REPORT OF THE EDINBURGH BOARD OF HEALTH. 16^ November 1831. EDINBURGH : PRINTED BY JOHN STARK. And to be had (Gratis) by purchasers of the medicines recommended by the Board, at Messrs Duncan & Ogilvie, 52, North Bridge Buildings ; Mr Butler, 73, Princes Street ; Messrs Scott & Orr, 67, Princes Street, and 100, South Bridge ; Mr Gardner, 52, George Street ; Messrs Pugh & Plews, 33, Princes Street, and 35, Northumberland Street. Also at Leith, at Mr Murray's^ Tolbooth Wynd, and Mr Marshall, Shore ; and from Apothecaries generally. To be had also, price Sixpence, (by the Poor, Gratis, j at the following Booksellers : Mr Blackwogd, 45, George Street ; Mr Black, 27, North Bridge ; Mr Whyte, 13, George Street ; Mr Anderson, 295, High Street; Mr J. Anderson Jun. 55, North Bridge; and Messrs Maclachlan & Stewart, opposite the College. Also at Leith, at Mr Allardyce, Tolbooth Wynd. Country Boards of Health, or other Public Bodies or Private Individuals in the country who wish to adopt the Report of the Edinburgh Board, will receive, at prime cost, any number of copies they may require, on communicating their wish to Mr W. Cunningham, Clerk to the Board, City Chambers. MEMBERS OF THE BOARD. The Right Honourable the Lord Provost, Chairman. The Right Honourable the Lord President. The Dean of Faculty. The Honourable the Solicitor-General. Adam Duff, Esq. Sheriff of Edinburgh. William Henderson, Esq. \ Robert Haig, Esq. ) James Sceales, Esq. Chief Magistrate of Leith. Duncan Matheson, Esq. Sheriff- Depute of Leith. Richard Mackenzie, Esq. Deputy- Keeper of the Signet. Dr Inglis, Dr Grant, Dr Dickson, >Clergymen of Edinburgh. Dr Lee, Dr Gilchrist, J Rev. James Grant, Minister of South Leith. Dr Davidson, President of the College of Physicians. Dr John Gairdner, President of the College of Surgeons. Anthony Dickson, Esq. late Senior Member of the Medical Board, Cal cutta. Dr Whitelaw Ainslie, late Superintending Surgeon, Madras Establish' ment. f Dr Abercrombie, Physician to the King. j Dr Alison, Professor of the Institutes of Medicine. ¦\ Dr Macwhirter, late Apothecary- General, Calcutta. Dr Christison, Professor of Medical Jurispi udciicc ami- Police? Dr Gregory, Physician to the Infirmary. f Dr Maclagan. Sir George Ballingall, Professor of Military Surgery. < Dr Adam Hunter, j Dr James Combe, Leith. l^Geo. Hamilton Bell, Esq. late Residency Surgeon, Tanjore, Madras. Mr^Sf o^} Medical Secretaries George Forbes, Esq. Treasurer. William G. Cunningham, Esq. W. S. Clerk. Coll. of Surg. Coll. of Phys. REPORT, &c. Ihe Edinburgh Board of Health having maturely considered what steps should be taken for checking the Epidemic Cholera, if it should appear in this city, are of opinion that the proper time is now arrived for making public the following directions for the guidance of the Inhabitants. I. The Board are satisfied, that the disease may arise spontaneously from hidden causes ; and that it may also become contagious in circumstances not yet ascertained. But they are fully warranted in declaring, that, when it does become contagious, the risk of its spreading in that manner is very much diminished if due attention be paid to cleanliness and sobriety. And they therefore intreat the inhabitants of Edinburgh, in the event of the disease appearing here, not to be misled by exaggerated notions of its contagious nature, — the inevitable tendency of which would be to leave the sick helpless, and without that attendance from friends and others which is more pressingly required in this disease than in any other 11. Experience has shown, that the most essential precaution for escaping the disease is sobriety, — that intoxication during the prevalence of the epidemic is almost sure to be followed by an attack — and that those addicted to drinking are the most subject to take cholera, and the most likely to sink under it. In like manner, strict attention to personal cleanliness, — to cleanliness and ventilation of dwelling-houses, — to warm clothing, — to regularity of hours for sleep, — to keeping as much as possible within doors at night, — and to taking food before going out in the morning, — may be relied on as important means of security. 111. The Board are providing, that, should the disease appear, several Hospitals shall be opened over the city ; — also that 4 stations shall be established, where, as well as at the hospitals, medicines and heating-apparatus may be procured at all hours of the day and night ; — and likewise that, if necessary, all night-watchmen shall be supplied with medicines for the immediate use of any who need them. By these means it will be in the power of every one to procure instant aid. Notice of the situation of hospitals and stations for medicines will be given the instant the disease may appear. IV. But to prevent the possibility of delay, especially in the dead of night, when the disease is very apt to begin, the Board recommend families to provide the following articles. 1. Mixture — Take sulphuric ether and aromatic spirit of hartshorn, of each half an ounce, compound tincture of cinnamon, one ounce : Mix and cork up carefully. 2. Laudanum An ounce to be kept in readiness. 3. Pills — Take of opium twenty-four grains ; camphor one drachm ; spirit of wine and conserve of roses enough to make a mass of proper consistence : Divide into twenty-four pills. 4. Clysters. — Take of laudanum an ounce, tincture of assafoetida two ounces : Mix for keeping. Before using, mix three teaspoonfuls with a wine-glassful of thin starch ; and retain it, when injected, by pressure below with a warm cloth, as long as possible. 5. Mustard- Poultices Have always at hand four ounces of powdered mustard. A fourth part of this, spread over porridge poultices, will be sufficient for one patient. 