/ 

EPIDEMIC CHOLERA: 

fife §ffafes 0f teitinitrt; 

THEIR RESPECTIVE RESULTS; 

WITH 

DIRECTIONS FOR PREVENTION: AND WHAT TO DO 

IN CASES OP •¦¦ Sf?©£>,,EN EMERGENCY. 

**/9p 

wraiiT, 

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JOHN F.gEARY, M.D. 

" Look towards the Eaft ; behold, he offers himself to your view ! His indefatigable hand is armed with a terrible scythe, under which fall succeffively all generations. On one of his wings are painted war, peftilence, famine, fhipwreck, and conflagration, with the other sad accidents which every inftant furnifh him with a new prey. On his other wing are to be seen young phyficians taking their doctor's degree in the presence of Death, who inverts them with the cap, after they have sworn never to dispense medicine otherwise than according to the present pradtice." — Le Sage, in Asmodeus, Chap. xm. 

SAN FRANCISCO: H. H. BANCROFT & COMPANY. 

1866. 



Entered according to Act of Congress, A.D. 1860, 

JOHN F. GEARY, 

In the Clerk's Office of the District Court of the United States for the Northern District of California. 



EPIDEMIC CHOLERA: ITS MODES OF TREATMENT, THEIR RESPECTIVE RESULTS, ETC., ETC. 

INTRODUCTION. 

As the following pages are designed for popular information, it is not my intention to enter on the discussion of the nature, or pathology, of Cholera. To the general reader it would be useless ; and all well-informed medical men know that on this point, as on many others, "doctors differ." Their differences, however, as to the nature of any given disease, do not so much concern the public as the practical, and, to them, vital question — How it should be dealt with when it appears 1 

How it may be relieved, or cured 1 In a word — " What will they do with it V* No one needs be told that Epidemic Cholera has at different periods appeared in every quarter of the globe ; that it has made its way from continent to continent, from city to city ; spreading terror and dismay among the people and strewing its passage with death. Nor has the fact that medical men — the honored guardians of health and life — have been almost powerless in their efforts 



4 

to arrest its progress or rescue its victims, proved the least element in increasing the public consternation. We have now, however, the advantage of past experience to guide us for the future ; and it is the part of wisdom and humanity to learn and to teach the costly lessons left us by Epidemic Cholera. To feel conscious of our weakness in past efforts may become the foundation for future strength. 

In its earlier visitations this plague had only the heavy-armed battalions of the Old, or Allopathic School of Medicine to oppose it. In later invasions it has been met by a comparatively small body of light artillery, a ready and willing auxiliary in every conflict to the larger and older body of veterans. I refer to what is now known throughout the world as the Homoeopathic, or New School of Medicine. I regret to be obliged to observe here, that, instead of being hailed with a shout of triumph and a hearty cheer of welcome, they were met with derisive laughter, and with haughty insolence ordered to quit the field ! How they merited this reception, and how well the original contending party was able to carry on the war alone, it is the object of these pages to to prove. 

The relation of these two Schools to each other, their present position before the world, what each has accomplished in the different Cholera Epidemics during which they have labored side by side, are matters of vast importance to the people of this city and to 



5 

the inhabitants of this coast. " Dead men tell no tales," it may be said ; but it is well the living can ; and so the past efforts of each, as attested beyond a doubt, remain with us now, and should be our guide when the new danger threatens, or when the enemy reaches our coast. 

Who is not interested in the important questions — 

Is the Cholera approaching ? 

How shall we prevent it ? 

What can doctors do for us ? What doctors can do most, and best ? 

What can we do for ourselves in the dead of 

night, before any doctor can be found 1 

How, by some ready and simple domestic appli- 

ance, shall we ward off, or weaken the first stroke of an enemy whose second blow is 

death ? 

The importance of these questions to the community in which I reside and practice my profession, is my apology for attempting to answer them. If any further were necessary, I could find it in the fact that, so far as I am aware, the School of Medicine to which I have the honor to belong has not yet on this coast claimed that public consideration, or found that open fearless advocacy which are its due; and which it is now receiving throughout the world. I seek not to draw invidious contrasts between the failure of one School or the success of another : I shall let each party plead its own cause in its own 



6 

words — by its own figures arid facts — and let all who are capable of drawing conclusions from legitimate premises judge. Let them decide whether it is, or is not worth the while of any one who has devoted himself to a profession, the object of which is the saving of life and the preservation of health, to stand for a time alone, to bear some social and professional disadvantages in his advocacy of that branch which he has felt and proved to be beneficent and hopeful — an inprovement on the prevailing system — and which years of experience have demonstrated to be the safest and best, when administering to the sick, and when skill and experience give force to mild and fitly chosen remedies. 



7 

CHAPTER I. 

ALLOPATHY AND ITS RESULTS. 

The combined and collective experience of the prevailing, or dominant School of Medicine — known as the Allopathic School — from the first appearance of cholera (supposed to be about the year 1817,) to the end of 1832, may be very briefly stated. I will invite the reader to be present with me at a meeting of medical gentlemen, representatives from every portion of the world where this plague had appeared, and whilst yet on its journey of destruction. The meeting shall be in London or Paris. The chair is duly taken, and the first speaker introduced. His words are few: "Gentle" men, I recommend timely and copious Heeding; I know 11 this treatment to have been proved by marked sue" cess !" "The learned gentleman will excuse me, if I " differ from him, and think a much higher degree of " confidence due to mustard emetics, and therefore re" commend them to your notice;" are the words of the second. " I," said a third, " have tried both these " modes, and have found them useless, and resorted to " the use of the hot air bath, which never disappoints "me." "Gentlemen," said a fourth, "you are all, I " trust, aware that I have taken no small pains to avail 



8 

" myself of all the light which science has thrown upon " our art, but I must say, with due deference to others, " that I have been forced to a very different conclusion. " I am in favor of introducing into the system a large 11 quantity of neutral salts, which will liquefy and redden " the blood, and so restore the /unctions of circulation /" "If," .replied the fifth, "the last speaker's patients, " as well as ours, were hogs and herrings, his extra" ordinary method might answer ; but as the matter " stands otherwise, I do not think that salting our " patients will cure them. I therefore recommend the " mechanical dilution of the blood by the injection of "warm water, or salt water, into the veins!" "All these " remedies," said a sixth, "are departures from ancient " and known usage. Give good brandy /" " Why not " try Oajeput oil t it has been sold by the barrel, and " never fails," suggested a seventh. " I recommend," urged the eighth, the "free use of opium, as the safest " soother in the pangs of cholera !" " Human life and " health are too precious to be risked, gentlemen," solemnly declared the last speaker, "by these divers and " strange experiments ; but for my own part, I have " trusted, and shall still trust, as do the large body who " think with me, in calomel alone! Three cheers, and " the ' congress' breaks up, with the thanks of the " meeting to the Chair, and the eulogium of the Chair " on the vast body of solid science and useful experience " brought out at the meeting !" 

But whilst this meeting is but the fancy of the 



9 

writer, every medical man knows that I have here given all that had been said and done up to that day in the treatment of epidemic cholera. How highly these recommendations were esteemed by the leading men of the old school, will appear from the opinion of Dr. Thomas Watson, of London, who practised during the epidemics of 1831-2, and who is one of the most distinguished men in the profession. " Now," he says, " I would not willingly " mislead, or deceive you on this point, by speaking " with a confidence which I really have no warrant " for, of the success, or propriety of any of these expe" dients. Never, certainly, was the artillery of niedi" cine more vigorously plied — never her troops, reg" ular and volunteer, more meritoriously active. To " many patients, no doubt, this busy interference made " all the difference between life and death ; but if the " balance could be fairly struck, and the exact truth " ascertained, I question whether we should find that " the aggregate mortality, in this country, was any " way disturbed by our craft." — See his Lectures on the Practice of Medicine, page 811. 

