History of the South Carolina Department of Mental Health

From: state.sc.us

From the establishment of the South Carolina State Hospital over 175 years ago, to the beginning of community mental health services in the 1920's, to the evolution of a complex mental health care delivery system, South Carolina has achieved an impressive record in its efforts to meet the needs of its mentally ill citizens.

As far back as 1694 the Lord Proprietors of the Carolinas decreed that the indigent mentally ill should be cared for locally at public expense.  In 1751 the colonial government similarly recognized the mental health needs of slaves.  In 1762 the Fellowship Society of Charleston established an infirmary for the mentally ill.  But it was not until the 1800s that the mental health movement received legislative attention at the state level.

According to legend, when Colonel Samuel Farrow, a member of the House of Representatives from Spartanburg County, traveled to Columbia to attend sessions of the legislature, he noticed a woman who was mentally distressed and apparently without adequate care.  Her poor condition made an impact on him and spurred him on to engage the support of Major William Crafts, a brilliant orator and a member of the Senate from Charleston County.

The two men worked zealously to sensitize their fellow lawmakers to the needs of the mentally ill, and on December 20, 1821, the South Carolina State Legislature passed a statute-at-large approving $30,000 to build the S.C. Lunatic Asylum and school for the deaf and dumb. This legislation made South Carolina the second state in the nation (after Virginia) to provide funds for the care and treatment of people with mental illnesses.

Robert Mills, a renowned architect, was chosen to design the new S.C. Lunatic Asylum.  In 1822 the cornerstone was laid for the Mills Building, which took six years to complete.  The building's many innovations included fire-proof ceilings, a central heating system, and one of the country's first roof gardens.  South Carolina's asylum was one of the first in the nation built expressly for the mentally ill and funded by a state government.

Citizens were wary of sending their loved ones to the asylum, and so, it was not until December 12, 1828, that the first patient was admitted. A young woman from Barnwell County, she was accompanied by her mother who worked as a matron while her daughter was a patient at the hospital.

The hospital admitted patients wealthy enough to pay for their own care, as well as the middle class and paupers. Although a few blacks, mostly slaves, were admitted during the first 20 years, they were not officially permitted until 1848.

Despite its innovative architecture, many problems arose within a few years after the asylum opened.  Complaints ranged from narrow halls and staircases and small activity rooms to flooding on the ground floor.  Another issue was expansion of the asylum grounds.

By the 1850s, the average patient paid $250 annually. A separate room and eating area cost another $100. Paupers were admitted for an annual fee of $135, which was billed to the patient's home district. As more paupers were admitted, it became harder to collect fees, and the asylum grew more dependent on state funding.  Due to the large number of people being admitted land was needed for new buildings and for patient recreation and gardens.  Some asylum leaders believed the institution should be moved to the country.  Largely because the legislature was unwilling to fund a new complex, it remained at the original location.  Land was purchased next to the complex, and more buildings were erected.  The headquarters for the South Carolina Department of Mental Health remain on these grounds even today.

Men and women were housed separately, originally on different floors, but later in separate buildings. When a new building was completed in 1858, male patients moved into it, and the women remained in the Mills Building. Despite the new building, the asylum reached its capacity of 192 by 1860. Many families preferred to care for their mentally ill relatives at home, while others wanted them closer to home even if it were in the county jail or the poor house. Only after the state assumed direct responsibility for all mentally ill in 1871 did county jails readily give up their patients.

During the Civil War, funding problems grew worse. Dr. John W. Parker, the superintendent, opposed a plan to turn his complex into a prisoner-of-war camp. Although the Confederate Army did not get the asylum, the grounds were used as a prison camp for Union officers from October 1864 to February 1865.

Despite worsening conditions late in the war, the asylum became a refuge for many Columbia residents when the city burned during Union General William T. Sherman's occupation in February 1865. With dwindling provisions, Parker did his best to provide for his patients and for the destitute citizens.

Like the rest of the South, the asylum struggled to survive in the aftermath of the war. Despite the lack of funds, the superintendent accepted more patients and often used his own money to provide them with food and other necessities.

J.F. Ensor, a Maryland native and former Union Army surgeon, became superintendent in 1870 and tried hard to find adequate funds for the institution. Several citizens from around the state contributed, and he received a $10,000 subscription from some Philadelphia Quakers, which helped repair the buildings. More than once, when local businesses could no longer give him credit, Ensor supplemented the institution's meager budgets with his own funds.

As the population grew, it became virtually impossible to treat patients.  The asylum became largely a dormitory to house the mentally ill.

In 1870 Ensor reported that the rundown asylum rooms "were mere cells of chink in the wall, dark and illy ventilated" and that there was not an adequate means of diagnosing patients.  These problems were solved to the best of his ability.  By 1874 Ensor had added central heating, plumbing, new furniture, pianos and books.

While Ensor made some strides in providing for patient's physical needs, overcrowding remained a problem.  This accelerated when the state government assumed the cost of patient care from the counties in 1871.

With slavery abolished, African-Americans became a larger part of the asylum's population. The admission of blacks not only added to the patient population, but led to another problem-providing separate facilities for the races. Temporary structures built before 1860 for blacks desperately needed replacement. Facilities for whites also were overcrowded.

While trying to accommodate this population increase, Ensor was forced to cut staff to have funds to buy food and meet other needs.  Sometimes this was not enough.   Even though the state was now required to pay for patient care, some asylum residents were sent home if they had no money to pay for their care.  Nevertheless, the population increased from 245 in 1870 to more than 300 by the time Ensor resigned seven years later.

Notable changes before 1900 included the founding in 1892 of a nursing school, which did not close until 1950, and changing the hospital's name in 1896 to the S.C. State Hospital for the Insane.

