Root to J. P. Root , Present, September 7, 1872

No. 74. Mr. Root to Mr. Fish.

Sir: In one of my last dispatches I alluded to the epidemic of smallpox which was raging with fearful results in Santiago, and suggested that perhaps at a later day I might give some account of the same, and inasmuch as the head of this legation has had more or less connection with the public endeavors to stay the progress of the pestilence, it may not be improper for me to give a partial history of his acts and their results. Having my family with me, of course felt all the personal interests attaching to that circumstance, and as some months since the small-pox assumed an epidemic form and threatened to prove of a most malignant character, I felt deeply the need of the adoption of some active sanitary measures to stay the spread of disease, but desired to prevent unnecessary personal notoriety, for which purpose I wrote some articles suggesting sanitary changes which appeared in the daily papers accredited to other sources, but as the disease assumed more and more terrible proportions, I hesitated no longer, but offered my professional services publicly and privately. My letters to the intendent and other articles published from time to time, together with complimentary letters received from various sources, and a few only of the many similar notices taken from the newspapers, the copies of which I inclose, will give you a general idea of my connection with the epidemic, and the manner in which the same is viewed here, all of which I trust may not be deemed unworthy of the representative of my country.

The disease early assumed a very malign ant form, seeming to pay but little heed to the usual preventives to the malady. As, for example, all the members of my family had been previously successfully vaccinated, and three times during my life had vaccination “taken” most thoroughly on my own person, the last time only a few months since, yet three of my children and myself were victims of the epidemic, though, tnanks to early and active treatment, none of us were long or severely ill. At the present time there are only a few hundred in the hospital. Nearly 50 per cent, of the adults attacked have died, and the mortality among children has been much greater.

My previous professional life as a physician and surgeon in civil and military life had given me an opportunity of knowing something of what should be done in such a trying emergency as the one alluded to, and I felt perfectly free to give all with whom I came in contact the benefit of the same. As well from visiting hospitals, attending meetings of the society for the care of “lazaretos,” &c, I have attended a vast number of the poorer classes who dislike to go to the “lazaretos, (small-pox hospitals,) and who were too poor to pay a physician. (It is unnecessary to state that all my services have been gratuitously given.) While confined to my room with the disease, I was daily visited by parties who described the symptoms of their friends sick with the prevailing epidemic, and whom I “doctored” by proxy, sending them advice and medicine from my room, and since my recovery, as well from visiting a large number as above alluded to, I have daily by proxy medicated great numbers in remote parts of the city. Since commencing this dispatch, a young mail just commencing the study of medicine has called to consult me touching a case I placed him in charge of this morning. This young man has for more than two months been similarly engaged. It is very gratifying for me to know that all whom I have treated, either directly or indirectly, have completely recovered or are out of danger. My system of treatment may be found in some of the articles which I inclose published in newspapers. They have been very generally copied by all the papers of the country, which, with the exception of the one from which said articles are cut, are printed in Spanish. Though full reports have not yet been made, it is fair to state that many thousands have died during the epidemic.

It is very creditable to the generosity and philanthropy of this people to be able to say that all classes of society lent a helping hand, and vied with one another in the Christian work of saving the sick and staying the scourge. The President of the Republic, and his Ministers, the Intendentes of the city, the Clergy, the Sisters of Charity, together with the physicians and students of medicine, gentlemen and ladies from all quarters, in person or with their money, assisted in the great work. The President and Intendentes in person often visited the lazaretos, thus setting a noble example to those in the lower walks of life.

At one time there were more than twelve hundred daily reported in the lazaretos, and probably, at the same time, an equal number were sick in private dwellings.