During the epidemics of 1848 and 1849, the experience of the School did not devise any better means, nor were its efforts crowned with any greater success ; as the sequel will show. 

In the face of this hopeless and complete inability to meet the present dreaded approach of Cholera, on its third periodical march of death, by any new medical 



10 

appliances that could offer a single chance of hope, the men of honor, ability and candor — and such only can afford to speak the truth — surrender gracefully to the enemy, go out from the battered fort of Therapeutics — but with their flag of Science still flying, promising to renew the conflict once more on the wide and open field of Sanitation ! And on this field we wish them, with all our hearts, abundant success, and promise them large re-enforcements to strengthen their hands and aid them to certain victory. 

To sustain this view of the present condition of the Old School of Medicine, I shall now quote from the best and most experienced living authority on this subject — a gentleman who has had many years' experience in India, and is now Deputy Inspector- General and Professor of Military Medicine, under the British Government — Dr. Maclean, [n a lecture delivered at the Royal Victoria Hospital, Netley, at the beginning of the present year (1866), he uses the following language to men who were about to go out to India to fight with this foe on its native battleground :—: — 

" Dr. John Macpherson, late of the Bengal army, " and for many years one of the physicians to the Cal" cutta General Hospital, one of the most conscientious " observers and recorders of facts in our profession, " after approvingly quoting the melancholy words of " Bauchardat (who concludes his account of what he 



11 

" calls the l funeste champ de bataille of the cholera " ' epidemic of 1850' with the confession ' that he " ' had not only not seen a single efficacious remedy, v l not one discovery, not a single thought indicative "' of scientific progress'), adds : ' The experience of " ' the last fourteen years in Bengal has not been dis" ' similar. How many of the new remedies have " ' stood their ground 1 Saline enemata, the successors " ' of saline injections into the veins, have had their " ' day. Croton oil and opium pills were at one time " ' pronounced to be nearly infallible. Bloodletting I " ' saw at one time employed ; it is now entirely " ' abandoned. A Madras surgeon found carbonate of " ' soda wonderfully efficacious, as if to neutralize the " ' acid of the Austrian cure. Ether and chloroform " ' were immediately seized on, not only to allay the " ' spasms, but to cure the disease. One surgeon re" ' commended to the service the practice of parboil" ' ing his patients, but lived to abandon the procedure. " ' The cold sheet, whether dipped in plain cold water, " ' as in Bombay, or in an acid solution, as in Bengal, " { has been considered to work wonders. Quinine was " ' recommended to the public, and immediately the " ' newspapers were filled with the accounts of cures " ' worked by the indigo planters by means of it. Ni" ' trate of silver has been recommended here, as in " ( France, and may deserve a more extended trial. " ' On the ground that, as an absence of bile from the " ' evacuations was the great characteristic of cholera, 



12 

" ' its restoration must be the great remedy, ox-gall " ' was recommended — and tried.' Among all these " remedies, adds Dr. Macpherson, ' I can scarcely say " ' that any one is an important addition to our stock, " ' except, perhaps, chloroform.' 

" This passage was often in my mind in the early " part of this winter, when men's minds were agitated " by the presence of the cholera in Southampton and " other places. You must all remember how not only " the professional journals, but the daily newspapers " also teemed with ' cures' and ' remedies' for cholera. " One gentleman thought he had made a great dis" covery in hot mustard baths, and announced it in " The Times with an honest confidence that somewhat " surprised others as well as myself. The truth is, " that seeing how prominent a symptom low temper" ature is in this disease, attempts to stimulate the " surface and restore the circulation in this way were 11 amongst the earliest remedies that occurred to the " minds of physicians — first in India, and subsequently "in this country. I well remember that all the " places set apart in Edinburgh for the reception of " patients, on the occasion of the first epidemic, were " fitted with every conceivable means for applying " both dry and moist heat. The extract given above " from Dr. Macpherson shows that in India the ' par" ' boiling' system has had its advocates ; and hundreds "of living Indian practitioners can testify to the " futility, to say the least, of this method, even when 



13 

" mustard has been added to give more activity to " the measure. My colleague Dr. Davidson, Assistant " Professor of Pathology at Netley, assures me that " he has seen as many as twelve patients subjected to " this method of treatment in one night at Peshawur. " I wish I could say that only negative results have " been obtained ; but it is not so. In any but the " trifling sort of cases in which this remedy was used " in Southampton, it is not only a useless, but a " highly dangerous remedy. To take a man in the " collapsed and pulseless stage of cholera out of the " horizontal posture, where alone there is a hope of " safety, and to plunge him in this condition into a " bath heated to the highest bearable temperature " short of absolute scalding, to which mustard in large " quantities has been added to make it more stimu" lating, is, in my judgment, about the surest method " that can be taken to exhaust the little remains of " vitality left. Experience has abundantly proved " this, for so many men have perished in this way " actually in the baths, that the practice thus urged " oh the attention of the public as novel and effica" cious has long since been abandoned in India. The " novelty to me was not the treatment, but the ex" planation of the modus operandi of the remedy. ll How mustard and hot water, used in this or any " way, can ' aerate the blood in the capillaries,' I do " not understand, and therefore cannot explain." 

Dr. Maclean then enters on a discussion of Dr. 



14 

Chapman's new theory of treatment by means of ice, which he does not consider sufficiently tested by experience to warrant any decided opinion in its favor ; and goes on to say : 

" Of all the methods of treating cholera that have " come under my notice, the most extraordinary is " certainly that which, for want of a better name, I " venture to call the 'corking-up method.' The essence " of this plan consists in restraining the evacuation of " the rice-water stools by mechanical means ; by ban" daging, and, it is gravely added, ' by plugging the " ' anus !' The author of this ingenious invention is " of opinion that if he can only cork our patients up, '' as he would a bottle, all must be well. It does not " appear to have occurred to him that once the serum " of the blood has escaped into the bowels, it may as " well be in the chamber-vessel as in the intestine, " for all the use it is, or can be, to the patient. So 11 completely does this fallacy of regarding the mere " purging as the essence of the disease underlie this, "as it does so many other remedies and modes of " treatment, that the author of this hopeful method •' holds out, as one of the advantages of mechanically " restraining the evacuations, ' that in time they will " ' be re-absorbed!' — i.e., that this poisonous excretion " will be again taken into the system to the advantage "of the sufferer ! Why not treat our patients suffer" ing under typhoid fever in like manner? The diar" rhoea in that disease is very l exhausting.' Why 



15 

" don't we learn from this gentleman, cork our patients " up, and so obtain from them all the advantages of " this ' re-absorption V No wonder the public were " stunned and bewildered by the cholera literature of " the past three months ; no wonder a cry of 'no con"' fidence' arose on every side when ' doctors' thus " ' differed,' adding to the panic and distrust by pro" mulgating crude, contradictory, and often irrational " modes of treatment. 

