TREATMENT OF COLLAPSE IN ASIATIC CHOLERA. 



393 



frequently from zero, the maximum was reached about one to three 

 hours after the injection. This maximum varied somewhat in indi- 

 vidual cases, but usually amounted to a slight rise above normal. 



There was no apparent difference in the frequency with which the 

 injections were required to be repeated in the two series of cases. The 

 physical signs indicating the absorption of fluid by the tissues were 

 quite similar after the use of either solution. Usually, after the second 

 or third injection, the shrinking of the fingers disappeared, the skin 

 over the extremities resumed its elasticity and the power of speech 

 returned. 



Neither the course of the diarrhoea nor the height of blood pressure 

 which was obtained, bore any apparent relation to the solution which 

 was emplo3 r ed. The following outline gives a general summary of the 

 two groups. 



Treatment. 



Average 

 number 



of in- 

 jections. 



Average 

 maxi- 

 mum 

 blood 

 pressure 

 after in- 

 jections. 



Deaths. 



Total 

 deaths. 



Total 

 recov- 

 eries. 



Collapse. 



Urae- 

 mia. 



Pneu- 

 mo- 

 nia. 



First 

 day. 



Sec- 

 ond 

 day. 



Third 

 day. 



Total. 





2 

 14 



128 

 121 



7 

 4 



7 

 8 



4 

 5 



18 

 17 



3 



5 



1 

 1 



22 

 23 



9 

 7 



Hypertonic 



As regards the secretion of urine, no differences were observed. The 

 proportion of cases dying in urasmia was practically unaffected by the 

 use of the hypertonic salt solution. This agrees with Eogers' results. 



In addition to the cases treated with hypertonic solutions of sodium 

 chloride, a series of patients was treated in this hospital with hypertonic 

 solutions containing relatively large amounts of sodium bicarbonate. 

 This salt is of especial interest in the consideration of hypertonic 

 solutions, since, in concentrated form, the bicarbonates have the prop- 

 erty of withdrawing fluid from the tissues. Twelve cases admitted at 

 the hospital received the alkaline hypertonic solution during the stage of 

 collapse. The comparison of the three solutions in the treatment of 

 collapse is as follows : 





Solution employed. 



Number 



of 



cases. 



Death in collapse. 



Number. 



Percent. 





31 

 30 

 14 



18 

 17 

 7 



58 

 57 

 50 



Neutral hvpertonic 

 Alkaline hypertonic . 









