Treatment of Cholera in the Royal Hospital, Haslar: during the months of July and August, 1849, with remarks on the name and origin of the disease.Wilson, John (Inspector of Naval Hospitals)
History
Treatment of Cholera in the Royal Hospital, Haslar: during the months of July and August, 1849, with remarks on the name and origin of the disease.
Wilson, John (Inspector of Naval Hospitals)
Cholera
Of the 12 fatal cases which occurred here, eight of the subjects were in
a state of complete collapse—cold livid and pulseless—on admission; in
another collapse was nearly complete, and death speedily followed in all,
without the slightest sign of re-action. In one of the remaining three
cases, there were slight and transient periods of re-action, alternations
of promise and discouragement for fifty hours, when fatal sinking came
on. In the other two, the first danger was past, but severe re-actionary
fever followed. In one there was restoration of the biliary secretion;
in the other, during the last eighteen hours the subject had the complete
appearance of a patient in West Indian fever, discharging largely from
the stomach, and more sparingly from the bowels, a fluid exactly
resembling _black vomit_.
In the cases, which terminated in recovery, the impression was severe,
though not equally so; and in each the symptoms, as already stated, were
considered clearly characteristic of the prevailing epidemic. In some of
them no hope was entertained for a time; especially in two cases, where
there was in excess, lividity of surface, cold sweats, corrugated skin,
bent fingers and toes, and failure of pulse.
In considering the probability of recovery from cholera, there is reason
to think that the manner of attack should be taken into account, jointly
with the severity of subsequent symptoms. From what was observed here,
it appeared that when there had been precedent diarrhœa, or when there
had been—though sudden—a gradual progress to the collapsed state, there
was a much better chance for the patient than when the disease, in
overwhelming force, fell upon him at once. When, soon after eating a
hearty meal, in perfect health, the subject is obliged to be relieved
from duty in the ranks, or on deck, becoming in an instant faint and
giddy, with a rush of fluid from the stomach and bowels, shrinking of
features, fluttering pulse, coldness of surface tongue and breath—struck
down, as it were, by electricity—to which soon followed the up-turned
ecchymosed eye and whispering voice—when the disease thus sets in, it is
doubtful whether art has any power to arrest, or materially modify its
fatal career. Such, at least, is the impression from what was observed
here; and such, without questioning what has been alleged to have been
done by others, or disparaging the means they employed, it is apprehended
will be the conclusion of most observers elsewhere.
The practice pursued in Haslar Hospital is submitted to the profession,
not because it had any very eminent success, nor on account of its
including new remedies, but because the proportion of recoveries was at
least fully as large as that which has followed other modes of treatment;
because there was some novelty in the combination of the means employed;
and because it is thought that any contribution to the therapeutics of
cholera will be acceptable.
Public-domain text, read in full here on John Shaqi.
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