No.
II.]
III.—THE
TREATMENT.
55
Query No. 9,—continued
influence of the electric fluid ou the brain and nervous system alone ; the instantaneousness
of death precludes any other supposition.
Orr, J. H., Deputy Inspector General, Mad. I.—The entire train of the symptoms of
cholera sufficiently proves the correctness of these views.
Peterkin, J., Surgeon Major, Mad. I.—The primary action of the poison seems to be on
the blood, and secondly on the sympathetic and ganglionic nerves ; by their paralysis re-action
is stopped in the various secreting organs. Probably the copious sweat and cold surface are
due to this condition of the minute twigs of this system ramifying on the coats of the vessels,
failing to maintain their tonic power, and thus admitting of the transmission of the serous
fluid by exosmosis, which, in health, is kept in control by this part of the nervous system.
Reade, W., Surgeon, Mad. B.—Generally admitted. In some cases the intensity of the
poison is such as to destroy life in a very short space of time.
Rennick, H. H., Deputy Inspector General, Mad. I.—Unquestionably the worst forms
of the disease I have met with were those in which the sufferers, without any warning
whatever, were struck down as if asphyxiated.
Ross, J. T. C., Surgeon Major, Ben. I.—This theory in the present state of the knowledge
on the subject is as good as any other.
Sainter, J. D., Assistant Surgeon, Bom. B.—I have seen cases in the jungly districts of
Bengal, in which there were no stages of the disease at all. Collapse set in at once, and a
fatal result ensued within two hours in cases of this kind. Of course all treatment is hope-
less, as the system is in a state of paralysis. I have tried the hot baths in such cases, but I
am sorry to say with only partial success.
Saunders, G., Deputy Inspector General, Ben. I.—This question again presupposes the
operation of a poison, and of this there is no proof whatever. The most important and the
most constant symptom in cholera is the arrest of secretion, which would lead one to imagine
an arrest of all healthy nervous vitality—but might not this state be induced in other ways
than the one supposed ?
Since diarrhoea, not choleraic, will either induce rapid death or cause a complete pros-
tration of the vital powers, is it not, therefore, as philosophic to assume that a great and sudden
development of the proximate causes which end in diarrhoea, may of itself induce all the
symptoms collectively which we call cholera, as to rely on the existence of a specific and a
special agent of which we know nothing. I by no means wish it to be inferred, that I believe
cholera and diarrhœa to be identica), I simply wish to point out that as much may be gained
by enquiry in the direction of common causes acting concurrently, as in the more vague, but
always more attractive, one of special and specific influence. Again, will nothing but paraly-
sis of the sympathetic arrest secretions ? Is it impossible that sudden and severe internal con-
gestions (even of the ganglionic system), may be induced by ordinary or perhaps extraordinary
climatic or météorologie changes, and would it not be possible for these to lead to that state
of the system which implies the advent of cholera ?
Sexton, E., Assistant Surgeon, Bom. I.—May not the separation of the fluid from the solid
constituents of the blood be also owing to paralysis of the sympathetic system; and may not
the arrest of the secretion be also attributed to this impaired enervation ?
Simpson, D., Assistant Surgeon, Bom. I.—To counteract the poison no antidote is known.
We must, therefore, modify its influences on the organic nerve-centre by nervine stimulants,
and keep the skin and kidney acting as the principal emunctories, as diminution of ñervo
force retards elimination and favors the accumulation of the poison.
Shelton, A., Suryeon Major, Mad. B.—The primary action of the poison is, I apprehend,
displayed on the mucous membrane of the stomach and intestines, thence on the blood ; and
the blood being disorganized, no longer has power to fill the organs which are supplied by it
for the performance of their respective normal functions.
Smith, H. S., Assistant Surgeon, Ben. I.—Recent French experiments tend to show that
deprivation of nerve power causes immense serous secretion into a selected portion of the in-
testines, whilst the system is under the influence of certain poisons such as strychnia.
Stewart, L. W., Surgeon Major, Mad. I.—This is, and has been, my theory for the last
fifteen years.
Style, M., Officiating Deputy Inspector General, Bom. I.—I think the theory good,
Spencer, R., Assistant Surgeon, Bom. B.—I think the poison is as a preliminary absorbed
into the blood, and acts secondly on the nervous system, causing depression and diminishing
or suppressing the secretions of organs.
Summers, J., Deputy Inspector General, Ben. B.—This I believe to be the truest theory ;
and it explains the absence of the secretions generally, and the failing of the circulation. -
Sylvester, J. H., Surgeon, Bom, I,—I believe that cholera is entirely an affection of the
sympathetie system.
15