From my observation and experience in this epidemic, and in previous years, I trust I may be excused for saying I am thoroughly convinced of the importance of the suggestions found in my articles, copies of which are inclosed. In fact, I am perfectly satisfied that by carefully following the indications therein found, every ease of small-pox may be cured when seen early in the disease, no matter how malignant its character may be. The grand idea never to be lost sight of being to destroy the poison of the disease both inside and outside of the body, and at the same time support the strength of the patient, and by following the rules referred to not only will all recover, but no pitting or other mark whatever of the disease will remain in any part of the body and the patients thus treated will not be confined to their beds except for a very few days, and frequently, as I have had cases, never take their beds at all, except at night, suitering no pain or especial inconvenience after the system is once thoroughly under the influence of the remedies prescribed, only requiring care for some weeks not to take cold, or otherwise expose the system by overt acts of any kind, for in this, as in all other exanthematoas diseases, there is danger of some one or more organs of the body becoming disabled through lack of care after convalescence is supposed to have given place to perfect health.

The copies inclosed are marked A, B, C, D, E, F, G, H, J, K, L, M. N, O.

I have, &c.,

Saturday, June 22, 1872. In our issue of the 15th instant we informed our readers that the Hon. J. P. Root, minister plenipotentiary of the United States, had generously offered to lend his-professional services toward checking the ravages of the present terrible epidemic of small-pox in Santiago; and we have now the pleasure of presenting to our readers the following highly interesting report, presented by that gentleman to the indefatigable Intendente of the capital, Don Benjamin Vicuna Mackenua:

“Santiago, June 16, 1872,

“To the Intendente of Santiago, Don Benjamin Vicuna Mackenua:

Dear Sir: In accordance with the resolution passed yesterday at the Intendencia, I have this day visited the lazarettes of Santiago, accompanied by Captain Castro, who kindly presented me to the directors of the various establishments visited, and by the, Rev. Mr. Ibanez, who examined with me each room occupied by the sick of the smallpox, as likewise all the departments annexed to the lazerettes My desire to set forth some of the principal facts connected with my visit of to-day as briefly as possible will be my excuse for anything that may be hasty in this report, since I consider it to be of vital importance that some changes should be made immediately in reference to the condition of the lazerettes, which are at present crowded with the victims of the terrible scourge that now afflicts this city.

“The first place visited was the hospital of San Rafael, situated in Yungai, opened yesterday, which contained on my leaving it twenty-six sick persons, two having been received during my visit. The hospital is under the charge of a doctor, who visited it at 9 a.m., and who, it is expected, will visit it the same hour every day. There are four male nurses, two for the day and two for the night, and one female nurse, who has under her special charge a sick boy, her own son; there are, besides, a steward, two watchmen, and a cook. There are two wards containing sick, and it is believed that when they are full they will contain seventy beds. The wards at present occupied are well ventilated, and the air was comparatively pure. I should not omit to state that four medical practitioners, possessed with love toward humanity, and impelled by their holy calling, lend their services there night and day; it being worthy of observation that in this hospital only have we found professors of medicine. The hospital and its appurtenances presented a good appearance, and all there appeared to be entering on their work of charity with a spirit that awakens hope for the well-being of the sick under their care.

“Saviour’s Hospital has one hundred and sixty-two sick; seven died during the last twenty-four hours, and twelve were admitted during that time. Four Sisters of Mercy assist there continually, and personally administer the medicines, besides attending to the general administration of the hospital. There are eleven nurses, seven for day and four for night service. There are seven wards occupied. A greater proportion of children die than adults. There are at present thirty children here. There is a cook who works under the immediate orders of a sister especially charged with the kitchen. There are no other nurses than the servants.

