THE NEW ZEALAND GAZETTE. 337

Clarendon, from Constantinople, by the British
Cholera Commissioners, dated the 25th May, 1866,
reporting the conclusions at which they had arrived
on some of the most important points relating to the
propagation of Cholera.

I have, &c.,
EDWARD CARDWELL.

Governor Sir George Grey, K.C.B.,
&c., &c., &c.

The British Cholera Commissioners to the Earl of
Clarendon—(Received 6th June.)

(No. 21.) Constantinople, 25th May, 1866.

MY LORD,—In our Despatch No. 20 of the 22nd
instant, we informed your Lordship that the "Com-
mission Plénière" of the Cholera Conference,
appointed to report upon the first and second groups
of the programme, had finished their labours and that
their Report would be submitted to the Conference
immediately after being printed.

We should have deferred any further notice of the
above-mentioned Report until the Conference had
decided upon it; but as we have observed in the
public prints just received that England is threatened
with an invasion of cholera from neighbouring Con-
tinental ports, and that some difference of opinion
appears to exist as to the measures to be adopted,
we think the emergency justifies us in departing
from the ordinary course, and in forwarding at once
to your Lordship the conclusions of the "Commission
Plénière" bearing upon the most important points
of the propagation of the disease.

We may observe that the "Commission," whose
conclusions are embodied herein, is composed of three
of the diplomatic and all the medical delegates, com-
prising altogether twenty-four out of the thirty-six
members of the Conference, and that with the excep-
tion of one medical delegate, who was absent on duty
during the latter half of the discussions, the sense of
tho conclusions numbered 1 to 6 was unanimously
adopted. We have reason to believe that the absent
delegate would have voted with the rest of his col-
leagues. On the 7th there was some difference of
opinion.

The conclusions comprise the following points:—

1. That cholera is communicable from the diseased
   to the healthy.

2. That it may be communicated—
   (a.) By persons in the state of developed cholera;
   (b.) By persons suffering from choleraic diarrhea,
   who can move about, and who are apparently in
   health for some days during the progress of the
   disease.

These last, from their passing unquestioned and
unsuspected, are the most dangerous to the com-
munities amongst whom they may move.

3. That the discharges of those in a state of
   developed cholera, or in a state of choleraic diarrhea,
   become the chief means by which the cholera poison
   escapes from the system, and by mingling with air or
   water diffuses the disease.

4. That cholera may be transmitted by exposure
   of persons to the atmosphere of buildings, places or
   vessels which have been occupied by cholera patients,
   and to the emanations from clothes, bedding or other
   articles which have been in contact with diseased
   individuals, or which may have become soiled by
   their discharges.

5. That when infected articles or places are shut
   up and excluded from free air, they preserve their
   dangerous qualities for an indefinite length of time.
   and, on the other hand, the freer the exposure to
   ventilation, the more rapidly they become innocuous.

6. That there is no reason to suppose that cholera
   is communicable by actual contact between indi-
   viduals.

7. That the period of incubation, counting from the
   time of the reception of the poison to its manifesta-
   tion in some form or other, is short. That the
   disease may show itself in two ways: first, by in-
   ducing fully developed cholera decidedly and rapidly;
   secondly, by producing slight disturbances, among
   which diarrhea may be considered the chief, and
   which may sooner or later pass into some more or
   less decided choleraic manifestation. The "Commis-
   sion" consider that the incubation in the acute form
   is generally rapid, and that it seldom or never
   extends beyond a few days from the moment of infec-
   tion. There was some difference of opinion as to the
   duration of choleraic diarrhea, and as to the time
   that it may continue to be infectious, the great
   majority of the Commission considering that persons
   with diarrhea which has lasted eight full days from
   the commencement of the period of observation,
   without showing any indications of a choleraic nature,
   may be excluded from the class of cholera patients.
   The minority think that the choleraic and infectious
   diarrhœa may last for several weeks.

In mentioning the views of the Commission upon
some of the most important points in the history of
cholera, we beg to lay before your Lordship our own
opinion of their practical bearing. We have little
doubt that the Conference will recommend measures
of restriction of intercourse between the sick and the
healthy; but as it has not yet entered upon the
measures to be taken, we must be considered as
representing our own views only in stating that we
believe that it logically follows from the above con-
clusions that if we wish to prevent the spread of
cholera, or its introduction into places free from it,
measures should be taken to restrain communication
between those suffering from cholera and the
healthy.

Examples taken from the history of the present
epidemic most strongly support the opinion of the
great advantage of such measures. We may mention
that Sicilly and Greece completely escaped the
disease which was raging around them in 1865.
Sicilly entirely cut herself off from all communica-
tion with diseased places. Greece caused all arrivals
from infected localities to perform severe quarantine
at four islands - Delos, Pondiconyssi (Salamis),
Skiathos, and Vido, and held no intercourse with in-
fected places.

The good results of isolation in the cases of Sicilly
and Greece are hardly negatived by the examples of
what occurred in other places said to be invaded in
spite of restrictive measures. The quarantines
enforced at Marseilles and some other ports of the
Mediterranean were ineffective, either from their in-
completeness or from their having been established
too late, that is, after direct communication with
infected ports had taken place.

It seems to us that in the case of ships or passen-
gers arriving from infected neighbouring ports, the
following measures might advantageously be
adopted :—

1. No persons should be allowed to land previous
   to efficient inspection by medical men appointed for
   the duty.

2. The healthy passengers should be removed from
   the ship, and isolated for a period which need not
   exceed five days, at the end of which time they
   should be again inspected, and if found without
   choleraic symptoms should receive pratique.

3. All persons with cholera or diarrhœa at the time
   of arrival, or at any period of the detention, should be
   isolated from the rest, and removed to a separate
   place. Cases of diarrhœa should be retained under
   observation until the diarrhœa is cured, or until the
   medical officer in charge is satisfied, from the features
   of the disease, that it is not of choleraic nature.