CAUSES OF CONTAGIOUS 
AND 
EPIDEMIC DISEASES, 
WITH HINTS FOR THEIR PREVENTION, 
AND 
REFORM IN MEDICAL POLICE, 
BY M. M. RODGERS, M. D, 
Author of "Agricultural Chemistry," "Physical Education and Medical Management of 
Children," "Scientific Agriculture," "Letters on European Agriculture," and 
Corresponding Member of the " Society of Arts," London. 
ROCHESTER : 
PUBLISHED BY DARROW 4 BRO., CORNER OF MAIN AND ST. PAUL STS. 
1854. PREFACE. 
The object of this little pamphlet is, to call attention to a subject which 
interests every individual in community, viz: Diseases, their causes and 
prevention. The author makes no pretensions to superior knowledge on these 
subjects, but feels it a duty to communicate a few facts, which are, probably, not 
known to all,-and to urge some measures of reform. The work was under- 
taken without advice or request from any person Qr " authorities." 
The labor was performed gratuitously, and the pamphlet is for gratuitous 
circulation. Truth, fairness, and scientific accuracy have been regarded, and 
the good of community kept in view. The book should not be considered as 
an index of the opinion of the public, or of the medical profession in this city 
but whatever is considered useful will doubtless meet the approbation of all 
who read it; whatever faults may be discovered, are to be attributed to the 
author alone. 
Rochester compares well, for cleanliness, enterprise, healthfulness, and good 
order, with most other cities; but although much has been done in sanatory 
and police reform, much remains, and always will remain, to do. Our city is 
peculiarly one of business; and business men are usually too much engrossed 
with their own private affairs, to give measures of public improvement the 
necessary attention. We want a higher standard of popular taste and feeling, 
to become the most perfect and enlightened city organization. We need more 
men to work for the public. Every man who has a dollar or an idea to con- 
tribute to the common stock, has the right, and is under obligation to throw it 
in. One may give money, another write, another lecture, and another work 
with his hands,- and all be equally useful in his capacity. Small efforts 
usually produce small results; but if we make no efforts, we expect no results. 
The cynical critic, who snarls at all suggestions not his own, and dispises 
small enterprises and humble efforts, will live without becoming better or 
happier, and die without seeing the world reformed. 
M. M. RODGERS. CAUSES OF DISEASE. 
CAUSES OF DISEASE IN GENERAL. 
Disease never occurs without a cause: the cause or causes are some- 
times known and sometimes unknown. When epidemics of fevers, 
dysentery, <fcc., occur in consequenee of nuisances, unwholesome food, 
cold and wet, they may usually be traced to their origin : and when the 
offending cause is removed, the disease will cease to prevail as an 
epidemic. When infectious diseases, such as small-pox and itch, prevail, 
they can be traced to the bodies of other persons, (having the same 
diseases,) for their cause: in this case, removal or insolation of infected 
persons from the presence of all others, will prevent farther increase of 
cases. 
Certain other diseases which prevail as epidemics, may depend upon 
some cause or causes, which may be hidden and unappreciable,-such 
as temperature, atmosphere, miasm, &c. Cholera, certain fevers, 
malignant erysipelas, or " black tongue," are of this kind. That they 
depend, usually, upon unknown causes, is proven by the fact that 
animals, as well as the human species, often suffer from such epidemics, 
-both at times when they prevail with the latter, and when they do not. 
The first step necessary in the investigation of any disease, is to 
search for its cause. The removal of the cause if possible, must prevent 
farther propagation of the disease. 
By far the most alarming causes which prevail, are those which 
produce the every-day sickness, which is not epidemic or contagious, 
but which, nevertheless, gradually and insidiously waste the powers of 
life, and cause more deaths than all epidemics and contagions. These 
causes are most to be feared, because they belong to the every-day 6 
habits of life : they are mingled with our air, drinks and food,- they 
sleep with us in our beds, go with us through all our business and 
pleasures, as constantly as our shadow,-they mingle in our social in- 
tercourse, engraft themselves on our offspring, and leave us only with 
our expiring breath. And still they accomplish their fatal work silently 
as certain, and are as unseen as spirits. 
The bills of mortality of any city will show a larger percentage of 
deaths from the ordinary sickness, than from all the epidemics com- 
bined : and the causes of this sickness, are precisely the ones which are 
most appreciable, and most amenable to hygeinic measures. All mor- 
tality above two per cent, of the population, is considered in England, 
as unnecessary, and capable of being prevented. 
A slight increase of sickness at certain seasons, is regarded as a 
necessary occurrence ;-a " sickly season," creates no alarm,-but an 
epidemic, which as its name implies, leaps upon the people almost 
instantaneously, carries terror to every bosom. And not till then, will 
people appreciate their danger and attempt to avert it by prompt and 
efficient sanatory measures;-although the measures which would 
prevent the ordinary sickness, are precisely the ones best calculated to 
prevent epidemics and disarm them of their fatality. 
INHERENT CAUSES OF DISEASE. 
Almost every individual has some inherent weakness or tendency to 
certain diseases ; such are hereditary taint, as in scrofula,-an unequal- 
mingling of temperaments,-a warn of balance between certain systems 
of organs,-malformation of certain parts,-precocious development of 
some part, as of the brain,-peculiar susceptibilities to external impres- 
sions,-inordinate appetites, or undue development of certain faculties. 
Such persons are more easily affected by particular external causes, 
which destroy the balance of health, and produce actual disease. Tn 
one climate certain persons are most liable to lung diseases, and in 
another to fevers, &c. In epidemic times certain persons are almost 
sure victims, while others enjoy better health than usual: some families 
constantly suffer from one class of maladies, while others escape them 
and suffer from entirely a different class; although no appreciable 
difference in constitution can be discovered. 7 
These inherent tendencies to disease, are too generally overlooked: 
We are too much disposed to look for its causes in the external world, 
and to endeavor to fix them on some blameless inanimate thing ; while 
the real germs of our disease are constantly circulating with our own 
blood through all our lives. Peculiarity of constitution, is no more to 
be overlooked in times of epedemics, than the rankest nuisance or most 
poisonous malaria. 
THE ATMOSPHERE. 
The atmosphere of our city, is damp and cool for a large portion of 
the year, in consequence of the solid and retentive character of the sub- 
soil : Water remains a long time in spring, and after rains, so that 
evaporation continues for a long time also, and keeps the air loaded 
with watery vapor. The cold at night condenses this vapor, and we 
often suffer from dense fogs. The evaporation also from the river, 
canals, feeders and races, together with the spray from the dams, " mill- 
tails," and the Genesee Falls, are sufficient, even in dry, warm w'eather, 
to render the air in certain localities too wet. In the vicinity north and 
east of the Falls, have often prevailed severe epedemics of dysentery 
and diarrhea, and many occasional cases of rheumatism. 
