AN ACCOUNT OF THE CHOLERA, AS IT APPEARED AT NASHVILLE IE" THE -YTttJ^Tt 1873. BY W. K. BOWLING, M. D. NASHVILLE, TENN. : PRINTED BY THE UNION AND AMERICAN PRINTING COMPANY. 1873. AN ACCOUNT OF rHE CHOLERA, AS IT APPEARED AT NASHVILLE lIsT THE TEAR 1573. BY W. K. BOWLING, M. D. NASHVILLE, TENN. : PRINTED BY THE TTNION AND AMERICAN PRINTING COMPANY. 1873. THE CHOLERA, AS IT APPEARED AT NASHVILLE IN THE YEAR 1873. BY W. K. BOWLING, M. D. From tho first volume of the " Nashville Journal of Medicine and Surgery." The City of Nashville is built principally upon three high hills, coming in from the country, and approaching, at almost a right angle, the Cumberland river, where they terminate in high precipitous limestone bluffs. The central hill is cut off from its neighbors upon the right and left by two creeks, which discharge their waters into the Cumberland between the bluffs. These creeks have each considerable bottom-land of alluvial deposit extending to the neighboring hills, so that, to an observer standing upon the State Capitol, which is built upon the summit of the central hill, this hill, which is shorter and higher than the others, seems to arise from an extensive plain. This plain is the creek bottoms, which separate the hills. Capitol Hill, I have said, is shorter than the others — that is, it does not extend so far back into the country, but slopes gently from its summit some six hundred yards back, and terminates in an alluvial plain but little elevated above the lowlands which border the creeks, and which it connects, and thus serves further to give the idea of Capitol Hill having its base in a plain. This entire plain, with the exception of an isthmus that connects Capitol Hill with the high lands in the rear, (and which itself is not sufficiently elevated to mar the idea of a plain), is subject to overflow at high tides in the Cumberland. 4 THE CHOLERA IN NASHVILLE. It is, notwithstanding, pretty thickly studded with dwelling houses, and is instinct with a large and bustling population. Capitol Hill terminates at the river, by a perpendicular bluff of limestone, one hundred and fifty feet in height, the highest point of which is the terminus of the suspension bridge which here spans the Cumberland. This central, or Capitol Hill, constitutes the heart of the city, the streets running parallel with the river descending both up and down the river, from points opposite the mouth of the bridge, until the low lands above and below are crossed, when they ascend again the sides of the hills above and below the centre, or Capitol Hill. The streets through the low lands are constructed on elevated fills, passing over the creeks on stone arches. The hill above Capitol Hill, called College Hill, because of being the site of the University of Nashville, is now nearly as compactly built up with fine family residences, &c, as Capitol Hill. The lower hill, called McGavock's Hill, is now being rapidly improved, but is nothing like so densely populated as College Hill. The river here runs nearly south and north. Now that portion of the city in the low lands, particularly in those dividing Capitol from College Hill, combines, in an eminent degree, all the elements for the rapid generation of malaria. Twice, in the early part of last year, was the whole population forced to leave that district on account of high water, and the communications between Capitol Hill and College Hill above, and McGavock Hill below, were, for weeks, kept up by ferry-boats and skiffs. What intermittent fever, and diseases universally recognized as of malarial origin, have prevailed in this city, have been confined almost exclusively to these districts ; but the cholera has chosen as its theatre the top of College Hill ! In 1833-4j but few houses existed on College Hill, but in 1849-50, the two last years the cholera has prevailed here, it has singled out the very summit of College Hill for its onslaught. lam aware that it has been ingeniously argued that miasm is rolled up a hill by the winds, and may follow the current of wind 5 THE CHOLERA IN NASHVILLE. from hill-top to hill-top, afflicting those who inhabit them, and passing harmlessly over those in the valley below. But in the particular case to meet which this argument was constructed, the British army in India had selected two heights to bivouac upon, as promising the greatest exemption from miasm. Multitudes were, however, assailed, and numbers, preferring the chances of the valley between the heights, moved below and escaped. But the sides of these hills were not inhabited, and the argument was at least plausible that miasm was rolled up one hill to the top, and was carried over the valley to the top of the neighboring hill, leaving the intermediate valley exempt. But the side of College Hill is densely populated, and upon the malarial theory, those nearest the bottom ought to have been the first to be assailed, and upon the principle of miasm being rolled up the hill, those residing upon the top should have been the last to have been attacked. Whereas, it is notorious that the top of the hill was the first point assailed ; a,nd as the disease spread, the side of the hill was involved, and, with the exception of a few scattering cases, the valley was exempt. With the word valley, let no one associate shade or greensward ! The fills upon which the streets are elevated are from ten to twenty feet in height, and cross the valley in parallel lines. Under and between the fills the creek winds its tortuous course, cutting deeper and deeper the alluvion as it approximates the river. On each side of the creek, and between the fills, (each serving as a dam to keep from the river the accumulating filth above), exists a common deposit for every imaginable abomination, which lies rotting, seething, and weltering, in the unobstructed summer's sun. Here, in this hotbed of miasm, rejoicing in the luxuriant abundance of raw material thrown into its very lap by two recent overflows, the last of which had just subsided and left its debris to a fiery sun, when cholera assailed the heights above — here, in this elysium of fevers and fluxes, did the inhabitants, in houses a few weeks before filled with water, and yet festooned with 6 THE CHOLERA IN NASHVILLE. damp and mould, escape the scourge that was decimating the heights above. We have said that the river here runs from south to north. This " slough of despond " is, then, nearly due north of College Hill, and the prevailing southern winds would have carried any exhalation arising from it, directly away from the hill, and rolled them up the side of Capitol Hill, facing College Hill. So much for the valley north of College Hill. The valley between Capitol Hill and McGavock Hill differs essentially from that we have described. It is broader and cleaner than the other. The creek that flows through it is larger, and, except near the river, has but slight depth of channel. The whole of it, however, is subject to overflow, and a general exodus of the inhabitants, as a consequence, had occurred but a month prior to the outbreak of cholera here in June last (1850). The houses were yet wet from the recent overflow, while cholera was ravaging College Hill; yet the inmates had returned to them, and, like their neighbors "over the hill," were rejoicing in an exemption from cholera. It was late in the season ere a single case of cholera (I mean by a " case/ a death,) occurred in the lower valley. It then assailed Mr. M.'s family, near the slope of McGavock's Hill, and destroyed some three or four of its members. There were also a few cases in that densely populated portion of this valley traversed by lower College street. But even on lower College street, where it passes through by far the most filthy portion of this valley, and where every house had been submerged the month before, there was not one case to ten among the same number of people that occurred near the Public Square, on the central, or Capitol Hill. It may be inquired if there be not sources of malaria on these hills. We answer, that we are not acquainted with any region whose topography indicates so complete an exemption. Every rain sweeps off all accumulations into the valleys which flank the hills, where a portion of it escapes into the river, by 7 THE CHOLERA IN NASHVILLE. means of the creeks, and the remainder is kept " on deposit " by the Jills. The only street in the valley, between Capitol Hill and McGavock Hill, running at right angles with the river, and near the borders of the creek, is Crawford street. It is unpaved, without sidewalks, and is, perhaps, the filthiest street in the city. All the houses on the street were submerged during the overflow, yet upon this street