ITVEJ£INUTES COMMON SENSE ABOUT THE ASIATIC CHOLERA; OR SHORT AND PLAIN RULES FOR THE PREVENTION, MANAGEMENT, AND TEEATMENT OP THE EARLY SYMPTOMS OP THAT DISEASE. INTENDED FOB THE UNPROFESSIONAL HEADER. A FELLOW OF THE ROYAL COLLEGE OF SURGEONS OF ENGLAND. " —^i — or wan * °^ me^y Millfops nave died of medicable wounds." — Akenside. I. " Erevention is better than cure." — Old ProverK;' (ffauvfy ewtian.) / LONDON: REEVE, BENHAM, & REEVE, KING WILLIAM STREET, STRAND. 1848. Price Threepence. Printed by Reeve, Benham, and Beeve, King William Street, Strand. ADVERTISEMENT. As the following suggestions by an eminent and experienced Hospital Surgeon, were productive of much good at the period of their first publication ; and were reprinted and largely circulated in America in 1831 : the Publishers, impressed with the conviction, that notwithstanding the numerous popular works on Cholera, and the reports and recommendations of the Board of Health, these plain, concise, and effectual rules may prove of great service at the present moment, have obtained permission of the Author, to publish them in the present form. King William Street, October, 1848. PREFACE TO THE FIRST EDITION. The following hints are published in the hope of mitigating in some measure the fears regarding the Cholera, which now so generally prevail ; of directing the attention of the rich to the condition of the lower classes, among whom if the disease should occur, it is impossible the former should escape; of impressing on the minds of the poor the protection which temperance, cleanliness, and confidence afford ; and for the purpose of suggesting a simple and effectual mode of treatment for the earliest stage of the disease, and until medical aid can be procured. To accomplish this object, and render these suggestions intelligible to all, a plain and familiar style has been adopted. November, 1831. SHORT AND PLAIN RULES FOR THE PREVENTION AND CURE OF THE ASIATIC CHOLERA. What are the symptoms of the Asiatic * Cholera ? Plow can we preserve ourselves from it? And what shall we do if attacked by it? These are questions which unfortunately now concern every one ; upon the conflicting theories respecting the origin and progress of the disease, and the disputes regarding its infectious or non-infectious qualities, we leave the Board of Health and the doctors to decide ;f plain and direct answers to the above inquiries alone concern the community at large. What are the earliest symptoms of Cholera ? As it is presumed no one will have the temerity to attempt the treatment of the disease, except in the absence of medical aid, and until such can be * I prefer the common term Asiatic, to the more expressive one of Algide, as being less ambiguous to the general reader. f The non-contagious nature of the disease is now universally admitted. 1848. 6 obtained, the invasion of the complaint, and the symptoms which characterize that stage of it, alone require our especial notice. An attack of Cholera comes on in the following manner : — Giddiness more or less severe is first felt, accompanied with a sensation of chilliness, the fingers and toes, and even the tongue, becoming very cold ; a burning sense of heat at the pit of the stomach succeeds, with cramps and spasms in the legs and arms ; the whole body is in a short time very cold, with a clammy dampness of the shin. Sickness, with vomiting, — -first of the usual contents of the stomach, and then of a liquid, like thin ricegruel — and purging, the discharge from the bowels being of a like character, — generally prevail. There are severe nervous agitations, and a feeling of extreme weakness; the breathing is hurried; and a sensation of great oppressio?i about the heart is experienced. As a relaxed state of the bowels oftentimes precedes this train of symptoms, persons labouring under such an affection should immediately apply for medical assistance.* Such are the principal symptoms that mark an attack of Asiatic Cholera ; the coldness of the hands * As a temporary remedy for relaxation of the bowels, twenty- five drops of laudanum in brandy and water, or in rice gruel may be taken ; if a druggist's shop be within reach, a draught composed of ]-§ ounce of compound chalk mixture, twenty-five drops of laudanum, and thirty drops of compound spirit of ammonia, should be procured, and repeated in one hour if re- quired. A dose of powdered rhubarb, with ginger and mag- nesia, should be previously taken, unless the relaxation is very severe, in which case the laudanum in rice gruel, or in the chalk draught, should be had recourse to in the first instance. 7 and feet, and of the whole body, the cramps and spasms, and the sudden and alarming loss of strength, are characters so strongly marked, and differ so entirely from the bilious attacks, and the griping and sickness arising from that disordered state of the stomach, which is so common among us, and known as the English Cholera, that no one can possibly mistake the nature of the malady. It bears some resemblance to an attack of congestive typhus fever, but in this last disease the cramps or spasms are wanting, and the head is more particularly affected. What should be done, if attached by Cholera ? As the great depression of the vital powers, and the consequent coldness of the surface, are the most formidable and striking symptoms, it is obvious that to rouse the system, and restore the warmth of the surface of the body, or, in. other words, excite re-action and bring back the circulation of the blood to a natural state, are the objects that require to be effected. A vapour, or Hot Airbath,* should be had recourse to if at hand ; as this however will probably but seldom be the case, put the patient into a hot bed, and apply a large hot mustard poultice over the pit of the stomach. Then let a blanket wrung out of a tubfull * The Hot Air-bath was first used by the late Dr. Armstrong in congestive typhus with great success, and is the most conve- nient and efficacious mode of applying heat to the body in Cholera; in the Lancet for October 7th, 1848, pp. 402-403, there are several kinds described. 