.5555 - V' ^ W fr^^v^M ■mwmm u\-rnJW; it, A JR-/r'^%' j »TBBtr-*HB 1 ''■■■■sbCiwa.^^'WEH "S 7 • : i&fW " * War JH #3 V' *.ti v< M&fi ifM ;*»:>. gsr * 5*? JOfi ' J ^jBi> ^ ^^S~WMki lln ■ ~1m1 l 1 LIBRARY OF CONGRESS,! # # | ^/y* BGJ &6 } I ^^ 'Sis^'fi J UNITED STATES OF AMERICA. J •IK>. to ^ -^l^* £»S • '■■■ ;53£ ^P&e**' ^v^r^ > ism, \M52L Jteu^* *& "«te AtilJL a^ > > • > > > r "3>» i > > ^ 1 ; 5 >> •■> - asp *t5&3 *3? *25L£ 5E8L^' &»*> ;.- ^ ^ >** t* T^^-i WT 'V> 3d* THE CHOLERA, ITS CAUSES, PREVENTION, AND CURE SHOWING THE INEFFICACY OF DRUG-TREATMENT, AND THE SUPERIORITY OF THE WATER-CURE, IN THiS DiSLaz£ BY JOEL SHEW, M. D. PRACTITIONER OF THE WATER-CURE, AUTHOR OP WATER-CURE MANUAL, EDITOR OF THE WATER-CURE JOURNAL. "AN OUNCE OF PREVENTION IS BETTER THAN A POUND OF CURE. » STEREOTYPED. Was^r i / NEW YORK: FOWLERS & WELLS, PUBLISHERS, NO. o C 8 BROADWAY. In Bobton : Philadelphia : 142 Waeoingtou Street, ■'*<>. 231 Arcb Street. c, 4 r C 5 Entered, according to act of Cong„ .as, in the year 1843, by FOWLERS & WELLS, lft ine Clerk's Office of the Diatrv't Court for the Southern District of New York. 1> \* ^ CONTENTS. LECTURE I. Definition of the term M Cholera." — Meaning of " Contagion and Infection." —Is the Cholera a Contagious Disease? — Causes of Cholera. — Fear a Cause of Epidemics. —Anger.— Excessive Grief.— Mental Distress from Want. — Sympathy a Cause of Disease. — Drunkenness and Intemperance. — Prostitution.— Filthiness and Degrada- tion. — Atmosphere and Electricity. — Animal and Vegetable Diet. — Howard, the Philanthropist.— Bible Christians in Philadelphia. — Conclusion Page 9 LECTURE II. Recapitulation. — Manner of an attack of Cholera. — Symptoms of Cholera. — First stage. — Second stage. — Stage of Collapse. — Length of time Cholera patients live. — Nature of Cholera — Medical Authority on the Treatment of Cholera.— Dr. Elliotson.- Dr. Watson.— Dr. Marshall Hall.— Dr. Billing.— Dr. Scouttetten.— Dr. J. V. C Smith. — Dr. Wood. — Dr. Dunglinson. — Dr. Mackintosh. — Dr. Condie.— Dr. P. C Tappen. — Philadelphia Board of Health. — Dr. Parkes. — Dr. Broussais. — London Morning Chronicle. — Drs. Bell and Condie on Saline Injection into the Veins and Arteriotomy. — Blood-letting. — Di. Tappen's Remarks thereon. — Homeopathic Treatment — Closing Remarks .... 42 LECTURE III. The System of Water-cure ; a Pictura showing what it is. — Water one of the Leading Constituents of all Living Bodies. — The Human Body composed mostly of Water. — Life may be Sustained for weeks by Water alone. — Facts in proof thereof — Wa- ter assuages Hunger. — Remedial uses of Water. — Animals take to Water when poisoned. — Boerhaave's theory of Fever. — Stimulating practice in Fevers and Inflam- matory Diseases wrong. — The cooling Regimen the mo6t natural and the best. — Wa- ter the greatest of ail Tonics. — Facts from Howard. — Dr. Baynard. — Dr. Hancock.— Dr. Adam Clarke. — Sir John Floyer and Dr. Baynard. — A Fever case. — Cold Wa- ter in Scalds and Burns. — Medical authorities on the use of Water in Cholera. — Neg- lect of Bathing in Medical Practice generally. — Water treatment in Cholera. — Di- arrhea preceding Cholera. — How to be Treated. — The great Thirst in Cholera.— Warm Water-drinking. — Cold Water with Calomel. — Cold Water promotes the Circulation. — Hot Water in Cholera. — Vomiting and Discharges from the Bow- els.— Warm Water-Injections. — Vomiting by Water. — Injection of Warm Water into the Veins. Hot Applications externally, bad in Cholera. — Spasms, how re- lieved. — Cold Perspiration in Cholera. — Stage of Collapse. — Priessnitz's Treatment of Cholera. — The Persian Treatment. — Difference between Water ana Drug-Treat- ment. — Conclusion ?/ • Entered, according to act of Cong„ „bs, in the year 1843, by FOWLERS & WELLS, tft the Clerk's Office of the Di*tr~'t Court for the Southern District of New York. ^ ,\* ^ CONTENTS. LECTURE I. Definition of the term " Cholera." — Meaning of M Contagion and Infection." —Is the Cholera a Contagious Disease? — Causes of Cholera. — Fear a Cause of Epidemics. — Anger. — Excessive Grief. — Mental Distress from Want. — Sympathy a Cause of Disease. — Drunkenness and Intemperance. — Prostitution. — Filthiness and Degrada- tion. — Atmosphere and Electricity. — Animal and Vegetable Diet. — Howard, the Philanthropist.— Bible Christians in Philadelphia. — Conclusion Page 9 LECTURE II. Recapitulation. — Manner of an attack of Cholera. — Symptoms of Cholera. — First stage. — Second stage. — Stage of Collapse. — Length of time Cholera patients live. — Nature of Cholera — Medical Authority on the Treatment of Cholera. — Dr. Elliotson.— Dr. Watson.— Dr. Marshall Hall.— Dr. Billing.— Dr. Scouttetten.— Dr. J. V. C Smith. — Dr. Wood. — Dr. Dunglinson. — Dr. Mackintosh. — Dr. Condie.— Dr. P. C Tappen. — Philadelphia Board of Health. — Dr. Parkes. — Dr. Broussais. — London Morning Chronicle. — Drs. Bell and Condie on Saline Injection into the Veins and Arteriotomy. — Blood-letting. — Di. Tappen' s Remarks thereon. — Homeopathic Treatment — Closing Remarks .... 42 LECTURE III. The System of Water-cure ; a Pictur3 showing what it is. — Water one of the Leading Constituents of all Living Bodies. — The Human Body composed mostly of Water. — Life may be Sustained for weeks by Water alone. — Facts in proof thereof. — Wa- ter assuages Hunger. — Remedial uses of Water. — Animals take to Water when poisoned. — Boerhaave's theory of Fever. — Stimulating practice in Fevers and Inflam- matory Diseases wrong. — The cooling Regimen the most natural and the best. — Wa- ter the greatest of a,! Tonics. — Facts from Howard. — Dr. Baynard. — Dr. Hancock.— Dr. Adam Clarke. — Sir John Floyer and Dr. Baynard. — A Fever case. — Cold Wa- ter in Scalds and Burns. — Medical authorities on the use of Water in Cholera. — Neg- lect of Bathing in Medical Practice generally. — Water treatment in Cholera. — Di- arrhea preceding Cholera. — How to be Treated. — The great Thirst in Cholera.— Warm Water-drinking. — Cold Water with Calomel. — Cold Water promotes the Circulation. — Hot Water in Cholera. — Vomiting and Discharges from the Bow- els. — Warm Water-Injections. — Vomiting by Water. — Injection of Warm Water into the Veins. Hot Applications externally, bad in Cholera. — Spasms, how re- lieved . — Cold Perspiration in Cholera. — Stage of Collapse. — Priessnitz's Treatment of Cholera. — The Persian Treatment. — Difference between Water ana Drug-Treat- ment. — Conclusion ?f PREFACE. On the evenings of the second and fourth of December, 1848, the author gave two lectures, in Clinton Hall, New York, on The Water- Treatment as a Means of Prevention and Cure of Cholera, The day after the last lecture, it was publicly announced that the dread disease had already appeared at Quarantine, Staten Island, opposite the city. The lectures were afterward written out at greater length, and have thus made three instead of two. In this form they are now given to the public. It will strike many, no doubt, as very strange, that the advocates of the old school practice are so at variance on the treatment of cholera. The writer hopes that this little work will do some good, in showing forth the fallacies of the old modes in their true light. Prevention of disease is the noblest of all medical subjects; and the author is persuaded, that if persons will follow the directions of this work in regard to water-drinking, daily bathing, abstaining from all alcoholic stimulants, tobacco, tea, coffee, and all medicinal sub- stances, at the same time observing a consistent and well-regulated diet — such as brown bread, unbolted wheat or rye mush, good and ripe vegetables and fruits, with a moderate allowance of milk and pure soft water as the only drink — they will find great benefit aris- ing therefrom. Multitudes of people there are in our country, who need just such advice, to enable them to regain that best of all earthly blessings, firm and enduring health. It is hoped this little work will be especially useful, in teaching people how to prevent disease. New York, January, 1849. LECTURES ON CHOLERA LECTURE I Definition of the word " Cholera." — Meaning of " Contagion" and "Infection.' — Is the Cholera a Contagious Disease ? — Causes of Cholera. — Fear a Cause of Epidemics. — Anger.