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TREATMENT OF ASIATIC CHOLERA.
435
TREATMENT OF ASIATIC CHOLERA.
of such medicines as will, we know, act as bactericidal antizymotics. An ingenious plan was adopted during a former epidemic by my friend, Dr. Jas. Arthur Power, by means of which all our households took anti-zymotic medicine inadvertently ; the plan was the mixtureof powdered hyposulphite of soda with ordinary table salt, in the proportion of a small teaspoonful to an ordinary salt-cellarful; thus a good antizymotic was administered daily in a tasteless form. A pill containing half a drop of creasote taken with meals is an excellent anti-zymotic remedy. All drinking water should
3’6 in Edinburgh. The fatal cases of diarrhoea, which had been 8, 22, and 25 in the three previous weeks, further rose to 48 last week. The 9 deaths from scarlet fever showed a decline of 4 from the high number in the preceding week. The fatal cases of whooping-cough showed a slight further increase upon recent weekly numbers, while those of "fever"corresponded with the number in the previous week. Four inquest cases and four deaths from violence were registered in the city during last week, and 34 deaths occurred in public institutions. The deaths of infanta showed a further increase upon those returned in recent weeks, while those of elderly persons showed a decline. The causes of 39, or nearly 17 per cent., of the deaths registered during the week were not certified. *
be boiled and filtered and allowed to cool. I am, Sir, obedient servant, your obedient servant, Sir, your F. EACHUS WILKINSON, M.D. Sydenham, August, 1884.
THE " METAPHYSICS" OF COMTE.
of THE LANCET. SIR,-Knowing something of the writings of Auguste ARMY MEDICAL DEPARTMENT.-Deputy Surgeon-GeneralComte, and being well acquainted with the distinguished Francis Holton, M.B., retires on temporary half-pay ; Sur-group of men who are the propagandists of his doctrines in I geon-Major Joseph Bourke, late Medical Department, hasthis 1 country, I am completely at a loss to understand what been permitted to commute his retired pay. Dr. Moxon means by his allusion to the " most rubbishy ADMIRALTY.-Fleet Surgeon William Shute Fisher, B.A. of Comte." It would, indeed, be hardly possible M.B., has been placed on the retired list, with permission tometaphysics 1 devise a more incongruous phrase, for that great thinker to assume the rank and title of Retired Deputy Inspector-claimed 4 before all things to be the prophet and apostle of General of Hospitals and Fleets ; Staff Surgeon John Buckscience; and if there be one feature of his system positive ] ley has been promoted to the rank of Fleet Surgeon in Her more distinctive than another, it is its complete divergerice Fleet. Majesty’s The j and antagonism to, metaphysical speculation. The following appointments have been made :-Surgeonsfrom, 1big, merciless hand," which Dr. Moxon deprecates as an George W. Low, Charles W. Hamilton, and Henry Harries,attribute of our profession, may be wielded by the critic to to the Alexand2ia ;Surgeon Albert P. Wells to be Surmalign the great as well as to crush the small, but the least geon and Agent at Douglas, Isle of Man; Surgeon J. we can look for is the exercise of some discretion in its use. Isle to be at of Castletown, Claque, Surgeon and Agent It is the fate of Comte’s philosophy to meet with assiduous Man; Staff Surgeon Hugh H. Hannay, to the Britannia ; misrepresentation; but no one who had ever read a I ine of Staff Surgeon Heaver Sugden, to the Hector; Surgeon of John Stuart Mill, of Buckle, or of G. H. Lewes, Littre, Edward Ferguson, to the Rapid; Surgeon John Ottley, tocould fall into the ludicrous error of taunting it with being the Vernon and Surgeon William H. O’Meara, to the metaphysical. Indeed, it is not necessary to go beyond Repulse. your own pages for the complete refutation of such an idea, which will be found well expressed in Dr. Walshe’s able and scholarly papers on "Physiology v. Metaphysics in Relation to Mind," published in THE LANCET of this year. To the Editor
THE SERVICES.
"
.
"
,
Correspondence.
I remain, Sir, your obedient servant, T. FITZPATRICK. Sussex-gardens, Hyde-park, Sept. 1st, 1884.
"Audi alteram partem."
TREATMENT
OF ASIATIC CHOLERA.
To the Editor
of THE LANCET. the SiR,-Notwithstanding rapid and effective strides which sanitary science has made and is making, and the manner in which it is being applied to stay the progress of the common enemy cholera, it appears to me that the medicinal treatment of this disease, whether prophylactic or curative, is uncertain, and that the writers upon the subject in the medical press touch upon the subject in a delicate manner. If a number of professional men were asked what their treatment would be, their replies, I think, would vary in form, and would be contradictory. We have to deal with (1) a zymotic disease; (2) a disease where everything is rejected by vomiting, and (3) a disease in which rapid collapse takes place. 2(zeM.—Pat the patient to bed. Inject hypodermically a solution of carbolic acid (half a grain of crystallised carbolic acid in twenty drops of water) with a solution of hydrochlorate of morphia, which may be repeated at intervals, as necessary. Let him have a hot-air bath made with a lamp and cradle over the bed, or hot bricks wrapped in flannel, and applied to the soles of the feet and armpits. Let him sip freely and frequently of sulphurous acid lemonade with glycerine, of which the following is the formula : Sulphurous acid, one ounce; glycerine, three ounces; tincture of lemon, four drachms ; syrup to eight ounces. , .
