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WESTMINSTER GENERAL DISPENSARY,
145 ON THE
TREATMENT OF DIARRHŒA, WITH REPORTS OF TWO CASES OF SPASMODIC CHOLERA. Clevelandstreet, Fitzroy-sguare. IN the ordinary cases of diarrhoea,, of which there have been, within the last month, many hundreds in my practice, I have generally found the following (universally I might say) successful :-To an adult labouring under a severe form of diarrhoea, with pain in the bowels, frequent dejections, at first dark, and afterwards rice-coloured, I give calomel, five grains; powdered opium, a grain and a half, in two pills: and follow it up by a mixture of prepared chalk, two drachms; aromatic confection, a drachm; powdered gum acacia, two scruples; tincture of catechu, half an ounce; compound spirit of ammonia, two drachms; essence of ginger, a drachm; cinnamon-water, to six ounces. Mix. A fourth part to be taken after every loose dejection, adding according to circumstances, ether, and tincture of opium. If there is vomiting, I direct sinapisms to the chest and belly; if cramps, to the feet and calves of the legs; forbidding all slops, and directing cold brandy and water, and solid aliment. When the diarrhœa is subdued, great care is necessary to restore the biliary secretion, by small doses of mercury with chalk, with a sedative, such as extract of hyoscyamus, and a gentle aperient of magnesia and rhubarb. For children under six years of age, I have generally been successful with the following:-mercury with chalk, three grains; Dover’s powder, two grains: mix for a powder; and compound chalk mixture without the opium; sinapisms to the pit of the stomach. F’0)’ food:-New-laid eggs and bread; thick arrowroot with brandy, as with adults. No slops, excluding even beef-tea, until the diarrhoea is stopped; then beef-tea, with a little portwine and arrowroot mixed. During the present epidemic, I have treated only two cases of well-marked Asiatic cholera. CASE I.-A female, fifty-two years of age, very fat, and asthmatic, living in a kitchen, under which there is a cesspool, said to have been there without being emptied for upwards of thirty years. I was called to her on Sunday, July 16th, at five, r.M. She had cooked the family dinner at two o’clock, and had eaten freely of roast lamb and green peas, at which time she appeared in her usual health. About four, she became very sick, vomited freely, and was once purged. I saw her at five o’clock ; she was then cold as ice, painfully so to the touch; the skin perfectly blue; without pulse, and without voice; still sick, but as I learnt, had not been purged more than once, the quantity about two quarts. I directed brandy and water to be given in large quantities; turpentine and hot water applied to the stomach; sinapisms to the feet, and had the legs, arms, and hands rubbed with turpentine embrocations. At six o’clock, she had somewhat recovered; but the vomiting and pain continued. The fingers and toes were contracted; cramps and spasms of the legs and stomach. I then ordered the calomel and opium pills, and the chalk mixture, with ether and laudanum. About ten o’clock the pain and cramps had ceased, as well as the vomiting. The surface became warm; a hoarse whisper could be heard; there was still no purging, nor had there been any secretion of urine. At twelve o’clock all the symptoms were mitigated; the skin was warm ; the pulse free ; the voice better; cramps only occasional; still no secretion of urine. I ordered a repetition of all the measures, frictions, BY W.
LAWSON, ESQ., L.S.A., &c.,
and water, and solid diet, frictions to the feet and legs. These remedies were continued with slight variations for nine days, and the patient has recovered, but continues very weak. In many cases of diarrhœa I have tried the diluted sulphuric acid, but have never seen any benefit from its use, unless perhaps on a few occasions, when it seemed to check vomiting. I am perfectly aware that the cases related are of a very ordinary kind, and I only mention them as confirmatory of the opinion I have always held, that diarrhœa is not a precursor of Asiatic cholera. In 1849, I attended upwards of 3000 cases of the severest species of diarrhoea, without one becoming cholera; and I saw in that year upwards of 100 cases of genuine Asiatic cholera, not one of which had been preceded by diarrhoea. This year I have seen many hundreds of cases of diarrhoea, which have been easily subdued; and I have only seen these two cases of cholera, neither of which have arisen as consequences of diarrhoea.