but a single case of cholera appeared. Line street is next to, and runs parallel with Crawford, and is upon the side of Capitol Hill. This street ascends as it passes along the side of the hill, and attains its greatest altitude opposite the capitol. It then descends, and is lost in the valley beyond. Of course all that portion of it in the valley is subject to overflow. That portion on the hill side, not subject to overflow, is well paved, while the end in the valley is neglected and dirty. On that portion of Line street on the side of the hill, not subject to overflow, and from whence all the elements of malaria would be washed by every rain down to Crawford street below, no less than forty persons died of cholera in June and July last, whereas on that portion of Line street that extended into the valley, not one died ! Nay, the most fatal section of Line street was precisely its highest point. One family, upon the highest point of Line, and upon the upper side of the street, lost seven members. If these facts, known to be such by all the practitioners of the city, are reconcileable with the notion of the miasmatic origin of cholera, I have not another word to say. This we wrote for a paper on cholera, prepared by Dr. Dorris, of this city, and published in the first volume of the Nashville Journal of Medicine and Surgery. Since 1850, Cedar street, which passes from the Public Square by the southern side of Capitol Square, has been improved for about a mile west from Capitol Hill. At the bottom of the hill it is subject to overflow, and out to the west end of it, to the Charlotte 8 THE CHOLERA IN NASHVILLE. Pike, it runs parallel with Cockrill's Creek, and about fifty yards from it. The creek crosses the street at its western terminus, and hugging it pretty closely for a mile, till, striking Capitol Hill, it leaves the street to the right, to pass directly over it, to wind itself along its base, and divide the low land between Capitol and McGavock Hills, and after appropriating the water from "Judge's Spring," and that of the great French Lick, it empties itself into the Cumberland. Parallel with Cedar street, and north of it, is Gay street, which lies north of Cockrill's Creek, so that the creek flows along between these two streets till, in the bottom, it cuts southwardly, through Gay street, and also Line street, to the north, and parallel with Gay. Commencing opposite the Medical College, a hundred yards from the river, from Priestly street, is Fillmore street, which runs along a ravine that partially divides College Hill from Kolling-Mill Hill, about fifty yards from and parallel to the precipitous bluff of the Cumberland river, upon the highest point of which are the Water-works. Between this bluff and the river, above the Water-works, is an extensive bottom. All of our physicians know that what few cases of intermittent fever they meet with in Nashville, exist on Cedar street, Gay street, beyond Clay, and Fillmore street, beyond the Reservoir, and in the low lands above mentioned. We have, in the last few days, asked our oldest and leading physicians how many cases of intermittent fever, originating in Nashville, would they average a year during their practice here, and not one has said he would average more than one a year, and this one would be in one of the localities indicated: — Cedar street, Gay street, or Fillmore street. I have never seen a case in the city proper, save in one of these localities. If intermittent fever does not point out the presence of malaria, Ido not know what does ; and if the people of any district are strangers to intermittent fever, to pretend that malaria exists there, notwithstanding, is a base prostitution of medical language, for which no one can have any respect — a man being the only miasmatometer known to science. 9 THE CHOLERA IN NASHVILLE. McGavock Hill is partially cut in twain by McGavock's Spring branch ; and along the margin of this branch, and on the slopes on either side of it, the few families that live there have chills every year ; but this is outside of the Corporation. Nashville has the best natural drainage of any town on the continent. Every drop of water that falls upon College Hill finds its way either to Brown's Creek, to the south, or to Wilson Spring branch on the north, both of which go, with rapid currents, to the river. Spruce street in part, and Vine street in part, form the back bone of Capitol Hill, which stretches back to Fort Negley, the most elevated point in that animated and picturesque panorama which surrounds the city, while the head, on which this back-bone suddenly terminates, constitutes the site of our magnificent capitol. On each side of this ridge are many springs (Wilson's being one), whose branches find their way into the larger streams which divide the low-lands on each side of Capitol Hill. These streams drain thoroughly the north side of College Hill and the whole of the south side of Capitol Hill. The north side of Capitol Hill plays watershed to Cockrill's Creek or Lick Branch, which also receives the water from the south side of McGavock Hill, while the north side of this hill is a part of the water-shed of McGavock Spring branch. Such is a hasty but sufficiently accurate representation of the topography of the site of Nashville. The late epidemic began here during the last days of May, at the culmination of the Exposition furore. The city was crowded to suffocation, and the trains from everywhere to everywhere burdened with human beings, coming to or going from " the show." Suddenly, on the last week of May, physicians would stop each other on the street and inquire, with long visages, " Anything strange in your practice ?" " Well, we always have cholera morbus here in late spring," I said to many who asked me this question. The people began to whisper of strange cases, ending in death, they had heard of. About this time the regular monthly meeting of the City Society came on (June 3rd), and the subject of cholera was ventilated. 10 THE CHOLERA IN NASHVILLE. We presided at the meeting, and agreed with all that no cholera was in Nashville, and an account of the meeting was reported to the city papers. Still the enquiry was ever returning, go where you would, " Is there anything suspicious in your practice?" Mr. J , No. 110 N. Summer street, in the very heart of the city, had diarrhoea on the 26th of May, on the 29th had vomiting, cramps, and colliquative diarrhoea, and died. On the same day (May 29th), Mrs. Johnson, colored, living on Front street, near Dickey's mill, took a purging at 2 p. m., quickly followed by vomiting and cramp, and ending in death at 4p. m. This produced great consternation in that neighborhood. The death of some negroes near Hackberry Spring, between Market and Front streets, in the low lands, was reported about the same time. On the Ist day of June, a little white girl, who staid at a fruit stand near the post-office, in the centre of the city, sickened with diarrhoea, and went to her boarding-house on Union street, between Summer and High, where she had vomiting and cramps, and was soon in a state of collapse. I saw this case with Dr. Hughes. She died in a few hours. On this day, a colored woman died with the above symptoms on High street, near Broad. She was seen by Dr. Menees. On the 4th of June, Mrs. J and child died at 166 N. Summer street. This is near the centre of the city. During these first days of June, Dr. McMurray and Dr. Stephens reported several cases to me in the neighborhood of the brewery, on High street, and the region beyond. I visited one there with Dr. M. The patient was a stout laboring man, 63 years of age. He had no pulse, was cold, and bedewed with a slippery fluid. His eyes were sunken, and his hands sodden and corrugated. He was perfectly intelligent. Had eaten cabbage and potatoes, being perfectly well. Shortly after purged and threw vp — potatoes, as he swallowed them, passed through him. He had had cramps, and had passed no water for six hours. Dr.. McMurray had seen him, and ordered 11 THE CHOLERA IN NASHVILLE. medicine, some hours before, but the old man had not sent for it, and had taken nothing. He died a few hours after. Up to this time I had doubts about cholera having our devoted city in its grasp. I doubted no longer. This man died of cholera. On the 7th of June and following days, the city papers got as correct a report from the various undertakers as it was possible to procure, which we give below, as follows, from the Union and American : PROGRESS OP CHOLERA IN NASHVILLE. There were a few cases of what, it is now clear, was cholera, in Nashville, during the last week in May and the first week in June, of which we have no record. Our record begins with the 7th of June, and shows the daily mortality of the pestilence to be as follows : DATE. WHITES. COLORED. TOTAL. June 7 11 10 21 8 8 10 18 9 7 11 18 10 5 6 11 ii :.... 