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Jefferson County Jefferson
County, Alabama Epidemics CHOLERA AT BIRMINGHAM, ALA., IN
1873.
By M. H. Jordan, M. D., Member of the Board
of Health. In reporting a history of the recent epidemic of
cholera as it prevailed at Birmingham, I will not discuss any
theories nor indulge in any idle speculations, but will
confine myself strictly to a simple, concise, narrative of
events. Our little city was terribly scourged for long
weeks; our citizens became panic-stricken; many left, almost
depopulating the town, and leaving the sick and indigent
principally in the care of clergymen and physicians. The
latter class, however, did not escape the disease, but two of
their number lay for many days and nights upon the brink of
the river, and it was only by the intervention of an all-wise
Providence and the assiduous care of their attendants that
they recovered. Birmingham is located in Jones Valley, near the
center of Jefferson County, with the Red Mountains lying a
short distance to the south and east, and what is known as
Reservoir Ridge to the north and west. The stone near the
surface is blue limestone, covered with a stiff clay soil,
such as is usually found in the hilly portions of Central
Alabama. The bed of the valley is formed by the old Silurian
limestone, which doubtless was brought to the surface through
the superincumbent strata, and is found throughout the entire
valley, almost on edge, dipping, as we recede from the valley,
to the northeast and southwest. From this fact we are led to
conclude that the only water that appears on the surface or is
fonnd in wells in this valley must be surface-water, for the
strata of limestone are not waterbearing, and only afford such
supply of water as may have filtered through the strata of
earth overlying the edges of this formation during the winter
or rainy months, which finds a ready outlet in a southwest
direction along the Hue of upheaval. This water finds numerous
outlets at various points in the valley, as is shown by tho location of the springs, to be seen on
the accompanying map, all of which, with others northeast and
southwest of Birmingham, are situated on the line of
upheaval. Birmingham is a railroad center, having about three
thousand inhabitants, a large number of whom live in houses
olosely crowded together, and in defiance of sanitary laws.
Each day four railway trains pass through this town, making
direct connection with Nashville, Chattanooga, and Louisville,
in the north, and Montgomery, Mobile, and New Orleans, in the
south. In addition, from six to eight freight-trains each day
receive and discharge freight. The mineral interests in the
neighboring mountains attract to the town many straugers, and
daring the summer months the transient population is quite
large. The ground upon which the city is located is
undulating, with many elevations and depressions, in some
places affording fine natural drainage; in others it is low
and marshy, and remains damp throughout the entire year. The inhabitants of Birmingham were in 1873 supplied
with water from two sources. A most admirable system of
water-supply had been instituted, but the work had only
advanced sufficiently to supply a small portion of the city.
This supply was obtained from a large creek northeast of the
city, distant nearly two miles, and separated from Joues
Valley by a high ridge, on the summit of which was located the
reservoir, which is over one mile from the center of the
city. The inhabitants who could not yet reach this
water-supply made use of several public wells and springs
within the city limits, or were obliged to haul it from
springs at the foot of Bed Mountains. The public wells and
springs referred to were in low, damp places, and so situated
that they received the washings from a large surface of
ground; and it was only at such points that water could bo
obtained. For that portion of the city north of the railroad,
(see map,) being built over the greatest dip of the limestone
rock, water could not be obtaiued. South of tho railroad,
where the rock-bed is nearer the surface, water is obtained
from private wells. But oue house in the city was supplied
with a water cistern. In the eastern portion of the city there is a pond,
(marked A,) from which flows a small branch, which takes a
westerly direction, crosses Twentieth street through a
culvert, and continues in the same direction to the comer of
Seventeenth street and Second avenue, where it unites with two
other small branches from the south side of the railroad,
(marked B and C.) At their junction these streams spread out
and form a low, marshy ravine, overgrown a portion of the year
with tall grasses, which continues in the same direction
beyond tho limits of the corporation. On the northern side of
this ravine, (marked E,) from Eleventh to Fourteenth street,
which pass along a hill-side, a number of shanties and negro
cabins, low, dirty, and ill ventilated, were located, which
were known as "Baconsides." (See map.) By each rain-fall the
filth of all kinds which covered the ground around these
cabins was washed into the ravine, and it was from a low
spring and a number of barrels sunk in the marshy bottom of
this ravine that the inhabitants of Baconsides and many of the
white residents of Birmingham obtained their
drinking-water. Until the alarm of cholera was sounded upon the
streets, no effort was made by the city authorities to clean
the streets and alleys, to drain and disinfect cess-pools and
wet places, nor had cleanliness been demanded in privies and
stables. The first case of cholera that occurred at
Birmingham in 1873 was in the person of a Mr.
