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That permission was not only generously granted but a valuable appendix added, so as to make the work complete and fully adapted to the exi- gencies of the times. It is, therefore, confidently hoped that the publication of the pamphlet, in its present form, will prove a public benefit. Montreal, July 7tli, 1854. I i \ Ik €1 (i ( e "t "I "( tt tt It . "( "1 H PRACTICAL VIEWS ON CHOLERA, AND ON THE .ANITARY, PREVENTIVE AND CURATIVE MEASURES TO BE ADOPTED IN THE EVENT OF A VISITATION OF ' THE EPIDEMIC. " It is easier to preserve health than to cure disease." " The diseases which affect human health are often obscure, " many of them so subtle that thpy are discerned with diffi- " culty, and can only be appreciatedby those who devote their ** time to the study and observation oj them through all their " changes. " No City can deserve immunity from epidemic disease, " except by making absolute cleanliness the first law of its " existence ; such cleanliness as consists in the perfect adap- ** tation of drainage, water supply, and ventilation, to the pur- " poses they should respectively fulfil ; such cleanliness as " consists in carrying nway by these means, inoffensively, ♦* all refuse materials of life, — gaseous, solid, or fluid — from " the person, the house, the factory, or the thoroughfare, as " soon as possible alter their formation, and with as near an '* approach as their several natures allow, to one continuous " current of removal. " The Board would call earnest attention to the evidence " which has been adduced of the surprising and almost in- " credible success that in some instances has attended well *« directed attention, even under circumstances in which ** temporary measures only were available, and when an out- " break seemed inevitable. — {Report of General Board of HedUh, Whitehall, England, Xlth April, 1864.) 2 The rsMcntial and specific cause of Asiatic Cholera is manifestly a peculiar epidemic inHuenee, which has hitherto set at defiance the most elaborate investigations. It does not visit all places alike, however strong the apparant simi- larity. It will skip from place to place without leaving a single trace of its course between them. It especially selects and tarries on the borders of rivers, small and muddy strean^.s, and low and marshy localities, more particularly where there is much organic matter in a state of decomposi- tion. It revels most on cold and damp spots, and fixes its fangs in a lower story, whilst the upper ones are almost ex- empt from the visitation. Warm, dry, and elevated sites are seldom aflfficted. " It will be found as the rule, that t!.e ** disease affects most fatally the low-lying seaports and "deltas of rivers, sparing the high grounds, even round river "sources." It s«'ts quarantine enactments at utter defiance, — :t overleaps walls and laughs at cordons sanilaircs ; and when the poison is abroad it may declare itself when and where least expected ; but, as a general rule, it may be said thit it first invades the miserable, filthy, and cheerless h unts of the poor, vicious, and depraved. " There is a dose affinity ** between moral d pravity and phyncat degradation.^^ The I.VTB>IPERATE arc its especial victims, whether they reside in a palace or a hovel. (It is well it should be understood that in the visitation of 1349, and during the present year in England, cholera has been more frequent among the com- fortable and wealthy classes than formerly. Hen«e, let those of every station take heed in time.) Those whose vital energies are reduced by excesses, want, privation, and anxiety of mind, or whose constitutions are originally weak, are among the first to fall before the scourge. Old age, pernicious in I nigences, deficient alimentation, — pirticularly a vegetable diet, — foul and confined air, crowd- ing in low, cold, and mi y places; gri'f, anxiety, and fear, and whatever else tends to debilitate the body and depress the niiiid, are sure to predispose most powerf ally to an attack i( ti (t of this ruthless visitor; which, as a general rule, respects cleanliness, sobriety, and decent habits. Itseidom in r.i'les where industry and good morals prevail. Hence, in rrgiird even to this dreadful pestilence, man is, in no »muli degree, the arbiter of his own fate. 7^5 contaqiousness has been alternately asser'ed and denied. The majority of the profession do not acknowledge this modeof transmission of the disease. At all events, even admittmg that it is contagious, experience proves that this properly exists only in a very small degree. With the most ordinary precaution, little danger is to be apprehended, and this fact should be known to all, as thousands have peri.