/ CIECULAE IST o . 5 . WAX DEPAKTMENT, ,A^. SURGEON GENERAL'S OFFICE, WASHINGTON, MAY 4, 1867. REPORT ON EPIDEMIC CHOLERA IN THE AEMI OF THE UNITED STATES, « DURING THE YEAR 1866. * ¦¦ i i»i i m — WASHINGTON: GOVERNMENT PRINTING OFFICE. \Bci CIRCULAR No. 5. WAR DEPARTMENT, Surgeon General's Offick, Washington, D. (7., May 4, 1867. re following report on the epidemic of cholera, as it occurred in the army r, is published for the information and guidance of medical officers. JOSEPH K. BARNES, Surgeon General. ON EPIDEMIC CHOLERA IN THE AKMY OF THE UNITED STATES, DURING THE YEAR 1866. By Brevet Lieut. Col. J. J. Woodwtird, Assistant Surgeon I . S. A. Surgeon General's Office, May 1, 1867. General : In accordance with your instructions, I have the honor to submit the following brief statement of the prevalence of cholera in the United States Army during the last six months of the year 1866. In preparing this statement, the official reports have been- carefully examined and compared, and the greatest pains have been taken to secure accuracy. Appended are statistical tables exhibiting the monthly number of cases and deaths of cholera, and of the allied bowel affections for each post where the disease prevailed, and such extracts from the official reports on the subject as have been thought to possess professional interest, whether as vouchers for the statements here made or otherwise. Although the total number of cases is not very great, yet they bear so large a proportion to the number of troops exposed to the disease, and the circumstances attending the transmission of the epidemic from post to post are, in most instances, so well known, and of such significance in connection with the question of quarantine, that the history here presented appears well worthy of the attention of all interested in problems of public hygiene. The first reported case of cholera in the army during 1866 occurred at Fort Columbus, Governor's island, New York Harbor, on the evening of July 3rd. The patient was a recruit from the recruiting rendezvous at Minneapolis, Minnesota, of whose previous history and exposure nothing is known. He had 6 REPORT ON EPIDEMIC CHOLERA. been but three days at the post. About an hour after his admission into hospital another case occurred, also a recruit of unknown previous history. Cholera was at this time prevailing in New York city.* Recruits from Governor's island carried cholera to Hart's island, where the first case occurred on the Bth of July. The epidemic becoming severe among the troops at this post they were moved on the 20th to David's island, where the disease subsequently prevailed to a limited extent among the troops thus transferred. These cases are reported from the De Camp Hospital, David's island, where they were sent for treatment. A single case also occurred at Fort Schuyler, New York Harbor. The patient was a lieutenant of the first United States artillery who had slept on board the steamboat used the day before in transporting the infected troops from Hart's island to David's island. No cases occurred in the garrisons of Forts Hamilton, Lafayette, and Wadsworth, the fort at Sandy Hook, Madison barracks, or Willett's Point, New York Harbor. Moreover, there were none among the officers and men on detached duty in New York City, Jersey City, and Williamsburg. The total number of cases reported among the troops in New York Harbor was 181, w 7 ith 78 deaths. On the 19th of July a soldier died of cholera at the "Soldier's Rest," Boston, Massachusetts. This man arrived in Boston on the morning of the 19th from Hart's island, where he had been on duty as a wardmaster in the cholera hospital. No further military cases occurred in Boston. On the 14th of July the steamship San Salvador left New York with 70 or 80 cabin passengers, and 60 in the crew and steerage. She touched at Governor's island and took on board 476 recruits for the seventh United States infantry. The men were lodged between decks, and were greatly overcrowded. On the second day out cholera appeared among the recruits, and when the vessel arrived at quarantine, near Savannah, Georgia, three deaths had occurred, and there were 25 ill of the disease. The troops w T ere landed on Tybee island and a hospital extemporized. Cholera continued to prevail on the island during July and the first few days of August. Altogether there were 202 cases and 116 deaths, including 18 deserters, reported as having died in the woods of Tybee Island, and one who escaped from the island and died in the Whitemarsh quarantine hospital. The cabin passengers and crew of the San Salvador appear to have escaped, but of the ten white citizens residing on Tybee Island, nine were seized with cholera shortly after the arrival of the infected ship and five died. The tenth fled from the island, and is reported to have died of cholera somewhere in the interior of Georgia. No cases of cholera occurred among the troops stationed in Savannah. Recruits from New York Harbor arrived at New Orleans on the Bth and * See annual report of the Metropolitan Board of Health, 18G6. REPORT ON EPIDEMIC CHOLERA. 7 16th of July, others from Carlisle Barracks, by way of New York Harbor, on the 23d. One of these detachments on the steamship Herman Livingston brought recruits from Hart's island, which she left on the 7th. On the Bth a case of cholera occurred which proved fatal next day. A week subsequently another fatal case occurred. The vessel arrived off quarantine in the Mississippi river on the 15th and put off two recuits said to have diarrhoea. On the 16th the command disembarked at Jackson Barracks, six miles below New Orleans, where two recruits were sent to hospital with choleraic diarrhoea. The command remained three days in New Orleans, and on the 19th of July embarked on the steamship Texas for Galveston. The first case reported among the troops at New Orleans was on the 22nd of July in company Gr, sixth United States cavalry, stationed at Holmes's Foundry. The patient was a recruit recently enlisted in New Orleans. It is not known whether he had been in communication with tfre New York recruits. On the 25th of July, a case occurred at Jackson Barracks, six miles below New Orleans. The patient was one of the recruits recently arrived from New York Harbor on the Herman Livingston. A number of cases subsequently occurred among the troops at this post, and in company Gr of the sixth United States