very unfavourable

found collapse;


condition, nearly all in a dying at the door of


state of prothe


determined to carry out as far as possible an uniform system of treatment, and that which appeared to me, and in my experience, has proved most favourable and deserving of a fair trial, was the saline plan, known as without treatment.



Steven's; it has at least the advantage of being simple, rational and inexpensive, and, I think, judging from the results, fairly successful, bearing in mind that the past epidemic in Peshawur has been one of cholera of a most virulent type, and of a very fatal nature, also a fact that every one is aware of, none but the most hopeless cases are ever sent to a Cholera Hospital. I think the figures below contrast favourably with those where more powerful and expensive remedies have been resorted to. The treatment adopted was the following:?The patient on admission had a mustard plaister applied to the epigastrium, frictions to the calves, &c., and a mixture of common salt, grs. 20, soda grs. 25, and chlorate or nitrate of potash grs. 6, in an ounce of water given to hinf every half hour; this often produced or encouraged, perhaps, a few free vomits, after which the same mixture was continued with the addition of half an ounce of lime juice given a few seconds after the soda mixture had been swallowed; this was said to give great comfort to the

patient, relieving the vomiting and distressing symptom of sinking at the pit of the stomach. Small frequent draughts of cold water were given, and occasional doses of Liebeg's soup made to suit the different classes of patients ; cases of severe collapse, with absence of purging had 3j or 5ii of magnesise sulphas, and as



re-action commenced with absence of bilious

doses of calomel continued up to about 6 or 8 grs. with soda or nitre were given, dry-cupping to the loins, followed if necessary by a fly blister, if the flow of urine was

evacuations, small

was about all that was done, stimulants when convalescence was established, opium the same, was never given except to check the diarrhoea after cholera, saline injection were used rarely, and the hypodermic

not established. were



By Surgeon G. K. Poole, 18th

Bengal Cavalry.

In continuation of some remarks by me in the December number of the Indian Medical Gazette, it seems advisable to publish the results of the above line of treatment, as carried out in the Cholera Hospital here during the late epidemic. The outbreak of Cholera in Peshawur commenced,

Indian Medical Department, the Station Ihe building selected and set Cholera Hospital was opened. an old mosque, situated about halfwas apart for the purpose and the sudder bazaar, well isolated and way between the city the purpose; and further, with a view for admirably adapted the whole of the epidemic I as during save to expense, as well as Staff and Garrison Civil of was holding the post to admit for treatment cases either determined I Surgeon, the plan has succeeded well. from cantonments or the city, and of an experienced native doctor, consisted establishment My of 1867, a dresser who had been here during the epidemic whom speaks Pushtoo (the and two medical pupils, one of and mehters and coolies as required. of the




far as



injection of strychnine in a few cases. The Hospital was visited by me twice a day, and sometimes thrice, and I am satisfied that the following results are correct, and that the I mention cases were those of genuine malignant cholera. this as it is not an uncommon thing for native doctors to enumerate as cures, cases that have never been cholera at all, and this I can vouch for was not done by the man in charge here. The following is the result of the treatment:? Total number of admissions


accurately ascertained, on the 31st of August last, with fatal on September 1st; between the 1st and the a solitary case 6 or 8 cases, all occurring in the city; 4th there were about with a recent circular from the and on the 5th, in accordance can


only given

on September 1st, From the commencement of the epidemic October no less than 23rd, about on or to its termination Most of them were 372 cases were admitted for treatment.

Treated with salines Do. hypodermic injection of Died witout treatment



338 14 20

180 4




strychnine ..





Died. 158 10 20 188

Of the above deaths the disease was fatal within 24 hours in 102 ; above 24 hours in 86 ; and many of the cases died within an hour or two of admission, and some even before entering tha


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