Although hospital finances became more stable in the 1880s, the legislature instructed the superintendent to economize wherever he could.  While most states were increasing their annual per capita spending, South Carolina was reducing hers.  The cost for each patient in 1877 had been $202.  It was reduced to $140 by 1888.  Nine years later, the per capita rate had fallen to $107.80, one of the lowest in the nation.

Image 1: The original drawings of the S.C. Lunatic Asylum, designed by Robert Mills, the United States' first native-born architect.

Image 2: This drawing of Camp Asylum was done by a prisoner, one of the 500 Union
officers imprisoned in the camp from October 1864 to February 1865.

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Health and Medicine in 19th Century Arkansas (excerpt)

By Michael B. Dougan, 10-5-16

Arkansas long had a reputation for being sickly because much of the state supported large mosquito populations, carrying malaria, yellow fever, and other diseases. Modern medicine, a largely nineteenth-century creation, arrived late, and throughout the twentieth century, diseases eradicated elsewhere continued to flourish. Only after World War II did sharp improvements in health occur, but the Delta lagged far behind. Problems in health and medical programs were compounded in part because many Arkansans deliberately engaged in forms of risky behavior such as tobacco use and unhealthy diets.

Prehistoric Arkansas
The first settlers more than 10,000 years ago brought to the New World only a few major illnesses. One was tuberculosis, evidence of which is visible in bones from burial sites. Open-air living limited the impact of this potentially devastating disease. Modern research shows that the first Arkansans, the Paleoindians, were the healthiest, having a balanced diet of roots, fruits, and fresh meat or fish. Their migratory practices limited the gastrointestinal disorders that came with settled populations. By the Mississippian Period, agriculture flourished, imposing an unbalanced diet of corn and beans on the lower classes, sometimes resulting in pellagra, a disease that later affected lumber and mining communities in the nineteenth century. Evidence of iron deficiency (anemia) has been uncovered in eastern Arkansas.

Sickness was sufficient to produce a class of persons to treat it. Called jongleurs by the French (for they also practiced juggling and magic) and “medicine men” by the Anglo-Americans, these native shamans combined religious incantations with a sophisticated application of herbs and techniques such as sweat baths (vapors). Closely connected was the practice of visiting the springs in what is now Hot Springs (Garland County).

Prehistoric Indians were unequipped genetically with resistance to the Euro-African disease pool that first came to Arkansas with Hernando de Soto in 1541. The subsequent virtual abandonment of Arkansas that French explorers Jacques Marquette and Louis Joliet noted in 1673 could have come about through smallpox, but malaria had arrived as well, putting all Delta peoples at risk. Abandonment may have been gradual rather than dramatic.

The Colonial Period
French settlement began at Arkansas Post in 1686, and reports of sickness appeared constantly in official reports as well as travelers’ journals. There was supposed to be a post surgeon. At least one resident, François Menard, had studied medicine in France but was best known as a merchant, and the post’s garrison and population were too small to support a formally trained physician. The affluent went to New Orleans for medical services.

Sicknesses were common among the newcomers, but the various tribes fared far worse. The Quapaw were hit repeatedly by smallpox after 1698. From perhaps 20,000 in 1600, their numbers fell to 215 by the end of the nineteenth century. Through intermarriage with Europeans, some immunity could be obtained. Contact with Europeans undermined native cultures, predisposing many to alcoholism, which made tuberculosis worse. Respiratory diseases, notably influenza, affected both Europeans and tribes. The biggest and still unsettled controversy concerns syphilis, a venereal disease that became a massive public health problem soon after the discovery of the New World. Other disease include scurvy (vitamin C deficiency), yaws (a skin disease from Africa), diphtheria (sore throat), dysentery, and typhoid fever.

The Antebellum Period
At least one doctor may have arrived prior to the Louisiana Purchase in 1803. Charlatans, as French and Spanish authorities described non-degreed alleged doctors, grew in importance, in part because they were more willing to embrace Indian practices. In the new republic, medical licensing was viewed as aristocratic. Contending “schools” arose, with chiropractic and osteopathy being modern descendants of earlier divergent medical paths. Practitioners were family members, Native Americans, well-meaning tradesmen, slaves, woodsmen, and preachers. Many could handle broken bones, snakebites, gunshot wounds, or arrows embedded in bone or muscle. Fevers were often beyond them, and even the most experienced midwives could not cope with obstetrical complications. Maternal and infant deaths were frighteningly common.

The disease-ridden lowlands lured settlers due to their rich agricultural lands, but many fled from the Arkansas River bottoms to the highlands. One minor improvement came in 1821 when the seat of government moved from Arkansas Post (Arkansas County) to Little Rock (Pulaski County). Doctors, surprisingly, were plentiful. A few of them can be identified: Robert F. Slaughter of Arkansas Post, Peyton R. Pittman of Davidsonville (Lawrence County), Matthew Cunningham of Little Rock, Caleb S. Manley of Batesville (Independence County), N. D. Smith of Hempstead County, and Nimrod Menifee of Cadron (Faulkner County). In 1829, Little Rock had five doctors serving the 250 to 300 residents. Although the ratio fell to one doctor per seventy-eight people by 1836, many, such as Solon Borland, turned from medicine to seek their fortunes in agriculture, law, or politics.

Arkansas’s regular physicians made one major attempt to control admission to the profession. Their 1831 medical licensing bill, which admitted to practice medical school graduates and tested other applicants, was vetoed by Governor John Pope, who proclaimed that “the highest authority known in this land, public opinion,” was superior to diplomas. Unable to get state standards, doctors in Van Buren (Crawford County) established their own county body; others came after the Civil War.