6 9 is 12 7 4 11 13 5 10 15 14 2 10 12 15 10 15 25 16 4 10 14 17 20 24 44 18 11 21 42 19 ....* 8 22 30 20 23 49 72 21 20 39 59 22 22 31 53 23 11 26 .. 37 24 10 19 29 25 12 13 25 26 7 17 24 27 10 10 20 28 5 7 12 29 8 16 24 30 4 6 10 July 1 8 8 16 Total 244 403 647 12 THE CHOLERA IN NASHVILLE. In addition to these, a considerable number of negroes died in the suburbs, and were buried in vacant lands near the city, by parties of their own color, without applying to our regular undertakers. We have heard of fifty -three being buried in one place ; not more than one-fourth or onethird procured coffins from the undertakers. The cases thus occurring, of which no account is had, added to those who died previous to the 7th of June, will, it is thought, bring the number fully up to 750, thus showing that the mortality of this year has been fully equal in number to that of 1866, while the death-rate, according to population, has been considerably larger. We may call this pestilence by whatever name may suit the fancy, but the record shows that it has been more virulent than that Avhich scourged our city so terribly in 1866. Thus we find that, from the 7th to the 30th of September, in that year, both days inclusive, the number who died from cholera was 659. This year, during the corresponding days in June, there were 631 deaths from cholera, of which the undertakers have a record, and then we know of from thirty to thirty-five negroes buried at one place who are not included in any undertaker's count. This clearly shows a greater mortality this year. The epidemic was not preceded by premonitory diarrhoea, or cholerine. There was no complaint of diarrhoea among our citizens during the first week in June. Like the people of Pompii, they were in a high state of enjoyment when the smoke that adumbrated the explosion of the volcano hovered above them. Their country friends were sojourning with them; hotels and boarding houses were crammed; green grocers were active in receiving vegetables from the South, and exchanging them for fractional currency, while visions of strutting in a bank to clarket their cash accounts, made their eyes dance in a delirium of happiness. " Italians black-eyed daughters " thronged the streets with violins and harps, and all public places were flooded with gas-light, and were animated with music. The Opera House, long silent as an oyster, was lighted up in her holiday habiliments, and sent forth song that reminded us of Jenny Lind, and the cormorant Barnum hawking tickets to the last moment for the last dime he could get for the last seat — " only one more, gentlemen /" Nashville was looking vp — was going to have a Fifth National Bank and two more dailies. Real estate agents saw, 13 THE CHOLERA IN NASHVILLE. in their mind's eye, corner lots, in Jones's addition, going off like hot cakes, and had bought a couple with their profits, built large store houses upon them, and were " taking stock " with the promise to the public, on a tin sign, to " Open next Wednesday." Young men felt able to marry, and did marry, and George, with his beloved, could be seen at furniture stores, selecting the garlands of the honey -moon. People were really glad to see each other, as well as themselves, in the mirrors of shop windows. When, boom ! The minute gun at sea ! — " Doctor, Bettie has the whooping-cough ! Do you not think I had better send her to the country with her mother ?" "By all means." Next day papa was with Bettie, and the halls that were brighter than Tara's, on last evening, are as dark as Egyptian midnight on this. What of the little Italian harpist ! Ah !we swung corners with him in the valley and shadow of death for forty-eight hours, and ten days after we had, at midnight, a serenade from the whole band, when the soulforce of the corps poured itself, in gushing song, upon the night, — the largest fee we ever secured. True, it could not buy a house ; but a house could not buy that. But while diarrhoea was not general, was it not prominent in individual cases — the music of the rattle before the poisoned fang festered in the vitals ! In a few, not many, cases, this was so. Miss H , aged 11 years, a fine healthy child, plump and ruddy, living on North College street, near Capitol avenue, retired to rest, on the 23rd of June, in perfect health, and arose, at 6 o'clock on the morning of the 24th, in the same condition. At 7 o'clock, an hour after she arose, her call to evacuate her bowels was so urgent that she could not run out, but squatting instantly upon a chamber, nearly filled it. I saw her in twenty minutes after. Rice-water was running from her bowels as she lay, and she threw up a similar material just after my arrival. Cramps now seized her, the pulse glided from beneath the finger, the skin was cold and damp, and she died in six hours after the first operation. This child had eaten twelve peanuts on the preceding evening ; she had been otherwise rigidly dieted. There were cases, however, 14 THE CHOLERA IN NASHVILLE. where diarrhoea had existed for days before vomiting and collapse. •WHENCE WAS ITP We are under no special obligation to show how cholera came to Nashville, and we do not assume that it had or had not been at New Orleans or Memphis before we were honored by its presence. We believe, however, that cholera was at New Orleans, on the coast, and at Memphis, before it came here. We believe that no town on the American continent can originate cholera. That this may be so hereafter we think not impossible. Man himself, and all that has afflicted him, were of Eastern origin ; not only the star of empire, but the pestilence that wasteth at noonday, westward holds its way. The small-pox and its congeners, measles and scarlet fever, came from the East, and for centuries the anxious eye of parents turned instinctively to the East at the bare mention ot these dread words. Like cholera in modern times, the malign trio, every ten to seventeen years, swept through the land, uglifying, crippling, and killing the population. Now neither doctors nor people bother themselves as to whence they come or whither they goeth. They have doubtlessly become domesticated, Anglicised; and so cholera will finally be classed among the ordinary diseases of the country. While art has suppressed the explosive violence of one of the trio, the smallpox, our profoundest thinkers believe that the loss of power in one to damage the human family is made up by an increase of that of another, the scarlet fever, and that the past bad eminence of the one is to distinguish the future of the other. Cholera may become domesticated without losing any of its malignity. Be this as it may, it comes to us now from Asia. Precious little is known about it. We know that its geographical prevalence is co-extensive with the habitable globe. But to the question why {and this is common to all great epidemics) it should delight to linger and destroy at one place rather than another, when so preeminently cosmopolitan, our science offers THE CHOLERA IN NASHVILLE. 15 no answer. To appeal to waters, or geological formations of particular areas, in explanation, is only ridiculous ; and that made to exhalations from vegetable matter, " living, dying, or dead," or gasses from the earth, air, or water, or all, through solar heat or otherwise, the most unsatisfactory of all — for these things exist only in definite places, in definite seasons of the year ; while no one has to learn that cholera exists, by turns, everywhere, and at all seasons. If it goes, as Frederick the Great said of an army, " upon its belly," has its poison elaborated in the body of a man, to be discharged from it with characteristic evacuations, the mystery about its manner of travelling disappears at once, and it seems to us difficult for any one to study this theory, with the facts recorded in illustration, without adopting it. Railroad trains might scatter the discharges of a cholera patient on board, through a hundred miles or more. We can imagine a countryman crossing the road thus sown with cholera, and becoming poisoned, going home and dying of cholera, to the consternation of the neighborhood. The first case of cholera I ever saw was in a negro woman, living on the Kentucky and Tennessee State line, in the centre of a wilderness. She died, and two of her fellow-servants died the same day. A public highway passed near the house, and the next day some emigrants, nine miles farther on the same road, were seized with cholera, and three of them died in a barn on the roadside. I also