“The wards are swept once a day, and the floors washed only when and where any impurity falls upon them. The building is a large house with two floors, with passages which traverse it centerwise, and corridors to both floors. The position is good, there being no other buildings near; nor is there any reason why the sick should not enjoy a wholesome atmosphere; but the air of the rooms is in a terrible condition, sufficient of itself to produce the most serious results even in a perfectly healthy person, it being difficult to understand why the mortality, at present so appalling, is “not even greater. The building, notwithstanding, can easily be converted into a lazarette of the first class, where, with the proper attention and suitable medical assistance., almost all the sick should recover. The rooms are all clean; each one, however, containing double the number of patients it ought to have. When it is ventilated as is thought proper, as was said, during the day a door or a window is opened from time to time, though this was done rarely during my visit, which took place about 12 o’clock on a beautiful day. At night the rooms are all closed, so that no fresh air can enter, the poisoned air within not being allowed to escape. The beds are all occupied, and thirty of them are without bedsteads. There was no doctor present or near. Up to the present time no disinfectant whatever has been employed. The bodies are buried every other night, being kept in the mean time in a ventilated house at a few yards distant from the principal building. The doctor in charge of the hospital was absent, but on a commission of the in tendency.

“The hospital of San Francisco de Borga contains 470 sick, 150 of them being children, many yet suckling. Seven died during the last twenty-four, hours; the day previously, 24.” The number of sick received during the last day has reached 30. There are nine wards, each one of which is under the charge of a Sister and two female nurses. There are twelve washerwomen, ten night-nurses, besides two Sisters, four female cooks, with two Sisters who direct them, one mattress-maker and six seamstresses, and six men-servants for the work in general. The wards are cleaned thrice a day, and some disinfectants are employed. Ventilation is comparatively good, and the yards extensive, which supply pure and wholesome air. The bodies are buried every night. The terrible mortality of this hospital cannot apparently be attributed to want of attention on the part of the self-denying Sisters who, moved by charity, lend their services to suffering humanity. The Lady Superior stated that there was yet a surplus of a hundred beds. There was no doctor present, though one or more daily visit the hospital.

“The hospital of La Maestranza contains 152 sick. Although we waited nearly half an hour, the only person who appeared in charge of the hospital was the porter, who, after taking a turn all round the establishment, said that he could not find any one that we could speak to; that the three sisters in whose charge the establishment is, must have gone out. In view of this, we suggested that he should show us the wards. Of these there are five, completely crowded, dark, ill-ventilated, and full of a terrible and extremely pestilential smell. We had to retire without having been able to obtain any satisfactory data, and under the impression that this sad establishment needs a prompt and complete renovation.

“To sum up, allow me to add that, in my opinion, there should be an immediate change in the treatment of the variolose; as likewise an early preparation of new buildings dedicated to the reception of those victims of the small-pox who apply to them in search of medical assistance.

“It is astonishing to see how little attention has been paid to the use of disinfectants for the purpose of destroying the deleterious emanations proceeding from the sick. Not a single case has been shown me in which all the body of the sick has been cleansed with any kind of bath, except when convalescence has so far been established that the patient is at the point of leaving the hospital. Thus the sick have been left to struggle against internal and external accumulations until, owing to good luck or a robust constitution, the sickness has been overcome, and the patient is allowed to withdraw from the putrid exhalations that have saturated his skin for days and weeks together. Bat I have neither time nor space to enter into details. An important fact, notwithstanding, I should not pass over, and that is, perhaps, with a single exception, that all the drains into which are thrown the vomits, the evacuations, and all kinds of contagious impurities, pass through, more or less, considerable portions of the city, producing thus an inevitable source of this malignant and mortiferous disease. This should at once be remedied, a thing not difficult to do. The same thing is taking place, likewise, in all parts of the city, where there probably exist at present thousands of cases of variolose; and what is surprising is that the disease has not spread more rapidly among all classes of society. A scab of the small-pox thrown into a drain may readily be carried miles off and find a multitude of means to produce contagious effects in persons far from its starting-point.

“That these matters, as also others of greater importance, may be placed under the control of the authorities, is a strong argument in favor of suitable places being immediately prepared, in order that those persons may be transferred to them who are suffering in their houses.

“Have the goodness to excuse the frankness of some of my observations, a frankness which proceeds from a sentiment of charity toward my fellow-creatures.

