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Title: The Cholera Gazette, Vol. I. No. 4. Wednesday, August 1st, 1832.
Author: Various
Language: English
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THE
CHOLERA GAZETTE.
VOL. I. _WEDNESDAY, AUGUST 1st, 1832._ No. 4.
_Injection of Saline Solutions into the Veins._
The following documents relative to the treatment of cholera by the
copious injection of a saline solution into the veins, communicated to
the Central Board of Health of Great Britain, are of so interesting
a character that we hasten to lay them before our readers; though we
are far from participating in the sanguine estimate of the curative
powers of the remedy, entertained by Drs. Lewins, Latta and others. The
measure has been resorted to in New York, and on the whole, with but
slender success, and the results of trials of it, in this city, so far
as we have been able to obtain authentic information, have not been
very encouraging. Some of the symptoms have been relieved, but we know
as yet of no cure effected by it.
No. 1.
SIR,--I conceive it to be my duty to let you know, for the
information of the Central Board of Health, that the great
desideratum of restoring the natural current in the veins
and arteries, of improving the colour of the blood, and
recovering the functions of the lungs, in cholera asphyxia,
may be accomplished by injecting a weak saline solution into
the veins of the patient. To Dr. Thomas Latta, of this place,
is due the merit of first having recourse to this practice.
He has tried it in six cases, three of which I have seen, and
assisted to treat. The most wonderful and satisfactory effect
is the immediate consequence of the injection. To produce the
effect referred to, a large quantity must be injected--from
_five to ten pounds_ in an adult--and repeated at longer
or shorter intervals, as the state of the pulse, and other
symptoms, may indicate. Whenever the pulse fails, more fluid
ought to be thrown in, to produce an effect upon it, without
regard to quantity. In one of the cases I have referred to, 120
_ounces_ were injected at once, and repeated to the amount of
330 ounces in twelve hours. In another, 376 ounces were thrown
into the veins between Sunday, at 11 o’clock, A. M., and this
day (Tuesday) at 4 P. M.; that is, in the course of 53 hours,
upwards of 31 pounds!
The solution that was used consisted of two drachms of muriate,
and two scruples of carbonate, of soda, to sixty ounces of
water. It was at the temperature of 108 or 110 degrees.
The apparatus employed in injecting was merely one of Reid’s
common syringes, (the fluid being put into a vessel rather deep
and narrow,) with a small pipe fitted, that it might easily be
introduced into an incision in the veins of the usual size that
is made in bleeding. It may, however, be well to keep in mind,
that, in the event of the operation being frequently repeated,
it may be adviseable to inject by different veins.
I forbear at present to enter further into the particulars;
nor have we had sufficient experience to speak decisively on
the subject. I may, however, mention, that the idea of having
recourse to this remedy in cholera, occurred to Dr. Latta,
from being convinced, (which I am also,) that the evacuations
upwards and downwards are in reality the serum of the blood;
that it is the duty of the physician to replace it, as speedily
as possible, by injecting a fluid, as similar to the serum as
can be formed artificially, directly into the veins, which
has been done here with wonderful, and, so far as we can yet
judge, excellent effect. An immediate return of the pulse, an
improvement in the respiration and in the voice, an evolution
of heat, an improvement in the appearance of the patient, with
a feeling of comfort, are the immediate effects. The quantity
necessary to be injected will probably be found to depend upon
the quantity of serum lost--the object of the practice being
to place the patient in nearly his ordinary state, as to the
quantity of blood circulating in the vessels.--I have, &c.
(Signed)
ROBERT LEWINS, M. D.
TO W. MACLEAN, Esq.
_Secretary to the Central Board of Health._
No. 2.
SIR,--I did myself the honour to address a letter to you
lately, on the effects of injecting a saline solution into
the veins of a patient labouring under cholera. We have not
frequent opportunities of trying this, which I denominate,
admirable remedy, as the disease is decidedly less frequent
here; but I have seen it employed in two other cases, in the
course of the last two days, with the same excellent effect.
Sixty ounces are generally thrown in at once, and repeated
at the end of three or four hours. In a case to-day, where
I saw fifty-eight ounces injected, (being the third time
of performing the operation,) the patient’s pulse, at the
commencement, was 180, very small, and very feeble. She was
excessively restless, with a feeling of great weakness and
tormenting thirst. Before twelve ounces were injected, the
pulse began to improve; it became fuller and slower, and it
continued to improve until, after 58 ounces had been injected,
it was down to 110. Before I left the patient, (a woman,)
her condition was altogether amazingly amended. There was a
fine glow and a slight perspiration on her face; the veins
on the back of her head were well filled; the restlessness
was removed, the feeling of excessive weakness gone, and the
thirst ceased. The pulse was under 100, free, full, and soft!
