SNIPPET: (Manchester) - "I had requested the younger members of the staff, charged with the visitation of the outpatients of the infirmary, to give me the earliest information of the occurrence of any cases indicating the approach of cholera. I had a scientific wish to trace the mode of its propagation, and to ascertain if possible by what means it would be introduced into the town. My purpose also was to discover whether there was any, and if so what, link or connection between the physical and social evils, to which my attention had been so long directed. A loop of the river Medlock swept round by a group of houses lying immediately below Oxford Road, and also on the level of the black, polluted stream. This was a colony of Irish labouorers and consequently known as Irishtown. I was requested by one of the staff of the outpatients of the infirmary to visit a peculiar case in one of these cottages. On my arrival in a two-roomed house, I found an Irishman lying on a bed close to the window. The temperature of his skin was somewhat lower than usual, the pulse was weak and quick. He complained of no pain. The face was rather pale, and the man much dejected. None of the characteristic symptoms of cholera had occurred, but his attendant told me that the strength had gradually declined during the day, and that, seeing no cause for it, he had formed a suspicion of contagion. I sat by the man's bed for an hour, during which the pulse became gradually weaker. In the second hour it was almost extinct, and it became apparent tha! t the patient would die. His wife and three children were in the room, and she was prepared for us by the too probable event. Thus the afternoon slowly passed away, and as evening approached I sent the young surgeon to have in readiness the cholera van not far away. We were surrounded by an excitable Irish population, and it was obviously desirable to remove the body as soon as possible, and then the family, and to lock up the house before any alarm was given. As twilight came on the sufferer expired without cramp or any other characteristic symptom. The wife had been soothed and she readily consented to be removed with her children to the hospital. Then suddenly the van drew up at the door, and in one minute, before the Irish were aware, drove away with its sad burden. No case of Asiatic cholera had occurred in Manchester, yet notwithstanding the total absence of characteristic symptoms in this case, I was convinced that the contagion had arrived, and the patient had been its victim. The Knott Hill Hospital was a cotton factory stripped of its machinery, and furnished with iron bedsteads and bedding on every floor. On my arrival here I found the widow and her three children with a nurse grouped round a fire at one end of a gloomy ward. I ascertained that all necessary arrangement had been made for their comfort. They had an evening meal; the children were put to bed near the fire, except the infant which I left lying upon its mother's lap. None of them showed any sign of disease, and I left the ward to take some refreshment. On my return, or at a later visit before midnight, the infant had been sick in it's mother's lap, had made a faint cry and had died. The mother was naturally full of terror and distress, for the child had had no! medicine, had been fed only from its mother's breast, and, consequently, she could have no doubt that it perished from the same causes as its father. I sat with her and the nurse by the fire very late into the night. While I was there the children did not wake, nor seem in any way disturbed, and at length I thought I might myself seek some repose. When I returned about six o'clock in the morning, another child had severe cramps with some sickness, and while I stood by the bedside, it died. Then, later, the third and eldest child had all the characteristic symptoms of cholera and perished in one or two hours. In the course of the day the mother likewise suffered from a severe and rapid succession of the characteristic symptoms and died, so that within twenty-four hours the whole family was extinct, and it was not known that any other case of cholera had occurred in Manchester or its vicinity." -- First-hand account, Sir James Kay-Shuttleworth, "Eyewitness to History," ed. J. Carey (1987)