Half
an ounce
mixed in
a
i,
H
tumbler of water makes sul-
"
phurous acid lemonade."
VACCINE. To the Editor of THE LANCET. SIR,-I observe in your annotation of July 5th on "Vaccina’, tion in the Metropolis,"you remark that arm-to-arm vaccinaI tion is "far more protective" than any other. I would respectfully ask if statistics are available to confirm this statement, for it has always seemed to me that a successful vaccination exhibiting the Jennerian vesicles is all that can be desired, let the source of the virus be human or bovine, tube, point or crust. If your position is the correct one, we have the curious spectacle of a human vaccinifer furnishing the ideal vaccine, without himself or herself having the best protection. In Canada the human crust is much used. I am, Sir, yours truly, T. D. REED, M.D. Montreal, August 4th, 1884. Our words vaccination is far more " arm-to-arm were, * *-* protective than the use of stored lymph, whether it be human or animal. The reason for this statement is that vaccination with stored lymph " takes" with much less certainty, and often produces much smaller vesicles than vaccination done directly from arm to arm. See also the report of the medical officer to the Local Government Board for the year 1882, article, " The Animal Vaccine Establishment."--ED. L.
Diet.-Let his diet be composed solely of white of egg well beaten up, and mixed with an equal quantity of water, and given cool in small quantities frequently. External treatment.-The patient to be sponged occasionally with hot solution of carbolic acid (as in small-pox, to protect the patient as well as the nurse). All soiled linen coming from the patient to be put into a like solution. During an epidemic of cholera something important also may be done in the prophylactic way, by the administration
HOSPITALS FOR INFECTIOUS DISEASES. To the Editor
ufTHE LANCET. from the seaside I saw the article on SiR,-On this subject by Dr. Wilson in your journal, in which he refers to a paper of mine read at the Society of Medical Officers of Health, and published (in part) in a medical contemporary. As the whole of the part referring to the 16 sport maps" I have made was left out in that abstract, my return
TREATMENT OF ASIATIC CHOLERA.
of such medicines as will, we know, act as bactericidal antizymotics. An ingenious plan was adopted during a former epidemic by my friend, Dr. Jas. Arthur Power, by means of which all our households took anti-zymotic medicine inadvertently ; the plan was the mixtureof powdered hyposulphite of soda with ordinary table salt, in the proportion of a small teaspoonful to an ordinary salt-cellarful; thus a good antizymotic was administered daily in a tasteless form. A pill containing half a drop of creasote taken with meals is an excellent anti-zymotic remedy. All drinking water should
3’6 in Edinburgh. The fatal cases of diarrhoea, which had been 8, 22, and 25 in the three previous weeks, further rose to 48 last week. The 9 deaths from scarlet fever showed a decline of 4 from the high number in the preceding week. The fatal cases of whooping-cough showed a slight further increase upon recent weekly numbers, while those of "fever"corresponded with the number in the previous week. Four inquest cases and four deaths from violence were registered in the city during last week, and 34 deaths occurred in public institutions. The deaths of infanta showed a further increase upon those returned in recent weeks, while those of elderly persons showed a decline. The causes of 39, or nearly 17 per cent., of the deaths registered during the week were not certified. *
be boiled and filtered and allowed to cool. I am, Sir, obedient servant, your obedient servant, Sir, your F. EACHUS WILKINSON, M.D. Sydenham, August, 1884.
THE " METAPHYSICS" OF COMTE.
