Ohio History Journal

CHOLERA IN CINCINNATI

 

By E. W. MITCHELL, M.D.

 

A worldwide epidemic of cholera, beginning in far-off India

in 1826, reached Russia in 1829, England in 1831 and was brought

to this country in 1832 by immigrants landing in Quebec.

Dr. Daniel Drake, with characteristic foresight, published

early in 1832 a paper on cholera, its causes, symptomology and

its treatment. The first case in Cincinnati was that of a passen-

ger on a steamboat from Portsmouth. He had left Kingston,

Canada, nine days before. The epidemic spread in the city very

rapidly and caused great consternation. Dr. Drake estimated

that 4% of the population was destroyed in the three years--

1832, 1833 and 1834. The number of deaths in the first year

was 571; the total for three years was 831.* In his paper on the

disease, he held the view that the disease was not contagious. He

reviewed the various causes of the disease, mentioning among

others, the "animalicular," saying about it, "I think it explains

more of the facts than any other of the hypotheses." It may be

recalled that in his great work he suggests the same cause for

malaria. There followed an animated discussion as to its being

contagious. Dr. Drake contended it was not.

When it became a problem to care for the numerous orphans

left by the epidemic, benevolent ladies of the city founded the

Cincinnati Orphan Asylum with funds contributed by the Ma-

sonic Lodge and other societies. The city gave a building on the

ground which is now Lincoln Park. The asylum was later re-

moved to Mount Auburn.

A second epidemic began in 1848. The epidemic of 1832

was described by several papers in the Western Journal of the

Medical and Physical Sciences. The best description of the sec-

 

* The population of the city at that time was 30,000.

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ond epidemic is found in two papers. One was a report read by

Dr. George Mendenhall at the annual meeting of the American

Medical Association in Charleston, S. C., in May, 1851, and later

published in their Transactions.

The other paper by Dr. Thomas Carroll was published in the

Western Lancet beginning with the June number of 1854. He

writes, "As early as December 25, 1848, patients laboring under

cholera arrived at our landing from the South and were hurried

through our midst to our Commercial Hospital. The decks of

many steamboats on the Mississippi became charnel houses at an

early period. From December 25 to January 10, fourteen cases

came from the river, there were seven or eight from the city.

There were few deaths up to May 10 when Judge John Brough,

a prominent citizen, died of the disease. This producing general

alarm and consternation. Between this date and June 15, sev-

enty-five people died." Death seemed to stare everyone in the

face. In one family, out of eight attacked, six died within ten

or twelve days. In a comparatively small house there were four-

teen deaths. In a small district in the region of Clarke and

Rittenhouse Street, sixty-nine of a population of three hundred

died. The crest of the wave was reached in July, there being on

the fourth, one hundred and thirty deaths. On the fifth, seven

more were added to this list. From May 1 to August 30 there

were four thousand one hundred and fourteen deaths from cho-

lera. The total deaths from all diseases for this period being six

thousand four hundred and fifty-nine, according to Mendenhall.

The population of the city was estimated at this time to be about

one hundred thousand.

It is not strange that there should have been a great deal of

confusion and dissatisfaction with the Board of Health and con-

troversy about method of treatment. There was quite a war

between the so-called "Regulars" and "Irregulars," pamphlets

being published by each side as well as numerous newspaper ar-

ticles. Dr. Carroll wrote about this period, "Often the alarm of

the moment was the occasion of patients being thrown in the

hands of quacks."

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OHIO MEDICAL HISTORY, 1835-58           291

 

Drs. Pulte and Ehrman, leading homeopathic practitioners,

published claims for the homeopathic treatment of one thousand

one hundred and sixteen patients (sixty to seventy of whom were

in deep collapse when coming under treatment) with only thirty-

five deaths. Dr. Latta, editor of the Methodist Expositor, after

having carried on the dispute for some time in his journal, issued

a bulletin claiming to show gross misinterpretation of the above

report. On the twenty-fourth of May, the old board of health

was displaced by a new one composed of one lawyer, one editor,

one dealer in spirits and one mechanic. The treatment employed

at the cholera hospital is described by Dr. Mendenhall as follows:

"Calomel in 1/₂-dram doses with three drams of camphor every

half-hour; after second half-hour, camphor given with brandy,

the calomel given three to five time only; cataplasm of mustard

applied over the abdomen as long as the patient could endure it,

with emplastrum cantharides as a substitute; cramps relieved by

friction with flannel wrung out of oil of turpentine; warmth re-

stored to extremities by putting lumps of lime in a stone pot,

water poured over the lime and the pot placed between the pa-

tient's feet which were enveloped in a blanket. In the most se-

vere cases in addition to the calomel, unguentun hydrargyri was

applied externally. Opium was given guardedly. This does not

differ greatly from the treatment of 1832, although bleeding is

less frequently mentioned. Dr. Drake's dose of calomel was 20

to 60 grains and was "Always required." The homeopaths gave

camphor in small doses frequently repeated. The Eclectic Medi-

cal Journal (February, 1849) advised opium, cordial stimulants,

perspiration induced by external heat, mild warm diluent drinks

given freely.