-«hed from the want of a little kind and christian attention, result- ing from the fear of infection. " Medical practitioners have " n >t, in any ascertained case, conveyed the infecticn in " their clothes to patients whom they were attending (cr " other diseases, or to iheir families ; neither have nurses or ** other casual attendants on the sick, suffered, although le- (t No " longing to a class more obnoxious to the disease." " evidence, thus far, has appeared, that the disea^e at pie- " sent prevailing in our City, has in a single ratse hern pro- '* dnced by contagion." — {Rf.port of Board of Healthy Niw Fork, 1849 ) But it IS right to observe, that the clothes of such as die of Cholera, as, likewise, the bedding of the sick and dead, if left for a short time huddled up in a heap, become eminently infectious, {fomities.) The ejections and emanation? thus confined, ferment, fester, and become very poisonou: . The mcmient a person dies, the clothes should be hurried oui tofiir and dry ; the bedding should also be thoroughly exposed, and the hair and feathers be well healed in an oven. IJnt should the bed be much soiled it would be well to destroy it alto> gether. The whole of the clo'hing should be handled with a stick, and after hinging a few days in the open air should be steeped for some time in hotwater^ and frequently stirred vigorously with a slick. Lime or ashes should be added to the water, and when the clothes are well washed and rinsed, they should again be hung out in the air for several days, or for weeks in a garret, before they are brought into use. The sanitary precautions are not many, nor always diffi- cult of observance, but they are imperative, and commonly very effectual, and to be relied upon with confidence. On the irruption of the epidemic, or, far belter, when it is apprehended, low, wet, and badly ventilated places should at once be abandoned ; old, filthy, and decaying buildings, as well as underground, cellar, and dark tenements should immediately be evacuated. Legal enactments should en- force this observance. The walls and floors of the dwellings of the poor should be well scraped, and washed with lye or lime-water, at least once in the season ; then well dry-scrubbed every day, as moisture rends to attract and absorb, and subsequenly give out bad odours. The walls should be completely brushed down and then white'Washed, particularly in the cellars. The cellar windows should be kept constantly open. Nor should the dwellings of the rich be exempt from a thorough cleansing when epidemic cholera, especially, prevails. The cellars, even in their dwellings, should be well cleaned and then sprinkled with a little lime ; but if damp and wet, a few inches of the surface should be removed, some lime applied, and two or three inches of coarse clean sand spread over this. Or, what is quite as good, blacksmith's cinders and ashes, or the rubbish and mortar of old walls, should be thrown over the whole bottom to a thickness of four or five inches, especially if the ground is wet and oozy. Sinks and Cess-pools should be at once emptied com- pletely, and lime abundantly strewn about. Privies should also be thoroughly discharged and limed, whilst every nook and corner about all premises should be brushed down and white-washed ; yet, when the cholera suddenly invades a locality, it would be far better not to disturb privies, &c. &c.» but to use lime abundantly, and, what is equally good, lo cast into cess-pools and drains, some of the black ammoniacal li- quor which is antiseptic a; i destroys animal mj^tter, and is thus a valuable disinfectant, that abounds in gas factories. The lime that has served for the purifying of the .jas is also very useful in destroying noxious odours. All holes, cavities, and wet places about dwellings should be first cleaned, and then filled with old mortar, ctrthe ashes, coals, and lime from the gas factories, which seem to be even better deodorisers than fresh lime. All these substances are excellent disinfectants, and, instead of being converted info nuisances in the streets, should be applied in the manner in- dicated, by which they would become useful and be sought after. Epidemics are sure to alight where terrestrial ema- nations of a mephitic nature exist. In cities it has almost always been the lowest, dampest, " most crowded and most filthy sections that have suifered most." Where there is not a free circulation of air, and