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SPEEDY PRODUCTION OF SALIVATION.
179
EXTRACTS
district
FROM COMMUNICATIONS RELATIVE TO THE
THE CHOLERA AT HOLBECK.
the disease transmitted td any
curred.
MALIGNANT CHOLERA, Received from the CENTRAL BOARD HEALTH.
was
adjacent houses, and in that instance it was entirely subdued after four deaths had oc-
OF
Only two cholera patients have been admitted into the hospital, and they were moribund when removed from their own dwellings, and died a short time after their removal. JAMES HARRISON, Res. Surg. of the Preston Board of Health.
CASES admitted into the cholera hospital, Preston, Sept. 20th, 1832. 109. Died 57. When the disease first made its appearance here, it was of a very malignant and SPEEDY PRODUCTION OF SALIVATION. rapid form, soon runninginto the stage of collapse. The remedies then employed It really would appear from the tenor of were small doses of calomel and opium, sina- recent reports to the Central Board of pisms, brandy, ammonia, ether, hot-air Health, that the experience of our Indian bath, &c.; but no impression was made, as brethren, who have treated cholera in its the first five or six cases soon proved fatal, native soil, ought not to be so much disre. but they were aged, or intemperate, or garded as the practitioners of Europe have pined and starved. We then used scruple seemed disposed to do. They (the former) doses of calomel every hour for adults ; have told us that bleeding and calomel, comomitted opium, diminished the quantity of bined with opium, enabled them to save a brandy, and found that our success was’ much greater proportion of cases than has as greater. yet rewarded the innovations of Europe ; In the collapse stage of the disease, we and recent reports to the Board the writer think that the most benefit was derived from has now the honour to address, which inlarge doses of calomel, scruple doses of timate a tendency to return to this practice, capsicum, with one ounce of brandy and seem to support the alleged great utility of hot water, every hour. In some of the the Asiatic method. Many years ago, when cases the calomel was alternated with the undersigned had some thoughts of proStevens’ saline. Some cases, we thought, ceeding to India to pursue his profession, were ameliorated by stimulant injections, and when his head was of course full of containing capsicum and spirits of wine or tropical diseases, and of plans for their cure, brandy. We derived no permanent effect he happened to witness a case of rapid salifrom transfusion, the patients rallying for a vation by an unusual method of introducing time, but eventually sinking. We inva- mercury into the system; and it occurred riably applied sinapisms to the spine and to him that if salivation was such a sovestomach, with hot-water to the feet by reign remedy in most tropical diseases as means of tins. it was reported to be, and if the method of W. CASSON. introducing the medicine into the body R. G. HORTON. which he had witnessed in Scotland was to be as speedy in its effects in India as it was Holbeck, near Leeds, Sept. 20, 1832. in a colder climate, then a very valuable resource might possibly be found, in adopting that method in the treatment of these very THE CHOLERA AT PRESTON. rapid and malignant distempers. Under Although the treatment of the cholera this impression the writer drew up a short in this town has been very unsuccessful, paper on the subject, and transmitted it to yet the means employed to prevent the his late lamented friend Dr. Andrew Dunspread of the disease have been attended can, jun., who was at that time (1819) ediwith the most happy results. The disease tor of the " Edinburgh Medical and Surgical has made its appearance in four different Journal," and who did him the honour of parts of the town at different periods, and inserting it in that most respectable perialways in districts where other infectious odical.* diseases usually prevail, yet by early interThe plan consists in scarifying with a ment in coffins smeared with tar and cblo- i lancet some portion of the surface of the ride of lime, fumigating the infected houses body, and sprinkling upon the wounded with chlorine, lime-washing the walls, surface a small portion (finely levigated) of scouring the apartments, and burning or the powder of corrosive sublimate. A conwashing the clothes of the deceased, the siderable degree of local irritation ensues cholera has not in a single instance recurred in the same dwelling ;and only in one *Vol. XV., page 46, 1819.
