This section is from the book "Materia Medica And Therapeutics Inorganic Substances", by Charles D. F. Phillips. Also available from Amazon: Materia medica and therapeutics.
It is not going beyond our knowledge to state that capillary spasm and congestion of vaso-motor centres are essential elements in the phenomena of cholera, and it would not, a priori, seem unreasonable to expect benefit from bromides; there is certainly some clinical evidence of it. Thus, Dr. James Begbie, giving 1/2-dr. doses of the potassium salt, noticed that capillary circulation was quickly re-established, as shown by the return of color to the limbs, and the recurrence of urinary secretion that had ceased: he considered the remedy a valuable one (Edinburgh Medical Journal, and Lancet, ii., 1SG6). Dr. Henry Sutton has also published cases of recovery under its use (Medical Times, ii., 1867).
Dr. Curtin has recorded that a severe epidemic in an institution under his direction ceased within twelve hours after the inmates were treated freely with "sulphuric acid lemonade" - the only fresh case occurring in a man who refused to take the medicine. Two days after it was discontinued two new cases appeared, and an epidemic threatened, but was again stayed by the acid, and in the surgical wards, where the acid was used from the first, no case appeared, while every other part of the institution suffered more or less (Philadelphia Medical Times, iii., p. 649). This experience makes it desirable under similar circumstances to adopt the same method as prophylactic.
The burning of sulphur fires round infected villages has been strongly urged (Tuson: Lancet, ii., 1876, p. 313).
In the epidemic at Warsaw, in 1831, it was highly approved by Leo, and in later epidemics at Paris it was commended by
Trousseau, and very largely used for the premonitory diarrhoea; at the commencement of the attack only, a little opium may be added with advantage; afterward, two full doses of bismuth daily will suffice.
The reputation which has been sometimes claimed for bismuth as a valuable remedy in intermittent fever, and in nervous disorders, as epilepsy, cephalalgia, asthma, and in whooping-cough, must be traced either to its relieving gastric complications of such maladies, or to the presence of contained arsenic: it has not been sustained in recent times.
In this malady, the sulphate has been considered by some physicians so valuable as to be almost a specific. I cannot place great reliance upon it, though I have sometimes observed it relieve the cramps, the retching and purging, and strengthen the weak intermittent pulse, and assist in warding off collapse. The careful observations of Gutmann have rendered improbable any specific action of the drug.
Some prophylactic power against cholera has been claimed for copper, for the neighborhood of towns where large copper-works are situated, such as Swansea, Birmingham, Rio Tinto, has been markedly free from the disease, but other circumstances, and other components of the vapor, such as sulphurous acid, must be taken into consideration (Medical Times, ii., 1854, ii., 1871). A similar immunity is recorded at the large powder factory at Madras, where the mixed chemicals are said to be exposed to a temperature of 500° F., which would be sufficient to develop sulphurous acid from the sulphur (Mr. Parker: Lancet, ii., 1873). More important is the fact, that among more than 5,000 copper-workers in Paris, not one was attacked by cholera, during an epidemic which affected other workmen in the proportion of about 1 in every 140; and of the former, not one died of cholera in the course of five epidemics (Burq: Lancet, ii., 1873). Dr. Clapton also remarked that the copper-workers seemed to have almost complete immunity from cholera and from choleraic diarrhoea, when it was very prevalent among the neighbors, and the same observation has been made by others. Still, such prophylactic virtue of copper is not usually recognized, perhaps because it is difficult to understand, but Dr. Clapton suggests as some explanation, the disinfectant power of the metal, and its destructive action upon fungi; the subject deserves further investigation.
Iron is one of the numberless remedies recommended for cholera, but I have very little personal experience of its use: it would, of course, not be depended upon alone, and Robiquet has reported a number of successful cases treated by the citrate and by reduced iron with quinine; frictions, and warmth, and nutriment being also conjoined (Jour-nal de Medicine, October, 1873; Practitioner, vol. xi., p. 452).
Dr. Maclean equally objects to any preparation of mercury in cholera, as "useless in collapse and dangerous when reviving" (Lancet, 1866), but although I am not myself an advocate for the calomel treatment, the results obtained by Dr. Ayre, of Hull, deserve attention. He gave 1/4 to 1/2 gr. calomel every ten minutes or every four hours, according to circumstances; it rarely salivated, but produced apparently good results in a majority of cases. Bloxam and some other observers have followed the same plan with advantage, and Niemeyer speaks well of calomel treatment. What is desired is to stimulate by this means a secretion of bile and to promote elimination, for we know that the reappearance of bile in choleraic stools is a favorable sign; besides this, large doses of calomel (1/2 dr.) have been said "to restore warmth" (British and Foreign. Review, i., 1870). Kohler thinks that its good effects are owing to the disinfecting property of the drug when brought into contact with the contents of the intestines. Of fifty-six cases, some of which received 200 gr. in two days, twenty-one died, but the reporter seems to think the results favorable to the treatment by calomel (Lancet, i., 1874). The general experience of the profession has not, however, adopted it, and it is clearly not free from danger, for under certain conditions a quantity of the medicine may remain for a time unabsorbed, and afterward produce serious toxic effects.
The carbonate of soda has been used both by the stomach and by injection in cases of cholera, but the chloride has been more depended upon.
A reasonable argument may be given for its employment, for a main fact in the disease is profuse discharge by osmosis from the vessels of the intestinal tract into the alimentary canal; this by itself can determine the cyanosis, shrunk features, blood stasis, etc. It depends upon a change in the albuminous constituents of the blood, and is increased by desquamation of intestinal epithelium, while by saline injections the physical conditions may be so far altered as to lessen such osmosis. Both rectal and venous injections have been used, and benefit also has been traced to salt given by the mouth in cases when the power of absorption has been retained.
During an epidemic at St. Petersburg (1830) salt water and salt milk relieved as much as any other remedies. In 1835, at Paris, Bracton reported fifty cases of Asiatic cholera treated with common salt, and only one was fatal; two tablespoonfuls were given dissolved in 6 oz. of water. Chomel, Aran, Richard, and others reported good results from the same treatment in the epidemic of 1865. On the other hand, Husemann concludes that the use of salt has no really good effect, and states that its intravenous injection has sometimes caused asphyxia. The question cannot yet be considered decided.
For Dysentery, the sulphate of soda has been much commended by American writers: 1 dr. is given with 1/6 gr. of morphia every two hours, until natural, though loose, evacuations occur; this treatment is said to control the malady in two or three days (New York Medical Record, February, 1872).