- - ___ - 
(SHOWING THE LOCATION OF EACH CASE OF 
"2- -1873. ' ' The American Practitioner. 
OCTOBER, 1873. 
Certainly it is excellent discipline for an author to feel that he must say all he has to say in the 
fewest possible words, or his reader is sure to skip them ; and in the plainest possible words, or his 
reader will certainly misunderstand them. Generally, also, a downright fact may be told in a plain 
way; and we want downright facts at present more than any thing else.-Ruskin. 
©ritjinal Communication?. 
A HISTORY OF CHOLERA AT LANCASTER IN 1873. 
BY WM, BERRY, M. D., AND F. C. WILSON, M. D. 
The town of Lancaster is situated near the center of Gar- 
rard County, Ky., five or six hundred feet above the level 
of Louisville. The stone near the surface is gray limestone, 
covered with a tough clay soil, such as is usually found in 
the "Blue-grass Region" of the state. The ground upon 
which the place is built is undulating, the court-house square 
marking the highest point, from which the surface slopes in 
every direction, affording fine natural drainage. The water- 
supply is from several wells situated usually in low places, 
where at every rain they receive the washings from a large 
surface of ground. In the eastern portion of the town a 
small branch, commencing near the cemetery (see accom- 
panying map), passes down through a low, marshy lot over- 
grown with tall grass, and crosses Richmond Street through 
a culvert, continuing in a direction parallel to the Sugar- 
creek Pike. On the bank of this branch where it crosses 
Vol. VIII.-13 194 
A History of Cholera at Lancaster in 1873. 
Richmond Street is the Tate well. On either side of the 
ravine, through which the branch runs, a large number of 
shanties and hovels are built, usually upon low ground, no 
provision being made for ventilation beneath. These were 
occupied by negroes, and were generally kept in an exceed- 
ingly filthy condition. Upon the branch at the point marked 
L was placed a slaughter-pen, the stench from which could 
frequently be perceived in the center of the town. The sani- 
tary condition of the town was found to be wretched, no 
effort having been made to clean the streets and alleys, nor 
had the privies and stables received proper attention. 
The first deaths from cholera occurred on Friday, August 
15th, and were those of Isham Jenkins, colored, and William 
Turner, white. Mr. Turner was the father-in-law of Mr. 
Bewley, who, coming from Jonesboro, Tenn., was taken sick 
on the way, and stopped at Mr. Tate's, marked 2 on the 
map. Here he was visited by Mr. Turner, who remained 
with him several days, and on starting home was taken vio- 
lently ill when a few miles from town, and was carried to 
the house of a negro man, where he died of cholera the same 
day. Isham Jenkins, who had waited upon Mr. Bewley, 
carrying out the discharges, was also attacked with cholera, 
and died in ten or twelve hours. He was said to have eaten 
largely of green corn, and had stood for several hours in a 
pond washing a buggy. 
Until the occurrence of these cases there was no suspicion 
that Mr. Bewley had cholera, though the physician attending 
him said that his attack so much resembled cholera that he 
would have considered it such had there been any cases in 
that section. From the description given us the discharges 
certainly very much resembled those of cholera; and though 
the patient seemed to be better for a few days, he fell into a 
typhoid condition, and finally died. No care was taken to 
disinfect the discharges, which were thrown out in the rear 
of the lot. This was upon the hillside immediately above A History of Cholera at Lancaster in 1873. 
195 
the Tate well, which, being located in the hollow, at each 
rain was nearly filled by the washings from privies, stables, 
hog-pens, and out-houses on every side. Isham Jenkins used 
water from this well. On Saturday there were no deaths, but 
on Sunday Fanny Bailey, colored, who lived with her mother 
in the shanty marked 3, was taken sick and died the same 
day of cholera. The house was low, damp, and in an ex- 
ceedingly filthy condition. On the following Wednesday her 
mother also died of the disease. Both used water from the 
Tate well. There were no more deaths then until Tuesday, 
when Cary Burnside, who lived in the room adjoining the 
one occupied by the Baileys, was attacked and died in ten or 
twelve hours, as did also Susan Carr, who lived on the same 
square at Mr. Gallagher's, marked 7, and Martin Hickman, 
living in another room adjoining the Baileys. Sally Hogan, 
living further down the ravine at 6, was also taken sick and 
died the same day. Out of twenty persons occupying the 
four rooms in this group of houses four died of cholera, and 
several others were more or less affected with diarrhea. On 
Wednesday Mrs. Collier, living at 9, but who had left town 
the day before, was taken sick and died in twelve or fourteen 
hours; as did also Antony Smith, who lived further down the 
ravine, at the house marked 8. On Thursday there were five 
deaths. First, Sam Salter, who lived at 10, and used water 
from the Tate well, was taken sick and died, having been 
nursed by his wife Edna and sister Alice, the discharges 
being thrown into the privy used by the two women. Second, 
Frances Bailey, mother of Fanny Bailey, was taken sick and 
died in the same room, marked 11. Third, Bell Soper, living 
at 12, but who left town on Tuesday, died at Camp Nelson- 
Of the fifteen persons occupying this group of houses, marked 
Q, one died of cholera, and three others had violent vomiting 
and purging, but recovered. They all used water from the 
Tate well. Fourth, Anderson West, who lived on the other 
side of town, at 13, and who, so far as could be ascertained, 196 
A History of Cholera at Lancaster in 1873. 
