No. II.]
V.—SECOND STAGE, DIARRHŒA—CHOLERAIC DIARRHŒA.
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Query No. 14,—continued.
Wilson, R., Assistant Surgeon, Mad. I.—Hot saline enemata frequently produce tem-
porary relief and re-action in the collapse stage ; but I do not know that they are particularly
valuable.
Query No. 15.—Bleeding is not generally followed by benefit, and sometimes by collapse.
Browne, J., Surgeon, Ben. I.—I do not approve of bleeding, generally speaking, in any
stage. I have seen patients bled in the third stage (collapse) ; and I consider that in this
stage bleeding is to be considered as a test of the severity of the disease, rather than as a
therapeutic agent. That is to say, in those cases where a vein was opened and the blood
came freely, recovery generally resulted ; but in those cases where the blood was so thick
( owing to the loss of its watery portion), that none would come from the opened vein, death
generally took place. In the stage of re-action, blood is frequently required to be taken by
cupping, or leeching, in order to subdue inflammation, or local congestion.
Gray, R., Assistant Surgeon, Ben. I.—Small bleeding in two or three cases seemed to
be beneficial ; and for a short time, the circulation was, or seemed to be, carried on more
vigorously.
Griffith, H., Assistant Surgeon, Mad. I.—I have applied leeches to the loins in eight
cases, with a view to relieve existing congestion of the kidney, but there was nothing
which I could perceive afterwards to show that it acted in any way beneficially, as all of
these cases terminated fatally.
Plank, C., Surgeon, Ben. I.—I have practised the method of small bleeding with a
view to re-establish the circulation, and have seen it practised by Dr. Playfair, who intro-
duced it. The result was not encouraging.
Reynolds, J. A., Deputy Inspector General, Mad. I.—I have seen bleeding tried in this
country many years ago, in some cases repeatedly. All terminated fatally.
Sinclair, E. M., Surgeon, Mad. B.—I have tried this plan when the right side of the
heart seemed much oppressed, by taking one or two ounces of blood. No success followed.
Style, M., Offg. Deputy Inspector General, Bom. I.—The benefit of bleeding is very doubt-
ful. I once bled in succession four cases all of which died. This was at Baroda. Three months
after, at Bombay, I bled in three cases, and all of these proved fatal. I believe that bleed-
ing is only of use to obviate congestion on the setting in of re-action.
Trestrail, J. C., Surgeon Major, Bom. I.—I bled at one time very largely, and I have
seen wonderful recoveries after it. Diffusible stimulants must be given immediately after,
and must be continued.
Ward, T. W., Deputy Inspector General, Bom. I.—I have seen bleeding cure a patient
when there was evidence of congestion of the lungs.
Young, H., Surgeon Major, Mad. I.—Bleeding I have seen adopted in many cases
without benefit.
Query No. 16.—Warm baths and wet sheets are sometimes useful, and not likely to be
injurious. Cold affusion is sometimes useful.
Fasson, T. H., Surgeon Major, Mad. B.—To supply warmth to the body is the direction
in which, I think, we can, in the stage of collapse, do most good ; and the most effectual
means of doing this I have found to be to envelop the patient up to his neck in a hot
wet blanket, wrung out as dry as practicable, and then to cover him over with hot dry
blankets.
Griffith, H., Assistant Surgeon, Mad. I.—I have found most marked benefit following
after a warm air bath, and it is far superior in its effects to the warm water bath. It seems
to have all the stimulating effects of the latter without its relaxing qualities.
Jackson, J. M., Deputy Inspector General, Mad. I.—Warm salt baths always restore the
circulation. Whilst the patient is in the bath colour returns in the lips, and the patient
converses sensibly, but he falls back into the collapse when taken out.
Joynt, F. G., Surgeon, Bom. I.—The cases were generally brought in the state of
collapse, and the cold affusion was tried with great success. A mussuck of cold water
poured rapidly over the face and trunk of the patient as he lay on the ground, usually
roused him to sit up and endeavor to resist the operation. He was now quickly dried and
rolled in a blanket with a view to induce diaphoresis. If he asked for water to drink he
was allowed to have some. In a large proportion of cases (about 80 per cent.), sound sleep
was induced, the desired re-action established, and recovery took place.
18