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 314 through 319 The case of the lady terminated fatally within twenty hours. The husband recovered slowly. this family had abandoned their home on the first day of the epidemic, and had remained in a healthy location until a period of ten days had elapsed from the last reported cae. During hte absence of this family their house had remained closed and unoccupied. Upon their return to the town they returned at once to this house, and no other precautions were adopted than that of bringing the drinking-water of the family from a well in a portion of the town that had not been infected. In each of these final cases the characters of the disease were exhibited. Malaise, painless diarrhea, which was neglected for two days, in both instances ushered in the attack. During this epidemic disinfectants were freely used. Sulphate of iron and choride of lime were added to the contents of the privy and sink at Maxville. Whenever any excreta were thrown upon the ground or into a privy by the attendants, the spot was at once disinfected. As far as possible all excreta were received in vessels containing chloride of lime; after use,a fresh supply of the chloride was added and the mass buried. The line of treatment adopted was the hypodermic use of morphia in the first stage of the disease, and of atropia in the others; calomel and camphor by the mouth; dry heat; sinapisms; hot baths; ice ad libitum. Dr. Craig reports favorably on the use of atropia in the treatment of cholera. The history of one case is given in full as indicative of the results in several cases. ADAIR COUNTY In Adair County the epidemic of cholera was confinedto the town of Columbia, to one locality of that town, and to a few cases who, having visited the infected locality, returned to their homes in the surrounding country. Comumbia has a population of about six hundred inhabitants. Very few negroes reside within the corporation limits. The town is built upon a hill-side, and is by nature most admirably drained. The arrangement of the town is upon a square, in the center of which stands the court-house, and from the square streets are laid off to the north, south, ease, and west. Opposite the court-house, and at the corner of the street leading north, is a hotel known as the Winfrey House. Upon the side street, and opposite to the hotel, is a large barn, which is used as a livery and sale stable, under the charge of the proprietor of the hotel. In the rear of this stable is a large covered privy, which was used not only by vivitors but by nearly all the male inhabitants of the town. Comumbia has always been considered a healthy town. The epidemics of the past were cholera in 1833 and 1835, from which disease the town suffered severely; dysentery in the fall of 1849, from which disease over sixty persons died; congestive intermittent fever in 1862, from which disease a large number of persons died; but from that time until 1873 no disease could be classed as epidemic. In the month of AUgust, 1873, the sanitary condition of the town was bad. The ground around the dwellings, as well as the streets, was covered with debris of all kinds. The privies, with the exception of that in rear of the Winfrey House stables, were built on the surface. Stables, pig-pens, chicken-houses were unclean, and around them human excrement was mixed with other debris. The rear premises of the Winfrey House were even in worse condition that is ordinarily observed at country hotels. The rear of the lot upon which the stable stands is lower than the surrounding lots which has been built upon. The privy was over a pit dug into the ground, but this pit was full to overflowing with excrement and the washings of the yard after each rain-fall being into it, the ground in all directions was saturated with the fluid contents of this pit. The rear windows of a row of brick buildings that face upon the public square open into this stable-yard. An effort was made early in August by the physicians of the town to improve the sanitary condition. In some instances they succeeded in inducing the property-holders to clean their premises, and an effort was directed toward at least the stable of the Winfrey House; this effort was opposed by the proprietor as an un- warrantable interferences with his property. On the 29th day of August a negro boy, fourteen years of age, who had been as a hostler, at the Marion County fair, returned to Columbia and went to work at the stables of the Winfrey House. He had a diarrhea when he arrived, and during the evening made frequent use of the stable-privy. At an early hour the next day (August 30) a negro man who was in charge of these stables was suddenly taken with cholera. He was carried into a basement-room of the hotel, where he died after an illness of forty-eight hours. About 8 o'clock a.m. the same day, the boy whose arrival from Lebanon has been noted, was found in a mule-shed adjoining the stable in collapse. He was carried into the stable preparatory to being placed in a bed, but died in a few moments. Later in the same day, a young lady twenty years of age, the eldest daughter of Mr. Winfrey, who resided some fifteen miles from the