Verily, sir, this is an astonishing method of medication, and I
predict will lead to wonderful changes and improvements in the
practice of medicine! I have addressed you upon the subject, as
the organ, from your high official station, of disseminating
a knowledge of the extraordinary facts referred to. It will,
of course, give me great pleasure to enter further into
particulars upon any particular point on which you may require
information, in reference to the cases that have come under my
observation.--I have, &c.
(Signed)
ROBERT LEWINS, M. D.
TO W. MACLEAN, ESQ. &c. &c.
In the hands of a man of ordinary dexterity, the common
injecting apparatus alluded to in my last will be found to
answer the purpose perfectly well; but if the practice I
recommend is, as I hope it will be, generally adopted, it will,
I conceive, be expedient to advise that a regular and perfect
transfusion apparatus be used; at all events, to warn those
who inject to beware of allowing air to get into the vein. The
tubes, of course, must be filled with fluid, as well as the
pipe in the vein, before commencing, and considerably more
fluid than it is intended to use ought to be in the vessel from
which it is pumped.
R. L.
No. 3.
_Leith, May 23d, 1832._
Sir,--My friend, Dr. Lewins, has communicated to me your
wish for a detailed account of my method of treating cholera
by saline injection into the veins, with which I now most
willingly comply. My scope for observation, since I commenced
this treatment, has been too limited to allow me to be very
copious on the subject, but I think I can adduce sufficient
proof to the unprejudiced, not only of its safety, but of its
unquestionable utility. I have never yet seen one bad symptom
attributable to it, and I have no doubt that it will be found,
when judiciously applied, to be one of the most powerful, and
one of the safest remedies yet used in the second stage of
cholera, or that hopeless state of collapse to which the system
is reduced.
Before entering into particulars, I beg leave to premise, that
the plan which I have put in practice was suggested to me on
reading in The Lancet, the review of Dr. O’Shaughnessy’s report
on the chemical pathology of malignant cholera, by which it
appears that in that disease there is a very great deficiency
both of the water and saline matter of the blood. On which
deficiency, the thick, black, cold state of the vital fluid
depends, which evidently produces most of the distressing
symptoms of that very fearful complaint, and is, doubtless,
often the cause of death. In this opinion I am abundantly borne
out by the phenomena produced on repletion by venous injection.
So soon as I learnt the result of Dr. O’Shaughnessy’s analysis,
I attempted to restore the blood to its natural state, by
injecting copiously into the larger intestines, warm water,
holding in solution the requisite salts, and also administered
quantities from time to time by the mouth, trusting that the
power of absorption might not be altogether lost; but by these
means I produced, in no case, any permanent benefit; but, on
the contrary, I thought the tormina, vomiting, and purging,
were much aggravated thereby, to the further reduction of
the little remaining strength of the patient; finding thus,
that such, in common with all the ordinary means in use, was
either useless or hurtful, I at length resolved to throw the
fluid immediately into the circulation. In this, having no
precedent to direct me, I proceeded with much caution. The
first subject of experiment was an aged female, on whom all the
usual remedies had been fully tried, without producing one
good symptom; the disease, uninterrupted, holding steadily on
its course. She had apparently reached the last moments of her
earthly existence, and now nothing could injure her--indeed,
so entirely was she reduced, that I feared I should be unable
to get my apparatus ready ere she expired. Having inserted a
tube into the basilic vein, cautiously--anxiously I watched the
effects; ounce after ounce was injected, but no visible change
was produced. Still persevering, I thought she began to breathe
less laboriously; soon the sharpened features, and sunken eye,
and fallen jaw, pale and cold, bearing the manifest impress of
death’s signet, began to glow with returning animation; the
pulse, which had long ceased, returned to the wrist; at first
small and quick, by degrees it became more and more distinct,
fuller, slower, and firmer, and in the short space of half
an hour, when six pints had been injected, she expressed in
a firm voice that she was free from all uneasiness, actually
became jocular, and fancied all she needed was a little sleep;
her extremities were warm, and every feature bore the aspect
of comfort and health. This being my first case, I fancied my
patient secure, and from my great need of a little repose, left
her in charge of the hospital surgeon; but I had not been long
gone, ere the vomiting and purging recurring, soon reduced her
to her former state of debility. I was not apprised of the
event, and she sunk in five and a half hours after I left her.
As she had previously been of a sound constitution, I have no
doubt the case would have issued in complete reaction, had the
remedy, which had already produced such effect, been repeated.
Not having by me the number of THE LANCET containing Dr.
