Various

“ As I have neither time nor inclination to write a long article, I will briefly state the principal symptoms of the Asiatic Cholera Morbus, the appearances on dissection, and then deduce from them the treatment. An attack is usually preceded by diarrhœa or by uneasiness in the stomach and bowels for some days, or is suddenly announced by vomiting and purging, commencing about three o’clock in the morning, when the temperature is lowest of the twenty-four hours ”

“ The language of those who advocate the administration of internal remedies, is to give so much of a mixture or so many pills, and if they produce vomiting, repeat the dose; but if a cure is to be effected by relieving the symptoms, why give those medicines which excite or aggravate them? ”

“ Practitioners speak with confidence of blood-letting at the onset of the disease, and before an approach to collapse has been recognised. Sweating has been much practised, and decidedly with advantage, when it is not allowed to run into that state of collapse indicated by a pulseless wrist, dejected countenance, blue extremities, tongue and breath cold, and a sunken voice, feeling as if it passed through the ears. ”

“ Hence the necessity which occasionally arises of thinning the inhabitants of certain districts—an exigency which, like that of war, often subverts civil authority, and demands the exercise of the most arbitrary power. We have recently seen our New York neighbours compelled to thin the population in some parts of their city, and we may yet be forced to have recourse to a similar measure. ”

“ To prevent an attack of cholera, cleanliness and sobriety ought to be most rigidly observed. All sudden or great impressions upon the system, as changes in the temperature of the air, cold and moisture, or emotions of the mind, excessive joy, fear, and the depressing passions, should be carefully avoided. ”

“ From this we may infer, that where the disease is attended to early, and properly treated, the state of collapse may be prevented in nineteen cases out of twenty.
“We must state, however, that as the numbers increased, it became necessary to dismiss those that appeared to be least ill, on purpose to make room for others. Of those that were dismissed as convalescent, two were reädmitted soon after in a state of collapse, and though every attempt was made to save them, yet they both died after a very short illness, with the symptoms of cholera in its most virulent form. ”

“ In the treatment of this disease, recourse has been had to almost every remedy favourably reported of by European practitioners, and they all have had, for a time, their advocates—some preferring stimulants, others opiates, while others satisfied themselves with an intermediate plan of treatment—the whole of the medical practitioners with one accord agreeing, however, in the application of external stimulants, such as oil of turpentine, mustard, warm applications and frictions; calomel and opium have been much relied on by many. ”

“ From the above symptoms and results of post mortem examinations, it would seem that the pathology of the cholera morbus may be explained by a want of oxegenation of the blood, which becoming surcharged with carbon is unfit to stimulate the heart to contraction, and hence the congestion upon the internal and vital organs at the expense of the surface and extremities. ”

“ M. Petit is said to have been more successful than most of his colleagues in the treatment of cholera. In a communication to the Academy of Medicine he states that under the above treatment two-thirds of his patients have recovered.
On Density of Population.
Density of population in cities becomes a matter of extreme importance connected with the visitations of pestilential diseases. A [66] too crowded population may of itself engender a pestilence, and must inevitably aggravate one should it prevail from other causes. ”

“ A change for the better, that appears almost miraculous, has taken place. The action of the heart is greatly improved; respiration not in the least laborious, but quicker than natural; pulse 120, small, but distinct. ”

“ The warm bath I have known to be of great service, but the time necessary to prepare it and the exposure of the body to the air, are serious objections to its general employment. The same will not hold good in relation to the vapour bath, where the patient can be kept continually warm. Excessive thirst is best relieved by cold gum water, or by a piece of ice dissolved in the mouth. ”

“ The undersigned, with one accord, have found purgatives injurious, if used before perspiration or blood-letting had been resorted to, to allay the irritable state of the stomach and bowels; and then only the milder purgatives should be employed, such as calomel or blue pills, guarded with minute doses of opium, and carried off, after a few hours, with rhubarb, combined with soda and carbonate of ammonia. ”

“ Some instances have been noticed, and also observed by our intelligent clergy, as well as by ourselves, where, in some mild forms of the disease, nature effected a cure by copious perspiration, encouraged by warm drinks and extra clothing. ”

“ Details of Two Cases of Malignant Cholera treated by Venous Injection, by Dr. Craigie, of Leith.
No. 1. Case successful. 15lbs. injected at intervals in nine hours.—Martha Smith, aged thirty-eight, a noted drunkard, thin and debilitated, in sixth month of pregnancy, admitted into the hospital at 8 P. M. May 16th, 1832.
It appears she had had vomiting and purging since Sunday morning, 12th inst. Cramps came on about four hours ago in both legs; great evacuations both upwards and downwards like dirty water. The countenance is now collapsed; eyes sunk; tongue cold; pulse imperceptible at wrists ”

“ Since the 4th of April, up to this date, (April 17,) forty cases in all have been under treatment. Of this number, nineteen were admitted into the Observation ward with the premonitory symptoms of cholera. All of these had bowel complaints and suspicious ejections; some of them complained of severe pain in the abdomen, sickness of the stomach, and in several cases these symptoms [78] were attended with cramps, chiefly in the lower extremities. The whole of them were immediately treated by Mr. Wakefield with non-purgative saline remedies, recommended by Dr. ”

“ Nine A. M. Has a good deal of vomiting; is getting warmer; pulse now [68] perceptible in right wrist; tongue warmer; she allows the enema to come away without giving notice to nurse. Saline enema as above, with the addition of white of eggs, to be repeated every half hour.
Ten. Vomiting and purging of watery fluid, with slimy matter in it.
Half-past ten. Cramps have returned severe in left leg; pulse again imperceptible; urgent thirst, and constant vomiting. Rep. enema et pulveres effervescentes.
Half-past eleven. Breathing becoming much affected; extreme restlessness ”

“ Pulse 110, natural; extremities of good colour and warm; voice much stronger.
[70]
Half-past four P. M. Pulse has been gradually falling off since last report; is getting listless, and dislikes to be troubled with questions, breathing becoming laborious, and head symptoms more marked, with squinting to a slight degree superadded.
Seven P. M. Pulse again imperceptible; respiration quick and laboured; countenance collapsed; tongue and breath cold; says he is dying.
Let the venous injection be repeated to ℔iij. ”