" Calomel has been used to fulfill every indication "in turn, according to the peculiar belief of the " prescriber. Some give it as a purgative, others as "a sedative; not a few 'to stimulate the secretions.' " I have seen it given as a cure for vomiting. Then " we have a pretty numerous class who give it for no " reason in particular. Calomel is the trump-card in " their hands ; so, like good whist-players, ' when in " ' doubt,' as men are apt to be in dealing with cholera, " they 'play trumps' — they give calomel. I have seen " it given in every conceivable way, and for every " possible and impossible end — in grain doses every " hour or half-hour, and by heroic practitioners in " scruple doses again and again. But, gentlemen, it "is the old story. Calomel is of no use during the " stage of collapse ; but by-and-by, when the powers " of life begin to revive again after the shock is over, " the first thing the system has to deal with and to " dispose of is twenty or thirty grains of calomel. " What results ? Very often vomiting of that ' green 



16 

" ' paint-looking matter' of which I spoke appears, " and you know how hard it is to stop that ; or bilious " diarrhoea is excited, which soon brings the case to "an end. At the best it disturbs the stomach and " interferes with nutrition. At such a time Nature " needs the helping hand of the physician to sustain " and assist her in the life and death struggle, instead " of being searched and goaded by powerful drugs, " prescribed no matter with what intention. Called " to see a case of cholera, a few months ago, I found " calomel in combination with opium being 'poured in' " every hour. I ventured respectfully to ask the " reason why; the patient being in a state of collapse, " the medicine was accumulating in the stomach like " water behind a barrier. ' What,' I asked, 'do you " ' expect will be the action of all this calomel " ' when the barrier gives way, when the functions " ' begin to be restored?' The prescriber was not very " sure, thought perhaps it might have a ' cholagogue " ' action — stimulate the bile.' I might have asked, "Is it not conceivable that Nature will do this her" self? And why not stimulate the kidneys as well? " Why concentrate all your attention on the bile? " Is the biliary more in abeyance than any other " secretion? and so on. Ido not think these are " impertinent questions. I recommend you to put " them to yourselves when you are tempted, in mo" ments of doubt, to prescribe as D'Alembert said we " sometimes do — using physic as a strong but blind 



17 

" man uses a club in a crowd, hitting friend and foe " with equal impartiality. 

" Stimulants, both of a medicinal and alcoholic " kind, have been much resorted to in cholera, and " very naturally. The prostration of the powers of " both circulatory and nervous systems is so extreme, " that we cannot wonder that strenuous efforts have " been made to rouse and to sustain them by the free " use of remedies of this class. Yet I think that those " who have used them most, if observant and candid 11 men, must admit that they have not answered their " expectations ; and, at least, all must allow they re" quire to be given with a cautious hand. They are " useful, as I shall presently show, when given at the " proper time and in the right way. I do not think " they are of any use during the stage of collapse, " when, at first sight, they might appear most appro" priate. 

" We have thus examined the therapeutic value of " the remedies that have been most used in cholera. " The result is not encouraging. I may say I have " tried most of them, and the above is the result of "my experience. You will perhaps say — Do you " then advise no treatment in cholera at all 7 Well, I " can only say that, in the collapsed stage, I know no " drug worthy of the smallest confidence. Must we, " then, abandon our patients to Nature, and do no" thing? Must we suffer them to die without any " effort to save them? My answer is, that efforts of 



16 

" ' paint-looking matter' of which I spoke appears, " and you know how hard it is to stop that ; or bilious " diarrhoea is excited, which soon brings the case to M an end. At the best it disturbs the stomach and " interferes with nutrition. At such a time Nature " needs the helping hand of the physician to sustain " and assist her in the life and death struggle, instead " of being searched and goaded by powerful drugs, " prescribed no matter with what intention. Called " to see a case of cholera, a few months ago, I found " calomel in combination with opium being ' poured in' " every hour. I ventured respectfully to ask the " reason why; the patient being in a state of collapse, " the medicine was accumulating in the stomach like " water behind a barrier, l What,' I asked, 'do you " ' expect will be the action of all this calomel " ' when the barrier gives way, when the functions " ' begin to be restored?' The prescriber was not very " sure, thought perhaps it might have a ' cholagogue " ' action — stimulate the bile.' I might have asked, " Is it not conceivable that Nature will do this her" self"? And why not stimulate the kidneys as well? " Why concentrate all your attention on the bile ? " Is the biliary more in abeyance than any other " secretion? and so on. Ido not think these are " impertinent questions. I recommend you to put " them to yourselves when you are tempted, in mo" ments of doubt, to prescribe as D'Alembert said we " sometimes do — using physic as a strong but blind 



17 

11 man uses a club in a crowd, hitting friend and foe " with equal impartiality. 

" Stimulants, both of a medicinal and alcoholic " kind, have been much resorted to in cholera, and " very naturally. The prostration of the powers of " both circulatory and nervous systems is so extreme, " that we cannot wonder that strenuous efforts have 11 been made to rouse and to sustain them by the free " use of remedies of this class. Yet I think that those 11 who have used them most, if observant and candid " men, must admit that they have not answered their " expectations ; and, at least, all must allow they re" quire to be given with a cautious hand. They are " useful, as I shall presently show, when given at the " proper time and in the right way. I do not think " they are of any use during the stage of collapse, " when, at first sight, they might appear most appro" priate. 

" We have thus examined the therapeutic value of " the remedies that have been most used in cholera. " The result is not encouraging. I may say I have " tried most of them, and the above is the result of "my experience. You will perhaps say — Do you " then advise no treatment in cholera at all? Well, I " can only say that, in the collapsed stage, I know no " drug worthy of the smallest confidence. Must we, 11 then, abandon our patients to Nature, and do no-11 thing? Must we suffer them to die without any " effort to save them? My answer is, that efforts of 



18 

" the kind described above are futile; your remedies " are either vomited, or, if retained, are inert, and if " given, as they often are, in excessive quantities, " they become a serious source of embarrassment, " interfering above all with nutrition. If opium, the " preparations of lead, or calomel, have been abstained " from, Nature, in the stage of reaction, starts, so to " speak, fair, which I am sure is not the case when " weighted with one or other, or, as, I have often " seen, with all the above. Because I objected to " bleeding intemperate old soldiers of twenty years' " service in tropical and malarial climates, taking " blood away to the extent of upwards of a hundred " ounces when suffering from peri-hepatitis, I was " called the other day ' the Micawber of medicine,' the 11 gentleman ' who waits to see what will turn up.' " Well, I don't object to the name in the least; I had " rather be the ' Micawber' than the ' Sangrado' of " modern medicine. The more I have ' waited' upon " Nature, the less I have attempted to force her — the " more , I have found that ' something' is pretty sure "to ' turn up' to the advantage of my patients. Very " notably has this been the case in cholera. Some — " unfortunately a great many — patients in severe " epidemics, will die, but such cannot be saved by 11 pouring drugs into them in the collapse of this " terrible disease. 

" No remedy has been more used — I should rather " say abused — than opium. Most India practitioners 



19 

" have abandoned it as treacherous and dangerous. I " must earnestly caution you against its use. In the " stage of collapse, if it is retained, it is, it must be, " useless. But when reaction sets in, the opium, pre" viously inert, begins to act, and is at once a serious " hindrance to the restoration of the secretions, and if " the quantity given has been large, often hastening "on cerebral symptoms ending in coma. These are " its dangers, without, so far as I know or could ever " discover, a single compensating advantage. 

