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diff --git a/.gitattributes b/.gitattributes new file mode 100644 index 0000000..d7b82bc --- /dev/null +++ b/.gitattributes @@ -0,0 +1,4 @@ +*.txt text eol=lf +*.htm text eol=lf +*.html text eol=lf +*.md text eol=lf diff --git a/LICENSE.txt b/LICENSE.txt new file mode 100644 index 0000000..6312041 --- /dev/null +++ b/LICENSE.txt @@ -0,0 +1,11 @@ +This eBook, including all associated images, markup, improvements, +metadata, and any other content or labor, has been confirmed to be +in the PUBLIC DOMAIN IN THE UNITED STATES. + +Procedures for determining public domain status are described in +the "Copyright How-To" at https://www.gutenberg.org. + +No investigation has been made concerning possible copyrights in +jurisdictions other than the United States. Anyone seeking to utilize +this eBook outside of the United States should confirm copyright +status under the laws that apply to them. diff --git a/README.md b/README.md new file mode 100644 index 0000000..2014162 --- /dev/null +++ b/README.md @@ -0,0 +1,2 @@ +Project Gutenberg (https://www.gutenberg.org) public repository for +eBook #52858 (https://www.gutenberg.org/ebooks/52858) diff --git a/old/52858-0.txt b/old/52858-0.txt deleted file mode 100644 index 708713b..0000000 --- a/old/52858-0.txt +++ /dev/null @@ -1,1398 +0,0 @@ -The Project Gutenberg EBook of The Cholera Gazette, Vol. I. No. 4. -Wednesday, August 1st, 1832., by Various - -This eBook is for the use of anyone anywhere in the United States and most -other parts of the world at no cost and with almost no restrictions -whatsoever. You may copy it, give it away or re-use it under the terms of -the Project Gutenberg License included with this eBook or online at -www.gutenberg.org. If you are not located in the United States, you'll have -to check the laws of the country where you are located before using this ebook. - -Title: The Cholera Gazette, Vol. I. No. 4. Wednesday, August 1st, 1832. - -Author: Various - -Release Date: August 20, 2016 [EBook #52858] - -Language: English - -Character set encoding: UTF-8 - -*** START OF THIS PROJECT GUTENBERG EBOOK CHOLERA GAZETTE, AUGUST 1, 1832 *** - - - - -Produced by The Online Distributed Proofreading Team at -http://www.pgdp.net (This file was produced from images -generously made available by The Internet Archive) - - - - - - - - - - - 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 the Project Gutenberg EBook of The Cholera Gazette, Vol. I. No. 4. -Wednesday, August 1st, 1832., by Various - -*** END OF THIS PROJECT GUTENBERG EBOOK CHOLERA GAZETTE, AUGUST 1, 1832 *** - -***** This file should be named 52858-0.txt or 52858-0.zip ***** -This and all associated files of various formats will be found in: - http://www.gutenberg.org/5/2/8/5/52858/ - -Produced by The Online Distributed Proofreading Team at -http://www.pgdp.net (This file was produced from images -generously made available by The Internet Archive) - -Updated editions will replace the previous one--the old editions will -be renamed. - -Creating the works from print editions not protected by U.S. copyright -law means that no one owns a United States copyright in these works, -so the Foundation (and you!) can copy and distribute it in the United -States without permission and without paying copyright -royalties. 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No. 4., by Various. - </title> - - <link rel="coverpage" href="images/cover.jpg" /> - -<style type="text/css"> - -a { - text-decoration: none; -} - -body { - margin-left: 10%; - margin-right: 10%; - font-size: 100%; -} - -h1,h2,h3 { - text-align: center; - clear: both; -} - -hr { - width: 65%; - margin-left: 17.5%; - margin-right: 17.5%; - margin-top: 2em; - margin-bottom: 2em; - clear: both; -} - -p { - margin-top: 0.5em; - text-align: justify; - margin-bottom: 0.5em; - text-indent: 1em; -} - -table { - margin: 1em auto 1em auto; - max-width: 40em; -} - -td { - padding: 0 0.25em 0 0.25em; - vertical-align: top; - text-align: justify; -} - -th { - font-weight: normal; -} - -.blockquote { - margin-left: 10%; - margin-right: 10%; - font-size: smaller; -} - -.borders { - border-top: double; - border-bottom: double; -} - -.center { - text-align: center; - text-indent: 0em; -} - -.footnotes { - border: dashed 1px; -} - -.footnote { - margin-left: 10%; - margin-right: 10%; - font-size: 0.9em; -} - -.footnote .label { - position: absolute; - right: 84%; - text-align: right; -} - -.fnanchor { - position: relative; - top: -0.4em; - font-size: .8em; - text-decoration: none; -} - -.indent3 { - text-indent: 3em; -} - -.pagenum { - position: absolute; - right: 4%; - font-size: 0.9em; - text-align: right; - font-style: normal; -} - -.right { - text-align: right; -} - -.shift-up { - margin-top: -1.7em; -} - -.smaller { - font-size: 80%; -} - -.smcap { - font-variant: small-caps; - font-style: normal; -} - -.tdr { - text-align: right; -} - -.tdtotal { - text-align: right; - border-top: thin solid black; -} - -.titlepage { - text-align: center; - margin-top: 3em; - text-indent: 0em; -} - -@media handheld { - -.blockquote { - margin-left: 5%; - margin-right: 5%; -} -} - </style> - </head> -<body> - - -<pre> - -The Project Gutenberg EBook of The Cholera Gazette, Vol. I. No. 4. -Wednesday, August 1st, 1832., by Various - -This eBook is for the use of anyone anywhere in the United States and most -other parts of the world at no cost and with almost no restrictions -whatsoever. You may copy it, give it away or re-use it under the terms of -the Project Gutenberg License included with this eBook or online at -www.gutenberg.org. If you are not located in the United States, you'll have -to check the laws of the country where you are located before using this ebook. - -Title: The Cholera Gazette, Vol. I. No. 4. Wednesday, August 1st, 1832. - -Author: Various - -Release Date: August 20, 2016 [EBook #52858] - -Language: English - -Character set encoding: UTF-8 - -*** START OF THIS PROJECT GUTENBERG EBOOK CHOLERA GAZETTE, AUGUST 1, 1832 *** - - - - -Produced by The Online Distributed Proofreading Team at -http://www.pgdp.net (This file was produced from images -generously made available by The Internet Archive) - - - - - - -</pre> - - -<p><span class="pagenum"><a name="Page_49" id="Page_49">[49]</a></span></p> - -<h1><span class="smaller">THE</span><br /> -CHOLERA GAZETTE.</h1> - -<div class="borders"> - -<p><span class="smcap">Vol. I.</span></p> - -<p class="center shift-up"><i>WEDNESDAY, AUGUST 1st, 1832.</i></p> - -<p class="right shift-up">No. 4.</p> - -</div> - -<h2><i>Injection of Saline Solutions into the Veins.</i></h2> - -<p>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.</p> - -<div class="blockquote"> - -<h3>No. 1.</h3> - -<p><span class="smcap">Sir</span>,—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 <i>five to ten pounds</i> 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 <i>ounces</i> 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!</p> - -<p><span class="pagenum"><a name="Page_50" id="Page_50">[50]</a></span></p> - -<p>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.</p> - -<p>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.</p> - -<p>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.</p> - -<p class="center">(Signed)</p> - -<p class="right">ROBERT LEWINS, M. D.</p> - -<p><span class="smcap">To W. Maclean</span>, Esq.</p> - -<p class="indent3"><i>Secretary to the Central Board of Health.</i></p> - -<h3>No. 2.</h3> - -<p><span class="smcap">Sir</span>,—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<span class="pagenum"><a name="Page_51" id="Page_51">[51]</a></span> -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.</p> - -<p class="center">(Signed)</p> - -<p class="right">ROBERT LEWINS, M. D.</p> - -<p><span class="smcap">To W. Maclean, Esq.</span> &c. &c.</p> - -<p>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.</p> - -<p class="right">R. L.</p> - -<h3>No. 3.</h3> - -<p class="right"><i>Leith, May 23d, 1832.</i></p> - -<p>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.</p> - -<p>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.