30
REPLIES TO QUERIES ON THE TREATMENT OF EPIDEMIC CHOLERA. [Appendix
Query No. 12,—continued.
therefore advocate the use of brandy properly diluted, and given cautiously so as to avoid violent
re-action.
Kirkpatrick, J., Surgeon Major, Mad. I.—They sometimes also do good. The result may
be predicated by the predilection which the patient may show for them.
Macpherson, H. M., Deputy Inspector General, Ben. I.—I think brandy, &c., are frequently
of the utmost use in assisting- re-action ; and I believe that if given cautiously and stopped when
re-action has commenced, the action is most beneficial. Dangerous re-action may set in and
too often does, when no such stimulants have been used.
Menzies, R., Surgeon, Ben. B.—I think that the less brandy or wine we give, the better;
like opium, they are dangerous.
Moore, W. J., Surgeon, Bom. I.—I may remark that the effect of alcohol in limiting the
waste of tissue, or in other words in retarding metamorphosis of tissue, is admitted by all.
When retained by the stomach, there can be little doubt that exhibited in moderate quantities
it acts beneficially in all stages of cholera. It is the abuse, and not the use of alcohol which
should be deprecated. If administered in too large quantities, it remains undecomposed, attacks
the nervous system, and, in the same manner as it would do in health, induces a congested
condition of the brain.
Norton, J. S., Surgeon, Mad. I.—These do to a certain extent stimulate the vascular and
nervous systems. But they do so to a comparatively limited extent, and they require to be used
with great caution, and the effects must be carefully watched. The best of these is good brandy.
Munro, W., Deputy Inspector General, Ben. B.—Yes; true.
Oldham, C. F., Assistant Surgeon, Ben. I.—If anything will restore the action of the
heart, stimulants with sinapisms and warmth will do it; but since no known remedy will
produce immediate re-action, there is no object in giving' such large quantities as would accumu-
late in the stomach. Food, it is generally admitted, should not be withheld at this stage, but
surely this is as little likely to be absorbed and as likely to accumulate in the stomach as
stimulants in any moderate quantity. I have never seen stimulants given at this stage cause
excessive re-action.
Rennik, R. H., Deputy Inspector General, Mad. I.—I have always observed that the
re-action was violent when brandy had been given too freely.
Ruttonjee Hormusjee, Sub-Assistant Surgeon, Bom. I.—It may be unhesitatingly stated
that it cannot be denied that the undue use of opium and stimulants given during the first and
second stage of the disease produces these symptoms. Exposure to the sun before the attack
strongly predisposes the individual to head symptoms. In the year 1865, cholera broke out
twice in the city of Ahmedabad; it was brought in by certain pilgrims who had gone to
Palitan and Dacore. Head symptoms were frequently attributed to exposure to the sun during
the journey.
Ross, J. T. C., Surgeon Major, Ben. I.—I place no reliance on alcohol or opium in the
advanced stages of the disease, or during collapse ; they would not be absorbed into the system,
and in the subsequent re-action their effect would then be to mask symptoms, and to increase
the intensity of secondary affections.
Summers, J., Deputy Inspector General, Ben. B.—Wine seems powerless, but may be of
use nevertheless. I have never seen troublesome re-action to occur in five epidemics I have
witnessed, by simply imperfect functions of the various organs.
Thom, W., Deputy Inspector General, Bom. I.—To be avoided altogether, except champagne
in small quantities.
Thomson, W. A., Surgeon, Mad. I.—I am not prepared, from my experience, to join in the
sweeping condemnation of brandy, alcohol or wine. I believe the injury attributed to their
use has resulted from their having been given rashly and indiscriminately, in fact, poured
down the throats of patients who were helpless to resist, until alcoholic poisoning was added
to choleraic poisoning. Given judiciously such evil results will not follow.
Van Someren, W. J., Surgeon Major, Mad. I.—If retained, these stimuli appear to facili-
tate re-action, but this is apt then to be turbulent and dangerous.
Waters, J. M., Assistant Surgeon, Bom. B.—Brandy and wine are injurious; they induce
violent and dangerous re-action.
Wood, D., Surgeon, Ben. B.—They prevent restoration of the secretions, produce coma,
and complicate re-action.
Query No. 13.—Active or powerful remedies should not be used, as in this stage their action
is in abeyance. This returns on re-action, and these remedies are often accumulated in
the stomach.
Banister; G., Surgeon Major, Ben. I.—I agree with the proposition. During one epidemic
after the recommendation of Dr. Searle, all my cases were treated with scruple doses of