“In concluding, allow me to suggest that the three great things that should be done are: 1st. To restrain immediately the development of the epidemic, visiting every house, and obliging every person not recently protected by vaccination to receive the cow-pox, employing force, if necessary. 2d. To cure the already immense number of sick, making use of all the science, wisdom, and philanthropy that are within reach. 3d. Cleanse perfectly streets, yards, drains, &c, to prevent the same or another disease in future. And as all these things require immediate attention, every good citizen should contribute with his best efforts, and thus co-operate with the indefatigable Intendente, who is giving an example worthy of being imitated, and to whom I have the pleasure of offering anew my humble efforts in all that which is connected with the sad crisis through which the beautiful city of Santiago is passing.

“May all extend a helping hand, adopting the golden rule of doing to the brother in humanity as they would be done by, and then purity, health, and happiness will return, and the beautiful light of the sun will disperse all the clouds which now obscure and sadden our sky.

“With sentiments of the highest consideration and esteem, I remain, your obedient servant,

“J. P. ROOT.”

We regret to say that the United States minister, the Hon. J. P. Root, is suffering from an attack of small-pox, contracted during his indefatigable efforts to combat that fell complaint while acting in his self-imposed capacity as a member of the board of health, in Santiago. We learn from a private source that the attack from which Mr. Root is suffering is of a mild form, and we are, therefore, glad to say there is no ground for alarm. The illness of the honorable gentleman has elicited the sympathy of the entire population of the capital, as it will most assuredly do from all our readers, both far and wide, who are already acquainted with the eminent and disinterested services he has rendered to suffering humanity during the prevalence of the present epidemic in the-capital.

Small-pox is raging with unabated vigor in Santiago and the adjoining districts, but the energetic measures adopted by the Intendente, and in which he has been nobly seconded by his fellow-citizens and many foreigners, notably among the latter the United States minister, the Hon. J. P. Root, are beginning to tell favorably, for, although there is little or no diminution in the number of cases, there is a decrease in the rate of mortality.

a few suggestions for the treatment and cure of small-pox patients,

To the Intendente of Santiago, Don B. Vicunã Mackenna:

In an epidemic like the one now in progress in Santiago, fear is always a promoter of the spread of disease, and the almost direct cause of the death even of multitudes. Therefore, while the community in general should be stirred to the greatest extent as regards its duty in warding off the pestilence and caring for the afflicted, the victims thereof should, from the first, be made to have full confidence in their speedy and safe recovery; and their confidence must be inspired by all those coming in contact with them, not only by words, but by looks, actions, and surroundings; the object of treatment and care being, in the language of the great physician of Galilee, to save life, and not destroy it.

