THE SALOL TREATMENT OF CHOLERA. By Surgeon J. H. TULL WALSH, i.m.s. My attention was first called to Salol as a remedy for cholera by Dr. Nicholson's article in the Indian Medical Gazette for September 1889. His results seemed so surprisingly good that it appeared as if we had at last found a drug which, if not infallible^ was at least more useful in the treatment of cholera than any other which has been tried up to the present time. The arguments of Lowenthal were extremely illogical and unsatisfactory, but the cases without a clinical results givinc O O eighteen 1 1 death were smgle good. A supply of salol was obtained for use in the Puri Cholera Hospital, and I give below in a tabular form the results in fourteen cases treated with the drug. The salol was given in the manner prescribed by Dr. Nicholson iu order The that our experiments might tally with his. mixture was given every three hours. ?
1
TABLE I, JANUARY 1st TO MARCH 1st, 1890.
Treatment, Rum No.
and Salol Mixture.
State on Admission and General
Race
and Sox. H. F.
Fairly nourished ; Cured. collapsed. Well nourished; Died. collapsed. Well nourished; Cured. collapsed. Fairly nourished; Died. collapsed. Died. Starved; with diarrhoea of Choleraic kind. Fairly nourished; Died.
H.M. H.M. II. F. II. M.
H. M.
collapsed.
Well nourished; collapsed. Fairly nourished; collapsed. Well nourished ; collapsed. Starved; collaps-
H. M. H.M. H. H.
H.M. H.M.
ed. Starved ;
H.M.
Fairly nourished;
H.M.
Result.
Appearance.
GO
[ed.
Time under treatment. 7
days.
Salol for 3
15
hours.
5 doses
days.
Doubtful case afte r war d s t r e a t e d for
3 13
hours..
45
days
Salol.
dysentery.
Doubtful case death pro-
6 hours.
lerated by starvation.
Died.
9 hours.
Died.
9 hours.
Died.
8 hours.
Died.
21 hours,
Cured. Died.
5 days. 2 days.
Died.
4
Feeble; collapsed.
Died.
Few
days.
collapsed.
H. F.
only.
8 hours.
collapsed. Fairly nourished;
collaps-
Remarks.
hours.
bably
acce-
Counting day
of admissiou and day o f
death. Dates not accurately given.
Total number of case 14 Deaths 11 Death rate p. c. 78*5 ...
July
203;
WALSH ON THE SALOL TREATMENT OF CHOLERA.
1890.]
The results were not encouraging, and from careful observation of the above cases it could in the symptoms; neither the not be shown that any extraordinary improvement appeared the salol. nor the diarrhoea were influenced by vomiting markedly This drug was first recommended by Professor F. Hueppe, and subsequently by Professor moie to the Lowenthal, and the most that cau be said in their favor is that they have added one number of medicines that will not cure cholera. As I have by me a tabular statement of all the will be, I think, interesting to cases of cholera treated in the Puri Cholera Hospital during 1889 it first two months o t us year. the salol two of sets 14 cases with the 14 treated by during compare
TABLE II. First No.
Race and Sex. H. JVL
fourteen
Age. Condition
on
~54~ Collapsed
cases
treated in the Puri Cholera Resume of treatment.
Admission.
Result.
Died
StimuiantsTmustard plasters.
IT
Hospital
1889.
Time under
Remarks.
treatment.
No drugs
3 days
given.
Mustard in all cases.
H. F.
50
Collapsed
...
H. M.
40
Early stage
of disease
55
Collapsed
H. F. H. M.
17 70
Callapsed Collapsed
H. M. H. F.
40 55
Collapsed Collapsed
H. F.
25
Collapsed
...
Collapsed
...
H. M.
11 12
H. M. H. F.
35 50 25
...
...
...
H. M.
30
Collapsed
14
H. M.
40
Collapsed
days Symptoms chole-
1 day
raic, but
...
4 days
Stim., diuretics, creasote, Recovered. Stim., chlorodyne, iodide of Recovered. mercury, ipecac, soda, sulph. acid drink, quinine. No stimulant; simple astrin- Recovered.
4 days 8 days
[chloroform,
soda.
acid gent mixture, sulph. drink, iodoform for hiccup.
...
,
As 13
?
...
6 days 6 days
o
16 days
T?t
l>Q 1^
-
Stim., iodide of mercury, ; Recovered sulph. acid drink. Died Stimulant only Stim., iodide of mercury, Died sulph. acid drink. Stim., iodide^ of mercury,] citric acid drink.
^
case
doubtful.
Stim., diuretic, chlorodyne Recovered. chloroform, creasote. Died As 4, except chloroform. Stim., chlorodyne, ipecac- Died soda.
...
Collapsed Collapsed
13
5
drink.
H. F.
10
Stim., mustard, diuretics Rec overed. creasote and sulph. acid drink. Soda bicarb, sulph. acid Recovered.
3 days
? o
& m
m
?