where the cheering rays of the sun seldom penetrate, the lo- calities are always moist, raw, and chilly, and there is con- stantly a very perceptible, repulsive, and musty odour, and the inhabitants are pale, wan, and debilitated. The utmost care should be observed to obtain perfect ven- tilation. Whilst impure and confined air in cro^vded apart- ments is always deleterious, it is eminently so in times of cholera and during the prevalence of all epidenriics. The breathing of foul air predisposes to every disease, enervates the body, and destroys all moral and physical energy. The fire-places should be kept open, and ventih itors placed in a couple of windows. All the stovepipe stoppers should be removed, and every room have, if possible, an opening into the chimney, near the ceiling, for the escape of the heated and deteriorated air. When the weather is rainy, damp, and raw, a fire should be kindled, for the double purpose of imparting warmth, and causing a draught in the house. Every tenement should be supplied with abundance of 6 good water. That from the wells in ordinary yards is al- ways more or less impure, and is frequently most injurious, being saturated with all the filth that soaks through the earth from the privies, as well as with other putrid matters that are so often cast about the premises, especially of the poor. " Every spring of water represents the drainage of a certain " surface or thickness of soil, and such as are the qualities of " this gathering ground, such must be the qualities of the " water," " The impurity in ihe water with which the in* " habitants of London, in the several districts are supplied, " is in nearly a direct proportion to the mortality from cho- " lera " ** The mortality is least w here the water is known " to be most pure," and this is equally applicable to the pu- rity of the atmosphere of every place. Sanitary inspection^ and the steps taken thereon, in so far as regards nuisances and unhealthy situations, are of para- mount necessity, and it is an imperative duty to see them duly carried out, as, if properly performed, they will tend greatly to prevent an irruption of cholera. These are the most efficient means for neutralizing and destroying th( force of epidemic diseases, and thus tend generally, if not to the prevention of epidemics, especially of fevers, at least power- fully to diminish their virulence, for the pa6M/«m of all infec- tious complaints is found to exist in the mephit c air of low, moist, and dark retreats, where there are crowding, bad ven- tilation, and the invariable accompaniments of filth, vice, and poverty. Add to these, impure water, and there is all thit is requisite to breed sickness, and to invite and assist cholera in its course. " The exciting causes of such diseases " are in great measure under our control, and by properly ** guarding against these, much, very much, may be done in "obviating the developement and extension of the disease." Hence, the absolute necessity for a systematic sanitary visi- tation of the dwellings of the poor, and the courts and alleys which they inliabit, such fis of late obtains in certain cities in England, and which can be cfTectually carried out only by (t (( it (i i( ti i( t( (i the appointment of " Inspectors of Nuisances*^ — able and intelligent men. Doubts may very legitimately exist, however, as to ihe pro* priety of a medical organization for systematic " house to h;)ijse" visitation to ascertain whether cholera is present. This necessirily entails much outlay, whilst it is well known that the intrusion, daily, of a dtictor into every house, inquir- ing in doleful tones if any one has diarrhoB'j, or cholera, or feels unwell in any way, at once engenders fear and appre- hension ; depression of spirits follows, and the panic becomes general, than which there is no more immediately predispos- ing cause of cholera. This, added to the unhealthiness of the locaiity,consthutes the whole intoa magazine which one spark of the poison ignites, and then the disease is estib- lished In the neighborhood. *' Nothing predisposes an indi- " vidual more to ihe influence of cholera, or tJ-nds more to " increase the malignancy of an attack than fear. It Is *' therefiire of the greater*! importance thai the public mind " should be relieved from all unnecessary apprenension with " regard to the true nature of this disease." " The moment ** you make your inquiries you sound the alarm." Youdis- " lurb "that calm and composed slate of mind which does " more than is generally supposed in the preventing the on- ".