TREATMENT OF CHOLERA AND DIARRHŒA IN THE
VARIOUS HOSPITALS, INFIRMARIES, AND DISPENSARIES IN THE METROPOLIS. No.I.
MIDDLESEX HOSPITAL. By Wednesday last, ten cases of cholera in an advanced stage had been received into this hospital during the prevalence of the present epidemic. Of these, five have already proved fatal; but it is remarked by one of the resident medical officers, that the disease at its present visitation has put on such unusual violence, and run its course with so much rapidity, that little hope of recovery has existed where the cholera has reached any advanced stage. The preliminary diarrhoea has speedily been succeeded by collapse, the intermediate stages noticed in former visitations having been altogether absent, The usual treator so transient as to be little observable. ment here of cholera in its malignant form is, first to administer a very full dose of calomel, (from ten grains to a scruple,) which is laid upon the tongue with little reference to the quantity, except a discretionary administration relative to the age of the patient, who is as soon as possible afterwards placed in a warm bath, where he remains from twenty to twenty-five minutes, or until some degree of reaction is restored. After this, two grains of calomel are administered every two hours, and alternately with this dose, Stevens’s saline mixture,consisting of chlorate of potass, six grains; chloride of sodium, a scruple; sesquicarbonate of soda, half a drachm; water, an ounce and a half,-is given. The latter mixture is also injected per anum, and during this part of the treatment, cloths wrung out of hot water, and sprinkled with turpentine, are laid over the region of the bowels. For the advent of the disease-the of diarrhœa--the treatment pursued has been to administer stage about forty minims of dilute sulphuric acid every half hour for the first six doses, and afterwards once every six hours, in conjunction with strong peppermint-water, and the results of this treatment have been, as we learn, in the highest degree satisfactory. The number of patients treated in this way for diarrhœa has been considerable; but as they are mostly outpatients, no record has been kept of their cases. Whenever the diarrhœa, has merged into the stage of collapse, they have promptly been received into the hospital, and subjected to the mode of treatment first-mentioned above. On Wednesday, sinapisms, brandy, &c. July 17th.-At eight A. M. she was still improving, but seemed three patients treated with the dilute sulphuric acid, after being lethargic. I discontinued the opium, and ordered the other in a state of collapse, were reported in a fair way for recovery. means to be continued, but being called away, I found on my return at six P.M., that supposing her much better, their appliST. MARYLEBONE GENERAL DISPENSARY, cation had been suspended, and the stage of collapse had reWELBECK-STREET, CAVENDISH-SQUARE. turned. She never again rallied, and at twelve o’clock she AT this institution, Dr. Armitage informs us that no cases died, without either vomiting or purging. CASE 2.-A man, thirty years of age, living in a confined of genuine Asiatic cholera havebeen presented for treatment. and unhealthy situation, in a house charged with the filthy Instances of choleraic diarrhœa have, however, been numerous, exhalations of privy and cesspool, was seized with cramps and and subjected to treatment with ordinary chalk mixture, chalk vomiting on the 5th of August. When I saw him first, he was with opium, or catechu. In a short time the disease has cold, blue, and pulseless, the eyes sunk, and the face with an succumbed to these remedies. expression of horror and fear, firmly impressed with the idea of cholera and death; there was violent pain in the stomach and WESTMINSTER GENERAL DISPENSARY, bowels; fingers and toes contracted; cramps in the legs, and GERRARD-STREET, SOHO. no urine had passed. I gave two calomel and opium pills, and the following mixture :-Spirits of camphor, two drachms; MR. ROBERTWADE, in cases of simple’ diarrhoea,, is in the oil of cajeput, thirty drops ; tincture of opium, fifty-five habit, when the motions indicate sluggishness of the liver, of minims; peppermint-water to six ounces. Mix. An ounce giving a mild dose of blue-pill, and the following mixture :every two hours. Turpentine applications, sinapisms, brandy Sesquicarbonate of ammonia, powder of rhubarb, of each half-a-