cavalry. On the 25th of July, also, a soldier of the eighty-first United States colored infantry at the Louisiana cotton press in the first district of New Orleans was seized with symptoms of cholera and sent to hospital; he died on the 26th. On the 27th another man of the same regiment, who had been on guard duty at Ball's Head stables, near the levee in the fourth district, was brought into camp with cholera and died the same day. The disease spread rapidly through the regiment. Cholera already existed among the citizens of New Orleans, and a number of the early victims among the troops were out of camp when attacked, many of them being brought in a state of collapse from hovels in the city. The health ordinance in New Orleans did not become a law until after cholera had manifested itself, and it is difficult, therefore, to tell when the first cases among: the citizens occurred. In the seventh, ninth, thirty-ninth and one hundred and sixteenth colored regiments, the disease had appeared while on duty in Texas; the large majority of the cases reported in New Orleans, however, occurred in company G, sixth United States cavalry, and in the eighty-first United States colored infantry. Altogether 93 cases and 24 deaths were reported among the white troops at New Orleans, and 254 cases and 149 deaths among the colored troops. The disease was carried to the colored troops at Forts St. Philip and Jackson, below New Orleans on the Mississippi river, by detachments returning to those 8 REPORT ON EPIDEMIC CHOLERA. posts after having been on duty in New Orleans during the riot. The first case appeared on the 10th of August, and during the rest of the month and September there were 17 cases and 11 deaths. At Ship island, Mississippi, the first case occurred September Bth. There was one fatal case among the colored troops at the post during September, and others among the hired men, convicts, &c. I On the 17th of August the first case was reported at Baton Rouge, ouisiana, in the sixty-fifth United States colored troops. During August, September, and October, there were 69 cases and 43 deaths. There was also a fatal case in August, and one during October, in the detachment of ordnance (white) stationed at the post. The reports do not indicate the mode in which cholera arrived at Ship island or Baton Roujre. w The first case at Shreveport. Louisiana, on the Red river, occurred September 22nd. in the eightieth United States colored troops ; for nearly a month previously cholera cases had been reported on the plantations below, and in the city of Shreveport just above the post. During September and October there were 11 cases and 4 deaths in the command. The steamship Texas, with recruits from Hart's Island, for the seventeenth United States infantry, left New Orleans, as already stated, July 19th, and arrived Galveston, Texas, on the 22nd. The day after their arrival one of the recruits was attacked with cholera, and died in thirty-six hours. In the outbreak which followed, 44 cases and 24 deaths are reported among the white troops at Galveston, and one fatal case of a colored soldier in the post hospital during August. The subsequent progress of the epidemic in Texas was as follows The first fatal case among the colored troops at Brazos Santiago occurred August 21st; in all, 90 cases and 47 deaths were reported. Among the colored troops at White's Ranch, the first fatal case was on the 13th of August; 98 cases and 37 deaths being reported during the, month. Among the colored troops at Brownsville, the first case was on the 20th of August, and proved fatal the same day. In all, there were 99 cases and 57 deaths reported during August and September. Among the white troops at the same post, the disease also appeared in" the latter part of August. The first death was on the Ist of September; 24 cases and 8 deaths are reported. Among the colored troops at Indianola, the disease appeared in the latter part of August. The first fatal case was on the 6th of September; 39 cases and 7 deaths are reported. At San Antonio, the first case occurred on the 10th of September, in the fourth United States cavalry, (white.) The regiment was moving at the time, part of it being in San Antonio and part in camp on the Medina river, about fifteen miles distant. In the latter detachment three cases appeared from the 7th to the 10th, in the former, two cases on the 11th. The first death occurred September JOth. Cholera was prevailing among the citizens of San Antonio at the time, the first case having occurred September 2nd, at San Juan mission, about six miles distant ; the patient had just arrived from the Rio Grande, where the disease was epidemic. A detachment of the seventeenth United States infantry at San Antonio escaped until after it was moved from town, September 16th, to camp on the Medina, near the cavalry camp. Cholera appeared in this detachment a few days afterwards, however, having apparently been introduced by two Mexican teamsters who came from San Antonio, stopped for the night near the camp, and died of the disease. The total number of cases reported among the white troops at and near San Antonio during September was 387, with 64 deaths. Among the white troops at Austin, to which place the disease was carried by recruits who arrived by way of Indianola, the first death was on the 18th of September. During September and November 12 fatal cases are reported. It is much to be regretted that several of the October reports of sick and wounded from Texas miscarried, and have not been received at the Surgeon General's Office up to the date of this report. It is probable that a small number of cases of qholera were lost, especially in the reports from Austin. (See letter of Assistant Surgeon C. Bacon, jr., Brevet Major United States Army, Appendix, page- 42.) At Richmond, Virginia, the first case occurred at Camp Grant, on the 12th of August. Recruits had been received during July and August from New York Harbor and Newport Barracks. It appears, however, that the earliest cases were not among those recruits, but among soldiers who had been at Richmond the entire summer. Cholera appeared in the city of Richmond about the same time. The total number of cases was 271, with 103 deaths, all white. On the 21st of August the third battalion of the eleventh United States infantry was sent from Camp Grant to Norfolk, Fortress Monroe, and Yorktown. Four cases and two deaths