The Sun.
London, England, 1854-09-12 00:00:00

TREATMENT OF CHOLERA BY CASTOR

OIL.

The following letter, on the new treatment of
cholera by castor oil in King's College Hospital,
has been addressed to us by Dr. George Johnson :
" Sir,—l shall feel obliged if you will permit me to make
your journal the means of pulilishiioetal, in the n
etphieresults of our re-
cent experience at King's College
treat-
ment of cholera by castor oil. I have no desire to rush
e
hastily into print, to deal in therapeutical novelties ;
my own inclination would lead me to collect facts now, and
to defer the publication of results to a time of more leisure
and less nx • ty; but I cannot reconcile myself to the
ndoptio an of- thisie cautious mode of procedure when I con-
sider that cholera is daily sweeping off hundreds of victims,
and therefore that any method of treatment which pro-
mises a
more than ordinary amount of success ought as
speedily as possible to be made known.
" All the cases of cholera which have come under my
care in the hospital have been treated by castor oil, ad-
ministered in a mode which I shall presently explain. We
have called no case `cholera' which has not presented well-
marked symptoms of collapse. Fifteen of these cases,
most of theta in the very extremity of collapse,* have been
under..treatment, and the result has beenl2 recoveries and
three deaths. One of the fatal cases was a child, six years
of age, who died half an hour after admission, in cense-
sequence, as I believe, of a large dose of brandy which had
been previously administered by its mother. In a second
fatal case the oil bad been given for some hours, and the
patient was rallying, when the oil was discontinued in
consequence of the intestinal discharges appearing to be
tinged with blood. I was absent when this case occurred,
and, although I impute no blame, yet I think that with
the discontinuance of the oil the patient's chance of re-
covery was taken away. In the third fatal case, a night
nurse disregarded her instructions, and we have good rea-
son for the belief that during several hours the patient
had very little, if any, of the medicine. Admitting, how-
ever,
that the fatal result in these three cases was inevita-
ble, the proportion of recoveries yet remains fourth-fifths of
the whole. The number of cakes is small, but my hopes
from this plan of treatment do not rest merely upeos? my
own individual experience. I have carefully studied
results of the various modes of treating cholera which have
been advocated and practised by different nrranbe
profession, and I have arrived at the conclusion that
with the
methods of treatment which have been attendedtythatetfheouser
largest amount of success have been essentially
b 'saline treatment
in their tendency. I allude especially eliminative
of Di'. Stevens, the treatment by
d the emetic plan
of calomel, as Piactised by Dr. Ayre,d,
small and repeated doses
hand, the largest amount
of treatment. While, on the other
amtautr has ociurred in Ow P a '1"1 ing!
""

given freely either opium or alcoholic etimulante—a prac-
tice long since characterised by Dr. Stevens as that of ad-
ding one poison to another. For, what reasonable expla-
nation can we suggest for the phenomena of cholera except'
this,—that some mysterious poison enters the blood,
which, while it exerts a powerful depressing and narcotio
influence on the entire nervous system, in most cases ex-
cites a copious secretion into the stomach and intestines,
whereby the poison is separated from the blood and thus
ejected from the body ? And if this be the rational patho-
logy of cholera, what treatment is so likely to be injurious
as that which attempts by narcotics and astringents to
arrest the discharges ? What procedure so full of promise
as that which has for its object to favour and assist the
elimination of the poison ?. _