town, upon Carey's Creek, but who had been in the town on the previous day, and who was known to have used the stable-privy, was attacked at his home with the same disease, and died after six hours' illness. This outbreak of the disease occurred at a time when the town of columbia was full of non-residents. The circuit court was in session, and a large number of strangers were registered at the hotel, where were also congregated a number of regular boarders. August 31, the proprietor of the hotel was attacked, and died within twelve hours, and during the early hours of the same day five members of the Winfrey family and six boarders at the hotel were taken ill, a total of twelve cases in one house, all being attacked within a few hours of each other, and within eighteen hours eight deaths had occurred. During this day, all who were able to do so left the house; among others, a Mr. Vaughn removed his wife to Cane Valley, a small village some eight miles east of Columbia. When Mr. V. returned to the Winfrey House to render aid to the sick. At about 3 o'clock p.m. Mrs. Vaughn was taken with cholera, and her husband was recalled from the town. September 1, four persons who had boarded at the hotel were taken sick, and within sixteen all had died. Of this group of cases Dr. Henr Owens, the rear windows of whose office opened into the stable-yard, and who had been assiduous in his attention to the sick, was, after he was himself attacked, carried to his home in the country, where he died. Another gentleman, Col. Robert Miller, who had the day before left the hotel and gone to the Griffin Springs, some six miles distant, was attacked, and died after an illness of sixteen hours. A negro man who had nursed the negro who was the first case reported on the 30th, died after an illness of fifteen hours. On the same day Mr. Vaughn, who had left the twon on the previous night to nurse his wife, sick with cholera at Case Valley, was taken with the same disease. The lady recovered, but Mr. V. died after a tedious illness. A white man, fifty years of age, who had used the infected privy on the 30th of August, died at his home, on Green River after an illness of fourteen hours; and a young girl living on Casey's Creek, whose father died of cholera on the 30th, was taken ill and died after ten hours' illness. September 2, a white boy who had frequented the hotel and stables was attacked, but recovered. Two white men, father and son, who had nursed the sick at the hotel, and had made the coffins for some of the dead, were taken ill. The father, aged seventy years, died; the son recovered. A farmer who lived some four miles north of the town, but who had been in the hotel-stables the previous day, was taken ill at his home and died in twenty-four hours. A gentleman who had left Columbia on Sunday, August 31, died of cholera at the hotel at Campbellsville, Taylor County. During the three following days no new cases occurred. September 6, a young daughter of Mrs. Winfrey was attacked and recovered. September 8, four cases occurred in persons who had been exposed to the infection at the hotel. The attack was mild in each instances, and all recovered. September 10, an aged man and his wife, residing in a secluded position some two miles from the twon, were both taken with cholera. The husband recovered; the wife died. It is not known how they were subjected to the infection. September 20, a man aged seventy-five years was taken with cholera, and died after a few hours' illness, and on the 23d his wife died of the same disease. After the disease had become epidemic, a general police of the town was made. The Winfrey House was closed. The stable was abandoned after the privy had been disinfected and filled with fresh earth. It is the opinion of the two physicians who remained in Columbia during the epidemic that in the majority of the cases the excreta were not disinfected, but that they were case upon the ground around the houses. A young man who nursed Mr. Winfrey during his illness informed the writer that the dejections of this case were emptied from the window of the room in which the man was sick into a dirty lane which separated the kitchen from the hotel. By Dr. U.L. Taylor, of Columbia, to whom we are under obligations for important aid in the collection fo the facts of this demonstration, we are informed that the treatment consisted of calomel, opium, astringents, and stimulants. Dr. Taylor is of the opinion that to the use of calomel the only beneficial results that were obtained should be attributed. On the 27th of October, 1873, the writer visited the Winfrey House, and asked permission to inspect the rooms in which the cholera cases had occurred. We found that no effort had been made at cleaning beyond a washing of the bed-clothing and brooming of the floors. The mattresses and other beds remained unchanged, and the stains of the defections were visible. Under the upper portion of the bed upon which Winfrey had died a number of soiled rags were found, in all probability just as they were tucked beneath the mattress during its last occupancy. The importance of prompt and immediate cleansing of these rooms, the removal of all soiled articles of property, and