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

TREATMENT OF CHOLERA BY CASTOR

OIL.

,thKing's ilf,
olera by castor oil in College Hospta ,
The following letter, on the new treatment o
ilag been addressed to us by Dr. George
Johnson :
" Sir,—l shall feel obliged if you will perm
it me
to male
alt..
the means of publishing the
your journal
King's College Hospital, in the treat-
ment of cholera by castor oil.
results of our re:
I have no desire to rush
hastily into print, to deal in therapeutical novelties ;
ny own inclination would or
lead me to collect facts now, and
to defer the publication of results to a time of more leisure
Ind less anxiety; but I cannot reconcile myself to the
..doption of this cautious mode of procedure when I con-
ide
r that cholera is daily sweeping off hundreds of victims,
:lnd therefore that any method of treatment which pro-
•nises a more thau ordinary amount of success ought as
speedily
possible to be made known.
Y althecases of cholera which have come under my
e,A
~:are in the hospital have been treated by castor oil, a,l-
ninistered 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 them in the very extremity of collapse,* have been
under treatment, and the result has been 12 recoveries and
three deaths. One of the fatal cases was a child, six years
,f age, who died half an hour after admission, in conse-
;queue°, as I believe, of a large dose of brandy which had
,eel, previously administered by its mother. In a second
i'atal ease the oil had been given for some hours, and the
:ettient was rallying, when the oil was discontinued in
:onsequenco of the intestinal discharges r,ppearing to be
inked with blood. I was absent when this case occurred,
md, although I impute no blame, yet I think that with
he 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 v, e • have good
red
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 propprtion of recoveries yet remains fourth-fifths of
the whole. The number of cases is small, but my hopes
from thiS plan of treatment do not rest merely upon my
own individual experience. I have carefully studied the
results of the various modes of treating cholera which have
been advocated and practised by different members o
profession, and I have arrived at the conclusion that
_f our-
those
methods of treatment which have been attendedwitnhattine
v:
largest amount of success have been essentiailyel,ireamltineut
in their tendency. I allude especially to the saline t
of Dr. Stevens, the treatment by
small
of calomel, as practised by Dr. Ayre, and
nd repeated
largest amount
of treatment. While, on the other , hand, the W
. et mortality has occurred in the practice the emetic
doses
emetic plan
of ee who have

given freely either opium or alooholio stimulanb--s praai;
tice long since characterised by Dr.. Stevens as that of ads ding one poison to another. For, what reasonable Txpla•
' nation can we suggest for the phenomena of cholera except
this,—that some mysterious poison enters the blvd,
which, while it exerts a powerful depressing and narcotics
influence on the entire nervous system, in most cases cx.
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 aid 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
'llisappenrs-while the latter continues with unabated ra-

" Assuming, therefore, that it is desirable to encourage
rather than to suppress the diarrhoea, the agent best
adaptedto accomplish this resultappears to be castor 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
_htavehadno
I
difficulty in administering the medicine. sometimes
dello° that the effort of vomiting is beneficial, that
excites vomiting, and we have had such decided en-
we are rather gratified than otherwise with this re-
sult. In every case we give cold water ad libitum. We
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
cramped muscles
; we most carefully avoid opium and
brandy until the period of collapse is safely past ; and we
have not as yet had one
case
of secondary fever. It may
be well to observe that the success of the plan depends
upon a steady, persevering, watchful attention to every
:ha al
st. h enheaslidmosntebaellgtuhiatet issu rr eo qtuhiarte
iws h
case, at every period of its progress.
sei Let no one imagine
nurse to give half an ounce of castor oil at certain inter-
" I must not omit to mention that
carried out. do onr
e 0 he
teoi
rohnatss
woaorr de
oe
frf euodl ayr
patients have been rescued from an almost fatal lethargy
on
t)y an emetic of mustard and salt, and that in
one the
addition of two drachms of oil of turpentine to
castor oil appeared to act as a wholesome stimulantocadsous f
during
the stage of icy coldness. As to the quantity of castor oil
which may be given with impunity, I may state that more
than one patient has had as much us a pint in the course
of 48 hours, and that in several cases in which, withz.
treme collapse, there has been a torpid condition of the
bowels, 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-
niona to their admission, medicines have been given fur 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 th•
brief and necessarily hurried remarks which I have now
made may be of service to those who aro willing to adopt a
mole of treatment which appears to promise results so
favourable.—l am, d:c.,
"3, Woburn-square, Sept. 6."

