within the range of the unhealthy action. 

The same variation of freedom and exemption, was observable in almost all the towns on the Jumna subjected to the Epidemick — Agrah, an airy, open, clean town, was comparatively free ; Muttra, a filthy place, with crowded bazars, was severely scourged. The cantonment of Nomilla, adjacent to Agra, being high and perfectly clean, was hardly touched. — How different was it with the cantonments of Muttra. — There the disease, after remaining in the city from the beginning of the month, on the 27th of June 

got into the lines of the 4th Regiment of Cavalry — These formed the most distant part of the cantonment, being fully two miles off; but were placed on very low ground near the banks of the river. — In them the disorder was most severe. From these lines it next visited those of the Ist Regiment of Cavalry ; then those of Captain Gillman's Levy, and lastly, those of the 12th Regiment of Native Infantry : a mile nearer the town. In the whole extent of this line, the ground gradually ascends from the river. Surely, no stronger proof 





than this could be given, of the influence of locality in modifying the prevalence of the disease.— In AUig'.:r the Jaiis, cantonments, and adjoining villages continued healthy ; whilst the virus was cherished, and fed in the filthy, and crowded bazars of Coel. — Thus too, the thickly populated, and close lanes of Delhi suffered more, than the rectangular and spacious streets of Jeypore ; and the low and nasty town of Saharunpore more than the city and cantonments of Meerut. So the military lines of Saharunpore had not a case, when the inhabitants of the town were very sickly. 

We might go on enumerating many other instances of a similar partiality, were we not afraid of tiring the reader's patience, without adding further strength to the position, which we are now endeavouring to maintain. — We shall, therefore, close with the mention of the Centre Divison of the Army, and tjie Rajpootanalwe. With the former, in the three grounds of encampment, in which the disease prevailed most, Terayt, Talgqng, and Silya, the soil was low, and moist ; the water foul, stagnant, and of bad, brackish quality ; and every where not more than two or three feet from the surface of the earth ; and the vicinity abounded in animal and vegetable putrified matter. — Whereas, at Erich, where the Army regained its health, the situation was high and salubrious ; and the water clear, and pure from a running stream. 

116 





The Kujpootaua Force, previously to the appearance of the disease, was encamped on a ridge of sandy soil, sloping for a mile or two to a much lower tract. — Both the immediate scit3 of the encampment, and the surrounding plain, wore covered with .long slender grass ; but tliis was thicker to the left of the camp, where the declivity was too gentle to allow the water to flaw off speedily. — On this side of the line, the disease broke out earlier, and was throughout; more violent, than in its right division. — No reason could be assigned for this irregularity of action ; except that in the one part, the tents were pitched higher, and were consequently drier, than in the other.* 

* Some peculiarities respecting the ground of enr campment of this Division, which have not found a place in the text, may be noticed here. The camp was pitched on a plain of considerable height ; with hills to the North and West, distant three or four miles. There was no river in the vicinity ; but frequent small, clear streams with sandy or gravel beds, often terminating in ponds. The neighbouring soil was little cultivated ; a few fields of Indian corn and maize being the only grain to be seen. The plains were overgrown with slender, light grass, wild plum thorn, and swallow wort. The hills were almost bare. The water was generally found at a distance of eight or ten feet from the furface; and was brackish in many wells. There wefί no marshes, or foul stagnant water near. The disease commenced on the 14 th. The Rains had not ceased. Dn the 17'h the troops made .n short movement in different 

117 





Amidst so many proofs of peculiarities of situation influencing the Epidemick, it is not intended to deny, that in the vast range which it took, there were many places, in which it not only failed in observing this rule, but even seemed to go right in the face of it. Thus, there were even whole districts, £8 Cawnpore and Juanpore, in which it affected all parts alike; without reference to their being high or low, damp or dry : — Others again, In which, though 

divisions, then halted for two days from bad weather; and again moved on the 20th to more favorable ground. A stationary camp then became necessary from the increasing numbers of sick. Luckily, the disease left them soon after this. The Rains continued with little variation to the 21st, with changeable winds. After the 22d, the wind was chiefly from the North West with heavy dews, and a clear atmosphere during the day : with exception of a few showers towards the end of the month. The mean heat of the month was 77 at sunrise ; 86 at noon : fluctuations from 15 to 82 at sun-rise; and 81 to 93 at noon. Nothing remarkable could be tliscovercd in the condition of the troops. They had recently been employed in the reduction of the Fort of Madhoonijgur. Their supplies of food and water were such as they had before generally used. Another division of the same force commanded by Brigadier Xnox, which was encamped on nearly similar ground in the valley of Ajmeer, was not at all visited by the Epidemick. 

Eittle can be said of the local peculiarities, under which ipearal in the Left Division of the Army, since ths ps were daily changing ground, both before, during, after the period ©fit* prevalence. All had been 

118 





!EFected particular lines, and villages, its liking those part?, was not to be explained on the position of greater general insalubrity, than tof the spots avoided by it. Lastly, there c even instances of its shewing a preference Jry and wholesome, over damp, and aguish ations : as in Allahabad, in which the lines he Native Artillery Details, lying in the low 

i»r a long time before on very active, harassing service, 'he main body, under the command of Major General lurshall, after moving from Seronj to Beresina, proceetdon the Ist of March to Kimlassa; where on the sth »ey were joined by several corps commanded by Briadier General Watson. All were then healthy. The hole Force now marched to Saugor, where they halt-1 from the 10th to the 16th; then to Dhamony, which ley besieged from the 18th to the 27th. Then they loved southerly, towards Jubbulpore. During March, le Thermometer ranged from 48 to 65 at Sunrise ; nd from 74 to 97 at noon, in tents. For 18 days the inds were from the North and West, with clear tmosphere ; the remainder from the South and East, with slight rain on the 26th from the West. The prevailing diseases were fevers, with congestions of the liver, and brain, and diarrhoeas from eating unripe grain. The troops got the Epidemick at Jubbulpore on the 9th or 10th of April, and carried it along with them in their march to Mundela, which they reached on the 21st. In the end of the month they moved back to Saugor, where they arrived on the 2tth May. The state of the weatner during April has already been described. Nearly the same fatigue whs undergone by the troop?, in rtconducting the train and stores from- Mundela to 

119 





swampy suburbs of the city, and much ex. posed to. putrid animal and vegetable exhalati. qm, were alone spared ; while those of the Euro. pean Invalids, which stood high and dry, and all around, was largely infected with the virus. J^ut these exceptions were comparatively few in number ; and should not be allowed to affect the general conclusion, founded on the large body of affirmative evidence previously adduced : that 

i^.iu^or in May, as in the two former months ; whilst kheat had considerably increased ; — .The Thermoine. ranging from 71 to 80 at sunrise, and from 9i to 109 oon. Early in the month, storms were frequent l the North and West with heavy showers; from the io the 27th the wind was generally westerly, hot and then there were a few days of cloudy calm weather; at the close, strong gales from the North and t, with rain. Fever, tertian and remittent, and hoea were frequent. Cholera continued in the Regiment, but less violent ; and reappeared ia 4th, which had been some time exempt j and in a chment of the 26th, which had come in from lloray I places adjacent to Saugor. A few cases also kred in the Artillery, but the other corps now kept free. All along, the Division had abundance ol sions ; the supply of water was from streams. 

The disease attacked the Nagpore Force when encamp* gn high ground, in a fine dry country, with neither lenor hills for many miles round — In like manner, t was no jungle or marsh in the vicinity of Hansi; the whole country, through which the troops movluring the prevalence of the Epidemickj was open 

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121 



the power and range of the Epidemick, the poison being once afloat, were always increased by such 

causes, as experience has shewn to exercise a marked agency in the generation and dissemination of Jail, Bilious, Remittent, and Intermittent fevers. 

Is the entire immunity of lofty and mountainous situations attributable merely to their being, from their greater altitude, less surrounded by those vapours, and less exposed to those extrinsic circumstances, which subjected the lower lands to the influence of the disease ? Or, was the peculiar poison of the Epidemick confined to the inferior strata of the atmosphere ? That this was not invariably the case, Was proved, by the pestilence getting over the ligh chain, which divides Nypaul from Tirhoot, and. Munniporc from Sylhet. — But the difficulty, with which it appeared to ascend these heights, md the perfect immunity of the elevated fortresses of Ilhotass,* Adjeegur, and Kallinjur ; of Kumaoon t t the Dhoon, and the hilly parts of liajpojtana, while all around them was infected, 

* We are assured, that whilst the villages situated near the woody base of lihotas mountain were suffering dreadfully, the only man residing near the top of the hill afected, was oxie, who went down and caught the disease in pc plain. 

f iiumaoon has s:nee been affected by the disease. 

Q 



>d rather incline us to believe, that there was thing in the air of elevated situations in. icaUy hostile to the existence of the poison, 









¦ THE CONTAGIOUS NATURE OF THE DISEASE. 

illE next point to be investigated, is, how he pestilential virus of the disease was comicable by Contagion. — If by Contagion, is fit, the communication of the disorder from on to person, by means of contact, or close ersation ; then, in this strict sense of the I, Cholera is certainly not contagious. 

In the absence of all positive proof, such a conclusion might have been fairly drawn, from its being observed, that in no quarter of India, during the time in which it was so sadly scourged by the disorder, did its infectious nature form any part of the popular belief. — Amongst a rude and superstitious people, the unexampled mortality caused by it, was, according to the fancy of the individual, ascribed to fatality, to the agency of malignant spirits, or to the anger of an offended deity : but it does not appear to have been once suspected, that its amount was increased, or diminished, by 

Q* 



the free, or restrained intercourse oi men. — it may be said, in diminution of the weight here attached to the popular persuasion, that the opinion of the vulgar is usually founded on misconception, or guided by caprice ; and is therefore, of little, or no value. — This is no doubt true, in res- X: of subjects, either foreign to their interests, or recondite for their understandings. — Eut, m ters of daily observation, and especially in those narrowly concerning the interests and safety of all, there is perhaps no fairer criterion of truth, than the common judgments of mankind.— The progress of any generally fatal disorder is exactly of this description; and accordingly we find, by looking into the histories of all the great epidemical and infectious distempers, to which the human race is subject : as the plague, small i measles, and scarlet fever : that the people i never slow to discover their true nature; ordinarily passed such judgments regarding 1, as corresponded, not merely with the opi-3 of more learned observers, but with the 1 itself. — So it is in the case of the present emick. — The whole body of the Medical ers in Bengal, who have had an opportunity eing, and remarking on £he disease, without senting voice, concur in declaring, that it is 

not contagious.* 

Ko this unanimity of conviction there was original* exception; but from more extended experience dividual has since modified his opinion. 

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125 



But, as neither the universal current of popular belief, nor the unanimous testimony of persons of the largest observation in the disorder, and most in the habit of weighing medical evidence, may be deemed sufficiently weighty to decide the point ; let us see, how far, a belief in its contagious nature, is consistent with the facts of the ease. — It may, then, first be remarked, that the rise and progress of the disorder, were attended by such circumstances, as shewed it to be entirely independent of contagion for its propagation — Thus we have seen, that it arose at nearly one and the same time in many different places; and that in the same month, nay in the same week, it was raging in the unconnected, and far distant districts of Behar and Dacca. — It will not be argued, that the virus travelled, or was conveyed, over the many hundred miles intervening between the cities of Patna and Dacca, within a few days ; since all experience proves, that where it really did appear to be communicated from place to place, — as along the course of the Jumna — its march was exceedingly slow: scarcely averaging a few miles a day.* 

* The distances, and successive periods of affection, may be marked in a few instances. — From Allahabad t<» Cawnpore, a distance of perhaps J2O miles, the uisen«c took from the end of March to the second watk ot' -April to travel; from Allahabad to Etawah, ISO miles, -i month ; from Etawah to Futtigur, GO miles, fourteen days; from Etawah to A grab, 70 miles, a month; from Agra to Cbelj 40 miles, ten days ; from A grab to Delhi, 



But, again, the whole habitudes of the disease, when once it had entered a town or camp, proved, that it was not kept up by infection. Instead of daily increasing, and being perpetuated by the very means on which it fed ; it invariably ran i regular course of increase, maturity, decay, and extinction. — Thus, in the Centre Division of the Army, it began on the 7th of the month ; was at its height from the 16th to the 22nd ; declined to the end of the month ; and finally disappeared aboii; the 2d or 3d of December. So in the Left Division of the Army, it commenced on the 10th of April; was at its full in the middle of the month; I lined from the 21st; and died away before beginning of May. — The case of the rpore Force is somewhat different. — The )s composing it fell at once into a medium ally fully impregnated with the poison ; and, lout passing through the primary stage, or ; of increase, immediately had the disorder in most violent form. — The only effect of this tige of circumstances, however, was to dimi- 

100 miles, 20 days; from Delhi to Meerut, 28 miles, nine days; from Delhi to Jeypore, 150 miles, a month; IJeypore to the Camp of the Rajpootana Force, 25 i, fourteen days ; from Jubbulpore to Nagpore, 180 ;, forty days. — From this comparative statement, it d appear that, admitting the successive propagation 6 disorder, it observed no regularity as to time.-distances are, it must be observed, marked from ;cture. 

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nish the usual period of the revolution ; for the disorder which began on the 31st of May, had abated previously to the sth, and nearly disappeared soon after the 18th of June. In the Raj* pootana Force, the sickly period was still shorter — The disease appeared on the 14th of September ; and continued violent to the 20th j after which it gradually declined till the Ist of October, when it wholly disappeared. Lastly, in the Hansi Division, it observed the same regularity .of course ; beginning on the 6th of August, increasing in severity for a time, and gradually becoming extinct towards the end of the month. 

Now, this uniformity of rise and declension, appears to be quite inexplicable, upon the supposition of Contagion. — For, if the virus were capable of reproducing itself, through the medium of the effluvia or secretions of individuals already infected; it must have gone on augmenting, until it either had no longer subjects, upon whom to exercise itself, or were counteracted by some means more powerful than itself: as uncongenial seasons ; or segregation, and the other prophylactic expedients, resorted to on such occasions. — Such at least, is the course commonly pursued by those great scourges, the small pox and the plague. — These, when once unfortunately introduced into a city, or tract of country, not only for a time remain attached to it ; but, manifestly depending on contagion, go on daily increasing, and perpetuating 

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themselves by fresh accessions of infectious matter, until they either have depopulated the place ; or are clwrcked by some of the counteract, ing circumstances just mentioned. Hence the frequent necessity of seclusion, and of a strict observance of all those salutary regulations, which, under the name of Quarantine Laws, have been, in times of such jeopardy, devised to secure the general safety.— -Had the form and progress of the present Epidemick, suggested tlu expediency of similar safeguards, they would no doubt have been proposed, and generally practiced, wherever it appeared. — But, excepting the Bi, wisely adopted in some of the camps in which disease largely prevailed, of moving from the vicinity of the dead, in quest of higher ground, and of a purer atmosphere — a step which could have placed no check upon Contagion, as many of the sick, and all the infected baggage, accompanied the main body, — no means of security whatever, seem in any case to have been thought of. The truth is, that all men were convinced, that they were wholly unnecessary. 

The opinion of the medical observer was, in nil situations, founded upon his noticing the following facts. — In his attendance upon patients labouring under the disease, he did not find himself, or his assistants, more liable to be attacked by it, thaivsuch persobs, ie inidno communication with 

128 





OF THE DISEA.SE. 

129 

the infected.* — He could not attribute his escape to the effect of precaution ; for he took none ; nor to the limited nature of his intercourse with his patients ; for the disorder, and the remedies employed in it, were such, that he was obliged to be constantly handling the body of the sufferer ; and could not with safety leave his bedside, during the height of the attack. — It might even be said, that in every case the patient and he breathed upon one another: So that, had the effluvium exhaled from the lungs or skin of the patient, been truly infectious, even in the slightest degree, he could have had no chance of escaping. — Next he saw, that where one member of a family was ill, the others were not more liable to get the disease, than an equal number of individuals picked out from the general body of the community. — This must be taken with some allowance. — Sometimes two or more mem- 

* This is a very striking fact. From a medical list, consisting of between two hundred and fifty and three hundred individuals, most of whom saw the disease largely, only three persons were attacked, and one death only occurred. — The fatal case took place at Barrackpore, a station very little visited by the Epidemick; the two others, which were not severe, occurred in the Centre Division of the Army. There too, one of the Surgeons of His Majesty's Corps was cutoff; the only Medical Officer belonging to the King's service known to have been affected. — In Nagpore the M«-tlical Staff remained for several days, night and day in the hospitals, and yet all escaped. 

n 



bers of one family were seized ; but in such cases, they were generally all taken ill together; were living in the same unwholesome situation; and had been previously exposed to some mani. festly strong exciting cause : as the eating of noxious food ; sudden vicissitudes of temperature; and the like. — In the rare instances, in which one fell ill at some distance of time after another, if we do not chusc to consider the concurrence as purely accidental, we shall be at no difficulty to explain it, upon remembering the depressing influence of fatigue, fear, sympathy, and griefall powerful predisposing causes.* 

!In camps, where the general body was more mpact, and the sick more numerous, and awded in smaller space, there was still ampler portunity of confirming the truth of these ob•vations. In no one instance were the doolev 

* A very striking example of the noncoinmunicability of the disease by contact was afforded in Colonel Gardner's Irregular Horse, which was attacked at Khassgunj in the Doab in August 1818. No two men were seized in the same hut, although from twenty to thirty troopers slept in each. A case exactly the opposite of this occurred in Lord Hastings' campi! Gorruckpore. A Sepoy died of the Pestilence. Five of the Corps, who had shown no signs of illness, were employed to carry the body to the grave. ThfJ wer« all seized with the disorder during the ensuing night ; and all died : This no doubt looks very suspicious ; but then we know nothing of the concomitant 

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bearers, native compounders, or any other part ot the large hospital establishments then necessarily kept up, — although all were often so hard worked as to be scarcely able to stand from fatigue — more sickly than other descriptions of followers; nor did the soldiers, who constantly flocked to the hospitals, to see and watch over their sick comrades, appear, by that means, to be more susceptible than others, of the disease. — Nor were those patients, who were ill of other disorders, although always surrounded by persons in every stage of Cholera, therefore more liable to be attacked; unless perhaps an exception be made in favor of convalescents : a class of persons always, from debility, much predisposed to fall into fresh disease. In the Centre Division of the Army all this was particularly remarked 5 and during the week in which the Epidemick raged with so much fury ; when the camp was a sick ward, and every tent was filled, or surrounded with the dead and dying ; the Officers suffered comparatively very little. From a number that could hardly have fallen short of three hundred, only five or six deaths occurred. And it should be remembered, that at this time Officers of all descriptions were equally exposed with the Medical men ; for the sick had become so numerous, that even the services of all were 

K stances ; which as in other instances of apparently s origin, might have been sufficient to do away uspicion of the agency of Contagion. 



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insufficient to tend them with proper care, and duly administer the requisite remedies* 

Let us now see, if these results deduced from general experience of the habits of the disease on a large scale, are strengthened by any such body of individual facts, as contraindicate the infectious nature of the poison. Here our only difficulty will be to choose the strongest, amongst a large number of instances bearing upon the point. To begin with the different Divisions of the Army. 

From the Centre Division, a few days prcvi. ously to the breaking out of the Epidemick, a small force, consisting of 4 troops of the 7th Regiment Native Cavalry, 3 Light Companies of Sepoys, and the Dromedary Corps, was |:hed on particular service in the neighbour. . A short time afterwads, the remaining iron of the Corps of Cavalry was sent as a brcement, from the great camp, in which lisease had then got head. It carried the i along with it ; and actually lost several j after its junction with the foregoing de« Kiment ; which nevertheless remained perfect, ealthy throughout. 

But, there is yet a still stronger instance of the possibility of a diseased body joining a healthy one, K out thereby communicating the infection to On. the morning of the 11th of May 1818, 

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133 

OF THE DISEASE* 

a detachment of 90 men of the Ist Battalion 2oth Native Infantry marched from an inferior post, to join the main body of troops then encamped at Saugor. After an ordinary march, it halted in perfect health, half way ; under shelter of a few trees on the banks of a small lake ; situated in the midst of an open space, about three miles in circuit, and surrounded by low, woody hills. The whole remained well until the fall of night; when Cholera broke out amongst them. The first man was taken ill at midnight, and died in half an hour. Several others felt sick within the next few hours ; and before sunrise, twenty out of the ninety were overtaken by the disease. Although the Saugor camp was distant only five or six miles, the detachment was too weak to move without assistance. The sick of the Sepoys and followers were therefore carried in, in carts and doolies sent from the main body ; but before 1 1 A. M. when they got to their ground, five were already dead, and two others moribund. Next morning, a man of the same party was seized in the act of scouring his accoutrements ; immediately became insensible ; and expired in a few minutes. During the three succeeding days, several others were taken ill ; and before the end of the week, of the whole Detachment, there was not a single man, but was sent to the hospital, labouring under Cholera, or other modifications of bowel complaints. The men of this party mixed promiscuously with 



those of the Saugor Iroops ; and yet 01 the lat> ter not one individual goc the disease. 

An instance of the same kind occurred in the Hansi Division ; except that here the party, Kch escaped, went into the infected medium, cad of the pestilence being carried amongst xi. When the disease was at the worst with the troops composing this Force, Casement's corps of Irregular Horse entered the camp, and oontinued with the Division during the remainder of the service ; yet it did not at all suffer. 

Vt may be supposed, that in these cases, the 50ns who escaped, owed their immunity to their not having been long enough exposed to the poisonous matter; or to some incidental peculiarity in their condition, for the time being. But, then, we shall find, that the same irregularity obtained, where those remaining unaffected were for a long period surrounded by the supposed infectious atmosphere ; and in all respects similarly situated with others, who suffered severely. Of the latter, a remarkable example was afforded in the Left Division of the Army, I Ist under the influence of the disease. Here 7th Regiment of Cavalry, and the 2d Batta-13th Regiment of Native Infantry remainentirely exempt;* and the 2nd Battalion 

* It is true, this and other instances to be cited, may be in some measure accounted for, by the Corps having €&ri!t'd exemption by previous exposure to the innf* 

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135 



Ist Regiment had only three mild cases ; w.ule the Ist Battalion 14th, and the 2nd Battalion 28th Regiments Mere greatly affected. The same partiality of affection here took place among different classes and descriptions of troops. — The Goolundaz, gun lascars, and miners were mildly affected ; while the pioneers, drivers, &c. who had undergone the same vicissitudes of weather, and fatigue, were not at all touched. — Some corps lost more than a hundred, others only three or four men. This could not arise from separation, or difference of situation and diet; for all used the same food j and there was constant intercourse, and daily change of ground. — The same observation may be extended to the Rajpootana Force, of which the right suffered more than the left portion — In Furruckabad Lines, the Jail and the Artillery Barracks, the former containing six or seven hundred prisoners, subject to great privations, and daily worked in the sun upon the roads, and the latter inhabited by 100 Europeans and 250 Natives of the I'2-pounder Experimental Brigade, had not a single case j whilst the Levy Corps suffered severely. The case of the Native Artillery Lines at Allahabad, which escaped, although in the very centre of the pestilence, has been already alluded to. — Bat at this station, there was something yet more to our pur- 

ence of the disease ; whilst forming part of Colonel Philpot's Detachment from the Centre Division. 



pose. For of 400 Supernumerary Invalids, assembled there for examination by the annual Invaliding Committee, not a man was affected; although they were living, under perfect simila. rity of circumstances, in the Lines of the Rcgu, lar Invalid Battalion, the men of which, in four. teen days had 50, of 680 their total number, tick of the disease. — So, while the disease raged virulently at Banda, not a man belonging to the 2nd Battalion 3d Native Infantry station. cd there was affected. — At Hutta, again, a heal. thy town on the banks of the Sonar in Bundlekund, the Epidemick committed such ravages, that the inhabitants fled, and took refuge in the neighbouring villages ; and so virulent was the poison, that three Sepoys and seven camp fol. lowers of the 2nd Battalion Ist Regiment were led, merely on that Corps marching through place. — And yet, the disease never appeared mgst a Company of Sepoys, or their followers, then in the fort, which was divided from the town only by a broad street. — What here served to Ren these men from infection? Certainly uspension of intercourse between the town and fort ; for this always remained free ; much less superior salubrity of situation, for the fort Ismail, and crowded with buildings, and the i high, and open. — Thus too, whilst the ise raged in Saugor, and in the lines of the Battalion 26th Native Infantry about a and a half distant ; not a case occurred in 

136 





the fort in the centre of the town, which \va s then garrisoned by 200 men of the 2nd Battalion Ist Regiment. — In like manner, in Kotah, three Companies stationed in the fort escaped entirely; whilst one hundred persons were daily perishing in the town. — And at Muhcdpore, when the Epidemick prevailed in the vicinity, and was daily attacking a detachment of Bengal troops, consisting of part of the Ist Battalion 6th Regiment Native Infantry, two Rissalas of Skinner's Horse, and 1500 Camp followers, it entirely spared a body of 500 of Holkar's Reformed Horse j although the two :amps closely adjoined, and a man, who had >een sent in from the Bengal Division after jetting the disease, went through every period >f it amongst the healthy Mahrattas. If the rims were capable of being procreated by Con* agion, surely the poisonous particles emanating rom the body of this infected person, would lave been sufficient to support and diffuse it all round. — For, this body, having an infected erson in the midst of it, was, except in respect f numbers, then in the precise situation of the irger Divisions of the Army; in which the disase always began with one or two unconnuced cases ; slowly, and gradually creeping on to neteracy. — With it, all that was wanting, was X' peculiar disposition to take on, and keep up ie diseased action ; and this being absent, the upply of vitiated matter, which, in small pox 

S 

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and other distempers, confessedly contagious, would have sufficed for its continuance, proved quite innoxious. 

We should fall into endless repetition, if we went on citing the great variety of evidence, which might be drawn in support of the doctrine of non-contagion, from the general progress of the disease, through the districts and towns successively visited by it.* Let the reader only call to mind the innumerable detached spots, which remained free, when all around w* sickly ; and remember, that in no single case, \va< any restraint placed, on free intercourse between » healthy and diseased ; and he must come tv conclusion, that the Epidemick was totally independent of the common laws of Contagion. 

Eut, as it cannot be denied, that there were c circumstances in the manner in which the disease arose both with the Hansi and Centre Divisions, militating against this opinion, let us, before leaving this part of the subject, examine them a little more narrowly. 

* One case is too remarkable to be passed orer. Of the cluster ef islands lying near the main land, as the Ganges discharges itself into the Bay of Bengal, Sundeep, a large and populous place, remained quifl free ; whilst those of Deccnn Shahbazpore, Human, and Bomney were ravaged. There was nevertheb constant and crcat intercourse between all. 

138 





139 



The persuasion of all the Medical Staff present with the Ilansi Force, regarding the mode in which it received the infection, has been already quoted. It consisted in the belief, that it was communicated by the Meerut Detachment, who got it on passing through Delhi, at the time of their crossing the Jumna. — The opinion of so many intelligent persons, is no doubt entitled to much respect; and would entirely set the question of Contagion, in that sense of the word in which by infection is meant the commmunication of the disease from one large body to another large body, at rest ; were it not counterbalanced by some circumstances of an opposite tendency — If we believe, as stated by one gentleman, that before the junction of this detachment, the disease had already found its way to several places intermediate between Delhi and Hansi, and Delhi and Kurnaul, we can be at no loss to account for its rise in Camp, without resorting to abelief in Contagion. — For, the Camp presented to the Epidemick exactly that face of things, which we know to have been always particularly affected by it ; namely a large body of men collected within a narrow space. — We are accordingly told, that previously to the junction of the Meerut Detachment, one or two cases had actually occurred amongst the Camp followers. — Admitting this to have been the case, the certain consequence of the great additional stock of pesti« 

S 2 



lid matter imported from Delhi, would be to •avate, and widely diffuse the disorder ; and whole mischief might very naturally be plac. Ed to the account of the new comers, by persons unaware of its having begun to operate, though in a less degree, previously to their arrival.— However this might have been, there were no grounds for supposing, that, even here, the disease ¦ communicable from person to person ; and Medical Officers are unanimously of opinion, that it was certainly not so. 

The case of the Centre Division is encompassed with still greater difficulties. The main body of this Division . crossed the Jumna at Shergurh on the 28th October: and after one or two days halt, marched, in a North Westerly direction, towards Loharee, Nuddeeka-gaon, and Teravt.— A Detachment, composed of 5 Companies of the 2nd Battalion 13th Regiment Native Infantry, and two Companies of Pioneers, was left behind, in charge of the bridge of boats thrown over the Jumna. — It was here, that the Epidemick first shewed itself. A few cases appeared as early a^ the ftad of November, in some troops then passing over ; but on the sth, the disease became common in the Detachment on guard. — On the 9th, this Detachment joined the main body of the Army at IVrayt ; and it is declared by some of the Medical Ofhcers then on the spot, that during the two immediately subsequent days, the disorder was <iK 

140 





observed in Camp. — In support of the opinion, that this Detachment brought the disease into the previously healthy Division, it is added, that the 2nd Battalion of the 13th Regiment was brigade d to the left of the Ist Battalion 24th Regiment "Native Infantry, and the Ist Battalion of the 24th o the left of the 2nd Battalion 11th Native Inantry ; and that the 24th was attacked before the lth. Lastly, in further proof of the coinmuniativeness of the virus, it is affirmed, that the previously healthy villages, and among other placs the town of Sumptcr, got the infection from Kivision. — This is the amount of facts in of the disease being capable of transmisy a large body from an infected, to a disalubrious atmosphere ; and thus commue by contaminated, to healthy individuals. 

It must be confessed, that this evidence is very strong, and would prove quite conclusive of the matter, were it to remain unshaken. But, unfortunately for the hypothesis meant to be established by it, there is hardly one item of it, that is not opposed by circumstances of a contrary tendency — And, first with regard to the appearance of the disease in the main body of the Division, the testimony of different individuals, is so much at variance, as to be quite irreconcilable. — Of twelve Medical Officers, who have given replies to the queries on this point, one states the disorder to have broken out on the Cth ; two on 

141 





the 7th j one on the Bth ; two on the 9th ; one en I 10th ; four on the 11th; and one on the i. This discrepancy, however great, is easi. xplicable, when the insidious nature of the •ise at its first onset is taken into account; when it is recollected, that the sphere of i individual's observation, would hardly go )iul the Battalion immediately under lm ¦gc. — But, how are we to reconcile the asser. of its having appeared on the 6th, 7th, Bth, or even the 9th, with the assumed hypothesis of infection from the Shergurh Detachment ?• 

In like manner, the fact of the Division com. licating the virus to the villages lying on its ;efrom Terayt to the Betwah, is equally disid — It is held by some, that those villages c not at all affected j by others, that they had disease independently of any intercourse with Division ; and by a third party, that the latter riably carried the infection along with it,— gentleman, having several times sent his Na- 

* We are assured by a gentleman, not of the medic.nl profession, but perfectly capable of ascertaining the fact, that the disease was brought into Camp at Terayt on the f)'Ai by the Raja of Sumpter's troops, who came in lor t. ; purpose of being reviewed, and took post in the idfc of the 25th Regiment Native Infantry. — And it was reported to the Commander in Chief, that in the town of hat name ravages had been committed by it, six weeks utioi'c tiic crossed tlic Tiiimvi 

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143 



ye assistants into the district, was uniformly told, lat the pestilence was not amongst them.* Anoler declares, that all the neighbourhood was ckly : the dry and clean town of Suinpter, jually Math the low and filthy village of Nuddeeaon. A third, that the Army having on the 13th inarched from Terayt to Talgong, the inhaitants of the latter place got the disease the fol- Wing morning ; and a fourth, that Sileia w^s rst affected, on being entered by the Division n the 19th. 