«et of the disease." All epidemics are aggravated more ** or less by mental disturbance, whether in the shape of an *' active panic or low despondency." '' Moral influences exercise no little control over the cholera." Another reason why these day visits seem a work of supererogation, to say the least, is that cholera makes its attack mo^t ofien after night-fall. " In the mnjority of cases the attack was noticed to lake place between midnight and 4, a. m." And it fre- quently happens that the premonitory symptoms are so slight as not to attract attention, and thus in a moment, and unex- pectedly, the disease bursts forth, and speedily destroys its victim. Whilst diarrhoea generally precedes the more de- cided symptoms, still it can scarcely be said to be an *' c^- 8 sential s) mptom of cholera." Let not the inmates of eveiy househoM have their peace of mind disturbed by such an un- wise and r3ally uncalled for intrusion. These visits, besides, add enorrtously to the expense attending this dreadful in- vasion. A far more eftlcient substitute, and which is free from the objections that attach to the " house to house visitation," would be to draw up a code of directions in clear and con- cise language, indicating what are the first means to be re- sorted to for preventing the localization, and also what may conduce to an attack of cholera. With these views the fol- lowing remarks, and suggestions have been prepared, not based upon any visionary hypothesis, but upon extensive ex- perience of the disease since its lirst invasion in 1832, as well as upon the knowledge derived from the best writers on the subject, and the recommendations, if duly appreciated and acted upon, may be attended with incalculable advan- tages, sucii as neither money nor medicine can procure. A carefu- Sanitary Inspection of all premises should take precedence of any other precautionary measure, and if tho- roughly put into effect it will, in the majority of instances, secure immunity from attack. The emanations from privies are always offensive and in- jurious to h jalth, particularly in close, pent-up yards. Even the best constructed water-closets are not at all free from ob- jection. The next point in importance is the employment of Disin- fectants, and there is a variety of them that may be used to correct foul smells ; yet it must not be forgotten that they do not entirely destroy the poisonous effects of the effluvia. The soot (which is an excellent deodoriser,) of every house should be collected, to be strewn occasionally into privies, especially before emptying them. Lime and lime water should be used for the same purpose. A handful of the Chloride of Lime in one gallon of water, or four ounces of Green V triol, (Sulphate of Iron) or a couple of ounces of Oil of Vitriol, (Sulplmric Acid) or a quarter of a pound of Alum in a buckei-full of water should be sprinkled in the privy before removing its contents ; and when emptied, half a bushel of Lime should be spread upon the bottom. A no- ther cheap and excellent disinfectant is the Nitrate of Lead, which forms the basis of Ledoyen's purifying fluid. One ounce of Sugar (Acetate) of Lead dissolved in a pail-full uf water, to which are added twoonncesof Nitric Acid, (Aqua Fortis) will make the preparation fit for use. That these substances, are, by their cheapness, accessible to the public, is shown by the following table : — Green Vitriol, (Sulphate of Iron) • 7«. 6rf. percwt. Alum, 22 6 »* Chloride of Lime, No. 1, • * 30 «* ♦* « No. 2, * * 42 " Sugar (Acetate) of Lead, • - 10 per lb. Nitric Acid, 10 *» These agents are so cheap, easily applied, and effectual, that it would be criminal not to resort to them to correct foul odours, and to prevent their for.nation. The Chloride of Zinc is likewise an efficient corrector of foul exhalations, but it is dearer than the others, and it is the same with the Nitrate of Zinc, — Sir Wm. Burnett's disinfecting fluid, yet it is so very manngeable and eflicien*, that every house should be supplied with a little of this fluid, to which there is always attached, clear and copious directions for its use. Every one should know that deodorizing agents ere not always disinfectants, and that some of the most deadly ex- halations, such as Carbonic Acid, Azote, and some other gases, as well as the mephitic vapoursof cemeteries and cer- tain malarious localities, are destitute of odour. It is likc> wise well to be informed, that shavings, sa'w-dust, corn- husks, straw, &c. $:c., which oftnn constitute the bedding* f the destitute, and a .