" GEORGE Joaxsor.

* Four of these cases aro still in tho hospital, but quite
convalesceut.

The Earl De Grey is staying at Studley•park, near
Ripon. The noble earl's regiment, the Yorkshire Hes.
'3 a r , assemble at York, the week after next, and, froze
his lordship's attendance with that brilliant yeomanry
corps, he will be detained in the north until late in the
ensuing month, when the noble 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,
The Right Hon. Sir Charles and Lady Mary' Wood
are expected to return to Hickleton Hall, near Douche-
t,er, the week after next, from a tour of visits in Scot.
land.
The Right Hon. Sidney Herbert, M.P., andiMre,
Herbert are staying at Wilton House, near Salisbury,
. and do -not return to town for a permanenoy until the
close of next mouth.
AMSTERDAM AND ROTTERDAM 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 firmest
among holders, and the advance was well supported. In
sugar there had been no great change, but the tendency
was toward improvement. The chief operations bad 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 Core, late Vicar of New-
castle, met with a serious accident on Wednesday in last
week. The venerable gentleman, whilst returning from
Bamborough to Eglingliam, and when near a place called
Noith,Cbarlton, 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.—Newcastle
Courant.
CRYSTAL PALACE.—Return of admissions for six days
ending Saturday, Sept. 9 Numbers, including season
tickets, 43,723 ; amount received for admission,
1,924/. 2s.
CRYSTAL PALACIL—SEPT. 71 (ONE SHILLING DAY.)
—Admission at the doors, 8,476 ; admission by seams
tickets, 424 ; total, 8,900.
PUBLIC SYMPATHY FOR LIRUTRNANT PERRY.—Last
night a public meeting was held at the Prinoe 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's 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 addressed.
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 BRITISH BRIG BET SEY.—The ship
Humboldt, arrived at New York from Hainburgh,
gives the following report of the loss of the Britisl
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
tain Watson e
broke ro;
feet below the top. We sent our boat alongside, and
took Captain Watson and nine men from the wreck,
;tldtobrtohuagthotnthethem tlo7tthhi
Julys port.a
heavyC sea
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 ROA 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•
eers for the kind treatmeitt that himself and crew re-
ceived while on board the Humboldt.
ARMIL—A
FATAL CARELESSNESS WITH LOADED
coroner's inquest was held at the GuildhaaFll,llld
Terry,
30th ult., when the evidence showed
whose
et Henry on the
death was the
the husband of the deceased womantow
draw the charge of
table" while he went
subject of the inquiry, was tryinge
his gun, and "laid the latter ourtobscrew.
Deceased and
into the pantry for a largerheturoom where the gun was.
four children were then
hick almost immediately
by his sister, took up
the
gull,
shot through the head, re.
to the account given
It appeared that the gun had
ceiving mortal injuries. Oweentof off,th
uret3so:
week or two before fur the
been loaded with shot
and thus by want of caution four
eanydou3nigrse..rblioe:rs,:irilictr
vd:i according
pose ollshooting 7
i a dnoTristant rendered motherless, while
the lin.banddraan
verdictu of "Accidental death."
jury rettirue
were "n
a and down " like a crazy man." The
MILES IN 22 HOURS for 25/.—Nir.
100
the Monmouthshire Militia, commenced
Thompson, of
s in 22 hours, at the Ball Court, Mer-
thyr,
ch
lilidiAreLnxma
walking
Friday,loom
and continued all night. At twelve
" l number assembled to witness the
° ►I en it was found that the task had been aceom-
close, w i
d an hour before the time specified. Although
plishe ,
1 son seemed fatigued, he on the whole did it in a
pedestrianlbom) style.—Cardiff Guardian.
d, SHOULD AULD ACQUAINTANCE BE FORGOT 7"—The
'clock to-day a large
Journal de St. Petersbury contains the following para-
graph :—" L ,rd 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 present himself'
, before the electors."