burg, and the latter among the faculty and inhabitants of Moscow, who, almost all of them, strenuously maintain that cholera is not contagious. Both parties cite facts which are met with point blank contradictions by the opposite party, whence the unprejudiced inquirer finds it as yet impossible to form a conclusive judgment. The vastness of the empire, the very unsatisfactory manner of the few reports sent in, the uncertainty of depositions, influenced frequently by personal motives, and the almost totally interrupted correspondence by letters, offer so many obstacles to inquiry, that, even with the best intention, it is often only possible in part to overcome them. When the cholera first reached Moscow, all the physicians of this city were persuaded of its contagious nature; but the experience gained in the course of the epidemic, has produced an entirely opposite conviction. They found that it was impossible for any length of time completely to isolate such a city as Moscow, containing 300,000 inhabitants, and having a circumference of nearly seven miles, (versts?) and perceived daily the frequent frustrations of the measures adopted. During the epidemic, it is certain that about 40,000 inhabitants quitted Moscow, of whom a large number never performed quarantine; and, notwithstanding this fact, no case is on record of the cholera having been transferred from Moscow to other places; and, it is equally certain, that, in no situation appointed for quarantine, any case of cholera has occurred. That the distemper is not contagious, has been yet more ascertained by the experience gathered in this city. In many houses it happened that one individual attacked by cholera was attended indiscriminately by all the relatives, and yet did the disease not spread to any of the inmates. It was finally found, that not only the nurses continued free of the distemper, but also that they promiscuously attended the sick chamber, and visited their friends without in the least communicating the disease. There are even cases fully authenticated, that nurses, to quiet timid females laboring under cholera, have shared their beds, during the nights, and that they, notwithstanding, have escaped uninjured in the same manner as physicians in hospitals have, without any bad consequences, made use of the warm water used a moment before by cholera patients for bathing.

These, and numerous other examples, which, during the epidemic, (we ought, perhaps, to call it endemic,) became known to every inhabitant of Moscow, have confirmed the conviction of the non-infectious nature of the disease, a conviction in which their personal safety was so much interested. It is also highly worthy of observation, that all those who stand up for contagion, have not witnessed the cholera, which is therefore especially objected to their opinion by their opponents. But in the very difference of the conviction of those who have to combat the violence of the distemper, and are likely to be more impressed by the facts, and of the conviction of such persons as can observe only at a distance, and are therefore more unbiassed judges of the results, will perhaps be found materials for the solution of a question so much controverted. The same was the case on occasion of the question relative to the yellow fever. It was only after a calm examination of all the results, that it became possible to refute the error of those physicians who had collected their experience during their daily and fearless intercourse with the distemper, and had arrived at the conviction of its non-contagious nature.

In the instance of the cholera, the question becomes more difficult of deeision; because if the cholera be at all contagious, of which I myself am not doubtful, in spite of all that is maintained here, such contagion differs from

the nature of all known contagions, and seems to approach nearest to that of the typhus. With whatever obstinacy the correctness of the facts is disputed by the anti-contagionists, it still appears highly probable, that the cholera may be communicated by persons proceeding from one place to another, and may lay the foundation of a fresh epidemic, if circumstances favor the communication.

It is greatly to be lamented, that neither of the contending parties is able to produce such authentic documents, and to set on foot such investigations on the spot, as would silence every contradiction; for, as the state of the question now is, we must be satisfied with probabilities.

Only one point seems to be completely made out by testimonies innumerable; namely, that the cholera is not communicated by articles of merchandize, or by any inanimate objects. This principle, as I have already had the honor of reporting sometime ago, has been adopted by the public authorities of St. Petersburg, and been acted upon now for nearly three months, without any sinister consequence having ensued. The only quarantine establishment still kept up, is between Moscow and St. Petersburg; every traveller, after staying there for a fortnight, may proceed without further detention; all mercantile commodities and effects pass without being stopped.

On our journey hither, we met many thousands of sledges loaded with goods, going from Moscow to St. Petersburg. As the rates paid for carriages are extremely reasonable, any stoppage in their conveyance would prejudice the merchant; hence the carriers, as I myself saw, proceed no further than the barriers of the quarantine establishment, and remain there, as far as their persons are concerned, and their sledges alone pass through, which being met on the other side by their partners or servants, are taken on without hindrance. The result of my own daily experience, therefore, perfectly agrees with the above stated principle; namely, notwithstanding all my inquiries, I have met with no instance which could render it at all probable, that the cholera is disseminated by inanimate objects.

No. 5.