Under such extreme contrariety of testimony, it would be vain to attempt drawing any certain conclusion. — This much, however, may be affirmed, from a review of the whole progress of the lipidcmick in this quarter, that the infectious medium, in whatever it consisted, was confined within a very circumscribed circle ; and was very s>owly extended to healthy parts of the atmosphere — If, setting aside the circumstances militating against it, we take it for granted, that the infection was truly received by the Centre and Hansi Divisions from the Detachments above mentioned, we must believe, that the disorder, although not communicable by con- 

K>l. Philpot's official reports state positively, that inly scattered villages oil the route of his march led unaffected ; while his Detachment was suflVr•y severely. 



tact from person to person, was so from one large; body to another large body ; and that, wherever the poison got head amongst a number of men, it assumed some new quality, so as, when mixed with the atmosphere, to become infectious.— What constituted this additional quality, we can* not pretend to determine ; but, in support of its existence, we may quote the predilection of the Epidemick for cities and camps ; the infection of the Left Division and the Nagpore, and Memit Troops, immediately after entering into the diseased, medium at Jubbulpore, Nagpore, and Delhi ; and the similar case of the troops, and followers in attendance upon the Governor Ge. neral, being attacked shortly after communicating with an infected village, in the Gorruckpore District. — To the same account may be placed, the progressive march of the disorder from one part of an infected place to another ; a* in the Centre and Hansi Divisions ; and more particularly, the Rajpootana Force, in which the virus seemed to be regularly propagated from Corps to Corps.* — In some instances, 

* The line of this Force faced nearly North and by Last. The troops were arranged in the following order, commencing from the left. The Ist 'Battalion 28 tit Native Infantry : 6th and 7th Companies Pioneers ; Goolundaz and Gun LoKartJ the Park in the Centre; 5 Companies Ist Battalion European Artillery; Ist Battalion 27th Native Infantry j Squadron 2nd Regiment Cavalry ; 2d Local Cavalry ; in the rear of the park 

144 





the suffering body would appear to have sickened 

immediately upon coming into the poisonous medium ; as was the case with the Nagpore Troops, who were affected on the very day in which they encamped at the infected village of Gaongong. — But, more frequently, one or two 

days would seem to have been requisite to bring the virus into action. — Thus the Meerut 

Detachment entered Delhi on the 29th, and was not affected till the 31st; thus too, the Hansi troops had not the disease till the Oth, the day after the junction of that Detachment. — Again, by those abetting the opinion of the disorder beincc communicated to the Centre Division by the Shergur Detachment, it is stated, that the first cases occurred on the 11th, two days after its junction. Lastly, the followers of the troops in personal attendance upon the Governor General in April, first suffered on 

were 4>15 Ordnance Drivers, with lines of Officers' tents intervening. The Ist Battalion 28th and Goolundaz were attacked on the 14th September; on the 15th a 

few cases occurred amongst the Pioneers and Lascars; but among them mid t&e Gunner Drivers they were 

not numerous till the 19th. On the 15th the squadron of Cavalry was attacked ; and on the 20th, the Local Cavalry, and Ist Battalion 27th N. I. It must, however, be remembered, that the ground was drier on the right, than on the left of the line. 

T 

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the 23d, three days after encamping near aa infected village.* 

»The disease recently appeared in a Detachment of Rajpootnna Force under such circumstances, as at seemed to warrant a suspicion of the existence of itagiou. A Detachment consisting of a troop of tho Regiment of Cavalry, two Companies of the Ist Battalion Ist Regiment, and one Company of the Ist Bat. talion 6th Regiment Native Infantr)', left Colonel Camp in March for Indore, to meet the Escort of Chimnajee Appa. In this Escort were four Itisahif t Skinner's Horse ; which had come from General ith's camp, South of the Nerbudda ; and from the c of their leaving it, had been affected with Cholera, the 22d of March, the disease appeared in the Detachment, then at Oujein ; and between that day and the 37th, when from the judicious means of separation and constant moving resorted to, it disappeared, forty cases, 37 in the Ist, and 9 in the 6lh Regiment, occurred : of which 8 of the former, and 3 of the latter proved fatal. There were likewise seven deaths among the Camp followers. No case occurred in the troop of Cavalry. Whilst this Detachment was performing quarantine at a distance of twelve miles, a similar force sent to take its duty was not affected in March; although Skinner's Horse and the Mahrattas marching only a few miles in their rear, were daily losing men. It would appear, but at what precise time is not men* tioned, that the disorder during the following month attacked the main body of Colonel Ludlow's Force stationed at Onail, about twenty miles distant from Oujein. The second Detachment with Chimnajee, had apparently become affected previously to this ; and like the former had been secluded During April six 

146 





147 



fresh cases were admitted into hospital from the Ist Battalion Ist Regiment j of which one only was fatal ; of 20 bearers and workmen 4> died. Of the 6th Regiment, 19 Sepoys w ere seized, and seven died. In the 3d Cavalry the disorder was slight, and only two grooms died. \V hen the disease got into the lines at Onail, the first person seized was a blacksmith, who died in a few hours. The brother of this man was attacked whilst bathing, after burying the corpse; and next morning a third inmate of the same tent ; but not an individual in the tent of the Ist Grenadier company Ist Regiment, which was only six yards distant, was seized from first to last. A case nearly similar occurrtd in the 6th Regiment. A Sepoy died of the disease. A Naick who had been sitting up with him, was attacked as they were closing his grave, and likewise died. But, not a single patient in hospital, nor any of the attendants, who slept close to the sick, breathed the same air, and were constantly lifting them up and laying them down, and rubbing their bodies with oil, were attacked. This is the sum total of the proof in favor of the contagious nature of the disease in this quarter. But in fact it amounts to nothing. Unfortunately we have no particulars regarding the seizure of the blackfmith's brother and companion ; but is it not more likely that their illness was ascribable, as in innumerable other well ascertained instances, to ilie depressing influence of fatigue, grief, and the other usual predisposing causes, than to infection ? How was it with the Naick ? His case is at first sight equally suspicious ; but fortunately we know more of i^ts concomitant circumstances. He had attended the Sepoy his friend during his illness, and wailed over him when dead ; and after a night of sorrow, when exhausted by fatigue, mental anxiety, and 

T2 



fasting, he followed his corpse to the grave, to a comiderable distance, in the heat of the forenoon. But thu is not all ; for it appears that, when heated by several fiours exposure to the midday sun, he incautiously drank a large quantity of cold water, and was immediately taken ill. So that in his case, we have all that constitutes the essence of the predisposing and exciting causes of the disease. It may be said, that the benefits derived by this Division from segregation proved the contagious nature oftha Epidemick; but in other quarters change of ground and scene had invariably the same good effects, without the aid of separation. The gppearance of sickness was here preceded by exactly the same atmospherical phenomena, as in almost every other part of India. Easterly winds ; very hot days ; and great variations of temperature between the day and night. The probability is that the whole atmosphere in that quarter soon became corrupt ; for a Detachment ofthe2d Battalion sth Regiment Native Infantry and of the Ist Corps Local Cavalry at the same time got the disease, and lost thirteen men, when encamped «v the bank 9 of the Miah River, where no mode of conveyance of the virus could be traced. Bat there too the days were very sultry and the nights chilly ; and the men had been indulging in eating unripe mangoes. No case of recurrence of the disease appeared in any ot thes« Detachments. Most benefit was derived from the free use of Spiritus Ammonia Compos itus, in doses ot 70 and 100 drops. 

148 







OF THE PREDISPOSING AND EXCITING CAUSES OF THE EPIDEMICK. 

ON these points, so much has been already said, whilst other branches of our enquiry were under discussion, that they cannot now be largely entered into, without the frequent repetition of many things previously mentioned, and yet fresh in the reader's memory. — But, as they are of sufficient importance, to require being treated of by themselves, in a Report professing to contain the results of general experience, we shall now proceed to notice them as cursorily as possible ; endeavouring to avoid the introduction of 

ill unimportant facts. — In so doing, we need not >c very anxious about the separation of the Vedisposing and Exciting Causes; for these two :lasses so much run into, and take the place of ach other, under different circumstances, that vhat in one case is a predisponent, in another cts simply as an exciting cause. — Thus, expoure to the heat of the sun, which was in all ases observed to be a powerful exciting cause, wuld, when long continued, or renewed during 



many successive days, b ecome a predispo. sing cause, by inducing fatigue or debility.— So, kiany other instances, the two classes were ually convertible. 

Of the causes strictly Predisposing, debility, in whatever way induced, was by far the most powerful, and most generally present. — To its operation, we are chiefly to ascribe the fact so universaliy observed, that the lower classes— those badly fed, and ill cloathed, and lodged,— sut. fercd more than persons in better circumstances of life. This was particularly remarkable in the different Divisions of the Army visited by the disease. — Thus in all of them, the Hindoo, who lives chiefly on poor, crude, and ascescent vegetables ; and is in all respects both of diet and cloathing sparing of expence ; was more lileI ile to be attacked, than the Mussulman, who i flesh meats ; sometimes uses spirituoustors; and is generally warmly dressed, and coinably lodged. — For like reasons, the European iier was less subject, than either rlass of the :ive troops ; and the European Officer, in, less so than the Soldier. — How much l depended on the possession of greater bodily strength and power of resistm? disease, was demonstrated in the rase i the European Flank Battalion, the men of which had been previously debilitated by attacks of the ]v)idemick fever at Allahabad durincr the forcj^ 







i:igyear. This Battalion suffered, accordingly, more than any other with the Centre Division. Of 800 officers and men, it had at one time 200 in Hospital ; and it buried its Surgeon and 5* men. — In like manner, convalescents, whose constitutions had been weakened by previous disease, suffered proportionably more, than persons of sound frame. — Many were taken ill, whilst under the influence of mercury, used for the cure of fever, hepatitis, and lues. — Thus too, persons of sober, regular habits, enjoyed greater immunity, than the drunken and dissipated ; who kept irregular hours, and were frequently exposed to the vapours and cold of the night, alter a debauch. 

The second great Predisposing Cause vtsls fatigue, accompanied with, and aggravated by exposure to the sun by day, and cold by night. Thus in Calcutta, it was remarked, that the men working in the open Dock Yards were far more frequently taken ill, than persons of nearly the same descriptions employed under shelter in the Cotton Screws. In respect of diet and mode of life, the advantage was undoubtedly in favour of the former, who are generally mechanics on high wages, whilst the latter are common Coolies, or day labourers of the poorest order. — For the snme reason, fishermen, boatmen, husbandmen, gardeners, travellers, bearers, washermen, and 

151 





B>ners working on the roads, suffered dreaj. 

i be ill effects of fatigue were particularly strike n the case of the Left Division of the Ar—All classes of this Division, for many days iously to the breaking out of the Epidcmick, undergone great exertion, in the sun by day, in the cold of the night, whilst conducting a y train, through a difficult country, to Mini. riela ; and accordingly suffered severely. — The Gnd Battalion 28th Regiment, which lost more men than any other corps, had been left in the rear to conduct the store carriages, and had necessarily gone through greater fatigue and expo*. sure, than the main body. 

In the Centre Division, again, more individuals were taken ill during the night, than in the day ; and more, previously to moving from their ground in the morning, when the troops were constrained to stand long in the cold heavy due, and at the termination of a long fatiguing inarch, than at any other period of the twentyfour hours. — Thus too, persons on picquets and night guards were almost certainly attacked ; and the succession of seizures was so quick, that it was more than on.cc necessary to relieve the sentries three times, during the two hours, which it is customary for them to stand guard. — This was especially the case with the artillery, of which 

152 





153 

CAUSES OP THE EPIDEMICK. 

scarcely a man on guard during the night escaped; and of the whole number seized, two thirds were taken ill between sunset and sunrise. Here tod, the different degrees of susceptibility amongst different descriptions of persons were very remarkable — The bearer, and Kkulassee general* Jv ; and with the Artillery, the Drivers and men. of the Magazine Establishment; were attacked in much larger proportion, than the regular Soldiers; because they were inferior in strength to the Sepoys, and Goolundaz j had no tents ; received less pay ; and were worse clad and fed. 

In Agra, and other Cities of Upper India, where it is the custom of the Natives of aliclasses 1 to sleep on the tops of their flat roofed houses, dv- Iring the great heats of summer ; the effect of exf posure to the cold and dew was particularly E exemplified : for the greater number seized were [ persons so situated ; and few escaped of such, as I having heated themselves during the day, lay [ out during the night, with little or no covering, fOn the other hand, almost all the gentlemen's Servants, who took to wearing woollens on the ghange of weather, continued in good health. A Bike circumstance was also marked in the Cen- Rre Division ; but there it was confined to the j Establishments of one or two Officers. Lastly, | Jong fasting, by disordering the functions of the j Itomach, and paving the way to indigestion, |*as a frequent precursor and cause of the disor. 

U 



Vik 

OF THE PREDISPOSING AND EXCITING 

der. Thus in the city of Delhi, where the Epide. Mick happened to prevail during the great annual fast of the Ramzan, in which it is unlawful for Ma. bometans to eat, while the sun is above the horizon, a much larger proportion of persons of that per. suasion suffered, than of the Hindoos, who were not similarly restricted as to the times of their meals.* 

It was observed, that individuals daily per- 1 forming a moderate portion of work, especially if I under shelter, were far more exempt, than those I who were alternately idle, and fatigued by In I vy labour. Thus the persons employed in the I Silk Filatures in different parts of Bengal, who I are engaged from morning to evening in tasks I of a light nature, suffered very little ; whilst 1 coo/ecs, and all classes casually bearing burdens,! or going long journeys, were frequent victiml fi reason might be, Uiat the bodies of the! ier were kept in good condition, by a sti-l quantity of labour ; whilst the latter were I one time exhausted by over exertion, and I another lay indolently asleep on the colill' 

If we were to look for an Epitome of all thai composes the Exciting Causes of Cholera, wf. 

* The greater prevalence of the disease generally^ the month of Uamzun, is remarked by Aviccnna, who* experience in the Kast gave him lull opportunity Ij ODscrviijg the fact. 



need only refer to the appearances presented in the Chittagong District, during the Hot Season of every succeeding year. This district is formed by a narrow belt of land, extending about two hundred miles from North to South ; bounded by the sea to the West ; and by lofty ranees of mountains to the East and North East. The surface of this tract is irregular, and interspersed with low hills, and rising grounds ; covered with brushwood, bamboos, and forest trees. The intervening flats are highly cultivated; and rice jbeing the chief produce, are quite dry during ( 'the Hot Season. The soil is light and sandy; and ithere are no swamps or marshes throughout the fdistrict. From the month of March, as the Sun tscends, strong Southerly winds begin to prevail. 

The atmosphere then becomes moist and cloudy j ftith great heats and occasional falls of rain duing the day ; and nights calm and sultry during he early part, and cold, with a chilly air from he East, towards morning. The effect of these reat diurnal vicissitudes upon the human body, 

I very striking. The moist wind from the sea, rul the stagnating air of the evening, produce rofuse sweats, relaxation, and great nervous ir- 

I lability ; and thus render the frame, especially [lring sleep, extremely sensible to external imressions; essions; and fit it for the reception of disease, l this state, it is acted upon by the cold wind id dew of the morning ; a strong check is ini_ 

U Z 

155 





mediately given to the previously violent peispi. rations ; the blood is driven towards the centre ; and that disturbance of the circulation, which we know to be one of the early attendants on Cholera, is thereby superinduced. This disease is accordingly endemial in the district during the Hot Weather of each year ; and does not subside until the air is cooled, and the atmospheri. cal temperature becomes more even, after the setting in of the regular Rains. 

We shall find, that causes of the same description, that is, great and sudden vicissitudes of the weather, from hot to cold, and from dry to moist, accompanied with changes in the direction of the winds, were almost uniformly in operation, wherever the late Epidemick shewed itself j and were generally the immediate precursors ofiti visits. It has been already seen, that in Cal. cutta, and other divisions of Bengal, its first El preceded by a long course of unusually and sultry weather; and that its subfc periods of increase and decline were modified by changes in the weather, n February 1818, and April 1819, the st marked periods of its aggravation, the >re sultry, and the nights cold and raw; javy storms from the South and East is in almost every part of the Lower Prom Jessore, Burrisaul, Dacca, Sylhet, ron"-, Nuddeea, Rajshahy, Bhaugulpoie, 







Monghyr : as well as in tne valley of Khatmaudoo, and in many ether stations. At Patna, the weather had been very hot and dry some time before its appearance. At Buxar no rain had fallen for nearly a month ; the days were exceedingly oppressive ; and the nights chilly, with heavy dews. — At Allahabad, although no great changes occurred in the range of the thermometer during the night and day : the mercury generally fluctuating between 81 and 91 : tie air was very sultry to the feel. — At Cawnpore again, the thermometer ranged from 72 to 112 during the whole of April and May, when the disease prevailed in the town ; and in Lord Hastings' camp in Gorruckpore, the mercury in tents stood at 80 at sunrise, and at 110 at noon. At Futtygur, the weather had been insufferably hot, and not a drop of rain had fallen for a month ; when a heavy Northwester occurred on the afternoon of the 9th of June, and next morning the Epidemick was first seen. So, in Agra, the morning and day of the Ist of July were exceedingly hot ; the thermometer stood at 96 in the shade ; and not a breath of air stirred. At 6P. M. a gale of wind from the East suddenly came on ; the air at once grew damp and chilly ; and next morning many persons were carried oft' by the Epidemick. And during the whole period of its continuance, the days were very hot, and the nights cold and moist ; with a keen penetrating 

157 









wind : the thermometer ranging from 84 to (H. But as the wind came round to the West, and the weather became steady, the disease withdrew. In Delhi, the rains had been very abundant, with Easterly wind, from the 20th- June; the whole country was covered with water ; and the atmosphere was loaded with moisture. At this time, not a case of the disease appeared. But, as soon as the wind veered round to the west, and brought with it a great change of weather ; sultry days and chilly nights, with the thermonieter varying from 72 at sunrise to 96 at noon ; the mortality began ; and continued unabated, until a recurrence of Easterly wind, and an abundant fall of rain, drove away the disease. Thus, the city continued free so long as there was simple moisture, with moderate, equable temperature ; but became sickly the moment the westerly wind produced great evaporation, and alternations of heat and cold. At Meerut, the weather was perfectly seasonable, with frequent heavy falls of rain, during the three first weeks of July. But, from the 24th until the 29th, when the disease broke out, there was not a single shower; the thermometer then fell four degrees below the monthly average ; and the nights became sensibly cooler, with heavy dews. Jeypore became affected immediately after the cessation of heavy rains ; and Saugor, and all the towns and posts in its vicinity, during the Hot Winds ; when the days 



ivery warm, and the nights so cold, tiiat s and blankets were used. But, without uing the reader with a vast number of ny res, aJI in proof of the same fact, we shall advert to the condition of the different ions of the Army, with res-pect to climate 1 severally attacked : as very strongly evinohe unvarying connection of the Epidemick marked vicissitudes in the atmospherical erature, and an unsettled state of the 

"With the Hansi Division, for some time before the appearance of the Epidemick, little, if any rain had fallen, and the heat was great: tlie thermometer generally standing at 96 at noon. The disorder^ however, after having once begun, continued with the Troops during wet and variable weather ; and then it was remarked, that such Corps as had brought their cloth pantaloons with them, as the 2Gth Regiment, suffered less, than those who had not, as the 29th Regiment* 

The Epidemick appeared in the Centre Division in the beginning of November. Of October, the first eight days had been cloudy, with Easterly wind, occasional falls of rain, and the thermometer ranging from 79 to 90. From the Bth to the end of the month, with little variation, the wind was strong from the West, and 

159 





!ury towards the latter part falling as low as ; sunrise, and keeping as high as 98 and 99 oon, and from 84 to 96 at sunset. The extraordinary fluctuations in the range of thermometer were remarked during the and middle parts of November : the raeri,uiy from the Ist to the 17th standing from 50 to 60 at 6 A. M. ; from 84 to 99 at noon ; and from 63 to 90 at 6P. M. ; the wind still keeping Westerly. About the sth, the effects of these sudden transitions began to be more marked than. before -, the days became insupportably oppress, rnve ; and the nights extremely chilly, with heavy dews, and fogs in the mornings. From the 6th to the 13th, Hie period within which it is agreed by all, that the Camp was first affected by the pestilence, the thermometer was never higher than 51 at sunrise, nor lower than 84 at noon. On the 6th, it was 50 and 90 ; and on the 7th, 45 and 90. These it will be remembered were the days during which the earliest ca^es, in all probability, occurred. About the middle of the month, the difference of temperature between the day and night became less ; and the disease sensibly declined from the 17th ; and wholly withdrew towards the latter part: as the E lions grew more equable j and the weather me such as is usual during that period 

The reader will fiiul Meteorological Tables for the 







It will be observed, that with this Division, moisture had nothing to do with the -production of the disorder : unless, indeed, we suppose, that the dews and fogs here stood in the stead of rain j abstracting the heat of the body by primary application, and subsequent evaporation. The sky was clear and serene, and throughout, light and dry. In like manner, the disease appeared in the Nagpore Subsidiary Force, and in all the towns and villages in its vicinity, when the weather was exceedingly hot and dry ; the thermometer ranging from 76 to 90 in the Officers, and 120 in the Soldiers' tents ; and wholly departed from the province, as the heavy rains, which fell in the middle of June, cooled the atmosphere. But, with this Force, probably, no exciting cause was necessary ; as it fell at once into a strongly impregnated pestilential medium; and was overtaken by the disease without any previous preparation. 



There were groat vicissitudes of temperature with the Left Division during the early and middle parts of April} with daily storms of thunder and rain. The days were extremely hot ; the mornings and evenings foggy; and the nights so cold, that blankets were required : the ther- 

Iber, with this Division 1 , annexed to the introductory fciscourse on the Wcaihcr. 

V 

161 





mometer ranging from 45 to 78 at Jay break, to 86 — 103 at noon. 

When the disorder broke out in the Rajpootana Force, a different state of weather prevailed. From the Ist to the 14th September, there was only one day's intermission of rain ; and the atmosphere was exceedingly cold and damp, There was continual small rain during the whole of the 13th, the day preceding that on which the disease broke out ; and the air was very raw and chilly. On the 21st the rains began to cease j and with them the Epidemick, 

We shall only mention two other instances, in which the j)ernicious effects of cold and moisture w T ere especially remarkable. From the 9th to the 15th August, the 2d Bn. 19th Regiment, then encamped on low ground, under damaged tents, in very rainy weather, at Mundessore, was severely visited by the disorder. Of thirteen sepoys taken ill, six died. After a few days, the Battalion moved to a higher spot ; and although one man was taken ill during the inarch, not a case occurred after it reached its new ground. So, with the Ist Battalion 6th Regiment in Malwa. This Corps, with a large body of Camp followers, on the 4th of May encamped on the R banks of a dry river bed at Jhanoor, three sivelv hot .A-t l) 1' iVI hfiw ruin pimG on * and 

162 





CAL'SES OF THE EPIDE3IICK. 

163 

Iliermometer, from being at 100, fell sudden-80. The disease, which was not then ki leighbourhood, attacked the detachment morning* 

It appears then, from the foregoing examples, that the principal exciting causes of the disease may be enumerated in the following order, according to their degrees of priority, and frequency of operation, lstly. Alternations of heat and cold, combined with rain, or a very humid state of the atmosphere. 2dly. Simple alternations of heat and cold, without moisture. 3dly. Excessive heat, without cold or moisture. 

We have yet spoken of these causes, only as they seemed to affect the health of large bodies, or of many persons at once. There was still another set of agents, confined in their operations to single individuals ; and the erTects of which, following instantly upon their application, could be immediately, and distinctly traced. Of this sort were the drinking of large draughts of good, or bad water, when the body was heated ; gorging after long fasting ; eating food of a deleterious quality; going suddenly from a hot, into a cold atmosphere; lying exposed to the wind when the cuticular pores were open, and the perspiration was flowing freely. In every part of the country, nothing was more common, than to see a person attacked by the disease, immediately on 

v i 



drinking a large quantity of water, after a lonr walk, or exposure to the sun. But in the Camp of the Centre Division, where the water was foul, scarce, and only procurable at considerable dis. sances ; and the Sepoys and followers drank gree. dily from every muddy puddle on their march ; hundreds were affected in this manner. So, in the Nagpore Force, where the heat and thirst of the men were excessive, the most fatal cases were brought up from the beds of the rivulets, in which the Sepoys had dropt, during the line of march. The mischievous consequences ofcating bad, raw, and indigestible food were equally remarkable. It would appear, that during the year, in which the Epidemick arose, much bad rice had been grown in Bengal ; and there seems no reason to doubt, that grain of this noxious description, when taken into the stomach of a person predisposed to the disease, frequently induced the attack. There was, at the same that, great scarcity in all parts of the Upper Provinces. All kinds of grain were very dear ; and the lower classes of the inhabitants, being able to purchase only the poor and unwholesome sorts, often fell victims after swallowing an innutritious and indigestible meal. Thus at Futtygur, many persons were seized immediately after eating water melons ;• and at Agra the too free use of that fruit, 

* The tendency of" melons and almonds to induce the disease is marked by Avicenna; and Galen says " the 

164 





of which the dry bed of the Jumna was then full, is mentioned as one of the leading causes of the disorder. Thus too, the eating of Bajru (Hokus IndicusJ, Joar (Holcus SergumJ, and other kinds of raw unripe grain, plucked by the troops in the field on their line of march, was in the Left Division, believed to have increased the number of the sick ; and in the Centre Division, before the true nature of the pestilence came to be understood, was considered as the sole cause of the mischief, and strictly prohibited throughout camp. 

K hen taken into the body produce avitious Inland render it especially obnoxious to Cholera 









MW«»4W»W» 

OF THE MORTALITY CAUSED BY THE DISEASE. 

THE data in our possession, are not lUfficient ]y numerous or accurate, to enable us to forma correct statement, or even a plausible conje^ :, of the number of persons, who have perished by tha Epidemick. Several circumstances have concurred to diminish the value, and to circumscribe the extent, of the facts amassed on this point. The vast tracts of country, over which the dbeaw ranged ; and the scanty and scattered state of the settlers, who alone are capable of col. lg the requisite information ; would, under Ky circumstance, have rendered it impossible, complete returns should be obtained, ry places distant from the larger stations, and imited population, would probably escape observation ; and, of those introduced into the Rims, the loss would be either exaggerated, or ered, according to the laziness, caprice, or in« tcrested motives, of the Native reporters. The inconveniences apprehended from trusting the requisite enquiry to the Native Police Officers, were, indeed, so great, that, upon application 



being made in the proper quarter, it was thought right to discourage the attempt. The grounds upon which this determination was taken, ward that the power necessary to be given to the Thannadars, and other persons of the same class, in order to enable them to form the desired census, could not t>3 delegated, without their immediately making a handle of it, to oppress the Natives under their jurisdiction ; and that the results of the enquiry, as dictated by carelessness, interest, or fancy, would run far wide of the truth. Besides, that the Native population have always shewn a rooted aversion to having their numbers reckoned; from a painful recollection, that under their former rulers, expedients of this sort were never resorted to, without leading to the imposition of capitation taxes, and other heavy burdens. 

Notwithstanding these obstacles, lists of the total number of deaths, purporting to have been carefully made out by the police officers, under the directions of the Magistrates, have been obtained from several districts. But, even these come in a very questionable shape. — They appear to have been mostly taken at a late period of the disorder ; when the mortality occurring during the early part of its progress, could only have been guessed from indistinct recollection. Another suspicious circumstance is, that the deaths are generally stated in round numbers, of thousands, 

167 





168 

CF THE MORTALITY 

Ptens of thousands ; partly for the sake of ucing greater effect, and partly from an in* distinctness, and propensity to exaggeration, Enon to the Natives of India with all other tic nations. — From which it may be suspect. ;hat the aggregate was not made up from a her of subordinate lists, but roundly put down at random. Another source of inaccuracy is, that, when the Epiaemlck was at its height, it was the fashion to lay every death to its account; so that every person, who was cut off suddenly, or in an unusual manner, was said to have died 

Having premised these observations, we shall proceed to lay our scanty materials before tin reader. — To commence with Calcutta. — The on. ly accounts we have been able to obtain, of persons taken ill in the city and suburbs, are those containing'the lists of individuals attended by the Native Physicians, at that time appointed by Government all over the country, to administer medicines to. the sick. Even these are imperfect. For in the city, they embrace a period of three months and eleven days only; whereas in the suburbs, they extend from the 19th of September 1817, to the 2Jtli of July of the following year: when the establishments were finally discharged, as being deemed no longer necessary. It app jars then, that from the 19th September to the *^ 1 af T~^nr«r»tv»V\r»t* f\f 1 Q OOfl nortnuc wlir» 111 I il'Cllt" 



CAUSED BY THE DISEASE, 

169 

ta applied for aid, 9595 were discharged cured ; 3595 remained on the convalescent list ; and 930, or rather more than one in ten, died. — In the suburbs, again, comprehending a circuit of five or six miles diameter round the boundary ditch of the city, of 21,876, to whom relief was afforded between September and August, 20,878 were saved; 1378 died, or nearly a 16th ; and 259 remained convalescent at the end of the period. Amongst these the mortality was greater at one time than another ; being from September to February as pne in 14< ; and from February to August as one in 13. Of those affected, the proportion of males to females was reckoned as four to one ; probabably from difference of exposure ; that of Children, and infants at the breast, a mere fraction.* It must not be imagined, that these lists afford any thing like a fair in^ex of the general mortality at the Presidency. JJoth there, and in other quarters of the country, thousands were prevented from applying for aid, from the rapidity of the attack ; from distance ; from aversion to European medicines ; and from a superstitious desire to 

S* These tables are printed at the end ot the work ; and 0 them has been added another, exhibiting the number of deaths by the disease, reported to the' Police, from Ja-» nuary, 1815, to November, 1819, inclusive. The latter is cWefly nm&il, as enabling the reader to judge of the comparawve mortality at different periods of the Epidemick. Recording to this criterion, September,' lίl 7, February, Mtrcbj April, May, and November, 1818, and November, 





170 

OF THE MORTALITY 





await the termination of the disorder in the vicia> ty of some .sacred spot. — /The mortality was ufr doubtedly very great ; but it would be vain to h* zard a conjecture of its amount. Of every second or third family, large and small, perhaps one, two, or three, and in some cases, five or six members perished. For many months numerous parties were constantly met carrying the biers of the dead ; and the banks of the river were crowded with Hindoos burning the bodies of departed relatives. 

In Jessore 10,000 persons were said to have been cut off in two months after the first appearance of the disease ; and as it has ever since been fatally prevalent in that district, a vast addition must since have been made to that number.-r-In Bao kergunge, of those who were attacked in the earlier months, scarcely any recovered without medicine; and the mortality was accordingly great. — The proportion of deaths was, however, less considerable, where medical aid was duly applied. Tii us of 82 prisoners seized, only 12 died — In Mymensing, where the disease has raged for two years, the deaths, according to the Police lists amounted to 10,714; according to the belief of the Medical Oilicer, to much more. — In ISI7. they occurred chiefly among the lower classes; in 1818, neither cast, age, nor sex was spared; 

1 8 1 L 1 , h.ive been the most unhealthy months; and Februa* 



CAUSED BY THE DISEASE. 

171 

and in September, October and November, the mortality was frightful. At Bulloah, and in the "whole of the South West Division of Tippeiah, few survived without medicine ; and it is estimated, that a tenth part of the whole population disappeared. 

In the Dacca district, we have some precise statements to go upon. From August, 181 7, to January, 1819, of ,6354 persons reported to have been attacked in the district, 3,7,57, or more than one- half, perished. In the city again, whore assistance was promptly given, of 1,081 taken ill before the eniof the first year, 7^ only died, and 0f 1,121 in the succeeding year, only 101, or scarcely one in a hundred. The houses in the to-wn and suburbs amount to 20,000; and as in many, five or six individuals were affected, it is estimated, that we should be near the truth, if we were to allot one case to each dwelling. — The disease was most destructive in the commencement. Males were liable in a double proportion to women ; and with them, the attack was more certainly fatal. 

