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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$troiTS effects on the heart. But unless thoroughly reliable and competent trained nurses be in waiting, the attending or some other plwsician must personally direct its administration. Dr. Maclean ' says that: Cramps are best relieved by the use of chloroform, given in doses of five or six minims in ,i little water, and if vomitinj^ be excessive a, little may be sprinkled on a patl of lint covered with oiled silk or g-utta-])ercha tissue and applitnl to the epigastrium; or spongio-piline may be used for the i)urpose. I have used chloro- form in this way botli externally and intin-nally, very freely, and always witli good clfect. Dr. Macnamara speaks strongly in favor of chloroform. Having pointed out the great importance tu the patient of procuring rest, he says: In furtherance of this latter object, I know of no remedy more efficacious than chloroform. If the patient is in much pain and very restless, I strongly advise his being placed under the influence of this anesthetic. The chloroform must be administered by inhalation, and its full eifects maybe safely induced; or at any rate we may put the patient into a sotind and comfortable sleep. . . . We must be prepared to continue the action of the chloroform, perhaps for four or five hours, or even longer, according to circumstances. Dr. Parrot ° also favors the employment of chloroform in cholera. He used one to two drachms of chloroform daily in severe cases, and less in mild ones. The vehicle was water 100 grammes, and syrup of quinine twenty grammes. This mixture was given in tea, a tablespoonf ul every half hottr; at the same time iced beef-tea was given very frequently in small qttantities. Warmth was applied to the skin, and dry and stimulatiug frictions were used. Chloroform given in this way calmed the anxiety and epigastric pain, and seemed to diminish the frequency of the vomitings, which were also less painful. Dr. Ilartshorne/ in 1854, spoke as follows concerning the use of chlo- roform: Expei'ience has shown that, taken into the stomach, it is as totally free from dang'er as any otlier drug'; and its employment is destined to be yet mucli more widely extended; a fluid-drachm of chloroform taken b} the stomach is not more than equal, in soporofic effect, to thirty or thirty-five drops of laudanum. In doses of fifty to seventy-live drops (about fifteen minims), I have given it every half hour for several hours togetlier. It differs from the opiate preparations in the promptness of its hypnotic action, the much shorter period of its duration, a less degree of cerebral oppression, and the absence of all stimulus to the circulation. It might be called a diffusible narcotic, comparing in this respect with opium as ammonia does with alcohol. To produce much etfect with it, repeated doses at short intervals will be necessaiy. Its pungent property causes it to require plenti- ful dilution, which is of course facilitated, by the action of some demulcent. Per- haps tlie orgeat syrup is the best. Every fluid drachm of chloroform should have at least two fluid ounces of water with it when taken; and it will need, it' in ordi- nary gum muc^ilage, considerable agitation to re-suspend the particles inuuediately before t,wallo\ving. When taken in aqueous mixture alone, however, unless in very small doses, it produces nausea with some p(n-sons. This is entirely pre- vent(Hl by the addition of a strong aromatic, or still better b^^ giving the chloroform in aromatic tincture. From the ready solution and kindred action of camphor with <-idoroform,their combination lias become a very counnon one. For many [>urp<)ses, however, a still better preparation is a sort of chloroform paregoric, or compound ' Lectures on the Treatment of Cholei-a, by Deputy Inspector-General Maclean, M. D., Professor of Military Medicine. London Lancet, Feb. 3d and 17th-, 186G. ^ Gazette liebdomadairc, December 8, 1865. * American Journal of Medical Sciences, Janviary, 1854.$