PULLET) FG? MICROFILMING
Morris, Oe^rge William
liloed-pressureJ it*; clinical appli
 CALL NUMBER:  WG 106 NSSSb 19.16
 auttop:
 TITLE
J            cat ionS3 2
SPLACE:       Philadelphia and New vork,
 DATF-       1916
^I>ATF PULLSDS  900207


3
\/*\ s >V
2C2- -—-e «••-......«......•.••■•"• ""•;  rr: 
OF MEDICINE     NATIONAL  LIBRARY OF MEDI CINE     NATIONAL LIBR/
111 IVNOIIVN     1NI3IQ3W JO  AaVaail  IVNOIIVN     3NI3l<13WJOA«
1       /Xl
£*J
II IVNOIIVN    1NI3I01W  JO  A a V I a I 1 IVNOIIVN     iNHIOiW JO AX 
 
     TREATISE


         ON



ASIATIC CHOLERA,




    BY DR. WHEELER.
     "0*
NEW-YORK
1849. 
     Entered nccording to Act of Cons res--, •" the jear 1849, h»
                       Dr. Whkklkr,
In the Clerk's Office of the DistrU t Court of the United States for
              Ihe Southern District of New Yoik. 
PREFACE.
Having been  engaged during my residence
in this city—a period of nearly a quarter of
a century—in  the successful treatment of dis-
eases of the eyes, in the practise of my legi-
timate vocation of surgeon-oculist, it  may
seem strange  to  many that I should  now
occupy myself with a subject so remote  from
the " beaten track," in which I have been so
long exclusively engaged.   The explanation
is easy, and  will be, I hope,  satisfactory'
When a disease so  terrible as the Asiatic
Cholera, hangs over  our heads, suspended,
as it were,  like the sword  of Damocles by a
single hair, it  surely behoves every man—I
will  not say every philanthropist—to  com-
municate, as fully and as clearly as may be
in his power, the results of his experience and
reflection on  so important a subject.   This
duty becomes still more  imperative  in the 
IV
case of him who possesses a remedial and
curative agent, whose  value  and efficiency
have been demonstrated by actual  and re-
peated trials.
  To those who  are unacquainted with
the services  rendered  by  the author  of
this publication,  to  hundreds  of severely
afflicted individuals,  during the fearful and
fatal  prevalence of the Asiatic Cholera, or
Cholera Asphyxia, in  the years 1S32-4, it
may appear surprising that he should, in the
ensuing pages,  so strongly and urgently re-
commend,  as an absolutely certain  remedy,
as well as preventive, for  that horrible dis-
ease, a preparation now almost universally
known as the  Balsam of  Moscatello.  It is
not from the mere circumstance of his being
ihe discoverer and sole proprietor of that ex-
traordinarily successful invention—nor from
any considerations of a selfish or  pecuniary
nature—that he now, at a period of appre-
hended public calamity, solicits the attention
of the community to the great advantages to
be  derived from the use of a specific which
has saved  thousands  from the  attacks of a
dangerous  pestilence, and averted death in
many instances where the dread scourge was 
V
 supposed to have made certain of its prey. He
 feels that his professional reputation, as well
 as his personal integrity, would be at stake<
 were he to descend to any empirical course to
 subserve a private  purpose  in such a crisis;
 and he solemnly protests to all who may peruse
 the  few pages which he has thought proper
 now to issue, that he has no other object or
 design in view than to contribute, as much
 as   may be  in  his power, towards the
 relief  of  his suffering and  afflicted fellow-
 creatures, in a  time of appalling danger.
  Although the  author has,  from  the re-
 sults of his experience—in  connection with
 that of many  learned  and scientific medi-
 cal  men  who  have  used his  preparations
 in their practice,—the most unlimited  and
 entire  confidence  in his peculiar  method
of treating Cholera, (both in  its incipient and
 advanced stages) it will be  seen that he has
not  hesitated  to give the  observations of
others, who  pursue a different system from
that  by which he has been enabled to rescue
so many from impending dissolution during
the   ravages  of the Cholera, when it  last
made its appearance in the United States.
  Conscious that in offering the suggestions 
VI
herein contained, he  performs but a  duty
which he owes to common humanity—and
with the hope that his brief remarks may be
beneficial to all who may have  occasion to
consult them, he commits them respectfully
to the public.