Before the Civil War, three venues of medical training were available to young men. The first was apprenticeship. An established physician agreed to accept a student for a given period of time, during which the physician served as mentor and teacher. The student paid a fee and served as an assistant, borrowed books to “read” medicine, accompanied the doctor on house calls, and observed surgeries. At the end of the apprenticeship, the mentor wrote a testimonial letter, reviewing the areas of medicine mastered by the apprentice, and this letter served in many states as the only credential required for being licensed to practice medicine.

The second venue was the “proprietary school,” or a for-profit medical school, in which a group of doctors owned the school and served as faculty. Each doctor taught the subjects he knew best, and students were required to purchase tickets to a certain number of lectures for graduation. These students never saw a patient during training, and the curriculum was often inadequate, depending entirely on the professional knowledge of the owners. A diploma from a proprietary school was licensure. Although most were regular or “allopathic,” schools were established for competing disciplines.

The third venue was a university medical school. In 1830, twenty-two such institutions existed in the United States, all east of the Mississippi River and all allopathic. Allopathic physicians learned from books and lectures to take “heroic” measures of therapy, believing that any therapy that changed patients’ symptoms was working on the disease itself. Blood letting, blistering, drastic purging, and agents to induce vomiting were employed to excess. Among the medical school graduates in Arkansas in this early period were Matthew Cunningham from the University of Pennsylvania, Alden Sprague from Dartmouth College, and James A. Dibrell Sr. from the University of Pennsylvania. Benjamin F. Scull from Arkansas Post, also one of Arkansas’s first composers, studied at the Medical College of Philadelphia.

In the 1830s and 1840s, another theory of medicine, homeopathy, became widely popular in the region. A German physician with a university background, Samuel Hahnemann, taught that, if a remedy given to a healthy person could produce symptoms of disease, that remedy would cure a patient with those symptoms. Few homeopaths settled in Arkansas before the Civil War, but there were several in Little Rock at the turn of the twentieth century. All too typical was J. H. Gray at Rocky Comfort (Little River County), who doctored sick horses along with dosing out calomel, blue mass, and quinine with no medical education at all.

Doctors also competed to some extent with midwives. No organized midwifery body existed, but many women preferred the presence of female midwives during childbirth. Difficult pregnancies often led to doctors being called in at the last moment. The advantage of an obstetrics practice was that it led to a general family practice; hence, doctors bad-mouthed midwives on both general and financial principles.

Finally, people practiced self-help. One Southern medical book for the home widely used in Arkansas was Tennessean John G. Gunn’s Gunn’s Domestic Medicine, or Poor Man’s Friend (1830), which was revised and reprinted for at least ninety years. Gunn gave special attention to the needs of women. The Reverend D. L. Saunders, MD, of Little Rock authored Woman’s Own Book: Or, A Plain and Familiar Treatise on all Complaints and Diseases Peculiar to Females in 1858. Planters especially relied on books in treating their slaves, and plantations were sickly places, both for blacks and whites, largely due to their geographic location in the lowlands. A great source of misinformation came from patent medicine advertisements. Throughout the state, women—especially those with an Indian background—were called upon to supply herbal remedies.

Epidemics occasionally interrupted the normal life cycle. The Mississippi River was an artery from the disease-rich tropics to the heartland. Helena (Phillips County) was regularly threatened. Editor James M. Cleveland of the Democratic Star died in the yellow fever epidemic of 1855 as many of the town’s residents fled. Cholera accompanied the Cherokee and other tribes during their forced migrations west. Cholera and other diseases also affected parties heading to the California gold fields. This disease, which hit Fort Smith (Sebastian County) before the Civil War, was marked by extreme dehydration, but the standard textbook treatment was to deny the patient any liquids.

Civil War through Reconstruction
During the Civil War, Arkansas became part of the Confederate Department of the Trans-Mississippi, a sprawling, poorly organized area of 700,000 square miles, reaching to Arizona and New Mexico. After the frightful carnage at the Battle of Shiloh (April 6–7, 1862), a group of Confederate surgeons met in Little Rock to create an examining board to recruit physicians for the Southern army. Doctor Philo Oliver Hooper, a graduate of the Jefferson Medical College in Philadelphia, practiced in Little Rock; later he would return to Little Rock, reestablish his practice, and help establish a medical school.

Medicines, especially quinine, were in short supply. Battle wounds were often compounded by fractures. Sanitary (antiseptic) practices had not yet been scientifically established, and the two forms of anesthesia, ether and chloroform, were used less than a fourth of the time. Many amputees died from shock. Nursing was only beginning to admit women; the first official female nurse, Mary Phelps, was the wife of John S. Phelps, the Union military governor of Arkansas. Post-operative care was lacking, and in towns, schools and churches were appropriated for hospitals.

The civilian population suffered malnourishment, especially in winter 1864. Cholera, which invariably followed armies, did not limit its damage to military personnel and arrived in force in 1866 and 1867. Nevertheless, the Civil War produced a medical revolution. Government studies documented medical treatment and photographed specimen patients. Organized female nursing followed, as did the building of hospitals. Two years after the war, Joseph Lister identified sepsis and brought in carbolic to fight infection.

The end of slavery had pronounced negative medical effects. The Freedmen’s Bureau found itself almost powerless while white authorities ignored the high death rate among African Americans. Left almost entirely to their own devices, most relied on “root doctors” or “conjurers.” One of the former, Patience Brooks Trotter of Monticello (Drew County), was highly regarded even by white physicians because of her successes in handling “female complaints” and cancers.

