74
REPLIES TO QUERIES ON THE TREATMENT OF EPIDEMIC CHOLERA. [ Appendix
Qtiery No. 4,—continued.
Munro, W., Deputy Inspector General, Ben. B.—They do give relief.
Orr, J. H., Deputy Inspector General, Had. I.—They give relief by assisting to eliminate
the poison from the system. I have always accounted it an unfavorable sign when the purging
entirely ceases. During the stage of collapse saline enemata have only a temporary effect.
Pelly, S. M., Deputy Inspector General, Bom. I.—Judging from my own sensations while
suffering from an attack, the relief is very temporary.
Wakefield, H., Surgeon, Bom. I.—The congee stools are not so much the cause of uneasi-
ness as the poison itself. They certainly do give relief, and it is at this time that my reme-
dies would be directed towards causing a healthy action of the organs. The evacuation of
alvine discharges is one of the most prominent symptoms of cholera, but I am inclined tu
think that the great prostration in collapse is due more to the poison itself than to the loss of
fluid. In common diarrhœa it is the reverse.
Query No. 5.—Cramps. Frictions with turpentine or dry ginger—hot bottles—hot saline
enemata—chloroform.
Banister, G., Surgeon Major, Ben. I,—The cramps are theoretically attributed to the
stoppage of the capillary circulation, by which the muscles are deprived of recently oxidized
blood and therefore contract. But as the rigidity is usually confined to the lower extremities,
and even to particular muscles, it is difficult to believe that a general cause should affect only
one locality ; and moreover, it might be fairly inferred, if this were the true and only explana-
tion, that spasm would pass progressively into persistent rigidity in proportion to the degree
of collapse, which however is not the case.
I have observed in many patients, not subjects of cholera, that cramps of a violent
character have been induced by irritation of the mucous membrane of the bowels, from the
presence of tapeworm or of masses of undigested matter ; and in one instance a patient of
mine invariably suffered in this way just before the natural relief of the bowels. I inclino
therefore to the opinion that in cholera the accumulated fluid is the source of the irritation,
and that the connection between the sympathetic and spinal nerves indicates the cours
through which the reflex nervous action travels. It is familiar to all that there is a marked
cessation of spasms after a terrible expulsion of the accumulated fluid.
Blacklock, Α., Surgeon, Major, Mad. I.—-All bad. It is better to apply diachylon bandage
to the feet, legs, hands and fore-arms, splints and tourniquets to the thighs, and pressure with
the hands on other parts.
Brown, J. C., Deputy Inspector General, Ben. I.—Native champooers should be employed
under an European who should not himself champoo ; he should have a glass of grog when
coming on duty.
Culder, W. M, Surgeon, Bom. B.—I was however led to believe, during a slight epidemic
which occurred at Secundra, that strychnine, which I employed for the first time in cholera in
the cases which occurred at that time, seemed in some to exercise an undoubted influence in
controling the cramps which form so painful a feature in the disease, although the relief
afforded was not permanent in all the cases. The drug was administered at first in doses of
1/10th to 1/8th of a grain, and repeated every half hour until ½ grain was taken. It was afterwards
given more frequently and until one grain was administered, beyond which it as not pushed.
If called upon again to deal with cholera I would not hesitate to exhibit this drug.
Daly, G. II., Surgeon, Ben. I.—Cramps arc relieved by frictions with turpentine and dry
ginger, hot bottles or bricks, and the inhalation of chloroform. I have often seen a single
inhalation followed by perfect relief from cramps, and good refreshing sleep ; and I cannot
record a single instance where the inhalation of the drug was attended with any dangerous
symptoms.
Joynt, F. G., Surgeon, Bom. I.—In a few cases extract of Indian hemp and calomel gave
marked and speedy relief.
Irving, J, Surgeon Major, Ben I.—All through the course of the disease it seems very
desirable to administer the juice of raw beef, or iced beef-tea in small quantities, and at fre-
quent intervals. In the stage of collapse, I am inclined to throw aside physic and trust to
\ill\-tea or other kinds of nourishment, with stimulants in small quantities.
Query No 6.—Feeble action of heart. Transfusion of saline fluid restores the action of
the heart and colour, but only for a short time. Hot saline enemata are sometimos
useful. Alcohol is powerless as a stimulant during this stage, and it is injurious in the
following.
Banister, G·., Surgeon. Major, Ben. I.— Aleohol is useless. The remarkably encouraging
effect of the trausfuaion of warm fluid into the veins suggests the belief that if it could be
continued, recovery from collapse would be certain. The explanation appears to be, that the
temporary improvement is due to the temperature of the fluids restoring for α brief period