The cholera belt was a flat strip of (usually red) flannel or knitted wool, about six feet long and six inches wide, that was wrapped around the bare abdomen. The item was standard army issue, and was purported to prevent the wearer from contracting cholera, dysentery, and other ailments believed to be caused by chilling of the abdomen. The belts use continued decades after the causative link between pathogen-contaminated drinking water and cholera was established. [1]
Attempts to prevent illness by wearing flannel body wraps date to the early 1700s. In 1707 Jeremiah Wainewright wrote "'I was perswaded'(sic) ... to wear Flannel next to my Skin some ten Years ago for a severe Cough ... I received some advantage'", and in 1726 author Richard Towne wrote, "'those who are subject to habitual Looseness may receive great Benefit by wearing Flannel and keeping their Bodies warm'". By 1799 the British army promoted a "flannel bandage to the whole abdomen," with surgeon Robert Jackson in 1817 recommending "the application of 'flannel over the abdomen, adding such pressure to it by a flannel roller'" to prevent dysentery, and James Annesley writing in 1828 that "'use of a thick flannel banyan and cummerband during the Monsoon will ... exert considerable influence in preventing bowel complaints'". [1]
According to historian E.T. Renbourn, flannel waistcoats and belts were commonly worn by British soldiers before the 1830s but as cholera epidemics spread from 1817 to the 1830s, fear spread leading to reports in the Cholera Gazette that soldiers should wear flannel to prevent cholera, possibly originating in the Polish-Russian War of 1830-31 though a "cholera belt" was not mentioned. Renbourn writes that although the phrase "cholera belt" was not being specifically mentioned in print, it was "being used fairly widely by the populace in general". It was not until 1848 when, Instructions to Army Medical Officers for their Guidance on the Appearance of the Spasmodic Cholera included the suggestion that every soldier should be provided two "cholera belts". In 1849 an anonymous author published the pamphlet "What has Cholera done in London?" advising "readers to wear a folded flannel belt around the belly ... recommended by the Board of Health'". [1]
J. McGrigor Croft, M.D. writing in the Westminster, England Marylebone Mercury in 1866 that he was the inventor of the cholera belt. Croft states that he did this to "aid the poor" and then describes how to make the belt out of ordinary flannel in the hopes that anyone will be able to make their own. He states that two medical doctors of his acquaintance vouch for the invention. He calls it an "abdominal respirator; it permits the heated perspiration of the body to pass off without any chance of chill ... without any inconvenience such as found in the old cholera belt". Croft goes on to say that he has declined the patent and gives it to the public freely. [2]
Surgeon in the Bengal Army, Andrew Duncan in 1888 wrote that "'Cholera belts must be stringently insisted on ... and there should be periodic inspection - and without warning - to see that men are wearing them'". [1] In 1898, The San Francisco Call reported that the belt is a "good thing for the troops" quoting advice from a Major Edward Field "that no soldier should think of going to Manila without a cholera belt". And although it is impossible to take everything a soldier would need in the tropics, the cholera belt holds the highest place in the emergency list". [3]
In 1914, donations by the tiny village of Middlemarch, New Zealand of items such as tobacco, shirts and tinned fruit for soldiers going to fight in World War I, included "26 cholera belts". [4] The idea of abdominal chilling as a factor in illness was brought up as late as 1947 although it was rejoined by those who pointed out that the idea was not based on experimental evidence. [5]
Renbourn sums up the history of cholera belts as an interest in wearing them fluctuated whether an outbreak was happening nearby or not. The argument seems to be that it "prevented suppression of 'perspiration' and the consequent flow of blocked excretions to the bowel". [1]
In 1946, L. E. Napier wrote in Principles and Practice of Tropical Medicine that "The flannel cholera belt, whose powers of cholera prevention were of course mythical ... has fortunately gone out of fashion". [6]
Diarrhea, also spelled diarrhoea, is the condition of having at least three loose, liquid, or watery bowel movements each day. It often lasts for a few days and can result in dehydration due to fluid loss. Signs of dehydration often begin with loss of the normal stretchiness of the skin and irritable behaviour. This can progress to decreased urination, loss of skin color, a fast heart rate, and a decrease in responsiveness as it becomes more severe. Loose but non-watery stools in babies who are exclusively breastfed, however, are normal.
