REPORT 
OF THE 
STANDING SANATORY COMMITTEE 
I 
OF THE 
BOARD OF HEALTH 
OF THE CITY OF NEW YORK, 
ON THE SUBJECT OF 
ASIATIC CHOLERA, 
AT PRESENT PREVAILING AT THE 
QUARANTINE ESTABLISHMENT of NEW YORK, 
AT STATEN ISLAND. 
NEW YORK: 
McSpedon & Baker, Pbinters, 25 Pine Street. 
1848. The Sanatory Committee of the Board of Health, deem- 
ing it to be their duty to lay before the public all the in- 
formation in their possession in relation to the cholera, at 
present prevalent at the Quarantine establishment, publish 
the following letter prepared at their request, from Alex- 
ander B. Whiting, M. D., Health Officer of the Port, con- 
taining an account of the introduction, progress und treat- 
ment of the disease. They also republish the communi- 
cation to the citizens of New York, prepared under their 
order, by a committee of their medical advisers. The 
Sanatory Committee are happy to state that only three 
cases of the disease have occurred in the City. They beg 
to assure their fellow citizens that every precautionary 
measure in their power has been adopted in relation to 
purifying the City, and that plans have been matured, 
(should the disease unfortunately assail us,) for meeting it 
with all the professional, and other aid, which may be 
deemed advisable. 
Wm. F. Havemeyer, Mayor. 
R. Hibbard, Chairman. 
Theo. R. De Forest, 
Clarkson Crolius, 
Niel Gray, 
Wm. Adams, 
Morris Franklin. 
Richard L. Morris, M. D., Health Commissioner. 
Seth Geer, M. D., Resident Physician. 
Joseph M. Smith, M. D., 
John B. Beck, M. D., 
Samuel AV. Moore, M. D. 
Medical Counsel. BOARD OF HEALTH. 
Sanatory Committee, 
Mayor's Office, Dec. 9th, 1848. 
At a meeting of the Committee held this day, it was 
i 
Resolved, That Dr. Whiting, Health Officer at Quarantine, 
be requested to report to this Committee, a detailed statement 
of the origin, progress and character of the cholera, as the same 
now exists at the Marine Hospital. 
Signed, Wm. F. Havemeyer, Mayor. 
Timothy R. Hibbard, Chairman. 
Theo. R. De Forest, 
Clarkson Crolius, 
Niel Gray, 
, Wm. Adams, 
Morris Franklin. 
Richard L. Morris, M. D., Health Commissioner. 
Seth Geer, M. D., Resident Physician. 
Joseph M. Smith, M. D., 
John B. Beck, M. D., 
Samuej. W. Moore, M. D., 
Medical Counsel. ORIGIN AND PROGRESS OF THE CHOLERA 
z AT QUARANTINE. 
Quarantine, Staten Island, 
December 11, 1848. 
TIMOTHY R. HIBBARD, 
Chairman Sanatory Com. Board of Health. 
Sir :-In compliance with a resolution of the Committee, 
I submit an outline of the origin, progress, and character of the 
cholera as it has prevailed at Quarantine recently. 
I shall not attempt to account for the origin of the disease, 
except so far as it may be deduced from the history of the cases, 
and all the facts as I have obtained them from Captain Lines, 
the intelligent and gentlemanly master of the ship New York. 
On the second of December, the packet ship New York arri- 
ved at Quarantine with a number of persons sick, having lost 
seven during the last week of her voyage, with a disease that 
has since proved to be Asiatic Cholera. The New York left 
Havre on the the ninth of November, with three hundred and 
thirty-one steerage passengers, twenty-one cabin, and thirty- 
three crew j a total of three hundred and eighty-five. All con- 
tinued well until the twenty-fifth, Saturday, when one of the 6 
steerage passengers, a German, aged twenty-nine, in robust 
health, was attacked with vomiting and purging, accompanied 
by cramps of the muscles of the upper and lower extremities. 
The Captain supposed it to be cholera morbus, and prescribed 
judiciously for the symptoms, but they continued until the third 
day, when death occurred. 
The next case was on the 26th, Sunday, when an old man 
aged sixty-two, in feeble health, was attacked with vomiting 
and purging, with coldness of the whole body, and violent 
cramps and spasms. He died on the second day after the attack. 
Monday and Tuesday, 27th and 28th, two cases occurred. A 
girl aged five years, died in two hours, and a boy also, aged five 
died in four and a half hours after their first attack, both perfectly 
well previously. Wednesday, 28th, a man aged forty, was at- 
tacked at 8 o'clock A. M., and died at 3 P. M., of the same day. 
