EFFECT OF THE CONCENTRATION OF SOLUTION IN THE 

 TREATMENT OF COLLAPSE IN ASIATIC CHOLERA. 



By Allan J. McLaughlin 1 and Andrew Watson Sellards. 



From the Biological Laboratory, Bureau of Science, and the Bureau of Health, 



Manila, P. I. 



One of the most prominent features of Asiatic cholera is the ex- 

 tremely rapid secretion of large amounts of fluid by the intestine during 

 the early stages of the disease. The excretion of water by the ordinary 

 channels practically ceases. The skin usually becomes dry and the 

 urine is partially or completely suppressed. In cases of average severity 

 this constant flow of fluid from the blood and other tissues into the 

 intestines ceases only when there is no more available fluid in the body, 

 and it usually recommences when liquid is supplied. This process 

 might be regarded as a compensatory reaction for removing bacteria 

 and their products and at the same time rendering conditions unfavor- 

 able for absorption from the intestine. Dangerous symptoms appear 

 only when the supply of fluid fails, and these symptoms are relieved, 

 at least temporarily, by the restoration of fluid to the body. Naturally, 

 the restoration of fluid becomes an important matter and the various 

 methods employed to accomplish this have attracted considerable atten- 

 tion. Sodium chloride is the solution which is in common use, and 

 the concentrations employed usually have been divided under a. physi- 

 ologic classification into three groups, namely, (1) hypotonic, (2) 

 isotonic, and (3) hypertonic solutions. The theoretical value of these 

 three concentrations may briefly be outlined as follows: The hypotonic 

 solution, by reason of its subnormal osmotic pressure, would tend to 

 continue the excretion of water from the vascular system into the 

 intestine, necessitating, perhaps,' the frequent injection of relatively 

 large amounts of salt solution. The hypertonic solution would tend 

 to restore water to the body with a minimum loss of injected fluid. 

 By reason of the higher osmotic pressure of the hypertonic solutions 

 the loss of fluid from the blood vessels into the surrounding tissues 

 might be delayed, thereby checking the diarrhoea. This increase of 



1 Passed assistant surgeon, United States Public Health and Marine-Hospital 

 Service, Assistant Director of Health, Manila, 



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