occurred during September and October among the companies thus removed to Norfolk. August 12th, a death from cholera occurred at Carlisle Barracks, and another on the 20th. Both were Swiss recruits from Philadelphia, where cholera was prevailing to a moderate extent. One of the attendants on these men was attacked but recovered. Two cases also occurred in September, but recovered. These men were attacked immediately after their return from Jefferson Barracks, Missouri, where cholera was prevailing. On the 17th of October a cavalry recruit was attacked and died in thirty-six hours. He had 2 9 10 REPORT ON EPIDEMIC CHOLERA. |>rrived the day before his attack, from Chicago, Illinois, where cholera was hen prevailing. " No other case occurred at this post. A detachment of recruits from Governor's Island, New York Harbor, arrived at Newport barracks, Kentucky, July 12th ; recruits were also received during the latter part of July and first of August from St. Louis, Missouri, and Cincinnati, Ohio; from the latter place almost daily after July 13th. The first case of cholera at this post occurred August 12th. The patient was a recruit who had been doing duty as a teamster, and visiting Cincinnati daily. Cholera was, at this time, epidemic in the city of Cincinnati.* From this time to the close of November there were 9 cases and 5 deaths of cholera reported at the station. During September cholera also appeared at Atlanta and Augusta, Georgia, among recruits who went from Newport barracks by way of Nashville. The disease w T as limited to the recruits. The first fatal case at Atlanta was on the 9th of September, and 19 cases, with 7 deaths, occurred during the month. At Augusta, the first fatal cases were also on the 9th, and the total number during the month was 8 cases, of whom 7 died. At Louisville, Kentucky, the first case occurred July 29th. The patient was a recruit from Governor's island, New York Harbor; 364 recruits from Governor's island arrived at Taylor Barracks, Louisville, between the 16th and 19th of the month. Cases of cholera occurred first among these recruits, but subsequently among the rest of the garrison. The first case in the garrison (excluding New York recruits) occurred August 18th. The total number of cases at Louisville was 36, with 23 deaths. On the 21st of August, company E, second United States infantry, was ordered from Taylor Barracks to Bowling Green, Kentucky. Six cases of cholera occurred in this company during the remaining days of August, and two in September. None were fatal. During the last days of August and the first of September, squads of recruits, numbering ninety each, arrived at Nashville, Tennessee, from Newport barracks, Kentucky, and were quartered for quarantine purposes in the immediate vicinity of the post hospital. The first three cases occurred among these recruits — the first fatal case being on September 2d. .About this time, also, cholera began to prevail among the citizens of Nashville, and it would appear probable that it was from this source that the disease was introduced into the detachment at Sibley Barracks, as the first two cases at this post were men who had been on a debauch in the town. Altogether, there were 72 cases and 39 deaths among the white troops. Two deaths of colored soldiers also occurred in September, in the Nashville post hospital. * Cincinnati Lancet, and Observer, vol. IX, p. 561. 11 REPORT ON EPIDEMIC CHOLERA. The first case among the white troops at Memphis, Tennessee, occurred September 6th, and died the next day. The patient was a recruit w T ho had arrived the day before the attack, from Nashville. Altogether, there were 21 cases and 16 deaths during September among the white troops at Memphis. On the 15th of August, however, a fatal case had occurred in the post hospital at Memphis. The patient was a soldier of the fifty-sixth United States colored troops, who was taken from on board the steamer Continental passing up the river from Helena, Arkansas. The first case among the white troops at Vicksburg, Mississippi, occurred on the 22nd of August, on which day two soldiers were attacked. The colored barber had died of the disease the day before. There were, in all, 59 cases and 25 deaths in Vicksburg. A detachment of 145 recruits had been received July 11th, from Fort Columbus, New York Harbor. Cholera also appeared in a detached company (E) of the fifteenth United States infantry, stationed at Jackson, Mississippi, where, during August and September, there were 8 cases and 6 deaths. A detachment of fifty-one recruits had been received at Jackson, July 17th, from Fort Columbus, New York Harbor. The fifty-sixth colored infantry left Helena, Arkansas, in two detachments — the first on the steamer Continental, August 9th; the second on the Platte Valley, August 10th. A death, probably of cholera, occurred on the Platte Valley about twenty-four hours after starting, and another while between Cairo and St. Louis. The disease, however, was not recognized until the morning of the 14th at St. Louis, when the vessel was ordered to the quarantine grounds at Jefferson Barracks. Cholera broke out on the Continental shortly after leaving Helena. A case was put on shore at Memphis, and died in the post hospital. This vessel also went into quarantine at Jefferson Barracks, where she arrived before the Platte Valley. During August and September, 256 cases and 134 deaths were reported in this regiment ; this number, however, does not include those who died on the river before reaching Jefferson Barracks. The disease spread to but a limited extent among the white troops at Jefferson Barracks. The first fatal case was August 15th, several days after the arrival of the 56th United States colored infantry. Altogether there were 8 cases and 7 deaths. Four cases and three deaths also occurred during August and September in the ordnance detachment at St. Louis Arsenal, the first fatal case dying on the 17th of August. On the 25th of August 384 cavalry recruits (white,) from Carlisle Barracks, Pennsylvania, by way of St. Louis, arrived at Fort Riley, Kansas. One of them died of cholera August 30th. From this time to October 16th, 59 cases and 27 deaths occurred, all among the recruits, the rest of the garrison escaping. At Fort Leavenworth, Kansas, (white troops,) the first case occurred September 18th; the patient died next day. Altogether there were 7 cases and 12 RKPORT ON