On Thursday two children sickened and died, after six and eight 
hours illness. 
/ 
The ship came to anchor at Quarantine on Friday night, and 
from that time until Sunday noon, when the passengers were 
landed, twelve new cases occurred. 
The best means of arresting the spread of the disease appeared 
to me to be to remove them from the confinement of the ship, and 
to separate the sick from the well. A steamboat was engaged 
to bring them to the Public Store Docks. The sick were sent 
to an excellent hospital room, and good nursing and medical at- 
tendance immediately provided. 7 
The well have been suitably provided for, and strict attention 
to diet and cleanliness enforced ; their clothing has been thor- 
oughly aired, daily, and the whole enclosure subjected to the 
disinfecting influences of Mr. Grant's valuable Disinfectant. I 
trust that these means may serve to modify, and soon entirely 
subdue the disease that appeared to be increasing its malignan- 
cy and victims on ship-board. 
Since the arrival of the ship at Quarantine, eighteen cases 
have occurred, making, with the twelve taken from the ship, 
thirty cases, of which number twenty have died. The whole 
number from the first case at sea, has been thirty-seven, of 
which twenty-seven have proved fatal. 
The disease was considered by Captain Lines as cholera mor- 
bus, and treated by him as such, with calomel and ipecacuanha 
opiates, warm drinks and mustard, and heat externally. Vomit- 
ing and purging, cold clammy skin, cramps and spasms were ob- 
served by him in several of the cases, but not the peculiar char- 
acter of the evacuations. 
♦ 
In the cases that have occurred here Diarrhoea has preceded in 
only a few, or about one third. A majority were attacked in 
the morning, between the hours of two and eight. 
Most of them have presented all or most of the following 
symptoms : Vomiting and purging of thin discharges, some- 
times at first, light brown, but generally from the first, of a 
white or yellowish white or pearl color, with white flocculi, form- 
ing a thicker whitish sediment on standing a short time. 
They are well described as rice water evacuations. In some 8 
cases a half gallon has been vomited, but generally in smaller 
quantities. A child six years old vomited fully this quantity 
at once, had no other evacuation, and afterwards recovered. 
The vomiting is usually accompanied by great uneasiness 
and pain, particularly at the epigastrium. In some cases vom- 
iting has existed without purging, and vice versa. In several 
cases neither vomiting nor purging, but the stomach and bowels 
were found filled after death with the same fluid. One or more 
large worms, the Lumbrici, have been discharged, either by 
vomiting or the bowels, in a large majority of the cases. This 
fact has been before remarked. 
The tongue and breath are icy cold; sometimes the tongue 
is clean, but generally slightly coated. The voice becomes 
weak and husky, and with a great effort the patient speaks in a 
thick whisper. 
The skin assumes a dark livid color, becomes cold and 
clammy, and when pinched up, remains so for a short time. 
The countenance wears a haggard, sunken look, the eye is 
dull and heavy, although the pupil is somewhat dilated. 
The extremities are shrivelled, the fingers and toes, and nails 
resembling those that have been long in the water, and of a 
purple hue. 
All the cases have been affected with cramps and spasms of 
the extremities and abdomen, in some slight, but generally a 
very painful symptom. 9 
The puise, from the inception of the real attack, becomes 
small and frequent, from 110 to 140, according to the progress 
of the disease, and in the stage of collapse entirely lost at the 
■wrist for hours. 
The breathing labored and hurried, and in the cases -where 
the spasms were severe, occasionally suspended momentarily. 
In some of the cases all these symptoms were present, while 
in others only a few of them existed. The number or apparent 
violence of the symptoms form no criterion for the prognosis. 
Fatal results followed in a number of cases in a few hours, 
where the dejections were slight, and spasms and other violent 
symptoms were absent. Death seems to ensue from the op- 
pression of the vital organs, and the nervous system, by some 
giant poison. The wretched expression of countenance, the 
icy tongue and breath, the sunken eye, reveal this most 
strongly. 
In this disease there has been but one stage-that of collapse 
-although every pains have been taken to detect the first de- 
viations from health, directions given to all to communicate 
them at once, and persons employed to inspect them constantly, 
and a physician to pass among them at all hours of the night 
and day. The first intimations are the extreme symptoms, de- 
fying the most prompt and decided remedies. 