180 it abates, which I have invariably found to be the case itfter three or four doses. I had tried nitrous acid and various other meupon the constitution. The gums became dicines, with blisters, &c. &c. without the intensely sore, and salivation was esta- least effect. blished in less than twelve hours after the CHARLES TnoTTER, TROTTER, Surgeon. Stockton on Tees, Sept. 18th, 1832. powder had been applied. The writer of this is well aware that the result of a single case is not much to be depended upon ; and that even were it esta- TREATMENT AT PLYMOUTH.—MERCURIAL blished, salivation might generally be proREMEDIES, &c. duced in this way on ordinary occasions ; yet in the new and strange circumstances under I am induced to add my humble testi. which cholera places the human constitu- mony to the essential importance of the mertion, where the powers of life, that of ab. curial plan of treating the second penod of sorption among the rest, are so signally de- the cholera, or that characterized by the pressed as to be suddenly almost annihilated rice-water evacuations. by some subtile aerial poison, the chances In the course of the fearfully extensive are that no mercurial effect would be pro- experience which the medical practitioners duced by the plan now suggested. All of Plymouth have just passed through, this may be very true, yet the undersigned numberless have been the instances in still thinks the plan deserves a fair trial by which the first stage of cholera has been those who may have great opportunities of successfully treated, and the serous dis. using it; and he does not think that be charges altogether prevented, by the im. would have been justified in entirely sup- mediate or early use of a warm magnesia pressing what he has thought of on this draught, containing a few drops of lauda. subject, whilst we are still labouring under num, and half a drachm of the compound the effects and the fear of a pestilence which spirits of ammonia, repeated twice or three seems hitherto to have set all human ef- times within the hour ; and then followed forts to arrest and cure it, very much at by a full dose of calomel (9ss to 9j), conW. MACLURE. joined with extract of henbane, a small nought. 14 Harley-street, London, portion of opium, or some aromatic powder. By treatment such as this, varied acOct. 13th, 1832. cording to circumstances, many lives, I am quite satisfied, have been spared. Of this CROTON OIL, CALOMEL, PRUSSIC ACID, &c. the of the Board of Health
upon this operation, and in the case the undersigned had an opportunity of seeing a very rapid mercurial effect was produced
give daily reports frequently-re- no information. peated small doses of irritating purgatives, In the second stage of serous evacuation, as the most likely means of restraining the the rapid introduction of mercury into the discharges. With this intention I have given svstem is the main object which I have felt a combination (in ;the form of a pill) of myself justified in attempting. Everything croton oil (Short’s) with calomel and ex- beside has seemed not merely secondary, tract ofhyosciamus, one-eighth of a drop of but trifling, and even cruel. The repeated the former and a grain and ahalfof each of the and persevering employment of calomel, in latter; and have invariably found it restrain doses of gr. ij, combined at first with very the evacuations. I repeat the pill every minute portions of opium (gr. --L or !,), the hour until that effect is produced; generally assiduous use of mercurial frictions, and from six to a dozen pills will be required, the application of siuapisms to the epigaswhen the evacuations (if any) will be of trium and front of the abdomen, in order to feculent matter, or frequently like chopped allay the irritability of the stomach and inspinach. I have not found the vegetable testines-these are the principal remedial astringents of the least use in restraining measures I have relied on in this period; I
WAS
led to the
use
of
diarrhoea when it is of the rice-water-like and, in the majority of cases, with unquesfluid. I have seen it continue for davs tionable success. The patients do not bear large quantities under their use, when half-a-dozen of the above pills put a stop to it. At first I gave of beverage without vomiting ; so that 1 the croton oil in quarter-of-drop doses every have only allowed them small spoonfuls at two hours, but frequently found it produce a time of toast-water, tea, or good beer, to so much pain and uneasiness in the stomach, satisfy the thirst, or rather to moisten the with frequent vomiting, that I reduced the mouth and throat. quantity and found it answer much better. Stimulants, for the most part, have proved The incessant vomiting was a very trouble- exceedingly prejudicial, aggravating the some
symptom until
prussic acid, two
I began the use of symptoms; and, by exhausting the little in doses of one and a half to remnant of excitability, hastening the fatal
minims, every two or three hours, until result.
