TOLERANCE FOR ALKALIES IN ASIATIC CHOLERA. 



385 



at least a normally bright color and usually considerable elevation of the 

 blood pressure., which sometimes registered as much as 140 to 180 and 

 even 200 millimeters of mercury. Constipation in these cases was not 

 uncommon in the later stages of the disease. Those patients who lived 

 three or four days, but with cyanosis, soft pulse, and normal or subnormal 

 blood-pressure, are considered as having died of enteritis rather than 

 uramia, even though respiration was labored and the suppression of 

 urine was absolute. The initial loss of fluid by rectum in these cases 

 might account for the absence of urine; also in these eases the diarrhoea 

 frequently continued until death. 



In reviewing the two groups it is noteworthy that the majority of 

 patients who recovered under the sodium chloride treatment did not 

 develop absolute suppression of urine for as long a period as twenty-four 

 hours. However, in the alkali series, in addition to those which did not 

 develop complete suppression, a considerable number recovered even after 

 two days of absolute suppression. 



The following outline gives a summary of the cases which recovered. 



Treatment. 



Number of days of absolute suppression. 



None. 



One. 



Two. 



Three. 





9 



7 



6 

 12 



1 



7 





 1 







The final results were as follows : 



Treatment. 



Number of 

 cases. 



Deaths in 

 uraemia. 



Total 



number of 



deaths. 



Number of 

 recov- 

 eries. 





56 

 55 



8 

 1 



40 



28 



16 



27 







Calculation of percentages upon such a small group of patients could 

 have little significance. However, it is noteworthy that the increased 

 number of cases recovering under the alkaline treatment corresponds 

 roughly to the number of deaths from uraemia under the sodium chloride 

 treatment. Assuming that alkalies affect uraemia only and have no 

 influence upon collapse, then the theoretical limits of this increase would 

 be the percentage of cases which ordinarily die in uraemia. Of the 56 

 cases treated with sodium chloride, 8, or 14 per cent, died in uraemia. 

 This corresponds closely to the conditions in India where Rogers (1) 

 reports an incidence of 13.2 per cent of uraemia in cholera. 



