' ASIATIC CHOLERA; ITS PREVENTIVES AND HOMOEOPATHIC TREATMENT. FOR TRAVELERS' AND DOMESTIC USE. By J. H. PTJLTE, M. D., Author of "Homoeopathic Domestic Physician," . "Woman's Medical Guide," etc., etc. ' * • ST. LOT) TS. MO.: 11. (i . (x , }j UYT I ES , hi \<>!:TII I-'IITII STRKKT. ASIATIC CHOLERA; ITS PREVENTIVES AND HOMŚOPATHIC TREATMENT. FOR TRAVELERS' AND DOMESTIC USE. By j. 11. pulte, Tffrrrr Author of "Homoeopathic Domestic Physician," "Woman's Medical Guide," etc., etc. ST. LOUIS, MO.: H. O. a. LUYTIES, 49 NORTH FIFTH STREET. Entered according to Act of Congress, in the year 186tf, BY H. C. G. LUYTIE3, in the Clerk's Office of the United States District Court for the Eastern District of Missouri. List of Remedies, Aconiium nap. Arsenicum alb. Belladonna. Bryonia alb. Camphor. Carbo veg. China off. Cuprum met. Hydrocyanic acid. La/arocerasus, Merc. viv. Phosphoric acid, Rhus toxicod. Secale cornut. Spirit, nit. dulc. Sulphur. Tdbacum. Veratrum alb. T. W. USTICK, BOOK AND JOB PRINTER 79 Locust street, St. Louis, Mo. ASIATIC CHOLERA; ITS PREVENTIVES AND HOMŚOPATHIC TREATMENT. Again this dreadful disease threatens to visit our continent, on its march around the globe. But this time its course has thus far been on the line of a lower latitude, and on that account it may lose a great part of the virulence which it exhibited on former visits, when it made its circuit around the globe from East to West on the line of our own latitude. The reason for this probable result is the fact, that all great epidemics move within certain lines, beyond which their existence is impossible, and within which their vigor is in proportion to a more central 4 or more lateral location. This time the Cholera originated on the southeastern coast of the Mediterranean, and exhibited its most dreadful ravages along its shores; on its progress northward it greatly diminished in virulence. On our hemisphere it appeared first on the Gulf islands, and it is to be hoped and expected that it will lose a great deal of its vigor on its march northward ; in Mexico, however, it may show the same virulence as it did in Egypt, and Southern Italy. This view of the case should diminish our fear, but not relax our efforts of successfully resisting its attacks. We should all know and do in such a time what is right; because a departure from this, may become fatal. We will give here, first, some general directions for every one, best calculated to prevent an attack of this dreadful disease. 5 GENERAL DIRECTIONS. Cleanliness in the house, particularly in the kitchen, cellar and sleeping apartments, is indispensably necessary — you cannot bo too scrupulous in this respect. In the privies, throw from time to time a pound of Chloride of Lime; also wash the gutters before your house with water in which some Chloride of Lime is dissolved. Go early to bed, and rise early — the Cholera attacks commonly in the morning, and we are more liable to be attacked by miasmatic influences in the sleep than when awake and active. Be active, but don't fatigue yourself too much by mental or bodily labor — don't give way to fear or anxiety; be cheerful and happy; trust in Providence; don't be awake for two consecutive nights — it would weaken you too much; be warmly covered during sleep, and dress warmer than common 6 in daytime; particularly keep the feet comfortable, and wear over the stomach a flannel bandage. Let your diet be simple, but nutritious, as beef, mutton, rice, potatoes, stale bread, etc.; avoid poultry, fish salt meats (except well cured ham), cheese, all vegetables except those above mentioned., cakes and confectionery. If you have no other but limestone water to drink, boil it first, and then drink it after it is cool again. If you have been in the habit of washing in cold water every morning or evening, don't give it up now. In general, keep up your usual habits, in so far as they have contributed to your health. Make as little change as possible. During the use of the preventive medicine, you must not drink coffee or use spices as freely as you formerly did. In the use of other articles, as 7 wines, brandies, tobacco, etc., to which you might be habitually addicted, you must be equally moderate and temperate. An entire and sudden change might be too hazardous. Be moderate in every thing. Extra meals, late suppers, in general, irregular hours for your meals, are bad, and predispose to bowel complaints. Avoid fatigue of body or mind; all excesses are detrimental. Attend to slight indispositions sooner now than you would at any other time. PREVENTION. In following the above general rules, we already contribute greatly to repel an invasion of the epidemic without the use of medicine. Yet if we wish to use medicine as a preventive, the best for that purpose is Sulphur, which, in the 30th dilution, may be taken 8 every week twice, 6 