6. Hot-air Bath. — The Board have approved of a hot-air bath of a simple construction, which may be seen at the Blind Asylum, and made by any carpenter, price about ten shillings. Every family who can afford it ought to have one. V. No time should be lost in sending for medical aid. But when the disease commences suddenly in a violent form, it is dangerous to lose even the time which must pass before such aid can be had. This form is at once known by sudden weakness, a contracted, ghastly countenance, blueness of the lips, and general coldness, accompanying or preceding vomiting, purging, and cramps. In such cases, the friends will without delay give a tablespoonful 5 of the Mixture, No. 1, with 60 drops of laudanum, in half a wine-glassful of cold water. Follow this with a tablespoonful occasionally of warm spirits and water, or strongly spiced wine. Repeat two tea-spoonfuls of the Mixture, with 30 drops of laudanum, every half hour if the first dose fail to relieve. — If the mixture be vomited, then give two Pills, No. 3, and repeat one every half hour if the first two fail to relieve or be vomited. But after the vomiting and cramps cease, the Mixture or Pills must not be repeated without medical advice. — The Clyster, No. 4, should be resorted to also from the first, and repeated once if not retained. — [N. B. The doses of the Mixture, Laudanum, Pills, and Clyster, must not be exceeded. For children of fourteen half the doses mentioned, and for children of seven one-fourth is sufficient. — The Hot-air bath, — or, if it is not at hand, dry heat over the whole body in any shape, such as by hot blankets and hot-bricks, sand, salt, or bottles of hot-water, — together with constant rubbing of the whole body, — should likewise be resorted to from the first. — The Mustard- Poultices should, as soon as possible, be applied over the belly and on the soles and calves, and kept on till the patient complains of the smarting. By the time these measures have been put in force, opportunity will have been given for procuring medical advice ; which is indispensable for the treatment afterwards. — The Board think it necessary to apprize the public, that where this disease has prevailed, blood-letting, when resorted to within the first, second, or third hour from the commencement of the attack, has been very generally found useful along with the other remedies, notwithstanding the appearance of sudden weakness and excessive sinking already mentioned. VI. By following these rules, and taking prompt advantage of the provision made at the Station-points, the Board are convinced that very many cases will be checked at the outset. But, at the same time, they strongly exhort the labouring classes to convey their sick friends with all speed to the hospitals, rather than try to cure them at home, where they can seldom have the proper means at command. The hospitals will, it is hoped, be so numerous, that one shall be near every man's habitation ; and carriages, 6 to serve at the same time as dry-heat baths, may be found always ready at the hospitals and stations, for the instant removal of patients at all hours of the day and night. — The Board feel assured, that, by quickly availing themselves of these provisions, working people will get their sick friends brought sooner and far more effectually under treatment than in any other way ; and they must not forget, that every minute's delay is highly dangerous. VII. The moment the disease is suspected to have appeared, information must be given to William G. Cunningham, Esq. Clerk to the Board, at the City Chambers. And, should it establish itself in the town, medical men are expected to send to the same quarter, every morning before half past nine, a report of each new case, death, or recovery, — specifying the name, residence, age, employment, date of seizure, and date of the event. The Board anxiously look for punctuality in this respect from every medical person. While the Board think it right to express their apprehension, that in certain circumstances the disease may be communicated by personal intercourse with infected persons or goods, they wish it to be distinctly understood, that, as they are satisfied it may also be diffused in other ways, not yet ascertained, — as they think it will be impossible in this country to establish a system of internal quarantine, or absolute seclusion of the sick, — and as the attempt to do so would throw very many persons into great distress, — they do not mean to recommend that any attempts should be made to prevent its diffusion in this city by seclusion of the sick, otherwise than as detailed above. N. B. — To Apothecaries. — As an inferior laudanum is sold in many shops, apothecaries are cautioned to use only the strong laudanum of the Edinburgh Pharmacopoeia. Copies of this Report, and printed labels for the articles recommended by the Board, with directions for their use, may be procured by apothecaries from the Clerk. authority of the Board, John Lear month, Lord Provost. 7 Specimens of the Labels are here annexed, for the information of medical persons and others in the country who may be applied to for the articles recommended by the Board. No. 1. CHOLERA MIXTURE. A table-spoonful, with 60 drops of laudanum, in half a wine-glassful of cold water. If this fail to relieve, repeat two tea-spoonfuls, with 30 drops of laudanum every half hour. Half these doses of mixture and laudanum for children of 1 4. One-fourth for children of 7. Do not exceed the doses prescribed ; and stop when the vomiting and cramps cease, unless you have medical advice. No. 3. CHOLERA PILLS. To be used if the mixture No 1 be vomited. Two pills at first, and then one every half hour, if the first fail to relieve. Half these doses for children of 14 ; one-fourth for children of 7. Do not exceed the doses prescribed ; and stop when the vomiting and cramps cease, unless you have medical advice. No. 4. CHOLERA CLYSTERS. Inject three tea-spoonfuls in a wine-glassful of thin warm gruel ; and retain as long as possible by pressure below with a warm cloth. If not retained, repeat immediately, but otherwise not. Half the dose for children of 14 ; one-fourth for children of 7> No. 5. MUSTARD FOR POULTICES. A fourth part is enough for one person. Dust it thickly over porridge poultices, of which apply a large one on the belly, and others on the soles and calves. Remove when the patient complains much of the smarting.