Asiatic Cholera: A treatise on its origin, pathology, treatment, and cureWhitney, Elijah
History
Asiatic Cholera: A treatise on its origin, pathology, treatment, and cure
Whitney, Elijah
Cholera
Let us now turn to a paper by the justly celebrated Professor Maclean,
whose observations and experiences have been more extensive than
perhaps those of any other professional gentleman either in Europe or
America. Unlike many of his brethren, he holds on this subject the
safer doctrines of practice, and very frankly and earnestly expresses
the same in the following language: "Opium in cholera should be given
only in the premonitory diarrhoea. At this stage, in combination with
a stimulant, it is of the highest value. If persevered in, particularly
in the strong doses (justly reprobated), it is a dangerous remedy,
inducing fatal narcotism, or, at the least, interfering with the
functions of the kidneys, and so leading directly to uræmic poisoning."
"Urgent thirst is one of the most distressing symptoms in cholera;
there is incessant craving for cold water, doubtless instinctive, to
correct the inspissated condition of the blood, due to the rapid escape
of the liquor sanguinis. It was formerly the practice to withhold
water--a practice as cruel as it is mischievous. Water in abundance,
pure and cold, should be given to the patient, and he should be
encouraged to drink it, even should a large portion of it be rejected
by the stomach; and when the purging has ceased, some may, with much
advantage, be thrown into the bowel from time to time.
In the stage of reaction, the fever may be moderated by cold sponging,
or by the wet sheet; the secretion of urine may be promoted by dry
cupping over the loins by the use of chlorate of potash, and the like.
But suppression of this secretion is most to be dreaded where opium has
been too freely used in the treatment. In men of intemperate habits, we
often see, during the stage of reaction, obstinate vomiting of thick,
tenacious, green, paint-looking matter, probably bile pigment, acted
on by some acid in the stomach or alimentary canal. It is a symptom
of evil omen, and often goes on uncontrolled until the patient dies
exhausted, and this although all other symptoms may promise a favorable
issue. I have known it last for a week, resisting all remedies, and
proving fatal when the urinary secretion had been restored and all
cerebral symptoms had subsided. Alkalies in the effervescing form, free
stimulation of the surface, and chloroform in small doses offer the
best hope of relief. The patient should be nourished more by the bowel
than the stomach when vomiting is present. Ice should be not only to
dissolve in the mouth, but to swallow in pieces of convenient size."
Public-domain text, read in full here on John Shaqi.
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