Report of Cholera Epidemic on Harts Island in Pelham in 1866

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In 1866, a cholera epidemic ravaged those who lived and worked on Hart Island, then part of the Town of Pelham. The epidemic grew so bad that the Brevet Lieutenant Colonel and Surgeon John J. Milhau who treated post-Civil War U.S. troops on the Island asked the commander of the Island to move all healthy personnel to nearby David's Island "as early as practicable". His request, included in a report about the epidemic dated July 20, 1866, appears immediately below.

"HART'S ISLAND, NEW YORK HARBOR, July 20, 1866.

Brevet Brigadier General A. D. DOUBLEDAY, Commanding Hart's Island:

SIR: With a view of preventing the further spreading of cholera in this command I have the honor to recommend that the well men and officers be transferred to David's Island as early as practicable. Previous to leaving, the bed-sacks in use, with the straw, should be burned, the blankets and clothing thoroughly fumigated, and every precaution taken to prevent the transfer to the new quarters of any article of clothing, bedding, or baggage that has not been thoroughly disinfected by active chemical agents. I deem the above measures imperative to prevent the extension of the disease.

The fumigations were superintended by the officer of the day and the medical officer. Sulphurous acid, nitrous acid, and chlorine were all used in disinfecting.

On the evening of the 20th, six companies of the seventeenth United States infantry (520 officers and men) were transferred to David's island, leaving on Hart's island the sick, a detail of attendants, and the sixth company first battalion Veteran Reserve Corps, to guard property, in all about eighty-five officers and men. On the evening of the 20th Dr. Carey, contract surgeon, and Hospital Steward Brumer reported for duty. During the night Brevet Major Warren Webster reached Hart's island with seven cholera (?) patients, taken sick shortly after landing on David's island. The commanding officer of Hart's island, Captain Bayne, Veteran Reserve Corps, refused to receive them, and they were sent back to David's island. Fearing that the cholera would now continue among the troops at David's island, I sent Dr. Carey and Steward Brumer to assist Dr. Webster.

Notwithstanding the diminished garrison at Hart's island the disease still kept on, attacking the nurses about the sick and showing itself in the Veteran Reserve Corps company, which up to this time had enjoyed an immunity. Several teamsters fell ill with cholera, one after another; they had carried off the dead; but I think the cause of their illness was attributable to their living in the stables. The two stewards became ill, and were confined to bed. Their disease not being cholera, I sent them to David's island to recover. On the night of the 21st Dr. Browne, contract surgeon, and eight contract nurses reported for duty. On the 22d I recalled Steward Brumer from David's island. This enabled me to relieve and send to David's island a number of soldier attendants, who had been very faithful and required rest.

Being satisfied that, owing to irremediable local causes, the disease would still continue, I, on the 23d, recommended that every well person not needed on the island should be sent off. I reduced the hospital attendants to the utmost limit consistent with the care of the sick; but the officer temporarily in command sent off nearly the whole company of the Veteran Reserve Corps, thus leaving the island without proper guard or police party: consequently, on the 25th I was obliged to call for a detail from David's island, and on the 26th the Veteran Reserve Corps returned, and I had them encamped on the parade grounds, their morale and condition having been much improved by their short absence from the post.

The following is a tabular statement of the cases of cholera at Hart's island, New York harbor, from July 20, 1866, to July 26, 1896:

In hospital July 19, 6 1/2 p.m., cases . . . . . 8
New cases received up to July 26 . . . . . . . . 11
Total . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19
Deaths. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13
Remaining in hospital July 26. . . . . . . . . . . 6

Of whom five are convalescing; three of these five were in the ward when I took charge. In addition to the above should be counted two citizens, both of whom died. [Page 25 / Page 26]

The disease was undoubtedly cholera Asiatica, presenting all the symptoms of a malignant form, viz., diarrhea, vomiting and purging of rice water, cramps, collapse, cold surface, cold extremities, cold tongue, cold breath, quick and weak pulse, leaden hue of surface, shrunken features, anxious expression, sunken eyes with dark hole, inelasticity of skin, incessant thirst, sensation of heat of body and extremities, entire suppression of urine, jactitation, nervous agitation, sometimes slight delirium, finally coma from anaemia, loss of pulse and death. After death, in many cases, the elevation of the temperature of the body and the muscular movements were very striking.

Owing to the multiplicity of duties imposed upon the medical officers in attempting to avert death and to prevent further illness, no autopsies were made. There being no microscope at the post, but little information would have been obtained in making simple post mortems.

The cholera ward became so infected with the cholera poison that every patient brought thither for several days died, notwithstanding the floors were kept covered with chloride of lime and sulphate of iron, and the utmost police enforced. I therefore, on the 24th, closed the ward, using the convalescent ward for choleraics, and removing the convalescent patients to the finest building on the island -- the library. The improved condition of all the patients on the following morning showed the propriety of the move.

Brevet Major and Assistant Surgeon McGill reported on the evening of the 24th. He immediately went on duty, examining the patients and records, and from him may be expected a very full report of all the cases since the insipiency of the disease.

July 26 I was relieved by Brevet Major McGill, in compliance with your order.

During my tour the medical officers had to be constantly in the hospital superintending the care of the sick and the police, the administration of medicines, stimulants, and food, and for a time had to dispense the medicines.

Although the medical officers devoted themselves to these duties, it was discouraging to see the patients die, one after another, in spite of their most assiduous efforts, the malignancy bing due to some endemic cause.

In reference to treatment, the results were unfavorable, owing to the fact that collapse came on so soon after the commencement of the choleraic symptoms that medicine had no time to act, and symptoms were treated as they arose. After faithfully trying ice bags, hot bags, heaters, sinapsisms, embrocations, &c, the plan of treatment which gave the most satisfaction was to follow the indications: First, a mustard emetic, then to allay vomiting by creosote, cracked ice; to arrest purging by injections of brandy, infusion of tea, and acetate of lead; to ease cramps and jactitation by hypodermic injections of morphia; to restore heat of surface gradually by gentle heat, extreme heat to be avoided; to restore secretion of urine by spirits of nitre or spirits of turpentine; to prevent collapse or avert death by stimulants, small quantities often repeated; when thirst is great, a little ice tea, or simply ice.

But nursing and constant attention are more important than medication. The patient should be kept in bed lightly covered, should use the bed pan, the stools and vomits should be immediately removed, and the utmost cleanliness observed about the patient and his bedding; a nurse should be constantly at his bedside attending to his wants.

I cannot lay too much stress upon the police and ventilation of the cholera ward, and the ward changed where there is evidence of an accumulation of the poison.

I cannot close this report without mentioning the untiring and zealous manner in which Brevet Major J. R. Gibson, Assistant Surgeon United States Army, discharged his duties. Brevet Major McGill and Acting Assistant Surgeon Browne deserve great credit for their prompt and efficient services. To Brevet Major Warren Webster, Assistant Surgeon United States Army, I wish to return thanks for his efficient and ready co-operation in furnishing stewards and nurses.

Very respectfully, your obedient servant,

JOHN J. MILHAU,
Brevet Lieutenant Colonel and Surgeon U.S.A.

Brevet Colonel WM. J. SLOAN, U.S.A.,
Medical Director Department of the East."

Source: Circular No. 5 -- War Department, Surgeon General's Office, Washington, May 4, 1867. Report on Epidemic Cholera in the Army of the United States During the Year 1866, pp. 25-26 (Washington, DC: Government Printing Office 1867).

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