No.
II.]
IV.—FIRST STAGE OR MALAISE. 57
Query No. 1,—continued.
Oldham, C. F., Assistant Surgeon, Ben. I.—Good if possible. If the poison can be elimi-
nated, the stomach and bowels appear to be the channels indicated by nature. But little
success has followed any attempts to remove the poison through them ; and in the early stages,
at all events, the disease appears often to be arrested by remedies which tend to check elimi-
nation and to diminish the secretions such as the cholera pill. Anything tending to depress
the vital powers is to be avoided.
Playfair, G. R., Surgeon Major, Ben. I.—Since 1862, I have made the removal of con-
gestion of the kidneys the very earliest part of my treatment of the first stage of cholera. J.
think the results have been very good.
Smith, C. M., Surgeon Major, Ben. I.—I believe there is a period of incubation lasting from
a few hours to three or four days. The first symptom of cholera is a kind of " malaise," with
lassitude and depression of spirits, slight feverishness, and headache. This is followed by
uncomfortable sensations in the epigastric region and bowels, and a tendency to diarrhœa; the
stools become light-colored and watery, and the urine is high-colored and scanty. If these
symptoms are neglected, or are not checked by medicine, they are soon followed by the
congee-water stools of cholera.
Thom, W., Deputy Inspector General, Bom. I.—Having seen a great deal of cholera during
my service, I have long been of opinion that the proper mode of treatment is to support the
strength of the patient, and not to check the vomitting and purging, which I believe to be
the method adopted by nature for eliminating the poison from the body. In the few cases
I have treated of late years, I have relied, upon external applications, with the use of cham-
pagne, beef and chicken tea, with an occasional dose of aromatic spirits of ammonia, the
patient being strictly watched day and night. The cases were not many, but 1 did not lose
one of them.
Walker, W., Surgeon., Ben. I.—I believe the poison of cholera, like that of typhus, will be
eliminated by nature without our aid, and that we want some mode of treatment that will
moderate the exodus and support the patient during the struggle.
Williams, H. F., Surgeon, Ben. I.—These indications are, I consider, of the utmost
importance in preventing the second stage.
Query No. 5,—Spices and Carminatives are useful.
Adley, W. H., Surgeon, Ben. I.—A combination of stimulants, astringents, and aromatica
with opium,
Gardner, E. B., Assistant Surgeon, Ben, I.—Opium also was never given, as I have known
only evil follow its use. In former "epidemics, the treatment followed was always a stimula-
,ting and cumulative one ; warm stomachics, pills containing essential oil, assafbetida, capsi-
cum, and copious draughts of hot water. The body was enveloped in a large poultice of meal
and mustard, and a fire was placed under the bed of each patient.
Grant, W., Surgeon, Bom. B.—A circumstance came under my notice at Nusseerabad in
Î867, which, I think, deserves notice. Several men came to the camp hospital, complaining
of looseness of the bowels, having to some extent a choleraic appearance, and a "crampy"
feeling of the legs. It was observed, that when these men sat or lay down, this " crampy"
feeling became more intense; and there seemed to be more general depression when they
talked about the " crampy" feeling of the legs'. The depression seemed gradually to wear off.
A system was adopted in such cases of giving small doses of brandy with opium and capsi
cum at short intervals, making the men at the same time walk, backwards and forwards at a
lively pace. In most of these instances the choleraic symptoms gradually disappeared.
There seems to be some resemblance between this mode of treatment and that adopted some-
times successfully in cases of blood poisoning caused by snake bite.
McDermott, P. A., Surgeon, Bom. B.—Some stimulants must be given, and some anodynes
and astringents also.
Penny, J. C., Assistant Surgeon, Ben. I.—Native Hakeems have long used them : they
say ginger will cure cholera, when used both locally and internally. Capsicum, nutmeg, &c.,
arc all useful adjuncts ; and camphor is good as a prophylactic, according to their ideas.
Peterkin, J., Surgeon Major, Mad. I.—I used to think so till I tried the system pro-
posed by Dr. Ayre, of Hull, of giving small doses of calomel repeated at short intervals. I
have a comparatively small experience of it. I view it, however, very much in the light of
a specific, but unless his directions are most carefully and implicitly carried out, it is no
better than any other remedy. In those cases under my supervision in which it failed, I felt
inclined to attribute this, not to the remedy, but to want of due attention on the part of
those who were charged with the duty of administering it. I do not think it applicable to
the early stages, or to those cases in fact that in all probability would never end in cholera
under any ordinary judicious treatment. I have never given it till the case assumed the
" algide'' form, or possessed unmistakeably the features of true cholera.