The appearances after death are those that have been usually 
observed after death from cholera. A shrunk and shrivelled 
livid exterior, a gorged and congested condition of the internal 
organs. The meninges and substance of the brain, and all its 10 
vessels, unusually red, either from actual congestion, or the re- 
tention of the cruor of the blood while the serum is drained off. 
The lungs, liver, spleen, heart, intestines and kidneys, present 
the same deepened color. I have observed no alterations of 
structure or softening. 
The bladder is contracted to an extremely small size. I 
should have observed that there is an entire suppression of 
urine in most of the cases. 
In several cases that I have examined, the entire mucous 
lining of the bronchial tubes has been much injected. 
That this is Asiatic Cholera, cannot be doubted. From the 
commencement of the disease to the present time, thirty-seven 
cases have occurred, twenty-seven of which have died in an 
average period often hours. The average duration of the dis- 
ease in the children that have died, has been four hours. 
t 
A new feature has appeared in the history of this disease, in 
the fact that six persons have been affected in a similar way, 
who had been but for two days exposed to contact or proximity 
to these people. 
Nothing like cholera existed at this place at the time of the 
arrival of the ship New York. When her passengers w'ere 
removed to the public stores they were occupied by about 
seventy persons, who had just recovered from other diseases. 
One of these, a man just recovering from a fractured patella 
assisted in the removal of the patients. This was on Sunday ; 11 
on the Wednesday following, he was attacked with vio- 
lent symptoms of cholera, and died the same day. A woman 
who had been a nurse, without having any communication 
with these people, but occupying another room in the same 
building, was attacked, and died the same day, with all the 
symptoms of cholera. A man who had been discharged and 
gone to the City of New York on Monday, and had remained a 
little over a day in this same enclosure, was returned from the 
City as a case of cholera, and died also on Wednesday. On 
perceiving this communication of the disease to the convales- 
cents, I immediately sent them aw'ay and distributed them 
through the other hospitals, since which three others have been 
attacked, two of whom have died, but none other than those at 
first exposed at the public stores, have been affected. These 
had all been inmates of the hospital for weeks, were ready to 
be discharged, and had but a limited exposure for forty-eight 
hours to the influences of the disease. 
At the time the first cases occurred, November 25th, the 
ship was in N. lat. 42°, long. 61°, about 140 miles S. S. W. 
from Sable Island. On the 23d and 24th, the two days pre- 
ceding the appearance of the cholera, the wind was N. N. W. 
On the 25th it changed to the southward, with squalls and rain. 
In the morning the barometer was at 30 inches, and fell during 
the day to 29* inches ; thermometer 60c Fahrenheit, Sun- 
day and Monday, 26th and 27th, wind westerly, and fresh, 
Tuesday, 28th, moderate from N. W. ; barometer 30, ther- 
mometer 42Q. 
I have given these particulars of the wind and weather in 
connection with the dates of the first appearance of the disease 12 
that all aid may be given to our attempts to account for its or- 
igin. Here its actual manifestations commenced. Did it orig- 
inate in a casual but unusual mingling of certain elements or 
condition of the elements, or from contact with an advanced 
■wing of the grand cholera army, or from the developement of 
seeds latent and waiting for peculiar culture ? Here we are 
met by interesting and peculiar facts. 
All the persons who have been attacked from the first case 
on board ship to the last, excepting the inmates of the hospi- 
tal, have been from among two hundred and seventy Germans 
who have been living in Havre and its environs, where there 
has not been a single case of cholera. These persons were 
originally from Germany, mechanics, and flourishing, until by 
the triumph of liberty aud equality, the native French artisans 
have succeeded in inducing the public to withdraw their pat- 
ronage, and the municipal authorities to proscribe them. 
The consuls of their native countries have come forward and 
provided for their emigration to America. The question arises, 
is there not some difference between these and the other pas- 
sengers that must enable us to account for the fact. 
The only one that may be adduced, is the depressing influ- 
e nceof grief at being driven from their homes and flourishing 
trades ; but this is not apparent in their appearance or manner 
They enjoyed promiscuously with the other passengers, the best 
accommodations, and I am assured by Capt. Lines, that their 
fare was the same with the other passengers. 
I have examined their provisions on board ship, casks of 13 
bacon, rice, flour, beans, biscuit and potatoes, unheaded and ex- 
hibited to me, as it has been dealt to them, and I am sure that 
more wholesome or sweeter provisions could not be provided. 
They are all healthy and robust-have not been exposed to 
the cholera at home, and have since leaving their port of de- 
parture, shared equally with the exempt, the comforts and 
privations of a sea voyage, variations of wind and weather, 
have breathed the same air, and fed on the same food. 