2 days 3 days
-2
c3 cS o
o
EHflfl
2 days 1 day
from the records foi Juue^ 1889. seriallv fiom The next table will inr.lndft fmivtpen cases taken serially include fourteen were treated in the June is generally a bad month for cholera in Puri, and 102 cases in a hospital during that month. III.
TABLE First No.
Race and Sex.
fourteen
Age. Condition
cases
on
treated in the Puri Cholera
Admission.
Result.
Resume of treatment.
in June 1889.
Hospital
Time under treatment.
H. M.
40
Collapsed
Stimulants only, mustard Died plaster (all cases).
H. F.
40?
Collapsed
Stimulants, astringents, soda, Recovered. 7 days
H.M.
25
Collapsed
4 5 6
H.M. H. M. H.M.
28 30 20
Collapsed
7
H.M.
50
8
H. M.
1
3 days
...
Remarks.
Day
of
ad-
mission and day of death counted.
am. vom.
sp.
9 10 11 12 13 14
H.M. H. F. H. M. H.F.
H.M. H.M.
40 60 45 55 60 55
tr.
nux
days
Recovered.
2
Died Died Died
2 days 1 day 4 days
Collapsed
Stimulants, sulph. acid drink. Died
2 days
...
Collapsed
Stimulants, astringent
days
...
Stimulants, astringents,
tifebrin. Stimulants only Stimulants only
Collapsed Collapsed
an-
...
...
Stimulants, diuretics, blister to nape of neck.
mix-
Recovered.
3
Died
4 days
Died
1 day 1 day 2 hours 2 days 4 days
ture.
Collapsed
Stimulants, of neck.
Moribund
blister to nape
Stimulants
Collapsed Died Stimulants Collapsed Died Stimulants Collapsed sulph. acid drink Died Stimulants, Not quite collapsed, very Stimulants, sulph. acid drink, Recovered, weak. quinnie. antifebrin. ...
...
...
...
...
???
,
"
'
aromat
...
Note.?In.Tables II and III Time under Treatment" means actual time after recovery were treated in the Wards of the General Hospital.
...
...
...
...
THO-Lj
...
...
?4-i
c3 c3
O O O
EHAQ ...
...
...
spent in the Cholera Hospital. Cases
of Debility
204
?
THE INDIAN MEDICAL GAZETTE.
Comparing Tables I, II, and III it seems clear that a miscellaneous treatment, with stimulants and astringents, gives better results than the salol treatment. There is, however, reason to believe that the cholera was of a milder type in 1889 than during the early part of 1890 which would in some measure account for the difference in the percentage of deaths. I will not attempt to discuss the general question of the treatment of cholera as I am of opinion that, after the algid stage is reached recovery depends in some way on the vitality of the patient and is generally independent of drugs.
Sanitation universal and perfect should, I think, be the only end and aim of those who desire to see the mortality from cholera lessened.
[Jdly
1890.
1
TABLE I, JANUARY 1st TO MARCH 1st, 1890.
Treatment, Rum No.
and Salol Mixture.
State on Admission and General
Race
and Sox. H. F.
Fairly nourished ; Cured. collapsed. Well nourished; Died. collapsed. Well nourished; Cured. collapsed. Fairly nourished; Died. collapsed. Died. Starved; with diarrhoea of Choleraic kind. Fairly nourished; Died.
H.M. H.M. II. F. II. M.
H. M.
collapsed.
Well nourished; collapsed. Fairly nourished; collapsed. Well nourished ; collapsed. Starved; collaps-
H. M. H.M. H. H.
H.M. H.M.
ed. Starved ;
H.M.
Fairly nourished;
H.M.
Result.
Appearance.
GO
[ed.
Time under treatment. 7
days.
Salol for 3
15
hours.
5 doses
days.
Doubtful case afte r war d s t r e a t e d for
3 13
hours..
45
days
Salol.
dysentery.
Doubtful case death pro-
6 hours.
lerated by starvation.
Died.
9 hours.
Died.
9 hours.
Died.
8 hours.
Died.
21 hours,
Cured. Died.
5 days. 2 days.
Died.
4
Feeble; collapsed.
Died.
Few
days.
collapsed.
H. F.
only.
8 hours.
collapsed. Fairly nourished;
collaps-
Remarks.
hours.
bably
acce-
Counting day
of admissiou and day o f
death. Dates not accurately given.
Total number of case 14 Deaths 11 Death rate p. c. 78*5 ...
July
203;
WALSH ON THE SALOL TREATMENT OF CHOLERA.
1890.]
The results were not encouraging, and from careful observation of the above cases it could in the symptoms; neither the not be shown that any extraordinary improvement appeared the salol. nor the diarrhoea were influenced by vomiting markedly This drug was first recommended by Professor F. Hueppe, and subsequently by Professor moie to the Lowenthal, and the most that cau be said in their favor is that they have added one number of medicines that will not cure cholera. As I have by me a tabular statement of all the will be, I think, interesting to cases of cholera treated in the Puri Cholera Hospital during 1889 it first two months o t us year. the salol two of sets 14 cases with the 14 treated by during compare
TABLE II. First No.