— Excessive Grief. — Mental Distress from Want. — Sympathy a Cause of Disease. — Drunkenness and Intemperance. — Prostitution. — Filthiness and Degrada- tion. — Atmosphere and Electricity. — Animal and Vegetable Diet. — Howard the Philanthropist. — Bible Christians in Philadelphia. — Conclusion. DEFINITION OF THE TERM " CHOLERA." Cholera signifies a flow of bile ; " cholera morbus,'* a morbid flow of bile. The term cholera, then, as used in modern times, is not correct, because, in the disease proper, there is no flow or discharge of bile whatever. The entire absence of bile in matters vomited and pass- ed by the bowels, is a characteristic feature of the dis- ease. Cholera, like many other medical terms, is used in a sense directly the opposite of its true and original signification. The term, however, is well understood > and that is sufficient for all practical purposes. MEANING OF " CONTAGION" ANI? " INFECTION." The word " contagion" (from contango, to meet or touch) signifies, properly, the application of some mor- bid or poisonous matter to the body, through the medi- Mm of touch. A contagious disease is taken by a per* 10 IS CHOLERA CONTAGIOUS? son coming in contact with another diseased, or by his being, in some mode or other, subjected to the morbid matter passing from the diseased body of the one affected An infectious disease is one the principle of which exists in the atmosphere, without any relation or refer- ence to the bodies of the sick. An infectious disease, then, is taken as easily without coming in contact with the sick as it may be with. If a disease is infectious and not contagious, all quarantine regulations are use- less ; and, in this case, there is no more danger in attend- ing, nursing, or being with the sick, than in not doing so. This is an important practical distinction between contagious and infectious diseases is the cholera a contagious disease ? This is a difficult question to determine, if indeed that be possible at all. It is a " vexed question." Much proof may be brought on both sides. It is very certain, I think, that cholera is not contagious in the same de- gree as small-pox, and some other diseases. If it were strictly contagious — or, at least, contagious in the same degree as small-pox — it would live perpetually in a city like London, Paris, or New York, and not of itself soon pass away, as it always has done. Besides, many per- sons have been much among cholera patients — physi- cians, nurses, and attendants — and yet have not received the disease. Persons have slept with triose having the cholera, dressed blisters for them, and nursed them in all manner of ways, remaining with them constantly night and day, and yet have not suffered an attack. We know, therefore that cholera cannot be contagious in the same degree as small-pox, measles, scarlatina, and CAISES OF CHOLERA. 11 the like. Probaoly a 1 epidemic diseases — ofiseases thai rage, or come upon great numbers at the same time — are, to a greater or less extent, contagious. The bodies of persons suffering with such diseases, doubtless throw off matter that has a tendency to produce the same form of disease in others, whose systems are in a low condi- tion of health. I believe a large majority of medical writers regard cholera as not a contagious disease. It appears, generally, that men are most subject to cholera, women less so, and children least. CAUSES OF CHOLERA. Whether cholera is, or is not, a contagious disease, we know that certain classes of persons are far more subject to it than others ; and investigations of this kind are far more useful in a practical view, than those con- cerning the question of contagion and non-contagion. Judging from all the facts of cholera, we may lay down the following axiom: that whatever tends in any way to depress or deteriorate the general health of the individual, must necessarily render the system more Ha- ble to an attack; and, growing out of this, another axi- om : that whatever tends to fortify and establish the gen- eral health of the individual, is a natural means of en- abling the system to ward off the disease. These are self-evident principles, and cannot be too well remembered or acted upon — not only w T ith refer- ence to cholera, but every known malady, and especially diseases of epidemic kind. This being premised, I will proceed to explain some of the more prominent causes of epidemic disease. 12 THE EFFECTS OF FEAR FEAB A CAUSE OF EPIDEMICS. Fear is one of the most prolific among the causes of epidemic disease. It is an old saying, that fear kills more than the plague. " Fear," says Haller, " diminish- es the powers of the body, enfeebles the movements of the heart, and weakens the circulation. Influenced by this passion, the scurvy and other diseases become more fatal, putrid and other contagious maladies acquire more malignity, and the body becomes more disposed to be affected by pestilential miasmata." When a disease like the cholera or the yellow fever comes among any people, the utmost consternation pre- vails. Exaggerations are multiplied on every hand. The laws of health not being by the many at all studied or understood, and there being, moreover, a general belief that disease is a thing of God's own sending, without any reference to errors in the volun- tary habits of the individuals and communities of the race, fear, and fear only, can be the legitimate result. I am acquainted with an intelligent clergyman, who in 1832 was upon the steamboat passing from Quebec to Montreal, when the first case of cholera happened in the latter city. It was sounded abroad in every quar- ter that the cholera had reached the city. The death took place in the night-time, and in the morning and throughout the day many cases occurred. No doubt now, in this city, the cholera might be caused any day, provided the public could be made to believe that the disease was actually, with all its terribleness, in our very midst. In the spotted fever, or cold plague, as some termed it, that broke out in and spread over a great part of New England, about forty years ago, it THf. EFrBCIS OF FEAR. 13 was ascertained that not onlv delicate females, but the most robust men, and even physicians, fell prostrate and almost lifeless, with all the apparent symptoms of a violent attack of that disease ; but which, according to their own subsequent confession, was entirely the effect of fear. And what adds greatly to the mischief in such cases, a great variety of destructive compounds in the way of specifics, elixirs, etc., are swallowed by the multitude, in the old belief that disease is a fixed some- thing within the body, which a medicine may be taken to kill ! I repeat, one of the most prolific of all causes of disease is fear. A fable should teach us wisdom in this matter : A pilgrim, meeting the plague going into Smyrna, asked, " What are you going for ?" " To kill three thousand people," answered the plague. Some time after they met again. " But you killed thirty thousand people," said the pilgrim. " No," answered the plague ; " I killed but three thousand — it was fear killed the rest." It is to be observed, also, that fear is itself contagious. A person in fear brings those who are about him into the same condition. Suppose a physician, when treat- ing a patient, exhibits fear : what success does he meet with ? If nothing worse, a dismissal from the case, as he ought to have. People would much rather die, if die they must, by the side of a strong man, even if he be unskillful, rather than a scientific man, if he be liable to the impression of fear. There is an opinion with many that physicians " take something," by which they are kept more free from epidemic and contagious diseases. But the truth is, they do not, as a general fact, fear disease as the com mon people do ; and they are, therefore, to say the 14 FEAR IN KRIS. least, not more .Sable than those who are among the sick much less than they are. " All persons, or at least those who have not uncom- mon courage and firmness of character," says Brous- sais, " should avoid the sight of patients suffering with cholera, as there is something very frightful in the con- tortions of their countenance ; and one must be accus- tomed to attend patients in order to behold with indif- ference so terrible a spectacle." In the time of cholera in Paris, in 1832, the royal family, we are told, set a noble example by remaining in the city; and the heir apparent, the lamented Duke of Orleans, made a personal tour of inspection through the hospitals. Casimer Perier (the President of the Council) accompanied him, and " this was an incontesti- ble proof of courage on the part of a man who had carried the seeds of death within him, whose nerves were irritable to excess, and who shuddered at the mere idea of a coffin." He is said never to have recovered from the impression, and died in three weeks afterward. There is a highly wrought account of the effects of fear in the city of Paris, when the cholera raged with unheard-of violence and devastation in 1832. The deaths at one time were calculated at one thousand and three hundred, to one thousand and four hundred per day. Hearses falling short, artillery wagons were used instead. These having no springs, the violent jolting burst the coffins, and the bodies were thrown :>ut, and the pavements were stained with their blood. The people went mad with terror, believing the wildest fic- tions, and indulged in the most dreadful atrocities. It .was rumored that the deaths were all owing to poison, and tb *^re was no such thing as cholera. Then you ANGER AND GRIEF. 15 might behold all the horrid secrets of a mode *n civili- zation, displayed in the rolling billows of a seething population. From those darksome quarters where mis- ery hides its forgotten head, the capital was inundated by multitudes of bare-armed men, whose gloomy faces glared with hate. What sought they ? What did they demand ? They never told this, only they explored the city with prying eyes, and ran about with ferocious muttering. Murders soon occurred. A Jew was kill- ed because he laughed in a strange manner, and carried a packet of white powder (which turned out to be cam- phor) in his hand. A young man was butchered for looking into a wine-seller's window, and a coal porter made his dog tear the dead body.* ANGER Doubtless is sufficient, in some cases, to cause the cholera. Anger we know causes violent fits of the spasmodic cholic ; so, too, it may bring on the cholera in some instances. A state of uniform equableness of temper, feelings, and disposition, cannot be too strongly recommended, as a means of prevention in all pestilen- tial d'seases. EXCESSIVE GRIEF Is well known often to have a powerful effect in caus- ing disease. Every one who has lost a wife, a husband, parent, child, or bosom friend, well knows the depress- ing effect which grief has had upon them at the time. Especially when the disease is of a sudden, dangerous, and terrific character, grief is found to do its most fear- nil work. Let us imagine that a man goes to rest at * London Morning Chronicle. 