O’Shaughnessy’s analyses, I adopted that of Dr. Marcet, only
allowing a smaller proportion of saline ingredients. This I now
find to be considerably less than natural, according to the
more recent analyses. I dissolved from two to three drachms
of muriate of soda, and two scruples of the sub-carbonate of
soda in six pints of water, and injected it at temperature 112°
Fah. If the temperature is so low as a hundred, it produces an
extreme sense of cold, with rigors; and if it reaches 115°, it
suddenly excites the heart, the countenance becomes flushed,
and the patient complains of great weakness. At first there
is but little felt by the patient, and symptoms continue
unaltered, until the blood, mingled with the injected liquid,
becomes warm and fluid; the improvement in the pulse and
countenance is almost simultaneous; the cadaverous expression
gradually gives place to appearances of returning animation,
the horrid oppression at the præcordia goes off, the sunken
turned up eye, half covered by the palpebræ, becomes gradually
fuller, till it sparkles with the brilliancy of health, the
livid hue disappears, the warmth of the body returns, and
it regains its natural colour--words are no more uttered in
whispers, the voice first acquires its true cholera tone, and
ultimately its wonted energy, and the poor patient, who but a
few minutes before was oppressed with sickness, vomiting, and
burning thirst, is suddenly relieved from every distressing
symptom; blood now drawn exhibits on exposure to air its
natural florid hue.
Such symptoms, so gratifying both to the sick and the
physician, must never allow the latter to relax in his
care--the utmost vigilance is still necessary. At first the
change is so great, that he may fancy all is accomplished, and
leave his post for a while. The diarrhœa recurring, he may find
his patient, after the lapse of two or three hours, as low as
ever. As soon as reaction by the first injection is produced,
mild warm stimulants, such as weak gin toddy, mixed with some
astringent, should be freely and assiduously administered. An
attempt should be made to fill the colon with some astringent
fluid. That such is requisite, is evident from the watery
diarrhœa returning with violence, and if not restrained, death
will ultimately make sure of his victim, therefore, so soon
as the pulse fails, and the features again shrink, the venous
injection must be repeated, taking care that the fluid in use
retains its proper temperature. The injection should be carried
on very slowly, unless the patient is much exhausted, when it
may be used more rapidly at first, until a little excitement
is produced, after which it should not exceed two or three
ounces per minute, and now is the time for the exhibition
of astringents by the mouth, which will be retained; for in
general the sickness entirely leaves during the operation.
Such remedies must be persisted in; and repeated as symptoms
demand, or until reaction is permanently established. I have
witnessed no violent symptoms accompanying the rapid injection
of the fluid; but I have thought that the hasty repletion of
the system was followed by great increase of the evacuations,
and, consequently, a more sudden depression of the powers
of life. The quantity to be injected depends on the effect
produced, and the repetition on the demands of the system,
which generally vary according to the violence of the diarrhœa;
the greater the degree of collapse, the greater will be the
quantity needed, though not uniformly, for a very slight loss
produces much depression in some systems; hence there is often
great collapse, without much vomiting, purging, or cutaneous
discharge.
Although in every case, even the most desperate, the cholera
symptoms were removed, some of my cases failed, which I
attributed to one or other of the following causes--either the
quantity injected was too small, or its effects were rendered
abortive by extensive organic disease, or its application was
too late.
I have already given an instance where deficiency in quantity
was the cause of failure, which I will now contrast with one in
which it was used freely. A female, aged fifty, very destitute,
but previously in good health, was on the 13th instant, at
four A. M., seized with cholera in its most violent form, and
by half-past nine was reduced to a most hopeless state. The
pulse was quite gone, even in the axilla, and strength so much
exhausted, that I had resolved not to try the effects of the
injection, conceiving the poor woman’s case to be hopeless, and
that the failure of the experiment might afford the prejudiced
and the illiberal an opportunity to stigmatize the practice;
however, I at length thought I would give her a chance, and in
the presence of Drs. Lewins and Craigie, and Messrs. Sibson and
Paterson, I injected one hundred and twenty ounces, when, like
the effects of magic, instead of the pallid aspect of one whom
death had sealed as his own, the vital tide was restored, and
life and vivacity returned; but diarrhœa recurred, and in three
hours she again sunk. One hundred and twenty ounces more were
injected with the same good effect. In this case three hundred
and thirty ounces were so used in twelve hours, when reaction
was completely reëstablished; and in forty-eight hours she
smoked her pipe free from distemper. She was then, for better
accommodation, carried to the hospital, where probably, from
contagion, slight typhoid symptoms were produced. She is now,
however, convalescent.
The second cause of want of success is the presence of organic
disease; this, probably, renders the possessor very liable to
attacks of cholera; and the latent evil, which previously gave
but little uneasiness, suffers aggravation in all its symptoms,
more especially after reaction has been produced, and has
evidently, in many cases, been the cause of death. A delicate
young female, of strumous habits, who had been for some years
subject to pectoral complaints, was rescued from a state of
collapse by the injection of sixty ounces of the saline fluid,
administered in separate portions, within the space of twelve
hours. After lingering for ten days she died; the heart was
found in a state of atrophy, covered with strong evidence of
the existence of ancient disease, and floating in eight ounces
of pus. In another case every internal organ was diseased; some
of them so much so, that it was astonishing the individual
lived so long.
