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Adopted I Govei jntrsi Conn Sine and its sj origin, a sideratioi world. It if liypothet discuBHiui of indivi inforniat about thi the dutir pentiieue MEMORANDUM ON CHOLERA, Adopted hjj a Medical Conference convened at Ottawa, the Seat of the Government of Canada, by thi Honorable the Minister of Agriculture, . pursuant to an Order oj His Excellency the Governor General in Council. March, 1866. MEMBERS OF THE CONFERENCE. Dr. MacDonnell, Chairman. Dr. Van Cortland. Dr. Hill. Dr. Landry. Dr. Dickson. Dr. Aikins. Dr. Beaubien. Dr. Grant, Dr. Tache, Reporter. PRELIMINARY REMARKS. Since the recent outbrpak of Asiatic GhoUra in the Levantine regions, and its spread into cotintries more directly connected with the localities of its origin, all the vexed and complicated questions arising out of the con- sideration of this terrible scourge have been re-agitated throughout the world. It is not the intention, in this memomndum, to examine any of the many hypothetical opinions and systems arising from such a fertile subject of discussion ; but to collect in a sonn^what condensed compass, for the guidance of indivin of carefully sillanimity, on of this memor- nd paragraphs 'quainted with ^suits, inteutlod ?rous fears, bv terest of everv ening scourge ; what ought to liich are so ajjt in this Memo- ice not invade et, as being so the measures , the domestic, CHAPTER T. PKSTILENTIAL DISEASES. To make use of th(i happy expression of M. Tardieu, " It is well to bear " in mind that pestilential diseases are not of that class of which it has been " given to man to penetrate the oi'igin and to understand the principle." From time inunemoi'ial the world has been periodically subjected to th« ravages of epidemic or pestilential diseases, varying in their intensity am' peregrinations, mysterious in their origin, and from whose occasional re- currences mankind, in all probability, will never be free, § 1- ,- :" EXTERNAL CIIAUACTERS OF CHOLERA, Any discovuse of a purely scientific nature would be out of place in such a document as this ; but it is of all importance to insert in this Memo- randum such information as would render the disease, in its ascertained character and effects, generally understood by members of the community at large : because no one knows to wliat extent even a small amount of know- ledge nuiy become usfiful in n moving painful and dangerous fears or equally perilous feelings of blind security, also in avoiding fatal errors, ancl thus making in numy instances and many ways its possessors serviceable to himself, relativRS and fellow-creatures generally. Cholera is apt to apiuiar in every cliuuite (very few countries, indeed, having escaped its visitation) ; it attacks both sexes, every age, and all conditions of life, the poorest and tiie wealthiest, the weak and the strong. Generally, but not always, it ap])ears moie fatal where misery, filth and crowding aio to be met with, and intemperance and other vices are sura to render its blows more disastrous. The approtuih of Cholera is oft( " [)r(oeded by contagious, endemic or e[)idemio diseases and a more thin, sual prevalence of affections of the stomach and bowels, and oftentimes also by diseases of a disastrous nature (epizootics), attacking domestic aninuils. Occasionally the appe;niince of Cholera "eems to have a marked effect either in increasing or diminishing the intensity of other concomitant diseases, at other times it appears to fail to exercise the slightest effect on them. Tho exjierience of Canadian medical i)ractitioners has gone, however, so far to establish that Cholera has generally superseded in a great measure ..A other diseases. There are only two circumstances connected with this scourge whicli seeuL to obser\ e a determined character of constancy, these are the i-atio of mortality to the number of persons attacked, and the iufiueuce of continual cold on the duration of the iiestilence. The ratio of mortality "almost at all times and in all countries is never J^elow 6 > f Benson anrl H8,SUrU)(J tliHfc nelow 07i(-thic11 the following tomach, cramj>s, increasing con- ' exjji-ession of 9 malady, puj^e sunk in their ■I'Je thirst and increase in the 'ines livid and of the fingei-s tJie pains and tish fluid, like wledge of the .jatient, the skin emits a fetid smell, a squalid appearance nervades the [whole surface of the body, the breath is colder and colder, the - .jpiration is much labored, a profound prostration of every vital action foUows, and death quickly closes the scene ; but the intellect remains almost as perfect as in state of health nearly to the last. The period of reaction, when it fortunately occurs, shows the following symptoms : the pulse rises giudually, the blue coloration of the skin disappears with the returning waruitli of surface, the respiratory movements become more regular, the voice is by degrees restored to its normal tone, a warm moderate i)erspifation shows' itself on the skin, the countenance ia more natural and the face becomes more or less turgid, and the eyes somewhat injected. Sometimes the reaction ia too violent, and then there is danger of 'jongestion of internal orgi^us, especially of the brain. The ]ieriod of Cholera of 1;<14 wbil ' countries it is the scou.>r,. of 1817 and for otheiHut ul^' "'"'''<•" 'J'^'"" enteml Canada bv Kington whe.e . ,I,? " ^'s (o have M«.y, 1849. Tl./ «... if :...r .'.'..:''..''''••' » s Hppe.uan..e at the en.l of jurs'U !sf tl... ir. he iK'stilonce ha.l. previously to that ,1a le lie i>es ited BttttrB, uud w Mippi rtud the Missomi Kivert appeai-ed ji tta ui that tjuie rapi(|ly ii.sceijdiug the .a] 1 ki«v'/ii'iil IHHIS- T, ^°".''th «'pic]ennc. of n., ^' "'-^' "^^^o"* four nuZh , '■^^""•eiice in ""'fJ fovm in Au ;,s/ \"^'''^«"'"i'-f^ of 'j ^ ,' ' ^""'^''« was th« Just of n '''«y.s of n / , ''o"st, and the i.,«, "'" P%iie took i.l.,,^ ""/"■''t ot our ion nM,ll„„/ " "« ':«l' " ."e.li«.J 2L.'™-P«'l-'h» «„„„. , „ _ ^""«, intL "" *^" «hi ,« ,ve ' ^ '^^'''^''''J to Qnebcc with fh '''^ ^','«''"»- '"> "i the i)ort of n„^\ " "ispectivJ n,, n " the rest of fl>„; 'Ot/l sIllD.s ul.,, '"^ -"HI, tli« eJlnl,,,-,. 1 , Sf ""O tJlO sJuMH f,i . . i ••'ties at tJioH,, „ • ' '^^''olom .sot-m- (.. i """'"^e of the i,„„' : " '*""'• '•«a «-'0"i.«unicutioi. with • •'" ^^"^ '^^''''-Hts whoT "''•■''•^' ^'th tho liiiiuitfrant*. ' "^'° ^"'''^ "ot know. ... .. " "are o^ July, and a few ^ole of Canada, it« '^.'