In the district of Sylhet, the deaths, according to the Thannadara* reports, came within a few of 10,000. The return of the Sudr Thanna (Sylhet town,) in which the houses were numbered, for Eilitating the assessment of the Choukeedaree j and the deaths more accurately ascertain- 

W 2 



172 

OF THE MORTALITY 

Ed ; might be better depended upon than the rest; and was to the following purport. Houses 5316; deaths from August, 1817, to January 1818, 1 197- Supposing this to be correct, and al. lowing six persons to each house, there would be a population of 18,896, from which the mortality would be as one to seventeen. — Throughout the district, the average of those attacked, is assum. Ed as one in eight ; and of deaths as one in twen. ty-nine.-— The mortality was greatest in the au« tumn of 1818. Amongst the servants of European residents at the chief station, of 298 individuals, 50 were seized, and 5 died; and all these were better off as to diet, lodging, and medical aid, than the bulk of the people. — In the Sylhet Corps, of 4.50 of all ranks, 29 cases, and two casualties, occurred ; and of 230 prisoners in the Jail, 42 seizures and 13 casualties. — From a re« gister of individuals in the town, who received aid, of 300 cases occurring in April, May and June, 1818, only 25 died; whereas of 430 cas23, under like circumstances, in the three last months of the year, 84 sunk. 

In the district of Nuddea, out of a population reckoned at 13,00,000, the disease between June, 1817, and July of tho following year, attacked 25,400 persons ; of whom die J 16,500, or more than two thirds. At first the mortality amounted to one half. Of 4,789 persons to whom medicine 



one finh. In the neighbourhood of Itaiuca, without medicine, the proportion of deaths was three fourths ; with it, only one fourth. In the town of Nattore, from September to June, MO-persons died, of a population between 45 and 50,000: or little more than one id a hundred. In f he district, the deaths were as one to four, of those effected. Numbers of women, oriel boys and girls, were attacked; b;it no child under eight years of age. : 

The disease was dread fully destructive ill Burdwan. Departing from its ordinary course, it was here milder in the commencement ; the mortality during the Rains of 1817 and subsequent Cold Weather, bring only about one in four ; rising in the Hot Winds to four fifths ; and again decreasing in the Rains to one tenth. It is singular too, that during the period of greatest mortality, the persons mostly affected were ths Sepoys, and well fed inhabitants of the town; whilst the convicts, and debtors in the Civiljaif, remained healthy till the Rains, when they alone were attacked. According to the Thannadari' registers, 15,571 persons perished in the Bhau« gulpore district between August, 1817, and May, 1813. In the beginning, all castes and classes were alike subject to its attacks ; and from August to the end of 1817, of those seized, it is affirmed, that not one in a hundred survived. 

173 





In Tirhoot it appeared from the doubtful reports of the Police Establishment, that between 9 and 10,000 persons were carried otE Here, it is said to have indiscriminately attack. Ed individuals of all classes, and of every age and sex. In the city of Patna, the total mor. tality wa9 not ascertained. In the end of 1817 the disease was more general ; in the following hot winds more rapidly destructive. From the 25th of April to the 10th of July, 1.539 deaths took place amongst a population of&50,000; and of 30 Sepoys attacked during that period, 15 died in spite of medicine. More males were affected than females. In Chupra the casual* ties were said to have exceeded 700. The mor» tality throughout the whole province of Behar, including Shahabad, and the Northern part* of Eamgur, was very great. 

At Chunar the casualties did not exceed one tenth ; at Benares one eighth, of such as took medicine. In the latter, females were seized equally with males. So, at Allahabad, persons of either sex, and of every age were affected ; and the total mortality in the district is stated at between 8 and 10,000. From this city upwards, as the disease was milder, and less general in its attacks, the casualties were comparatively fewer. Thus, in Cavvripore, of 80,000 inhabitants, 500 only were seized ; of whom no 

174 





jnents the mortality amounted to one fifth of the diseased. In Shahjehanpore 500 died. ]$o returns have heen received from any part qf Gorruckpore or Oude,* if we except the 2nd Battalion 15th Native Infantry, which during the time it was stationed at Lucknow, had 55 cases and 11 deaths, from a strength of 1000 men. In Fuitvgur, the list of deaths was very small. In Coel, of 300 sick 70 died. In Agra the deaths did not exceed ten daily ; although the town contained 30,000 people. Not 500 in all died in Muttra ; and about a like number in the immense city of Delhi. In Meerut town, which has 35,000 inhabitants, only 400 were seized, of whom ()(), or about one seventh, died : giving a proportion of deaths to the whole population of one in 120. Of 600 persqns living in the great Bazar, 200 were affected, and 50, or pile fourth died. Of these, 29, were, men, 15, wopen, 3, young persons, and 3, children. — -In an adjoining village, the inhabitants of which coulfi ,not be persuaded to use any remedies, every individual attacked died.—^ln the whole district, of which only a few principal towns, as Shamlee, JDabun, &c. were visited, 1,399 deaths occurred. 

• In this province the mortality is described by eyewitnesses to have been exceedingly great, — a reason for which might be, that the inhabitants, living under a .Native ruler, had not the medical attendance and mrdicines, which were so bountifully supplied to all per- 

175 





Of the casualties it is strange, that 1,000, more than two thirds, occurred in Deoghat, a small town containing only 7,000 inhabitants, in the Begum Simiroo's territories. The I'ict is given on the authority of an European Gentleman, who satisfied himself of its accuracy by minute enquiry; but no mention of local peculiarities accompanies it. — In Saharuapore, no more than 250 perished, of a population of 30,000.— The mortality in the whole of the Jeypore principal Tity is said not to have surpassed l}2oo.l } 200. In Ko. tah 100 men are stated to have died daily ; but we have no precise account of it'j ravages ii Ougein, Indore, Nagpore, or any others of the great Mahratta towns. — In Hutta, and other places in the vicinity of Saugur, the mortality was undoubtedly great ; and in the district ad» joining Banda the deaths were reckoned at 10,000. — In the town itself, the disease attacked all descriptions indiscriminately from two to ixty years of age j but as medicine was sedulously administered to the sick, only 67 died of 2VJO individuals known to have been seized. 

Let us next examine the amount of the le* sustained in the different Corps of the Army. — In the Centre Division the mortality was, on conjecture, variously calculated at five, eight, and twelve thousand. — The truth is, that in all cases, it r> next to impossible, to compute correctly, the 

176 





stitufc'ng the class of Camp followers with an Indian Army ; and amid the confusion and desertion occurring in the Centre Division during the sickly period, even had its original strength in numbers been known, the real extent of its Joss could hardly have been ascertained. The mortality was undoubtedly greatest from the 14th to the 19th of November ; and it was calculated, that, at the very least, five thousand of all classes perished during these five days. The armed force consisted of 3,500 Europeans, and 8,000 Natives. Of the former, 230, and of the latter 534f 9 died. The average loss of each Battalion was computed at 50 men ; but this is mere conjecture, as no accurate returns were obtained.* In some Corps the number attacked was very great. Thus 

• Since the account given above was written, the rep turns of all the Corps composing this force, monthly* weekly and daily, for the period during which the pestilence raged, have been procured from the office* of the King's and Company's Adjutant Generals; but they are so defective and indistinct, that little use can be made of them. Until the 16th November, the reiurni were weekly, and contained the sick of all descriptions, 'From the 16th to the Bth of December they were daily, and restricted to an enumeration of those affected by the fdemick only; but between the 17th and 22nd of No ber they were very irregularly given in ; as during the fusion of daily marching, amidst promiscuous attack, as nearly impossible to ascertain the extent of the sickness and mortality in the different Corps. Another cause operated to prevent accuracy. Towards the end of the 

X 

177 





the Ist Battalion Bth Native Infantry had 350 seizures, and 4 ) deaths ; and the 3rd Regiment Cavalry 154, and 18 deaths. In the 2nd. Bat, talion Ist Regiment Native Infantry, 48 Sepoys, and 25 followers died, between the 10th and 26th. From the 2nd Battalion 11th Regiment Native Infantry, 268 cases were admitted, of whom 43 died. — In the Rocket. Troop, 27 Europeans, of whom one only died. ; and 87 Natives, of whom 18 died. Of 2,000 of all classes, attached to the King's 67th Regiment of Foot, 90 died. The mortality amongst a given number seized, va. ried, according to the difference in the period, and in the class of the individuals attack. cd. From the 10th to the 15th, it did not 

jnonth, the survivors of the sick left at Sileia rejoined their respective Corps; and, as convalescent?, wereadmit« ted into the Hospitals, without any proper distinction bring made in the reports, between them and the fresh cases of disease. Two monthly returns of a more satisfactory nature have, however, been 1 obtained ; and shall be inserted at the end of the work. The one contains the casualties of the whole Army from the Epidemick, ( excepting the 24th Regiment of Dragoons, and the 3rd Regiment Native Cavalry, and a detachment of the 7tl Native Cavalry, then on a distinct duty with Colonel Philpot); the other the casualties of every description i* H. Majesty's Troops, from October to January following. If these can be trusted, the mortality among the troops was much smaller than it is rated at in the text. For according to them, of 9,595 hoops of ail descripti- I*P - 'ii Iv 441 ny nnp n#»i*s( 11 in 22V YiCTC CHI TICII Oil* * * 

178 





Ejxceed one in eight ; and was then chiefly ned to the bearers and other descriptions of p followers ; from the 15th to the 19th, it ;ased to one in three and a half, and then rred, principally, amongst the Europeans and ys ; and from the 22d, to the 30th, it decreas•eatly. We have said, that the disease was i height on the 18th. Of the 2nd Batta-11 th Native Infantry, 56 Sepoys were ad:d on that day ; from 20 to SO on each iucceeding day to the 22nd, and from thence to the end of the month only 20 in all. Of the European Artillery, the average of deaths was one fourth ; of Golundaz, rather more than a fifth ; of gun lascars, less than a fifth ; of drivers a third ; and of Magazine men, a half. Of the 

have no grounds, on which to estimate the total number of persons affected. — It was likewise attempted to make an abstract of all the casualties occurring amongst the troops of every description (exclusive of those fornyng the Centre Division) as well Native as European, and Irregular as Regular, serving on this establishment. The numbers appeared wonderfully small. From November, 1817, to May, 1819, the total amount, as shewn by the Superintending Surgeons' Returns, was, of seizures 1540, and of deaths 483: a large proportion, being nearly a third of the whole. This i* entirely exclusive of Camp followers. BuC these telurns do not exhibit a fair estimate of all the deaths ; for these is reason to suspect, that in the earl}'' part of the p<. stilonce, many persons who died from Cholera, were classed under the head of Bowel complaints, or of <tnonialcus cases* 

X 2 

179 





180 

©F THE MORTAL IT V 

Natives, the two former daises are chiefly Moos* sulmans, the two latter Hindoos. The great mortality amongst Europeans may be ascribed, to their constitutions having been previously debilitated by irregular modes of living, and uncongenial climate; to the comparative se« verity of the attack, and greater struggle in a plethoric habit and muscular frame. Women were equally with men obnoxious to the disease; and died in a like proportion. Thus of 268 females attacked, 43, or one sixth died., It was observed, that concubines and prostitutes suffered in a' larger proportion than other descriptions of women : probably from their dissipated habits, and precarious mode of life. 

The mortality in the Hansi Force was very inconsiderable. Not more than 271 persons in all were seized ; of whom 51, or one in five and a half perished. Of these a large proportion ¦was Sepoys ; of whom 126 were attaoked, and 27, or rather more than a fifth, died. The majority of deaths occurred in the early part of the disease j when it was more virulent than afterwards. Six Europeans only were attacked ; of wham one died. 

Kthe Rajpootana Force, which in fighting tn4 followers amounted perhaps to 15,000, crtality was greater. The armed part o( wee consisted of 96 Europeans, (Officers 



CADSEB BY TH« DISEASE. 

181 

jiot included) and 4,100 Natives.; of whom 295 were admitted, and 12 2, nearly one bal£ died* The different Corps were variously affected. Qf the European Artillery, only 3 were seized : all of whom recovered. Of the Goolundaz £40 in number, 6 sickened, and 2 died •, of 250 Gun lascars, 21, of whom 12 died ; of 392 Ordnance Drivers, 44, of whom 17 died ; of 294 Pioneers, S3, of whom 23 died : Of the 2d Cavalry, 600 Kg, 8, of whom 2 died; of the 2d Local lry, 720 strong, 4, of whom 2 died ; of 5 Companies Ist Battalion 27th Regiment, 18, |f whom 7 died; of the Ist Battalion 28th liegimeίt, 944 strong, 1 35, of whom 57 died and of 2d Battalion 19th Regiment, 887 strong, 3, of whom none died. Of 75 Camp followers who took medicine, 15 died. Here Europeans were slightly affected, and the lower classes suffered most. This was not uniformly the case ; for according to one statement, the Sepoys suffered more than the Camp followers in the Ist Battalion 28th Regiment. By this account, the strength of the Battalion is stated at 1,004; of whom fell ill 144, and died 60; whilst of 513 Camp followers, 35 only were seized, and 14 died : the casualties among the Sepoys being » double proportion to those of the followers. 18 Battalion consisted of 878 Hindoos, and 126 Mussulmen ; of the former, three fifths were 



Rajpoots, 47, and 16 died ; low casts, 21, and 9 died >j.*)r of the whole affected, a little more than one half. Of the Mahometans, 19 were seized, and 5, or one fourth, died. So that ttie disease was more fatal to Bramin?, than to Kajpoots ; to Rajpoots than to the lower casts; and to Mossulmans the least so of all. It was most destructive from the 14th to the 22nd September; of 108 admitted from this Battalion in the first week of its visit, 51 died ; after which tht average was about one fourth. 

In the Left Division, of 8,500 fighting men, cases occurred, of whom 49, more than a cl, died ;30 in April, 18 in May, and 1 line. Here the disease equally attacked doos and Mussulmans of all orders : Drivers, :ars, Bearers, Grooms, and Grasscutters, being more liable than the regular troops, dren were peculiarly exempt ; females not. 1 mortality was greatest from the 10th to 21st April. 

In the Nagpore Force, from the 31 st May to the 15th June, of about 4,000 regular troops, 13 Europeans were seized, of whom 6 died; 211 Sepoy.', of whom 29, or one seventh, died. The mortality was greatest, perhaps two thirds, at first. The Camp followers were affected very severely ; grooms more so than any others. 

182 





carriers were most exempt. Women were af. fected equally with men ; and childicii at the breast were not safe from its attacks. 

From the whole of the foregoing statements, we think it may perhaps be inferred : Ist, That the sum total of the mortality occasioned by the Epidemick fell far short of the rate assigned to it, by the voice of the public, during the season of alarm.* 2d, That the mortality was proportionately much greater, among large and dense, than among small and dispersed bodies of men. 3d, That in a given place, it was generally greater in the commencement, and middle, than towards the termination of the disorder. 4th, That, when unlimited by the intervention of remedial means, it gener.-iily amounted to one half, and sometimes to two thirds of the seizures. sth, That where medical aid was duly exhibited, it rarely amounted to one third, and was generally as low as one fifth of the attacked. 6th, That men were gene. 

• As a proof, however, of the great extent of its ravages in the European portion of the community, the experience of two Offices, the Laudable and Union Societies, for insuring lives, where the ris>ks taken were almost entirely upon the lives of European gentlemen, may be briefly stated here. The number of deaths amongst those insured between October, 1817, and November, 1818, was so great as to reduce the value of lives to one half of .the estimate formed on the best tables, and on the experience of former years, The register of th« latter 

183 





fallv more susceptible than women ; and that infants and children were nearly exempt. 

Society, indeed, shews a proportion of deaths for that period, four tiroes as great as the average of the four preceding years : being no less than C| par ceut oa 







SECTION IX. 

OF SOME PECULIARITIES OF THE 

DISEASE. 

THE general appearances and habits of the Epidemick, have been already so fully described in the body of this essay, that little now remains to be added. Before, however, proceeding to treat of the curative means, a few words may be said in illustration of one or two character: istic features of the disorder, not yet alluded to. [Whilst the contagious nature of the disease was jnder discussion, it was stated, that those lying sick in Hospital of other ailments were not attacked by it, in larger proportion than persons in health : with the single exception of convalescents, whose greater liability seemed solely attributable to their enfeebled condition. We might iience conclude, that unlike the plague, small fcox, and others of the exanthemata, which, when f pidemick, have been observed to suspend the Influence of other maladies ; and as it were, for a lime to convert all other kinds of disease into jheir own specific mode of action ; the Cholera las no power of transmuting, and turning to 

V 



itself, other forms of illness. In further proof of this assumption, it may be stated, that no where did the disorder, when prevailing epidemically, seem decidedly to take the ascendant ; so, as for the time, either wholly to banish, or sensibly diminish, other species of morbific action, common to the seasons and place. It is no doubt true, that throughout the whole of the year of its rise, fevers and bowel complaints were in Calcutta milder than usual j but it is not known, that the cases were fewer in number, or that when the morbific action of fever or dysentery had once fairly begun in an individual, it was ever disposed to run into that of Cholera. It is likewise true, that in the camps of the Centre and Hansi Divisions, it was by some believed, that the common endemials of the climate were less frequent, during the period in which the Epidemick was among them ; but then, this was perhaps attributable to the milder forms of disease attracting little notice, whilst the attention of all classes was strongly arrested by the ravages of a new and formidable distemper. Besides, that this persuasion was by no means general ; at least one half of the Staff concurring in the opinion, that it did not exert any influence whatever, on other complaints. 

Moreover, the probability of the supposition wa3 much lessened, if not quite destroyed, by what happened in other quarters. Thus, in the 

186 





187 

OF THE DISEASE, 1 

Nagpore Force, bilious remittents were more than commonly prevalent during the existence of the Epidemick ; and the season was particularly sickly all over the province of Berar. So, inJubbalpore the usual diseases went on at their wonted pace; and throughout Saugor Province the Small Pox raged at the same time with Cholera. Alike circumstance occurred in Cawnpore ; in which the Small Pox was extremely fatal in April and May, 1818, when the city was visited by the Epidemick ; and in Calcutta in the spring of 1819, at the very time in which Cholera was in one of its periods of greatest aggravation. In like manner, autumnal intermittents were common in the Rajpootana Force during August and September ; and in the cities of Jeypore and Delhi, fevers of the remittent and intermittent type, diarrhoeas, and dysenteries, continued very prevalent, until the end of the Cold Weather. 

Many other instances to the same effect, might be found in the Upper Provinces ; but to save needless accummulation, let us now advert to those situations in the lower part of the Country, in which the disease long existed in full force; and must necessarily have displayed this peculiarity, if it had constituted any part of its essence. In Chupra, fevers and other endemics were less common; in Tirhoot just as usual. Neither in Bhaugulpore, nor at Monghyr, did it exert any influence. At Malda, and at Nattore, 

Y2 



other diseases were less frequent. In Burden, bowel complaints were fewer j fevers not so.— In Nuddeea, remittent fevers, liver and bowel complaints were more thjui usually frequent a. mongst Europeans ; the Natives were more healthy.—At Dacca, fevers were, during the first year, less frequent; in the second, more general and obstinate. In Sylhet* intermittent and remit, tent fevers, running into and alternating with dysentery, were more than usually common ; undit was remarked, that, so far from their shewing any disposition to coalesce with Cholera, an attack of the one disease generally protected the person attacked from the influence of the other: so that he who had fever* would not afterwards have Cholera ; and vice versa. In Tipperah, intermittents, and in Backergunj, bowel complaints, were more general than in former years. In Mymensing, Bulloah, and Chittagong there was no perceptible difference. 

From a comparison of the foregoing facts m think it is clearly deducibie, that the Epidemick did not exert any influence, in iessening the frequency, or in modifying the symptoms of fetand other disorders common to India ; and in every case, in which an apparent exception to the general Uuth of this proposition oc« Bred, it probably arose from causes purely m cntal. 







The next observation to. be made, is, that an individual having once undergone the disease, thereby became much less, subject to be again attacked, than a person, who had. net passed through the same previous seasoning. It is not by this meant to be asserted, that reUpsea.did not sometimes occur, in persons who had not perfectly recovered from the effects of the first attack; nor even to deny, that, in some rare instances, the disease recurred at long distant intervals, when the individual had entirely regained his strength ; and was to, all appearance in perfect health. All that we intend to affirm is, that such cases were exceedingly uncommon. To many of the Metical Officers, who possessed large opportunities of observation, it did not occur to observe a single instance. Thus the Centre Division of the Army hardly affords half a dozen of instances ; not one of which happene d to the Medical Officers left in charge of the whole body of the sick, from the beginning of December until February following. Previously to the retrogade movement of the Centre Division from Erich upon Gwalior, early in December, the European and Native Sick were removed to Sumpter, an elevated healthy town, on an open plain, in which a field hospital had been established. The Sick amounted to about 200 Europeans, and 1,000 Natives. They soon got over the dysenteries and diarrhoeas, which formed the sequelae of 

189 





the disease ; and not a case of relapse, orsecon. dary attack came to notice. 

In the Left Division and Rajpootana Force, according to the unanimous declaration of the Medical Staff, no case of reseizure occurred, after the strength had been fully restored. In the Nagpore Force, two or three instances came to notice j but all came under the strict denomination of relapses ; for although the individuals had re. covered from the primary shock, a long enough interval from the first attack, had not been al. lowed, for the complete restoration of their strength. The most decided case, was that of an European, who having been twice attacked, whilst under the influence of mercury, had so far recovered, as to return to his duty ; when, after a lapse of five or six days, he got the disease a third time, and died. With tho Kurnaul Division not a single case offered. The same immunity from secondary visitation, was observed in every quarter, in which the Epidemick prevailed; aud we should perhaps not be far wide of the truth, were we to affirm, that of the many myriads attacked, the returns o£ the whole country do not afford a score of well authenticated cases of a recurrence of the disease, after the removal of debility, and every other consequence of the primary attack- 

Another curious circumstance in the economy of the disease, was, that, not only were persons, 

190 





191 

OF IHS LI3EASE. 

who had once undergone its attack, free from its further assaults ; but even individuals, and bodies of men, who having come within its pestilential influence, had escaped unaffected, were nevertheless much less obnoxious to its future visits, than those , who had not before been exposed to the virus. In other words a village, which was visited by the Epidemick during the first year of its prevalence, would, on the disease reappearing in that part of the country, be much less likely to suffer, than another village, which had not before been affected ; and an individual going from the former, into the infected air of the latter, would have a better chance of immunity, than its inhabitants, who had not undergone the previous seasoning. This was the case, to a greater or less degree, in every part of the Provinces; in which it was generally remarked, that the Epidemick, on its recurrence, either did not at all revisit the places formerly affected, or only in a much lighter manner, than those, to which it was yet a stranger. In Tirhoot, particularly, in which the Epidemick twice appeared at two distant periods, the truth of this observation was strikingly illustrated ; since according to the information of a very intelligent observer, not a single instance occurred, of the disease revisiting the same place, throughout the whole extent of the district. 

But, it is in the different Divisions of the Army, the bodies composing which long remain 



192 

OF SOME PECULIARITIES 

under the eye of the same Medical Officers, that we should expect to find the existence of this law most clearly established. It is here, accoi. dino-ly* that we have the best examples of its reality. Thus in the Jubbulpore Force* the 7th Regiment of Cavalry, and 2nd Battalion 13th Native Infantry, which Corps had suffered severely in November with the Centre Division, and at the Bridge of Boats* remained quite exempt. Thus too, the 2nd Battalion 19th, which was violently affected by the disease in August, had only three slight cases in Septeraber; when the other corps of the Rajpootana force were so roughly visited. But the best illustrations are to be found in the Centre Division. When this force broke up after the termination of the campaign, His Majesty's 24th Regiment of Dragoons, and 87th Regiment of Foot, and the Ist Battalion Bth Regiment Native Infantry, marched to Cawnpore ; where they were stationed in April and May, when the city and cantonment were suffering from the disease. At this time the 24th Dragoons remained quite free ; His Majesty's 87th had two slight cases, among the recruits who had not been with the Centre Division, and no death; and the Ist Battalion Bth Regiment N. I. had, according to one statement, no case, according to another, one only, and according to a third, three or four, all slight attacks. The situation 



0* 

THE bISEAsi). 

193 

al proof of the immunity of bodies previously exposed not being accidental. For it so happened, that this Battalion Wai placed right between the fnd ίattalion Isth>J. I. and Cra'gie's Levies; bo'J 1 of which suffered severely, as not having earned the same means of protection. Camp followers of all descriptions were equally exempt ; and one person only, an European Officer, who had been with the Centre Division, fell a victim to the disorder. In like manner, the 2nd Battalion £sth Regiment Native Infantry, which again fell in with the disease in April, whilst marching from the Tiraee for Lucknow by Gorruckporc, then suffered comparatively little. It had indeed 25 cases and 5 deaths ; but of these only one was a case of relapse or recurrence, and even in it the symptoms of both attacks were very mild. But, a still more extraordinary instance occurred in Lord Hastings' camp, during the march to Gorruckpore, towards the kitter part of the same month. The disease here first broke out amonc 

o 

the followers tf a gentleman, who had just joined the party ; and in a few days attacked between 50 and 60, out of 4.00, chiefly of the class of bearers. It next got among the servants of several Gentlemen in the Civil Service then in attendance upon the Governor General ; and to the period of its decline, was confined to such persons, as had notbsen With the Centre Division. This could not be explained on any difference of situation ; for the party dnily 

Z 



changed ground, and the new comers were mixed promiscuously with those, who had been previously exposed to infection. Nay, it further Kars, that after attacking the first party, the is'e made a long stretch, and next shewed itself amongst other persons, not yet seasoned, in the opposite end of the line : leaving all between untouched. If any other proofs were necessary, we might cite the case of the 2nd Battalion 3d Regiment, the greater part of which, having had the disease at Shergnrh, were not at all affected, although stationed at Banda, when the town suffered severely. But enough, we think, has been already said, to shew, that the human frame, on being exposed for some time to the pestilential virus, got habituated to it, and in a great measure became insusceptible o; its malignant influence, 

There is reason to believe, that the lower animals were in some measure affected by the Irupt state of the air at this period. For, it » observed in many places, that an unusual rtality occurred amongst black cattle, sheep, p, and other domestic animals. Thus in the ikergunge District, cattle had the disorder, I were cured by opium and the other reme- I found most serviceable in the human spe?. Cows when seized, shed their yon rig. So, Tipperah great numbers of horned cattle and 

194 





sheep were seized with vomiting and convulsion?, and suddenly expired. In 1815 again, half the cattle of the lower part of Tipperah were carried. oft' by a disease similar to Cholera. In Delhi, dogs died rapidly - f and more horses than usual were carried oft' by the dry gripes.* In the Kajpootana Force, and throughout the whole of the Jeypore and Nagpore territories, the season was remarkably fatal to camels ; and in the Centre Division domestic animals of all descriptions died in great numbers ; but in the latter instance the mortality might be ascribed to want of proper care and food. At Sumbhulpore, an Elephant had every symptom of Cholera 5 and was cured by brandy and laudanum. But the affection of brutes was by no means general. Thus in Dacca, Mymensing, Rajshahy, Nuddeea, Bhaugulpore, Tirhoot, Sarun, &c. the lower orders of animals are expressly stated to have enjoyed their usual health : So that the circumstance of their sickness in other quarters, during the prevalence of the Epidemick, may have been perfectly fortuitous. 1 j 

* In this city, a curious thing was, that large swarms of flies, which had infested the place before the breakng out of the Epidemick, wholly disappeared during its prevalence ; and returned as it withdrew. This might )e owing to the cold, sharp, westerly wind then blowing*. 



195 







OF THE TREATMENT OF THE DIS. 

ORDER. 

IT is not easy tc determine how this very important branch of our subject can be best liand. led. For although, there was every where a striking uniformity in the principal means resorted to, in resisting the disease : there was yet, in different quarters, a remarkable difference in their mode of application, and a great discrepancy of opinion regarding their various degrees of eilieacy. With one individual, bleeding was considered the remedy to be chiefly depended upon ; with another calomel ; and with v third opium and stimulants ; just as their opinions were modified D }\ the results of their single experience, varied according to the form of th 3 disease, and class of subjects, chiefly coming under their notice. Hence, any one attempting to set dawn the results -pf the general experience, in the shape of a .summary, would ba constantly checked in his progress by the opposition of contrary facts ; and at length, harassed 



by the impossibility of reconciling dissimilar judgments, be forced to give up the endeavour, as quite impracticable. The only mode, as it appears to us, of avoiding this unpleasant dilemma, is first, briefly to state the several modes of practice followed in different parts of the country; and then, to see, whether we cannot from the whole, deduce some general rules, applicable under every circumstance of the disorder. In adhering to this plan, it will not be necessary, that the exact line pursued by each individual practitioner, should be minutely described : for this would lead to endless repetition. All that seems requisite, is to notice, only such facts, as evidently tend to establish the true method of combating the disorder ; or as appear important, from their novelty, or opposition to the general run of experience. 

To begin with Bengal, in which the Epidemick originally excited attention. When the disease first broke out in Calcutta, with such fury as to menace destruction to every family, the public mind was naturally impressed with feelings of great alarm, and apprehension. A corresponding degree of solicitude was excited amongst the medical men ; and on their part, every effort was made, to discover an adequate remedy for the evil. Bleeding, stimulants, sedatives, narcotics, and ©ther descriptions of medicines were 

197 





i;ssively tried ; according as analogical rea* ig, or the peculiar opinions of various mdi. ils, seemed to warrant their use. Each in m failed, if not always, at least so often, as ove the extraordinary depressing powers of oinplaint, and the inefficacy of all curative is, to stop its progress, where the attack was 11 violence. 

These failures produced a state of perplexity and indecision, which frequently induced the Medical Officer, to employ in one and the same case, and sometimes at the same moment, remedies of an opposite description ; rather than that the patient should sink, without every practicable means having been employed for his recovery. At first, laudanum, calomel in large doses, brandy, and the most powerful internal and external stimulants, were chiefly depended on ; but when these were found unavailing, and an exa. mination of the bodies of those who died, shewed great venous accumulation in the Centre, and inflammation of the stomach and intestines, a new practice came into use. From fts being observed, that the blood always withdrew from the extreme vessels, and gorged the great trunks, it was naturally concluded, that the cure would lie in restoring the balance of the circulation. Hence, venesection was resorted to ; and in many if n of Europeans carried to the greatest warjrantable 

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extent. When the patient was of sound habit, and seen in the early part of the disease, the practice was to tie up his arm, and allow the blood to flow, until from twelve to twenty or thirty ounces were abstracted. In some instances, where the violence of the spasms, and seve* rity of abdominal pain seemed to indicate it, or where benefit had been evidently derived from its use in the first instance, the bleeding was repeated, after an interval of some hours. We must, upon the whole, speak unfavorably of the results of the practice, at this early period of the Epidemick. It was, almost in every case, found difficult, from the sluggishness of the circulation, to get the blood to flow, even when assisted by frictions, and the hot bath. Frequently, it had a thick, jet black, oily, appearance ; and even where several veins were opened, would only trickle down in drops, so as scarcely to give a spoonful in half an hour. Sometimes, again, it would spout out freely for a few moments, as the muscles of the arm were violently contracted by spasm ; and then entirely cease, as the patient fell into the state of collapse.* The pulse, if 

* In some cases the blood at first flowed freely, in a good and continued stream; but instead of tjnc action of the heart and arteries being roused by the flo\r, the pulse rapidly sunk ; and in a minute or two the blood began to trickle, and at length to come awny in drop* 

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previously imperceptible, did not in any instance return to the wrist ; and in cases in which it had been felt before, it decidedly grew weaker, as the blood flowed- No stop was put by it to the discharge by the mouth and bowels ; ami the spasms seemed to hold their course quite un. affected by it. The blood, on coagulating, did not show the bufFy coat ; and was rather of loose texture, with an overflow of serum. It must be confessed, however, that the ill success of bleeding at this time was greater in appearance, than in reality. — For, the persons, upon whom it was principally tried, were patients in the General Hospital composed of various classes, collected from the town and shipping ; and seldom coming under treatment, until some hours after the commencement of the attack. In His Mi- 

jest/s 59th Regiment, in which the patients were usually seen at a very early period of the disease, the practice was more successful ; since of IS) men admitted into hospital, between September, 18 17, and March, 1818, only three, or not quite one in six, died - f whereas of the promiscuous cases of the General Hospital the deaths were in the proportion of six to one recovery : although in both hospitals the mode of treating the patient* was precisely the same. — Still, it cannot be doubted, that during the first months of the Epidemick, there were many instances, in which the loss of pulse, cold sweats, shrunk ft* 

200 





tures, and other terrible symptoms of depression, were almost immediate ; and where the abstraction of blood was, therefore, from the beginning, quite impracticable. Latterly, that is in the second year of the disease, the symptoms were generally milder j and venesection rarely failed to give relief. 