The third case of the occasional want of success, is the late
application of the remedy. Hitherto I have had opportunity
of injecting only in extreme cases, after every other means
had entirely failed, cases which apparently soon would have
proved fatal. Here the obstacles to be overcome have been of
no ordinary kind, notwithstanding the result of the practice
is of the most encouraging nature, and the number of cases now
convalescent or doing well highly gratifying. In every fatal
case we have had an opportunity of examining, independent of
organic disease, I have found a large quantity of fibrine in
the cavities of the heart, especially on the right side, where
it had extended from the auricle through the ventricle in the
pulmonary artery. Such deposition must have formed a certain
obstacle to recovery, and is, no doubt, from the interruption
it gives to the pulmonary circulation, the cause of the
heavings of the chest, and the inordinate action perceptible in
the centre of circulation many hours before death. Now surely
it is reasonable to suppose, that if this, the most simple of
all remedies, were applied early, before the blood drained of
its water has collected in the larger vessels, in fact before
such fibrinous depositions have taken place in the cavities of
the heart, is it not reasonable to suppose that such would be
entirely prevented?
But not only is early injection adviseable on this account,
not only is stagnation of the blood prevented by it, and
the laborious breathing, and the præcordial oppression, the
intense sickness, the burning thirst, the extreme depression
of the vital powers, and the chances of aggravating chronic
disease, or of producing new organic lesion, in a great measure
avoided: but it is rational to suppose that the consecutive
fever will be rendered much milder, and that this is the case,
is supported by my own experience, even though the remedy has
not been applied earlier, indeed the fact is very evident.
In an ordinary attack of cholera, much fluid is lost; and if
the individual is so fortunate as to get out of the stage
of collapse, if consecutive fever of typhoid type comes on,
the system, left to its own resources to replace the lost
serum, must be but ill fitted for the task, for the debility
is extreme, absorption goes on slowly, the fever will be
much aggravated by the irritation of internal congestion;
local inflammation will thereby be produced, and the chance
of recovery will be but small. Much of this evil is to be
mitigated or entirely avoided by injection into the veins, of
which circumstance I can adduce living instances; and where the
patient, who had been injected, has sunk under organic disease,
the usual marks of congestion are not perceptible.
The apparatus I have used, is Reid’s patent syringe, having a
small silver tube attached to the extremity of the flexible
injecting tube. The syringe must be quite perfect, so as to
avoid the risk of injecting air; the saline fluid should never
be injected oftener than _once_ into the same orifice, and the
vein should be treated with much delicacy to avoid phlebitis.
The wound should be poulticed and carefully watched, if it does
not heal by the first intention.
I am, sir, your most obedient servant,
THOMAS LATTA, M. D.
(To be continued.)
_Origin and Progress of Cholera at Albany._
The following report made by the medical staff of Albany to the
Board of Health, furnishes some interesting information relative to
the origin of the epidemic, and the character of the diseases which
preceded its appearance in that city.
“In presenting to the Board of Health the following tables,
showing the bills of mortality of this city from the 22d ult.,
when the board directed the deaths to be recorded, up to this
day, we deem it our duty to make some remarks relative to the
health of the city during the above period, and likewise in
relation to our future prospects, and the measures we consider
useful to accelerate the departure of the pestilence from among
us.
“We stated in our last report to the board, that immediately
prior to the breaking out of the epidemic, our city was
unusually healthy. Until about the 20th of June, few diseases
prevailed, and the mortality was less than common. From the
22d of June to the 3d of July, only eleven deaths occurred--of
those, six were children. In a population of twenty-six
thousand, an average of less than one death a day for near two
weeks, indicates a degree of health almost without a parallel.
From the 30th of June to the 3d of July, _not one single death
was reported_. It was, however, but the calm which precedes
the storm. All other diseases gave way to the silent but the
irresistible march of the epidemic.
“Although but few deaths took place from the 20th of June
to the 3d of July, there was considerable sickness; and
experienced physicians foresaw the coming danger, in the usual
prevalence of diarrhœa, and common cholera morbus--hence it was
that your board was urged to make all ready--to be prepared
with hospitals, physicians, nurses, &c. and to this timely
warning, and the preparations made in consequence, we may,
under Providence, attribute the limited ravages of this fell
pestilence.
“On the 3d day of July, the epidemic assumed its malignant
and characteristic form. From that time until now, it has
maintained its residence among us. For the first week it
gradually extended, and during the second it has been rather
stationary, the number attacked varying a little from day to
day and but little.
“It is now a fortnight since the first deaths took place. The
number of cases reported within that period is two hundred
and forty-five, and the deaths seventy-two--or a little over
one-quarter of the whole. It must however be recollected,
that during the same time hundreds had been attacked with
_Cholerine_, or the slightest influences of the epidemic.