*f generally moist and damp, corrupt the air by robbing it of its vital i)riiiciple, oxygen, and cxlui- 10 log carbonic %cid. It is likewise proper fo state, that a candle may burn where the air is so deleterious as to cauaie instant death when breathed. The following observations, as regarding individuals, should be respected as preempts that have received the entire sanction of time, and the autnority of every experienced and welMnformed medical man ; indeed, they should be looked upon as axioms not to be de\iated from with impunity, dur- ing the existence of cholera in particular. Old habits, even vicious ones, of a dietary nature are not to be suddenly and totally corrected. The inebriate and guzzler should diminish the number and amount of his liba- tions, and substitute in a great measure, Tea and CofTee, which should constitute the morning and evening meal, with toast and butter, to which might be added a small quantity of meat as '• a relish." Even during the day Tea and Coffee should be taken as the common beverage. Either will re- move that constant **■ gnawing" at the vitals with which the old tippler is more or less tormented, as one of the efTects of his pernicious indulgences. His " craving for drink" will be cured if he take a bowl of good spiced beef tea. These different articles stimulate kindly, and do not exhaust, but are, indeed, restorative, tonic, and exhilarating. Moderation in eating is as necessary as in the use of drinks. Little alteration should be made in the dress, even in wanh weather ; and on no account should flanntls be discontinued^ Woollen or silk hose should be worn by all. The food should be plain, well cooked, and agreeably sea- soned. Roast meats, rather underdone, to be preferred, with little gravy. Pork, very fat meat, and old mutton, should be abstained from. Boiled meat and soup, with few vegetables, and well^ baked stale bread, make wholesome food. ** Salted meat," bacon, and other cured meats, as also saur sages, eBpecially if long laade, aie all to be shunaed ; thongh s r 11 I i; salt, as a condiment, is an indispensable addition to fresh meats, vegetables, &c. All kinds of fish should be partaken of with extreme cau^ tion ; even the most fresh and best looking are to be used with much circumspection. Leguminous and succulent vegetables should be sparingly indulged in, — such as green peas and beans, in the pod or other-wise. The same may be said of green com, boiled or roasted. Good mealy potatoes roasted, are not objectionable, but boiled waxy ones should be ** mashed," well seasoned, and moderately partaken of. Butter, whilst eminently nutritious, is, with many persons, very indigestible. Butter sauce should not be taken m quan- tity. Milk, raw, or better when boiled, with dry toast, makes a safe and good meal. Hot bread should be avoided, as well as bran bread used only by those who are habitually costive, and that wisely in other times than those of a cholera epidemic. Rice is very nourishing, slightly binding, and agrees with every constitution. Boiled in milk it would be excellent when cholera threatened or prevailed. Oat-meal and barley, as weU as Corn-meal, are better dis- pensed with in such times, and should not constitute the food of persons ; mixed with molasses they are much more pre- judicial, as causing a tendency to dianrhcea, and readily be- coming acid in the stomach. Buck-wheat and rye-cakes should not be indulged in. Str- gar and butter do not add to their being digestiid. " Pastry is an abomination," (Dr. Paris) especially if under-done and saturated with butter. Desserts should be avoided, par* ticularly such as are composed of mixed articles. Ripe juioy fruits need not be dtS|>ensed with, the skins and seeds however should be rejected, but green and unripe fniit must not be partaken of. Nto fcxKl should be taken on going to bed. 13 If any liquid as oTdinary beverage, between meals, is to be indulged in — which, however, is not advisable, unless it be Tea or Coffee, which experience has proved to be very useful — the best are port wine and water, brandy, or spirits, in water. Poor sour wines, cider, stale beer, and all drinks readily aniditied should be eschewed. Let the miserable inebriate be cautious not to invoke these recommendations as a justification for his constant potation.s. Kemedial Measurks.