PRAC T I C A L VIEWS ON CHOLERA, AND ON iilK Innifnnj, |sminittue nab Cimititie Mmiwm TO 15 E \j ADOPTED IN THE EVENT OF A VISITATION OF THE EPIDEMIC, *flfti>jn«nii i to preserve health than to cure disease.'' MONTREAL PUBLISHED BY B. DAVNp*^ 1854. PREFACE. The first edition of this pamphlet was so limited as to place it beyond the reach of the public. Numerous inquiries for the work induced the Publisher to ask permission of the Author, his Worship the Mayor, to bring out an Edition adequate to the public want. That permission was not only generously granted but a valuab'e appendix added, so as to make the work complete and fully adapted to the exigencies of the times. It is, therefore, confidently hoped that the publication of the pamphlet, in its present form, will prove a public benefit. Montreal, July 7th, 18M. PRACTICAL VIEWS ON CHOLERA, AND ON THE SANITARY, PREVENTIVE AND CURATIVE MEASURES TO BE ADOPTED IN THE EVENT OF A VISITATION OF THE EPIDEMIC. " It is easier to preserve health than to cure disease." "The diseases which affect human health are often obscure, "many of them so subtle that they are discerned with diffi" cully, and can only be appreciated by those who devote their " time to the study and observation oj them through all their 11 changes. " No City can deserve immunity from epidemic disease, " except by making absolute cleanliness the first law of its " existence ; such cleanliness as consists in the perfect adap" tation of drainage, water supply, and ventilation, to the pur" poses they should respectively fulfil ; such cleanliness as " consists in carrying away by these means, inoffensively, " all refuse materials of life, — gaseous, solid, or fluid — from " the person, the house, the factory, or the thoroughfare, as " soon as possible after their formation, and with as near an " approach as their several natures allow, to one continuous " current of removal. " The Board would call earnest attention to the evidence " which has been adduced of the surprising and almost in" credible success that in some instances has attended well *« directed attention, even under circumstances in which "temporary measures only were available, and when an outbreak seemed inevitable. — (Report of General Board of Health, Whitehall, England, Xlth April, 1854.) 2 The essential and specific cause of Asiatic Cholera is manifestly a peculiar epidemic influence, which has hitherto set at defiance the most elaborate investigations. It does not visit all places alike, however strong the apparant similarity. It will skip from place to place without leaving a single trace of its course between them. It especially selects and tarries on the borders of rivers, small and muddy streams, and low and marshy localities, more particularly where there is much organic matter in a state of decomposition. It revels most on cold and damp spots, and fixes its fangs in a lower story, whilst the upper ones are almost exempt from the visitation. Warm, dry, and elevated sites are seldom affected. "It will be found as the rule, that the "disease affects most fatally the low-lying seaports and "deltas of rivers, sparing the high grounds, even round river " sources." It sets quarantine enactments at utter defiance, —it overleaps walls and laughs at cordons sanitaires ; and when the poison is abroad it may declare itself when and where least expected ; but, as a general rule, it may be said that it first invades the miserable, filthy, and cheerless hmnts of the poor, vicious, and depraved. " There is a close affinity " between moral depravity and physical degradation.'''' The intemperate are its especial victims, whether they reside in a palace or a hovel. (It is well it should be understood that in the visitation of 1849, and during the present year in England, cholera has been more frequent among the comfortable and wealthy classes than formerly. Hence, let those of every station take heed in time.) Those whose vital energies are reduced by excesses, want, privation, and anxiety of mind, or whose constitutions are originally weak, are among the first to fall before the scourge. Old age, pernicious indulgences, deficient alimentation, — particularly a vegetable diet, — foul and confined air, crowding in low, cold, and miry places; grief, anxiety, and fear, and whatever else tends to debilitate the body and depress the mind, are sure to predispose most powerfully to an attack 3 of this ruthless visitor; which, as a general rule, respects cleanliness, sobriety, and decent habits. It seldom intrudes where industry and good morals prevail. Hence, in regard even to this dreadful pestilence, man is, in no small