What is Cholera?
According to the U.S. Centers for Disease Control and Prevention, cholera is an acute, diarrheal illness caused by infection of the intestine with the toxigenic bacterium Vibrio cholerae serogroup O1 or O139. The infection is often mild or without symptoms, but can sometimes be severe. Approximately one in 10 (10%) infected persons will have severe disease characterized by profuse watery diarrhea, vomiting, and leg cramps. In these people, the rapid loss of body fluids leads to dehydration and shock. Without treatment, death can occur within hours.
- Immoderate vomiting and discharge of vitiated humours by stool, with great difficulty and pain
- Violent distension of the abdomen and intestines
- Heartburn, thirst, quick pulse, heat, and anxiety
- Irregular pulse
- Great nausea accompanied by colliquative sweats
- Contraction of the limbs
- Syncope (fainting)
- Coldness of the extremities
- Lexington, Kentucky, 1833
Lexington, Kentucky, 1833
In 1838, Dr. John E. Cooke, authored Remarks on Cholera, as it Appeared in Lexington in June 1833. Topographically, Dr. Cooke noted that there were three important things to remember. The first being the overall flatness throughout the town; secondly, the flat ground extended throughout from east to west, and from the ridge, south of the stream, northwardly to Main Street, and across it at its eastern end; and, third, the comparatively low situation of the range of squares immediately adjoining Limestone Street on the west side. Lexington managed to escape significant cholera threats in the past thanks, in part, to a “gentle” descent which was sufficient enough to carry water at a speed in which rarely left water standing. The exceptionally warm temperatures in June of 1833 also helped contribute to the cholera epidemic along with bilious fever and even dysentery.
There was an unoccupied flat on the east of Limestone Street and north of Main Street which had been used as a receptacle for offal of every kind. Offal is viscera or organ meats. This particular site was quite convenient and out of site as well. Near that spot, a filthy old house sparked the attention of residents and was deliberately burned during daylight hours as the prevalence of cholera continued worrying everyone. The house, ironically, was not the most important concern. The site nearby used for disposing of offal would come into play. During the month of May, there was an unusually high level of moisture, which mixed with the offal, along with the hot sun, to encourage the production of communicable disease. According to Dr. Cooke, there were reports that pools of water had developed in the offal area. The area amounted to approximately one acre of land. Additionally, some cellars on Water Street had water in them and rear yards abundant in vegetation to a fit state to produce disease.
The first cases of cholera were reported on the north side of Main Street; this location was to the rear of the offal mass. To the south of the offal mass, some 66 persons died. On High Street to Main Street, 244 persons died. Eastwardly across Limestone and in nearby areas some 30 persons died. The deaths continued and from June 1st to August 1st, according to a committee appointed by the Common Council, 489 persons died from cholera during a period of about two months. A house near Short Street had 10 persons die in it; this was reportedly a house of entertainment and, during the entire epidemic, was kept open. Dr. Cooke was told that the mistress remarked that the number of deaths in her house was attributed, primarily, to travelers. About four of those deaths were from the mistresses’ family with one of those being a child. The bulk of the deaths in Lexington, however, took place in the first few weeks of June with the remaining approximately 108 deaths happening between June 22nd through the 1st of August.
According to Dr. Cooke, cholera potentiates as the season advances. In 1833, physicians knew little as to why an epidemic could assume strange patterns; why the diseases assume this or that particular form in different persons, or why, for example, one year there were more cholera cases occurring with fever, intermittent or remittent, or of dysentery. They were, however, able to understand that autumnal diseases were largely all dependent upon the same circumstances (that is, associated with the weather (e.g. heat and moisture)).
Cholera epidemics in the 1660s and 1670s throughout Europe raged at great levels and of significant severity due to the heat of the season. The epidemics during this time included more violent and inveterate convulsions and all of the muscles of the body, particularly those in the arms and legs, were affected with terribly painful spasms. These spasms would result in patients leaping out of bed by accident and writhing himself, “in order, if possible, to mitigate their violence.” Back in Lexington, some physicians had used calomel (a mercurial purgative and fungicide) as a treatment for cholera. Calomel was commonly used in yellow fever and some parasitic infections. According to some reports noted by Dr. Cooke, some patients were given a quarter of a pound of calomel within a period of two or three days. This would, of course, beg to ask whether the massive use of calomel could have potentially increased the rates of mortality in Lexington during the 1833 epidemic. It should be important to note that no specific physician was charged with excessively using calomel. The use of calomel during that time was perfectly acceptable, though it eventually became clear that the deleterious effects of calomel far exceeded any potential benefits, along with the development of less harmful treatments.
A number of remedies were sought out. Dr. Cooke examined the efficacy of bleeding in his own practice and found it to be “somewhat hazardous.” Basic recommendations included, in warm, stable, patients to encourage them to eat at their pleasure small bits of ice. It was noted that filling the stomach with anything would likely induce vomiting along with interfering with calomel. Camphorated spirit of wine, a few drops every few minutes on a lump of sugar, and mint julep were used for when the patient became cold and his or her pulse began to fail. Attendants were told to wipe off perspiration that covered the face and body of patients as fast as it appeared. To help with cramping the patient was to be rubbed with camphorated whiskey. When all else failed and the patient slipped into lividity and pulselessness, “it is useless further to strive to save, and the whole object out to be to render the patient as comfortable as possible, by strict attention to keep him dry with warm flannels, to keep his room quiet, and to give him everything he asks for.”
Statement of Cholera Cases at Lexington, Kentucky
The following data was procured and compiled by Mary Hatton before her death. As such, credit belongs to her unless otherwise specified.
Notes for year 1833
By Cholera, in the CITY OF LEXINGTON, from the 1st of June to the 1st of August, as reported to the City Council by a committee appointed for that purpose, consisting of Messrs. Leavy, Layton, M’Kinney & Gough. Persons whose names are preceded by a star, died of other diseases.
Notes for year 1849
The number of deaths at the asylum is not so great as we had supposed, nor as we had been informed by the treasurer of the institution, Mr. W.E. Milton, but as the list was made out by Dr. Allen, general superintendent of the asylum, for the editor of the Observer and Reporter, we presume it is correct. Those marked with an asterisk died of the consecutive effects of the disease, having lingered a week or two.
Contributed by Mary Hatton (Posthumously) & Shawn Logan | email@example.com
⁘ Works Cited ⁘
- Cooke, John E. Remarks on Cholera, as it Appeared in Lexington in June, 1833. The Transylvania Journal of Medicine and the Associate Sciences, vol. 6, 3, 1833.
- The Kentucky Atlas of August 24, 1849, as reprinted in the Lexington Leader, Lexington, Kentucky, 25 August 1901, p. 10 cols. 1-4. Microfilm held by the Kentucky Room, Lexington Public Library, Lexington, Kentucky.
- The Kentucky Reporter [Lexington, Fayette, Kentucky], 22 August 1833, p. 1. Microfilm held by the Kentucky Room, Lexington Public Library, Lexington.
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