Report from Sir William Crichton, on the progress of the Cholera.-An account of the introduction and progress of the Cholera Morbus in Russia, to the end of the year 1830, exhibiting the principal facts which strengthen the belief of its being a contagious disorder, extracted from a memorial presented to the medical council of St. Petersburg, by Sir William Crichton, physician in ordinary to the Emperor of Russia, &c.

In the spring of the year 1830, the first authentic accounts of the cholera morbus having appeared in Persia, were received by the medical council of St. Petersburg. It spread itself from the province of Corasan to Tabrez, the residence of Abbas Mirza, where it made great havoc. A number of the Russian mission to that prince fell a sacrifice to it, and Prince Dolgorouky, the Russian minister at the same court, was saved with great difficulty, from a serious attack of it.

In the beginning of July, the disease penetrated the Russian provinces of Schirvan and Bacon, from whence it spread by land as far as Tiflis, and by sea from the port of Bacon to Astracan.

It broke out in these two last mentioned towns nearly at the same time; that is to say, on the 20th of July It appears from the accounts we have received, that neither at Tifflis nor at Astracan, any precautions were taken to prevent its spreading further, probably from its not having been thought contagious, so that it extended with rapidity from Tiflis throughout Georgia and the province of Caucasus, always following the principal roads.

At its first appearance at Astracan (which took place soon after the arrival of a vessel from Bacon, on board of which eight men had been seized during the voyage, with the cholera, and had died of it,) thousands of people employed in navigating the Volga, together with fishermen of that river, made their escape from the town, the first re-ascending the Volga, the others going up the river Pural or Jaik. The disorder showed itself at Gowrieff, on the 26th of July, at Ouraesk on the 3d of August. Let us now observe its course along the Volga, the great line of communication by which the disease penetrated into the interior of Russia. At Senolayerisk the cholera broke out the 22d or 23d of July, at Krasmoyar the 25th of the same month, at Tzaritzen the 6th of August, at Donbooka and Saratoff the 7th, at Khoalinsk the 19th, at Lamara and Neigni Novogorod the 27th, at Kostroma the 3d of September, at Zaroslaff the 6th, and at Rybinsk the 11th of the same month. In all those places the first victims of the disease were either navigators of the Volga, or individuals arrived from places where it already raged.

A Cossack, who had been sent, the beginning of August, from the station named Katshalinskara on the Don, to buy provisions at Donbooka, on the Volga, died of the cholera on the 7th, after his return to the station. After that circumstance, the malady spread successively through the different Cossack villages along the river Don. Without enumerating all these, suffice it to say, that the first deaths from cholera at Novetcherkash, the principal town of the Cossacks, took place on the 18th of August, at Rastaff its ravages began some days later, and that on the 9th of September it had penetrated as far as Jaganrog. A great number of persons of all ranks escaped from Saratoff, (a town containing 40,000 inhabitants,) and took refuge in the next government of Peusa, but the cholera did not fail to follow them, and commenced its depredations in that province on the 13th of August.

The first death at Kasan was on the 9th of September, an individual who had come there from Neigni Novogorod.

It has not been exactly ascertained who was the first individual who died at Moscow of the disorder, as most of the physicians of that city did not believe in its having visited them, consequently no exact information was then taken of those who were attacked with it. There is, however, reason to believe that the first victim was a student, who had leave of absence from Saratoff, and whose servant died on the road thence to Moscow.

Symptoms of the Disease.

General uneasiness; violent headache and giddiness; great langour; oppression at the chest; pain at the pit of the stomach and at the sides; a very weak pulse, and frequent vomitings, first of undigested food, and then of a watery fluid mixed with phlegm; frequent purging; severe pains, which make the patient roll about and scream; cessation, or very scanty secretion of urine; excessive thirst; cramp in the legs, beginning at the toes, and by degrees reaching the body; voice feeble and hoarse; the eyes dull and sunk in the head; the features changed, and like those of a corpse; coldness; conraction and bluish tinge of the extremities; a coldness over the whole body;

the lips and tongue become blue; a cold and clammy perspiration. The vomiting and purging soon exhaust the strength of the patient. The spasms become greater, attacking, successively, the most vital parts. The pulse ceases, the beating of the breast becomes scarcely sensible, and the patient, after having suffered the most horrible martyrdom, dies quietly, having a few minutes ease just before his end. The duration of the malady is, generally speaking, from twenty-four to twenty-eight hours; but sometimes its course is still more rapid; and sometimes slower.

Of the Causes.