10 MENIAL SUFFERING. night with his family, all in apparent good health, and long before the sur shines out upon him in the morning, his wife, with all the agonies of cholera, becomes a corpse in his arms, and in a few hours more his only child ; is it any wonder that, under such circumstances, he, too, should be struck down wLh the same disease? From all the facts that can be gathered on the subject, it is evident that grief has a very powerful influence as a proximate cause of the cholera. MENTAL DISTRESS FROM WANT. Mental distress, arising from destitution and want, may act as a powerful cause of epidemic disease. A husband and father, poor in this world's riches, has bu- ried the mother of his children, the companion of his best and happiest days. A widow, with her children about her, toiling with anxious solicitude by day and by night, that she may keep them under her own paternal roof, rather than leave them to be provided for by the cold charities of the world ; anxious, as by pawning her arti- cles of dress, she pays her last cent for an exorbitant rent, being not able to imagine what merciful dispensa- tion of providence can provide her for the next quarter day, or even with bread to eat. Such things, I need not repeat, occur every day, even in our American cities, where the people are the happiest and best provided for of any on the globe. Need it be said, that mental dis- tress, arising from destitution and want, causing depres- sion of spirits, anxiousness for the future, yes, for the bare bread one is to eat, wil act, in many cases, as a cause of the cholera, should that dreaded pestilence again come among us ? SYMPATHY ITS EFFECTS, 17 SYMPATHY A CAUSE OF DISEASE. What may be called sympathy in the human consti- tution, should throw light on the causes of cholera and other epidemic diseases. At the venerable old Cathe- dral of Notre Dame, in Paris, it was found necessary to allow no person to go upon its towers alone. Every one must have a companion, because it became gener- ally understood that nervous people were very apt to throw themselves off. So, too, over the top of the Fire Monument, in London, there was put an iron rack work, so that people could not precipitate themselves from that height. In some hospitals, hysteric fits have caused the same symptoms in others ; indeed, we see this thing often exemplified. You have heard of the account of the poor-house for children, at Harlsem, in Holland, where a girl from some cause, fell into convulsions, or a kind of convulsive disease, and which, being witnessed by the other children, communicated itself to nearly all of them. And the learned Boerhaave could find no other mode of putting a stop to the disease, except by prepar- ing red-hot irons in the presence of the patients, at the same time declaring most solemnly, that any one who should manifest the least symptom of the disease, should be forthwith burnt to the bene. Other nervous diseases, as the St. Vitus's dance, have been known to become epidemic by sympathy. When the cholera raged before in Europe, it is said that the intrepid gayety of the French seemed at first to brave off the terrible disease. Amid the festivities of Mid-Lent, the streets and Boulevards were thronged as is usual on such occasions, and the people in great num- bers amused themselves by looking at caricatures in the 16 RELIGIOUS EPIDEMICS. shop windows, the subject of which was the cholera morbus— a strange subject, certainly, for caricature, and such as none but a Frenchman could have conceived of. Now, at this very time, the cholera broke out in Paris in such terribleness as has seldom if ever been equaled elsewhere. As ever, there were here vari- ous causes at work, but one among the rest, doubt- less, was the effect of sympathy in looking at those strangest of all exhibitions, the caricatures of cholera morbus. The religious epidemics, as they may be not inaptly termed, should be mentioi H m this connection. In one part of the country, persons are struck down, as it were dead, by the inscrutable power of God, as is believed. Every one has seen these things among that worthy de- nomination, who do more to spread the gospel every where than any other, the Methodists. Among the colored people we see, under a state of excitement, the audiences often become affected with violent spasmodic motions of the head, limbs, and other parts of the body. Years ago, in the Southwestern states, there was a pre- vailing religious excitement in which the subjects were affected with what was denominated the "jerks." Peo pie would gather themselves together in large circles for prayer, when one after another would become affect- ed, until all experienced those particular symptoms, which were regarded as the most positive and indubita- ble evidence of the operation of the Holy Spirit in the soul. Even wicked young men, scoffers of religion, who entered these circles in a spirit of derision, intend- ing to practice a deception upon the religious, were as- tonished and confounded to find themselves affected in the same way. Such became often powerfully impress- INTEMPERANCE. 19 ed, and in many instances went away converted, as they believed. The eccentric Lorenzo Dow saw, in some of the Southern states, one of the Carolinas, I think, people become affected with what he called the " kicks." Where the meetings were held, saplings were cut off, breast high, for the people to hold upon when they were affected with the " kicks ;" and their motions were so energetic, that the ground about these saplings looked as if horses had been there, stamping at flies. The really pious, he says, were not affected by the symp- toms ; it was the lazy, lukewarm professor, who was most subject ; and those who wanted to get the " kicks" to philosophize upon, were not affected at all. How much the principle in question had to do in the causa- tion of the Salem witchcraft, I will not assume to de- termine. I mention all these things in no spirit of irrev- erence, but merely because they are calculated to throw light upon the subject of the causes of epidemic disease. DRUNKENNESS AND INTEMPERANCE, The temperance reformation, although coming far short of what it should accomplish, has yet done a vast amount of good ; and this good is not confined merely to matters of a moral kind. It is a fact worthy of ob- servation, that in 1832 the profession generally recom- mended a generous diet, including also the "moderate" use of wine, brandy, and the like. There were then those who objected to fermented, drinks, but yet recom- mended wine instead ; and through this, great quantities of vile mixtures of whiskey, logwood, etc., etc., were palmed off upon the people for wine. Such will doubt- less again be the case, in those parts of our country 20 TEMPERANCE. where people are not sufficiently enlightened to be guarded on the subject. At this moment, Dec. 28th, 1848, tnere came news tG us that the cholera is raging in New Orleans. A writer in a New York paper tells us, that " the bar-rooms have been filled for the past two days, and inordinate quanti- ties of brandy, which is said to be a preventive, are consumed," and that great numbers become intoxicated. Why did not the cholera rage in New York, when it appeared a few weeks since here, as it did in 1832? Is it said, because the season was unfavorable? I answer, the extreme warmth and closeness, so to say, of the atmosphere, was remarkably favorable for the spread of the disease. Such exceedingly warm weather was never known in the month of December, as this year. But the cholera has had now, as it hereafter must have, hard work to get much hold of New Yorkers ; the tem- perance reformation has done too much. The Southern cities will suffer most, and in great part because the peo- ple are far more intemperate than in the North. I have not time here to enter into an explanation of the philosophy of the action of alcohol on the human frame, but will merely remark, that alcoholic drinks, of whatever name or kind, always necessarily irritate the entire track of the mucous membrane of the stomach and alimentary canal, more than two thousand square inches in extent, and therefore predispose the system to this fearful disease. In Great Britain, the temperance reformation has gone mostly among the poor. When Father Matthew first went to London, there was but one clergyman in the whole city to stand by him in his benevolent work. He could gain influence only with the pocr. He did not obtain SPIRIT-DRINKING. 