"Report on the Epidemick Cholera Morbus, as it visited the territories subject to the Presidency of Bengal, in the Years 1817, 1818, and 1819"

Instead of loading a massive PDF (nearly 112 MB) into KORA, I recommend downloading a digital copy of Jameson's book directly from the "Curiosity Collections" offered by Harvard Library. It's a beaut!

Below you'll find some of my notes, as well as transcribed excerpts, organized by the table of contents:

Sent inquiry forms to 238 individuals, received 124 replies of which 24 said they were unable to assist the board. After reviewing the responses, the Board decided to develop a digest/compendium of facts derived from information they received.

“It has been a prevalent opinion throughout the country, that the Epidemick was essentially different in nature from the Cholera Morbus [taught in British medical] schools.—This is no doubt true if by Cholera is meant only the disorder occurring sporadically during hot weather in the higher latitudes, and usually accompanied by bilious vomiting. But ... the word Cholera is a generic term, comprehending many species or varieties of disease, all more or less differing from each other in their diagnostick [sic] symptoms.... A disease similar in all its appearances to that which ravaged these provinces has been known from remotest antiquity; and accurately described by the medical writers of every age. 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 universality of its attacks, became a much more general and grievous scourge, than it had hitherto been...” (xii–xvi).

The endemic form had “ong existed partially” in various places, but never before the autumn of 1817 “did it prevail generally over the country” (xvi).

Begins with weather, and what is typical in the lower provinces of the Bengal Presidency—three seasons, so to speak: the cold, the hot, and the rainy. “Seasons are considerably modified” in central and northern provinces.

COLD: November — February. Mid-Oct, cooling in mornings and evenings, prevailing winds change from south and east during rainy season –> from west and north. Atmosphere changes, from damp and watery –> dry and elastic. Skies brighter, fewer clouds. But still variable, with hang-on remnants of the SE Monsoon.

November fair and pleasant. December and January are variable months, often fog at night; but “very pleasant. Air in January is “piercingly cold” (xxxiii). Second week of February” when mid-day grows warmer, wind changes to the S and E, with thunder clouds as anticipating beginning of hot season.

HOT Season: March — June. Sun very powerful. Days warn, but southerly winds moderate temps. Interrupted by heavy thundershowers, often. By end of April, nights are “close and sultry.” May is “most disagreeable month in the year ... close, still, and oppressive” (xxxvii) . Sometimes second half of May contains the “lesser rains” with considerable rain for several days.

RAINY Season: July — October. Cooler weather, pleasant with exception of occasional sultry nights. Shift in winds, from SW. In November, shift in winds to NW frequently and cooler weather mark ending of rainy season and beginning of cold season. Average rainfall in Bengal is 70 inches/year, but considerable variation year to year.

(xli): Discusses diseases generally associated with the various seasons. Bilious dysentery and bloody flux predominate in cold season.

1815.

Excessive rain during rainy season, bursting of Ganges, Soane, and Coosee rivers from banks, inundating the land. Damp, unpleasant cold weather in December and January.

1816.

Hot season “remarkable” with a late and scant appearance of thunderstorms, great heat and drought. End of May, oppressively hot in Bengal. Heat and drought continued through August, but followed by rain entire September, again with inundations. Sudden and unusual extremes associated with changes in prevailing diseases — very little acute dysentery and other inflammatory diseases. Low fevers, particularly typhoid. (xliv); infectious. Malignant sore throat and typhoid fever became epidemic, especially in the upper provinces, toward end of August.

Deviations from typical three seasons continued into 1817. Rains set in 15 to 20 days early in May. Rain nearly every day in June and July – fevers continued, with dysentery. By end of July, rivers full and much of Bengal under water. Excessively heavy rain in August; middle of month oppressive and hot, with sultry, disagreeable nights. Main European complaints were dysentery and hepatitis; epidemic cholera began among native population (lv).

“In the districts of Jessore, Backergunge, Nuddeea, and every other portion of the Gangetic Delta, there had been a long protraction of heavy rain; and nearly the whole county, especially in the lower division of the province, was one sheet of water before the middle of August.” (lxi).

Concludes introduction: “There was a remarkable coincidence between the extraordinary irregularities manifested throughout India in 1816 and 1817, and the rise of the Epidemick [sic]; and that its subsequent abatements and revivals, were in some measure dependent on corresponding vicissitudes in the state of the weather” (lxviii).

Medical Board Office, Calcutta

1st July, 1819

“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, that a disorder [Indian cholera], possessing the principal characteristics of that disease, has prevailed more or less endemically, during the Hot and Rainy Seasons of every successive year, in the Lower Provinces [eastern portion of the Bengal Presidency] of Hindostan [India]" (1).

“Previously, however, to the year 1817, when for the first time within the memory of man, the disease assumed the epidemical form; the sphere of 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 debilitated 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 of the night.— It rarely appeared in the dry and equable months of the Cold and Hot Weather.... It always shewed itself in greatest vigour towards the autumnal [equinox]; when the 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.... The better descriptions of Natives, those who were well fed and sufficiently clad, who ventured little into the sun, and inhabited high, dry, and freely ventilated dwellings, were but little subject to its influence.... So rarely did it reach the European portion of the community, that" two medical men who had served as directors at "the General Hospital for Europeans at the [Bengal] Presidency" had never seen "a single case of the disorder, until it occurred epidemically throughout the Provinces" (1–3).

The endemic form of cholera "would seem to have occurred in an unusual degree in ... [some] districts in May and June. But its attacks were yet restricted to particular places, and not very commonly fatal; it does not appear to have excited much attention, until ... the 28th of [August, when] it was reported that the disease had suddenly appeared epidemically in Jessore, a populous town situated in the centre of the Delta of the Ganges," attacking all classes, killing 20-30/day (3).

Flight from the town eventually reduced the number of fatal attacks, but "it is reported within the space of a few weeks, [to have] cut off more than six thousands of the inhabitants" just in the Jessore district (4).

“Because ... [of] the alarming nature of the circumstances, which attended its appearance in [Jessore]; 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 focus, its pestilential virus [the mysterious matter that defines the disease], of whatever nature, emanated, to the surrounding districts. What served to give validity to this conjecture, was an opinion then entertained, and since industriously propagated, that the fomes, or specific poison producing the disease, had its rise, not in any vitiated state of the atmosphere, or other cause of general operation, but in circumstances of a purely local nature: such as the use of rancid fish and blighted grain.

It is nevertheless certain, that nothing could be more erroneous than this notion of the local origin of the Epidemick ... [because] before the expiration of the first week of August, it had firmly established itself in many other parts of Bengal” (4–5).

– concludes that it’s non-contagious since it appeared in several places, remote from each other, at the same time or within short intervals (7) [the official medical board explanation to save the general atmospheric theory of epidemic diseases].

Disputes belief in a local origin in Jessore, from which it spread; based on a widely spread “opinion” that “the fomes, or specific poison producing the disease, had its rise not in any vitiated state of the [general] atmosphere, or other cause of general operation, but in circumstances of a purely local origin” (4-5) – [could be place to connect to Dr. Barnes’ interpretation, in Farr, Report on 1848-49].