Blisters to the abdomen were largely employed, with a view to allay irritation and spasm. Even where they had time to r>se, they were rarely useful in stopping vomiting ; and probably did harm by the pain and uneasiness of a large, exposed surface ; the raw sides of which were constantly brought into contact, by the agitation of the patient's body. In some instances, a tin plate oval vessel, shaped so as to fit the pit of the stomach, and filled with very hot water, or a towel dipped in water heated nearly to the boiling point, and immediately applied to the abdomen, was usefully substituted for blisters. In many cases, it was thought, that setting fire to balls of cotton dipped in oil of turpentine, and placed on the Epigastric region, prevented recurrence of spasm. 

The warm bath, heated as high is the finger could bear it, was administered in numerous instances. It allayed the spasms ; partially restored the circulation ; and, perhaps, diminished tie sickness ; so long as the patient was kept in 

201 





the water. — But these advantages were merely temporary; for the moment ho was removed, the cramps and other deadly symptoms recurred ; I the general debility was evidently increased, lie previous exertion. In some instances, patient remained immersed id the bath dusjvjral hours, with little perceptible bene— Friction with camphorated spirits, Arrack, laium, anodyne lin'.msnts, &c. ; fomentations, the application of dry heat in bags of sand, or bottles of boiling water; placing stoves with t charcoal under the bed; and wrapping body in blankets and flannel, were among most successful means of bringing back the heat of the surface. 

X ran while, internal remedies were not neg< d. Large doses of laudanum, and ofcalo mcl, were in all cases exhibited ; with cordials, as soon as the patient was seen. Sixty drops of laudanum, with a dram of vitriolic ether, on desert spoonful of warm brandy, were poured into the stomach, every ten minutes, or quarter of an hour; until diminution of spasm, retching, anJ anguish, and partial returns of heat, and circuit 

* Sometimes, the patient had a great aversion to the bath ; and struggled violently, whilst being placed in it.— Sometimes, the attempt to move him produced 1 \iolent return of the spasms, or, retching, invariably did it seem to increase the debility. In the latter stages of the attack, a dread that the patient might die in the act ireneralta deterred the attendants from its exhibitiontion 

202 





203 



shewed, that the powers of life were again beginning to act.* — The calomel was given in doses of from ten to forty grains ; and, unless where rejected immediately upon being swallowed, repeated at intervals of four or six hours. — When the calomel was thrown up, it was repeated every little v:b.i'e : the patient being, in. the meantime, kept froui drinking evon tb<B smallest quantity of fluid. — This was un lo.ibted\y the mode of practice most" successful m Calcutta — It may, however, be questioned, whether the calomel was generally serviceable, until th j stimulants and anodynes had in some decree quieted the stomach. — In the General Hospital, it did not in any one instance app;ar to exert any specific power in checking the vomiting or spasms ; and the majority of the medical men at the Presidency concurred in thinking, that it woi oniy beneficial, in so far, as it ten Jed to emulge the biliary ducts, and to pro.note the regular alvine discharges. Others, again, no doubt believed, that it would stay on the stomach, when every thing else was rejected ; and reckoned upon it, as their chief means in the cure of the disorder. 

I The diffusible stimuli employed were very va•us. Volatile alkali, in combination with brandy, 

* The laudanum mid brandy were sometimes pushed to such extent as to produce intoxication ; but the appearance of this state was no sure sign of the patient's escape. 





1.1 • • • 1 ll' rum> and other vinous spirits; sulphuric and nitrous ether, beer, essential oils of cinnamon, peppermint, anise, and juniper, tincture of Lavender, camphor, mulled and plain wine, and the empirical bitter tincture named Brogue Amcre: each had their advocates, and all were probably found useful, exactly in a ratio with the extent of their stimulating powers. Anodyne and stimulating enemas, were likewise beneficial, where the dejections were very numerous. 

If, by the exhibition of these means, or by the strength of his constitution, the patient were so fortunate as to withstand the first violence of the attack; the tone of the bowels, after the laspe of two, three, or even four days, got sufficiently reestablished, to allow purgative medicines to act; and then the calomel began to shew its peculiar power of emulging the chylopcetic viscera, by discharging downwards, large quantities of dark, vitiated bile. It was necessary to assist this operation, by the administration of repeated doses of compound powder of jalap, infusion of senna, and other saline and resinous purgatives. But, as the system, during the whole process ot throwing off these depraved secretions, was in a state of high excitement and disturbance; and apt to sink beyond recovery, from the slightest error in practice ; great discrimination was required, in the mode and time of administering the cathartic medicines Viid the utmost 

204 





care was necessary, to keep up the strength or the patient by the use of gentle tonics; and, by the constant exhibition of small portions of vine, sago, arrow ioot, jelly, soup, and other articles of mild nourishment, to prevent his being exhausted, and carried off by excessive ventral discharges. The foul, dry tongue, parched mouth, thirst, irritation of stomach, hurried pulse, hot skin, and general feverishness, which marked this sta^e of reaction, sometimes continued many days j and were treated with the remedies found most readily to relieve similar symptoms in common cases of fever. Kelapes, which during the state of great debility ¦not very uncommon, and proved very fatal , red no difference of treatment. 

Amongst the Native patients, the treatment consisted in the judicious use of opium and stimulants ; followed up by calomel, and other purgatives. In such cases, as happened to come under the immediate care of the European practitioners, the plan usually followed, was, as soon as the stomach and bowels had been pretty well emptied of their immense load of watery secretions, to give from sixty to eighty drops of Laudanum, in strong brandy punch, or with aromatic spirit of ammonia, and peppermint water ; and to repeat the dose within ten minutes, if the vomiting and purging threatened to recur. If these means failed to check the 

205 





206 

OF THE TREATMENT 

progress of the disease, which was rarely tl\o case, a bolus containing fifteen or twenty grains of calomel, and one grain of opium, with the aid of frictions with hot oil, flannel, #c. usually succeeded in quickly subduing irritability, ani c'langin^ the distoaed action. And, as theft was no stage of reaction with trhs class of per. sons, the cure required nothing more for its completion, than a dose of castor oil, or other mild laxative. Nearly the same treatment was followed by the Native Physicians,* and otlitrs in distant parts of the city, and suburbs: that is, solid opium, laudanum, ether and other stimulants were very freely used in the first instance; and subsequently unusually large doses of calomel, upon the primary symptoms being checked. The latter medicine, by men of the largest experience of the disease amongst the Native part of the population, was deemed to have up specific 

* Immediately upon the disease assuming a decidedly epidemical ibrni, instructions were humanely issued liy Government to the Magistrates in different quarters pf the country, to entertain Native Physicians at the public expence ; and station them, with the necessary supply of medicines, in the places, in which their services seemed to be moit wanted. Medicines were, at the same time, given for distribution to ihe Native Police Officers and respectable land-holders, and to all European gentlemen not in the service, residing in distant parts of the several districts. It would be i mposstble to calculate the quantity of life that was saved, by the adoption of these truly paternal, and humane measures. 





207 

effect in allaying the distressing symptoms. The preceding means were eminently successful in subduing the attack; since it appears that of 85,796 persons so treated by the Native physicians at the Presidency, only 2308, a little less than a fifteenth part of the whole, sunk under the disease. Probably, an equal, or even a larger number of individuals was saved by a similar practice, in the Dock Yards, Cotton Works, and other large establishments adjoining the city ; the superintendents of which were liberally supplied with the requisite means, to be dispensed as occasion might require, among the many thousand workmen under their charge. 

Nearly the same means were used in the Jessore, Buckergunge, Myniensing, Chittagong, Dacca, and Tipperah districts. Bleeding was now and then resorted to ; but with no evident advantage, even where the blood could be got to flow. In lion of calomel the seeds of the purgative nut Jumdgota (Jatropha carcasj were sometimes beneficially substituted ; and, after the removal of the disease, the tone of the stomach was restored by infusions of (gentiana cheryla) and other light bitters. In all these quarters, it was deemed a very favorable Ktom, if drowsiness were produced by the •tics. After sleep, the patient generally c much relieved; with a warm equable 



I; all over liis body ; the spasms and gene* Stability gone, or greatly diminished ; and only one remaining unpleasant symptom : me thirst. •To relieve this, small quanti>f brandy, or other spirit, and water, or of tery infusion of spices, with saline efferves. draughts, were, from time to time, adminis- 

In Sylhet, it was sometimes found, that where neither solid opium, laudanum, nor cordials would remain more than a few minutes on the stomach, scruple doses of calomel would allay the irritability, and produce the relief sought in vain from other means. In general, however, opiates, brandy, and spirits of ammonia and lavender, were used as auxiliaries. The patient was always prohibited from drinking large draughts of any liquid ; and his thirst was allayed by spoonfuls of rice water spiced, with the addition of a little spirits ; and in some cases, the corner of a towel dipped in water, and then slightly squeezed, was given to Him to suck. This plan was generally successful. In May, 1818, however, a Sepoy was attacked, in whom the sickness and retching were so violent, that nothing would even enter the stomach. — A vein was opened ; and as the pulse was still firm, twenty ounces of blood were taken away, until deliqinurn ensued. The best effects were instantly 

208 





calomel were given, and retained; and after taking one dose of castor oil, the patient on the fourth day returned to his duty. Subsequently to this, venesection was, in the first instance, employed in every case, in which the pulse could be felt at the wrist; and whenever the blood flowed freely, the sickness, spasms, and burning sensation at the scrobiculus cordis were invariably relieved. But calomel, and laudanum or opium were always administered, either immediately before, or after the bleeding. 

In Rajshahy, laudanum and opium, with cordials and frictions, followed by mild laxatives, were in the early period of the Epidemick, very successful. Afterward^, opium and calomel combined, followed by drastic purges chiefly composed of calomel ; blisters to the stomach and extremities ; cordials ; frictions ; and glysters, were the means principally trusted to. Then mercurial pill, and infusions of gentian and cheryta, were employed, as alteratives and tonics. In the neighbourhood of Baulea, in addition to the antispasmodics and sedatives, sinapisms to the pit of the stomach, and the internal use of the expressed juice of green ginger, proved advantageous. In Nuddeea, in the latter periods of the Epidemick, bleeding was successfully used in more than forty cases ; and only three instances of failure offered. Sometimes, it was necessary to open two or three 

Bb 

209 





veins, before the blood would now. No faith was placed in the eificacy of calomel alone. Opiates, cordials, and purgatives were mainly depended upon. Solid opium was more frequently retained, than the same medicine in a Xi form. Aloes, rhubarb, and jalap ; calowith the purgative extracts, were given healthy evacuations were produced. Stiting and warm tinctures, of myrrh, and other gums, proved good auxiliaries, 

At Burdwan, where the disease appears to have bee*} more virulent than in any other quarter, the repeated failure of every probable means of relief, at length, left the Medical Officer in doubt, whether the attack were more frequently arrested, or mitigated by human skill, than by a simple obedience to the wants and cravings of the sufferer, and dependence on the unaided powers of nature. The disease seemed to proceed onward to destruction, without being checked by any power opposed to it ; and seldom failed to secure its victim, where the vomiting had been trifling, and had early, and spontaneously ceased. The disease was most readily controlled amongst the convicts, and lower orders of the Natives. In these cases, no alteration could be perceived in the appearance of the excretions, after the first symptoms had subsided ; and large and repeated doses of opium were eminently serviceable. The quaiv tity of laudanum given with ultimate success, not 

210 





unfrequently amounted to eight and ten drams within the first twelve hours ; aTid it was necessary to repeat it, in doses of forty drops every six hours, for several days, and gradually to discontinue its use. At this time, the least dose of calomel increased the affection ; and opening medicine exhibited in very small quantities, during any stage of the disease* was invariably, and immediately followed by relapse. With the Sepoys, again, and those of a higher and more respectable class, even where their age and constitution was such, as to lead to an expectation of great resistance to the power of the disease, its character was of a most formidable nature ; and after the first shock had been sustained, the only chance of safety seemed to rest upon inducing free alvine evacuations. — Here, accordingly, calomel and laudanum conjoined, were more efficacious in relieving the vomiting and purging, than calomel alone. The stools were like tar and 

blood ; and recovery was in no instance obtained, except where they were early and plentifully procured; and where their condition rapidly changed. As in neither form of the disease, were spasms of the trunk or extremities present, in any case* and as complete exhaustion was always a speedy attendant on the attack, there was no inducement to blood letting. 

In the Bhaugulpore District, the powder oif 

B b 2 

211 





212 

OK TH£ TRE.ATJ^TE^7 

dried Neem blossoms* (Mclia Azadiracht&J given in repeated doses of twelve grains, seemed to ¦ck the vomiting and purging ; but, as it was ally administered in conjunction with opium, the extent of its counteracting power cannot, without farther experience, be determined. At Malda, Monghyr, Patna, and Moozuffurpore, Bum and calomel, combined with cordials and er auxiliaries, were principally trusted to.— In Tirhoot, large doses of Calomel* often repeated, were resorted to in the secon4 year of the disease. Pills of Calomel and opium were distributed amongst the Native population in the neighbourhood of the Indigo Factories, all over the district, and used with great success. — At Mullhye, after the failure of the combined plan to remove the agonizing thirst and burning heat, and its appearing to cause constipation, scruple doses of calomel alone were substituted, with manifest advantage. It was rarely found, that more than two doses were required to allay the irritability; after which, a pujrgative of compound powder of jalap, and calomel, given at an interval generally of fight or ten hours, completed the cure*— -The discharge produced by this, was Usually only a little watery fluid ; minted with mucus, and very offensive. — The patient was allow- 



• An acrid bitter largely employed by tke Native phyiicians; internally, in bilious and pituitous disorders, herpes, leprosy, and foulness of blood ; externally, as an application ta tumour* And bad cores 



i quench his thirst, by swallowing a little rice water, or by gargling his mouth lie:ly with a mixture of vinegar and water. 1 the extremities were cold, and the muss- Tamped, fomentations, frictions, and heat in us forms were applied ; but in no instance internal stimulants given to excite reaction, jy were observed invariably to do harm by rbing the functions of the stomach. 

At Chuprah, the disease was at first peculiarised by strong spasmodic action ; and yielded to large and repeated doses of powerful stimulants and opium. Counter irritation, effected by raising the skin near the scrobiculus cordis, or opposite the seat of the most violent pain was in every instance very beneficial ; and as the ordinary vesicatory means would, from the great rapidity of the disorder, not have had time to act, even had the skin been sensible to their stimulus, the burning of a piece of real, or factitious moxa, on a circumscrioed portion of skin, was substituted in their room. It is added, that it is impossible to speak in too high terms of this simple expedient ; as giving instantaneous relief to the patient, and much valuable time to the medical man, for the exhibition of other remedies. — Latterly, when the spasms were mild and uncommon ; when the attack was less sudden ; and the vomiting and purging, with pain of the abdomen, were the most distressing symptoms : calomel in large 

213 





doses, and brisk purges were very advantageous; while the former method was decidedly mischiev. ous . — At Buxar, large and frequent doses of laudanum, combined with two parts of tincture of catechu, and three parts of any cordial tincture, or of brandy, were administered beneficially u\ every case. Calomel was not at all employed. 

In various parts of the district of Chunar, bleed, ing was tried without advantage ; in the severer cases, the blood would not flow ; and in those, in which it did, no perceptible benefit followed. Purgatives, in the first instance, were always prejudicial ; and opium and stimulants could alone be relied upon. — In some instances, in which the patient had been for hours retching and straining without bringing up any thing beyond a little phlegm or mucus, full vomiting gave immediate ease. In such cases, the quantity of watery fluid ejected, would sometime; exceed a quart. — In the cold stage, which for several hours, in most cases, preceded death, stimulants, under every variety of form and combination, were tried in vain : mustard poultices to the pit of the stomach, spine, and feet ; injections of camphor, ether, turpentine, and opium ; and all other means, proving insufficient to rescue the patient from impending death. Among the Europeans in the Fort of Chunar, direct stimulants were laid aside, upon being found to prove hurtful ; and the lancet was 

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215 



used, with the happiest effects, in every case, in which complete exhaustion had not taken place. — The plan followed, was to take at once twenty ounces, or more ; and if the symptoms did not soon yield, to repeat the bleeding, to the same extent, in an hour and half j or two hours. — Tlie blood in most cases flowed easily ; but where the veins in the arm were small, the jugular was opened in their stead. Calomel, given by Itself j appeared to increase the irrita- 

Amongst the Native population of Benares, the anodyne and stimulant plan, succeeded by Calomel, was generally successful. — In addition to the ordinary outward stimulants, frictions upon the Epigastrium with powder of cauthaiides and oil of turpentine, were tried. — With Europeans, in whom strangury was no unfrequent accompaniment of the disorder, the benefit of such practice would perhaps be problematical. In four men out of six, upon whom bleeding was practised, the circulation was too languid to allow the blood to flow ; in the remaining two, who were young plethoric Sepoys, and presented themselves at an earlier period of the attack, the abstraction of twelve ounces was attended by an immediate removal of all alarming symptoms j and followed by a speedy recovery. — In the case of an European, the vomiting, pain, and burning heat of stomach, 



B relieved by the application of leeches to pigastric region, 

At Allahabad, bleeding was not used, either with Europeans, or with Natives ; the common mode of treatment being in all cases resorted to. The same plan was followed by the several Medical men at Cawnpore with the Native part of their patients. By none of them was calo. mcl conceived to prove generally useful, until the stomach was prepared for it, by the exhibition of stimulants and opiates. — When the vomiting was ajlayed, calomel alone, or combined with extract of jalap, colocynth, or other active purgative, was administered. The partial application of heat to the surface, by fomentations, hot bottles, bricks, or stones, was preferred by some to the bath or pediluvium ; upon its being observed, that the fatigue and disturbance caused by moving the sufferer, were, as in Calcutta, more than a counterbalance to its good effects. — In the more fatal cases, it was not difficult to check the vo miting ; but the spasms could not by any means be allayed; nor the circulation and warmth of surface restored. Large blisters were in many applied to the pit of the stomach ; but the patient's fate was generally determined ere they began to rise. Bleeding was rarely tried. In one case, in which it was carried to the extent of twenty ounces, it did not seem to produce any effect, in allaying 

216 





It, or relieving irritability of stomach, igst the Europeans, venesection, the free 'purgatives, blisters, the warm bath, and ionally opiates, were administered. Relief 3t always immediately consequent upon the ng ; the patient, sometimes, remaining in danger, till stools tinged with bile were 

In His Majesty's £lst Regiment of Dragoons, which h:id occasional cases from the month of September, shortly before the time of its leaving Calcutta, until the end of May, when the die-ease ceased to be Epidemick at Cawnpore ; the following was found to be the most successful mode of treatment. The patient was placed in .1 warm bath ; and a scruple of calomel in powder, followed by an ounce of castor oil or Epsom Salts in peppermint water, given to him. If this were rejected, a dram of laudanum, and of sulphuric ether, in peppermint water, was substituted ; and the calomel afterwards frequently repeated. Blisters ; frictions ; fomentations ; anodyne and foetid injections ; and saline and other purgatives, were used as auxiliaries. In same, the calomel was combined with solid opium. Brandy and water could seldom be retaiued on the stomach. Bleeding was tried in four cases, in which spasms were the primary v'mptoms, and the veiy cold surface and feeble 

Gc 

217 





218 



pulse had not supervened. In two, it appeared to produce beneficial effects ; and the patient recovered. The two others died ; and from one of them, only six ounces could be procured The success attending it was not such, as to lead to a belief, that it could be safely resorted to, in the severe or advanced stage of the com plaint. And yet, in those attacked in this corps the severity of the spasms, and other charactei istic symptoms, during life, and strong appear ance of abdominal inflammation after deatl were peculiarly remarkable j and the large pro portion of deaths, ten out of nineteen, prove the disease to have existed in extreme violencr. 

In the Governor General's camp, near Gorruckpore, blood could seldom be procured in the more aggravated cases ; but where it flowed readily, it frequently removed the great collapse of the arterial system, after the most powerful stimulants had failed in producing any effect Calomel in doses of 30 grains, repeated if necessary, soothed irritation, and immediately induced sleep. 

At Futtygur, the combined use of mercury, opiates, and stimulants was generally successful. Friction of the extremities with hot Ghee (a native preparation of clarified butter) in which common Salt was suspended, seemed to relieve the spasms. Bleeding, in some early cases, 





219 

was useful ; in general, it could not be practised ; and in one case, in which the brachial veins would not bleed, the temporal artery was opened and twenty ounces abstracted ; yet the patient died. In one form of the disease, however, in which there was violent pain of the stomach, with nausea, vomiting, intense thirst, headach, blood shot eyes, and quick strong pulse, without purging ; venesection, followed by large doses of calomel and purgatives, was resorted to with the happiest effects. At Agra and Coel, there was no departure from the common modes of practice. 

At Muttra, in some very violent cases, simple dilution, by means of large draughts of water, as hot as it could be borne, seemed to act like a charm, in checking the vomiting and purging, and restoring the pulse and natural heat. A gentle perspiration broke out ; and the cure was completed by a dose of calomel, or castor oil. In the case of an European Artillery man, labouring under the worst symptoms of the disorder : severe head-ach, tightness across the chest, difficulty of breathing, thirst, burning sensation of stomach and bowels, scarcely perceptible pulse, sunk eyes, ghastly countenance, and tormenting spasms of the extremities : instantaneous relief was afforded by blood letting. When about twenty ounce* 

Cc 2 



220 



had flowed, the rrtan called out, that he was perfectly well ; his countenance brightened ; his eyes regained their lustre ; and his pulse filled, — *and health was restored by one dose of calomel and castor oil. In this case, the blood at first came with great difficulty. The Natives were successfully treated with laudanum, cordials, and calomel. 

In Delhi, bleeding was tried in every case, in which there seemed a chance of its proving successful ; but as the vessels collapsed generally within two or three hours, and sometimes within a few minutes, it was vain to attempt it, except in the earliest stage of the attacks. No patient died from whom twenty-four ounces could be got speedily. Others again, from ¦whom a smaller quantity was obtained, slowly, and with much difficulty, did not recover. After bleeding, large doses of calomel alone, or conjoined with opium and cordials where there was much alimentary discharge, followed up by saline and resinous purges in infusion ol ginger, succeeded well. In many cases, mercury sat better on the stomach, when given without stimulants. These means, generally, soon relieved the bowels, by bringing away large quantities of dark, offensive matter, mixed with mucus and bile ; but when they failed to produce this effect, recovery was greatly retarded; 



221 



and it was necessary to commence a course of mild mercurials, and tonic purgatives, to remove the acidity, flatulence, and sluggish state of the viscera, which then invariably remained. In aid of other endeavours, to restore the circulation and exterior heat, embrocations with country cantharides (meloe trtanthema) and opium in bazar spirits, were sedulously applied to the abdomen. The good effects of the warm bath, fomentations, and blisters were in some measure doubted. Injections of assafoetida were supposed to lessen abdominal pain and spasm. In several cases, in which the vomiting and purging had spontaneously ceased, the extremities become cold, and the pulse left the wrist, from the advanced state of the attack, a large dose of calomel was observed to tranquillise the patient j produce diaphoresis, and moisture of tongue ; allay internal heat and thirst ; and pave the way to a recovery, previously almost hopeless. 

In Meerut, little opportunity offered, of judging of the general effects of bloodletting ; for few plethorick Europeans presented themselves ; and with the Natives it was almost always found impossible to make the blood flow. — One case, however, deserves notice, from the strikingly beneficial use of the lancet. A stout young Bramin was suddenly 



222 



seized, in the most violent manner, With the disease. He was immediately seen ; and twenty-four ounces of blood were drawn from a large orifice. Even after the blood had I flowing, the vomiting, purging, and other violent symptoms were in full force ; but as the quantity taken increased, they gradually disapppear«d; the pulse rose ; the countenance brighten. cd; and the patient declared himself to be freed from the severity of pain. A dose of laudanum, followed up by castor oil, completed the cur-; and next morning, all thai; lie complained of, was, a sense of stillness in the limbs, and of general soreness, as if he had been beaten, by a stick : the usual after effects of spasm, and violent exertion. The mode of treatment usually pursued, was either immediately to commence with large doses of laudanum (from 60 to 120 drops) and cordials ; or previously, to cleanse the stomach, and endeavour to renew the healthy action of its vessels, and those of the skin, by the administration of small quantities of rice water, or slightly aromatic diluents. The dose of laudanum was varied according to the strength cf the patient, and violence of the spasms ; and repeated oncu, twice, or even thrice, within an hour: suitably to the urgency of the case. Where obstinately rejected by the mouth, the opiate was repeated in double dases by clyster. When the extreme violence of the symptom* 



223 



was by these means subdued, and the vital powers so far restored, by the exhibition of small quantities of salop and sago, with spiced madeira or brandy, as to produce an equable moisture on the skin, a moderate dose of castor oil, or some other laxative, war, given* and repeated, with or without calomel, until the uneasy sensations of heat, and fulness of the primie viae, were removed. It w r as, in all cases, deemed indispensably necessary, to support the strength, by small quantities of light nourishment, repeated at short intervals. The warm bath, fomentations, and frictions with hot flannel, were, meanwhile, used as auxiliaries. No manifest advantage accrued from imbrocations with warm oil, spirit of turpentine, or tincture of cantharides ; or from the application of hot sinapisms. The exhibition of calomel and other cathartics, was generally postponed, until the spasms and intestinal irritability had been allayed. Even after this period, a operation was sometimes conceived to hurtful, by adding to the direct debility, :>usly induced by the vast visceral discharges — In other cases, the administration of cakmiel, in scruple doses, seemed to increase the irritability of the stomach; and the practice was thence abandoned. Some gave large dose» of opium, with, and without calomel, and succeeded equally with both plans. In some advanced cases, the calomel seemed to sooihe the bowels 



and aid recovery ; but then it should be remembered, that in such instances, the patient, having outlived the most active stage of the complaint, his fate would probably hare been the same, with or without the intervention of medicine. It was upon the whole, concluded, thatf it generally proved hurtful in the early part of the Pack ; and that amongst Natives, its use might general be advantageously superseded, by giv. ing, in its room, small doses of very mild laxa- 

Having now mentioned the principal varieties of treatment followed at all the great stations successively visited by the Epidemic k, it would be a mere waste of time, and of the reader's patience, were we to persist in minutely describing the endless diversity, wh.ic.li obtained, in the exact mode of applying the several great means of which they consisted, at the different outposts, and places of scanty population. ¦, — However they might diiTer in the order an:l time of their application, opium and calomel, were used by all the tlical Staff; and in, almost every case fled to, lie sole means of resisting the disease. — Let ow, therefore, turn to the several Divisions le Army, where, from the greater width of field of experience, larger opportunities offered, of judging of the efficacy of the different remedies employed - x and every observer W 

224 





225 



enabled, from personal communication, to profit by the observations, and opinions of his brethren. 

In the Jubbulpore or Left Division, the mode of treatment with all the practitioners, at first consisted in opiates, carminatives and calomel. Stimulants and antispasmodics were varied. Volatile alkali in combination with vinous spirit, sulphuric and nitrous ether, essential oils of peppermint, juniper and anise, tincture of lavender, brandy, and wine were severally employed. Frictions, fomentations, application of dry heat, and blisters, were successively tried. Calomel was in all cases administered in large doses, at short intervals ; followed up, after a proper lapse of time, by saline purgatives. In cases in which it was rejected, or did not appear to produce sufficient effect, the rapid saturation of the system by fumigation with cinnabar ; inunction on large surfaces ; passing of shocks from a galvanic pile through the region of the liver; the internal use of oil of turpentine; immersion in warm water ; and friction of the whole body with stimulating oils and liniments, were severally resorted to, amid the alarming difficulties which surrounded the practitioner. At an early period of the attack, bleeding was generally followed by an alleviation of symptoms ; particularly of anxiety and spasm. — But, the state in which the men were generally brought to the hospitals, ren» 

Dd 



226 



d&red the practice in most cases hopeless. In some, the blood would not flow •, in others, when the pulse was strong, and the blood came freely, it produced no benefit; whilst in others again, carried to the extent of sixteen ounces, and aided by repeated doses of (40 to 60 grains) calomel, and other cathartics, it produced a favorable resuit. In these latter cases, opiates and stimulants of all kinds were withheld ; and diluents freely used. — The blood was rather loose in texture, and shewed no buffy coat. The pulse did not rise immediately; but in the course of an hour an evident mitigation of symptoms appeared, and amendment was gradual. Other cases, »n, proved fatal when bleeding and purging alori-e been relied on ; so as to leave the mind in doubt, whether those that had been cured, were not originally less violent affections. It being thought, that those cases, in which opiates were exhibited, either alone or with cordials and calomel, generally proved fatal, the use of them was latterly entirely abandoned in several Corps. With persons of this opinion., their employment was superseded by the exhibition of ether, ammonia, and other cordials calculated to allay the irritability of the stomach, and rouse the general system, without producing constipation ; and by jalap, and such other cathartics, as readily brought away those dark and foetid stools, on which the cure was supposed mainly 



227 



giend. Calorrtel was, by some, conceived iet the alimentary canal ; by others, it was ed as too sluggish in its cathartic ope. In no instance, was this medicine trusalone* 

When the Epidemick first broke out in the Nagpore Subsidiary Force, the attacks were so exceedingly virulent, and the irritability, spasm, and universal depression so violent, as to be quite beyond the reach of art. The fate of the patient was so quickly decided, that of seventy or eighty patients brought to the hospital in the course of tlie first day, more than ten were found dead, or in the act of expiring in the Doolies. In such terrible examples of the disease, it was vain to try to bleed ; for there was no pulse at the wrist, and arterial action was so completely gone, that the heart had lio power to propel the blood from the centre. The internal exhibition of stimulants was equally useless ; for in all, the abdominal muscles were spasmodically contracted, and drawn back to the spine ; and the stomach instantly rejected, without distinction, every thing that was poured into it. When, however, the violence of the disease had somewhat abated; and the spasms of the belly, and general cramp were less marked, medicine was of some avail. At this milder period, laudanum, brandy, and other stimulants, usually quieted the patient, and induced diaphoresis and sleep $ after which. 

D d ° 



228 

OF THE TREATMENT 

Piing more was required, than a dose of com. nd powder of jalap, or car.tor oil, to un. load the bowels, and procure foeculent or bilious motions. By the unanimous consent of all ths staff of the Division, calomel was reprobated as injurious, in every case, and form. In whatever way given, in repeated scruple doses, with or without other aid, washed down with fluid, or dry on the tongue, whilst fluid of every sort was denied to the sufferer ; still, it was immediately thrown up, and invariably added to the irritabi. lity of the stomach. In many cases solid opium was observed to be kept down better than lav. danum. Magnesia, in peppermint water, was Peful in allaying sickness, and by passing off idily by the bowels. As auxiliaries in restoring Eficial warmth, blankets, frictions, fomenta. blisters, and occasionally the hot bath, were i beneficial. In camps, however, the warm Xl can seldom be employed on a large scale. too cumbrous in its form, and consumes too h hot water, to be used in situations in which, as here and in the other Divisions of the Army, the individuals likely to derive advantage from it are hourly pouring in, in almost unlimited numbers.* At Mooltye again, and Hoshun. 

