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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![FUTILITY OF SPECIFIC TREATMENT. 0,71 •eral management, is utterly impotent to clfect a cure. And let us not for- get that there is no disease which, in its malignant manifestations, acts witt a^reater energy and speedier virulence than Asiatic cholera. It cannot!, therefore, be jnstly construed as a reproach to the science and art of medicine that we have no power in such cases of stemming the tide that ' hurries the patient to an inevitable doom. Having thus frankly acknowledged our helplessness with regard to the worst types of the disease, we must on the other hand em])hati(?ally assert our power to deal successfully with cholera in its earliest and mildest manifestations. It is true that even here our power may be limited, but to dispute it completely would be as much of an error, as to claim it with regard to the graver attacks of well-marked cholera. At this point the question naturally arises, if cholera is a specific dis- •ease, dependent upon the invasion of intestinal parasites, why is it not possible to abort an attack by the early employment of parasiticides. I'liere are several answers to this query. In the first place, assuming the truth of the micro-parasitic doctrine of cholera, it has been shown by Koch and others that the destruction of the specific bacilli within the intestinal •canal is, in the present state of our knowledge, impracticable. For it would in most cases necessitate the employment of drugs that would prove as surely fatal to the host as to his parasites.' Again, as for example in trichinosis, by the time the symptoms of an invasion make diagnosis pos- sil)le, the fatal harm may be already accomplished, and the most potent parasiticides would then arrive too late. Without wishing to discourage too much the continued search for a specific against cholera, it may be well to remember that, should one be discovered, it would fail to check an attack of the disease except when employed sufficiently early to prevent ihe very symptoms upon wdiich, in most cases, we base our diagnosis of this malady. Semmola ^ has recently published some suggestions regarding the man- :agement of cholera that have a direct bearing on the question under dis- cussion. He boldly states his conviction that the parasitic doctrine can never be taken as the point of departure for rational treatment. For, as intimated above, apart from the difficulty of using enough of a sufficiently strong parasiticide to kill all the microbes, their poisonous action (ptomaines) is already accomplished by the time w^e have positive symp- tomatic indication of their presence in the human body. Indeed Semmola ^oes so far as to state that the diarrhoea of cholera, instead of being due to the local and primary visitation of the microbes, may be regarded as the first result of poisoning of the nerve-centers and abdominal sympa- thetic, which have an undeniable influence over intestinal nutrition and circulation. He thinks it probable, also, that in cholera there occurs in- testinal absorption of the poison generated by the microbes, which, enter- • It is of course possible that future research may provide us with some agent that, while a reliable parasiticide, may be devoid of toxic properties so far as the human being' is concerned. The dilute mineral acids are remedies which have a large experience in their favor, and rest also on an apparently sound theoretical basis. Weak chlorine water may also be thought of; and it is, of course, possible to give corrosive sub- limate so dilute as to be harmless. But even if these remedies kill germs we must I'emeniber that germicides are not antidotes to ptomaines and like poisons. 8ee also Dr. Sternberg-'s article on Internal Disinfection, in the preceding part. - Nouvelles Recherches therapeutiques sur le cholera asiatique, in Bulletin](https://iiif.wellcomecollection.org/image/b20996421_0397.jp2/full/800%2C/0/default.jpg)
