Click here to load reader


  • Upload

  • View

  • Download

Embed Size (px)

Citation preview





IT will appear rather strange, to those who know the crowdedstate of the localities lying between the Strand and Holborn,that only one solitary case of Asiatic cholera was admitted intothis hospital up to August 14th. The patient, a man aboutforty years of age, was brought in July 24th, at one o’clock inthe afternoon, and died at seven in the evening.

Before his admission, as we were informed by Mr. Diamond,house-surgeon to the hospital, the man had had about twenty-five evacuations, looking like yeast; but he had none in thehospital. On the day before the attack, the patient had par-taken of a meal of bread and cheese and cabbage; he hadformerly been very intemperate, but had given up drinkingsome time, and was living near the banks of the river by theside of Scotland-yard.At five in the morning the poor man had been taken ill, and

when admitted into the hospital, eight hours afterwards, hewas already blue, collapsed, and without pulse. Dr. Goldingcould of course not do much for him; but great exertions weremade with external warmth, frictions, brandy, &c. &c., thoughto no purpose.

If the cases of cholera have been almost absent from thishospital, diarrhoea has, on the other hand, been extremelycommon, the applicants to the dispensary having been verynumerous. The looseness of bowels was mostly treated bynitro-muriatic acid, in doses of one drachm and a half of theacid to two ounces and a half of water: a teaspoonful to betaken according to the symptoms. Sulphuric acid and opiumhave also been successful in checking diarrhoea.



THIS hospital has received, from the 1st of August to the 17th,a rather large number of cholera patients, there having beenabout thirty-two altogether. Of these, about twelve havedied, and Mr. Wilson, the physician’s assistant, stated to usthat the cases admitted were mostly bond fide cases of Asiaticcholera.Here again we find that the patients attacked by - the

epidemic have been placed in separate wards. On August17th, there were seven cholera patients in the house, all in avery precarious condition, and who probably have since suc-cumbed to the attack. The cases have been very severe, andmany patients were brought in a hopeless condition. Inexamining the patients in the house, on August 17th, we couldnot help remarking the ever - constant type of this fearfuldisease; the sunken feature, the half-closed eye, the shrivelledand cold extremities, the icy breath, the peculiar listlessness socharacteristic of cholera, cannot indeed for a moment be mis-taken.The line of treatment followed in this institution consists of

drachm doses of dilute sulphuric acid, and also calomel andopium, in doses of five grains of the first, and one of the second.Restorative means are resorted to at the same time, but brandyis not so largely given as in some other hospitals.The cases of diarrhoea amongst the out-patients have been

extremely numerous, and the treatment by dilute sulphuric acidparticularly successful. Mr. Wilson mentioned to us that onSunday, August 13th, he had had to prescribe for almost onehundred cases of diarrhoea, Sunday being, besides, an unusualday for out-patients presenting themselves.


WE are informed by Dr. Willshire that, "from the institu-tion being situated close to those districts of the metropoliswhere cholera has most abounded, the demands which havebeen made -for drugs to allay gastro-intestinal irritation anddischarges have been in truth excessive. A combination ofthe chalk mixture with the tincture of catechu and the tinctureof ginger, has been the medicine usually administered in theordinary cases of diarrhoea. Of the mixture in question no lessthan six gallons have been dispensed in a single day. To theabove combination are added the tincture of opium andaromatic confection in more obstinate cases; while, in stillmore severe forms of choleraic diarrhcea, solid opium, eitheralone or in union with the acetate of lead and capsicum, isadministered. Camphor and henbaue, in pills, are also given

where there is much tormina. The dilute sulphuric acid hasbeen tried, but although frequently appearing to hold for sometime the intestinal discharges in restraint, has not impressedthose of the medical officers who have used it with a very highopinion of its merits. The infusion of cinchona, combined withkino and camphor, have been administered apparently withmuch benefit to the younger patients."


At the Royal Infirmary for Children, hsematoxylon and thenitrate of silver are employed in addition to the above agents,according to Dr. Willshire.




MR. JAMES reports that up to Thursday, the 17th inst., themedical officers had not been called upon to attend any case ofgenuine malignant cholera, although they have had to treatmuch simple cholera and a few cases of choleraic diarrhosa. Thetreatment of the latter consists in first administering thefollowing draught:—Powdered rhubarb, a scruple; carbonateof magnesia, half a drachm; carbonate of ammonia, ten grains;tincture of opium, fifteen minims; peppermint-water, an ounceand a half; followed in two hours, if necessary, by the dilutesulphuric acid treatment, or the following mixture:-Carbonateof soda, aromatic spirit of ammonia, of each two drachms;tincture of opium, one drachm; cinnamon-water, eight ounces;of which an ounce is given every four hours. From this treat-ment the medical officers consider the most beneficial resultshave been derived during the present epidemic, they havingin many cases been obliged to have recourse to it when theacid treatment has failed. In some cases, where the vomitinghas been severe, they have resorted to the following pill, givenevery half-hour for the first three doses, and afterwards, ifnecessary, every four hours, but usually the first three doseshave proved all that are requisite: - Calomel, one grain;opium, one-third of a grain; powdered capsicum, one grain.Mix.

ISLINGTON DISPENSARY.Treatraeot for simple Diarr7ecea. -Chalk mixture, with

small doses of tincture of opium, and with or without catechu;perhaps a pill of calomel and opium.

Diarr7ecea, with vomiting or cramps, .3e7-ous purging, &c.-Chiefly calomel and opium, with chalk mixture, ammonia, &c.Developed Cholera.-Calomel, small doses, frequently re-

peated ; No onuM in any form, (Dr. Ayre’s treatment.)


THE resident medical officer states that for young childrenthe chalk mixture of the London Pharmacopoeia, with theaddition of bicarbonate of potass, or sesquicarbonate of soda, ascruple to a drachm and a half, and occasionally tincture ofcatechu, a drachm, has been found very advantageous, in dosesof a teaspoonful every two, three, or four hours, preceded bya dose of mercury with chalk and compound ipecacuanhapowder, of each a grain. In the case of some few aged people,the compound chalk mixture, made with compound chalkpowder with opium, two scruples, cinnamon-water, eightounces, and given in ounce doses, with the addition of com-pound spirit of ammonia, half a drachm; also, in obstinatecases, tincture of catechu, half a drachm, has answered well.One of the honorary surgeons employs, frequently with

success, the solution of acetate of ammonia, and aromatic spiritof ammonia. The others, and he himself, as he has stated,use the dilute sulphuric acid, from twenty to thirty minims,alone, or with small,doses of opium. During the week endingAugust 16th, there had been treated seventy casual applicantssuffering from diarrhoea of a more or less severe character,besides those that had obtained out-patients’ letters. Notmore than six of these have found it necessary to apply asecond time; usually the second or third dose (sometimes thefirst) produces a marked improvement. There has been butone case of decided cholera.


DR. DoLTo-N informs us that there have been no cases ofmalignant cholera at the Northern Dispensary, but diarrhoeahas been unusually prevalent. The majority of cases haveyielded to the ordinary treatment of chalk mixture with opium,and others have been treated with gallic acid, or dilute sulphuricacid, and opium, assisted in most of the cases by alterative

I doses of mercury.