146 had more than the usual amount of diarrhoea at this season of a drachm; oil of peppermint, drachm; compound tincture of the year, and not, as yet, one case of Asiatic cholera. " My usual treatment in these cases of diarrhcea, where camphor, and compound spirits of lavender, of each three drachms; distilled water, eight ounces; of this three table- there havebeen frequent dejections, with violent griping pains and sometimes sickness, has been to administer one or two spoonfuls are given every four hours. When the cases are more severe, and the motions watery, grains of solid opium, followed up by chalk mixture, five the following is administered:-Dilute sulphuric acid, three ounces and a half; tincture of opium, a drachm; tincture of drachms; syrup of ginger, half an ounce; peppermint water, catechu, half an ounce; aromatic confection, a drachm and a
drachm ; sesquicarbonate
six drops; white sugar,
of
soda,
one
Three tablespoonfuls after each liquid motion. ounces. half. Two tablespoonfuls to be taken every hour. This has In addition to this, a one-grain opium pill is given at bed- generally acted like a charm. In this stage the disease is time, and strong mustard plasters applied over the entire completely under control. " In 1849, I had a district of the parish assigned to me as abdomen, and kept on as long as the patient can bear them. well as the workhouse, and, from March to October, I attended 1669 cases, the principal part being in August, September, WESTERN GENERAL DISPENSARY, and Octoher; out of these I had twenty-seven deaths. LISSON-GROVE. "Where the deaths occurred, with one exception, the THE ordinary treatment adopted here, for diarrhœa, in patients, when I first saw them, were labouring under children under seven or eight years of age, consists of a vomiting, rice-water purging, the peculiar sepulchral hoarsemixture of the following composition: Prepared chalk, ness, suppression of urine, cold tongue, breath and surface, powdered gum acacia, aromatic confection, of each an ounce; cramps, blue skin, and were sometimes nearly pulseless, caraway water to eight ounces; of which two drachms are indeed, in complete collapse. " To several of these I gave large quantities of ammonia and given every four hours. For adults the same mixture is ordered, with the addition brandy. In some I tried dilute sulphuric acid; in others, Dr. of half a drachm of tincture of opium to the eight ounces. Ayre’s plan of scruple doses of calomel every ten minutes, Dilute sulphuric acid, two Or else: compound mustard poultices, frictions, &c., but no remedies appeared to tincture of cardamoms, half an ounce; water, seven ounces have the slightest effect, as there was no absorption. ’’ The conclusion to which I have come from actual observaand a half. Mix. An ounce to be taken every four hours. About 1000 cases of diarrhcea have been treated during the tion of this disease is, that the remedies I have mentioned are last month. We have no returns of cases of genuine Asiatic almost specific in ninetv-nine cases out of one hundred, if given Where the patients are nearly pulseless, cholera under the care of the medical officers of this establish- sufficiently early. with rice-water motions and general collapse, I believe all ment. remedies are unavailing." INFIRMARY OF ST. GILES AND ST. GEORGE.
