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Photographic

Sciences
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CIHM/ICMH

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• 1,11

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FRACTICAL ^ULES AND PRECAUTlONi*

FOR THE PREVENTION AND CURE OF '•.••'

SPASMODIC CHOLERA: :

Addressed by the Central Board cf Health, at Charlotte-Town, to the'In^
habitants of the Island, as necessary to be generally known and adopted.

The Board are anxious to impress upon the pi.l >lic attention, that they
deem nrecautionary measures to be of paramount miportance and par-
tuTarW those conLcted with cleanUness pf the Streets, of Houses, and
ot- persons, as well as the amelioration of the evils arising from poverty
and distress, such as bad clothing and poor diet.

1st The first precaution is one within the reach of all, and which is ceiv
tainly the most important-and that is, the necessity of temperance, regulan Y
of 1 vino^, and cleanliness, personal and domestic. It has been found m every
par of The vvorldthat Spasmodic Cholera uniformly seizes and destroys, with the
?apdUv of lightning, those who indulge in fermented or Spirituous Liquors, and
nt^eSr^nce of any kind. The dissolute, the dirty, the idle, all become its v.c^
tims, while those who are cleanly, temperate and industrious, escape.

'grAs there is much reason to believe it s of a contagious nature al
unnecessarry communiaation should be prevented between the infected and the
Shy This is not a reason, however, for neglecting the sick; duty and
affeS win, it is hoped, secure the faithful and tender discharge of that duty
Tal tL afflcted; but it is the best of reasons for limiting the number of atten-
dant upon them to those alone who are necessary for that object, and to
exclude carefully all others (even of the same family) who are not required

3d ThTBoard feel the great importance of destroying, m so far as they
are able those ill-founded apprehensions of danger from infection which create
^nreason^^^^^^^ in the publh. ^ind, to the great aggravation of the mischief

'''^^th. It is commonly supposed that a person ill with an infectious disease
spreads he contaglua to a considerable dis'.ance r*«^/h, however, ,. POt the fact,

Wh respect to any known disease, so that it is safe to approach very near the

ck wi hout any danger, and even to perform all the kind oftices to our friends
which he°r illness requires, without a great increase of it, provided care be taken
To keep the apartment, patient, and the personal Imcnclean, the former

reely Ventilated and fumigated, it being we'd understood that per.ec. cleanmess
4d free ventilation are the great securities from infection of all kinds, rc^ndering
'he poisonTnnocent by dilution and diffusion through the atmosphere. I or this
re'son the patient labouring under Cholera shou dbe placed m a separate and
wXired apartment, either of his own house, or be removed to a building fitted
i.n to receive the sick, according to circumstances. . ,, ,•

^ 5 h The personal clothing of the sick, during the course of the diseas^
should be immediately plunged into cold water, and permitted to s^oak until

Sed &c The where he has been attacked should bo thoroughly

cle insed bv scrubbing, limewashing (the lime being fresh and hot), and by
free ventilation; and,^'if the means be at hand, by aspurgation with chloride

""^ ''Tth To correct the atmosphere around the sick, or to purify apartments
which cannot be easily ventilated, the two following methods of annihilating
Contagion by the vapours of Nitric and Muriatic Acids are of general efficacy,

-'^:r1^& the Nit^us A^idis^prc^uced in tl^^^

1 over a lamu ui >" n^ai.^^ .^i.wv., .. „ -

some Nitre. One, two, or three of these vessels may be placed on the floor,
as the size of the apartment may require.

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8th. Fumigation by Muriatic A«id is considered preferable to the above ; it
h, more diffusible, and may be produced by putting one pound of common Salt
into an earthen vessel, and pouring over it from time to time a small quantity
of Sulphuric Acid, or Oil of Vitriol, till the whole Salt is moistened. If the
air is foul and offensive, apply a gentle heat under ^the vessel, to extricate u
larger quantity of vapour; but, in general, the simple additionjof acid to the
salt will be found i,ufficient, unless the apartment is very large.

9th. As soon as the disorder breaks out in any house, the Board recom-
mend one of these fumigations in every room, in addition to free ventilation,
and the greatest cleanliness. The same precautions should be adopted in
Schools and places of public resort.

10th. The personal clothing should be complete, and warmer than usual,
particularly that on the abdomen and feet. The greatest safety has been ex-
perienced in India from a dress of flannel, next the skin, from head to foot. A
medical gentleman of ten years' experience in Bengal sates that he never knew
a case occur to an individual who adopted fully this precaution.

11th. No person should allow himself to sit down and get cool with wet feet:
they should be kept drv and warm.

12th. Avoid every irregularity, and excess in diet, particularly green or
raw vegetable?, and poor and unwholesome food of every description.

13th. Patients dying of Cholera should, with the least possible delay, be-
placed in coffins well smeared inside with pitch and tar.

