1855.] 



REPORT ON THE RESULTS OF TREATMENT IX EPIDEMIC CHOLERA. 



tion ; — bis apprehensions of summary punisliment: 'any man that 

 fincletii me will slay me' ; — his fieeiug into another region, of which 

 Josephus so understands the text as to affirm that Cain obtained confe- 

 derates and became a pluuderei- and robber, implying the existence of 

 a population beyond his own family ; — and his building a * city,' a con- 

 siderable collection of habitations. 



" ' Thus, if contrarily to all reasonable probability, this great ques- 

 tion should ever be determined in the way opposite to what we now 

 tiiink the verdict of truth, the highest interests of man will not be 

 affected.' 



" If then Agassiz adopts the idea that the human family has a plu- 

 rality of ancestors, it is evident that he holds it in common with 

 learned, pious, and good men. and it is plain that the doctrine would 

 not have disqualified him in l)r. Pye Smith's estimation for any chair 

 of Natural History." 



These observations offer a fair summary of the arguments 

 which present themselves to the mind of an earnest and 

 thoughtful inquirer in reference to this extremely difficult 

 question. The simple declaration addressed by St. Paul to the 

 assembled Athenians, that God has " made of one blood all 

 nations of men to dwell on the face of the earth," has been 

 produced as conclusive ; but a more rigorous criticism com- 

 pels the Christian student of science to admit that the inter- 

 pretation of it, as meaning strictly a universal descent of evcrj' 

 human being from one common pair of ancestors, is not neces- 

 sarily the logical deduction from that beautiful and significant 

 passage. The writer on this vexed question, whose remarks 

 we have specially referred to above, concludes by observing : 



" One would think that the folly of attempting to settle phj sioal 

 questions in this w.ay has been sulficiently exposed .already. When 

 Galileo affirmed that the earth turned on its axis, and revolved in an 

 orbit round the sun, the Inquisition met him with texts of Scripture, 

 denounced him as a heretic for his glorious discoveries, and put him 

 in prison. What intelligent Catholic would not be delighted if these 

 disgraceful proceedings could be blotted from the anuals of his 

 Church ? How firmly was it believed, iu very recent times, that all 

 the existing species of land an:mals came out of .N'oah's ark ; and how 

 reluctant were many religious men, taking the words of Moses au pied 

 de la lelire, to receive the new and sound doctrine th.at every great re- 

 gion of the world lias animals peculiar to itself, and that there must 

 have been many distinct centres of creation. When geologists first 

 announced the vast age of the earth, and that its creation, instead of 

 beiu'^ completed !n six days, extended over millions of years, texts of 

 Scripture were again appealed to to put them down, and great was the 

 outcry. The progress of science has been retarded, not arrested, by 

 these proceedings, and have they not brought obloquy upon religion?" 



The circumstances to which we have referred above, as call- 

 ing special attention, at the present time, to this question of 

 the Unity of the Human Race, cannot fail to give an additional 

 interest to it in the minds of all who sympathise in the pro- 

 gress of science ; and will abundantly justify us, wo feel assur- 

 ed, in the estimation of our readers, for thus bringing it under 

 their notice. At the same time, we are fully alive to the many 

 difficulties with which the inquiry is beset, and to the deeply- 

 founded nature of all the preconceived ideas with which it 

 seems to come into collision; and we might have hesitated to 

 introduce the discussion in our pages, had it been character- 

 ised by a less reverential recognition of the sacred narrative, in 

 all that relates to the origin and the destiny of man. 



Report on the Pesiilts of the different Methods of Treatment 

 pursued iu Epidemic Choleia.* 



This report is restricted to an analysis and statistical records 

 placed in the possession of its authors, and supplied from the 

 various metropolitan hospitals and medical practitioners, such 



deductions only being made from the results of their analysis 

 as are plain and une(|uivocal. 



2,749 ca.ses ,f cholera are selected, of which 1,194 occur- 

 red in the metropolitan hospitals, 1,645 iu the metropolitan 

 districts (not iu the hospitals), and the remainder in the pro- 

 vinces. 



The treatment of the disease is divided into four heads : — 

 1, the alterative mode of treatment ; 2, the astringent; 3, the 

 stimulant; and 4, the eliminant (or cathartic). The alterative 

 and astringent modes are, according to medical writers, based 

 on the theory that the speeifio poison of cholera attacks the 

 mucous lining of the intestinal canal and sets up an action 

 which provokes an exhausting effusion of the serum of the 

 blyod. The eliminative treatment obviously presupposes the 

 necessity of assisting nature to get rid of the virus, her at- 

 tempts to effect which object constitute, according to this theo- 

 ry, the leading symptoms of the disease. The alterative treat- 

 ment includes the administration of calomel, in small doses at 

 shurt intervals, and in larger doses at longer intervals, with or 

 without emetics, salines, external stimulants, icewater, hot 

 baths, injections into the veins, clysters, and sometimes opium 

 (with calomel). The "astringents" consist of sulphuric acid 

 (dilut.), chalk and opium, alum, salines, cinchona, gallic acid, 

 quinine, and some of the remedies indicated under the " alter- 

 ative" system. The "stimulants" administered under ihe 

 third mode of treatment include ammonia, calomel, brandy, 

 turpentine enemata, ether, opium, nitrous oxyde, camphor, and 

 chloroform, with external stimulants, emetics, and hot baths, 

 the " cordial tonic mixture," eajeput oil, icewater, salines, &c. 

 The " eliminants," prescribed under the fourth head, were 

 castor oil, with and without emetics, external stimulants and 

 hot baths, calomel, capsicum, ginger, <fcc., emetics, ipecacuanha 

 in small doses, olive oil, and the potass, tartr. of antimon}-. 

 Many of these remedies are common to the various classes of 

 treatment, such as the mineral acids, calomel, opium, and oth- 

 ers. Out of the hospitals, chloric ether, soda, and mineral 

 acids were prescribed under the first head (in addition to the 

 other remedies); catechu, acetate of lead, tincture of the sescjui 

 chloride of iron, logwood, and sugar, under the second, or as- 

 tringent mode; chloroform, capsicum, creosote, &e., under the 

 stimulant course of treatment; and crotju oil under the fourth 

 or cathartic. 



And now for the result of this great experiment. The evi- 

 dence of a carefully-prepared series of tables, set forth in the 

 report, condemns altogether, as a principle of practice, the 

 fourth, or eliminant, mode of treatment ; it testifies against the 

 stimulant principle, excepting as a resource in extreme 

 cases ; it displays a decided advantage in the alterative 

 principle ; especially as carried out by calomel and opi- 

 um ; and it shows a still superior advantage in the astrin- 

 gent principle, as applied through the medium of chalk and 

 opium. The percentage of deaths was as follows : — viz., un- 

 der the eliminant mode. 71.7 ; under the stimulant, 54 ; under 

 the alternative (calomel and opium). 36. 2; and under the aslrin- 

 ccnts (chalk and opium), only 20.3 per cent. Tlicse statistics 

 are tested by the relative proportion which the cases of col- 

 lapse bear to the number of deaths of their own classes res- 

 pectively. Calomel and opium stand higliost in the scale of 

 success, if this criterion be adopted, the order of preference 



* Addressed to the President nf the Genernt Honrd of Ilen'th by 

 the " Treatment Committee of the Medical Council." Prosente I to 

 both Houses of Purliameut by command of her ilujesty. — £ixn. Muil. 