eight
-
drachms;
-
-
MR. BENNETT, the senior surgeon, states, that in mild cases COLDBATH-FIELDS PRISON.—HOUSE OF of diarrhoea., the ordinary prescription has been a mixture of DETENTION. aromatic confection, compound spirit of ammonia, (or of sulTHERE have been no cases of cholera under the care of Mr. phuric ether,) chalk mixture, peppermint water, and. tincture of opium; the doses graduated according to age. When there Wakefield; but from the 24th of July up to this time there has been great irritability of the stomach, and vomiting, a pill have been 133 cases of diarrhœa, most of them attended with of calomel and opium has been given, and no drink suffered sickness. The stools have generally been of a bilious character, but in some instances there was a deficiency of bile; in until an hour after taking the pill. Dilute sulphuric acid has not been used, as the preceding re- none was there any appearance of rice-water evacuations. At first, in most of the cases, there was a feeble pulse, with coldmedies have been found successful. When cramps have occurred, frictions, mustard plasters, and ness of the tongue and extremities, and violent pain in the hot wet cloths, sprinkled with turpentine, have been employed; abdomen. All of the cases soon recovered. The treatment in the latter applied, according to circumstances, over the limbs every instance was as follows :-A scruple of the sesquicaror the abdomen. In severe cases, two grains of calomel, with bonate of soda in a wineglassful of strong mint tea, repeated every half-hour, if necessary; sinapisms to the abdomen. The a quarter of a grain of opium, are given every two hours, and diet consisted of beef-tea for dinner, and cocoa night and brandy freely. Two cases of Asiatic cholera have been attended out of the morning. At the House of Detention, also under the care of Mr. house by the medical officer. They were a husband and wife, there has been no cholera, and only one or twoWakefield, in one of the worst localities in the Church-lane, living very cases of ordinary diarrhoea, which soon recovered. of The treatment St. Giles. recommended for the parish former was not carried out, and, indeed, when first visited the man was in collapse and speechless, and the case rapidly ST. GEORGE’S, SOUTHWARK, proved fatal. The wife was treated with brandy; the mixture first above-mentioned; calomel and opium; mustard plasters MR. J. W. WAKEM writes :-"I beg to inform you that I and turpentine externally. The treatment was so far success- have treated 400 cases of diarrhoea, and 28 of cholera, since ful, that her life was prolonged through a state of collapse the 26th of July, in the London-road district of St. George’s, lasting sixty hours, but she subsequently sank from the conse- Southwark ; 6 cases of diarrhœa, proved fatal, of which 3 cutive fever, dying on the eighth day of the choleraic attack. were previously debilitated, and 3 passed into cholera; the remainder recovered, most of them speedily. Of the 28 cases of cholera, 12 died in from twelve to forty-eight hours; 3 PUBLIC DISPENSARY, fresh cases are now under treatment; of the remainder most LINCOLN’S-INN-FIELDS. CAREY-STREET, are convalescent. In one case paralysis of the left arm FROM fifty to sixty new cases of diarrhoea have been occurred, and the patient (a muscular young man, about twentyattended here during the present month. One plan of treat- five years of age) has now, twelve days after attack, but ment adopted has been, at the outset, the administration partial use of it, but is daily improving. In this case the of two grains of calomel with eight of rhubarb, followed by a patient was in a state of collapse in half an hour; he also mixture, of which ammonia and tincture of opium are the suffered extremely from cramp in his stomach, legs, and arms, chief ingredients. At other times, the two following formulae for two hours. have been made use of :-Chalk mixture, decoction of logwood, "Symptoms (Di(,zri-7icea).-Puroing in most cases has been equal parts, with five minims of tincture of opium, every four very frequent, attended with severe tormina, and in many cases hours; or, chalk mixture, with five minims of tincture of cramps in the stomach, bowels, &c.; motions, from pale yellow opium, four grains of carbonate of ammonia, and a drachm of to rice-water; in about a third vomiting has been very severe. In diarrhcea I have found the following pills more effectual than tincture of catechu, for a dose. In certain cases two grains of calomel, witha third of a grain any other medicine :-Powdered opium, capsicum, camphor, of opium, were followed by an ounce of castor-oil. No cases and calomel, of each half a grain; commence with two pills, of confirmed cholera are reported. afterwards one to be given after every liquid evacuation. " I have not found the dilute sulphuric acid generally succeed ; but in some few cases I haveused it, combined with opium and MARTIN’S-IN-THE-FIELD’S WORKHOUSE. ST. decoction of logwood, when the disease has assumed a someIN a communication received from Dr. Bainbridge, medical what chronic form. I find very large mustard sinapisms of the officer of !"it. Martin’s-in-the-Fielcls, he says:greatest service in all forms of diarrhcea and vomitings, whether "I have to state, that up to the present time we have or not attended with pain or cramps. They should be applied