" What of astringents 1 No class of remedies have " been more used in cholera. The great anxiety has " ever been to ' restrain the evacuations.' Yet I am " persuaded that the mere purging rarely kills ; and, " as I have already said, in the most fatal form of " cholera there is no purging, or very little. Graves " recommended acetate of lead with opium, and this " combination has been more used than perhaps any " other remedy, in cholera. Sometimes capsicum is " added by way of a stimulant. Here, again, we are " met by the old difficulty : what service can we ex" pect from such combinations during the condition of " collapse 1 Very little, I fear. And what is likely " to be the action of large quantities of this powerful " sedative during the stage of reaction ? Will it aid, "or embarrass the struggling system? Again, sup" posing the remedy to be retained, and to act, how " far do we benefit the patient by controlling the " purging 1 I don't believe that cholera is caused by 



20 

" { hypersemia of the nervous centres from heat.' If " this hypersemia be present, there is something else " present also, some materies morbi, some subtle poison " — what, I know not, Ido not pretend to know. If " it be the case, as so many suppose and as I believe, " that this poison is in part at least eliminated in the " intestinal canal, how far do we benefit our patient 11 by restraining it ? I have ridiculed the attempt to " secure this object by mechanical means : will the use " of astringent drugs stand the test of argument any " better ? But then experience has sanctioned them. 11 Alas ! I have had much experience, and I am sure " that I was more successful, as a rule, when I with" held them. Still, there are cases where some as" tringent is necessary. Granting that the purging, " within certain limits, is salutary, it may go on to 11 such an extent as to lower the patient hopelessly. " In such cases an effort must be made to restrain it. " Acetate of lead should then be used, in solution, but " without opium. In such cases pernitrate of iron, in " full doses, might be tried. My friend Surgeon-Major 11 Mudge, of the Madras Army, made a trial of turpen" tine in egg emulsion with an aromatic, and in a " number of cases found it more than answer his 11 expectations. The sufferers in whom Dr. Mudge " tried it were all Asiatics. It does not seem to have " caused vomiting, or even nausea — the objection to " which we might expect to find it open, as turpentine "is generally a nauseous medicine. In one epidemic 



21 

" I found nitrate of silver exceedingly useful as an " astringent in excessive purging, particularly, as I " noted at the time, in children ; some of my native " pupils used it extensively during the same epidemic " in the great native city of Hyderabad, and with so " much success as to gain for themselves considerable " reputation. I used it again, in the following year, " with disappointing results — another proof of the " ' varying constitution of epidemics.' 

" I have felt it to be my duty to speak distrustfully "of many methods of treating cholera which have " lately been urged on the attention of the profession " and the public. Many of them, if you will excuse a " homely metaphor, are the cast-off clothes of Indian " practitioners, brushed up to look like new. ' Old " ' Indian' doctors know them well, and make a pres" ent of them to their new and complacent wearers " without a sigh. Well, gentlemen, I know no • cure' " for cholera. What is more, I suspect we are never " likely to see one. Nevertheless, I believe we shall " in time extinguish cholera as we have, in this coun" try at least, extinguished plague. This is one of the " certain triumphs that await the slow progress of " sanitation. It is probable that a whole generation "of obstructives must pass away before even the " initiatory steps in this great movement are likely "to be taken. We have sanitary commissions in all " the great Presidency towns of India ; but they are " without the necessary authority to act in an effect" 



22 

ive way, and, in some instances, very notably in " Madras, the whole weight of those in power is exer" cised to obstruct the efforts of the commissioners " for the public weal. We are not very much better " off at home. Men ignorant or indifferent in such " matters abound in high places, and in almost every 11 municipal body in the kingdom trading selfishness " and apathy prevail to detriment of the public health. 

" It would be unprofitable to pursue this part of my " subject further. I wish I could hope that we had " seen the last of a practice which is neither dignified " nor useful. 

" Note. — Since the above lecture was delivered, I " have seen and read with pleasure and profit Dr. " George Johnson's Notes on Cholera. This able phy" sician has been led to much the same conclusions as " to the action of most drugs in cholera as are ex" pressed above. Dr. Johnson puts more faith in the " action of purgatives than I can do ; for, like every " known class of drugs, they have been freely used "in India. I sincerely trust that Dr. Johnson may " never see so many cases of cholera as I have done ; " but I cannot help thinking, should it be otherwise, " that he will see cause to believe with me that, in a " vast majority of cases, there is quite enough purging " without artificial aid. Still, for my own part, if " again smitten by cholera, let me rather fall into the " hands of & purging than an astringing physician — " one who thinks he does you service by retaining 



23 

" what Nature is so solicitous to expel from the sys" tern."*-- -See London Lancet, for May, 1866. 

But as modes of treatment, like other agencies, can be fairly judged only by their results, I will now give the official statistics of the School under consideration, reported by its own authorized agents. In 1831-1832 there were, in New York City alone, 5232 cases of cholera, and of these there died 2031, or nearly two out of five of the whole ! But of the above number, there were treated in the hospital, 2373 ; and in private practice, or at their homes, 2859 patients. Of the former, 1094, or about one-half died ; of the latter, 937, or nearly one-third died. In France and Italy the results are no better. We have returns from twenty-one hospitals, and the average gives 63 deaths in every 100 cases. In the epidemic of 1848-1849, we take from the government reports of Great Britain, of 24th of February, 1849, these figures — there were reported 12,485 cases, of which 5546 died, 3788 recovered, and still under treatment 3164 — that is, more than one-third had died, and more than two- thirds had not recovered. 

In the city of New York, in the same year, there were, during fifty-two days' private practice, 2631 cases and 915 deaths, or about 35 out of 100. In five hospitals, there were 1901 cases, 1021 deaths, and 880 

* The justly celebrated Magendie, in his address before the College of France, in February, 1846, says: "If I were to say all I thought, I should " add, that it is especially in those cases in which the most active means are "employed that the mortality is the greatest." 



24 

cures ; by which it appears that more than one-half died. During three months, in Liverpool, the most favorable average gives 46 deaths in every 100 cases ! 

These facts and figures require no comments ; they are such results as might naturally flow from that very " rational" and " scientific" mode of treatment quoted above. 

I have now laid before my readers the opinions and statistics of the Old School in the treatment of cholera. These are drawn from undoubted and unimpeachable sources. They are the expressions of independent thought and unbiased observation. They are all that the Old School has been able to do for humanity, and for the world, in Therapeutics, at least, since " the 11 blind, the maimed and the halt" sat, in hopeless expectancy, " waiting for the moving of the water," till this present year of grace ! And yet, strange to say, we are told by thousands of these gentlemen every day, that they are the exponents of " scientific 11 medicine," of "rational treatment," and " effectively" curative means !" But let it be borne in mind that, as the swaggering subaltern ranks but indifferently by him who can " set a squadron in the field," the " village statesman" is heeded little when Chatham, Burke, or Webster speaks, so " medical gentlemen," " whose fame full four miles round the country ran," had better be prudent when such men as Watson, Liston, Maclean, and Magendie have spoken to the world ! 



25 

Is it, then, an unnatural result, or a wonderful phenomenon, that, wearied, oppressed and fettered by this conglomerate of contradiction and empiricism, which has hardly moved an inch or changed an atom since the days of Hippocrates, there should have been found in its ranks some who desired more light, more safe, scientific, and effective methods of healing? The presence of a New School of Medicine is a standing demonstration that such men existed in its bosom. To this School, its claims, its position, its character and its results, I shall now direct attention. The Homoeopathic School is to-day known, honored, trusted, and legally protected in all its rights and privileges in every well-governed nation and country on the globe ; and may fairly and without presumption claim a hearing on this coast, when it speaks for the lives of the people — for a more simple and effective mode of saving them ! 



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CHAPTER 11. 

HOMOEOPATHY AND ITS RESULTS. 

As much, popular ignorance prevails on this Coast as to the nature of Homoeopathy, and the qualifications and standing of its practitioners, and no effort having been made to place these matters fairly before the public, I may be allowed to state that, over sixtyfour years ago, a reformation in Therapeutics, or the mode of administering medicines, and the principles on which they should be administered, was inaugurated by Dr. Samuel Hahnemann, an accomplished scholar, a clear and careful observer and a profound medical philosopher. He published to the world his discovery as soon as made. It consisted in this proposition : There exists a general law which guides in the selection of remedies for all forms of disease '• This law is expressed by the formula, Similia similibus curantur; or, in English, that any substance which 'produces in the healthy an affection similar to any given disease, will cure the disease which resembles this affection. Every physician practising according to this law is a Homoeopath. But, by a deduction from this mode of administration, founded upon experience, 



27 

it became necessary to give the medicines in much smaller doses than they had been given in the other school. This arose from the fact that when the medicines were first given in the usual quantity, a serious aggravation of the disease took place. In this reduction, however, every physician is left to the guidance of his own judgment and experience as to the exact size of the dose. 

