NARRATIVE OF THE CHOLER AEPIDEMIC OF 1873 IN THE UNITED STATES. 43D CONGRESS, 2d Session, House of Representatives. Ex.Doc.No.95 Images submitted by Deb Haines Transcribed by: Sherri Hall ************************************* USGENWEB NOTICE: In keeping with our policy of providing free genealogical information on the Internet, data may be freely used for personal research and by non-commercial entities as long as this message remains on all copied material. These electronic pages may not be reproduced in any format or presentation by other organizations or persons. Persons or organizations desiring to use this material for profit or any form of presentation, must obtain the written consent of the file submitter, or his legal representative and then contact the listed USGENWEB archivist with proof of this consent. ************************************* Pages 308 through 313 in the town of Lebanon, that during the week preceding the opening of this fair a handbill was prepared, stating that cholera had not occurred at Lebanon, which circular was apparently signed by a number of the physicians resident in the town, among others the writer, who at the time the circular was issued was on duty at the town of Lancaster, some fifty miles distant, and who in no way authorized the use of his name. This handbill was extensively circulated in the counties adjoining Marion. The water-supply of the Marion County fair-grounds being limited, a contract had been made to carry water from the town to supply the deficiency. A well was selected in the western portion of the town, on low ground, and within 40 feet of Jordan, and in the immediate vicinity of the houses in which the cases of cholera had already occurred. The individuals having this matter in charge selected this well because it was of easy access, and because they supposed the water to be pure, and to be far better than they could obtain from any other locality. No suspicion of blame could be attached to them for this selection, for, even if they had recognized the fact that several cases of cholera had occurred in its immediate vicinity, they had been taught the theory of non-contagion by the laborious newspaper articles of individuals who were held as oracles. The well was old, having been dug in 1854, on what was formerly a drain leading from an elevation upon which is a grave-yard. It had been sunk through a shaly kind of mud-stone, and the first water that entered the well came in about 8 feet from the surface, and from the direction of Jordan. On the evening of August 27 a violent rain-storm deluged the country, the banks of Jordan were overflowed, and the well was filled flush. So great an amount of water fell that the surface of the ground was completely washed, and nothing but a direct interposition of Providence could have prevented the surface-washings from contaminating the water contained in the well. During August 28 and 29 the attendance upon the fair was large. The water from this well was served as upon the former days. No case of violent illness had occurred in the town since the 25th. A fatal security seemed to possess all, but the night of August 29, and the early hours of the 30th, the blow was struck. It might be said, simultaneously thirteen cases of cholera occurred, and within ten hours twelve had terminated fatally; one case lingered for nine days and then died. All of the individuals where were thus attacked had been in constant attendance upon the fair; the cases were not confined in any one locality, but were scattered over the entire town. At almost the same hour at which the Lebanon outbreak occurred four cases occurred at the town of Saint Mary, in the same county, and five miles distant from Lebanon, and one case occurred at Raywick, also of Marion County, and nine miles distant. These cases all terminated fatally; all had attended the fair. During August 30 cholera was epidemic in all portions of Marion County. Whenever individuals who had attended the fair and drank the water resided, there cholera was developed, no matter how isolated or how healthy the location. From August 30 to September 14, cholera was epidemic in Marion County, and isolated cases of the disease occurred until October 1, when it disappeared. The disease was not confined to the lower classes of the community, but was confined to those who indulged in the water at the fair-grounds, and to those who came in contact with the sick. In many instances but one member of a family attended the fair; that individual having been taken with cholera after his return home, communicated the disease to other members of the family, and one or more cases occurred. Active disinfection of the excreta was employed in the majority of the cases; and it is noticeable that wherever this method of precaution was instituted no second case occurred. The same remark may be made of a few isolated instances in which no disinfectants were used, but many other cases can be noted in which the neglect of such precautionary method was followed by the occurrence of several cases of the disease. A company of United States Infantry occupied the barracks in the town of Lebanon during the entire epidemic. In the management of these men extraordinary precautions were adopted. They were kept constantly employed, their food was carefully inspected, and the water of the well from which alone they were