434 
THE COTTAGE GARDENER 
March 9. 
usefulness; and in the way of prevention, and deprecat¬ 
ing the judicial punishment of many sins of omission 
and commission against the natural laws of Providence, 
every man has it most in his power (under Providence) 
to become his own physician. 
Now the following popular directions for the ma¬ 
nagement of sudden cases of incipient cholera, or choleraic 
diarrhoea, are, beyond comparison, the plainest of any 
yet put forward for general use, by authority. Yet to 
us every sentence breathes a protest against the necessity 
which required the promulgation of any such document 
; at all. In truth, the true science of medicine is ex¬ 
hausted when once the cholera has been allowed to 
establish itself. Timely warnings have been unheeded; 
disastrous courses have been recklessly continued; aud 
! when the crash comes, as surely it will come, the busi¬ 
ness is just like that of winding up a bankrupt estate, 
and deprecating the just wrath of the creditor and the 
judge. The same is the case, to a less extent, no doubt, 
in the incipient stage. It has been found that timely 
removal to a higher, drier, purer air, aided by good 
plain food and clothing, is the only effective way to 
stop an epidemic of diarrhoea, and to prevent its be¬ 
coming cholera. It may be kept down by incessant 
attention and physicking, and daily visiting from house 
to house among the poor, debauched, ill-fed inhabitants 
of low, damp, dirty, crowded places. So, with all hands 
to the pump, a leaky vessel may be brought into port 
with ever so many feet of water in the hold ; but is it 
not far better, when there is a chance, to lighten the 
cargo and put the passengers on a sound bottom? J. J. 
“ DIRECTIONS OF THE IRISH COLLEGE OF PHYSICIANS FOE THE 
TREATMENT OF CHOLERAIC DIAERHCEA AND COMMENCING 
CHOLERA. 
“As the malignant cholera is, in the majority of cases, 
quite amenable to treatment in its earliest period, or that 
of premonitory diarrhoea; and, as this being free from pain 
is apt to be disregarded, all cases of this kind should be 
diligently sought for and promptly treated. A judicious 
system of house-to-house visitation should be organised in 
the poorer districts in every large town threatened with the 
epidemic. The medical visitors entrusted with the care of 
the poor should carry with them appropriate remedies to be 
administered at once on discovering any case of premonitory 
diarrhoea. 
“ In addition to this system—by which the committee 
j hope to check the spread of the disease at its first approach 
—it will be necessary to provide means of relief should 
cholera become epidemic. In that case, the city should be 
divided into a number of districts, at some convenient point 
of which a medical depot for each should be established, 
with a sufficient number of medical attendants to have one 
; always on the spot, both by day and night, to administer 
medical relief, on application, without any recommendatory 
ticket, or other formality. Notices should be posted, urging 
all parties affected with diarrhcea to apply at once for relief; 
and each district, in the first instance, should be subjected 
to careful house-to-house visitation. In cases of destitution, 
there should also be given relief in the shape of nutritious 
food, as well-boiled rice and milk. The most destitute 
should be removed to hospitals. 
“ The services of physicians who have had experience of 
cholera should be obtained, and a staff of senior medical 
students organised to assist. Means of conveying patients 
safely to the hospital should be provided, available on the 
shortest notice. The patient should be conveyed in the 
recumbent posture, and vehicles on springs, with beds, and 
sides padded, with proper means of wanning aud ventilating, 
will be required. 
“ It cannot be too strongly impressed upon the public, 
that in the great majority of cases of cholera there are two 
distinct stages, and that precautions should be taken to deal 
with each of them as it presents itself. The diarrhceal stage j 
is, in most instances, manageable if treated properly. 
“ The moment an individual is affected with diarrhoea, 
when cholera is prevalent, let him get into bed, and take j 
every precaution to maintain the temperature of the surface 
of his body and extremities by the application of warm j 
blankets or other covering; bottles of hot water, or heated i 
bricks, to his feet and hands; warm flannel swathes to the . 
abdomen ; and take a small quantity of whatever domestic < 
stimulant may be at hand, such as punch, made with j 
brandy or whiskey, warm negus, or mulled port wine; and j 
let him send at once for medical aid. As a large proportion j 
of cases occur at night, to avoid delay, we should advise | 
all families to be provided with medicine to meet the | 
diarrhceal stage of the disease; and as such a medicine 
should be one whicli will not injure by keeping it should be 
prepared aud kept in a dry form. The committee advise 
the following, to be kept in every house, to check looseness 
of the bowels in slight cases :— 
“No. 1 Recipe.—Pulveris cretse opiati, drachm ij.; Divide 
in cliartulas duodecim. 
“ Signa. No. 1.-—Twelve astringent powders. One of the 
powders mixed with a little milk to be taken by an adult 
(full grown man or woman), after every liquid evacuation, 
until the arrival of medical assistance. 
“ If the purging be sudden and violent, let one of the fol¬ 
lowing pills be taken every half-hour instead of the 
powders:— 
“ No. 2 Recipe.—Acetatis plumbi, gr. xxiv.; Opii, gr. iij.; 
Ft. massa et divide in pilulas duodecim. 
“ Signa. No. 2. —Twelve astringent pills. One to be taken 
every half-hour. In cases of sudden prostration, or sinking, 
a dessert spoonful of whiskey,or brandy, and a table spoonful 
of water, may be taken every fifteen minutes until the arrival 
of the physician. In cases of sickness of stomach, let a 
large mustard poultice be applied over the pit of the 
stomach until it produces decided irritation. Rice milk or 
beef tea, with or without well-boiled rice, may be taken in 
small quantity in the diarrhceal stage. 
“ It is not an uncommon, and occasionally fatal, error for 
persons attacked with premonitory diarrhoea to take castor 
oil, or saline, and other aperients: this must be strictly 
avoided. 
“ When diarrhcea occurs in young people, the dose of the 
astringent powder, No. 1, must be gradually diminished, 
reducing the quantity one-half for a child ten years of age. 
“ For diarrhcea in children under ten years of age, the 
committee recommend for a child a year old the following 
powder after every liquid evacuation, taking care not to 
repeat the dose oftener than every hour. 
“No. 3 Recipe.—Pulveris cretse composit: gr.ij. Pulveris 
Crete; opiati, gr. i. 
“ Misca et Signa. No. 3. —Astringent powders for child¬ 
ren. Tiro of these powders may be given combined to a 
child from one to three years old; three to a child from three 
to five years of age. In a child from Jive to ten, this quantity ; 
might, in urgent cases, be repeated every half-hour until 
medical assistance is obtained. These should be given in ! 
a little milk. Where there is urgent thirst, pure milk, milk- 
and-water. or rice milk-and-water, may be freely given to 
drink. If cold water appears to produce chill, a small pro¬ 
portion of brandy may be mixed with it. 
“Although desirous to supply information which may be 
readily available by unprofessional persons, the committee do 
not deem it expedient to embarrass the public mind with 
detailed directions for treatment when the disease is deve¬ 
loped, or iu the secondary state ; being fully convinced that 
in these stages prompt and experienced medical assistance 
is alone to be depended on as offering any chance of reco¬ 
very. They shall, therefore, only at present observe, that, 
in some cases, the diseaso commences suddenly, with symp 
toms of great intensity, such as shiverings, coldness of the 
surface, great prostration of strength, cramps, with purging 
or vomiting, or both. In such circumstances, while medical 
aid is sought for, let the patient be immediately put to bed, 
in a well heated apartment; heat applied to the extremities 
by bottles of hot-water, heated bricks, &c., while a largo ! 
