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decline of the first choleraic wave, it attained its maximum; and then, steadily
declining, but much more slowly than it rose, to the end of November.
Relation of Choleraic Diarrhœa to Cholera.
I have said that "choleraic diarrhœa," as it is vaguely termed, is but a choleraic
attack which fails to undergo a complete development in the system. Our own
experience demonstrates that such is the case. For, 1st—it is seen from the table
that whereas ordinary diarrhoea formed only one wave of increase and decrease,
"choleraic diarrhoea," like the true cases of cholera, formed two waves—the first
high and more overwhelming ; the second lower and less overwhelming. 2nd—It
increased and diminished as cholera increased and diminished, attaining its maximum
and minimum in the same weeks, or as nearly as possible so. 3rd—It affected chiefly
the localities principally affected by fully-developed cholera, concentrating itself
mostly in the localities I have designated as the chief foci of cholera, and most of all
in the grand cholera focus to the south of the Essex Road. 4th—There are
numerous instances in my records of the epidemic, where cholera, having attacked
one or more persons in a house, others have suffered, at the time or immediately
afterwards, with an attack of "choleraic diarrhœa;" or where the first choleraic
attack in the house has been designated "choleraic diarrhœa" after which some one
else has had an attack of true cholera, and died from it. Again,—in has been, over
and over again, noticed that persons who have been in association with cholera
patients have suffered from the milder attack, while others have suffered from the
fully-developed disease. It is not necessary to lengthen out my report by the
details of these instances.
It is not my intention to enter at any length into the evidence afforded by our
limited outbreak, of the method in which cholera propagates itself when the specific
virus of the disease gains access to a neighbourhood or a house. This is a subject
which more befits those whose districts suffered more than that which it was my duty
to superintend. But there is one point to which I must not fail to draw attention,
because, although a negative fact, it has a force of instruction which must not be
lessened by any omission on my part. And this is, that certain parts of our parish,
which suffered very severely in former epidemics, scarcely suffered at all on this
occasion. I have never seen an epidemic of cholera in this parish before; but the
leading particulars of those which have occurred have been detailed to me by several
medical men who were professionally engaged in their suppression. The parts I
particularly allude to are the Irish Courts, the White Conduit district, and Brand
Street, Hornsey Road. In the actual Irish Courts themselves, which suffered greatly
on former occasions, not a single case of cholera happened. In Brand Street only two
cases, one of which was a mild case and recovered; and in the streets of the White
Conduit district, about Henry Place and Payne Street, only three cases, of which one
recovered. I might mention other of the older streets in the parish occupied by
poor people, where a similar remarkable contrast was observable. Now, whatever
the specific virus of cholera may be, and however it may become diffused from place