None of these have been reported, _because by timely aid, the
disease, in its more formidable shape, was prevented_. We can,
we believe, say with truth, that few have entirely escaped the
influence of the disease.
“From a consideration of all the circumstances connected with
the visitation of Providence, we think our citizens have great
cause for thankfulness, that we thus far suffered so little.
Compared to our neighbours of Canada, we have suffered less
than we had cause to anticipate. The disease has been among us
for a fortnight; has passed all over the city, and in one form
or other has affected more or less persons of all classes, and
yet the deaths have not much exceeded five in a day, whilst
at Quebec and Montreal, in a population not much exceeding
ours, the deaths some days exceeded one hundred, when the
disease had not been so long among them as it has been with
us. From the history of the disease in other countries, and
the circumstances connected with its progress in this city,
we would fain indulge the hope, that it has already spent its
venom, and that we shall ere long be free from it entirely. For
the last two days, notwithstanding the number of cases reported
and the high state of mortality, we are inclined to believe
that we see, in the character of the prevailing disease,
indications of returning health.
“We have as yet, had no cause to change our opinion
respecting the nature of the prevailing disease--we consider
it essentially epidemic. It continues to attack people in
different parts of the city, and had not been traced from one
person to another, as might have been done were its progress
dependent on contagion. It is true, in some houses, several
persons have been attacked and died; but this only shows that
similar causes produce similar effects in individuals placed
in like circumstances--all were equally exposed to the local
and general causes which engender this disease. The disease
_may_, under certain circumstances, be contagious, but no very
striking instances of the kind has yet come to our knowledge in
this city.
“We cannot reprehend in too strong language, the cold-hearted
and inhuman conduct of many of our people, to the unfortunate
victims of cholera. They are too often abandoned to their fate,
even their friends being afraid to do to them the ordinary
offices of charity. Were they labouring under the plague of
the Levant they would not be looked upon with more dread. All
this is folly. The risk of taking the disease from the sick is
little or nothing; much more is to be dreaded from foul air
by which the disease is engendered. The first care of friends
should be, not to run away, but to take the sick into more
healthy and airy lodgings.
“We would also protest against the indecent haste with which
the scarcely cold remains of the dead are hurried to their last
abode, without a neighbour to follow, or a friend to mourn.
Such conduct is discreditable to the character of a Christian
people. We trust that we shall not again have to complain
of similar indifference to the performance of the duties of
charity and humanity.
“To the members of the medical profession, and particularly
its younger members, we willingly award due credit for their
attention and diligence, under circumstances of no usual
difficulty.
“We would again most earnestly entreat our citizens not to
neglect to apply for medical aid the moment diarrhœa, or sick
stomach and head-ache take place. We have not yet known one
instance in which the disease in its malignant form, was not
preceded by one or more of these symptoms, for some hours, if
not days; and we have not seen or heard of a single instance
where these premonitory symptoms were properly attended to,
an attack was not prevented. It cannot be too strongly or too
often impressed upon the minds of our citizens, that cholera,
in its early stages, is easily cured; but that when neglected,
in a majority of cases, no human aid will avail. Almost all
the deaths have occurred in persons of intemperate habits,
and of broken constitutions. A few estimable citizens have
fallen victims to it, but these were either aged and infirm, or
had neglected the premonitory symptoms, or had tampered with
medicines, without proper advice.
“To our constituted authorities we would recommend the most
assiduous attention to cleanliness in our streets, along
our wharves and docks; to our citizens, strict attention to
cleanliness in their houses and persons, to pay due attention
to dress, avoid exposure to the night air, and observe
strict temperance, not only in _drink_, but in _food_. We
would caution them against the free use of _fruit_, _ripe_
or _unripe_, and the employment of Glauber or Epsom salts
as medicines. Several cases of cholera have been brought on
by their operation. If due attention be paid to all these
precautions, we have every reason to hope that the epidemic
will soon cease to prevail among us.
“JONA. EIGHTS, Chairman.”
_Bill of Mortality from 22d June to the 7th July, 1832._
June 22, 2--1 poison,
1 small-pox.
23, ----
24, 1 pneumonia,
25, 1 convulsions,
26, 2--1 convulsions,
1 marasmus,
27, 2--1 convulsions,
1 consumption,
28, 1 scarlatina,
29, 2--1 consumption,
1 unknown,
30, ----
--
11 deaths from 22 June to July 3.
July, 3, 2 cholera,
4, ----
5, 4 cholera,
6, 2 cholera,
7, 3 cholera,
8, 4--3 cholera,
1 intemperance,
9, 5 cholera,
10, 8--1 apoplexy,
7 cholera,
11, 9 cholera,
12, 4--1 consumption,
3 cholera,
13, 8--6 cholera,
1 congestion of the brain, after cholera,
1 typhus fever,
14, 7--1 hydrocephalus,
6 cholera,
15, 7--1 debility,
6 cholera,
16, 7 cholera,
17, 8 cholera,
--
78
Cholera 72
Other diseases 6
CHOLERA REPORTS.