— ( liolera is a n:o3t insidious dis- ease, requiring untiring vigilance. If mvM at once it is read- ily subdued, but give it any quarter and :t becomes almost iavmcible. It c.ui be erred with certa'n and positive suecess, if the well proved means are at once resorted io. and for this end Xlv.t remedies required should )e in every i imily, or at least, itDSt easy of access. They are few, c!ii y p, and easily pro- cured ; consisting mainly of cordial ati.nufjanta. Perhaps the safest are compound Tincture of Laveider, or Camphor- ated Tincture of Opium, (Paregoric) or t'lr Compound Tinc- ture of RhubHrb, or any of the Aroma i« Tinctures ; but warming spiced drinks will be very usef r. When there is a sensation of chilliness, coldness of the lands and feet, or *' sinking at the s'omach,'* rumbling of wind, or a disposi- tion to looseness of the bowe's, half a tea-spoonful of the Tinct. of Lavender, or Paregoric, orTinct. of Hhubarb, taken with a little sugar or sweetened water, or a cup of spiced tea, (cinnamon, nutmeg or ginger, &c. &c.) hot and sweetened, will quell these premonitory symptoms. This process might be repeated every ten, fifteen or twenty minutes, if the un- pleasant feelings do not subside. At the same time the per- son should go to bed, and get into a gentle perspiration the soDuest possible, for to sit up or go about is sure to increase the disposition todiarrhcea, which, of all the distress, must be first and at once arrested. Should the tendency to it be su'lJen, in addition to the articles menti<)ned above, 10, 15, 2d or 30 drops of Laudanum should be taken, whilst the Pby- it (( 13 sician is sent for, as there is not a moment to be lost, should the sufferer not feel bette Every family should be provided with a two ounce phial, at least, of the Tincture of Lavender, or of PareijOiic, or of the Compound Tincture of Rhubarb, or of any Aromatic Tincture, as also with one of Laudanum, each being properly labelled, and the word poison in large letters afFxed to the Laudanum phial to distinguish it. At the very outset of the disease, these measures alone frequently arrest it, hut should much uneasiness continue, application should be mi.de to the nearest Physician. Every intelligent person being possessed of these articles, the poor should be supplied with th^m at the expense of the (Mty. Travellers should have some of these phials by them, in order to be prepared against at majority of instances, at once arrest it in its course. Tie pernicious habit which certain persons have, of taking Seid'iiz ind other laxative powders, Epsom Salts, Moriison^s Pills, and sitnilar Patent Medicines, is to be denounced in the str.>ng«!8t terms. Such practices have sent thousands to a prerraliio grave. Even moderate costiveness should be borne with or relieved by injections rather than run the risk of settiii,? the whole bt)dy in commotion, which may prove of a mos'. dangerous nature, and exceedingly difficult to compose. Large draughts of cold, iced, soda or mineral water, id^iouUI not be indulged in when thirst prevails, and cold drinkn should rather be sipped and taken gradually, for, swaKcxired with j 14 avidity, colic, and derangement of thr digestive otgans, often ensue ; Ginger Beer, or Nectar is preferable during times of sickness, to any of the ordinary cooling drinks. Melons and Cucumbers are also much used in hot weather as refriger* ants, than which nothing is more pernicious. Many lives are lost annually by the use of unripe Melons. Eveti the most mellow should be taken with great c&ution, but cucum'> bers should be tolerated by none. In one word, ev3rything that is taken, whether for food or luxury should be used with much circumspection and moderation. Although We may be so fortunate as to escape from cholera this year, yet the above remarks will 6e found useful in pre- serving health generally, and will always be found to apply to the invasion of all epidemics. The tWo following brief extracts from the report of the Registrar General of England, should serve as beacons to Communities, to Governments, and to individuals. " In all epidemic diseases the mortality is invariably com- " mensurate unto ihe filth and destitution of the inhabitants " and the impurities of their abodes." " Internal sanitary arrangements, and not quarantine and " sanitary lines, are the safe-guards of nations against the " epidemic diseases." WOLFRED NELSON, M. D., Mayor, Board of Health, City Hall, Montreal, 16th May, 1854. ( 1 i \ APPENDIX. \ K Since the foregoing was written, the cholera has been in* troduced into the city by the emigrants who arrived in a ship from Liverpool. Several were talien to the Montreal General Hospital, where they received the best and kindest medical treatment, notwithstanding which the major part died. A few days subsequently a case of cholera occurred in a l.idy, and was speedily followed by