^ Jes.s, and also ^'-ye disappeared ^ ot J-ecun'eiife in ' and a Jialf. '1 1851. ■is the last of our '»-'« lUKier a ratlier 'Jl-ei' tJuin the first i"g Oauacia as a rust to the 2ud of ' the Perthshire, ''•om Quebec tJ.o ne suilor Jiavin.r '6 ; hut in a feu^ 'out any further Jred Canada at e wJioJe JiistoiT '7 and Jacksoji fwcts connected \ '"id the ^o/^« We before the ioft a number Jo.'it fi\-,. p^j^^_ 't the g.iaran- erestoftlieJr f'"' 1 7th of 'Wo infants, letween the ""pt ft' )ni alj J 9th. Ti,o • ' "'aiJs mui tmieousiv in larino Hos. 'tl.V Ni)read. "'«iants in '■"'^ntioned d "» other "^"trf. but '« to liave 11 In Hamilton, on the 23rd and 24th June, on immigrants. The cholera of 1854 ended in the latter part of the month of Sojttembor, having lasted about three months. The Central Board of Health closed its' iaVwrs on the 22nd of Hei)teiiil)er by formal resolution. The Report fi-om wliich these informations anj j^athered spoakf. of the imnnmity from cholera enjoyed by the town of Brock ville, on the St. Lawrence, although situated on tlie same grand route as the ravaged cities, towns and villages bordering tlie river side, and although immigranl,s had been allowed to go ashore in passing by. A fact of some importance is also recorded in the siime Report, wliich it is well to insert : The cholera ai)i)eaied in the Provincial Penitentiary at King.ston on the 21st of July— that is, nearly a month after ic had commenced its riivHgeH among the inhabitants of the sun-ouncing neighborhood. The number of deaths from cholera throughout the whole of Canada during this last epidemic, as recor.led in the minut« book of the Centnil Board of Health of 1854, is i>ut dovn at 3,48lj ; a figure which, from th- enormous difficulties to be met with in collecting coirect statistical informations, must of necessity fall a good deal short of t'le reality. The difficulties— insurmountable when the small localities Imvo to be accounted for — have rendered impossible any i.ttempt at gather! ig in this Memorandum figurative statistics of tl>c former cholera fi.idemics, tiesides the figui'es above given. These figures may convey a deductive idea of the losses inflicted I y cholera on our country, when it is known that the number recorded is nccessiinly IhjIow the maik, and that the epidem.c of 1 JOi was about one of the mildest of the five. CHAPTER U. PUUI.IC AND I'KIVATE DUTIK8 AH CONNElTliD WITH CHOLKU . The imiamding danger of a public calamity, and still more, its appearanco in the midst of a community, in addi.i^ to the ordinary wants, adds letessiuily to the duties of all. The State, the municipal eor|>om'ion8, the ditteront assm-iations, some juofessional corps and private individuals, have each special duties, more or less onerous, more or less dangerous ol'ten times to |K>rform. Cholera Wing, us it is, one of tlie most awful of all scourjjies. cannot appear, not even be simply tlnvat^'iuiig, without a general call for the i.erfoiniimce of such duties, in the accomplishment of which ii is within the p'-ovince of every one to i-ender eminent servicea to his fellow-<>iti/.ens. I'.eKides, it needs the concurrence of every one : fir, in. vain, the State wo'i!!! t>v ♦:! sbs -Its ••.:^;f •** tho municipal and otlior public bodicH were refusing their concurrence, or ! \ gatJ,eri„,, ofT''T"^ ^'evolves the ; . '^i""»t,o,> a„U dofe,.^;' .""""•8 «.,d * ^'i ;""'-■ f".M,ii,. ., ... . , ° "' '^""■-1 "«t/.,„ f,.„, ; "«;:i:::-:-'^-;'S:^^^^^^ ,.. -"zi^T " -. tr;£ - ■^'^s-.-.r r '^ - ? *.,., «-'fc.rrvt-"..J^ " ""'^''-^ ?'S'"i initio,, of fi ^^ . HU.I to 'i''ecl notion might lea.l to very dutv^fhev^win'^"'''''' ,"^ '*' \"'""" ""'' ^""'^^<^y '^'-•^"'^*'''l '^^- ^ I'isl. .sense of 7oo: ^ . .*•'."'"«' ^••■« t« aet, and when they shonhl call to their aid tie eo ns s or adm.mstrafon of men whose speeilie n.ission is to ae,,uire for "I), « hat all c.nnot, l.y any possibility, be made to ao.p.ire for ihemse ves CHAPTER III. MKASl'KKS AGAINST CHOLKRA. Tt is nseless and also hi.Lthly det.'in.ental (this rann-t bo too ofton nn,.ated) t,o flatter ourselves with the idea that.Sf .ueh a particular Z^ we.e done ,n such a particulu- manner, complete immnnity from this .Hsease ould be attained ; it is e.p.ally .laugerous to .lespon.l under the depressing liehel tliat nothing can Ix^ done to mitigate the evil Cholera has visited almost the world entire (eontim-nts an.l islands) at east hve tnnes. in spite of all uu.usures a.Iopted by the most enlighteuo.l and 7 Tnl r '" '"■"'"'"^' '*' '"'•■"••"^•»i'>"- Tt n.ust be accepted, then, as a truth, hat Cholera must and will prevail whenever the higher eonnseh of tho AJmi-hty de.ree that it shall be so. Mut Cod has given to man a certivin power over things natural, in a ;. ordanc with he general laws established by Hi,„ ; „„d the legitimate u«o ol sneh power 1 not a ways Htt^u.Ie.l with cou.pleU' success, never fails however, to be followed bv some good residts. » " ""ih. It has l,e,.n even so with (Jholera. A happy disposition of soul and mind. goo.I salubrious eonditums of life, caution an.l hopef.d faith, modomte and teu.perate habjts, have saved, and will always sav... thousands from tho ff.HXs of this and other scourges. Notwithstan.ling that the same views liavo already been enunciated, it is thought important to b.i„„ M...,. .,„,i„ .oai aga.n i,eiore the uotue of the public, even at thi- risk of being conaidm-d u The measiires to be adopted against Cholera, and in fact against any contagious (spideinic or endemic disaise, may be classed imder the following heaxUngs :— 1st, Sequestration or Separation ; 2nd, Hygienic precautions ; 3rd, Diffusion of sound ideas and judicious advice, and inculcation of obedience thereto ; 4th, Prophylatie timely interfereiice ; Sth, Intelligent curative treatment. The meas>ires of the first class are evident ly a|)pertaining to the func- tions of the Governiti'ut and municipal botlied, as defined by law ; the measures of the second, tliird, and fourth classes necessitate the co-operation of the community generally, and of all its members individually ; tlie measures of the fifth and la.st relate to duties which devolve on members of the medical profession, and, under their guidance, on health otlicei-s, Sistei-s of Charity, and other attendants on the sick, and on them alone. If every one could pause to reflect on the imj>ortance of the performance of his own duties, do them well and not embarrass others in the accomplish- ments of tlieirs, and if all were to work in harmony, good will, devotion, and forbearance, without assuming other than their own task, at the same time fulfilling it unflinchingly, it would be no great stretch of prophecy to predict grand results for present and future good. § I. SKQUESTRATIOX. Tlie means of sequestration or separation, as a preventive measure, are of two ki ds : firstly, those employed against the introduction of pestilence from infected countries ; and, secondly, those which are adopted in centres of population, witliin a country already invaded by an infectious or epidemic disease. 