Uth. The bodies should be buried immediately, and should not be taken
to Churches, but directly to the place of interment.

15th. In every case" of death from Cholera, the house must be kept a? free
as possible from visitors, and the friends who attend the funeral should not as-
semble in the house.

16th. The Board would advise all persons to go out at night as little a»
possible, during the prevalence of the disease, and to use warm clothing, par-
ticularly during inclement weather.

17th. It is recommended to wear a broad flannel belt over the abdomen,
and to take a meal before going out in the morning.

18th. it is of very great importance that all complaints of the stomach and
bowels should be attended to during the prevalence of Cholera, however slight
they may appear at first, and to place themselves under the observation of a
medical man, the moment siioh symptoms occur.

19th. As it has been fully ascertained that, in a great majority of cases,
the proper symptoms of Cholera are preceded for some hours, or even for one
or two days, by slight stomach and bowel complaints, attended commonly by
headache, frequency of the pulse, and langour, the most prompt measures arc re-
quisite to prevent the urgent symptoms from being fully formed, as this will ren-
der the disease milder than it otherwise would be ; whereas, if those warnings
are neglected, and the proper symptoms of epidemic Cholera are allowed to
form, medical treatment, in a great proportion of instance.s, proves of little
avail.

20th. The personal clothing of the sick, and all substances capable of being
impregnated with the effluvia, or of vitiating the atmosphere, ought to be re-
moved from the apartments of the sick to situations where the healthy cannot
suffer by them, and where they may undergo a proper purification and ventila-
tion. The linen and other clothes of the sick should be washed frequently
besides.

21st. Those who die of the disease should be wrapt in the clothing in which
they expired.

22d. It is of importance to avoid whatever weakens the body, by giving
way to intemperance or sensuality, or by making use of a poor diet, great
fatigue, or considerable evacuations.

23d. The mind should be kept cheerful, and as free from care, anxiety,
fear, and lowness of spirits as possible, and the general health improved by
Wine, Bark, and other tonic medicines.

21th. The leading and p/imary symptoms of Cholera should be generally
known — they are either purging, spasms, or cramps ; giddiness, with nausea or
loathing; and more or less of vomiting. Added to the above, are the following
characterg: a great alteration in the general aspe«t of the patient — his appear-

! 3

ance is shrunk anil ghastly, often ol'a blue tint, with great coldness of the skii
when felt by another person, 'i'hese are the principal symptoms 5 but persons
cannot be too much on their guard, lest they be deceived, and imagine that any
one so affected labours under Spasmodic Cholera. These appearances are those
common to a disease well known in this country, the commuii Cholera.

25th. Whenever any or all of the above signs of the disease appear, and
under such circumstances, the purging should be checked by 40 drops of Lau-
danum in a wine-glass of strong peppermint water, or weak spirits and water,
and this may be repeated in an hour. If the purging be not checked, the patient
should be confined to bed, and the heat kept up by long continued friction, by
hot tiannels, by heated bricks to the feet, and hot plates placed to the stomach.
Should the patient be suddenly seized with the above symptoms, let him then
be immediately placed between warm blankets ; and should no medical person
be at hand, let two table-spoonfuls of common kitchen salt, dissolved in six
ounces of warm water, be given immediately, and at once, if he be an adult ;
let dry and steady heat be applied along the course of the spine and to the pit of
the stomach (if no other means be at hand) by a succession of heated plates or
platters. Let the upper and lower extremities be t:urrouuded with bags of
heated bran, corn, ashes or sand, and let him be asr>iduously rubbed with a
warm hand, and a little oil or grease to protect the skin. Energetic, complete
vomiting will probably be produced by the salt, and perhaps bilious purging
with straining. On no occasion let the patient take a purge of Salts, such as
Epsom Salts, for they have been found to be most injurious.

Under these circumstances no time should be lost in procuring medical aid ;
yet much will be gained by adopting the above measures previously, by atten-
tive nursing, and by constantly rubbing the patient, who should keep most
strictly to a horizontal position, for death has often instantly followed whon a
person labouring under the disease has attempted to stand, or even to sit in an
half erect position.

Such are the measures wliich the Board recommend to be adopted before
a medical person visit the patient.

The The AT MK^YT OF Cholera:
Chief, y extracted from the Report of the Edinburgh Board of Health, and
which is regarded as decidedly the most successful mode of treating the
Cholera which has any where been practised.

I. The Board are satisfied thai the disease may arise from hidden causes;
and that it may also become contagious in circumstances not yet ascertained.
But thev are fully warranted in declaring, that, when it becomes contagious,
the risk'of its spreading is very much diminished if due attention be paid to clean-
liness and sobriety, and therefore entreat every one, in the event of the disease
appearing here, not to be misled by exaggerated notions of its contagious nature,
and which would tend to place the sick in a state ofdestitution.