21 {.ledges of the rich, for he could not, if he had tried — only among the poor, such as the Five-Points people of this city. The cholera does not rage in Great Britain now as it did before, nor any thing like. This, we have every reason to believe, is caused in part by what the temperance reformation has already accomplished there. It is plain, from all authority, that this disease manifests a decided preference for the intemperate every where. Often it has passed harmless over a wide population of temperate country people, to commit its most terrible ravages upon the drunkards of another locality. I will now cite some facts on the subject of temper- ance, as bearing on cholera. Dr. Sewall, of Washington, while on a visit to the cholera hospitals of New York in 1832, wrote, that of two hundred and four cases of cholera in the Park Hos- pital, there were only six temperate persons, and these had recovered ; and when he wrote, one hundred and twenty-two of the others had died. Dr. Mussey stated, in reference to the prevalence of the disease in the city of Albany: "Cholera prevailed for several weeks, attended with a severe mortality ; and it is a remarkable fact, that during its whole period, it is not known that more than two individuals out of the five thousand members of the Temperance Societies n that city, became its victims. " The French Academy said, in 1832, "it is especially necessary to avoid spirituous liquors." And again : "The abuse of wine, brandy, and spirituous liquors, al- most inevitably causes the cholera: we cannot repeat this too often to those who sometimes indulge in these excesses." The cholera raged principally among the 22 SPIRIT-DRINKING. poor in Paris, the subjects of which were almost al .n- temperate. Dr. Rhinelander, who, together with Dr. DeKay, was deputed from New York, to visit Canada, for the pur- pose of making investigations concerning the best modes of prevention and cure of cholera, wrote as follows : '' We may ask who are its victims ? I answer, the in- temperate ; it invariably cuts them off." It is said that in Poland nine tenths of all who died of cholera, before it reached this country in 1832, were addicted to habits of. strong drink. Mr. Greenhow, of England, says that " innumerable instances might be brought forward wherein the attack supervened either during the continuance of, or imme- diately subsequent to, excessive indulgence in ardent spirits. Such was the case in two of the earliest in- stances that occurred in Newcastle, those of Eddy and Mills ; and others have come under my observation." And this author very properly remarks : " Nor will it admit of a question, that the habitual use of ardent spirits greatly diminishes the healthy tone of the sto- mach and bowels, and induces an irritable condition of the mucous lining." Such remarks by a man living in a country of such universal drinking as England, and at a time when the temperance question had been so little agitated, exhibits a correctness of physiological and pathological knowledge altogether in advance of the mass of the profession at the time. Dr. Scouttetten, of Strasbourg, in speaking of the causes of cholera, mentions " the abuse of alcoholic liquors and of all too stimulant substances." At Warsaw, the individuals affected generally belonged to the lowest class. Their condition, say Messrs. Briere CHOLERA AT OYSTER BAY. 23 and Legallois, is wretched ; their wants are extreme, and their food is very coarse brown bread, potato whis- key, salted meat and herrings, cheese of the country, and a paste made of water, which is very difficult of digestion; their habitations are very dirty, and are poorly ventilated, or not at all ; they are situated on the borders of the Vistula, and are in fact mere drains ; hence it is in this part, and in the low and narrow streets, that sickness and death are the most frequent." Dr. Condie, of Philadelphia, remarked that in many cases occurring in old drunkards, where complete reac- tion has been established (after the state of collapse), and the patient has been convalescent for two or three days, delirium tremens has come. In all these cases, save one, which he had seen, the patient died. Ordinarily, before an attack of cholera, there is with the patient more or less of indigestion ; but Broussais observed that men who were in good health, having been intoxicated, have been seized the day following with cholera, though they had experienced no previous indigestion. Such are the pernicious and health-de- stroying effects of alcoholic stimulants on the human system, even in health. No wonder, then, that cholera comes hard upon old topers and habitual dram-drinkeis. There happened on Long Island, at a small village with which I am well acquainteJ, some cases of cholera, which, on a small scale, strikingly exemplify the perni- cious effects of spirit-drinking. At this village — Oyster Bay, situated about thirty miles from the city of New York, on the north side of Long Island — there lived, in 1832, about fifty colored persons of various ages. Some clothes of a colored woman who had died in the city, were taken to the place. These were thought to 24 CHOLERA AT OYSTER BAY. generate the cholera at this place. The colored in- habitants were all, or nearly all of them, very intemper- ate. In about one month's time, thirty-one or thirty- two of the fifty had been attacked, and of these twenty- one died. Only one white person, who also was a dram-drinker, was attacked with the disease. He had been laboring with a colored man, who was taken down with cholera, and took it from him, as would seem. These colored people were so degraded in their feelings and habits, that they could be induced to bury the dead only by being offered a gallon of rum as a reward. The authorities gave this, for no white persons could be found who would undertake the revolting task. All believed the disease contagious ; but yet the negroes would do any thing for the sake of the rum. One old man lost his wife very suddenly ; fought over her grave as she was being buried, himself nearly falling into it, and it was necessary to separate him and his antagonist by main force, as if they were fighting brutes. The same night the miserable old man, who was a fiddler, went and fiddled all night at a ball. These facts were given me by Dr. Lucius Kellogg, a very worthy citizen and physician of the place, and who lived there at the time alluded to, and himself attended personally many of the cases. These facts of Oyster Bay prove what intemperance, in connection with other bad habits, may do in causing cholera. Some regard pure water and fine air quite suf- ficient to keep off an attack. But in no known place are the water and air better than at this most beautiful locality. I do not believe that a healthier place 3an be found in the whole United States, and yet we see how sad was the result of cholera among the intemperate. PROSTITUTION. 26 PROSTITUTION, Intemperance anc. prostitution go hand in hand. AH of that unfortunate and much-neglected class of per- sons who follow a life of infamy, are habitually intem- perate. They of all others are most subject to the dread epidemic of which we are speaking. In a single street of Paris, where resided thirteen hundred of this class of persons, we are told, on good authority, that in a very short period twelve hundred perished with cholera ! and that in another, containing sixty persons, every one died ! When cholera rages in a great city, and comes upon persons of this class, it is sad to think how soon often the husky, hollow, unearthly voice of the prostitute becomes stilled in death ! Could the most abandoned, God-forsaken mother on earth know upon her death-bed that her daughter should come to such an end, how would it add to the death-agonies even of a harlot ! There is a very unpleasant subject, akin to this, of which it is my duty to speak. With persons of licen- tious habits, these terrible evils do not come upon one sex alone. The great Broussais, of Paris, tells us that one of his colleagues, a professor in the military hos- pital of "Val-de-Grace, informed him of numerous ex- amples of students who were seized with the cholera, after having visited a house of ill-fame; and that all those physicians who had studied the disease at War- saw, in Russia, and other places, have observed similar facts. With no class of persons than the licentious, is the saying more true, "The way of the transgressor IS HARD." 26 DOSING AND DRUGGING. DOSING AND DRUGGING. The interminate, never-satisfied, and never-ending dosings, with the ten thousand " cure alls" which the American people, above all other nations, are fond of, will prove a most prolific source of any and every ra- ging disease. Suppose we are to follow the advice of a New England divine, "Fear God and keep the bowels open ;" it does not follow, necessarily, that we must keep dosing, dosing, continually therefor. Dosing is perilous in the cholera. Dr. Mackintosh, of Edinburgh, who had much opportunity for observation in this disease, said he had seen several people sink rapidly into a fatal collapse, during the cholera epidemic, under the operation of aperient medicine ; persons who had no previous bowel complaint, but felt only slight oppression, which they imagined would be relieved by an action of the bowels. Persons, in their ignorance and disregard of hygienic rules, are ever ready to go on gorging their stomachs with food, crude and indigestible, and such as would give a hyena a " fit of dyspepsia," and then expect that, by dosing their bowels right earnestly, their physical sins will thus be atoned for. Think of a person eating sausages, smoked meat, and tripe, well charged with pepper, mustard, and the like, and then a good dose of pills withal, what suppose you would be the result in cholera times ? It is easy for us to see that, if the cholera should again prevail among us, there would be great numbers of spe- cifics advertised for the disease, and not only advertised, but actually bought and swallowed. I need not cite you that even now, in ordinary times, our papers are well filled with the thousand-and-one infallib.e specifics to DIETETIC IMPROPRIETIES. 