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for every quarter of an hour, at the same time, a mixture of chalk and other binding medicines-perhaps pills of opium, occasionally of creosote. Coarse brandy was generally given, and latterly a little sago was allowed. But there was no variety, and little difference in the quantities administered; though throughout the time there appeared great individuality in the cases. The quantities of calomel were so small as to be useless in a large number of them. It became clear, that whether in the individual case, the cholera could be encountered by the system it had fastened on, or whether it finally sunk under it, the dose given would never rouse that system effectually. Three grains, at a later period five, were given for the first dose; two or three being repeated every quarter of an hour afterwards. This the Clergy, where they had to act as physicians, increased to five, eight, or ten at first,-each quarter of an hour five, for an hour or an hour and a half,—then three. Brandy was given to sustain the sinking forces. In some very desperate instances much larger quantities were given (one of the most eminent medical men had given 200 grains to a lady who had been given over. She recovered). This treatment was sometimes blessed with success; but it had become very evident that the ordinary practice pursued would not succeed. It grew into a moral certainty that under it the patient was sinking at a rapid rate into
The symptom most destructive, and least to be encountered by medicine, was the sickness. There were cases in which the vomiting came on with spasmodic violence: the poor creature would spring up and cast forward like the bursting of a pipe. At other times it would continue at intervals of two to five minutes, during a period of seven or eight hours, or even days and nights, till the system shrunk from complete exhaustion. Some patients recovered apparently the shock of the disease, regained the voice and the natural colour, and continued so during four or five more days vomiting at intervals, shorter or longer, but incessantly, till those who had seemed saved, almost by a miracle, imperceptibly wasted away. That this sickness might be subdued, and if possible, to give a fillip to the system, six or ten drops of spirit of camphor, in a little water, were given, in some cases, every quarter of an hour, and sometimes found of great use. When a patient was far gone, and an effort was imperative for a few moments for the priest's office, one or two drops of tincture of ammonia generally produced a temporary revival. These were matters beyond our province, and a medical man might be tempted to smile at these clumsy efforts, were it possible for an earnest man to smile when he remembered the cholera.
The Clergy, could they have begun with the experience gained
in the sequel, would have opened some house in the parish for an hospital, and managed it themselves. The personal labour of keeping at least one of their number day and night on the spot, would have been more endurable than it proved amongst a number of patients scattered over a district, and demanding all their care. Certain arrangements only would have been necessary, which could always be provided by moderate means. 1st. A house in each parish, or any arbitrary division of district agreed on, to be used as an hospital for that district, so as to avoid concentration of the infection as much as could be. 2d. In these, a separate dispensary, or depository of medicine; a dépôt of blankets and beds; fresh beds, i.e. fresh straw and the ticking washed, to be used for each patient; a supply to families of beds used in houses by patients; also, beds covered with a a low awning, such as are used in Russia. The patient is laid on the open matting of the bed, the hangings are let fall all round, and a hot iron introduced underneath, on which, at the moment of dropping the hangings, an attendant pours a jug of water; a violent steam is thus produced, and profuse perspiration results. The patient can then be rubbed dry and rolled in warm blankets. This treatment is often successful in the Russian hospitals, even after collapse. A medical man and his one or two assistants, and such nurses as could be secured, would thus be well able to attend all the most pressing cases constantly. One vehicle at least, for the immediate removal of the patient, 'should be at the service of every such house. Had such a course been pursued we are convinced many lives would have been saved. And we will add, by way of cogent argument, the cost would not have exceeded, or not materially have exceeded, the cost of supplying such dilatory and hopeless relief as the town authorities doled out in the town which is the subject of these remarks.
The Board of Works there, as it was, did little on the part of the town. One small hospital was opened, which had been a mendicity office; and at a later period, a temporary building, formerly used for hospital purposes, was also employed for the cholera patients, but not till the worst of the mortality had already taken place.
The fear amongst the richer classes was great. Other motives, which should not have found their place at such a time, influenced, it was said, many of the owners of mills, and checked the expenditure of money. One large mill-owner was seized by the disease, and carried off. He had been part owner of one of the largest of the mills; and the vast mass of window-pierced brickwork was shut for the half day on which he was buried. The workpeople were dismissed with their half-day's pay, and the gloomy pile for a few hours maintained silence amongst its pitiless fellows. This event made authorities rather more in earnest to do something. It was evident rich as well as poor might be taken by the cholera. To the last, however, , resources were sadly insufficient. For the one whole eastern division of the town, in which the parish is situated, if not for the whole town, one coach, that is a fly drawn by one horse, was the only vehicle for conveying patients to the hospital. None but the “fever coach' would have been ventured by its owner for the desperate enterprise. There were but few nurses, barely
, sufficient even for the small hospitals, where the patients were collected in a narrow space. In two or three rare instances one was spared and sent out. Medicines and medical attendance were provided, but the doctors were too few to do the work, and so completely were they over-worked that in many cases the Clergy were the only physicians that could be got. Medicine had to be fetched; that for the whole town—90,000 inhabitantsfrom one dispensary. The result of this was generally a delay of an hour at the dispensary, which, with the time taken in going and returning, where even a messenger could be got at once, (not always possible,) took from the poor sufferer the slender chance which immediate applications and remedies might have promised for him. The physician appointed for the district in which lay this parish, a most amiable person, did what he could, but was quite exhausted with his work : half his cases fell under the charge of a young apprentice. The hurry of all this made constant attendance a simple impossibility.
