NOTES ON CHOLERA IN SOUTHWESTERN OHIO
By DAVID
A. TUCKER, JR., M. D.
The first invasion of the North American
continent by
epidemic, or Asiatic cholera, occurred
in 1832. The disease ap-
pears to have been carried across the
Atlantic by emigrants from
Ireland who landed during April and May
at Gross Isle, thirty-
two miles below the city of Quebec.
Cholera had appeared in a serious
epidemic at Jessore, India,
on the Delta of the Ganges in 1816-1817.
It had spread slowly
over almost the whole of Asia in the
succeeding ten years and
finally reached Europe in 1829-1830,
being seen first in the Near
East and in Russia. It passed westward
along the river trade
routes of the Danubian Basin and
northward to the Baltic areas.
A severe epidemic occurred in Moscow
during 1830. It was
found in England during the summer of
1831 on the river front
below London, and aboard vessels
recently in from Baltic ports,
and quickly spread over all of England,
Scotland and Wales. In
the latter part of the year it reached
Ireland from which area it
was carried to America. It is known that
the ship Constantia
from Limerick arrived at Gross Isle on
April 28, 1832, with 170
emigrants aboard, twenty-nine deaths
from cholera having oc-
curred during the voyage. Within the
next few weeks a number
of vessels carrying the disease
disembarked their passengers. On
June 8 the disease was found at Quebec,
and at Montreal a day
later. The explosive nature of the
epidemic was due to the com-
bination of intense heat and heavy rains
contaminating the water
supplies, and the unsanitary conditions
of the receiving stations.
It reached its height in ten days, then
slowly declined.
Medical records show that the disease
moved along the routes
of travel from Canada to New York State.
There is some evi-
dence to indicate that cases had arrived
in the port of New York
before or at the same time that they had
reached Quebec and
(378)
OHIO MEDICAL HISTORY, 1835-1858
379
Montreal from abroad. By July 5 official
reports in New York
City were issued and in two weeks some five
or six hundred
deaths were reported. Cholera was noted
in Philadelphia on
July 7, in Baltimore on August 12,
or 13, and in Washington,
D. C., about August 20.
It appeared first along the tributaries
of the Ohio at Pitts-
burgh on July 2, in a boarding
house frequented by immigrants
who had crossed from Canada. Shortly
thereafter cases were
found among immigrants who had come by
way of New York
City. Meanwhile, soldiers of the United
States Army traveling
westward carried the infection to
Detroit, Mackinac and Chicago.
The advent of cholera in Cincinnati was
quite generally at-
tributed to an immigrant from Canada,
who, coming by way of
the canal from Cleveland to Portsmouth
on October 8 reached
Cincinnati on the steamboat, Sylph, dying
a few hours after he
arrived. However, Dr. Daniel Drake
maintained that there were
some twenty cases in the city prior to
the arrival of the Sylph.
The disease really broke out extensively
about September 20. At
first officials attempted to deny the
existence of the malady, but
on October 18 a death list from cholera was published. In
October 423 individuals died, the
epidemic then receding, only
to return the next spring and summer. In
July, 1833, there were
176 deaths from cholera and whereas the
epidemic of 1832 was
thought to have reached the Ohio Valley
from the north, the
pestilence in 1833 came from the region
of New Orleans. A
contemporary description of Cincinnati
during the first epidemic
is as follows:
"The city, during the prevalence of
this dreadful epidemic, presented
a mournful aspect. Thousands of citizens
were absent in the country; very
many were closely confined by personal
affliction or the demands of sick
friends; hundreds were numbered among
the dead; the transient floating
population had entirely disappeared; the
country people, in terror, stood
aloof; business was almost wholly
suspended; the tramp of hurrying feet
was no longer heard on the streets, the
din of the city was hushed, and every
day appeared as a Sabbath. Instead,
however, of the sound of church-going
bells and the footsteps of happy throngs
hastening to the house of God, were
heard the shrieks of terrorstricken
victims of the fell disease, the groans of
the dying, and the voices of
lamentation. For weeks funeral processions
380
OHIO ARCHAEOLOGICAL AND HISTORICAL QUARTERLY
might be seen at any hour, from early
morning to late at night. All classes
of people were stricken down in this
fearful visitation. Doctors, ministers,
lawyers, merchants and mechanics, the
old and the young, the temperate and
the intemperate, the prudent and the
imprudent, were alike victims."1
The return of the cholera in 1834 seemed
to cap the climax of the city's
misfortunes and for a time the universal
depression had a serious effect upon
the business of the city and its general
atmosphere was one of hopelessness
and despair. The town seemed lifeless
and inert and property fell to very
low prices. The following year however
was free from the expected return