EPIDEMIC CHOLERA 5 deaths at this post. A few days before the appearance of cholera, about twenty cases were reported among the citizens at Leavenworth city, two miles south of the garrison. Intercourse between the city and the post was unrestricted. One case, not fatal, was reported at Albuquerque, New Mexico, in October; particulars not known. At Helena. Arkansas, the first fatal case (white troops) occurred August 30th, and during August and September there were 10 cases and 6 deaths. A detachment of 28 recruits was received at this post August 3rd, supposed to be a portion of a detachment of recruits which left Newport barracks, Kentucky, for Little Rock, Arkansas, July 28th. At Little Eock, Arkansas, the first case occurred September 12th. Altogether there were 131 cases and 64 deaths among the white troops. A company of the fifty-fourth United States colored infantry, stationed at the same post, had 3 cases and 1 death in September, and 4 cases and 1 death in October, the first fatal case among them being September 27th. Nine recruits for the nineteenth United States infantry arrived at Little Eock, August 10th, from Newport barracks, Kentucky. It docs not, however, appear probable that cholera was imported into Little Eock by this detachment of recruits. The report of Brevet Lieutenant Colonel J. E. Smith, Surgeon United States Army and Medical Director, would rather seem to show that it was carried there by steamboats coming up the river from infected points. Surgeon Smith says : "From time to time during the month of August, steamboats arrived both at Little Eock, on the Arkansas, and Duvall's Bluff, on White river, on which rumor said that cases of cholera either existed or had occurred. Examination made by other physicians here and at Duvall's Bluff, as well as by myself, failed to confirm the report of the present existence of cholera on board these boats, although I was satisfied, in several instances, from the histories related to me, that fatal cases of cholera had occurred during their trip from Memphis to Little Rock." At Huntersville, a suburb of Little Eock, Arkansas, there were 21 cases and 9 deaths during September, in the fifty-fourth colored infantry, the first case occurring September loth, and proving fatal the next day. -; At Fort Smith, Arkansas, there were 2 cases in September, and 6 cases and 2 deaths in October, among the white troops. Four cases and two deaths among the colored troops for the same time. The disease was carried to Fort Smith on a steamer from Little Eock. Three cases and two deaths occurred at Fort Gibson, Cherokee Nation, during October; the first case occurred October 15th. Two of these cases were soldiers belonging to company F nineteenth infantry, which arrived at Fort Gibson October 12th from Fort Smith, Arkansas The third had attended them during their illness. One fatal case occurred during November. REPORT ON EPIDEMIC CHOLERA. 13 Finally, the latest appearance of cholera during the year was in a party of recruits who left New York for San Francisco, November 20th. On the 16th of December cholera appeared, the vessel then being on the San Juan river. On the 20th the command reached La Virgin, on Lake Nicaragua, about twelve miles from the Pacific ; went into camp and established a hospital. Altogether there were 54 cases and 27 deaths during the month. Ths foregoing brief statement will serve to give a summary view of the progress of cholera through the army. The reports reproduced in Appendix B will furnish many interesting details. Appendix A, presents a brief statistical synopsis for each po?t, for the total white troops at infected points, the total colored troops, and a general summary embracing, so far as the reports permit, all the troops exposed. In preparing these statistical tables, the reports used for each post embrace the month during which cholera appeared, and all subsequent months for which reports were received, to December 1866, inclusive. The reports are believed to be very nearly complete ; blanks subsequent to the appearance of cholera being generally due to change of station, or, in the case of colored troops, to the muster-out of the command. The only important deficiency is in the case of the October reports for certain stations in Texas, which have been indicated in the tables by an appropriate foot-note. This deficiency, however, does not probably represent any very considerable number of cases. The mean strengths given in the summaries for white and colored troops, and in the general summary, only represent the troops embraced in the reports, and have nothing to do with the strength of that part of the army not exposed to the epidemic. It appears from these tables that out of a total mean strength of 12,780 men, there were 2,708 cases of cholera reported, and 1,207 deaths. Of these there were 1,749 cases and 706 deaths out of a mean strength of 9,083 white troops; and 959 cases and 501 deaths out of a mean strength of 3,697 colored troops. Besides these, there were 4 cases and 3 deaths of white, and 12 cases and 7 deaths of colored soldiers at various isolated points, as set forth in the table VI, Appendix A, making a total of 2,724 cases and 1,217 deaths of cholera for the six months. In the folio wing 1 considerations no count has been made of these last 16 cases, w T hich have been ignored in order that the ratios presented might have a definite relation to strength. The three summary tables here presented show the prevalence of sickness and mortality among the troops exposed to the epidemic, expressed in the ratio of cases and deaths per 1,000 of mean strength, for cholera, diarrhceal diseases, and all other diseases, for each month, and for the six months. From these tables it will be seen that for the white troops, the number of cases of cholera reported during the six months was 192.6, with 77.7 deaths per 1,000 of strength. Of diarrhcoal diseases there were 741.8 cases, and 7.5 deaths per 1,000; 6 of all other diseases, 1328. cases, and 15.5 deaths per 1,000. For the colored troops the number of cases of cholera reported was 259.4, with 135.5 deaths per 1,000 of strength. Of diarrhoeal diseases 574.5 cases, and 3.5 deaths per 1,000; of all other diseases, 833.9 cases, and 11.4 deaths per 1,000. Tables showing the prevalence and mortality of cholera and other diseases among the troops exposed during the last six months of 1866, expressed in ratio per 1,000 of mean strength. 