With no better preparation, then, than this, the place awaited the coming storm. A church was built there a few years since, and in the buildings of the vicarage adjoining, which are confined enough, live the Clergy attached to the church. During the period in question, they were four in number,—the vicar, one curate in priest's orders, one deacon, and a person in priest's orders taken in as a guest during a part of the time. The first case of cholera appeared in the last week of July. It was also the first appearance of the disease in the town. Three were attacked, and two carried off suddenly. Cholera was then sweeping up the country. Paris had suffered the worst, 800 having died in one day; some of them instantaneously in the open streets. In London it was increasing rapidly. It was showing itself at Liverpool, Hull, and other ports. ere, however, for the present, no great alarm was created. Instant measures were taken for the removal of the bodies, and the matter rested. But in this district, in which the streets were close, (though not always crowded, there was no drainage. The filth was excessive; the personal habits of the poor greatly increasing it. It was felt that cholera, if once it took a firm
hold of the place, would not soon leave it. It would be well if the thoughtless and irreligious could be roused to consciousness of what might, at no distant date, be impending. July passed. In August it appeared again, and this time more decisively: several persons died: great alarm was created : the Litany, with permission of the Ordinary, was said daily in the church at twenty minutes to one, which enabled workpeople to dine and attend the service in the hour allowed between noon and one o'clock. Women, men, and children, came in considerable numbers. The workmen employed upon the church asked permission to attend in their working dress, and their devotion was in real earnest, for they feared for their lives. For seven days no other case occurred—a feeling of security succeeded. Again the disease re-appeared, this time in its full violence. "The distress,' writes one of the Clergy, 'is now great; the vicarage ' is open all day, and looks like an apothecary's shop. The people ‘run to us for countenance and relief. We have had a prayer 'printed, and many apply for it: others come to ask the num
bers of the penitential Psalms : others for physic. In'Street, at the back of the vicarage, where one or two were 'taken, the people turned out of their houses like a swarm
of bees and burnt tar fires in the streets. In short,' he adds, they are half mad, poor creatures, with terror. We have been 'obliged to act as nurses from the beginning to the end of the attack in many cases. No one will go near them, and 'we have had to lay out the bodies after death.' Again- Whole 'families have been swept off. The lost the father and mother and three children, the uncle and aunt, and another (uncle and aunt at a distance. The poor creatures look upon
them. selves as doomed, which no doubt aids the cholera-cholera does its work in from eight to ten hours. Men strong and healthy ‘are dead in twelve hours, and buried within the twenty-four.'
This account was in no respect overdrawn: the disease continued to increase. The deaths, which in this parish had been at the time the above letter was written, at the rate of only two in each day, steadily rose in number; four, six, seven, and even ten in a day which were known to the Clergy; there were others also that were not known to them till afterwards. The Eucharist was now celebrated at the church daily at seven o'clock-no one knew where or what he might be ere night fell, As soon as this was over the day's work began. Two, three, perhaps half-a-dozen applications for assistance had been brought to the vicarage during the service; an anxious face would be waiting, pressing a request for instant attendance, with such earnestness as could not be resisted a moment longer than was necessary. The priest laid aside his stole and surplice, snatched, if he could, a morsel of breakfast, and in a few moments was following his guide. Clothed in the cassock, which was kept on all the day, girded tight with a cincture, in which were stuck a bottle of liniment for rubbing, another perhaps of spirits of camphor, and some powerful doses of calomel, he hurried forwards to the house indicated, or to the first, if there were several. Ruminating sadly as he went of the little that was possible for him to do and, alas! the few instruments put into his hand, and the scant instruction under so great a necessity, even to do that little, he enters the house with the oft-repeated blessing. The closet ransacked for basins and cups, the relics of mustard mixed hastily, perhaps the half-laid breakfast—a child sitting in uneasy and silent wonder, meet his glance as the hat is deposited below. Eager feet and dismayed faces are the sights and sounds of the upper room--sounds that have become familiar, and chilling from that familiarity. A sister or a daughter hurries from one kindlymeant office to another, and between terror and dismay, does none effectually; rubbing the distorted muscles of the calf, or the feet of the sufferer. The toes are drawn with unnatural tension-one back towards the instep, another down, from the violence of the strain; the calf is in knots,—the veins and lesser arteries distended and defined. Or she would quit her hold as the patient turns from side to side seeking relief, to fetch the drink, so eagerly shouted for amidst his cries.
For awhile perhaps the priest can do nothing. Having ascertained that the doctor has not yet been, he calls for a spoon and water, and puts on the tongue of the sufferer a strong dose of calomel, which is swallowed with the aid of minute quantities of water, contriving as he does so to feel the tongue itself; the cold tongue, though not invariably a fatal sign, leaves him no doubt as to its being Asiatic cholera. Countenance from any one at such a time is a welcome boon to the perplexed and sorrowful assistants; they lean on him, and obey directions with affectionate readiness. * Put all your blankets over him, or send your boy for another; rub the limbs with some of this. All assist in this, and the mixture (acetic acid and oil of turpentine, one to two,) affords a temporary relief. Five grains more of calomel are administered, and the patient obtains a few moments of calm. Now the priest's work begins—he has watched eagerly for this, and knowing, from an experience of facts, how little time is to be lost, he hurries the attendants from the room, and standing or kneeling by his patient's head, commences the probing and dressing of wounds deeper, perhaps, and more diseased even than the strained and exhausted hody. An awful work is before him; a hundred thousand thousand years are as nothing to