Non-Purgative Salts in Cholera.

The following statement, relative to the treatment of cholera in the prison at Cold Bath Fields, are interesting, and are said by the editor of the London Medical Gazette, to be entitled to entire confidence as to its accuracy.

“The first twelve cases occurred in the vagrant’s ward, and the patients were attacked soon after some prisoners had been admitted from St. Giles’s, and other infected districts. The first case that was reported as cholera, occurred on the 5th of April. This man was suddenly attacked, and died after a very short illness with all the symptoms of the prevailing epidemic.

“When the first cases occurred, there were in all about twelve hundred persons in the prison; but, up to the beginning of this month, they were not afflicted with bowel complaints, nor, in fact, with any other epidemic disease, being as healthy as they generally are at that season of the year.

“The first four cases were treated in the common way, with brandy and opium, an ammoniated mixture, ginger, sinapisms to the region of the stomach, the hot air-bath, &c. &c.; and all of them died after a short illness.

“Since the 4th of April, up to this date, (April 17,) forty cases in all have been under treatment. Of this number, nineteen were admitted into the Observation ward with the premonitory symptoms of cholera. All of these had bowel complaints and suspicious ejections; some of them complained of severe pain in the abdomen, sickness of the stomach, and in several cases these symptoms were attended with cramps, chiefly in the lower extremities. The whole of them were immediately treated by Mr. Wakefield with non-purgative saline remedies, recommended by Dr. Stevens, and in general they were convalescent in one, two, or three days, from the commencement of this practice. From this we may infer, that where the disease is attended to early, and properly treated, the state of collapse may be prevented in nineteen cases out of twenty.

“We must state, however, that as the numbers increased, it became necessary to dismiss those that appeared to be least ill, on purpose to make room for others. Of those that were dismissed as convalescent, two were reädmitted soon after in a state of collapse, and though every attempt was made to save them, yet they both died after a very short illness, with the symptoms of cholera in its most virulent form. With the exception, however, of the two that died, none of the cases, (seventeen in number,) were reported to the Central Board, partly, we believe, from a wish to avoid spreading alarm with respect to the prison, and partly because the disease was checked in the beginning; consequently, the patients had not all the symptoms of cholera, such as occur in the worst cases, or in the last stage.

“In addition to the above seventeen which were not reported, there were twenty-one cases where the symptoms of cholera were very distinctly marked. Of this number, four of the early cases were treated in the common way, with diffusible stimuli, &c. &c., and all of them died after a short illness. These, with the two cases of relapse from the Observation ward, make in all six deaths. Mr. Wakefield, however, having lost all faith in the common treatment, changed the practice:—at the request of Dr. Stevens, the other fifteen cases were put under the saline treatment, and all of them recovered.

“When the patients were first admitted, the following powder was immediately given, either in half a tumbler of tepid water, or occasionally in a little thin, clear, beef-tea:—

“Supercarbonate of Soda, ℨss. Muriate of Soda, ℈j. Chlorate of Potass, grs. vii.

“The above was given every hour, and continued until the patients were recovering from the state of collapse; after which it was diminished in frequency, in proportion as the reäction increased.

“In all these cases, the outline of the practice was nearly the same; but in several instances the treatment was varied according to circumstances. When the stomach, for example, was extremely irritable, it was found that the carbonate of soda, given by itself, or the tartrate of soda, in a state of effervescence, were the most effective remedies that could be used on purpose to allay the irritation, so as to enable the stomach to retain the stronger salts.

“During the progress of the disease, an enema, with a large table-spoonful of muriate of soda, dissolved in warm water, was administered with or without sugar, starch, &c. every three or four hours, at as high a temperature as the patients could well bear it. Sinapisms were also applied as early as possible to the region of the stomach, betwixt the shoulders, &c.; and in the cold stage, frictions were also frequently used with warm towels. Of the seventeen cases that were treated in this way, two died, (namely, the two patients who were reädmitted in a state of complete collapse,) making in seventeen cases, two deaths, and fifteen recoveries. But including the whole of those that were under the saline treatment, the total amount is, in thirty-six cases, two deaths, and thirty-four recoveries.

“The cases in question were under the care of Mr. Wakefield, the medical attendant of the establishment, and during his absence they were attended to by Mr. J. Wm. Crooke, who kept notes of the cases, and saw that the medicines were properly administered. We may add, also, that Mr. Wakefield, with a degree of fairness which does him great credit, invited Dr. Stevens to attend along with him to witness the effect of the saline treatment, which has here, we may say, for the first time, been fairly tried in this disease.

“We can also state, that the cholera made its appearance about the same period amongst a small colony of Italians, who live in a narrow lane within a few hundred yards of the prison. Of these, eleven were attacked. The three first cases were treated by bleeding, brandy, and opium, all used at the same time, and they all died. The other eight cases were attended by Mr. Whitmore, a surgeon in the neighbourhood, who, having witnessed the effects of the saline treatment in the prison, adopted it. All his patients speedily and completely recovered, except one, who, on the 13th, was so ill that he was not expected to live many hours; even he, however, is now in a state of convalescence. Thus there have been in all fifty-three cases, seven of which were treated in the common way, with diffusible stimuli; and out of this number seven died; while, of the forty-six that were under the saline treatment, there were two deaths and forty-four recoveries.”