'I'lie fii-st are effected by the establishment of Quarantine or Lnzarettot' ; the second, by the establishment of tempornry upecM honpitah or re/uyps m isolated situations, if possible. Such measures, it has been already said, are useful and extremely advantiig( ous ; but ic would be a dan^'erous fallacy to calculate upon their" absolute succsss, and to neglect the far better measures of a moral, sanitary, and hygienic character. A few remarks and obHf>rvations would be sutKcient to convince every unsophisfi^'ated mind of this trutli. To he satisfied of the infallible result of a Quaianuiio wouhl recpiire that the c( rtninty of the disease being contagious be thorou;.,'lily established ; oi', if simjily infectious, it would require a certain positive knowledge of the natuir of its mode of transmission, of the time it can lay Intent on jMMsons or tilings, and a close insight into the nature of chemica; or otlutr agi-uts ciipalile of destroying the virus. It would again require tlie certitude of its being iiu'ai»al)le of travelling on the winds and with the currents of running watei-«, or, it otherwise, to be fully aware of tho exact ilistance at which tlie virus .-annot be any more hurtful by imving luttl iu> ptoptt^Mtiag iailueuoe. gainst any ! following •ecautions ; ilcation of Intelligent 3 the fiinc- law ; tlie o-opei'ation ually ; the nembers of ei-s, Sisteivs eiformance iccomplish- votion, and ! same time f to predict leastire, are i" pestilence 1 centres of )r epidemic niiUme or n/ hoHpilals extremely upon their* 1, sanitary, /ince every jle result of ; contagions re a ceitain the time it le nature of would again winds anr\' intercourse mediate or immediate, between all persons or things apportainiiig to the country to be protected, and also of every thing oi- ]iorson started from all suspected OY infected regions, and even from all pei-sons anil things connected With the Quarantine station itself, such station beconiinsr itm fm-to an infected spot. Even if wo were entirely con\ersant witji the mysterious propagation of those maladies, such total prohibitifm of intercourse between countries in constant intercoui-se with one another would bo, in itsf-lf, a great, calamity. The recent successful in-+,ance of sequestration at Now York, on board the English ship Atakinta, connected as it is, perhaps, witli jMjlitical, social, and commercial tendencies of the day (not altogether modii al), has received amongst our republican neighbours, an advocacy of al)Solut« proliibilion by mea: s of extremely rigid qtiarantine and non-intercourse. To adopt extreme measures on tlie isolated experience of the case of tho Atah">ta would be indulging in the very fatal philosophical error of arguing of 'lie general by the particular ; and possibly the non-spreading of the disoaso in the case of the Atalanta may, after all, be attributed to the presence of the cold 8(!ason. All this reasoning, nevertheless, is not a plea for the abandonment of the principle of sequestration and of measures of quarantine, m already and repeatedly enunciated. Hap])ily, however, there is a n.iddle coui-Ht! that can be observed, equally distant from extreme determination (Milled for by most opposite opinions. It would be impossible, even if it were of absolute nooeshity, to guard the country against the importation of Cholera on tho line o;' our inland frontier, extending over hundreJs of miles. But here it may be said that our neighbours, in defending themselves from such an importati )n into their own territory, are virtually making us participants of tlie sam. advantages. Ihat argument, however, cannot apply to our numerous ports s tuated along the coast of the Gulf and the lower St. Lawrence, sucii as an» tho free port of Gaspe, the ports of Pasp^biac, Perce, Rimonski, Escoumins, i nd the ports of the Counties of Saguonay and Ghicoutimi. A modieal 1 ealth officer chosen on the spot might perhaps be appointed at each of these i»ort«, with instructions to inspect every ship, and in case of sickness, to st )p eacli ship from pratique, and by instituting the ship herself as quarantiu • ground to the master and -crew, whilst those on board may bo submitted to ipecial treat- ment, till the sickness has disappeared, i)roviding for any niao n which, by death, the crew is reduced to an insufficient numlmr of hands. The point, however, at which a quarantine is of all iniporlance, as proved by the constant exjKirience of former opidemicH. is on the St. Lawrence, at the entrance of the port of Quebec. The (Jovernir nut iwssesses already, and very fortunately, at that very point an admirable e: tublishment, which only requires to be made at times of more than (.rdii ary daiuMrs adequate to the circumstance,^. A better selection for a Quiiraii iu'e than th(> Orosse Jsle Station cannot be made, situated as it is at some thii ty odd miles from Quebec, on an island of nhout finn n^rea oniM.,.*;,.;.... ...:*i ,k._ .i_.. and good anchorage, at least three miles distant from any |MU-itli or village, and yet sufficiently near to prompt and commodious public uiouui of ooiumu- mcation. 16 -ncl, on the oth.,' «ido, neSe oxSsT^^^ ™'"^'""''^ «^" ^^^^rd mternational intercours;. The rues oL"°'i '""'r"" ^"^ ^-"'"'""rce and iea«onaI,le quarantine, need not bLiVId •''''•f,^- *?/^'''*"'^ °" ""^^ a constitute no new science to n™ "f.'^"'''',}'' this Memoi-andum ; thev the .orks of ma^T. t^o T"t Xe^ "d ' 'T'""^ "^^^ document, being inten le 1 fo,- \ '^°'^''' °^ "^°'^* "'^tions- This moveover/as this ^o h " r^vI-nZ"'^."^ 'T 'f"^*^^' ^«*-'« ' -»" the Executive lu.s alreadr an cxn ! w 'rr"'''\''"^^''*^' "1^°" *^^ «t'^te, of i.^...„.ation sought fb' tc;^t:;ni.;;lr:eu;r "' ^"^ """"""'' ''^^ --- inu>oSrtK,::;S:iJ:^,::^|;,*!;\'^''--^"^ -.question on which it is to prevent one-sidei o onJtkirnr;'"'"' ^Tf"^ information, in order become a subject erf verr^ iou^e f bL;^^^^^^^^^ ?,"• P"^'-;. "'-'J' -^ thus wntt(.n : What rules shall apL o SZ-^n^^ . ' '*"''•''" '"^^ ^^^ *'"'« the ports of Quebec and MontreJ^r If 1^-*^^ '" ^'""■'' f'-«qu«nting >V<.