</p> - -<p>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<span class="pagenum"><a name="Page_52" id="Page_52">[52]</a></span> -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.</p> - -<p>Not having by me the number of <span class="smcap">The Lancet</span> 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.</p> - -<p>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<span class="pagenum"><a name="Page_53" id="Page_53">[53]</a></span> -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.</p> - -<p>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.</p> - -<p>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.</p> - -<p>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.</p> - -<p>The second cause of want of success is the presence of organic disease; this,<span class="pagenum"><a name="Page_54" id="Page_54">[54]</a></span> -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.</p> - -<p>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?</p> - -<p>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.</p> - -<p>The apparatus I have used, is Reid’s patent syringe, having a small silver<span class="pagenum"><a name="Page_55" id="Page_55">[55]</a></span> -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 <i>once</i> 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.</p> - -<p class="center">I am, sir, your most obedient servant,</p> - -<p class="right">THOMAS LATTA, M. D.</p> - -</div> - -<p class="center">(To be continued.)</p> - -<hr /> - -<h2><i>Origin and Progress of Cholera at Albany.</i></h2> - -<p>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.</p> - -<div class="blockquote"> - -<p>“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.</p> - -<p>“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, <i>not one single death was -reported</i>. 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.</p> - -<p>“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.</p> - -<p>“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.</p> - -<p>“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<span class="pagenum"><a name="Page_56" id="Page_56">[56]</a></span> -recollected, that during the same time hundreds had been attacked with <i>Cholerine</i>, -or the slightest influences of the epidemic. None of these have been -reported, <i>because by timely aid, the disease, in its more formidable shape, was prevented</i>. -We can, we believe, say with truth, that few have entirely escaped the -influence of the disease.</p> - -<p>“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.</p> - -<p>“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 <i>may</i>, under certain -circumstances, be contagious, but no very striking instances of the kind has yet -come to our knowledge in this city.</p> - -<p>“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.</p> - -<p>“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.</p> - -<p>“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.</p> - -<p>“We would again most earnestly entreat our citizens not to neglect to apply<span class="pagenum"><a name="Page_57" id="Page_57">[57]</a></span> -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.</p> - -<p>“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 <i>drink</i>, but in <i>food</i>. We would caution them against the free use of -<i>fruit</i>, <i>ripe</i> or <i>unripe</i>, 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.</p> - -<p class="right">“JONA. EIGHTS, Chairman.”</p> - -<h3><i>Bill of Mortality from 22d June to the 7th July, 1832.</i></h3> - -<table summary="Bill of Mortality"> - <tr> - <td>June</td><td class="tdr">22,</td><td class="tdr">2—</td><td class="tdr">1</td><td>poison,</td> - </tr> - <tr> - <td></td><td class="tdr"></td><td class="tdr"></td><td class="tdr">1</td><td>small-pox.