Dysentery, historically known as the bloody flux, is a type of gastroenteritis that results in bloody diarrhea. Other symptoms may include fever, abdominal pain, and a feeling of incomplete defecation. Complications may include dehydration.
A hernia is the abnormal exit of tissue or an organ, such as the bowel, through the wall of the cavity in which it normally resides. Various types of hernias can occur, most commonly involving the abdomen, and specifically the groin. Groin hernias are most commonly of the inguinal type but may also be femoral. Other types of hernias include hiatus, incisional, and umbilical hernias. Symptoms are present in about 66% of people with groin hernias. This may include pain or discomfort in the lower abdomen, especially with coughing, exercise, or urinating or defecating. Often, it gets worse throughout the day and improves when lying down. A bulge may appear at the site of hernia, that becomes larger when bending down. Groin hernias occur more often on the right than left side. The main concern is bowel strangulation, where the blood supply to part of the bowel is blocked. This usually produces severe pain and tenderness in the area. Hiatus, or hiatal hernias often result in heartburn but may also cause chest pain or pain while eating.
Constipation is a bowel dysfunction that makes bowel movements infrequent or hard to pass. The stool is often hard and dry. Other symptoms may include abdominal pain, bloating, and feeling as if one has not completely passed the bowel movement. Complications from constipation may include hemorrhoids, anal fissure or fecal impaction. The normal frequency of bowel movements in adults is between three per day and three per week. Babies often have three to four bowel movements per day while young children typically have two to three per day.
Colonoscopy or coloscopy is the endoscopic examination of the large bowel and the distal part of the small bowel with a CCD camera or a fiber optic camera on a flexible tube passed through the anus. It can provide a visual diagnosis and grants the opportunity for biopsy or removal of suspected colorectal cancer lesions.
Abdominal pain, also known as a stomach ache, is a symptom associated with both non-serious and serious medical issues.
Diverticulitis, specifically colonic diverticulitis, is a gastrointestinal disease characterized by inflammation of abnormal pouches—diverticula—which can develop in the wall of the large intestine. Symptoms typically include lower abdominal pain of sudden onset, but the onset may also occur over a few days. There may also be nausea; and diarrhea or constipation. Fever or blood in the stool suggests a complication. Repeated attacks may occur.
Gastroenteritis, also known as infectious diarrhea and gastro, is inflammation of the gastrointestinal tract; the stomach and intestine. Symptoms may include diarrhea, vomiting and abdominal pain. Fever, lack of energy and dehydration may also occur. This typically lasts less than two weeks. It is not related to influenza, even though in the US it is sometimes called the "stomach flu".
Campylobacteriosis is an infection by the Campylobacter bacterium, most commonly C. jejuni. It is among the most common bacterial infections of humans, often a foodborne illness. It produces an inflammatory, sometimes bloody, diarrhea or dysentery syndrome, mostly including cramps, fever and pain.
Travelers' diarrhea (TD) is a stomach and intestinal infection. TD is defined as the passage of unformed stool while traveling. It may be accompanied by abdominal cramps, nausea, fever, headache and bloating. Occasionally bloody diarrhea may occur. Most travelers recover within three to four days with little or no treatment. About 10% of people may have symptoms for a week.