^.».v/.> 6'o,«^a«yV Z ".«_is '"ii^^^^^^ wluch-the Cr«^^,«/J Ocean Ji:..rof,ean weekly mail ? ■'^"'•«'^'i^ed by our Government and carries our -i.:!c::;=;tb^ir™i;L;sr'-^^^ f- ^— *-« -hen the greatest danger, on^Jne stlf ind of rn nn" '"?"''^ ^" '^" '^"°"'^"«« «f P't.sse„,.n^s. and merchants, on the'otT^r'""^ '^^'^'^^ *° *^« •^^•"P-ny. Austi^u ~:::rs:i^:!;f ci;:;^f^ ^ "-^^ ^^^^p*^^ ^ *>'« Smyrna and Trieste. This n.uctieo would "^ *"'•'"'''' *'"'"''"« between the ease of our stean.ers, frL^somo n3e„f n 'T'' '"'•'*^'^"^ '^'^'^'^y i» •^"•1 fVom the fact of the greaterTnXof S^ \"'°'"' '^""«^"<^ »«^"'-^. Quebec than between J^.Sy.'na a^S Triest^ TTI? '^Ir" ^^^^n'ool and ••••M'"- that a special me.licul hea th oK'is ^l ^° '^^ *his practice would which will then be, whether the^ is £e o ' w T ^T^ '""'^ ^*«'^"'«'-. •l-'arautine station. This officer to bfaroin^L?K n ^''''^' '^^^n'ilated to a warning of Cholera, for a limited rem3'^Z. , -^i ^°r'""'""'^*' ''' *'«" «'^t of the ship. ''^""^®'* *•">«' besides the ordinary phyMiciau Koods. by the L, for inst-UK^ of ZTy^ loHd'e Tf '"' *" ^'"""^^ *''« etlicic.ous disinfectants, and white^LhC 5 T- T ."•" '""''' *''1>"^"y water. These .eeonune.ulations .^ 3 "nLe in^ ^^ ''"'' ''""'•'' ^^^^ ''"^^ "Hi'l naainst the r,.,.! «j«„...... Ir ,""'^ '"''^*^ '^ 'gnorance of what cm K« wu.er course ia to iudinetowurd«tL7Lif^''^r' ^"' '* '" "''""'"'^ *'"»'^""*^« ?, on one sifle, 3s can afford, Jriuiiorce and T on such a and 1 1 m ; they 1 set down in tions. This details ; and >n the State, d, the means which it is ion, in order id, and thus may be thus frequenting 'dian Ocean I carries our ntine when quarantine ous for the s one of no s. Inni, it will ti of which foidance of company, ited by the K between ficiency in nt nature, ?rj)ool and ice would I steamer, ilated to a t the fii-st lihysiciaii nve to be mage the > pqually viih lime it can he that thtt 17 to, ac^c^XgTot^lSns^' ^"^^T.T'^^''^-' "^"'^ ^^-"^ *« '^' '•^««rted goods and effects oThn ^ ?. -^«°*'' '^''^ *™o"g«t others, the on deck " passengers m daily use would have to be ventilated on botratTelomLS arS IT' "^T^ '''' '''' '^"-'^ ^' C^^'^- convalescent lists beinalniS 7.! f • ^"""-'^ ^''"' ^" *'h°«*' ^^^ '"^ «i°k and permitted to oc.J to Onrl !^^^^^ '■"^*^'- ^'^^^^^i«n. would be Quebec, then 'alS t^p^rtire -Tf not t' f-^'^Choler. o. her arrival at at anchor at the mouth of tKt' f' «f --*- -hidi should li ofthe pop^uTaJLTvilw^^^^ f ^r' -^^°^--- -^r to the rnunicipal autSies' Tn orZ V '''' °V^^' *^ ^' P"* ^" requisition by the brlgh beLe the Dub c ^ ?1 1*1 '^ "''"'?''^ ^* *'^^"' ^"^8 repeatedly lest,;fLhavinlbr^^^^^ 'VhJ , ^rS '^^^ carelessly heard, they shou d be entirelv forcrottf.n of old wSn paVemL^s nknlV„rS' T/""^T' ^"^"' ""'^ Cities quantities streets and in anTS 4^?^ f ^'^^ ^'""^^"^^ *""^^'' ^^^"g i'^ t^'« and absolute^ s^ umSd w^t^^^^^^^^^ ^ state of partial decoraj^sition burned, o/cartTd o^f In itn !^ ^f """"'f''^ °^" '""'^ '"^''^ «1^°"W be sidered'avaikbt fcr;,;;hr usefuf "^'^ " *'^ ^^"^•^' ^^^^"^^ ^* ^« -- are not wn,,L^f aisease Out of place, is intended to mean where thev .ppeL^cJ'oTSo&n wXi !" "'"""'^^ *" ^''^ ^'^''J^* ''^ *»»« '«fl-»- "f --ter on the tlon from t1.e .aW ofX'iV'tfc^^^^^^^ ""waiZ^tZ'^'i'/ ^ /iffereUcomS iU. Louden indl-crimuiately. AaVly^r^al^nrellukrre'iott^c^rUie^^tr w"^^^^^^^^ ill 20 of a litti; cMoZe7liZint\. 1 -'«"""? of polluted places the'ise during hot weatho • nd in tint or '"^S "''"*, '''"^'"•^•'"S ™^««es of matters walls and oth^r ' nface of wellinr i'""' "'' '^P^''' *" ^^'^' ^°"^°t«^ "'» influence of extrln X,t * n J^!''T '^"^ ^'f'"'^"'^. ^h«" '>»^1«'- t'^e immediate acquires an im n ,^se imne;n^,,n ?"'',' '':^*^-^'^^^''^^"» •'^'-' '^iff'^^i-n of miasm, nol be unattenllTi i Il'i; ^ :';r;.t.;"'"nr -'"-'l^-tly it mi,d.t' of these dwellings durincr suit, v^ /i ''"•> ;'y*'^"«^^« l^ot v^-ater washings the surfaces of sTch welling o^. Z ' '-^"'^ '^ "^^g'^* be better to cover paint or lime. 'l^«>''"g« or then- app,u-tonances with a thick coat of well to rema'rk' so thaTitlr t"' '[ ''^"^ T'' '' simpl Aood a^J:! "'^^: ^ .;:i, S; W^ 'T^'^^ resourceLthey are JMiot a simple but a complex nrnlS"^ '^ ^'•''* ''"'"'^tions .f salubrity J^rations of variout ^rce Tonve i . ""T^\ '"'" ""'>' '"^ ^'»t'^'^^'' ''y the But few onhThlTZonZt^T" rr'' *^'" ■'''""•^ l^'^^"*^ of action. -ate coufuBiot S th^ Ltd "f, ::t,r^^ r"f ^""'^ '^r^ "^ -■''-• -* *« and also in order that sneci-d . tn/ "f . '^'"^l^'y ^'«'««1 i-' those matters, certainty of an ami Z,W '^^f " I"". ^«"'g >'«»centrated on a few, nu.ro po.si^eWtion!X:S^Ull^^^^^^^ I---- of obtaiSfei;:;;,;:rrr;^::l:t t r*\^''^^^^'TT'^' ^^« '^^'-^ - -^iiy known to eyer/one 'it s wen in' i- "'"' *^!' ^**^ ^^"^8 «« familia,l> dored charcoal.^ '" "''° *° '"'^"*^^" P^'-'^y^ng qualities of pow- potaAt^^.^';;:!^;^!:^^!!,;^:'^-^^^ -^^ permanganate of is hoped that t'I.ey will l" htortSd /tt'tin "'\'"'""'T"''^*^ ' ^"^ ^* ::r2i^Li:'?s^^ -'' --"" ^a::i:;?.^lst^-^rar: :fi^c:;ST;^er"'^.rJ:ZS^^ ^n places •twf'is, h^aps of dirt or manure, outside privies, night .. .ils &/ uZh • ' " ' '," '^ "'^^ "' «::ghi^«-n^he^i^^ they aa on. - > -very three and ^ ^1^ I cond, 5;'?^ tht ff'^^^^t ^"4'-'^ l^^O t?. loft or destroy. \. jhe Southwark w.ater, X would hav^ 1, 'i"''' supnhed that 2.500 persoi* were s^>;"Hi;. --i'a, li^s' -^ff ^;n^3yf -'^ '^"3a» water w we Ji;-; ... lu.OOO." ' ""* '^^''"'■' "' ''""s«8 supplied by the Southwark I and carting to places tlie uge fit. Tlie same ises of matters til collocted on the imnibdiate lion of miasm, lently it mij^lit r'uter washings if'tter to co\'er . thick coat of is, it is just as 'Stances called h properties : iry measures) cos — they are s jf salubrity tained by the f action. order not to iese matters, a few, more rovention of ig so readily lo familiarly ties of pow- anganate of led ; and it ured in the 1 sold at a m places s, r -aps of I'loj '. they :hc source of •ecisely in the the Lambeth I to 10,000, or person* were ave_ obtained epidemic of pany taking plied by the ! Southwark 21 Chloride of lime mny be used in the proportion of one pound of Chloride to a gallon of water, find it i^ itssiinied that a pound of chloride of lime so diluted i« sulBcient to paitially Jisinfeet one thousand gallons of running sewerage , when used for washing a nmch weaker mixture is to be made, say an o!iT\(«} to a jrallon of Vctcr, and the articles are *o be well rinsed and cleaued in ;,ure