1. WHITE TROOPS. -. „ , ? , i -p. , | Total for the July. August, j September, j October. November. ; December. I six luont j ls> S_ a \_6 & I i_\J_ p I pi s p I 6 p " " " I i ! i : I ill; ; i Cholera 78.6 3T. 7 33.' 7 16.8 82.6 26.8; 6.1 3.2 3. 2 j 2. 0 j 5.9 2.9 j 192.6 77.7 Diarrhoeal diseases 185.8 1.0 214. l! 2.7 149.6 1.3 125.4 1.4 74.0 .7 47.0 .7 741.8 7.5 I ! All other diseases 178.1 1.8 277.4 3.9 245.6 3.6 269.8 2.9 196.2, 2.2 155.5 j 1.0 1,328.0 15.5 I I ; 2. COLORED TROOPS. July. August. September. October. November. December. six months.' CO 03 CO CO CO. CO CO aj^3co^3tOr=lco^Cco-i3co-a d ,a 1 ills ill i?li I "3 Cholera 2.5 2.5 116.5 58.8 40.9 23.2 17.8 11.3' 15.0 5.7 2.2 1.1 259.4 135.5 Diarrhoeal diseases 15.0 142.0 .4 97.7 75..4 1.4 92.5 1.0 61.3 .7 574.5 3.5 All other diseases 70.0 6.3 142.0 .2 113.3 1.7 147.5 2.0 172.8 2.2-149.2 3.6 833.9 11.4 3. WHITE APp COLORED. ' • - July. August. September. October. November. December. six months . ¦ i ; ~ : ~~~. i '. ; Cfi EC a m • 2 CO . M . X CO rC CO j -= CO ,-S GO *CI co^S CO ,£S CO ,£1 II II II II II II I I oPoPOPIoPoPOR c 3 P " ~~~ " ' i Cholera 63. 1 32.8 66.1 33.2 68.3 25.6 9.3 5.4 6.5 3.1 5.1 2.6 21). 9 94.4 I Diarrhceal diseases 162.3 .9 185.5 1.8 131.7 .9 111.9 1.4 79.1 .8:50.0 .7 693.4 6.3 All other diseases 163.2 2.4 223.8 2.4 200.0 2.9 236.6 2.7 189.6 2.2 154.2 1.5 1,185. 1 14.3 14 The ratio of deaths to cases was as follows : For cholera, 403.7 deaths per 1,000 cases, or one death to 2.5 cases among white troops ; among colored troops, 522.4 deaths per 1,000 cases, or one death to 1.9 cases; so that somewhat less than half the white, and somewhat more than half the colored soldiers attacked with cholera died. For diarrhoeal diseases the mortality was small, 10. 1 deaths per 1,000 cases for white, and 6.1 per 1,000 for colored troops. For all other diseases the mortality was 11. 7 per 1,000 cases for white, and 13.6 per 1,000 for colored troops. As to the duration of the disease in fatal cases, there are reports from Camp Grant, Eichmond, Virginia ; Tybee Island, Georgia ; and Little Bock, Arkansas. It would appear from these reports that the great majority of patients die on the first or second day of the disease. The greatest duration of any fatal case being to the fifteenth day. Table showing the duration of fatal cases of cholera at Camp Grant, Richmond, Virginia, at Tybec Island, Georgia, and at Little Rock,^ Arkansas. Died on the — * Caunp Grant. Tybee Isl'nd. Little Rock. First day 29 43 85 Second day 22 26 12 Third day 5 7 3 Fourth day 4 5 3 Fifth day 4 4 Sixth day 4 4 1 Seventh day . 2 3 2 Eighth day 3 2 Ninth day 3 ] Tenth day 1 ] 1 Eleventh day 1 Fourteenth day 1 Fifteenth day 1 Total 74 94 65 A thoughtful consideration of the facts embraced in the foregoing brief general statement, and in the appended reports, shows that they possess a two- fold significance ; on the one side in connection with the question of quarantine, on the other, in connection with that of local hygienic and therapeutic agencies. As to the question of quarantine the facts are not perhaps conclusive, yet they are too numerous and too important to be overlooked, and although certain breaks in the chain of evidence exist, there can be doubt as to the general facts of the case. The epidemic appears from the record to have radiated distinctly from two chief centres. Originating in the overcrowded barracks of Governor's island, New York Harbor, in the immediate vicinity of an infected city, through which recruits 15 passed with more or less delay before arrival, the infection spread by readily traceable steps to Hart's island and other posts in the harbor, to Tybee island, Georgia ; to Louisiana, by way of New Orleans ; to Texas, by way of Galveston; to Louisville, Kentucky ; to Richmond, Virginia, and to La Virgin, Nicaragua bay. From Richmond it was carried to Norfolk, Virginia ; from Louisville to Bowling Green, Kentucky. The probabilities appear to be that the disease was carried from New Orleans up the Mississippi river to various points on that stream, and west of it, and though the whole chain of evidence is not complete, yet there are a sufficient number of known cases of the transfer of the epidemic from one post to another in this region to put this view of the whole movement beyond reasonable doubt. The other principal centre appears to have been Newport barracks, Kentucky, where the disease was plainly introduced from the infected city of Cincinnati, on the opposite side of the Ohio river. Although it did not prevail to f\y great extent at this post, yet it is in evidence that it was carried thence to ugusta and Atlanta, Georgia, to Nashville and Memphis, Tennessee. At several points, as, for example, at Augusta and Atlanta, Georgia, the epidemic did not extend beyond the infected recruits by whom it was imported. In many cases, however, it involved the rest of the command, and it is highly probable that this would have been the case far more generally but for the stringent hygienic precautions adopted. As a particular example of the value of such precautions, attention may be appropriately drawn to the appended extracts from the reports of Brevet Major E. McOlellan, Assistant Surgeon United States Army, (Appendix p. 60,) from which it appears that cholera broke out at various points in the vicinity of Fort Delaware, in fact, encircling the post, but did not invade the garrison, although one case, which recovered, occurred in the family of an officer on the island. On the whole, it must be admitted that the general tenor of army experience, during 1866, is strongly in favor of quarantine, and especially points to the danger to the army incurred by the distribution of recruits or other bodies of men from infected points. As to the question of therapeutic agencies, it cannot be said that any new light has been shed upon the existing obscurity of the subject by the army experience. The chief modes of treatment employed are indicated in the appended reports, and the general tendency of the facts recorded must be to direct attention rather to hygienic precautions, intended to mitigate the violence of the epidemic, than to methods of treatment which have hitherto unhappily proved so unsuccessful. Among these hygienic precautions, besides cleanliness, the use of disinfectants, ventilation, proper air-space, &c, especial attention is directed in the report of