not
TREATMENT OF DIARRHŒA, WITH REPORTS OF TWO CASES OF SPASMODIC CHOLERA. Clevelandstreet, Fitzroy-sguare. IN the ordinary cases of diarrhoea,, of which there have been, within the last month, many hundreds in my practice, I have generally found the following (universally I might say) successful :-To an adult labouring under a severe form of diarrhoea, with pain in the bowels, frequent dejections, at first dark, and afterwards rice-coloured, I give calomel, five grains; powdered opium, a grain and a half, in two pills: and follow it up by a mixture of prepared chalk, two drachms; aromatic confection, a drachm; powdered gum acacia, two scruples; tincture of catechu, half an ounce; compound spirit of ammonia, two drachms; essence of ginger, a drachm; cinnamon-water, to six ounces. Mix. A fourth part to be taken after every loose dejection, adding according to circumstances, ether, and tincture of opium. If there is vomiting, I direct sinapisms to the chest and belly; if cramps, to the feet and calves of the legs; forbidding all slops, and directing cold brandy and water, and solid aliment. When the diarrhœa is subdued, great care is necessary to restore the biliary secretion, by small doses of mercury with chalk, with a sedative, such as extract of hyoscyamus, and a gentle aperient of magnesia and rhubarb. For children under six years of age, I have generally been successful with the following:-mercury with chalk, three grains; Dover’s powder, two grains: mix for a powder; and compound chalk mixture without the opium; sinapisms to the pit of the stomach. F’0)’ food:-New-laid eggs and bread; thick arrowroot with brandy, as with adults. No slops, excluding even beef-tea, until the diarrhoea is stopped; then beef-tea, with a little portwine and arrowroot mixed. During the present epidemic, I have treated only two cases of well-marked Asiatic cholera. CASE I.-A female, fifty-two years of age, very fat, and asthmatic, living in a kitchen, under which there is a cesspool, said to have been there without being emptied for upwards of thirty years. I was called to her on Sunday, July 16th, at five, r.M. She had cooked the family dinner at two o’clock, and had eaten freely of roast lamb and green peas, at which time she appeared in her usual health. About four, she became very sick, vomited freely, and was once purged. I saw her at five o’clock ; she was then cold as ice, painfully so to the touch; the skin perfectly blue; without pulse, and without voice; still sick, but as I learnt, had not been purged more than once, the quantity about two quarts. I directed brandy and water to be given in large quantities; turpentine and hot water applied to the stomach; sinapisms to the feet, and had the legs, arms, and hands rubbed with turpentine embrocations. At six o’clock, she had somewhat recovered; but the vomiting and pain continued. The fingers and toes were contracted; cramps and spasms of the legs and stomach. I then ordered the calomel and opium pills, and the chalk mixture, with ether and laudanum. About ten o’clock the pain and cramps had ceased, as well as the vomiting. The surface became warm; a hoarse whisper could be heard; there was still no purging, nor had there been any secretion of urine. At twelve o’clock all the symptoms were mitigated; the skin was warm ; the pulse free ; the voice better; cramps only occasional; still no secretion of urine. I ordered a repetition of all the measures, frictions, BY W.
LAWSON, ESQ., L.S.A., &c.,
and water, and solid diet, frictions to the feet and legs. These remedies were continued with slight variations for nine days, and the patient has recovered, but continues very weak. In many cases of diarrhœa I have tried the diluted sulphuric acid, but have never seen any benefit from its use, unless perhaps on a few occasions, when it seemed to check vomiting. I am perfectly aware that the cases related are of a very ordinary kind, and I only mention them as confirmatory of the opinion I have always held, that diarrhœa is not a precursor of Asiatic cholera. In 1849, I attended upwards of 3000 cases of the severest species of diarrhoea, without one becoming cholera; and I saw in that year upwards of 100 cases of genuine Asiatic cholera, not one of which had been preceded by diarrhoea. This year I have seen many hundreds of cases of diarrhoea, which have been easily subdued; and I have only seen these two cases of cholera, neither of which have arisen as consequences of diarrhoea.