In addition to the vapors suspended in the air, are at all times various 
gases from the gas works, different manufactories, combustion of fires, 
respiration of men and animals, and also dust and smoke. These 
causes of impure air exist in all other cities as well as our own, and 
always tend to render the air of towns unhealthy. The air of towns is 
constantly warmer than that of the country, and is consequently more 
rarified, and less rich in oxygen, which is the vital element. The best 
protection against the injurious effects of such an atmosphere, is fre- 
quent bathing in cool water, the use of woolen flannel next the skin, 
and avoidance of night exposure. 
THE SOIL, 
In Rochester and its vicinity, is mostly loamy, underlaid by lime rock, 
clay-slate and soft clay. Hundreds of acres are overflowed by the Gen- 
esee during high water, and remain wet for some'weeks. The floods 
deposit mud and decaying organic matters along the shores, which, as 8 
the waters recede, ferment and become covered with green vegetables 
in the form of microscopic plants ; these, in their turn, die out and 
decay, exhaling a miasm, which is a sure guarantee for fever and 
ague to all who are long exposed to its influence. 
THE CANALS, 
For a large part of the way through the city, lie above the surface of 
the ground, so as to prevent thorough drainage,-and even to render 
some lots constantly too wet, which are well supplied with drains or 
sewers. In some places small ponds of canal water remain through the 
entire summer, and become stagnant and covered with a green film of 
organic filth, and exhale the most poisonous species of miasm, The 
influence of these pools is too apparent in the large number of fevers 
and agues in their vicinity. The wet, decaying timber, old boats, chips, 
Ac., about boat-yards, are also great nuisances, and might be abated. 
WATER. 
From the "eolomcal character of our soil, a chemist would infer the 
existence of very impure water in it: and we doubt whether the 
opposers of the " Water Works " will question this conclusion. Both 
the river and well-water are " hard," and unfit for washing, bathing, 
cooking or drinking. An analysis by Prof. Silliman, of one of our 
average wells, shows 1^- per cent, of solid matters, which are mostly 
lime, clay, sulphur and floating organic particles, washed from the sur- 
face of the ground. 
The limy crust adhering to the inside of tea-kettles, gives some idea 
of the impurity of our well-water# Boiling or filtering, however, do not 
purify this water ; boiling precipitates a part of the lime, and filtering 
removes only the loose particles of earthy or vegetable matters. The 
lime, which constitutes its hardness, is chemically combined, and is in- 
separable by any available means. This water, from its acid and caustic 
properties, is a constant cause of disease with those who use it for cook- 
ing and drinking. Diseases of the mucous membranes, such as gravel 
and other diseases of the bladder and kidneys, catarrhs, bowel com- 
plaints, bronchitis, &c., are sure to result sooner or later from the use of 9 
our water, unless means are constantly used to counteract them. The 
earthy matters which we drink with the water are not digestible, or 
capable of being assimilated, only to a very limited extent, or combined 
with the elements of the blood. They are precipitated, or deposited, 
in the bladder from the urine, and also about the joints, causing 
rheumatic affections, &c. Many other ailments from which we suffer, 
without knowing their nature or cause, have their origin in hard water, 
and disappear speedily when we adopt the use of pure, soft water. 
Snow or ice water, or pure filtered rain water are the most pleasant 
and wholesome. Abundance of soft, fresh water can be always had by 
a good cistern and filter. These are the best, and only water works 
necessary. 
DAMAGED PROVISIONS. 
Although we have a law which prohibits the sale of tainted and un- 
wholesome meats, &c., still, it is a practical nullity ; for various articles- 
of food are daily sold in warm weather, which are entirely unfit to her 
eaten. Meats which are stale, tainted or spoiled, are sold to poor per- 
sons, and especially to foreigners, who are induced to buy them at re- 
duced prices : these persons often suffer from diarrhea, fever, and even 
cholera, in consequence of eating such meats. Spoiled fish, poultry, 
oysters and other shell-fish are sold in the same way; spoiled eggs, 
tainted, or " ammoniacal" cheese, adulterated milk, tainted hams and 
salt fish,-in many cases alive with maggots,-rancid lard and butter, 
mouldy bread, decayed vegetables, adulterated coffee and tea, vinegar 
compounded from sulphuric acid and other drugs, are all sold daily by 
men of sufficient intelligence to know the consequences. Such a traffic 
involves disgraceful penuriousness and serious danger. 
All animal or vegetable matter in a state of putrifactive fermenta- 
tion or decay, contain more or less poisonous matters, which are al- 
ways generated by the process. That such matters are capable of pro- 
ducing serious disease, and sometimes death, no physician will deny. 
The poor, whose necessities compel them to live in the cheapest man- 
ner possible, but who are also most liable to sickness, and least able to 
bear it,-these are the very persons exposed to such gross abuse. 
If it be admitted that such articles of food may cause disease, then 10 
it is clear that life and health are periled or sacrificed, and pauperism 
and taxation increased, by the unscrupulous avarice of a few men, who 
hold it as a principle to sell whatever they buy. 
TOBACCO. 
Without entering into detail of the nature and effects of this poison- 
ous drug, we shall at once give our verdict against its use in all forms. 
It ought to be sufficient to say, that tobacco is a virulent poison, and 
most pernicious to health ; it is not even a safe or useful medicine, in 
any form of disease. A mere enumeration of the diseases which are 
caused by the use of tobacco, will give some idea of its poisonous pro- 
perties. 
From smoking and chewing, often result dyspepsia, dizziness, apo- 
plexy, nervousness, debility, ulcers of the mouth, sore throat, cough, 
bilious diseases, constipation, diarrhea, piles, partial blindness and 
deafness, loss of memory, disease of the heart, insanity, hypochondria, 
and sometimes consumption. From snuffing, arise catarrhs, headaches, 
partial loss of voice, dizziness, fainting, polypus of the nose, &c. In 
addition to all this, tobacco renders the breath fetid, the face pale, the 
teeth yellow, the eyes dull, the mind cloudy, and its devotees, if invet- 
erate, disgusting and offensive. The cost of using tobacco is, by no 
means, an insignificant item in the expenses of those who use it,-but 
any allusion to this is at once repelled as an offence. 