degree, the arbiter of his own fate. Its contagiousness has been alternately asserted and denied. The majority of the profession do not acknowledge this mode of transmission of the disease. At all events, even admitting that it is contagious, experience proves that this property exists only in a very small degree. With the most ordinary precaution, little danger is to be apprehended, and this fact should be known to all, as thousands have perished from the want of a little kind and Christian attention, resulting from the fear of infection. " Medical practitioners have " not, in any ascertained case, conveyed the infection in " their clothes to patients whom they were attending for " other diseases, or to their families ; neither have nurses or " other casual attendants on the sick, suffered, although be" longing to a class more obnoxious to the disease." "No " evidence, thus far, has appeared, that the disease at pre" sent prevailing in our City, has in a single case been pro" duced by contagion." — (Report of Board of Health, New York, 1849 ) But it is right to observe, that the clothes of such as die of Cholera, as, likewise, the bedding of the sick and dead, if left for a short time huddled up in aheap, become eminently infectious, (fomities.) The ejections and emanations thus confined, ferment, fester, and become very poisonous. The moment a person dies, the clothes should be hurried out to air and dry ; the bedding.should also be thoroughly exposed, and the hair and feathers be well heated in an oven. But should the bed be much soiled it would be well to destroy it altogether. The whole of the clo'hing should be handled with a stick, and after hanging a few days in the open air should be steeped for some time in hot water, and frequently stirred vigorously with a stick. Lime or ashes should be added to 4 the water, and when the clothes are well washed and rinsed, they should again be hung out in the air for several days, or for weeks in a garret, before they are brought into use. The sanitary precautions are not many, nor always difficult of observance, but. they are imperative, and commonly very effectual, and to be relied upon with confidence. On the irruption of the epidemic, or, far better, when it is apprehended, low, wet, and badly ventilated places should at once be abandoned ; old, filthy, and decaying buildings, as well as underground, cellar, and dark tenements should immediately be evacuated. Legal enactments should enforce this observance. The walls and floors of the dwellings of the poor should be well scraped, and washed with lye or lime-Water, at least once in the season ; then well dry-scrubbed every day, as moisture tends 1o attract and absorb, and subsequen'ly give out bad odours. The walls should be completely brushed down and then white-washed, particularly in the cellars. The cellar windows should be kept constantly open. Nor should the dwellings of the rich be exempt from a thorough cleansing when epidemic cholera, especially, prevails. The cellars, even in their dwellings, should be well cleaned and then sprinkled with a little lime ; but if damp and wet, a few inches of the surface should be removed, some lime applied, and two or three inches of coarse clean sand spread over this. Or, what is quite as good, blacksmith's cinders and ashes, or the rubbish and mortar of old walls, should be thrown over the whole bottom to a thickness of four or five inches, especially if the ground is wet and oozy. Sinks and Cess-pools should be at once emptied completely, and lime abundantly strewn about. Privies should also be thoroughly discharged and limed, whilst every nook and corner about all premises should be brushed down and white-washed ; yet, when the cholera suddenly invades a locality, it would be far better not to disturb privies, &c. &c> but to use lime abundantly, and, what is equally good, to cast 5 into cess-pools and drains, some of the black ammoniacalliquor which is antiseptic and destroys animal matter, and is thus a valuable disinfectant, that abounds in gas factories. The lime that has served for the purifying of the gas is also very useful in destroying noxious odours. All holes, cavities, and wet places about dwellings should be first cleaned, and then filled with old mortar, or 1 he ashes, coals, and lime from the gas factories, which seem to be even better deodorisers than fresh lime. All these substances are excellent disinfectants, and, instead of being converted into nuisances in the streets, should be applied in the manner indicated, by which they would become useful and be sought after. Epidemics are sure to alight where terrestrial