two more. These were not very severe, and being attended to, on the invasion of the first symptoms, recovered. The disease then presented itself in the lower part of the city, where, in one family, four, and in the immediate vicinity three, deaths occurred. Three re- coveries onlv were effected among the number taken ill, ap- plication for advice having been too long delayed. The most searching investigation was instituted to ascertain whether there had been, either directly or indirectly, any communi- cation with emigrants, or with any person who had visited the ship in port, or even been on the wharves, but not the slightest intercourse could be traced. Many other cases came under my notice, and in no instance could any com- munication with those primarily affected be detected. Hence, I was forced, irresistibly, to arrive at the conclusion that the disease was atmospherical, and in thiswise accom- panied the unfortunate emigrants ; and that it had not been conveyed to other individuals by contact, or the most distant intercourse. It is true, however, that two nurses of the Hos- pital manifested choleraic symptoms, which were soon ar- rested, but it was also stated that these persons offered a great predisposition to the epidemic by being greatly alarmed on seeing some of the patients in the last struggles of life, — blue, cold and ghastly, — presenting, indeed, an aspect well dftlculated to excite apprehension and unnerve the tiniid. 16 The inteiisiry of the poison, and peculiarity, or, rather, ex- treme »u.<(;e|)tibilily of constitution giving a predisposition to be influence i by the disease to a much greater extent in some persons iUa.i in others- ** It appears in certain localities, af* " fecting numerous detached individuals almost simulta* " neousty, -.viiijst not only neighboring localities, but atten* " dauts on iick remain unaffected." " In Scotland, those who had close intercourse with the *^ sick wore not affected with the disease in a larger propor* ** tion than tliose who avoided such intercourse." " We han; ourselves seen many instances of the immunity ** of the i.Tirnpdiate attendants on the sick, and nearly simul* " taneou.'i aH'ection of many within a limited distance, who ** had no di.-fct communication with one another." " Cholera has a mode of epidemic extension independent " of actual iiitercourse." " The spread of cholera by conta- " gion is tht; rare exception, and its spread from other causes " the common rule." Yet, let it be remembered that " ca- ** daver'c po.son is evolved during a certain stage of decom* " po.«'itioii " *^ In ciuimon with other epidemics, cholera is liable to the ** most stfiki ig variations in the intensity of its attack, and, " therefore, in its influence on the human body in difTeient ** visitations." **• Avoid >.nintact with such as are affected with the plague, " fever, &•:., and you will escape ; not so with cholera, *^ which e\hnds without actual contact or communication." " The t>iy:ih of cholera may be raised into activity by cer» **■ tain tnetturological changes brought about by thunder* " storms, ;;»\'.vy rains, by crowding in ill-ventilated apart* **" ments, and by the efBuvia of foul drains, filthy premises, " &c." " The p'Aiod of incubation may last from two to twenty* " seven days." The abovn extracts have been taken from some very re* ecnl pub. icacions by en.ijent men, but mainly from the coo* 17 tribntions of two highly distinguished practitioners in Edin- burgh, — Drs. Alison and Reed. The foregoing conclusions arrived at by eminent men have been transcribed for the purpose of convincing the public how erroneous it is to look upon these dire visitations as a proof of the contagiousness of the disease ; an unhappy im* pression which has led the most affectionate relatives to abandon those dearest to them, to their cruel and certain fate. Every day adds to my conviction of the correctness of the advice given in the foregoing pages, and I am more than ever positive that the drunkard is the especial subject of at- tack. All excesses J of whatever description, are to be avoided . Late hours and wet weather, stagnant pools and damp locali- ties, are to be carefully shunned. Adverse as I am to the abuse of alcohol in any shape, I am not blind to the well-established fact, that, as a remedy it is sometimes most valuable. It is from this knowledge that I would recommend every family to be provided, in these times, with a bottle of good Brandy, and one also of the strongest (Singer Syrup, (to be had at Apothecaries of well established reputation.) When, during