Oct. 3. 4. 1771. April 1. 1772. Feb. 22. Ice so strong as to bear me, 12 inches water. Snow this morning that covered houses. March 9. Snow-11th, snow-13th, snow-15th, March 16, Snow-18th, snow, and 19th, snowabout two feet deep on a level. April 3. Snow about 6 inches deep. [In our II. Vol. pp. 23, 379, will be found similar memoranda of the weather for nearly 150 years.-ED. 228,803 75 20,074 66 1,487 77 24,888 20 REG.] 10,970 98 91,925 00 682,379 64 4,045 43 3,115 44 1,144 05 1,188 77 143 84 10,283 30 4,602,204 88 117,167 16 $4,719,372 04 SINGULAR CIRCUMSTANCE.-In selecting the Jurors for Chester county, for the present year, the name of a father and his two sons, were placed in the commissioner's box. In drawing from thence by lot, the Jurors for the second week of last court, the father and sons were amongst the number drawn. When a jury was to be empannelled, the clerk of the court drew out of the box by lot, the names of the same father and sons, and what is not less singular, they were drawn in successive order, so that the father and his sons took their seats as called, side by side, and thus sat during the trial of the cause.-Amer. Rep. THE REGISTER. PHILADELPHIA, DECEMBER 1, 1832. Our columns this week are enriched by the eloquent discourse of P. S. DUPONCEAU, Esq. before the Pean Society. We hope shortly to present another, delivered on Thursday, before the Historical Society of Pennsylsylvania, by PETER MCCALL, Esq; both addresses elucidating the early history of our state. The Penn'a State Temperance Society have, at the suggestion of the American Temperance Society, invited the temperance societies of the state, as well as all citizens friendly to the cause, to meet in their respective cities, towns, and villages, on the 26th February, 1833, "to declare and publish their sense of the great plan of moral reformation which seeks to abolish intemper ance from our beloved country." The suggestion is a good one, and well calculated "to increase the interest which is felt on the subject." We add a wish, that each society would in the mean time, collect statistical facts, as to the number of distilleries, taverns, and other places for selling ardent spirits, and of the effects produced within their sphere of operation-to be laid before the meeting in some suitable form for general information. If all the societies in the United States would attend to the suggestion, much good would probably result from such an united exposition of the evil which it is the object of these societies to remove. REGISTER OF PENNSYLVANIA. DEVOTED TO THE PRESERVATION OF EVERY KIND OF USEFUL INFORMATION RESPECTING THE STATE. VOL. X.-NO. 23. EDITED BY SAMUEL HAZARD. PHILADELPHIA, DECEMBER 8, 1832. NO. 258. REPORT ON CHOLERA. Report embracing a view of the principal facts connected with the prevalence of Malignant Cholera in Philadelphia, in 1832, made to the Consulting Medical Board, by S. Jackson, M. D., Secretary to the Consulting Medical Board. The regular westward progress of the great epidemic, known under the designation of the Cholera, left but little doubt that its visitation would be extended to this continent. It became a subject of mingled curiosity and anxiety to watch the period of its arrival, and the point of its invasion. In this state of uncertainty, intelligence arrived that the disease had appeared at Quebec on the 8th, and at Montreal on the 10th June, in both which cities it immediately assumed the character of a most destructive pestilence. munication with the city, and no admission into the ward she occupied, had taken place for a month. Several cases immediately ensued in this and the other wards of the house. The epidemic reached its maximum in this establishment on the 11th July, and terminated on the 4th August. In the city of New York, the climax of the epidemic arrived on the 21st of July, from which period it continued very steadily to decline. The time that elapsed from the out-breaking of the epidemic at Quebec, and its appearance at New York, is a period of 16 days, or 19 at Bellevue Alms House. The distance between the two cities in a direct line, is 450 miles. It is to be remarked, that all the intermediate cities on the sea-board of the province of New-Brunswick and Nova Scotia; of the states of Maine, Massachusetts, and Rhode Island, remained entirely exempt from the epidemic; and even to the present period, except in Providence, Newport, and Boston, no cases have From the numbers of emigrants, who, about this period, had landed at Quebec, and arrived at Montreal from England and Ireland, a first impression was created, that they had been the means of transmitting the epi-as yet appeared. demic across the Atlantic. A more close investigation In this city, the epidemic was much more tardy in into the facts connected with the commencement of the its progress than it had been in the Canadas, or in New disease in those cities, served to destroy this supposition. York. The first decided case of Cholera occurred on It could not be traced to importation. The emigrants Thursday, July 5th. A man of the name of Musgrave, and