attended these, and the next day was seized myself and barely escaped. The cholera being on this continent, with continuous lines of railroad from San Francisco to Galveston, and from ocean to ocean, it is not difficult to imagine how its seeds might be sown at thousands of places, while thousands of other places would escape. The very language employed by the ancients proves that the idea was familiar to them, of disease coming down upon a people, like the contents of Pandora's box, just as we see is the case with cholera to-day — epi demos upon the people ; not from man to man, but upon. No one pretends here that the disease entered the city like 16 THE CHOLERA IN NASHVILLE. an invading army, at one point, and diffused itself through it, for all our physicians know that the facts concerning the irruption of the disease here are just as we have stated them — the facts being, indeed, obtained from them. Every ward in the city, about the same time, offered up one or more victims. The disease fell upon them. The seed-cloud had spread itself over the city, and sifted its destructive missiles upon its population. Those who received the missiles in their bodies were more or less affected, according to their susceptibilities — very many of them, possibly, not so much so as that their bodies became, in turn, elaborators of cholera germs, to go up by sunlight, and fall, as their predecessors, upon the people. That these germs are under the influence of a law that ensures them a vitality only for a very limited period, would seem probable, from the fact that the disease can only keep itself alive but for a very short period at any place ; or which would seem more probable, the people at the points assailed rapidly lose their susceptibility to the power of these germs, if, indeed, it is not true that a very trifling per cent, of any population possess any susceptibility whatever. AH people cannot be successfully vaccinated, and many will not take small-pox when exposed to its contagion. But few children seem susceptible to the power of scarlet fever, while almost every one takes influenza. Providence has seen to it that epidemics are not to depopulate the world, and to do this it was necessary to secure a large exemption by withholding inherent susceptibility. This important truth is illustrated by the fact that opposite modes of treatment secure about the same results ; or, to state it more accurately, the result is conditionally predetermined and inevitable, and in defiance of what art attempts to achieve, save by hygiene ; God here, as elsewhere, helping those who help themselves. That our cholera was not contagious is proved by the fact that no physician or professional nurse took it, and our first cases were among those who had been living quietly, for a long time, where assailed. This epidemic, then, was not contagiou 17 THE CHOLERA IN NASHVILLE. — the precise conclusion of Dr. Drake concerning the cnolera that prevailed at Cincinnati in 1832. Nor here, as there, had any particular part of the city a disobliging preference shown it. He says, " That it was not introduced from abroad, either by persons or things, is now universally believed ; and I may add that, during its whole continuance, not a single fact occurred that went, in the slightest degree, to establish its contagious character. * * * Nor had miasmatic localities any apparent agency in its production, for it appeared in all parts of the city, high and low, thickly and thinly peopled, clean and dirty, nearly all at the same time." All this was preeminently so here. We can, in perfect truth, say of our epidemic what Drake has recorded of his. Man here, as elsewhere, employs himself to find some one to find fault with ; somebody, or something controlled by somebody, did it. At Cincinnati, there were twenty-one cases of well-marked cholera occurring between the 30th of September, 1832, and the Bth of October following. These cases, all ending in death, and given in detail by physicians, with name and place, sex, nationality, race, and social position, all happened before any person, with cholera, had arrived from the cholera district — then the valley of the great lakes and the St. Lawrence river. This is a clear record, now forty-one years old, from the pen of by far the greatest medical observer America has ever produced. But on the afternoon of the 9th of October, 1832, a European, who had left Kingston, in Upper Canada, nine days before, and, crossing the State of Ohio from Cleveland, on the lake, by canal to Portsmouth, one hundred and twenty miles above Cincinnati, came from thence to the city on a steamboat. Down the Ohio river he was seized with cholera, and arrived at the quay of Cincinnati with what was conceded to be that disease, upon him. As the record does not show that he died, but only that he had cholera upon him, the presumption is that he did not die. But from that day to this, contagionists and favorers of quarantine regret that that poor fellow could not have been kept away from Cincinnati, though twen- 2 18 THE CHOLERA IN NASHVILLE. ty-one people had died of unmistakable cholera before he arrived there. And so they have already begun here. Every one of our physicians agree that nobody did come here from any place, and die with, or recover from cholera, neither before our cholera commenced, during its progress, or since its departure. The great trouble with our doctors, in the beginning of cholera here, was, that the coming man didn't come. Parties to medical opinions diametrically opposite, all agree in this, that none of our citizens returned from a journey home, and had cholera, and that no one in the wide world came here with it from any where ; and yet a flying medical peripatetic, sent, he says, from Gotham, knows, of his own " personal knowledge, that cholera was conveyed from New Orleans and Memphis, by steamboats, to Louisville and Cincinnati. I have also very positive information that cases were brought by railroad to Nashville, and died there." How he had personal knowledge that cholera was carried by steamboats to Louisville and Cincinnati, from New Orleans and Memphis, is incomprehensible. As well might a wild goose, after " honging " her way through the clouds from the lagoons of Louisiana to the sources of the Mississippi river, pretend to have collected and arranged, en route, the ornithology of the interior valley of North America. And as to his " very positive information that cases were brought by railroad to Nashville, and died there," we can apply no milder term to it, than that it is a sheer fabrication. One of our most distinguished physicians gave him a correct history of the advent of the disease here, assuring him that it had not come here through persons from anywhere. We will show, in the proper place, that his other cholera assertions about Nashville are equally unfounded and unreliable. Had any stranger come here with cholera, it is impossible that all of our physicians should have been ignorant of the fact ; and had one of our own people returned from a visit to infected places, and sickened, surely some one physician among us must have known it. The cholera, then, of 1873, at Nashville, was not brought 19 THE CHOLERA IN NASHVILLE. here by persons or things, any more than was the cholera of 1832 carried to Cincinnati by persons or things; but, in both cases, the germs being in the air, passed over large districts of country, without injury to them, to fall finally upon the populations of these cities. It is not strange that these germs should be attracted by the murky atmosphere of crowded cities, and not by that purified by the foliage of trees in country places. City atmosphere, all know, is extremely prejudicial to malaria, which creeps away from crowds, and exercises its powers on the thin-spread inhabitants of the country. Now as city air has power to repel malaria, there is nothing illogical in the conclusion that it may attract the poison of cholera. It is only by conceding some such law that we can account for such facts as notoriously exist in association with the freaks of cholera. PREFERRED SPOTS OR PLACES. In the beginning of the epidemic here, as in that of Cincinnati in 1832, no preference was shown for localities. High places and low places, clean places and dirty places, were alike assailed. But, as the epidemic influence deepened, and the angel of death reached farther, and with a longer and keener blade, then all could see that wherever were poverty and destitution, the howl of anguish was loudest. If colored humanity suffered most, as all know was the fact, it was that portion of our colored fellow citizens who were crowded into noisome shanties, whether these hamlets