</td> - </tr> - <tr> - <td></td><td class="tdr">23,</td><td class="tdr"></td><td class="tdr"></td><td>——</td> - </tr> - <tr> - <td></td><td class="tdr">24,</td><td class="tdr"></td><td class="tdr">1</td><td>pneumonia,</td> - </tr> - <tr> - <td></td><td class="tdr">25,</td><td class="tdr"></td><td class="tdr">1</td><td>convulsions,</td> - </tr> - <tr> - <td></td><td class="tdr">26,</td><td class="tdr">2—</td><td class="tdr">1</td><td>convulsions,</td> - </tr> - <tr> - <td></td><td class="tdr"></td><td class="tdr"></td><td class="tdr">1</td><td>marasmus,</td> - </tr> - <tr> - <td></td><td class="tdr">27,</td><td class="tdr">2—</td><td class="tdr">1</td><td>convulsions,</td> - </tr> - <tr> - <td></td><td class="tdr"></td><td class="tdr"></td><td class="tdr">1</td><td>consumption,</td> - </tr> - <tr> - <td></td><td class="tdr">28,</td><td class="tdr"></td><td class="tdr">1</td><td>scarlatina,</td> - </tr> - <tr> - <td></td><td class="tdr">29,</td><td class="tdr">2—</td><td class="tdr">1</td><td>consumption,</td> - </tr> - <tr> - <td></td><td class="tdr"></td><td class="tdr"></td><td class="tdr">1</td><td>unknown,</td> - </tr> - <tr> - <td></td><td class="tdr">30,</td><td></td><td class="tdr"></td><td>——</td> - </tr> - <tr> - <td></td><td class="tdr"></td><td class="tdr"></td><td class="tdr">11</td><td>deaths from 22 June to July 3.</td> - </tr> - <tr> - <td>July,</td><td class="tdr">3,</td><td class="tdr"></td><td class="tdr">2</td><td>cholera,</td> - </tr> - <tr> - <td></td><td class="tdr">4,</td><td class="tdr"></td><td class="tdr"></td><td>——</td> - </tr> - <tr> - <td></td><td class="tdr">5,</td><td class="tdr"></td><td class="tdr">4</td><td>cholera,</td> - </tr> - <tr> - <td></td><td class="tdr">6,</td><td class="tdr"></td><td class="tdr">2</td><td>cholera,</td> - </tr> - <tr> - <td></td><td class="tdr">7,</td><td class="tdr"></td><td class="tdr">3</td><td>cholera,</td> - </tr> - <tr> - <td></td><td class="tdr">8,</td><td class="tdr">4—</td><td class="tdr">3</td><td>cholera,</td> - </tr> - <tr> - <td></td><td class="tdr"></td><td class="tdr"></td><td class="tdr">1</td><td>intemperance,</td> - </tr> - <tr> - <td></td><td class="tdr">9,</td><td class="tdr"></td><td class="tdr">5</td><td>cholera,</td> - </tr> - <tr> - <td></td><td class="tdr">10,</td><td class="tdr">8—</td><td class="tdr">1</td><td>apoplexy,</td> - </tr> - <tr> - <td></td><td class="tdr"></td><td class="tdr"></td><td class="tdr">7</td><td>cholera,</td> - </tr> - <tr> - <td></td><td class="tdr">11,</td><td class="tdr"></td><td class="tdr">9</td><td>cholera,</td> - </tr> - <tr> - <td></td><td class="tdr">12,</td><td class="tdr">4—</td><td class="tdr">1</td><td>consumption,</td> - </tr> - <tr> - <td></td><td class="tdr"></td><td class="tdr"></td><td class="tdr">3</td><td>cholera,</td> - </tr> - <tr> - <td></td><td class="tdr">13,</td><td class="tdr">8—</td><td class="tdr">6</td><td>cholera,</td> - </tr> - <tr> - <td></td><td class="tdr"></td><td class="tdr"></td><td class="tdr">1</td><td>congestion of the brain, after cholera,</td> - </tr> - <tr> - <td></td><td class="tdr"></td><td class="tdr"></td><td class="tdr">1</td><td>typhus fever,</td> - </tr> - <tr> - <td></td><td class="tdr">14,</td><td class="tdr">7—</td><td class="tdr">1</td><td>hydrocephalus,</td> - </tr> - <tr> - <td></td><td class="tdr"></td><td class="tdr"></td><td class="tdr">6</td><td>cholera,</td> - </tr> - <tr> - <td></td><td class="tdr">15,</td><td class="tdr">7—</td><td class="tdr">1</td><td>debility,</td> - </tr> - <tr> - <td></td><td class="tdr"></td><td class="tdr"></td><td class="tdr">6</td><td>cholera,</td> - </tr> - <tr> - <td></td><td class="tdr">16,</td><td class="tdr"></td><td class="tdr">7</td><td>cholera,</td> - </tr> - <tr> - <td></td><td class="tdr">17,</td><td class="tdr"></td><td class="tdr">8</td><td>cholera,</td> - </tr> - <tr> - <td></td><td class="tdr"></td><td></td><td class="tdtotal">78</td><td></td> - </tr> - <tr> - <td colspan="3">Cholera</td><td class="tdr">72</td><td></td> - </tr> - <tr> - <td colspan="3">Other diseases</td><td class="tdr">6</td><td></td> - </tr> -</table> - -<p><span class="pagenum"><a name="Page_58" id="Page_58">[58]</a></span></p> - -<h3>CHOLERA REPORTS.