And now, although the use of tobacco cannot reasonably be made a 
subject of legislation, nor made amenable to sanitory laws, still, the in- 
sufferable nuisance of smoking in the streets, with such persistent im- 
pudence as our smokers do, might be effectually abated. In the city 
of Boston, whoever smokes in the streets or other public places, does so 
at his peril. And if our Common Council would veto street smoking, 
they would confer a public blessing and receive the infinite thanks of 
all who regard decency and the rights of others. 
INTEMPERANCE. 
To discuss this subject at length, would be labor thrown away. The 
evils that result from intemperance in the form of disease, crime, pau- 11 
perisin, taxation, &c., are now too well known to all. The nature of 
the various liquors used to produce intoxication, however, may not be 
so generally known. Liquors of any kind are seldom found pure in 
this country; but most of them are base adulterations, and " vil* inous 
compounds" of poisonous drugs. Most liquors sold at retail have their 
stimulant quality increased by the addition of cayenne pepper or mus- 
tard seed,-the intoxicating quality is often increased by the addition 
of mix vomica, or " dog button," coculus indicus, or " poison fish bait," 
poison hemlock, &c. The astringent property of wines is increased by 
alum, logwood, sugar of lead, litharge, kino and white vitriol. Sour 
wines are manufactured over, and sweetened with sugar of lead, alka- 
lies, molasses, &c. Ale and beer often contain aloes, quassia, coculus 
indicus, soft soap, and water from, barn yards. Besides these poison- 
ous additions, water constitutes a large portion of all cheap liquors; 
and in fact, few of them are supposed to contain more than one gallon 
in five or ten of the pure original liquor; so that the drinker not only 
gets large quantities of drugs, which must always ultimately produce 
disease, and often death, but he is cheated of the pure spirit, and its 
desired pleasing, intoxicating and exhilerating effects. The remedy for 
many of the evils arising from this source, would be the " Maine Law," 
enforced in all its details. 
LICENTIOUSNESS. 
This may appear a strange subject to mention in a paper like this; 
but the vast amount of fearful disease resulting from it, renders it 
worthy of notice and investigation in all sanitory accounts,-it may 
not, however, be to any great extent, approachable by sanitory or hy- 
gienic measures. But the subject (out of the hospitals) requires to be 
approached with exceeding delicacy; it cannot be discussed in the 
public journals,-they would be unfit for our families ; it must not be 
talked, of in the pulpit, except in an unintelligible and ambiguous man- 
ner ; it may not enter into the dirty waters of politics,-it will not be 
made a subject of police action,-it cannot be discussed before our 
children,-no man will peril his safety and reputation by becoming a 
champion of " moral reform." The haunts of immorality are secluded, 
and are shunned by the virtuous and respectable ; hence, the evil is 12 
left undisturbed, to spread like a contagion, to taint the moral atmos- 
phere, and destroy the bodies of its victims. What the best remedy 
for this scourge is, wiser heads have failed to discover. 
IDLENESS, 
Is no insignificant agent in causing disease. Persons who stand 
idly about the streets, contract colds, fevers, pleurisies and other lung 
diseases. Those who lounge about beer cellars and other drinking pla- 
ces, are often engaged in scuffles, fights, assaults and batteries, and suf- 
fer from broken limbs or heads, and often more serious injuries. Those 
persons are generally objects of public charity as soon as they are dis- 
abled. A more efficient police would prevent much of this evil. 
DOMESTIC ANIMALS, 
Kept and fed about dwellings are unwholesome. They exhale nau- 
seous odors from their bodies, deposit their excrements, and exhaust 
the oxygen of the atmosphere, in respiration. Dead animals, which 
are often allowed to remain about dwellings, are sickening nuisances, 
and ought always to be buried, with lime and copperas thrown over 
them. In this way animal matters are turned to account as fertilizers 
of the soil, and nuisances avoided. 
CEMETERIES, 
Should never be tolerated within the precints of a town ; besides the 
unsightly exposure of graves, gaseous exhalations arise from them in 
consequence of decomposition, and taint the air with the worst of 
miasms. But as Rochester is free from this evil, and moreover possesses 
one of the finest cemeteries in the world, we need not enlarge on this 
point. Mount Hope redeems us most nobly, from the imputation of 
neglect or parsimony. 
SLAUGHTER HOUSES, 
Create extensive nuisances, and ought never to be allowed within city 
limits,-nor in any locality destitute of abundance of water. In the 13 
I 
city of Paris, the "abbatoirs" or butcheries, are all in the suburbs, 
and are under the strict surveilliance of the police : they are built with 
reference to cleanliness and ventilation ; are supplied with means of 
catching all the blood of animals slaughtered,-they are furnished with 
a supply of water and disinfecting agents. 
THE CENTRE MARKET, 
Although usually kept sufficiently clean inside, is still the cause, at 
times, of a pestiferous and disgraceful nuisance. During the warmer 
months, it needs but slight observation to discover that there is " rot- 
tenness in Denmark." In the rear of the market may be seen various 
kinds of meat, bones and offal, which have been thrown into the river, 
where they lie and putrify, if the water is too low to wash them away. 
May not the miasm arising from this cause, together with the foggy 
atmosphere at night, have some agency in causing fevers, agues and 
cholera ? 
Opposite the market, on the east bank of the river, are several tan- 
neries and sheepskin factories, from which are thrown various animal 
matters into the river,-when the water is low, however, as it nearly 
always is in summer, these matters remain and putrify, exhaling an 
intolerable stench,-as all the inhabitants of the bridge can testify. 
This nuisance is often so offensive as to oblige merchants on the bridge 
to keep closed windows, and suffer much injury to their trade. 
Besides this, there are numerous soap and candle factories, glue 
factories, breweries, and one or two distilleries, in the city, which exhale 
miasm enough to spoil the air for respiration. The large number of 
hogs which are confined in wet filthy pens at the distilleries are a 
nuisance of the grossest kind to the whole neighborhood. 
Nuisances scattered about streets which are generally dry, might 
much better be left, than to be gathered up and deposited in large piles 
to ferment and decay. Such matters as well as street mud, are usually 
deposited on vacant lots, for the purpose of leveling them up. A damp, 
noxious atmosphere arises from these places, and seldom fails to gene- 
rate disease in their vicinity. If we must have a given quantity of 
filth, let it be as attenuated as possible, that it may become dry or be 14 
washed away by rains without fermentation. Where large quantities 
of such matters are deposited together, measures ought to be employed* 
to prevent their fermentation, and arrest all exhaled gases. A few 
bushels of plaster, lime or tan-bark, or a few pounds of copperas, would 
effectually accomplish this end. 
NOSTRUMS. 