globules each time, in the evening. This remedy, more than any other, destroys within the system. the liability of attack, by diminishing the psoric diathesis more or less inherent in every one. Nevertheless, the disease may spread, and then we are under the necessity to arrest it in its first movements, before it has gained too much strength. For this purpose we advise to pursue the following treatment : If persons become nervous, being very much afraid during the prevalence of the epidemic, let them take, several times a day, say every two or three bours, a dose of Aconite (either a drop of the dilution or six globules). If this fear, as it sometimes does, should produce a diarrhea, watery and very weakening, with trembling and nervous agitations, rumbling of the bowels, with or without vomiting, take Tabacurn in dilution, (one drop,) or six 9 globules dry on the tongue, every two or three hours a dose, until better; at the same time lie down, and eat nothing but toast and rice, and drink nothing but black tea. If a diarrhea, however, has set in from disorders of the stomach, by faults in diet or by exposure, cold, etc., then take China and Phosphoric-acid, in alternation, after every evacuation a dose (one drop of the dilution or six globules). If the diarrhea is caused by cold, especially during wet weather, take Bryonia and Bhus in the same manner. If a diarrhea is attended with pains in the bowels, resembling dysenteric pains, take Mercury, every two or three hours a dose, until better. ATTACK OF ASIATIC CHOLERA. Diagnosis. — Sudden prostration of strength; diarrhea of watery substan- - 10 ees (rice - water discharges ), without fcmell or color ; similar, profuse vomitings, which follow each other quickly. Although these evacuations may give the patient a little relief, it is only momentary; his prostration increases constantly until cramps appear in the feet, hands, limbs, and arms, sometimes in the bowels and breast ; insatiable thirst, with a burning sensation under the sternum (in the region of the heart). Agonizing restlessness precedes the last stage — that of collapse, in which, to the above symptoms are added, cessation of circulation of the blood in the extremities, which assume an icy coldness, while the heart palpitates violently, no pulse is perceptible ; tongue and breath grow cold, agonizing oppression in breathing; hollow, hoarse, and shrill voice; blue lips and nails; livid countenance; sunken eyes; shriveled skin on hands and feet. During 11 all this time, the secretion of urine is stopped. Finally, the skin of the patient is covered with a cold, clammy perspiration. Up to this time, the patient was perfectly conscious, although feeble; but now he sinks into stupor, with bloodshot, upturned eyes, and expires. Although Asiatic Cholera presents itself in the form of a diarrhea, yet it is not such ; because no fecal matter is found in the discharges; its nature consists in a decomposition of the blood, produced by an unknown agent (miasm or animalcula), and aided by mental and physical debilities, such as fear, care, overpowering sympathy, weakness of body and mind by nightwatching, exposure, etc. This decomposition of the blood in its solid and liquid parts (coagulum and serum) may be the work of days, hours, or minutes. Generally, however, it com- 12 menees in the early morning hours, at which time most of the Cholera attacks begin. The watery part of the blood (serum) escaping from the bloodvessels, passes into the stomach and bowels, whence it is ejected in violent gushes, or runs from the bowels in streams. Thus we see that the first appearances of Cholera Asiatica are those of a hemorrhage of the white part of the blood ; a view with which the consequent symptoms in the following stages of the disease can easily be harmonized. The cramps in the muscles of the extremities and bowels are caused by the cessation of the action of arterial blood on the muscles, and cease immediately, as soon as the arterial irritation reaches them again. It would carry us too far, to explain all the following symptoms of the disease; nor would it be of any practical use. This, however, we must state 13 yet, that in that form of Cholera Asiatica called the sicca, or dry Cholera, where no discharge from the stomach and bowels takes place, the disagreement with the above theory is only apparent ; because, by the suddenness of the attack, the decomposition of the blood is rendered so general and great at once, that the cramps follow immediately, before the serum has time to escape. CURE OF AN ATTACK OF ASIATIC CHOLERA. Not every diarrhea, in time of Cholera, is real Asiatic Cholera, yet it predisposes to it ; and we must, therefore, immediately and energetically attend to it. The first and most imperious duty in such a diarrhea is to lie down; as the horizontal position is indispensable to a