Colic in horses is defined as abdominal pain, but it is a clinical symptom rather than a diagnosis. The term colic can encompass all forms of gastrointestinal conditions which cause pain as well as other causes of abdominal pain not involving the gastrointestinal tract. The most common forms of colic are gastrointestinal in nature and are most often related to colonic disturbance. There are a variety of different causes of colic, some of which can prove fatal without surgical intervention. Colic surgery is usually an expensive procedure as it is major abdominal surgery, often with intensive aftercare. Among domesticated horses, colic is the leading cause of premature death. The incidence of colic in the general horse population has been estimated between 4 and 10 percent over the course of the average lifespan. Clinical signs of colic generally require treatment by a veterinarian. The conditions that cause colic can become life-threatening in a short period of time.
Oral rehydration therapy (ORT) is a type of fluid replacement used to prevent and treat dehydration, especially due to diarrhea. It involves drinking water with modest amounts of sugar and salts, specifically sodium and potassium. Oral rehydration therapy can also be given by a nasogastric tube. Therapy should routinely include the use of zinc supplements. Use of oral rehydration therapy has been estimated to decrease the risk of death from diarrhea by up to 93%.
Necrotizing enterocolitis (NEC) is a devastating intestinal disease that affects premature or very low birth weight infants. Symptoms may include poor feeding, bloating, decreased activity, blood in the stool, vomiting of bile, bowel death, multiorgan failure, and even death.
Abdominal bloating is a short-term disease that affects the gastrointestinal tract. Bloating is generally characterized by an excess buildup of gas, air or fluids in the stomach. A person may have feelings of tightness, pressure or fullness in the stomach; it may or may not be accompanied by a visibly distended abdomen. Bloating can affect anyone of any age range and is usually self-diagnosed, in most cases does not require serious medical attention or treatment. Although this term is usually used interchangeably with abdominal distension, these symptoms probably have different pathophysiological processes, which are not fully understood.
Neutropenic enterocolitis is inflammation of the cecum that may be associated with infection. It is particularly associated with neutropenia, a low level of neutrophil granulocytes in the blood.
Blunt trauma, also known as blunt force trauma or non-penetrating trauma, is physical trauma or impactful force to a body part, often occurring with road traffic collisions, direct blows, assaults, injuries during sports, and particularly in the elderly who fall. It is contrasted with penetrating trauma which occurs when an object pierces the skin and enters a tissue of the body, creating an open wound and bruise.
The second cholera pandemic (1826–1837), also known as the Asiatic cholera pandemic, was a cholera pandemic that reached from India across western Asia to Europe, Great Britain, and the Americas, as well as east to China and Japan. Cholera caused more deaths, more quickly, than any other epidemic disease in the 19th century. The medical community now believes cholera to be exclusively a human disease, spread through many means of travel during the time, and transmitted through warm fecal-contaminated river waters and contaminated foods. During the second pandemic, the scientific community varied in its beliefs about the causes of cholera.
Abdominal trauma is an injury to the abdomen. Signs and symptoms include abdominal pain, tenderness, rigidity, and bruising of the external abdomen. Complications may include blood loss and infection.
Abdominal compartment syndrome (ACS) occurs when the abdomen becomes subject to increased pressure reaching past the point of intra-abdominal hypertension (IAH). ACS is present when intra-abdominal pressure rises and is sustained at > 20 mmHg and there is new organ dysfunction or failure. ACS is classified into three groups: Primary, secondary and recurrent ACS. It is not a disease and as such it occurs in conjunction with many disease processes, either due to the primary illness or in association with treatment interventions. Specific cause of abdominal compartment syndrome is not known, although some causes can be sepsis and severe abdominal trauma. Increasing pressure reduces blood flow to abdominal organs and impairs pulmonary, cardiovascular, renal, and gastro-intestinal (GI) function, causing obstructive shock, multiple organ dysfunction syndrome and death.
Charles Stuart Tripler was a United States Army brigadier general and surgeon. On March 8, 1867, he was posthumously promoted to brigadier general by President Andrew Johnson and the date of rank was backdated to March 13, 1865. The Tripler Army Medical Center in O'ahu, Hawaii is named in his honor.
There is a great deal of merit in the proposition that troops should obey the injunction of the Sanitary Corps and never go across the street without the flannel belt.