emanations of a mephitic nature exist. In cities it has almost always been the lowest, dampest, " most crowded and most filthy sections that have suffered most." Where there is not a free circulation of air, and where the cheering rays of the sun seldom penetrate, the localities are always moist, raw, and chilly, and there is constantly a very perceptible, repulsive, and musty odour, and the inhabitants are pale, wan, and debilitated. The utmost care should be observed to obtain perfect ventilation. Whilst impure and confined air in crowded apartments is always deleterious, it is eminently so in times of cholera and during the prevalence of all epidemics. The breathing of foul air predisposes to every disease, enervates the body, and destroys all moral and physical energy. The fire-places should be kept open, and ventilators placed in a couple of windows. All the stovepipe stoppers should be removed, and every room have, if possible, an opening into the chimney, near the ceiling, for the escape of the heated and deteriorated air. When the weather is rainy, damp, and raw, a fire should be kindled, for the double purpose of imparting warmth, and causing a draught in the house. Every tenement should be supplied with abundance of 6 good water. That from the wells in ordinary yards is always more or less impure, and is frequently most injurious, being saturated with all the filth that soaks through the earth from the privies, as well as with other putrid matters that are so often cast about the premises, especially of the poor. " Every spring of water represents the drainage of a certain " surface or thickness of soil, and such as are the qualities of " this gathering ground, such must be the qualities of the " water," " The impurity in the water with which the in* " habitants of London, in the several districts are supplied, " is in nearly a direct proportion to the mortality from cho" lera." " The mortality is least where the water is known " to be most, pure," and this is equally applicable to the purity of the atmosphere of every place. Sanitary inspection, and the steps taken thereon, in so far as regards nuisances and unhealthy situations, are of paramount necessity, and it is an imperative duty to see them duly carried out, as, if properly performed, they will tend greatly to prevent an irruption of cholera. These are the most efficient means for neutralizing and destroying the force of epidemic diseases, and thus tend generally, if not to the prevention of epidemics, especially of fevers, at least powerfully to diminish their virulence, for the pabulum of all infectious complaints is found to exist in the mephitic air of low, moist, and dark retreats, where there are crowding, bad ventilation, and the invariable accompaniments of filth, vice, and poverty. Add to these, impure water, and there is all that is requisite to breed sickness, and to invite and assist cholera in its course. " The exciting causes of such diseases " are in great measure under our control, and by properly " guarding against these, much, very much, may be done in v obviating the developement and extension of the disease." Hence, ihe absolute necessity for a systematic sanitary visitation of the dwellings of the poor, and the courts and alleys which they inhabit, such as of late obtains in certain cities in England, and which can be effectually carried out only by 7 the appointment of " Inspectors of Nuisances" — able and intelligent men. ' Doubts may very legitimately exist, however, as to the propriety of a medical organization for systematic " house to house" visitation to ascertain whether cholera is present. This necessarily entails much outlay, whilst it i 3 well known that the intrusion, daily, of a doctor into every house, inquiring in doleful tones if any one has diarrhoea, or cholera, or feels unwell in any way, at once engenders fear and apprehension ; depression of spirits follows, and the panic becomes general, than which there is no more immediately predisposing cause of cholera. This, added to the unhealthiness of the locality, constitutes the whole into a magazine which one spark of the poison ignites, and then the disease is established in the neighborhood. " Nothing predisposes anindi" vidual more to the influence of cholera, or tends more to " increase the malignancy of an attack than fear. It is " therefore of the greatest importance that the public mind " should be relieved from all unnecessary apprehension with " regard to the true nature of this disease." " The moment v you make your inquiries you sound the alarm." You dis" turb "that calm and composed state of mind which does " more