84.
REPLIES TO QUERIES ON THE TREATMENT OP EPIDEMIC CHOLERA. [Appendix
Query Wo. 4,—continued.
stage. Lucky is the physician who at this encouraging moment has not his hopes dashed by
the remembrance of half a dozen or more opium pills, belladonna, strychnine, brandy, nitrate
of silver, &c, to be still accounted for under the head of re-actionary fever.
Martin, T. E. F., Surgeon, Bom I.—Quinine is valuable in all sorts of ways in this country
as a tonic and antiperiodic, but it is of particular use in commencing re-action after collapse.
Young, IL, Surgeon Major, Mad. I.—I have frequently used quinine in small doses in this
stage, added to small quantities of nourishment, with benefit.
Query No. 6.—Suppression of urine calls for immediate treatment ; fomentations and blisters
to the loins, nitrate of potash, ether, tincture of cantharides.
Allen, M., Assistant Surgeon, Ben. I.—Hyposulphite of soda mixture every 3 hours.
Mustard plasters, dry cupping for congestion of the head. Blisters to templos.
Bell, A., Surgeon, Ben. B.—I have never seen this symptom benefited by any treatment.
Blacklock, A., Surgeon, Major, Mad. I.—Turning the patient on his abdomen and keep-
ing him in that position as much as possible is best of all. Enemata (cold) containing sweet
spirit of nitre are good. Frequent sponging of face and hands with very cold water is also
good.
Brougham, J. P., Surgeon Major, Ben. I.—Diuretics, calomel in small doses, citric acid,
benzoate of ammonia, iced milk.
Chevers, N., Surgeon Major, Ben. I.—I avoid cantharides and turpentine, even externally.
I apply dry cupping, sinapisms, simple fomentation and large poultices to the loins. I give
no diuretic, except the most natural of all, i. e., diluents in considerable quantities. "Where
there is uræmia I use small doses of castor oil or seidlitz powder, with saline enemata. In
ordinary cases where the stools are deficient, the tongue coated, the eyes injected, or the
Durant, J. J., Assistant Surgeon, Ben. I.—All very useful, and should be tried in turn.
Counter-irritation to the loins, and tincture of cantharides with large doses of calomel, seems
to claim a foremost place in restoring the secretions.
Faucs, J., Assistant Surgeon, Ben. I.—Purging to ensure at least six full motions daily.
Francis, C. R., Surgeon Major, Ben. I.—Attend to existing symptoms. For uræmia use
diluents and diuretics, sinapisms, and dry cupping. Castor oil, repeated at intervals, should
be given to relieve congestion, and to remove the superfluous calomel.
Fayrer, J., Surgeon, Ben. I.—"Restore secretion to the kidneys and bowels. Diuretics,
laxatives and salines may be needed. Look out for pneumonia or "other low forms of inflam-
mation.
Fogo, J. M. S., Surgeon Major, Ben. B.—But suppression of urine may still exist, and
small doses of oil of turpentine given with castor oil, if this is still indicated, have been found
most beneficial, or these may be given (always watching the effect of the medicine) without
the castor oil, in mucilage or with beaten yolk of egg.
Fuller, S., Assistant Surgeon, Ben. B.—The suppression of urine is the result of all the
watery portion of the blood having passed off by the bowels, and is not due to the impaired
function of the kidneys.
Greene, J. A., Civil Surgeon, Ben. I.—Potas, chlorat. grs. 3, liquor. ammon. acet. 1 dram,
water 1 oz., every 2 hours ; vinegar and water to the head, and also sponging the body.
Jardine, J., Staff Surgeon, Ben. B.—Blisters to the loins might prove very distressing to the
patient and should be avoided. Nothing need be dune till re-action begins/for nothing will be
of any avail. The turpentine fomentations, dry heat to the loins (for the intolerable sense of
internal heat is by this time subsiding, and warmth to the loins can now be borne), with mild
diuretics e. g., acetate of potash, sweet spirit of nitre, and barley water, will generally be
found sufficient. Cantharides should be used sparingly if used at all.
MacLeod, A. C., Surgeon Major, Mad. I.—With the restoration of the renal function, the
patient may be considered comparatively safe. As long as it is absent, he is in imminent
danger. There is no such certain diuretic under these circumstances in my opinion as a large.
square blister covering the whole of the loins. I have known the kidneys' act within a very
short time after its application. In such cases, it may he immediately removed. Once fairly
set a going, the kidneys will continue to act without further stimulation.
I am opposed equally to the administration of internal remedies in this stage, as the
stomach is still in an irritable state, and needs rest. I should not resort to other diuretics till
the blister had first been tried. In very young children cajuput oil rubbed over the loins and
abdomen will be found the best diuretic.