</h3> - -<table summary="Cholera reports"> - <tr> - <td>July</td><td class="tdr">3,</td><td>Cases</td><td class="tdr">2</td><td>Deaths</td><td class="tdr">2</td> - </tr> - <tr> - <td></td><td class="tdr">4,</td><td></td><td class="tdr">1</td><td></td><td class="tdr">0</td> - </tr> - <tr> - <td></td><td class="tdr">5,</td><td></td><td class="tdr">7</td><td></td><td class="tdr">4</td> - </tr> - <tr> - <td></td><td class="tdr">6,</td><td></td><td class="tdr">12</td><td></td><td class="tdr">2</td> - </tr> - <tr> - <td></td><td class="tdr">7,</td><td></td><td class="tdr">10</td><td></td><td class="tdr">3</td> - </tr> - <tr> - <td></td><td class="tdr">8,</td><td></td><td class="tdr">11</td><td></td><td class="tdr">3</td> - </tr> - <tr> - <td></td><td class="tdr">9,</td><td></td><td class="tdr">18</td><td></td><td class="tdr">5</td> - </tr> - <tr> - <td></td><td class="tdr">10,</td><td></td><td class="tdr">22</td><td></td><td class="tdr">7</td> - </tr> - <tr> - <td></td><td class="tdr">11,</td><td></td><td class="tdr">28</td><td></td><td class="tdr">9</td> - </tr> - <tr> - <td></td><td class="tdr">12,</td><td></td><td class="tdr">10</td><td></td><td class="tdr">3</td> - </tr> - <tr> - <td></td><td class="tdr">13,</td><td></td><td class="tdr">28</td><td></td><td class="tdr">7</td> - </tr> - <tr> - <td></td><td class="tdr">14,</td><td></td><td class="tdr">27</td><td></td><td class="tdr">6</td> - </tr> - <tr> - <td></td><td class="tdr">15,</td><td></td><td class="tdr">17</td><td></td><td class="tdr">6</td> - </tr> - <tr> - <td></td><td class="tdr">16,</td><td></td><td class="tdr">29</td><td></td><td class="tdr">7</td> - </tr> - <tr> - <td></td><td class="tdr">17,</td><td></td><td class="tdr">23</td><td></td><td class="tdr">8</td> - </tr> - <tr> - <td colspan="3">Total,</td><td class="tdtotal">245</td><td>Deaths,</td><td class="tdtotal">72</td> - </tr> -</table> - -</div> - -<hr /> - -<h2><i>Board of Health, New York, July 20th, 1832.</i></h2> - -<p class="indent3"><span class="smcap">To Walter Bowne</span>, Esq. President, &c.</p> - -<p>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.</p> - -<p class="right">ALEX. H. STEVENS, M. D. President.</p> - -<div class="blockquote"> - -<p>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,<span class="pagenum"><a name="Page_59" id="Page_59">[59]</a></span> -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.</p> - -<p>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.</p> - -<p>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.</p> - -<p>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.</p> - -<p>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.</p> - -<p>We were also informed by John Targee, Esq., one of the Commissioners of<span class="pagenum"><a name="Page_60" id="Page_60">[60]</a></span> -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.</p> - -<p>The foregoing being all the facts which have come to our knowledge after -a strict examination, are respectfully submitted.</p> - -<p class="right">JOS. BAYLEY.</p> - -</div> - -<hr /> - -<h2><i>Magendie’s Treatment of Cholera.</i></h2> - -<p>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:—</p> - -<p>1st. For common drink—℞. Infus. chamomil. ℔iv.; acet. ammon. -℥ij.; sacch. alb. ℔j M.</p> - -<p>2d. Half a glass every hour of the following punch—℞. Infus. flor. -Tiliæ Europeæ, ℔iv.; limon. iv.; alcohol, ℔j.; sacch. alb. ℔j. M.</p> - -<p>3d. From time to time he gives half a glass of the following—℞. -Vinum calefac. ℔ij.; tinct. cannel. ℥ij; sacch. alb. ℥ij. M.</p> - -<p>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.</p> - -<p>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.</p> - -<p>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<span class="pagenum"><a name="Page_61" id="Page_61">[61]</a></span> -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.</p> - -<hr /> - -<h2><i>Health of Philadelphia.</i></h2> - -<p>Bowel complaints continue to be the prevailing diseases, and within -a few days several cases of cholera have assumed malignant characters.</p> - -<table summary="Cholera in Philadelphia"> - <tr> - <td>July</td><td>27th</td><td>the Board of Health reported</td><td class="tdr">2</td><td>cases of malignant cholera.