No. II.]
VI.—THIRD
STAGE—COLLAPSE.
77
Query No. 9,—continued,.
so many patients get out of what appeared to be complete collapse, that T· think friction; hot,
bottles, and small quantities of fluids good, and that some stimulants should be persevered m
until hope is gone. .
Miles, H. L., Surgeon, Bom, B.—With the exception of hot air baths, the whole of these
agents are not now Considered worthy of trial.
Morton, J. S., Surgeon, Mad. I.—I have tried only sulphuric acid, acetate of lead, opium,
hot water and vapour baths ; sometimes these seem useful, but at other times they are power-
less or of doubtful value.
Ross, J., Assistant Surgeon, Mad. I.—I have tried quassia as an infusion, and Dr.
Honigberger's tincture of quassia prepared by himself and used according to his directions.
The first Case, and a Very bad one it was, in which I used the tincture, recovered. In every
other instance it was useless. I think I have found chlorate of potash, sulphuric acid, acetate of
lead opium, hot water baths, simple and with mustard or salt added, all occasionally useful.
Spenser, R., Assistant Surgeon, Bom. B.—Not one of these remedies is of the slightest use.
In one epidemic of cholera in Bengal, I recollect being ordered to inject all cases with in-
fusion of quassia beneath the skin, and the result was sloughing sores and speedy death.
Stewart, L. C., Deputy Inspector General, Bom. B.—No, I do not think any of these re-
medies likely to be of use in the collapse of cholera, except chlorate of potash in solution. I
have seen the endermic use of quassia prove utterly useless.
DeTatham, H. D., Assistant Surgeon, Bom. I.—I have injected atropine under the skin,
and although the pupils became dilated, no effect on the disease followed. I gave strych-
nine in one case, but it was not until many other remedies had been tried, and so the drug
can hardly be said to have had a fair trial.
Townsend, S. C., Surgeon, Ben. I.—I believe that in belladonna we have a therapeutic
agent which in its action on the nervous system is better calculated to do good in the treat-
ment of cholera than opium. It is a powerful excitant, its action on the circulation is more
decided and more persistent than that of opium, and it does not check secretion. Of 213
cases treated at one branch dispensary with belladonna, 54 died, or 25.3 per cent., and out of
205 cases treated at another branch dispensary, there were only 18 deaths. In the neighbour-
hood of this last dispensary, however, the disease did not appear until it was declining else-
where, and it was of a much milder type ; but of six cases in a state of collapse thus treated
with belladonna by hypodermic injection, four recovered. In these cases the action of the
remedy was more rapid, and the increased warmth of the skin very marked.
Turner, J., Surgeon Major, Bom. I.—Every one has his hobby.
Query No. 10.—Opium is injurious, preventing re-action, and causing coma should
re-action come on.
Atkin, H., Surgeon Major, Mad. I.—I have not seen opium, if properly administered, have
any injurious effects or induce comatose symptoms. Coma comes on sometimes whether
opium is given or not.
Brown, J. C., Deputy Inspector General, Ben. I—I do not approve of opium or internal
stimulants in the late stages. I recommend external warmth, with cold drinks and frictions.
Cardew, G. S., Deputy Inspector General, Ben. I.—Opium in the advanced stage should be
forbidden, or if given at all, it must be in small doses as a stimulant, and not as a sedative.
Cox, C. L., Deputy Inspector General, Ben. I.—Except as an ingredient in cholera pills, to be
used in the first and second stages, I would banish this drug from all cholera hospitals ; for in
all the other stages it acts as a poison, suppressing the secretions and accumulating in the
system, ready to cause fatal coma when re-action sets in. The first case of cholera I ever saw
was at Calcutta in 1842. The patient was treated with large doses of calomel and opium.
The cholera symptoms were subdued, but he died of opium poisoning.
Moir, R, Assistant Surgeon, Ben. I.—In this stage, opiates and large quantities of sti-
mulants are to be avoided with equal care, as the administration of either seems to hasten
the termination of life.
Naismith, J., Deputy Inspector General, Ben. I.—I believe opium, alcohol, and chloroform,
in every form and combination, to be most hurtful in the latter stages of cholera, as encouraging
the tendency to cerebral congestion and effusion which proves so frequently fatal after re-ac-
tion has fairly set in.
Pitman, H., Surgeon Major, Bom. I.—In my earlier career, I often saw the ill effects of
repeated doses of opium, not only in preventing re-action, but also in causing the tendency to
death from opium poisoning after re-action, and after the powers of digestion had set in.
Saunders, G., Deputy Inspector General, Ben. I.—Opium I considered absolutely perni-
cious in every stage of cholera.