   Desirous of placing before ihe public  all
the information we have in relatio 1 to the
dread and fatal disease,  which the author
of this treatise is so  desirous to avert, he has
with  minute care, searched through the most
elaborate works of distinguished medical men
of  all  countries  (ancient and modern), to
ascertain the primary exciting cause of Cho-
lera,  and the means best calculated both to
meet and destroy the enemy.  In pursuance
of his  investigations, the following remarks
of Bontius,  a  celebrated Dutch physician.
whose  fame  was  in the ascendant in  the
year 1629, are not without  their uses and
 applications at this eventful period :—
   In the cholera,  hot,  bilious matter, irri-
 tating the stomach  and intestines,  is inces-
 santly and copiously discharged by the mouth
 and anus.   It is a  disorder of the most acute
 kind, and therefore  requires immediate  appli-
 cation.  The principal cans? of it, next to a 
VII
hot and moist disposition  of the  air,  is an
intemperate  indulgence  of  eating  fruits,
which,  as  they are generally green, and ob-
noxious to putrefaction, irritate and oppress
the stomach by their superfluous  humidity,
and produce an seruginous bile. The cholera
might, with some degree of reason, be reck-
oned a salutary exertion ; since such humors
are discharged in  it, as if retained,  would
prove  prejudicial.   However,  as  by such
successive  purgation, the animal spirits are
exhausted,  and the heart, the fountain  of
heat and life,  is  overwhelmed with  putrid
effluvia, those  who are seized with this dis-
order generally die, and that so quickly, a»
in the space of four and  twenty hours,  at
most
  Such, among  others,  was  the fate  of
Cornelius Van Royen, steward of the hospital
of the sick, who, being in perfect health  at
six  in the evening, was suddenly seized with
the  cholera,  and  expired in terrible  agony
and convulsions before twelve o'clock at night;
the violence and rapidity  of  the disorder
surmounting the force of every remedy. But
if the patient should survive the period above-
mentioned, there is  great hope of performing
a cure.
  This  disease  is   attended  with a  weak
pulse,  difficult respiration, and coldness  of
the extreme parts; to which are joined, great
internal  heat,  insatiable  thirst,  perpetual 
VIII
 Watching, and  restless and incessant tossing
 of the body.  If,  together with these symp-
 toms, a cold and foetid sweat should break
 forth, it is certain that death is at hand."
   Dr.Huxham, Dr. Brady, and other writers,
 notice its prevalence in London, in 1669-76,
 and in  1741.  It is said to have  prevailed in
 several parts of Europe, from 1600 to 1780.
 At Paris extensively in the summers of 1730,
 1750, and again in 1780, and in  Switzerland
 in 1696.
   Anterior to the present age, the epidemic
 or pestilential form of cholera, had, however,
 rarely appeared in Europe.  It had occurred
 more frequently in  India, and  its ravages
 there had been greater.
   Lebegue de  Presle says  it prevailed in
 Upper Hindostan in 1762, where  it destroyed
 thirty thousand  blacks, and eight  hundred
 Europeans.
   Dr. Paisley, in  a letter dated  at Madras,
 12th of February, 1774, says that the cholera
 is  often  epidemic there.
   The late illustrious Dr. Shannon observes
 that, " this affection arises from some  occult
 cause affecting the atmosphere, whereby the
 blood is rendered inimical to its proper func-
 tions, and that the man who will be enabled
 either by science or chance, to discover a spe-
 cific for this disease, will secure to himself a
fa me more glorious than all the achievements
of the most renowned heroes." 
IX
  M. Sounerat, in his Travels in India, from
1774 to  1781, says that cholera  prevailed
epidemically on the Coromandel coast, and
at one  period assumed a  very malignant
character, destroying  above sixty thousand
people, from Cherigam to Pondicherry.
  The epidemic cholera morbus prevailed at
the  island  of Mauritius in 1819 and 1820;
and  from inquiries then made by a Com-
mittee  of British Medical Officers,  it  was
ascertained  that a similar disease prevailed
there in 1775, and which continued about
two  months, causing  great  mortality,  par-
ticularly among the blacks.
  In 1781, a division  of British troops,  con-
sisting of about  five  thousand men, were
assailed  by cholera, with almost inconceiv-
able fury.   Men previously in perfect health
dropped  down by dozens ;  and those even
less  seriously affected were generally dead or
past recovery within less than an hour.  The
spasms of the extremities and trunk were
dreadful; and distressing vomiting and purg-
ing were present in all.  Besides those  who
died, above  five hundred were admitted into
hospital on that day.  On the following two
days, the disease continued unabated,  and
more than one half of the army were then ill.
  In April, 1783, its prevalence at Hurdwar,
on the Ganges, was alarming in the extreme.
It was computed that  from one to two  mil-
lions of people had assembled on the banks of 
X
the Gangas, where they passed several days
and  nights crowded  together, and exposed
to a burning sun by day, and to heavy dews
and cold blasts from the mountains at night.
  The cholera  suddenly appeared among
this crowd of devotees, and was undoubtedly
generated among them, and raged with such
violence as to destroy above twenty thousand
people in the short space of eight days.  But
it is a remarkable  fact that  this disease did
not spread from this  point, not even  to the
villages within a (c\v miles,  and ceased im-
mediately on the dispersion of the multitude
who had assembled at Hurdwar.
   In 1787,  the  cholera prevailed at Vellore,
Arcot, and Trincomallee.  At these places it
raged with great violence, and so rapid was
its progress, that  many  were carried off in
twelve hours.
   In  1790, the  cholera again appeared, and
was  very destructive in a detachment of
Bengal  troops,  marching thro' the Northern
Circars, in the months of March, April, May.
and June, of  1790.  In one division, consist-
ing  of one thousand artillerists, the cholera
made victims of seven hundred in six days.
Hundreds dropped down in every day's  ad-
vance, aud covered the roads with dead and
dying;  the ground of encampment, and line
of march, presented the appearance of a field
of battle, and of the track of an army retreat-
ing under every circumstance of discomfiture 
XI
and distress.  From the military returns,  it
appears,  that  in one  fatal week, of 11,500
fighting men of all descriptions. 764 fell vic-
tims to the disorder ; and of the camp follow-
ers, it was conjectured, that about 800,  or,
one-tenth of the whole, Was cut off.
   Dr.  George Hamilton  Bell, an  eminent
practitioner, during the worst stages of the
cholera hi India says, in an  able article on
the subject:—"The invasion of cholera is so
insidious, that the individual attacked may
be quite unconscious of the presence of the
first stage of it.   Generally speaking, in-
deed, it is only to  be detected by those well
acquainted with the  disease,  and by careful
observation.   Not only in this  stage,  but
throughout the whole course of the disease,
the appearance of  the countenance  is one  of
most  highly characteristic  symptoms.  An
intimate  friend, perhaps,  observes,  that the
person attacked has an expression of anxiety,
that his  complexion  is unnaturally earthy,
and that his eyes seem sunk  in his head.  In
reply  to inquiries,  the  patient will per-
haps  deny  that he is unwell: he may say,
however, he is a little deaf; and if minutely
questioned,  he may admit that he has inde-
scribable  sensations  of being out of order,
and that he is unaccountably depressed and
listless- he  may have no nausea, but he has
tormina of the bowels, and perhaps an un-
comfortable sensation of heat at the pit of the 
XII
 stomach ; the pulse will be found quick and
 weak;  the hands and feet cold; and he has
 had one or more unnatural alvine discharges.
 The first of these is generally characteristic;
 there is a sudden call, and the whole intes-
 tines seem to be at once emptied,  followed
 by a feeling of weakness.
   " It is unfortunate  that the first stage of
 cholera  is only to be discovered by  the most
experienced eye; and that even when  the
 patient himself has a  suspicion of his condi-
 tion, the risk of exposing himself to ridicule,
 from its being ' a false alarm,' may keep him
 silent, while  the acknowledgment of his fears
 might have been the means  of saving  his
 life.  It is to this insidious approach of a
malady  at all times so mortal, that, in part at
least, must be ascribed its being so alarmingly
destructive on its  first  breaking out  at a sta-
tion—patients being extremely apt to go be-
yond remedial measures  before  they seek
assistance.
  On the 23rd of August, 1820, it raged at
Chittagong, far around the eastern corner of
the tract lying east of the Bay of Bengal; at
the same moment in Rajshahy, a central dis-
trict lying east of the Ganges; and not a week
afterwards, in the high  and distant tracts of
Bhaugulpore and Monghyr.  Soon after the
middle of September, the disease, now strictly
epidemical,  extended  itself in  every direc-
tion.  Within the area of  several thousand 
XUI
miles, thus in so short a period brought under
its influence,  few towns  or villages of any
considerable size wholly escaped its attacks.
The  only spots on  the  eastern side of the
Ganges, beyond the  precincts of Bengal, at-
tacked  by the  epidemic  in  the autumn of
1817, were Moozufferpore and Chupra, the
principal stations of the Tirhoot and Sartin
districts;  and the cantonment of Ghazeepore;
and in each of  these places its attacks were
confined to the towns themselves, or villages
in their immediate vicinity : the great bulk of
the adjoining country,  at this period entirely
escaping the disease.
   In the month of November it  reached the
central  division of the grand army then en-
camped in India, where the disease put forth
all its strength, and assumed its most deadly
and appalling  form.   After creeping about.
however, in its wonted insidious manner, for
several  days among the lower classes of the
camp followers;  it, as  it were in an instant,
gained  fresh vigor, and at once burst forth
with  irresistible violence in every direction.
Unsubjected to the laws of contact and prox-
imity of situation, which  had been  observed
to mark, and retard the course of other  pes-
tilences, it surpassed the plague in the width
of its range ; and outstripped the most fatal
diseases, hitherto known, in  the destructive
rapidity of its progress, sparing  neither sex
nor age iu the undistinguishing virulence of 
XIV
its  attacks.  The  old  and the  young, the
European and the native, fighting  mei and
camp followers, were alike subject to its a isits;
and all equally sunk in  a few hours  i uder
its most powerful grasp.   The sick wei ? so
numerous, and  still pouring  in  so qui.-kly
from  every  quarter, that the medical Men,
although night  and day at their  posts, were
no  longer able  to  administer to their  neces-
sities.  The whole camp then  put on the
appearance  of  a hospital.  The noise and
bustle almost   inseparable from  the inter-
course of large  bodies  of people, had  nearly
subsided.  Nothing was to be seen, but indi-
viduals anxiously  hurrying from  one divi-
sion of the camp to another to  inquire after
the fate of their  dead and dying companion;
and melancholy groups of natives bearing
the biers of their departed  relatives  to tie
river.  At length, even  this consolation wa *
denied them; for the mortality finally becani ■•
so  great, that  there was neither  time nor
hands to cany off the bodies; which wen:
then  thrown into  neighbouring  ravines, or
hastily committed  to the earth," on  the spots
in which they had expired and even  round
the walls of the officers' tents.  All  business
had given way  to solicitude for the  suffering.
Not a smile  could  be discerned, nor a sound
heard except the  groans of the dying and
the wailing over the dead  Throughout the
night especially a gloomy yileuco. interrupted 
XV
 only by the well  known dr.adful sounds of
 poor wretches laboring under the distinguish-
 ing symptoms of the disease, universally pre-
 vailed.

   In all that we have advanced on the pain-
 ful and unpleasant subject, to  which  these
 papers are devoted, especially in reference to
 the  probably speedy approach  of cholera to
 this continent,we are thus sustained by a dis-
 cerning  and eloquent writer  in the London
 Snn, of i ;cent date.
  "The  jjreat scourge of humanity—a scourge
 more awful than Auila  and his  Huns—more
 terrible th tn tlv; eruptions of a  volcano—more
devastating than the throes of an eurthqn ike—
 the great scourge of the (.-liolera—is  at tins
 moment  a I vancing towards us with silent but
 indomitable rapidity, if  we  may believe  the
intelligence  received  almost  daily  from  the
frontiers  of the Russian  empire.  Its course is
 described as beinjj north-wesierly, and it is said
 already to have penetrate I into the interior of
 Europe.  Cod defend ns from the agonies which
desolated  the  world in 18'S'l. !  Those agonies
 are not y« t forg otten ; nor can  years obliterate
the recollection   of  a pestilential  malady  so
 mysterious in its character,  so inexorable in its
diffusion, and so inexplicably dismal in its pro-
gress thro-i<[h tlie nations of Christendom.  It
are^sed forward  like an avenging fiend, and
 decimated  the nations,  as  at  a  breath of the 
XVI
Nemesis.   This terrible and destructive plague
has again made its appearance. After ravaging
the territory of the Calinucks,  it has dissemi-
nated in contagion among the serfs of Nicholas.
It has travelled from the walls of Astrachan to
the hovels of Charkay,  and appears  to have
already descended like a curse upon the inha-
bitants of Kiev, on the banks of the Dnieper,
There may unquestionably  be much exaggera-
tion  in the accounts  received  from Caucasia,
namely, that during an interval of nine months
no less than  17,050  individuals were attacked
with the disease in that kingdom, and that out
of these 6,310  perished.   There may be like-
wise a certain  degree  of exaggeration  in the
assertion,  that during its passage throtigb the
streets of  Astrachan, 137 persons were smitten
down with the cholera in a  single day, viz: the
30th of July.  But, heightened as in  all its like-
lihood  the intelligence  is, by  the  fear of  its
recipients, there  cannot  be a moment's doubt
but that  the  pestilence  i*  again abroad upon
the wings of the wind,  and that it is stealing
gradually  towards the centre  of  continental
Europe.   With the experience  of 1S32 before
them, it becomes the bounden duty of the legis-
lature to provide  such measures of precaution
as may tend  to mitigate the miseries resulting
from the cholera, in  the  event of its advancing
so for in a south-westerly direction  as to assail
the population  of these  islands. Better even
than the vigilance of the most stringent code of
quarantine, are those simple measures of sana-
lory legislation  for which we have clamored  so 
                    XVII

long and so earnestly.  A contagion that defies
the obstacles of quarantine, may be deprived of
a consi lerable portion  of its virulence  by the
systematic  cleanliness introduced  among  a
whole  people by a proper scheme of sanatary
legislatio 1.   Is not this self-evident?  And,
being self-evident, shall  its importance be de-
preciated, when the great scourge of the cho era
is fo" a second  time impending over the plains
and  cities  of the eastern and  western  hemi-
sphere ?   God  forbid !   God forbid that  men
should be so blind to the dictates of  reason, or
rather, that  they should shut their eyes against
the ttnth which is forced upon their compre-
hension as if by instinct !  The warning voice
which comes to  us from the banks of the Dnie-
per, i ells us of the danger ; the combined argu-
ment-: of experience, reason  and instinct, pro-
claim  to us  how that danger  may  be in  the
readiest manner avoided, or, in the more terrible
extremity,  how  its auger may bij in the most
efficient manner assuaged.'^