Dr. Armstrong, in the report to the Board of Health, of this city, 
for 1852, says, ''a respectable physician, extensively engaged in the 
practic of medicine in this city, and in nowise connected with the Board 
of Health, gave it as his opinion that half the cases of cholera which 
have occurred here, can be traced to the indiscriminate use of quack 
medicines, or nostrums,-represented as certain cures or preventives, 
by venders ; and in this opinion we are disposed to acquiesce, in part, 
at least." 
There are numerous objections to this class of medicines : 1, they are 
usually prepared by incompetent men, who never studied medicine: 
2, they are made of impure drugs, and in a cheap way: 3, they are 
directed to be taken daily for a long time together,-and this practice 
will nearly always produce disease: 4, it is absurd to suppose one 
medicine can cure all diseases, or that any medicine is always a specific 
in any disease: 5, what will cure disease in one constitution, will pro- 
duce it in another; 6, any useful nostrum soon comes to be counter- 
feited, and is unsafe: 7, their composition is usually unknown, so that 
patients do not know what they take; and finally, this practice of tak- 
ing patent medicines, begets a preference and taste for self-made doctors, 
and irresponsible doctring, which is both foolish and dangerous. 
Physicians ought to send all prescriptions to druggists, where there 
are those who are well qualified to put them up. They would then 
secure preparations of more uniform strength, and avoid mistakes from 
extempore mixtures. Every person who is entrusted with physicians' 
prescriptions, should be well acquainted with chemistry, pharmacy and 
the Latin language; and, moreover, they should be careful, and of 
mature age,-none others should be trusted. Those, too, who deal in 
patent medicines, are constantly in the habit of undertaking to pre- 
scribe for patients; this is quackery, and is unjust to physicians and 
dangerous to patients. 15 
As a general rule, those druggists are to be preferred, who sell no 
nostrums, and never attempt to prescribe. All medicines which could 
produce poisonous effects, should be marked " poison," and also with 
their common name; written directions should accompany all prescrip- 
tions : each one should be numbered, and the name and residence of 
the patient, and person to whom the prescription was delivered, should 
be registered by the druggist; his name ought also to accompany each 
prescription. 
SEWERAGE. 
From Mr. Bruff's report to the Board of Health, it appears that be- 
tween eight and nine miles of sewerage are in operation in this city; 
and this, he thinks, is but a fraction of what our wet soil requires. 
These sewers are nearly all imperfect, according to the same report. 
Mr. Bruff remarks,-" The most serious evil in relation to the sewers of 
Rochester, is the great deficiency in the outlets ; there is not a single 
sewer, with one or two exceptions, that has a good outlet,-one of 
sufficient size and depth." He recommends the " brick or barrel 
sewers," as being the best and cheapest of all forms; they being the 
least liable to fall in or become obstructed ; in such cases, no sewer at 
all would be preferrable to an obstructed one. The old decaying 
matters in sewers are often direct causes of disease ; " the proper con- 
struction of sewers involves the question of sickness or health, life or 
death." 
But sewers are by no means sufficient to produce thorough drainage; 
every cellar, yard, garden,- and in short, every foot of soil should be 
drained as soon as possible in the spring, and after heavy rains. For 
this purpose blind drains, open ditches, stone drains, tile and pipe, and 
other forms may be used according to circumstances. The inquiry may 
arise as to the amount of drains necessary, &c. This depends entirely 
on the locality; sufficient should be made to drain the soil quickly and 
thoroughly. 
PRIVY VAULTS, 
Are objectionable in a locality like ours, where the soil lies on a sub- 
stratum of rock. The wells and vaults are often of the same depth,- 16 
both having the rock for a bottom ; in such cases the two maybe near 
together, or communicate by seams in the rock, or by precolation of fluids 
through the soil, and in this way the well become so impure as to both 
taste and smell offensively. It is better never to construct privies with 
vaults at all: the best method is to build them entirely above ground, 
with a box to contain the " night soil"-into this should be thrown, 
occasionally, lime and copperas, to prevent offensive changes, till the 
box requires to be emptied and replaced,-which may be two or three 
times a year. The matters thus removed are valuable fertilizers. 
EPIDEMICS AND CONTAGIONS. 
FEVERS. 
This class of diseases prevails mostly during the warmer months of 
the year, when the decomposition of animal and vegetable matters are 
going on most actively. The exhalation of different gaseous miasms, 
and the generation of organized, microscopic atoms, either animal or 
vegetable, are the principal causes of all primary fevers. Some fevers, 
as typhus, typhoid, and ship fever, (which is a bilious typhus,) are 
contagious,-the latter is highly so. Fevers are dependant upon local 
as well as general causes,-such as filth, stagnant water, damp dwell- 
ings, impure air of close rooms, cellars containing decaying vegetables, 
&c. When they depend upon general causes, they may prevail as 
epidemics, as in the case of the fatal epidemic of yellow fever during the 
past year: or they may depend on local causes, and prevail as endemics 
in small districts only. The medical profession are not agreed as to 
the contagiousness of yellow' fever. Bilious fevers and agues, are caused 
most commonly by exposure to cold, damp air, which is loaded with 
miasms from decaying vegetation. Typhus by confinement in ships, 
prisons, &c., where too much carbonic acid gas, and too little oxygen 
exist,-also by the stench arising from putrifying animal matters, as in 
dissecting rooms,-£'om poor diet, tainted meats, blighted or " smutty " 
grains, and other causes which produce great nervous depression or 
impure blood. 17 
The miasm arising from the decay of vegetable matters is more likely 
to produce sickness than that from animal. The bilious fevers and 
agues which prevail in our new Western States, are the result of mala- 
ria originated by the decay of vegetable matters in wet localities: 
when the swamps and marshes are drained, and become arable lands, 
the fevers disappear. Where fevers prevail extensively, consumptive 
affections are rare,-but where the fevers became more rare, lung dis- 
eases replace them. 
The best preventives of fevers are, pure, dry air, bathing, cleanliness, 
good diet, regular digestion, avoidance of night exposure and excessive 
heat. The ordinary summer drinks, such as ices, lemonades, small 
beer, &c., are unwholsome and should be avoided. 
CHOLERA. 
This terrible scourge of all countries, usually makes its appearance 
in summer; but sometimes at all other seasons. Two years ago it 
prevailed in Russia, as an epidemic, in winter, and during the past 
winter it has visited with fatal effects, some towns in England; during 
the spring, and probably at the present time, it is prevailing in the 
hospitals of Paris. 