II. To prevent the great danger of delay to those situated in remote parts
of the country, and to those attacked at midnight, when the disease is very apt
to begin, the Board recommend families to provide the following articles, viz:

1. Mixture — Take Sulphuric Ether and Aromatic ^'pirit of Hartshorn,
of each half an ounce; compound tincture of Cinnamon, one ounce. Mir and
cork up carefully.

2. Laudanum — An ounce, to be kept in readiness.

3. Pills— Take of Opium twenty-four grains; Camphor, one drachm;
Spirit of Wine and Conserve of Roses, enough to make a ma*.s of proper consis-
tence,* divide into twenty-four pills.

4. Cltsters — Take of Laudanum, an ounce; Tincture of Assafoetida, tww
ounces. Mix for keeping. Before using, mix three tea spoonfuls with a wine
glass full of thin starch; and retain it when injected, by pressure below with a
warm cloth, as long as possible.

5. Mustard PouLTicii— Have always at hand four ounces of powdered
mustard. A fourth part of this, spread over porridge poultices, will he sufS-
cient for one patient.

6. HotAiu Bath — The Board have approved of a hot air bath, of* sim-
ple construction, which may be made by any carpenter. Every family who
can afford it ought to have one.

( -l

R54.

in No time should be lost iu sending lor medical aid. But when the dis-
ease commcnres suddenly in a violent form, it is dangerous to lose even the time
wl^ch repass before such aid can be had. This form is at once known by
TuLn weakness, a contracted ghastly countenance, blueness of the lips, and
General coldness,' accompanying or preceding vomitmg, purging and cnaips
^ In such cases, the friends will, v'rhout delay, give a table ^VOoMoH^^
mixture No 1, with 60 drops of Laudanum, in half a wmegiass full of cold
wtr Follow this with a t'able spoonful, occ-fo..^^,.o^J^'^^^^^

half hour, '^^t^^^'^'^.^''^?.,' ,,Vor Pills must not be repeated without medical
:SvicrThrS;'st:r,' ^rrshouM bc^eJorted to also^rom the first, and re-

P^^^^4Ti^T\1TsiTofthe Mixture, Laudanum, Pills, and Clyster, must
not be exceed;d. For children of fourteen, half the dose mentioned, and for

'^'^:'^^Z^t^^^^^ hand, dry heat over the whole body
in anv shape, such as bj hot blankets and hot bricks, sand, salt, or bottles of
hot waer together with constant rubbing of the whole body, should likewise
be rlsorted to from the first. The Mustard poultices should as soon as possible,
be appHed ^ver the belly and on the soles and calves, and kept on till thepa-

^^^"^B^llrthtrerr^sh^^ opportunity will have

been fffven for procuring medical advice: which is mdispensible for the trea -
^Pnt^Xrwards The Board think it necessary to apprize the public, that
wWethsTsease Jas prevailed, bloodletting, -he^resorted to wi^^hin he
first second or third hour from the commencement of the attack, has been
^eneraUv found useful along with the other remedies, notwithstandmg the ap-
pearance of sudden weakness and excessive sinking already mentioned.
^Specimens of the Labels are here annexed for the information of medical
persons and others in the country who may be applied to for the articles recom-

mended by the Board.

No. 1. ^T 1 •

rnoLBRA MixTUHB.— A table-spoonful, with 60 drops of Laudanum, m
half a wine glassful of cold water. If this fail to relieve, repeat two spoonfuls,

-''' Se^: d^sStS^^^^^ ior children of U. One-fourth

for chUdren^of 7^^^^ the doses prescribed,- and stop when the vomiting and
cramps cease, unless you have medical advice.

raoLERA PiLLS.-To be used if "the Mixture, No. 1, be vomited. Two
niUsat firsrand^ben one every half hour, if the first fail to relieve. -Half
Se e doSor chiM^^^^^ one-fourth for children of 7. Do not exceed the

doses prescribed ; and stop when the vomiting and cramps cease, unless you have

medical advice.

No. 4.

Cholbra CLYS'fERS.-Inject three tea-spoonfuls in a wine-glassful of thin
warm gruel, and retain as long as possible by pressure below with a warm cloth.
K n^t^re'ained, repeat immediately, but otherwise not. Half the dose for
childrenof 14; one fourth for children of 7.

MusTAEi FOR PouLTicBS.-A fourth part !s enough for one person.
Dust it thickly over porridge poultices, of which apply a large one on the belly,
a^d other' on the goles and calves. Remove when the patient complains much

of the smarting. « , « j

By order of the Board, '

^f j S ^Bii/t iT.i ^y- XJ MJlM^-^Si. ~ * r:7i.-.-.-v . -,—» J •

Charlotte Town, July 1st, 1832.