The National tribune., 1892-09-15
CHOLERA TREATMENT.

Surgeon General Sutherland, Of the Army.
| issued the following circular last week for the
| guidance of medical officers of the Army in
case the cholera should make its appearance in
this country. As we have had several requests
| to publish preventives of this dreaded disease
| we give the Surgeon Generals instructions to
/ his officers:
! WAR DEPARTMENT
! SURGEON GENERALS OFFICE.
| WAsHtSGToS ID. C., sept. 9. 1892
| CIRCULAR:
| This circular is published for the information
| and guidance of medical officers who may be I'M
| familiar with the general management and pre-
| venion OF cholera and for others who have
received no specific instructions from Medical
| Directors OF the Army.
| AS this disease by its presence at the New York
| quarantine now threatens the whole country,
/ great object will be gained if we succeed in pre-
venting it from appearing at military posts by
| thorough and effective sanitation and ceanliue-s
| Science and experience have demonstrated that
cholera is caused by a specific germ which must
reach the bowels in living state; that this germ
maintains its vitality aud harmful properties under
many conditions. the most important being IN the
| discharges from the bowels of the sick, in their
soiled clothing and bedding. in the privies and cess.
pools which receive the discharges and in the soil
and subsoit waters which become secondnrlly con-
| taminated.
| Guided by these principles may determine
what Is to be DONE first, in antici patton Of al In
vasion and, second, when tbs invasion has taken
place.
FIRST. As cholera germs can live and multiply Tor
a time outside the body IN the presence Of decay
| ing organic matter, particularly that of animal
origin. all conditions favorable TO their existence
should be excluded. The measures necessary to
accomplish this TO remove Mi deCaying matters
from post, whether found in dwellings, cellars, bar
racks. Stables dung hills, old wells or cesa- pools,
coat- bina, or other hiding places, and TO require
| absolute cleanliness of all persons. These are
general but particular instructions should be given
for the inspection. condemnation, aud destruction
OF all tainted meat, Ash nsound vegetables. fruit,
| or airy other articlc of food that would tend to
cause diarrhea.
II cholera be in Tie vicinity of post thorough
and efficient quarantine should be KEEP. up against
the infected locality. No person should be ad-
| mitted within the lines without undergoing quar-
\ antthe examination; no baggage nor supplies with
out being disinfected passed by the medical
officer. Police regulations should be scrupuiously
carried out. The troops should be preserved from
| all nntiilygieuio influences. There should be no
unnecessary exposure TO sun, rain, Or nigh. air,
and no drills nor fatigue duties other than to fur
nish occupation and ncedfui exercise. When the
military conditions permit, The post should be
viewed rs engaged in al active campaign against
| an irsidious and implacab!e enemy, and the at
tention of every officer should be devoted to super
| intending the conduct of his men with special
| reference to this view.
| Articles Ct leather, such n trunks boots and
| shoes suspected of cholera infection, should be
either destroyed washed with disinfeetiuR solu-
ton. Attention has been called to the influence OF
| old shoes as . means Of propagatHg the disease;
when = person treads a soil moro or less damp In
| an infected locality thero 10 every chance Of bis
conveying the germs Of the disease.
| quiescent state OF mind should be enioined
upon all; nothing Is more calculated to spread the
disease than unusual excitement or the depressing
influences Of fear and fatigue.
Tho use Of acid drinks, II cholera Is threat
| ening, should be prescribed. This II for tbs
| purpose Of acidifying tho stomach and Its CON
| tents, which are always alkaline except when
| digestion 10 In progress Acids antsgon-
| istie, alkalies favorable, to the development OF
bacteria. II the stomach be kept reasonably
acid by pure dilute ncids ell bacteria will be de-
| stroyed before reaching the fntestines, which are
always alkaline in health Diluted or aromatic
sniphnric acid, hectic acid or good vinegar, lemon
or lime juice, are suiiabls agents to employ Hy-
dro- cIiorie acid is also useful. This acid is always
more freely secreted when the gastric DIcmbranes to
stimulated by the presence Of salt; hence salt meat
is an excellent article of diet during the prevalence
| of cholera.