Cholera is not generally believed to be contagious,-it is clearly not 
contagious. Whenever it has prevailed in a district or neighborhood 
in such manner as to appear to be propagated by contagion, all cases 
could doubtless be traced to some local cause operating on the people 
at the same time and in the same way. The weakest, or most suscep- 
tible, being attacked first, and so on, in succession. Genuine cholera 
has sometimes been caused by filth, intemperance, crude unwholesome 
food, impure air, night exposure, excessive purging by nostrums, fresh 
excavations of earth, panic, and several other causes. But when it 
prevails extensively as an epidemic, there seems to be some unknown 
cause, which operates imperceptibly on all constitutions, predisposing 
them to its attacks,-which usually follow some exciting local cause. 
This general and unknown cause may be dependant on the atmosphere, 
electrical conditions, microscopic organic matters floating in the air,-or 
some other with which we have never become acquainted. 
Bait if we cannot always trace it to its cause, enough is known to 18 
enable us, with proper sanatory measures, to avert its progress to a 
great extent, and lessen, by a large per centage, its mortality. 
The best preventives are perfect cleanliness, dry, pure air, a diet of 
bread, meat and milk,-but without too much change from the usual 
course,-avoidance of all sudden changes of temperature and night ex- 
posure, entire freedom from excitement or fear, regularity of the bowels, 
bathing, temperance, occupation of both mind and body. The obser- 
vance of these precautions, however, avail little to single families or 
neighborhoods, if the remainder of the people disregard them. 
One of the most important means of prevention is to suppress all 
reports of cases through the public journals, as is now done in Paris. 
All persons requiring reform, should be compelled to make it without 
delay; all nuisances, from a quid of tobacco or a " dirty shirt," to a 
goose pond, or an obstructed sewer, should be at once effectually 
abated,-the poor should be furnished with food, fuel, work, and all 
other necessaries of life. Physicians should be employed, and paid, to 
give prompt attention to all real or suspected cases,-the use of cholera 
medicines and nostrums should be discouraged, and the community, 
as far as possible, inspired with confidence in the preventive measures 
employed. Cholera may prevail anywhere, at any season, among all 
classes, and despite of all hygienic measures ; but, until all such mea- 
sures are tried and exhausted, we Should never despair, or regard its 
visitations as unavoidable dispensations of Providence. 
SMALL POX. 
This loathsome disease is highly contagious, and is not known to 
originate in any other cause. It is usually caused by contact, or by 
inhaling the effluvia from the bodies of those affected with it; it may 
also be communicated by clothing or other articles which have been 
about the patients,-and doubtless by beds, towels, brushes, &c., about 
public places, and in some cases by handling money which has passed 
through their hands. In such cases the medium through which it is 
communicated contains some of the virus which has not lost its power 
to propagate the contagion,-the quantity, however, must be exceed- 
ingly minute. 
The preventive of this disease is vaccination : this should be done in 19 
early childhood and repeated once in ten or twelve years, through life, 
as it loses its efficacy after a longer or shorter lapse of time. Vario- 
loid, which is modified small pox, or the same disease in a milder form, 
is often taken, and small pox itself occasionally, by those who have 
once been effectually vaccinated. When this contagion appears, the 
persons affected should be at once removed, or completely insolated 
from all others, except the necessary attendants,-the rooms which they 
occupy kept clean and well aired, and purified by the " disinfecting 
lamp." All clothing used about the patient should be destroyed, or 
washed, fumigated and aired for several days. All persons not recently 
vaccinated, should be re-vaccinated. When the small pox prevailed so 
extensively in Rochester six years ago, about sixty deaths occurred from 
it, and nearly all among adults, who had, so far as could be ascertained, 
been vaccinated many years previous. This fact establishes beyond 
question, the necessity of re-vaccination. 
ITCH, 
Is a contagious skin disease, which usually prevails among children, 
and is propagated mostly at schools. It is exceedingly disagreeable, 
but not dangerous,-it is justly considered disreputable to have it,-and 
persons who send their children to school with itch, are highly repre- 
hensible. 
WHOOPING COUGH, 
Is a contagion which prevails among children, and is not without 
danger. It is often propagated in schools, with the knowledge of both 
parents and teachers. 
MEASLES AND SCARLET FEVER, 
Are also contagions which prevail mostly among children, and should 
never be progagated if possible to avoid it. Chicken Pox belongs to 
the same category. These minor contagions have been noticed for 
the purpose of calling attention to the fact of their being spread in 
schools; this should be prohibited. 20 
DYSENTERY AND DIARRHEA, 
Are epidemics which usually prevail in the warm months, and are 
sometimes very intractible and fatal. They sometimes assume an ap- 
parently contagious form. They are caused by exposure to cold, damp 
air, excessive heat, crude, unwholesome food, fruits and green vegeta- 
bles, and improper use of medicines. The same hygienic measures 
used to prevent cholera, should be adopted to prevent these diseases. 
We may briefly notice the effects of certain occupations on health. 
Shoemaking and sewing are apt to produce dyspepsia, spinal affections, 
consumption and gravel. Operators in cotton mills are subject to 
coughs, catarrhs and dyspepsia. Persons engaged in flouring mills and 
morrocco factories, are often affected with skin diseases. Millwrights 
and founders suffer from rheumatism : workers in lead and brass, from 
bowel complaints. 
PREVENTION OF DISEASE, REFORM &c. 
QUARANTINES, 
Should be established in all towns in times of epidemics : all vessels, 
boats, cars, and other public conveyances, should be examined outside 
the town limits, and all sick persons be detained or removed to hospit- 
als, if their disease prove to be contagious or epidemic in its character. 
There is no reason why persons should be allowed to enter any town 
and spread disease, alarm and panic,-their sickness is a misfortune 
rather than a fault; but the public have a right to protect themselves, 
without being liable to the charge of inhospitality. Many cases have 
occurred, in which canal boats have left in our city persons sick or 
dying from cholera, small pox, or ship fever; for although quarantine 
regulations exist, they are often thought to be unjust, and are evaded 
or disregarded. 
Quarantines offer an impediment to commercial affairs,-but still, as 
economy of human life is the important end, they are just and wise ; 
they may have been sometimes enforced with unnecessary rigor, in 
consequence of popular panic in times of great sickness. Quarantines 21 
were first adopted by the Venetians: in some eastern countries, at the 
present day, solitary foot travelers are obliged, at large towns, to sub- 
mit to from four to twenty days quarantine. 
DISINFECTING AGENTS. 
The public ha^e, heretofore, seemed to suppose that all epidemics 
depended on some miasm or gas, generated from filth; and they sup- 
posed lime was the only agent necessary to destroy this miasm. Acting 
upon this supposition, lime is almost the sole agent employed, and is 
held responsible for all that can be done by all chemical agents com- 
bined ; and whatever lime fails to accomplish, is considered impossible ; 
whatever diseases prevail after the use of lime, are submitted to as a 
divine scourge, which no human power can avert. 