a general police of the grounds was most earnestly impressed upon the person in charge of the property, with the only result of eliciting an expression of displeasure at such interference - a closing demonstration of the same foolish obstinacy that had subjected the town to a fearful epidemic. WASHINGTON COUNTY. Springfield, the county-town of Washington County, nine miles north of Lebanon, with which town its inhabitants are in daily communication, escaped almost entirely. A full record of every case in which the disease became pronounced has been obtained; and it will be seen that in every instance the connection is positive between the subject of the disease and either the Marion County fair or the town of Lebanon. That the county escaped an epidemic is undoubtedly due to the active course of disinfection to which each cae was subjected. August 30, the negro driver of the carriage of Mr. E.D. Davison, residing near Springfield, returned from the Marion county fair with an active diarrhea. He was removed to his house on the outskirts of the town, where at 9 a.m. the next day, he was found fully collapsed, and died in a few hours. The same day a negro man is reported as being attacked with cholera at Mackville, a small village near the Boyle County line. This man had been attacked with the disease after his return from the Marion County fair, and recovered after a tedious illness. September 1, a young white man, twenty years of age, died of cholera at his home, a few miles from Springfield. This case also is referred to the Marion county fair. September 2, three negroes (two males and one female) living in the Pleasant Run district were taken with cholera, and all died within thirty-six hours. Each of these individuals had been at Lebanon within two days of their attack. On the same day two cases (a white man and his wife) occurred at the village of Texas, in the northeastern portion of the county. The two last mentioned had attended the fair. September 3, Dr. Mat. Logan, a physician of much prominence in his county, who had been actively employed in attendance upon the cases of cholera in Marion as well as Washington Counties, was taken with active diarrhea. Dr. Logan, being a breeder of blooded cattle, had with his family, been in constant attendance upon the Marion County fair, where he had exhibited stock. The diarrhea continued until an early hour of the 4th, when cholera was fully developed, and he died after twenty-four hours' illness. The same day a negro death near Springfield, and a white recovery are Texas, are reported. The last was a member of the same family in which it has been recorded that two cases had occurred. September 7, Mrs. R., the daughter of Dr. Logan, who resided with and had nursed her father in his illness, was attacked with cholera and died in seventy-two hours. With the other members of the family, this lady had attended the Marion County fair. The same day a negro man was found in a field near Springfield, where he had lain during the preceding night exposed to a rain-storm. He had started to walk home from Lebanon, on the road was taken with cholera, and sought shelter in a stable. From this he was driven by the inhuman owner. When found he was fully collapsed, and soon died. A fatal case is reported at Mackville, in the person of a white man who had been in attendance upon the cases which occurred at that point. September 9, Mr. R., the son-in-law of Dr. Logan, was attacked with cholera and barely escaped with his life after a tedious illness. this case was followed by that of Mrs. Logan and the young child of Mr. R., both of whom recovered. On September 11 and 13 recoveries are reported. The treatment which was most generally adopted was that of calomel, opium, and camphor; morphia hypodermically; stimulants. In some cases atropia was exhibited, but with- out beneficial results. Hot saline injections seemed to be productive of good in some cases. BOYLE COUNTY. Boyle County, joining Garrard upon the east and Marion upon the west, was exposed to two distinct lines of cholera infection; the disease becoming epidemic in Garrard on the 14th and in Marion on the 30th of August. So far as can be ascertained, no caes of the disease were imported from Garrard, while all the cases which were developed in Boyle can be distinctly traced to the Marion County fair. When it was ascertained that cholera had become epidemic at Lancaster, the authorities of Danville, the county town of Boyle, adopted extraordinary precautions. The town was thoroughly policed, after which a rigid house-to-house system of inspection was adopted, the town having been divided into districts and to each district one member of the town trustees and one member of the Boyle County Medical Society were assigned as inspectors. The negro inhabitants were compelled to keep their houses and grounds in good sanitary condition. Everything that was detrimental to the public health was removed, ponds were drained, debris buried or burned. During the month of June preceding, the embodied circular had been issued by the Boyle County Medical Society: CHOLERA. For the public. The Boyle County Medical Society having been requested by the board of trustees, in