of THE LANCET. SIR,-Knowing something of the writings of Auguste ARMY MEDICAL DEPARTMENT.-Deputy Surgeon-GeneralComte, and being well acquainted with the distinguished Francis Holton, M.B., retires on temporary half-pay ; Sur-group of men who are the propagandists of his doctrines in I geon-Major Joseph Bourke, late Medical Department, hasthis 1 country, I am completely at a loss to understand what been permitted to commute his retired pay. Dr. Moxon means by his allusion to the " most rubbishy ADMIRALTY.-Fleet Surgeon William Shute Fisher, B.A. of Comte." It would, indeed, be hardly possible M.B., has been placed on the retired list, with permission tometaphysics 1 devise a more incongruous phrase, for that great thinker to assume the rank and title of Retired Deputy Inspector-claimed 4 before all things to be the prophet and apostle of General of Hospitals and Fleets ; Staff Surgeon John Buckscience; and if there be one feature of his system positive ] ley has been promoted to the rank of Fleet Surgeon in Her more distinctive than another, it is its complete divergerice Fleet. Majesty’s The j and antagonism to, metaphysical speculation. The following appointments have been made :-Surgeonsfrom, 1big, merciless hand," which Dr. Moxon deprecates as an George W. Low, Charles W. Hamilton, and Henry Harries,attribute of our profession, may be wielded by the critic to to the Alexand2ia ;Surgeon Albert P. Wells to be Surmalign the great as well as to crush the small, but the least geon and Agent at Douglas, Isle of Man; Surgeon J. we can look for is the exercise of some discretion in its use. Isle to be at of Castletown, Claque, Surgeon and Agent It is the fate of Comte’s philosophy to meet with assiduous Man; Staff Surgeon Hugh H. Hannay, to the Britannia ; misrepresentation; but no one who had ever read a I ine of Staff Surgeon Heaver Sugden, to the Hector; Surgeon of John Stuart Mill, of Buckle, or of G. H. Lewes, Littre, Edward Ferguson, to the Rapid; Surgeon John Ottley, tocould fall into the ludicrous error of taunting it with being the Vernon and Surgeon William H. O’Meara, to the metaphysical. Indeed, it is not necessary to go beyond Repulse. your own pages for the complete refutation of such an idea, which will be found well expressed in Dr. Walshe’s able and scholarly papers on "Physiology v. Metaphysics in Relation to Mind," published in THE LANCET of this year. To the Editor
THE SERVICES.
"
.
"
,
Correspondence.
I remain, Sir, your obedient servant, T. FITZPATRICK. Sussex-gardens, Hyde-park, Sept. 1st, 1884.
"Audi alteram partem."
TREATMENT
OF ASIATIC CHOLERA.
To the Editor
of THE LANCET. the SiR,-Notwithstanding rapid and effective strides which sanitary science has made and is making, and the manner in which it is being applied to stay the progress of the common enemy cholera, it appears to me that the medicinal treatment of this disease, whether prophylactic or curative, is uncertain, and that the writers upon the subject in the medical press touch upon the subject in a delicate manner. If a number of professional men were asked what their treatment would be, their replies, I think, would vary in form, and would be contradictory. We have to deal with (1) a zymotic disease; (2) a disease where everything is rejected by vomiting, and (3) a disease in which rapid collapse takes place. 2(zeM.—Pat the patient to bed. Inject hypodermically a solution of carbolic acid (half a grain of crystallised carbolic acid in twenty drops of water) with a solution of hydrochlorate of morphia, which may be repeated at intervals, as necessary. Let him have a hot-air bath made with a lamp and cradle over the bed, or hot bricks wrapped in flannel, and applied to the soles of the feet and armpits. Let him sip freely and frequently of sulphurous acid lemonade with glycerine, of which the following is the formula : Sulphurous acid, one ounce; glycerine, three ounces; tincture of lemon, four drachms ; syrup to eight ounces. , .
Half
an ounce
mixed in
a
i,
H
tumbler of water makes sul-
"
phurous acid lemonade."
VACCINE. To the Editor of THE LANCET. SIR,-I observe in your annotation of July 5th on "Vaccina’, tion in the Metropolis,"you remark that arm-to-arm vaccinaI tion is "far more protective" than any other. I would respectfully ask if statistics are available to confirm this statement, for it has always seemed to me that a successful vaccination exhibiting the Jennerian vesicles is all that can be desired, let the source of the virus be human or bovine, tube, point or crust. If your position is the correct one, we have the curious spectacle of a human vaccinifer furnishing the ideal vaccine, without himself or herself having the best protection. In Canada the human crust is much used. I am, Sir, yours truly, T. D. REED, M.D. Montreal, August 4th, 1884. Our words vaccination is far more " arm-to-arm were, * *-* protective than the use of stored lymph, whether it be human or animal. The reason for this statement is that vaccination with stored lymph " takes" with much less certainty, and often produces much smaller vesicles than vaccination done directly from arm to arm. See also the report of the medical officer to the Local Government Board for the year 1882, article, " The Animal Vaccine Establishment."--ED. L.
Diet.-Let his diet be composed solely of white of egg well beaten up, and mixed with an equal quantity of water, and given cool in small quantities frequently. External treatment.-The patient to be sponged occasionally with hot solution of carbolic acid (as in small-pox, to protect the patient as well as the nurse). All soiled linen coming from the patient to be put into a like solution. During an epidemic of cholera something important also may be done in the prophylactic way, by the administration
HOSPITALS FOR INFECTIOUS DISEASES. To the Editor
ufTHE LANCET. from the seaside I saw the article on SiR,-On this subject by Dr. Wilson in your journal, in which he refers to a paper of mine read at the Society of Medical Officers of Health, and published (in part) in a medical contemporary. As the whole of the part referring to the 16 sport maps" I have made was left out in that abstract, my return