than is generally supposed in the preventing the on" set of the disease." All epidemics are aggravated more v or less by mental disturbance, whether in the shape of an " active panic or low despondency." " Moral influences exercise no little control over the cholera." Another reason why these day visits seem a work of supererogation, to say the least, is that cholera makes its attack most often after night-fall. "In the majority of cases the attack was noticed to take place between midnight and 4, a. m." And it frequently happens that the premonitory symptoms are so slight as not to attract attention, and thus in a moment, and unexpectedly, the disease bursts forth, and speedily destroys its victim. Whilst, diarrhoea generally precedes the more decided symptoms, still it can scarcely be said to be an ." essential 8 symptom of cholera." Let not the inmates of every household have their peace of mind disturbed by such an unwise and really uncalled for intrusion. These visits, besides, add enormously to the expense attending this dreadful invasion. A far more efficient substitute, and which is free from the objections that attach to the " house to house visitation," would be to draw up a code of directions in clear and concise language, indicating what are the first means to be resorted to for preventing the localization, and also what may conduce to an attack of cholera. With these views the following remarks, and suggestions have been prepared, not based upon any visionary hypothesis, but upon extensive experience of the disease since its lirst invasion in 1832, as well as upon the knowledge derived from the best writers on the subject, and the recommendations, if duly appreciated and acted u.pon, may be attended with incalculable advantages, such as neither money nor medicine can procure. A careful Sanitary Inspection of all premises should take precedence of any other precautionary measure, and if thoroughly put into effect it will, in the majority of instances, s.ecure immunity from attack. The emanations from privies are always offensive and injurious to health, particularly in close, pent-up yards. Even the best constructed water-closets are not at all free from objection. The next point in importance is the employment of Disinfectants, and there is a variety of them that may be used to correct foul smells ; yet it must not be forgotten that they do not entirely destroy the poisonous effects of the effluvia. The soot (which is an excellent deodoriser,) of every house should be collected, to be strewn occasionally into privies, especially before emptying them. Lime and lime water should be used for the same purpose. A handful of the Chloride of Lime in one gallon of water, or four ounces of Green Vitriol, (Sulphate of Iron) or a couple of ounces of 9 Oil ofV ? tri*>V (Sulphuric Acid) or a quarter of a pound of Alum in a bucket-full of water 3hould be sprinkled in the privy before removing its contents ; and when emptied, half a bushel of Lime should be spread upon »he bottom. Another cheap and exce lent disinfectant is the Nitrate of Lead, which forms the basis of Ledoyen's purifying fluid. One ounce of Sugar (Acetate) of Lead dissolved in a pail-full of water, to which are added two ounces of Nitric Acid, (Aqua Fortis) will make the preparation fit for use. That these substances, are, by their cheapness, accessible to the public, is shown by the following table :—: — Green Vitriol, (Sulphate of Iron) '• 7*. 6d. perewt. Alum, « « • - ¦ • - 22 6 " Chloride of Lime, No. 1. - - 30 0 " " ¦" No. 2, - - 42 0 " Sugar (Acetatfi) of Lead. - 0 10 per lb. Nitric Acid, 010 *> These agents are so cheap, easily applied, and effectual, that it would be criminal not to resort to them to correct foul odours, and to prevent their formation. The Chloride of Zinc is likewise an efficient corrector of foul exhalations, but it is dearer than the others, and it is the same with the Nitrate of Zinc, — Sir Wm. Burnett's disinfecting fluid, yet it is so very manageable and efficient that every house should be supplied with a little of this fluid, to which there is always attached, clear and copious directions for its use. Every one should know that deodorizing agents are not always disinfectants, and that some of the most deadly exhalations, such a?s Carbonic Acid, Azote, and some oi her gases, as well as the mephitic vapours of cemeteries and pertain malarious localities, are destitute of odour. It is likewise well to be informed, that shavings, saw-dust, cornhusks, straw, &c. .