TREATMENT OF CHOLERA AND DIARRHŒA IN THE
VARIOUS HOSPITALS, INFIRMARIES, AND DISPENSARIES IN THE METROPOLIS. No.I.
MIDDLESEX HOSPITAL. By Wednesday last, ten cases of cholera in an advanced stage had been received into this hospital during the prevalence of the present epidemic. Of these, five have already proved fatal; but it is remarked by one of the resident medical officers, that the disease at its present visitation has put on such unusual violence, and run its course with so much rapidity, that little hope of recovery has existed where the cholera has reached any advanced stage. The preliminary diarrhoea has speedily been succeeded by collapse, the intermediate stages noticed in former visitations having been altogether absent, The usual treator so transient as to be little observable. ment here of cholera in its malignant form is, first to administer a very full dose of calomel, (from ten grains to a scruple,) which is laid upon the tongue with little reference to the quantity, except a discretionary administration relative to the age of the patient, who is as soon as possible afterwards placed in a warm bath, where he remains from twenty to twenty-five minutes, or until some degree of reaction is restored. After this, two grains of calomel are administered every two hours, and alternately with this dose, Stevens’s saline mixture,consisting of chlorate of potass, six grains; chloride of sodium, a scruple; sesquicarbonate of soda, half a drachm; water, an ounce and a half,-is given. The latter mixture is also injected per anum, and during this part of the treatment, cloths wrung out of hot water, and sprinkled with turpentine, are laid over the region of the bowels. For the advent of the disease-the of diarrhœa--the treatment pursued has been to administer stage about forty minims of dilute sulphuric acid every half hour for the first six doses, and afterwards once every six hours, in conjunction with strong peppermint-water, and the results of this treatment have been, as we learn, in the highest degree satisfactory. The number of patients treated in this way for diarrhœa has been considerable; but as they are mostly outpatients, no record has been kept of their cases. Whenever the diarrhœa, has merged into the stage of collapse, they have promptly been received into the hospital, and subjected to the mode of treatment first-mentioned above. On Wednesday, sinapisms, brandy, &c. July 17th.-At eight A. M. she was still improving, but seemed three patients treated with the dilute sulphuric acid, after being lethargic. I discontinued the opium, and ordered the other in a state of collapse, were reported in a fair way for recovery. means to be continued, but being called away, I found on my return at six P.M., that supposing her much better, their appliST. MARYLEBONE GENERAL DISPENSARY, cation had been suspended, and the stage of collapse had reWELBECK-STREET, CAVENDISH-SQUARE. turned. She never again rallied, and at twelve o’clock she AT this institution, Dr. Armitage informs us that no cases died, without either vomiting or purging. CASE 2.-A man, thirty years of age, living in a confined of genuine Asiatic cholera havebeen presented for treatment. and unhealthy situation, in a house charged with the filthy Instances of choleraic diarrhœa have, however, been numerous, exhalations of privy and cesspool, was seized with cramps and and subjected to treatment with ordinary chalk mixture, chalk vomiting on the 5th of August. When I saw him first, he was with opium, or catechu. In a short time the disease has cold, blue, and pulseless, the eyes sunk, and the face with an succumbed to these remedies. expression of horror and fear, firmly impressed with the idea of cholera and death; there was violent pain in the stomach and WESTMINSTER GENERAL DISPENSARY, bowels; fingers and toes contracted; cramps in the legs, and GERRARD-STREET, SOHO. no urine had passed. I gave two calomel and opium pills, and the following mixture :-Spirits of camphor, two drachms; MR. ROBERTWADE, in cases of simple’ diarrhoea,, is in the oil of cajeput, thirty drops ; tincture of opium, fifty-five habit, when the motions indicate sluggishness of the liver, of minims; peppermint-water to six ounces. Mix. An ounce giving a mild dose of blue-pill, and the following mixture :every two hours. Turpentine applications, sinapisms, brandy Sesquicarbonate of ammonia, powder of rhubarb, of each half-a-