Y., No care was taken to disinfect the
discharges, which were thrown on the ground in the rear of the
house, on the slope of the hill, immediately above the branch
marked D. No other cases occurred until June 17,
when a young girl named Hughes and her sister were taken with
cholera within a few hours of each other, and both died within
twenty-four hours. The home of these children (see map 2) was
in a miserable little hovel near the edge of a small branch
(marked F) which runs through several acres of low, marshy
ground. It was determined that the different members of this
family had been constantly at the house of Y., the first case,
during his illness. The discharges from these patients were
not disinfected, but were thrown into the branch, which flows
down to the same marshy ground from which the inhabitants of
"Baconsides" obtained their drinking water. June 19, a man named Bennett, who was
a shoemaker, and lived at the point marked 4 on the map, was
taken with cholera, and died after an illness of eighteen
hours. This man had been absent from home for several weeks,
and returned, suffering with an acute diarrhea, from
Chattanooga the night previous to his attack. The discharges
in this case were disinfected, and the bed and bed-clothing
were burned. Under the house in which this man died was a
damp, filthy cellar, which had been nearly full of water in
the early spring. June 20, a comrade of Bennett, who had
waited upon him in his illness and had carried out the
discharges, was taken with cholera, and died in twelve hours.
The excreta were disinfected and buried. June 21, a sister-in-law of Bennett,
who was constantly with him until his death, was taken with
cholera at her house, (marked 6,) and died in twenty hours.
Tho discharges of this patient were not disinfected, but were
thrown into the branch in rear of the house. June 22, a negro boy was found in a
low, dirty shanty close by the line of the Alabama and
Chattanooga Railrond, (marked 7,) in a state of collapse, and
he died in a few hours. In the evening of the same day a negro
named Edwards was taken with the disease at his home on the
banks of the ravine marked C. The disease was fully developed,
but reaction was stablished, aud he recovered. June 23, a negro named Eubank was
taken with the disease at the residence of a gentleman,
(marked 9.) He had copious rice-water discharges, cold skin,
profuse perspiration, small, frequent pulse, and cramps in the
extremities; he responded to the treatment and recovered.
Great care was taken to disinfect and bury the excreta. He was
kept as much isolated as possible, and no other case was
developed on the premises or in the immediate
neighborhood. On the same day several cases of
cholera occurred at Baconsides, all of which terminated
fatally within twenty hours. No disinfectants wereused; the excreta were thrown upon the
ground: the epidemic was inaugurated, and deaths occurred in
every household. At first, all of the negroes in this portion
of the city who took the disease invariably died within a few
hours; but when the violence of the epidemic began to subside,
many recovered. Along the banks of the branch
marked 0 upon the map are a number of cabins, in one of which
Edwards, the case of June 22, had the disease, and in one of
these cabins, on the 24th, Minerva, a negro girl who had
nursed Edwards and carried out the dejections, was attacked,
and died within ten hours. Before this girl's body was buried,
two other cases occurred in the same cabin, which rapidly
proved fatal. The discharges in these cases were disinfected
and buried, and by order of the board of health the beds and
bed-clothing were burned. The occupants of all the cabins upon
the line of this branch suffered so severely with the disease
that they were abandoned. June 27, Hughes, the father of
the two girls who died upon the 17th, was taken with cholera,
and died on the followiug day; the third death in the same house, out of a
family of five individuals. July 1, cholera was declared
epidemic over the entire city of Birmingham, and it is now
impossible to give step by step tho progress of the disease,
for the spread of the disease was so rapid aud its virulence
so great that the physicians could take no time to record
cases. July 2, Mr. H., who was a
clerk in the city, but who slept at his home at Elyton,
distant two miles, was attacked with cholera, and died within
ten hours. The excreta of this case were disinfected with
carbolic acid and buried. No other case of the disease occured in
the village. July 4, an excursion-party of
about two hundred of the citizens of Birmingham visited Blount
Springs, some thirty-odd miles north, on the line of the South
and North Alabama Railroad. They spent the day in eating,
drinking, danciug, &c., and returned to Birmingham
about 8o'clock in the evening. Before daylight the next
day seven of their number had died of
cholera. July 7, a Mrs. H. had slight symptoms
of diarrhoea, and concluded to go to the house of her
father-in-law, who lived on the top of Thodes Mountain,
distant about eight miles. The next day she was taken with
cholera, and died in twenty-four hours. Her mother-in-law, who
nursed her carefully until her death, was taken with cholera
July 10, and died in twelve hours. The discharges from these
cases were received upon cloths, which were washed out, and
the water thrown upon the grass in the back-yard, but after
the arrival of a physician they were disinfected and buried,
and the beds and bed-clothing were burned. No other cases of
cholera were developed in this family, although several
members of it suffered from diarrhea. July 9, was called to see Lee
Anderson, the carriage-driver of Colonel T., who lived in an
elevated portion of the city, in which there had been to this
time no cholera, and found him with the symptoms of the
