PREVENTION OF CHOLERA.

751

skin cool; had several dark-fluid motions case should present itself, every individual residing in the house, or having communicaduring the night; passes urine. Hab. pil. calomel, colocynth, et sulphat. quinœ. tion with the patient or family, should take Seven p.m. Pulse 76; tongue pretty the following medicine. clean; skin natural ; has had several darkR. lllisturce cretœf. 3viiss ; fluid feculent stools. Complains of fulness, Tinctarce catechu f: 3ss; and slight

pain on pressure of the abdomen.

Continue Pilulœ.Hab.

enema

Oliimenthœ piperitœ, guttasiv. Misce.

purgans sta-

1)osis pro ætate adulta cochlearia duo ampla ter quotidie.

tim. 5. skin

Eight a.m. Pulse 94; tongue clean; is one of everv-dav use iri natural ; has had one bilious motion This medicine diarrhœa; but the novelty of practice conduring the night. Hab. pil. calomel c. colocynth ij, 2da qq. hora. sists in the time of administering it, a time, I a Nine p.m.

Pulse 68 ; tongue dry ; skin less urgent; has had one more natural stool ; passes her urine in bed. Continue Pil. Hab. enema statim. 6. Ten a.m. Pulse 68 ; tongue clean, but dry ; heat of surface natural ; had no stool during the night; passes urine freely. Continue Pil. Rep. enema. Eleven p.m. Pulse 76 ; skin and tongue natural; has had three fluid feculent motions ; mouth slightly sore. Omit Pilulœ. Hab. ol. ricini 3ss, cras mane. Reported

hot; vomiting

grant, very unusual for

medical man to

prescribe. Still, under all circumstances consider the practice defensible, whether

1

look to the great susceptibility of the whole alimentary canal to morbid impressions at this season, or the importance of inspiring confidence and firmness of nerve, a tlii ng very difficult atthe present juncture. It was therefore with no ordinary pleasure that I found this last effect realized. The progress of the disease was soon and sensibty arrested. I can adduce many instances of families, in each of which a death from convalescent. 7. Ten a.m. Pulse 64 ; tongue clean ; the most malignant type had taken place, rather drowsy; had two stools since last without any of the others (who had regularly taken the medicine) becoming report. Hab. vin. rub. 3j, 2da qq. hora. with it, or even experiencing pre. and skin Pulse 76; tongue Nine p.m. symptoms. 1 am not so dogmatical natural ; bowels open. Omit Medicamenta monitory as to assert, that this was a sequence resultomnia. 9. Complains of diarrhoea; in other re- ing- from the use of these means, but there seems great probability of it ; and I can spects well. safely aver, from numerous cases, that no Hab. haust. rhei statim, et post horas tres ill consequence has followed the practice. linct. opii gtt. xx. The practice may seem tame and inert, but Continued well in the convalescent ward I venture to anticipate, that a trial of it in for ten days longer, when she left the hos- any place will be found greatly conducive G. M. in clechinb the progress of this most pespital. tilential disease. Drummond Street Hospital, Having closely attended a malignant and Edinburgh. fatal case on the 30th of June, I experienced on the following morning some nausea with slight diarrhœa, a peculiar sensation of numbness in mv leas, inahilitv in the PREVENTION OF CHOLERA. muscles to perform their function well, and a tendency to cramp. I immefiiatly pro To the Editor of THE LANCET. cured a cretaceous astringent mixture with SIR,—Having had the opportunity of an increase of creta and gum, over that which observing’ this disease in every degree dur- the pharmacopoeia, prescribes, aud have ing its progress in Lynn I haveendeavoured taken it regularly more or less up to the to ascertain the juvantia et lœdentia, both in present time, without the least iiieoiive. nience as regards its constipating effect, diet and medicine. In July last cholera made its appearance having only on two ocasions required a. in that part of Lynn which is called North simple enema of half a pint of water, in we

affected

11

End," where the fishermen reside,

-

a

situation most conducive to a rapid extension of the disease, and there certainly was (judging from the first few cases) an expectation of such a result. Fearing this, and explaining my views to our dispensary surgeon, whose assiduity in this epidemic I am in justice bound to declare has been

unremitting,I

ordered that whenever

a

preference to taking any hind of aperient. The difficulty of procuring reaction under

extreme evacuations, induced me to attempt the prevention of the preliminary

stae.