were on the hill top, as Rolling-Mill Hill, or on the low valley of Sandy Bottom, the heights of New Bethel or the flats of Trestletown. But the truth is, the high hill selected for a fort by Union Generals during the war, on Tunnel street, or Granny White pike, in the neighborhood of the Rev. Mr. Ament, being thoroughly drained, but with a miserable colored population, suffered ten times more than any village of shanties in the low grounds. Says the Rev. Mr. Ament, in a letter to ex-Mayor Verbeke, of Harrisburg, Pennsylvania, published in the Patriot of that 20 THE CHOLERA IN NASHVILLE. city, " In my neighborhood, more than two hundred have died since the dread angel of death first spread his dark wings over it." Since the above was written, I have visited New Bethel and adjacent villages of shanties. The ground is higher than the heights occupied by the reservoir or the State capitol, and consists of about two, hundred acres of as finely-drained highland as exist in the State or out of it. I visited it with Dr. Currey, of this city, among the most distinguished of our physicians. He was born on the spot occupied by Fort Morton, two hundred and ninety-five feet above Cumberland river, and the territory of New Bethel was the play-ground of his childhood. He never so much as heard of a chill and fever on that great elevation and adjacent highlands, and yet nearly, if not quite, half of its population died of cholera from the 20th of June last to the 10th of July, or in twenty days. We visited the residence of the venerable Colonel Ament, who gave us chapter and verse for his published account of the two hundred deaths in his immediate neighborhood. Let this well-verified mortality, in a locality where malaria was never heard of, settle forever the antagonism of the causes of cholera and intermittent fever. This number is about one-fourth of the entire mortality. We have taken the pains to have the mortality of regions subject to intermittent fever definitely ascertained by reputable physicians, by repeated visits to the localities since the subsidence of the epidemic. Cedar street, from the foot of Capitol Hill to where it ends on the Charlotte pike, where Cockrill's Creek crosses it, a distance of three-fourths of a mile, lies on the bottom land of, and parallel with, the creek. The street is not provided with side-walks, but was once Charlotte pike, and is McAdamised. Both sides of it make a very respectable show of family residences and store houses, or retail family grocery houses, many of them well built and sightly ; many buildings of a better class have gone up upon it the present and past season. The upper portion of this street is to a greater extent infected with THE CHOLERA IN NASHVILLE. 21 intermittent fever than any portion of Nashville ; the lower part, as it approaches Capitol Hill, less so. There were four cholera deaths on this street ; but upon that portion of it most subject to intermittent fever, not a single death occurred. The street parallel with Cedar, on the other side of the creek, Gay street, having a handsome, well-built village upon it, was not afflicted with a single cholera death. The case reported for Gay street, and so marked, I ascertained myself, neither lived nor died upon that street, but did die somewhere on the low grounds not far off. The next place most subject to intermittent fever is Fillmore street, beyond the reservoir. This street reports two deaths from cholera. Rolling-Mill Hill lies between Fillmore street and the precipitous bluff of the river, a rocky hill densely populated with colored people in shanties. Dr. Bailey, who was long hospital physician in the neighborhood, tells me he was familiar with what sickness they had in this village during a period of four years, and that he had never known a case of intermittent there. During our late epidemic, this hamlet was known as Rolling-Mill village. Twenty-one died of cholera there, in a population of three hundred. A fine residence fronts this village, on the west side of Fillmore street, on an eminence higher than Rolling-Mill village — nay, higher than the reservoir. Two died of cholera at this house, who could not have contracted it anywhere else. Thus it is shown that those localities subject to intermittent fever, our epidemic avoided in a striking and unmistakable manner, as was the case of all the choleras which preceded it here. Indeed this, after the first visitation here, ought to have been looked for ever after. Of all the towns, from the lakes of the north to the Gulf of Mexico, Nashville is undoubtedly freest from malaria ; and of all the towns in the same area, demonstrated the greatest aptitude for cholera at its first visitation. No wonder that this exalted aptitude should have been referred to dirt, to springs, &c, but how any one should look to malaria as a cause, surpasses all understanding. 22 THE CHOLERA IN NASHVILLE. Columbia, forty miles south of us, upon the Duck River, with its annual chills and fevers, was never visited by cholera, while Lebanon, amid her majestic cedars, and as innocent of chills as the heights of Kamskatka, is terribly scourged by it. When it is remembered that cholera shuns the country, where malaria abounds, to prey upon cities that suffer but little from malaria ; and again, that those cities most exposed to malaria, as Louisville and Clarksville, enjoy the greatest exemption from cholera, together with facts recorded above, going to prove that it has ever dodged malarious districts here, the conclusion is logical — I had almost said indisputable — that the absence of malaria here explains the ravages of our fair city by this pestilence that wasteth at noonday. Cholera infantum is fearfully like cholera in its symptomatology and fatality. It exists almost exclusively in large towns, where there is no malaria, unless generated there by that sum of all follies, underground sewerage. In a slower form, under the name of " summer-complaint," all writers and practical observers agree that there is no remedy for it like country air — that is, malarious air. It acts like a charm. This truth, to say the least, must be regarded as suggestive. We have mentioned above that McGavock's Spring branch is in a ravine that partially divides McGavock Hill. This is not at present in the Corporation. We have attended several families near this branch with chills — one family last year with five members of it down at once, and another of six members, all of whom have suffered with chills. We believe, out of the few houses fronting this branch, though some of them are a hundred yards from it, and sixty feet above it, not one has escaped intermittent fever among its inhabitants, any year since it was built. In this valley, commencing at the barracks and ending at the Horticultural Gardens, its entire extent, not one died of cholera during the late epidemic. But reaching the brow of the valley, and descending the slope on the north side, which has a natural drainage that secures it from intermittent fever, you pass over a region in which the death-rate from cholera, in June last, was appalling. 23 THE CHOLERA IN NABHVILLE. Now in the face of these facts, known to be such by our entire thinking population, does it not seem hard that the very opposite will go into history, and be believed and quoted for a thousand years? Says Dr. Peters, (who came here on a flying visit from New York, to pick up cholera items,) in his report to the New York Board of Health, about Nashville : " The cholera was almost exclusively confined to the outer limits and low portions of the city, and carried off hundreds of those living near the small streams, or so-called branches, licks, and runs of water, especially lick branch, upon one side, and Wilson's spring branch upon the other." We have shown that the terrific mortality in the hamlet of New Bethel, which carried off nearly half of its inhabitants, occurred in a high and dry region, thoroughly drained, and no branch or run in a mile of it. Also that of Rolling-Mill Hill, with no branch or run near it, except the Cumberland river, and that separated from the village by a bluff of rock two hundred feet high. Lick Branch (generally so called here), is Cockrill's Creek, which, on its way to the river, receives the Judge's Spring branch (one of the finest springs in the world), and two hundred yards below, and three hundred from the river, swallows up the Lick branch, from a glorious sulphur spring that bursts out on the side of the creek, and, a. few yards below, mingles its delicious waters with those of the creek- This is the creek that runs between Cedar and Gay streets,, and we have shown that there were but four deaths (and we now add that two