| Moreover, all arrangements should be made for
the isolation and Treatment. OF first and succeed
| Ing cases should they unfortunately occur.
| Second. When n case Of cholera appears 1t should
be promptly isolated and all unnecessary contact
| with outside people be prevented. The patient or
patients should have nurse to wait upon them
exclusively. When cases occur IN quarters other
than barracks they should be isolated in the special
cholera hospital; but if treated in quarters all Alb
sorbent articles Of furniture such carpets cash'
toned articles and hangings should be Immediately
removed from the apartment.
| All cases of premoni.ory diarrhea should be de-
tected by careful inspection and treated immedi-
ately and full instructions should be given regard
ing food drink and the disinfeciion of excresa.
With the exception of fruits that protected by
an outer rind no article of food shoud be eaten
that has not been subjected To boiling heat In is
preparation for the table; and all vessels used for
the cooking. serving, or storage OF food should be
| soaked in boiling water prior to being used.
/ All water for potabe should be boiled before
use IL not received directly from a condenser; and
| 1t is we'll to acidify It as before stated
As the infection resides in the stools all dis
charges should be received into vessel containing
disinfectant soed bed linen and clothing should
| be STEPPED in solution of corrosive sublimats or
clorde OF lime before being removed from the ward
| or sicl-ehamber. The floor and furniture when
tainted in any way should be Immediately washed
with of the solutions mentioned; the person
Oft he her a
| ton Of chlorinated soda and the ward or sick
room in all infectious diseases. should be freely
| ventilated.
As the disease Is propagated chiefly by the intro
duction of its infection in connection with food or
drink, should be exercised by attendants and
others i'm purifying the hands after conac. with in
fected articles, particularly before eating; and OBJ
vousy food or drink should be used in the ward
! room save by the cholera patients.
Boiling in water may be relied upon to purify
articles of bodybuilding and bedlinen that have
been infected by the discharges from the bowels.
rate from the general wash. Solutions of corrosive
subiinlate, one druchm to the gallon OF water;
chlorinated lime. one ounce to the gallon; solution
of chlornated soda diluted with nine volumes OF
water. and carboc acid in q two per cent solution
are efficient Gsinfectanis. They may be used fog
soaking soiled linen before sending it to the
| laundry. and for washing the floors, woodwork,
and walls of the room. They may also be used for
the hands, and, with the exception OF the sub-
mate solution. for general personal use. Stronger
solutions OF these disinfecauts or of sulphate OF
iron, should be employed for the treatment of ex-
CTeta Tor SaLuTAtnY the 6EeotS In WHICH y
dead body is enveloped pending arrangements for
burial. A suitable strength is obtained by dissolv
ing two draciims Of corrosive submate or four
ounces OF chlorinatcd lime in q gallon Of water,
by making five per cent. solution Of carboc acid
Any of these should be added in volume equal to
that Of the material to be disnfected. The disin
fectart should be permitted to act excreta for
an hour after which tile contents Of the vessel may
be disposed of, preferably by burial. AS contact
with metals decomposes the subimate solution, Is
should be used only in earthenware or other sGta-
BILE vessels.
Privy-vsuts or cess pools that have become In
fected by tho addition of discharges direct from
patient must be treated literally with chlorinated
lime, suphate of iron. strong solutions OF subli-
mate carboiic acid
A dry oven heat OF 1900 Fahr., continued for
two hours, or an exposure to superheaied steam,
Is pounds pressure for one hour Is useful for deal
ing with infected garments.
Temporary treatment until medical officer In
called in should consist Of applications Of mustard
on the abdomen with warmth TO the body and feet,
and hot brandy punch in small and repeated
doses the diet to consist of weli-boiled rice snd
milk and If the discharges continue. laudanum.
80 drops should be given two three times with
the brandy. The medicine recommended aad
generally used In India Is mild carmiaatiye con.
sisting OF part of opium, two Of assafeida. and
three of black pepper, made into fve.grain pills.
which is said, when taken early, to have checked
the disease in thousands of cases.
If the post becomes thoroughly infected security
be obtained only by aband oning the dangerous
locality Troops that have fallen back befsFs the
advance Of the disease have often escaped seizure
or escaped further diseasen Withdrawn subsequent
Il