27 cure all manner of maladies, from the pimple on the face to the most inveterate consumption. Witness how ignorant pretenders, and villainous quacks, every day grow rich in their vile traffickings in this free country of ours, and you have the evidence of a degree of super- stition, ignorance, and credulity, that has never been ex- ceeded in any age. Already in our city, there is a medicine for cholera advertised, with the plausible statement that people must send for a physician as soon as possible, when they are attacked, but that this medicine is the best possible, and perfectly safe to be taken, before the doctor can be got. How very considerate are these medicine venders of the public health ! DIETETIC IMPROPRIETIES. In regard to dietetic habits, it should be remembered, that comparatively trifling excesses are, in certain states of the system, often sufficient to derange seriously the general health. Remember, too, that attacks of cholera are invariably preceded by more or less disturbance of the digestive organs. True, this is sometimes so slight that the individual may not notice it ; but such, how ever, is the fact. Without previously disordered digest- ive organs, to a greater or less extent, no individual could ever experience an attack of this fearful dis ease. Every one must have noticed how easily the system becomes deranged by dietetic improprieties, when the stomach and bowels were already in a disordered state Who does not know that a little too much, even of the best nnd most healthful forms of food, sets one at once 2 28 RIOTOUS LIVING. back into a troublesome diarrhea that had just been cured ? And does not every sensible practitioner un- derstand, that dietetic improprieties are by far the most frequent causes of those terrible relapses in acute dis- eases of the stomach and bowels ; relapses which al- ways cost the practitioner so much anxiety, and the patient so much suffering, and not unfrequently his life ? As you value life, be careful, in cholera time, of diet, whenever there is in your system the least disorder of the digestive ogans. There are facts in abundance that prove, beyond all doubt, the ill effects of" riotous living," in causing the out- breaks of disease. Thus the great Dr. Benjamin Rush was in the habit of telling his students in his lectures, that he had for many years observed a very great increase in the number of cases of acute disease on the fifth and sixth days of July ; and this, he said, was undoubtedly caused by the excesses of the fourth. And Dr. Greenhow, of New- castle-on-the-Tyne, England, tells us that the extraordi- nary irruption of the disease at Gateshead, in the midst of the Christmas feastings, offers a remarkable example of the dietetic and drinking excesses. The French Academy said, " that all excesses in eating, even a slight indigestion, during the reign of the cholera, is almost certain to produce the disease." In New York there was found to be a disproportionate increase of new cases of cholera, immediately after the celebration of the fourth of July, in precise accordance with the fact? noticed by Dr. Rush in other acute diseases. After there was a decline of the disease at Riga, the occur- rence of the Whitsun holidays was immediately fallow- ed by an augmentation of fresh cases of cholera- As cholera began to rage in Paris, many thought to ward WASH AND BATH IOUSES. 29 off the disease by hilarity and excess. The theatres were crowded in the evening, and there were young men, who, in the extravagance of their foolhardiness, plunged into unusual excesses. Since we are to die to- morrow, they said, let us exhaust all the joys of life to- day. Most of these rash youths, we are told, " passed from the masked ball to the Hotel Dieu, and died before sunset the next day." FILTHINESS AND DEGRADATION. Cholera, as is true of all pestilential diseases, comes first among the low, miserable, and filthy of the cities. There should be in New York, and every American city, free baths and wash-houses for promoting clean- liness among the poor. I saw last winter, in London one of these establishments used also for lodging poor persons, in Rosemary Lane. This is not far from Spitalfields, the great "Five Points" of London — a dis- trict covering the space of a square mile — St. Giles the former "Five Points," having been renovated bj the authorities, its streets widened, and the poor scat- tered about. It would be difficult for an American to conceive of the utter squalidness and misery of the peo- ple of some parts of London, without visiting them ; and yet there is a much better state of things now than there was before the temperance reformation began. The Health-of-Towns Associations are also doing much to better the condition of the ooor. In the bathing es- tablishment above mentioned, a large number of poor people congregated every night. Four hundred and fifty could be accommodated at a time, and great num- bers had to go away beside. There were people of the 30 BATH AND WASH HOUSES. very lowest class, beggars, thieves, the lowest prosti- tutes, and such as had no home but the streets. The name and age of every one were registered in a large book, together with other particulars, as to where they were from, their occupation, where they had lodged the -light before, etc. Those only who declared that they had no tr.pney were received. Everyone w r as required at finst to perform a thorough ablution with soap and tepid water, so that for once they might have a clean skin, for it was in many instances doubtless the first time in their life. Then, after the bath, a half-pound of the very best London bread was given to each person ; and the bread in London is bread, and not such stuff as the people require our bakers to get up in New York. England, with all her misery, has science, and she ap- plies it to every thing — even to that small matter, as people regard it, making bread. But there was one great mistake in this matter ; the bread was superfine, which is always bad — bad, because it is so rich that neither man nor animal can long subsist upon it ; where- as the bread from unbolted flour, containing in itself a proper portion of innutritious with the nutritious matter will sustain life any desirable time. I said to the Super impendent, " Why do you not give these people brown bread, which would be so much better for them?" He said he knew it was so, but they would not eat it ; many would curse them for it, and cast it into the street. After this bread-and-water repast, these people were lodged — not exactly upon a bed, but in rows on the soft side of a hard floor. Each one had a little box by him self, and the whole floor was covered with these divi- sions, with the exception of the narrowest aisles to walk among them. There was a little angular elevation of PHILADELPHIA 30ARD OF HEALTH. 31 plank for the head to rest upon — and even that served as a pillow for which many a poor man was thankful enough. One skin coverlet served as a covering for each. The rooms were large and airy, warmed and well ventilated, and each sex had its own apartment. Men, women, boys, and girls were not here huddled to* gether half-naked, as in multitudes of penny and two- penny lodging houses in certain parts of London, or as in the steerages of our world-renowned American ships. In these bath and washing establishments — and there are a number of them in London — religious meetings are held on the Sabbath ; a clergyman comes and preaches, and they are able to have singing, as people elsewhere. Such, at least, was the case in the one I visited. The meeting is held in the largest lodging room, but there are no seats except those little divisions spoken of, five or six inches high, the edge of the board forming a seat. On Sundays the people have half a pound of bread at noon, as well as night and morning, and an ounce or two of cheese extra. The Ragged Schools in Great Britain, are doing much toward bettering the condition of the poor. The Philadelphia Board of Health gave lately the following excellent advice concerning the means of pre- venting cholera: "Early and constant inspection of the yards and cellars of houses, with a removal of the rub- bish and filth that may be found therein; to be followed by thorough whitewashing and purification ; a most frequent cleansing of the streets and gutters, and atten- tion to paving and grading the same, so as to avoid ac- cumulations of water or garbage any where ; an especial attention to the cleansing of private courts and alleys common to several dwellings the suppression of pig* 32 FRUITS AN3 VEGETABLES. sties and piggeries, cleaning foul privies with the use of deodorizing agents ; filling or draining of pools or ponds of stagnant water, and personal cleanliness by bathing ; in short, to keep the physical and moral man clean." FRUITS AND VEGETABLES. There is a prevailing opinion that vegetables and fruits should be discarded in cholera time. But this is a wrong notion, and not one founded on fact. Professor Dunglison, of Philadelphia, remarks, that " ripe fruits and the succulent vegetables were generally proscribed ; the facts are, that in eleemosynary institutions where no such articles were permitted, cholera was most fatal ; that the disease prevailed at Moscow and St. Petersburgh, and elsewhere, at seasons when ripe fruits and vege- tables could not be procured ; that when ripe fruits were freely allowed, as in London, at a later period of the ep- demic, no inconvenience was found to result from them." The plain truth in this matter is, that the kinds of food which are in all respects best adapted to man's nature under ordinary circumstances, are also best during the prevalence of epidemic disease. THE ATMOSPHERE AND ELECTRICITY. Some believe that atmospheric changes, or a peculiar condition of air, is the principal cause of cholera. Some also believe that we are to look to electrical changes as the great cause. I would speak in all deference to the opinions of others in these matters, but it appears to me that very little or nothing is known about these agen- cies. Bad air we know is always bad ; but as to wheth- HOWARD, THE PHILANTHROPIST. 