60
REPLIES TO QUERIES ON THE TREATMENT OF EPIDEMIC CHOLERA.
[Appendix
Query No. 1,—continued.
it is the result of au allied epidemic influence. It is amenable to treatment, and we should
endeavour to moderate it, with a view to prevent its becoming exhaustive, and by inducing
debility, rendering the subject more liable to true choleraic seizure. This is the period in
which carminatives, astringents, and various " cholera pills" prove useful, and during which
" house to house visitation" should be undertaken.
Macpherson, H. M., Deputy Inspector General, Ben. I.—The indications are to check
the looseness, soothe the irritation, and promote the secretions. When cholera prevails
epidemically it is dangerous to administer castor-oil or other purgatives.
Pilsher, J. G., Assistant Surgeon, Ben. I.—To check the looseness is doubtless the
indication. And this is often accomplished by a mild purgative combined with carmina-
tives, which has the effect of clearing out the bowels. Many cases of undoubted cholera are
apparently saved by this timely purgative. The passing of thin feculent discharges contain-
ing semi-digested matter, specially calls for the use of gentle purgatives with stimulants or
carminatives.
Turton, F. A., Assistant Surgeon, Bom. B.—To check the looseness is the first step,
and I believe it to be most readily attained by the use of iced cold water, as recommended
by me.
Query No. 2.—Remedies.—Opiates remove pain and check looseness, tout retain irritating
ingesta and diminish the action of the liver.
Adley, W. H., Surgeon, Ben. I.—A combination of nitrate of silver and calomel, with
¼ grain of opium.
McDowall, C., Surgeon, Bom. I.—Opium also checks the function of the kidneys, which
is much more dangerous than stopping the bile flow; indeed, we see cases of jaundice last
for weeks without coma following. The liver, however, in cholera may be induced, perhaps,
to eliminate more than bile, and calomel also, I think, tends to eliminate urea, &c., in more
ways than one. Opium, if given (and some miraculous cures sometimes follow a single
dose), must be combined with or followed by calomel.
Murphy, M. W., Deputy Inspector General, Bom. B.—Opiates are most essential.
When combined with quinine or small quantities of blue pill they are unobjectionable.
Spencer, R., Assistant Surgeon, Bom. B.—Of all remedies I consider opium the most
useful for this stage ; and when the diarrhœa is checked, one or two small doses of calomel
will probably restore the secretions of the liver.
Townsend, 8. C., Surgeon, Ben. I.—It is by its stimulating effects on the nervous
system that opium given in the early stage, so often proves efficacious in arresting the
progress of the disease. But opium often fails to do this ; and on the other hand, it acts
injuriously by its action on the secreting organs, preventing the elimination of the poison
and aggravating the secondary fever.
Query No. 3.—Chlorodyne is more energetic than opium with analogous action on the
secretions—it stimulates the brain.
Chapple, R. A., Surgeon, Bom. B.—I endeavour to check the diarrhœa which usually
ushers in an attack of cholera. With this object, I have tried at different times all the
vegetable and mineral astringents in use, and I have found that all yield in efficacy to
chlorodyne. It possesses over other remedies of the class of astringents, either alone or
when combined with opium, two great advantages ; these are, that it produces immediate
effect on the system, and is tolerated by the most delicate stomach. It is only of value
in the first stage.
Barker, Assistant Surgeon, Ben. I.—Rum, 2 ounces, or brandy, with 20 drops of
chlorodyne.
Brougham, J. P., Surgeon Major, Ben. I.—Chloroform inhalation ; chloroform with
sulphuric acid mixture ; chalk with Chloroform and ammonia.
Browne, J., Surgeon, Ben. I.—Chalk mixture, with aromatic spirits of ammonia and
chlorodyne ; a rhubarb draught if undigested food is passed.
Chuckerbutty, S. C. G., Surgeon, Ben. I.—Tincture of opium, 25 minims ; water one
ounce. Or, chlorodyne 20 minims ; or extract of opium 1 to 2 grains, mustard plaster to
abdomen. Ice or cold water.
Donaldson, J., Surgeon, Mad. I.—Below is given a formula which I have found most
safe and effectual in the preliminary treatment of cholera, for cutting short the disease, or at
least making it apparently milder and more manageable in all its stages, and for warding off
extreme collapse, and so obviating violent reaction. The ratio of deaths with treatment
based upon the theory of support, in a very violent outbreak (Vizigapatam, 1861), amongst
the European population, was six out of eighteen picked and extreme cases, Scores of cases