76
REPLIES TO QUERIES ON THE TREATMENT OF EPIDEMIC CHOLERA. [ Appendix
Query No. 6,—continued.
Morton, E., Surgeon, Bom. I.—I am not in a position to offer an opinion. Alcohol is all
Lut powerless as a stimulant.
Young, H., Surgeon Major, Mad. I.—I have seen temporary benefit from transfusion of
saline fluids, as well as from enemata.
DeTatham, H., Assistant Surgeon, Bom. I.—I have seen the most marked effects from
transfusion of saline fluid, the pulse at the wrist returning, and in one instance the patient
turning round on his bed and speaking, although he had previously been quite collapsed.
But although these effects were very striking, in one case that I saw injected at the London
Hospital and in two that I injected myself at St. Mary's, the patients all afterwards relapsed
and died. I believe alcohol to be powerless in this stage.
Wilson, R., Assistant Surgeon, Mad. I.—I have no personal experience of transfusion of
saline fluid into the veins in cholera. Hot saline enemata have the same temporary action.
Alcohol I believe to be almost powerless, and if administered in any quantity it may produce
grave complications when re-action becomes established.
Query No. 7.—Sinking or dead feeling in the epigastrium (due to paralysis of the sympathe-
tic nerve?). Infusion of chillies or red pepper, camphor, ammonia, aromatic spices
useful in small quantities. Brandy, chlorddyne, ether have little action in
collapse and are dangerous on re-action.
Kennedy, J., Deputy Inspector General, Mad. I.—Probably paralysis of the sympathetic
nerve. These remedies are likely to be useful, and cannot be injurious.
Stewart, L. W., Surgeon Major, Mad. I.—All the symptoms of this disease I consider may
be traced to paralysis of the sympathetic and ganglionic nerves. In some cases very strong
spiced tinctures (chillies and brandy) have brought about re-action.
Query No. 8.—Quinine in small doses before the hour of exacerbation is often useful in
aiding re-action and warding off the recurrence of sinking.
Blacklock, A., Surgeon Major, Mad. I.—Yes; where cholera and the miasm of intermittent
fever are mixed in a subject who has previously experienced malarious poisoning.
Felly, S. M., Deputy Inspector General, Bom. I.—I have sometimes given quinine in large
doses (10 grains to a scruple), repeated a second time at an interval of one hour, with benefit.
Smith, C. M., Surgeon Major, Ben. I.—I witnessed a remarkable epidemic of this kind in
1845 at Chinsurah in the European barracks.
Ticehurst, W. D. T., Surgeon, Bom. I.—I found this treatment beneficial during the pre-
valence of cholera in the monsoon, while serving in the Mhow Jungles in 1858.
Williams, H. F., Surgeon, Ben. I.—I have always combined it with strychnine, with ap-
parent benefit, but mostly so after re-action, and in convalescence. I am led to attribute most
"benefit to the strychnine.
Query No. 9.—Belladonna, quassia, chlorate of potash, sulphuric acid, strychnine, acetate of
lead and opium, hot water, air baths, and small bleeding are said by some to be useful.
Hypodermic injections, tartar emetic, mustard emetic, have been used.
Bustead, W. J., Assistant Surgeon, Mad. I.—I have tried chlorate of potash, Condy's fluid,
and quinine in large doses, but the effect has been doubtful.
Harrison, J. B., Surgeon Major, Ben. I.—In 1861, at Meean Meer, I tried as a last resource,
with an European female, subcutaneous injection of quassia; and certainly the effect was won-
derful. To use her own words, she felt she was dying. But a short time after the injection,
she felt a glow through her. She gradually recovered. No other remedy was used, ex-
cepting support to the system. I afterwards tried it with success in other cases ; but in 1862,
during another epidemic, I failed. It was tried in Guy's Hospital, at my suggestion, by
Doctor Owen Rees in two cases ; one patient rallied, but after two or three days, he had a
relapse and died. I have not seen any success from the other remedies.
Hunter, G. Y., Assistant Surgeon, Bom. I.—I have seen frequent draughts of common salt
and water employed with apparent benefit. Packing in cold sheets I have also seen useful;
the patient being afterwards covered by large quantities of clothing, profuse perspiration
followed.
McDermott, P. A., Surgeon, Bom. B.—Chlorate of potash and sulphuric acid is useful,
but the strychnine, belladonna, quassia, and lead I would not give ; as for bleeding, it is, I
think, certain death.
Martin, Τ. E. P., Surgeon, Bom. I.—The advantage of remedies in this stage depends
very much upon the intensity of the collapse, In many cases all are useless. But I have seen