A very famous case in epidemiology and cholera:
http://www.winwaed.com/sci/cholera/john_snow.shtml
Also:
The English response to the 1832 Cholera Pandemic is historically significant. In mid 1831 with cholera's "terror" loose on the continent and approaching the British Isles, the government established a board of health within the Royal College of Physicians. This Central Board of Health was proclaimed in June of 1831 and consisted of seven physicians, the comptroller of the navy, a deputy of the Board of Customs, director general of the army's hospitals, and several other similarly important officials. Among its first proposed recommendations, rules, and regulations, applicable to each town and village, was "there should be established a local Board of Health." Local boards were to consist of the local chief magistrate and clergymen, one of whom, would serve as a correspondent with London's Central Board of Health. Additionally, ". . .in each town or its neighborhood," temporary hospitals were to be established to which ". . .every case of the Disease as soon as detected . . ." might be removed. Finally, "The Houses from which the Sick Persons had been removed should be purified in the following manner. The wearing apparel and household furniture should be thoroughly washing and scoured, the walls and ceilings lime washed, the doors and windows of each apartment left open for many days . . ."
[xx] Eventually, over 1200 local boards of health (822 in England and Wales, and about 400 in Scotland) were established in Great Britain.
[xxi]
AND:
Most physicians felt that cholera was particularly susceptible to medical management during its Premonitory stage. The onset of lesser stomach spasms and "painless" diarrhea was considered not part of the disease but a precursor; if prompt medical attention were received, individuals could escape, prevent, or otherwise avoid the disease. It was "not improperly termed the curable stage."
[xxxiv] The Premonitory stage, and the medical community's fixation that it could be managed, was erroneous. The "curable stage" was simply one of the many common "stomach upsets" other than cholera. The conclusion that cholera was curable was based upon a faulty premise: all similar symptoms are the same disease and were related.
Treatment of the first stage (Premonitory) of cholera consisted of confining the victim to bed and the taking of some warmed mild aromatic drink such as spearmint, chamomile, or warm camphor julep. Once the individual had commenced to perspire, calomel, camphor, magnesia, and pure castor oil was administered.
[xxxv] If the cholera victim had recently consumed food, an emetic such as ipecacuanha or sulfate of zinc was given. It was also recommended that bleeding of the victim be performed. "The object of the bleeding is to relieve the internal congestion," and should be discontinued if the victim faints.
[xxxvi]
During the second stage, which 19th century medical professionals considered the actual onset of cholera, treatments were intensified. During this stage, as cholera's victims suffered excruciating nausea, massive diarrhea, cramps, physical collapse, cold clammy extremities, and a feeble pulse, medical therapies included, "put the feet and legs in water as warm as could be born, with the addition of mustard and common salt to the water; open a vein in the arm, and bleed from five, to sixteen to twenty ounces . . apply a large mustard cataplasm over the stomach and give . . .calomel, opium, an camphor, every half hour." If the patient continued to deteriorate, and was there any reason to think he would not, "Sulphuric ether in small doses should be given . . .at the same time an enema of a pint of chicken tea, with a table spoonful of salt . . .should be thrown into the bowels . . ."
[xxxvii]
Few persons survived cholera's third stage which was sometimes called the "stage of asphyxia." The principle of treatment during this portion of the illness was to "arouse the dormant energies of the system." Larger doses of calomel and camphor were recommended; in addition, quinine and morphine were to be administered every half hour, and "a cholera patient . . . should never be left a moment without the presence of an intelligent nurse."
[xxxviii]
If the patient survived the treatments prescribed for the third stage, further bleeding or the attachment of leeches was recommended for the fourth stage. More calomel, magnesia, camphor, opium, and morphine pills were given, and if during this stage of cholera, "consecutive fever" or typhoid appeared, "it may be necessary to resort to tonics and stimulants such as sul. quinine, serpentaria, carb. of ammonia, wine whey, oil of turpentine, etc."
[xxxix]
Variations upon these therapies were as numerous as there were physicians. Some treatments emphasized exterior stimulants to the system, in hopes of energizing the collapsing patient, by rubbing the victim's body with rebefacients, the most common being combinations of mustard, oils of turpentine, and cayenne pepper.
[xl] Other physicians routinely recommended immense dosages of calomel, a chalky mercury compound, until the victim's gums stared bleeding. The most common, and considered as conservative therapies, always included some combination of calomel, opium (laudanum), and bleedings.
More exotic and radical treatments abounded: tobacco smoke enemas, electric shock therapy, beeswax/oilcloth plugs forced into the victim's rectum to stop the diarrhea were among the most distressing encountered.
[xli] Curiously, at least one physician, New York City's Dr. W. Rhinelander, located at 342 Broadway, suggested in July of 1832 that cholera could be treated by the infusion of saline solutions into the victim's veins.
[xlii] Such a treatment along with a regimen of attendant antibiotics is the preferred therapy for modern cholera victims. When treated early the fatality rate is very low.
I got the above from:
http://www.earlyamerica.com/review/2000_fall/1832_cholera_part1.html
Cholera is particularly interesting in that it hit the North America and Britain at a time when they were poised for action by science and public health organizations rather than by individuals.
Hope this helps.
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