had not been near any cases, died after a short illness. Fifth, 
Wilson Logan, the husband of Sally Logan, who died at the 
house marked 6, was taken sick in the same room and died 
in twelve hours. The house containing three rooms, low and 
damp, but kept clean, was occupied by an aged couple with 
several children and grandchildren. Of the seven or eight 
persons two died of cholera; the two old people remained 
in the house suffering for several days with nausea, vomiting, 
and diarrhea, as did also the son of the woman who died, 
while two others left town and had no symptoms of cholera. 
On Friday Mrs. Temple, who lived at 15, and who had left 
town with her family, was taken sick and died. One son 
also had diarrhea, but recovered. On the same day Edna 
Salter, the wife of Sam Salter, who died on Wednesday, was 
taken sick at the house of her father, Moses Doty, and died 
that night. Moses Doty's house was on the other side of 
town, at 16, near a branch somewhat marshy. The discharges 
from Edna were thrown into the privy used in common by 
Moses Doty and his next neighbor, Ned Cecil. Alice Salter, 
who had also helped to nurse her brother Sam, went home 
to her husband's house, marked 17, where she was taken sick 
and died in twelve hours. The discharges were carefully dis- 
infected and buried, and no other cases were developed in her 
family. On Saturday Mr. Brown, the miller, who boarded 
at 18, was attacked and died in ten hours. He was very- 
dissipated, and had been drunk for a week before his attack. 
His discharges were disinfected with carbolic acid and buried. 
In the same house were four or five other persons, none of 
whom were affected except the landlady, Mrs. Bishop, who 
was sick for several days with nausea, diarrhea, and vomiting, 
but recovered under treatment. 
Ned Cecil, who lived next to Moses Doty, and who had 
used the privy into which the discharges of Edna Salter had 
been thrown, was taken sick and died in the bank-building, 
marked 20. On the same day Hayden Spoonamoore, who had A History of Cholera at Lancaster in 1873. 
197 
worked at the bank-building, boarding at the hotel marked S, 
was taken sick in Lincoln County and died of cholera. On 
Saturday night, at 9 p. m., Rushbrook, a soldier, living at 21, 
in quarters clean and well policed, was taken with symptoms 
of cholera. He was treated with chloroform, camphor, and 
laudanum-mixture, together with the external application of 
heat and mustard poultices. At 5 a. m. his temperature was 
970; purging and vomiting excessive, with violent cramps in 
the muscles of trunk and limbs; surface cold and livid; skin 
shriveled; entire suppression of urine. We saw the case with 
Dr. Jackman and Dr. T. S. Warren, A. A. Surgeon U. S. A., 
and upon consultation it was agreed to give hypodermically 
one fortieth of a grain of atropia. By this the cramps were 
controlled, and the temperature rose to 990, though there 
was still no secretion of urine. At 8 a. m. the surface again 
became livid and the breathing short, and he died at 8:30 a. m. 
His wife was seized at 2 A. m. with violent cramps, vomiting, 
and purging, the discharges being a rice-water fluid. At 
5 A. m. her temperature was 96°; at 5:30 A. m. 95 °, at which 
time there was given hypodermically one fortieth of a grain 
of atropia with one fourth of a grain of morphia. At 8 a. m. 
her temperature was 970; pupils not dilated. At 9:30 A. m. 
all her symptoms were worse; temperature 950; suppression 
of urine complete; gave one fiftieth of a grain of atropia. At 
10 A. m. temperature 970; at 10:45, at 11:15, IOO°, but 
pulse weaker; lies quiet, with no vomiting or purging; still 
not a drop of urine in the bladder. Ordered ten drops tinct. 
digitalis to be given every two hours. At 12 M. temperature 
ioi°; lies quiet, with no more vomiting or purging. At 
1 p. m. her temperature was 103 j4°; breathing quick and 
superficial. In this condition she remained, gradually sink- 
ing until 2 p. M., when she died. Both these patients, living 
in a high, clean locality, used water from the Tate well. 