of these were babies) on Cedar street, and none on Gay street, as far as it runs parallel with it to Clay street. Gay street is the north border of Capitol Square, and opposite the capitol, and; within a stone's throw of it, is one hundred feet above the level cut by Lick branch ; it then descends, crossing Vine, Spruce, and McLemore streets, into the low lands, and crosses Lick Branch, or Cockrill's Creek, and continuing through the low lands, mounts higher land at Clay street, and is pretty well improved from this point as far as it 24 THE CHOLERA IN NASHVILLE. goes. Where it passes down to Cockrill's Creek, and just before reaching and a little beyond it, are shantied hamlets, inhabited mostly by colored people. Here were nineteen deaths from cholera, and these are all the deaths that occurred from cholera (adding the four on Cedar street, which runs parallel with the creek,) from the beginning of Cockrill's Creek, at Cockrill's Spring, at the Fair Grounds, two miles out, to its confluence with the Cumberland River. And on Wilson's Spring branch, taking in a territory of a hundred yards on each side of it, from the spring to the river there were six deaths from cholera. Hackberry Spring is near Wilson's Spring branch, between Market and Front streets. Near this spring lived Mary Payne, colored. She was the first to die of cholera in this epidemic. Being in good health, she washed all day on Wednesday, the 28th of May, 1873. On Thursday morning, the 29th, at 3 o'clock, she was seized with diarrhoea and vomiting, collapsed, and died at 11 a. m. Sick eight hours. In the immediate neighborhood, and on the day Mary Payne died, Mrs. Patterson, colored, who had been with Mary Payne, took sick with diarrhoea, which continued through the 30th and 31st, and on the Ist day of June she had vomiting and cramps, and ;going into collapse, died. On this day Jim McKisic, who had seen Mrs. Patterson in her sickness, and lived near her, was seized wiith similar symptoms, and on the next day (June 2nd) died. On this day a colored man at the same house was taken at sa. m., and died at 9p. m. This is the great mortality of Wilsori'-s Spring branch. Peters' report, a tissue of misrepresentations from beginning to end, will figure in sanitary science hereafter, and serve a purpose for ring-makers and job-hunters. Here is the naked truth, that contradicts everything he says; but what will that amount to, when, with the money collected from the solid men of Gotham to put more money in the pockets of some of them at the expense of others, a palpable contradiction of truth will be sent to the four winds of heaven, and by them kept in motion for ever. 25 THE CHOLERA IN NASHVILLE. This wandering collector of cholera items shows, by certain expressions, that he is in the service of a ring. The italics I put in the quotation are mine, and I make them to show what I state above : "At Nashville, the localizing causes were so extended and apparent, that no importation of the disease was looked for or generally believed in." If it wasn't looked for, how could it be generally believed in ? " They are so patent " (these localizing causes) " that they force themselves upon every one's attention." Now these localizing causes, if they mean anything, mean filth. Dr. Peters leaves the impression that filth in Nashville is lying piled up all around, and everywhere, when I assert, without the slightest apprehension of successful contradiction, that there is more filth, this day, on Broadway, in the city of New York, than there is in the entire city of Nashville. And further, I believe this day, July 28th, 1873, that it is the cleanest city upon the American continent, having been washed yesterday, by a great rain, as clean as a bride's face. The truth is, Nashville has been lied upon and belied so long that half of its population believe that they are living up to their eyes in filth, and employ not a little time in cursing the authorities for not giving them a cleaner city. Sometimes they vent their pent-up spleen upon the swine, for contributing their part to nastying up things, and the hogs are voted to the work-house, where, refusing to work, they are worked upon, and disappear from human view ; then, as the hogs are all gone, there is no use for a hog-law, and the law is repealed ; and then, somehow, the hogs all come back again, and are seen as busy all day, eating watermelon -rinds, wasted peanuts, and cast-away apple-cores, as if they were paid so much a day as scavengers. Presently Mr. hog, by economy and constant application, gets into a good condition, and he awakens visions of ham-gravy wherever he goes. Then his scavenger service is forgotten, and the cry of " down with the hog !" is raised along our thoroughfares. N. P. Willis, "the literary fop," said, when speaking of mowing lawns, that sheep were cheaper than folks, for after 26 THE CHOLERA IN NASHVILLE. Mr. sheep had done the mowing, you could settle with him byeating him. Ah! filthy Nashville! Sewer, screw her, and renew her, till she is purer. Give her insides, that she may have bowels of compassion for her poor cholera-bedeviled citizens. Then the Gospel of soap and water will foreshadow her millenium. Wash well her outside, and pour the soap-suds down her inside, and let them deposit their solid filth in the convolutions of her bowels, to belch up such stinks upon every vibration of the atmosphere, as would amaze one not accustomed to it, like myself, who, having a hole at my office door, to let the surface-water of the street into a sewer, reaching to the river, have the advantage of a mile of concentrated stink, composed of such a combination of gases as would bewilder a chemist. We said to the man, when preparing that nuisance under the supervision of a street committee-man, " What do you want to tap that infernal sum of all villanies and depository of mingled stinks right at my door for?" " I want to let the water from the gutter, along the east side of High street, into the great sewer." " But you can't let the water in without letting the stink out. Why not let the water run along the gutter down hill to Summer street, through Union ; down Summer to Cedar, down Cedar to Cherry, and down Cherry to Lick branch, and clean the gutters with its torrent, instead of losing the great cleanser here, and sending forty carts and spade-men to clean out these gutters by force of muscle. Why don't your folk of the Board use more brain and less muscle?" "I suppose," said the man, "because they have more muscle than brain." The cholera, then, was not brought here by man, nor kept here by filth, so that Nashville could no more, unaided, get up this slaughter than could Diogenes lift himself, by the handles of his tub, forty feet in the air. We have just returned from Fort Gillem. It is one of the villages upon the outskirts of the town. The plateau upon which it stands is of the same elevation as that of the waterworks. It embraces the territory around Fort Gillem, from THE CHOLERA IN NASHVILLE. 27 the Northwestern railroad to Jefferson street, extended, and from Harding's spring to Clay street, east. The site of the village embraces five hundred acres of ground. The inhabitants number fifteen hundred, two-thirds of whom are colored. The houses are generally comfortable, and many of them substantial brick dwellings. The natural drainage is perfect, and the intermittent fever unknown. The loss from cholera here was about one and a half per cent. Dr. Brooks (who resides there), the editor of The Working Man, assured me that, in his opinion, the population of Fort Gillem were the most industrious, sober, and orderly, of any villagers in the United States. The Fort, around which the village is built, is nearly of the same elevation as our capitol, and is about one mile and a half from it. The four Forts — Negley, Houston, Morton, and Gillem — all occupy great elevations ; the three first named being south of the capitol, and Fort Gillem to the west. These were the nuclei around which negro villages naturally formed during the war ; ISTew Bethel, lying about and between Fort Houston and Fort Morton, being called, until very lately, " Contraband Camp." HOW WAS IT FOR HIGH? It loved the high places, and the clean places — clean because high — and did not nourish on runs, or licks, or branches. Thanks to the faithfulness of the reporters of our city papers, we have before us irrefragable evidence of the correctness of this statement. The name, sex, race, and place of residence, of each victim of the remorseless invader, is given for each day. This record, and a map of the city, are before me. We have given a few of the first deaths that occurred ; that of Mary Payne, on the 29th of May, being the first, as all of our physicians believe. We made diligent inquiries of her intelligent neighbors. She had been living quietly and industriously where she died, for many years. She died in eight hours after the first symptom. She lived near the mouth of Wilson's Spring branch, near the river, and it was this death, and those 28 THE CHOLERA IN NASHVILLE. in the immediate vicinage, that gave that "branch" an infamous celebrity, which was subsequently intensified by the death of two estimable ladies, higher up, and in a well-improved portion of the city, but within a hundred yards of this " branch." The record of deaths begin on the 7th of June, and we copy from the record the places where, and the names of all who died of cholera on that day : 1. Mrs. Rose, corner of Spruce and Fogg — a clean and elevated portion of the city, well drained, and not within half a mile of any " branch." 