allowed to drink, was constantly tested as to its purity. a constant vigilance was employed to discover the disease in its incipient stage. Whenever a man was observed, by a non-commissioned officer detailed for the purpose, to visit the company- sink more than once, he was at once reported to the hospital, where the next dejection was received in a commode and carefully inspected. The least tendency to diarrhea was treated. The commanding officer recommendations were rigidly enforced. No case of the disease occurred in the garrison, although during the epidemic cases of acute diarrhea were of frequent occurrence, but all yielded to treatment. The child of a married soldier who resided with his family outside the garrison- limits, and who was not subjected to the same sanitary regulations, died September 8 of cholera. This death occurred late in the day. On the 9th the father, Private William Moore, while arranging for the funeral, drank largely of whisky, in each drink of which he placed a quantity of quinine, of which he had purchased an ounce, under the impression that it could prevent his taking the disease. At 11 o'clock p.m. of the same day this man was found in his bed collapsed, and he died before morning. In the town of Lebanon, during the epidemic, in but one instance did more than one case occur in a private house; in that instance a mother and her young daughter both died of the disease. At the Guthrie House, the railroad-hotel, five cases occurred, three of which terminated fatally. The other hotel, distant about one hundred and fifty yards, was free from the disease. No cases occurred in any of the county institutions of charity or correction. The majority of the physicians adopted the calomel and opium treatment, combined with camphor of aromatics. The opium was used with care. No favorable results were obtained by atrophia. In all instances (after the first blow of the disease upon the community) in which the patient was subjected to active treatment and perfect rest in the first stage of the disease, it was found to be perfectly amendable to treatment. On the 3d of September a case of some interest occurred in the person of a negro man about forty years of age, who was found by Dr. Cleaver and the writer, lying on the floor of a deserted cabin fully collapsed. There was absolutely nothing in the room; the man had no home, and was deserted by his kind. A bed was procured, upon which he was made comfortable; a large dose of calomel was administered, and as it was found utterly impossible to obtain a nurse he was provided with a light, some calomel- powders, and a large bucket of iced water, and a cup. He was vomiting occasionally, having involuntary discharges, was pulseless and voiceless; his body was icy cold, and bathed in profuse perspiration. Other cases demanding attendance, the man was of necessity left to himself; at midnight Dr. Avritt visited him, replenished his ice, but left him without being able to discover any favorable change in his condition. At daylight he was again visited, and was found to have reacted; his recovery was gradual. During the night, which was passed absolutely alone, with the exception of the midnight visit by Dr. Avritt, he had drank every drop of water from the bucket. NELSON COUNTY The history of the epidemic of cholera, as it affected Nelson County, is of value as demonstrating the portability of the disease. The first cholera-case which occurred in this county was in the person of a young man who resided upon a farm some six miles northwest of the town of New Haven. This man was taken with cholera upon the 20th of August, the day after he had returned from the town of Lebanon. While at Lebanon he had visited the house of a friend who had died in that town of cholera, and had assisted in preparing his body for the grave. In this instance the disease lasted but nine hours from its inception, and when Dr. N.G. Leake, who had been summoned when the symptoms became violent, arrived at the house the patient was dead. The dejections had not been disinfected, but had been thrown out upon the grass around the house. Dr. Leake attempted the disinfection of the premises, but was unsuccessful, for the next day, August 21, the mother and brother of the first case, who resided in the same house, were both taken with cholera, and within fifteen hours both were dead. August 23, a married lady, the sister of the first case, and her husband, who had both been in constant attendance upon the sick in this house, were attacked with the same disease, and both recovered after a lingering illness. August 25, the grandmother of preceding cases, a lady sixty years of age, who also resided at the same house, died of cholera after an illness of eighteen hours. August 26, an aunt of the same family, who also lived at the same house, was taken with cholera but recovered. The residence of this group of cases was not in a malarial district. September 2, a white man, twenty-six years old, was attacked by cholera at his home, near New Haven, and died after an illness of sixty hours. The day before his attack he had visited the house of a near relative in Marion. County. At this house several cases of cholera had occurred, and at the same time of his visit two of the family were ill of the disease. He did not enter the house, but sat upon a back porch, upon which the dinner was that day