of the disease and a period of
extraordinary activity ensued. Enterprise and
business growth rapidly increased. Many
public works were projected dur-
ing this period, including the great
Southern Railway route to Charleston,
the railroad to St. Louis, the little
Miami, the Cincinnati, Columbus & Cleve-
land railway, the Mad River & Lake
Erie, Covington & Lexington, and the
White Water Canal. All of these
enterprises though perhaps under different
names were finally carried out.2
Under the date of July 20, 1832, and
before the disease had
reached the Ohio Valley, Drake issued a
small volume, entitled
A Practical Treatise on the History,
Prevention and Treatment
of Epidemic Cholera--Designed Both
for the Profession and the
People. In the preface the author stated, "The object of
this
little volume has been to present to the
physician and reading
public of the Valley of Mississippi with
an authentic digest of the
most important facts relative to the
Cause, Symptoms, and Treat-
ment of the Epidemic which is now
impending." He further
stated:
When the news of Cholera sickness in
Quebec reached Cincinnati regu-
lations to prevent its contagion, were
immediately proposed in our City
Council; but no steps to this end, have,
I believe, been taken. Other towns,
in the valley of Mississippi, have
possibly indulged the reverie of shutting
themselves up from the pestilence. They
who cherish this scheme, have
thought little on the consequences of
its execution. In the first place, even
in the despotic kingdoms of Europe,
where such restrictions could be best
enforced, they have not stayed the march
of the disease a single hour.
Secondly, such restrictions cannot be
executed without a military force, and
a superintending head. Thirdly, the health of those who
are thus shut up,
invariably suffers. Fourthly, the losses
in business, and the discomforts and
inconveniences, consequent upon such
restrictions, are calamitous in the
1 C. T. Greve, Centennial History of Cincinnati and
Representative Citizens
(Chicago, 1904), 1, 588,
quoting from the Life of Bishop Morris.
2 Ibid., I, 589.
OHIO MEDICAL HISTORY, 1835-1858 381
highest degree. I cannot but hope,
therefore, that no state government or
civic corporation in the West, will
undertake so mad an enterprize. Look at
the example of New York. Did not her
legislature and people exert their
utmost power to confine the pestilence
to the shores of the St. Lawrence?
And has it not already settled over the
valley of the Hudson? Did not the
disease appear in her Capital, and disperse
the very Assembly which the day
before had sent out a decree against its
approach! And has it not overspread
her great Emporium, without any human
eye having been keen enough to see
by what channel it approached! These are
facts which should instruct us.
They display the utter fruitlessness of
all restrictions on the social and com-
mercial intercourse of society, and call
loudly on us to prepare for that which
we cannot avert.3
Drake did not accept the popular
miasmatic theory as to the
cause of the disease but believed it to
be due to some very small
microscopic agent--an animalicule. He did not believe that it
was contagious, advocated strict
sanitation and good personal
hygiene as the measures most likely to
prevent the pestilence. He
published as a supplement to the
Cincinnati Chronicle, dated
October 13, 1832, an extra sheet with
the following notice.
Cure of Cholera
FELLOW CITIZENS,
Would you be cured of Cholera take the
disease in time.
It begins with some sort of Bowel Complaint,
or disturbance of the
stomach. In this stage it is easily
cured; and all who neglect this stage are
in danger of perishing.
Whoever has a lax or sickness at
stomach, or Colic, should instantly
take to his bed, in a warm room and
drink hot tea of sage, balm, or
Thorough wort, or even hot
water--bathing his feet if cold, and applying
a warm poultice over the bowels.
Without this nothing will do any
good--All who go about in the damp
air after the bowel complaint has set in
will get Cramps and Spasms and die
--I again say they will die. Besides
what I have mentioned, they should take
a powder, of ten grains of Calomel and
one of Opium mixed, if grown
person, and children should take less in
proportion; or a teaspoonful of
powdered Rhubarb.
They should, also take a teaspoonful,
every hour, of the Aromatic
Camphorated water, which is a cheap
article, and may be had of most of the
Apothecaries.
All who are of a full habit, or have
Fever, or Colic should be bled.
3 Daniel Drake, A Practical Treatise
on the History, Prevention, and Treatment
of Epidemic Cholera (Cincinnati, 1832), 167-8.
382 OHIO ARCHAEOLOGICAL AND HISTORICAL
QUARTERLY
Again let me warn every one, that the
dreadful Epidemic commences
as a mild bowel complaint, and in that
stage may be cured--when vomitting
coldness and spasms combined, come on,
death will follow--has followed,
in almost every case that has yet
occurred in the city. He who goes about
with a mild complaint upon him should
expect to perish.