2. L. P. Cook, Ewing avenue — high and clean, and well drained. 3. Charles A. Payne, Park street — the street on which is the great carriage entrance to the grounds of the Capitol, one of the highest and best improved streets in the city, consequently clean and well drained. 4. V. Otto, corner of Jackson and Market streets — ground not very high, but a hundred feet above the bed of the river ; clean, and well drained. 5. Miss C. Ullan, corner of High and Ash streets — an elevation nearly equal to that of the reservoir or the University, from the entrance gate of which Ash street leads ; clean, and thoroughly drained. 6. Miss Hamilton, Rutledge Hill — the hill on which the University stands, the highest and cleanest in the city. 7. Patrick, son of P. M. Ryan, corner of South Union and Spruee — high ground, well improved and drained, and remote from streams. This was the first day's cholera report, which was mixed up with deaths from other causes, making eleven whites in all ; but we have above separated the cholera deaths from the others. All of them, except one, occurred on high ground, and dotted an area of three miles in extent. The other, though not on high ground, is not on low ground, and is remote from " runs," and in a well-built portion of the city. 29 THE CHOLERA IN NASHVILLE. We give now, on the same day, the cholera deaths among our colored population : 1. David McEwcn, Murfreesboro' pike — the portion of this pike just beyond the city limits is very high, and the adjacent country well drained. 2. Monroe Hadley, North Summer, below Line street — this borders on the low ground through which runs Lick branch. 3. Stephen Wilson, Line street, portion not mentioned — the street is high, except where it crosses Cockrill's Creek. 4 and 5. Two colored women, names unknown, near Wilson's Spring — Wilson's Spring bursts out of a limestone bluff. 6. James Bunch, South Summer street, exact locality not designate — the greater part of this street runs over high ground. 7. Child, six months old, place not given. Of these seven, one only is known to be from low land ; but like the whites, the deaths come from all parts of the city. June 13th. — The following white persons died : 1. Mrs. Hosse, German, South Summer street — elevated ground. 2. Jno. McCormack's child, Gay, below McLemore street — low ground. 3. Maria Allen, Gay street, no number given. 4. Mrs. McFadden, West Broad street — high ground. 5. Mrs. McFadden's child, West Broad street — high ground. June ISth. — The following is a list of colored persons who died this day : 1. Sydney O'Neal, corner of Summer and Monroe streets — high ground. 2. David Hadley, North Front street — not high, but well drained. 30 THE CHOLERA IN NASHVILLE. 3. David Isor, Thirteenth District, near the northwest limits of the city — high ground. 4. Jo. Davis, Franklin pike — high ground. 5. Delia Martin, corner Line and McLemore — bordering on the low ground. 6. Eli Dodd, Cherry street, south of Broad, no number. 7. Woman at the Work-house — high bluff of the river. 8. Sarah Brown, Criddle street — low ground. 9. Lewis Williams, near the Howard School — high ground. 10. Child of Henry Eankin, locality not designated. June 20th. — The following persons died on the 20th, the day of greatest mortality : WHITE. 1. James Hinton, South Cherry street, number not given. 2. James A. Halley, Decatur Depot — high, dry, and well drained. 3. Mr. Lannom's child, North Summer street, No. not given. 4. E. H. Conley, Franklin pike — high ground. 5. James Ryan, Cedar street, below Trestle — low ground. 6. Charles Luxford, Spruce street — high ground. 7. James Thurman, corner Payne and Walnut streets — high ground. 8. T. Dorgan's wife, South Vine street — high ground. 9. W. H. Nance, McGavock street, West Nashville — high ground. 10. I. K. Jenkins, book-keeper at the Jail — high land, thoroughly drained. 11. B. Lighter, corner College and Jackson streets — land not high, but well drained, and a hundred feet above the bed of the river. Near no " branch." 12. Miss Sallie Show, South College street, number not given — College street passes through the low grounds, but even there is on a high " fill," above high tides, and the other portions of it are all high. 31 THE CHOLERA IN NASHVILLE. 13. A. L. Sullivan, Gay street, Thirteenth District — high ground, well drained. 14. Mrs. L. Hale, South Vine street — high land, well drained. 15. Dandridge, Fillmore street — high, and well drained. 16. George Dale's child, corner Lee and Wharf avenue — high and well drained. 17. W. L. Terrill, 140 South Front street — high ground, well drained. 18. Alfred Victory, South College street, no number given. 19. W. R. Boon, at Wliite Bluff— high ground. 20. Martin Barret's child, corner Gleaves and Overton streets — high ground. 21. Miss Beasley, Franklin pike — high ground. 22. Miss Spain, Maple street, South Nashville— high ground. These deaths are reported from every part of the city. • COLOEED. 1. Isaac Hobb, Kolling-Mill Hill. 2. Granville McGavock, South College street, No. not given. 3. Child of Dave Wilkin, place not given. 4. Frankey Bonner, Rolling-Mill Hill — high land. 5. Elmira Bomont, Jefferson street — high land. 6. Melinda Graham, Murfreesboro' pike, near Brown's Creek, four miles out. 7. Jerry Olwill, Granny White pike — high ground. 8. Eliza Adaline Brown, Granny White pike — high ground. 9. Child of Reuben Payne, Eighth Ward — high ground, remote from any stream. 10. Mary Harvey, Clark street — high ground. 11. Israel Mason, South Spruce street — high ground. 12. Mary Lewis, Broad street — high ground. 13. Pauper at New Bethel — high, dry, and well drained. 24 (( (( «. t( 16. Adaline Bell, Red Row, Rock Town — high land. 17. Child of A. W. Beaty, place not given. 32 THE CHOLERA IN NASHVILLE. 18. Eliza Duncan, New Bethel — high ground. 19. Margaret Smart, Demombreun street — street runs from high land to the low. 20. Jacob, New Bethel — high land. 21. Lizzie Queen, New Bethel — high land. 22. A. Bell, Franklin pike — high land. 23. George King, residence unknown. 24. Lucinda White, Crawford street — low ground. 25. Dilsey Pearl, corner Cherry and Gay streets — high ground. 26. Felix Rains, back of McCann's Mill, on Market street — — high ground. 27. George Sledge, near Belleview, North Nashville — high land if beyond ; low, if on the city side. 28. Wife of Peter Bosley, place not given. 29. Colored man on South Cherry street, number not given. 30. George Smith, North Front street — near the river. 31. Child of Ed. Easley, Rock Town— high land. 32. Wife " " " " 33. Child " " " " 34. Nolan, Trimble's Spring — low land. 35. Infant of Albert Cabler, Market street, number not given. 