146 had more than the usual amount of diarrhoea at this season of a drachm; oil of peppermint, drachm; compound tincture of the year, and not, as yet, one case of Asiatic cholera. " My usual treatment in these cases of diarrhcea, where camphor, and compound spirits of lavender, of each three drachms; distilled water, eight ounces; of this three table- there havebeen frequent dejections, with violent griping pains and sometimes sickness, has been to administer one or two spoonfuls are given every four hours. When the cases are more severe, and the motions watery, grains of solid opium, followed up by chalk mixture, five the following is administered:-Dilute sulphuric acid, three ounces and a half; tincture of opium, a drachm; tincture of drachms; syrup of ginger, half an ounce; peppermint water, catechu, half an ounce; aromatic confection, a drachm and a
drachm ; sesquicarbonate
six drops; white sugar,
of
soda,
one
Three tablespoonfuls after each liquid motion. ounces. half. Two tablespoonfuls to be taken every hour. This has In addition to this, a one-grain opium pill is given at bed- generally acted like a charm. In this stage the disease is time, and strong mustard plasters applied over the entire completely under control. " In 1849, I had a district of the parish assigned to me as abdomen, and kept on as long as the patient can bear them. well as the workhouse, and, from March to October, I attended 1669 cases, the principal part being in August, September, WESTERN GENERAL DISPENSARY, and Octoher; out of these I had twenty-seven deaths. LISSON-GROVE. "Where the deaths occurred, with one exception, the THE ordinary treatment adopted here, for diarrhœa, in patients, when I first saw them, were labouring under children under seven or eight years of age, consists of a vomiting, rice-water purging, the peculiar sepulchral hoarsemixture of the following composition: Prepared chalk, ness, suppression of urine, cold tongue, breath and surface, powdered gum acacia, aromatic confection, of each an ounce; cramps, blue skin, and were sometimes nearly pulseless, caraway water to eight ounces; of which two drachms are indeed, in complete collapse. " To several of these I gave large quantities of ammonia and given every four hours. For adults the same mixture is ordered, with the addition brandy. In some I tried dilute sulphuric acid; in others, Dr. of half a drachm of tincture of opium to the eight ounces. Ayre’s plan of scruple doses of calomel every ten minutes, Dilute sulphuric acid, two Or else: compound mustard poultices, frictions, &c., but no remedies appeared to tincture of cardamoms, half an ounce; water, seven ounces have the slightest effect, as there was no absorption. ’’ The conclusion to which I have come from actual observaand a half. Mix. An ounce to be taken every four hours. About 1000 cases of diarrhcea have been treated during the tion of this disease is, that the remedies I have mentioned are last month. We have no returns of cases of genuine Asiatic almost specific in ninetv-nine cases out of one hundred, if given Where the patients are nearly pulseless, cholera under the care of the medical officers of this establish- sufficiently early. with rice-water motions and general collapse, I believe all ment. remedies are unavailing." INFIRMARY OF ST. GILES AND ST. GEORGE.