During the time this epidemic has prevailed amongst us, the cases of diarrhœa, or diarrhma combined with vomiting, have exceedingly numerous and severe in

been

752

dispensary practice. They have all Aug. 29. Complains of pain, increased yielded to the cretaceous astringent medi- by pressure, in the uterine region. Had cine alone, or united with moderate doses severe rigors ; pulse 130, sharp ; skin hot ;

the

of laudanum, without one particle of mer- nausea and restlessness; lochia and milk cury in any form, and not one case has ceasing ; tongue clean ; thirst; oil had been attacked with cholera. operated three times. Dreadinginflammasubsequently , Several of my medical brethren in Lynn, tion of the uterus, or its appendages; bled of extensive practice, have assured me that her to sixteen ounces. Calomel gr. ij, the same has obtained with them; one of opium gr. ii, every four hours. Warm fothem, however, prefers the infusa. catechu mentations to the abdomen. to the combination of creta and catechu. It Evening, ten o’clock. Blood cupped, and strikes me, however, that creta is more strongly buffed. The nausea and pain on had increased ; pulse quicker but particularly beneficial at the present period, the bowels gently acted upon. because that alkali is preferable which in I union with an acid will not form a purga- Perstat in usu pil. Hirudines x parti doet emp. lyttœ scrobic. cordis. To retive compound, and such unquestionably the carbonate of lime, in preference to the lieve the nausea-soda water in small doses. salts of soda or potash. Morning, Aug. 30. The disease now treatment of is cliolera itself; eyes sunk; tongue and developed the Although foreign to this letter, 1 wish to observe, breath cold ; incessant purging and vomit. that the suggestion thrown out by Mr. ing of rice-coloured matter; pulse small, Searle, of injecting serum lactis into the and hardly to be distinguished ; coldness; veins, in lien of saline solution, was tried non-secretion of milk or urine; cramps and prostration of vital powers; incessant by me on the 6th of July last, and I sorry to say, not with success ; the patient, thirst. Calomel gr. j, opii gr. 1/3, camhowever, was, in fact, moribund, and quite phor gr. ii, and capsici gr. i, everytof unconscious of what was passing. On this an hour, and one ounce of soda water occa. account, therefore, I am not disposed to sionally, with bottles of hot water con. relinquish the plan, but purpose repeating stantly applied. it earlier in the disease, not by injection but Evening. Symptoms unmitigated. gravitation, under the regulating power of Morning. Sept. 1. Symptoms the same, a stop-cock, for which purpose I have con- with the exception that the pulse and heat trived an instrament.—I have the honour of body are improving. Continue the pills. to be, Sir, your obedient servant, Evening. Warmer ; pulse improving; JOIIN WAYTE, M.D. nausea less; purging less; sense of heat in JOHN the stomach ; no ptyalism ; continue the Lynn, Sept. 3, 1832. pills every two hours, omitting the capsicum and camphor ; nausea and purging less, and green. CASE OF Sept. 2. Pulse stron;er ; biliary stools; MALIGNANT CHOLERA urine and milk secreted, and signs of improvement in every respect. Slight soreTHREE DAYS AFTER PARTURITION. ness of mouth. 3. Has feculent stools ; increased secre. To the Editor of THE LANCET. tions of milk and urine; ptyalism con. SIR,—As a member of the profession, 1 tinues mild, although she has taken 160 deem it my duty to lay before you an ac- grains of the submuriate. The infant has been rather poorly during count of the treatment adopted by me in a the night, and is this day cold and col. case of malignant cholera (from which the Gave it two grains of calomel and lapsed. is to inrestored health), patient happily asmuch as the applications confirm the some carminative mixture, and directed views and treatment of other satisfactory the warm-bath and friction. 4. The child in every respect better. reports recorded in your valuable work. The mother improved, and requiring merely M. D., aged 20, residing in a central laxatives andnutriment; ptyalism tritling. a natuwas delivered after of London, part During my attendance on this ladv, I ral labour, and the secondines expelled soon after by nature, on Sunday, the 26th have had under my care a gentlemanafllictof August, and continued in every respect ed with nearly the same train of symptoms, and as who was treated in the

Ipressure smaller ; isBlenti,

am

bad, doingwell duringthe two succeedingdays, samequite manner, and on the appearance of ptvaas a laxative some oil on castor taking early lism recovered, but it did not go to so the morning of the 29th. I shall therefore proceed, from this date, great an extent ; he also took calomel large. I am yours, &c. to give you a history of the precursory, de- ly. H. E. CHURCH, M.R.C.S. H. ceitful symptoms, and their treatment, as 94, Lane, Sept. 5, Chancery themselves. they daily developed