water, ami well exposed afterwards. In every case the chloride must be well mixed with water. Sulphates of iron and coppei- may be used in the proportion of a pound to a g!,ilon of water for disinfecting flth and sewerage. Condy's strong or red fluid may be diluted in the proportion of one gallon to fifty gallons of water, and the weak or green fluid in the proportion of one to thirty gallons. How- ever strong may be the faith in disinfectants, in spite of what is alleged against them, they can nev.T supevKede or cause to be overlooked the more reliable measures, as are cleanliness and ventilation for instance. Good ventilation infers, firstly, perfect cleanliness of dwelling : sect udly, the avoidance of crowding, coupled with a free circulation of ;\holesome air. The enunciation of this bioad principle is suggestive of advice in a general form : that crowded and long standing gatherings of people are to be (as r.rich as religious, educational, militarr and civic duties can permit) avoided dunng the reign of pestilence, especially at night, and that this precaution or rule appl*3s not only to theinteiior of buildings, but even to meetings in the open air. Of course, in the application of such a principle no one ought to indulge in pusillan'mity and the drawing of extreme consequences. Times of epidemic are not times to fly from the service of God in his own house ; and they are no excuse for dereliction of other public duties, hut they are times for prudence on the part of legitimate rulers, and of obedience on the part of other members of the community. It would be a desirable measure that, duiing the prevalence of Cholera, colleges and schools should b« closed and racated. It is a lule to be always observed during mild seasonp, that churches, ])ublic halls, and rooms in ordinary dwellings, when not actually occupied, should be open by means of their windows to the access of currents of fresh air, as sweeping as the state of the atmosphere and artificial means when at connnand can alloM'. This sufrgestion is not to be understood as recommend- in i the introduction of cold draughts or direct strong currents of air where pcreons are standing, sitting or reposing; but under these circumstances ventilation should be effected quietly as well as steadily. Fresh air is a commodity which men can use and abuse. In the present state of science no fixed fornnda can be given for the space of loom allowance requisite for each person, nor is there any one admitted method of ventilating buildings, for the simple reason that ventilation depends on a multitude of circumstances, varying with the external ambient air. the habits, temperaments, healthy or unliealthy condition of pei-sons, the disposi- tions and situations of tenements, and so forth. A man can be ventilated to death by fresh air in a box and can be suffocated by foul air in an immense hall. It devolve upon every one in his public or private capacity to adopt mcuiiurcs . 2 tbii nd, and upon the 22 to en.langor the luil'lic lu.fui; ^"^''^■'^'"^'^« "^ •^P^-^'a"'! vontilntion ar., all.^ve.I vcy ^:n;:; wSit^;:;. ^.l^ir'^ '"" '''*''^ """">'""- -^ <^^-->^-t pestilence, tl.o so , c V ", ' , ^^ '"7;"'" •'*>'' ^^""^^ '"'^^ ''«' "^ «'"^ "f Railways a„,l so" > L^s Sr4.tr''~ ''' ^'' *'" "^"-o-'ing of cars on more, passenKors iu a" " < Er'v^ "1 /.; '"", '""^ "^ " ^'^''P'"? '^"^' '^^'^ "" Wiilespoaklngof iT- [iwlvs T t *^7 ^''?''« *''« "^'^^s to accommodate, to the necessity of .;.evh;^fI'''T "^*''« ^^'"^^^ import.u.ce to .^vert Railway Stations and ote^ S l^*^"""'^ ' " '""«'">'>" of pHvies of all our every sLppin^pirl^u^R^llr^^^^^ ^^" ^"^'"'^ ^^'^ ^P^--- o^ attenMo: i;;^ r,::^^:^:,:"' ''"'""^ ^''°"'^' ^^'^^ '- ^-'-'^i-* ^r ve.^ .pecial gases or odors, eitll r too ho o t 'o n T °'r"' ^^''''-loaded with noxious purposes. I3e.sides\t wo!;! ' o im o^ssiSto "aS:"' *" ''''''f '"' •''"•^"'"•>' to come, even if it were a nmssitv t^^ . „ ■* ""''^' "^ *^°'' "''^"•^ .V«*'"* public or private. S , i il t ft .'/n ' ''"""i";""^ circumstances of dwellings and to resort in v.IdH o to he s ,"''''';''"'' *'^"''" '^"«^*'""'^ of discussion, thing clean, of mak n^Zo of I 7 ■ '?'"'"^" ''''""' ""^ ^«*'Pi'^« «^«'y- fans to agitate e X o the insHe'''' ^"''^7'' ^''"^''^' '^'"> "'«« «f l'^^' «pl>ere is still and he W Ft s.'.. /"■'/'" ""''••«""''i»8 --Eternal atn.o- condition of anv hZn. tlmt if. ?7 .;"'*«"«^| *- J»^1ko "f the sanitarv reasonable time^allo hei- 1 Ls heW "'n .""''^ ^'"'' *'^"'* "^ i* f"'' « Hean. Htrong and^ealtt^p Zn^^ ^ 'Z" '" ^-^I-'^i-'y "-king every reason to believe that 1 ,;1 V • • "'^ oircumstancs, there is Rreat, even if there were ^n^S^^^^-^^T''^"''^ "?.'*"''•'' '^ 'l^""iug an, n.,t This, of course, woul ,e o . s f 7 T ■^ ^"^^"'^^^'.'^r ^^ ''^i'^K a.aeliorated. rrovement, but it svonld 1 "a "m ie t o ns '" /?^' ';''" "^ P-«>««-ve in.- against the proprietor or uz:::!'::; :i^:zZ2 •^"^••*^"'^'^*^«- »>— ^Iwellings should be kep f.-i Ja 1 t "^"'''•'', '"" '""^*"'» "PPHmtus of thoy can be used n . iv t, Ir.'Z' /■ T' ""'''^'"^ "'■''•"•• «" *''"t an-l also in case of extre u ,L „ Z ZZ '"^''r'-'"« «f ^^e t.mporatun, dimin.ition of ti'mj-erature a ' . nf i, '^'though ordinary and gnidual J'oralds the approad of win ZT "l T'^ "' ""''' «""*^"» «"^''' "« disease, the Han oefTecfL 7 """.'''■'' *'''^''<-'* "» the stopping of the effect on the animal ^mJii^l :! rit.: 'Z' I'*:'''"" ^ '7^'"'^ wems to act by the way of reacH,., ..1 • ' .^'.'' " « from the "k tlut i\ tU. It is an important duty dnvolvin- on tlie municipal authorities of towns and cities to see that all aaiiltorat:ons and altenitious of articles ot tood and common beveriges aro prevent^a. A lai'^re town or city ou-hl to hiive a medical inspector, who, b-lu.,' a practicMl ciiemist and microscopist, should watch over the buying and s-jlling of all alimontary substancecs m common "'*''' As to i)rosfirvatioiis of a puroly iivgienic character applying particularly to ordinary dailv rejhne, thev do not diiler from those which apply at other times, with the «"^xceptiou tliat some iunoceut indulgences, such as vuMidly .Gatherings, might perhaps better be avoided, as well as anything indifferent in itself which is known bv every one t. have a .lepressive effect on the natural fiiuctions of the organism, and p;u-ticularly any over-exertion of the mind and body. , . i ^ e Acain and a^ain let it be repeated t'lat drunkenness, immoderate use of food and drink, ex-esses and vice l>i general are pnr sc pr.Mlisposing causes of sickn.!ss, cholera specially ami fatal eump ication of the malady. There is no necessity in timo of epidemic for a cliange of customary habits and diet, jirovidod they are -oa I ; far from it, there may be .langor m making any im[)ortant change. , ,, ^ ^, i u But if the habits or dic^t are bad, it is of much moment that they should be moditien recommended, and great care should be taken not to allow the feet to become cold and damp, especially when not in actual bodily activity. „ , . • ^i As se Ml in i\w pre 'eding lines, the principloH of hygiene are in the mam very simple, still their being enforced with strict ol)sorvanoe on tho public retiuiivs not a small share of indudry and understanding on the part of those who are -ii trusted with tint .lutv. Th., execution, howevui, of sonio of tlie nieasures (as ain.lied t i local eiiruMntaiic m) iinpiired in ciso of .