Cleveland daily leader. [volume] ([Cleveland, Ohio]) 1865-1873, 1866-05-11
The First Blow against Cholera

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Christ. Amen.
The First Blow Against Cholera.
From the London Examiner.l
There is every reason to expect that we
shall hear more of cholera next summer,
and that it may come nearer home to US
than it did last year. While politicians
have been sitting in conference for the
outlawry of the disease as q political Of
fender, one of the most eminent of our
English physicians has been ripening the
fruits of his own study and experience,
and he has within the last few weeks Civ
en- them to the public in q little book of
"Notes on Cholera" which concerns the
public very much. For in that small
book of about a hundred lightly printed
pages there is given to the world what the
foremost members Of the medical profess
sion are now readily accepting as the first
true and complete explanation of the dis
ease, whiehis moreover such a demonstra-
ton as Immediately excludes the method
of treatment founded Hpon a mistaken
theory hitherto dominant, the method
which has actually aggravated danger,
killed instead of cured.
The first real blow struck against chol-
era is the discovery of what it is. For
the physicians are its true antagonists, and
knowledge of their enemy is the condition
of successful battle. Some Of our read
ers may remember that at the time of the
cholera epidemic In 1854, DR.. George
johnson who was then, as now, physician
to Kings College hospital, and whose
credit stood high in his profession for i'm
portant original addition that had been
made by him to the known pathology of
disease Of the kidney, strongly supported,
by results of his own hospital experience,
the treatment of cholera with castor oil.
He spoke with knowledge and with rea-
son, though he is now convinced that he
often ' excessive quantities of castor
oil. Upon what path of inquiry he was
travelling when he made that recommend
alton we are now quite able to understand.
The true doctrine of the nature of chole-
ra as ex~plained..in his little book with a
mastery c~learness and cogency, is really
unassailable by any rebutting facts, and
will henceforth pass bodily into every
good text book upon the character and
Treatment Of the disease.
The theory hitherto dominant has been
that the worst symptoms of the disease
are caused by the drain of fluid from the
blood. The treatment, therefor, has been
to check purging by opiate and astring-
ents, and even to restore to the blood its
lost constituents by saline injections into
the veins.
But if this was so, il is argued, there
would be some relation between the symp-
toms of eholeraic collapse and the loss of
hEid by vomiting and purging. Yet the
authority of all who have written upon
cholera from much experience, in India
and in Europe, afirms that there is no
such direct relaxation; that they often
bear sven an inverse ratio to one another.
Cholera cases have been most malignant
where there was least passage of fluid
from the intestines. If there were any
correspondence between loss of fluid and
degree of collapse, it would still have to
be shown that they stood to each other in
the relation of cause and effect-that they
were not effects of a common cause. But
in fact, so far as there is any relation at
all between the discharge of fluid from the
system and the peril of collapse, it points
to the existence, not Of a direct, but of an
inverse ratio between them.
Again, if the collapse in cholera be
caused by the watery constituents of the
blood, it should have such symptoms as an
excessive drain of fluid from the blood is
known usually to produce. The collapse
caused by q profuse drain from the blood
is marked by a small and frequent pulse,
pale skin, dim sight, and singing in the
ears; symptoms SO much increased by the
erect posture, that in extreme cases the
raising Of the head, even for a moment,
from the pillow causes fainting. The col
lapse of cholera is quite different from
this. There is the peculiar blueness and
GOODNESS, with other symptoms indicating
interference with aeration of the blood;
and the patient whose skin is blue and
icy cold, with a pulse hardly perceptible,
is often able to stand up, and aver walk.
Several authors have expressed their sur
prise at the amount of muscular e~xertion
of which even a cold and pulseless patient
is capable. Again, the patient exhausted
by drain from the blood, whether of water
alone, or of the blood constituents, slowly
RECEIVERS strength.
A cholera patient who RECEIVERS, is him
self again in a few days. al have SEEM
SAYS Mr.. Granger, "a man stand at his
door on Wednesday, who on Monday was
in perfect collapse - and a professional
observer of the disease in India speaks of
recoveries from cholera as "almost as
sudden and complete as in cases of pa
tients who are resuscitated after suspen-
sion of animation from submersion in
water"
Again, compare results of treatment in
collapse through drain of liquid from the
blood and in collapse through cholera. In
one case wine of brandy will soon cause
improvement of the pulse and visibly
assist recovery. Give them in the col
lapse Of cholera as they have given
freely and bodily, and the patient will
even grow colder, his pulse diminish in
volume and power, apparently as a direct
result of the stimulant. Or again, no
sane physician would order venesection
as a remedy for collapse from a drain
upon the blood, yet it has been a puzzle
to physicians in India that blood-letting
in cholera does not producesyncope, butts
often a relief that seems miraculous A
man struck by cholera was brought to one
physician unable to move a limb, and,
except that he could speak and breathe,
to touch and sight a corpse. Free bleed
ing enabled him in half an hour to walk
home with his friends. Sir Randall Martin
tells how his farrier major was reported
dying of cholera, and he found, using the
language of the theory now happily dis
| posed of, "that during the night he had
| been drained of all the fluid portion of
his blood" Sir Randall opened a vein.
The blood oozed at first like a dark
treacle, presently flowed freely, of its own
natural red color, and he who had been
dying a moment before stood up and said,
"Sir, you have made a new man of mel
Such experience, which represents the
rule, not the exception, is utterly incom-
patible with the old doctrine that loss of
blood, or of constituents of blood, il tho
cause of the fatal collapse in cholera. In
the cholera epidemic of 1s49 the cases
brought into Kings College Hospital we're
treated, in accordance with accepted doe
trine, by liberal doses of brandy and
wine, to stimulate the circulation and to
| check discharge. Under this treatment
the mortality was very great, and it was
changed for an administration of large
quantities of salt and water. This excited
frequent vomiting, and rather increased
the purging, but it increased the number
of recoveries. Observation of the results
of these two opposite modes of treatment
produced the train of thought which led
DR.. George johnson, when he himself had
charge of the hospital during the epidemic
of 1854, to act on his conclusion that the
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