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.
360/440 page 334
![cessful in establishing itself as a reliable remedy for this fatal malady. In a severe epidemic at a frontier fetation, wliich the writer passed throntrh in ISGT, the calomel treatment was em})loyed in many cases, but without any very notable success. The impression remained upon my mind, however, that when the cases were seen early, this ti-eatment had a certain value in favorably influencing the result. The dithculty in judging of the value of any methoil of treatment is greatly enhanced by the fact that many cases (iuring the prevalence of an epidemic are not seen until fatal poisoning lias already occurred. A patient in the algid stage of the disease is evidently sulfering from the effects of a poison which has already been absorbed, and which acts powerfully upon the vaso-motor nervous system. The pressing indication when a patient is seen in the stage of collapse, is evidently to neutralize the manifest effects of the toxic agent, rather than to attempt to kill the cholera germs in the intestine, which we sup- pose to have produced it. At the same time it is very probable that a fatal result depends, to some extent at least, upon the continued production and absorption of the poison, and we must not neglect to kill the germs, or restrict their development, if any practicable means of accom])lishing this object presents itself. If the patient dies notwithstanding the administration of germicide remedies during this stage, it does not follow that treatment with agents of this class is futile. It may be, simply, that the treatment was commenced too late. To kill a murderer after his vic- tim has been fatally wounded, does not save the life of the murdered man. Experience proves that the time for successful treatment is during the premonitory stage,'' when the chief symptoms are a certain looseness of the bowels and a feeling of lassitude. The deadly germ is no doubt already present at this time; the toxic product, evolved as a result of its vital activity, is being absorbed, and perhaps has a cumulative effect,until finally the nerv- ous centers are overwhelmed and we have the frightful symptoms of the stage of colla})se rapidly developed. That cholera is very amenable to treatment during the first stage of premonitory diarrhcea^is generally conceded by those who have seen the most of this disease, and any abortive treatment based upon the ger- micidal action of the remedies employed should be applied during this', stage. The object in view should be to cause the remedy to come in con- tact with the material to be disinfected, with the least possible loss from vomiting or by absorption. Calomel has the advantage of easy adminis- tration, and of being retained by the stomach when other remedies might, be rejected. But the adniinistr:ition of calomel with a view to the forma- tion and germidical action of corrosive sublimate is a very unscientific pro- ceeding. In the first place it is uncertain whether the conversion of a portion of the calomel into bichloride occurs at all; and in the next place, it is evident that the amount formed would be so much a matter of acci- dent that the attempt to kill germs in this way would be like shooting at a flock of partridges with one's eyes shut. If mercuric chloride is to be fairly tested it must be administered in definite amount, and at definite intervals; and it woiild seem as if the hi- dications might be best fulfilled by the admiuistratioiuaf small amounts at frequent intervals. We would suggest, for example, ui)on theoretical grounds, that granules containing,'77 of a grain of mercuric chloride, mixed with milk sugar (f), and coated with some substance Avhich does not dissolve too quickly, might be administered, two at a time, every five](https://iiif.wellcomecollection.org/image/b20996421_0360.jp2/full/800%2C/0/default.jpg)