" I have not time, even if you could afford me the space,
to detail the numerous facts and arguments which favour
that view of the pathology and the treatment of cholera
which I advocate. I may, however, remark in passing,
that there is no relation between the degree of collapse and
the amount of fluid which is lost by purging; that in many
cases there is rather an inverse ratio between the collapse
and the diarrhoea, and that the former often decreases and
disappears while the latter continues with unabated ra-
pidity.
" Assuming, therefore, that it is desirable to encourage
rather than to suppress the diarrhoea, the agent best
adapted to accomplish this result appears to be ca.stor oil, the
mildest, least irritating, and yet withal the quickest pur-
gative which we possess. Our plan has been to give the
oil in doses of half an ounce every half hour, and to con-
tinue these doses until the bowels are freely acted on, when
we give it at longerintervals, and discontinue it altogether
as soon as reaction is fairly established. It is usually
given in cold water. A patient with a cold tongue has
not a very delicate sense of taste, and we have had no
difficulty in administering the medicine. It sometimes
excites vomiting, and wo have had such decided evi-
dence that the effort of vomiting is beneficial,. that
we are rather gratified than otherwise with. this re-
sult. In every case we give cold water ad libitum.
put mustard poultices over the stomach to relieve the pain
which is usually complained of in that situation ; we
apply dry heat to the cold extremities, and friction to the
clamped muscles.
twhaet mthoests
brandy until the period of collapse is safely past ; and we
be well to observe carefully avoid opium and
have not as yet had one case ofsecondary -fever. It may
oessof
upon a steady, persevering wa'let fif 1 attention to every
case, at every period of ita-'ll
the plan depends
that he has done all that is progress. Let no one imagine
a
nurse to give half an ouncereo7uciredt when he has orderedi
Rt
.0e
vals: He must be quite sure thaatshi.-
carried out. is directions are fully
" I must not omit to mention that one or two of our
patients have been rescued from an al
by an emetic of mustard and salt, and almost fatal lethargy
that in one case the
addition of two drachms of oil oiturpent'
castor oil appeared to act as a wholesome turpentine
et
dose of
the stage of icy coldness. As to the quantity of
lour,
r which may be. given with impunity, I may state that
than one patient has had as much as a pint in thea mere
of 48 hours, and that in several cases in which, with
ex-
treme collapse, there has been a torpid condition of obowels, we have given the oil in doses of a full ounce. •
"And now a few words as to the treatment of epidemic
diarrhoea, characterised by vomiting, purging, and cramp.
There appears little reason to doubt that the unaided
efforts of nature will suffice for the cure of by far the
greater number of these cases, and that it is a matter of
comparative indifference whether the patient is dosed
with sulphuric acid or with carbonate of soda, except that
the sulphuric acid in large doses must irritate the mucous
membrane, and thus act as an aperient. I am per-
suaded, however, that the plan of attempting to check
these excretory efforts by opium and astringents is
as hazardous as it is unreasonable; and I trust that
the time is not far distant when the profession will
be unanimous as to this important point of practice.
We have recently at the hospital cured hundreds of
these cases by one or two doses of castor oil. Several of
our nurses and one pupil in attendance on the cholera
patients have been seized with severe premonitory symp-
toms of cholera. They have all been quickly cured by
castor oil, and not one has passed into the stage of collapse.
On the other hand, I have known, in the year 1849, an
attack of vomiting and purging quickly converted into
one of fatal collapse by one or two small doses of opium ;
and some of the worst cases of cholera that we have re-
cently had under our care have been those in which, pre-
vious to their admission, medicines have been given for the
purpose of checking the diarrhoea.
"At some future time I shall probably publish a full
account of all my cases ; in the meantime, I trust that the
brief and necessarily hurried remarks which I have now
made may be of service to those who are willing to adopt a
mode of treatment which appears to promise results so
favourable.—l ant, he,,
"3, Woburn-square, Sept. 6."

"GEORGE JOHNSON.

* Four of these cases are still in the hospital, but quite
convalescent.

The Earl De Grey is staying at Studley-park, near
Ripon. The noble earl's regiment, the Yorkshire Hus-
sars, assemble at York, the week after next, and, from
his lordship's attendance with that brilliant yeomanry
corps, he will be detained in the north until late in the
ensuing month, when the nobilt earl repairs to Wrest-
park, Bedfordshire, to welcome a succession of visitors.
The Earl Granville is expected to arrive in London
the week after next from Carlsbad.

The Right Hon. Edward Cardwell, M.P., the Presi-
dent of the Board of Trade, will return to town towards
the close of the present month, from a tour of the Ger.
man_ Spas, accompanied by Mrs. and Miss Cardwell.
—T Right Hon. Sir Charles and Lady Mary Wood
are expected to return to Hickleton Hall, near Doncas-
I ter, the week after next, from a tour of visits in Scot-
laud.

The Right Hon. Sidney Herbert, M.P., and Mrs.
Herbert ai e staying at 'W ilton House, near Salisbury,
and do not return to town for a permanency until the
close of next month.

(AMSTERDAM AND ROTTERDA3I PRODUCE MARKETS.—
The weekly reviews from the above markets state that
business was rather more active. The favourable result
of the late sales of coffee had caused greater firmness
among holders, and the advance was well supported. In
sugar there had been nn great change, but the tendency
was toward improvement. The chief operations had been
in raw descriptions. There was increased steadiness in
rice, some purchases having slightly improved the tone
of prices. Indigo and tea, although the operations were
limited, had been maintained at former quotations.
ACCIDENT TO ARCHDEACON COXE.—We regret to
announce that Archdeacon Cose, late Vicar of New-
castle, met with a serious accident on Wednesday in last
week. The venerable gentleman, whilst returning from
Bamborough to Eglingham, and when near a place called
North Charlton, was by some means or other thrown
from his horse, and sustained a severe concussion of the
brain. Dr. Wilson, of Alnwick, was speedily in atten-
dance ; and the unfortunate sufferer now lies at North
Charlton, in a critical state of health.—Nelocaetle
Courant.