</td> - </tr> - <tr> - <td></td><td>28th</td><td></td><td class="tdr">6</td><td></td> - </tr> - <tr> - <td></td><td>29th</td><td></td><td class="tdr">6</td><td></td> - </tr> - <tr> - <td></td><td>30th</td><td></td><td class="tdr">15</td><td></td> - </tr> - <tr> - <td></td><td>31st</td><td></td><td class="tdr">19</td><td></td> - </tr> -</table> - -<p>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.</p> - -<p>Report of the Board of Health for the twenty-four hours, ending -August 1st, noon:—</p> - -<h3>PRIVATE PRACTICE.</h3> - -<table summary="Private practice health report"> - <tr> - <th>CASES.</th><th>RESIDENCE.</th><th>DEATHS.</th> - </tr> - <tr> - <td class="tdr">1</td><td>No. 94 Dillwyn street, N. L.</td><td class="tdr">1</td> - </tr> - <tr> - <td class="tdr">1</td><td>No. 1 Clymer street, Moyamensing.</td><td class="tdr"></td> - </tr> - <tr> - <td class="tdr">1</td><td>No. 3 do. do. do.</td><td class="tdr"></td> - </tr> - <tr> - <td class="tdr">1</td><td>No. 16 Vine street, City.</td><td class="tdr">1</td> - </tr> - <tr> - <td class="tdr">1</td><td>Between Race and Vine and Tenth and Eleventh streets, City.</td><td class="tdr"></td> - </tr> - <tr> - <td class="tdr">1</td><td>Corner of Bedford and Twelfth streets, Moyamensing.</td><td class="tdr"></td> - </tr> - <tr> - <td class="tdr">1</td><td>South side of Cedar above Twelfth street, Moyamensing.</td><td class="tdr">1</td> - </tr> - <tr> - <td class="tdr">1</td><td>Peach between Green and Coates’s, N. L.</td><td class="tdr"></td> - </tr> - <tr> - <td class="tdr">1</td><td>Parham’s Alley, Southwark.</td><td class="tdr"></td> - </tr> - <tr> - <td class="tdr">1</td><td>Queen near Passyunk Road, do.</td><td class="tdr"></td> - </tr> - <tr> - <td class="tdr">1</td><td>Second below Carpenter st. do.</td><td class="tdr"></td> - </tr> - <tr> - <td class="tdr">1</td><td>Frankford Road above Bedford street, Kensington.</td><td class="tdr"></td> - </tr> - <tr> - <td class="tdr">1</td><td>St. John above Poplar Lane, N. L.</td><td class="tdr"></td> - </tr> - <tr> - <td class="tdr">1</td><td>Shirker’s Alley, Moyamensing.</td><td class="tdr">1</td> - </tr> - <tr> - <td class="tdr">1</td><td>Third st. above Globe Mills, Kensington.</td><td class="tdr"></td> - </tr> - <tr> - <td class="tdr">1</td><td>Otter st. near William street, do.</td><td class="tdr"></td> - </tr> - <tr> - <td class="tdtotal">16</td><td></td><td class="tdtotal">4</td> - </tr> -</table> - -<p><span class="pagenum"><a name="Page_62" id="Page_62">[62]</a></span></p> - -<table summary="More board of health report"> - <tr> - <th>Hospitals.</th><th>Physicians.</th><th>New cases.</th><th>Died.</th><th>Cured.</th><th>Remaining.</th> - </tr> - <tr> - <td>Alms-house,</td><td>H. L. Hodge,</td><td class="tdr">1</td><td class="tdr">1</td><td class="tdr">1</td><td class="tdr">0</td> - </tr> - <tr> - <td>Jones’ Alley,</td><td>Parrish,</td><td class="tdr">1</td><td class="tdr">0</td><td class="tdr">0</td><td class="tdr">2</td> - </tr> - <tr> - <td>Locust st.<a name="FNanchor_1" id="FNanchor_1"></a><a href="#Footnote_1" class="fnanchor">[1]</a></td><td>Chapman,</td><td class="tdr">2</td><td class="tdr">1</td><td class="tdr">0</td><td class="tdr">1</td> - </tr> - <tr> - <td>Moyamensing,</td><td>Thomson,</td><td class="tdr">1</td><td class="tdr">1</td><td class="tdr">0</td><td class="tdr">1</td> - </tr> - <tr> - <td></td><td></td><td class="tdtotal">5</td><td class="tdtotal">3</td><td class="tdtotal">1</td><td class="tdtotal">4</td> - </tr> -</table> - -<div class="footnotes"> - <div class="footnote"> - <p><a name="Footnote_1" id="Footnote_1"></a><a href="#FNanchor_1"> - <span class="label">[1]</span></a> A white woman was brought from the - Alms-house in a dying state, and expired soon after admission.</p> - </div> -</div> - -<table summary="more"> - <tr> - <th></th><th><span class="smcap">New Cases.</span></th><th><span class="smcap">Deaths.