On Monday Mrs. Sellers, who for several days nursed Mr. 
Bewley, was taken sick and died in the country of cholera. A History of Cholera at Lancaster in 1873. 
198 
On Wednesday Moses Doty, the father of Edna Salter, who 
died at his house, was taken sick at twelve o'clock at night 
with violent vomiting, purging, and cramps. He had been 
complaining for several days before, but had taken nothing. 
At 2 a. m., when we saw him first with Dr. S. L. Smith, his 
pulse could scarcely be felt. His temperature was 970 in 
axilla, under the tongue 96.6°, and in the rectum 1020. He 
had voided a short time before a very small quantity of urine. 
We gave hypodermically atropine and morphine. At 3:50 
a. m. his temperature in axilla was 96.6°, in rectum 102°, and 
there had been no more vomiting or purging. At 4:30 a. m. 
temperature in axilla 98°, in rectum 102.8°; at 5 A. m. tem- 
perature in axilla 100.4° The catheter obtained only a few 
drops of urine. Without any more vomiting or purging he 
passed into a state of complete collapse and died at 9 a. m. 
On the evening of the same day Mrs. Finley, the daughter of 
Mr. Singleton, died in the country after an illness of twenty- 
four hours. She was attended by Drs. Frazee and Pettus, 
who pronounced it a well-marked case of cholera. The Sin- 
gleton family lived in the house marked P, opposite to the 
Tate well, from which they obtained water. Underneath the 
house the ground was low and wet, so that it had to be 
drained. The children occupied the second story. On Tues- 
day the whole family, consisting of Mr. and Mrs. Singleton, 
with four children, moved four miles into the country to 
the house occupied by their married daughter, Mrs. Finley. 
This house stood upon the top of a high hill. Here Hunley 
Singleton, who had been troubled with diarrhea since the 
day before he left town, was taken sick on Monday, having 
violent vomiting, purging, and cramps, with great prostration 
and complete suppression of urine for forty-eight hours. He 
was seen by Drs. Hill, Pettus, Frazee, and Berry, who pro- 
nounced it a genuine case of cholera. Under treatment he 
recovered. At the same time his brother and sister were 
seized with choleraic symptoms, though in a milder form, both A History of Cholera at Lancaster in 1873. 
199 
recovering. The discharges at first were voided in the privy 
used by the family. Mrs. Finley and her husband remained 
only a few days, moving to a house about a mile off, where 
she died on Wednesday. She had not been to town for two 
or three weeks. Her husband on the next day was seized 
with nausea, cramp, and diarrhea, with every indication of 
impending cholera, but was promptly relieved by the hypo- 
dermic use of atropine. 
On Friday Eugene Hasbrouch, a soldier, died after an ill- 
ness of eleven and a half hours; and the same day another 
soldier, Herman Rathjen, was seized and died the next morn- 
ing. The latter had been in close attendance upon the first 
two cases that died in camp, while the former had only passed 
through the room in which they died. In the case of Has- 
brouch the temperature was as low as 96°, reaching before 
death as high as while in the case of Rathjen the 
temperature was not at any period lower than 990, and reached 
before death In both cases the discharges were dis- 
tinctly rice-water in character, the pulse scarcely to be felt, 
the skin livid and shriveled, and the urine completely sup- 
pressed. In both cases the atropine given hypodermically 
controlled the cramps, though it had no effect upon the action 
of the kidneys. We saw the cases in consultation with Drs. 
Warren and Smith. 
French Smith, a feeble old negro man, who lived at 28, 
a law-office, died after an illness of forty-eight hours, his 
discharges and vomit being rice-water in character and very 
copious. He at first suffered severely with cramps, which 
werd controlled by atropine. His temperature at one period 
was 96°. That morning we were called to see Reilly Burdett, 
two and a half years old, the child of a man who had nursed 
nearly all the cases, and who lived in a house, marked 27, 
which stood on a low, damp lot, much lower than the level 
of the street, which had been filled up in grading. His 
symptoms were those of well-marked cholera, and he died A History of Cholera at Lancaster in 1873. 
200 
the same night after an illness of twelve or fourteen hours. 
The discharges, received upon cloths, were at first merely 
washed out in water, which was thrown into the back yard. 
After we saw him care was taken to disinfect and bury them. 
