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

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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$used. But should the stomach prove rebellious to the liiudanum, hypo- dermics may be from time to time repeated, the quantity l)eiiig adjusted to the varying indications of the particular case, but rarely again reaching tlie maximum of the initial dose. Bed-rest is absolutely necessary noi^, and indeed, as a rule, the patient's general malaise will not incline him to disobey orders. It is advisable to place a large poultice made of equal proportions of ground mustard and flaxseed meal over the entire abdomen, and after decided reddening of the skin, replace it by ordinary poultices, 0[)ium liniment on cotton flannel, warm flannel alone, or simply a hydro- pathic bandage, fitting snugly but not uncomfortably around the abdomen,' The latter especially often gives the patient a sensation of grateful ease that it is very desirable to maintain. Vomiting may still be absent, or, when present, it may be possible to restrain or suppress it by allowing small bits of cracked ice, cold cham- pagne, or simple water charged with carbonic acid. Drop doses of the wine of ipecac, or 1 to 3 grain doses of oxalate of cerium, may likewise aid in controlling the vomiting. If the patient now grows very thirsty, there is no objection to allowing him to drink plain water, that it is well to have previously boiled, then cooled, shaken and iced. Claret or small quantities of brandy or whisky may also be added to the water, but need not be forced upon the patient. It does not seem advisable to allow the imljibi- tion of large quantities of liquid at one time. Small quantities given at short intervals answer much better. Any attempt to prevent collapse by nsing large quantities of alcoholic stimulants is decidedly reprehensible. Small quantities of tea-punch, hot or cold, preferably hot, made of green tea, arrack, or some other nice light spirits, to which the rich can add champagne, makes a light and digestible drink which will warm, without overstimulating. Vermouth wine, which is merely a light white wine, flavored with aromatic and slightly bitter herbs is excellent. Sour and Uhine wine is better than heavy sherry, which should not only be pure, but diluted with water; 10 per cent, of alcohol is as strong as any wine or diluted spirits should be used, (Peters), Althougli cholera patients, as a rule, crave cold fluids, it is neverthe- less worthy of rememl^rance that, in some cases, hot weak tea, or pepper- mint water or simply very hot water, is borne better than iced drinks, and may be used in place of them. In this connection it is perhaps de- serving of notice that ]\Iacnamara and several other competent writers nrge abstinence from all fluids. They rely solely on the use of bits of ice, allowing the patients an unlimited supply of this cooling substance. On the other hand, Macpherson from his own experience in one of the severest cases of cholera on record which recovered, says he will never deny a cholera patient a reasonable amount of water, either plain or carbonated. Any other symptoms arising at this period call merely for cautious treatment directed toward their mitigation, but all meddlesome inter- ference is very much to be deprecated, Nothing seems to the writer's mind more irrational than to attempt by potent and varied drugs, frequently given in large quantities, combined with the use of harassing external measures, to do battle against a foe that in many cases is clearly beyond the reach of all treatment. The following table is based on 800 cases of cholera treated in the prov- inces throughout England and Scotland in 1854, and represents the percont- ' Flannels wrung- out in hot cayenne pepper water are also useful.$