•pidemio are exclusirely within tie- provinc ■ of the me lieal profession, ami it st-.uuli to reason that there should be a e )uii.uacively largo proportion ot its members \\\ the nompoHitiou of the local Boards of HuUtH. fiu* i» not to grant ;^ 24 undertake it. ^ ''"SeJ I.y the nature of their avoeution to §3. INSTRUCTIONS AND ADVICE. Olio of the evils connecteil with tu^ Ks the indulgence in H,,rSS ,lol f «)'I'e^'«nce of public pestilence Ther,ce timid r>eople aL ftthi Le In I v n""'^ "^•'"'""'' '^f «" 'ovt.. possession. ' "'g"tened, and e.xcitable people lose their self- sonsXtthrti:oiit"r,HTi::i"? ^'""^^', '^"^> "^^'""- p- chance of such ti.nes, and lona Se til' "''^ t° "I^* ^ ^'^^e their nients are .seen offering for sale .dl 1 ^.f "Ppearance of Cholera, advertise- «courge. Patent .ne.Ucines 1 Lus[^ T ""'^ ■''I'«^"^^« f««- that against ahnost everv known a nu A. """°""^^'', "« «-'"'-ative con.pounds which the word Cholera i. alTt; X T'fV'"''' ^ "'-M'lacard. in debility, inflannnation, gangrene d abates ,.?•' ^""''^ '-^"''^''*^8"« «*" f^^^'"- cl.arrh«.a, .tc, ic, allof widcllVrto .1;., 'r^'r" ?f """*'' *=«n«ti|«vtion j.08.sible oriniagiinuv. Th and hi n fnv 7l ""''''' "' "•'-""'stances, real ing its meshes to credulity and fea,^ ' "" "^'^^ ^^''«'-l"tarisn. is open- p.on.i:ii^:r rs:^:TJ^^:'.^rpx ^"'"^-r ';7^^^"«- -• from giving countenance to sucT mr^ies^L t. '-''^ '•'""''^ '^^ K"'^'-^«d resulting, could they be realize would T: f f \"J"'r"'" ""'""« therefrom The duty of evVry on! i.f;^,.? , , 3'1 « '^ "*^ '^'-'"-K magnitude, means of ex,,ecting in.munitv fo, o, 3f . / "«^"mpl,sh it is the onlv laws of the countiy ha v ,Tov 1°! .Jf r ."",? ""'^"' *° "t'""-- The each locality, to collect inf. .a tl wL'T ' ^'^u'"" "^""'^> ''« "'''-'^•^^d in and to give or,lers for the executio^J lif "'' ^ '^' f''-"*^'''«« «<" ^''^ '""ladv course, sunly i.s to look to IL's^ ueLl fl T"'^ .'""""'"•^'« ' ^''" ^i«««t accomplish cheerfully and Su Iv vl . t ' '"'°""'^^«". ^^ »«eded. „n,l to them. ^ laitlifuiJy what is )ecommended or ordered by .ii.«"itr;tx^TTh;txr:'n,r;r'" "'t " '- >- '«" diHCttse; th#ir duty as well .s . i. • V ''"™"" '^''""« "»d tJ.e cure of "■" -r:;; ■; 't-i-H^ ?^ r'f ~ "• '■•■' - - -^ he other side. ill-advi«e I .lev^ ed 's „ 1 v « ' ""'"' T' '*'"'"' ' «"^' "'» danger. A vc^y simple rulA-reJir ^Lf^'T '"^j''" *" unnecesHary. iuteiiect .Id t. th. .iings of' •;^:;;:; i^r! '^t rS'i^'"^ ;:5^ 25 on a class of avocation to ic |jostilenc« of all HortH. i their self- eduloiis per- to take tlieir a, aclvertiae- fics for that conipoiuuls t' placard, in ue of fever, :onstii)ation, itances, real, ini in opeu- iictions and be guarded s tlierefroni Tnajjnitude. iH tho onlv thci-s. Tlie Helected in the malady the wiwest led, and to ordered by have been the cure of "man 8k ill peace and iir IcHs risk n the Hick nrget what f ; and, on nnecPHsarv >f a Houni^ « of guvu. Whoever is the sick, and wherever he lies the prey to the malady, whatever your station in life, yon owe to him help and comfort : if he is in need of medical assistance, seek ii ; if he requires anything in your power to give, give it to him ; if he has no attendance, attend to him or procure it for bini. But if the sick person happens to be well provided and atteniled to, then there is no occasion to go near him unless he is a bosom fiicn or a relative. This y)lace is just as };;ood as any other to insert a remark wliich is to be taken as one of paramount importance. The articles of clothing and bedding which have been soiled by the dejections of the nick are to i e irst disinfected, and chen washed carefully : if of small comparative value they had better be burned or buried. The dejections of the patients are to be received in pails containing soma disinfectants, and are not to be then thrown into sewers, privies or cess-pools, but are to be interred at some depth. The crowding of }>eople around a aick bed ia especi'illy bad in regard to Cholera, In duty and honor you aie bound to face every danger when called upon for a good purpose ; in duty you are bound to avoid the smallest risk when there is no useful object to be att«,ined. If we except unwholesome ci-owding, there is not, generally speaking, so great danger as jjeoplo may fancy in the attendance on the sick, and provided that the precautions indi- cated in this memorandum are observed, there ia hardly any more peril than in the mere walking the streets of a locality under ths .scourge. Most of the medical men, sisters of charity and attendants of hospiuxls in the country, have weathered several Epidemics without having been seriously ill, although living in close communication with the sick day and night for months ; their secn-'t has been to avoid fear, to be calm, cleanly and prudent. In time of Cholera Cemeteries must be the subjuct of very strict atten- tion and are not to be allowed as places of public i-esoit ; it is batter not to attend funerals in large numbers. Once on this subject it is well to guard r HHinHt precipitate as well an too long delayed burials. The medical membei-s of local Boards can frame instructions to persons connected with such a ser- vice ; the inHpiHitiou of a modifiil man ia sometinuw absolutely necessary. With proper precautions, there would be no danger in allowing families who have the means of going into tiie expenses necessitated to carry on such nre- tyuitions to hnvo the consolation of Imvinfj; their dead buried in the usual way adopted by thcni, and b« aliowiHl the usiial church service. § 4. PHOPllVLAC'TIC TIHULY TREATMENT. In time of Cholem epidemics the stomach and bowels are apt to be easily •leranged, and