speedy cure. With the rice-water discharges or vomiting, commences the 14 first stage of the disease, in which Camphor is the specific remedy, having actually the power of killing or destroying the animalcula or malignant agent which has infested the system. The application of the Camphor must be effectual and immediate, in the following manner : Cover the patient, up to the chin, well and abundantly, particularly his feet, do not allow his arms out of bed ; then give him quietly, without showing anxiety by unnecessary hurry, of the tincture of Camphor,'* every two, three, or five minutes, one drop, on a little piece of sugar; also, after fifteen or twenty minutes, some brandy and water, if he can retain anything on the stomach. As soon as the patient *The tincture of Camphor ought to be made out of one part of the gum to live parts of alcohol. 15 begins to get warm, and to perspire, give the doses less frequently, and discontinue them altogether when he perspires freely. A few doses of brandy and water will then do him good and strengthen him. In this perspiration the patient must remain without change for eight or ten hours, when he will generally have a good appetite for a lunch of cold beef or mutton, with salt, dry bread and cold water. If, however, the. slightest indisposition yet remains, he must not leave the bed, as a relapse might take place. During the reaction, following the use of the Camphor, frequently a headache ensues from congestion to the head, which in children and middle-aged persons disappears after the exhibition of one or two doses of Belladonna (for children three glob.; for adults six glob.); in aged persons, when stupor is combined with it, Secale corn, (third dilation) 16 is yet necessary, three hours after Belladonna is given. If costiveness follows the use of Camphor, a cup of coffee without milk, and twenty- four hours afterward a dose of Sulphur (six glob.) is indicated. If the diarrhea is not entirely checked, but changed into a dysenteric one, with straining and bloody tinge, Mercury will suffice, followed by Sulphur, twenty-four or thirty-six hours afterward. If by the Mercury, however, the dysenteric stool is changed into the choleroic, the use of Camphor is necessary again, followed by one or two doses of Veratrum alb. (3d dilut.) If, however, the Cholera proceeds into the second stage, where cramps appear in different parts of the body, Veratrum and Cuprum are necessary ; the former, when the cramps are more in the extremities and bowels; the latter, when in the breast, or when 17 great oppression in breathing is present. It is frequently best to give these two remedies alternately, in the following manner : Dissolve of each remedy twelve or sixteen globules, in four tablespoonfuls of water, and give alternately every fifteen minutes a teaspoonful (each remedy having its separate teaspoon), giving less frequently as the symptoms decrease in violence. In this stage, it is not so much the diminution of diarrhea or vomiting, which indicates an amelioration,but the greater regularity and lessened rapidity of the pulse, which always will be followed by a discontinuance of the cramps, although these may yet threaten to break out again. If these remedies are not successful within four or six hours, or if the cramps are more in the calves of the legs, where the slightest motion will excite them, or when stupor threatens, which is particularly the case in old 18 persons, or when the diarrhea still continues, Secede corn, must bo given, in the intervals of half an hour a teaspoonful dissolved in water like Veratrum and Cuprum. If a few doses are given, wait an hour or two, if the case does not grow worse ; if, however, there is a great deal of nausea or retching, increased by motion of head or body, Tabacum (six glob.) must be given, at any time during the attack. If in this stage congestions to the lungs and heart appear, indicated by violent stitches in the side, almost preventing respiration, and producing restlessness and great anguish, give Cuprum and Hydrocyanic acid (Prussic acid), in alternation, every ten or fifteen minutes a dose (dissolved in water, a teaspoonful as a dose. JST. B. Prussic acid must be given in the second dilution). The covering of the patient during 19 the second stage ought still to be warm, but already more according to the feeling of the patient; his drink, cold or warm water, left to his choice. Ico pills may be given to him freely, or injections of ice water if the bowels are cramped ; rub slightly the cramped parts with the hands; warming bottles, and all the other heating apparatus heretofore applied, are not of much use, although a homceopathist may allow them as not interfering with his medicine. If the disease should go into the third stage (collapse) the scene and treatment change entirely. No pulse, livid countenance, hoarse