eight
-
drachms;
-
-
MR. BENNETT, the senior surgeon, states, that in mild cases COLDBATH-FIELDS PRISON.—HOUSE OF of diarrhoea., the ordinary prescription has been a mixture of DETENTION. aromatic confection, compound spirit of ammonia, (or of sulTHERE have been no cases of cholera under the care of Mr. phuric ether,) chalk mixture, peppermint water, and. tincture of opium; the doses graduated according to age. When there Wakefield; but from the 24th of July up to this time there has been great irritability of the stomach, and vomiting, a pill have been 133 cases of diarrhœa, most of them attended with of calomel and opium has been given, and no drink suffered sickness. The stools have generally been of a bilious character, but in some instances there was a deficiency of bile; in until an hour after taking the pill. Dilute sulphuric acid has not been used, as the preceding re- none was there any appearance of rice-water evacuations. At first, in most of the cases, there was a feeble pulse, with coldmedies have been found successful. When cramps have occurred, frictions, mustard plasters, and ness of the tongue and extremities, and violent pain in the hot wet cloths, sprinkled with turpentine, have been employed; abdomen. All of the cases soon recovered. The treatment in the latter applied, according to circumstances, over the limbs every instance was as follows :-A scruple of the sesquicaror the abdomen. In severe cases, two grains of calomel, with bonate of soda in a wineglassful of strong mint tea, repeated every half-hour, if necessary; sinapisms to the abdomen. The a quarter of a grain of opium, are given every two hours, and diet consisted of beef-tea for dinner, and cocoa night and brandy freely. Two cases of Asiatic cholera have been attended out of the morning. At the House of Detention, also under the care of Mr. house by the medical officer. They were a husband and wife, there has been no cholera, and only one or twoWakefield, in one of the worst localities in the Church-lane, living very cases of ordinary diarrhoea, which soon recovered. of The treatment St. Giles. recommended for the parish former was not carried out, and, indeed, when first visited the man was in collapse and speechless, and the case rapidly ST. GEORGE’S, SOUTHWARK, proved fatal. The wife was treated with brandy; the mixture first above-mentioned; calomel and opium; mustard plasters MR. J. W. WAKEM writes :-"I beg to inform you that I and turpentine externally. The treatment was so far success- have treated 400 cases of diarrhoea, and 28 of cholera, since ful, that her life was prolonged through a state of collapse the 26th of July, in the London-road district of St. George’s, lasting sixty hours, but she subsequently sank from the conse- Southwark ; 6 cases of diarrhœa, proved fatal, of which 3 cutive fever, dying on the eighth day of the choleraic attack. were previously debilitated, and 3 passed into cholera; the remainder recovered, most of them speedily. Of the 28 cases of cholera, 12 died in from twelve to forty-eight hours; 3 PUBLIC DISPENSARY, fresh cases are now under treatment; of the remainder most LINCOLN’S-INN-FIELDS. CAREY-STREET, are convalescent. In one case paralysis of the left arm FROM fifty to sixty new cases of diarrhoea have been occurred, and the patient (a muscular young man, about twentyattended here during the present month. One plan of treat- five years of age) has now, twelve days after attack, but ment adopted has been, at the outset, the administration partial use of it, but is daily improving. In this case the of two grains of calomel with eight of rhubarb, followed by a patient was in a state of collapse in half an hour; he also mixture, of which ammonia and tincture of opium are the suffered extremely from cramp in his stomach, legs, and arms, chief ingredients. At other times, the two following formulae for two hours. have been made use of :-Chalk mixture, decoction of logwood, "Symptoms (Di(,zri-7icea).-Puroing in most cases has been equal parts, with five minims of tincture of opium, every four very frequent, attended with severe tormina, and in many cases hours; or, chalk mixture, with five minims of tincture of cramps in the stomach, bowels, &c.; motions, from pale yellow opium, four grains of carbonate of ammonia, and a drachm of to rice-water; in about a third vomiting has been very severe. In diarrhcea I have found the following pills more effectual than tincture of catechu, for a dose. In certain cases two grains of calomel, witha third of a grain any other medicine :-Powdered opium, capsicum, camphor, of opium, were followed by an ounce of castor-oil. No cases and calomel, of each half a grain; commence with two pills, of confirmed cholera are reported. afterwards one to be given after every liquid evacuation. " I have not found the dilute sulphuric acid generally succeed ; but in some few cases I haveused it, combined with opium and MARTIN’S-IN-THE-FIELD’S WORKHOUSE. ST. decoction of logwood, when the disease has assumed a someIN a communication received from Dr. Bainbridge, medical what chronic form. I find very large mustard sinapisms of the officer of !"it. Martin’s-in-the-Fielcls, he says:greatest service in all forms of diarrhcea and vomitings, whether "I have to state, that up to the present time we have or not attended with pain or cramps. They should be applied
not