                    JOHN  WHEELER,
  Nr.\v  Vo:tK,  1849.          33 Greenwich-street 
 
TREATISE
         ON

CHOLERA.
This most dreadful  scourge  and visitation
upon the human  family  has again made
the circuit of nearly two-thirds of the globe,
with all its devastating consequences; spread-
ing death and terror as it advances, leaving
nothingbuthorror,misery.and despair behind.
It does not come within the province of a pub-
lication, like this, to enter into the causes of
this dire and malignant malady, or to know
if it be the dispensation of an Almighty Being
for the wickedness of mankind; or for what
other purposes the All-seeing God has thought
it necessary to depopulate portions of the earth.
It is enough  for us to know that it is steadily
advancing upon us, if it be not  at our doors
already,  and  the  sense implanted in  our 
20
natures,  for our  self-preservation, at once
demands our attention, and recommends to
our prudence that we avnil ourselves of
such means which will enable us to combat
so potent and so terrible an enemy.
  In the brief preface  to this treatise, the
author has stated that during the years 1832
and 1834, he had frequent occasions to test
the virtues of a preparation  called Balsam
of Moscatello (long previously known to him)
in the most malignant cases  of Asiatic Cho-
lera, and that in not a single instance did he
fail, by the  timely and prudent application
of this remedy, together with other appro-
priate prescriptions, to  accomplish  a  speedy
and a permanent cure, even after other medi-
cal men  had exhausted every  means to
attain the same desirable result.
  The Balsam  of Miscatello is not only
known in the United States,  as an excellent
and efficient medicine in all intestinal  de-
rangements, but the good leports of its ad-
ministration  have  reached   distant lands.
Through the instrumentality of a merchant,
it has been introduced into Russia, where
even  a limited  supply produced  the  most
satisfactory results, and elicited the warmest 
21
commendation from several eminent medical
practitioners. During the brilliant campaign
of our  victorious  army in Mexico, when
many a brave soldier all but escaped the can-
non's shot,  to  suffer  death  by diarrhoea,
in numerous instances, the cordial influence
of this healing and reviving balsam imparted
vigor to the sufferer,  and enabled him to go
"rejoicing on his  march."  In England its
important properties  have been  acknow-
ledged, and claimed for it the golden opinions
of liberal and unbiassed physicians.  In fact,
it may be relied upon as a boon to mankind,
in alleviating and curing several of the most
acute, dangerous  and  sudden maladies to
 which the human system is liable.
   I am aware of the scepticism prevalent in
 the community relative to > all  remedies
 which have acquired  publicity through the
 medium of the press.   By its means  trutn
 and falsehood are alike disseminated through-
 out the  land.  The latter, it is  true, after a
 brief career, expires, entailing disgrace, dis-
 honor, and merited  infamy on its mercenary
 propagators; but unfortunately, in too  many
 cases,° founders in its vortex  those  truths
 which should and  would benefit mankind. 
oo
 Of sue'i remedies that have escaped the scep-
 ticism of the public are those useful remedies,
 James" and Dover's Powders and this Balsam
 of Moscatello.
  The necessity, then, and vital importance of
 having an efficient remedy as a safeguard
 against the sudden attacks of this disease,'can-
 not be loo seriously impressed on the minds
 of the community. The great erring principle
 of human nature, is procrastination !   Some
 individuals lull ihemselves into fancied  secu-
 rity, from the intervention  of  frost, which
 they  imagine has  the peculiar  power of
 '• killing"  disease, or  checking the cholera.
 Little do they dream  in their  philosophy of
 the power of the latent principle of this de-
 populator  of nations.   Its  erratic  course is
 beyond the comprehension of man. Localities
 have been spared its blighting influence, as
if by a special interposition of Providence,
 whilst in other places subject to  its peculiar
phenomena,  the atmosphere, with the quick-
ness of lightning, has received this messenger
of death, and thousands have fallen victims
to its  devastating course.
  The cholera  broke out in the following
places, at the dates annexed : 
23
    At Moscow, (Russia)  Sept. 2Sth,  1830.
       Sunderland, (England) Oct. 2Sth, 1S32.
      Quebec (America) June 8th, 1832.
       New York, June 2Sth, 1832.
       Philadelphia, July 30th, 1S32.
       Louisville, September 18th, 1832.
       Cincinnati, September 30th, 1832.
       Nashville, December 18th, 1832.
   In Cincinnati the cholera had ceased almost
 entirely on the first of December, and there
 was none of it (unless, perhaps, two or three
 cases) during the winter of 1S32-3.  In April
 or May next, it  again broke  out, and  pre-
 vailed in Cincinnati with  considerable seve-
 rity during the summer.   In the winter it
 was again latent, but in the summer of 1S34
 it again  broke out, but in the latter part of
 the  season it entirely disappeared, when in
 October, it again broke out, a large number
 of cases occurring in  one  night, after  which
 it entirely disappeared.
   Of its  progress iu  the United  States, the
 following facts are worth noticing.  It landed
 at the Quarantine Ground, Quebec, from an
 viii'jrraiit ship.   It passed up die St. Law-
 M'nce  to  Montreal  with the emigrants.   It
jiaosjd down tlu '.'hannduiu  canal in canal 
24
boats.  It passed along  the  Erie canal in
canal boats.  It passed  along the Lakes in
steamboats.   It broke out among the soldiers
of Scott's army in steamboats.  It arrived at
Chicago.  It  passed with them to the Upper
Missisippi.  It reached Louisville in the steam-
boat Columbus.  It  ascended  the Ohio in
steamboats.   It arrived  at Louisville before
Cincinnatti, before Wheeling, and at Wheeling
before Pittsburgh.  Pittsburgh was but 400
miles by land from Philadelphia, and yet cho-
lera arrived at Pittsburgh by a circuitous wa-
ter course of 3000 miles.   But in that water
travelling it pursued steadily  the line of pas-
sengers, emigrants and business.
  This fact is not to be got over by any theory.
It signalizes the  progress of cholera in the
United States more than any other thing.
  Injudicious treatment of  this complaint
has  also  increased  the  awful mortality.
Many physicians, wedded to their own fa-
vorite theories, have discarded  the measures
dictated by common sense; and although the
fallacy of their treatment has been strikingly
manifested by the most signal want of success,
 still unconvinced, they  hold  to their skill  as
being the most sound. 
2o
   It is not my wish or intention to cast re-
 flections on any one of my professional bre-
 thren, as it is too notorious that many of them,
 with a self-sacrificing spirit, have nobly ex-
 erted  themselves in  the  midst of  the most
 imminent peril to rescue their fellow-creatures
 from this insidious disease. I merely reiterate
 my  solemn conviction, that the Balsam  of
 Moscatello is  the most efficient remedy that
 can  possibly be employed to  meet the  exi-
 gencies of  every symptom of cholera.   It is
 a medicine which has been sustained by pub-
 lic confidence, and  the cures it has effected
 in the most violent  and dangerous attacks  of
 cholera morbus, &c, are sufficient to stamp
 it  as a preparation  most happily adapted  to
 conquer, with  the uso of the other remedies,
 the most violent paroxsysms resulting  from
 disorders of the bowels.
   As regards the question of the contagion
 of Cholera, I remember perusing, with con-
 siderable interest, a discussion at the West-
 minster Medical Society, at which were men-
 tioned two facts that occurred in a  town in
 the north of Scotland in 1832, at the  time
 the Cholera was so prevalent, to which was
quoted, in the London Lancet, that the popu- 
26*
 ltition  was about  2,000,  nud the  Cholera
 gradually spreading northwards; the autho-
 rities  and inhabitants  became  alarmed;
 houses  were  white-washed;  disinfecting
 agents were freely used, and  patrols were
 stationed at all the approaches of the roads
 and by-ways,  to  prevent the ingress of all
 persons from the infected districts. The Cho-
 lera raged fiercely  on almost every side.
 Many of  the victims  were known to have
 been seized suddenly in  the open  air, and
 death  often  took place  in  a few   hours.
 In  one  small  fishing village, about  five
 miles  from the town, out of a population
 of  300,  it was reckoned  that  about one-
 half of  the inhabitants  were  carried  off
 by this  scourge;  yet in the town  itself
 not  one case  occurred.   Similar  results 1
 could relate in other parts of the continent,
 where medical men attended daily in the
 infected  districts,  and in close attendance
 upon the sufferers, yet they escaped and did
 not carry the infection to others.
  In my judgment, however,  the arguments
thus employed  rather prove  that  to the
preventive  means made use of—to the sani-
tary regulations enforced,—and the  disiu- 
27
fecting  agents  employed—did  the "town"
alluded to escape from the pestilence; and
not because the disease  is not contagious.
To controvert the position so complacently
aimed at by a majority of those who attend-
ed  the discussion mentioned,—to  wit, that
Asiatic Cholera is  not contagious—I have
before me the copy of a letter from a scientific
gentleman  of St. Petersburgh, who  asserts
that recent  discoveries  have clearly pro-
ven that the  malady is in the  air, and
that  quarantine  regulations  were  utterly
useless.  He proceeds to show that when
the disease was raging in the Russian capi-
tal, the air  had  a very  singular effect  on
magnetic power.  Whilst the Cholera was
at its height, the action of the magnet was
nearly neutralized; but  when the disease
was gradually subsiding, the  magnet  as-
sumed, by degrees, its former power.  As
the magnet block, which used, by its electric
power, to support eighty pounds, would not,
durng the worst time of the Cholera, support
by electric attraction above thirteen pounds;
and at one  time,  from  the  same alleged
cause, the electro-telegraph would  not work
at  all.  But I  contend that  the Cholera is 
2S
both epidemic and infectious;  and it is from
observations and experience,  which  have
convinced me of the facts, that I now unhe-
sitatingly and boldly affirm the correctness
of my judgment,  in  adopting and recom-
mending the Balsam  of Moscatello, both as
a sure preventive and  a certain cure for this
disease.  Those undoubtedly able and scien-
tific  gentlemen, who express themselves so
warmly in favor  of an almost indiscriminate
use  of calomel  and   opium,  are  not  only
divided  in  their  opinions as to the precise
nature  of the malady, but they are  also at
issue upon the proper mode of administering
their remedy, and persist in remaining igno-
rant  of the therapeutical  agents in the pre-
paration I have ever successfully used in my
extended practice.
  I argue, and no competent medical autho-
rity will deny the fact, that if the  small-pox
may be communicated across a street, why
not the much more fatal disease, which it is
now my desire to explain to my non-profes-
sional readers?  Contagious atmosphere, if
you  please, thrown off from the body of a
person afflicted with this disease, the poisoned
exhalations from the lungs and the skin, su- 
29
perinduced by the blood being contaminated
all parts of the body participate in  the evil
Which  is communicated  to  the sccretorics
and  excretories;  and  this poison may  be
dispersed  in  the  air,  or  confined  by  the
clothes.  To illustrate  the manner in which
miasm  may  be conveyed, I  will mention
the common instance  of a tobacco smoker
scenting  a  street, every  atom  of which
odour  has proceeded  from  his furnigatory
enjoyment.   We  know nothing of the  na-
ture of these exhalations  more  than that
one  is  a  vegetable and  the  other  an ani-
mal product;  and in  the present  state of
our knowledge, we cannot fix  the limits of
their influence on our senses  or our bodies.
All miasmata are volatile, and arc suspended
in the air and follow its movements.  These
emanations proceeding from  a number of
persons affected with cholera, or any other
infectious disease, may thus, in certain states
of the atmosphere, retain sufficient force and
concentration to infect individuals at a  dis-
tance,  who—from the absence of proper pre-
ventives, such  as  those 1  urgently  recom-
mend—arc predisposed to receive their im-
pression. 
30
  The symptoms in the early stage of malig-
nant Cholera are somewhat obscure; some-
times an obstinate  costiveness, or torpor of
the bowels, exists, but most generally it com-
mences  with a  rumbling sound in the in-
testines, arising from a collection of flatus, or
wind; slight diarrhoea, or an uneasy purg-
ing, such as generally accompanies an un-
healthy  relaxation of the bowels.  Unfor-
tunately, indications of this  character  are
most  generally overlooked.  The imagina-
tion desiring that it shall be nothing par-
ticular,  too  frequently induces a culpable
inattention to the deranged condition of  the
system, resulting in  entire prostration, and
after  in  painful and horrible  death.   An
old adage says, " an ounce of prevention is
better than a pound of cure," and by a little
attention  and  judicious  treatment,  the
worst symptoms may be overcome and life
preserved. The progress of this premonitory
action  is increased diarrhcea,  nausea,   or
sickness  at the stomach.  An eminent  and
an  experienced writer says,  "that this dis-
ease is almost as infallibly prevented by early
attention,  as an incipient conflagration is
extinguished by a copious effusion of water. 
31
 I therefore, cannot avoid dwelling upon and
 impressing this important fact upon the minds
 of  every individual.   The  symptoms still
 increasing, the system may  now be said to
 be completely under the influence of malig-
 nant Asiatic Cholera.  The purging is fol-
 lowed by a great weight in the  bowels and