Only one medicine is given at a time. 

The medicines are always " proved," or tested on the healthy before they are given to the sick. 

These indicate the principles on which Homoeopathy stands, and the practice of the School. The associates and immediate followers of Hahnemann were converts from the Old School, men of education and experience, who were fully qualified to test the truth and practical value of his discovery. And it will be observed that it admits of a very easy and simple test. 

It will be necessary for me to notice here that in all the other branches of medical science there exists no difference of opinion between these schools; — Anatomy, Physiology, Surgery, Obstetrics and Chemistry are common ground, on which we meet as equals, and on which the discoveries have been both rich and extensive — much to the honor of the Old School — so that the law of administration, the quality and quantity of the medicines given to the sick mark " the line on which we are fighting it out." 



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As to the standing of each physician who calls himself a Homoeopath, he must be what every Allopath is expected to be, — but what every Allopath certainly is not, — an educated gentleman, — a legally qualified graduate of a medical college, properly so called, — one who has well and carefully studied every branch of medical science, and who devotes all his time to the practice and study of his profession ; before he can claim any recognition in the Homoeopathic School. The man who professes his readiness " to practice according to either system," proves that he knows neither. The man who takes up a "Manual " of Domestic Practice" and a small case of globules, has as little claim or relation to the New School as the man who takes up the little "dose-book," in which all is ready cut and dry, and fit for his pocket, has to the Old. These are only "gentlemen on their last legs," who have turned out to play the doctor : that being a calling which, in this country, any one is at liberty to take up without legal restriction, or probability of detection. 

Consultations are incompatible, because ineffective, between the members of each School, except in surgical cases. As surgeons, there must always exist perfect harmony between qualified and skilful men and decided advantage to the patients be the practical result. 

It would be unnecessary to say a word as to the present position of Homoeopathy, were it not that our 



29 

city and State have hardly kept pace with the progress of the world in anything, save the production of material wealth, for the last seventeen years. But science and literature have been progressing elsewhere without our knowleege or our aid. Homoeopathy has not slept. Its literature, its colleges, its hospitals, its dispensaries, its practitioners and their vast body of supporters are as clearly and distinctly a marked feature of the age as the motive triumphs of steam. It made its appearance in the United States in 1827 ; and in 1828 had just two medical men to represent it. To-day, it reckons nearly five thousand practitioners ! How these are patronized, and by what class of the community, let the world judge. There is not a town or a city in which every qualified member of the School has not as much to do as he can accomplish ; and even some, who are no honor to it, or part of it, succeed under the shadow of its name ! And all this success is obtained among the best educated and most intelligent of the people. Indeed, it finds favor only with these everywhere; since it appeals only to such as are able to rise above the habits of past ages and and the material aspects of heroic practice. Its colleges are legally established, on the same footing as all others, in New York, Philadelphia, Chicago, St. Louis and Cleveland. Its hospitals and dispensaries — its monthly and quarterly journals, are public institutions and creditable witnesses in almost every city in the Union, deserving the name. In South 



30 

America its triumphs are as marked and its success as great. By a recent order of the authorities of New York, hospitals have been ordered for Homoeopathic practice, in view of the approach of cholera. 

In 1830 it was introduced into England, by Dr. Romano, who was called from Naples by the Earl of Shrewsbury, its first advocate : whilst the Queen Dowager, two years afterwards, was restored to health under the treatment of Dr. Stapf, who was brought from Germany for special attendance. To-day it fills the land ; its advocates are the royal, the noble, the educated — those who can look back to ten generations of culture, taste and refinement. When I say that the " Fairs," or " Bazaars," for the benefit of its hospitals, have been held in rooms exclusively used by the Queen's Life-guards and adjoining her Royal Palace, that at the tables may be seen, as saleswomen, her immediate blood-relations ; and some of the wares offered by their hands the handiwork of her royal daughters and late royal mother ; I have said enough to establish my point. Shall I remind my readers of the fact, lately so public, that some of the Life Assurance Companies of London have declared in favor of taking risks on the lives of those under Homoeopathic treatment at a much reduced rate of premium (whilst some of our own, never slow to profit by good example,) have acted on the same principle. Those who desire further information on these points may consult our public English organs, The British Journal 



31 

of Homoeopathy — now in its twenty-fifth year — and the Monthly Homceopathic Review, and judge whether they compare favorably with any medical periodical which the world has produced. 

The Emperor of Austria early placed Homoeopathy on an equal footing with Allopathy — allowing them a fair trial to measure lances ; and with what result 1 Homoeopathy has spread throughout the length and breadth of the empire with marked and distinguished success, and is more generally practised in Austria than in any other part of Europe. The Medical Schools are divided between both practices, and each student left to his free choice. 

In 1844, Homoeopathy was established in Hungary by a decree of both Houses, under the Viceroy Joseph, and still holds its own and progresses as elsewhere. In Prussia a Royal College and Hospital are established. Both the King and the Prince of Prussia have, as their medical advisers in-ordinary, Homoeopathic physicians. 

Throughout all Germany, the birthplace of Hahneman — and whence, by the persecution of the apothecaries, he was once exiled — he is now almost canon, ized; statues are erected to his memory, and the reign of the New School perfectly triumphant. Schools, colleges and hospitals abound everywhere. In France, equal rights and privileges are granted to the School, and brilliant marks of success have crowned it, both in private practice and in the wards 



32 

of the hospitals set apart for its trials. In Russia, the late Emperor's ordinary medical adviser was a Homoeopath ; under whom he died. Though this may prove no recommendation of the system, it proved the Emperor's faith ; and, as Emperors as well as plain people have often died under the other system, I do not see the point to be very strong. It is, however, still the court practice in that royal household, and established in the empire by legal authority, and its share of military and civil practice guaranteed. 

Among the students of the Founder of Homoeopathy, in Paris, about the year 1836-1838, was a young Spanish physician, who spent a large fortune in translating the works of his new master into his native language, for the benefit of his nation. His only reward, on his return to Spain, was derision and neglect. His early death was caused by undeserved and painful disappointment. In 1848, however, we find Dr. Nunes, the President of the Homoeopathic Society, receiving the " Grand Cross of the Royal Order of Charles III," from the hands of Isabella 11, and the appointment of physician in-ordinary to her majesty. In 1864 we find him rewarded with the rank of marquis, by her most catholic majesty. And, by a royal decree of the sth of January, 1865, we find a Homoeopathic Hospital and Chairs of Instruction in its therapeutics, established in Madrid, the cost to be defrayed by the Government: In Italy it moves as fast as it is possible for new ideas to progress in so 



33 

conservative a nation ;—"; — " still rfmoves," — and is very well represented. The society has received, by legal enactment, the title of " Royal Academy." This is equally true of the Two Sicilies. And the Duchess of Parma has established a Homoeopathic Hospital in her Royal Palace. 

So much, then, for the spread and present aspect of Homoeopathy. I come to my next question : What has it done, and what can it do, in cholera ? 