lower classes of the Canadians were attacked sim-residing in the cellar of a house in Filbert street, near ultaneously in both cities. Numbers of the emigrants Schuylkill Fifth street, was attacked with symptoms of were in circumstances eminently predisposing them to malignant Cholera on that day. This man had but latesuffer attacks of disease, and they and the lower Cana-ly been discharged from the New Jersey Prison; he had dians were precisely the description of persons most obnoxious to the ravages of epidemic Cholera, and such as have been universally observed to be its first victims. The lines of communication between the cities of Quebec and Montreal, and the cities of the United States, are by the Richelieu river, Lake Champlain, and the northern canal leading to Troy and Albany; or by the St. Lawrence to Lake Ontario, to Buffalo, and by the Erie canal leading to Rochester and Albany. It was confidently expected that the disease would penetrate into the United States from Canada by these routes. Along the first, many cases of the disease did certainly occur in the persons of emigrants, but they terminated without its communication to others. On the contrary, the epidemic manifested a decided predilection for the shores of the St. Lawrence, successively attacking the towns and villages along its banks, then following the borders of Lake Ontario, until it entered Lake Erie. been affected with a diarrhoea for two or three weeks previous to the Cholera symptoms. The disease proved fatal on Sunday the 8th. The next case was a black man residing in St. John's street, Northern Liberties, above Callowhill. He had been employed working on board a ship from England, lying at Pratt's wharf. He was seized with symptoms of malignant Cholera the night of Tuesday, July 9th, and died on Friday. This man was perfectly sober in habits; no premonitory symptoms existed. No other cases presented themselves until Sunday, Ju- * ly 14th, when two females occupying a room in a dwelling in Coates street, a few doors above 3d, were the victims of the pestilence in its most aggravated shape. Both these females were exemplary in their habits of life, The husband of but appeared to be infirm in health. one of these unfortunates had arrived on Saturday, July 7th, from New York, exceedingly alarmed respecting the Cholera. He was taken sick the next day, and died on the succeeding Friday. On Saturday the widow felt unwell, and without advice took grains xvi. of calo. While attention was directed to the northern and western boundary, supposed to be threatened by the invasion of the disease, it suddenly and most unexpect-mel in the evening. She was soon after seized with edly appeared in the city of New York. The first case occurred, it is said, on the 24th June, when a man, a native citizen, residing at the corner of Gold and Frankfort streets, was attacked by the disease. Four cases soon succeeded, the location of which was in Cherry street. The subjects were Irish emigrants, who had arrived at Quebec in the autumn of 1831, and had resided in Albany until the month of May, when they removed to New York. On the 27th June, the disease manifested itself in Bellevue Alms House, distant about three miles from the city. The patient was an aged woman who had not left the house for three years, who had held no comVOL. X. 45 vomiting and purging, and in the course of the night she sunk into collapse. She died Sunday night. The mother of the deceased husband, on Sunday morning complained of feeling unwell, but without definite symptoms. Having been up with her daughter-in-law during the night, her uncomfortable feeling was attributed to fatigue. She was then going about the house, and had been out on an errand. She was requested to lie down as a matter of precaution, and a small dose of opium administered to her. This was at 8 o'clock in the morning, Dr. Schott who was in attendance, an hour afterwards, went up to her chamber to inquire into her state. He found her lying on the floor; copious dejections of rice-water looking fluid had occurred, and she was in complete collapse: death ensued in the evening. These were the only cases to which the slightest suspicion of communication by contagion could attach; but on the same day a French woman, temperate in habits, about 50 years of age, living in Kensington, beyond the close built part of the town, at the head of West street, was also a victim of the disease. This woman had not been from her dwelling for three weeks, the house is isolated, being surrounded by kitchen-gardens for the supply of the markets. She had been affected with diarrhoea since Friday, for which she had dieted, but had taken no medicine: the case proved fatal next day. From this time, not more than three or four cases occurred, all scattered in different quarters, particular Date. September 30, Quebec, 1st, Montreal, August 22d, New York, ly Kensington, Northern Liberties, and Southwark, until the 27th and 28th July, when the epidemic fairly set in, and cases continued daily to be developed. The disease attained its height in this city on 