• Mr. Dalton, Superintending Surgeon on the ma- 

t Establishment, recently suggested a very happy sof removing the obstacles to the general use of iin armies and camps. The following is a descrip>f the apparatus used by Mr, Dalton. 



229 



I, where the Epidemick attacked Detach; of the same body of Troops, calomel given alone, was conceived to allay the ion of stomach and urgent thirst, and even il cases, to afford much relief. It vas ally, however, combined wilh opiates and 

11 Me' hod of' using the Medicated vapor Bath" 

" Take a rattan or widely taped couch about 2A fl-et from the ground, and tightly surround the frame with a thick cumbhf valence, or flounce, to reach or trail on the ground 3 inches, or more; then cover the rattans with a cumbly or blanket to reach over the sides of the couch a few inches, on which lay the patient, who must be covered iighdy with a longer blanket or cumbly, as a bed is covered with a counterpane. When this is done, take two metallic basons and put half a pint of good ardent spirits into each, and into each bason place a metallic cup with as much vinegar as will quarter fill it, to which must be added, one or two drachm* of camphor, dissolved in a little rectified spirits of win.?, with a scruple also of opium, if necessary; then lift up the valence or flounce, and place the bason with the tumblers or cujps therein, under the couch at an equal distance, and throw a small piece of lighted paper ini> t&dk bason, when the spirits will immediately tike fire. The flounce, or valence must he replaced without dei»y, to prevent the escape of the heat and vapor, which in for 3 minutes will be so great as probably to render the removal of one of the basons expedient or necessary, at the heat of the Vapor Bath duly prepared, is only known to those, who have judiciously used, and prtpartd it, according to my directions." 

Thf employment of steam, spirit, and medicated vamissible 



from the early depression of the. vital 

In the Rajpootana Force, bleeding was largely practised, with various result ; according to the period, and seventy of the attack. If a patiem were brought in soon after he was seized, with a full, or even moderate, pulse, severe vomiting, and purging, and spasms of the belly aud extremities ; he was generally bled, to a pound, or a pound and a half. In all the Europeans, and in some of the Natives, so treated, the practice appeared to produce beneficial consequences If tlx? blood flowed freely, the pain of stomach, and harassing muscular spasm, were mitigated j and the ventral discharges lessened ; trauquility and perhaps sleep, ensued ; and a warm critical discharge soon broke out over the whole of the body, and 

por baths is almost as old as the medical art itself; and an apparatus somewhat similar to that used by Mr Dalton may be found described in the old systematic authois: see particularly Hoffman cap.de balneorum hsu, vol. Ist. P. 4-65 ; and vol. 4th. P. 292 and 3H; but Mr. Dalton has the merit of first applying them to the cure of the recent Epidemick. Dr. Girdlestone, indeed) states that a Dutch Physician was in the habits of employing them, at the time the disease prevailed general!} on the coast in 1 782 (see Essays P. 64) ; but then he l «- 'f | |» - 1 ••. i or — — 

230 





lemoved the severity of the complaint. But with many of the Natives, the circulation was so languid, from the beginning of the complaint, that no blood could be obtained. Thus in the first Battalion 28th, from 144 patients in hospital, the lancet was used in 77 ; of these 20 bled freely, of whom S died ; and from 57, little or no blood could be extracted, of whom 42 died. This average would speak much in favor of the practice, if all the cases, in which it was tried, had been of equal degrees of violence. But this was far from being the case ; for those, in which it succeeded, are stated to have been slight affections, in which the circulation was little impaired, and the general system not greatly depressed ; whilst the unsuccessful cases were so violent, as to leave it doubtful, if the bleeding produced any sensible effect, good or bad. Again, of twenty cases bled in the first Battalion 27th Regiment, not more than three or four ounces were obtained from five ; and from the remainder from twelve to sixteen ounces. Nearly the whole of these men were bled soon after the commencement of the attack; and the opposite results of the practice, seemed to depend, more upon the different degrees of depression, produced on different constitutions, by the malady, within a given time, than upon any difference in the length of its duration. The blood did not shew any buffy coat j nor did the 

231 





pulse rise rapidly on its abstraction. Along with bleeding, where its use seemed to be indicated, opium in a solid or fluid form, camphor, brandy, oil of peppermint, and various other stimulants, external and internal, were solicitously employ, cd with various success. In the earlier days of the Epidemick, when it had not arrived at its greatest degree of malignity, they no doubt often rescued the patient from death. But at a later period, they often seemed of no avail. Then, the disease marched on to a fatal termination, in spite of every human means ; the stomach indiscriminately rejected every thing that was offered to it : and the spasms and vomiting, and internal heat continued unabated by calomel and opium, whether given separately, or administered together. In the cases which proved favorable, the opiates and calomel were repeal ed every second or third hour, until the cramp, oppression, and other violent symptoms subsided. Where the stomach would not bear laudanum, solid opium was given in its place. Cold water, and fluids of every kind in large quantity were rigidly abstained from. Thirst was mitigated by warm rice water in mouthfuls. Some ot the patients fell asleep after the first dose of opium ; others after a second. They awoke with a warm moisture on the skin, and the spasms and irritability of bowels quite gone. In some cases, the exliibition' 

232 





233 

OF THE DISORDER. 

of the different spirits was pushed so, as to cause slight inebriation, with apparent advantage ; in others the patient was thought to recover more rapidly, if the mercury touched his mouth. — -In all, the cure was completed by laxatives. Calomel alone, was seldom used ; in the few instances in which it was solely trusted to in the first instance, no confirmed good opinion was formed of its efficacy. — With some careful observers, large experience both here and in the Left Division, produced a conviction, that the primary exhibition of narcotics and stimulants, was not nearly so successful in allaying the morbid action of the intestines, as the practice of first unloading the stomach of its noxious contents, by the use of simple diluents, or infusions of anthemis and other 

In the Hansi Division, venesection according to the age and constitution of the patient was very freely practised, with good success. Amongst Europeans, and the robuster class of Natives, one copious bleeding, to the extent of iwenty, or twenty- four ounces, taken in a short space of time, almost in every case produced immediate relief; settling the stomach, diminishing the spasms, vomiting, and restlessness, and inducing sleep. Of eleven Europeans, in whom this course was followed, only one died. A second bleeding was seldom requisite ; but when 

Ec 



the spasms happened to return, and the pulse kept full and strong, the operation was repeated ; always with the same relief. The Natives were, however, seldom seen, until the long continuance of the disease, and languor of the circulation, rendered the lancet a precarious and doubtful remedy. Thus with one gentleman, it was possible to procure blood, only from two, out of a hundred cases. — With another, little benefit followed its employment. Of six Sepoys, who were bled, three died ; in one the quantity desired was gained j in two others, from six to ten ounces; and in the remaining three fatal cases, only from three to five ounces. On the other hand, of fifteen Sepoys, who were not bled, only one died. In another Corps six persons were bled. By thn aid of warm, fomentations to the arm and hand, from ten to twelve ounces were procured, in every instance ; and all recovered, but one. — The blood at first flowed slowly, and of a dark purple colour; afterwards it became quite florid. After blood letting, the practice followed was somewhat various. By some, who placed faith in the sedative powers of calomel, that medicine was given alone, in doses of twenty grains placed on the patient's tongue, with ;i little sugar ; and laudanum was abstained from, unless the violence of the retching required i\< subsidiary aid* With others, it was usual to precede the exhibition of the calomel, by large 

234 





draughts and clysters of rice water, to cleanse the stomach and bowels. The calomel was repeated every four, or six hours, till the urgency of the symptoms had completely subsided. This usually took place in twelve or fourteen hours : sometimes not until ptyalism had ensued. After the vomiting and purfftns were wholly allayed, castor oil and other mild laxatives were used, during several days ; to carry off the acrid and fetid evacuations, which invariably appeared at the termination of the attack. When the patient was brought in, at an advanced sta^e of the disease, or the ¦©verity of the attack was such, as at an early period oreatly to depress the vital powers, and produce all the symptoms of exhaustion, the anodyne and stimulating plan was very generally followed, — with the same partial success, which attended it in other quarters. 

We now come to the Centre Division of the Army, where the disease was seen on the largest scale ; and each remedy was brought to the full test of experience, by numerous and repeated trials. Here, therefore, it will be necessary to be somewhat more particular, than we have been, while speaking of the other Corps of the Army. — When the disorder first fell upon the Camp, in so insidious a manner, as to lead to no suspicion of the dreadfully Epidemick form it was soon to assume, 

Ee2 

235 





the cases coming under observation were comparatively mild ; and were treated successfully with calomel, opium, and brandy, in moderate doses, at regular periods. But, as the symptoms increa«ed in intensity, this plan frequently failed ; and it became necessary greatly to augment the quantities of these medicines. At length, even the largest doses of stimulants proved useless ; and the miserable sufferers were cutoiij in spite of every means, after an hour or two of illness. — The bodies of some of the Dooly bearers, and Native details, were then opened, and such inflammatory appearances discovered, as seemed to warrant a new mode of treatment. The lancet was accordingly had recourse to ; but as, at this period, the patients were almost all Natives, seen at an advanced stage of the disease, and in whom universal coldness and coliapse had usually taken place, it was rarely found, that the blood would flow; and the practice was soon abandoned in despair. — Then, brandy and other cordials were freely given, to raise the pulse, and remove debility ; and large doses of laudanum, to relieve spasm; but still almost all died. 

Kiilst the practice was in this unsettled state, le Medical Officers were in extreme sus, as to the proper means of resisting the disthe European poriion of the Army begin to acked. About 5, A. M. of the 14th of No- 

236 





vembef, two Europeans belonging to the Fla^k Battalion were admitted into Hospital. — They had the disease in its most violent shape. The spasms especially were tremendous. A scruple of calomel, and 100 drops of laudanum in a glass of brandy and water, were given to each of the sufferers, and repeated at intervals during the day ; but without the least relief. They continued in horrible torture ; and died before eight at night. — During the course of the same evening, four ii_en of the same Corps were admitted together. It was resolved to try bleeding on all. From two no blood could be obtained ; but from the other two it came freely ; and as it instantly relieved th? patients, thirty ounces were taken from each. Next morning of these men, the two latter were out of danger ; whilst of the former, one was dead, and the other expired before noon. — Emboldened by the successful results of this trial, the Medical Officers of the Flank Battalion from tin's time endeavoured to bleed every one taken ill ; tnd with one solitary exception, no person thereafter died, from whom twenty-four ounces were obtained. If the patients were seen within two or three hours from the beginning of tiie attack, the practice usually succeeded : but at a later stage, when the pulse was gone, the skin cold, and the nails blue, no means could make the blood flow. — Softetisfes, even in the commencement of the attack, the attempt was ineffectual, from the extreme violence of the symptoms. 

237 





About the same time, a similar mo^inciuicu of treatment was adopted in the Artillery ho*. pitals. From the ill success, that attended its employment amongst the Native details, venesection was for a few days laid aside. But, as it soon appeared, that all other means were unavailing, it was shortly after again had recourse to among the Europeans ; and from that time forward, not a patient was lost, except one from whom only a few ounces of blood could be drawn. Whilst the blood was flowing, the patients generally expressed themselves to be much relieved \ the spasms instantly abated in violence, and in many cases, totally disappeared on a second bleeding. Sound sleep frequently ensued ; and after a few hours, the patient awoke refreshed, with scarcely an unpleasant feeling remaining. From eighteen to twenty-four ounces were always taken on admission ; and the operation was repeated to the same extent, it the spasms did not yield, after an interval of three hours. In some instances, it was had recourse to, even four or five times in twelve hours ; the quantity of blood taken away being solely regulated by the symptoms, without attention to the state of the pulse, which was generally weak and frequent. Some of the Europeans lost more than five pounds within twenty-foot hours; yet they did tipcat- to experience a greater degree of defrom this extent of depletion, than 1 ad not lost half the quantity. 

238 







239 

Moderate bleeding was practised generally in Kis Majesty's 21th Regiment of Dragoon's, and S7th Regiment of Foot ; and with equal success. So, in the Rocket Troop, the practice was to take; thirty ounces from each patfent. Here, in 27 cases it was successful, with exception of or.f man from whom not a drop of blood could bfc drawn, although the veins of both arms were 

In the Artillery hospitals, at the same time that a vein was opened, a scruple of calomel wm given and repeated every two hour* exevy hour, and where it was frequently rejected from the excessive vomiting, even every half hour, till the irritability was moderated, or it was evident, that do benefit was to be expected from the medicine. It in many instances appeared to produce the best effects ; but although frequently pushed to the extent just mentioned, and even given in doses of forty grains every half hour, both alone and conjoined with two to four grains of opium, or fifty to a hundred minims of laudanum, from the very commencement of the attack, it so often failed, that it could not bo allowed to possess any specific power to allay the irritable, or spasmodick state oi^ the stomach and bowels. It was, however, upon the whole, thought more uniformly successful in alleviating that state, titan any other medicine. In some cases, large doses oi'iaudaiium in saline drangbts succeeded, 



240 



when calomel and solid opium had failed; in Bts, opium gave relief, when calomel alone, ombiued with laudanum, had been tried in . Wine and brandy were added with the effects, when great debility had supervened. Anodyne clysters were sometimes beneficial: but no good was perceived to result from anodyne embrocations, or blisters to the Epigastrium. The warm bath could not be fully employed. A mild purgative, given as soon as the state of the stomach would admit of it, was necessary to bring away the large watery discharges, with which the bowe's were filled. The vomiting and irritability of stomach in numerous instances kept up many days ; and yielded, sometimes to one remedy, sometimes to another. Diluted '!• phurie acid was at this period largely given, with, out effect. 

In the Flank Battalion, after bleeding, calomel and opium were administered, and in three or four hours followed up by jalap or castor oil ; which produced ibeculent stools, and completed the cure. In some cases, it was long before the patient regained his strength. In such as would not bleed, stools were procured with great difficulty; the dangerous slate continued se\!.r;i! days ; and recovery was very tardy, 'i again, in whom the blood flowed freely, rapidly mod health ; ;:nd generally returned to their duty in three or four days. In the R'ockel 



241 

OP THE DISORDER.' 

Troop, an emetic of ipecacuana, given after bleeding, so as to bring up a quantity of the dirty fluid, and curdled matter, with which the stomach was filled, was thought to do good. Blisters, and effervescent draughts were found very useful in allaying the irritability of stomach, which harassed the patient throughout the whole course of the disorder. In His Majesty's 87th Regiment, calomel given alone, either in large or small doses, always proved hurtful. Combined in small and repeated doses with opium, and aided by turpentine and anodyne clysters, fomentations, and frictions with warm oils and camphorated liniments, it seemed to allay the irritability of the stomach and bowels, and relax the spasms. 

The same mode of treatment was generally followed amongst the Natives ; with exception of bleeding, which in most cases proved quite inadmissible. In the early periods of the Epidemick, the generality of the Native patients were brought in, either moribund, or in such a slate of exhaustion, as to render all attempts at bleeding useless. But, even at a later period, when the Natives, having become sensible of the great danger of delay, applied for assistance soon after the commencement of the attack, venesection was usually impracticable. Whethei from the violence of the disorder in this quarter, the constitution of tv& class of persons 





Br more readily depressed, than that of Euros; the powers of life appeared to be in them st immediately extinguished, and ( universal collapse soon took place. An entire stop seemed to be put to the circulation ; and the blood wholly forsook the superficial veins. It is plain, that, however large the orifice in such cases, no blood could be expected to flow. It was, accordingly, scarcely in one instance found possible to obtain more than six ounces from a Native labouring under the disorder ; and from upwards of a hundred patients, whose veins were opened in the Artillery Hospital, pne ounce was most commonly the extent of what could be got. In such cases the strongest stimulants seemed necessary to revive the sinking powers ; and all, accordingly, placed their main dependence on powerful and repeated doses of ether, brandy, oil of peppermint, camphor, &c. with laudanum, calomel, blisters and other topical means. That these were often successful, it cannot be doubted; but still they so frequently failed, as to convince the most sensible observers that, bleeding amongst Europeans being alone excepted, but little confidence was to be placed on any mode of treatment hitherto discovered ; and that the disease often attacked with such awfully fatal violence, as to bailie all human skill. 

The diarrhoeas and fluxes, often consequent on the attack, were here, and in other parts of 

242 





OF THE DI3ORDER. 

243 

the country, found to yield readily to opiates, calomel, ipecac uana, and such mild astringents, as are usually serviceable in the removal of similar complaints, arising from different causes. 

I very enquiry into the practice followed by Natives, in resisting this most formidable ase, has only tended to shew, that wherever ' departed from the methods usually pursued European practitioners, the remedies used by i were either of a frivolous, or of a pernicinature. In the Moohumudan cities of Upper a, the Native Physicians adhered to the rules down by the writers of the Arabian school ; after cleansing the primag viae of their ous secretions, by means of salt and water,* mild diluents, had recourse to opium and 

• This practice was tried very successfully by the Nativ« Doctor with Colonel Skinner's Horse at Shapoor in R.ijpootana in the Autumn of 1818. Every man wai as soon as taken ill, vomited with salt and water, and then had opiates ; and although the Corps was largely affected, not a single death occurred. The practice is thus described in a letter from the Corps. "Warm salt and water is given till the stomach is well cleared ; and then small doses of laudanum, and peppermint, or the essence of cardamoms, when the irritability of stomach is stopt. Afterwards, violent thirst comes on, for which boil anise, and when cooled, give it, as often as required by the patient. Great numbers were cured by this method. The Natives of Indore cured great numbers. I may say the only medicine they had, was juice of onions 





244 



apices :as cardamoms, and the different sorts of pepper. Sometimes they used preparations of lime, decoctions of the bark of the Neem tree, and other powerful astringents. Where, again, the judgment of the medical attendant was warped by some absurd theory, of the malady originating in great internal heat ; he placed his chief dependence on cold drinks, and killed his patient with deluges of rose water and lemonade. And, as if these were not sufficiently speedy in their operation ; he often stripped the sufferer completely naked, and having rubbed his body over with dust of Sandal wood, kept fanning him, until the little heat and life remaining, was extinguished. But, the great mass of the people expressed by their conduct, how fully they were convinced of the inutility of all human aid to subdue the calamity ; for no sooner did the disease appear, than they fled for assistance to their offended deities, and allowed the sufferer to expire amidst their unavailing prayers and incantations. Latterly, however, when they saw their superstitions fail them, men even of the highest castes, throwing off all their religious prejudices, applied to the European practitioners, and learnt to place 

their faith in the only means, which have been 

wul Bazar arrack. It was also practised at Mow ; and 

« great number of men were cured in the camps ; but with the salt and water as above, not a single man was lost in this Corps; and stopping it suddenly, with a Urge Jose oi laudanum and calomel, was certain death.'* 



Bund, in any measure, adequate to resist the 

A deliberate review of the whole of the preceding remarks, on the modes of treatment pursued by different individuals in combating the disease, and a careful comparison of the results of opposite lines of practice in the several Divisions 

* The practice of the Ancients in this disease was very unsettled. Galen tells us, that Asclepiades cured it by pastils made of spikenard, hyoscyamus, aloes, and rue with juice of roses, inspissated in astringent wine; and that Chrisippus and his pupil Erasistratus used purgatives, and wine diluted with cold water. Galen himself gave wine mixed with cold drinki, quinces, pomegranates, and other austere fruits; placed the patient in a cold bath; and largely cupped the abdomen. He sometimes gave mint and cinquefoil, in wine and hot water ; but he chiefly placed faith in Theraica, a nostrum compounded of viper'i broth, and nearly a hundred simples, with wine, spices, and warm purgatives. (See his treatises do usu Theraici : de compos. Pharmac. de yen. Sect, et de Medicin. fncil. parat). Celsus proceeded upon sounder principles : he first freely used diluents, and then wine, when the crudities were expelled. When the cramp was severe, he administered rue. and applied sinapisms, and cupping instrument! to the stomach ; and where the extremities got cold, he used hot oils and warm fomentations. He admits, however, that few disorders so obstinately resist every means employed. Avicenna, and the authors of the Arabian school, first vomited the patient ; and then gave hot water, vinegar, 

245 





of the Army, would seem to authorise the following conclusions. 

1. The disease sometimes attacked with such extreme violence, as from the commencement, apparently to place the sufferer beyond the reach of medical aid, and to render every curative means employed equally unavailing* 

2. The difference in the degree of mortality amongst those, who did, and those who did not take medicine, was such, as to leave no doubt, that, when administered in time, and with discrimination, it frequently saved the patient from death. 

3. The chances of a patient's receiving benefit from medicine, diminished in proportion with the increased duration of the attack. 

4. In Europeans generally, and in robust Natives, bleeding could commonly be practised, where the patient was seen within one, two, or I haps three hours, from the beginning of the ick ; and in all cases, in which it was resorted under such favorable circumstances, it was re successful than any other remedy, in cutl short the disease : usually resolving spasm ; ,ying the irritability of the stomach anil vels ; and removing the universal depression, icr which the system laboured. 

246 





OF THE DISORDER. 

247 

E Amongst the generality of Natives, the deing influence of the disease was so powerful, apid in its operation, as almost immediateproduce complete collapse, and nearly desarterial action ; and therefore, to reader lection, for the most part, from the beginimpracticable. 

Kin such cases the cure was best attempted vents, powerful anodynes, and stimulants -, ined with calomel; and followed up by axatives, and tonics. 

7. Although it cannot be affirmed, that calomel possessed any specific power in checking the disorder, it was undoubtedly frequently useful in loothing irritability ; and was perhaps, of more certain sedative operation than any other mcdi- 

How to apply these deductions to practice, and to vary the different means at our disposal, according to variety in the form and severity of the attacks, will be best learnt from a frequent observance of the disease ; aided by a careful perusal of the Cases attached to the body of this 







List of Persons attacked by Cholera Morbus 

if in the town of Calcutta, to whom Medicine was administered, from September to January, 1819. _ Dates. $ t Ijj | From 19th Sept. to Ist Oct. 1817. W 5464 2102 934. 378 gd Oct. to 14th 13 2916 1994 701 221 15th do. to 28th 13 2012 1498 449 65 $Bth do. to 9th Nov IS 1515 1127 346 42 10th Nov. to Md 13 1253 883 294 76 23d do. to sth Dec 13 1054 771 224 59 6th Dec. to 19th Dec 13 1001 702 240 59 19tb do. to 21st do. IS 705 518 157 30 Total 104 139"2()1 9595 3395 930 





List of Patients attacked with Cholera Morbus, to whom the Native Doctors, in the Suburbs 6f Calcutta, entertained for that purpose, afford- 

Ed relief, from the 19th of September, 1817, to the 31st of January 1818, inclusive. . 58 ' . •*! a "is Months. ,** "§ Cured -i b? From the 1 9th to the 30th September 1817, 2190 1920 243 27 From the Ist to the 31st October, $275 31QQ 132 21 From the Ist to the 30th November, .' 1597 1554 40 3 From the Ist to the 31st December, ....1413 1368 40 i From the Ist to the 31st j J imarv. 1818* 691 643 46 2 

Total 9171 8607 607 57 

The Native phjίiciani were temporarily disclu; during uv:a three weeks. 





Report tor the same period of Native Villagers, S:c. who have applied to the Native Doctors of the Guards at AHipore, Bhowariypore, .Soorah, and Russapuglah, those with the Mysore Princes, &c. 

?^ i i • Months. * * Cured. Di J | f> (S V> \< t; CJ J Q Month of September ISI7 547 489 36 [22 Ditto October, 485 464 14 ' 7 Ditto November, 164 157 4 3 Ditto December, 162 153 6 3 Ditto January, 1818,... 65 64 1 Total 1423 182? 6l \SS 





to whom the Native Doctors in the Suburbs ot Calcutta entertained for that purpose, afforded relief, from the 25th of February to the loth of July, 1818, inclusive. 

•— — ——————— , j —•— 5 "S J § Mouths. ?»"g 3 Cured. Died, -it , r_ <_>~_r~~ _______ From the 2.5 th to the 28th February, IS 18, 629 532 73 |24 From the Ist to the 31st .March, .. * 2197 1950 216 SI From the Ist to the 30th April, 8187 1958 209 20 From the Ist to the 31st May, 1557 17*« 97 18 From the Ist to the 30th June, 1605 1510 73 1? From the Ist to the 15th July, ---- - - - - 918 887 46 |15 Total I \)l^\ 8.579 719|l^j 





253 

Report for the same period of Native Villagers, &c. who have applied to the Native Doctors of the Guards at Allipore Bhowavypoie, Soerah and Russapuglah, those with the Mysore Princes, &c. 

"- "So ; ?S i I Months. Cured. Oied.^ Month of February 1818 172 146 11 15 Ditto March, - - - 638 584 42 12 Ditto April, - -- - 377 352 20 5 Ditto May, - -- - 263 250 10 3 Ditto June, - - - - 256 244 6 6 Ditto July, I« W» *_^ Total, - - - 7T" 1859^726|_jn! Grand Total, - - 7777. 21876^0239^378,259 



254 

Abstract of Deaths from the Cholera Morbus, reported to the Magistrates from the princi, pal Burying Groun Is, and Ghauts or Ferries, in the Town of Calcutta. 

1815* 5 1817 1818 1819 § January, 11 1? 8 407 73 February, .-- - 11 14 131324 81 March, 612 51130 203 April, 0 8 4 586 266 May, 5 0 11 490 187 June, 10 5 20 175 87 July, 16 6 26 76 84 August, 24 10 133 156 36 September, - - -- 37 21 468 132 57 October, - - - - 25 29 259 145 86 November, - - - - 26 10 186 373 349 December, - -- - 11 9 190 115 0 Total, 182141 1 3Q3 5 1 09 1459 8 jj* • Th^setwo years shew only tiic number of Hindoos reported to have diod of the Cholera Morbus; the three following of both Hin duos, and MmMlWli 



RETURN of Casualties in the Centre Division Grand Army from the disease lately prevalent, up to November 30, 1817. 

Eurapm. N. SoUI-i,,; Pul.lic Establishment. H.M. 87t!iReg: 87.^ 31991 8 , - 3 ... ls.Bl.lnf. ¦> lίu.2.)tlillfgt 938 sij... ] , ...'...... Ist Bn. 29M1 dv. 987' I ..J... 3j ItM >#> " >m ' >#< .idίii. Ist d 0 .... 950 1 0... sO| '.'.y... ... "l ... '... Id Ditto. Flank Battn. ... 'o.S 6 ... it ... "j .30 17C! 5 Ist Battn.Sth do 93s IgJ.. .„ ']" # " []" -\lίatt. lltlido. 95" || 41 .. ... ... ... ... ..] ... J... 3d Ditto, Ist 811. 24th do. 958 1 0... 42 ... 1 ... ... 4 ... ... 1... Horse Artillery. .3-~5 l|...iii> .. .'|i.gt.. o ] 10 7 ... Artillery, Rocket Artillery, 98 3 ...'... (...,!.. ... 2 ...i... ... ?J 7 2... 5' 8 ... Foot Artillery, 27<» li si ... Miner*, 130 l ... t\ ... Pioneers, ,390 1 8;... ¦ J I li i Total 5531 14 1 98 g| J 2/247 i ill 9 5 80 22 1 13 15 3 iGrand Total 8531 113 057 ' 

— This is exclusive of the Corps which Colonel Philpot's Detachment, viz. H. M. agoons, 676 strong, the 3d Regt. N. C. \<r ; the Dromedary Corps 296 strong ; the ) Horse Artillery, and the 2d Batt. 13th 

Rear. N. I. 900 strong j and of the 7th llegt. N. C. 





nin His Majesty's 22 1 th Light Dragoons, 87th Foot, and Flank Battalion, from the 25th October, 1817, to the 25th January, 1818. October 1817. November 1817. December 1817. January 1818. iith Lt. Drags. 00 0 2222 2 47 53 0 0 0 5500 0 3 3 63 87th Foot, - 0 0 1 1213 2 3 1 39 45 0 1 0 7800 0 1 1 67 Flank Battalion, 0 0 0 4J 4 1 6 1 37 45 0 0 0 6 6 0 0 0 2 2 57 ¦ I I I I Total. - 0 ! 0 1 1819 511 4 123143 0 1 0 is'l<) Oj o| 0 f>| 61876 187 tN. B. — 1 he above are Deaths in His Mijesrifs Corps alone in the Grand, or Centre Division of the nay. The Casualties in the months of NoveinbiT in only 3 Corps are imu-ciise, viz. 5 Officer*, and 143 uk and File, which marks the period of the Cholera. 





APPENDIX. 

CASES OF CHOLERA. 

NONE of the following cases were drawn up with a, t iew to publication. In most of them, the symptoms were, amid the hurry, and busy occupation of a very sickly period, noted down at the patient's bedside, more to serve as memoranda to the medical attendant, than for any other purpose. Hence they are not so full or elaborate, as they might have been made under other circumstances. It is to be regretted, that no cases hare been received from the Centre Division of the Army, in which the disease was so extremely formidable. But, there every man's hands were so full of business, that far from having leisure to write down the diseased appearances of the sick, he found it impossible even to pay the requisite attention to the numerous calls on his humanity. The usual journals were, accordingly, for a time entirely closed. Most of the instances among Europeans, given below, occurred in the General Hospital of Calcutta, in the shipping in the river, and at Cawnpore. The Native cases, with hardly any exception, happened partly at Delhi, and partly with the Nagpore Division of the Army. Many others might be added; but as in all, the symptoms were nearly alike, it is thought needless further to increase the size of a Report, already perhaps too greatly prolonged. 

CASE FIRST. 

GENERAL HOSPITAL, STH SEPTEMBER, 1817« 

Corporal Clayton, His Majesty's 59th Regiment ; admitted into Hospital about three o'clock P. M. Was 

II h 



258 



taken ill at 7 in the morning, with swelling of the belly, sickness at stomach, Vomiting, purging, and cramps of the legs, stomach, and belly. Was greatly purged — knew no cause of his illness. Oh admission, his body was covered with cold sweats ; the vomiting incessant ; cramps very severe; pulse scarcely to be felt ; countenance very heavy and pale. Laudanum was rejected. Calomel, opium, and every thing swallowed, came up. A Blister to the pit of the stomach ; small doses of calomel and opium, frequently repeated; frictions to the surface ; mulled wine; all seemed to be of little service. The pulse sunk; the extremities became cold; hiccup ensued; and he died at 3 next morning. 

Dissection — On opening the abdomen, the inner surface of the stomach, from the cardia to the pylorus, was found inflamed, red, covered with slimy, bloody, greenish matter; in some parts slightly abraded. The marks of inflammation were strongest towards the pylorus. The duodenum was in the same state; of reddish colour, and covered with bloody mucus ; but, little thickened. The liver was sound, and full of blood; the gall bladder contained about two ounces of ropy, dark green bile. The colon was distended with air to a great size ; mo»t ox the intestines externally had a reddish tinge. 

CASE SECOND. 