voice, and sunken eyes characterize this period. Yet our hope is not gone ; particularly in cases which, up to this stage, were treated strictly homoeopathically, or where the disease ran quickly through the first stages. This period generally 20 lasts much longer than any of the former, and medicines must be given at longer intervals. The disease frequently stays in this stage for two or three days, almost unaltered ; a slight improvement in the pulse is sometimes perceptible only within two days. In such cases, the medicine must not be changed or repeated often. The principal remedy is Oarbo veg., in the thirtieth dilution, prepared as Veratrum above, of which for the first six hours, every hour a teaspoonful should be given. If a great deal of burning remains in the stomach, with drinking frequently, but little at a time, Arsenic, thirtieth dilution, prepared similarly, may be alternated with Carbo veg. But thus four or six teaspoonfuls of each remedy have been given, their use should be discontinued for ten or twelve hours — particularly if the pulse has shown evidence of returning during 21 that time. The improvement of the pulse is, in this stage, the most important amelioration ; the coldness of the surface is not of so much importance, as it often remains for a longer time without injury. If, after twelve hours, the patient's condition is not much improved, the same remedies may be repeated, and in this manner continued for a couple of days, when, in most cases, a healthful reaction takes place. The covering, in this stage, must be altogether left to the feelings of the patient, and only so much put over him as decency requires, as the patient generally refuses all covering, and is restless. To try to M 7 arm patients in this stage by external means ; is not only useless but cruel; as they actually complain of burning up internally; such means only hasten dissolution. We rather recommend to wrap the patient in a sheet, wrung in cold water, ¦t& which may, after a few hours, be repeated, if he desires it. But, in such a case, the patient ought to be covered beside -with a blanket or two, to follow up the beginning reaction. Cold drinks, particularly ice water, are preferable in this stage. During collapse I have generally avoided all external applications; those of a heating nature are positively injurious, distressing the poor sufferer, who already complains of insufferable internal heat beyond endurance; heated bricks, bottles, etc., are perfect torments to them, — exhausting the little vitality still struggling internally against the disease. Gentle rubbings with the hand under a light cover are, however, very beneficial; it quiets and strengthens the patients. Hahnemann was decidedly right in recommending to mesmerize patients when in a state of collapse. Rubbing with a cloth, 23 dipped in ice-water, with gentle dryrubbing after it, is also very beneficial; it ought to be repeated frequently, say every half hour ; the patient must be slightly covered after it. If salt, as much as the water will dissolve, is put into the iee -water with which the patient is to be rubbed, it will increase the possibility of a speedier reaction in the peripheric nervous system — the vomiting and squeamishness is frequently relieved by small draughts of salt water — it induces quick reaction. Salt water will be an important remedy in Cholera. CONVALESCENCE. In the period of convalescence, which is usually very short, great care ought of course to be taken in diet and exercis — rice and other gruels, afterward small quantities of broth, meat, and vegetables: 24 i If a typhoid fever appears, it mv.it be treated accordingly. In that torpor or stupor which sometimes succeeds a severe attack of Cholera, when the patient cannot easily be aroused, is very weak, pulse slow, yet the expression of his countenance is natural, Spiritus nitri dulcis is of the greatest benefit, as Laurocerasus is in those cases of stupor or lethargy which border on paralysis of the brain or on exhaustion of the nervous system, where the expression of the countenance is indicative of great suffering, the patient very weak, pulse slow, eyes half-closed, in continual lethargy, only broken by deep sighs and moaning. Notice to Homśopathic Pharmaecutists. The medicines which should accompany these directions, may either be put up in. dilutions or globules ; in either case they should be of ' the 3d dilution for those of vegetable, and of the 6th dilution for ti e of mineral origin, except the tincture of ( ;:m-phor, which, as elsewhere stated, should consist of one part of the gum to five parts o. alcohol ; I prefer globules made wet with this tincture to the tincture of Camphor in its liquid state ; Sulphur, Arsenic and Carbo-veg. should be of the 30th, Spirit, nitr. dulc. of the Ist dilution, and Hydrocyanic acid of the 2d dilution.