 stomach, and cramps, vomiting, and  great
 debility quickly attend each  additional step.
 followed by a diminished action of the heart
 and arteries, and a consequent coldness over
 the  skin of the whole body.
  A change in the voice is one of the earliest
 symptoms.  The symptoms  increase, if not
 checked  by medicine; cramps  of the most
 violent description come on, chiefly in the
 feet, calves  of the legs, thighs,  and hands,
 which cause such excruciating tortures, that
 even the most resolute are unable  to  resist
 screeching out.  The skin now becomes quite
 cold, assumes the blueish hue so remarkable
 in Cholera, and in a short time you will find
 it eorrugated in almost every part, remind-
 ing one  exactly of  a  woman's hand after
 washing  for  several hours.  You will also
be struck by the very peculiar countenance
of the patient; the features are all sharpened; 
32
the eyes sunk in  the  orbits,  but staring
wildly;  the t< ngue, if you place your finger
on it, will be found quite cold ;  the patient's
breath, if he breathes on your  hand, is also
cold.  All this time the  patient screams out
for cold water, or  drink; if you ask him, is
he cold, he says,  no, he is burning hot; he
 wants something cold to drink.  It has never
 been actually tested how much a man in this
 state would drink, but fancy it would be some-
 thing enormous, for he  generally throws it
 up as fast as he  drinks it; sometimes, one
 would fancy, by a spasm of the oesophagus,
 for it has hardly time  to reach the stomach
 and  still, while  he is vomiting, he stretches
 out his livid hands, crying, more, more!  It
 is a remarkable feature in cholera, that a pa-
 tient seldom  makes water during  the exist-
 ence of the disease; indeed not more than
 three or four instances of patients voiding
 urine in true Asiatic cholera are on record. The
 skin secretes  peispiration, the mucous mem-
 brane  mucous, nnd the saliva glands saliva,
  for it frequently  has been known  in the last
  stage of cholera, when his strength was com-
  pletely exhausted spit nearly across the roon^
  and in the same way eject water while drink, 
33
ing.  The change in the countenance is most
wonderful in so short a time; men whom I
have known intimately, I have been unable
to recognize.  Restlessness is a very marked
feature, it is almost the only sign of raving I
have  usually remarked;  a patient will tell
all about his symptoms, how he was attacked,
talk of his will and of all his affairs in a most
rational  manner, yet he will constantly try,
while no one is watching, to get out of bed,
to turn from one side  to the  other, kick off
the bed-clothes, and rail at everything. This
species  of case, if it ends fatally, generally
does so in one or two wrays—either the purg-
ing and, occasionally, the vomiting continue
almost to the end, or else both cease and the
patient dies, laboring  under the symptoms
of effusion on the brain; the pupils are dilated
and fixed, it is impossible to rouse him, and
his breathing is stertorous.       *
  It appears, then, from the writings of most
all the first  medical men on  the continent,
that they all agree that the first symptoms
of  the  Cholera commence with diarrhoea,
which,  if proper remedies were immediately
resorted to, the majority of those attacked
would be spared, and those violent sufferings 
34
which  ensue from the neglect of  treating
(in  all  appearance) so trifling a  complaint
Now as diarrhoea seems to be the forerunner
of this dreadful scourge, why are families so
tardy in procuring one  of the most effi-
cacious and best tried medicines that ever
emanated from the materia medica—viz., the
Balsam of Moscatello, the  virtues of which
some of the most respectable famil.es in this
city have had ample proof, and are  ready to
substantiate. 1 can with the greatest confidence
assert,  that from the experience I had of the
treatment of the Cholera in  1832 and IS34, it
is a certain cure for thisdveadful scourge. Per-
sons who have paid attention to the  ravages
of this disease on the continent, will find that
more than  two-thirds of those who  were
attacked fell victims to it; how, then, can  it
be  said  that the treatment pursued was  a
proper  one?   One  of  the  sheet-anchors
of  medical  men  is opium,  which I con-
sider to bevery'injuriousto the recovery of the
patient, because while it may relieve  the pain
it but prolongs the disease,  as the acrimoni-
ous and corrupt humours which ought to be
discharged, are  by the use of this drug de-
tained  within the system, and exert their 
35
pernicious powcis upon the blood.  There is
another remedy which was strongly advo-
cated here in 1834, namely, the use of ice.
Let me ask  the advocates of it, how many,
of their patients recovered under its exhibi-
tion? and I will boldly assert, who ever has
recourse to such a remedy must sink under
its influence.
  As regards the mode of treatment that has
been adopted here,  I would,  with  all due
deference to the skill of my professional bre-
thren, who have  extolled the use of calomel
and opium in such large doses, simply ask,
 have they not discovered their practice id be
founded upon  erroneous principles, and the
use of either of  those articles, administered
 in the way they  have  prescribed to be used,
 to  be very injurious to the patient? Opium,
 1 will admit, relieves the sufferer of the excru-
 ciating pain, while the effect of it is produced
 and lasts; but, at the same time, it causes
 the disease  to  remain in the system, and by
 that means  ma!:es such an inroad on  the
 system that no  remedies  will reach  it,  as
 the intestines,  in  general, are  overloaded
 with the worst of acrid secretions.  Is opium,
 then, a proper  medicine  to be administered? 
3G
Is it not more desirable to have  the intes-
tines properly freed from all the bilious se-
cretions, and, at the  same time, taking  the
precaution  that proper remedies should be
applied to  prevent spasms;  and gradually
to brace the system for this purpose, I do
not consider a  more  valuable medicine can
be used than the Balsam of Moscatello. The
jealousy whichever characterizes the faculty,
debars me  from making known the compo-
sition of this ar.'icle to the public, but I will
challenge any  one to produce a  medicine
that will have a better effect and act  more
immediately on diseases of the bowels, at
the same time to be so directly beneficial.
  Now as regards calomel, who ever would
think of giving it in  doses of scruples, and
even in much larger quantities,  as  have
been prescribed in this country? They must
be convinced it has but little effect  upon the
blood,  and  must act very injuriously npon
the  patient's system  and constitution;  and,
ev.n should he overcome the disease", he
will bo, during the  remainder of  his days,
tormented  with Rheumatism, and with  a
poor, feeble, mercurialised constitution.   On
the injurious effects of this drug, I  will  give 
3?
the opinion of Dr.  C. W. Bell, K. L.  S.,
and physician to  the Manchester Infirmary,
and late physician to II. M. embassy in Persia,
as worthy of notice,  being  formed from his
long  experience  of  a series  of  epidemics
which raged in Persia, in 1842, when he was
attached to the  embassy and  was  in the
medical charge of the Persian army.  He con-
siders that opium is  likely to prove injurious
in the treatment of Cholera, by diminishing
the sensibility (irritability?) of the heart.  He
disapproves even  of the ordinary use of calo-
mel while cholera prevails, and still more of
its employment in the disease itself.
   Ollapod, II. C.  S.  Madras, justly remarks,
that opium in every shape, given in cholera,
too universally resorted to, tends to embarrass
the cerebral functions, causing pervigilation,
and, by consequence, commotion  of the vis-
vittc.
   Another very eminent French  physician,
Monsieur Broussais, who had charge of the
cholera patients  at Val de Grace, says, in  a
work recently published under the auspices
of the medical faculty of Paris, that  opium,
either in  small doses as a stimulant, or in
large ones as a  sedative, was  equally unfit
to be relied upon.  The last class specified, 
US
comprises calomel, with or without opium,
cold  water, salines,  and quinines; although
the author never met with a  single case of
real  cholera in which  he could trace the re-
covery of the patient to  the influence  of
calomel, nor ever observed that it  produced
any specific  effect whatever.
  Dr. King, who had  the charge of a  large
district during the prevalence of cholera, re-
marks, that he invariably found calomel and
opium  to be very unsuccessful in  the  treat-
ment of this disease, and such you will find
to be the case from other medical men  in
Europe, who  have had to   treat  the real
Asiatic cholera.
  A  letter was recently published in several
of the journals of the day from the Hon. R. J.
Walker, dated Washington, December 6tii,
in which the writer speaks in terms of almost
unrestricted  praise of the successful mode of
treatment for Cholera sometime ago adopted
by  Dr. Samuel A. Cartwright,  a distin-
guished physician  of  Natchez, Miss.  1 am
glad to find that the system invariably pur-
sued by me is, with  the almost single excep.
tion  of my own important, discovery, similar
to that which has elicited from Mr. Walker
the  encomiums I have mentioned. In the 
39
course of his communication, he says that he
is convinced not only of the uselcssness, but
the absolute danger, of opium, and concludes
his very  interesting missive, by  invoking
upon  all persons precautionary measures as
being of the greatest importance.  Among
these, he says, are ''a cheerful temperament,
au  exemption from all excitement, a brave
heart resolved to do its duty, and leave the
result  to Providence. Dry, airy, and  com-
fortable  apartments, elevated  above the
ground, with a great regard to coolness and
free use of proper disinfecting agents;  plain
nutritious diet, with less of vegetable food,
and entire abstinence from all  stimulating
drinks, with rest undisturbed, and, above all,
the immediate application of the  remedies,
both of friction and  medicine, at the very in-
stant-of the attack, are important."
  Thus, it will be seen, is my principle sus-
tained by  persons  of high authority in  the
United States, as well as by men of exalted
reputation in Europe.  The  celebrated Dr.
Leonard Stewart, of London,  in an address
recently delivered by him before a large and
enlightened number of the medical faculty,
declared that he had no faith in opium for 
40
the cure of Cholera ;  and that in relation to
those  who  insisted upon the  disease being
non-contagious, the most  staggering argu-
ment against such a doctrine was the fact of
its invariably  appearing in  sea ports-al-
though he admitted that  local  circumstances
might  occur to cause it in such places  as
well as elsewhere.
  For the  management of  the  remedies
in the early stages of the disease,  if at the
beginning there is great  weight at the chest
and inclination to  vomit, mix half a tea
spoonful  Cayenne, a tea spoonful salt,  tw0
table  spoonfuls vinegar  in  half pint warm
water, and  take the whole of it at once. After
tliis has  acted upon  the stomach, which  it
will do by  creating vomiting; (this  dose  is
for an adult, therefore according to  the age
of the patient divide the quantity)—when
his has acted freely take half of the powder,
(accompanying, the Balsam of Moscalello)  to
be mixed in a  table spoonful of honey  or
molasses, or any other syrup, and taken, and
after,  fifteen  minutes  have  elapsed, take
the  remaining  half  of  the powder  in the
same manner.   This will at once clear the
bowels,  and cause a sufficient  reaction  to 
41
secure recovery.  The powder which I have
recommended, promptly relieves the stomach
of the offending matters which tend  to in-
crease the existing irritation, and it effectually
emulges the  liver;  whilst the Balsam exer-
cises a soothing and tonic influence, which
at once  produces its remedial and  happy
results.  Take a wine-glassfull of the Balsam
of Moscatello,  made as warm  as it can be
conveniently swallowed; and  repeat half  a
wine glass of die same, if cramps be present,
every hour :  if, however, cramps are not pre-
sent, the Balsam should be taken every two-
or three  hours, till relief is afforded; at the
same time applying either  hot  bricks or
bottles filled with  hot  water, wrapped in
flannel, to the region of the stomach, inner
part of the thighs, and upon the soles of the
feet.  The patient should  be,  under  every
circumstance, placed between blankets, and
active  and severe friction be  resorted to.
The patient should be kept in  a recumbent
position, under the bed clothes, and the defe-
cations received in a bed pan, for if the patient
be faint it is exceedingly dangerous for him to
be removed from the bed—the bed-pan after
it is used, should be rinsed out with chloride 
4:2
of lime and water, and the patient should in
all cases be  restrained  from  removing  the
covering from the body.  When febrile symp-
toms, or fever, are present in the early stage,
three grains of tartar emetic  should  be dis-
solved in a  pint of boiling water, and when
cool, a table spoonful every half hour should
be administered, until the fever abates, and
perspiration appears upon the surface of tbo
skin. If the evacuations from  the bowels are
slimy, or surcharged with mucus, and offen-
sive, an injection of a table spoonful of mo-
lasses, a  tea spoonful of tab'e  salt, a  tea
spoonful of laudanum, and a pint of blood-
warm  water, should be administered.  This
done, and the dejections still proceeding to the
peculiar "rice water" appearance,character-
ising this  affection; an injection  of  a wine
glass  full of Balsam of Moscatello, mixed
with a half-pint of warm water, is to be used as
Avarm as  it can be admitted  by the  patient.
For the  purpose of allaying the irritability
of the stomach, the following formula will be
found to act most advantageously in combi-
 nation with the Moscatello:
        Rj Super. Carbonate of Sodae, 3s?
       Rluriale of Soda:, 3j.
        Chlorate of Potass Grvij.
        Misce. 
                   43

