INDICATIONS OF
TREATMENT.
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communication be restricted with the affected city or district. The appearance
of a single case of cholera, or the unusual prevalence of diarrhoea, should be
reported by the Regimental Surgeon to the Deputy Inspector General of
Hospitals, who should at once examine the case, and if he considers it to be
decidedly cholera, or merely suspicious, bring the subject to the notice of the
Military Authorities. On the appearance of a second case within the week, or
an increase of diarrhœa, the preliminary camp should be pitched, and carriage
held in readiness to move all the troops m the station. The preliminary camp
should consist of tents, with 8 cots each, for 15 per cent. of the European Troops
at the station. It should not be more than a miles from the station, on
raised ground, previously selected and carefully prepared, and if practicable
across a river. It should be surrounded with a double row of trees, with
trees planted on both sides of the streets of the camp, having a range of
covered latrine trenches to the leeward, outside the outer line of trees. The
ground on which the tents are pitched should be ploughed at the end of
the season. The responsibility of recommending the removal of the troops,
or delaying the removal till the appearance of the third or fourth case, will
rest with the Deputy Inspector General, or the principal Medical Officer of
the station; after the appearance of the fourth case the removal should bo
compulsory. The men should be moved progressively from each barrack
as the disease appears in it, and they may return in a week after they have
been free from the disease, if there has been no fresh case in the cantonment.
The severity of most epidemics comes to a climax in about a fortnight, and.
when the disease is subsiding, it may be worthy of consideration whether the
men may not return to their barracks (after they have been thoroughly disin-
fected) a few days earlier, when the intensity of the heat (as in the Punjab)
is such as to induce fatal sunstroke. Should the premature return be followed
by a revival of the disease the men should again be moved out; as this would
clearly show that the locality was not yet free from the danger.
The presence of the infected men is a source of danger to the rest of the
station. The sooner they are removed the safer for the station, and the better
for themselves. If the preliminary camp be ready the men should leave the
infected barracks before sunset of the day on which the presence of the
epidemic is declared. This detachment should march from the preliminary
camp on the second day, to render it available for future use.
Should cholera attack a Regiment on the line of the march, it should bo
separated into two or more parties, and keep making short marches every day,
diverging slightly from the ordinary line of march, till the disease disappears
MEDICAL TREATMENT.
The course of the disease is generally divided into three stages, in each of
which a distinct line of treatment is indicated, viz., Diarrhœa, Collapse, and Re-
action. Previous to this there is generally a stage Malaise in which there is
depression of spirits, with want of appetite and torpor of the bowels, which are
induced by the presence of the poison in the system.
The indications of treatment in the earlier stages are to assist nature by
supporting the strength, counteracting the depressing action of the poison,
promoting its elimination, and defending the parts through which it is dis-
charged from the irritating action of the poison or vitiated contents of the bowels.
The poison depresses or diminishes the action of all the organs by which
nature purifies the blood. The first symptom of rallying from the most intenso
attack is the discharge of the contents of the stomach and bowels, followed by
the peculiar congee-like fluid ; this likewise forms the last sign of vital energy,
when the symptoms progress from diarrhcea, which is the ordinary preliminary
to collapse. In both instances this congee-like evacuation is a most exhausting
process.
As the poison is contained in these evacuations, it would appear theoreti-
cally that purgative medicines were the best means indicated for assisting
nature; but experience teaches that there are other and safer channels through
which the poison may be eliminated, and that purgatives are most dangerous.
Their action is very liable to be followed by congee stools and collapse, during
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