A treatise on Asiatic cholera / edited and prepared by Edmund Charles Wendt, in association with Drs. John C. Peters, Ely McClellan, John B. Hamilton, and Geo. M. Sternberg.

  • Wendt, Edmund Charles, 1857-1903.
Date:
1885
Catalogue details

Licence: Public Domain Mark

Credit: A treatise on Asiatic cholera / edited and prepared by Edmund Charles Wendt, in association with Drs. John C. Peters, Ely McClellan, John B. Hamilton, and Geo. M. Sternberg. Source: Wellcome Collection.

Provider: This material has been provided by the Gerstein Science Information Centre at the University of Toronto, through the Medical Heritage Library. The original may be consulted at the Gerstein Science Information Centre, University of Toronto.

    413/440 (page 387)
    SEMMOLA'S PHYSIOLOGICAL TREATMENT. 3^7 ploy them is in the l^cginning of the disease, before the algid stage lias set in. For the object is not to warm the chilled cutaneous surface, as was formerly supposed, l)ut to maintain the normal physiological relations between the cutaneous surface and the gastro-intestinal mucous membrane. The hot bath, of 100 to 104°, excites the very rich peripheral nervous plexuses, aiul then by reflex action the nervous centers of tlie circulation. The hot bath favors also the elimination with the perspiration of the toxic principles, which are the cause of the nervous and other symptoms charac- teristic of the algid stage. The bath should be repeated every hour or two, and in the intervals the patient should be kept covered with woolen clothes and should take some warm aromatic and alcoliolic drink. Sem- mola advises that the baths should be begun as soon as the patient, even though the diarrhwa be slight, feels any epigastric uneasiness whether vom- iting have occurred or not. The uneasiness or distress is the precursory sig- nal of a terrible struggle, and no time should be lost in putting the patient into a hot bath for ten or fifteen minutes. In other cases also, when there is simple diarrhoea without any epigastric discomfort, if the diarrhoea is not speedily arrested by the ordinary treatment, fasting, rest, opium, etc., the writer counsels a recourse to the hot bath. He says he has seen hun- dreds of cases of diarrhoea rebellious to ordinaiy remedies, which would probably have eventualiy passed into actual cholera, but which yielded at once after one or two hot baths. 3. The administration of small doses of opium to blunt the nervous centers and thus render them less susceptible to the influence of the toxic agent. This is independent of the favorable influence which opium may exert upon the intestinal secretion. The stupefying action of the drug upon the nervous centers increases their power of resistance to the cholera poison, and thus really constitutes part of the physiological treatment of the disease. Some of Semmola's suggestions are Avorthy of being heeded. The ad- vantage of obtaining as much rest as possible for the digestive tract is self- evident. Nevertheless we cannot enforce a prolonged regime of fasting in every case menaced with an attack of cholera. The weak Avould, in place of being benefited thereby, suffer positive injury. Nor does the in- discriminate employment of warm baths strike us as a measure free from possible harm. It should be restricted to those cases, in which the physir cian feels satisfied that no mischief can be wrought, rather than extended to all, in which a possiljle benefit might he obtained. Professor Hayem,' the well-known ha?matologist, has recently published in extenso his views on the treatment of cholera. The following brief summary embodies the points on which he appears to lay the most stress. He first draws attention to a circumstance, which all competent writers are agreed upon, namely, how important it is to remember that, in a very large proportion of cases, cholera begins with gastro-intestinal troubles, and that if these are arrested in their incipiency, a grave attack may pos- sibly be prevented. It is, therefore, necessary during an epidemic to at- tend at once to all intestinal or digestive disturbances, and especially to diarrhoea. If there is indigestion or if there are signs of an overloaded stomach, ipecac may be given in a dose of 20 to 30 grains. It may even suffice, in certain cases, to produce emesis by tickling the fauces with a feather or by causing the patient to drink large quantities of warm water. ' Bulletin General tie Therapeutique, November 30, 1884, and Traitement du