Brevet Brigadier General T. A. McParlin, Surgeon United States 16 Army, to the efficacy of the use of pure drinking water in arresting the spread of the disease, even after it has made its appearance. The troops exposed in New Orleans were, by his direction, supplied with cistern water, (rain water,) as far as practicable, and where this could not be obtained, distilled water was, in some instances, purchased by the quartermaster's department. The disease did not spread to any extent among the troops thus supplied, and the majority of the cases at New Orleans occurred in the detachments of the sixth United States cavalry and first United States infantry, and in the eighty-first colored, at times when these troops were so situated as, for the most part, to be obliged to use the water of the Mississippi river for drinking purposes. The interesting details of this important practical experiment will be found in the appended reports of Surgeon McParlin, and of Assistant Surgeon Hartsuff. The importance of the character of the drinking water used during epidemics of cholera had attracted attention in Europe before the date of the recent outbreak in this country, and it had been shown by the Registrar General of England that the prevalence of the disease in the several districts of London bore a direct proportion to the amount of. the organic impurities of the water furnished. Accordingly, when the epidemic made its appearance in New York Harbor, attention was at once directed to the character of the drinking water used by the troops, and samples sent to this office were analyzed in the laboratory by Dr. B. F. Craig. (See Appendix B, p. 61, for Dr. Craig's report.) A^l these waters contained a considerable quantity of organic impurity, sufficient, under the circumstances, to justify the recommendation of means of purification. This recommendation, so far as known, was not acted upon, and the only point where practical attention was directed to supplying pure water was at New Orleans, as above stated. The success there obtained has been such as to direct attention anew to Dr. Craig's recommendations. Although rain water collected in proper cisterns, is, of course, much more free from organic impurities than river or well water, it is nevertheless seldom entirely free from them, and it is not often practicable to obtain pure and sufciently aerated distilled water in the necessary quantities. An agent which is capable of destroying the contained organic matters, without impairing the flavor or other good qualities of drinking-water, is therefore of the first importance, and such an agent is found in the per-manganate of potassa. Dr. Craig says : " A good practical rule for purifying water is to add any solution of the per-manganate until the water, as seen in an ordinary sized tumbler, appears perceptibly pink. This corresponds to the addition of from half a grain to one grain per gallon. After standing for a few hours the color disappears, and the water is left pure as far as regards organic matter. If, after two hours standing, the water has a pinkish color when received in a large white dish or in a 3 17 bucket of polished tin, the amount of per-manganate used has been sufficient, and if a pink color still remains after twenty-four hours, it has been used in excess." The water is ready for use after standing twenty-four hours. A slight excess of the per-manganate is injurious only to the appearance of the fluid. An interesting and valuable discussion of the general question of the use of disinfectants during epidemics of cholera will be found in the report on this subject, also, by Doctor B. F. Craig, which is presented in Appendix B, page 63. This report contains a brief practical discussion of fhe merits of the more mportant disinfectants, their mode of action, and the conditions which call for ;he use of each. It contains, in fact, a brief summary of the most important facts which have been established in connection with this subject, and will be found well worthy of thoughtful consideration. I The following medical officers died of cholera while engaged in the active erformance of their duties in connection with the epidemic : (Ist. Brevet Major J. T. Calhoun, Assistant Burgeon United States Army, ied of cholera July 20th, 18G6, at Hart's island, New York Harbor. 12d. John E. McDonald, Assistant Surgeon United States Army, died of holera September 10th, 1860, at St. Louis, Missouri. 13d. Acting Assistant Surgeon J. F. Burdett died of cholera August 6th, 1866, t Tybee island, Georgia. 14th. Acting Assistant Surgeon Samuel Catlin died of cholera November 7th, 1866, at New Orleans, Louisiana. 15th. Benjamin Hobbs, Surgeon one hundred and sixteenth United States )lored troops, died of gastro-enteritis (?) August 28th, 1866, after rising from a ck bed to attend cholera cases in his regiment at White's Ranch, Texas. I have the honor to be, general, very respectfully, your obedient servant, J. J. WOODWARD, Assistant Surgeon and Brevet Lieut. Col. U. S. Army, in charge of the Record and Pension Division, Surgeon General 1 s Office, and of the Medical Section of the Army Medical Museum. Brevet Major General J. K. I^arnes, Silvcicoii Ctgyigvcil TTmtpfl Sitcitp^ Avvnn 18 APPENDIX. A.-STATISTICAL TABLES. 8.-EXTBACTS FEOM OFFICIAL REPOETS * I. WHITE TROOPS AT INDIVIDUAL. POSTS. 1. FORT COLUMBUS, GOVERNOR'S ISLAND, NEW YORK HARBOR. Months JULY. AUGUST. SEPTEMBER. OCTOBER^ NOVEMBER. DECEMBER. TOTAL. Mean strength 1,013 1, 152 1,268 1,046 866 1,022 1,061 Oases. Deaths. Cases. Deaths. Cases. Deaths. Cases. Deaths. Cases. Deaths. Cases. Deaths. Cases. Deaths, lera 92 25 25 13 6 3 123 41 leramorbus 10 4 3 17 Acute diarrhoea 297 245 110 11l 26 20 809 Chronic diarrhoea 4 4 Acute dysentery 19 2 3 2 1 27 Chronic dysentery 3 1 6 4 1 1 1 11 6 Total 392 26 305 17 117 128 4 28 21 991 47 All other diseases 186 2 195 128 6 136 4 130 1 146 1 921 14 Aggregate 578 28 500 17 245 6 264 8 158 1 167 1 1,912 61 2. HART'S ISLAND, NEW YORK HARBOR. Pg JULY. AUGUST. SEPTEMBER. OCTOBER. NOVEMBER. DECEMBER. TOTAL, strength 510 Cases. Deaths. Cases. Deaths. Cases. Deaths. Cases. Deaths. Cases. Deaths. Cases. Deaths. Cases. Deaths. Cholera 39 30 39 30 Cholera morbus 8 8 Acute diarrhoea 203 203 Chronic diarrhoea Acute dysentery 1 1 Chronic dysentery Total 251 30 251 30 All other diseases 122 2 122 2 3. DE CAMP HOSPITAL, DAVID'S ISLAND, NEW YORK HARBOR. Monthg