served. The head of this house being fully convinced of the non-communi- catibility of cholera, had declined to make use of disinfectants, and all the excreta of the patients had been thrown upon a heap of debris within a few feet of the porch. These cases were followed by the occurrence of twelve others in the town of New Haven. In each case the infection was traced either to the Marion County fair, or to the two localities, the infection of which has been noted. BOSTON The second demonstration in Nelson County was at the town of Boston, ten miles west of New Haven, and upon the line of the Knoxville branch railroad. At this town on second of September, a negress, who had just arrived from the town of Lebanon, was taken with cholera, but recovered after a severe illness. This case was followed by six others in the same house, all of whom died, the last occurring September 8. September 9, three deaths occurred in the persons of individuals who had left the infected house after the outbreak of the disease. This house was located upon low, wet ground, and its sanitary condition was most miserable. BARDSTOWN The third demonstration was at the county-town. Bardstown is situated in the northern portion of the county, and is an inland town of much importance. It is the terminus of the Bardstown branch of the Louisville and Nashville Railroad. The town is in constant communication with adjoining counties. It has been impossible to obtain full information as to this demonstration of the disease. We are informed by Dr. Alfred Smith that the first case which occurred in that vicinity was in the latter part of August, in the person of a young man who had been on a business-trip to the town of Lebanon; that several persons had died of the disease, when he was called to see a man who had been in attendance upon these cases, and found him, within five hours from the inception of the disease, profoundly collapsed, and he shortly died. Disinfectants were freely used, and no other cases occurred. Within a few days of this case, Dr. Smith was called to a man sick at the Ellis House, in the town, with cholera. This man had just come from Lebanon. He died after a short illness. This case was followed by two others, who had come from Lebanon, and by several among the inhabitants of Bardstown and its vicinity. Dr. Smith attributes to the use of dilute sulphuric acid the most favorable results which were obtained. At Bardstown, as at many other points, a diversity of opinion existed among the medical men as to the genuineness of the disease. That the views of all may be represented, we append the following letter: "Bardstown, KY, December 4, 1874." "Dear Sir: I am sorry that I am not able to give you any available information that may aid you in making up your report, and this is the reason I did not reply immediately after your first letter came to hand. "During the months of July, August, September and October, 1873, there was a great deal of sickness, nearly all showing a malarial type, from the mildest to the most severe grade. Those of the last usually died in from six to eighteen hours, if not seen immediately by a physician, and given large doses of quinine. They were attacked usually with coolness of the surface and great enervation of the nervous system, paleness, and after a time a haggard and worn-out expression of the face, nausea, vomiting, great thirst, and diarrhea that varied in its character. If reaction was not soon produced, death was the result. "As I kept no notes of the cases that I treated, I will give you from memory an account of some cases that occurred at the residence of a family one and a half miles from the town on the 4th day of October. "Upon the north side of this house there was an old cellar that was partially filled with debris of all kinds, the sweepings of house and yard. At the date specified this cellar was nearly full of rubbish, upon which the family were in the habit of throwing all wash-water. From it a most offensive odor was emitted. "I was first called to see the lady of the house and her little girl, some eight years old. The mother had simple bilious fever, the daughter the same, complicated with dysentery. On the next day I found tree others of this family sick, a negro servant-girl with the fever, and two young girls twelve and fourteen years of age. One of the last noted had been taken in the early part of the previous night with diarrhea and vomiting, but as she and her sister had eaten freely of green tomato-catsup it was thought she was not much sick, and no attention was given her until I arrived at the house. The first case (of the young girls) died in six hours; the other, who was similarly affected, recovered. "Both had cold surfaces, pale, haggard expression of the countenance, great thirst, nausea, vomiting and purging. After a time the dejections became serous, without odor, and producing scarcely any discoloration of the bed-linen. The same treatment was adopted in both cases. Quinine in large doses, diffusible stimulants, and calomel. Mustard was applied to the extremities, abdomen, and along the spine, and dry heat. These two cases were more marked than any I had, and at the time I did not regard them as cholera, but as pernicious fever, described by Wood and others. "Respectfully, "JAMES MUIR, M.D." "Dr. Ely McClellan, Assistant Surgeon U.S.A." Dr. J.F. Hickman