Good evening gentlemen and thank you for joining me here today. I wish to discuss in detail the great

pestilence that passed less than one year ago; you know of course I talk of Asiatic cholera. We must

prepare ourselves should that remorseless disease decide to return to our town of Bolton.

From my readings of fellow medical practitioners within The Lancet it has come to my attention that

towns free from disease such as Cheltenham have adopted certain public health practises of

cleansing and improved sanitation and the ejection of nuisance persons of low character such as

vagrants and tramps. I suggest that improvements be made to several areas of our town. I have seen

such sights as families crammed into overflowing cesspits barely inhabitable, where no hope of fresh

air or cleanliness could ever hope to invade. It is within these foul places that cholera thrives and may

rise up from again, the putrid smells and foul persons fuelling its spread. Cheltenham was able to keep

itself from the pestilence by ensuring levels of sanity, clean living and fresh air be maintained around

the poorer parts of their town. This proved to be of great benefit to them and I feel following their good

practises could prove to also benefit our town.

It is therefore essential that we make plans to cleanse these rotten places and make available to the

poor, brushes, buckets and lime that they might cleanse their properties of filth. I have also observed

pigs living within close proximity to inhabitants, privies overflowing with filth and dirty stagnant water

that children play freely in. In one street the privy was but a trench to the back of the houses, the

contents of which was cleared and stacked against the last house, to be removed every six months!

We must ensure these practices are stopped! I feel the sole cause of cholera is the abundance of dirt,

grime and uncleanliness that shadows many parts of our town. This is evident from the last visit of

cholera, where most of the ill persons in our town came from these destitute places. It is my

understanding that this is also the viewpoint of the church. In Oxford the Rev Vaughan Thomas

advised to look "for moral and religious guidance as to vicious indulgences, imprudent negligences

and generally as to things done or omitted either positively or probably injurious to health". It was his

firm belief after surveying the areas of his town, that the problems of destitution within the poor

communities, overcrowding, insufficient drainage and poor ventilation were to blame and

improvements in these areas would much improve the situation.

We must also make ready premises that can serve as a dedicated cholera hospital for those suffering

the ill effects of the disease. We have already a fever hospital, but it is better I feel, that those suffering

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from cholera be kept separate from those suffering from other ills, as it is my belief that cholera is

contagious. This building should be close to a graveyard, as it is imperative that the dead be buried

quickly to ensure infectivity of others is reduced. In this respect we must ask the support of our church,

perhaps they could advise those of our communities who have traditions of burial which come into

conflict with this need for quick burial. The Irish community and their traditions of burial are of

particular worry. During the last cholera outbreak, the dead were found to be hidden away in their

homes for up to a week!

We must also not forget our medical colleagues in Liverpool who had to endure the most awful of

uprisings and riots. Mobs were heard shouting “Bring out the Burkers” and many a window of the

hospital was shattered. We must ensure the public is calmed and necessary measures taken to

protect our hospital and all those within it. It is our duty to ensure this behaviour does not occur within

our town, by taking action such as distributing pamphlets, explaining correct practises of treatment and

preventative measures so people might protect themselves and neighbours from harm. I do believe a

pamphlet similar to that distributed in Preston outlining the following points would prove most helpful:

1) Attend immediately to any complaints of the bowel! Persons must ensure that on the first signs

of illness they take two table-spoons of castor oil, thirty drops of laudanum and thirty of ether,

in a wineglass full of strong peppermint-water, sipping frequently of strong brandy and water.

Medical aid to be called at once.

2) Fermenting, decaying, unripe and flatulent foods must be avoided entirely such as ALL

FRUITS, cabbage and cauliflower. Salt use is strongly encouraged and food must be

thoroughly cooked!

3) Avoid excesses of ale, wine and strong liquors as these have been shown to encourage the

cholera.

4) Each individual must take it upon themselves to wash daily ensuring cleanliness of your own

person is maintained. A flannel or woollen belt is advised to be worn covering the bowel area.

5) Privies, houses and yards MUST be kept inoffensive, free of dirt and of smells and any matter

that is considered offensive removed immediately. Good ventilation is essential but dampness

and drafts are to be prevented. The house should be whitewashed with lime at least once

weekly.

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I have confidence in the latest treatments such as those used by Mr McIntyre that have shown

promise in Newcastle. Treatments of gruel and turpentine enemas along with doses of castor oil and

opium have been very effective and from 700 cases only 80 perished. It is to my knowledge from

several sources including The Lancet and a report from Dr. W. H. Duncan a physician at the Liverpool

North Dispensary, that the use of saline injections into the vein have been wholly abandoned due to

the ineffectiveness of this treatment. Patients appearing revived for short periods quickly relapsed

following ejection of this fluid by the bowel. It appears this treatment does more harm than good and

therefore I suggest the treatments proposed by Mr McIntyre be adopted for any cases we are to treat.

It is essential that as medical practitioners we are well prepared, before the pestilence arrives. By

making ready such resources as a dedicated cholera hospital along with medical practitioners who

have knowledge of the latest and best remedies and treatments we may possibly avert death and

disaster entering our town. It is my belief gentlemen that by implementing these strategies and

cleansing the great unwashed and destitute we can prevent this cholera from returning.

Primary Sources

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Baird, D., Macrorie, D., M'culloch, S. & Nightingale, B. 1832. Treatment of the malignant cholera, at

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Morris, R. J. 1975. Religion and medicine: the cholera pamphlets of Oxford, 1832, 1849 and 1854.

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