When I speak of treatment, and mention twenty deaths out 
thirty cases, I can evidently not be expected to produce a suc- 
cessful plan of treatment. 
I will mention the general plan however, as in some cases it 
has been successful, and in others failed from the fact that the 
disease presented its first and final stage simultaneously. On 
admission, the patient is enveloped in warm blankets, next the 
skin, and warm mustard applied largely to the stomach and 
bowels and extremities. Hot bricks, bottles of water, or bags 
of sand applied to various parts of the body, and a stream of hot 
air conveyed from a hot air apparatus under the bed clothes. 
With this is combined as much friction with hot tincture of 
capsicum as can be carried on under the clothes without expo- 
sure of the body to the air. This is done in all cases, and is an 
efficient method of restoring warmth to the surface, if practi- 
cable. 
Various internal means of treatment have been tried. In a 
number of cases, Dr. Joseph Brown's practice of administering 
mustard emetics, has been adopted, but without the blood let- 14 
ting. Only two cases that were treated in the first stage of 
the. disease in this way, were benefited, reaction occurring after 
the emetic, followed immediately by a scruple dose of calomel, 
combined with Dover's powder. Unless reaction is effected by 
the emetic, the prostration and irritation of stomach produced 
by it can only serve to enhance the disease. 
In eight other cases, the large doses of calomel capsicum 
and camphor, as administered in the practice of Dr. Cartwright, 
of Louisiana, and suggested to me by S. M. Fox, Esq., were 
carefully tried, combined with the rubbing in of hot tincture of 
capsicum. But the results did not encourage the continuation 
of the treatment. 
Chloroform has been administered in a number of cases, 
carefully and repeatedly, and at first gave some hope that it 
would prove a successful remedy, but no other permanent good 
has resulted from its use but to relieve the spasms and cramps. 
For this purpose I have used it in all cases moderately, and if 
not a cure for all the symptoms, it is an invaluable remedy in 
subduing one of the most painful symptoms of the disease. 
Hot wine whey and mustard whey have been administered, 
in combination with other means, particularly in the latter 
stages of extreme prostration. 
The saline mixture has also received a careful trial in a 
number of cases from the commencement of the disease, and al- 
though hopefully watched for beneficial results, laid aside as 
worse than inefficient. If administered in a condition of the 15 
system when it might be absorbed, advantage may be derived 
from it, otherwise it can but increase the irritability of the 
stomach, the thirst and prostration, and aggravate the disease. 
Sugar of lead and opium have been administered in large and 
small doses, but soon abandoned as impotent. 
The treatment that has proved of most service has been cal- 
omel in scruple doses, combined with opium and camphor, fol- 
lowed at two or three hours intervals, by smaller doses of calo- 
mel, until reaction is indicated by some action of the liver. 
This plan, combined with the faithful application of external 
heat, &c., I. am satisfied has proved of most advantage in the 
cases that have come under my notice. Every case in which 
the slightest bilious evacuation has been procured, has com- 
menced to recover from that moment, and although of itself, 
unable to effect the reaction necessary for its own peculiar ac- 
tion. Calomel will doubtless always prove the most potent aux- 
iliary in the catalogue of remedies for cholera. 
No one specific can ever control a disease whose nature is 
made up of so many complications, an obstinate exsanguina- 
tion and paralysis of the surface with a fearful congestion of all 
the internal vital organs, and a derangement of the nervous 
system, indicated by convulsions of every portion of the body. 
December 19th. Since the above was submitted, I have had 
further opportunity to observe the character and treatment of 
the cholera, existing at the Marine Hospital. Since the 11th 16 
December to date, there have occurred thirty-three new cases. 
All but three of these have been from the same class of Ger- 
mans from Havre, as the other cases. One, and the only one 
that has occurred among the French passengers of the New 
York, was a Frenchman from Paris, a fatal case. 
Two others were old inmates of the hospital of Irish nativity. 
They were just recovering from typhus fever, and located in a 
hospital most distant from the cholera hospital. One was at- 
tacked on the 10th, the other on the 11th of December, with all 
the symptoms of the disease, proving fatal on the third day in 
the first case. The other is convalescing. No intercourse be- 
tween these patients and the cholera cases can be detected, 
neither of the convalescents that were at first returned from the 
public stores, and were afterwards attacked had visited their 
wards, and their physicians in attendance had been but little 
among the cholera patients. 