33 er any particular electrical state can be identified as a causu of cholera, I think does not appear. I will close this lecture by citing some most impor- tant and instructive facts, not only touching diet, but the general hygienic regimen of the individual. I first men* tion HOWARD, THE PHILANTHROPIST. Howard, the philanthropist, was exposed to the influ- ence of pestilence and disease in its most malignant forms, probably more than any other human being who has ever lived. " This man," says one biographer, " vis- ited all Europe, not to survey the sumptuousness of pal- aces, or the stateliness of temples ; not to make accurate measurements of the remains of ancient grandeur, nor to form a scale of the curiosities of modern art ; not to col- lect medals, or to collate manuscripts ; but to dive into the depths of dungeons ; to plunge into the infection of hospitals ; to survey the mansions of sorrow and of pain ; to take the gauge and dimensions of misery, depression, and contempt ; to remember the forgotten ; to attend to the neglected ; to visit the forsaken ; and to compare and collate the distresses of all men in all countries." " He traveled," says another, " between fifty and sixty thou- sand miles, for the sole purpose of relieving the distress- es of the most wretched of the human race. The fa- tigue, the dangers, the privations he underwent or en- countered for the good of others, were such as no one else was ever exposed to in such a cause, and such as few could have endured. He often traveled several days and nights in succession, without stopping, — over roads 34 HOWARD, THE PHILANTHROF ST. almost impassable, in weather the most mclement, and with accommodations the meanest and most wretched. Summer and winter, heat and cold, rain and snow, in all their extremes, failed alike to stay him for a moment in his course ; while plague, and pestilence, and famine, in- stead of being evils that he shunned, were those with which he was most familiar, and to many of whose horrors he voluntarily exposed himself, visiting the foul- est dungeons, filled with malignant infection, — spending forty days in a filthy and infected lazaretto, — plunging into military encampments where the plague was com- mitting its most frightful ravages, — and visiting wnere none of his conductors dared to accompany him." Under such circumstances, the habits of Howard were very simple, rigid, and abstemious in the extreme. In all seasons he made it a point of the utmost importance to practice daily bathing. " Water," says Dr. Aiken, " was one of his principal necessaries, for he was a very Mussulman in his ablutions ; and if nicety had place with him in any respect, it was in the perfect cleanliness of his whole person." "These ablutions," says another, (Dr. Brown), " he regularly performed in the depth of winter, by plunging into a bath whenever he had the opportunity of doing so, — and when he had not, he would frequently lay himself down for some considera- ble time between two sheets, wet for the express pur- pose of communicating to his body the desirable degree of cold." According to another author, " both on rising and going to bed, he often swathed himself in coarse towels, wet with the coldest water; in that state he re- mained half an hour, or more, and then threw them off freshened and invigorated, as he said, beyond measure." He never used a great-coat, we are told even when in HOWARD, IHE PHILANTHROPIST. 35 the coldest, countries. For many of the last years of his existence, he tasted neither flesh, fish, or fowl ; and near he close of his life, he wrote in his diary, " I am firmly persuaded, as to the health of our bodies, that herbs and fruits will sustain nature, in every respect, far beyond the best flesh !" So prudent was he of time, that he strenuously avoided dining parties, nor would he sit when taking his simple meal of tea, milk, and rusks. On becoming acquainted with these singular habits of Howard, one would naturally be led to suppose that his constitution must, from the first, have been a strong one, capable of enduring great exposures and fatigue. Such, however, is not the fact. He was, when young, as he himself tells us, of very feeble health.* But notwithstanding all Howard's good habits, he no doubt injured himself materially by the use of tea, of which he was said to be very fond. * " A more puny youngster than myself," says Howard, " was nevei seen. If I wet my feet I was sure to take cold. I could not put on my 6hirt without its being aired. To be serious, I am convinced that what emasculates the body debilitates the mind, and renders both unfit for those exertions which are of such use to us as social beings. T therefore en- tered upon a reform of my constitution, and have succeeded in such a de- gree, that I have neither had a cough, cold, the vapors, nor any more alarm- ing disorder, since I surmounted the seasoning. Formerly, mulled wines, and spirits, and great fires, were to comfort me, and to keep out the cold, as it is called ; the perils of the day were to be baffled by something taken hot on going to bed; and before I pursued my journey the next morning, a dram was to be swallowed to fortify the stomach! Believe me," said Mr. Howard, " we are too apt to invert the remedies which we ought to prescribe for ourselves. Thus we are forever giving hot things when we should administer cold. We bathe in hot instead of cold water, we use a dry bandage when we should use a wet one, and we increase our food and clothing when we should, by degrees, diminish both. " If we should trust more to Nature, and suffer her to apply her own remedies to cure her own diseases, the formidable catalogue of maladies would be reduced to one haU at least, of their present number." — Pratt t Gleanings, 1796. 2* 36 THE BIBLE CHRISTIANS. BIBLE CHRISTIANS OF PHILADELPHIA. Theie is, in the city of Philadelphia, a people little known — the Bible Christians. The members of this sect abstain religiously from all intoxicating substances, and from flesh. They aim to live temperately and soberly in all things. The Rev. Mr. Metcalf, of this sect in Philadelphia, furnished Mr. O. S. Fowler and myself, at our request, the following account of their experience duiing those fearful epidemics, the yellow fever and the cholera: "When the yellow fever broke out at the foot of Market street, in the autumn of 1818, my residence was in the immediate vicinity of the infected district, name- ly, in Front near Market street. There I continued with my family, while most of our neighbors fled from the site, for fear of being affected with that dread- ed malady ; yet we all continued to enjoy excellent health. The following year our experience was simi- lar. During the period of the cholera, I am not aware that any of our members were in the least affected by that disorder. My duty as a minister frequently led me to the bedside of the sick and dying poor, and often to perform the last obsequies over the dead ; yet, amidst all these painful duties, the same kind and merciful Providence which - tempers the wind to the shorn lamb,' protected and preserved me in the enjoyment of uninterrupted health. You doubtless remember there were many conflicting rumors of opinions among emi- nent physicians and others, about the propriety of avoid- ng vegetables and fruits during the continuance of the epidemic. I have no knowledge that any of our mem- bers ma^e the least alteration in their accustomed mode VEGETABLE DIET. 37 of diet doling that time, and yet they al f i escaped suffer- ing from that fatal contagion. In my own family, vege- tables and fruits were as freely used as in former sea- sons, without suffering any inconvenience." VEGETABLE DIET IN NEW YORK. The experience of those in this city who adopted a course similar to these Christians, was not less striking. It will be recollected, that Mr. Sylvester Graham was the means of inducing a considerable number to follow his peculiar modes. Mr. Graham says, in his work on the Science of Human Life : " The opinion had been imported from Europe, and generally received in our country, that a generous diet, embracing a large propor- tion of flesh meat, flesh soups, etc., with a little good wine, and a strict abstinence from most fruits and veg- etables, were the very best means to escape an attack of that terrible disease. Nearly four months before the cholera appeared in New York, I gave a public lecture on the subject in that city, in which I contended that an entire abstinence from flesh meat and flesh soups, and alcoholic and narcotic liquors and substances, and from every kind of purely stimulating substances ; and the ob- servance of a correct general regimen in regard to sleep- ing, bathing, clothing, exercise, the indulgence of the nat- ural passions, appetites, etc., etc., would constitute the surest means by which any one could rationally hope to be preserved from an attack of that disease. I repeated this lecture after the cholera had commenced its rav- ages in the city, and, notwithstanding the powerful op- position to the opinions which I advanced, a very con- siderable number of citizens stir -tly adhered to my ad- 38 CONCLUSION. vice. And it is an important fact, that v.f all who fol- lowed my prescribed regimen uniformly and consist- ently, not