</span></th> - </tr> - <tr> - <td>Private practice,</td><td class="tdr">16</td><td class="tdr">5</td> - </tr> - <tr> - <td>Hospitals,</td><td class="tdr">5</td><td class="tdr">3</td> - </tr> - <tr> - <td>Alms-house,</td><td class="tdr">1</td><td class="tdr">1</td> - </tr> - <tr> - <td></td><td class="tdtotal">22</td><td class="tdtotal">9</td> - </tr> -</table> - -<p class="center">By order,</p> - -<p class="right">WM. A. MARTIN, <i>Clerk</i>.</p> - -<p>The following table exhibits the whole mortality, and also that -from bowel complaints, for the 4th week in July for five successive -years.</p> - -<table summary="Mortality for the 4th week in July, five successive years"> - <tr> - <td class="tdr">1828.—</td><td>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.</td> - </tr> - <tr> - <td class="tdr">1829.—</td><td>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.</td> - </tr> - <tr> - <td class="tdr">1830.—</td><td>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.</td> - </tr> - <tr> - <td class="tdr">1831.—</td><td>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.</td> - </tr> - <tr> - <td class="tdr">1832.—</td><td>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.</td> - </tr> -</table> - -<hr /> - -<p><span class="pagenum"><a name="Page_63" id="Page_63">[63]</a></span></p> - -<h2><i>Liability of Negroes to Cholera.</i></h2> - -<p>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.</p> - -<hr /> - -<h2><i>Cholera at New York.</i></h2> - -<p>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.</p> - -<p>The report for the twenty-four hours, ending Tuesday, July 31st, -at 12 o’clock, announces—</p> - -<table summary="New York cholera report"> - <tr> - <td>In private practice,</td><td>new cases,</td><td class="tdr">59,</td><td>deaths,</td><td class="tdr">23</td> - </tr> - <tr> - <td>Hospitals</td><td></td><td class="tdr">52</td><td></td><td class="tdr">20</td> - </tr> - <tr> - <td>Bellevue</td><td></td><td class="tdr">1</td><td></td><td class="tdr">3</td> - </tr> - <tr> - <td>Harlaem and Yorkville</td><td></td><td class="tdr">9</td><td></td><td class="tdr">2</td> - </tr> - <tr> - <td></td><td>Total</td><td class="tdtotal">121</td><td></td><td class="tdtotal">48</td> - </tr> -</table> - -<p>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.</p> - -<hr /> - -<p><span class="pagenum"><a name="Page_64" id="Page_64">[64]</a></span></p> - -<h2><i>Montreal.</i></h2> - -<p>The following is a statement of the cases and deaths from the commencement -of the epidemic to the 14th of July inclusive:—</p> - -<table summary="Cholera at Montreal"> - <tr> - <th></th><th></th><th>Daily cases.</th><th>Daily burials.</th><th>Total cases.</th><th>Total deaths.</th> - </tr> - <tr> - <td>June 10th to</td><td class="tdr">15</td><td class="tdr"></td><td class="tdr"></td><td class="tdr">1328</td><td class="tdr">175</td> - </tr> - <tr> - <td></td><td class="tdr">16</td><td class="tdr">381</td><td class="tdr">86</td><td class="tdr">1709</td><td class="tdr">261</td> - </tr> - <tr> - <td></td><td class="tdr">17</td><td class="tdr">474</td><td class="tdr">102</td><td class="tdr">2183</td><td class="tdr">363</td> - </tr> - <tr> - <td></td><td class="tdr">18</td><td class="tdr">261</td><td class="tdr">128</td><td class="tdr">2444</td><td class="tdr">491</td> - </tr> - <tr> - <td></td><td class="tdr">19</td><td class="tdr">337</td><td class="tdr">149</td><td class="tdr">2781</td><td class="tdr">640</td> - </tr> - <tr> - <td></td><td class="tdr">20</td><td class="tdr">165</td><td class="tdr">94</td><td class="tdr">2946</td><td class="tdr">734</td> - </tr> - <tr> - <td></td><td class="tdr">21</td><td class="tdr">151</td><td class="tdr">76</td><td class="tdr">3097</td><td class="tdr">810</td> - </tr> - <tr> - <td></td><td class="tdr">22</td><td class="tdr">109</td><td class="tdr">52</td><td class="tdr">3206</td><td class="tdr">862</td> - </tr> - <tr> - <td></td><td class="tdr">23</td><td class="tdr">83</td><td class="tdr">31</td><td class="tdr">3289</td><td class="tdr">893</td> - </tr> - <tr> - <td></td><td class="tdr">24</td><td class="tdr">51</td><td class="tdr">21</td><td class="tdr">3340</td><td class="tdr">914</td> - </tr> - <tr> - <td></td><td class="tdr">25</td><td class="tdr">44</td><td