After Reconstruction, some graduates of black medical schools, notably Meharry Medical College in Nashville, Tennessee, served a small part of the black population. Most located in towns, for while the needs were greater in the rural areas, patients there could not afford to pay. Little Rock, Pine Bluff (Jefferson County), Helena, Forrest City (St. Francis County), and Newport (Jackson County) were served by doctors and dentists. The customers’ poverty was reflected in the career of Dr. William D. Black, who relied on the income generated from the plantation lands of his father, Pickens Black. Dentistry was a particularly sore point, for while some white doctors would see black patients, white dentists usually refused to do so.

The Foundations of Modern Medicine, 1870–1920
The foundations for future progress started with organizing and establishing medical licensing. Shortly after the end of the war, Hooper and twelve medical colleagues organized the Medical Society of Little Rock and Pulaski County. Then, on November 21, 1870, a group of physicians from around Arkansas met at the Little Rock Pacific Hotel to establish a statewide medical society. The yellow fever panics of the 1870s spurred a state licensing law.

When yellow fever struck Memphis in 1873, Little Rock was flooded by refugees. Luckily, they did not bring the disease with them. In 1878, a Little Rock board of health sprang into operation when “yellow jack” was first reported in New Orleans. Other communities followed suit, with “shotgun” quarantines being common in small towns and rural areas. The chaos that followed prompted demands for a coordinated state policy to work with the Sanitary Council of the Mississippi River, a multi-state coordinating body. In the absence of legislative action, Governor William Read Miller appointed the Little Rock board as the de facto state body, which at least legitimized its existence and allowed it access to funds from the National Board of Health. With more than $7,500 in aid, the board in 1879 established quarantine stations to keep that year’s epidemic from expanding.

Quarantines operated both regionally and locally. As the nation’s transportation grid increased, it became increasingly difficult to block all human contact. Locally, communities set up pest houses, leaving sick people there to die. If that could not be used, a black flag outside a house warned those in not to leave and others not to come. In the case of smallpox, death was followed by the destruction of all clothing, bedding, and other property.

The existence of a temporary board of health in Arkansas dated back to 1832 in Little Rock, but the de facto board of 1879 led Arkansas into uncharted waters. Dr. Charles Nash, the 1879 president, for example, called attention to adulterated and impure foods. In 1881, the legislature did establish a state board of health, but lacking in the law were requirements for death, marriage, birth, and other statistics that had become routine elsewhere in the nation, and the funding was adequate only for a small staff.

In the absence of any outbreaks, the board became inactive until 1897, when smallpox surprised the state. Salem (Fulton County) was the center, and local doctors at first failed to recognize the disease that eventually spread across the state. Galloway College in Searcy (White County) and Beavoir College at Wilmar (Drew County) were both hit. Despite some 7,000 to 10,000 cases yearly, legislators rejected inoculations, with country doctor and long-time legislator W. H. Abington saying that they did not work.

Medical licensing legislation also dated to 1881, but this “Quack Law” grandfathered in all existing practitioners and required “doctors” only to appear before a county board, which not need even have a doctor on it, and register with the county clerk. Those utterly ignorant of medicine could go to Benton (Saline County) and appear before the Saline County Board, which between 1881 and 1891 certified 149 doctors although the entire county contained only eleven physicians.

Not only was the state overrun by incompetents, but fraud was rampant as well. Hot Springs, where the baths were a major medical drawing card, had a problem with physicians and boarding houses who hired “drummers” to steer in customers. Seriously ill persons, especially on arriving trains, were victims of these scams, and the national scandal prompted a state law in 1903 and federal legislation in 1904. A constitutional argument in favor of medical commercial freedom was rejected by the state Supreme Court in Thompson v. Van Leer (1906).

Closely connected to medical licensing was the rise of hospitals. Arkansas’s first hospital (today called Sparks Regional Medical Center) was founded in Fort Smith in 1887. The following year, the Sisters of Charity of Nazareth, a Roman Catholic order of nuns, opened Charity Hospital, now St. Vincent Infirmary in Little Rock. The Sisters of Mercy then established Saint Joseph’s Hospital—known as St. Joseph’s Mercy Health Center and then renamed Mercy Hot Springs in 2012—in Hot Springs. In 1892, Isaac Folsom of Lonoke (Lonoke County) made a bequest in his will to endow a free clinic bearing his name in Little Rock to be used for teaching. The widow of Colonel Logan H. Roots, furthering her husband’s dream of a city hospital, gave funds in 1895 to construct a city hospital on land purchased by the City of Little Rock. In 1896, the new hospital, under-funded and poorly equipped, opened its doors with seventy-five patient beds. In 1900, the Olivetan Benedictine sisters at Holy Angels Convent founded Saint Bernard’s Hospital, now St. Bernards Medical Center, in Jonesboro (Craighead County). Public support for improved standards of medical education and healthcare seemed to be building in Arkansas.

From: encyclopediaofarkansas.net

Image: Little Rock, c. 1864

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Cholera

By Edmond Davis, 8-26-11

Cholera, a deadly, infectious gastrointestinal disease that usually spreads through contaminated water, is an acute infection of the small intestine caused by the toxin released by the Vibrio cholerae bacteria, leading to severe diarrhea and dehydration. Left untreated, cholera can be fatal in a matter of hours. The first cholera pandemic of 1817–1823 spread from India to Southeast Asia, Central Asia, the Middle East, Russia, and Europe, especially England. Cholera was prevalent in the 1800s in America beginning in New York City. Due to increased traveling, the use of steamboats, and more navigable waterways, cholera made its way to the Mississippi Delta region.

