The cholera unmasked ; or its true name, nature, and causes pointed out ; also a more consistent and successful mode of treating it / [Bracy Clark].

  • Bracy Clark
Date:
1832-1833
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Licence: Public Domain Mark

Credit: The cholera unmasked ; or its true name, nature, and causes pointed out ; also a more consistent and successful mode of treating it / [Bracy Clark]. Source: Wellcome Collection.

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    explain many circumstances and appearances attending the complaint that were before quite obscure and thought inexplicable. Under these views and impressions we shall now venture to take up some others of the most approved writers on the subject; and first, with reverential feelings due to so great a cha- racter for learning and worth, the justly-admired Sydenham, and we shall see, that guided by his acute practical observation, and that admirable tact which he so eminently possessed, and aided also by the study of the ancients, how very near he came to the true treatment of the disease, though his views upon it were evidently not distinct, hut considerably clouded by the prevailing feeling of preceding ages, of its bilious character and a redundant bile. In other respects he describes the disease well, calling it cholera morbus, see Sect. 4. cap. 2. and says, that in his days, that is from the year 1669 to 1674, it made its appearance every year in the autumn season, on the first chills of the declining summer, with as much regularity “ as the coming of the cuckoo in the spring, or of the departure in autumn of the swallow.” He describes it with its three characters, vomiting, purging, and gripes, and recommends for its treatment, not exactly the warm water of Celsus and Hippoci’ates,* hut something of a more digestible quality—plenty “ of warm chicken broth it is, in its effects not very distantly allied to our hot water, which, however, has the advantage, in all situations, of being more quickly attainable. He recommends encouraging the vomiting, and especially on no account to suppress it; and, aware that some cause of offence remained with the stomach, he recommends spear-mint tea also ; and also laudanum in the advanced stage of the disease, but expressly forbids its use in the early stage, that it might not repress the vomiting. No doubt finding from expe- rience that it tended to arrest the stomach from performing any of its usual functions, such at least it is fair to conclude would be its effect, and with injurious consequences as to digestion. But towards the latter end, and when in reality the danger was passed, he recommends, as did the ancients, small por- tions of generous wine. Here, according to our notions, he was somewhat deficient, and in a very bad case would, in all probability, have lost his patient, for the want of these stimuli being more early applied ; but washing the stomach out, instead of digesting its contents, may suffice sometimes in mild cases and in feeble attacks of the disorder, and hence the proceeding by emetic will often be found to have succeeded, as may be seen from the history of very many cases where the mustard emetics were employed; which were much used in England at the commencement of the appearance of the epidemic, but were discontinued afterwards, from finding, perhaps, that they had often failed. For if we view the indication for cure rightly, “ it is the return of the digestive, and cliylopoietic functions'’ that can alone ensure the safety of the patient. And, in the course of our perusing later writers on this epidemic, both French and English, it was singular to observe, how frequently they relieved partially, and even at times wholly cured, their patients, by stimulants opportunely exhibited, yet from their feeble manner of doing it, and in doubting and want of faith in what they were doing, instead of persevering, they often left them, in pursuing other measures, miserably to perish ; not following up the treatment with the suitable auxiliaries in aid of the remedy: and what was most unfortunate, they afterwards drew conclusions unfavourable to the practice, and forbad their use as prejudicial and injurious, trusting, afterwards often, to the frail aid of mercurials, opium, bleeding, saline slops, venous injections, and other worse propositions. At other times, again, were these strong stimuli applied naked, if I may be allowed the term, and with nothing given along with them, to qualify and aid their operation, and therefore with injurious effects ; for pure brandy in itself, and alone, is certainly no digester of food, quite the contrary ; but where it acts well it is aided by combining with the mass of matter already in the stomach, or with fluids given along with it: it then does so, by calling forth the powers of the stomach to throw out its juices and to perform those actions which are necessary to the digestive function ; but where it was so circum- stanced as not to produce these effects, it would be likely to do harm and be mischievous; or when not supported by the aid of warm demulcent fluids, or aided in every other way that could remove the operation of the paralyzing cause, it would get into discredit also. The placing the contents of the stomach favourably, in order to digestion, and the whole system also, should first, we humbly apprehend, obtain our care and attention, and then the stimuli administered will generally have the desired result; one measure co-operating with another, encouraging and aiding their effects by frictions and mechanical measures, not applied to the legs on account of the cramps, but to the abdomen itself and stomach, the seat of the mischief. Diluting also the spirit and facilitating its digestion, by easily * Who appears to have taken it from Erasistratus, Lib. 2. as quoted by Ccelius Aurclianus, p. 262.— “ Salutarium utatur tepido potu vomitum provocans vel acrimoniam temperans fellis.”
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