No.
II.]
III.—THE TREATMENT.
51
Query No. 1,—continued.
MacLeod, A. C., Surgeon Major, Mad. I.—Restoration of function is impossible so long as
the poison remains in the blood unneutralised. When once eliminated into the bowels, thence to
be dejected by stool, the poison may be said to be out of the blood, and in some sense ont
of the system. Simultaneously with this purification of the blood, and if sufficient vital-
ity remains after such an exhaustive process, the hitherto suspended secretions will begin
to flow spontaneously. We may assist firstly, and indirectly, by artificially augmenting
the vitality of the system ; secondly, and more directly, by the use of remedies calcu-
lated to act on the organs whose secretions more particularly it is important to res-
tore. Whenever I use the term "neutralisation," I would wish it to be understood that
I simply mean that unknown process by which the cholera poison is rendered innocuous ;
it may be neutralisation, or disorganization, or decomposition, or even simple dilution. By an
excess of stimulants during the active stage of the disease, or by their protracted use when no
longer needed, I fear that many have been lost. A still more violent form of re-action, however,
is that which succeeds the use of opium, or of other astringents. It is as if a strong tide had
been temporarily restrained by a dam, to burst forth with redoubled and fatal force.
Simpson, D., Assistant Surgeon, Bom. I.—The treatment of cholera by emetics and pur-
gatives is contra-indicated, as its only tendency is to depress the already overtaxed nervous
system ; and besides, such treatment has not the power of eliminating the materies morbi.
Stewart, L. C., Deputy Inspector General, Bom. I.—I have seen every mode of treatment
adopted, in numerous cholera outbreaks, great and small, and I have come to the unsatisfactory
conclusion that success in the treatment of the disease is not greater now-a-days than in my first
experience in 1842. I believe that very many seizures are averted by sanitary precautions and
prompt treatment of the premonitory symptoms, but a confirmed attack is not more likely to
recover under one mode of treatment than another.
Sutherland, J., Deputy Inspector General, Ben. I.—I regard the doctrine of elimination, when
applied to cases of cholera, to be one of the fallacies of the faculty, and the practice to which it
leads, most dangerous. In the case of a person who is under the influence of a poisonous dose of
opium, or who has been bitten by a venomous snake, do we attempt to eliminate the poison ;
does not experience show that all our efforts should be confined to support the system for a
while, knowing, if we can do this, that nature will rid the system of the poison. I regard the
vomitting and purging of cholera to be the morbid action of the poison, and in no way connected
with its elimination. Would any one say that the action of antimony in causing vomitting and
purging was the result of an effort of nature to eliminate the drug from the system.
Townsend, S. C., Surgeon, Ben. I.—The cholera poison may be received into the body
and eliminated from it without producing the violent effects that constitute true cholera.
Whether it does so or not appears to depend very much upon the state of the individual when
the poison is imbibed. Any circumstance that depresses the nervous system, such as fatigue
of body, anxiety of mind, previous excess in wine, or a dose of aperient medicine, apparently
renders a person exposed to the morbid influence more amenable to its effects. In fact, the
nervous system in one individual resists the action of the poison, and it passes out of the body
without any or after but slightly injurious effects ; while in another, or in the same individual
under different circumstances, the nervous system succumbs to the morbid influence, and the
symptoms of cholera are fully produced.
Trestrail, J. C., Surgeon Major, Bom. I.—I have had very considerable experience in the
treatment of cholera, for which I have tried calomel, bichlorid of mercury, opium, Condy's
fluid, acid halleri, bleeding from the arm and foot, friction, heat applied to the body and
extremities, salines (soda, chlorate of potash, and salt), and stimulants of all kinds. Finding
all of these fail, I have ceased to have faith in any. Heat, frictions, and stimulants I should
rely on more than on any other treatment.
Walker, W., Surgeon, Ben. I.—Honest investigation will prove that the physician who
discards all attempts to cure the disease itself, but waits expectant on nature, aiding her efforts
and using those auxiliaries which are found useful in relieving individual symptoms, will have
a larger percentage of recoveries amongst his patients than the man who prescribes specific
remedies to cure the sufferers.
Query No. 8.—The different stages of the disease require different remedies.
Banister, G., Surgeon Major, Ben. I.—This axiom should never be lost sight of. I have
witnessed irretrievable mischief from the plan of treatment by calomel and opium, and stimu-
lants being continued in collapse. I have to confess that in my own practice I have lost
many patients from enteritis and meningitis who might have escaped these evils had I with-
held calomel and opium when the circulation failed.
Query No. 9.—The primary action of the poison depresses or paralyses the sympathetic and
ganglionic nerves, and diminishes or suppresses the secretions of the organs supplied
by them.
Banister, G., Surgeon Major, Ben. I.—Arrest of capillary circulation, which is presided
over by the vaso-motor system of nerves, is certainly the first obvious and palpable effect of
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