&<;;, which often constitute the bedding of the destitute.,- and -aw generally moist and damp, corrupt the air by robbing it &t its vital principle, oxygen, and exkaling 10 carbonic add. It is likewise proper to state, that a candle may burn where the air is so deleterious as to cause instant death when breathed. The following observations, as regarding individuals, should be respected as precepts that have received the entire sanction of time, and the authority of every experienced and well-informed medical man ; indeed, they should be looked upon as axioms not to be de\iated from with impunity, during the existence of cholera in particular. Old habits, even vicious ones, of a dietary nature are not to be suddenly and totally corrected. The inebriate and guzzler should diminish the number and amount of his libations, and substitute in a great measure, Tea and Coffee, which should constitute the morning and evening meal, with toast and butter, to which might be added a small quantity of meat as '* a relish." Even during the day Tea and Coffee should be taken as the common beverage. Either will remove that constant " gnawing" at the vitals with which the old tippler is more or less tormented, as one of the effects of his pernicious indulgences. His " craving for drink" will be cured if he take a bowl of good spiced beef tea. These different articles stimulate kindly, and do not exhaust, but are, indeed, restorative, tonic, and exhilarat ing. Moderation in eating is as necessary as in the use of drinks. Little alteration should be made in the dress, even in warm weather ; and on no account should flannels be discontinued. Woollen or silk hose should be worn by all. The food should be plain, well cooked, and agreeably seasoned. Roast meats, rather underdone, to be preferred, with little gravy. Pork, very fat meat, and old mutton, should be abstained from. Boiled meat and soup, with few vegetables^ and wellbaked stale bread, make wholesome food. v Salted meat," bacon, and other cured meats, as also sausages, especially if long made, are all to be shunned ; though 11 sail, as a condiment, is an indispensable addition to fresh meats, vegetables, &c. All kinds of fish should be partaken of with extreme caution ; even the most fresh and best, looking are to be used with much circumspection. Leguminous and succulent vegetables should be sparingly indulged in, — such as green peas and beans, in the pod or other-wise. The same may be said of green corn, boiled or roasted. Good mealy potatoes roasted, are not objectionable, but boiled waxy ones should be "mashed," well seasoned, and moderately partaken of. Butter, whilst eminently nutritious, is, with many persons, very indigestible. Butter sauce should not be taken in quantity. Milk, raw, or better when boiled, with dry toast, makes a safe and good meal. Hot bread should be avoided, as well as bran bread used only by those who are habitually costive, and that wisely in other times than those of a cholera epidemic. Rice is very nourishing, slightly binding, and agrees with every constitution. Boiled in milk it would be excellent when cholera threatened or prevailed. Oat-meal and barley, a3 ¦ we'l as corn-meal, are better dispensed with in such times, and should not constitute the food of persons ; mixed with molasses they are much more prejudicial, as causing a tendency to diarrhoea, and readily becoming acid in the stomach. Buck-wheat and rye-cakes should not be indulged in. Sugar and butter do not add to their being digested. "Pastry is an abomination," (Dr. Paris) especially if under-done and saturated with butter. Desseris should be avoided, particularly such as are composed of mixed articles. Ripe juicy fruits need not be dispensed with, the skins and seeds however should be rejected, but green and unripe fruit must not be partaken of. No food should be taken on going to bed. 12 If any liquid as ordinary beveTage, between meals, is to be indulged in — which, however, is not advisable, unless it be Tea or Coffee, which experience has proved to be very useful — the best are port wine and water, brandy, or spirits, in waler. Poor sour wines, cider, stale beer, and all drinks readily acidified should be eschewed. Let the miserable inebriate be cautious not to invoke these recommendations as a justification for his constant potations. Remedial Measures. — ( holera is a Tost insidious disease, requiring untiring vigilance. Ifmotatonce it is readily subdued, but give it any quarter and it becomes almost invincible. It c in be cnred with certair and posi We success, if the well proved means are at once resorted to, and for this end the remedies required should l>e in every family, or at least, most easy of access. They are few, cheap, and easily procured ; consisting