  Divide into two powders, one to bo taken
night and morning; (but in cases of violeu
sickness of the stomach  or  looseness of the
bowels, the  dose may be increased  and
taken every hour,) iu  a  little water, tea, or
soup.  If the patient at any time should  re-
ject the Moscatello, let the dose be reduced
to about half a wine glass, and repeated every
Half hour till relief is obtained.
  So complete and decided  are the actions
of the powders and Balsam of Moscatello,
with  the adjuncts of the two or three simple
remedies mentioned, that, were  I so disposed,
I might fill a volume  with  successful cases
cured in this manner, at  the period when  the
malignant Cholera first made its appearance
in 1832 and 1834.  One or two cases I cannot
help mentioning,  and which indeed are  the
types  of the numerous cases successfully
treated by mc.  I mention these cases with-
out the knowledge or authority  of the persons
named, that those interested, (and who  are
not ?) may proceed to the dwellings of those
gentlemen,  and there hear  for themselves;
and behold the ocular demonstrative proofs in
the living monuments of my success; and
be  it  remembered, that in each  instance? 
44
these were after their previous medical at-
tendants had given up their cases  as being
beyond hope, and had left them to the powers
of Nature.   Mr. and Mrs. David Haig,  No.
100, Mercer  Street, were under the influence
of malignant Cholera, in  its worst  form.  I
found them  in the " collapsed stage ;" voice
and pulse  gone, and so far as death could be
reached, they, I  may say, were  within  his
grasp.   With the few simple rules  above
mentioned, they at once rallied and recovered,
exemplifying the adage, " Whilst there is life
there is hope."
  The next  person I refer to, is Captain De-
peyster, now Superintendent of the  "Sailor's
Snug Harbour."   This gentleman  has  had
ample  opportunities of testing and observing
the unqualified  benefits  that the  excellent
properties of the Balsam of Moscatello have
produced in numerous cases of Asiatic Cho-
lera, and the ordinary diarrhoea and cholera
morbus.
  The  case of the Count de Otrante, (a gentle-
man well known to  the diplomatic corps
at all  the courts of Europe) afflicted with
the Spasmodic Cholera, on board the packet
ship Columbus,  F.  A. Depeyster,  com- 
4.',
mander,  is  peculiarly  worthy  of  notice.
Captain Depeyster,  in a communication  to
Dr. Wheeler, in addition to the vital benefit,
the Balsam produced in the Count's case,
goes on saying, " I feel great pleasure in tes-
tifying to the great efficacy of this medicine ;
it having given immediate relief,  not only
to myself, but also to several of my crew,
who were severally attacked with Diarrhoea
and Spasmodic Cholera;  and so high in esti-
mation do I hold the virtues of this compound
as a  medicine  for   this  dreadful  malady,
that I think every packet ship,  as well  as
all other vessels,  should  be  properly  and
amply supplied wth  it."
   The Balsam, then, will produce all the re-
sults required for the cure of Asiatic Cholera.
The vomiting and purging being stayed, it
now behoves the attendan.s lobe careful of the
food administered.  It will  be borne in mind
that the  patient is  not  well  because he  is
better.  The greatest  care  is necessary that
the food be light, nutritious,  and free from
all acrid, or anything likely to-be irritating
in its  nature ;  avoiding, for a few days, ani-
mal  food.  The beverage should  be toast
water, or good wine well  diluted, and warm. 
4G
           DIRECTIONS FOR  USE.
   1st.  For Diarrhoea, or Cholera  Morbus-
When  the discharges of the patient exhibit
no unnatural appearance, but are merely in
a  relaxed state, the Balsam alone will  be
sufficient to effect a cure without the aid of
any other medicine. For  a dose, take a wine
glass full every hour until relieved  In very
violent cases, when the attacks are unusually
severe, the tongue foul, with an  unpleasant
taste in the  mouth, which indicate  that the
stomach  is surcharged with  bile,  an adult
should take one,  half of the  powder, and
fifteen  minutes  afterwards   the  remaining
half on going to bed.   When this medicine
has operated, then continue with the Balsam
as prescribed for the different ages.
  Young  persons from  twelve  to fifteen
years of age, a small wine glass  full of the
Balsam.
  For an adult, a good wine glass full.
  It is  important to observe, that the opera-
tion of this valuable medicine will be much
acceierated by being administered as warm
as the patient can conveniently take it.
   In all cases  wh'ers the looseness of the
bowels, or any symptoms of griping pains 
47
 should continue upon the patient, the  dose
 of the Balsam should be repeated every hour
 till relief is obtained; and when it proceeds
 into the malignant form, or collapsed state of
 the Asiatic Cholera, take for a male adult, a
 wine glass and a half of the Balsam, as hot
 as can possibly be taken, and apply bottles
 of hot water or hot bricks, wrapped in flan-
 nel, to the stomach and  feet.  For a female
 adult, a wine glass full of the Balsam.  For
 children under fifteen years, a smaller quan-
 tity in proportion to  their age: and  those
 under five years, about half  a wine glass of
 it, diluted with  the same quantity of hot
 water.   The  patient must retire to  bed, and
 use every means as above, to induce profuse
 perspiration, as a preventive of  cramp.—-
 Should the dose not remain on the stomach
 (which only happens when the latter is in an
 extreme  state,)  it  must be  repeated,  and
 again repeated every half hour, until relief
 be obtained.
   Follow the directions  as given ;  but pro-
 vided the  bowels  should be very relaxed,
 and in the watery state,  then administer an
 injection made of a wine glass full of Mosca-
tello, and  the  same quantity of  molasses, 
4S
mixed in  a pint  of warm water.   After  it
has operated, give the Balsam as directed,
and use the warm application  to the feet and
bowels.   On no  account, is  the patient to
take water; but if thirsty, a little cold toast
and water.
  It would be advantageous to have a small
tin vessel kept in  the bed room, with a bottle
of the Balsam, so that if a person  were to
be attacked in the night, by holding the ves-
sel (containing the dose of the Balsam) over
a candle or night  lamp, the delay occasioned
by  lighting a  fire to  warm  the  medicine
would be  altogether  avoided.  Attention to
this  may  be the means of frequontlv pre-
venting a severe attack of this disease.
  If  the  bowels  of  the patient, as  above
stated, do not exhibit any unnatural appear.
ance, but are merely in a very relaxed state,
the Balsam alone will be sufficient to effect a
cure, without having recourse to any  open-
ing medicine whatever.
   The importance of clean streets need not
be  adverted  to  here, this being merely a
peisonal matter  between the  afflicted and
the  disease.  It is to be hoped the  Corpora-
tion  will  attend  to  the  one; the patient is 
u>
     sure to attend to the other.  If both be carried
     out, the cholera, and all  other  epidemics,
     may,  to a great extent be put at defiance.
■*    From the position  and topography of New
     York, our city ought to be one of the most
     healthy cities in the world.  With the many
     natural advantages, which few others in any
     part of the world  possess, it  could  be ren-
     dered so clean, that no  aliment could be
     found to provide for any disease to live upon.
     The ground  gradually  ascends  from both
     the East  and  North Rivers to  the  centre,
     which may be called the  back-bone  of  the
     island, furnishing   unrivalled  means  for
     carrying  off  all  surface water.   Within
     the past year or two, a great  portion of the
     city  has  been  sewered,  and  in  addition
     to all this, we have a bountiful supply of
     pure water, by means of  the Croton Aque-
     duct.   Still, in spite of all these,  New York
     is  emphatically a  dirty city.  The  streets
     are never clean,  except  after a deluge of
     rain. They could, however, be made so, with
     a little trouble, and I trust that some move-
     ment of the kind will be undertaken before
     the pestilence shall  be among us.
        My  readers can  perceive,  therefore, that 
50
if a system of cleanliness of the person, and
the cleanliness of the streets and the houses
of our city be adopted  and followed out,
there need be no  feeling of  alarm  at the
approach of the cholera.  In one month, we
could make  such  arrangements  as  would
enable us  to put  the  scourge, as it  Were,
hors de combat.  When we  have the means
of doing so,  it were madness not to avail
ourselves  of  the blessings  we possess for
meeting this virulent disease.   It is certain
that, on the disease breaking out in an epi-
demic form, everybody is more or less affected
by the malady, and I know on  former occa-
sions that  every one felt more or less de-
rangement of the system—cholic, lassitude,
and avariety of  similar sensations, particu-
larly indicating the germ of the disease  in
the  body, which  "notwithstanding, may  be
only  developed, by some   act  of  impru-
dence.  It  is now  proved  that no  case  of
cholera arises spontaneously, and that  every
one  may  avoid the chance of attack, that is
with common care  and precaution, except,
however, the poorer classes, who have unfor-
tunately not the necessary means. The three
chief causes of its  developement where the 
51
system is within the miasmatic influence of
the disease, are cold, derangement of the sto-
mach,  and violent mental agitation.  The
abdomen  should  be covered with  two o<'
three folds of flannel, and every precaution
taken against cold.  Fear is an active cause
in superinducing this affection, over-fatigue»
and  exposure  to night air, and  above every
thing else, the  morning atmosphere at sun-
rise.  Every house in  the  inlected district
should  be simultaneously fumigated with
Chlorine  Gas,  and  to   do  it  effectually,
a  mixture of three parts of common  salt
and  one  of black oxide  of  manganese,
should  be  placed  just  inside  the outer
or street door  of the dwelling house, and a
little common vitriol poured  upon  it.  The
inward current of air will convey the chlo-
rine gas to every part of the  interior,  and
wherever it can be smelt, the  effect is  pro-
duced—the miasma is destroyed.
   Let immediate attention  be  paid  to the
above rules,  however slightly  the  bowels
may be disordered.
   Let every room be kept  completely dry
and  well ventilated, a free current of air, if
possible, should be allowed to pass  through, 
b-i
every  aparini3nt .  Acids, fruits, and vege-
tables  should be avoided.   The upper story
rooms  should be used as dormitories.
   These  internal domestic sanitary mea-
sures, with the treatment  above laid down,
will do more to check and, when it appears,
to cure the malignant cholera, than  all the
combined cordons and  quarantines  of  the
world can accomplish.
   The Cholera, when remedies are taken for
its first symptoms, need not to be dreaded
except  by drunkards and  persons of  a very
bilious habit, and living in contaminations,
&c.  It may, then, be asked  by  those un-
acquainted with  its progress, or insidious
approach, how those symptoms  are to be
known, so as to instruct them on this point?
I have, in this little treatise, pointed theni out,
and their proposed treatment, which if only
attended to, many, many Jives will be saved,
and the deaths will fall very short of those
usually published under  the  former treat-
ment.   On  examination  of  the practice,
hitherto, of the medical professors to combat
such a  terrible disease, I find that they have
only applied themselves to allay  its  symp-
toms;  they  have neglected its source and 
53
thereby eradicating the cause, failing in which;
there can be no cure.   It is evident, when
two-thirds die out of the number attacked*
that those prescriptions and treatment have
been erroneous, and quite contrary to the in-
dication o( the case.   Can any one wonder
at the bad success that has attended them?  I,
without  doubt,  consider  the  real  exciting
cause of Cholera to be a highly vitiated, mor-
bid, and  acrimonious state of the humours
and the  blood,  and being in  such  a  state,
these corrupt humours obstruct, choke up,
convulse, and paralyse  the  vis vitaz\ pro-
ducing upon the heart and other vital organs
all those  natural phenomena depending upon
the presence or absence of this power  The
sinking of the vital energy,  and coldness of
the extremities,  are not the  causes,  but the
effects, and  can  only  be relieved by taking
out of the system the morbid humours which
are oppressing it. To effect this, I have pre-
scribed the  powder, which soon  discharges
the stomach of the morbid, malignant matter
collected  there, and also the ejections from the
intestinal  canal  by the  natural evacuations
downwards.  A small dose of the Moscatello,
taken warm afterwards, gives instantaneous 
54
relief;  the patient generally falls into a calm
sleep, and  awakes, though in  a languid
state, I may say, to life and health.  On no
account should the patient be  allowed  to
leave the bed till totally free from spasms
and  perspirations, which have  been caused
by the warm  applications  recommended to
be used ; and though he may feel very faint,
it would be very injurious to open the win-
dows, or to expose the patient to the cold air.
As to the subsequent part of the treatment
to be pursued, when  in  a state of convales-
cence, great caution is to be observed to pre-
vent the patient overloading the stomach.
The food should be light and nutritious; and
with his meals, (dinner) a small quantity of
the  best old brandy in water may be taken;
and for a lew  days thin arrow  root, a light
pudding, and weak  black tea,  with soda
biscuits, may  be taken.  Frequently during
 the day some  effervescing draughts, made by
 dissolving half a drachm of carbonate of soda
 in three ounces  of water, and  add thereto a
 table-spoonful of  fresh  lemon juice,  which
 must be  drank off while effervescing. 1
 should recommend all  water intended for
 drinking,  1o  be  filtered through charcoal, 
                    55