26TH FEBRUARY, 1818. 

tJohti Donnochan, seaman, active; good constitution, fter being much in the sun, was today suddenly seized ith giddiness, then spasm in the body, thighs and •ins; followed by looseness, vomiting, cold shivering, Kisensibility. Admitted at midnight with severe ingand purging, spasms and cold skin. Pulse quick eak. is exceedingly thirsty. Has pain of right 



side and some tendency to delirium. V. S. ad \b, 1 Hab opii griss calomel gr. xii itnt Appl. Einpl. vesicut. wagn. abdom. Ad/rib. Bain calid. — 27th. No relief from tlie bleeding. Blood flowed easily ; constant vomiting during the night; had several stools like pure rice water. Very thirsty; tongue fur r ed; no cramp; pulse very feeble and weak. Capt. Mistur. salin Bii aether vitriol git. xxx Tinct. opii. gtt L. Spir. Lavend. Comp. 3fs. duab. hor. —fi P. M. Four stools ; perfectly pale ; vomited a little. Thirst excessive ; skin cold ; pulse still feeble. Is rather lower. Hab calomel gr. xx et rep. ad vesper. Repr. Bain, calid. — 28th. Slept well; hadno stool; vomiting lessened; no cramp; pulse fuller ; skin now warm ; tonguefoul. Hab. Infus. Sennae ad plen. resolut. alv. — P. M. vomited once. Five light rice water stools; skin warm ; pulse sharp and quick ; feels low ; but appears better. Repr.pil c calonn i. — March I st. Slept well. Three stools of rather a dark colour; no retching or cramp; now very thirsty, with nausea hot skin, full, rather quick pulse; and tongue furred white Repr. mist. Senn. — P. M. Three light coloured motions t united twice ; considerable fever.— Repr. calomel 'arch 2d. Many natural, watery, frothy motions; pulse 11, and more moderate ; tongue less furred ; skin warm , ) vomiting. — Feels great oppression at his heart; and sickness of stomach. Is dull. Repr. mist. — P. M. Seven or eight watery, brownish motions; pulse quicker; not so full. Vomited several times. Repr. calomel — 3d. Two natural motions. Still a little feverish ; i'eels very low. — To have wine and sago. — P. M. Several dark motions ; in other respects as in the morning. Repr. pi], — 4th. Going on well. Four or five brown stools. Still sick. Pulse good. — P. M. Three dark stools; pulse sharp; feels low. Repr. calomel. — sth. Much purging of very dark bile. — Stomach lighter ; but still a little vomiting ; pulse full and quick ; skin hot; great thirst ; tongue cleaner. Repr. calom. — 6th. Only one scanty, more ibeculent motion. A little squeamish. 

II h 2 

259 





Pulse of lrsi volume. Repr. calcm. — 7th. No stool ¦ince yesterday. Is low; with considerable lioat, •harpness and celerity of pulse, and sickness. Repr. mist. Scnn. — P. M. Mouth sore. Three or four, more natural stools ; feels much better. — Omr. pfl s# Passing much dark matter ; continues lighter — 9th. BoweTs discharged freely yesterday ; still a little hot, with white tongue; appetite returning. Sum. Decoct, cinchon. §111 1 quatvr indie.— loth. Bowels free; stools natural. Convalescent. 

CASE THIRD. 

MAIICH 2D, 10£ A. M. 

Thomas Hughes, Seaman, about 30 years of *ge, constitution debilitated by previous disease ; was attacked a quarter of an hour ago, with vomiting, retching, severe purging, with frequent dark watery stools. Spasms universal (and particularly severe in the extremities ; the muscles of which are incessantly quivering; the whole body is cold and clammy; skin discoloured of a bide purple colour; no pulse to befelt ; tongue white; breathing very uneasy; eyes heavy and dull; is speechless, and apparently in great agony; hands shrivelled; fingers twisted— V. S. statiin-Tinct. opii gtt. lxxx. Ether Sulphur 3ss stat. Bain, tepid.— l P. M. Very Hub blood could be got to flow ; although several veins were opened in i'uch arm. Has been in the bath for nearly three hours ; spasms greatly relieved, whilst he remained in the water; but recurred, the moment it was attempted to remove him from it, at which time the general convuUions grew so violent, that it required several person* to hold him. During the time he remained in the bath he vomited eight or nine times; rejecting the laudanum, ether, and brandy which were given to him largely »t intervals, and a little water and phlegm. 

260 





Id several stools in the bath. Calomel gr. viij opii stat. — 5 P. M. Vomited once on taking tlie pill, t and back a little warm ; extremities cold ; has very restless ; but is now lying quiet, taking no of any thing ;no stool ; pulse quite indistinguishhas been taking hot brandy and water, and ntly using every subsidiary internal and external of excitement. Repr. haust c iEther et Tinct. Died a few minutes afterwards. 

Dissection. — On opening the body the intestines were discovered to be of a deep rose colour. The stomach externally, had a natural appearance : internally, its whole surface was covered with coaguable lymph; on removing which, bloody gelatine was found laid on the inner coat, in ridges or elevated streaks. The liver was of a dark blue colour, and very much gorged with blood. The diaphragm, and inner parietes of the abdomen, were blue from venous distension. The vena eava was greatly distended- Nothing else particular in the abdomen or thorax. On taking ofF the skull cap, a considerable quantity of coagulable lymph was seen ou the surface of the brain. The ventricles were completely filled with water, which was likewise found in quantity at the base of the skull, and top of the vertebral canal. This man, during several days preceding the attack, had been exposing himself much to the sun. On the night before the attack, he had pain of stomach, and was purged. The appearances in the brain were probably accidental ; as he formerly had had a paralytick stroke, from which he never perfectly recovered. 

CASE FOURTH. 

c 2d march. 

John Smith, Seaman, aged 22, of good constitution. 

261 





9A. M. Has had Cholera since last night. Pulse now very small; severe cramp, with frequent severe vomiting and purging; skin cold ; tongue furred white; face pale and anxious. V. S. ad lbj. Capt. iEther Vitr. 3s Tinct. opii g. L. Hab. Bnln. calid.— H. 91. Was bled to fainting. The pain and spasms were relieved ; but the pulse did not rise. The aether and laudanum are repeated every ten minutes. Says he was taken ill about nine o'clock last night ; first with looseness, then vomiting and universal spasm.-- First vomited what he had ate; then pure water ; stools quite watery. Had severe cramp of the chest and stomach frequently during the night, and great thirst. — 9£. One small watery dark motion — again cramped. Pulse very small and quick ; skin still cole face blue. Bath did no good ; had spasm immediate after being in it. Repr. JElher. Capt. calomel, gr. rxadhi fot. ad abdom. — 10. Not so sick now. Pulse quicker, am rather less feeble ; skin more natural. — 12. Severe cram o''h;inds and feet ; pulse more natural; skin warm; coloi returning ; no stool or vomiting. Repr. Tinct. Ov.ii jfEther. Conr. fotus. — 1 P. M. Vomited his medicin with much watery fluid. Appr. Empl. vesicat. magn. a< region, ventri. Repr. Tinct. et 7Ether.--3 P. M. No fu ther vomiting; several stoolslike muddy water. Pulse be ter, still universally cramped. Conr. — 7 P. M. Easier every respect. Very slight spasms. Stools pass away invcr small quantity, nearly involuntarily ; and arequitemiu dy ; pulse and skin quite natural. Rep. caloni. — 3d Marc Slept well ; no cramp ; many muddy stools ; pulse m derate; face natural; skin moist. Very thirsty. — P. M Passed much muddy water ; very sick at stomach a day ; but did not vomit ; pulse and skin natural. — Rep C'alom. Blister rose well. — 4th March. Urine made wit difficulty; some straining ; no high action; pulse, ski mid bodily appearance natural; no stool; tongue very fou Mist. JSenn ad sol. Alv.— Fot. ad pelv. — P. M. stools hay not been passed freely.— sth March. Much stiaineddu 

262 





263 



ing the night ; and has passed a great deal of dark thin bilious matter. No vomiting ; has a feeling of tightness jn his breast and abdomen ; pulse and skin natural. Repr. Infus. Senn. — Sago. Wine. — 3 P. M. Stomach bad; vomited once on taking the medicine; stools watery, and dark green ; pulse good. Calomel 91h.5.--6th March.Passed a tolerable night; several dark stools; complains much of constriction of chest and abdomen. Reprl Cal- P. M. S;ck all day; has ate nothing ;no stool ; no fever; tongue not very foul. Repr. Calom. — 7th March. Still sick at stomach, with severe twitches in the feet — otherwise much as .yesterday ; stools dark. Cap. iEther. S. gtt. xxxv Sp. Lavend. C. 3s mist. Camphor. sss tern. lior. — P. M. Moulh tender. Easier. Omr. Pil — Bth March. Going on well ; sickness gone; motions yet dark. Conr. haust. — 9th March. Mouth, face, enrs, and throat gore ; stomach still feels constricted : stools getting natura — Omr. medicam — Hab. gargar. Commun. — 10th March. Only one stool ; looks clear and well ; and only complains of his blister. Hab. Decoct. Cinchon. Bit saepe. Fowl diet. — Uth March. Still has constriction of breast ; tongue clean; stomach good; bowels open. Conr.— 18th March. Complains of pain of bowels and looseness; tongue foul. Hab. mist, cretae. saepe. — 20th March. Was last night seized with vomiting, and purging; and is still sick. — An abscess has formed where he was bled in the arm. Adde singul. dos. mist, confection. Opiat grl x, et capt. sii quater in die. — 21st March. Looseness stopt; no complaints. Milk.--22nd March. Still a little purged with griping. Arm quite easy.— 2<tth. Bowels yet irregular with tenesmus. Cap 01. Ricin. Ss. — 26th. Five or six stools with tenesmus. — 27th. Bowels painful and costive. Repr. Ol. — 30th. Discharged well. — April 7th. Returned last niirht with irregular action of bowels; purging; and pain as if the guts were knotted; weakness ; and want of appetite. Ordered tonicks and astrii <r >t ¦ Bth Arr md deal nurircd last ni^ht ' stools sii- 



S9th. Only one stool. — Had cramp in left leg yester-10th. Was purged, with griping and numbness of Utr. Mist. Cretac. — 15th. Bowels yet a little loose. lams of pain, or rather oppression of stomach. >ischarged well. — This man before being attacked :en much exposed to the sun, whilst at work on ship in the river. 

CASE FIFTH. 

sth march. 

Joseph Jerams, aged 43, a hale, powerful man. Has been sick at stomach, with headach, and disposition to cramp since last night; pulse good ; tongue clean. Belly open. Capt. calomel. 91 opii gr 1. — 6th March. Sweated much in the night. Had three stools with pain of bowels and flatulence — Habt mist. Senn — P. M. six green motitions. Is qualmish with griping — Repr. pil — 7th March, griping sind purging considerable. — 12th Discharged well.— 1 lth. About half an hour before 9 A. M. returned, with cold skin, covered with clammy sweat; livid countenance; quick, very small, feeble, fluttering, pulse; sickness; oppression and pain across the Epigastrick region and loins; foul furred tongue; loose bowels; laborious breathing ; and cramp upon moving. Immediately took half a dram of ether and fifty drops oflaudanum. Gave the following account of himself — licmained well till yesterday, when he was very hard worked in the hold of his ship. At one this morning, ¦was seized with violent purging, succeeded by vomiting of yellow fluid; and then by cramps of the legs, hands, and trunk: all within an hour. Has since been very frequently purged; and has vomited a dozen of times — a thin, mealy looking fluid. Ascribes his ill- 

264 





APPENDIX. 

265 

Tinct. Opii. Appr. Empl. Epispast. ventricul. Ha Bain. Calid — 9^ A. M. a little relieved by the bath cramp confined to the toes and fingers, which are sti fened and irregularly twisted. — Stomach sore on bein touched ; belly not hard ; eyes glassy ; features co lapsed ; very sick and faint; with hurried respiration Has been in the bath twenty minutes; pulse 144 ; scarce ly discernible ; evidently smaller since he went into th hot water; is extremely thirsty; hot bottles are put t his feet and hands ; he is allowed to mitigate his thirs by a mixture of sweet spirits of nitre and water. — 1 A. M. Vomited a little once; one stool, like seething of oatmeal ; severe spasms of the hands and feet ; res piration caught by paiu of stomach ; skin keeps per fectly cold. — Pulse distinct, feeble and irregular; some times very quick, then slow for one or two beats. Repr Tinct. Opii. et caet. — 3 P. M. Confused and delirious — Body quite cold ; pulse'imperceptible ; breathing shor and hurried ; face much collapsed ; no vomiting; severa stools as before ; has had several touches of spasm. I ordered to take capsicum with other powerful stimu lants; and camphorated spirit externally. — 5 P. M. I sinking ; No stool or vomiting ; keeps cold withou pulse; is sunk in the .bed; breathing laborious; face very anxious; incapable .of speaking. — 6 P. M. dead 

Dissection. — The intestines here and there flushed, as if from increased arterial action; and, together with the stomach, filled with a fluid like that passed off by stool. A very small number of red, mottled spots in the stomach ; more numerous in the duodenum ; g;ill bladder full of thin dark bile. — All else healthy in the abdomen and thorax. In the brain, the sinuses, and veins leading to them gorged with black blood* 

I i 



266 



CASE SIXTH. 

SOtII JANUARY. 

Private Emerson, His Majesty's 59th Regiment.— About one o'clock P. M. seized with purging, vomiting, great anxiety, and pain of stomach, and spasms in his limbs. By mistake lie was not reported till between five and six, when he got a dose of laudanum, and was ordered into Hospital. On admission, the vomiting and purging had ceased ; the spasms had nearly gone off; but the pain below the pit, of the stomach, and most distressing anxiety, continued; the countenance wai pale; the eyes heavy, red and inflamed; the pulse weuk; the arms and hands moist, and much below the natural temperature; and the thirst dreadfully urgent — He took a scruple of calomel ; and at 10 o'clock was bled to 14 ounces; more blood could not be procured. — After bleeding the pulse was more frequent and weak ; the anxiety continued. — A little before 11, he was put into the bath — He said he felt easier; and the pulse rose a little. — A blister was ordered for the pained part of the abdomen; and at 2 o'clock A. M. another scruple of calomel was given to him. He slept a little after coming out of the bath. In the morning, the symptoms were much the Same; the pain and fullness of abdomen continued, with restlessness; the'pulse was very feeble; and the skin cold. He took another scruple of calomel, and had a purgative injection which operated. — Xhe blister had risen partially. He died at one, P. M. exactly twenty-four hours from the time of his being taken 

Dissection. — On opening the abdomen, the viseeni had a general red appearance. Tlie omentum contained little fat, but its blood vessels were distended. The stomach was found inflamed internally; being of a dusky red colour, and covered with reddish mucus, in some 



part* the villous coat was abraded. The inflammation was greatest towards the pylorus. There was no thickening throughout, nor even a single corrugation to be seen. The under part neur the pylorus was of a dirty brown colour; some of the calomel was discovered adhering to the stomach ; us it were, imbedded in the m*» cus. There was no bile in the stomach, but about a pint of thin watery fluid : probably what lie had drank. In the abdomen bilious matter oi very pale yellow colour was found. — The duodenum exhibited no marks of disease. — The small and large intestines were of a preternatural ly red appearance. The spleen was much enlarged, weighing upwards of two pounds. The liver was of the natural size ; colour thai of brown nankeen ; structure hard and firm, cutting like new cheese; containing Tery little blood; surface rough and covered Kith inequalities or small tubercles about the size of peas ; the lower edge of dark colour, bent in, and appearing as if it had adhered to the neighbouring parts; the whole internal substance of the viscus of 

Bt pink colour. — The gall bladder shrivelled, ntuming about half an ounce of dark green bile. 

CASE SEVENTH. 

STII MARCH. 

Humphrey Blackburn, Seaman, act. 26th, nt eleven to day, from being in perfect health, was suddenly seized with trembling and weakness, followed by sickness, vomiting, and purging of clear watery fluid ; was purged nine times. The cramp then ensued ; first in his feet, and afterwards in his thighs; — now, at three o'clock, has great pain in the abdomen; spasms in the extremities; thirst ; sickness ; and looseness ; face blue ; skin cold and covered with clammy sweat ; pulse gone at the wrists. He is ordored to take a dram of aether and fitly 

I i 2 

267 





drops of laudanum cvsry ten minutes. Heat to be applied in every form to the surface. — Z\. The cramp of his thighs exceedingly severe ; extreme thirst ; great anguish ; whole body blue and cold. — 3-J. Pulse now returning; feels much easier. — 5. One stool of muddy water ; face very blue ; hands deadly cold ; Pulse very feeble and rapid ; anxiety subsists ; spasms return on his being moved. — Has taken one dose only of the medicine since last report. — Appr. Empl. vesicat. magn. abdomen. Adhr. Bain. Calid, — 10. Still very low* with extremely quick, feeble pulse ; great oppression and thirst; no stool. — One slight fit of vomiting ; skin cold. — Bath gave temporary relief, but weakened him much; and the spasms returned immediately upon his leaving it. Capt. Calomel 91 st. Sum Sp. Lavend. C. 3& iEiher. vitriol, gtt. xxx, in mist, camphor. §ifs duab. hor. Hot brandy and water— Dry fomentations. — 6th March. Slept a little ; had very little vomiting ; two watery stools, slightly mixed with faeces ; still oppressed, with feeble puke and coldish ikin ; tongue loaded with fur. Ilepr. Calom. et caet.— P. M. Three muddy stools; no vomiting, nor cramp ; much hiccup ; pulse nearly natural ; but feeble ; skin coldish— Repr.— 7th March. Some scanty, dark green motions; no spasms or vomiting; hiccough severe; pulse and skin natural; T. deeply furred, cream white — Conr. — P. M. Once very sick to-day; now easier; three dark stools. — Repr.— Bth March. Had hiccup all night; passed very little by stool ; still sick at stomach ; pulse moderate ; tongue very foul— Conr.— P. M. Sick all day without vomiting ; much hiccup; no stool ; pulse tolerably good— 9th March. Slept ill from feeling cold ; hud no stool, vomiting, or pain; pulse rather feeble ; skin warm ; tongue keeps foul ; much hiccup. Sum. Mist. Senn. :ul. resolut. vent.— P. M. No change since Diornino • tour foetid stools black and pitchy ; no 

268 





269 

AWENDIX. 

fever. Repr. Calom.-—lOih March. Still tick at stomach with chilliness ; stools dark; hiccup severe; pulse tolerably good. Hab. Yin. calid. pauxiil. — P. M. Only one motion ; no vomiting ; pulse full ; skin warm ; face red ; tongue dark ; hiccup continues. Has taken a little nourishment. Repr. calom. 1 1th March. Still sick at stomach, and labouring under great oppression with constant moaning ; tongue cleaner ; pulse and face natural ; hiccup diminished ; stools quite black. Repr. Mist. Senn. — P. M. Many pitchy stool., j In other respects as in the morning. Repr. Calomel. 12th March. Passing immense quantities of dark liquid matter; much oppressed, but thinks himself rather easier ; pulse natural. Repr. Mist. — P. M. Much worse since morning ; low, oppressed, and nearly iu¦ensible; breathing laborious, with long inspirations ; heat natural ; skin moist ; pulse slow, not feeble ; tongue and teeth black ; no stool ; has not taken more •uina. Died at 5 A. M. 

Dissection. — Stomach containing a light watery fluid, and slightly streaked ; gall bladder full of dark bile, and intestines lined with it ; left ventricle of the heart turbid— all eke healthy. 

CASE EIGHTH. 

17th march. 

John Blackney, seaman, aged 25. On the first of the month admitted with severe symptoms of scurvy ; from which he progressively recovered under the usual remedies, until the 14th, when he was seized with pain of bowels and looseness, which continued till the 17th, when he was attacked at ten P. M. with severe spasms and vomiting, cold sweats, feebl« indistinct pul*e, and the 



was exceedingly low and weak ; his akin was damp and cold ; he had no pulse ; but frequent vomiting and stools; »nd severe pains of knees and cramp of limbe. He died at day breaks — Upon dissection no diseased appearance whatever could be discovered. 

CASE NINTH. 

20th march. 

Dr. L. aged 46, of sickly spare habit, in the evening felt himself a little unwell. At two of the following morning he took a dose of purgative salts; they operated about six; at seven he went out to take his usual ride ; he soon returned, and was immediately seized with vomiting and purging of clear fluid, cold extremities, loss of pulse, blue countenance, oppression and cramp of hands, and feet. Laudanum, brandy, hot frictions, and the warm bath were severally used without effect, and he died at half past two, after suffering great pain from spasm. — He was relieved whilst in the bath ; but one of his attendants thought him weaker on leaving it. —He was opened next morning; the stomach especially, and the gut» were found relaxed and distended from loss of tone — In the stomach was a large quantity of light coloured fluid, mixed with small pieces of potatoe and undigested food — no redness or appearance of inflammation through the whole extent of the alimen- 

¦<-> 

tary canal. Liver natural; gall bladder flaccid; and containing only a little pale coloured bile. 

CASE TENTH. 

19th may. 

Private Black, His Majesty* 59th Regiment, was seized at four this morning wilh' vomiting, which wa* 

270 





271 



¦oon followed by pain and giddiness of head, and graft thirst. On admission into Hospital at 11 o'clock, lie complained much of headach and gi tidiness, sickness, i.nd spasms in the legs. His countenance was altered ; his oyts sunk ; colour of body bluish ; respiration hurried; pulse quick and contracted; skin covered with sweat. Cold water was thrown over him ; he was rubbed dry, put to bed ; and took a little warm ricewater aud wine. Soon after, a scruple of calomel was given, and the temporal artery was opened. — About five ounces of blood were taken away. — The pulse sunk; the extremities became cold : the breathing more hurried; every thing swallowed was instantly rejected; and he died at 12 P. M. 

Dissection. His body was opened about ten hours afterwards — The omen turn was loaded with fat, and of reddish colour; the stomach much inflamed, thickened, and of red colour ; the lower part of the oesophagus and upper portion of the duodenum in the »ame state. The other abdominal viscera were sound, except that their vessels seemed to contain more blood than usual. The dura mater was reddish; and its vessels loaded with blood ; in one place there was slight extravasation. The lateral ventricles were full of 

CASE ELEVENTH. 

CALCUTTA. 

fist April, 1819. Mr. R. M. Assistant Surgeon, act 28, a stout muscular man. — Has been for several days past going about Calcutta, and backwards and forwards between Calcutta and the General Hospital, in a Palanqueen. On the 18th and 19th instant, was constipated in his bowels, but general health good, and spirits high, especially on the evening of the 19th ; and vis ascertained 



272 



that he had committed no excess in eating or drinking. On ihe morning of the 20th his bowels became loose without any assistance from medicine ; and he had early several free stools. About 10 A. M. he was again purged, and at the same time vomited freely; and expressed himself much relieved by these evacuations.— He felt himself so easy after this, that he got into his Palanqueen, and went from the General Hospital into town.— On reaching Cosxitollah Street he felt languid and thirsty; and he there drank a glass of water. — Feeling himself uneasy he returned to the Hospital before 12 o'clock, and he was purged \ery severely.— About 2 P. M. lie sent for Dr. from the Hospital, and said that he had had about 20 ntools since returning to the Hospital^ copious and watery, but passed without pain; that he felt wry weak and excessively thirsty, but he had no pain in hi* stomach or abdomen, and no spasms of any kind or in any part of him. — lie also had vomited at several time 3 a quantity of liquid mutter of no bad taste, which came away without pain or much retching; and seemed to be brought up more by a voluntary eil'ort than by the throes of the stomach. He said he had taken a cup of tea about 20 minute* before this time, which was retained.—An injection of an ounce of olive oil and two drachms of laudanum was ordered, but he objected to this as being troublesome — He was then given a tea spoonful and a half of laudanum without uny admixture ; and he was allowed to wash his F mouth with a little tea, of which he did not swallow ny. In a few minutes the laudanum was rejected, along with some of the tea he had taken before it. A mouthful of hot water was then given him, and he vomited up a considerable quantity of liquid of a whitish colour, or rather limpid. He then drank nearly v tumbler of hot water, which remained quietly on hi* stomach. Till this time his pulse was perceptible, but very tveak ; and his eyes were much sunk ; tuid the whole 



273 



hollow of the orbits almost black ; other features shrunk and sharp ; body and limbs covered with cold and excessively copious perspiraiiou. He had another stool, liquid, but not copious; alter which he said his strength was gone; pulse now sunk entirely ; and the spasms seized his limbs while getting into bed. — An anodyne injection of $i 01. oliv. c. Tinct opii. 3jj was then ordered ; and another medical man coining in, gave him about a drachm of laudanum, which was retained. Injection was administered and retained ; but spasms became severe and more frequent. About 4 P. M. he passed the injection with some fluid matter; but stomach remained easy: spasms however continued, and now extended to upper part of the thighs; and along the abdomen. He had the injection repented, and a few spoonfuls of sngo and brandy as hot as it could bo administered, given him, and this last was to be repeated every half hour. In course of next hour some other medical men came, and gave him some compound spirit of ammonia in a little brandy ; this immediately rejected, tho' the stomach had been perfectly quiet since taking the hot water ; and had retained ihe sago and brandy; of which he had taken a little several times. He then had a purging injection administered, which operated immediately, and pretty copiously. Many medical men were now on the spot; but patient's strength seemed entirely gone ; spasms still severe,*extending from toes to the pit of the stomach ; much tossing and restlessness ; very copious perspiration, but now considerable heat had returned to the forehead, on which the perspiration was warm ; but that on the body and limbs was cold and clammy. The sago and brandy were continued at very short intervals, and in small quantities, and hot water in bottles applied to the feet and stomach ; no more stools and no more vomiting occurred ; but spasms and restlessness continued. About half past 8 o'clock he complained that deglutition 

X k 



had become difficult; some brandy and water was substituted for the sago and brandy ; but the patient gradually sunk ; till he expired at 20 minutes before ten o'clock. 

On examining the body about 10 hours nftcr death, the extremities of the body were cold, livid, and stiff; but a considerable degree of heat was perceptible on the integument! of the abdomen ; and internally the heat was higher. On hiying open the abdomen, the omen turn was found very thiu for a man of his habit of body ; ami excessively vascular, and of h pretty bright red colour. The whole tract of small intestines was very red and florid ; and the mesenteric veins turgid, being loaded with dark coloured blood. Large intestines perfec f Jiealthy, and natural in colour. The whole external su face of the stomach extremely vascular, and the veil turgid with dark blood. Liver for the greater pa natural in colour, but one point of right lobe found ;u hering to the side so firmly, that thesubstance of the live vas torn in attempting to bring the liver forward ; ant at this point it appeared gorged with blood ; but tl substance was quite soft when cut into ; lower margi of lefc lobe where in contact with the stomach some what gorged, and colour a little darker than in othc parts. Gall bladder moderately distended with bile of usual fluidity, but of a deep olive colour. Spleeji quite natural; urinary bladder empty and shrunk; pericardium and heart quite natural ; right lung adhering wry firmly to ihe sternum. 

On opening the stomach, about one pound and a ha of blood, mixed with a little bile, discoverable by th smell, was found in its cavity. The whole Tenou System of internal surface exceedingly turgid and load ed with black blood, except in a spot of about 4- inchc by 3 immediately below the Cardiff, where the* vein were entirely empty, and a ppoi wu discovered wrher 

274 





275 



tlicvein liad given w;,y, and the blood in the adjoining vessels hud made its escape. The whole trnct of intestines empty ; and whetrJMty parts of alimentary or foeculent matter vtri ioutid, they wore quite natural. Inflammation on internal surface of small intestines not so strongly marked as on the external. 

CASE TWELFTH. 

A. B. aged 40 ; healthy, and of a remarkably strong and robust frame of body ; after dining and eating a quantity of vegetables and pickles, travelled to Calcutta a tli<tanceof 30 miles on the evening of the 11th November 1819. The weather was cold, raiy, and very unpleasant; with overcast sky, and north-westerly wind. After again eating pickles, he went to bed. About 20 minutes after 1 a. ni. he was roused by a severe shock of an earthquake, and inconsiderately exposed himself in. Ml night-dress in an open veranda to the damp night air. He then felt, that he had caught cold in his bowels ; and in* the course of the morning, that is, be? f.veen day light and half past ten, had eight loose, watery motions, with soreness of the abdomen, and sickness of stomach: short, hovrever, of vomiting. Between 9 and 10 a. m. the symptoms were aggravated ; he now vomited once; the cold symptoms came on, with prostra* tion of strength, diminution of arterial action, and t'ireatenings of spasm. Betvveeen 10 and 11 he was seized with cramp in the toes. He was now seen for the first time by his medical attendants. All the signs of collapse were then strong upon him ; the cold clammy blue surface, shrunk features, shrivelled skin, pearly •yet) anxiety, thirst, and small hurried pulse. The vomiting and purging had teased ; and from this time faff ward, there was no discharge from the bowels, excepting a small quantity of fluid passed off by the ;•.;¦! its, 

X L- ' 



mi ct so perfectly transparent th.it it ciiu not in the least discolour the sheet underneath. The tongue was foul, but moist. The mind was firm and unclouded as in perfect health. The spasms were confined to the toes, and lower part of the feet. Hot brandy and water was immediately given to him, as often, and in as lar^e quantities, as the stomach would bear. Hot bottles were put. to his lowar extremities; he was covered with blankets, and constantly rubbed all over. His ana ivas instantly tied up, and blood drawn by a large orifice. This was a little before eleven. The operation was again repeated a little after twelve. The blood at first came quite freely; but afterwards slackened, as the exhaustion and feebleness of pulse increased. Latterly, it came with great difficulty, and only in little jets or drops, as it wa.«s urged along the veins by the hands of the assistants. In all about forty ounces were procured. Further endeavour was then given up as entirely useless. Shortly after the first vein was opened, he took ten grains of calomel, and one of opium. Meanwhile, the symptoms were rapidly running on. The spasms, which for a time seemed to yield to the first bleeding, returned to the feet; and seized the wrists and fingers. — The pulse sunk, so as scarce to be perceptible. The .thiist, anguish, and restlessness were intolerable. The cold sweat ran in streams from the forehead and temples; the patient could not rest a moment in one place; and as the smallest motion produced n renewal of the cramps, his sufferings were cruelly aggravated by every change of posture. The most singular feature in this case, was the regular succession and rise of the spasms. From midday, when they had reached the calves of the legs, they gradually ascended, by regular attacks coining on at intervals of ten minutes or a quartet of an hour, first to the thighs, and hips, 

276 





277 



the diaphragm and praecordia. As they seized the psoae muscles, they were distinctly seen to raise the pelvis and thighs. The abdomen was now hard and swelled. When the spasms had reached the trunk and diaphragm, they produced hiccough and excruciating pain in the chest, back, and loins; with a feeling as if a sharp instrument were striking through the breast. Nothing could be more affecting than to hear the patient accurately describe their progressive rise ; exclaiming, in the midst of torment, " that now they had got to his thighs, then to his back, then to his- chest :" Last of all, that " they had reached the heart, and all would soon be ov«r." This scene of agony lasted till about two o'clock ; after which there was little else than a last expiring struggle for life. — All pulse was now gone; the motion of the heart scarcely to be felt ; as the circulation stopt, water began to collect in the air cells of the lungs, and partial suffocation was evinced by deep moans, and long drawn, broken inspirations. The mind, which from the beginning had been remarkably clear and composed, now became clouded. The patient became blind and talked incoherently; but these symptoms might perhaps be ascribed to stupor caused by the large quantities of laudanum and brandy given to him in the hopes of checking the disease. Finally, he sunk about S P. M. exactly five hours from the first appearance of the decided symptoms of the attack. The body was not examined. 

CASE THIRTEENTH. 

NEW ANCHORAGE. NOVEMBER 4TH, 1817- 

George Frith, Seaman H. C. S. Carnatic, a stout healthy man, at 9 o'clock last night was attacked with severs vomiting and purging of a fluid quite transparent, accompanied with griping, and soon after followed by 



?pasms over the trunk and extremities , but particularly in the muscles of the calves of the legs; the pulse was small and intermitting. 

Large draughts of tepid water were given and repeated until the vomiting ceased. To allay the spasmodic action 40 drops of the tincture of opium were given ; this not having the desired effect, the dose was repeated with the addition of 3i vitriolic JEther. This allayed them for a short time ; but they returned. The dose was again repeated in Siij of Hollands; but without effect. The patient was then taken out of his hammock, and had three buckets of cold water dashed over him ; he was then dried, and put in again. This, together with friction over the abdomen, relieved the spasms for a term ; but they again made their appearance ; griss of opium was now given, and repeated in Ml hour ; from this he seemed to obtain much relief. At J 2 o'clock he again became considerably worse, accompanied with difficulty of breathing; pulse scarcely perceptible; lips of a livid colour; 3 1 of aether with gt Lof Laudanum was given. The abdomen was well rubbed with a liniment of Spt. of wine, camphor and laudanum. By this treatment the spasms gradually subsided ; grx. of calomel were then given. From this time, till £ o'clock in the mornning he continued free from the spasms, and slept pretty well ; when he rose to go to stool. He returned to his hammock, and had remained there about half an hour, when a person by accident discovered that he was dead. After death the gastrocnemii muscles were very much drawn upwards, and very rigid. From the suddenness of his death, it would appear, that the spasms had returned upon his going into his hammock, und seized on the muscles of respiration, or perhaps the heart itself ; 

278 





CASE FOURTEENTH. 