But how has lime been used in our city, as a purifying agent ? A 
few loads have been scattered about the principle streets, which are 
usually dry and mostly free from filth, and therefore needed no lime. 
This has been repeated two or three times in a season, while most of 
the smaller streets and alleys, as well as the innumerable small local 
hot-beds of filth, were to a great extent neglected. But, if we admit 
lime has been used to the utmost extent that could be deemed necessa- 
ry, it is in most cases, insufficient for the accomplishment of the desired 
end. There are several different gases which arise from decomposition 
of organic matters, some of which cannot be destroyed by lime. Each 
gas which arises must be chemically combined with some substance, 
which will form with it an insoluble compound, or one that is not 
volatile : this, in common language, is destroying a gas. The various 
gases are generated from different substances. Carbonic acid gas, is 
generated largely in breweries and distilleries, and also by combustion 
and the respiration of plants and animals. Carburetted hydrogen, is 
evolved where vegetable matters are in an advanced state of decay, as 
in stagnant pools, beds of muck, &c. Ammonia, is given off by 
manure heaps, privies and stables. Sulphuretted hydrogen, arises from 
privies, decaying animal bodies, gas works and sulphur waters. 
For the destruction of these gases, which are all pernicious to health, 
several different agents are necessary. For carbonic acid, one of the 
best is charcoal: this does not destroy, but absorbs and retains the gas : 22 
sulphate of zinc, acetate of lead, and chloride of lime, are also effectual. 
For carburetted hydrogen, copperas and common ground plaster are best. 
For ammonia, copperas, dilute nitric or sulphuric acid and plaster, suffice. 
For sulphuretted hydrogen, quick lime, white vitriol, chlorides of lime 
and zinc, are the best. Most of these salts are to be pulverized and 
scattered over the places where the gases rise. The operation, to be of 
much avail, should be repeated every few days, a^ new portions of 
matter enter into chemical change, and more gases are generated. 
Carbonic oxide is a gas which arises from coal fires along with carbonic 
acid, and is unfit for respiration: it can be driven away only by free 
ventilation and strong draft of the stoVe or grate where it arises. 
The conditions necessary to putrefaction of organic bodies, are, 
warmth, moisture and air. Cold, then, effectually prevents fermenta- 
tion and putrefaction : perfect dryness, although heat be present, pre- 
vents putrefaction. Antiseptics are a class of substances which prevent 
putrefaction, and used to preserve organic substances and destroy noxious 
odors. Decay may be prevented in dead bodies when desirable, 
by enveloping them in cloths or straw, wet w ith alcohol, or a solution 
of alum, chloride of zinc, or chloric ether. Smoked hams are preserved 
by the creosote or " oil of smoke," with which they are saturated. 
We may briefly notice the practical application of some of the other 
chemical agents enumerated. The best mode of purifying privies and 
sinks, is to sprinkle them thoroughly with solution of copperas,-a 
pound to one pail of water will suffice. Quick lime prevents animal 
and vegetable decay, where there are not too much heat and moisture. 
Common plaster (gypsum) is the only agent necessary to apply to 
stables, manure heaps and cellars; it is1 applicable also in nearly all 
filthy places. In rooms where dead bodies are lying, or in which there 
are sick persons whose bodies emit nauseous odors, a saucer of chloride 
of lime may be used; the fumes of burning coffee or sugar, are also 
used ; the floor may be sprinkled with vinegar or dilute oil of vitriol. 
But by far the best and most convenient disinfectant for sick rooms, 
dissecting rooms, cellars, &c., is chloric ether. A common fluid lamp 
is filled with it and lighted, and kept burning: whatever effluvia may 
taint the atmosphere is at once effectually destroyed, while the atmos- 
phere is not rendered unfit for respiration. The "Disinfecting Lamp" 
is all that can be desired in most cases. 23 
In cleaning the streets, &c., all wet places, such as " goose ponds," 
"frog ponds" and "hog holes," should be drained off, dried up and 
sprinkled with lime. Masses of fermenting or putrefying matters wrhich 
cannot be effectually destroyed by some application, should be entirely 
removed, and the place purified as we have indicated. Cisterns which 
exhale a putrid stench, may be cleansed by opening them, so as to 
admit air freely, and throwing into them pulverized alum or charcoal: 
half a bushel of charcoal, or one pound of alum, will purify a large 
cistern of water. A dish of water placed on a stove, tends to destroy 
coal gases, and render the air more fit for respiration. 
HOUSE INSPECTORS. 
It is well known that many of the tenements occupied by the poor, 
are totally unfit for the abodes of human beings. And yet there is no 
remedy ; the owners of such houses are the last to repair and render 
them comfortable, and the first to distress the poor tenants for their 
rents. In view of these facts, we should have men appointed, whose 
duty it should be to examine every tenant-house in detail, and report 
its condition to the proper authorities ; and whenever a house was 
found untenantable, it should be marked, and the owner be obliged to 
forfeit his rents, until such house or tenement should be properly 
repaired and certified to by the inspector. 
All houses badly located, or having leaky roofs, wet cellars, naked 
stone or brick walls, no means of ventilation, smoky chimneys, insuffi- 
cient light, no drains, no privies, wells or cisterns,-are unfit to be 
rented or occupied-, and all cases of sickness and death resulting from 
such causes, are justly chargeable to the owners of such tenements ; 
they are morally responsible, and should be so held in law. 
Hundreds of families in our city, and in many other cities, constantly 
live, work, eat and sleep in small, damp, dark, smoky cellars, with 
mouldy, dripping walls, and their noses on a level with the street gut- 
ters, which exhale a stench sufficient to sicken any person not " accli- 
mated." These places are often crowded to excess, having two or three 
times the number of persons they ought to accommodate. In addition 
to this, many families keep, in or near their apartments, pig-sties, dog- 
kennels, hen roosts, &c., which send abroad their odoriferous fumes, to 24 
the unspeakable annoyance of their neighbors. Persons who indulge 
this morbid affection for brutes, at the expense of their children's life 
and health, are little in advance of barbarians. Many of these people, 
moreover, are disgustingly filthy in their persons, clothing, beds, cook- 
ery, and every habit and thing pertaining to them. Much of their 
sickness, and consequently much taxation, may be traced to these causes. 
The remedy, would be found in efficient house inspectors; among all 
the other " inspectors," some of whom do their duty, and some of 
whom do nothing,-let us have house inspectors in each ward, whose 
visits shall be made periodically through the whole year. 
MEDICAL HEALTH OFFICERS. 