On the following Wednesday Ellen Lusk, the grandmother 
of the child, living on the other side of the town, at 30, but 
who during the sickness of little Reilly had been with him 
a great deal, was taken sick, having what appeared at first as 
a bilious diarrhea. Toward evening, however, the discharges 
and vomit became rice-water, and she sank rapidly, dying at 
about twelve oclock that night. The temperature in this 
case was at no time below 98°. Atropia was used in suffi- 
cient doses to control the cramps, and opium, quinine, and 
calomel had been given by Dr. Jackman, but was rejected by 
the stomach. Upon consultation it was determined to resort 
to the transfusion of milk. Having to improvise an apparatus, 
the necessary preparations were not completed until 11:30 
p. m., at which time the patient was pulseless, could only 
speak in a husky whisper, and was so weak as to be unable 
to raise her head. It being impossible, because of her dark 
color and the lateness of the hour, to find the cephalic vein, 
the median cephalic was exposed, the tube inserted, and milk 
fresh from the cow, and kept at the temperature of IOO°, was 
slowly passed into the vein. In five minutes six or seven 
ounces had been transfused, when the pulse became moder- 
ately strong, the voice returned so that she could be heard 
in the adjoining room, and her strength was increased so 
that she partially raised up in bed and turned over on her 
side. The movement of the arm threw the tube out of the 
vein, when we determined to let her rest for an hour, and 
then procure more fresh milk with which to repeat the in- 
jection. At the end of half an hour she was found sinking 
rapidly, and before the preparations could be made she was 
dead. A pint and a half of milk had been prepared, but not 
more than six or seven ounces were thrown into the vein. A History of Cholera at Lancaster in 1873. 
201 
The next day Chany Dunn, a negro woman living diago- 
nally across the street, at the house marked 32, and who had 
been sick with rheumatism for two months, was seized with 
diarrhea, which at first was of a bilious character. It soon 
developed into well-marked cholera, having the character- 
istic discharges, with severe cramps, cold surface, temperature 
reduced to 95j4°, and suppression of urine. She died about 
twelve o'clock. Ellen Mason, living at the house marked 33, 
died the following morning after an illness of twenty-four 
hours. This was the last death that occurred. Mrs. Stevens, 
who lived at 30 in the same house with the family of Mr. 
Collier, and who had left town, died in the country on the 
previous Tuesday. Her husband also had a mild attack, but 
recovered. 
The first case that recovered was that of William Arnold, 
the undertaker, living at the house marked R. He had for 
several days suffered with a diarrhea, which he had somewhat 
checked by a mixture of chloroform, camphor, and laudanum. 
On Sunday morning, when first called to see him, we found 
his temperature 970, his pulse very weak; and he was ex- 
cessively emaciated, though he had no nausea and no pain. 
His evacuations were frequent and very thin, but somewhat 
colored. Ordered to continue the mixture and take five grains 
of quinine every four or five hours. 8 p. m. : He has had five 
or six thin, watery actions since morning, and vomited freely 
once. Ordered to continue the mixture, adding fifteen drops 
of laudanum to each dose. 10 p. m. : Has had a severe cramp- 
ing spell; temperature 95°; thirst excessive; surface cold, 
clammy, and livid; skin of hands and feet shriveled. He 
can only speak in a whisper, and his kidneys have not acted 
since 5 p. m. We gave hypodermically one fortieth of a grain 
of atropine with one fourth of a grain of morphine, and in 
fifteen minutes he said he felt easy and comfortable. He was 
then ordered a mixture of white of egg, water, and whisky, 
to be given at frequent intervals. During the night he slept 202 
A History of Cholera at Lancaster in 1873. 
a little, his bowels moving only once. The evacuations were 
copious and thin, like rice-water, but he had no vomiting or 
cramping. 8 a. m. : Temperature 970; pulse very feeble; says 
he feels a little better; still no urine secreted. We repeated 
the injection of atropine, omitting the morphine. 4 P. m. : 
Temperature ioi°. He still has passed no urine. Ordered 
R. Spts. nitrous ether, . . . gj; 
Infusion digitalis, , . . 5 vij. 
M. S. One ounce every two or three hours. 
Tuesday morning: His kidneys acted this morning; bowels 
moved only twice, the actions being better in consistence and 
color; temperature appetite returning, and he feels 
better. He rapidly convalesced, and in two or three days 
was on the street. 