Although there is still a difference of opinion among physicians on this subject, the medical council of St. Petersburg is obliged to acknowledge that the exciting cause of this disorder (and the only one well proved,) is a specific contagion, less virulent, perhaps, than that of the plague, and requiring a certain pre-disposition in the human body for its development, but which contagion certainly exists; numerous proofs of this fact, were presented by the epidemic of 1829 and 1830.

1st. The progress of the cholera along the high roads.

2d. The remarkable circumstance that the first who died of it wherever it appeared, were individuals who arrived from some infected place.

3d That the places where immediate precautions were taken, were not attacked by it, as for example, the small town of Sarehta (inhabited by a colony of Moravians,) situated on the high road from Astracan to Tzaritzen, and only twenty-five versts from the latter place. Also, several farms and country-houses near Astracan, and German colonies in the government of Saratoff, the military school of cadets at Moscow, &c. around all of which the malady raged furiously.

4th. That in Moscow, which contains at least 200,000 inhabitants, there have been since the 16th September, up to the present instant, 6th January, only 6,000 or 7,000 sick, or one-twenty-ninth of the population; an incredibly small number if we look for the general cause of cholera morbus in atmospheric influence.

On the mode of Treatment in Russia.

Circumstantial accounts not having yet been received from all the places where the cholera has 1aged, we are not able to give any exact information relating to the best mode of treatment. Bleeding at the commencement of the disorder, has been generally recommended. At Astracan in Georgia, calomel with opium, after the Anglo-Indian method, has been found of use. At Saratoff, a diaphoretic treatment was found efficacious; after bleeding, vapour and warm water baths, warm drinks, aromatic and stimulent frictions, were applied with a good deal of success. At Moscow, where there are several physicians of various nations, many different modes of cure were of course tried; but the diaphoretic method was that most general preferred. Our information respecting the differences of practice in Moscow, is not sufficiently complete, to enable us to decide which has been the best. Detailed reports are equally wanting from Neigni Novogorod, Kasan, Kostroma, &c..

The mortality has been great, the deaths almost every where exceeding the number cured; but this circumstance may be accounted for, 1st, By the novelty of the case: 2d, By the rapidity with which it overran the districts, and caused death in four or in six hours: 3d, By the fool-hardy indifference

of the Russian character, from which cause most of the invalids did not apply for succour till too late.

Means of Prevention.

Considering the contagious nature of the disease, and the rapidity with which it spreads, the Government, at the recommendation of the medical council, ordered quarantines to be formed on the frontiers of every province in which the disease raged; and afterwards entirely to surround all places where it existed. After the experience of the epidemic in 1829, the medi cal council found that a quarantine from fourteen to twenty-one days was sufficient to ascertain the state of health of any person coming from an infected place, instead of confining him six weeks, as in the case of the plague. During the whole course of the years 1829 and 1830, there is not a single instance that can be relied on of the contagion being communicated by articles of dress or furniture, &c.

Fumigations made with chlorines, were generally employed as means of disinfection, but experience does not justify us in speaking positively as to their efficacy.

The number of persons attacked daily by the cholera at Moscow, while at its height, was 244; while at present (6th January, 1831) there are only from six to eight new cases daily.

The disease has wholly ceased at Kostroma, Neigni Novogorod, Saratoff and Astracan. It has broken out at Nicolaeff since the arrival of an infected vessel, and has now made its way into the governments of Cherson, Kieff, Podolia and Volhynia, but as strict measures were adopted to stop its progress, it ravages have not been very great. The disease, however, still exists; and although the number attacked by it is not great, yet the mortality is proportionably the same as it has been in other districts.

6.

Report on the Cholera Morbus, discussed and agreed to in the Extraordinary Committee established at Moscow by order of his Majesty the Emperor.

An Extraordinary Committee, composed of the most eminent public officers, has been established at Moscow, by order of his Imperial Majesty, for the purpose of discussing the expediency of a general purification of all merchandize in Moscow after the cessation of the cholera morbus in that capital. The committee in consequence proposed the following question to the members of the provisional medical council:-Can goods or merchandize communicate the cholera morbus? and in case of an answer in the affirmative, what is the degree of the intensity of the contagious principle? The result of the examination of the opinions of the twenty-four members of the council is, that three of them admit, it is true, the possibility of contagion by means of goods and merchandize, but under certain conditions; eighteen entirely reject it. One member admits it, but, from the experiments which he has made, he does not think fumigation necessary. Another member recommends the adoption of this measure, but only for the purpose of tranquillizing men's minds. Finally, another declares that he