In all times of epidemics, a portion of the health officers should be 
medical men; they could, in making their visits, detect cases of 
epidemic or contagious disease, which might escape the notice of ordi- 
nary observers. They would be more efficient in detecting the real 
causes of disease, and in advising proper corrective measures. The 
public would also repose in them, a degree of confidence, which would 
give to their action more authority and efficiency. These officers 
might, in many cases, be these who served as public physicians, which 
would be a matter of convenience and economy. 
MEDICAL CORONERS. 
The office of coroner, has never been properly administered in our 
State. Coroners should always be medical men. The arguments in 
favor of this proposition, we have only time and space to notice briefly. 
Firstly, it would save a large part of the expenses attending inquests in 
some cases. Secondly, it would prevent the calling of many inquests, 
now held unnecessarily ; and thereby spare many families the annoy- 
ance and excitement 'which they usually cause. Thirdly, it would pre- 
vent the contemptible political bargaining, between coroners and their 
" procurers " and physicians. It is too well known to need proof, that 
in our own city, coroners and their favorite physicians, play into each 
other's hands in obtaining inquests, the fees of which are divided by 
stipulation. Fourthly, medical coroners, in cases where inquests were 25 
necessary, would be better qualified to bring out facts, and place them 
in their proper light. This would sometimes prevent painful suspicions, 
exhumation of bodies, and criminal prosecutions ; it would also give a 
degree of authority to inquests, which do not attach to them at present. 
In England, France and Germany, coroners are always medical men; 
in some of our own cities, as Boston and New Orleans, this is also the 
case. If the office of coroner were made a salary office, instead 
of a fee office, no inducement could be presented for holding unneces- 
sary inquests, and the duties would be equally as well performed ; 
their average cost would be much less than at present. 
INSPECTOR OF MARKETS, &c. 
Every town ought to have one or more officers, whose duty it should 
be to visit, periodically, every meat and fish market, grocery, flour store, 
bakery, confectionery, and all places where liquors are sold, and to 
report all cases in which spoiled provisions, decayed vegetables, poison- 
ous confectionery, drugged liquors, or sickly animals, or those too young, 
designed for food, and offered for sale alive. The exposure and publi- 
cation of such sales, with the offender's name, would perhaps be the 
only means necessary to prevent their repetition. An inspector of this 
kind might be one of the public physicians, or some other medical man. 
PUBLIC BATHS AND WASH HOUSES. 
The idea of establishing such institutions in our city, may appear to 
those who have never investigated the subject, as quite visionary. But 
statistics from other cities where they are established, show conclusively, 
that they are both beneficial to the poor and profitable to the stock- 
holders. Their object, of course, is to furnish to the indigent, the 
means of preserving cleanliness and health, or of pursuing a livelihood, 
at a cost entirely within their means. Neatness is always favorable to 
good morals, and is an indispensable element in the reformation and 
amelioration of the condition of the poor and the immoral. 
The principal reason why the poor do not bathe their persons and 
wash their clothing, is usually a want of the necessary conveniences,- 
viz : fire, water, soap, and convenient places. These are as needful as 26 
their food, and all public charities ought to dispense to them the one 
as well as the other. But this is no more a matter of individual 
necessity than of public interest; hundreds of women in all cities 
make washing and ironing their business ; and they must have the 
means to carry on this business,-without them, they remain idle, or 
resort to vicious courses,-with them, they work cheerfully for an honest 
subsistence. These poor women usually work for those who know little 
of the disadvantages of poverty, and who can endure very little from 
want of punctuality, or from bad work. In most cases, where a poor 
washerwoman has done her utmost, with her scanty means, to serve 
her unsympathizing superiors, she meets no better encouragement than 
poor pay and harsh censure. Here is a large and useful class, mostly 
mothers of dependant families, who have strong claims to substantial 
assistance ; " material aid." 
Wash Houses were established in London, by subscription, in 1844. 
The success of the first experiment proved beyond doubt, the public 
demand for such institutions,-the money invested paid well also. 
Parliament, therefore, passed an act to authorize parishes to raise money 
for their establishment. In one wash house alone, the clothes of 
1,500,000 persons were washed, dried, and ironed, in one year. The 
charge to each woman is three cents per hour ; this includes the use of 
tub, fire, soap, irons, water and starch. All these conveniences are fur* 
nished six days every week; the clothes are dried, with dispatch, by 
hot air from the furnaces which heat the water and irons. 
The writer visited one of these establishments in Paris also, which 
was a model of neatness and convenience ; its tubs and tables were 
■occupied by long files of neat and cheerful women, washing and iron- 
ing in the most business-like manner. 
Wash Houses have recently been established in New York, and the 
enterprise has succeeded beyond all expectation. But why did New 
York wait eight years after London had demonstrated the expediency 
of such houses, before she adopted them ? Will Rochester delay as 
long ? Why not establish one on scientific and business principles this 
year ? It would confer a lasting blessing on the poor ; but their voice 
is feeble, and cannot be heard,-let the wealthy and influential speak 
for them, and they will secure their unfeigned gratitude. 27 
PUBLIC BATHS, 
Have also been established in London, Paris, Brussels, &c., and have 
been equally successful. One bathing house in London gave over one 
million baths in one year. A warm bath, including soap and towels, 
costs twelve cents : and very few persons who once enjoy this luxury, 
will forego it for more than one week. In this luxury, the poor of 
London are blessed beyond the rich in most American cities. Can we 
have public baths ? They would prove profitable, and conduce to health, 
comfort and morality. 
HOSPITALS. 
American cities are not as well supplied with these institutions as 
European. London has 3,192 beds, supported by private charity alone, 
besides many thousands more, sustained at public expense. Paris has 
thirty-six hospitals, public and private, with more than 15,000 charity 
beds. New York, with half the population of Paris, has four public 
hospitals, and, according to Dr. Stewart's report, " only 250 charity 
beds ; and nearly one half of these supported by State Annuity and 
pay patients." Albany has a small hospital,-Boston has two,-New 
Orleans has three,-Cleveland, one,-Buffalo, one,-Chicago, one,- 
Rochester, 0. Perhaps no town with a population of 20,000, in France 
or Germany, is destitute of a good hospital. 
Some of our cities claim more hospitals than are entitled to the name. 
Many of these are private "institutions" and "cures," designed for 
particular diseases, and are beyond the means of the poor. The private 
hospital system is one serious obstacle to the establishment of sufficient 
public hospital accommodations. 