36. Infant of S. Leech, Murfreesboro' pike — high land. 37. Rose Buchanan, Jefferson street — high land. 38. Colored man, Franklin pike — high land. 39. Alice Brown, Hillsboro' pike, two and a half miles out — high country, well drained. Ten colored persons, in addition, died, and were buried by the colored undertaker, whose names and residences he did not learn. These deaths are distributed over an area of three miles by four, an overwhelming majority occurring on high, well-drained land, and remote from " creeks." Black Friday, June the 20th, 1873, the disease culminated. Seventy-two deaths are recorded from cholera, and six from other causes. The reports show that the columns of deaths from cholera and other causes lengthen and shorten together, as the mercury in parallel thermometers would ascend and descend 33 THE CHOLERA IN NASHVILLE. at the same time. The reporters did all they could to get the deaths on this day of horrors, but how many were buried can never be known. We learn that in some places, as at New Bethel, funeral ceremonies were remarkably primitive, and that the dead, in many instances, found such resting-places as the dreadful circumstances of their survivors determined, or enabled, them to procure. Houses there were with all the inmates dead ; one man assured me, while pointing out the house, that six corpses were found in it,, and no live one to tell of it. New Bethel was a great slaughter-house. From this hamlet it is known that forty-nine were buried in New Bethel grave-yard, fifty-three at Mount Ararat, forty at Bosley's grave-yard, thirty-eight at Fort Zollicoffer, and twenty-eight at Mill Creek. To this number the deaths of three whites are to be added. We have thus taken from the reports of cholera deaths those occurring on three days — First, the day on which the record begins, June 7th ; second, those occurring on the 13th of June; third, the day on which the greatest number, of deaths occurred, June 20th — " Black Friday." These days will certainly be taken as a fair sample of the whole*. We can only point out the fact that they occurred in every part of the city, high, low, thinly and thickly populated; near " branches " and on hills, which in height and magnitude might be called, and have been called, mountains, and that, too, by book-makers. These reports show that, in the city and beyond its limits — On the 7th of June fourteen died. Of these, seven are shown to have occurred in high places, six doubtful, and one in the low lands* On the 13th of June, fifteen died. Of these, eight are known to. have lived on high ground, three on low ground, and four doubtful. On the 20th of June — " Black Friday/' — there were seventy-two deaths. Of these, forty-two were from high places, three from low, and the remainder doubtful. The bottom through which Wilson's Spring branch passes, 3 34 THE CHOLERA IN NASHVILLE. bounded north by Broad street, and south by Lincoln alley and Franklin street, east by the river, and west by High street, over which bottom pass, on " fills," Front street, Market street, College street, Cherry street, and Summer street. The area is about three hundred yards by six hundred. This space is pretty densely populated, containing several of the largest warehouses in the city, and many substantial family residences. It embraces the south side of Broad street, the fronts of the houses giving them the appearance of being upon high ground, while the basement story, to place the front above the street, requires to be from twelve to twenty feet high. These basement stories are full of water at high tides in the Cumberland. It is said, by old citizens, that in former years intermittent fever was common among the few people who lived there, but for twenty years I have never seen a case of intermittent fever in that area. Seamed by other spring branches, running into Wilson's Spring branch, this bottom is thoroughly drained, and the dip of the rock, upon which the alluvion, of two or three feet in thickness, lies, being very considerable, as is seen from the bottom @i Wilson's Spring branch, as it passes under College and Market streets, the water that falls upon it soon finds its way into the river. Since being built ujpon extensively, it is, moreover, no longer a deposit of garbage, but really a handsome portion of the city. In these low grounds there were thirty-five deaths in all, from cholera. The number of deaths in this entire area we have had definitely ascertained in the last few hours; and if any portion of our history seems to overlap ground already discussed, we beg, in apology, to say to the reader that definite information, from personal observation on the field, and diligent inquiry, enlarged and enriched by the assistance of medical friends, grows upon me while I write, and while I am obliged to write, under the mingled cries of go here and go there — copy ! copy ! Again, much of this minute detail I would have gladly omitted but for a systematic attempt, from parties at a distance, to 35 THE CHOLERA IN NASHVILLE. make falsehood, and not truth, give form and pressure to our late scourge. What becomes of Peters' assertion, after a day or two with us after the enemy had decamped, that " the cholera was almost exclusively confined to the outer limits and low portions of the city, especially to Wilson's Spring and Lick branch." On these branches, and all the low grounds they and their tributaries drain, there were but sixty out of eight hundred deaths, seven hundred and forty being on high land. PREVENTION OF CHOLERA. A homely and a truthful adage is that an ounce of preventive is worth a pound of cure. A number of the prophylactic ideas that have obtained pretty generally in regard to cholera, have been suggested by those evolved in the discussion of yellow fever. Every reading physician knows this. Filth, as a " localizing cause," is connected with both of these diseases ; so is malaria ; and, as an exciting cause, water, holding organic matters in solution, figures conspicuously. When we come to the treatment, we will find that these ideas modify or control it. Dr. Drake assures us that the clean places and the dirty ones fared alike at Cincinnati, in 1832. But then, it must be allowed, if filth possesses the power attributed to it, though it exist but at one or two places in a city, it might send oft' exhalations that would taint the atmosphere of clean places. But we hold, if filth can operate as a " localizing cause " of cholera in June, 1873, it ought to have done it in some of the Junes since 1850, which it did not, in this city. If the filth of Nashville could become a • ¦ localising cause " of cholera in September, 1866, the filth of September in some of the long years since the introduction of cholera in this country, in 1832, ought to have operated to the same end, which it did not. If filth only becomes active when cholera breathes upon it, which would seem to be the case, if it have any effect under any circumstance, then cholera affects the filth as it does the people, and neither filth nor the people affect cholera. It is well known that the most offensive places in cities, to sight and 36 THE CHOLERA IN NASHVILLE. smell, are the most healthy in a cholera season. It has never been known, I believe, to attack the operatives or the managers of livery stables. This had been asserted in Cincinnati, in 1832, and we had it examined into in 1850, in 1866, and during the late epidemic in this city, and believe these places are exempt, and, as far as I have been able to ascertain, cowhouses, the filthiest houses in the world, are exempt. Portions of every. city, more than others, become the depositories of the exuviae of slaughtered animals, and where soap factories naturally find a foot-hold, and fill the air for a great distance with a suffocating stench. Cholera shuns such places as naturally as folks. We have visited, in person, the street-car and other stables of the city — one, at the corner of Broad and Spruce streets, exists in the midst of filth. No cholera at any stable. The Evansville Journal of July 18th, says of the cholera at Mount Vernon, Indiana : "It has almost depopulated the town. All the people who could get away have left. The banks and business housss are all closed, and the town seems without population. Every person in the place has had cholera symptoms, and of some large families only two members are left. * * * The city is a clean one, and on one of the highest points between Evansville and Cairo." Filth, then, is not a localizing cause of cholera, or a cause without localization, or any sort of a cause. lam not writing a commentary on Carlyle's Gospel of Soap-and-Water, where such admissions as the above would be out of place, but simply engaged in the pursuit of truth, which is never out of place. Indeed, it is known that none of the deadly poisons that produce the whole class of zymotic diseases, is cognizable to the senses. Among these non-cognizable causes of diseases is that of cholera. If a stink be above ground, with the only true disinfectants operating on its cause — the circumambient air and gorgeous sunshine — there can be no reason, but that of folly, for expending money to place this same filth beyond the reach of the disinfectants of nature, with breathing holes for the escape of poisonous and noisome emanations. THE CHOLERA IN NASHVILLE. 37 " As to the causes of epidemic cholera, it is well to remember that it is not given to man to penetrate the origin or to know the principle of pestilential diseases. There, using the expressions of LittrS, all is invisible, mysterious ; all is caused by powers, the effects of which alone are revealed to us. Nevertheless, there is no subject upon which so many theories and vain hypotheses have been heaped. For ourselves, well satisfied of the sterility of such efforts, we will not