“Brigade-Surgeon Pringle said that when he went out to India he thought alcohol was something to stand by, but he had soon found out his mistake; he had himself suffered from it. He could confirm what Dr. Richardson had said as to the demoralization produced by alcohol to which men resort to keep up their spirits, and men seized under these circumstances were in the greatest danger. Nature effects a cure in many cases without assistance, and often with wonderful rapidity. People apparently dead and about to be buried, he had known to get up and recover. When alcohol is given during collapse there is often no absorption until reaction occurs, and then the quantity accumulated speedily produces intoxication. It was the same with opium: he had found pills unchanged in the stomach for hours. He recommended hot drinks; he had tried every kind of medicine and had little faith in it. The nursing was very important, and it was important that the nurses should abstain.
“Dr. Morton said it was easy to see that on physiological grounds alone, alcohol, with its strong affinity for water and its tendency to lower temperature, could not be a useful drug in the treatment of cholera collapse, and with its powers of paralyzing vascular inhibition and checking elimination of effete matter, could not be otherwise than harmful in the stage of reaction. As these conclusions were corroborated by practical experience he did not think members would hesitate to banish it from their equipment against cholera.
“Dr. Ridge said it should be remembered that Doyen had made experiments on guinea-pigs and had found they were proof against cholera, unless they had previously had a dose of alcohol. This explained why drunkards and hard drinkers were so much more liable to have cholera, and have it badly as all observers declared to be the case. Another reason might be that small quantities of alcohol, such as would be found circulating in the blood, favored the growth and multiplication of bacteria, certainly those of decomposition, and probably those of cholera. Hence, other things being equal, the abstainer had a great advantage.
“Dr. Norman Kerr said that he had observed both in America and Glasgow that not only notorious drunkards but free drinkers suffered; abstainers were less liable unless they took contaminated water, and the less liquid taken the less chance of taking cholera; beer-drinkers often took more than abstainers. The alcohol-drinker uses up more water from his blood and so has less to flush out the system. Alcohol, given to a patient, disguised his condition so that he might seem better though really worse. Hence it is better and safer not to give any. The doctors and nurses ought to be abstainers. A doctor after dinner was more likely to take a roseate view of a case, looking at it through an alcoholic pair of spectacles. Alcohol was not really a stimulant, but a depressant, and this is a very depressing disease; it was important to have our vital resisting power as vigorous as possible. Hot water both relaxes and stimulates, and the whole cry of the sufferer is for water. Many persons who died in cholera did not die of the disease, but of the drugs such as alcohol and opium. Acid drinks should be given, as the bacilli could not live in acid mixtures. Cholera might come, but he believed we were better prepared to meet it and to treat it.
“Surgeon-General Francis sent a communication which was read by the Honorable Secretary. He said: ‘Having had many opportunities of treating cholera in various parts of India and amongst all classes, I have no hesitation in affirming that alcohol in any shape is one of the very worst remedies. Life is, so to speak, paralyzed, and we give a remedy which, apparently stimulating, is in reality, a paralyzer and therefore mischievous; the death-rate might be considerably reduced provided alcohol were rigidly excluded.’”
Dr. Norman Kerr in a valuable paper upon Cholera says:—
“The first thing is to get rid of the poison. How? By assisting it out; but alcohol keeps it in by blocking the doors, just as the doors were blocked in the terrible calamity at Sunderland not long ago. The alcohol makes the heart and circulation labor more. Alcohol not only retains the cholera poison, but retards the action of the heart. Brandy and opium used to be employed, but the records show that if the object had been to make cholera as fatal as possible, that object was achieved by the indiscriminate administration of brandy and opium. Better leave the victim alone, and his chances of recovery will be greater than if he have a thousand doctors, and as many nurses, administering to him brandy and opium. Alcohol is especially dangerous in the third stage, that of reactive fever, because it adds to the fever. Then, alcohol is not only unsafe in the three stages of genuine cholera, but especially unsafe in the premonitory diarrhœa stage, which gives nearly every one warning before they are attacked by genuine cholera. Brandy is taken simply because it puts away the pain. If there are only the pain and slight diarrhœa, speaking medically, it is all right, but if there is anything behind the pain, it is all wrong. After the alcohol, the mischief is going on, only the patient does not know it, and valuable time is lost. All the alcohol does is to deaden sensation. * * * * * Here I can thoroughly recommend ice and iced water. I have always treated cholera patients with these. Let them drink iced water to their hearts’ content; they can never drink too much; and this opinion is fortified by that of Professor Maclean, of Netley. There is no need of a substitute for brandy in cholera, because in ordinary circumstances in that disease the action of a stimulant is bad. Flushing of the blood is required, and water will do it. Milk will not do it, because it is too thick—nothing but pure, cold water, all the better if iced.”
In 1893 Dr. Ernest Hart, editor of the British Medical Journal, read an able paper upon Cholera before the American Medical Association. His argument was that the introduction of such a substance as alcohol, itself being a product of germ action, into a system already suffering from the toxic influence of a ptomaine, could not be otherwise than pernicious.
Cholera Morbus:—Dr. Kellogg says: “The stomach should be washed by means of the stomach-tube when possible. A large hot enema should be given after each evacuation of the bowels. The addition of tannin, one drachm to a quart of water, is serviceable. When the vomited matter no longer shows signs of food, efforts should be made to stop the vomiting. Give the patient bits of ice the size of a bean to swallow every few minutes. At the same time apply hot fomentations over the stomach and bowels. If the patient suffer much from cramp, put him into a warm bath. The first food taken should be farinaceous. Oatmeal gruel, well boiled and strained, is useful.”
Cholera Infantum:—“Iced water may be given in very small quantities every few minutes. Give the stomach entire rest for at least twenty-four hours. There will be no suffering for want of food as long as the stomach is in such a condition. Withhold milk until nature has had time to rid the alimentary canal of the poison-producing germs. White of egg dissolved in water is an excellent preparation in these cases. Egg enemata may also be advantageously used.