In 1831-32, in Vienna, there were 581 cases of cholera treated Homoeopathically, of which 49 died, or eight per cent. The well-known Dr. Quin, late Physician in-ordinary to the King of the Belgians, and afterwards to the late Queen Dowager and the Duchess of Kent, gives a report of the treatment of ten Homoeopathic physicians on the Continent, giving, as the worst result under any one of them, one death in every five cases. Of these, Dr. Weith, of Vienna, treated 125 cases, and lost only 3 ; or cured 40 out of every 41. They had 1093 cholera cases, they lost 95 and saved 998 ; that is, 21 out of 23 recovered ! In April 1832, by order of the King of Bavaria, Dr. Rath made an official report on the treatment of fourteen Homoeopathic physicians. They had treated 1269 cases, saved 1184, lost 85. In Russia and Austria, at Berlin and Paris, 3,017 cases are reported, of which 264 died and 2,753 recovered ; giving an average of more than ten out of eleven saved ! By order' of the Emperor of Russia, the Consul-General, Eustaphieve, reported 



34 

as having taken pla«e in 1830-1831, 1,270 cases in different parts of Russia under Homoeopathic treatment. Of these, 1,162 cases were saved, and 108 lost — or, nearly one death in every twelve cases. 

In 1848-1849, there is a return of 162 cases having taken place in Liverpool. The cures were 119 ; deaths, 43. In New York, under the care of 22 physicians, from the Ist of July to the 9th of October, there were 350 cases, of which 53 died, or a little over 15 per cent. In Cincinnati there were 1,116 cases, and only 35 deaths, or a mortality of 3.1-7 per cent. The gross result obtained in Edinburgh, Liverpool, New York, and Cincinnati, was 4830 cases, of which 445 died, showing 91 out of every 100 saved ! 

In 1853, for the months of May, June and July, we have a report from Shahabad, India, of 629 cases ; deaths, 199, cured, 430. 

From a comparison of the statistics of both Schools now before us, it would appear that under Allopathic treatment, in general practice, four times as many cases of cholera are lost as under Homoeopathy ; and three times as many in private practice. These facts speak for themselves. They are the expression of mathematical demonstration, and have never been called in question ; and were I not restricted from encroaching on space, which I require for matter of more importance, I could show, from the statements of the Government officials — members of the Old School — appointed to ascertain most of the facts above quoted, 



35 

the most candid and unreserved acknowledgments in favor of the New School over the Old, in dealing with Epidemic Cholera. 

But the majority of the inhabitants of this Coast, especially the earlier settlers, may very naturally feel some surprise at the preceding statements. To them they will, perhaps, seem new, startling, and even incredible. They may, therefore, be pardoned if the question should naturally arise : " If Homeopathy is this simple and effective mode of cure which you have described, then why, we desire to know, have not all the doctors everywhere adopted it 1 Are they not ready to avail themselves of every new improvement and addition to their system 1" Both points are well and fairly made. I meet the second point first ; and admit that they are always ready to try every new remedy, but only as an addition to, or a patch on, " Old Physic." But Homoeopathy is a total reformation — a radical change, an abnegation of old therapeutics, both in principle and practice — an unlearning of all that has been acquired in the choice and administration of drugs ! In reply to the question, " Why is it yet in the minority, and not embraced by the doctors generally V 1V 1 I answer : First — that in all ages and countries, the practice of medicine has been considered a sort of second Religion ; and that next to the creed to which people look to save their souls, the creed which professes to save their bodies has the firmest hold on their prejudices. Until within a comparatively 



36 

short period, the two offices were blended in the same venerable personage ; the "medicine man" and the priest were one. Second — Great truths have always developed and traveled slowly. The first sixty years of the Christian Reformation ga^ve little promise of later poogress, and the journey to the end is still long and toilsome. It is not yet one hundred years since the effulgence of the Gospel extinguished the flames that had consumed our unfortunate "witches." 

It was long before it would be granted that steam could relieve men and horses from the heaviest portion of their toil, cause the mill to grind without its motive stream, and fleets to traverse the ocean indifferent to the uncertain winds ! These, the impossible dreams of yesterday, are the facts of to-day. Third : But few men are gifted with the capacity for receiving new ideas, and still fewer to act on them, when they would overthrow established usages and cherished systems. Fourth : There are but few medical men who, having acquired hy years of toil and drudgery a knowledge of prescribing medicines according to their Pharmacopoeia, are willing, or indeed able, to undertake, in advanced life and, perhaps, full practice, another long and tedious course of study, and of a new mode of treatment, which requires careful analysis, close and constant thinking and unwearied observation, before they can hope to feel at ease by the bed-side, and conscious that they are able to cope with acute and dangerous 



37 

maladies with fair prospects .of success. Fifth : The amount of pecuniary risk involved — and at first it must be serious — has much weight with by far the largest number of men of every profession and calling. Sixth : The greatest and most difficult trial which falls to the lot of even the truly brave, though conscious of right and of being engaged in the best of causes, is to stand out single-handed against the opinions of the multitude : — to bear the jeers, the scoffs, and scornful epithets of even the ignorant, the unreflecting and worthless ! To be of the " unfashionable minority, " even among the very " smallest people, " and in the " smallest community " requires more pluck and philosophy than falls to the share of the general run of men. But how impossible this hard labor, self-assured calmness and dignity for that large class of medical men, to be found everywhere, who require to devote so much time, thought, and peculiar talent to the cultivation of those meretricious shifts that produce and maintain among the masses the impression that they possess professional gifts and attainments which Nature has denied them. Seventh. All know that " habit is a second nature ;" and when men have been for ages accustomed to believe that in sickness they must swallow large quantities of disgusting compounds, be reduced by the painful ordeal of bleeding, purging and blistering, almost to the verge of dissolution before they can be restored, it is not easy to convince either the patient or attendant 



38 

that both could do better by the aid of good nursing, plenty of cool air and water, and, in most cases, a comparatively imperceptible atom of medicine. 

But the sophism, deduced from these heroic measures, is ready in every one's mouth, when this harmless method is suggested — " How can it do me good, if it does me no harm /" — a sophism easily refuted, since the whole economy of nature is its contradiction, but hard to erase from the undisciplined mind. 

These are but a few of the many answers that may easily be given to above questions. But they are sufficient to show that Homoeopathy is " doing as well as can be expected." And in being thus slow in its progress it only fulfils its destiny and proves its celestial origin, as a spark of that Heavenly fire which at first only reached the earth in spite of the vigilance of the gods ! 



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CHAPTER 111. 

PUBLIC SANITAEY MEASURES. 

The general question of public sanitary measures against the inroads of Cholera, in large towns and cities, has been as well considered and as carefully investigated as any that has ever occupied the public mind ; and no question has been so ably and pressingly urged upon the attention of those at the head of public affairs at home and abroad. It would, therefore, be only a repetition of what has already been said to go over the ground again. It will be observed, however, that, whilst declaring himself well satisfied with the regulations adopted by the heads of public departments, in the cities and towns of Great Britain and India, Dr. Maclean expresses great regret at the open negligence and corruption of the subordinate officials whose duty it has been to give practical effect to those measures ; nor does he hesitate to charge them with incapacity and dishonesty, — with obstructing, rather than forwarding, the course of wholesome and safe legislation. The danger, therefore, arises not so much from want of knowledge as from delinquency. 

But as we live in a younger and more vigorous community, in which, it may be thought, mal-administration 



40 

has not had time to mature, it may not be unreasonable to hope that our sanitary measures may have more effective force, and be carried out for the benefit of the public; and not retarded or obstructed for the accommodation of the few. It is a matter of course that no improvement can be made on a large scale in this, or any city without some disturbance of " vested interests," or " private rights ;" but as it is often found that these embrace the worst nurseries of moral degradation and disease, it would be uncharitable to suppose that they should be allowed to interfere for a moment with the public good. 