The epidemic in 1866 was milder in degree and less exten-

sive in this country than the two preceding epidemics. It also

came from the South and in the Lancet and Observer, September,

1866, Dr. Carroll described the disease as it occurred in Cincin-

nati. The invasion began about the last of July and reached its

height in August. There being on the fifth ninety deaths, the

greatest number for any one day. In the treatment one finds that

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292   OHIO ARCHAEOLOGICAL AND HISTORICAL QUARTERLY

 

calomel was still given but instead of half-dram doses, one or

perhaps five grains was the dosage. Dr. Carroll's treatment of

the epidemic was as follows: In the first stage calomel--five

grains, opium--I grain at bedtime, followed the next morning by

castor oil or rhubarb. After the bowels had moved bluepill--five

grains at bedtime every night or every other night with one-fourth

grain of opium. After the irritation of the stomach and bowels

subsided the patient was put upon the Compound Tincture of

Bark and Brandy t. i. d. When the patient was first seen in the

second stage, five grains of calomel with 1/2 grain of opium every

ten minutes until twenty and two grains respectively had been

taken. With each dose a teaspoonful of brandy was to be given.

Other practitioners gave small doses of calomel frequently re-

peated and various combinations of capsicum, piperine, bismuth

and tannin. Most physicians used opium, though some objected

to it. On August 16, Mercy Hospital was opened for the care of

cholera patients and closed September 1. Dr. David Judkins was

chairman of the committee in charge. Dr. George Courtright

served as attending physician. Fifty patients were treated in this

hospital with twenty-five deaths. Professor Roberts Bartholow

published an interesting paper in the Lancet and Observer (1866,

p. 652) entitled "Observations Pathological and Experimental,

in Cholera." He reported a number of experiments on dogs with

rather indefinite results. The laboratory era had begun. As

routine treatment Dr. Bartholow advised a prescription as fol-

lows: Dilute sulphuric acid two drams, Tincture of Opii Camph.

six drams, Aquae Camphorae one ounce--a teaspoonful every

fifteen minutes to one hour.

The number of deaths during this epidemic was 2,028. A

smaller number relative to the population than in the preceding

epidemic. The disease last visited Cincinnati in 1873. The epi-

demic was less extensive and less fatal than any of the preceding.

The number of deaths reported in the United States was 7,336.

In Ohio 740 deaths, in Cincinnati 207. The epidemic was most

severe in the Mississippi Valley. In 1874 Dr. J. J. Quinn, health

officer, published a report of 82 pages with maps and charts (pre-

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OHIO MEDICAL HISTORY, 1835-58           293

viously read to the Academy of Medicine). At the first session

of the forty-third Congress a resolution was passed and approved

by the President on March 25, 1874, "Whereas an epidemic of

cholera had prevailed during 1873 in various parts of the United

States causing deplorable mortality it was ordered that a medical

officer of the army in connection with the supervising surgeon of

the Marine Hospital service, should ascertain the facts and make

a detailed report on or before Jan. 1, 1875." This work was

carried on under Asst. Surgeon Ely McClellan and Dr. John M.

Woodworth, supervising surgeon of the Marine Hospital service.

The exhaustive report covered 1000 pages. Dr. John S. Billings

contributed a full bibliography of cholera up to that date. Dr.

William Clendenin, late health officer of Cincinnati, contributed a

report on the epidemic in Cincinnati. This report with recom-

mendation had so great an influence in improving sanitary and

quarantine administration that the disease has never gained a

foothold in this country since 1873. During this time and includ-

ing 1873, much was written about meterologic and geologic con-

ditions, overcrowding, bad food and various other causes. In

1850 many observers drew attention to water as a means of con-

veying the disease. By 1873 contamination of the water supplies

was generally recognized as a source of infection and the belief in

its bacterial origin common among advanced thinkers. Koch's

announcement of the discovery of the causative organism came

in 1884.

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