(1 1Of the following para, Sections i. to iv. were written for and published in a non-medical journal, the Independent, in November and December, 1865.
To avert any possible charge of presenting an ex parte case, the testimony to the superiority of homoeopathic treatment in Cholera was chiefly taken from the writings of impartial Government officers, or of hostile allopathic physicians; as, example, Mr. Wilde, of Dublin, the distinguished aural surgeon, and Dr. McLaughlin, of London, Inspector of Cholera Hospitals for the Golden Square District, in 1854-55.
To these sections a fifth is now added, on the Prevention and Treatment of Cholera.-C.D.
NEW YORK, April 20, 1866.)
I
There can be no doubt that Asiatic Cholera, which has prevailed during the past summer in various parts of Europe, has been brought to our shores. Reasoning from analogy, we have good grounds for believing that it will be epidemic in the Atlantic states next summer. It is, therefore, the part of produce in us to refresh our knowledge of the history and character of this terrible disease, and of the causes which seem to favor its propagation, in order that we may be the better able to meet the great practical problems: HOW TO WARD IT OFF, AND HOW TO DEAL WITH IT.
1. HISTORY. Like all invasions and all epidemics, cholera comes from the East, marching westward. It is known to have existed in the delta of the Ganges since 1629. But in 1817 it appeared in Hindostan, as a wide-spread and terribly fatal epidemic. From Calcutta and Jessore its progress was westward, although it spread also into China and the Indian Archipelago. In July, 1821, it had reached Muscat in Arabia, and in 1823 it touched the Georgian frontier of Russia. Thence it spread northward through Russia, Poland and Austria, extending in July, 1831, to St. Petersburg and Cronstadt, and in October, to Berlin, Vienna and Hamburg. In October 1831, it appeared in Sunderland, England, having been brought from Hamburg. It extended to London in February, 1832, appearing first in the immediate neighborhood of the shipping. From England it crossed to France, breaking out, March 23d, in Paris, where in one month it carried off 20,000 persons.
It was conveyed in an emigrant vessel from London to Quebec, where it appeared June 8, 1832. A few weeks later it became epidemic in the city of New-York, where it prevailed with great fatality until late in the autumn. It re-appeared in 1834.
In 1847 and 1848 cholera again invaded Europe from the East. December 8, 1848, the packet-ship “New-York” arrived at quarantine at Stalen Island, N.Y., having on board a number of passengers sick with cholera. Several had died on the voyage. From this infection, cholera prevailed at quarantine for several weeks, and two or three cases, which were traced to this vessel, occurred in this city.
Again, February 13, 1849, cholera borke out on board the packet-ship “Liverpool,” on her way to this port. There were fifty cases, of which forty died. During the succeeding months of spring and early summer, several vessels successively brought the disease to the quarantine; but it did not become epidemic in the city of New-York until June, 1849. It prevailed until October. In the summer of 1854 it was again epidemic in New-York.
In June, 1865, we heard of cholera as prevailing at Mecca, and on the route from Mecca to Alexandria. It was very fatal at Alexandria, Cairo and Constantinople. It extended to Jerusalem and along the shores of the Mediterranean and Adriatic. At Marseilles, we have reason to believe, it was and is still quite fatal, although no official reports have been allowed to be published. At the present time, November, 1865, it prevails extensively in Paris. The cases which recently arrived at our quarantine were from Paris, by way of Havre. A few cases have appeared at Southampton, England. We may hope that the influence of winter will prevent the malady spreading at present, but we should look for its re-appearance as an epidemic next summer.
The characteristic features of an attack of Asiatic cholera are, in brief, as follows: In the chest and at the pit of the stomach, a distressing anxiety and sense of oppression. General, and often extreme, prostration. Nausea, faintness, loud rumblings in the bowels. Sudden and forcible vomiting of a milky or watery fluid, in large quantities. Evacuations from the bowels, consisting of a similar watery substance, containing white floating grains. These vomitings and evacuations are attended and followed by spasms, tremors, and very rapid loss of the heat of the body. The skin becomes cold, clammy, and shriveled. The fingers look like those of a washerwomen; the skin has lost its elasticity, and if pinched into a ridge it retains that form for a long time. There is often great thirst; but, in many cases, the liquid is no sooner swallowed than it is forcibly ejected from the stomach. The extremities are frequently the seat of very painful cramps.