July 3, Cases 2 Deaths 2
4, 1 0
5, 7 4
6, 12 2
7, 10 3
8, 11 3
9, 18 5
10, 22 7
11, 28 9
12, 10 3
13, 28 7
14, 27 6
15, 17 6
16, 29 7
17, 23 8
--- ---
Total, 245 Deaths, 72
_Board of Health, New York, July 20th, 1832._
TO WALTER BOWNE, Esq. President, &c.
Sir--I have the honour to transmit to your Board of Health, an
additional report of the Committee appointed to inquire into the
history and origin of the disease at the Bellevue Alms-house, &c.
ALEX. H. STEVENS, M. D. President.
The committee consisting of Drs. Bailey, Macneven, and A.
L. Anderson, to whom was referred the inquiry into the
origin of the malignant cholera in the Alms-house and the
different institutions connected with it, further report:
the Penitentiary, situated about five hundred feet from
the Alms-house, and containing three classes of criminals,
have no communication with one another; but the Bridewell
and Penitentiary prisoners have a common stairway to their
apartments; and the yards of the Female State and Female
Penitentiary prisoners are separated by a high open picket
fence, near to which the Penitentiary prisoners pass to and
from their work-house, and on the opposite side of the Female
State prisoners yard, and at a little distance is situated the
Cholera Hospital, first opened on the 5th or 6th of July. In
this building were confined, on the 1st of July, fifty-four
Female State, about one hundred and twenty Female Penitentiary,
and about fifty Bridewell prisoners; and the first person who
had malignant cholera in that prison was Ann Smith, taken up at
the Five Points, and sent there July 2d--she sickened on the
5th, and died the next day, and on the 7th, four more Female
Penitentiary prisoners had the disease. On the 8th of July, all
the remaining prisoners of this class were sent to Blackwell’s
Island, and put into a fresh white-washed building prepared for
them. The removal of those persons to a healthy residence, and
an unrestrained exercise in the open country air, appear to
have checked the development of that disease among them, for
not until the 10th did any of them sicken, when four of them
were taken with that disease, and since then seven more. Dr.
Spring, the physician stationed there, informed us that the
disease had become milder since their removal to the Island,
two only having died of thirteen patients, and the remaining
eleven, visited by us, were doing well, except one.
The first State prisoner had that disease on the 9th of July,
and eight more on the 12th and 13th, four each day; and since
that time five more, the greater part of whom have died. They
are all in one very large apartment, having three tier of
windows on one side only, but the three stories are one open
space from the top to the bottom of the building.
The first two cases occurred in the Bridewell class also on the
9th, the next on the 11th instant; since then, six more have
had the disease.
When at Blackwell’s Island yesterday afternoon, pursuing
our inquiries respecting the Female Penitentiary prisoners,
sent there from Bellevue, we considered it appertaining
to the duty assigned to us, to extend our inquiry to the
occurrences relating to the same subject, which happened on
that Island, the institution there being a part of the Bellevue
establishment. We were informed by Dr. Spring, the physician
stationed there, that the first case of malignant cholera which
occurred on the Island, was an Alms-house pauper, who slept
there, but worked on the Long Island farms; he was permitted to
go as far as Brooklyn, July 1st, but he frolicked in the city
all the next day, returned at night to Blackwell’s Island, and
slept out of doors all night, and sickened and died July 3d--no
other case took place there until the 11th, (three days after
the Female Penitentiary prisoners were removed from Bellevue,)
when three persons sickened and died the same day; one, a very
feeble black man, aged sixty-five; another, a black lad, who
had been much reduced by medical treatment for rheumatism--both
patients in the hospital, and able to take exercise out of
doors. Their building is about one hundred yards from that
occupied by the Female Penitentiary prisoners. The third, a
white pauper, aged sixty-five, who worked on the Long Island
farms, but slept on Blackwell’s Island, formerly in the
shanty now occupied by the sick blacks; but some days before
he sickened, he slept in a small building at a considerable
distance from his former lodging place; but he not being
under confinement, would go to any part of the Island when
unobserved, and without hindrance to the outside of the Black
Hospital.--Since then, three blacks have had that disease.
We were also informed by Dr. Spring, that no case of malignant
cholera had occurred among the two hundred and eight male
Penitentiary prisoners--that a lad, aged sixteen, who
frequently complained of being unwell, died on the 13th inst.,
after three or four hours sickness of common cholera. Those men
are employed in the open air, and their prison is in the most
perfect order; the air within was as free from any impure smell
as the atmosphere without. We were informed by Col. Woodruff,
the superintendent, that it was in contemplation to remove the
Bridewell prisoners from Bellevue to this prison--and asked our
opinion as to the propriety of the measure; we give it as our
opinion, that as there was already a large number of men now
confined there, and room only for about thirty more, that the
crowding of the prison at this time, and especially from places
where the malignant cholera existed, would be exposing the
health of the prisoners to some hazard.