On September 4th Frankie Burdett, the daughter of Ellen 
Lusk, who died on Friday, and the mother of Reilly Burdett, 
who died on Wednesday, was taken with a diarrhea, the pas- 
sages not becoming watery until that night, when she had 
four or five, the last two very copious and resembling soap- 
suds. We saw her the next morning at 9 a. m. Her kidneys 
were very inactive, though she had passed a small quantity 
of urine. This, upon microscopic examination, disclosed tube 
casts. Her temperature was normal, her pulse moderately 
full, tongue flabby and coated, and she complained of a bitter 
taste in her mouth. She suffered some pain in the bowels, 
and had some nausea, but had not vomited. She complained 
of an intense itching in her hands and feet, the same thing 
having been noticed in the case of Ellen Lusk, her mother, 
and her child. She also complained of cramp in one leg. 
We gave hypodermically atropine and morphine, and ordered 
five grains of quinine to be taken every four hours. 4 p. m. : 
She has been easy all day. Her bowels moved at 3 p. m. for 
the first time since morning, the evacuation being thin and 
rice-water in character, and in quantity sufficient to fill a large 
chamber. At 7 p. m. she had taken two doses of quinine; A History of Cholera at Lancaster in 1873. 
203 
temperature still normal; has no pain except an occasional 
cramp in the leg; no more urine secreted. The quinine 
producing some nausea, it was discontinued, and she was 
ordered to take ten grains of calomel every hour. At io 
p. m. she had taken only two doses of calomel. Her pulse 
was weaker, though the surface was warm, and she com- 
plained of some pain in the stomach. An evacuation just 
passed is large enough to half fill the chamber, and is dis- 
tinctly rice-water in character. Ordered to continue calomel 
in same doses. At 1:30 a. m. she vomited freely, the matter 
thrown up being slightly tinged with bile. Her temperature 
was ioo°, and she had passed no urine since the morning 
before. She has not complained of much pain, except an 
occasional cramp in the bowels and in one leg. Her knees 
are cold though her feet are warm. Her bowels have just 
moved, the action being copious, looking like soap-suds, a 
shade darker than the others. Gave atropine hypodermically, 
and ordered another dose of calomel to be given at 2:30 a. m. 
After taking the last dose she slept the rest of the night. On 
this morning at 7 a. m. her temperature is 98°; her pulse 68, 
and moderately strong ; her kidneys have acted, her appe- 
tite has returned, and she feels much better. She recovered 
rapidly and was up in a few days. 
Two other cases-those of a soldier by the name of Graff, 
and a negro woman living at the hotel marked S - were 
treated with atropine and calomel by Drs. Smith and Warren. 
They both had all the symptoms of genuine cholera, and 
both recovered. 
There were seven well-marked cases in all that terminated 
in recovery. In one of these there was suppression of urine 
for forty-eight hours, and in several others for twenty-four 
hours. In six of the seven atropine was used hypodermically 
in doses sufficient to control the cramps and produce reaction 
in the temperature. Three of the cases were treated, in con- 
junction with atropine, by calomel, given in doses of ten 204 
A History of Cholera at Lancaster in 1873. 
grains every hour, until the vomit and discharges showed 
the presence of bile. The calomel was then discontinued, 
and five grains of quinine were given every three or four 
hours. One was treated by atropine alone until reaction 
occurred, when it was followed by infusion of digitalis and 
sweet spirits of niter. Three of the cases were treated with 
calomel and opium in combination. 
Living in the immediate neighborhood of the Tate well, 
at the houses marked My N, 0, P, were four families, two 
of whom used water from the well, while the other two did 
not. Of the two who used the water, in one family there 
were three cases, while in the other every person in the 
house was more or less affected with diarrhea. In the two 
families who did not use the water there was not even a case 
of diarrhea. 
We prescribed for a large number of cases of simple 
diarrhea, frequently accompanied with nausea and vomiting. 
They were, as a rule, easily controlled by an opiate and 
astringent, followed by quinine; as almost invariably the 
tongue presented that peculiar appearance which is indica- 
tive of a malarial influence. In cases where the cramps were 
severe, and the surface already cold and clammy, atropine 
and morphine were at once administered hypodermically, 
usually affording prompt relief. By resorting early to treat- 
ment no doubt many cases were checked in the first stage. 
To sum up: of the first twenty-three cases that occurred 
there was not a single recovery, while of the remaining seven- 
teen well-marked cases ten ended fatally and seven recovered. 
Of the forty cases, twenty-five were black and fifteen white; 
twenty-one of the blacks dying, while four recovered; twelve 
of the whites dying, while three recovered. All of the cases 
were adults with the exception of one child aged two and 
a half years. 
Louisville.