We are aware that those interested in maintaining such places undisturbed, are always willing to make it a matter of some consideration to be left unmolested. But in view of the probable approach of Cholera, no one could suppose that, on this account, our officials would for a moment neglect the onerous and sacred trust committed to them. For should this destructive scourge reach our city in its present unprepared condition, among the large portion of the inhabitants it might sweep away, may be counted the families and persons of the officials themselves. It would, however, be pleasant, as well as hopeful, for those who understand these matters to see more attention paid to extensive and effective sewerage, more watchful care over the condition of our streets, — the speedy removal of all public and private nuisances from the city and suburbs, and a close supervision of the public 



41 

markets ; in which objectionable animal and vegetable matter will sometimes accumulate. 

It has been observed that in large cities, the haunts of drunkenness and degrading vices were the first spots selected by Cholera ; and formed the centres from which it radiated and extended far out among the dwellings of the well-ordered and wealthy inhabitants. It would, therefore, be well if in our city it could, for the time being, be so ordered that there should not be found a drinking house, and a house of a worse class still, to alternate each other through whole streets ! If three of the corners of nearly all our street intersections were not occupied by three drinking houses, (styled, for the sake of morality, " family groceries,") the fourth being invariably a drug store. This peculiar feature gave rise to a remark we heard a short time since, " that our street-crossings were guarded by three hells and a purgatory. 11 

It is true that by the suppression of so many of these places, there may be some considerable loss to the revenue ; but the counterbalancing gain in the diminution of crime, closing the fountains of demoralization and removing the head-quarters of disease should outweigh this consideration. It does not seem to be good policy for a city or State to enrich itself at the expense of the degradation and death of the citizens. But, as these are public affairs, out of the reach of any private person, I shall now pass on to what is more within my province : — to direct each family and individual as to 



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what they can do for themselves by way of prevention, and in cases of emergency. 

CHAPTER IV. 

PREVENTION. 

The mission of the true physician is to prevent disease where he can, to cure, if possible, and to palliate and modify, when neither prevention nor cure is practicable. He should appreciate its germs in early infancy, track its course through the periods of youthful development, and take due notice of its advances in the after stages and changes of life. He should give timely warning of the individual habits and general causes which invite and nurture it in each single patient, as well as in the whole community. 

Whilst this is desirable in every form of disease, it is specially important in Cholera. Everything depends upon effective methods of prevention, and on arresting it during the invading stage. In order to accomplish the former, it is absolutely necessary to have some clear ideas o£ predisposing causes. Perhaps the very 



43 

worst of these, because the most difficult to control, is Fear, or Panic. Now, it should be borne in mind, and laid down as a settled principle by every intelligent person, at least, that Cholera is not contagious ; that is, that a person does not necessarily " take it," because he is brought into immediate contact with one who lias Cholera. 

This question has been settled by the most experienced, careful and extensive observation of the most reliable and competent men of this age. Cholera is an Epidemic, not a contagion. It will be well for those who are subject to this weakness to remember the well-known fact that medical men enjoy an immunity from what are generally deemed infections. No reason can be given for this than that they are never afraid. The feeling of fear is as foreign to a true physian in the discharge of his duty, as to a true soldier in the heat of conflict. And it is very important that neither medical men nor others should become alarmists by expressing themselves doubtful, or at all undecided on so important a point.* Every one should remember the dialogue between the Turk and the Pestilence. " Where are you coming from ? asked the Turk. " From Smyrna, where I slew 2000 people," said the Pestilence. " I know that is not true," said the man, "for you killed 6000 

*The writer is aware of the long array of arguments for, and against contagion. The balance seems to him in favor of the non-contagionists. His unqualified affirmative, however, has been given rather in tho interest of humanity than on the side of mere theory. 



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there I" " You are mistaken," said the Pestilence :"I killed only 2000, but Fear killed the other 4000 !" 

Due regard to cleanliness in and about the dwelling and its apartments, must be kept steadily in view, and strictly enforced. No filth must be allowed to accumulate ; water-closets, drains, sewers, etc., must be carefully looked after and kept in good condition. The free use of disinfectants is indispensable in every case. The most useful and easily provided are Quicklime, Chloride of Lime, Coal-tar, Heat — in the shape of boiling water, or steam, required for purification of clothes, etc. — and Charcoal. Every intelligent person is acquainted with the use and value of the above substances as disinfectants ; but people are very apt to overlook their practical application. We are ready to do anything when we see the enemy, but often forget him whilst at a distance. 

Personal cleanliness must not be overlooked. In general, little more than the usual ablutions, and the frequent and regular change of inner garments, is necessary for extraordinary, as well as ordinary purposes, to promote and sustain the healthy action of the skin. But considerable danger arises from the habit of too frequent cold bathing, whether as shower, plunge, or sponge baths. This habit interferes with the natural and healthy circulation of the blood, retards the action of the heart for the time being, and not unfrequently disturbs its functional office. If the bathing-tub is preferred to the sponge, twice a week 



45 

is sufficient in nearly all cases. The water should be used tepid, except for those parts of the body which are exposed to the atmosphere. 

Excessive mental excitement and depression should be studiously suppressed and prevented, as they lower the healthy functional action of the whole system, and predispose it to take on more readily any prevailing epidemic. In our unsystematic community there is no small danger from over-work, which, by regulating the hours and quantity of labor, for mind and body, may easily be prevented. The dissipated and the intemperate have generally become the first victims of cholera, with hardly a hope of recovery. He who bears a depraved mind in a diseased body, has but a poor chance where the balance of power, under the most favorable circumstances, is on the side of the enemy. The due observance of the laws of Nature, which are the laws of Health, and of the still higher law which regulates the requirements of morality and conscience, answers to the strictest demands of medical science. 

Diet. This is a most important element in the category of preventive measures. It may safely be asserted that he dines best, and even most luxuriously, whose fare is the simplest and plainest, and whose table is weighed down by the least number of dishes. . It is a matter of great regret that an impression should exist in society generally, that the consequence of a family is enhanced by the plurality of the 



46 

dishes off which they make a meal. It is perhaps as doubtful a foundation for respectability as it is injurious to health and dangerous to happiness. It leads to the bad habit of overloading the stomach with a variety of indigestible, unwholesome and incongruous substances from which nothing but ill health and, too often, sudden and acute disease result. One or two plainly and well-cooked dishes of good meat, and as many of vegetables is a better dinner than the feast of a London Alderman, or the banquet of Sardanapalus. " Eat to live," is an old, but very good rule, and forbids all excesses in eating and drinking. 

On this Coast, as well as in the other States of the Union, there is an inordinate appetite, amounting to a sort of passion, for early fruit and vegetables. It is, indeed, very commonly expressed by the phrase, " O, I love them so /" I may safely assert, after many years' experience and observation, that these "beloved objects" are the cause of seven-eighths of all the cases of bowel complaints that occur in the United States during the season. The very large demand for them, and at any price, makes it an object to have them early in market. They are, therefore, gathered in an unripe state, brought a long distance to town, exposed in the hot sun till partial decomposition takes place ; they are purchased and eaten, and all the consequences that may be expected from a large mess of decayed vegetable matter in the human stomach is the result. In 



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" Cholera times," and at all other times, the best advice we can give is that, — 

" Some are good, and sell dearly ; while some, 'tis woll known, " Are so dear, and so bad, they are best let alone." 

Cucumbers, radishes, cabbage, &c, &c, do good to none and mischief to many. 

