Cholera

CHOLERA - The Board of Health have issued the following statement: “The following are the early symptoms of the disease in its most marked form, as it occurred to the observation of Dr. Russell, and Dr. Barry, at St. Petersburg, corroborated by the accounts from other places where the disease has prevailed:— Giddiness, sick stomach, nervous agitation, intermittent, slow, or small pulse, cramps beginning at the tops of the fingers and toes, and rapidly approaching the trunk, give the first warning.

Vomiting or purging, or both these evacuations of a liquid like rice water or whey, or barley-water, come on; the features become sharp and contracted, the eye sinks, the look is expressive of terror and wildness; the lips, face, neck, hands, and feet, and soon after the thighs, arms, and whole surface assume a leaden, blue, purple, black, or deep brown tint, according to the complexion of the individual, varying in shade with the intensity of the attack. The fingers and toes are reduced in size, the skin, and soft parts covering them are wrinkled, shrivelled, and folded; the nails put on a blueish pearly white, the larger superficial veins are marked by flat lines of deeper black; the pulse becomes either small as a thread, and scarcely vibrating, or else totally extinct. The skin is deadly cold and often damp, the tongue always moist, often white and loaded, but flabby and chilled like a piece of dead flesh. The voice is nearly gone: the respiration quick, irregular, and imperfectly performed. The patient speaks in a whisper. He struggles for breath, and often lays his hand on his heart to point out the seat of his distress. Sometimes there are rigid spasms of the legs, thighs, and loins.

The secretion of urine is totally suspended; vomitings and purgings, which are far from being the most important or dangerous symptoms, and which, in a very great number of cases of the disease, have not been profuse, or have been arrested by medicine early in the attack, succeed.

It is evident that the most urgent and peculiar symptom of this disease is the sudden depression of the vital powers: proved by the diminished action of the heart, the coldness of the surface and extremities, and the stagnant state of the whole circulation. It is important to advert to this fact, as pointing out the instant measures which may safely and beneficially be employed where medical aid cannot immediately be procured. All means tending to restore the circulation and maintain the warmth of the body should be had recourse to without delay.

The patient should always immediately be put to bed, wrapped up in hot blankets, and warmth should be sustained by other external applications, such as repeated frictions with flannels and camphorated spirits; poultices of mustard and linseed (equal parts) to the stomach, particularly where pain and vomiting exist; similar poultices to the feet and legs, to restore their warmth. The returning heat of the body may be promoted by bags containing hot salt or bran applied to different parts of it.

For the same purpose of restoring and sustaining the circulation, white wine whey, with spice, hot brandy and water, or sal volatile, in the dose of a tea-spoonful in hot water, frequently repeated, or from five to twenty drops of some of the essential oils, as peppermint, cloves, or cajeput, in a wine glass of water, may be administered; with the same view, where the stomach will bear it, warm broth with spice may be employed. In very severe cases, or where medical aid is difficult to be obtained,from twenty to forty drops of laudanum maybe given, in any of the warm drinks previously recommended.

These simple means are proposed as resources in the incipient stage of the disease, where medical aid has not yet been obtained. In reference to the further means to be adopted in the treatment of this disease, it is necessary to state that no specific remedy has yet been ascertained; nor has any plan of cure been sufficiently recommended by success to warrant its express recommendation from authority.

The Board have already published a detailed statement of the methods of treatment adopted in India, and of the different opinions entertained as to the use of bleeding, emetics, calomel, opium &c. There is reason to believe that more information on this subject may be obtained from those parts of the continent where the disease is now prevailing; but even should it be otherwise, the greatest confidence may be reposed in the intelligence and zeal which the medical practitioners of this country will employ in establishing an appropriate method of cure.