july. AUGUST. SEPTEMBER. OCTOBER. NOVEMBER. DECEMBER. TOTAL. Mean strength Cases. Deaths. Cases. Deaths. Cases. Deaths. Cases. Deaths. Cases. Deaths. Cases. Deaths. Cages. Deaths. Cholera 11 7 4 2 1 18 Cholera morbus 4 19 1 24 Acute diarrhoea 58 74 6 1 6 144 1 Chronic diarrhoea " Acute dysentery 1 Chronic dysentery - Total 74 7 97 9 1 10 190 All other diseases 31 1 24 3 1 1 23 79 5 Aggregate 105 8 121 3 10 2 33 269 13 4. FORT SCHUYLER, NEW YORK HARBOR. Months JULY. AUGUST. SEPTEMBER. OCTOBER. NOVEMBER. BECEMBRR. TOTAL. Mean strength 121 132 133 126 197 238 158 Cases. Deaths. Cases. Deaths. Cases. Deaths. Cases. Deaths. Cases. Deaths. Cases. Deaths. Cases. Death?. Cholera 1 1 Cholera morbus 1 1 Acute diarrhoea 8 12 10 1 2 3 36 Chronic diarrhoea 3 3 Acute dysentery 2 2 Chronic dysentery 1 1 Total 10 14 10 1 2 7 44 ... All other diseases 10 13 11 10 14 39 97 Aggregate 20 27 21 11 16 46 141 5. EECEUITS ON STEAMER SAN SALVADOR, AND AT TYBEE ISLAND, GA. Months JULY. AUGUST. SEPTEMBER. OCTOBER. NOVEMBER. DECEMBER. TOTAL. Mean strength 402 335 Cases. Deaths. Cases. Deaths. Cases. Deaths. Cases. Deaths. Cases. Deaths. Cases. Deaths. Cases. Deaths. Cholera 198 112 4 4 202 116 Cholera morbus Acute diarrhoea 12 19 31 Chronic diarrhoea Acute dysentery 1 2 3 Chronic dysentery Total 211 112 25 4 236 116 All other diseases 4 1 5 Aggregate 215 112 26 4 241 116 4 6. NEW ORLEANS, LA. Months JULY. AUGUST. SEPTEMBER. OCTOBER. NOVEMBER. DECEMBER. TOTAL. Mean strength 1,444 914 961 923 844 931 ],003 Cases. Deaths. Cases. Deaths. Cases. Deaths. Cases. Deaths. Cases. Deaths. Cases. Deaths. Cases. Deaths. Cholera 44 8 37 14 7 2 2 3 93 24 Cholera morbus 8 10 10 8 1 37 Acute diarrhoea 132 1 235 152 1 82 77 53 731 2 Chronic diarrhoea 1 1 1 1 g 3 1 2 2 12 8 Acute dysentery 1 3 6 117 1 1 19 2 Chronic dysentery ""1 Total 186 10 285 14 176 4 j 99 4 86 1 60 3 892 36 All other diseases 217 3 302 4 350 1 j 306 3 197 119 1,491 11 Aggregate 403 13 587 18 526 5 i 405 7 283 1 179 3 2,383 47 7. GALVESTON, TEXAS. Months JULY. AUGUST. SEPTEMBER. OCTOBER.* NOVEMBER. DECEMBER. TOTAL. Meanstrength 1,103 968 968 246 246 Cases. Deaths. Cases. Deaths. Cases. Deaths. Cases. Deaths. Cases. Deaths. Cases. Deaths. Cases. Deaths. Cholera 7 6 31 14 6 4 44 24 Cholera morbus 2 3 2 7 Acute diarrhoea 125 1 133 5 15 50 2 18 1 341 9 Chranic diarrhoea 2 12 5 9 1 Acute dysentery 2 1 27 9 1 8 46 2 Chronic dysentery 2 2 4 Total 134 8 197 20 31 1 71 6 18 1 451 36 All other diseases 194 1 327 6 220 5 44 2 28 3 813 17 Aggregate 328 9 524 26 251 6 115 8 46 4 1,264 53 8. BROWNSVILLE, TEXAS. Months JULY. AUGUST. SEPTEMBER. OCTOBER.* NOVEMBER. DECEMBER. TOTAL. Meanstrength 82 191 291 279 Cases. Deaths. Cases. Deathß. Cases. Deaths. Cases. Deaths. Cases. Deaths. Cases. Deaths. Cases. Deaths. Cholera 5 12 3 2 1 5 4 24 8 Cholera morbus 1 3 4 Acute diarrhoea 10 12 40 40 102 Chronic diarrhoea 1 1 Acute dysentery Chronic dysentery Total 16 27 3 42 1 46 4 131 8 All other diseases 34 51 1 43 1 45 173 2 Aggregate 50 78 4 85 2 91 4 304 10 — * No reports received. 5 6 STATISTICAL TABLES. 9. AT AND NEAR SAN ANTONIO, TEXAS. Montis JULY. AUGUST. SEPTEMBER. OCTOBEK. NOVEMBER. DECEMBER. TOTAL. Mean strength 727 Cases. Deaths. Cases. Deaths. Cases. Deaths. Cases. Deaths. Cases. Deaths. Cases. Deaths. Cases. Deaths. Cholera 387 64 ! 387 64 Cholera morbus 1 1 1 1 Acute diarrhoea 66 , 66 Chronic diarrhoea < 5 2 5 Acute dysentery • •. t Chronic dysentery ; 2 2 2 2 Total 1 461 69 461 69 All other diseases ! 95 2 95 2 Aggregate 556 71 556 71 10. AUSTIN, TEXAS. Months JULY. AUGUST. SEPTEMBER. OCTOBER.* NOVEMBER. DECEMBER. TOTAL. Mean strength 442 670 472 , Cases. Deaths. Cases. Deaths. Cases. Deaths. Cases. Deaths. Cases. Deaths. Cases. Deaths. Cases. Deaths. Cholera 2 2 10 10 12 12 Cholera morbus Acute diarrhoea 4 , 58 8 70 Chronic diarrhoea 3 1 3 l Acute dysentery 1 1 Chronic dysentery 1 1 Total 10 3 69 10 8 87 13 All other diseases 29 84 21 2 134 2 Aggregate 39 3 153 10 29 2 221 15 11. RICHMOND, VA. Months JULY. AUGUST. SEPTEMBER. OCTOBER. NOVEMBER. DECEMBER. TOTAL. Meanstrength 1,586 1,049 1,002 1,267 1,281 ¦ Cases. Deaths. Cases. Deaths. Cases. f Deaths. Cases. Deaths. Cases. Deaths. Cases. Deaths. Cases. Deaths. Cholera 56 33 215 70 271 103 Cholera morbus 17 8 1 og Acute diarrhoea 293 198 63 22 16 592 Chronic diarrhoea 4 4 34 g jq ,g Acute dysentery 8 H 31 13 5 68 Chronic dyßentery g _ P Tot a l 378 33 436 70 127 42 31 1,014 103 All other diseases 382 2 240 2 210 3 105 3 102 1,039 10 Aggregate 760 35 676 72 337 3 147 3 133 2,053 113 * No report received. 12. NOEFOLK, VA. Months JULY. AUGUST. SEPTEMBER. OCTOBER. NOVEMBER. DECEMBER. TOTAL. Meanstrength 355 355 147 Cases. Deaths. Cases. Deaths. Cases. Deaths. ! Cases. Deaths. Cases. Deaths. Cases. Deaths. Cases. Deaths. Cholera ' 113 1 4 2 Cholera morbus I Acute diarrhoea 16 J 9 6 31 Chronic diarrhoea Acute dysentery I I Chronic dysentery ' I Total 17 1 12 1 6 35 2 All other diseases 47 ...J 24 13 84 1 Aggregate 64 1 36 1 19 119 2 13. CARLISLE BARRACKS, PA. Months JULY. AUGUST. SEPTEMBER. OCTOBER. NOVEMBER. DECEMBER. TOTAL. Meanstrength 324 350 535 325 505 Cases. Deaths. Cases. Deaths. Cases. Deaths. Cases. Deaths. Cases. Deathß. Cases. Deaths. Cases. Deaths. Cholera 3 2 2 1 1 6 3 Cholera morbus .• 2 4 3 9 Acute diarrhoea 19 23 28 7 9 86 Chronic diarrhoea Acute dysentery 2 2 2 6 Chronic dysentery Total 26 2 31 32 1 9 9 107 3 All other diseases 70 76 126 98 1 124 494 1 Aggregate 96 2 107 158 1 107 1 133 601 4 14. NEWPORT BARRACKS, KY. Months JULY. AUGUST. SEPTEMBER. OCTOBER. NOVEMBER. DECEMBER. TOTAL. Meanstrength 286 386 440 454 400 Cases. Deaths. Cases. Deaths. Cases. Deaths. Cases. Deaths. Cases. Deaths. Cases. Deaths. Cases. Deaths. i Cholera 32114111 9 5 Cholera morbus » 1 2 2 1 1 6 Acute diarrhoea 28 22 16 26 ! 