THE SULPHUROUS ACID TREATMENT OF CHOLERA. TO
Sik,?It is not ray wish to fill your pages with useless correspondence on the treatment of cholera by sulphurous acid, but
I trust you will give me space for a few remarks I feel it necessary to make on a letter from Surgeon McConnell, M.B., published in your paper (received yesterday) of the 1st June. Before going further, let me say that I have no desire in any thing I have said, or in this letter may say, to in any way reflect on Dr. McConn ell. I am well aware that he occupied a distinguished position among the students of St. George's Hospital during his period of study there, and that his professional repute in the service is high ; but the subject in question is one which has to be dealt with on its own merits, quite apart from personal considerations, and believing firmly, as I do, in the theory I bring forward, that sulphurous acid is a cure for and prophylactic against cholera, it becomes my duty to expose any fallacies I may perceive, or think I perceive, in the arguments or reasoning of those who oppose my view. I propose in the first place to answer certain questions raised in Dr. McConnell's letter, and then to remark on certain conclusions he has arrived at, and which appear to me untenable. I will, therefore, first of all note that the dates on which the ten cases of cholera, recorded in my letter under reference, occurred are as follow:? No. 2, 8th August. No. 3, 8th August. No. 1, 8th August No. 4, 29th July. No. 5, 30th July. No. 6, 10th August. No. 7, 14th August. No. 8, 14th August. No. 9, 9th No. 10, 24th July. September. During all this period 'cholera was more or less epidemic in the town of Cuttack and in those portions of the town within cantonment limits; the cases noted were, therefore, not sporadic, but probably fair types of the general epidemic. Secondly.?Dr. McConnell has misquoted my letter ; what I said was that under the sulphurous acid treatment " probably the vast majority of cases treated within four hours from their commencement would, with God's blessing, recover." Thirdly.?Dr. McConnell has, therefore, not met my objection to the course adopted in three of his five fatal cases in removing them from the sulphurous acid fumes, just as the first faint indications of improvement were beginning to shew themselves, a course moreover not warranted in any test trial of any remedy. Fourthly.?Though Dr. McConnell says that he nsed the sulphur strictly in accordance with the plan recommended by me, and no doubt says so in perfect good faith, I feel sure there must be some difference in our respective modes of treatment, a conclusion forced on me by the very different results obtained ; for? Fifthly.?I have not lost a case of cholera since I adopted the acid in which the treatment has been
sulphurous properly carried
out. I will now make a few remarks on the suggestion offered by Dr. McConnell that in the ten successful cases noted by me, the successful issue may, " with equal or greater probability, be attributed to external warmth, strong broths, and stimulants." It is difficult to believe that a view so untenable can be forward. All I can say is that if external warmth,
THE INDIAN MEDICAL GAZETTE.
strong broths, and stimulants can cure cholera like this, the they are universally resorted to, the better. To return to the subject, however, I am under the impression that one of of sooner
the great difficulties hitherto met with in the treatment cholera, consisted in. the entire cessation of absorptive power in the stomach and intestines, either as regards medicine or food, so that were broth or brandy poured in, they would for the time stomach retain them, heing be perfectly useless, even could the but it needs only a slight acquaintance with cholera to convince one that the retention of food or stimulants in any appreciable the fully developed stage of the disease, is an
quantity, during impossibility.
Be this however as it may, it remains a fact that neither external warmth, strong broth, nor stimulants played the part ascribed to them by Dr. McConnell, in the successful cases referred to for broth was given but in small quantity, and only when the patient had so far recovered as to be able to retain it, while brandy or other stimulants were given anything but freely : for example, in case No. 9, one of the most protracted, only about 11 oz. of brandy were given, extending over a period of 19 hours, not much in fact over half an ounce an hour; and as to external warmth, the only external warmth was that of the fire, not half so effectual, I should suppose, as the hot bottles constantly renewed, so generally used in the treatment of cholera, but with which I entirely dispense. However, let the matter be brought to an issue ; let Dr. McConnell treat 10 or any greater number of cholera cases, with external warmth, strong broths and stimulants and produce the results noted by me, if he can; results, I beg to say, by no means indefinite or difficult to seek, amongst which the chief are, l,s(, speedy relief of the cramps and muscular spasms; 2nd, speedy cessation of rice-water purging and vomiting; 3rd, restoration of circulation, in general rapidly, to a healthy and normal state, including, of course, restoration of natural warmth; 4th, speedy restoration of the biliary and urinary secretions. To the last named, viz., the restoration of the urinary secretion, I would particularly draw attention, its re-establishment being specially the sign of the entire elimination, or as I hold it to be in these cases, the destruction of the cholera poison. In these ten cases the time that elapsed between the commencement of the attack and the commencement of the treatment averaged a fraction under seven hours, so that they were not taken in hand unusually early. The time that elapsed between the commencement of the treatment and the passing of urine freely, averaged 15| hours. Is this an ordinary average, or is it not a quite exceptional result in cholera treatment ? But to conclude, this is not a question to be settled by reports and counter-reports. I am anxious and ready to carry out my plan of treatment in presence of competent medical observers. I am quite ready, should the Surgeon-General, Bengal, desire it, to carry out my treatment on fairly selected cases at the General Hospital, Calcutta ; it is some nine months since I informed the head of my Department of my willingness to prove the treatment before a committee of medical officers but this has not, I presume, been considered desirable, and I should not in the present famine-stricken condition of Madras, feel that the persons likely to come under treatment there, would be fair tests for the remedy. If we have in this plan of treatment, as I believe by God's blessing we have, a sure and certain antidote to the cholera poison, what a sad thing it is to let human beings perish by thousands rather than use it ? I am, Sir, Yours faithfullv. 11. G. Parker, Surgeon-Major. C. 3 13th May 877. CUTTACK,