great care should be taken to remedy, at once, such deiaiige- ments, without fancying any danger when there is actually none. Sometimes (Cholera is ])reoeded by (J/iu/erin^ or prinnniifory n/mptumii, and sometimes it comes on withmit warning, even sometimes without many of its uioat Htriking eliuracteristic symptoms. la 9YGXJ VMS uf ^ iiiducn uiiiHout, wi^ppQVO^ w^icsi u mtusion of tea, chamoiaile, gmger, mint, coffee or similar substances 1. thi symptoms increiuse, or even at the onset of the complaint, there is a sensatioi of chill an 1 inclination to vomit, then the patient must be „ut in a warm bei between woollen blankets or sheets. The use of aromatic drinks are to be continued and frictions under the bed-clothes, not uncovering any part of th> body, and every other e.Ktornal means of warming the skin ai-o i be applied. It has been deemed wiser to abstain from offering any suggestion con cerning tr3atment by medicines or drugs, on account of the dangei accompany- ing the use ot such agents by othei- than medical practitioners Once on the subjecl of duties connected with attendance on the sick it IS proper lo remark that whilst it is at all times the duty of the physician and others to maintain a cheerful and encouraging demeanor'towards a patient yet It would be exceedingly culpable, especially with such a prompt malady as Cholera, to conceal Irom the patient his true condition Certain precutinary public meiu-ui-es of a prophylactic or preventive character, which may be adopted with immense advai;tage everywhere and wl-.ich are of absolute necessity in large towns and cities have to bo indicated m general terms. Amongst such me,isures the appointment of a medical health inspootor stands hrst. The duties of such officer would be to examine beforehand, an.l during the prevalence of epulemic, the streets, yards, edifices, dwellings, w,.11h and other water supply, fx, see whether such hygienic con.litions, which a.-o of a feasible nature under the circumstances have been adopted, and to renorl thereon to the local Board of Heilth and to the Municipal Corprration. This oftcer would also i.e entrust^.l with the duty of imparting genomlly to the people such infornmtion as is lik.,Iy to be of use in warning sonie against incurnm; unforoseen , an-ers, in alleviating the Uutoi-h canned by the appr«.- lu'iision of tvxaggerate.1 or totally imaginary perils, an.l in det«.cfi„g incipient sickness and enforcing tw-atment. Such service has been already establish(.d with good results in seve.al rhiroixmn otmntries under the title of preoe„tiv« The establishment of temiK)rary public dispensaries in diffe.-ent parts of large citi-s, nn.ler the inuuHdinto control of th.- local Board of Heulth is also a measure of th.- utmost importance, whereeve- vone eonld be furnished with Huoh reuieduM asare rec-omm..mled fur the t.vatment of ptvn.onitory syprntoms "Lr:!-!!.'l.rr'"'r;'''^"' '■' " 'r*'^^'"' ""e-nlant at a cheap price for all. and* g,_. „,^. .u;- ,uy j>yyi,_ ^^^^, g^,j.g ustttUlialauent could aisq by umtlo » «7 deposit ofdi8infoctar.tH,«ndofflannelBand other articles for the destitute to l,e deliveie.1 on the production of a ticket from the local autbonties at t)^o roat of the nnmicipalitv. In hirge comtmmitios it would be also advisable to have always in reqnisidon proper vehicles or t,mbulanceB for the removal oi the sick, such conveyances could be in connection with the service ot botb Cholera hospitals and dispensaries. S 6. CIRATIVE TREATMENT. The treatment of Cholera is one of thci most difficult of all tlierai^enUc ..ffoi-ts which can be required from even the most experienced medica nu i. To enunciate such a proposition is t<. say that none but u F'^f^^?;""^^^ I^^^^,\; titioner should undertake such a tusk. To meet the symptoms ot the malady as they appear in theii protean foru., in accordance with the g«'«fal 1^^« which goveVn the human body and the pre-acquired knowlec^e of the mar^y agents employed as medicines, is the problem, to solve which w not a little l»eri)lexinK for the most accomplished physician. ^ ' Thence the wisest counsel which can be given to the family, fnends or .haritable attendants of any person apparently laboring under an attack ol Choleia is ;— Send for the physician ! , . ^i. i i i But there are many i>eople in the new settlements and in the backwni.l l.arts of the country (and the case may also happen in older and nearer parishes and townships) who cannot obtain the advice or ministration of a physician and there are a great many mo.-e who by no i^oss.bility can procure such help in time, for these parties some advice may become «f/^«"'/" "f; if not in teaching what is to bo done at least m warning them of what ti.e.v oueht not to do. . , . ^ i. . * «f In the preceding section the prophyhvctic and primary treatment ot prev,,m{tory^ymptm>iBormviiAmtQhn\em h.i« been described, and such treat- Cent, in the total absence of a pl> vsi.-iau or while waiting his arrival can be undertaken by any intelligent person, and is to b» resorted to without ail . but now we have to deal with tho confirmed malady, when the symptoms have chanaed and when the dise.iHc is uuti.-rgoing a rivpid su<;cession of phases, nUling conse^iuently lor a : accession of modes of treatment dUlerentlrom quo """* Tn'the absence of a physician then, the four stages of Cholera may U treated in the following manner. At the period of htvanion and during the followinc period of collt ime the extt-rnal meaimres recommended for f»^em>m- torv xymptovi, are co be continued, that is t« m.y, keening the suk inare*-u.n- b..nt position in bed Inftween woollon sheet* or blanket>i dry an.l warm-- frictions under the be-lding to avoid the action ot cold .ur, the us« ot hot bricks, sinapisms, turiHJiitine stupes and other stin>ulat,ng agents not however carried to vesication or bliMfriiig the skin ; i" ttH« «:«rd, »ppl..u.ce!« t.