mainly of cordial stimulants. Perhaps the safest are compound Tincture of Lavender, or Camphorated Tincture of Opium, (Paregoric) or the Compound Tincture of Rhubarb, or any of the Aromatic Tinctures ; but warming spiced drinks wili. be very useful. When there is a sensation of chilliness, coldness of the hands and feet, or " sinking at the s'omach," rumbling of wind, or a disposition to looseness of the bowels, half a lea-spoonful of the Tinct. of Lavender, or Paregoric, or.Tinct. of Rhubarb, taken with a little sugar or sweetened water, or a cup of spiced tea, (cinnamon, nutmeg or ginger, &c. &c.) hot and sweetened, will quell these premonitory symptoms. This process might be repeated every ten, fifteen or twenty minutes, if the unpleasant feelings do not subside. At the same time the person should go to bed, and get into a gentle perspiration the soonest possible, for to sit up or go about is sure to increase the disposition to diarrhoea, which, of all -he distress, must be first and at once arrested. Should the tendency to it be sudden, in addition to the articles mentioned above, 10, 15, 20 or 30 drops of Laudanum should be taken, whilst the Physician 13 is sent for, as there is not a moment to be Lost, should the sufferer not feel better. Every family should be provided with a two ojiice phial, at least, of the Tincture of Lavender, or of Paregoi ie, or of the Compound Tincture of Rhubarb, or of any Aromatic Tincture, as also with one of Laudanum, each being properly labelled, and the word poison in large letters affixed to the Laudanum phial to distinguish it. At the very outset of the disease, these measures alone frequently arrest it, but should much uneasiness continue, application should be made to the nearest Physician. Every intelligent person being possessed of these articles, the poor should be supplied with them at the expense of the City. Travellers should have some of these phials by them, in order to be prepared against emergencies. It has been properly stated that " if taken in time and " properly treated, the expense for medicines would not ex" ceed a shilling a head for those subjected to 'reaiment." Let it be well understood, that there are no specifics for this disease, and that, like all others, it should be managed according to those rational principles which long and discriminating experience has sanctioned. Should not the Sanitary measures just inculcated prevent the epidemic, they will at least greatly diminish its virulence, and the remedies suggested will, in the great majority of instances, at once arrest it in its course. The pernicious habit which certain persons have, of taking Seidiitz and other laxative powders, Epsom Salts, Morrison's Pills, and similar Patent Medicines, is to be denounced in the •strongest terms. Such practices have sent thousands to a premature grave. Even moderate costiveness should be borne with or relieved by injections rather than ran the risk of setting the whole body in commotion, which may prove of a most dangerous nature, and exceedingly difficult to compose. Large draughts of cold, iced, soda or mineral water, should not be indulged in when thirst prevails, and cold drinks should rather be sipped and taken gradually, for, swal'ovred with 14 avidity, colic, and derangement of the digestive organs, often ensue ; Ginger Beer, or Nectar is preferable during times of sickness, to any of the ordinary cooling drinks. Melons and Cucumbers are also much used in hot weather as refrigerants, than which nothing is more pernicious. Many lives are lo3t annually by the use of unripe Melons. Even the most mellow should be taken with great caution, but cucumbers should be tolerated by none. In one word, everything that is taken, whether for food or luxury should be used with much circumspection and moderation. Although we maybe 30 fortunate as to escape from cholera this year, yet the above remarks will 6e fonnd useful in preserving health generally, and will always be found to apply to the invasion of all epidemics. The two following brief extracts from the report of the Registrar General of England, should serve as beacons to Communities, to Governments, and to individuals. " In all epidemic diseases the mortality is invariably com" mensurate unto the filth and destitution of the inhabitants " and the impurities of their abodes." " Internal sanitary arrangements, and not quarantine and " sanitary lines, are the safe guards of nations against the " epidemic diseases." WOLFRED NELSON, M. D., Mayor. Board of Health, City Hall, Montreal, I6ih May, 1854. APPENDIX. Since the foregoing was written, the cholera has been introduced into