5th, 6th, and 7th of August, since which time it has gradually declined, and appears now to be extinct. Taking the 27th or 28th of July as the proper commencement of the epidemic in Philadelphia, there will be a period of 24 or 25 days intervening between its first appearance in New York, and in this city. The distance in a direct line is about 90 miles. A comparative view of the population, number of cases and deaths in the cities, which have been brought under observation, presents the epidemic in an interesting point, and exhibits in a clear manner the character it assumed in this city. September 13th, Philadelphia, 160,000¶ The results of this table show conclusively, that the causes productive of Cholera were less numerous in the city of Philadelphia than in Quebec, Montreal, or New York, or were so modified as to possess a much less degree of activity. The causes of this result so favourable to Philadelphia, important in the hygienic his tory of Cholera, and consoling to humanity, as placing this formidable affection, to so great an extent under control, it is interesting to investigate. The following are the circumstances which, existing more particularly in Philadelphia, may be regarded as influential in ameliorating the violence of the epidemic cause, circumscribing its activity, and diminishing its fatality. 1. The plan on which the city is built, arranged in hollow squares, separated by wide and paved streets, prevents excessive crowding of inhabitants, procures free ventilation, and gives facility to the means of cleanliness. It is to be regretted that any deviation has been permitted in the original design of Penn, whose sagacity, and foresight, have been so amply demonstrated in the circumstances of the late epidemic. 2. The abundant supply of wholesome water placed at the command of the whole community, affords a healthful beverage, and gives the means of the most complete cleanliness, by washing the dirty gutters of the streets, close alleys and lanes. 3. The well arranged measures of sanitary police, devised and actively carried into effect by the councils of the city and the boards of commissioners of the district, and the sanitary committees appointed by them, and by the Board of Health. These measures consisted in a thorough investigation into all existing nuisances, and in their immediate abatement; in a complete system of cleanliness of the city steadily pursued; in the early establishment of numerous local hospitals, provided with ample medical attendance, nurses, and every means applicable to the treatment of the disease; and in spreading before the public early information, derived from the consulting medical committees, of the methods hygi enic, dietetic, and medicinal, best adapted for guarding against the attack of the disease, or to arrest the symptoms on its onset. 4. A very considerable influence may be attributed to the annunciation made by the mission sent to Canada, immediately on its return, and before the epidemic had commenced its career in this city, of the different periods of the disease, and especially of the existence, in almost every instance, of premonitory signs, and a preliminary stage, with a description of the symptoms indicating its existence. This information was communicated to the public by the sanitary committee through the daily journals of the city, by handbills liberally distributed, and by placards on the corners of the streets. The Board of Health adopted the same measures, and pursued the same course. In this manner the whole community, before the beginning of the epidemic, were instructed in the most important points in the general knowledge and management of this affection-its commencing period, the premonitory symptoms, its general curability in that state, the necessity of immediate attention and medical advice, and the methods of relief. These facts had been overlooked, and this attention to the instruction of the public, were entirely neglected in Quebec, and Montreal, and in New York, from being taken unprepared by the epidemic, earlier than was anticipated, they were not communicated to the public until the measure had been adopted in this city, and when the epidemic there had already attained its maximum of intensity. 5. The moral resolution, calmness and perfect freedom from alarm and panic, generally manifested by our citizens, and inspired by a thorough confidence in the efficacy of the preventive means enforced, in the advantages for salubrity of the city, and in its medical resources, contributed in no small degree to diminish the number of cases, and the intensity of the attacks. Nostores were closed on account of the epidemic, and not more citizens left the city than usually abandon it every summer. A stranger entering our streets, from the busy throng and cheerful aspect of all he met, would never have suspected the existence of an unusual and a desolating scourge. vate practice in as favourable a light as they really were. A considerable number of physicians in the more respectable practice, reported only the cases that proved fatal or exceedingly