It has been said that some one in one of the hospitals of Santiago has been in the habit of telling those that are brought thither that they must at once prepare for another world, as they will never leave the hospital alive. Such a view of the situation, from such a source, is sufficient to make the life of the unfortunate sufferer very short in this world. The person alluded to, however, deserves a great deal of credit for honest efforts; and right here I will say that those parties who are devoting their energies and their lives to the curing of the sick—toiling night and day amid far from sweet and pleasant scenes—are offering prayers that amount to something, their faith showing itself by their works. Science, however, should step in and give direction to the truly Christian labors of love of these individuals, whose works of self-denying charity will surely find their reward, as no good deed, in wisdom performed, was yet even forgotten or ever can go unrewarded. But never frighten the sick; fear is a most depressing agent, and the hospital should be made an attractive place, where pleasant thoughts may be engendered, a pure air breathed; where smiles, and hope, and joy, and gladness may mingle in all that appears; everything which can help to enliven and strengthen the prostrated energies of the patient, and dissipate the sad thoughts and fearful forebodings incident to a weakened condition of body and mind, should be cultivated in the hospital. The aim should always be to make everything connected with the place devoted to the curing of the sick perfect in all their parts. Not an impure spot should be allowed anywhere from which an unwholesome emanation can arise. Not a tainted breath should be permitted a second time to enter the lungs of the sick, but the currents of air should be so arranged that each breath loaded with disease may be taken at once beyond the contact of any one into the outer air, and fresh air supplied in its place. It is surprising what a vast amount of disease is thrown from the lungs of an invalid in the act of breathing, and how soon a room ill-ventilated is poisoned thereby; therefore the importance of continued and active efforts in this direction. The air of the sick-room must be kept constantly perfectly sweet and pure, so that not even the slightest unpleasant odor can be noticed. In order that this may be the case, an easy ingress for fresh air, and an equally easy egress for foul and tainted air, must be had, and all so arranged that unpleasant currents may not strike directly upon the patient. A quite strong current of good air, however, is infinitely safer to be in than to be obliged to breath over and over again an atmosphere poisoned by the diseased exhalations from lungs, body, bed, &c, as is too often the case; and this condition of pure air must continue during the night as well as day. To ventilate properly, the air must enter near the floor of the room and go out at the upper part; and where rooms are not thus provided, the fault should immediately be remedied, a task not difficult; but, whether difficult or not, it must be done at once, care being taken that the air entering from the lower parts through the walls of the room comes from a pure source, the great fact being kept in view that the patient must at all hazards breath nothing but a continually pure atmosphere. The walls and ceilings of rooms should always be white, a thing easily done by whitewashing. The temperature also of the room is of great importance, and can only be regulated by artificial means. At this season of the year fires are very necessary, so that, without closing the room, and thus preventing a free circulation of fresh air, the atmosphere of the apartment may be kept constantly at an even temperature, the heat being regulated by a thermometer in each room. Heat from an open fire-place, with a good chimney, is preferable, but a stove is the next best thing where the heat cannot be obtained from pipes or ranges, heated by steam or hot air. Heat materially assists in the ventilation of the room, the heated air rising and passing out at the upper part, carrying with it the impurities in the atmosphere. The brasero is a very unsafe and even dangerous source of heat.

It is often the case when the vital powers are exhausted in some of the later stages of disease that the patient dies from lack of heat; an hour’s cold, in a large hospital, caused by the sudden change of the temperature of the air, no provision having been made against its effect, may cause the death of a large number who otherwise might have recovered.

It is important that a hospital should be located, if possible, apart from the thickly settled portions of the city. The location of the “Hospital del Salvador” is fortunate in this particular, and the building now occupied might be made very serviceable by being arranged in accordance with the above suggestions.

It is of great importance that disinfectants are constantly used in and arround all hospitals, not only the yards, the houses, the rooms, the floor, the beds, but the patient must be constantly cleansed from all poisonous and infectious emanations. The object should be to destroy the poison both in the body and out of it; the first by proper remedies properly administered, and the second by a variety of appliances and precautions. Fire, the surest destroyer of contagious matter, should be used for all articles not possible to be cleansed by other means. Nothing should be swept or thrown into any corner, or allowed to remain in waste-heaps; but all filthy rags, sweepings of rooms, &c, should be instantly burned. Never bury any article or throw it into an acegnia. All vomits, evacuations, washings, &c, not subject to be burned, should be thrown into a deep hole in the ground, in which quicklime, strong solution of sulphate of iron, carbolic or other acids, or other appropriate articles, are constantly kept, sufficient in amount and strength to destroy at once all contagious influences; and the hole, when partially full, thoroughly covered, and a new one opened; but never should anything unhealthy be thrown into an acegnia, even though it runs directly into the country, the constant effort being to annihilate both the disease and its possible future effects.

The sick-room should be the object of constant and unremitting care and attention; it is not enough to purify once each day; every moment the condition of the atmosphere must be watched, and wherever and whenever an unpleasant or foul and unwholesome odor or influence is observed, at once it must be eradicated. Every part of the room should be constantly so sweet and pure that the most fastidious could detect nothing disagreeable. In the severest cases the sheets and the shirts of the patient should be changed every day and the whole clothing of the bed often aired and purified, that the diseased accumulations maybe removed as speedily as possible; every article being thoroughly disinfected, either by fumigations, washings, or otherwise, before being used the second time, and all being thoroughly fresh, sweet, and dry before coming in contact with the patient. The floor, walls, ceilings, bedsteads, and furniture of the room need constant cleansing and purifying, so that the air, when coming in contact with them, cannot be vitiated thereby. Some of the best disinfectants for the purpose are carbolic acid, chloride and other preparations of lime, together with many other articles commonly used for this purpose.