The Epidemic would lose all its terrors,
if people would attend,
instantly, to the first symptoms--Go to
bed, drink hot water or tea, promote
a perspiration, and send for their
family Physician.
Terror is a great exciting cause. The
disease produced by terror
requires treatment. Let no one presume
to laugh another out of his fears.
All the terrified should take to their
beds--this will best counteract its bad
effects.
Let all who read what is here written,
recount it to their friends. Let
us unite in aiding each other, for a few
days--The Pestilential Cloud will
soon pass away. The disease, absolutely,
is not catching.
DANIEL DRAKE, M.D.4
Cholera prevailed in the vicinity of
Cincinnati during the
years 1832-1833 and 1834. During the
first two years there were
831 deaths due to this cause. Epidemics
also occurred in terri-
tories surrounding Cincinnati. Many
deaths were reported in or
near Salem, Madison and Versailles,
Indiana. To the north the
disease raged at Lebanon and Dayton,
Ohio, and at Richmond,
Indiana. Cases occurred in Columbus during July and August
The upper Ohio was also invaded
particularly at Gallipolis (June,
1833) and spread through the Kanawha
Valley at Charleston,
and other places in West Virginia.
Wheeling was an important
center for the spread of this disease,
which progressed eastward
to the Valley of the Potomac, but then
did not reach to the eastern
seaboard. Previous to its infestation of
the Cincinnati region it
had appeared among the laborers along
the Lake Erie and Ohio
Canal. It took a heavy toll in 1832 near
Chillicothe.
The second great invasion of cholera
occurred in 1849. As
in the first, the starting focus was
India, where at Calcutta a very
virulent form of the disease appeared in
1840, and passed as if
in a wave through China to Siberia and
then to Russia. From
the Near East the epidemic spread to the
Mediterranean areas.
In Russia during 1847-1848 more than a
million succumbed. In
4 Cincinnati Chronicle Extra, Sat.
afternoon, Oct. 13, 1832.
OHIO MEDICAL HISTORY, 1835-1858 383
France 150,000 died. The German areas
were also infected and
with the large stream of German immigration the cholera was
again brought to North America. It
invaded the Ohio Valley
from the South in 1849. In Dearborn
County, Indiana, the toll
was very heavy, the town of Aurora alone
having 132 deaths.
Cincinnati in 1849 was a city of
110,000, the largest in the Middle
West. It had a public water system by
means of which water
was pumped into reservoirs in the hills
and then piped by gravity
throughout the city. A few cases
appeared in January, but the
epidemic reached severe proportions in
April and its peak in the
last week in June when the deaths
numbered 903. The toll of
the fifteen weeks' period was 5969 or at
a rate of 188 per 1000.
A feature of this epidemic was the
controversies which raged
between the Allopaths, the Homeopaths
and the Eclectics, each
group maintaining its own method of
treatment to be the superior
one.
Drake wrote two open letters5 to
the public which I quote
in full:
To THE PEOPLE OF CINCINNATI: The publication of the Board
of
Health and the weekly report of the
trustees of the Hospital in yesterday's
Daily Gazette, having shown that the
cholera has at length begun to prevail
among us as an epidemic, I propose to
say a few words on certain points on
which all have a deep interest.
In the first place, then, let no one
leave the city because the epidemic
has come. In whatever known manner this
disorder travels from country
to country, it is not like smallpox, a
catching disease; if it were, going
out of the city would be a preservative.
As in 1832, the cases that have
occurred, were in various retired parts
of the city, and largely among women
and children, who had been in no degree
exposed to boats, railroad stations
or hotels, where they could have caught
any disease. In fact the cause has
spread through the city, and already
been received into the bodies of its
inhabitants--old and young, rich and
poor; and those who escape to the
country are as likely--more likely--to
be ill than if they remained at home.
The true and safest course is for
families and friends to draw closer than
common and watch over and assist each
other.
In the second place it ought to be
known, that epidemic cholera has no
premonitory symptoms. When the sentinel
on the walls of a fortified city
fires his gun, it is a premonition that
the enemy is close at hand--when there
5 Cincinnati Daily Gazette, May
10-11, 1849.
