NOTE ON treated

by

FOURTEEN hypodermic

By Surgeon G. K.

CASES OF CHOLERA injection

Poole, M.D.,

18th

of

strychnine.

Bengal Cavalry,

Oft/. Civil Surgeon, Peshawur. The cholera hospital for patients irom the city, cantonments and regimental bazars was opened

(Peshawur),

on the 5th and up to this date (14th October) 363 cases have been admitted, of which 180 have been fatal. An uniform plan of treatment has been followed, viz., the saline plan known a3 Steven's saline treatment; and, considering that all the cases, or nearly all of them, were desperate ones, as natives will not go voluntarily to a cholera hospital until they are in the last stage, I think the figures shew a very fair amount of success,

September,

Decembee 1,

CASES PROM PRACTICE.

1869.]

further details shall be sent to you for publication in a future number. I merely wish to bring forward a few cases treated by the hypodermic method of injection, in continuation as it were, of three published by Surgeon Christison in the Gazette of the 1st October treated with ammonia. The solution of strychnine employed was -fj-th of a grain, dissolved in 10 minims of rain water acidulated with one minim of dilute hydrochloric acid. The success was not encouraging, and as cases became more numerous, the hypodermic method ?was discontinued, and the saline plan persevered in. I.?Suntoo, syce, admitted from artillery lines in a state of complete collapse; injected hypodermically with the strychnine solution three times at intervals of four hours; re-action partially established. Death from uraemia three days after admission. II.?Buksee, dooley-bearer, admitted on the 13th September; injected three times at intervals of four hours ; re-action established and secretion of urine partially establisned. Died on the 20th, six days after admission. III.?Membode, syce from royal artillery lines admitted on 13th collapse; strychnine was hypoSeptember in a state of profound the effect of the first dermically injected as a " forlorn hope injection was striking. Tetanic spasms were slightly visible, but the man got into a comatose state after the second injection, and complained of pain in the arm at the point of puncture, lie passed urine the third day, and took food on the fourth day, but fie remained in a weak sickly state, and at last a low form of typhoid fever set in, and he died of diarrhoea, &c., on the 30th. This case may be called a favorable one, and a cure from cholera, the low fever being a post hoc, and prevalent in Peshawur at this time of the year. IV.?Gool Ahmed, coolie from the city, admitted on the 13th ; injected three times ; skin became warm, and pulse become perceptible, but he died of uraemia on the 19tn, six days after

admission.

V.?Dookee, syce from artillery lines, admitted on the 13th; injected three times us a forlorn hope ; was in a profound state of collapse; re-action established on the 14th; urine passed on the 15th; and recovery was complete on the 20th, seven days after

admission.

VI.?Ghinow, dooley bearer, admitted profoundly collapsed; injected four times

,

the 13th, not very without much effect. Died on the 16th, three days after admission. VII.?Mahomed Kajuek admitted in a moribund state on the 14th ; injected twice, but without much effect, though it apparently preserved his life till the 16th, when he died. VIII.?Lutchman, jeweller from sudder bazar, admitted in a state of profound collapse on the 14th; was iujected three times; re-action was established; pulse became perceptible, but urine was not secreted in spite of blister and diureties, and he died on the 18th, four days after admission. IX.?Goomanee, an old man, admitted from the city on the 14th ; injected six times with the above solution of strychnine ; re-action established on the third day; urine passed, and recovery complete on the 19th, five days after admission. X.?Soobhan Khan, aged 20, admitted on the 18th; injected twice ; on 18th once, on 19th re-action fully established; urine secreted, but diarrhoea of a bilious nature set in, and he died on the 25th. XI.?Sooltan admitted from the city on the 18th ; re-action and secretion of urine established after four hypodermic strychnine injections, recovery complete on the 29th, thougn he still remains weak, and subject to diarrhoea. XII.?llampaul, syce, admitted from sudder bazar on the 19th injected three times; no re-action whatever was established. Died on the 21st. XIII.?Mahomed Aseem, admitted from the city on 22nd September; injected four times; re-action came on the third morning; urine passed, and he made a complete recovery by the 2nd October; left the hospital of his own accord. XIV.?Shewchurn admitted from 18th cavalry on the 22nd; was in a state of profound collapse; injected three times; re-action established on the 24th. IIemakks.?In looking over these cases it must be borne in mind that they were all of the most virulent type of cholera; recovery seemed and was almost hopeless, or such a violent of as the remedy strychnine would injection of ^th of a grain not have been resorted to. I cannot say I am satisfied with the of not treatment; however, it did plan injure the patient in any way, and in most cases re-action was established and death did not occur in the stage of collapse as has been so common in the late epidemic here; in publishing these cases I do so with a view to shew the value or otherwise (leaving others to judge) of the treatment. on

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Notes on Fourteen Cases of Cholera Treated by Hypodermic Injection of Strychnine.

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