As regards the medical treatment of the small-pox patients, no special rules can be given which will meet the wants of every case, therefore it becomes necessary that a scientific physician examine carefully each patient very often, that each change may be noted, and the treatment modified to meet the sometimes rapidly changing phases of the disease, as a few hours lack of proper attention may decide the fate of the invalid.

The first thing to be done with patients when attacked with small-pox is to revaccinate them properly with virus known to be good, no matter whether they have ever been vaccinated previously or how recently. The philosophy for this treatment I have not time to give, but of the beneficial results I have no doubt, and it should be done at anytime previous to the suppuration of the small-pox pustules; after this stage its efficacy is perhaps questionable, though even then it can do no harm.

There is not a single stage of the disease when the bathing in some form of the entire body every day, and sometimes oftener, is not absolutely necessary. This operation, however, must he performed with the utmost care, and not left to the charge of ignorant or careless nurses, else dangerous results may follow. The skin is one of the great emunctories of the system, and the amount of waste and diseased matters thrown upon the surface of the body is truly wonderful. Nature exerts itself to the utmost to get rid of the poisonous matters that circulate in the body in various ways, but constantly by means of the lungs and the skin. I have already shown how the impurities thrown from the lungs by the act of inspirations may be disposed of in a harmless manner, through the means of perfect ventilation. It becomes as necessary also to dispose of the emanations from the skin, which, by being allowed to accumulate around the body, not only prevent the free exit from the surface of the body of other vile and diseased matters, thus by force preventing the escape from the system and obliging the poisons to continue in the circulation, with all their fatal tendencies and actual effects upon the vital forces of nature, but contaminating the clothing, air, and everything coming in proximity with the person, as well as poisoning the atmosphere further, thus forming a sort of endless chain of poisonous influences, which, entering through the lungs into the circulation, and thence after a time finding their way to the surface, again contaminate the air destined once more for the lungs, and so on; this must be avoided. The time and mode of bathing must be directed by the physician in charge, and whether it shall be cold, tepid, or hot water, or whether ice in various ways may be used, must depend entirely on circumstances; whether the bathing shall be with strong or weak acids, of an alkaline character, or of water alone, must also be subject to the decision of the time, but some one of these it is necessary to use every day, that the emanations from the skin may be thoroughly cleansed therefrom. Sometimes a mixture of chalk and water, or chalk, charcoal, and water, may be used on the entire surface of the body with decidedly beneficial results; also an ointment of chalk, charcoal, and sweet-oil, in certain stages may be of benefit, having a decidedly disinfecting and healing effect upon the suppurating surface.

It is impossible to specify what remedies shall be absolutely given, as each case must be treated upon its own merits, and whoever prescribes a wholesale treatment, applying the same to each and every case, will see his patients die on his hands. There is no specific for small-pox; that which comes nearest to this is perfect purity and cleanliness of everything connected with the patient. The medicines most of service are those of a supporting and cleansing, or antiseptic and stimulant character; all debilitating remedies are worse than useless. Severe purging is very dangerous. Enemas of various kinds are frequently indicated, and in a multitude of ways may be advantageously used. This is often a popular method of introducing antiseptics into the system, as well as by the mouth.

The internal administration of antiseptics and disinfectants, such as “crystallized phenic acid,” is of vast importance; also chloride of potash dissolved in water; chloride of sodium (common salt) dissolved in water, with an addition of acetic acid, (common vinegar answering,) or citric acid, (the juice of the lemon serving a good purpose.)