* tU« ^\tr'W»> 'Jt' tl'e body to iesi,gie ihc aniinid he«V 28 At this stof'^ ordinary atimuknts may b« used internally to endeavor to revive the pulse and i)awer3 of tlie orsraiiization generally. The period of reaction when well characterized by subsidence of the wor.t symptoms and not acc-ompanu-d will, coni,'ostion ' reqnires no special treatment. * ^ In case of s^gn of congestion an.l non-reai)pearance or continuous scarcity ot .mne, the on y remedies which can l)e attempted without danger by a stranger to mecicine would be the warm foot bath, fiiction with nmstard o- other rubehcienc to the feet and calves of the legs, and diluent d.inks like Unseed ea not fc)o thick, poultices in the region of ti,e kidneys (or holK)wed l)art ot the back) in order to i-estore the urinary functions Congestion may be detected by non-medical attendants sometimes by noticing an extra turgescence and redness of the face, if the head iu threat- ened or by a sensation of fullness if another part is the seat of the rush of Oloocl, and increased anxiety in both cases. If the period of ienmn.tion is accompanied with no unfavorable symi,- toms and it the urinary functions are well established, tlie better plan is to let the patient a one as far as medication is concerned, and to begin feedin" him gradually-but if «ympt.,ms of a typhoid type superveae, which maybe noticed principally by tiie oppressed aspect of the patient, anxiety, unsteadi- ness, and a .somewhat stupid appearance of countenance, accompanied or fol- lowed by delirium, .some stimulants in small quantities are to be .riven to the patient, and beef tea administere.l to him, as exhaustion and want of action IS generally the cause of the complication at that j.eriod of Cholera Of coui-se such remarks are only intended for the gui.Iance of people in the absence of medical attendance. ' ^ To attempt more than such a simple treatment cinied out with caiv attention and perseverance wouhl be, to .say the least, risking a good deal ' A precept to be invariably followed is to leave the sick entirely to natures care, rather than to try drugs and remedies, the effects and results malll" ' '""" """* '""'''''''^■'■'' unknown aiul at unascertained j.eriods of the It has been thought a duty not to close these remarks without touohiii-' a point of great magnitu.le as well ..s of great delicacy, that is, in case of the actual d..ath of a i.ivgn..int w„man the Ca-saivan s.'ction ought to be porforme.I If allowed i>y t .e family ; although there is probably very little'chance of 8.iv.ng the child, tortile reason that no harm is .lone on one side, and that a great result may possibly be obtained on the other. A SERVICE TO RK RENDKIIKD TO 80CIETV. Medical science being founded in a gre.t measure on the study of facts grouped together, the i.iportance of collecting the facts co.uu^tywith th. lamentable i a country b ot the statif^ only be gal of collecting of some iiiti special Jioii If Can be taken t science. Statist I'oard. E' brcuglit to; asceitiiined localities, v generally ii large cities jit all accpii i'ive certaii places wlu- Jilaiik elergymiin, o;lier pers( The V the follow! ber of ca^ number of The (■ the patien the durati To t statistics ( A''ery way the c possible) < news bt^toi from othe disease, ai be, after local iuib of tlu' mc all other whole an It > baroinetr during a 29 mdeavof to ice of tlio no Hpecial )ns scarcity igcr by H nuHtiird o" links lilcd r liollowcd lotimes by I h tlireat- le nisli of bio synip- )lan is to in feeding ch may be , unsteadi- lied or fol- ^ given to 1 want of ' CJioIera. )p]e in the k'itli caro, tl deal, itircly to 111 I'tvsulfs ids of the ; toiicliing i»v of tlie orforinod, jhaiice of iiid that a r of fat'tH with tha lamentable ovonts of such a notice. ble character a« the passage of Cholom u a country become self evident. Unfo, tunately very little hasbeen reconliMl ot the statistics of former epidemics in Canada, and this v«;ry .ittle oven can onh be -athcie.l by tin,- very tedious, imperfect, and not very rolmble mo.le „f Jc^llecti^ig them from the s.vo.al uewspapersof the tune with the exception „f some intx.resting ofllcial reports and papers, which are, howc>ver, lunit<.d to (iiieeiid iioints. . i i i If Canada is again visit .1 bv the threatening scourge, precautums hIiouWI b„ taken that the experi..uce ac.'pnred (hiring its prevnlence be not loHt to ""'"statisti<.s ought to be collected by local Boards and directed to the tVntral lk)ard Even tlu. most limite.l fields of observation are very apt, when brcu.d.t touether, to throw light on a subject of such interest. It has b.M... asce.tained' in some Eu.opean countri.^s that the observations ma.le in Hiiudl l,K.alities, when collected by men of real tact, have a particular inlereHt, being ...neralh' more accurately ma.l.. The ollicers charged -^1' «'"•'' '^';' ,' Unre cities are over buidened ^vith work, and not being so well, ami olte i not at all acuainted with the persons and their circumstances cannot simietunes llivecertliin interesting ,.ar{iculars which are so easily ascerta.ued ... sm.dl iilaees where everythiiiL' is of p\iblic notoriety. ' Blanks of a unif.nn. plan M,ouhl be furnished, l^o be i.Ued by evei.y ..jerc^vman, medical ,.ractitioner, hospital oriicial, health olbce,, sexton .uid o:hc"r nersia.s cenuecte.l with the service of the sick and d.-ad. The vet.ni.s of sickness and death ought to contain, as much ixh possible the following information : the nun.ber of cases of real cholem ami the niun- ber of cases of othe.^ .liseases, the number of deaths from cholera a..d the nundier of deaths from otlKH' diseases. , . r , a *i ,. f The date of the attack, tl.e date of recovery or dat« of death, the ag. of the patient and sex, his profession or trade, his general habits, his nationality, the duration of the ailment. , .i n . r i To these statements might be added any renmrkn the collector of Huch statistics could furnish, which wouhl appear to him of any value. Verv interesting and veiy useful information could also be recorded ; tho wiv the cholera was introduced into the locality and the j.recise moment K p.;ssible) of its appea.ance and disappearance ; what was the .loniu.ant sick- Lcss belore the appearance of Chole.-a, and ^yhether sickness and n.o.- al ty from other causes have deceased er increased du.mg the prevalenci- of the disease, and whether they have kept away or nanrned back, as the e.ise nmy be after th. disappearance of the scou.ge. The .ipparent effect of cer .u.i local iniluences and of the hygienic conditions on the malady, the deHcn,.t.on of tl;. n.eaMUcs adopted for the proj.hylaxy or the mitigation of Cho eiu and all other information in regard to the sanitary comiitions of the locality as a whole and of the dwellings and premis.-s. It wcaild 1)6 very useful to collect thermometrical, and when ponKihlo, baronu^trical and hygrometrical observations made from .lay to day bofon^ during and after the epidemic. A description of the locality ; the quttlity Ottawa, B.;rbau of Aoac iLn'RK. March, iStUi, J. C. TACHE, Reporter. a i] W \..* ■•■f..^ ii V