severe. They did not return to the Board of Health the lighter cases, which yielded to the vate practice in the reports, appears, in consequence, to have been far greater than it really was. 6. The treatment of the disease generally pursued in the city, in the preliminary stage, had most probably no small share in preventing the development of the dis-operation of remedial measures. The mortality of priease in innumerable instances. In the lighter forms, it was limited chiefly to diet, rest, tranquillizing doses of anodynes, or mild diffusibles, with occasionally the mildest laxatives or gentle cathartics, conjoined with sinapisms or other rubefacients. The drastic and purturbating cathartics, were seldom, if at all prescribed, and the stimulant practice, but rarely resorted to. The foregoing circumstances appear to us as those principally instrumental in producing the favourable results attending the epidemic in this city. As such, they acquire a high degree of interest, and afford most instructive lessons as regards the measures of municipal and civil regulation connected with sanitary police. In its general features and character the disease differed in no respect from the many descriptions that have been made since it first attracted attention in Asia, and subsequently in its progress through Europe. It will be unnecessary to make the repetition here; it is, however, important that the fact should be signalized, that during the prevalence of the epidemic, very few persons in the city were entirely exempt from some derangement or disorder of the digestive functions. It is not probably exaggeration to assert, that two-thirds of the population were affected in this manner, which is to be attributed entirely to the epidemic influence. It should also be stated, that in the majority of cases which assumed the decided character of malignant Cholera, preliminary symptoms had existed, varying in duration from a few hours to several days. In those rarer instances which were not preceded by any premonitory signs, the subjects were the aged, the intemperate, individuals who had committed some great imprudence in diet, or whose constitutions had been enfeebled, and such cases were, generally, if not universally, fatal. The disease was not confined to any one portion of the city, but extended to every district. Neither did it progress gradually from one quarter of the town where it first appeared to others, but broke out almost simultaneously in the most opposite and distant points. The following table exhibits the number of cases that were reported from the different districts, with the ratio to the population. City Popula-Cases. Ratio of Cases 1 in 200 11-12 Table of cases and deaths with the ratio as occurring in private practice, and the public institutions. Private practice, Cases. Deaths. Ratio of deaths to cases. Had the returns of cases in private practice been complete,, the proportion of cases would have been much greater. It would have ranged probably as 1 to 70 or 80, or even more. In the hospital practice, the first cases introduced were nearly all fatal. This circumstance is to be accounted for from the universal observation wherever Cholera has prevailed epidemically, that the worst constitutions were the first to suffer attacks. In the commencement of the epidemic, persons first attacked, unaware of their danger and the nature of the affection, neglect application for aid, and resist the offer of hospital assistance until reduced to a hopeless condition. Besides, misled by the authority of the English and Scotch writers, extensive means had been prepared for warming the patients by heated air, steam, and other means. Experience in a short time, proved the pernicious effects of this system. The patients succumbed most rapidly under the exhaustion induced by the profuse watery exhalation from the skin caused by this treatment. The disease first appeared in the Alms House, July 29; it reached its period of greatest activity the 8th and 9th of August, gradually declined, and terminated on the 25th of August. In the Arch Street Prison are confined vagrants, disorderly persons, criminals guilty of petty larceny, most of them the victims of low and brutal debauchery, and a limited number of debtors. The disease manifested itself on the 31st of July. Cases continued to occur daily, but on the fifth of August the number of cases and deaths suddenly augmented, producing a scene of almost unexampled desolation. In the same room were mingled the dead, the dying, the sick, and the well. The prisoners became frantic with despair, and threatened the lives of the officers and attendants. A number of medical gentlemen, the inspectors and others repaired to the prison to alleviate the sufferings of these unhappy beings. The vagrants were discharged, the sick were conveyed to the hospitals, and all the prisoners whom it was possible to release, were dismissed. The confusion was so great that a return of the cases and deaths was not made to the Board of Health on that day. By reference to the meteorological table, it will be seen that on the 5th