In the first week of October, 1818, the Boatswain's jnate of the Phoenix fell down on deck, while at work, with most complete and sudden prostration of strength and loss of speech, but with every agonized expression of great suffering, cold svreats, shrunk features, pnd moaning; the content.? of his stomach running from his mouth as if a sluice had opened — Two pounds of blood were taken from him immediately; he was put into a warm hath, &c. had swallowed nearly 200 drops of laudanum before he begmj to revive. After which he fell into a profound bleep. This treatment was followed up by evacuating the bowels, and application of mustard poultices to the .abdomen.— -The HUM is now, iOth October, r*e&rly well. 

CASE FIFTEENTH. 

lOth October. John Chapman, Seaman H. C. S. Warren Hastings, having gone on shore on the Island of Saugor for the purpose of interring the body of another Cholera patient, was left in charge of the boat, while the others proceeded to a proper place for depositing the corpse of their messmate. — Upon returning they found this man lying retching violently in the bottom of the boat ; his extremities were cold, cramps had attacked his limbs ; violent spasms had seized the muscles of the abdomen : he says he was suddenly attacked with a pain in his stomach, violent retching, vomiting, griping, and purging; quickly succeeded by cramps in his limbs. When lie arrived on board he was in the lowest state of depression ; the disease had only attacked him 3 hours before — He left the ship at 4> P. M. and arrived at 8 P. M. — It. T. Opii. gtt. c. in hot brandy and water; rejected. — The Laudanum 

279 





280 



he is in the bath. Habt. stat. calom. gr. xx. Retained H. 9 P. M. The symptoms seem rapidly to increase in violence. The depression «eems to warn us that the scene is nearly finished- — Capiut. Opii. gr. 11. Calomel gr. iii omu. semihor. Hot brandy and water ad libit. H. 10 P. M. — Extremities livid and insensible. —No pulsation returning to the extremities ; heart palpitates and intermits in pulsation. 12th. Departed this life about 4 o'clock A. M. 

CASE SIXTEENTH. 

1 lth October. — Edward Powers, Boatswain Warren Hastings, suddenly seized with depression, sickness and pain in his stomach; tenderness and griping of the abdomen ; quickly followed by violent vomiting and purging of a clear watery fluid ; stomach rejecting instantly what is takon in ; great thirst, pulse 1 30 ; very small, and almost indistinct. T. opii gtt. 80 in hot brandy and water ; rejected. Hab. opii. solid gr. v. Hab. c;i-lom. gr. xx. Rejected. — Repr. calomel gr. xv. Retained. H. 10 P. M. Griping and purging little abated; vomiting only occasionlly of fluid taken into the stomach. Capt. Opii grss calomel, gr. iv. quart, q. q. hor. 12th. The inoro violent symptoms have in a great measure subsided ; passe 9 thin watery matter by stool, almost inssnsibly ; much thirst; pulse 120; partial perspiration ; startiug in his sleep —Calom gr. iii quart q h. H. 3 P. M. Complains of slight headach and vertigo; pain in his back and loins; thirst vciy great; tongue white; pulse 120; great heat of skin.— Omr. 80l c calom. Capf. Camphor gr. iii cal.gr. 11 quart, q. hor. Bib. decoct, hord. H. 10 P. M. Apparently composed, sleep quiet aiui uniutarrupted ; general and proluse perspiration * pulse 100. more full. 13th. Towards morv.rif^jkin 



281 



became hotanddry;delirium ensued. — Tongue is how mcr asted with a dark brown fur ; thirst very grfat ; pulse 120 ; very weak. Repr. pil. — H. 5 P. M. Delirium subsided; perspires freely; mouth begins to get sore. Habt. Decoct. Cinchon. lbj. vin. Rub. Bij. Capt. iiv quater in die. — H. 10 P. M. Greater part of the medicine rejected. Purging continues ; delirium recurs.— Applic. Emplast. Epispast. inter scapul. — 14th. He is very low ; delirium, low and muttering all night. Tongue very foul; thirst unabated j Pulse 130; very wreak and tremulous— R. Sp. ./Ether, sulph. 31ss Sp. Lavend, comp. gtt xl. Aq. Font *iv. aq. Cinnam §ii cap. %] tert. q. hor. Yin Ruhr, ad libit. — H. 5 P. M. Depression rapidly increases ; pulse very quick ; scarcely perceptible at the wrists or ankles ; delirium has almost entirely gone ; complains much of the soreness of his mouth.— Conr. medic. Appr. pedib. sinapism, sinap. — 15th. Hiccups h jve ensued ; cold perspiration over his limbs ; pulsation has forsaken the wrists and ankles ; passes his urine and fceccs involuntarily. — H. 3. P. M. Departed this life. 

CASE SEVENTEENTH. 

CAWNPORE J CASE OF LT. M. APRIL 2Sth, 181 S. 

Has been complaining 4 or.fl d;rys of being sick at stomach; but did hid duty, until 7 A. M. this morning on parade, suddenly obliged to quit from a watery purgij;.r — At 10 A. M. informed me: of the latter, and that lie felt inclined to throw up. Seat him calomel g. xx. and desired him to wash it down with laudanum, 40 drops in 2 pi of peppermint water; staid down an hour; had some sleep, and av/oke with cramps in the calves of his legs ; he neglected to inform me, and that he had retchwir. — Thinks he threw up so. no of the calomel* 

J. 1 



282 

APPENDIX. 

At 5 P. M. vent over and found him walking about ¦„ retched before me ; pulse small } at this time had no spasms; livid circle round the eyes ; watery purging continues ; gave immediately 2 oz. ot' castor oil, which staid down an hour, but on his chinking a mouthful of peppermint water, retching again came on ; and a part of tjie oil was thrown up. — 7 P. M. Was put into the warm bath; Spasms of his legs, thighs, hands and arms frecjitent — 8 P. M. Put a blister to the pit of the stomach. Ten minutes past 8 gave him 2 oz. of castor oil; staid down, and evidently immediately relieved the spasms, as he remained altogether quiet ; and had been previously compluiningand crying out much; watery purging at interval.-; — \ past 8. Repeated the calomel; washed down (is before ; no vomiting now. £ past 9. Spasms occasionally of the neck and lower jay/; much oppression and jactitation j blister rising; feet warm ; bands rather c.oltl ; pulse very quick, small and feeble; 2 watery stools since the calomel. — Ten minutes to 10 P. M. Cramps of the legs. \ past 10. Pulse more full; spasms transient ; blister rising; less' oppression. — ,'; past 11. Removed the blister; complaining much of it; oppression much less ; pulse feller, and hands warmer. — 29th April, 1 A. M. Retched once, having taken a mouthful of warm brandy and water; brought nothing up. — J minutes past 'i. A watery stool; no oppression; hands warm ; pulse much fuller; complains much of the blister, which had risen well. — g past lA. M. Repeated the oil, but ftlmoft immediately rejected the greater part, 1 with much watery fluid; then sunk down, and slept for halt an hour. —At 2 A. M. some incoherency and subaiiltus tend in urn ; tongue while and loaded; but moist at tht edges. — 4-. A. M. has been rather restless ; but no complaint except from the blister : no vomiting or stool since. — 5 minutes past 4. A. M. A watery stool.— \ past 4 A. M. repeated the calomel gi ::x ; but without laudamim 





283 

— 20 minutes' past. 4. A.M. Another watery :t.ool, I past 5. AM. Another.— 6. A. M. Tongue cleaner, but dry. — 7. A. M. Pulse not so good as at midnight ; hands colder ; feet natural ; countenance anxious ; eyes sunk* with a livid circle round them ; much annoyance from the blister.— -8 A. M. A stool, watery » hut wi'h a wry slight tinge of green (all former ones being colorless — \ past 9 A.M. A stool; feculent matter about the sLie of pins heads' to be discerned; makes no complaint; says he is much better; no pain. — 'JO minutes past 10 A. M. Administered v glysfcerj clozes at intervals; hands and skin nearly of natural warmth ; pulse fuller, but still very weak and. quick ; tongue more moist. 4 to 1 1 A. M. Passed the injection, slightly tinged with fuecesof dark green colour. — Noon, a stoolasat 9.— \ past noon gave him Pulv. Jalap, gr. xxx Super — Tart. Pot;iss. gr. xl. — IP\ M. complains much of heat; skin rather warm and dry; hands warm; pulse quicker, but not weaker; countenance not so anxious; much flatulence ; medicine stays down. — 20 past 1 P. M. A stool toniewliat better than the last; passed urine for the Jtrst time since his attack. — \ to 2 P. M. a stool, the name.— iP. M. Threw up the Jalap mixture. — 4 P. M. A stool, if any thing more consistent; passed some urine also.— 10 initiate* past 4 P. M. Another stool; evident green bile mixed.--- \ pasto. Another; not so good — Suusetgnve calomel, gr. xx. — j to BP. M. Vomited a little phlegm and Coty'ee, but Ido not think any calomel ; sleeps at intervals, but is re ails.v^, and complains of heal. — \ past 3 P.M. Vomited again; inclined to sleep.— 9 P. M. Ketching much. — 25 minutes pa»t 9 P. M. A stool and passed Urine. — Midnight. A stool more copious ; has slept fof an hour, but U delirious ; pulse sintdi and weak; complains of difficulty of breathing ; £of an hour after, another stool, much the same. — 30th April, 4- A. M. Another stool, more brownish color. — 6 A. M. Better; nulse and look improved. — £ past 6 A. M. Took 

L 1 2 



284 

APPENDIX. 

calomel ,cr\'. — 8 A. M. A stool, dark green bile mixed.— 11 A. M. Repcate'd calomel gr. x; sleeps quietly at intervals. — h past 2 P. M. A dark groan coloured stool. !'Q triinutei to IP. M. Calomel repeated. — Sunset retched slightly; but did not bring any thing up.--9 P. M. Gave him a pill.— Extr : Coloc: C. ctGum Scaminon. act g. iij. — \ an hour after retched, but brought nothing lip. — Ist May, 3A. M. A dark stool, more copious th:m any yesterday ; not slept much. — \ past 3 A. M. Another almost black, but more consistence. —6 A. M. A stool, dark green bilious matter. — \ to 7 A. M. Another, more yellow mixed with the dark green. —8 A.M. Dark stool, small in quantity. 10 minutes A. M. Another, dark green, more consistency.— 2o minutes past 10 A. M. Another, not so green. — \ past 10 A. M. Took calomel gx.. — } 2 past IP. M. Repeated the calomel. — 4- P. M. A stool, dark green, bili( us consistency. — Sunset a slight one*.---7 P. M. More copious dark green. 

—9 P. M. Repeated the pill of colocynth and scammony. 2d May, 6 A. M. Good night; 3 stools; did not sec them ; one copious.— 8 A.M. A stool, better. — \ past OA. M. Gave Jalap and Cream of Tartar a.; before, which staid down ; his mouth slightly affected with mercury ; his stools now being nearly of a natural color and consistency. From this time I considered him as convalescent. 

CASK EIGHTEENTH. . 

JosEi'ii Widows, I'hivatk 21st Duagoon^ 

Aged .'39 Ylaus. 

April 28th, 9 P. M. lias hud a looseness of his bowels for some time; was seized tiiis afternoon with violent E)asms of the abdomen, arms, and legs, with vomiting nd purging, which still continue. Pulse small ai>d iieuent; tongue clean; thirst intense; skin cool. — R. Calolel. pptt.^l statiin. Empl. Lyttse. scrub. Cord, applicct.; 



and after the Calomel R. Aq. Mcnlha* glss Tinct. Opii. gtt. XL Vitriol gt. xxx. — 10 P. M. No vomitiagV but frequent spasms ami pttrgfhg, ft. Magnes. Vitriol. 3a solve in Aqua -men thae, cvi addo iEther Vitriol, gtt. XL. 4.0 be taken during the night. — 2.9 th. Has had lib vomiting during the night, but frequent spasms and several watery stools ; countenance much dejected ; eyes dim; clamminess of the skin; pulse small and frequent. Semicup'ium ; to have brandy and water for common drink. Sago and Madeira. — R Calomel, pptt. gr. V. Opii. gr. ss 3 tiis horii. Blisters to be applied to the calves of the legs. — 7 A. M. Was faint after being a few minutes in the bath ; appears greatly debilitated ; eyes sunk; no vomiting or purging; Be mist. Campt. !ss /Ether Vitriol, g. xxx Tinct. Opii. gt xxx. Ha* taken sago and a little brandy and water.— B A. M. A copious watery stool. Kept, haust. dimid : quant : oinni hora. — 12 Horn. Has had some sleep, and feels better; has taken nourishment, and brandy and WBter; R. Calom : pptt. gr. v Opii. gr. ss 2 horis. — £ past 5. Has been dozing a great deal ; no vomiting; one watery stool without any bilious appearance, which has always been the case ; no pain or spasm ; pulse better ; skin of natural temperature. Cont. calom. & opium. Inunrgr. ungt. hydrr.g. 31.-- } past 3 Contr. pil. — 30th. Has passed a quiet night; slept tolerably well ; no Mckncss : 2 stools ; appears much dejected.— 6 A. "Nf. Pulse small and weak, with coldness of the skin ; has taken his medicine and nourishment. Rr. Mist, camphor li] /Ether Vitriol gt. xx Tinct. opii. gt. x 2 horis.— 9 A. M. Has been sleeping; no vomiting or purging. Habt. 01. ricin. i'l aq. nienthae 5i statim.— Vespei e. No stool since the morning. R. calom. ppt. g. xv.— May Ist. Slept well, and feels better; had one motion this morning. Rept. calom. gr. x.— 2d. !¦ much better. R. calom. pptt. gr. v opii. gr.ss. ter in die.— 3d. Appeared «oing on well an hour ago; but is now seized 

285 





B convulsions ; pulse intermits; countenance and dejected. Be. ./Ether Vitriol gt, xxx Tinct, opii L. The convulsions continued till the afternoon ; q died at £ past 6 o'clock. 

On opening* the cavity of the abdomen, nnd examining the intestines, intro-susceptio of the Ileum to the extent of 12 inches was found to have taken place, where there was considerable inflammation, and thickening of the cont of the intestine. Inter-susceptio was also found in two other parts of the Ileum ; but no alteration of structure could be discovered. The Colon wag of its natural length, but contracted in various places ; the stomach was greatly contracted; not larger in circumference than the colon, but shewed no appearance of inflammation ; the liver gorged with blood ; the gall bladder full of bile of a dark green color ; the lacteals distended with chyle, and having a knotted, appearance; the mesentery turgid. 

CASE NINETEENTH. 

JOSEPH 1 INKER, PRIVATE 21ST DRAGOONS, AGED 24 YEARS. 

1818. April 29th. Was seized to-day about 1 o'clock with headach and nausea ; pulse full ; skin hot. About 16 oz, of blood were subtracted ; and ten grains of calomel given, which produced two or three bilious stools: shortly after he was attacked with spasms in different parts of his bo'ly, chiefly in his limbs ; his extremities became cpld, and a clammy sweat covered his face, neck, and breast. He immediately got some arrack, and his belly and stomach were also rubbed with it ; his bowels had been costive previously, and it was ascertained, that he had been drinking rather freely yesterday. — H P. M. He has been in the warm bath, and had a draught of aether and laudanum aag. XL ; pulse still very feeble, und ex- 

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287 



* -* » • J»A ¦ I i 1 1 J IJ» J| y I V«lvT J.III jT el Mill pplicet.— Rept. /Ether Vitriol gt. xx. Tinct. opii. gt. omni horn.— £ past 8. Has liad no return of sickness, nit one watery stool; pulse small and wenk ; countenance unk; clamminess of the skin; had once a return of lasms of the legs ; thirst intense. R. calomel 3i opii gi— ). — Expired at \ past 12 o'clock. 

Dissection. — On opening the cavity of the abdomen, there nppearcd great vnscularity of the omentum, stomach, and small intestines; the liver was perfectly sound, but of a light color ; the gall bladder distended with bile of a dark green color; the stomach greatly distended; the small intestines in a state of incipient inflammation — and the colon contracted so much, n$ not to be of larger circumference, than a man's little finger, excepting a small portion, which was of the natural size. 

CASE TWENTIETH, 

THOMAS LOW, PRIVATE 21ST DRAGOONS, AGED 33 YEARS. 

April SO, 1818. 6 A. M. Was seized last night nt eleven o'clock, with violent cramps in ihe abdomen; followed by vomiting and purging, which have continued •ill night. He is now extremely debilitated ; pulse not to he felt; coldness and clamminess of the skin ; has cramps of the calves of his legs; and passes involuntary stools; countenance shrunk ; eyes sunk ; has taken a draught of 60 drops of Tinct. opii with SO drops of /Ether and afterwards g ij. —of brandy. — Trismus came on ; he was placed in a warm bath, but could not remain many minutes. He has taken since another draught of /Ether, &c. as before; also some sago and madeira. — Habt. Calomel B\ in Pulv. Frictions to the extremities. ft~~ Lnip : Lyttae Epigastri. 9A. M. Iso return oi" 



vomiting or purging; skin cold; countenance aimm: t))ack; eyes glassy and dim with targescence of the vessels; pulse scarcely to bo felt. — Habt. 01. Iticini %i in aq. meiithss %i — Expired at 10 o'clock. 

Dissection. On opening the cavity of the abdomen, the omen turn, stomach, and small intestines appeared in a state ofincipient inflammation, and the colon considerably contracted. The liver was indurated; the gal! bladder full of bile ola dark green colour. 

CASE TWENTY-FIRST. 

May 3d, 1818. Francis Carpenter, Prjynfe 21 si pragoons, a strong and muscular man, aged 2 years. Was relieved froni guard yesterdny evening, on account of a purging and inclination to vomit ¦which came on in the afternoon. Ho had no spasms or cramp; was ordered a solution Antim : Tart. grij. in magnes: vitriol. I'\ which operated freely on his bowels ; but he has had violent cramps in the ann«, legs, thighs, and abdomen during the greater part of the night, with frequent vomiting and purging. Pulse t<ni all, weak and irregular; countenance shrunk ; and coldness of the skin. — ft iLther. Vitriol, gt. xxx Tinct. opii. gt. LX after which calomel Di with li of h randy— Semicupium. In removing him from the bath a little brandy and water was given him, which produced sickness; he then took Tinct. Opii. gt. XL /Ether Vitriol, gt. xxx Spt. Via* Gallic Si. m. and afterwards Calomel fii cum. Opii. grj. ; frictions to the skin, and a blister to the abdomen. A vein in the arm was opened, as his pulse appeared oppressed, and 6 oz. taken, when the pulse began to flutter, and the ligature was removed. — 10 A. M. — No sickness; one watery stool ; but the cramps unabated ; pulse small and weak ; tongue furred ; Re 01. riciili gi in aq. meulh. 

288 







289 

?i. cum JEther Vitriol: gt. xxx. Blisters to b applied to the calves of the legs. Enem : Anodyn : — 1 P. M. — The injection retained about half an hour no vomiting or purging ; spasms still violent ; pulse ra tlier fallen. Habt. calomel : ppt. £)i. in pulv. — 6 P. IV — Seems rather better; no vomiting or purging; cramp somewhat diminished; had at S o'clock 01. ricini § in aq. inenth. cum /Ether Vitriol: gt. xxx.; Puls rather stronger; tongue foul. Be — Calomel, ppt. gi x opii. gij. stathn. Vespere — He of. ricini. ?,j. v ea. Enema Purgans. — Horn 9. P. iM. ft Calo tuel })pt. gt. x;etg. v. 4- ho-ris.— .¦> A. M. 4th— Ha passed a tolerable night; % stools; no vomiting, but IVe quent retching; spasms stilltroublesome; puUetmall, anc ii regular ; tongue furred, and dry ; complains of intent thirst. Has taken 5 gr. of calomel since 10 o'ciock ---Habt. Pil. opii gi. — Brandy largely diluted for com mon drink. — 7 A. M. Seimcupium — Be ol : Ricin 51 aq. menth. Si gt, xxx. — Bore the batl well, continued in 25 minutes — Be calomel, gr. v et opi gi 4 horis.— 6 P. M. Has thrown up the castor oil and vomited frequently. — Dy surra; several 'vatcry stools; pulse small and weak — surface cold. Habt Calomel EH 01. Ricini §ij aq. meuth : |ii — 9 P. M". The castor oil retained, but the surface more cold , pulse not to be felt. Habt. calomel gx. — May sth. Died at 3 o'clock A. M. 

I dissection. On opening the thorax, the lungs appeared asped. On opening the cavity of the abdomen, the nach was found to be greatly contracted, not larger l the colon, and its inner coat singularly corrugaor drawn up into folds, particularly near the earbut no appearance of inflammation. — The colon of usual size. — Intus-susceptio of a few inches of lleum without any change of structure. — The vesof the liver turgid witU blood ; the gall bladder 

M m 



292 



examined the contents of the cranium. The skullcap, on being removed, exhibited a very considerable degree of inflammation on the external surface of the dura mater; and an apparent circumscribed effusion 6n the cerebral surface pointed out a rupture of the longitudinal sinus in its occipital portion. The dura mater, on being carefully detached from ' before backwards, displayed a rupture of the sinus, and extravasation to the size of a crown piece at thejunction of two veins, formed by the superficial cerebral plexus, inosculating with the sinus itself. More minute dissection of the ialx demonstrated this rupture; also a high degree of inflammation on the upper surface of the brain and pia mater ; also evident venous congestion, and, in some p*rts of this membrane, a thickened serous effusion. Oft examining the lateral cavities, about % o/,s. of fluid escaped from the left ventricle ; more however was found in the remaining three. The cerebellum was of a natural appearance, and free from any marks of vascular action ; but the membranes lining the case of the skull were considerably affected. 

CASE TWENTY-THIRD. 

DELHI. 

Pahar Sing, Sepoy Light Company Ist Battalion 5t Regiment Native infantry ; a stout young man ; admit ted July C 23d, 6P« AI. — While on duty, was seized wit purging ; he vomited 3 times in the course of 2 hours without violent retching; he took some sherbet to alia the sickness, and a burning sensation in his stomach.— Upon being brought into the Hospital he vomited once extremities cold ; countenance sunk; and pulse scarcely perceptible. — A scruple of calomel and 100 drops of laudanum were administered.—- Did not vomit after the eilomel. — The cold in the extremities increased, notwithstanding the use of frictions with warm cloths, && rtl * I and in less than ail hour, at 7 F« M. he died. 



CASE TWENTY-FOURTH. 

Khemma, Ordnance driver, died in a Dooly on the way to the Hospital. He hud had considerable purging, with slight vomiting for 5 or 6 hours. — Hud drank a considerable quantity of cooling and diluent liquors. — This case is mentioned on account of the dissection, as the disease followed its natural course without any medicine having been administered. — Upon opening the abdomen the stomach was completely distended with a fluid resembling conjee wafer. — The vessels of the stomach and bowels turgid with blood ; and one spot on the inner coat of the former, about the sue of the palm of the hand, highly inflamed; a general inflammation over the bowels : the other viscera more turgid with blood than natural, but not otherwise affected. — /Not the slightest appearance of bile in the gall bladder, ducts, stomach or intestines. Head not inspected. 

CASE TWENTY-FIFTH. 

Omnee Opudeali, Sepoy Light Company Ist Bitr. sth N. I. Admitted 31st July, 7 A M. Complains of slight purging, without pain or griping; skin and pulse nearly natural ; tongue foul; purging came on about 2 A.M. — Habt calomel gr. viij. rhei. gr. xxv. At 1 1 A. M. hands and arms getting cold : pulse scarcely perceptible; countenance sunk as in Cholera.— No burning heat in the stomach.-— Upon the most particular enquiry it is found that he has not vomited once; and the calomel and rhubarb remained on his stomach.— Had 6 watery stools.— Habt Calomel Dl et Tinct. opii 3i in aq menth. Pip Si — 2 P. M. Continued frictions with the hands and warm cloths were used without any effect. — Also blistered over the Epigastric region with Tiuct. Cantharid. At 2 P. M. he died. 

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294 



lie vomited one mouthful of watery fluid while in articulo mortis ; there was no vomiting during the whoi* of the disease except tins. 

CASE TWENTY-SIXTH. 

Doorbiju Sing Sepoy ,. sth Company Ist Battalion sth Native Infantry. Admitted 30th July at 10 A. M. A few minutes before 10 A. M. had been seized with raiher severe vomiting and purging. Was previously in perfect health. Extremities cold and clammy ; pulse just perceptible nt the wrist ; tongue foul ; burning sensation at the •stomach j great anxiety and restlessness. — V. S. statim «d Bxxiv. Habt calomel B\ et Tinctopn gtt. 100 — 1 1 A. M. heat of stomach lessened; but the vomiting continues. Repr. calomel et Tinct opii. — c z P. M. vomiting has ceased ; uneasiness and anxiety gone ; pulse perceptible; extremities still cold; skin blistered by the Tincture of Cantharides.— s P. AT. Habt. Infus. Sennas Biv. — 31st, €). A.M. A restless night ; has been purged by the senna freely.— No bile in his stools ;no vomiting ; veiy \yeak.-- Habt. md. Spt. Vim §i. Hubt. Sulph.Magnes. 3l C P. M. freely purged by the salts; mouih sore; tongue still foul; no appearance of bile in his stools. August Ist, no complaint but weakness and sore mouth; tongue cleaner; some mixture of bile in hii stools. Habt. Tir.ct. Sennae i i— -August 2d. Convalescent-— Cont. Tinct. sennae. — sth. Convalescent. — 7ih. Discharged. 

CASE TWENTY-SEVENTH. 

NAGPOHE. 

11l S<Mvbuccus HfiviJdar; probable age 33 years; admitted 



frequent lPMtfy stools; vrith griping pain in tlic bowels ; poise small and irregular ; skin cold ; spasm* of the extremities. R Tinct. opii gtt. 80 01. menth. pip. gtt. xx aq. purae jsss ft. haustus; to be given every half hour. 9 o'clock P. M. has had the above given twice j symptoms not relieved ; complains of violent pain at the i:avcl ; let a Blister be applied to the part. R Tinct. opii gt. 60, 01. menth. pip. git. xx. aq. purae 3ss ft. haustus; to bo given every half hour with 10 grains of calomel. —31st. May. Excessive retchings ; frequently going to stool, but. passes nothing but water; pain in the bowels increased ; pulse small ; skin cold, and clammy ; spasms of the extremities ; great prostration of strength. — The Blister has risen well, but no relief produced by it.— A« the above draught has been constantly thrown up, omit it ; and let warm brandy and water be given, every half hour, with five grains of calomel. — 12 o'clock P. M. Symptoms not relieved ;. prostration of strength increased; no stool produced by the calomel. R Brandy 5« Landan. gtt. 60 aq. bullient. ?ss ft. haustus ; to be given every hour with ten grains of calomel ; and let the feet be bathed in warm water every hour. — 6 o'clock P. M. No stool as yet produced by the medicine ; symptoms : excessive retchings ; general coldness of the body; pulse scarcely perceptible ; spasms of the extremities more frequent; constantly going to stool, but passes nothing but water; gnping pain in the bowels; general prostration of strength. R Brandy Bss Tinct. opii gtt. 100 01. rnenth. pip. gtt. xx aq purae !ss ft. H. to be given every half hour with ten grains of calomel. This medicine was given until 9 o'clock regularly ; after which he was incapable of swallowing, and remained sinking i n this wretched way, until half past three o'clock,- A. M* of the Ist of June; when he expired. 

295 





296 

APPENDIX. 

CASE TWENTY-EIGHTH. 

Sewuk Misser Havildar, aged 43 years ; admitted £ past 1 1 A. M. Slst May. Symptoms: vomiting; burning heat of the body; total insensibility; pulse quick and irregular ; stertorous breathing ; tongue dry. R calomel Dlj to be put on the tongue, and washed down with two ounces of peppermint water ; apply a blister to the nape of the neck.' — S o'clock P. M. Has vomitted twice since twelve o'clock ; heat of the body increased; insensibility ; convulsions of the lower extremities ; pulse irregular; breathing difficult. R calomel. 91 Pulv. Jalapi Bl ; to be put on the tongue and washed down with peppermint vrater. The blister has not risen. May 31st, 6 o'clock A. M. Burning heat of the body ; total insensibility j Pulse quick and intermitting; difficulty of breathing; convulsions of the whole body ; great prostration of strength ; involuntary discharges of fceces and urine. The Blister has not risen ; let one be applied to each temple. R Tinct. opii gt. xxx 01. menth. pip. gtt. x ./Ether Nitr. gtt. xxx aq. purae Si, to be given immediately. — 9 o'clock P. M. burning heat of the body ; total insensibility ; pulse irregular ; general convulsions of the body; involuntary discharges of foeces and urine; incapability of swallowing ; difficulty of breathing increased. Let an Enema of Congie and Laudanum be thrown up frequently. — He continued sinking through the night, and died at 2 o'clock A. M. on the Ist of June. 

CASE TWENTY-NINTH. 

Bowany Deen Dooby, Golundauze. 31st May, 1 o'clock P. M. complains of burning heat and acute pain at the scrobiculus cordis, with a watery vomiting and purging. — Let him have 20 grains of calomel, 60 drop*; of laudanum, and an ounce and a half of brandy, with 





297 

ing incessant; pulse very quick and feeble; extremities cold; and his body wet with cold clammy sweats. — Repeat the calomel, laudanum and brandy. — 5 P. M. Is lying in a state of perfect listlessness ; countenance collasped ; pulse scarcely to be felt at the wrist; eye* fixed in their sockets, and of a glassy appearance. — Let him have two ounces of brandy in the same proportion of water. —Died at 8 o'clock P. M. On dissection found the following morbid appearances. — The intestines and s tomach highly inflamed ; the former clogged up by a yellow fluid, something resembling the matter of an abscess ; and the latter filled with muddy water. The liver was natural ; but little or no bile in the gall bladder and ducts ; and that little, vitiated and foetid, of a dark green color, almost approaching to black. 

CASE THIRTIETH. 

MALWAH. 

PurumSook Dooby, Sepoy, admitted 24th April 1819; aged, 24. — Symptoms — he was admitted this morning at \ o'clock ; about fifteen minutes before he was brought into Hospital, he was suddenly seized with vomiting and purging of a discoloured watery fluid in small quantity. When I was called to visit him, I found him in the following condition : he complained of great thirst ; his extremities were violently convulsed, as were the muscles of the face ; the mouth was much contorted ; his eyes were sunk; his extremities became cold; the pulses were imperceptible; he did not complain of pain in the abdomen, which he allowed to be pressed without shrinking. — He took a scruple of calomel, and eighty drops of laudanum on admission. — Bibat. aq: ammon : foet. 3i j ex pocnl aq: hord. dimid. quaque hora; frictions with flannel moistened in brandy were assiduously applied to the abdomen, and cxtrcmiiie6.— He continued much in the same state till about six o'clock, A. M. when the 

>l n 



298 



pulse became perceptible ; after tills period he took only one dose of the stimulating draught ; his thirst was much abated; his heat began to return: he had a pleasurable son^ition of warmth at stomach. — The convulsions ceased after he had taken the calomel with laudanum, and two of the draughts : his pulse increased in strength, And about nine o'clock A. M. perspiration was apparent m his forehead; which soon became general; and at ten o'clock A. M. he declared that, with the exception of debility, he had no other complaint, when I reported him out of danger to the Commanding Officer. — Bstk; Ho slept soundly during the night, and had a natural motion this morning; he has no complaint, but that of weakness; he says ha is very hungry.— 26th. No complaint. 