The carbolic acid as an antiseptic, deodorizer, and disinfectant should be largely used in various ways in and around the hospital. An excellent method of purifying a room filled with unpleasant and infectious emanations is, with an atomizer (an instrument which, by a rapid current of air, separates fluids into minute parts) to throw the vapor of a mixture of carbolic acid and water and a very little alcohol (the alcohol assisting in dissolving the carbolic acid) into all parts of the room, beneath the bed, and in all corners and places where there is any impurity whatever; this should be done several times each day. Whenever the floors, walls, vessels, or furniture of the sick-room are washed, carbolic acid should be put into the water; its daily use in strong or weak solutions for bathing all parts of the body is highly beneficial.

When there are hemorrhagic tendencies, the oil of turpentine may be given with good results. Quinine and other articles of its class are indicated when the strength seems failing from exhaustion, and it is always better to be too early than too late in their administration.

Acidulated drinks of various kinds are usually very grateful to the patient; sometimes, however, those of an alkaline character are indicated; weak lime-water with water of roses, or even a chalk mixture, or, as before observed, a solution of the chlorate of potash, are often remedies of very great service, and are more frequently indicated than acids.

Suppurated surfaces artificially made upon the chest or other portions of the body have often prevented an excess of pustular pitting upon the face. When this operation is performed upon the chest, its tendency is also to prevent lung complications. An ointment made of sweet oil, charcoal, and wax, and placed upon the face and neck, is a favorite remedy with some, to prevent pitting in those places.

As much sunlight should be obtained in the room as the eyes of the patients can tolerate, and if some of them are too sensitive, owing to the location of their beds or other cause, it is better to use shades for them than to exclude all the light from the room, as the rays of the sun are great promoters of health. The statement that pustular inflammation is seriously aggravated by the light is not well supported, but if there is danger of this, it is better to cover the exposed surfaces with the ointment above alluded to, or to cover the same with oiled silk, making holes for the eyes, nose, and mouth, rather than lose the health-giving effects of God’s pure sunlight.

Great care should be taken that not too many patients are crowded into each room, as in this condition it is impossible to obtain a sufficient amount of fresh air for the use of all; aside from this, it is important that patients should not be inconvenienced and disturbed by the condition of their neighbors, as the mind has much to do with the restoration of health; and when it is impossible to prevent the death of a patient, the scenes necessarily connected therewith should be excluded as much as possible from the other inmates of the room.

All persons attacked with small-pox should at once be placed under the care of an intelligent and attentive physician.

Sometimes wines and other similar stimulants maybe used with good effects, but their indiscriminate administration cannot be too strongly deprecated. Diffusible stimuli, like the carbonate of ammonia, are often of great service. No preparation of mercury should be given. A multitude of medicinal and remedial agents might be named, and their use commented upon, but the fact that from time immemorial educated physicians have never agreed upon the exact remedies suitable for the treatment of this disease is a strong argument against placing too much reliance upon the beneficial action of any one article of medicine; but experience has satisfactorily demonstrated the efficacy of what may be called the hygienic treatment, and that when certain great sanitary principles are carried out, such as are intended in this article, a very small percentage of small-pox patients will die; but when there is a failure in this direction, no matter what the medical treatment may be, a very large percentage must die.

The general rule, therefore, is to support the patient from first to last, obliging perfect purity and cleanliness to be observed on all sides, being careful not to push medical aid so as to interfere with nature’s operations, but only to follow her indications, and assist instead of hindering her efforts to drive out the foreign enemy that has taken forcible possession of her territory; thus nearly all those taken with the small-pox will recover. Those only need have any fears whose constitutions have been broken down by severe dissipations of any kind.