 the effect would prove  beneficial to those
 using it, being a  good preventive against
 diarrhoea.
   Occasionally I use  charcoal as  a pre-
 ventive  of cholera;  and in  proof  of my
 practice being correct, I will relate that when
 the cholera last visited Europe, it  was par-
 ticularly observed,  while the  porters and
 other, laborers were engaged in discharging
 the cargoes of vessels laden with charcoal
 at Malta, they were totally exempt from this
 disease ; the same fact was noticed at all the
other ports of the Mediterranean, where char-
coal principally is used for fuel.  The anti-
septic property of this substance is believed
to have  been the chief cause of the exemp-
tion of this particular class of people, who in-
hale, in the course of their labour, the minute
particles of its dust, so as to correct internally
any tendency to the disease, that might have
been produced by the unusual  condition  of
the atmosphere.
  In view of the apprehended visit to the Brit-
ish shores of the pestilential  scourge, the
progress  of which is rapidly onward towards
(his continent, the Government of this coun-
try ha.\ through its General Board of Health, 
m
 issued a long and  interesting circular, from
 which I have  taken the subjoined extracts,
 their views agreeing in a great measure with
 my own:
  "The extent, uniform tenor, and undoubted
 authority of the evidence obtained from ob-
 servers of  all classes in different  countries
•and climates, and amidst all varieties  of the
 physical, political, and social conditions of
 the people, appear to discredit the once pre-
 valent opinion that Cholera is, in itself, con-
 tagious—an  opinion  which,  if fallacious,
 must be mischievous, since  it diverts  atten-
 tion from the source of danger, and the real
 means  of  protection, and  fixes it on those
 which  are imaginary; creates  panic; leads
 to the neglect and  abandonment of the sick ;
 occasions great expense  for what is  worse
 than useless; and withdraws attention from
 that brief  but  important interval between
 the commencement and the developement of
 the disease, during which remedial measures
 are most effective in its cure. Although it is
 so far true  that certain conditions may favor
 its  spread  from person  to  person, as when
 great numbers of  the sick  are  crowded to-
 gether in close unvcntilated apartments, yet 
57
this is not to be considered as  affecting the
general principle of its non contagious  na-
ture,  nor are such conditions likely to occur
in  this country.  Moreover, the preventive
measures founded on the theory of contagion
— namely, internal quarantine  regulations,
sanitary cordons,  and  the  isolation of the
sick,  on which, formerly, the strongest reli-
ance  was placed, Ifave  been recently aban-
doned in all countries where Cholera has ap-
peared, from the general experience of their
inefficiency.
   "Whenever Asiatic Cholera is epidemic,
the slightest  degree  of  looseness of  the
bowels ought to be regarded and treated as
the commencement of the disease, which at
this  stage is capable of being  arrested  by
simple means, but if neglected only for a k\v
hours, may suddenly assume a fatal form.
   " Medical  authorities are agreed  that the
remedies proper  for the premonitory  symp-
toms are the same as those  found efficacious
in  common diarrhoea;  that the most  simple
remedies  will suffice, if given  on  the  first
manifestation of this  symptom.
   " Next in importance to the immediate em-
ployment of such  remedies is  attention to 
58
 proper diet and clothing.  Whenever Asiatic
 Cholera is epidemic, there is invariably found
 among  great numbers of the inhabitants an
 extraordinary tendency  to  irritation of the
 bowels,  and this  fact suggests that every
 article of food which  is known to  favor a
 relaxed state of the bowels  should, as  far
 as possible, be avoided—such as every variety
 of green vegetables, whether cooked or not, as
 cabbage, cucumber, or salad.  It will be im-
 portant  also to  abstain  from  fruits of all
 kinds,  though  ripe and  even cooked,  and
 whether dried or preserved. The most whole-
 some articles of  vegetable  diet are—well-
 baked but not new bread, rice, oatmeal, and
 good potatoes.  Picktes should be avoided.
 Articles of food and drink which, in ordinary
 seasons, are generally wholesome, and agree
 well with the individual constitution, may,
 under this unusual condition, prove highly
 dangerous.   The diet should be solid rather
 than fluid; and  those who have the means
 of choosing should  live principally on animal
 food,  as affording the  most concentrated and
 invigorating diet;  avoiding salted or smoked
meats, pork, salted and shell fish, cider, perry,
ginger  beer,  lemonade, acid  liquors of  all 
50
 descriptions, and ardent spirits.  Great mode*
 ration, both in food and drink,  is absolutely
 essential to safety, during the whole duration
 of the epidemic  period.  One single act of
 indiscretion has, in many instances, been fol-
 lowed  by a speedy and  fatal attack.   The
 intervals between  the  meals should not be
 long, Cholera being uniformly found to pre-
 vail with extraordinary intensity among the
 classes that observe the protracted fasts com-
 mon in Eastern and some European countries.
   "On  account  of the intimate connexion
 between the external skin and  the internal
 lining membrane of the bowels, warm cloth-
 ing is of great importance.  The wearing of
 flannels next the skin is therefore advisable.
 Recent experience seems to show that it was
 useful to \vear in the day time a flannel ban-
 dage round the body, and this may become
 necessary during the damp and cold weather
 of the approaching season.
   " Particular attention should  be paid to
 keeping the feet warm  and dry;  changing
 the clothes  immediately after exposure to
 wet; and maintaining the sitting  and  bed
rooms well aired, dry and  warm.
  "It  may be necessary to  add  a caution 
fiO
against the use of cold purgative medicines,
such as salts, particularly Glauber salts, Ep-
som salts, and Seidlitz powders, which taken
in any quantity, in such a season, are dan-
gerous.   Drastic  purgatives  of  all  kinds
should be avoided, such as senna, colocynth
and aloes,  except under  special medical
direction.
   "In  conclusion, the General  Board of
Health would again  urge the  consideration
that whatever is preventive of Cholera is
equally preventive of typhus and of every
other epidemic and constantly recurring dis-
ease; and would earnestly call the atten-
tion of all classes to the striking and consol-
ing fact that, formidable as this malady is in
its  intense form and developed stage, there
is no disease against which it is in our power
to  take  such  effectual precaution, both as
collective  communities and private indivi-
duals, by vigilant attention to  it in its first
premonitory stage, and by the removal of
those agencies which are known to promote
the spread of all  epidemic diseases. Though,
therefore, the issues of events are not in our
hands,  there is ground for hope  and even
confidence in the sustained and resolute cm- 
61
ployment of the means of protection which
experience and science  have now  placed
within our reach."
   It will be seen, from the above, that  the
main features of the system so successfully
adopted by me in the years 1832 and 1834
are recommended by the high authorities I
have cited, and that my mode of treatment,
in cases of Cholera, receives the sanction and
approval of the most distinguished  medical
men in Europe.
   Were  these  same eminent men abroad
acquainted with the nature and properties of
the Balsam, which  I  have confidently and
unhesitatingly  advised as the best specific
extant for  all diseases of the stomach and
bowels,  I doubt not that  they would have
endorsed its merits, and would, at once, adopt
its use. Members of the medical profession, cf
the most exalted standing in the United States,
haveaccordedthe highest praise to the Balsam
of Moscatello, and in many disorders of the
character for which it  is specially adapted,
they have used and prescribed it when other
remedies have baffled their ingenuity and
skill.  Under such circumstances, the author
does not deem any apology necessary  for 
ea
fussing upon  this great therapeutical com-
bined medicine the favorable opinions which
have been here freely expressed.
  As an anti-spasmodic, the Balsam of Mos-
catello has not its equal in the Materia Medica;
hence  its  worth  has been appreciated by
captains of ships,  and all those whose avoca-
tions render them  subject to the diseases origi-
nating in the vicissitudes of climate.
  Hundredsof respectable individuals,aware
of its benign properties, have provided them-
selves with a supply of the  Balsam, as a pre-
cautionary measure, to be in readiness during
their journey  to  California.   They have
wisely concluded, that " Health is above all
gold and treasure," and in  every spasmodic
attack, a dose  of Moscatello  will  prove of
more real value to them, in the hour of need
than all the wealth  in the bed of the Sacra-
mento.
  In the absence of  any  letters from  the
newly discovered  region last mentioned, the
subjoined communication is presented from
one who was an adventurer on  a former re-
markable  occasion, to a  different  and  less
healthy climate, and who is known to fame
in every section of the United States.  For ob- 
viousjreasons it would be improper to give pub-
licity to the name of the writer in this work;
Dr. Wheeler, however, has no hesitation in
exhibiting the original1 letter to any one who
may be desirous of seeing it.  .