EXTRACTS
district
FROM COMMUNICATIONS RELATIVE TO THE
THE CHOLERA AT HOLBECK.
the disease transmitted td any
curred.
MALIGNANT CHOLERA, Received from the CENTRAL BOARD HEALTH.
was
adjacent houses, and in that instance it was entirely subdued after four deaths had oc-
OF
Only two cholera patients have been admitted into the hospital, and they were moribund when removed from their own dwellings, and died a short time after their removal. JAMES HARRISON, Res. Surg. of the Preston Board of Health.
CASES admitted into the cholera hospital, Preston, Sept. 20th, 1832. 109. Died 57. When the disease first made its appearance here, it was of a very malignant and SPEEDY PRODUCTION OF SALIVATION. rapid form, soon runninginto the stage of collapse. The remedies then employed It really would appear from the tenor of were small doses of calomel and opium, sina- recent reports to the Central Board of pisms, brandy, ammonia, ether, hot-air Health, that the experience of our Indian bath, &c.; but no impression was made, as brethren, who have treated cholera in its the first five or six cases soon proved fatal, native soil, ought not to be so much disre. but they were aged, or intemperate, or garded as the practitioners of Europe have pined and starved. We then used scruple seemed disposed to do. They (the former) doses of calomel every hour for adults ; have told us that bleeding and calomel, comomitted opium, diminished the quantity of bined with opium, enabled them to save a brandy, and found that our success was’ much greater proportion of cases than has as greater. yet rewarded the innovations of Europe ; In the collapse stage of the disease, we and recent reports to the Board the writer think that the most benefit was derived from has now the honour to address, which inlarge doses of calomel, scruple doses of timate a tendency to return to this practice, capsicum, with one ounce of brandy and seem to support the alleged great utility of hot water, every hour. In some of the the Asiatic method. Many years ago, when cases the calomel was alternated with the undersigned had some thoughts of proStevens’ saline. Some cases, we thought, ceeding to India to pursue his profession, were ameliorated by stimulant injections, and when his head was of course full of containing capsicum and spirits of wine or tropical diseases, and of plans for their cure, brandy. We derived no permanent effect he happened to witness a case of rapid salifrom transfusion, the patients rallying for a vation by an unusual method of introducing time, but eventually sinking. We inva- mercury into the system; and it occurred riably applied sinapisms to the spine and to him that if salivation was such a sovestomach, with hot-water to the feet by reign remedy in most tropical diseases as means of tins. it was reported to be, and if the method of W. CASSON. introducing the medicine into the body R. G. HORTON. which he had witnessed in Scotland was to be as speedy in its effects in India as it was Holbeck, near Leeds, Sept. 20, 1832. in a colder climate, then a very valuable resource might possibly be found, in adopting that method in the treatment of these very THE CHOLERA AT PRESTON. rapid and malignant distempers. Under Although the treatment of the cholera this impression the writer drew up a short in this town has been very unsuccessful, paper on the subject, and transmitted it to yet the means employed to prevent the his late lamented friend Dr. Andrew Dunspread of the disease have been attended can, jun., who was at that time (1819) ediwith the most happy results. The disease tor of the " Edinburgh Medical and Surgical has made its appearance in four different Journal," and who did him the honour of parts of the town at different periods, and inserting it in that most respectable perialways in districts where other infectious odical.* diseases usually prevail, yet by early interThe plan consists in scarifying with a ment in coffins smeared with tar and cblo- i lancet some portion of the surface of the ride of lime, fumigating the infected houses body, and sprinkling upon the wounded with chlorine, lime-washing the walls, surface a small portion (finely levigated) of scouring the apartments, and burning or the powder of corrosive sublimate. A conwashing the clothes of the deceased, the siderable degree of local irritation ensues cholera has not in a single instance recurred in the same dwelling ;and only in one *Vol. XV., page 46, 1819.