In October 1832, cholera reached Arkansas. An infected passenger boarded the steamboat Volant, captained by Charles Kelley. The Volant traveled from New Orleans, Louisiana, up the Mississippi River and into Arkansas via the White River. At the time, no deaths were reported on the Volant, but more steamboats traveled up and down the Mississippi River, where the disease preyed on travelers. That same year, the steamboat Reindeer had several infected passengers and crew members. The ship’s captain, David Miller, died near Montgomery Point, located along the river in present-day Desha County, which was a transfer point for passengers and freight that was used by bigger boats of the Mississippi River and the smaller ones running on the Arkansas and White rivers. On June 23, 1833, when the Reindeer stopped in Little Rock (Pulaski County), it had an infected crew and had already lost six people to cholera, also including the pilot and chief engineer.

In 1831, Dr. Matthew Cunningham, a physician, became the first mayor of Little Rock. He was directly involved in the formation of a board of health created by the new town council in response to a cholera epidemic brought by migrating Native Americans. In the 1830s, tens of thousands of Native Americans passed through Arkansas as part of Indian Removal, and many traveled on steamboats such as the Smelter, Volant, Thomas Yeatman, Reindeer, Little Rock, Tecumseh, and Cavalier, or on the keelboats often towed by these vessels. Arkansas became a highway not just for people and animals, but also for diseases. During the relocation of Native Americans called the “Trail of Tears,” many died from the scourge of cholera in Arkansas. Cholera prevailed amongst the Cherokee camped at the mouth of Cadron Creek.

Cholera became a problem all over the state but was more prevalent in communities near water. The growth of the major industrial cities also caused water pollution. Rivers that passed through urban areas became receptacles for human waste products, both domestic and industrial. Sewage was washed out into the streets, where it found its way to the rivers. Cholera was hardest felt in heavily populated areas, and it visited populations that had the highest poverty rates. During the Civil War, cholera hit large encampments of soldiers, such as those at Helena (Phillips County), due to poor sanitary practices, although dysentery, typhoid, and malaria claimed more lives than cholera.

Cholera struck Little Rock in 1873. According to the State Board of Health, on July 5, the first recorded case of cholera in Little Rock had sickened a woman in the Capitol Hill area. The section was often described as the most “salubrious and elevated” portion of the city. A day later in a different part of Little Rock, a man who had been in a damp and unsanitary environment was stricken. Both cases were fatal. Also, an African-American man traveling from Memphis, Tennessee, was treated for cholera and sent to the “County Poor-House,” where he died a few hours later. This facility was described as a “miserable establishment” full of undesirable inmates. The sanitation and food were unhealthy by any measure. Several more cases were registered as being cholera related.

In 1852, England passed the Metropolitan Water Act, which required water companies to filter and chlorinate the water. This sanitation effort helped to set a global trend, and it slowed cholera epidemics in London. In America, legislative interest in water pollution began in 1887, when the Connecticut General Assembly authorized the formation of a sewer study commission to “investigate the subject of sewage disposal.” In the twentieth century, many great strides were made to minimize the chances of a cholera outbreak. The last major epidemic in the United States came in 1910–1911. In the twenty-first century, cholera has all but vanished from the United States, though it remains a concern in other parts of the world, as exemplified by the outbreaks of cholera following a major earthquake in Haiti in 2010.

Several types of cholera associated with domesticated animals, such as birds and pigs, have occasionally been reported in Arkansas. In 1885, a New York Times story titled “Hog Cholera in Arkansas” reported that cholera was killing hogs in Van Buren, Stone, and adjoining counties by the hundreds. According to the U.S. National Wildlife Health Center’s quarterly wildlife mortality report, avian cholera (a.k.a. “fowl cholera”) was recorded in Arkansas and Baxter counties in January and March 2001. The species affected were American coot, an unidentified grebe, ring-necked duck, gadwall, and common grackle. This outbreak killed 226. In 2006, avian cholera was reported by U.S. Fish and Wildlife Service biologists to have killed between 1,300 and 1,500 snow geese at Bald Knob National Wildlife Refuge.

For additional information:
Dungan, D. H. “Summary of Evidence and Local Reports upon Cholera, as It Has Prevailed in the Mississippi Valley and Elsewhere in America during the Year 1873: Cholera in Little Rock, Arkansas.” Public Health Papers and Reports 1873: 257–260.

“Hog Cholera in Arkansas.” New York Times, October 7, 1885, p. 2.

Huddleston, Duane. “The Volant and Reindeer: Early Arkansas Steamboats.” Pulaski County Historical Review 24 (Summer 1976): 21–33.

Kohl, Rhonda M.“This Godforsaken Town”: Death and Disease at Helena, Arkansas, 1862–63.” Civil War History 50 (June 2004): 109–144.

McClintock, Charles T., Charles H. Boxmeyer, and J. J. Siffer. “Studies on Hog Cholera.” Journal of Infectious Diseases 2 (1905): 351–374.

Scholle, Sarah Hudson. A History of Public Health in Arkansas: The Pain in Prevention. Little Rock: Arkansas Department of Health, 1980.

From: encyclopediaofarkansas.net

Image: The Cholera Prevention Man. Moritz Gottlieb Saphir, Germany and England, ca., 1832.

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Cholera: Sickness and Death in the Old South

From: tngenweb.org

Epidemic Cholera = Asiatic Cholera = Vibrio cholerae

Cholera is an acute, infectious disease characterized by extreme diarrhea, vomiting, and cramps. Cholera is primarily spread by feces-contaminated water and food; or as some say, it is a deadly water borne disease usually resulting from poor hygiene and untreated water. The cholera bacteria produce a toxin which keeps the human body from absorbing liquids. It is one of the most rapidly fatal illnesses known. Untreated individuals may die from severe dehydration within two to three hours. This disease has been the killer of millions worldwide. It is endemic in both Bangladesh and Peru. In 1991, a cholera epidemic swept down the west coast of South America. Africa suffered a similar cholera surge in 1991.