AuIn the city, though the cases as occurring in differ- gust, the day the disease in the prison acquired its sudent parts, were not kept distinct in the reports, yet, it den intensity, the barometer had fallen lower than it had is well known that the larger proportion of them took been for a month previous, the maximum of the therplace in the external limits, especially the western bor-mometer was at the highest point for the month, and ders, towards the Schuylkill, and the southern extremity, while a very small number only were developed in the central portion. From the above table it appears that the epidemic prevailed with greatest severity in Moyamensing and Southwark. This is to be attributed to the character of the population, rather than to local causes. In both those districts reside the worst portion of our popu lation, and in Moyamensing, especially, there is a dense population, some of whom are of the lowest order and most abandoned habits. The chief mortality of the disease existed in the public institutions. It was much lighter in private practice. The following table exhibits the cases and deaths as reported in private practice and the public institutions. The reports, however, do not exhibit the results of pri the dew point at a very high elevation. The atmosphere in consequence was light, moist, and oppressive. Was this meteorological state of the atmosphere, and the sudden augmentation of the disease mere coincidences, or were they connected? The mortality of the disease in relation to sexes, is shown in the following table. The relation as to cases cannot be ascertained. Under 1 year Between 1 and 2 388 81 Ratio 1 in 604 1 503 2 and 5 30 1 912 5 and 10 39 1 919 10 and 15 102 60 46 28 1 212 tion, in proportion to numbers. The fact is shown in WHITE POPULATION. Three hundred and thirty-eight cases. Ratio of cases to black population-1 to 41. It has been a common observation by writers on epidemic diseases, that during the prevalence of an epidemic, it appeared to subdue and suppress all other diseases, monopolizing to itself, for a time, all the energies of destruction. This observation has been repeated since the days of Sydenham, by whom it was announced, though it has not been supported by statistical evidence. In the present epidemic, although its influence was so extensively felt in the city, the observation has not been sustained. The following table shows very clearly, that during the prevalence of the late epidemic, other diseases continued, not only unabated, but actually augmented, causing an increase of mortality independent of that produced by Cholera. During the months of June, July, and August, of this year, the deaths from the diseases generally prevalent, 425. It is to be remarked however that the diseases in exceeded those of the corresponding months of last year, which the augmentation of the mortality was the greatest, are those congenerous with Cholera, viz: gastric, enteritic, febrile diseases, and inflammations. All those diseases appear to have derived an accretion from its presence. It is also to be observed that scarlet fever inThe ravages of the disease were more extensive in stead of yielding to the sway of Cholera, was actually the coloured than in the white portion of the popula-augmented. 100 and 110 909 From this table it results that the earlier periods of life give the greatest exemption from the attacks of the disease, especially the ages from 2 years to 10 years; and that the period of life most prone to be affected, is from 40 years to 60 years, and more particularly from 50 to 60 years. TABLE, Showing the prevailing diseases independent of Cholera; what influence it exerted over them; and the rate of their mortality. Excess in mortality of 1832,.... ... Do. after deducting mortality from Cholera, From the whole of the premises, and the result of observation, and experience in this city, the following conclusions may be adopted. 1st. From the manner of its commencement and mode of progression, no evidence exists that the disease was of foreign origin; or introduced and propagated by immediate or mediate propagation. 2d. Its commencement and progress were in the character of a wide spread epidemic, suddenly invading an extensive district, indicating the existence of an active epidemic influence or agency operating at once on the mass of the population. 3d. In far the greater number of instances, the dis ease was preceded by premonitory signs and a preliminary stage, during which it is perfectly manageable. 4th. That when those precursory symptoms were absent, the patient was usually in an enfeebled state of health, having a broken down constitution, or had committed some great imprudence to excite it. 5th. That in almost every case, the disease was called into existence by some exciting cause. The cause was most commonly error in diet, over fatigue, exposure, and other sources deranging the healthy or, der of some organ or function. 6th. That all portions of the population, though equally exposed, were not equally affected. The dif • For this table I am indebted to Dr. Emerson. |