one fell a victim to that fearful disease, and very few had the slightest symptoms of an attack." In conclusion, it is too much for people to believe that mankind can have any considerable control over health. Disease is not regarded as being subject to laws. The world, has long been taught that the most deadly diseases may come at any time upon the most healthy. But such a thing cannot be. Facts every where prove the contrary. When the cholera rages among us. as it doubtless will, in a greater or less degree, the coming summer, then let it be seen who are the most subject to the disease — with whom it is the most fatal. The clean- ly, temperate, honest, industrious persons — these are the ones who, of all others, are most certain of remain- ing free from an attack. As you value life, health, and happiness, avoid, in times of cholera, fear, panic, anger, immoderate grief, and all undue excitements of the mind. I cannot too strongly recommend you to maintain an equable serenity and cheerfulness of temper and feel- ings. Be industrious, and habitually regular and tem- perate in all your habits and actions. As one of the most powerful auxiliaries in governing and regulating the mental and moral manifestations, pay particular re- gard to your dietetic and other personal and physiologi- cal habits. Avoid spirits as poison, in every form. To- bacco, one of the vilest of things, is especially bad in causing indigestion, and thus predisposing the system to cholera. Tea and coffee, those articles so much in vogue in our favored country — every where used, even among the poorest of the poor — depress the vital ener WATER THE BEST DRINK. 39 gies of the system by their stimulant and poisonous effects, thus rendering you more subject to fear, and more liable to prevailing diseases, of whatever kind. They make you dyspeptic, nervous, tremulous, irreso- lute, subject to sick headaches ; as many may prove, if they will but drink pure, soft, cold water only, and that plentifully, for three months. The homoeopathic theory very properly proscribes tea and coffee, because of their medicinal effects, although in practice the theory is not carried out. It was well said, by an ancient poet " Water is the best thing ;" and by another : " Nothing like simple element dilutes The food, or gives the chyle so soon to flow.' And still another : " O, madness ! to think use of strongest wines And strongest drink our chief support of health, When God with these forbidden, made choice to rear His mighty champion, strong above compare, Whose drink was only from the limpid brook.'' So, too, Shakspeare : " Though I look old, yet I am btrong and lusty, For in my youth I never did apply Hot and rebellious liquors in my blood ; Nor did not with unbashful forehead woo The means of weakness and debility ; Therefore my age is as a lusty winter, Frosty but kindly." "The more simple life is supported," says Dr. Paris, " the better, and h* is happy who considers water the best drink." Ana Dr. F. Hoffman long ago said : "Pure water is the best drink for persons of all tem- peraments ; it promotes a free and equable circulation of the blood, on which the due performance of every 40 BATHING RECOMMENDED. function depends. Water-drinkers are not only the most active and vigorous, but the most healthy and phoer-fuL" Make no great and sudden changes in diet, but as soon as may be, get upon the brown bread and cold water plan. Superfine bread, if eaten continuously, without any counteracting substance, would destroy life, because of its too great richness. Good brown bread, as of wheat, Indian, or rye, or even potatoes alone and witl> out salt ; any of these, with pure soft water to drink, is amply sufficient to sustain you in the firmest health. A very moderate use of milk may be indulged in, but flesh meat is better omitted wholly. And of bathing — daily cleansing the whole body with water, tepid, cool, or cold, according to the strength — too much cannot be said. A story relates : A French doctor went to Damascus to seek his fortune. When he saw the luxurious vegetation, he said, " This is the place for me, plenty of fever." And then on seeing the abundance of water, he said, " More fever ; no place like Damascus !" When he entered the town, he asked the people, "What is this building?" "A bath !" " And what is that building ?" " A bath !" " And that other building ?" " A bath !" " Curse on the baths ! they take the bread out of my mouth," said the doctor ; " I must seek fever practice elsewhere." So he turned his back, went out of the gate again, and hied himself else- where. It would be well if every city were, in respect to baths, like Damascus, and all the people bathers. There will be no cholera practice to be had among the temperate and the clean. Finally, I recommend to you the earnest study of all the laws of health. This is a great study ; one that re- quires much time and hard thought ; and once you un* TEMPERANCE IN ALL THINGS. 41 derstand these laws, you have yet much to do in resist- ing temptations, and will be very apt often to come short of the true mark. Both as a means of prevention and cure in cholera, I cannot too strongly recommend to you " temperance in all things." Study it ; prac- tice it ; so that with God's blessing, you may live on to a ripe old age, without suffering, without pain, and your life cease in natural death, when, 11 Like a clock, worn out with eating time, The wheels of weary life at last stand still !" The cholera is a most fearful epidemic. In the buoy- ancy and gladsomeness of health, we aie not apt to think of disease. It is a serious thing to be attacked by a mal- ady that destroys its victim, as it were, in ■* single hour. "Take heed to yourselves, lest you be overcharged with surfeiting, and drunkenness, and tfo % ares of life, and that day come upon you unaware?/' 42 RECAPITULATION. LECTURE II. Recapitulation. — Manner of an attack of Cholera. — Symptc ftis of Cholera — First stage. — Second stage. — Stage of Collapse. — Length of time Cholera patients live. — Nature of Cholera — Medical Authority on the Treatment of Cholera. — Dr. Elliotson. — Dr. Watson.— Dr. Marshall Hall.— Dr. Billing.— Dr. Scouttetten.— Dr. J. V. C. Smith. — Dr. Wood. — Dr. Dunglinson. — Dr. Mackintosh. — Dr. Condie. — Dr. P. C. Tappen. — Philadelphia Board of Health. — Dr. Parkes. — Dr. Broussais. — London Morning Chronicle. — Drs. Bell and Condie on Saline Injection into the Veins and Arteriotomy. — Blood-letting. — Dr. Tappen's Remarks thereon. — Homeopathic Treatment. — Closing Remarks. In the preceding lecture I spoke chiefly of the causes and prevention of cholera. In the present I propose to describe the disease more fully, and to speak of the various modes that have been adopted by the so-called orthodox school of medicine in the treatment of this most formidable of all modern epidemics. I remarked that the name of cholera is incorrect, inasmuch as it signifies a discharging of bile. It is characteristic of the disease, when fully developed, that there is no discharge of bile whatever. This is one of the most peculiar features of the disease. I laid down as an axiom, that every thing which tends in any way to depress the general health, predisposes the system to an attack. Dr. Elliotson, of London, very properly remarks : " The disease has great difficulty in attacking those who are in good health, and well off." I remarked, also, that it is- the filthy, miserable people, and above all, the intemperate, and those that lead a life of prostitution, who are of all persons most subject to the disease, and the most certain of being cut off. Whether cholera be a contagious disease or not, we know it visits large cities principally ; that it often MANNER OF AN ATTACK OF CHOLERA. 43 passes directly, at a single stride, from one large city to another, as from London to Paris, leaving all inter- mediate places untouched. But this is not always the case ; it sometimes comes upon small country places, where the condition and habits of the people are bad. I remarked also, that one thing should be particularly remembered in reference to the coming on of cholera. There will be a great variety of specifics put forth as sure preventives and cures ; and such things will be heralded forth, in the way of advertising, in many of our papers ; and these will be bought and used by many, else they would not be thus advertised. Now all such articles, if they have any potency in them, will always be more or less injurious, in proportion to their charac- ter, and to the individual's health. The strictest ab- sence from all medicinal substances, spirits, tea, cof- fee and spices, tobacco — in short, from all stimulants in cholera, is the only safe rule. "Avoid physic and phy- sicians if you value health," was never more applicable than here. MANNER OF AN ATTACK OF CHOLERA. If it is impossible to arrive at the true nature of chole- ra, we may know and treat it by its effects. Mark well one thing: in its beginning it is in general a mild dis- ease. People are not struck down all of a sudden, as we have been often told, and without any premonitions of an attack.