The whole number of cases, thus far, at Quarantine, has 
been sixty-three. Of these twenty-nine have died. A large 
proportion have been children under fourteen years, twenty, or 
about one-third of the whole number having been of this class. 
Most of them passed through the first attack of the disease, 
and died from subsequent congestion or effusion in the brain. 
Of the thirty-three cases that have happened since my report 
of the 11th, I am glad to state that only nine have been 
fatal. And as there appears to be no difference in the severity 17 
of the symptoms at the outset of the disease, I cannot but at- 
tribute the diminished fatality to a more happy plan of treat- 
ment. 
From the results of the first thirty cases, and post mortem 
revelations, I became convinced that the stimulating plan was 
not the treatment for this cholera, and abandoned at first the 
mustard, then the capricum, ammonia, brandy, wine whey, etc., 
and relied on calomel in large doses, with opium, Dover's 
powder, and camphor. 
With regard to camphor, even though it has been always 
lauded, and by some as the specific in cholera, I entertain sus- 
picions of its utility. 
The treatment I have now adopted and adhere to, from its 
decided agency in controlling the symptoms and inducing early 
reaction, is the exhibition of moderate doses of calomel, with 
morphine, at short intervals. Five grains of calomel, with a 
quarter of a grain of sulph morphia, is at first given to an 
adult; in a half of an hour, or one hour, a scruple dose of calo- 
mel is exhibited, and is usually retained; afterward, a pill of 
Cah grs. V, Sulph Morphine gr is given each hour, two hours 
or three hours, as the effect may indicate. This is observed in 
the subsidence of the pain and spasms, the diminished quantity 
and frequency of the evacuations, the return of warmth, and 
the restoration of the pulse. 
C-lThis treatment is continued until some indications of bilious 
action appear; the first is usually a change of color and con- 18 
sistence from the light, thin, rice water, to a greenish, and 
then brown or brownish yellow color. The evacuations from 
the stomach and bowels will frequently continue green, or of 
the color of sulphate of copper, for hours, but I have not 
known a single case to relapse where this effect had once been 
produced. 
I was led to substitute the morphine for opium, from its be- 
ing less liable to disturb the stomach or to produce narcosis, an 
effect to be deprecated in this stage of congestion, except it re- 
sult naturally from the obviation of pain and excitement. 
In children, however, under six or seven years, I have used 
Dover's powder in preference to morphine, as being more man- 
ageable in regard to the dose. A very simple remedy, but one 
that I have used in children with happy effects, has been the tea 
of the spearmint, given hot in the first stages, and afterwards 
cold, in a small quantity, a large spoonful occasionally. 
The most valuable external means is the stream of hot vapor 
of alcohol, poured over the patient by a very simple apparatus 
at the foot of the bed. This is a large alcohol lamp placed un- 
der a sheet iron cylinder, with a pipe running from it. The 
lamp is placed on the floor, and the tube with an elbow, and 
terminating in a large funnel to elevate the clothes, is inserted 
under the bed clothes. 
This and hot mustard applications are the only external 
means that I rely on. They are potent, and can be continued 19 
without the fatigue or exposure of the patient, a paramount de- 
sideratum, as there is plenty of both to contend with as the 
inevitable effects of the disease. 
I should do injustice did I not mention the faithful attention 
of the physicians of my staff, particularly Dr. F. L. Harris, 
Deputy Health Officer, and Dr. John Gallaer, who has devoted 
his whole time and care faithfully to these patients, through all 
hours of the night as well as the day. 
Respectfully, 
ALEX. B. WHITING, 
Health Officer. 20 
At a meeting of the Special Committee of the Board of 
Health, held this day, at the Mayor's office, the following re- 
port from the medical advisers of the Committee, prepared in 
accordance with the resolution adopted by the Special Com- 
mittee, at a previous meeting, was made, which, on motion, 
was accepted, adopted, and ordered to be published in the City 
papers. 
W. F. HAVEMEYER, Mayor. 
NIEL GRAY, 
MORRIS FRANKLIN. 
Mayor's Office, Dec. S, 1848. 