180 it abates, which I have invariably found to be the case itfter three or four doses. I had tried nitrous acid and various other meupon the constitution. The gums became dicines, with blisters, &c. &c. without the intensely sore, and salivation was esta- least effect. blished in less than twelve hours after the CHARLES TnoTTER, TROTTER, Surgeon. Stockton on Tees, Sept. 18th, 1832. powder had been applied. The writer of this is well aware that the result of a single case is not much to be depended upon ; and that even were it esta- TREATMENT AT PLYMOUTH.—MERCURIAL blished, salivation might generally be proREMEDIES, &c. duced in this way on ordinary occasions ; yet in the new and strange circumstances under I am induced to add my humble testi. which cholera places the human constitu- mony to the essential importance of the mertion, where the powers of life, that of ab. curial plan of treating the second penod of sorption among the rest, are so signally de- the cholera, or that characterized by the pressed as to be suddenly almost annihilated rice-water evacuations. by some subtile aerial poison, the chances In the course of the fearfully extensive are that no mercurial effect would be pro- experience which the medical practitioners duced by the plan now suggested. All of Plymouth have just passed through, this may be very true, yet the undersigned numberless have been the instances in still thinks the plan deserves a fair trial by which the first stage of cholera has been those who may have great opportunities of successfully treated, and the serous dis. using it; and he does not think that be charges altogether prevented, by the im. would have been justified in entirely sup- mediate or early use of a warm magnesia pressing what he has thought of on this draught, containing a few drops of lauda. subject, whilst we are still labouring under num, and half a drachm of the compound the effects and the fear of a pestilence which spirits of ammonia, repeated twice or three seems hitherto to have set all human ef- times within the hour ; and then followed forts to arrest and cure it, very much at by a full dose of calomel (9ss to 9j), conW. MACLURE. joined with extract of henbane, a small nought. 14 Harley-street, London, portion of opium, or some aromatic powder. By treatment such as this, varied acOct. 13th, 1832. cording to circumstances, many lives, I am quite satisfied, have been spared. Of this CROTON OIL, CALOMEL, PRUSSIC ACID, &c. the of the Board of Health
upon this operation, and in the case the undersigned had an opportunity of seeing a very rapid mercurial effect was produced
give daily reports frequently-re- no information. peated small doses of irritating purgatives, In the second stage of serous evacuation, as the most likely means of restraining the the rapid introduction of mercury into the discharges. With this intention I have given svstem is the main object which I have felt a combination (in ;the form of a pill) of myself justified in attempting. Everything croton oil (Short’s) with calomel and ex- beside has seemed not merely secondary, tract ofhyosciamus, one-eighth of a drop of but trifling, and even cruel. The repeated the former and a grain and ahalfof each of the and persevering employment of calomel, in latter; and have invariably found it restrain doses of gr. ij, combined at first with very the evacuations. I repeat the pill every minute portions of opium (gr. --L or !,), the hour until that effect is produced; generally assiduous use of mercurial frictions, and from six to a dozen pills will be required, the application of siuapisms to the epigaswhen the evacuations (if any) will be of trium and front of the abdomen, in order to feculent matter, or frequently like chopped allay the irritability of the stomach and inspinach. I have not found the vegetable testines-these are the principal remedial astringents of the least use in restraining measures I have relied on in this period; I
WAS
led to the
use
of
diarrhoea when it is of the rice-water-like and, in the majority of cases, with unquesfluid. I have seen it continue for davs tionable success. The patients do not bear large quantities under their use, when half-a-dozen of the above pills put a stop to it. At first I gave of beverage without vomiting ; so that 1 the croton oil in quarter-of-drop doses every have only allowed them small spoonfuls at two hours, but frequently found it produce a time of toast-water, tea, or good beer, to so much pain and uneasiness in the stomach, satisfy the thirst, or rather to moisten the with frequent vomiting, that I reduced the mouth and throat. quantity and found it answer much better. Stimulants, for the most part, have proved The incessant vomiting was a very trouble- exceedingly prejudicial, aggravating the some
symptom until
prussic acid, two
I began the use of symptoms; and, by exhausting the little in doses of one and a half to remnant of excitability, hastening the fatal
minims, every two or three hours, until result.