11 103 Chronic diarrhoea Acute dysentery 4 4 3 11 Chronic dysentery 6 C Total 36 2 29 1 25 1 34 I 1 11 135 5 All other diseases 37 57 64 1 66 j 55 279 1 Aggregate 73 2 86 1 89 2 100 1 66 414 6 7 Monthg JULY . AUGUST. SEPTEMBER. OCTOBER. NOVEMBER. DECEMBER. TOTAL. Mean strength 93 72 75 107 Cases. Deaths. Cases. Deaths. Cases. Deaths. Cases. Deaths. Cases. Deaths. Cases. Deaths. Cases. Deaths. Cholera 19 » 19 7 Cholera niorbus 1 Acute diarrhoea 5 1 2 2 10 Chronic diarrhoea Acute dysentery | 1 1 *¦ Chronic dysentery j 1 Total 25 7 4 3 3 35 7 All other diseaseß 1 22 1 24 26 26 98 1 Aggregate ' 47 8 28 29 1(0 133 8 I 16. AUGUSTA, GA. Months JULY. AUGUST. SEPTEMBER. OCTOBER. NOVEMBER. DECEMBER. TOTAL. Meanstrength 122 138 181 238 Cases. Deaths. Cases. Deaths. Cases. Deaths. Cases. Deaths. Cases. Deaths. Cases. Deaths. Cases. Deaths. Cholera 8 7 8 7 Cholera morbus j Acute diarrhcea 13 15 19 9 | 56 Chronic diarrhoea 3 2 3 3 11 Acute dysentery t Chronic dysentery 1 1 2 1 Total 25 7 17 23 12 j 77 7 All other diseases 33 1 37 50 40 j 160 1 Aggregate 58 8 54 73 52 237 8 (17. LOUISVILLE, KY. 8 JULY. AUGUST. SEPTEMBER. OCTOBER. NOVEMBER. DECEMBER. TOTAL, itrongth 422 505 376 289 334 327 376 Cases. Deaths. Cases. Deaths. Cases.' Deaths. Cas Deaths. Cases. Deaths. Cases. Deaths. Cases. Deaths, a 2 1 33 21 1 1 36 23 amorbuß 1 7 2 1 11 .... diarrhoea 62 118 41 13 5 9 248 c diarrhoea 1 1 1 1 dysentery 3 4 4 2 2 15 o dysentery otal .68 1 163 22 47 16 8 19 311 24 er diseases 129 246 3 232 2 155 1 123 100 1 985 7 ggregate 197 1 409 25 279 2 171 1 131 1 109 1 1,296 31 8 4 Months JULY. AUGUST. SEPTEMBER. OCTOBER. NOVEMBER. DECEMBER. TOTAL. Meanstrength 68 44 33 34 45 Cases. Deaths. Cases. Deaths. Cases. Deaths. Cases. Deaths. Cases. Deaths. Cases. Deaths. Cases. Deaths. Cholera 6 2 • 8 Cholera morbus 1 1 Acute diarrhoea 2 3 1 10 16 Chronic diarrhoea Acute dysentery 1 1 1 2 5 Chronic dysentery Total 10 6 1 1 12 30 All other diseases 5 9 3 7 24 Aggregate 15 15 4 1 19 54 19. NASHVILLE, TENN. Months JULY. AUGUST. SEPTEMBER. OCTOBER. NOVEMBER. DECEMBER. TOTAL. Meanstrength 762 743 766 763 Cases. Deaths. Cases. Deaths. Cases. Deaths. Cases. Deaths. Cases. Deaths. Cases. Deaths. <'nses. Deaths. Cholera 58 33 14 6 72 39 Cholera morbus 2 1 2 5 Acute diarrhoea 136 74 28 3 241 Chronic diarrhoea 2 2 Acute dysentery 1 1 5 8 1 4 3 20 1 Chronic dysentery Total 201 33 97 7 36 6 340 40 All other diseases 136 1 209 1 126 1 85 556 3 Aggregate 337 34 306 8 162 1 91 896 43 20. MEMPHIS, TENN. Months JULY. AUGUST. SEPTEMBER. OCTOBER. NOVEMBER. DECEMBER. TOTAL. j Mean strength 337 439 439 378 Cases. Deaths. Cases. > Deaths. Cases. Deaths. Cases. Deaths. Cases. Deaths. Cases. Deaths. Cases. Deaths. Cholera 21 16 21 16 Cholera morbus Acute diarrhoea | 67 21 18 4 110 Chronic diarrhoea 1111 2 2 Acute dysentery 5 4 5 14 Chronic dysentery 1 1 2 Total 95 17 26 1 24 4 149 18 All other disease* 62 4 150 2 96 1 76 384 7 Aggregate 157 21 176 3 120 1 80 533 25 9 21. VICKSBURG, MISS. Moutbg jut.y. AUGUST. SEPTEMBER. OCTOBER. NOVEMBER. DECEMBER. TOTAL. Meanstrength 544 591 567 648 461 Cases. Deaths. Cases. Deaths. Cases. Deaths. Cages. Deaths. Cases. Deaths. Cases. Deaths. Cases. Deaths. Cholera 34 15 16 8 1 8 2 -. 59 25 Cholera morbus 2 2 Acute dlarrhoßß 100 1 62 39 1 6 6 213 Chronic diarrhoea 3 3 5 11 3 1 22 Acute dysentery 27 6 14 2 14 6 61 Chronic dysentery Total 104 25 97 10 67 4 25 3 6 359 42 All other diseases 186 10 213 4 191 7 144 4 62 796 25 1 | Aggregate 350 35 310 14 258 11 189 7 68 1,168 67 38. JACKSON, MISS. Months JULY. AUGUST. SEPTEMBER. OCTOBER. KOVEMBEH. DECEMBER. TOTAL. ! Mean strength ! 78 72 58 63 64 j Cases. Deaths. Cases. Deaths. Oanes. Deaths. Cases. Deaths. Cases. Deaths. Cases. Deaths, i Cases. Deaths. Cholera 117 5 8 6 Cholera morbus 1 2 ! 3 Acute diarrhoea 10 20 4 3 3 j 40 Chronic diarrhoea j Acute dysentery I 1 2 1 1 4 9 Chronic dysentery j Total 13 1 29 5 7 4 7 \ 60 6 All other diseases \ 48 45 1 38 I 16 32 179 2 ! ; Aggregate j 61 1 74 6 45 1 20 39 ! 239 8 23. JEFFEKSON BARRACKS, MO. Months JULY. AUGUST. SEPTEMBER. OCTOBER. NOVEMBER. DECEMBER. TOTAL. Mean strength j 284 344 313 316 301 j Cases. Deaths. ' Cases. Deaths. Cases. Oeaths. Cuses. Deaths. Cases. Deaths. Cases. Deaths. CaseH. Deaths. Cholera 6 5 2 2 8 7 I Cholera morbus 1 1 Acute diarrhoea 103 i 103 70 44 51 371 Chronic diarrhoea Acute dysentery | 3 5 1 4 3 16 Chronic dysentery ' t Total 1 j | 112 5 111 271 48 54 396 7 thor diseases j 114 212 160 114 99 699 Aggregate ! | 226 5 323 2 231 162 153 1,095 7 — _ — j ! . 1 10 24. DETACHMENT OF ORDNANCE AT ST. LOUIS ARSENAL, MO. Months JULY. AUGUST. SEPTEMBER. OCTOBER. NOVEMBER. DECEMBER. TOTAL. Menn strength 99 100 101 118 129 Cases. Deaths. Cases. Deaths. ' Cases. Deaths. Cases. Deaths. Cases. Deaths. Cases. Deaths. Cases. Deaths. Cholera 3 2 11 4 3 Cholera morburf 2 2 Acute diarrhoea 14 20 7 5 46 Chronic diarrhoea 1 1 Acute dysentery 1 1 2 Chronic, dysentery - I Total 20 2 22 1 1 7 5 55 3 All other diseases 44 1 30 17 27 24 1 142 2 Aggregate 64 3 52 1 18 34 29 1 197 j 5 25. FORT RILEY, KANSAS. Months JULY. AUGUST. SEPTEMBER. OCTOBER. NOVEMBER. DECEMBER. TOTAL. Meanstrength 227 583 780 449 438 Cases. Deaths. Cases. Deaths. Cases. Deaths. Cases. Deaths. Cases. Deaths. Cases. Deaths. Cases. Deaths. Cholera 1 1 46 19 12 7 59 27 Cholera morbus Acute diarrhoea 27 301 192 62 53 635 Chronic diarrhoea Acute dysentery 2 2 1 1 6 Chronic dysentery Total 30 1 349 19 204 7 63 54 700 27 All other diseases 63 140 156 94 2 105 558 2 1 Aggregate 93 1 489 19 360 7 157 2 159 1,258 29 1 i ' 26. FORT LEAVENWOETH, KANSAS. Months JULY. AUGUST. SEPTEMBER. OCTOBER. NOVEMBER. DECEMBER. j TOTAL. Mean strength , 520 594 771 806 j I Cnses. Deaths. Cases. Deaths. Cases. Deaths. Cases. Deaths. Cases. Deaths. Cases. Deaths. i Cases. Deaths. Cholera 2 1 4 3 1 1 7 5 Cholera morbus 4 4 Acute diarrhoea 14 HO 105 63 292 Chronic diarrhoea 8 ...¦ 2 1 1 I 11 1 Acute dysentery 112 2 ' 5 1 Chronic dysentery 1 2 2 3 2 Total 17 2 125 3 114 1 66 3 322 9 All other diseases 80 1 157 1 166 3 136 1 539 6 Aggregate 97 3 282 4 280 4 202 4 861 15 j I , __ ! 11 27. HELENA, AEK. Months JULY. AUGUST. SEPTEMBER. OCTOBER. NOVEMBER. DECEMBER. TOTAL. Mean strength 109 109 Cases. Deaths. Cases. Deaths. Cases. J Deaths. Cases. Deaths. i Cases. Deaths. Cases. Deaths. Cases. Deaths. I j •_ __^_ Cholera 7 2 3 4 10 6 Cholera morbus Acute diarrhoea 4 6 l 10 l Chronic ditirrhcua 1 1 Acute dysentery 4 1 5 Chronic dysentery Total 15 2 11 5 26 7 All other diseases 43 1 14 3 57 4 Aggregate 58 3 25 8 83 11 28. LITTLE EOCK, ARK. Mouths JULY. AUGUST. SEPTEMBER. OCTOBER. NOVEMBER. DECEMBER. TOTAL. Mean strength 1 389 331 362 354 Cases. Deaths. Cases. Deaths. Cases. Deaths. Cases, j Deaths. Cases. Deaths. Cases. Deaths. Cases. Deaths. I — — Cholera 127 60 4 4 131 64 Cholera morbus Acute diarrhoea 78 59 13 8 158 Chronic diarrhoea 1 1 1 2 1 Acute dysentery 8 5 3 16 Chronic dysentery ' Total 205 60 72 | 4 19 1 11 307 65 All other diseases 124 3 233 2 135 1 117 1 609 7 Aggregate 329 63 305 j 6 154 2 128 1 916 72 29. FORT SMITH, ARK. Months JULY. AUGUST. SEPTEMBER. OCTOBER. NOVEMBER. DECEMBER. TOTAL. , , | I Mean strength I ]3