Severe cases pass on, in the course of eight to sixteen hours, to the stage of COLLAPSE. Indeed, the most severe cases may almost be said to commence with collapse. In this condition the features are pinched and sunken; the skin is of a bluish color, icy cold, and clammy; the tongue is cold, and the hands are corrugated. The voice is husky and faint, and the breath is cold. The pulse is frequent, very small, and often imperceptible. The evacuations from the stomach and bowels become less and less frequent as this stage becomes more fully developed; and, in most cases, they entirely cease several hours before death. The secretion of urine is suspended. The thirst is intense. The external surface of the body is very cold, but the patients complain of an internal burning heat.
During the whole course of the disease the minds is clear and composed. It is very remarkable that, although fully aware of their condition and danger, the majority of cholera patients manifest a singular apathy and indifference with regard to the result. The stage of collapse may last from two to twelve hours. In a majority of cases it ends in death. In the more fortunate minority, reaction sets in, marked by returning warmth and re-established secretions.
It is to be noted that the more rapidly fatal the case, the earlier the collapse occurs, and the less abundant are the evacuations. In the most terribly rapid cases, which destroy life in a few hours, there are almost no evacuations. It is evident, therefore, that death, in cholera, does not come from the drain on the system resulting from the evacuations, and, consequently, mere astringent remedies will not cure cholera.
During an epidemic of cholera, diarrhoea is very prevalent. It almost always precedes an attack, and doubtless predisposes to it. Instant attention should therefore be paid to such premonitions. In like manner, slight cramps are often felt. They should be regarded as premonitions, and medical advice should be sought at once.
The mortality of cholera has been very uniform. In 1830-32, on the continent of Europe and in Great Britain, the deaths in private practice were about 391/2 per cent of the cases; in hospital practice they were about 571/4 per cent.
In Great Britain, there occurred, in 1831-33, 137,080 cases of cholera, of which 52,547 died, or about 381/4 per cent. In subsequent epidemics the figures have been about the same. From the official returns in the daily newspapers of New-York, in 1849, it appears, that in this city there occurred, in a period of fifty-two days, 2,631 cases, of which 915 died, or 34.78 per cent. The resident physician reported, as treated in the hospitals, 1,021 cases; of which 880, or 53.71 per cent., died.
These facts are startling; but they are nevertheless facts. Instead of striving to avoid and ignore them, we should calmly accept them as incentives to our next topic: The study of the causes which favor the occurrence and increase the malignity of epidemic cholera.
II.
In coming to consider the causes which favor the occurrence and spread of cholera, and increase its malignity, we are met by the questions: Is cholera contagious, that is, does it spread by touch or contact? Or, on the other hand, does it exist in a community by virtue of some poison diffused through the atmosphere, and to which all persons in the community are alike exposed, and under the influence of which all who are predisposed to the disease sicken, whether they had been previously in the presence of cholera patients or not?
The ablest minds in the medical profession have sought to solve these questions and have come to different conclusions.
In favor of the contagiousness of cholera, its general line of march has been urges as an argument. It followed established routes of travel: along the track of Eastern caravans; from Asia to Moscow; thence to St. Petersburg; thence to Berlin and Hamburg; from Hamburg on board a vessel bound to England, and from this vessel to Sunderland, the port at which she arrived; from Sunderland throughout England.
Dr. Dunham graduated from Columbia University with Honours in 1847. In 1850 he received M.D. degree at the College of Physicians and Surgeons of New York. While in Dublin, he received a dissecting wound that nearly killed him, but with the aid of homoeopathy he cured himself with Lachesis. He visited various homoeopathic hospitals in Europe and then went to Munster where he stayed with Dr. Boenninghausen and studied the methods of that great master. His works include 'Lectures on Materia Medica' and 'Homoeopathy - Science of Therapeutics'.