               New  York, July 28,  1S47.
Dr. Wheeler:
   Sir,—Soon after my return  from Texas
and Mexico, in 1837, my atiention was called
to an  editorial notice  in a New York  paper of
your alleged cure of diarrhoea and dysentery
in its worst forms.   In addition, I  saw the
names of Major Arapes, U. S  A., and M. M.
Noah, now of the '• Sunday Times," and the
names of these gentlemen in recommenda-
tion of it, was a sufficient inducement for me
to make an  immediate trial of the same;
with what results I will presently state.
   During the  whole of the campaign  in
1S36,  the greatest amount  of sickness and
suffering endured by the Revolutionary Army
of Texas was caused solely by that terrible
scourge of soldiers in warm climates, viz.—
diarrhoea:  almost  invariably  terminating
in dysentery  and death   I  speak of  this
fact  as  coming  under  my  own   imme-
diate  observation.   Filling the position of 
64
special courier to General Thomas Jefferson
Rusk (commanding), now U S. Senator, and
also  to Brigadier General T. J. Green, from
May, 1836, until the army was disbanded, I
had  abundant  opportunities  of  witnessing
the frightful ravages  of that  scourge (diar-
rhoea) amongst our soldiers, at  various points
from the Sabine River to the Rio Grande
del Porte.  But it was particularly  at the
town of Velasco, on the Guadaloupe  River
that  its ravages were most frightful; here,
one time, daily our  men died literally by
dozens of this disease, called the "curse of the
camp."   It was here  that General Stephen
F. Rusk, Dr. Lyon, of Charleston, S. C; Dr.
Branch ; J. Archer, of Va.; Lieut. Conrad,
brother of Judge  Conrad, of  Philadelphia);
Major  Lysander Wells, of Conn.; Colonel
Cook, and over a hundred other officers and
soldiers, were  lying sick with diarrhoea at
the same time.  General Austin and Dr.
Lyon (the able and highly esteemed Surgeon
General of the army) shortly after died of
this  disease.   Dr. Fossgate was our regi-
mental surgeon: he is the son of the cele-
brated  Dr. Fossgate, of Auburn, in this state,
the inventor  of the celebrated " Fossgate's
Anodyne Cordial," which has been  termed 
65
a specific for diarrhoea ; he knew the ingre-
dients of his father's medicine, and had them
with him there and used them, but without
effect;  and,  finally, three  camping  grounds
had to be abandoned in quick succession, in
consequence of this scourge, and  it was not
until after the army was disbanded, and the
majority of the men had  returned to  the
United States, that they even partially reco-
vered  from its withering  effects.   All the
efforts  of  the most skilful physicians that
were with the army in Texas,  (and we were
well supplied) failed to effect a cure for this
affliction.   Amongst  live  vest I was taken
down  with  this disease, and tried every sup-
posed  available remedy, under  the advice
of Drs  Lyon,  Fossgate, and Anderson,  but
without any beneficial effect; for three weeks
lecovery seemed impossible, and I did not
recover until  my  arrival  in  New Orleans,
after a long cruise through the Gulf,  It is
the recollection of the  terrible sufferings I
there saw and endured,, that has induced me
to turn my attention to the great universally
prevailing cause of disease  at present devas-
tating  our  army at  Point Isabel, Tampico,
Tera Cruz. 6cc, &:c.   Of every 100 cases of 
60
death that have occurred at those places this
summer, over 90 have  been  from diarrhoea
and dysentery, and  the medical  men there
seem unable to  check it or cure it.
  I merely mention these  matters, in order
that you may see that I have had considera-
ble practical experience in regard to the nature
of the disease and the usual means resorted to,
in order to attempt to arrest its progress. But I
assure you that  I never found any medicine
either in Europe or this country,  that would
effect a radical cure of the same, until I made
tnal  of your invaluable " Balsam of Mos-
catello.'"  Change of air, change  of climate,
and change of  water will  do much to alle-
viate,  and frequently a strong constitution,
with the  simple assistance of nature,  has
done the rest in young persons;  but all the
middle-aged and elderly men who were then
attacked in our army, invariably died from it;
and amongst them many stout veterans who
had endured the rigors of the campaign  in
the Peninsula, and  wound up the same  by
the fight at Waterloo.  I have seen many of
these veterans sicken and die in six  days
from diarrhoea, and  in less time.
  After my return to New York in 1837, had 
67
another attack of this  '■ scourge," (probably
a relapse) and  after trying every thing  re-
commended in the Pharmacopoeia, I was  in-
duced  to try your " Balsam of Moscatello,"
by a gentleman, two  of the members of whose
family had their lives saved by it in the cho-
lera of 1834.   The effect of your medicine
was most  extraordinary;  although I had
been suffering  for weeks, yet in less than
six hours I was relieved from all pain, and
entirely cured of the disease in  less than
forty-eight hours—nor did I have another at-
tack of it in less than two years afterwards.
I have  used it  now for years in my family,
and never once  knew it to fail in effecting a
radical and easy cure in less than two days,
and always  leaving  the system in a per-
fectly natural and healthy state.

