(EPIDEMIC CHOLERA).–Asiatic cholera is an infectious disease due to a specific poison, which has been identified in the well-known coma-shaped bacillus of Koch, but the conditions of its development and mode of propagation are still imperfectly understood, and the outbreak of an epidemic is dependent on the co-operation of many other factors which it is impossible to accurately estimate.
The disease commences with violent chills, and the poisoning may be so intense as to destroy life within one or two hours. The patient shakes with the chills and becomes visibly shrunken, the blood collects in the internal parts, and generally there is diarrhoea and vomiting, the patient becomes cold, and a complete and fatal collapse very frequently occurs in this stage. In favourable cases there is cessation of the violent purging and vomiting, some warmth returns to the skin, the patient gradually recovers, and asks for drink and food.
General Treatment.– (I) Prevention.–When cholera is prevalent, or when the approach of it is feared, wear next the skin a plate of copper (6 in by 4, for a man of large size; 5 in by 3 for a small man, and for a woman; 4 in by 2 for children). Let it be fastened round the waist by straps attached to longitudinal slits cut in the ends of the plate, which should be oval. Let the plate rest on the front of the abdominal wall, and let it be made slightly concave, so as to adapt itself to the shape of the body. The plate should be worn day and night. It may be cleansed from time to time by rubbing with vinegar.
In addition to this, if the person to be protected is much exposed to the disease, one drop of Cuprum aceticum 3x should be given in a little water night and morning.
(2) Preliminary Symptoms.–In cholera times, when diarrhoea occurs, give Rubini’s Tincture of Camphor, five drops on a lump of sugar, every fifteen minutes to every hour, according to the urgency of the symptoms, until the diarrhoea is completely removed.
Should an attack come on without premonitory diarrhoea, sudden clothes and lividity seizing the patient, give Rubini’s Camphor, five drops every ten minutes. This may be given if there is diarrhoea at the same time, provided it is not excessive.
(3) Care of the Patient.–The patient should now be kept at rest, and as warm as possible, hot flannels being applied to the abdomen,and hot bottles to the feet. No solid food whatever should be given; water may be taken ad libitum; and small pieces of ice may be given to suck. Milk is the best food, if it is tolerated.
Movement is to be avoided. It is better to treat patients of their own homes if at all possible, as the very fact of moving a patient into a hospital may make the difference between death and recovery.
Medicines.–(Every fifteen minutes until reaction sets in, then less often, waiting until the effect of each dose is exhausted.)
Camphor (Rubini’s).–The use of this has been explained above.
Veratrum alb. 3.– Should reaction not come on with Camphor; vomiting, purging, cold sweat on forehead.
Cuprum 6.– Cramps, with vomiting and purging.
Arsen. alb. 3.– Collapse deepening, great general depression, endangering life.
Hydrocyanic acid 3x.– Collapse most profound, respiration slow, gasping, patient appearing dead in the intervals between the breaths.