THE TREATMENT OF CHOLERA BY INJECTIONS OF HYPER- 

 TONIC SALINE SOLUTIONS WITH A SIMPLE AND RAPID, 

 METHOD OF INTRAABDOMINAL ADMINISTRATION.' 



By Leonard Rogers.'' 



The abrupt onset and rapidity of the course of cholera make it an 

 exceptionally difficult disease to treat efficiently. Indian statistics show 

 that the recorded mortality has certainly not decreased with the advance 

 of our knowledge of its causation through the discovery of the comma 

 bacillus by Koch twenty-five years ago. Although Haffkine's preventative 

 inoculation doubtless has a protective influence, it has not been found 

 practicable to use it as a routine measure and it is now very little em- 

 ployed in India. No serum treatment has come into use, while a study 

 of the writings of physicians from the time of the first great modern 

 Indian outbreak in 1817, shows extremely little advance in the treatment 

 by drugs or by other therapeutical agents during the last century. 



RELATIONSHIP OF LOSS OF FLUID FROM THE BLOOD TO THE SEVERITY OF CHOLERA. 



I have been studying the blood changes in cholera for some years 

 past in the hope of obtaining thereby indications for a more definite 

 line of treatment directed toward combating the actual pathological 

 changes produced by the disease. It is well Ictiown that the blood be- 

 comes greatly concentrated, owing to the extensive drain of fluid from 

 the body, yet as late as 1866 (and even in a book on nursing in the 

 tropics, published last year), the evacuant treatment of cholera was ad- 

 vocated, in order to remove the toxins of the disease. Moreover it was 

 strenuously denied that there is any relationship between the loss of fluid 

 and the death rate. As Wall and others have pointed out, the effect of a 

 given loss of fluid from the blood will depend as much on the rapidity as 

 on the actual quantity of the loss. In order to estimate the actual degree 

 of concentration of the blood in cholera, I have rapidly defribrinated 

 and centrifuged it in a hsemocrite, the percentage of corpuscles and 

 serum respectively being thus ascertained. As the corpuscles are not 

 lost (except to a very small extent, in the rare hgemorrhagic cases), as 



' Read at the Sixth Annual Meeting of the Philippine Islands Medical Associa- 

 tion, February 11, 1909. 



^ Professor of pathology, Medical College of Bengal, Calcutta, India. 



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