176 THT ABORTIVE TREATMENT OF CHOLERA. 



if ice is not at hand the patient should have cold water freely allowed 

 him when confirmed cholera has supervened ; for irrespective of the 

 comfort given, the power of absorption by the veins of the stomach, 

 may not be altogether lost. 



Stevens' treatment consisted in giving previous to and during col- 

 lapse, large quantities of water with saline ingredients to replace those 

 lost in the dejections. The injection of liquids into the veins to replace 

 directly the lost serum has been often adopted, and has sometimes 

 appeared successful. Some writers urge that its usefulness depends 

 on the degree of heat of the injected liquid, and its consequent power 

 of relaxing the spasm of the pulmonary circulation, and there appears 

 some ground for the opinion, although it may be equally due to the 

 replacing of some of the lost watery parts of the blood. 



Dr. George Johnson argues in favonr of the former view, and it 

 does appear that if the inspissation of the blood were the sole cause of 

 the obstruction, restoration from collapse should be almost impossible, 

 except where venous injection is performed. 



Various liquids have been injected ; the blood of healthy subjects, 

 the milk of cows, the sp. gr. of which is about that of serum, and 

 more frequently solutions at a blood heat, containing salts to replace 

 those supposed to have been lost in the evacuations. 



It has been proposed, by Dr. Johnson, to use the liquids at the 

 temperature of from 106° to 120° F., under the impression that the 

 heat itself will relieve the obstructive spasm of the minute pulmonary 

 arteries. 



The exhaustion consequent upon excessive discharges must be con- 

 sidered an element in the production of death, and should be steadily 

 met as the exhaustion is manifested. Stimulants are indicated, and 

 especially those of an antispasmodic class : as chloroform with 

 brandy, in small quantities, with a little opium in some soluble form, 

 so as to be available at once. Turpentine and creosote have been 

 highly recommended, in the stage of invasion, to arrest discharge, and 

 are worthy of extended trial. Astringents : Acetate of lead, in scru- 

 ple doses, with opium, was Dr. Graves' favourite ; and large injections 

 of dilute solutions of Catechu have been used in the East. There 

 can be no doubt that any means of checking excessive serous hcemor- 

 rhage, and of rousing the system, is most desirable, if it can be ac- 

 complished by remedies that cause no difficulty when reaction comes 

 on. It is at this latter stage that the mischief resulting from the 