Hospital accommodations in New York, are only one twenty-fourth 
of what they are in Paris. In the latter city, all theatres and public 
places of amusement, pay to the hospital fund, ten per cent, of their 
gross receipts. All pawnbroking is under the charge of hospital agents, 
and the profits go to the same fund. If we had some regulations of 
this kind, we should have ample hospital charities. 
While we have as many Churches and Schools as any city of the 
same population,-a commodious Poor House,-a House of Refuge,-• 
a University,-a Female College,-two Orphan Asylums,-^a Home for 28 
the Friendless,-a comfortable Jail,-and a Work House in progress 
of erection,-and finally, a home for the dead, unsurpassed for beauty 
and convenience-still we have no Hospital; that ensign of enlightened 
civilization and living charity,-and the absence of which, should be 
considered the evidence eternal, of barbarism. 
But it may be said that Rochester has provisions for the sick poor 
in the form of " temporary hospitals; " but these are not usually ready 
for the reception of patients until an epidemic is fairly established, and 
the poor who are sick of cholera, ship fever, or small pox, are literally 
turned into the streets. And these poverty-stricken places, when estab- 
lished, are the merest burlesque on hospitals; institutions,^ e meanness 
and littleness of which ought to shame any citizen freeholder of Roch- 
ester. 
But we are told that the Board of Health, or some body else, was 
authorized to furnish all necessary accommodations, Ac. This may be 
true,-but no body was "authorized" to pay for them. The truth is, 
that in all such cases, officers are unreasonably expected to accomplish 
everything, without the means. They cannot work with their 
bands tied. Let certain men who have money, cease their wise and 
dictatorial blarney, and give money to officers to work with : the w'oik 
will then be done. We have always been stinted in means, and certain 
bills for these public expenses, remain, at this moment, unpaid. We 
intend no attack upon any body, but only to throw' in a plea for the 
sick poor. 
We are proud and happy to say, however, that a hospital is in embryo, 
but it has not advanced beyond the " grub stage? A lot has been 
purchased and fenced,-a subscription opened, and long since laid aside; 
but we hope the project is not abandoned. 
A hospital with 200 beds, and provisional wards for 200 or 300 
more, would be sufficient for all patients who would require admission 
perhaps for many years. If properly constructed, it would be the only 
one necessary for general and surgical diseases, and all contagious or 
epidemic cases. The wards should be so arranged that each class of 
patients could be isolated to any desirable extent, and thus obviate 
the necessity of a " pest house," and prevent the spreading of infectious 
diseases. European hospitals are arranged on this plan. In conclu- 
sion,-a hospital affords the best, cheapest, and most respectable means 
of providing for the sick poor. 29 
MORTUAIRES OR DEAD HOUSES. 
These are established in many European cities, and in times of epi- 
demics, ought to be in all others where they prevail. The great num ■ 
her of premature burials which occurred during the great epidemic of 
cholera, led to their establishment. Not less than forty persons were 
resuscitated in these houses, after having been supposed to be dead : 
some were in their grave clothes, and a few bad actually been put into 
coffins and buried, or deposited in tombs. The object of the Dead 
House is, to afford a place of deposit for bodies for a given time, before 
burial. These bodies ought always to be removed from among the 
living, and kept until evidences of death place the event beyond doubt: 
the practice of hurrying bodies to the grave as soon as apparent death 
occurs, is barbarous and wrong. A Mortuaire should be isolated, and 
furnished w ith all the appliances for resuscitation, and also with one or 
more persons in constant attendance, to watch for any signs of life, and 
apply means to restore it, if such signs were discovered in the body. 
The only infallible evidence of death is putrefaction. When this com- 
mences all hope ceases, and bodies should be buried. But detail is un- 
necessary ; if one life can be thus saved, it will abundantly compensate 
cost. Tombs are justly becoming obsolete. 
A VACCINE INSTITUTION, 
Should exist in every city. A physician should be in attendance daily 
at stated hours, to vaccinate all who require it. All children should be 
vaccinated as soon after birth as practicable: as a general rule, it can- 
not be done too early. At the " Hospital of Foundling Infants," in 
Paris,, children are vaccinated when only one day old. Vaccination 
ought to be done for the poor, free of charge, and they should be com- 
pelled to submit to it. Older persons ought to be re-vaccinated every 
ten or fifteen years, or they are not secure against Varioloid, or even 
Small Pox. A vaccine institution would be a great convenience to 
those who are able to pay, as well as those who are not: it would also 
be the best safeguard against epidemics of that dangerous and loath- 
some contagion, Small Pox. Boston has recently established one,- 
very few European cities are without them. We can and should have 
one also. ' . 30 
MISCELLANEOUS REMARKS. 
There has been just ground of complaint in some cases, in relation 
to the unfaithful performance of duty by health officers, and public 
physicians. The former have in some cases, neglected to search for 
nuisances on the premises, in certain streets, and merely made inquiry 
whether any existed; when informed in the negative, they have quietly 
departed, to leave undisturbed active and serious causes of disease: 
and yet these places were " reported " in good order. We are happy 
to say, that only a few such cases were known. 
When physicians are appointed to attend the sick poor, they are 
supposed to be competent, and expected to give personal attention to 
the duties of the office. But in many cases the business has been en- 
trusted to students, or partially neglected, while the patients' lives 
were periled or sacrificed: the physician in the meantime sat in his 
office and received his regular salary. These cases may be few and 
exceptional, but justice requires that they should be noticed. Some 
palliating circumstances may be mentioned in extenuation : in a few 
cases, persons resisted officers until compelled to comply with the law, in 
removing nuisances, &c. A few of the sick poor also, from pride or 
prejudice, have refused the services of public physicians, and lost their 
lives in consequence. 
Several subjects have been alluded to in this pamphlet, which have 
no special connection with epidemic diseases: the author's design was, 
as far as possible, to make a collection of facts that might be generally 
useful: many more still might be embraced, but they would be incon- 
sistent with the title we have adopted, however interesting they might 
be. The subject of ventilation, bathing, and many others of a kindred 
character, and connected with hygiene, ought to be better understood 
than they are. But books on physiology and hygiene, are plenty and 
cheap, and ought to be in the hands of every family, who would enjoy 
health and happiness. 
Perhaps we cannot suggest any idea in relation to hygienic reform, 
of more practical value, and so easily adopted as the use of pure soft 
water. This luxury and indispensable auxiliary to health, may be 31 
always had in Rochester, at a mere nominal cost, by one of Kedzie^s 
Patent Filters : a scientific, cheap, durable article,-it is highly recom- 
mended by physicians and all others who have used it. No family 
ought to be without one. Mr. Kedzie's manufactory is on Buffalo 
street, and his office No. 5 State street, Rochester, N. Y.