It seems that the bacteria prefers brackish coastal waters (moderately salty waters, i.e., coastal estuaries). Traditionally, this link to the seacoast areas has been credited with the transmission of the disease to other areas via ships.

The bacteria is controlled by chlorination of water and by waste water management. Of course, the less developed nations with their less developed water and waste systems are more at risk of outbreaks than the more developed nations. Natural disasters can greatly heighten the cholera risk by damaging the water and waste water systems.

Today . . . “Cholera can be simply and successfully treated by immediate replacement of the fluid and salts lost through diarrhea. Patients can be treated with oral rehydration solution, a prepackaged mixture of sugar and salts to be mixed with water and drunk in large amounts. This solution is used throughout the world to treat diarrhea. Severe cases also require intravenous fluid replacement. With prompt rehydration, fewer than 1% of cholera patients die.” U.S. Centers for Disease Control (CDC)

Cholera is still with us, lurking . . .

History

Asiatic Cholera appears to have started on the Indian subcontinent, ca. 1826. In India it became endemic. By 1831, it had spread to Russia. Eastern and Central Europe have suffered outbreaks and epidemics through World War I. The disease came the United States via English immigrants, ca. 1832.

Unfortunately, when the first epidemic hit our shores, there was no preventive, no good treatment, and no cure for the disease. The cause of the disease was not known, but we do see that early on, poor sanitation was suspected. During the years that King Cholera reigned in the United States (1832-1873), our cities were filthy, especially the ghetto areas. Waste management in those years was poor at best, but usually nonexistent. Waste would run down the middle of the streets, exposed. The streets were “ripe” with odors. Once cholera was introduced into the waste system, it was easy for the drinking water systems (poor as they were) to become cross contaminated; and once the water system was comprised, neither poor nor rich were spared. King Cholera was and is an “equal opportunity” killer. In London England, 1854, Dr. John Snow was able to stop a major cholera epidemic by closing the Broad Street pump, and thus he showed that cholera is a water borne disease. This was not previously known. According to Snow, prior to his finding it was believed that cholera “was communicated by effluvia given off from the patient into the surrounding air, and inhaled by others into the lungs ...”   Yes, London was filthy too!

One of the most common treatments for cholera in the United States up through the Civil War was the medicine calomel (Mercurous Chloride; Calogreen; Mercury Monochloride; Mercury Chloride). It was commonly used as a purgative (laxative) for the treatments of bowel illnesses ranging from diarrhea to cholera; unfortunately calomel’s effects were seriously harmful. It may have cleansed the bowels, but at the same time it caused teeth to loosen, hair to fall out and could destroy the patient’s gums and intestines. In other words, it could cause acute mercury poisoning. By 1870, we see remedies for diarrhea, brought on by long-continued use of calomel. We would need to ask -- if a person who had contracted cholera and taken calomel as treatment, could have survived to suffer calomel’s side effects?   There are a number of diseases which cause extreme diarrhea other than cholera.

Whenever there were major epidemics in the United States, it was common in the urban areas to send wagons to collect the dead. As the wagons passed the homes, the drivers would cry out, “Bring out your dead.” The deaths and burials often went without being recorded. Some families were so devastated that no one remained to put up headstones in the cemeteries -- assuming that a private burial was even possible.

The Cholera Epidemic Years in the United States

Major epidemics struck the United States in the years 1832, 1849, and 1866. There were smaller epidemics between the major ones.

1832:
   Major Epidemic
   New York City: over 3,000 people killed.
   New Orleans: 4,340 people killed.

1833:
   Columbus, Ohio.

1834:
   New York City.

1848:
   New York City: more than 5,000 killed.

1848-9:
   Major nationwide epidemic.
   See: 1849 Cholera Letter, Memphis Tennessee

1849:
   New York

1851:
   Coles Co., Illinois, The Great Plains, and Missouri

1865-73:
   Major nationwide epidemics.
   Baltimore, Memphis, Washington DC - Cholera.
   Baltimore, Memphis, New York City, Philadelphia, and Washington DC: recurring epidemics of cholera, scarlet fever, smallpox, typhus, typhoid, and yellow fever.

Learn more about cholera and other diseases of the Civil War era at www.CivilWarRx.com

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John C. Chamberlain and the Christian Commission at Gettysburg

From: edinborough.com

John Calhoun Chamberlain, brother of the hero of Little Round Top, served with the United States Christian Commission during the battle of Gettysburg. He filed this report to the central office. Chamberlain's Christian Commission diary, kept during the battle of Gettysburg, is found in our book, "Gettysburg and the Christian Commission".

This letter from a gentleman of Bangor, now a delegate of the Christian Commission, gives some idea how the delegates work. Two hundred such were on that battlefield.

Middletown Md. July 11, 1863
Charles Demond, esq.

My Dear Sir:
Although my epistolary conveniences are not of the first order, I will tell you something of my experiences at Gettysburg, where I happened to arrive in advance of the rest of the Commission.

I came up with the Fifth Corps on the morning of the 2nd. As we advanced we saw nothing that told of the battle, except now and then, at long intervals, a dash of smoke from the heights held by Howard. As we drew nearer, however, the hospitals told the story of what had been and what was to come. Our forces proceeded right up in line of battle, and speedily every hill was capped with smoke, the most terrific cannonading on right, on left and front -- the whizzing and bursting of shells, and the clatter of musketry. Then came the wounded; they were lying under every tree, the woods seemed full of them, they issued from every path and were scattered along the road-sides. They were wandering around searching for their respective hospitals. It was a very small portion who could be accommodated in ambulances. Many of their hospitals I was able to point out to them after washing their wounds. Poor fellows! after reaching their hospitals many of them were little better off. The houses and barns would hold but a handful. At one hospital I found hundreds lying on their backs in the open fields -- sun pouring down into their faces. Their bleeding and neglected wounds were not half so tormenting as this. They entreated, with all their powers, as the last request of dying men, to have some plan devised to screen them from the heat. Every one thought it useless, for there were no spare tents at hand nor blankets enough to wrap about them. In this exigency I hardly knew which way to turn, but I soon found myself driving stakes with a rock and twisting every spare corner of their bedding over them. My success started others and soon I had the comfort of seeing the whole hospital in the shade. But toward evening we saw a shower coming up and here was a new labor. We did the best we could, but few escaped the water that night.