The undersigned, having been appointed by the Sana- 
tory Committee of the Board of Health to prepare a com- 
munication to the public, in relation to the epidemic 
cholera with which this city is at present threatened, re- 
spectfully 
REPORT: 
That, as yet, the disease is entirely limited to the Quaran- 
tine, and the hope is cherished that under the protection 21 
of a kind Providence, this City may be preserved from its 
ravages. It is evident, however, that the cause of the dis- 
ease is hovering in the atmosphere about us, and it there- 
fore becomes a duty to adopt in season all such precaution- 
ary measures as may tend, if possible, to mitigate its evils, 
should it unfortunately assail us. Under this impression, 
they beg leave to make the following suggestions : 
As the whole history of the cholera shows that its diffu- 
sion is promoted by all those causes which have a ten- 
dency to render the air impure, the first and most import- 
ant concern relates to the cleanliness of the City. To 
accomplish this, the undersigned are satisfied that the 
Board of Health have taken such measures, and will con- 
tinue to do so, as they trust will be efficient. The Board 
of Health, however, it is evident, cannot do everything, and 
the Committee would respectfully call upon their fellow 
citizens to co-operate with them in every possible way in 
their power. Sources of filth and impurity may exist 
without the knowledge of the public authorities, and 
every citizen should feel the necessity of keeping a watch- 
ful supervision over his own premises, and when individu- 
al efforts are inadequate, to call upon the Board for aid 
and assistance. 
Believing that much maybe done in the way of preven- 
tion, if not cure, of the disease, in case it should unfortu- 
nately attack us, the undersigned would offer a few sug- 
gestions of a general nature, founded on experience, 
leaving the application of them to the good sense and dis- 
cretion of the community at largs. 22 
In the first place, they would advise particular attention 
to clothing. From the nature of the complaint, it is evi- 
dent that much depends upon keeping the body warm, 
and protecting it from sudden exposures to cold and moist- 
ure. Flannel next the skin should be a universal article 
of apparel, and they would respectfully suggest to those 
charitable associations which are in the habit of supplying 
the poor with clothing, to make this an object of special 
attention. At this season of the year, too, the supply of 
fuel to the poor should be liberal. 
In the second place, the diet should be particularly at- 
tended to. The undersigned would not recommend any 
sudden or great change in the ordinary modes of living, 
where those modes are temperate, and have been found to 
agree. Such changes, they believe, would do more harm 
than good. From the peculiar nature of the disease, 
however, it is well known that certain kinds of food are 
injurious, and, without going into particulars, they would 
merely state that all such articles as have a tendency to 
relax the bowels, ought to be avoided. All crude and 
raw vegetables, as well as violent purgative medicines, 
are calculated to do mischief. Excesses, either in eating 
or drinking, cannot be too religiously abstained from. 
In the third place, attention to personal cleanliness, by 
the frequent use of the tepid bath, is particularly recom- 
mended. 
In the fourth place, the preservation of a calm and com- 
posed state of mind is all important, and may do more 23 
than is generally supposed in preventing the onset of this 
disease. It is the result of experience that all epidemics 
are aggravated more or less by mental disturbance, 
whether in the shape of active panic or low despondency. 
To the cholera this is particularly applicable. While our 
citizens, therefore, use every prudential and precautionary 
measure, let them keep up a good heart and dispel all 
fear. 
• In the fifth place, with regard to the treatment of 
cholera, it may be observed that, as a general rule, the 
disease does not attack so suddenly as to preclude the pos- 
sibility of calling in timely medical assistance. A relaxed 
state of the bowels for a longer or shorter period, gives 
notice of its approach. In all cases, therefore, when any 
disorder of this kind exists, common prudence will suggest 
the necessity of resorting to medical aid. If this be done 
in season, the disease may generally be promptly arrested. 
When professional aid cannot be immediately obtained, 
and where simple relaxation of the bowels exists, fifteen 
or twenty drops of laudanum may be taken ; to be repeat- 
ed in one or two hours, according to circumstances. For 
young persons and children, the dose must be reduced ac- 
cording to the age-at the age say of ten years, five drops 
at the age of two or three years, two or three drops. 
Where the symptoms are more severe, and the patient 
is cold, in addition to the laudanum, he should be put im- 
mediately to bed, between blankets, and every appliance 
in the shape of bottles of hot water, bags of hot salt or 
sand, frictions, &c., &c., &c., be diligently resorted. A 24 
strong mustard poultice, too, should be applied over the 
region of the stomach, to remain on till it produces smart- 
ing of the skin. In addition to this, a little brandy and 
water should be given, with the view of restoring warmth. 
As in this City no difficulty in obtaining the speedy assist- 
ance of a physician can exist, any directions in relation to 
the after treatment are deemed unnecessary. 
JOHN B. BECK, M. D., Chairman. 
RICHARD L. MORRIS, M. D. 
JOSEPH M. SMITH, M. D. 
New York, December 8, 1848.