the epidemic^ any one experiences a rumbling in the bowels, or a sensa- lion as of the transfusion of liquid from one part of the belly to another, or if there be a tendency to evacuate, or sickness at the stomach, let a table-spoonful of Brandy with as much Syrup of Ginger be taken immediately, and these unpleasant sensations will be promptly removed, which are the common precursors of an attack. Should these symptoms occur at night, (which most often happens,) the patient should get oiU: of bed and have recourse to a dose from his bottles, after which, returning to bed and covering himself warmly, in the majority of cases, all will soon be well. On the contrary, should the symptoms return, or not yield, the dose should be repeated, and then, with all despatch, a Physician sent for. This in addition^ dr substitute for the Aromatic Tinctures, al- ready mentioned. I may here mention that Ginger Syrup, 18 agreeably diluted in water, forms a most safe and pleasant beverage on all these occasions, and may, indeed, form the ordinary drink in hot weather. I deem it incambcnt to state, that I have found the diluted Sulphuric Acid an excellent auxiliary in the treatment of cholera. From two drachms, (^ of an ounce,) to ^ an ounce of the dUuted Sulphuric Acid, with two ounces of the Syrup of Ginger to a pint of water, make a very palatable drink, and assuages thirst, being at the same time tonic and as- tringent. Indeed I have lately used this as the principal be- verage for my cholera patients. When collapse supervenes, I add Brandy to the mixture. When, in the state of exhaus- tion, much liquid cannot be taken. Brandy should form a third, or even half, of the patient'9 drink, which must inva- riably be used in amall quantities at a time. Having for many years found the following preparation of Morphine and Calomel the best, most agreeable to the taste, easily administered, and very efficacious, I have much plea- sure in presenting it to the profession, and would advise its being kept as an officinal preparation :— R. Morphic, • - - 3i. Cochineal. • • - xx oks. Calomel, - • ♦ 3 iv " Hard White Sugar, • • IviasXiOBS. The whole making twelve drachms. Twelve grains of the powder contain one of Morphine and four of Calomel ; six grains hold i gr. of Morphine and two of Calomel ; three grs., I of Morphine and one of Calomel. With this preparation, no great danger of a mistake of too large a dose of this powerful agent can exist. The powder mixes well in a very small quantity of water without stining ; it is pleasant ta the sight, and not disagreeable to take. The ingredients should be most intimately blended by considerable trituration. It will be found very convenient and manageable, but none but professional men should pre- sume to administer so potent an agent; 10 I hope that my professional brethren will take these hints in good part, emanating as they do, from the most disinter- ested motives. However presumptuous it may appear, I he- sitate not in the firm conviction of the practicsd utility of the remarks I have thought it my duty to make, as a public man, to terminate these hasty observations with the following lines, from a celebrated French writer :^>" Qmnd on a^occupe de ** riformea de bienpubliCj on pent aiaiment ae riaigner d dea **iraiuinix aana Hcompenae, maia non d dea efforta auM riauUata Cnanslation) When we are occupied in reforms for the pub- lic good, we can easily resign ourselves to labor without pe- cimiary compensation, but not to fruitless and useless efforts. WOLFRED NELSON, M. D., Montreal, 7th July, 1864, ^^^^' ^ ■"«*: ^ € ll 1 V I 11 ,' "•'fc^ r-V y ,^' r B. DAWSON, ^oobseiltr, ^tstioncr, anb ^uiobinil ^gtnt, HAS much pleasure in announcing his intention to remove about the close of this month from No. 2 Place D'Armes, to the Old Post Office, No. 15 Great St James Street. These spacious premises are now being fitted up in a suitable manner, and will afford greatly enlarged ac* commodation for additional stock. His chief study will be to obtain the earliest possible supply of everythins new and interesting, and to keep up his usually arge stock of Standard Authors in the various depuartmente ot Literature, Metlical Works, School Books, British and American Ma- fazines and Newsfwpers, Maps, Guide Books, Blank Books, Engravings, In^tineers' and Artists' materials, and a large assortment of Mercantile and General Stationery. B. D. hopes, by strict attention and moderate charge, to secure a con- tinuance of the patronage with which he has been heretofore favored. Montreal, July 7th, 1864. '^.^ *.. .JPL..'!