CRYSTAL PALACE.—Return of admissions for six days
ending Saturday, Sept. 9 : Numbers, including season
tickets, 43,723 ; amount received for admission,-
1,9241. 2s.
CRYSTAL PALACE.—SEPT. (ONE SHILLING DAT.)
—Admission at the doors, 8,476 ; admission by seasoa
tickets, 424 ; total, 8,900.
PUBLIC SYMPATHY FOR LIEUTENANT PERRY.—Last
night a public meeting was held at the Prince Albert
Tavern, York-street, Kingsland-road, "to take into
consideration the late iniquitous proceedings against
Lieutenant Perry, and to forward, by combined efforts,
Mr. Perry 'a manly exertions to free himself from the
trammels of his persecutors." Mr. Steadman occupied
the chair, and moved the following resolution :—" That
this meeting pledge themselves, by all legal and consti-
tutional means in their power, to assist Lieutenant Perry
' in his praiseworthy endeavour to counteract the tyranny
and machinations of his oppressors." He also addreesed,
the meeting on the injustice and illegality of the pro-
ceedings before the late Court-martial. Mr. Russell
seconded the resolution which was unanimously adopted
by the meeting. Mr. Gale then moved an address, to
urge upon her Majesty the propriety of taking the
opinion of the judges on the evidence taken before the
late Court-martial, which was seconded by Mr. Ferdi-
nand, and unanimously adopted. A. committee was
then formed to carry out the objects of the meeting, and
a subscription entered into.

Loss of THE BEITISH BRIG BETEEY.—The 8131 p
Humboldt, arrived at New York from Hamburgh,
gives the following report of the loss of the British
brig Betsey :—July 24, lat. 60 deg. 42m., long. 4
deg. 51m., fell in with a wreck at 9 p.m. Came
alongside of her. It proved to Le the British brig
Betsey, Captain Watson, from London from Ouebeeri,
with about 10 feet water in the hold. Her foremast
was gone by the deck, and the mainmast about 6
feet below the top. We sent our boat alongside, and
took Captain Watson and nine men from the wreck,
and brought them to this port. Captain Watson re-
ports that on the 17th July a heavy sea broke on
board of the vessel, while under close-reefed topsails
and foresail, which took away foresail and foretop-sail,
and hove the vessel down with her lower yards in
the water ; stove in the hatches, and set the whole of
our fresh water adrift. At 7 a.m. (18th) cut away
the foremast to right ship, and pumped successively
until the 19th at night, when we were taken off the
wreck by the Humboldt, Captain Paulson, having
then been without water two days. The sea being
so heavy it was impossible to save anything from the
wreck except what we stood in. Captain
Watson
returns his Sincere thanks to Captain Paulson and offi-
cers
for the kind treatment that himself and crew re-
ceived while on board the Humboldt.
Rms.—A
FATAL CARELESSNESS WITH LOADED IR
coroner's inquest was held at the Guildhall,
Henryy Terry,on the
30th ult., when the evidence showed that
death-Id wasthe
the husband of the deceased whosewomanto
draw the charge of
subject of the inquiry, was trying
into the pantry for a larger
the
room where the gun was.
his gun, and " laid the latter otnoroth
se
otraetl
.e"
Dwhecileeahseedwaenndt
four children were then iaccording to the account given
One of the younger boys,
swhichho t through almost
theimmediately
head,
re.
It appeared that the gun had
ceiving
mortal injuhmotesa week or two before for t four
pose erlcautione s s.
while
by
wenthi so
sister,ff , an d took3.lrs . u 1
Pet 4 gwuasn,
been loaded with
children were in a
and down " like a crazy man." The
the hushanddraanup
verdict of "Accidental death."
'n
as
t an dn
t thusr
rendered n db eyr evida I'M
pose of shooting a togi
jury returned
%%TALKING
100 MILES IN 22 HOURS for 25/--11r.
of the Monmouthshire Militia, commenced
Thompson,
miles .
22 hours, at the Ball Court, Mer-
u Friday, and continued all night. At twelve
thcyro,c_o
l k to-day a large number assembled to witness the
walking 100 in
close, when it was found that the task had been accom-
plished an hour before the time specified. Although
Thompson seemed fatigued, he on the whole did it in a
pedestrian style.—Cardiff Git a rdian.
" SHOULD AULD ACQUAINTANCE BE FORGOT I"—The
Journal de St. Petersburg contains the following para.
gra
ph :—" Lord Haddo, son of Lord Aberdeen, has
Just been elected, like his brother, a member of the
House of Commons. He was so sure of his return that
he did not think it Worth his while to provost wawa
' before*, glootoro."' , - - - - -- -
i --- --