Cleveland daily leader. [volume] ([Cleveland, Ohio]) 1865-1873, 1866-05-11

oil, a treatment invariably followed by re-
eovery. During the epidemic of 1919,
several nurses and patients so seized had
been promptly treated by opiates, passed
into collapse, and died.
In a number of the British Medical
Journal, Mr.. Watkins tells that having
observedin 1s54the mortality under treat
ment by opium, at a time when the cpl
demic was increasing both in number of
cases and severity, he treated twenty-one
cases BY repeated doses of castor-oil, and
nineteen recovered. His colleague treat
ed seven cases by full doses of opium, and
every one died.
The morbid poison, which is the exciting
cause of cholera, and which may enter
the blood either through the lungs or
through the stomach, causes also that co.
pious secretion from the mucous membrane
Of the stomach and bowels, by which ma
ture %endeavors to get rid of the p~erilous
intruder. The secretion is, probably, as
much apart of the natural process of cure
as the eruption on the skin in case of
smallpox. At any rate, no patient ever
recovered from smallpox without the ap-
pearance of the eruption, and no patient
chCI ICCOh IIOAu CuOACId NlLnOlL SOLlb
vomiting and purging.
The blue skin, the more or less hurried
and difficult breathing, the GOODNESS and
the great diminution of the volume and
force of the pulse in choleraic collapse,
point, says DR.. johnson, to the great een-
trail fact "that the passage of bloodthrough
the lungs from the right to the left side
Of the heart is, in q greater or less degree,
impeded.n The fact is also demonstrated
by the appearances observed in the heart,
blood-yessels, and lungs after death. The
right side of the heart, and the pipes
leading thence TO the lungs, are filed,
often distended, with blood; the left side
of the heart is almost or entirely empty.
The tissue of the lungs is pale and dense,
containing less than the usual amount of
blood and air. That is the state of things
when death has occurred from collapse;
and, on the other hand, there is a great
engagement of the lungs when death has
occurred in the febrile stage, which often
follows reaction. In the state of collapse,
venesection, by relieving the o~ver-disten-
sion of the right cavities Of the heart, re-
stores to them their contractile power.
And it is this impediment to passage of
blood through the lungs that, reducing
the flow through the arteries to a minimum
causes shrinking of the skin, collapse of
the features, and sinking Of the eyeballs
by reason of the more or less complete
emptiness of the branches of the artery
that brings them their supply of blood.
But what is the cause of this blockade
of the circulation Not mechanical
thickening by loss of fluids, for we have
seen how untenable that notion is. And
the occurrence of collapseis often remark
able for s~uddenness. Sir William Burnet
in his Report on Cholera in the Black
Sea Fleet, gives the account of a surgeon
who says, "the attacks were in many
cases so sudden, that many men fell as if
they had drank the concentrated poison
of the upas-tree.n notwithstanding by
dram or fluid cannot happen thus in a
minute or two. Thiekening there is, but
as a necessary consequence, not as a cause,
of the arrest of circulation in the vessels
that convey the blood from the right side
Of the heart into the lungs.
DR.. George Johnson's explanation of
the stoppage is, that the poison of the
disease, having entered into the blood,
acts as an irritant upon the muscular It's
sue, as is shown by the painful cramps it
occasions that it thus acts in producing
contraction of the minute capillary YES
sells of the lungs into which the heart in
jects the blood for aeration, and that the
result of this contraction is entirely to
arrest or to impede the flow of the blood
through the lungs, whence it should pass
revivited into the arterial system.
We heed not dwell upon further evil
dence that this arrest Of blood at its en-
trance to the lungs is the true cause of the
collapse in cholera, or on the way in which
the chemistry of life will be affected by
impediment to aeratiOn of the blood. The
blood in cholera is black and thick only
during the stage of collapse, as a simple
consequence of the deficient supply of OK
ygen. One curious fact however, DR..
johnson mentions, and shows how ex-
actly it confirms his theory. While other
secretions fail, that of milk, during col
lapse from cholera, remains abundant.
This has been observed by others, and va
riouEly accounted for. The explanation
now given is, that the chief constituents
of milk-casein, oil, and waterway
be obtained from the blood without the
addition of oxygen.
The fact that immediate but not perm
anent relief has been obtained by hot in
%jections into the veins this theory accounts
for by the mechanical action of the fluid
in diluting the irritant poison, and the eff
feet of its heat in overcoming for a little
time b econtractile force of the capiIlaries.
The last link in the chain of the argu-
ment is evidence of the presence of a NOR
bid poison in the blood as cause of cholera.
But this fact is generally admitted, and
the evidence by which it is supported we
will take for granted. So we come to
what is the main question for tie public.
If this be, as it surely Is, the true theory
of the action of cholera poison, of what
practical use is it d? 1t teaches the physi-
clan to walk in the light where he has
hitherto walked in the dark. 1t tells him
how to assist nature, and how he may
avoid interfering with theproeess by which
nature herself labors towards cure.