Medical notes and reflections / by Sir Henry Holland.

  • Sir Henry Holland, 1st Baronet
Date:
1855
Catalogue details

Licence: Public Domain Mark

Credit: Medical notes and reflections / by Sir Henry Holland. Source: Wellcome Collection.

    625/664 (page 605)
    rather a sanguine spirit than a sound reason to be satisfied of their stability. Where Cholera reaches the state of collapse, our practice is still that of experiment only; and of experiment little guided by any principle or uniformity.* If the disease should still continue in the world, and a remedy, justly so called, be happily discovered hereafter, it will probably be of the nature of a specific antidote to the action of the virus on the blood. I hazard this opinion, look- ing to the singular importance of this action in the pathology of Cholera; to the promise which animal chemistry gives of new methods of altering the state of the blood; and to the * I allude here chiefly to the report of the Cholera Treatment Com- mittee of the Board of Health. The Committee took cases, under col- lapse from the disease, as the foundation of their inquiry; and reasonably so, since in no other way could they have obtained even an approach to parity of trials. Slight or incipient cases of the disorder are obviously incapable of furnishing any scale of symptoms explicit enough for com- parison. Allowing for difference of results from the treatment within hospitals or elsewhere (a manifest source of ambiguity in many ways) the inference from these tables would seem to be that the treatment by Calomel and opium, and by Salines, tends most to lessen the mortality under collapse. But we are bound to remark that this inference is drawn merely from the comparison with other modes of treatment (by stimulants, astringents, emetics, acids, castor oil, &c), which, though pro- pounded by medical authority, would appear on the evidence of these tables to be positively injurious in effect. It is an ancient medical maxim, and of high authority, » u>$e\HV v M pXaTrruv. A question may be started, with which this maxim has close concern, whether it is possible to reach any sound conclusion without in- cluding in the averages those cases where there has been no treatment at all. If the tables show a mortality of 75 per cent, under one method of treatment, and only 60 per cent, under another, this does not logically prove the latter to be beneficial, but merely gives evidence that the former is injurious. The only valid comparison is that to which I have just referred. And to this we must look for whatever certain conclu- sions regarding the treatment of Cholera we are likely hereafter to obtain.