This is the way I spent my time at Gettysburg -- going round the hospitals, reading in the faces of the men their wants and trying to relieve them, speaking words of comfort and religious consolation, and gathering their dying messages to their friends at home. After all, my dear sir, our labors at such times are of such a nature that we can give but a faint idea of them on paper. There are a thousand little nameless acts which the world cannot know, nor we ourselves recall, that are none the less important in their issues. The grateful soldier notes them, one by one, and thanks God for the Christian Commission. I cannot close without telling you the pleasure it gave me, as I walked over the battle field among the dead, to find lying by their sides, and many already open, books of the Christian Commission distribution.

I am, your obedient servant, John C. Chamberlain

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Civil War Life: A Letter to Her Husband, Benjamin Wells

From: edinborough.com

This letter was written by Melissa Hoisington Wells of Fabius, Michigan, to her husband. At the time, Benjamin was stationed near Nashville, Tennessee with the 11th Michigan, Company A.

Fabius
Sunday June 22nd 1862
Dearest Ben,

After a silence of three long weeks I again resume my pen to let you know that I am still in the land of the living although I am not enjoying the best of health at the present time. I do not know how long or how nicely written my letter will be for my hand trembles so that it is with difficulty that I can write but I will do the best I can, hoping that you will make all due allowances. No doubt you are feeling anxious to hear from me and I would have written before had I been well enough but likely you know the reason before now. I have received five letters from you since I wrote and I will answer them all as soon as I can the dates of them were May 23rd and 26th and 30th and June 5th and 10th. To tell the truth I hardly know what to say but I will try to think of enough to make out a letter if it is not as interesting as it might be. The rest of the folks are well as usual.

I have been quite sick for nearly three weeks but am on the gain now. I have not fully regained my strength yet but if nothing happens any more than I know of now, I think I shall soon be restored to good health again. Perhaps you would like to know some of the particulars concerning my sickness but to be frank about it, I am half ashamed to tell you anything about it. But I presume there is no one that feels any more anxious to know than you do and if you will not think that I am immodest I will tell you.

Fred wrote to you two weeks ago today and told you all the news. You have doubtless received the letter by this time however I hope you have not for I would have been much obliged to him if he had waited and given me a chance to write the particulars. I think it would been more suitable than for him to have done it. After he had written the letter, he brought it down and read it over to me before enclosing it. I did not feel very well pleased with all he wrote and I do not see what he meant by writing as he did. I should thought he would know that you would feel bad enough without his taking particular pains to hurt your feelings. Now I have not the least recollection of wishing any such thing on you as he stated to you in his letter.

It would been very ungenerous for me to wish you to suffer because I had to and I do not think that I said any such thing, although I was suffering such extreme pain that I might have said and done a great many things that I know nothing about now-- for I do not believe that I was conscious half the time of what was going on. As for Em, I cannot say much for her for you know as well as I do that she is very apt to say just what she thinks when she is angry but since I have been sick she has been very kind and attentive and willing to do all she possibly could for me, and I do not believe she really meant what she said-- at least she says she did not and I have every reason to believe what she says and I cannot help feeling out of patience with Fred for writing such a letter. He should never sent it-- had it been in my power to prevent it but I could not help myself. The letter was written and of course he would do as he pleased with it whether I liked it or not. I think it was very unfriendly of him but likely he thought it was all right so I thought I would do the next best thing as soon as I was able I would write to you and tell you how the thing was and have the matter made right if I possibly could. You must not feel hard nor mind anything about it for I certainly do not wish to hurt the feelings of the best friend I have and now don't feel bad nor care anything for what he said and I am sure you will not, now that you know how it is. I cannot blame you if you did feel hurt when you received his letter I think I would had I been in your place.

I had a long painful time in the beginning. I was sick over 48 hours and it seemed as if I never could live through it I was in such agony all the time from the time I was taken until I got through-- which was from Thursday night until Sunday morning. But it appears I did and am living yet and thank fortune I managed to get along without the help of a doctor and I think that is half of the battle and it is my most earnest wish that I may never be called to pass through another such a siege, although I little know what suffering there is yet in store for me. I can be content to live with but one child in all the rest of my life rather then endure again what I already have. I thought of you many times during those long tedious hours and often wished that you were with me. It seemed as if I could endure the trial with much better fortitude, but since it is over with, I cannot help feeling thankful that you were not here to witness my suffering, for such it surely is I do not think I never had one faint idea of what it was until I had the experience. I had no other help but Mother and Mrs. Parsons. I think she is excellent help at such a time and if there were more like her, the world would be so much the better off. I shall never believe if I live to be a hundred years old that it is any place for a Physician-- but perhaps you are getting impatient to know the result of all this fuss, but you likely know for Fred wrote it in a letter to pay me for all this trouble.

I have a boy that weights 8 lb and 1/4. He is two weeks old today, born the 8th inst. I cannot describe to you how he looks but he resembles other babies I think for they all look alike to me when they are so young, but just as he is at the present time you can imagine a little round chubby form lying near me as I write in a long white flowing dress and blue edged blanket sucking his tiny fist in the innocence of babyhood.

