On the curative effect of carbonic acid gas or other forms of carbon in cholera, for different forms of fever, and other diseases / by C.J. Lewis.

  • Lewis, C. J. (Charles James), 1875-1937.
Date:
1903
Catalogue details

Licence: In copyright

Credit: On the curative effect of carbonic acid gas or other forms of carbon in cholera, for different forms of fever, and other diseases / by C.J. Lewis. Source: Wellcome Collection.

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    CONCLUSION. There are few things more difficult than to arrive at a jxist appreciation of the value of a remedy in the treatment of disease. On the one hand, it is so easy to believe that post hoc is propter hoc, and either to assign solely to the remedy the improvement which has followed, or to attribute its failure to coincident malign circumstances. (Jn the other hand, it is no less easy, when the case has done well, to find more than one iiiflueiice which may claim to share with the remedy in the pro- duction of improvement, or when the case has done badly to feel that the remedy was useless and that something else might have acted better. 'I'liese difficulties confront one very formidably in the endeavour to estimate the value of carbonic acid gas and the various forms of carbon. It will therefore be best to consider separately each of the remedies and diseases with which this in^'estigation has been concerned. Carbonic Acid Gas. Cholera.—In the first place cholera deserves our attention. From the experiments of Frankland and Fraenkel, and from the results detailed above of my own research into the subject, it is apparent that, so far as cholera is concerned. Dr Parkin’s treatment with carbonic acid gas may claim to have a basis in the antagonistic influence which this gas under certain definite conditions exerts upon the Vibrio cholerre. _ While recog- nising to the full the very definite toxic efiects which carbonic acid gas can exert upon the Vibrio choleric under the conditions of laboratory experi- ment, one realises that clinically in treating cholera cases the conditions, which are requisite in order to obtain in tlie laboratory these toxic effects, are not exactly reproduced. In particular, the temperature of the human body is that at which in tlie laboratory a very high concentration of carbonic acid gas is necessary in order to exhibit any marked bactericidal effect. It is necessary to ask the question whether carbonic acid gas given as described by Parkin can attain this high concentration in the liiiman intestine, and whether it does reacli and destroy the cholera organisms in this situation. Further, one must inquire how, if the curative action of carbonic acid gas in cholera be granted, is this result achieved ? In cholera cases the organisms are mainly to be found in the intestinal contents and in the rice water dejecta, which are often almost pure cultures of the organism. The comma bacilli are not usually found in the blood or in the other organs of tlie body, nor is it very common for the stomach contents to contain them. As a rule, the vomited matters are bilious and devoid of comma bacilli, thougb, if the vomiting be very severe, the rice water material and its pervading organisms may occasionally reach the stomacli. It is evident, therefore, that carbonic acid gas administered into the stomach will not there meet with the organisms, nor, if it be absorbed from the stomach, will it have much cliauce of doing so. For the carbonic acid gas to come in contact with the organisms it must reach the intestine. We may conceive that, when given in freipiently repeated doses, some portion of the gas will ])ass out of the stomach into the intestine, and that the gas will not be wholly absorbed from the stomacb. The iieristaltic movements .so continuous in cholera may assist in transferring some volumes of the gas to the lower portions of the alimentary tract. IG’cn so