We were also informed by John Targee, Esq., one of the
Commissioners of the Alms-house, that a boy, whose parents had
both died in Laurens street with the malignant cholera, was
sent from there in the beginning of July, to the house on Long
Island Farms, where there are a large number of pauper boys; he
sickened and died of that disease the day after, and no case of
that disease has since occurred.
The foregoing being all the facts which have come to our
knowledge after a strict examination, are respectfully
submitted.
JOS. BAYLEY.
_Magendie’s Treatment of Cholera._
M. Magendie’s success in the treatment of cholera has been vaunted
in many of the journals, and we have been repeatedly applied to for
information respecting the remedies prescribed by him. His treatment
consisted in the administration during the cold stage of the
following:--
1st. For common drink--℞. Infus. chamomil. ℔iv.; acet. ammon. ℥ij.;
sacch. alb. ℔j M.
2d. Half a glass every hour of the following punch--℞. Infus. flor.
Tiliæ Europeæ, ℔iv.; limon. iv.; alcohol, ℔j.; sacch. alb. ℔j. M.
3d. From time to time he gives half a glass of the following--℞. Vinum
calefac. ℔ij.; tinct. cannel. ℥ij; sacch. alb. ℥ij. M.
By these stimulants, reaction was sometimes induced, and it was at
once concluded that the patient was cured. But violent reaction is not
less dangerous than collapse, and M. Magendie’s patients relieved from
the latter condition by internal stimulants, soon exhibited evidences
of congestion of the brain or digestive organs, which resisted, for
the most part, general and local bleeding, cold to the head, and the
most active revulsives to the feet. The patient became delirious, coma
supervened, and death closed the scene.
It is shown by authentic documents in our possession, that the result
of M. Magendie’s treatment was not less unfortunate than that of his
colleagues; he lost more than one-half of his patients.
A careful examination of the results of the various modes of treatment
adopted in India, Russia, Poland, Germany, Great Britain and France,
has satisfied us that the internal administration of powerful
stimulants in large doses, in the collapsed stage of cholera, has been
eminently injurious, and such appears to have been ultimately the
conviction of nearly all the practitioners who resorted to them. Panic
struck, with the utter state of prostration of patients in the collapse
of cholera, physicians appear every where to have at first been led to
administer the most powerful stimulants in large and repeated doses, to
rouse the action of the heart. Recovered from their first surprise, and
admonished by their ill success, and by the violent and uncontrollable
reaction sometimes induced, these remedies were subsequently abandoned,
or only applied externally, and with incomparably better results.
_Health of Philadelphia._
Bowel complaints continue to be the prevailing diseases, and within a
few days several cases of cholera have assumed malignant characters.
July 27th the Board of Health reported 2 cases of malignant cholera.
28th 6
29th 6
30th 15
31st 19
The whole number of cases, as near as can be ascertained, is 52, of
which, 30 have occurred in the districts, 6 in the Alms-house, 1 in the
Arch street prison, and the remaining 15, in the outskirts and dirtiest
parts of the city.
Report of the Board of Health for the twenty-four hours, ending August
1st, noon:--
PRIVATE PRACTICE.
CASES. RESIDENCE. DEATHS.
1 No. 94 Dillwyn street, N. L. 1
1 No. 1 Clymer street, Moyamensing.
1 No. 3 do. do. do.
1 No. 16 Vine street, City. 1
1 Between Race and Vine and Tenth and Eleventh streets, City.
1 Corner of Bedford and Twelfth streets, Moyamensing.
1 South side of Cedar above Twelfth street, Moyamensing. 1
1 Peach between Green and Coates’s, N. L.
1 Parham’s Alley, Southwark.
1 Queen near Passyunk Road, do.
1 Second below Carpenter st. do.
1 Frankford Road above Bedford street, Kensington.
1 St. John above Poplar Lane, N. L.
1 Shirker’s Alley, Moyamensing. 1
1 Third st. above Globe Mills, Kensington.
1 Otter st. near William street, do.
-- --
16 4
Hospitals. Physicians. New cases. Died. Cured. Remaining.
Alms-house, H. L. Hodge, 1 1 1 0
Jones’ Alley, Parrish, 1 0 0 2
Locust st.[1] Chapman, 2 1 0 1
Moyamensing, Thomson, 1 1 0 1
-- -- -- --
5 3 1 4
[1] A white woman was brought from the Alms-house in a dying
state, and expired soon after admission.
NEW CASES. DEATHS.