CASE THIRTY-FIRST. 

NAGJOttE. 

Hindoo Sirrg Sepoy, admitted into Hospital on the morning of the 90th May 1818 ; probable age D 2 years. >Svmptonis : excessive retchings ; great thirst ; pulse small and scarcely perceptible; skin cold, and clammy; spasmodic affection of the limbs and muscles of the abdomen ; eoirstantly going to stool, but passes nothing '"it water ; griping pain in the bowels. R. Tinct. opii gtt; GO 01. tntnth pip. gtt. xx aquae purae Bji ft. haustus; to be given with twenty grains of calomel every half hour. — JO o'clock A. M. has had the above given three times symptoms greatly aggravated ; coldness of the body, and spasms increased; complains of violent pain about the navel. — Let a blister be applied to the part ; and repeat the medicines as above directed. — He continued sinking in this dcploiable state until 12 o'clock, when he expired; being two hours and a quarter from his admission — The medicines had not the least effect to overcome the disease. ¦ 





THE body of the foregoing Report was completed towards the end of June, from documents coming down to the commencement of that month. — From the general tenor of those documents, there seemed some grounds for hoping, that the dreadful mortality, to which they related, was on the decrease ; and that we should soon be wholly released from a pestilence, which had ravaged India during a period of more than two years, and spread dismay and destruction into every portion of its provinces. 

The six months, which have since elapsed, have, unhappily, disappointed these expectations. During no part of this time, can the country be said, to have been wholly free from the disorder ; and at Several distinct periods, and in distant quarters, it has again shewn itself in such an appealing, and widely Epidemick form, as to leave no doubt, that the distemperature of the air, in which it originated ; yet subsists, and is ever ready to be brought into action, by those external agents, which have been enumerated above, under the head of Predisposing and Exciting Causes. O o 



Awfully violent as some of its recent attacks have been, it cannot be said, that, during their prevalence, the disease ha* developed any new laws ; or displayed itself under any new form, different from that in winch it first came amongst us. Much cannot, therefore, be learnt from a narrative of its latter progress. But, as the appearances of those attacks generally, have tended materially to confirm some* and to overthrow others, of the inferences respecting the peculiar habits of the disorder, which we ventured to draw on the strength of former experience j and further to establish the efficacy of particular modes of treatment; it will be necessary that, at the risk of tediousness, and of fu rther prolonging a work already too diffuse, we should give some account of them. In doing so, however, it shall be our endeavour, to avoid the introduction of all unnecessary matter ; and to comprise what we have to say, in as short a space 

twill be in the reader's recollection, that in piing of the present year, the Epidemick i extensively in Nagpore and Mahvah j and ly affected the Nerbudda Field Force, and Lveral Detachments serving under Colonel o,v in the vicinity of Neemuch, in April and On the Bth' of the latter month, it reach-16 Saugor Division of the Army ; became 

300 





violent on the 18th ; declined towards the end of* the month ; and finally ceased on the 4th of June. The Natives alone were affected. Sixty* four persons were admitted ; of whom 19 died. The Ist Battalion 26th Native Infantry, the* men of which had previously suffered much fxom fever and dysentery, and had impaired their constitutions by remaining long in the hospital, were chiefly affected. It had 54. admissions, and 18 deaths, from a strength of 868. On the tflst it buried six men. This corps was with the Left Division on its being attacked during April of the preceding year ; and had then 8 seizures, and % deaths ; but the 2nd Battalion 28th Regiment, which on that occasion had 56 seizures and £9 deaths, now wholly escaped. So, the 2nd Rohilla Cavalry, which had likewise been seasoned, when with the llajpootana Force in September, did not lose a man, from a strengthof 1125: although encamped closely to the 26th Regiment. Calomel, opium, and other usual remedies, here seemed of no avail; tho' the former was often pushed in doses of 60 grains. The lancet could alone be depended on ; and when used early, and to the extent of from 20 to 40 ounces, oflen saved the patient, 

The disease next reappeared in the Rajpoo* tana Force. It first shewed itself mildly on the Bth oi June in the Rainpoora Local Battalion - y 

301 





302 



but did not affect any other corps till the 20th,' when it became general. The attack was upon the whole a mild one. Excepting one officer, who unfortunately sunk from debility and relapse in a late stage of the disorder, the Europeans remained wholly exempt ; and from a Native force of 97^8 men there were during the month only. 106 admissions, and 25 deaths. Tiie mortality fell chiefly upon the 2nd Battalion 7th Native Infantry, llifen affected for the first time ; and on a detachment of 340 recruits: the former having 18 admissions, and (3 deaths ; and the latter 5J admissions, and 3 deaths. The remaining casualties were shared by the other corps. But the Ist Battalion 28th Native Infantry, and 5 companies of the Ist Battalion 27th Native Infantry, both of which had suffered severely in the previous September, ljo w wholly escaped ; and only a few cases, all terminating favorably, occurred in the 2nd Battalion 19th Native Infantry, which lost many men at Mundespore in August. In one division of the 27th Native Infantry, there v.vre 7 admissions and 5 deaths; but all the jc took place in persons who had been absent from the corps during the sickly period of September. Some cases appeared in a detachment of the 2nd Battalion 7th Native Infantry 011 duty in the garrison of Jaragurh, a thousand feet above the plain j while the inhabitants of the town of 



Ajrnecr, on the declivity and at the base of the hill, escaped. The disease still continued to prevail in th^ Division, though with graduallydeclining violence, during the beginning and middle of July; but entirely ceased on the 20th of that month. The number of admissions during the month was 70 ; and of deaths, 20. The 2nd Battalion7thand Ist Battalion 19th, each lost 7 men. Several Europeans were likewise affected, and 2 Officers, 3 Privates, and 1 woman cut off. The disorder appeared to abate after a long and heavy fall of rain. The weather previously to the reappearance of the disease in this quarter had been cloudy and sultry, with frequent thunder storms and showers, variable winds, and but little fluctuation of the thermometer ; which usually stood at 81 at sun-rise, and 97 at noon. In the early stages, the treatment was nearly as during the former year. The secondary symptoms were uncommonly severe j and to counteract them, mercury was largely employed. 

At this time, the virus did not in this quarte appear to spread in any particular direction the body of the air seeming to be generally corrupt, and indiscriminately to exert its malig nant qualities, wherever they happened to be called into action by great and sudden vicissi tudes of the weather. Thus the disease lef Neemuch in the end of May, and appeared in 

303 





Nussurabad, nearly eighty miles further North, on the 1 2th June ; but it was not till the 18th of the latter month, that it reached a Detachment posted half way between these two stations, just after its being exposed to remarkably inclement weather. — In July, some Corps of the Ncrbudda Force suffered considerably. Thus the Ist Battalion Bth Native Infantry had 40 cases and 9 deaths ; and the l?t Battalion 15th Native Infantry, 13 cases and 5 deaths. Both rtf these Corps had been previously exposed ' t but we have no particular^ regarding the ueseriptions of men now affected. From this month downwards, the disease ceased to be epidemick equally in the Neibudda, Saugor, and Itajpootana Divisions; and gradually gave place to fevers, and other complaints common to the climfkte and season. 

"We must row turn our attention to the Ceiir tral and Upper Provinces. The state of the atmosphere in the whole of these tracts was at this time remarkably favorable to the existence of the Epidemick. The Rains did not regularly set in for many weeks after their customary time j and as the Hot Winds continued to blow without interruption during June, July, and part of August, the heat had latterly become almost intolerable, and the whole face of the country entirely parched up. — Nevertheless, the epidemical dis* 

304 





position of the air had certainly abated ? since from Cawnpore downwards, the disorder can scarcely be affirmed to have prevailed generally, subsequently to the conclusion of the period included in the Report. — For, although a few cases now and then appeared at Dinapore, Mulbye, Chunar, and places in their vicinity, in May, June, and July, the aggregate amount of thosa was very inconsiderable ; and only went to shew, how greatly the sickness was on the decrease. — In Cawnpore too, it soon gave way to violent remit* tent lever; which proved exceedingly severe and fatal, especially amongst the European Troops : sometimes cutting oif the patient almost instant taneonsly, with every symptom of apoplexy. 

I The Epidemick made its second appearance Agrah* on the 27th of May ; was very desuctive during the first week of June ; abated >outthe 10th of that month, and wholly withew on the 15th, after several rainy days. Coniryto what had been observed in the preceding 

I* We are indebted for the account of the progress of 5 disease in this quarter, almost wholly to the valuable rnmunic itions of Mr. Gibb, Superintending Surgeon the Division, and of Mr. Surgeon Jackson, H. M. th Reginrint. Mr. Gibb'i views, indeed, of the true ture and treatment of the malady, appeared to tht ¦dicril Board so just and luminous, that nothing but c lateness of their arrival, and the previous great length this Report, prevented their being published in full. 

305 





year, it raged with great violence and mortality in the city.— lts range in Cantonments was comparatively limited, and chiefly confined to the Ist Battalion 7th Native Infantry, which had 36 cases and 15 deaths. The total number affected was 3 Europeans and 39 Natives: of whom 17 died. There were likewise four deaths in the Jail. — Following the course of the Jumna, the disease reached Muttra in the end of June; and there exert* ed its influence in a plight degree throughout the whole of the succeeding month. It could scarcely, however, be said to be Epidemick ; as only 29 cases and 7 deaths occurred in the Infantry Lines j and not one in the Cavalry Corps, or in the town. Thus Agra, which in the former year had nearly escaped, was now severely visited ; whilst Muttra, then dreadfully scourged, now remained wholly unaffected. During this period Mynpooree and Futtigur were, quite healthy ; and at Coel the disease scarcely appeared. Not a single case offered in the town, or jails ; and although no less than fourteen Sepoys labouring under the disorder were received into the Battalion Hospital from a party which had returned from Agra, two cases only occurred in Cantonments, and both of these nearly a month subsequently to the 

arrival of the infected party. 

306 





Sporadiejc cases had been very frequent a. mong the European* — especially the drunkardsat Meerut, for several months ; but it was not until August, that the disease recurred in an epidemical shape. On the 9th of that month, it appeared in the Ba?ar of J£is Majesty's 14th ltegiment of Foot, and ceased there after carrying off 40 out of 50 attacked.* Moohummudans and Hindoos suffered equally ; and among the Jatter, three persons who were understood to have had the disease in August of the former year. This bazar is a remarkably confined and noisome place in the pentre of the Cantonment. On the J2th, the pestilence reached the town, in which, between the time of its first approach and the end of the month when it wholly disappeared, it, according to the Police .reports, killed 70 out of an unknown number attacked. On the 28th, jt entered the bazar of His Majesty's Bth Dragoons ; and, after destroying 14 persons (10 Mussulmen and 414 1 Hindoos), withdrew on the 17th September. Many cases, but of a milder type, at the same time occurred in the bazar of the Native Battalion ; and some of these secondary to attacks in the preceding season. In the Sudder Bazar, which during the first visitation had suffered more severely than any other spot, a few cases only occurred now, and those 

* The numbers attacked were probably underrated. 

p p 

307 





Iw generally mild, although through neglect ore than one half proved fatal. 

We next come to its effects upon the troops And as there was here something very remark; ble in the great fatality, and partial distributio or'its attacks, it will be necessary to enter some what more largely into particulars, than the coi cisc nature of these remarks may perhaps we admit. The total strength of the Force in Can tonments, was 2364 Europeans, and 1342 Ni tives. It was composed of His Majesty's 8t Light Dragoons, His Majesty's 14th Regimen the Horse Brigade, the Ist Battalion C 2sth Reg ment Native Infantry, a Detachment of the Pro vincial Battalion, and the Gun Lascars of th Horse Brigade. Part of the Horse Brigade ha suffered severely with the Centre Division i 1817 : and slightly in 1818. Of the other; Corp. His Majesty's Bth Dragoons had had 7 teituti and 2 deaths at Meerut in August 1818 ; Hi? Majesty's 14th Regiment 3 seizures and 1 death and the Provincial Battalion had remained, free On the present occasion, the Bth Dragoons hac only eleven cases and two deaths ; whilst th Horse Brigade, the 2,5 th Native Infantry, th Provincial Battalion, the Gun Lascars of th Horse Brigade, and all the Officers, entirely es caped ; so that nearly the whole force of the dj«ase 

308 







309 

was directed against the unfortunate 14th Regiment. 

During all July and the early part of August, the weather had been very sultry and close ; with little heavy rain, frequent drizzling showers, low clouds, and hazy atmosphere ; — the heat being almost insupportable at night, and at all times much higher to the feelings than it appeared by the Thermometeri which usually ranged between 83 and 90 at 2 P. M. with a fluctuation of only a few degrees between morning and evening, flic wind was throughout Easterly. — The prevailing diseases had beeij fever, hepatitis, gastritis, and enteritis. 

On the Bth of August, the first case of Cholera appeared in* the 14th Regiment, which, including invalids and convalescents, had then 200 sick in Hospital from other complaints. On the 12th two cases occurred ; on the 13th and 14th about 10 were brought in. On the 15th the morning was more sultry than any in the month. Eight hundred men of the Regiment went to Church in the Dragoon Lines. Some were attacked in Church"; some on the march back; and some ii) the barracks after breakfasting heartily. Several wrrc dead before night. JJ envy rain fell in the afternoon, and cooled the atmosphere ; no fresh cases occurred, and the s\ mptpms of such of 

p p g 



bose already affected as; were not too far gone, 

iecame less severe. On the lOth, there way rizzling rain ; and fresh cases offered, but of a lildersort. On the 17th and 18th, the men ame in so fast that the Hospital got exceedingly rowded ; and it became necessary to accommoate the fresh case 3in the school room, and the onvalescents in ail empty Barrack in the Dra-0011 Lines. It rained heavily in the day of the [)th, and there were few fresh admissions; but 1 the night, which was sultry, they were more umerous than ever.— The pestilence was at its eight on the 20th ; the day was hazy, damp, and oppressive ; and many men were brought iv. past hope of recovery: all vital energy being from the commencement nearly extinguished. Many invalids in hospital, were now seized* and, being much debilitated by previous disease, sunk almost without an effort. On the morning of the 21st, a steady breeze sprung up from the East, and brought with it clear weather; and happily from this time the disorder declined quickly, and soon after entirely disappeared. Two slight cases occurred in the succeeding night, and one or two next day. On the 23d, the Regiment moved out of barracks, and encamped on the race ground, where it remained till the 29th : the barracks, privies, &c. being in the mean time thoroughly cleansed and white washed. Three or four case? appeared in camp \ but the weather being wet. 







with rain, dysentery soon got the ascendancy, and proved remarkably severe. 

During the whole period of its present visit, the Cholera in this Regiment attacked 221, and cut off 41 persons, from a body of 1,200 rank and file : the seizures being as one in five and a half of the whole Corps ; and the deaths nearly in like proportion to the seized. Some relapses occurred and terminated fatally. The disease commenced, in the Eastern . wing of the barracks, and proceeded in a westerly direction ; but suddenly stopped at the 9th Company : the Light Infantry escaping with one or two slight cases only. The Bth Dragoons were situated to the left or west ; and the Horse Brigade to the right of the 14th, 

The symptoms in some respects differed from those usually presented by the disease in other quarters. Bilious vomiting was very common in every stage ; and probably one third of those attacked had greenish discharges in the first instance, and many for several hours, or even days. In such cases the tongue was covered with a yellowish, or dark brown fur ; whereas in those with watery evacuations, it was whitish, and clammy, or but little changed from its natural state. The stools were generally bilious, and watery. Sometimes tliprp wis no vornitinff * sometimes no sdesitis * 

311 





312 



and sometimes the intestines were torpid. In the irst few days, all the deadly symptoms of cold and collapse were invariably present; but towards the 1 8th the disease was sometimes accompanied vith ardent fever : quick, hard, small pulse ; Darning skin ; flushed face ; inflamed eves ; and xcessively foul and loaded tongue. These cases vere marked father by a tingling and numbness of lie limb?, than by violent spasm ; and were less estructive, than those coming under \ he usual brm of the disease. The attack, was in general udden, and where fatal, cut off the sufferer in a )eriod ranging between nine and forty-eight lours. Want of appetite, however, usually preeded; and in many instances slight looseness. t seized the sober and drunken equally ; but the atter sooner fell victims to it. Two puerperal women were attacked, and both died. The dissections shewed nothing particular. Traces of visceral inflammation were commonly found, The stomach was filled with greenish, muddy fluid. The urinary bladder was always empty. In ail other points, the appearances corresponded with those described in the body of the work. 

Large and repeated bleedings proved the only efficacious means of opposing the disorder. During the first few days bleeding was not always practicable ; and then the cure was attempted by large doses of calomel, with lav* 



danum aiul stimulants. But this plan wholly failed ; and there seemed reason to doubt, whether calomel was not always either useless, or hurtful. The lancet was then universally resorted to, and with great success. It would be mere repetition to go on enumerating the variety of means used in aid of this chief remedy. They were such as have been found generally efficacious in other quarters. Opium and laudanum were advantageously given in very large quantities. In many cases laxatives were throughout safely dispensed with ; and when required, the mildest proved the best. The most approve*! means often failed, from the unparalleled violence and rapidity of the attack.* 

• Trismus occurred in one or two cases. The inflammation in the internal coats of the stomach had sometimes gone on nearly to sphacelus. Sometimes it was so slight, as to be nothing more than venous congestior. Sometimes it wa9 wholly absent ; and at Kurnaul not a trace was found in five bodies, tho' several had been long ill, and had used every kind of stimulant. Some were taken ill whilst under the influence of mercury lor other complaints ; in others a salivation supervening upon the primary attack was followed by relapse and death. Calomel sometimes seemed to re-txeite the allayed irritability of the stomach. In one division of'H. M. Bth Dragoons it was not at all employed ; yet all I lie patients, European and Native, recovered under tho lancet, and large doses of opium Laudanum was usually given in doecs of 100, or even 200drppt, or two drachms at a time. A sickly Native io< k COO drops in one night jmj recovered ; nail I gentleman al a distance from Mciirut 

313 





¦shall, upon enquiry, find that there existed ome reasons why the cantonment of Meerut iould at this time have again fallen under the diease; and why His Majesty's 14th Regiment lould have been so peculiarly singled out, and so ruelly affected. The cantonment bazars were in a cry filthy state ; the roads in a broken, bad ondition ; and the drains a mere succession of tinking pools. No filth carts were allowed ; nd the cleaning of the streets and dunghills was eft to the beasts and birds of prey. This was le general state of the Cantonment at large ; nd it is natural to suppose, that the immense oad of foul, and corrupt matter, thus constantly generated, must, especially when aided by the great heats of June and July, and the moist weather of July and August, have presented to 

as saved from impending death by swallowing 400 rops in two or three hours. It never in the largest uantities induced affection of the head. Fatal relapse as not very uncommon where bleeding was largely, id even repeatedly employed in the commencement. "he warm bath was decidedly useful. Among the uvantia, dilute sulphuric acid seemed to be serviceable. ced water was successfully employed in one case, in hich there was incessant vomiting, and unquenchable lirst. In the severer cases, every thing taken into the tomach was rejected instantly, and generally with great orce. — It may be here mentioned, (.hut the Actual Cautery, by binning with a hot iron in the Epigastric rgion, has been recently found effectual in allaying the ritability of stomach and abdominal sprain, in another >art of the country. 







315 

SUPPtEaiEIJT. 

any epidemical disorder, afield peculiarly favorable for its malignant operations. Ths state o£ that portion of the cantonment which was set apart for the accommodation of His Majesty's 14th Regiment was yet more inviting. The barracks, although clean and well ventilated, were originally too confined; and from the married and unmarried men being thrown together, were still more contracted and shut up by the latticed partitions, and large curtained cots set up by. the former for the purposes of separation and comfort.* The privies were too few in number j and could hardly be kept rlean or wholesome. The effluvia proceeding from them was at times exceedingly offensive, even to a great distance ; and many of the worst cases were those of men seized in them with violent spasms and vomiting. The bazar, too, of the Regiment, in which the disease first broke out, ww r a3 an abominably filthy, confined hole. It moreover appears, that the men ofthe*l4th were in the habits of sleeping in the open air; and of going into the sun, and constantly resorting to the Sudder Bazar : " the most noisome of all filthy and suffocating places." 

These perhaps, were sufficient causes for this Regiment suffering more than the others. But they leave us unsatisfied on many material points. 

* There were about 170 women, with their children in the Barracks. 

Qq 





They do not tell us, why, when the Epidemick was present in the former year, this same Reginient shqujd have nearly escaped ; nor why in the >resent instance, the disease, when once amidst t, should have stopt short at the 9th Company; nd after a few days, of tremendous destruction lave suddenly disappeared, without apparent dequate cause. They do not explain, why the lorse Brigade on the right, and the Bth Dragoons on the left,* should have scarcely suffered, and the whole qf the Native tr.Qppshave entirely escaped, although the latter were, from their modes of life, doubtless much exposed to. thp damps of the night, and to the heat and- sun by day — nor why the Sudder Bazar, the most crouded and filthy of all tJie Bazars, should have enjoyed entire immunity. Lastly, whatever might be the influence of these exciting causes, how shall we, upon the uppositipn of nothing more being necessary to he production of the pestilence than their exisence simply, account for their lying dormant, duingthe burning months of June and July, and after a short period of action, for their again becoming inert towards the end of August ? 

It was the opinion of the Surgeon of the Corps, that latterly the disease had become 

* The Hospital of this Regiment was situated nejir the Hospital and Barracks of the 14th, and subject therefore to the same local influences. But, then, it WjU * remarkably fine and'spacious building. 



contagious. This opinion was grounded upon -his observing, that the Apothecary of the Corps, the Hospital Serjeant, anj an apprentice were successively attacked, and that several men were taken ill whilst nursing their dying comrades. But, it should be recoliected, that all these persons, besides being equally exposed to tha pestilential virus with the general body of the Corps, were in an especial manner rendered liable to its attacks, by watchfulness, incessant fatigue, despondency, and grief — all powerful debilitating', and predisposing causes. Moreover, without going at large into the argument, it maybe stated, that the total exemption of the Medical Officers* notwithstanding their being in constant attendance upon the living, and frequently having to handle the dead, here, as in almost every other instance, is hardly reconcilable with a belief in infection ; and that the unaccountable rise and speedy diffusion of the disease, its rapid increase and equally rapid decline, the narrow bounds of its influence amid great and unrestricted intercourse, its limited duration, and above all, its sudden and entire cessation without a single precaution being taken against its further extension, are facts decidedly characteristick, not of contagion, but of pure epidemical influence. — It was remarked, that in the 14th, fbvcr and dysentery were less prevalent, 

W 4 ~ 

317 







especially the latter, in August • than in July , and that, in proportion to the strength of the Re T giraent, fever was more severe, but less frequent than in the other Corps. 

Nearly at the same time when it broke out at Meerut, the Epidemick displayed itself in Kumaoon, at Boreilly, and at Moiadabad to the East, and at Kurnaul to the West. It visited Almorah on the 10th of August ; and disappeared about the middle of September, after a great fall Qf rain from the East. It confined itself to the suburbs in the South East angle of the town, which were inhabited by persons of the lowest casts only ; and did not fairly enter the Sepoy Lines, or the body of the town. The disease was comparatively mild and easily checked. Twelve deaths only took place from 76 seizures. One Sepoy only of the 13th Native Infantry was seized, and even he got the disease when in the infected part of the town. — Few instances occurred of more than one of a single family being affected. The disease appeared to proceed in a westerly direction j coming from Dotee on the East bank of the river Kalee 10 Almora, and moving thence towards Kassipoar to the West. It was accompanied by a westerly wind; a moist atmosphere ; and a temperature from 70 to 76 — We have no note ol the effects produced by the disease at Bareillv. 



ETie mortality could not, however, ' be great ; nee the Jails in the quarter from July to Octo- MP gave Only nine admissions and three deaths, t Moradabad it was more deadly. During the onth tiie deaths in the town were from twelve 

to sixteen daily. In the Jails, out of 700 persons, there were only four admissions, and two deaths. 

The disorder shewed itself at Kurnaul on the 10th of August ; and wholly disappeared in September. •It attacked the 2nd Battalion SGth Native Infantry first, and most severely. It kid 10 cases and 5 deaths. Part only of this Battalion was with the Ilansi Division in August of the former, year ; the whole was now present. The 2nd Battalion sth Native Infantry bad 9 cases and 7 deaths; and the 6th Regiment of Cavalry 2 admissions and no death. Immediately upon the appearance of the disease, all the Corps were ordered to wear wariffl clothing. — F»om Kurnaul the disease spread in the direction of Loodhceana, but as in the former year, died away before reaching that station. Delhi, and every other station coming within the Division, now kept healthy ; so that the only place visited was Kurnaul, which had escaped on the former occasion. 

1 After visiting Meerut, the disease seemed to te a Northerly- course ; reappearing in Saharunre, and attacking first the town and then the 

319 







cantonment. Neither in number, nor in violence, however, did the cases equal those of Ser* tember and October of the former year. There were only 14 cases and 4 deaths in the Provincial and Nussuree Battalions, and in the Jails only ona case, and no death. — On the 2d October it for the first time entered the Deyra Dhoon ; and although it remained only three days in the valley, it worked fearful desolation during its stay. Of the deaths in the village we have no certain information ; all that we learn, being that they were very numerous ; but in the Sirmoor Battalion the seizures, out of "a body of 900 men, were lIS, and the deaths 74, almost two thirds ; and in the Lines, 73 women and children were cut off. This almost unprecedented mortality is accounted for from the circumstance of the Medical Officer bring himself early seized with the disease ; and the miserable MifFcre-rs being thence in a great measure left to their fate. It will be observed that the successive affection of Kumaoon and the Dhoon, which are both situated beyond the lowest range of the Himmalaya, greatly weakens the force of some preceding deductions on the inaptitude of the disease to ascend mountainous tract?. On the other hand, the stopping short of the virus, v.ithout seeming cause, both in this and ticformer year, on the hither ride of the Northerly 



•MCA ? /*» +11/» /» /> rt • /-\T n c^w«r rtnn'intnfi + l-i rt ,1 •»^^n«.* rise iv vile cunsoiaxory conjCCT.iiri:j ni.it mc pesti* lential virus cannot live in the higher latitudes. 

luring the last half year the Epidemick has eery been on the decline in the Lower Provinces. Jail Returns, which yield a pretty good rion by which to judge of the health of their 'ctive districts, have been ge nerally favorable, in many instances perfectly clean.* Ths 

* The M. C. Shipping at the new Anchorage was again visited during the squally irregular weather of September. As on the former occasion some vessels wholly escaped, and others suffered fttverety. But the case of the Carnatic was peculiar. This Ship anchored ir> Madras Roads on the sth of August ; clean, and with a healthy crew. Whilst at ancher she hnd six case* of Cholera, all terminati?ig favorably. She sailed on the 20th with fine weather and light breezes. — On the night of the 27th, a robust man, frfio had recovered from an attack at Madras and returned to duty, was rese'zed and died at SA.M. of the 2sth. At B*P. M. of the 29th, the Joiner wns seized, and diet! at S A. \I. of the 30th. At 4- A. M. of the 30th a healthy Seaman, 35 y( art old, was seized, and died at i»idd;iy. In the same morning, of two other healthy lads taken ill, one died at 3, and the other at 6 P. M. Another man waa seized in the succeeding night, and died in seven hours. At 8 A. M. of the 3J st a healthy, stout, middle aged Sear man dropped down in convulsions ; and died at 6 P. M. After this there were six other cases, Imt all terminated favorabl)'. The Midden mortality in this instance appears to have been wholly produced by the unfavorable itat 0 of the atmosphere. The Ship seems in her pas•'•Atre an the Bay to luivc kcDt close in with 'lie shore • 

321 





disorder has perhaps in no one quarter raged with its .former violence ; and wherever its attacks have been such as to attract particular notice, their severity could generally be attributed to some sudden change, or marked irregularity of the weather. Thus, Calcutta continued tolerably healthy until the end of the Rains, which suddenly broke up about the middle of October, and after two or three cold, sharp days, with dear sky and Northerly wind, were succeeded by nearly a month of such damp, disagreeable weather, as to the experienced eye clearly forebod- 

And di'ring the Oih, Wa» wf Ganjam within 15 miles of the land, with a cold damp land wind blowing a'} day. The disease had no appearance of contagion, Tt Occurred only among the Seamen, although between their condition and that of the soldiers there was only jhii difference, that they slept on the gnu and the tfoidierf on the orlop deck. Seine wore seL'cd, who had no Communication with the sick ; whilst other* f.-caped \vho constantly sat by their hammocks. There wns nothin 1 peculiar in the circumstances of the crew. Their diet was of fresh provisions. They were not unnecessarily exposed ; for an awning was spread fove and aft. The whole of the persons seized were of sober, regular habits. They had all drunk largely of cold water previously to being taken ill. In those who recovered, the attack was succeeded by bilious purging. Venaesection failed in several. 

The disease is now (December) prevalent in some spots of Nud'leea, and among the Cooley establishment employed in clearing the island of SftUftor ; but, as far as we are acquainted, in no other purl oi 13cii""a!— that is as an Epidemick. 







323 



e'd the return of Cholera. The air was then hazy, raw, cold and uncomfortable to the feel. The thermometer ranged from 74 to 83 j but it felt much colder. There were no sudden variations of temperature. The appearance of the sky was peculiar. It was cloudy; but only partially so. The clouds were not dense, or heavy, or fleeting ; but thin and fixed, with frequent breaks through which the blue sky appeared. They were generally of a dark grey colour, flat, dull, and gloomy; and for several days formed along, broad, fixed bank towards the West and North West verge of the horizon ; and remained wholly unchanged in shape or appearance. The wind varied from North West to North East. There was seldom regular sunshine. This state of things continued to the 12th, when there was a severe shock of an earthquake, followed by rain and variable winds for several successive days, till the 20th, when a dry cold wind came round from the West, and brought with it a clear sky and regular weather. During the whole of this period of irregularity numerous cases of the disease occurred, and proved very fatal in Kalinga and other Native Departments of the town ; * but no sooner had the season become 

EAt this time the disease chiefly prevailed anong the ssulman population of the city ; and as it was then sacred month of the Moohuirum, it was at first ight that much of its violence mi^ht be attributed 

Rr 



j^c^. iliSn the Epideraick ceased to be heard 

However, we may hope that the late favorable change is merely a precursor to the entire restoraion of their long lost salubrity to these regions ; here is much cause to apprehend, that the pestience, in leaving India, is only about to transfer its Lestructive influence to other climes : for we have ust learnt that it has reached the distant island of Penang,* after ravaging the province of Arracan, 

o (he effects of watchfulness and other irregularities! roinmoj) in that season of mourning nnd dissipation, t was, however, learnt upon enquiry, that persons of ober, regular habits, and secluded women suffered qually with others. Two persons were rarely affected n one house.— Some Natives placed crcat faith in boild water as a preventive; and one or the principal N iive gentlemen in the city ascribed the singular healthiness of his numerous household, during the whole peiodof the Epidemick, to his having taken the simple precaution of allowing no water to be drank by them mtil it hod been previously boil'd. Bad water no doubt sometimes immediately induces the disorder ; )ut we must not suppose it is the sole cause of it, any more than that cold is the sole cause of fever, because when applied in certain ways to the human body, it sometimes produces that disease. 

* The disease appeared here on the 23d of October, and disappeared or greatly declined in the first week of December. From a population estimated at 14,000, he deaths exceeded 800. For a considerable period they amounted to above 30 a day. St, George's Town suffered 



SUPPLEMENT. 



SUPPLEMENT. 

325 

nnd the whole of the Malayan Peninsula. 31st December, 1819. 

I and nearly one half of the fatal casrs occurred ampng Natives of the Southern Peninsula, who hue} migrated from the Coromaijci.-l Coast.