384
OHIO ARCHEOLOGICAL AND HISTORICAL QUARTERLY
is a circle around the moon, it is a
premonitory sign of a storm, but cholera
attacks without any premonition. We are
accustomed to apply the word
cholera to a summer disease of our own
climate, which generally begins with
vomiting, or that symptom and diarrhoea
combined; and have, therefore,
fallen into the fatal error of regarding
the first stage of epidemic cholera
as a forerunner of that, from the moment
when the diarrhoea sets in the
cholera is as positively present as when
it has advanced to vomiting, or
coldness and collapse. When one shingle
sends up smoke, the roof is as
positively on fire as when the flames
light up the city. The man who should
stand still when he saw the smoke, it
was only a premonitory sign, that his
house might be on fire after a while,
would be regarded as insane; yet his
absurdity would be no greater than that
of the individual who does not
regard himself as laboring under the
cholera, from the moment the diarrhoea
begins.
In the third place, it may be declared
as a fact, that the disease may
generally be stopped, if met in the
early stage; at all events, if it cannot then
be put an end to, it cannot afterwards.
It will run its course, and the patient
may or may not recover, according to his
constitution--but let no one believe
that this first, mild stage, can be
successfully treated, if the patient continues
on his feet. His life depends on his
lying by--no medicine can succeed if he
should not. They may check it for a
moment, and delude him into a fatal
security, but can go no further. In the
fourth place all persons who can
have warm flannel during the winter
should keep it on, until the epidemic has
passed away. They may put on cooler
outer clothing but should not throw
off what they have worn next the surface
of the body.
Tomorrow these practical remarks will be
extended, meanwhile I may
say, that they most certainly express
the experience and settled opinions of
the medical profession, both in Europe
and this country.
CINCINNATI, May 10, 1849, DANIEL DRAKE, M.D.
TO THE PEOPLE OF CINCINNATI:
I briefly pointed out yesterday, in the
public prints, that no one should
leave the city for the purpose of
escaping the cholera--that it is not a disease
which has premonitory symptoms, but that
it is present from the beginning
of the diarrhoea, which is its first
stage; that early treatment and rest are
indispensible to its cure; and that warm
clothing should not be laid aside
until the epidemic shall have passed
away.
The last opinion relates to the
prevention of the disease, and on that
point I propose to say a few words.
Strictly speaking there is no prevention
of the cholera; but all consti-
tutions are not liable to it, any more
than all are liable to ague and fever.
influenza or any other form of disease.
But although we know of nothing
that will prevent the disease, we know
of many things which can and do
OHIO
MEDICAL HISTORY, 1835-1858 385
bring it on, after the poison has been
taken into the system. These are
exciting causes, and ought to be
carefully avoided.
Of the exciting causes one has just been
mentioned, the premature lay-
ing aside of flannel and other warm
clothing. In addition to this (and be-
longing to the same head) getting wet in
a shower--remaining long in damp
places--sitting in a strong current of
air at night--and sleeping with but
little bed covering--should all be
carefully avoided. Every sitting and lodg-
ing room ought to have a fire in it for
a part of every day, especially for a
few hours before occupying it, thus the
shop, office, family sitting room,
church, and school house should have
fires kindled in them early in the
morning, and kept up for two or three
hours; but this is still more necessary
in lodging rooms which should be warmed
and dried by brisk fires, kindled
in the early part of the evening, and
allowed to burn down before bed time.
A second class of exciting causes is
connected with diet. Loading the
stomach with any kind of food,
especially at night, may bring on the disease;
and omitting to eat at the usual time
may do the same thing. Much reduc-
tion in the quantity (the individual
still be in health) is not proper. In fact
a nourishing diet is best; but should be
plain and digestible. Meat or boiled
eggs, should be eaten every day. Boiled
ham, corned beef, and poultry,
corned mutton, and well seasoned, beef
steak are the best. On the whole
salted meats are more proper than fresh
and all should be well seasoned.
Veal, fresh pork and fresh fish should
be avoided. Of salt fish, mackerel
and salmon are too hard; but codfish
with potatoes is proper. Old cheese is
safe, and macaroni prepared with cheese
may be eaten. Hot bread should be
avoided--stale bread or crackers only,
should be used. Of culinary vegetable
mealy potatoes, well boiled hominy and
rice, are not only the best but all
others had better be omitted. Pie, tarts
and all kinds of pastry are improper,
except perhaps, well baked and highly
spiced gingerbread.
Of drinks, sweet milk, tea, coffee and
chocolate may be taken as usual.
Those who drink malt liquors at their
meals should limit themselves to
freshly brewed beer, well hopped. As to
brandy and whiskey, they cannot
prevent cholera. They who are in the
habit of using either, should not lay
either aside; but they should by all
means not begin it now. The use of
brandy in the treatment of disease, must
not be confounded with its use as
a preventive. The irritation of the
stomach and bowels produced by the first
impress of alcoholic drinks, may even
contribute to bring on the disease, and
sour wines are still more likely to have
that effect.
DAN DRAKE, M.D.
CINCINNATI, May 11, 1849.