Private practice, 16 5
Hospitals, 5 3
Alms-house, 1 1
-- --
22 9
By order,
WM. A. MARTIN, _Clerk_.
The following table exhibits the whole mortality, and also that from
bowel complaints, for the 4th week in July for five successive years.
1828.--4th week, ending July 26th. Whole mortality, 127; of
which, the deaths from cholera morbus, were, adults, 3;
children, 26; Total, 29.--Diarrhœa, adults, 0; children,
3; Total, 3.--Dysentery, adults, 0; children, 3; Total,
3.--Total from bowel complaints, 32.
1829.--4th week, ending August 1st. Whole mortality, 100; of
which, the deaths from cholera morbus were, adults, 1;
children, 23; Total, 24.--Diarrhœa, adults, 0; children,
4; Total, 4.--Dysentery, adults, 1; children, 3; Total,
4.--Total from bowel complaints, 32.
1830.--4th week, ending July 31st. Whole mortality, 183; of
which, the deaths from cholera morbus were, adults, 0;
children, 38; Total, 38.--Diarrhœa, adults, 0; children,
2; Total, 2.--Dysentery, adults, 2; children, 2; Total,
4.--Total from bowel complaints, 44.
1831.--4th week, ending July 30th. Whole mortality, 123, of
which, the deaths from cholera morbus were, adults, 0;
children, 32; Total, 32.--Diarrhœa, adults, 0, children,
6; Total, 6.--Dysentery, adults, 1; children 3; Total,
4.--Total mortality from bowel complaints, 42.
1832.--4th week, ending July 28th. Total mortality, 147; of
which, the deaths from cholera morbus were, adults,
5; children, 27; malignant cholera, adults, 8;
Total, 40.--Diarrhœa, adults, 3; children, 4; Total,
7.--Dysentery, adults, 2; children, 5; Total, 7.--Total
from bowel complaints, 54.
_Liability of Negroes to Cholera._
An impression appears somehow or other to have got abroad that negroes
are not liable to be attacked with cholera; such a notion, however,
has no foundation. In New York, it has been observed that they have
enjoyed no greater immunity than the whites, and the natives of India,
whose constitution much resembles that of the negro, were more liable
to cholera than Europeans. There is ample grounds for fearing that the
disease will be productive of terrible mortality among the slaves of
the southern states, and proper measures of hygiene should be promptly
adopted; and on the very first symptoms of derangement of the digestive
organs, remedial measures immediately resorted to.
_Cholera at New York._
It affords us pleasure to notice that the cholera is abating in our
sister city. During the last few days, the number of cases have
considerably diminished, and though accidental causes may occasionally
interrupt their constant decrease, it is manifest that the epidemic has
reached its height and is on the decline.
The report for the twenty-four hours, ending Tuesday, July 31st, at 12
o’clock, announces--
In private practice, new cases, 59, deaths, 23
Hospitals 52 20
Bellevue 1 3
Harlaem and Yorkville 9 2
--- ---
Total 121 48
The number of interments during the week, ending Saturday, July 28th,
were 879; of which, there were from cholera morbus, 10; malignant
cholera, 689; cramp in the stomach, 1; diarrhœa, 3; dysentery, 4;
cholera infantum, 18; inflammation of the bowels, 4; inflammation of
the stomach, 2.
_Montreal._
The following is a statement of the cases and deaths from the
commencement of the epidemic to the 14th of July inclusive:--
Daily cases. Daily burials. Total cases. Total deaths.
June 10th to 15 1328 175
16 381 86 1709 261
17 474 102 2183 363
18 261 128 2444 491
19 337 149 2781 640
20 165 94 2946 734
21 151 76 3097 810
22 109 52 3206 862
23 83 31 3289 893
24 51 21 3340 914
25 44 33 3384 947
26 27 23 3411 970
27 21 26 3432 996
28 22 20 3454 1016
29 37 21 3491 1037
30 32 22 3523 1059
July 1 23 17 3546 1076
2 13 20 3559 1096
3 11 14 3670 1110
4 23 17 3593 1127
5 22 13 3615 1140
6 19 4 3634 1144
7 13 9 3647 1153
8 14 11 3661 1164
9 10 9 3671 1175
10 7 6 3678 1184
11 14 10 3692 1190
12 15 10 3707 1200
13 9 10 3716 1210
14 8 10 3724 1220
NOTICE.
_The American Journal of the Medical Sciences._
The August No. of this Journal will be delayed a few days in
consequence of the illness of the Editor. The No. will contain copious
details of the cholera of Paris by two American physicians who were
in that city during the prevalence of the epidemic, a review of the
principal works on cholera, and the Periscope will be enriched with
various documents relative to that disease.
PHILADELPHIA--CAREY & LEA--CHESNUT STREET.
*** End of this LibraryBlog Digital Book "The Cholera Gazette, Vol. I. No. 4. Wednesday, August 1st, 1832." ***
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