class="tdr">33</td><td class="tdr">3384</td><td class="tdr">947</td> - </tr> - <tr> - <td></td><td class="tdr">26</td><td class="tdr">27</td><td class="tdr">23</td><td class="tdr">3411</td><td class="tdr">970</td> - </tr> - <tr> - <td></td><td class="tdr">27</td><td class="tdr">21</td><td class="tdr">26</td><td class="tdr">3432</td><td class="tdr">996</td> - </tr> - <tr> - <td></td><td class="tdr">28</td><td class="tdr">22</td><td class="tdr">20</td><td class="tdr">3454</td><td class="tdr">1016</td> - </tr> - <tr> - <td></td><td class="tdr">29</td><td class="tdr">37</td><td class="tdr">21</td><td class="tdr">3491</td><td class="tdr">1037</td> - </tr> - <tr> - <td></td><td class="tdr">30</td><td class="tdr">32</td><td class="tdr">22</td><td class="tdr">3523</td><td class="tdr">1059</td> - </tr> - <tr> - <td>July</td><td class="tdr">1</td><td class="tdr">23</td><td class="tdr">17</td><td class="tdr">3546</td><td class="tdr">1076</td> - </tr> - <tr> - <td></td><td class="tdr">2</td><td class="tdr">13</td><td class="tdr">20</td><td class="tdr">3559</td><td class="tdr">1096</td> - </tr> - <tr> - <td></td><td class="tdr">3</td><td class="tdr">11</td><td class="tdr">14</td><td class="tdr">3670</td><td class="tdr">1110</td> - </tr> - <tr> - <td></td><td class="tdr">4</td><td class="tdr">23</td><td class="tdr">17</td><td class="tdr">3593</td><td class="tdr">1127</td> - </tr> - <tr> - <td></td><td class="tdr">5</td><td class="tdr">22</td><td class="tdr">13</td><td class="tdr">3615</td><td class="tdr">1140</td> - </tr> - <tr> - <td></td><td class="tdr">6</td><td class="tdr">19</td><td class="tdr">4</td><td class="tdr">3634</td><td class="tdr">1144</td> - </tr> - <tr> - <td></td><td class="tdr">7</td><td class="tdr">13</td><td class="tdr">9</td><td class="tdr">3647</td><td class="tdr">1153</td> - </tr> - <tr> - <td></td><td class="tdr">8</td><td class="tdr">14</td><td class="tdr">11</td><td class="tdr">3661</td><td class="tdr">1164</td> - </tr> - <tr> - <td></td><td class="tdr">9</td><td class="tdr">10</td><td class="tdr">9</td><td class="tdr">3671</td><td class="tdr">1175</td> - </tr> - <tr> - <td></td><td class="tdr">10</td><td class="tdr">7</td><td class="tdr">6</td><td class="tdr">3678</td><td class="tdr">1184</td> - </tr> - <tr> - <td></td><td class="tdr">11</td><td class="tdr">14</td><td class="tdr">10</td><td class="tdr">3692</td><td class="tdr">1190</td> - </tr> - <tr> - <td></td><td class="tdr">12</td><td class="tdr">15</td><td class="tdr">10</td><td class="tdr">3707</td><td class="tdr">1200</td> - </tr> - <tr> - <td></td><td class="tdr">13</td><td class="tdr">9</td><td class="tdr">10</td><td class="tdr">3716</td><td class="tdr">1210</td> - </tr> - <tr> - <td></td><td class="tdr">14</td><td class="tdr">8</td><td class="tdr">10</td><td class="tdr">3724</td><td class="tdr">1220</td> - </tr> -</table> - -<hr /> - -<h2>NOTICE.</h2> - -<p class="center"><i>The American Journal of the Medical Sciences.</i></p> - -<p>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.</p> - -<p class="titlepage">PHILADELPHIA—CAREY & LEA—CHESNUT STREET.</p> - - - - - - - - -<pre> - - - - - -End of the Project Gutenberg EBook of The Cholera Gazette, Vol. I. No. 4. -Wednesday, August 1st, 1832., by Various - -*** END OF THIS PROJECT GUTENBERG EBOOK CHOLERA GAZETTE, AUGUST 1, 1832 *** - -***** This file should be named 52858-h.htm or 52858-h.zip ***** -This and all associated files of various formats will be found in: - http://www.gutenberg.org/5/2/8/5/52858/ - -Produced by The Online Distributed Proofreading Team at -http://www.pgdp.net (This file was produced from images -generously made available by The Internet Archive) - -Updated editions will replace the previous one--the old editions will -be renamed. - -Creating the works from print editions not protected by U.S. copyright -law means that no one owns a United States copyright in these works, -so the Foundation (and you!) can copy and distribute it in the United -States without permission and without paying copyright -royalties. 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