Dear Ben, how I wish you could see him. I am sure you would love it quite as well as I do it you could only come home now what times we could have I feel even more anxious to see you than before, but I live in hopes that the time will soon come when you will be at home again and we will be happy once more as we used to in times gone by. I feel sometimes as if I could not wait for the time to come it seems so long since you went way. It is nearly 7 months ago. I think that is a long, long time to be separated from the dearest and best friend I have, but I will hope for the best. I feel more encouraged now than I have for some time before, for I feel that with me the worst time is now passed and if you were only with me now I should think that long dark night had indeed passed away and the bright morning had again dawned.

I received those things you sent also your likeness for which I was very happy to receive. It looks quite natural but I cannot help think very sober. You must felt downhearted about something when it was taken. What was the matter with you, my Benny dear? I would like to know. You must excuse this bad writing for my pen is a miserable concern. I can hardly make a respectable looking mark. I will write again as soon as I feel well enough and try to write a longer letter and a better one if I can write soon and I remain,

your affectionate wife
Melissa
Courtesy: Bentley Historical Library at the University of Michigan.

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Malaria: An Epic Tide of Sick and Wounded Flows into Civil War Hampton

By Mark St. John Erickson

One of the most epic sights recorded in a place that has seen many was the immense tide of sick and wounded Union soldiers that washed up on the east bank of the Hampton River in August of 1862.

Ferried by the thousands from the giant Army of the Potomac camp at Harrison's Landing in Charles City County, the stream of casualties filled ship after ship in a makeshift hospital fleet -- then made those vessels repeat the long trip up and down the James River over and over again for nearly a week.

By the time the massive evacuation was completed, some 20,000 soldiers recovering from wounds or laid low by typhoid, dysentery, malaria or Chickahominy Fever had been rescued from the endless expanse of tents that had served as the Union field hospital during the Peninsular Campaign near Richmond.

Nearly a quarter of them -- mostly those too ill or hurt to endure the longer trip north -- ended up in the sprawling complex of newly built wards and hastlily erected tents that would soon transform Hampton into the second largest facility in the Federal hospital system.

"Near the end, the Hampton hospital was like the drain for the whole campaign," says Terry Reimer, director of research for the National Museum of Civil War Medicine in Maryland.

"The Union was evacuating the sick and wounded as fast as it could. It was just insane."

Just how overwhelming this stream of soldiers became can be seen in a Harper's Weekly story that reported on the scene from nearby Fort Monroe.

""For several days ... the hospital steamers, with their little crimson flags flying from the masts, were at the upper dock,"  the correspondent noted.

"A large number (of the patients) were convalescing, so that they walked to the hospitals ... It was a touching and sympathetic sight, with forms and faces indicative of disease, some with fans, and most with staffs in their hands, they slowly walked along, like pilgrims to the promised land."

Hampton Military Hospital became a dreaded dateline in the New York Times, which published the lists of the dead on a regular basis. Amputees abounded, resulting in the construction of an isolated Gangrene Camp where many died and many others lingered.

By the time the war ended, the constant flow of sick and wounded from the Siege of Petersburg had resulted in a vast building complex that stretched from near the mouth of the Hampton River to just short of today's Booker T. Washington Bridge. So far did it extend that administrators built a special rail line from Fort Monroe and then through the camp just to keep their patients moving.

Today the only evidence that remains is Hampton National Cemetery, where many patients of the Civil War hospitals are buried, and the Veterans Administration Hospital, which is the successor to the Soldiers Home that was formed from the hospital's buildings after the war ended.

Image: Taken shortly after the Civil War, this close-up view shows the 4-story Chesapeake Female Seminary building commandeered by Union doctors for use as officers' wards. (Courtesy of the Library of Congress)

From: dailypress.com

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Abraham Lincoln- a Homeopathic Enthusiast

From: seattlehomeopathy.com

Homeopathic SupporterDana Ullman, owner of Homeopathic Education Services, is a prolific writer on the homeopathic subject.  His latest article in the December 23, 2012 edition of the Huffington Post titled “Lincoln and his Team of Homeopaths” is another timely look at past accomplishes of homeopathy.  The 1800’s were a high time in homeopathy.  It had numerous accomplishments and many people in Europe and the Eastern United States sought homeopaths for medical care as Ullman shows in his article.  He states that Lincoln surrounded himself with homeopathic supporters.  Many prominent citizens and politicians participated on the board of trustees of the Hahnemann Medical College, which Lincoln obtained a charter for.  Lincoln’s Secretary of State, William Seward, frequently sought the advice of homeopaths.  The American Institute of Homeopathy dedicated a monument, named Scott Circle, which can still be seen today in Washington, DC, in honor of  Tullio Suzzara Verdi, MD, doctor to William Seward.  Dr. Verdi was appointed to the bureau of health in Washington, DC.  Lincoln’s appointed Major General to the Union Army during the Civil War, George Brinton McClellan, fell ill from typhoid fever and was treated by homeopathic doctors.  The Major General was well enough to work during the illness and full recovered to live another 23 years.  Typhoid fever is known to have killed more people during the Civil War than warfare itself.  Lincoln was a regular customer of homeopathic medicines at the Diller Drug Store in IL.

To put Lincoln’s time into perspective:
1796: Homeopathy was invented by Samuel Hahnemann, MD in Germany
1825: First American Homeopath, Hans Burch Gram, MD
1835: First American Homeopathic School run by Constantine Hering, MD
1843: Hahnemann dies
1847: AMA established
1861: President Lincoln inaugurated as the 16th President of the United States
1861-1865: U.S. Civil War
1865: President Lincoln assassinated
1870: Germ Theory began to come together

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