* There must be pre-existing disease. If a * The Rev. H. G. O. D wight, a missionary of the American Board, writing to the New York Observer, Aug. 27, 1848, says: " The Asiatic cholera, which, when fairly seated, is one of the most unmanageable of all diseases — despising all human art and skill, and mocking all the assidui. ties of friendship — in almost all cases, begins with a mud diarrhea- 44 SYMPTOMS OF CHOLERA. person is in all respects well, and practices uniformly good and regular habits, no attack of cholera can come upon him. There are people, however, who are thought by themselves and the many to be perfectly well, who are yet among the subjects most liable to cholera. Cor- pulent men, with red faces, high livers, the very per- sonification of health, as people say, are very liable to diseases of the bowels, and consequently to cholera. The truth is, such persons are never well, and carry constantly within them the seeds of disease. Facts abundantly prove that no really healthy person can be attacked with cholera. There is, then, preceding the real attack of cholera, a diseased condition of the stomach and bowels — a state of things which it is possible, in almost every con- ceivable case, to manage safely, and thus prevent the final invasion of the terrific disease. SYMPTOMS OF CHOLERA FIRST STAGE. The symptoms of cholera, as authors give them, are many and various. As in all other severe diseases, 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 before night; and it is not to be doubt- ed, that there are some cases in which the very first attack of the disease is the collapse, from which recovery is rare. But I can say with 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 in* dividual had been laboring under diarrhea for some days previous. Generally, it 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 par- ticular inconvenience. But it is this very diarrhea which is insidiously preparing the system for the most dreadful onset of the disease." These remarks are very judicious, although not made by a medical man. SYMPTOMS OF CRCLERA. 45 there will be much variation in the manner of the attack. The disease has been by some divided into three stages. After the mild diarrhea, which has been generally for some days present, there occur griping pains in th6 stomach and bowels, nausea, tenesmus (or a bearing down and desire to evacuate the bowels, and without any effect) ; at other times there are watery discharges from the bowels ; sometimes there is a thin, slimy dis- charge, streaked with blood. But generally the dis- charges are not attended with pain, as in dysentery, but take place with ease, almost without the consciousness of the patient. It is said that " in the debilitated, and especially in the intemperate, the evacuations from the bowels are, from the first, often extremely copious, whey-like, and produce a sense of extreme exhaustion, a faintness, or even fainting ; and that in such cases, in a very few hours, the most terrible cramps, vomiting, and collapse come on." Any improper exposure, and especially any imprudence in eating, drinking, or the taking of medicine, will in such cases accelerate the coming on of the second and third stages. In the first stage the appetite is diminished or entirely gone, and the desire for cold water is proportionably increased. There are also shooting pains in the extremities, par- ticularly the calves of the legs. Patients describe their symptoms as of all the blood rushing to the interior of the abdomen ; sometimes feeling as if electric shocks were passing through the bowels, accompanied with very great and unendurable heat. SECOND STAGE. In what may be termed the second stage, there is al- most constant \ omiting and purging of what has been 46 STAGE UF COLLAP3 3. denominated " rice-water fluid." This turbid, whitish li- quid, "pours again and again from the bowels in streams and is spouted from the mouth as if from a pump." The vomiting itself is generally easy, and comparatively without effort, and appearing to give momentary relief. Again, there are violent pains of the stomach and bow T - els, and of the head and back, with violent spasms of the muscles, and more especially of the extremities. The pain, we are told by those who have seen much of the disease, often causes the most courageous to make noisy outcries, and to roll themselves about as if fran- tic. The agony about the heart often experienced in cholera, is believed to be as great as that of any which mankind are ever brought to endure. In consequence of this agony, there comes on necessarily such extreme weakness, that the patient cannot move ; the trunk of the body in particular becomes powerless. The pulse may be full, or small and contracted. The skin is bathed in a clammy perspiration, and has a pecu- liar feel, like dough. Some have compared the skin in this state to a wet hide. The countenance is expres- sive of great anxiety and distress, although the mental faculties remain unimpaired. Already in this stage the secretion of the kidneys often entirely ceases ; the thirst is inordinate — so great, in some instances, that the patient gets out of bed, goes to the pump, or wherever he may obtain water, and sometimes even drinks the fluid which he has before vomited. In no disease is the thirst so great as in cholera. STAGE OF COLLAPSE. Next comes the stage of collapse, as it is called. A remarkable change takes place in f he appearance of the COLLAPSE IN CHOLERA. 47 patient. The surface becomes cold, and in many in- stances blue ; the lips are purple, the tongue cold, and of the color of lead. The wrist becomes pulseless. The breath is also cold ; the eyes are sunk deep in their sock- ets, and the whole appearance has changed and become ghastly as that of a corpse. In many instances so great a change takes place in a few hours, that near friends can- not recogni'ze the sufferer. The peculiar appearance of the physiognomy in confirmed cholera, is so expressive of extreme anguish, that the name " triangular face" has been used to designate it. " It bears a striking resem- blance to the appearance of age ; and seems to arise from the paleness, wasting, and shrinking of the features, and the depressed and disturbed state of the mind, conveying into the countenance a strong expression of care, anxi- ety, and alarm." — Orton, as quoted by Dr. Jas. Johnson. There is cold, profuse perspiration, which seems to exude in large drops from every pore ; and, notwith- standing this coldness, the patient complains of the burning heat at the stomach, and craves more than ever cold water, and the cool fresh air. The watery dis- charges from the bowels continue ; " the hands and fin- gers are shriveled, white, corrugated, and sodden, like those of a washerwoman after a long day's work. The voice is very peculiar, husky, and faint. At last the patient is free from pain and vomiting, and remains ap- parently tranquil ; not willing to make the least exer- tion, and as if quietly awaiting the approach of death." Such are the symptoms constituting what is termed a state of collapse. The symptoms will, of course, vary greatly in different cases ; sometimes coming on very suddenly, almost without any warning ; at other times lingering for days. 48 BROUSSAIS' DESCRIPTION. If reaction or return of warmth and circulation ap- pear in collapse, there is more hope for the patient ; and yet there is danger from consecutive fever and kindred local affections ; especially where inordinate dosing has been practiced, this holds true. It has been remarked that when inebriates passed into a state of reaction fol- lowing collapse, they were very apt to be attacked by delirium tremens, and were almost certain to die. I be- lieve that about one half of all cholera patients in regu- lar practice have perished with the disease.* * Broussais thus describes the " exterior" symptoms of cholera: " The muscles are strongly marked under the skin; the eyes are hol- low, dry, and sunken ; after some hours, the consistence of the eyeball seems to be dissolved ; and one would say the eyes were turned inward by means of a thread. The aspect of the patient is hideous ; the face very soon loses its fullness, and is contracted in a manner peculiar to these affections : but what causes the greatest astonishment, is the livid hue which spreads itself over the countenance as the disease advances. The extremities are cold ; the tongue is usually pale, chill, broad, and flat ; the breath cold, and the pulse feeble ; the words are rather breathed than pronounced. The patient remains motionless, on the back ; if you force them to lay upon the side, tiey cannot continue so long, but beg to be laid on their back, so that the breast may be raised. While the body thus remains still, they move the feet and hands, uncover the breast, com- plain of a fire within, and tear off the poultices and other warm applica- tions placed on the stomach ; they turn from one side to the other, but are not able to ris« up. Tbe color becomes darker and darker, and is soon livid. It varies, however, according to the natural complexion of the patient. Dark complexions become black or bluish ; but those which are more transparent turn yellow, taking the color of bad gilding. This is followed by cessation c f the pulse, which I shall call asphyxy. The pulse grows weak rapidly, and sometimes disappears in three hours, or even less. As soon as the pulse begins to grow feeble, the patient falls into the heaviness I have referred to : there are cases, however, in which he still preserves his strength when the pulse is extinct, and is even able to raise himself up, and go from one place to another ; but this Btrength is soon lost, and the unhappy person falls powerless. After the cessation of the pulse, the black hue manifests itself with various rapidity, sometimes at the end of two or three hours, sometimes even in less; thin depends upon the promptitude with which circulation >3ases." VATURE
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