Mixed Treatment—First Stage.—Besides the above treatment, calomel and Dover's powders was a very frequent prescription; also scruple doses of calomel, and calomel and opium in small doses, and all with success. Nevertheless, I believe they occasionally did harm.
Second Stage.—First, blood-letting less frequent than above; second, calomel and Dover's powders continued; third, calomel and opium; fourth, calomel, capsicum and opium; fifth, soda powders; sixth, scruple doses of calomel every half hour; seventh, ice.
Third Stage.—Calomel and Dover's powder; calomel and opium; calomel, capsicum and opium; carbonate of ammonia and capsicum; scruple doses of calomel every half hour. External heat in various ways; ice, etc. Severe shocks of electricity along the course of the muscles to allay the cramps; also, the burning of alcohol on the skin. The first was the practice of Dr. Devan, the second, that of Dr. Gardner, and both lay claims to having been the first to use these means."
The ointment alluded to above is composed of mercurial ointment, one pound, camphor finely pulverized, seven ounces, and the same quantity of capsicum. With this, the patient was rubbed briskly from head to foot and repeated at short intervals. The result was, that mercury generally showed its specific effects upon the gums in from five to ten hours from the commencement of reaction. The success of this external application of mercury, conjoined with its internal administration and frequent blood-letting, may be learned from the cholera statistics of this and other institutions.
Dr. Pereira employed sixty-grain doses of calomel, it is said, with success, and Dr. Barton of New Orleans, in 1849, gave in ten cases from 120 to 150 and even to 180 grains of calomel at a dose, and, in one case, gave 220 grains, intending, it is said, to have weight sufficient to keep it down. This brave and heroic practice did not afford relief in a single instance; the cramps, and vomiting, and purging continued, and a few hours closed the scene—all died.
The treatment recommended in the American Practice of Medicine, by Dr. W. Beach, which was fully tested by the author himself while in discharge of his official duties as physician of the Tenth Ward, city of New York, during the prevalence of cholera in 1832, is worthy of consideration on account of its simplicity, its great efficiency and wonderful success. "Among all the medicines," says the author, "ever given or proposed in the incipient or premonitory stage, none will be found so efficacious as our neutralizing mixture, made of genuine materials and given very strong. Occasionally, it may be proper to add fifteen or twenty drops of laudanum; this, however, is very seldom necessary. A vast number of medicines are recommended in this stage of cholera, but there are none, I am convinced, so efficacious as the above."
In the second, or confirmed stage, the same medicine was continued in larger and more frequent doses, with hot fomentations to the abdomen, stimulating lotions, sinapisms and injections. The cholera drops were also administered, composed according to the following formula:
| ℞. | Tincture of Capsicum, | ||
| Tincture of Opium, | |||
| Spirits of Camphor, | |||
| Essence of Peppermint. | |||
| Equal parts—mix. | |||
Give a tea-spoonful every hour or half hour, according to the severity of the symptoms.
In the third, or collapsed stage, he directed a tea-spoonful of pulverized black pepper to be mixed and given in a tumblerful of hot gin-sling; also, the same to be prepared and applied hot to the bowels and extremities. Also, to two tea-spoonfuls of either pulverized red or black pepper, pour on a sufficient quantity of hot water, let it stand till nearly cold; strain and inject the whole up the bowel. This would often arouse the patient in the collapsed stage when there was little or no hope of recovery. Such are in brief the remedies which were used so successfully in the Tenth Ward of this city, in 1832. Here it will be noticed that the general principal evolved in this treatment consists in its prompt and diffusive stimulant, its antispasmodic and corrective power so combined as to act gently and kindly, yet promptly and successfully, as the records show, to which we shall refer in the sequel.