Race and Sex. H. JVL
fourteen
Age. Condition
on
~54~ Collapsed
cases
treated in the Puri Cholera Resume of treatment.
Admission.
Result.
Died
StimuiantsTmustard plasters.
IT
Hospital
1889.
Time under
Remarks.
treatment.
No drugs
3 days
given.
Mustard in all cases.
H. F.
50
Collapsed
...
H. M.
40
Early stage
of disease
55
Collapsed
H. F. H. M.
17 70
Callapsed Collapsed
H. M. H. F.
40 55
Collapsed Collapsed
H. F.
25
Collapsed
...
Collapsed
...
H. M.
11 12
H. M. H. F.
35 50 25
...
...
...
H. M.
30
Collapsed
14
H. M.
40
Collapsed
days Symptoms chole-
1 day
raic, but
...
4 days
Stim., diuretics, creasote, Recovered. Stim., chlorodyne, iodide of Recovered. mercury, ipecac, soda, sulph. acid drink, quinine. No stimulant; simple astrin- Recovered.
4 days 8 days
[chloroform,
soda.
acid gent mixture, sulph. drink, iodoform for hiccup.
...
,
As 13
?
...
6 days 6 days
o
16 days
T?t
l>Q 1^
-
Stim., iodide of mercury, ; Recovered sulph. acid drink. Died Stimulant only Stim., iodide of mercury, Died sulph. acid drink. Stim., iodide^ of mercury,] citric acid drink.
^
case
doubtful.
Stim., diuretic, chlorodyne Recovered. chloroform, creasote. Died As 4, except chloroform. Stim., chlorodyne, ipecac- Died soda.
...
Collapsed Collapsed
13
5
drink.
H. F.
10
Stim., mustard, diuretics Rec overed. creasote and sulph. acid drink. Soda bicarb, sulph. acid Recovered.
3 days
? o
& m
m
?
2 days 3 days
-2
c3 cS o
o
EHflfl
2 days 1 day
from the records foi Juue^ 1889. seriallv fiom The next table will inr.lndft fmivtpen cases taken serially include fourteen were treated in the June is generally a bad month for cholera in Puri, and 102 cases in a hospital during that month. III.
TABLE First No.
Race and Sex.
fourteen
Age. Condition
cases
on
treated in the Puri Cholera
Admission.
Result.
Resume of treatment.
in June 1889.
Hospital
Time under treatment.
H. M.
40
Collapsed
Stimulants only, mustard Died plaster (all cases).
H. F.
40?
Collapsed
Stimulants, astringents, soda, Recovered. 7 days
H.M.
25
Collapsed
4 5 6
H.M. H. M. H.M.
28 30 20
Collapsed
7
H.M.
50
8
H. M.
1
3 days
...
Remarks.
Day
of
ad-
mission and day of death counted.
am. vom.
sp.
9 10 11 12 13 14
H.M. H. F. H. M. H.F.
H.M. H.M.
40 60 45 55 60 55
tr.
nux
days
Recovered.
2
Died Died Died
2 days 1 day 4 days
Collapsed
Stimulants, sulph. acid drink. Died
2 days
...
Collapsed
Stimulants, astringent
days
...
Stimulants, astringents,
tifebrin. Stimulants only Stimulants only
Collapsed Collapsed
an-
...
...
Stimulants, diuretics, blister to nape of neck.
mix-
Recovered.
3
Died
4 days
Died
1 day 1 day 2 hours 2 days 4 days
ture.
Collapsed
Stimulants, of neck.
Moribund
blister to nape
Stimulants
Collapsed Died Stimulants Collapsed Died Stimulants Collapsed sulph. acid drink Died Stimulants, Not quite collapsed, very Stimulants, sulph. acid drink, Recovered, weak. quinnie. antifebrin. ...
...
...
...
...
???
,
"
'
aromat
...
Note.?In.Tables II and III Time under Treatment" means actual time after recovery were treated in the Wards of the General Hospital.
...
...
...
...
THO-Lj
...
...
?4-i
c3 c3
O O O
EHAQ ...
...
...
spent in the Cholera Hospital. Cases
of Debility
204
?
THE INDIAN MEDICAL GAZETTE.
Comparing Tables I, II, and III it seems clear that a miscellaneous treatment, with stimulants and astringents, gives better results than the salol treatment. There is, however, reason to believe that the cholera was of a milder type in 1889 than during the early part of 1890 which would in some measure account for the difference in the percentage of deaths. I will not attempt to discuss the general question of the treatment of cholera as I am of opinion that, after the algid stage is reached recovery depends in some way on the vitality of the patient and is generally independent of drugs.
Sanitation universal and perfect should, I think, be the only end and aim of those who desire to see the mortality from cholera lessened.
[Jdly
1890.