   So thoroughly convinced am I that your
Balsam of Moscatello  is a perfect specific
for Diarrhoea and Dysentery, that I have on
every occasion, recommended it strongly to
every officer and soldier of our army, whom
1 knew  was  going to  Mexico.   Amongst
others to Col. Cushing, Capt. Fairchild, Capt.
Tompkins, and many others, all of whom I 
                   63

believe  supplied  themselves with it, and
have realised i's beneficial effects.  Indeed, a
near relative of mine, who- commenced; his
cimpiign with  Taylor  at  Palo Alto, and
s-rved with Twiggs n\ Ccvro Gordo, writing
Hi"1 from Jala pa,  states, that in.  cotisequenee
of b.aving your medicine with him lie has
u°t had a day's  sickness  duviuo: the warr
whilst many  of  I.vs immediate comrades
have died iu. a  few days from Diaruhoca.

  Under line so cinmrxs'ances,  Poc'w. you
rniy be  assured, that I ar»  never without  a
b)tile of it in r.iy house, nnd  never  travels
a:iy  considerable distance without it \ be-
e-.i'ise cltangc of water, even in strong. crnK-
situtions, almost  invariably  brings on Di-
n.rhrca; as was the case, with President Polk
during his late Northern  tour.   And  from
long pergonal and careful experience,  in my
own fam'ly, \\ is my firm conviction that
y-nir Bahtmnf Mtsratelh is a specific for
all that  class of diseases commonly known
n^. Summer f,»mohmt, Cholera Infantum,
Bowel  Complaint,  Clmlera Morbus,  .Diar-
rhea, and eve'i Ore-worst form of Chronic
Dy^iv'ery: an I li-rcforc- i consider that no 
69
family in the United States should ever be
without it.
             I am yours respectfully,
                  —           W.H.A.
  I have endeavoured to lay before the reader
of this treatise as many authorities in sup-
port  of my system of practice in Cholera, as
I could possibly crowd  into the brief space
which I have allotted to myself.  In conclu-
sion, I will add a few remarks  from a  com-
munication lately received from Dr. Dwight,
a justly eminent medical  practitioner,  now
residing at Constantinople:—
   " The Asiatic cholera, which when  fairly
seated, is one of the most unmanagable of all
diseases—despising all human art and skill,
and mocking all the assiduities of friendship,
in almost all cases begins with a mild diar-
rhoea,  which in that stage  is most readily
cured.  True, where the  cholera  is raging,
we are continually hearing of persons  who
arose well in the morning,  and are, in their
graves befoie night; and it  is not  to  be
doubted that there are  some cases  in which
the very  first attack is  the  collapse, from
which recovery is rare.  But I can say with 
70
truth, that in every instance of these sudden
deaths of cholera, in which I have been able
to investigate the circumstances, I have found
that the individual had been laboring under
diarrhoea for days previous.  Generally this
is so slight as not to be much noticed; it is
attended with no  pains, and  no sickness of
stomach, perhaps, and  gives the  person no
particular inconvenience.    But  it  is  this
very diarrhoea, which is insidiously prepar-
ing the system for the  most  dreadful  onset
of disease.  Whenever the cholera is prevail-
ing in any place, it should be a rule, in every
instance, to stop even the slightest  diarrhoea
immediate1 y.''
  These observations  entirely accord  with
my own experience, and fully corroborate
the views and opinions heretofore expressed
by me, as to the method of euro which should
be adopted—with the  very material excep-
tion, however,  that  I would not check the
diarrhoea too .suddenly, so as to  produce a
dangerous, and perhaps fatal, reaction.  The
constituent  elements of the Balsam of Mos-
catello, combined with  the necessary action
of the powders pres'-rihed Ky me; will effec- 
71
tually preclude the dangers to be apprehend-
ed from the hasty mode of treatment sug-
gested by the learned geutleman from whose
letter I have quoted.
THE END.
G. Mitchell, Printer,965 Bowery. 
A*
.w<-
aei>
-»© 
 
i"V"\?»
OF MEDICINE    NATIONAL  LIBRARY OF MEDICINE    NATIONAL LIBRA
IVNOIIVN    3NI3IQ3W  JO A II V » 9 I 1  IVNOIIVN    3NI3IQ3W  JO All
Y OF MEDICINE    N A T I O N A I I I B R A R Y O F M E D I C I N E    N A T I O N A L I I B R A
(HI!  IVNOIIVN    3NI3IQ3W  JO ARVIiail  TVNOI1VN    3NI3IQ3W  JO A*
 


? *#'
AEDICINE NATIONAL LIBRARY OF MEDICINE NATIONAL LIBRARY O
W5r^
\
p"\ - r
^ * i»k/I<#
VNOI1VN 3NI3I03W JO 11*1111 IVNOIIVN 3NI3I03W JO 1IVIII
•\2* I *^S 1
>!

? H
>/ - V./J
MEDICINE NATIONAI LIBRARY OF MEDICINE NATIONAL LIBRARY I
VNOI1VN 3NI3IQ3W JO A R V a I I 1 1 V N O I i V N  3 N I 3 I 0 3 W JO A B V efl I
^\  :      iN  \ :  /
.<+&!
i< 
NATIONAL LIBRARY OF MEDICINE
NLM  DMmDHSfl  D
NLM041404580