view of the threatened outbreak of an epidemic of cholera, to recommend to the public such measures as are deemed most efficient in preventing and controlling the spread of this disease, most earnestly suggest the following for the careful consideration of every one: At once begin a most thorough and painstaking process of sanitary cleansing in your houses, your premises and persons. Be sure that you attain to the utmost cleanliness possible in everything, and never relax your vigilance and care in this matter. See that in your yards no garbage from the kitchen is allowed to accumulate. To prevent this, bury it in your gardens two or three feet under the surface, or obtain the privilege of manuring the country farms with it. The object is to be attained, it should be borne in mind, is to prevent drainage from such accumulations into springs and wells from which drinking-water may be used, and disposing of it in the way mentioned endangers nobody. Precautions of a similar character should be taken with privies. Whether you have a pit or not under them, you should see to it that there is no danger of surface-drainage in the one case, or its escape through the wall of intervening earth in the other, into wells or springs where the water is used for drinking purposes. Well-cemented cisterns are free from such dangers, if kept carefully closed at the top. the garbage of kitchens and the contents of privies cannot be kept, however, at too great a distance even from cisterns; for in many apparently of the most unaccountable and therefore unsuspected ways, all sources of drinking-water are continually becoming contaminated from such sources. These precautions become many hundred fold more important in dealing with the discharges from the bowels of persons actually attacked with cholera. These discharges undoubtedly contain the poison which has frequently been the cause of propagating the disease by getting into water used for drinking purposes. The contents of the privy may be dis- infected by pouring dialy into every privy-seat a pint of copperas-water, made by dissolfving in a gallon of boiling water about one and one-half pounds of copperas; but this should not forego the necessary careful supervision of the drainage from it. The same may be said of the disinfection of any mass of filth. Allow no accumulations of stagnant water about your premises, and see that all your cellars are always clean and dry. At all times, but especially while sleeping, every apartment should be most thoroughly ventilated. Avoid all excess in eating and drinking, and in your whole course of life. Plainly-cooked meats and vegetables, and sound, ripe fruit may be allowed for foodp; but all use of the frying-pan as a cooking-utensil should be abandoned. If you cannot roast or broil meats properly, stew or boil them. Any kind of food sodden with the fat or grease of the frying operation is at all times a powerful predisposing cause of diarrhea, dysentery, and cholera morbus. New or unmatured potatoes, and unripe fruits, should be studiously avoided. Exposure to sudden changes of temperature should be shunned, and if accidentlly exposed to a rain, change the wet garments as soon as possible. If attacked by cholera lie down in bed at once, and with warm wrappings, warm bricks, and hot bottles, sustain any loss in the temperature of the body. Pass the evacuation in a bed-pan, and don't rise from a horizontal position for any purpose whatever. If there is a tendency to vomit, apply a mustard poultice over the stomach. Have a qualified physician in attendance as soon as possible, and swallow no medicines prescribed by any one else - especially avoid patent medicines and quack nostrums. Avoid at all times a panicky state of feeling about cholera, and this is best accomplished by keeping the mind and body well employed; but be careful to engage in no exhausting physical or mental labors, especially avoinding excessive exposure to the direct action of the sun during the extreme heats of the summer. Cooperate to the full extent of your time and ability with the board of trustees and the medical men of the place, all of whom have volunteered their services for the town as a sanitary police, and who are ready now to do everything in their power for the common good, in purifying the streets, and in making suggestions for individuals and their premises; and also assist them in carrying into efficient and prompt execution any health ordinance they may deem proper at any time to enact. To conclude, your attention is called to the following significant statements from the American Public Health Association, deservedly the highest authority in sanitary matters in this country: "To combat and arrest the progress and prevent the epidemic prevalence of this scourge of sanitary negligence, it is necessary that the inhabitants of every city and town should promptly resort to the most effectual purification, and the best known means of disinfection, and that this sanitary cleansing and preparation should as far as possible be under- taken before any cases of cholera occur; and that in the presence Continued on page 320. Original images can be viewed at http://www.usgwarchives.net/ky/state/cholera.