1820.] Reports on the Epidemic Cholera in India. 371 



Bombay government. When the epidemic approached that 

 presidency, Sir Evan Nepean authorized the Medical Board to 

 take whatever steps they thought as most hkely to check its 

 progress, or to alleviate the calamities which it might be expected 

 to produce in so populous a place as Bonabay. In consequence 

 of this permission, as it was evidently impossible from the preju- 

 dices of the natives to collect them together in hospitals, a 

 number of native assistants were hired and stationed in different 

 parts of the island, in order to afford medical aid at the houses of 

 those who might require it. For their instruction and guidance, 

 a brief description of the disease, and of the mode of cure, was 

 drawn up, and translated into the different languages which they 

 understood. This most difficult and most important part of the 

 arrangement was principally conducted by Dr. Taylor, from whose 

 report we shall extract an account of the mode of treatment 

 which was found most successful, with which we shall close our 

 observations on this publication. 



The metliud of cure which, after consulting with you, I ordered to be used by 

 the native assistants, was extremely simple. They were supplied with scruple 

 doses of calomel, and a mixture composed of laudanum, essence of peppermint, 

 brandy, and water, each ounce of which contained 50 minims of laudanum, 10 

 minims of essence of peppermint, three drachms of brandy, and four drachms of 

 water. The calomel was first given in powder on the tongue, and then washed 

 down with an ounce of the mixture. A similar dose was ordered to be repeated in 

 two or three hours, if the patient derived no material relief from the former, or to 

 be repeated immediately should the first be rejected, a circumstance, however, 

 which very seldom happened. Besides giving these medicines, the assistants were 

 directed, in all cases where it was practicable, to use the warm bath; and when, 

 as it generally happened, this could not be done, to endeavour to alleviate the 

 spasms, and the pain in the abdomen by fomentations with cloth wrung out of 

 warm water, or by fomentations with warm bricks or tiles, or salt wrapped up in 

 cloths. Frictions with warm spirits were also directed, which almost uniformly 

 afforded great relief. The patients were ordered to be laid on a cot, underneath 

 which, shigras, filled with warm ashes, were placed when it was necessary; ves- 

 sels filled with warm water were also applied to the extremities. When by the use 

 of these remedies the more violent symptoms were removed, but some pain or unea- 

 siness in the abdomen still continued, and the bowels were not moved, an ounce, or 

 an ounce and a half, of castor oil was given. In addition to tlie o(ber stimulants 

 already mentioned, I sometimes directed cloves and cardamoms to be taken, when 

 the extremities were cold and the pulse feeble. Particular injunctions were given 

 not to allow the patient to drink cold water; but to allay in some measure his 

 urgent thirst, he was permitted sparingly the use of warm congee. The assistants 

 were also enjoined not to suffer any one to be disturbed who felt a disposition to 

 sleep. 



As the majority of cases were seen only by the native assistants, I have judged It 

 proper tn give this account of the general plan of practice they were directed to 

 pursue. Considering every circunistauce, the success attending it has been much 

 much greater than could have been expected. 



The if.me practice was adopted by myself, with this exception, that usually I 

 had recourse in the first place to bleeding. The accounts I had read of the disease, 

 and of some dissections wliicli showi-d a great congestion of blood in the abdominal 

 and thoracic vessels, led me to conclude, tliat bleeding, in many cases, would be 

 the most efficacious remedy. Accordingly it will be observed that I wislicd to try 

 the effect of blond letting in one of the first cases, but was prevented by the unwil- 

 lingness of the patient. A d.iy or two afterwards I was called to see a person who 

 had been ill 18 hours, and had received from one of my assistants two doses of 

 calomel and tivo Inudanum draughts. At the lime I saw him, though his mouth wag 

 affected, he had excruciating burning pain in the abdomen, with tormenting (hirst 



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