the city by the emigrants who arrived in a ship from Liverpool. Several were taken to the Montreal General Hospital, where they received the best and kindest medical treatment, notwithstanding which the major part died. A few days subsequently a case of cholera occurred in a lady, and wa3 speedily followed by two more. These were not very severe, and being attended to, on the invasion of the first symptoms, recovered. The disease then presented itself in the lower part of the cily, where, in one family, four, and in the immediate vicinity three, deaths occurred. Three recoveries only were effected among the number taken ill, application for advice having been too long delayed. The most searching investigation was instituted to ascertain whether there had been, either directly or indirectly, any communication with emigrants, or with any person who had visited the ship in port, or even been on the wharves, but not the slightest intercourse could be traced. Many other cases came under my notice, and in no instance could any communication with those primarily affected be detected. Hence, I was forced, irresistibly, to arrive at the conclusion that the disease was atmospherical, and in this wise accompanied the unfortunate emigrants ; and that it had not been conveyed to other individuals by contact, or the most distant inteieourse. It is true, however, that two nurses of the Hospital manifested choleraic symptoms, which were soon arrested, but it was also stated that these persons offered a great predisposition to the epidemic by being greatly alarmed on seeing some of the patients in the last struggles of life, — blue, cold and ghastly* — presenting, indeed, an aspect well calculated to excite apprehension and unnerve the timid. 16 The intensity of the poison, and peculiarity, or, rather, extreme susceptibility of constitution giving a predisposition to be influenced by the disease to a much greater extent in some persons thari in others. "It appears in certain localities, af" feeting numerous detached individuals almost simulta" neously, whilst not only neighboring localities, but atten" dants on sick remain unaffected." " In Scotland, those who had close intercourse with the " sick were not affected with the disease in a larger proporu tion than those who avoided such intercourse." " We have ourselves seen many instances of the immunity " of the immediate attendants on the sick, and nearly sirnul" taneous affection of many within a limited distance, who " had no direct communication with one another." " C ho era has a mode of epidemic extension independent "of actual intercourse." " The spread of cholera by conta" gion is the rare exception, and its spread from other causes " the common rule." Yet, let it be remembered that " ca" daveric poison is evolved during a certain stage of decom" positiri." v In common with other epidemics, cholera is liable to the " most striking variations in the intensity of its attack, and, " therefore. in its influence on the human body in diffeient " visitations." " Avoid contact with such as are affected with the plague, ." fever, &c. v and you will escape ; not so with cholera, " which extends without actual contact or communication." " The sociJs of cholera may be raised into activity by cer" tain melt orological changes brought about by thunderu storms, h-iivy rains, by crowding in ill-ventilated apart" ments, aui by the effluvia of foul drains, filthy premises, " &c." " The period of incubation may last from two to twenty" seven da vs." The above extracts have been taken from some very recent publications by eminent men, but mainly from the contributions 17 of two highly distinguished practitioners in Edinburgh — Drs. Alison and Reed. The foregoing conclusions arrived at by eminent men have been transcribed for the purpose of convincing the public how erroneous it is to look upon these dire visitations as a proof of the contagiousness of the disease ; an unhappy impression which has led the most affectionate relatives to abandon those dearest to them, to their cruel and certain fate. Every day adds to my conviction of the correctness of the advice given in the foregoing pages, and I am more than ever positive that the drunkard is the especial subject of attack. All excesses, oiwlmtever description, are to be avoided . Late hours and wet weather, stagnant pools and damp localities, are to be carefully shunned. Adverse as I am to the abuse of alcohol in any shape, I am not blind to the well-established fact, that, as a remedy it is sometimes most valuable. It is from this knowledge that I would recommend every family to be provided, in these