reports a series of fifteen cases, but two of whom died. The first of these cases occurred July 10. Seven of these cases occurred in one family, with no deaths. No history of the cases accompanies the list, and we are unable, therefore to include them in the narrative. The last case reported by Dr. Hickman was on the 30th of August, and in the person of a white man who had that day returned to his home from the Marion County fair. LINCOLN COUNTY The epidemic of cholera in Lincoln County, so far as reports can be obtained, was confined exclusively to the immediate vicinity of the county town. To Dr. S.P. Craig, of Stanford, who was constantly in attendance upon the cholera-sick, we are indebted for the notes upon which the history of this local demonstration of the disease is based. Cholera, of a malignant type, made its appearance in Stanford on the morning of the 29th of August. About five days pervious to the appearance of the disease in the town a young man named Spoonamore died of cholera at his home, about two miles east of the town. Two or three days previous to his death Spoonamore left Lancaster, where he had been engaged at some carpentering-work during the epidemic at that point, and passed through Stanford on his way home, where a day or two later he was taken sick. During the prevalence of the disease at Lancaster, where it continued until after it had become epidemic at Stanford, a large number of negroes, who were refugees from the first-named town, are known to have stopped at Maxville, that portion of the town of Stanford where cholera first made its appearance, but as far as can be determined, none of these refugees had the disease or any symptoms of it. This point, however, is involved in much uncertainty, for negroes being notorious wanderers, many of these refugees made but a few hours' rest at Maxville, and then went on to other points. One of the number is known to have died of cholera at Campbellsville, Taylor County, a distance of nearly sixty miles southwest. The town of Stanford is situated in a little valley, through which passes Saint Asipha Branch, a small stream of very pure water, having its origin from the celebrated Buffalo Springs, about one mile from the town. It has always been considered a remarkably healthy town. It has always been free from miasmatic diseases. Epidemics of any kind rarely visit it. The portion of the town where cholera first appeared is known as Maxville. It lies northwest of the depot of the Knoxville branch of the Louisville and Nashville Railroad; is the most elevated portion of the town, and is inhabited almost exclusively by negroes. The sanitary condition of the town at the time of the cholera-appearance was very bad. The authorities had used considerable efforts at sanitary reform; had succeeded somewhat in the main portions of the village, but Maxville, like all negro settlements, remained filthy. In the rear of the houses where the disease first broke out was a sink some fifty yards in diameter. On the northern edge of this sink, and about thirty yards from the houses, was the privy of the neighborhood. On the western edge were two small springs of muddy, impure water that empty into the sink about 20 or 30 feet from the privy, which, being used by a large number of persons, was filled to overflowing with putrid excrementitious matter. The odor from this privy and sink, in the latter of which there was mingled organic matter of all kinds, pervaded the entire neighborhood. This privy was used by the Lancaster refugees, and beyond doubt became the "hot-bed of pestilence." On the first day of the epidemic (August 29) five cases of cholera occurred at Maxville, in houses close to the sink already described. These cases were all in the persons of negroes, (four of whom were males, and one a child five years of age,) and all were dead within thirteen hours. August 30, in the same group of cabins, four other cases occurred. The disease was still confined to the negroes, and was equally divided as to sex; one case was in the person of a boy seven years old. In twelve hours all the cases had terminated fatally. On this day the town authorities took possession of a church used by the negroes, and in the building organized a cholera-hospital, which was placed under the charge of Dr. Craig. From August 31 to September 14, eleven cases of cholera occurred at Stanford, six of which were fatal. The disease for some days was confined to Maxville, and to those of the inhabitants who had fled from their homes after the first fatal cases. After the epidemic had been some five or six days in existence, the town was dotted with cases. Four occurred near the center of the town, and in the portion occupied by the whites, but only one of the four cases was in the person of a white. Of these four cases two occurred in one house; the others were in separate houses, but all three were close together. The person first attacked in this group of cases, a negro girl, died. About the same time cholera appeared in the western suburbs of the town; three cases occurred, all of whom died. From the 14th to the 28th day of September no new cases occurred in the town of Stanford; but on the last-named date a gentleman and his wife, living quite near Maxville, were both taken sick with cholera. [cont'd on Page 314] Original images are at http://www.usgwarchives.net/ky/state/cholera.