A treatise on Asiatic cholera / edited and prepared by Edmund Charles Wendt, in association with Drs. John C. Peters, Ely McClellan, John B. Hamilton, and Geo. M. Sternberg.
- Edmund Charles Wendt
- Date:
- 1885
Licence: Public Domain Mark
Credit: A treatise on Asiatic cholera / edited and prepared by Edmund Charles Wendt, in association with Drs. John C. Peters, Ely McClellan, John B. Hamilton, and Geo. M. Sternberg. Source: Wellcome Collection.
Provider: This material has been provided by the Gerstein Science Information Centre at the University of Toronto, through the Medical Heritage Library. The original may be consulted at the Gerstein Science Information Centre, University of Toronto.
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![383 excellence, cannot be relied upon for the destruction of spoi'cs, but the pure acid in one to two per cent, sohition destroys bacteria in active growth within an liour or two. It is safe to say that a five per cent, solution may bo relied upon for the destruction of cholera germs, and of the otheV pathogenic organisms which do not form spores. Hydrogen Peroxide is another agent which possesses a certain value, but owing to the want of stability and comparatively high price of con- centrated solutions, it is not likely to replace the more potent oxidizing disinfectants heretofore recommended—the hypochlorites. Internal Disinfection.—Is it practicable to destroy cholera germs in the alimentary canal, and thus arrest the progress of the disease, or pre- vent its development? And, if so, what agents are best suited to accom- ])lish this purpose? It is impossible to answer these questions in a definite manner in the absence of any carefully conducted clinical experi- ments, but it may jiot be unprofitable to consider the therapeutic possi- bilities from the point of view of the germ-theory, and in the light of recent experiments which establish the comparative germicide value of various therapeutic agents, We naturally turn first to the most potent germicide in our list—mercuric chloride—an agent which, in the proportion of 1 part to 5000 or less, Avould doubtless quickly destroy all micro-organ- isms in the intestine, of the class to which the cholera germ is supposed to belong. The question is, first, whether it is practicable to administer this potent poison in doses which would, secure its presence in the intestine in this amount; and, second, whether Ijy accomplishing this result we can cure cholera. If we estimate the contents of the intestine at half a litre —about a pint—the amount of mercuric choride necessary to disinfect this amount of material may be put at . 1 of a gramme, or about one and a half grains, a quantity considerably in excess of the medicinal dose. It is evident that even if this amount of mercuric chloride could be intro- duced into the intestine witli safety, the problem of getting it there pre- sents serious diflftculties, on account of the incessant vomiting which occurs in cholera, and because of the loss which would result from absorption through the mucous mem]>raije of the stomach and bowels, and by the combination of the salt with albuminous material with which it comes in contact. The prospect of internal disinfection with this agent does not, then, seem verv encouratjinof. But mercuric chloride in a much smaller proportion than that named has a decided restraining nifluence upon the develo}unent of bacteria of all kinds, and there is reason to believe that one-tenth of this amount—i.e.^ one part to 50,000, or 0.15 of a grain- would, if constantly present in the intestinal contents, notably and perhaps entirely restrict the growth of any cholera germs, or other bac- terial organisms present. This In-ings us quite within the medicinal dose of this agent, and to the question of the best method of introducing it to the place where it is required, with the least possible loss by absorption, and the least possible injury to the patient from its toxic action. Whether this may accomplished l)y the administration of calomel, which, according to some authors, is converted by contact with the chlorides of the stomach into corrosive sublimate, is worthy of further consideration; but we are inclined to agree with Dr. II. C. Wood ' 'that the action of calomel upon man is so different from that of corrosive sublimate as to render this theory exceedingly improbable.' Certain it is that calomel, in heroic doses, has been thoroughly tried in the treatment of cholera, and has not been suc- ' Tlierapeutics, Materia Metlica and Toxicology, 3d ed., p. 396.](https://iiif.wellcomecollection.org/image/b20996421_0359.jp2/full/800%2C/0/default.jpg)