times, with a bottle of good Brandy, and one also of the strongest Ginger Syrup*, (to be had at Apothecaries of well established reputation.) When, during the epidemic, any one experiences a rumbling in the bowels, or a sensation as of the transfusion of liquid from one part of the belly to another, or if there be a tendency to evacuate, or sickness at the stomach, let a table-spoonful of Brandy with as much Syrup of Ginger be taken immediately, and these unpleasant sensations will be promptly removed, which are the common precursors of an attack. Should these symptoms occur at night, (which most often happens,) the patient should get out of bed and have recourse to a dose from his bottles, after which, returning to bed and covering himself warmly, in the majority of cases, all will soon be well. On the contrary, should the symptoms return, or not yield, the dose should be repeated, and then, with all despatch, a Physician sent for. This in addition, or substitute for the Aromatic Tinctures, already mentioned. I may here mention that Ginger Syrup, 18 agreeably diluted in water, forms a most safe and pleasant beverage on all these occasions, and may, indeed, form the ordinary drink in hot weather. I deem it incumbent to state, that I have found the diluted Sulphuric Acid an excellent auxiliary in the treatment of cholera. From two drachms, (| of an ounce,) to \an ounce of the diluted Sulphuric Acid, with two ounces of the Syrup of Ginger to a pint of water, make a very palatable drink, and assuages thirst, being at the same lime tonic and astringent. Indeed I have lately used this as the principal beverage for my cholera patients. When collapse supervenes, I add Brandy to the mixture. When, in the state of exhaustion, much liquid cannot be takej], Brandy should form a third, or even half, of the patient's drink, which must invariably be used in small quantities at a lime. Having for many years found the following preparation of Morphine and Calomel the best, most agreeable to the taste, easily administered, and very efficacious, I have much pleasure in presenting it to the profession, and would advise its being kept as an officinal preparation :—: — &. Morphis, - - 3i. Cochineal, - - - xx gus. Calomel, - - - 3 iy " Hard White Sugar, - - Ivi=xxghs. The whole making twelve drachms. Twelve grains of the powder contain one of Morphine and four of Calomel ; six grains hold £ gr. of Morphine and two of Calomel ; three grs., 4of Morphine and one of Calomel. With this preparation, no great danger of a mistake of too large a dose of this powerful agent can exist. The powder mixes well in a very small quantity of water without stirring ; it is pleasant to the sight, and not disagreeable to take. The ingredients should be most intimately blended by considerable trituration. It will be found very convenient and manageable, but none but professional men should presume to administer so potent an agent. 19 I hope that my professional brethren will take these hints in good part, emanating as they do, from the most disinterested motives. However presumptuous it may appear, I hesitate not in the firm conviction of the practical utility of the remarks I have thought it my duty to make, as a public man, to terminate these hasty observations with the following lines, from a celebrated French writer :—": — " Quand on s'occupe de ** rS/ormes de Men public, on pent aisement se resigner d dcs "travaux sans recompense, mais non & dcs efforts sans resuUats (Translation) When we are occupied in reforms for the public good, we can easily resign ourselves to labor without pecuniary compensation, but not to fruitless and useless efforts. WOLFRED NELSON, M. D., Mayor. Montreal, 7th July, 1854. B. DAWSON, fkolistlk, Stationer, antr |Jmabira.( !|geni, HAS much pleasure in announcing his intention to remove about the close of this month from No. 2 Place D'Armes, to the Old Post Office, No. 15 Great St. James Street. These spacious premises are now being fitted up in a suitable manner, and will afford greatly enlarged accommodation for additional stock. His chief study will bo to obtain the earliest possible supply of everything new and interesting, and to keep up his usually large stock of Standard Authors in the various departments of Literature, Medical Works, School Books, British and American Magazines and Newspapers, Maps, Guide Books, Blank Books, Engravings, Engineers' and Artists' materials, and a large assortment of Mercantile and General Stationery. B. D. hopes, by strict attention and moderate charge, to secure a continuance of the patronage with which he has been heretofore favored. Montreal, July 7th, 1854.