Report on epidemic cholera and yellow fever in the Army of the United States, during the year 1867 / By Brevet Lieut. Col. J.J. Woodward.

  • Woodward, Joseph Janvier, 1833-1884.
Date:
1868
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Licence: Public Domain Mark

Credit: Report on epidemic cholera and yellow fever in the Army of the United States, during the year 1867 / By Brevet Lieut. Col. J.J. Woodward. Source: Wellcome Collection.

Provider: This material has been provided by London School of Hygiene & Tropical Medicine Library & Archives Service. The original may be consulted at London School of Hygiene & Tropical Medicine Library & Archives Service.

    183/210 (page 137)
    It assumed here sometimos a fororable appearance, and then suddenly changed to the worst; patients apparently in a state of convalescence sometimes expired in the course of twelve hours. As regards the ti-eatment, I would simply remark, that, with the mass of practitioners, it was, as in former similar epidemics, as much at variance as their ideas of its cause. I, and, I pre- sume, all the physicians who have lived here for some time, must admit that in the majority of cases the resources of our art were of little benefit in its woi'st forms. To obviate the inflammatory diathesis which prevailed in the first stage of the disease, and to divert the determination from the head, as well as to cleanse the primse viiE of acrid and oifending humors, I employed gentle purging, castor oil by the mouth or rectum, cold effusions, hot mustard pediluvia, to be immediately followed by sinapisms applied between the shoulders and to the epigastrium and calves of the legs, for the purpose of assisting in arresting the hot stage and to produce a free determination to the surface ; at the same time, either stdution of acetate of ammonia or tincture of aconite in small doses until perspiration was pro- duced, or the desired object of reducing the circulation was effected, and as the most useful auxiliaries during the whole course of this disease. I consider enemata, with or without castor oil, with warm or ice-cold water, of the greatest importance. * * With reference to the icewater clysters, I convinced myself fully of their most immediate and sensible effect, particularly in cases where vomiting, oppression about the prajcordia, and great irritability appeared. I had to contend with cases of very great irritability of the stomach, where excessive vomiting prevailed, and the application of a blister over the part was not attended with any effect. The vomiting did not even cease upon the application of a large poultice of mustard flour to the stomach and feet; cupping, blisters along the spine, internally mineral acids, creasote, etc., etc., failed to allay irritability. In such emergencies, ice-water per anum, swallowing pieces of icj, and ice applied to the stomach, have always been attended with success. I commenced with sulphate of quinia at the outset in 10 grain doses with a small portion of sulphuric acid, as the circumstances of the case indicated. During the convalescence, I ordered that champagne wine, porter, and ale be freely given to the sufferers. * * * * * # -» * # # # » * * Very respectfully, your obedient servant, JULIUS JACOB AUERBACH, Acting Assistant Surgeon, U. S. A. Brevet Brigadier General T. A. McParl[N, Medical Director Fifth Military District. Po.ST Hospital, Greenvillk, La., January 17, 1358. Sir: I have the honor to present my special report of yellow fever patients during the recent epidemic, embracing the months of August, September, Octolicr, and November, 1867. Probably my duty would have been performed had I only sent a list of those under my care during the entire period of each case to its result, wliich would embrace three of the U. S. post band, treated by me in private quarters, and a portion of the officers reported, all of whom I attended a great part or the entire period of their sicknes.s. But at one time all of the attending Surgeons of the post hospital were down with the disease, so that I thought that although the report from these might embrace all, it would do no harm to give the entire list of those sent fi'om under my care. I have therefore added to the tabular form given us, a column showing the date when patients were sent to the hospital. The dati's of recovery or death I obtained from their respective company books. I report 83 colored and 93 whites, including 9 officers. The colored troops under my care were: 225 of the 39th U. S. Infantry, of whom 50 were unassigned recruits, but a few days before from Philadelphia; 13 of the 41st U. S. Infantry; 79 of the 9th U. S. Cavalry—all recruits brought here, shortly before or during the progress of the epidemic, fi'om Cincinnati, Ohio, and Louisville, Ky.—making a total of 320 colored. Of whites, there were of the U. S. post band, 24 men; of Companies A and B,'' 1st U. S. Infantry, 114; making a total of 138 white men. Both commands had 10 officers present. The colored cases, in proportion, were not only fewer, but less severe. The only facts noteworthy in reference to its introduction, and bearing upon its importation from infected points, may be best presented in a short history of its appearance and spread among the^roops. The white troops named were stationed in New Orleans until cases of yellow fever occurred among ihem, causing them to be removed here, where the colored troops had been since the January previous. The band came on the 12th of August, and the companies on the 17th of the same month. Up to that date, some were being- sent daily from their former quarters to the post hospital with the disease—for how long, or in what number, I have not ascertained. There was no case of the fever reported among the colored troops until the 24th of August; and I have very grave doubts whether the seven first reported on the list were yellow fever cases; if not, there were no cases of it until the IGth of September. The two companies of infantry were located next to a yellow fever ward—one ward intervening; next to them, the 39th colored wards; and last, and adjoining mj' office, was the band. It is well to state that all the wards are in a circle. With the hospital wards past the Surgeon's office there was seldom any communication. In the other direction it was frequent and almost unavoidable. I would state that' the 9th Cavalry recruits were encamped a few hundred yards behind the 1st Infantry and first hospital wards—the 41st about five hundred yards behind the colored troops. Three days after the arrival of the 1st Infantry three new cases occurred.' In the band no new cases occurred until the 6th of September, twenty-five days after their arrival. Not until the 1st and 5th of September did the fever become epidemic, although the white troops were infected when they came. My impression iiB tliat the epidemic was hastened and intensified, if not produced, by the intercourse between the hospital and barracks. I sent none of the 41st to the hospital, and knew of no case among them. Great care had been taken to keep the wards of the troops clean and pure. Apprehending the po.ssibility of both cholera and yellow fever, all efforts within our reach were used to prevent or mitigate such attacks, if they came. Besides the usual means of police, I daily put in the sinks a strong solution of sulphate of iron, and used carbolic acid and permanganate of potash solution freely wherever they promised to be of us-3. Tliree times a week each ward was fumigated with sulphurous acid 18