8 i of boiling water, as hot and dry as possible, be laid over his body, and confine in the vapour, by placing dry blankets over it, renewing it the moment it loses its heat. Put bottles or bladders of hot water, bags of hot sand, or hot bricks or tiles wrapped in flannel to his feet ; at the same time rub the feet, legs, and arms, with hot flannels. Give the patient a glassful of hot brandy and water; — or a tea-spoonful of sal-volatile, — or of hartshorn, — or of sprits of turpentine,* — in a glassful of water ; or a tea-spoonful of sulphuric ether in a wine-glassful of camphor julep ;f if neither of these liquids be in the house, give hot coffee or tea until some of the above-mentioned remedies can be obtained. If there be much pain in the stomach, or the spasms be severe, or either of the above remedies do not afford relief, give a tea-spoonful, or from 60 to 80 drops of laudanum in the hot brandy and water; if there be a severe burning sensation in the stomach, the laudanum should be the first remedy. If the liquid given be rejected, repeat the dose in a few minutes ; and if one remedy will not keep down, try another. Persist in these means till you find the warmth of the skin restored, and the cramps and spasms relieved ; but in the mean time send for a medical person, who will find on his arrival half the danger removed, if you have diligently * This remedy is quite as effectual as either the cajeput oil or naphtha, which some have recommended as a specific. f The strong solution of camphor of Sir John Murray should be obtained if possible : an ounce of it with a tea-spoonful of ether is an excellent remedy in cramps or spasms : with or without the addition of laudanum. 9 employed the plan here recommended. Do not fear catching the complaint yourself; let not that selfish feeling one moment enter your head : your very exertions will be the best and surest means of preventing your being attacked. How can the Cholera be prevented ? This is the last, but not the least important question : before we reply, let us inquire who have been the principal victims, and what have been the causes which have aggravated the Cholera in other countries? Wherever the disease has occurred, whether in India, Persia, Egypt, or Europe, this striking fact has been noticed, — " That the ill-fed, " uncleanly, and consequently unhealthy part of " the population, and especially those persons who " were addicted to drinking spirits, and indulgence " in irregular habits, have been the greatest sufferers " from the disease ; and that it has been most vio" lent, and spread most rapidly and extensively, " in the towns where the streets are narrow, and " due attention had not been paid to ventilation " and cleanliness."* It is obvious, therefore, that cleanlinesss and temperance are the grand preservatives. Every apartment should be thoroughly ventilated : if the windows be made close, they should instantly be altered, so as to admit of being opened; if the weather be damp, make a fire, particularly in bed * Eeport of the Board of Health. 10 rooms, for nothing promotes thorough ventilation so much as a brisk fire with the doors or windows open.* Cesspools and sewers should be removed from the vicinity of dwellings. f Where white- wash is necessary, it should be used without delay, but the room should not be slept in, till it be thoroughly dry and aired. Blankets and other bed-clothes should be exposed to the air or fire every day. A notable housewife can do more to keep away the Cholera, than a host of physicians. "Cleanliness is next to Godliness," says the proverb, and it deserves to be written in letters of gold. Personal cleanliness more surely preserves health, and prevents an attack of Cholera, than a chest full of medicines. If a man cannot have a clean shirt every day, he can at least have a clean body; the feet are too generally neglected — like faithful servants, they labour all day and are forgotten at night ; washing them every evening, and, if they be cold, immersing them in hot water with mustard, and afterwards rubbing them thoroughly dry, is highly conducive to health. Temperance in mind and body is as important as cleanliness ; excess of any kind is most injurious. The most simple and nutritious diet is the best. The rich can obtain and select what they please ; but the poor must do the best they can, and to * A capital little work on Ventilation, entitled " Ventilation Illustrated, or a Tract for the schools of rich and poor," has recently been published by Churchill, Princes Street, Soho, price 6c?. It cannot be read by the non-medical reader without pleasure and profit. f Pig-sties particularly require attention. This caution is most requisite in country towns and villages. 11 them this advice is particularly addressed. Good broth or soup well spiced may be made for the same cost as tea, which so generally forms the essential dish at the poor man's table ; the soup is highly nutritious ; take soup then instead of tea, if you would guard against Cholera. Avoid spirits except as medicine ; instead of spending your pence on gin, put them in the Savings' Bank, to buy brandy or other cordials when really necessary ; if, happily, you should not want your money for such purposes, let it remain for a wet day. A pint of good beer taken warm, with spice, is an excellent cordial; and a basin of hot gruel, flavoured with sugar and ginger, is a supper fit for any body. But mental is as necessary as bodily temperance ; suffer not your passions to be over excited ; guard against being overcome by fear ; nothing produces such depressing effects, and renders the body so susceptible of disease. The only charm which a medical man has against infection, is confidence ; he visits persons labouring under the most frightful diseases with impunity, because he has no fear. And what have you to fear ? A man with a waterproof coat defies the storms and rain ; so he who, by attending to the above simple rules, maintains his body and mind in a sound state, may be considered cholera -proof, and need not fear the invasion of the enemy. A parting word of advice to the ladies : — above all things be clothed sufficiently warm at this season of the year; avoid cold and damp to the feet, heated apartments, and late hours. Early to bed, and early rising, plenty of exercise, plain diet, and 12 ij i above all a cheerful disposition, are the golden rules for the prevention of Cholera. Note. The following medicines should be kept in the house, in glass stopper bottles, and properly labelled : viz. — Laudanum (Tinct. Opii): one ounce; dose, for an adult, from 25 to 60 drops; for young persons the dose may be regulated in the proportion of one drop for each year : thus, for a child five years of age, five drops will be the dose. Compound Sulphuric Ether : one ounce and a half : dose, a teaspoonful in camphor or peppermint water. Sal Volatile (Bp. Ammon. C.) : one ounce and a half : dose, a teaspoonful in a glassful of camphor or peppermint water. Of flour of mustard, two pounds at least should always be at hand. THE END. Reeve, Benham, and Reeve, Printers, King William Street, Strand.