disease strongly defined. This man had remained well until he
had visited some of his friends at Baconsides. His system
responded to the remedies exhibited, and late in the evening
he had fully reacted, but the next morning at an early hour
was found fully collapsed. It was discovered that during the
night he bad several times left his bed and had gone to the
cistern on the premises for drink, and that he had several
dejections in the yard, which were not disinfected. He died in
a few hours. July 10, Colonel T., his wife, and
several members of his family, were taken with diarrhoea,
which, with the exception of Mrs. T., yielded readily to the remedies used. This lady, however,
fearing that the medicine might injure her sucking child,
concluded to dose herself with Simmon's liver-regulator, a
proprietary medicine much in vogue throughout the Southwest;
and the next day an attack of cholera was fully developed. She
however reacted, and for several days seemed convalescent; her
dejections contained bile; the secretion of urine was
re-established, but on the fifth day she sank and died. This
lady had been exposed to the disease by assisting in washing
and dressing the body of a Mrs. K., who had died of cholera a
few days previously in another portion of the city. The premises of Colonel T. was one of the few in
the city which were provided with cisterns of rain-water, and
the generous owner, thinking that cistern-water was the safest
for drinking purposes, allowed free access to his water-supply
to all in his neighborhood. In this portion of the city no
cases of tbe disease occurred until after the negro Anderson's
visit to Baconsides; but after his death the persons who used
this cistern-water, and the immediate neighborhood of Colonel
T.'s property, suffered as severely, if not worse, than any
other portion of tbe city. Tbe most popular hotel in the city, located close
to the line of the railroads, around which the disease
prevailed, escaped the disease. This house is built upon
pillars several feet above the surface of the ground, allowing
free ventilation. The drainage was admirable, the
water- It was observed during the course of the epidemic
that wind from the south and east, or that blowing from
Baconsides to the more populous portions of the city,
increased the violence of the disease and the rate of the
mortality, while when it came from the north and west there
was a decided moderation in the severity of the symptoms. Every shower of rain apparently aggravated the
disease. These showers were unaccompanied with thunder, of
short duration, and the subsequent heat was intense. It having been stated by some physicians of local
repute in the State that the disease which prevailed at
Birmingham was not epidemic cholera, it is proper to state
that the exhibition of the disease, both in its introduction,
its mode of communicability, and in all its symptoms, closely
and fully followed tbe history of cholera as it is laid down
by authorities. The active treatment of tbe premonitory diarrhoea
was most successfully instituted, and the general expression
of the profession of this city is that in not a single
instance where this stage of the disease was treated, and
where tbe patient followed fully the orders given, did the
disease advance to its second stage; and so marked was this
immunity that it is desired to add to the testimony on record,
that by proper precautions, and the observance of hygienic,
laws, cholera attendants may enjoy tbe most perfect security
from the disease. Tbe treatment adopted was tbe opium and mercurial.
When tbe stomach seemed so inactive that nothing made any
impression upon it, an emetic of mustard, salt, ginger, and
pepper, suspended in hot water, in many cases produced a warm
glow over the surface of the body in a few moments. For the
relief of cramps which would not yield to ordinary remedies, a
number of dry cups applied from the neck to the sacrum, over
the spine, in every case in which they were used furnished the
desired relief. The use of iced water ad libitum was found
injurious; in many instances the unrestrained gratification of
the thirst was followed by a fatal relapse. Ice and ice-water
in small quantities and at short intervals was
found most useful. Many of the cases were complicated with
urraemia, and the majority of these died, although they were
carefully treated. Diuretics produced no good results. No
condition in life, sex, or age escaped. The sucking babe and
those of extreme age suffered alike from its ravages. Before closing this paper, justice demands that we
should briefly allude to the heroic and self-sacrificing
conduct, during this epidemic, of that unfortunate class who
are known as "women of tbe town." These poor creatures, though
outcasts from society, anathematized by the church, despised
by women, and maltreated by men, when the pestilence swept
over the city, came forth from their homes to nurse the sick
and close the eyes of the dead. It was passing strange that
they would receive no pay, expected no thanks; they only went
where their presence was needed, and never remained longer
than they could do good. While we abhor the degradation of
these unfortunates, their magnanimous behavior during these
fearful days has drawn forth our sympathy and gratitude. In closing this brief record we desire to state
that, in tbe experience of our observations, facts will not
justify us in believing that any local conditions of the soil,
or peculiarity of climate, or moisture of the atmosphere, or
masses of decomposing debris, either animal or vegetable, can
in or of themselves produce the specific poison of cholera,
"but they are the hot-beds in and on which the cholera
excretions having been placed, the poison is reproduced with
fatal rapidity." Birmingham, Ala., August, 1874. Transcribed by C.
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