As regards diet, the patient should be fully nourished, but in the early stages the food should be free from oily substances, which will not be readily digested, and only tend to produce increased febrile excitement, and perhaps tend to prepare the way for intestinal complications. At this stage also the stomach loathes this class of food, an indication that it is not needed. But, during this period, the diet should be largely of boiled rice, or similar articles of food, with broth without a particle of grease. The patient should be strongly encouraged to use quite freely rice-gruel and a thick mucilage of gum-arabic for drinks during the entire disease, being careful that they are always pure and fresh, and preserved for use in apartments not occupied by the sick, as fluids have the power of absorbing impurities from the atmosphere. All drinks may be cold or hot, to suit the taste of the patient. If the stomach is not crowded with articles too oily or difficult of digestion during the early stage of the disease, it will readily digest more supporting food a little later. Nourishment should be given with as great regularity as possible, though no arbitrary rules can be followed in this or any other plan of treatment; therefore, as has been previously observed, each patient must be the object of especial care on the part of the medical attendant, as well as of all his assistants.

The above presents a general view of the proper treatment of small-pox patients, the adoption of which will cure those already sick, and prevent the spread of the contagion from the persons of those being cured.

It will be very apparent from the foregoing somewhat hastily written suggestions, that the labor absolutely necessary to be performed in the cure and treatment of small-pox patients is far from being light; the number of assistants required should be in proportion to the service demanded. The number of nurses should be such that they should not be exhausted with overwork or watching, as it is all important that those coming in contact with the sick and feeble should not only be free from disease themselves, but be able to impart from their own pure, healthy, strong, and vigorous constitutions, life-giving influences. The weak, diseased, and those lacking life and energy, should never, if possible to avoid it, attempt the cure of the sick. A cadaverous face with tottering limbs and a trembling hand, cannot successfully combat disease and debility. The presence of the elastic step and smiling, joyous face, together with the touch of the steady hand of the strong and healthy, carry hope and actual life to the suffering invalid. There is a nervo-magnetic fluid circulating in all our bodies which is imparted to a greater or lesser extent to those with whom we come in contact, and its effects correspond in a great degree to the conditions of our own persons and lives.

He who saves his patients and they who labor under his guidance occupy no easy position; their tasks during such trying epidemics as the one now afflicting this country are arduous in the extreme, and strongly test their moral, mental, and physical capacities. All such parties should be freely and liberally sustained by the community at large. It speaks well for Santiago that there are so many who are most philan-thropically giving all their energies to this noble work.

Christ, the great physician, commanded his followers to “pray without ceasing;” I believe that, whether they think it or even desire it, the labors of the faithful, self-denying physician, assistant, and nurse, passing quietly yet firmly through danger, disease and pestilence, are not excelled in their Christian character by the acts of any other human beings. If they do their duty, no matter what their mouths utter, their hearts, brains, and hands mutually unite in working out unceasing prayer most acceptable to God and humanity. I have written the above in plain language that it may be easily understood by all.

The Hon. J. P. Root, though scarcely convalescent from his recent attack of smallpox, has again taken his seat at the board, and a few days ago he visited all the hospitals in company with Dr. Aguirre, and we are happy to say that his inspection has been the means of introducing many beneficial reforms in the lazarettes.

The representative of the United States, Mr. Root, has contributed in a great measure to manifest to the authorities the true condition of the lazaretos, (small-pox hospitals,) and the best means to combat the epidemic.

Mr. Root has visited all the places of contagion, in many of which the Sisters of Charity lend their important and pious services.

The self-sacrificing conduct of the North American minister is a demonstration of his sympathetic sentiments, and his opinion is a most valuable assistance in the present situation.

The Honorable Mr. Root, minister of the United States, is now sick with the small-pox. Mr. Root has examined, visited, and Carefully studied all the lazarettos of the capital with an indefatigable constancy. The public health owes him a great debt of gratitude, and the epidemic, of which to-day he is a victim, has found him among its most vigorous adversaries.

Mr. Root possesses a grand spirit and a grand heart. The men of science have been able to judge his works as above science. All noble souls have been able to estimate the spontaneity of his services. Representative of a friendly nation, he has contributed with the sacrifice of his person to manifest the lofty sentiments of that nation.

This time diplomacy has taught humanity, and humanity self-denial. Mr. Root has been wounded on the field of battle. There is nothing more honorable than the scars of war.