Some of the worst cases of Cholera-morbus I have met with on this coast I have traced to eating fish of different kinds, and, perhaps, in a doubtful condition for the table. Ido not think that too much caution can be exercised by those who are in the habit of eating a hasty meal at public tables as to the character and quality of what they eat. On the whole, whether at home or abroad, perhaps the less fish, of any kind, people eat, during hot seasons, when bowel complaints mostly prevail, the better. As to pork, it is not now necessary to refer to it ; the people are pretty well cured of it already. Mince-pies, sausages, and the like, may be fairly tested, as to their fitness for human food, by placing them before any well-cared-for dog, and being guided by his action in the premises. To go into further detail here is both undesirable and unnecessary for my present purpose. Most persons, who are in the habit of exercising any caution at all, know what generally agrees with them ; and so long as they keep within these limits they have not much to fear. 

Errors, however, may arise on the other side from motives of fear, or religious duty. It is not right that people should stint themselves of a full and sum"-cient 



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quantity of wholesome food, lest they may overload the stomach and disturb the function of digestion ; this is the other extreme. 

When the cholera appeared in Paris, in 1832, it was during the season of Lent, and it was noticed that the mortality was much greater than during any other period of the year. In Louisiana, where the majority of the people are Roman Catholics, four times as many died of cholera as in Protestant communities of the same numerical population. This has been attributed partially to the strict fasting and abstinence required by the rules of the Catholic Church ; since it is well known that insufficient and inferior diet reduces the system below par faster than the hardest labor, or even sickness. I may here remark that the laws of Nature are admitted by all to be the laws of God. Religious ordinances need not conflict with them ; and when they do, it is very clear that the penalty is always sure to be exacted to the full on behalf of the former. 

With regard to wines, alcoholic and fermented liquors, there is but little to be said. They who use them least are, I believe, in a better state of mind and body at all times, than those who use them in excess ; they are less liable to contract disease, and more likely to have a shorter sickness and a better recovery. If, however, they can be obtained of a good and pure quality — which admits of some doubt — they can be used at all times without 



49 

abuse ; and often, under certain circumstances, to great advantage. They are dangerous elements only in the hands of the weak and the foolish ; whilst the wise and the prudent use them for the purpose for which they were intended by Providence. 

It may, perhaps, be for the good of the people generally, if our lawmakers would remove dangerous weapons as far as possible out of reach of those who do not know how to use them. If to get drunk cost as much as the " concealed deadly weapon," and the " fine for carrying it," health and morality would be great gainers. It will doubtless be so, when our laws are framed to prevent crime rather than to license its inducements, and then punish the culprit ! 



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CHAPTER V. 

WHAT TO DO IN CASES OF SUDDEN EMERGENCY. 

In dealing with this part of our subject, it is a matter of congratulation that in our climate, mild and uniform as it is, there is not that danger of sudden and fatal attacks with hardly a moment's forewarning, so common and so much dreaded in India, China, on the coast of Africa, and in the Southern States of the Union. Cholera generally gives notice of its advent by a group of well marked premonitory symptoms. By giving due and early attention to these, there is everything to hope and little to fear. These are lassitude, that is, " a weary, tired feeling of body"; depression of spirits — a kind of undefined foreshadowing of approaching danger or evil ; a gradual, or sudden, derangement of the bowels, with vomiting generally ; or what is known as "purging and vomiting." When these assume an obstinate character, or " hang on," as the common phrase goes, it is time to think of what had better be done. It will be wise to form this resolution as early as possible ; a delay of a few hours, " hoping that it will pass off," may have very serious consequences. 

But what is to be done ? — There is still a more important 



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question — What is not to be done ? for in these cases, generally, people in their haste use means that are most likely to hurry matters to a rapid and fatal termination. First, then, do not delay sending for your physician. If he is enlightened and experienced, so much the better ; but if not, and that his first efforts should be to dose and deplete, you had better trust to Nature and to Providence. Second: Do not, in the meantime, dose yourself with opium, laudanum, calomel, " pain-killer," or with any other strong drugs or quack nostrums. Do not drink strong doses of brandy or whiskey— do not, in a word, rush blindly, in your terror, upon certain death by swallowing a quantity of deadly poison to cure a disease which may, by the aid of Nature and good nursing, terminate with your recovery ! 

Now, as to what you should do ? First : Go at once to bed, be made comfortably warm with sufficient cover and hot bricks or bottles of hot water to the feet, if cold. Lie as still as possible, do not move a limb, if you can avoid it, restrain the desire to go to stool as much as you can, and make up your mind "that you are going to get well soon." Have hot linseed-meal poultices applied over the abdominal region, and frequently changed, so as to keep up heat and moisture as long as may be necessary. If you are thirsty, which is likely, drink cool water, iced water, barley water, toast water, rice water, or iced soda-water ; or keep ice in the mouth as much and long as you choose. 



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Have by you a few ounces of Spirits of Camphor in a well-corked bottle. On the very first intimation of trouble, take a teaspoonful of white sugar and add to it 12 or 15 drops of Camphor, then dissolve it in as many tablespoons of water, find take a table spoonful every 5, 10, 15 or 20 minutes as the necessity of the case demands, till relief is obtained; the first symptom of which will probably be perspiration ; and as improvement advances double the interval between the doses. This very simple and convenient domestic method has been tested more fully than any other we know, and attended with the happiest results. It is strictly Homoeopathic. If, however, the case should resist, which it has been seldom known to do, when taken in time, it becomes too critical and serious for domestic treatment, and will require the skilful hand of a physician and the watchful care of a good nurse to bring it to a favorable issue. 

But in the meantime a physician may have arrived, — your own or somebody's, — Allopath, or Homoeopath. But you must take good care, if of the Old School, that he is of Dr. Maclean's stamp ; one who will " not goad you with physic," who " will not pour calomel in combination with opium into you every hour," and destroy your only chance of recovery. If of the New School, see that he is not an illiterate quack, who is " ready to treat you either way," — a broken-down pedlar or preacher, who goes about with a case of globules and a pocket-manual," — one who doses 



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an infant with " wine and iron," and an adult with " calomel and jalop," under the guise of Homoeopathyi! — or some female impostor, who talks of being "a graduate" and " having a die-ploma /"* 

During the period of convalescence or recovery, the greatest care must be taken not to produce a reaction by injudicous or careless diet. Of this there is great danger, as it is supposed, the patient being now so weak and reduced, "he must be, at once, built up." Almost every one knows how much care is required in the diet of a patient recovering from Typhoid fever; the same rule holds in recovery from Cholera. When the acute symptoms, vomiting and purging, have ceased, it is well to begin with a little well cooked arrowroot flavored, and with a couple of teaspoonsful of brandy in it ; oatmeal gruel, " thickened milk," etc., may be used. " Little and often " should be the rule here — not more than a tablespoonful at a time should at first be given ; but as recovery advances, chicken-broth, mutton-broth, beef-tea, or beefessence may be administered ; gradually improving the patient's diet till his cure is complete. Any other course than this may produce a relapse that will defy both domestic and professional means. Persons who are liable to " weakness of the bowels," may do well 

*Almost daily instances of the necessity of the above caution, as it regards the New School, have come under the writer's notice for the last four years in this city, jo the disgrace of a School of Medicine which has had too few faithful and competent representatives to uphold it. But the better and more hopeful any cause, the greater i 3 its number of parasites and hypocrites. 



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to wear a strong and tolerably wide belt made of linen or " drilling," lined with flannel round the abdomen. I will conclude with one important caution : When the first case of Cholera is reported in the city, do not rush into the country through fear of " taking it." You put yourself out of the reach of good nursing and efficient medical aid, if the terror that hurries you away should produce the disease ; no very unlikely result. To be certain that Cholera is contagious, remember that it must be shown from whom the first cases have been "taken"; and how, in the midst of a densely crowded city, it terminates by a last case, when there are so many in the immediate vicinity of the patient to " take the infection."